Monday, 19 March 2012

Cesamet


Generic Name: nabilone (NAB il own)

Brand Names: Cesamet


What is nabilone?

Nabilone is a man-made form of cannabis (marijuana is an herbal form of cannabis). Nabilone causes many effects on your central nervous system.


Nabilone is used to treat severe nausea and vomiting that is caused by cancer chemotherapy. Nabilone is for use only when other medications have been unable to control the nausea and vomiting.


Nabilone may also be used for purposes other than those listed in this medication guide.


What is the most important information I should know about nabilone?


Nabilone may be habit-forming and should be used only by the person it was prescribed for. Nabilone should never be given to another person, especially someone who has a history of drug abuse or habitual marijuana use. Keep the medication in a secure place where others cannot get to it. Do not use nabilone if you have ever had an allergic reaction to natural or man-made marijuana.

Before taking nabilone, tell your doctor if you have high blood pressure, heart disease, a history of mental illness or drug addiction, or if you are also using other medicines that can affect your central nervous system, such as a tranquilizer, sleep medicine, or anti-psychotic medications.


Use this medication exactly as it was prescribed for you. Do not use it in larger amounts or for longer than recommended by your doctor.


Avoid using other medicines that affect the central nervous system (such as stimulants, diet pills, cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression, anxiety, mental illness, or Parkinson's disease). These other drugs can add to the effects of nabilone.


Nabilone causes effects that will impair your thinking or reactions. Do not drive or do anything that requires you to be awake and alert until the effects of nabilone wear off.

There are many other medicines that can add to the side effects of nabilone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.


What should I discuss with my health care provider before taking nabilone?


Do not use nabilone if you have ever had an allergic reaction to natural or man-made marijuana such as dronabinol (Marinol).

Before using nabilone, tell your doctor if you have:



  • high blood pressure (hypertension);




  • heart disease;




  • past or present mental illness such as depression, schizophrenia, or other psychotic disorders;




  • a history of drug or alcohol addiction; or




  • if you are also using other medicines that can affect your central nervous system, such as a tranquilizer, sleep medicine, or anti-psychotic medications.



If you have any of these conditions, you may not be able to use nabilone, or you may need a dosage adjustment or special tests during treatment.


Nabilone may be habit-forming and should be used only by the person it was prescribed for. Nabilone should never be given to another person, especially someone who has a history of drug abuse or habitual marijuana use. Keep the medication in a secure place where others cannot get to it. FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether nabilone passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be especially sensitive to the side effects of nabilone.


Nabilone is not for use in patients younger than 18 years old.

How should I take nabilone?


Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.


Nabilone is usually given 1 to 3 hours before you receive your chemotherapy treatment. Your doctor may recommend that you take a small dose of nabilone on the night before your chemotherapy.


Nabilone may also be used 2 or 3 times each day of the chemotherapy treatment cycle, and for 48 hours after treatment ends, if needed.


The effects of nabilone may last for 48 to 72 hours, and this length of time may not be the same every time you take the medication.


Store nabilone at room temperature away from moisture and heat.

See also: Cesamet dosage (in more detail)

What happens if I miss a dose?


Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a nabilone overdose may include extreme drowsiness, fainting, hallucinations, fear, disorientation, unusual thoughts or behaviors, or feeling extremely happy or sad.

What should I avoid while taking nabilone?


Avoid using other medicines that affect the central nervous system (such as stimulants, diet pills, cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression, anxiety, mental illness, or Parkinson's disease). These other drugs can add to the effects of nabilone.


Nabilone causes effects that will impair your thinking or reactions. Do not drive or do anything that requires you to be awake and alert until the effects of nabilone wear off.

Nabilone side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using nabilone and call your doctor at once if you have any of these serious side effects:

  • hallucinations (seeing or hearing things that are not there);




  • paranoia, extreme fear;




  • fast heart rate;




  • feeling light-headed, fainting; or




  • unusual thoughts or behavior.



Continue using nabilone and talk with your doctor if you have any of these less serious side effects:



  • dizziness, drowsiness;




  • feeling "high";




  • weakness, lack of coordination;




  • depression, anxiety, confusion;




  • dry mouth;




  • headache, trouble concentrating; or




  • sleep problems (insomnia).



Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.


What other drugs will affect nabilone?


Before taking nabilone, tell your doctor if you are using any of the following drugs:



  • amphetamines, including stimulants and medicine to treat attention deficit hyperactivity disorder (ADHD);




  • prescription or over-the-counter weight loss aids (Dexatrim, Meridia);




  • antidepressants such as amitriptyline (Elavil), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor);




  • barbiturates such as butalbital (Fiorinal), phenobarbital (Luminal, Solfoton), secobarbital (Seconal);




  • sedatives such as Ativan, Dalmane, Halcion, Klonopin, Librium, ProSom, Restoril, Tranxene, Valium, Xanax;




  • lithium;




  • theophylline (Respbid, Slo-Bid, Theo-24, Theo-Dur, Uniphyl);




  • buspirone (BuSpar);




  • atropine (Donnatal, and others);




  • belladonna, dicyclomine (Bentyl);




  • clidinium (Quarzan);




  • glycopyrrolate (Robinul);




  • hyoscyamine (Anaspaz, Cystospaz, Levsin, and others);




  • mepenzolate (Cantil);




  • methscopolamine (Pamine), and scopolamine (Transderm-Scop);




  • methantheline (Provocholine), propantheline (Pro-Banthine); or




  • street drugs such as cocaine or Ectasy.



If you are using any of these drugs, you may not be able to use nabilone, or you may need dosage adjustments or special tests during treatment.


There may be other drugs not listed that can affect nabilone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.



More Cesamet resources


  • Cesamet Side Effects (in more detail)
  • Cesamet Dosage
  • Cesamet Use in Pregnancy & Breastfeeding
  • Cesamet Drug Interactions
  • Cesamet Support Group
  • 1 Review for Cesamet - Add your own review/rating


  • Cesamet Prescribing Information (FDA)

  • Cesamet Monograph (AHFS DI)

  • Cesamet Advanced Consumer (Micromedex) - Includes Dosage Information

  • Cesamet Consumer Overview

  • Cesamet MedFacts Consumer Leaflet (Wolters Kluwer)

  • Nabilone Professional Patient Advice (Wolters Kluwer)



Compare Cesamet with other medications


  • Nausea/Vomiting, Chemotherapy Induced


Where can I get more information?


  • Your pharmacist has more information about nabilone written for health professionals that you may read.

See also: Cesamet side effects (in more detail)


chlorzoxazone


Generic Name: chlorzoxazone (klor ZOX a zone)

Brand names: Parafon Forte DSC, ...show all 8 brand names.


What is chlorzoxazone?

Chlorzoxazone is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain.


Chlorzoxazone is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.


Chlorzoxazone may also be used for other purposes not listed in this medication guide.


What is the most important information I should know about chlorzoxazone?


Before taking chlorzoxazone, tell your doctor if you have liver disease. You may need a lower dose or special monitoring during therapy.


Chlorzoxazone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of chlorzoxazone.

What should I discuss with my healthcare provider before taking chlorzoxazone?


You should not use this medication if you are allergic to chlorzoxazone.

Before taking chlorzoxazone, tell your doctor if you have liver disease. You may need a lower dose or special monitoring during therapy.


This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether chlorzoxazone passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take chlorzoxazone?


Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.


Take the medicine with a full glass of water.

Clorzoxazone is only part of a complete program of treatment that may also include rest, physical therapy, or other pain relief measures. Follow your doctor's instructions.


Store chlorzoxazone at room temperature away from moisture and heat.

See also: Chlorzoxazone dosage (in more detail)

What happens if I miss a dose?


Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention if you think you have used too much of this medicine. An overdose of chlorzoxazone can be fatal.

Overdose symptoms may include nausea, vomiting, diarrhea, drowsiness, dizziness, headache, muscle weakness, shallow breathing, or fainting.


What should I avoid while taking chlorzoxazone?


Chlorzoxazone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of chlorzoxazone. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by chlorzoxazone. Tell your doctor if you regularly use any of these medicines, or any other muscle relaxer.

Chlorzoxazone side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using chlorzoxazone and call your doctor at once if you have any of these serious side effects:

  • nausea, stomach pain, low fever, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);




  • black, bloody, or tarry stools;




  • coughing up blood or vomit that looks like coffee grounds; or




  • feeling like you might pass out.



Less serious side effects may include:



  • drowsiness, dizziness, tired feeling;




  • restlessness;




  • slightly discolored urine; or




  • mild skin rash or bruising.



This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.


Chlorzoxazone Dosing Information


Usual Adult Dose for Muscle Spasm:

250 to 750 mg orally 3 to 4 times a day.

The dosage may be reduced as the condition of the patient improves.

Usual Pediatric Dose for Muscle Spasm:

125 to 500 mg orally 3 to 4 times a day.

Alternative dosing: 20 mg/kg/day in divided doses 3 to 4 times a day.


What other drugs will affect chlorzoxazone?


There may be other drugs that can interact with chlorzoxazone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.



More chlorzoxazone resources


  • Chlorzoxazone Side Effects (in more detail)
  • Chlorzoxazone Dosage
  • Chlorzoxazone Use in Pregnancy & Breastfeeding
  • Drug Images
  • Chlorzoxazone Drug Interactions
  • Chlorzoxazone Support Group
  • 10 Reviews for Chlorzoxazone - Add your own review/rating


  • chlorzoxazone Advanced Consumer (Micromedex) - Includes Dosage Information

  • Chlorzoxazone Prescribing Information (FDA)

  • Chlorzoxazone Professional Patient Advice (Wolters Kluwer)

  • Chlorzoxazone Monograph (AHFS DI)

  • Chlorzoxazone MedFacts Consumer Leaflet (Wolters Kluwer)

  • Parafon Forte DSC Prescribing Information (FDA)



Compare chlorzoxazone with other medications


  • Muscle Spasm


Where can I get more information?


  • Your pharmacist can provide more information about chlorzoxazone.

See also: chlorzoxazone side effects (in more detail)


Sunday, 18 March 2012

Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance


Pronunciation: EYE-urn/sux-IN-ic AS-id/VYE-ta-min C/VYE-ta-min B 12/DES-ih-kay-ted STUH-mak SUB-stans
Generic Name: Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance
Brand Name: Examples include Anemagen and Chromagen

Accidental overdose of products that contain iron is a leading cause of fatal poisoning in children younger than 6 years old. Keep this and all medicines out of the reach of children. In case of accidental ingestion, call the poison control center or a doctor at once.





Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance is used for:

Treating certain types of anemia that can be helped by increasing the amount of iron in the body (eg, anemia caused by pregnancy, blood loss, low dietary iron, metabolic disease, surgery). It may also be used for other conditions as determined by your doctor.


Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance is a combination of vitamins and minerals. It works by replacing iron in the body.


Do NOT use Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance if:


  • you are allergic to any ingredient in Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance

  • you have too much iron in your body (eg, hemochromatosis, hemosiderosis)

Contact your doctor or health care provider right away if any of these apply to you.



Before using Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance:


Some medical conditions may interact with Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, planning to become pregnant, or are breast-feeding

  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

  • if you have allergies to medicines, foods, or other substances

  • if you have another type of anemia (eg, hemolytic anemia, megaloblastic anemia, pernicious anemia)

  • if you have stomach or bowel problems (eg, Crohn disease, inflammation, ulcer), metabolism problems, porphyria, or a blood disease (eg, thalassemia)

  • if you have had multiple blood transfusions

Some MEDICINES MAY INTERACT with Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance. Tell your health care provider if you are taking any other medicines, especially any of the following:


  • Doxycycline, penicillamine, or thyroid hormones (eg, levothyroxine) because their effectiveness may be decreased by Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance

This may not be a complete list of all interactions that may occur. Ask your health care provider if Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.


How to use Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance:


Use Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Take Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.

  • Swallow Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance whole. Do not break, crush, or chew before swallowing.

  • Take Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance with a full glass of water (8 oz/240 mL). Do not lie down for 30 minutes after taking Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance.

  • If you also take antacids, bisphosphonates (eg, etidronate), cephalosporins (eg, cefdinir), doxycycline, hydantoins (eg, phenytoin), levodopa, methyldopa, penicillamine, quinolones (eg, ciprofloxacin, levofloxacin), tetracyclines (eg, minocycline), or thyroid hormones (eg, levothyroxine), ask your doctor or pharmacist how to take them with Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance.

  • If you miss a dose of Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance.



Important safety information:


  • Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.

  • Do not take large doses of vitamins while you take Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance unless your doctor tells you to.

  • Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance may cause your stools to darken. This is normal and not a cause for concern.

  • Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance may interfere with certain lab tests, such as tests used to check for blood in the stool. Make sure your doctor and lab personnel know you are using Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance.

  • Lab tests, including blood counts and iron levels, may be performed while you use Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

  • Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance while you are pregnant. Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance is found in breast milk. If you are or will be breast-feeding while you use Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance, check with your doctor. Discuss any possible risks to your baby.


Possible side effects of Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance:


All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:



Constipation; darkened or green stools; diarrhea; nausea; stomach upset; vomiting.



Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; blood or streaks of blood in the stool; severe or persistent vomiting or stomach pain.



This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.



If OVERDOSE is suspected:


Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include black, tarry stools; chest pain; coma; dizziness; fast heartbeat; fever; increased or decreased urination; increased thirst or hunger; seizures; severe nausea, vomiting, diarrhea, or stomach pain; shortness of breath; sluggishness; trouble breathing; unusual tiredness or drowsiness; unusually pale skin; weak pulse.


Proper storage of Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance:

Store Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance out of the reach of children and away from pets.


General information:


  • If you have any questions about Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance, please talk with your doctor, pharmacist, or other health care provider.

  • Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance is to be used only by the patient for whom it is prescribed. Do not share it with other people.

  • If your symptoms do not improve or if they become worse, check with your doctor.

  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.



Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance resources


  • Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance Use in Pregnancy & Breastfeeding
  • Drug Images
  • Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance Drug Interactions
  • Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance Support Group
  • 11 Reviews for Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance - Add your own review/rating


Compare Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance with other medications


  • Anemia
  • Vitamin/Mineral Supplementation and Deficiency

Monday, 12 March 2012

Cerezyme


Generic Name: Imiglucerase
Class: Enzymes
Chemical Name: 495-L-Histidineglucosylceramidase (human placenta isoenzyme protein moiety)
Molecular Formula: C2532H3843N671O711S16
CAS Number: 154248-97-2

Introduction

Biosynthetic (recombinant DNA origin) form of human β-glucocerebrosidase (glucosylceramidase).1 4 6 7


Uses for Cerezyme


Gaucher’s Disease


Long-term enzyme replacement therapy in adults and pediatric patients with confirmed diagnosis of nonneuronopathic (type 1) Gaucher’s disease that results in one or more of the following conditions: anemia, thrombocytopenia, bone disease, hepatomegaly, or splenomegaly (designated an orphan drug by FDA for this use).1 9 31


Role of imiglucerase therapy in patients with neuronopathic forms of Gaucher’s disease (type 2 or 3) not established31 (designated an orphan drug by FDA for this use).9


Cerezyme Dosage and Administration


General



  • Individualize dosage and/or frequency of administration according to disease severity and individual requirements and response.1 17



Administration


IV Administration


Administer by IV infusion.1


May be administered using an inline, low protein-binding, 0.2-mcm particulate filter as slight flocculation (evidenced by thin translucent fibers) may occasionally occur after dilution.1 31


Reconstitution

Determine number of vials to be reconstituted based on patient weight.1


Reconstitute appropriate number of vials containing 200 or 400 units of imiglucerase lyophilized powder with 5.1 or 10.2 mL of sterile water for injection, respectively, to provide a solution containing 40 units of imiglucerase per mL.1


Dilution

Use strict aseptic technique since drug product contains no preservative.a


Withdraw appropriate dose from reconstituted vials and dilute with 0.9% sodium chloride injection to a final volume of 100–200 mL.a


Rate of Administration

Administer over 1–2 hours.1


Dosage


Pediatric Patients


Gaucher's Disease

IV

Children and adolescents 2–16 years of age: Initially, dosage ranges from 2.5 units/kg 3 times weekly to 60 units/kg every 2 weeks.1


Increase or decrease dosage and/or frequency of administration according to disease severity and patient response and convenience.1 17


Individual doses occasionally may be increased or decreased slightly to avoid wasting a partially used vial, as long as the total monthly dosage is not altered substantially.1


Clinical improvement in hematologic and visceral manifestations generally occurs within the first year of therapy;17 response to skeletal manifestations may require 2–3 years of therapy.17


Failure to respond within 6 months may indicate the need for increased dosages.17 31


Adults


Gaucher's Disease

IV

Adults >16 years of age: Initially, dosage ranges from 2.5 units/kg 3 times weekly to 60 units/kg every 2 weeks.1


Increase or decrease dosage and/or frequency of administration according to disease severity and patient response and convenience.1 17


Individual doses occasionally may be increased or decreased slightly to avoid wasting a partially used vial, as long as the total monthly dosage is not altered substantially.1


Clinical improvement in hematologic and visceral manifestations generally occurs within the first year of therapy;17 response to skeletal manifestations may require 2–3 years of therapy.17


Failure to respond within 6 months may indicate the need for increased dosages.17 31


Cautions for Cerezyme


Contraindications



  • No known contraindications.1



Warnings/Precautions


Sensitivity Reactions


Hypersensitivity Reactions

Hypersensitivity reactions (e.g., pruritus, flushing, urticaria, angioedema, chest discomfort, dyspnea, coughing, cyanosis, hypotension) reported during or shortly after IV infusion; anaphylactoid reactions reported in <1% of patients.1


Carefully reevaluate therapy if substantial clinical evidence of hypersensitivity develops.1 Use with caution in patients who have exhibited manifestations of hypersensitivity reactions.1 Further therapy can generally be administered successfully following a decrease in infusion rate and pretreatment with antihistamines and/or corticosteroids.1


Antibody Formation

Development of IgG antibodies to imiglucerase reported in approximately 15% of patients, usually within the first 6 months of therapy and rarely after 12 months of therapy.1 (See Distribution: Special Populations and Elimination: Special Populations under Pharmacokinetics.)


Possible increased risk of hypersensitivity reactions in patients with detectable IgG antibodies.1 (See Hypersensitivity Reactions under Cautions.) Use with caution in patients who have developed antibodies to the drug; monitor periodically for imiglucerase IgG antibodies during the first year of therapy.1


Cross-hypersensitivity

Use with caution in patients previously treated with alglucerase who developed antibodies or exhibited hypersensitivity reactions to alglucerase.a


General Precautions


Pulmonary Hypertension and Pneumonia

Pulmonary hypertension and pneumonia reported rarely; however, no causal relationship with the drug established.1


Evaluate patients with respiratory symptoms in the absence of fever for the presence of pulmonary hypertension.1


Specific Populations


Pregnancy

Category C.


Lactation

Not known whether imiglucerase is distributed into milk.1 Use with caution.1


Pediatric Use

Safety and efficacy not established in children <2 years of age, although the drug has been used in this age group.1


Common Adverse Effects


Children 2–12 years of age: Dyspnea, fever, nausea, vomiting, flushing, coughing.1


Adolescents >12–16 years of age and adults >16 years of age: Headache, pruritus, rash.1


Cerezyme Pharmacokinetics


Absorption


Onset


Steady-state enzymatic activity reached in 30 minutes during a 1-hour IV infusion.1


Distribution


Extent


Volume of distribution ranges from 0.09–0.15 L/kg.1


Special Populations


In patients who develop IgG antibodies, volume of distribution is decreased.1


Elimination


Half-life


Following IV infusion, plasma enzymatic activity rapidly declines with a half-life of 3.6–10.4 minutes.1


Special Populations


In patients who develop IgG antibodies, clearance is decreased and half-life is increased.1


Stability


Storage


Parenteral


Powder for Injection

2–8°C.a


Following reconstitution, stable at room temperature (25°C) and 2–8°C for up to 12 hours.a


Following dilution, stable at 2–8°C for up to 24 hours.a


Compatibility


For information on systemic interactions resulting from concomitant use, see Interactions.


ActionsActions



  • Replaces the deficient endogenous enzyme (β-glucocerebrosidase; glucosylceramidase) in patients with Gaucher’s disease.1 2 3 5 10 12




  • Increases the degradation of glucosylceramide (glucocerebroside) in macrophages1 2 4 6 10 by hydrolyzing the β-glycoside linkage of glucocerebroside to glucose and ceramide (N-acylsphingosine)1 4 7 10 with resultant reduction in liver and spleen size, amelioration of anemia and thrombocytopenia, decreased bone pain, decreased cachexia, and increased bone remineralization over a period of several years.1 2 3 8 10 12 14 15 17 19 27 28 29 33



Advice to Patients



  • Risk of hypersensitivity reactions (pruritus, flushing, urticaria, angioedema, chest discomfort, dyspnea, coughing, cyanosis, hypotension).a




  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and herbal supplements, as well as any concomitant illnesses.a




  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.a




  • Importance of informing patients of other important precautionary information. (See Cautions.)1



Preparations


Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.


















Imiglucerase

Routes



Dosage Forms



Strengths



Brand Names



Manufacturer



Parenteral



For injection, for IV infusion



200 units



Cerezyme



Genzyme



400 units



Cerezyme



Genzyme



Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.


The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions July 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.


† Use is not currently included in the labeling approved by the US Food and Drug Administration.




References



1. Genzyme Corporation. Cerezyme (imiglucerase) for injection prescribing information. Cambridge, MA; 2003 Mar.



2. Barton NW, Furbish FS, Murray GJ et al. Therapeutic response to intravenous infusions of glucocerebrosidase in a patient with Gaucher disease. Proc Natl Acad Sci USA. 1990; 87:1913-6. [PubMed 2308952]



3. Anon. Alglucerase for Gaucher’s disease. Med Lett Drugs Ther. 1991; 33:82. [PubMed 1865852]



4. Brady RO, Kanfer JN, Shapiro D. Metabolism of glucocerebrosides: II. Evidence of an enzymatic deficiency in Gaucher’s disease. Biochem Biophys Res Commun. 1965; 18:221-5. [PubMed 14282020]



5. Britton DE, Leinikki PO, Barranger JA et al. Gaucher’s disease: lack of antibody response to intravenous glucocerebrosidase. Life Sci. 1978; 23:2517-20. [PubMed 732537]



6. Basu A, Prence E, Garrett K et al. Comparison of N-acyl phosphatidylethanolamines with different N-acyl groups as activators of glucocerebrosidase in various forms of Gaucher’s disease. Arch Biochem Biophys. 1985; 243:28-34. [PubMed 3933429]



7. Furbish FS, Blair HE, Shiloach J et al. Enzyme replacement therapy in Gaucher’s disease: large-scale purification of glucocerebrosidase suitable for human administration. Proc Natl Acad Sci USA. 1977; 74:3560-3. [PubMed 269414]



8. Beutler E. Gaucher’s disease. N Engl J Med. 1991; 325:1354-60. [IDIS 287428] [PubMed 1922238]



9. Food and Drug Administration. Cumulative list of orphan drugs designated and/or approved. Rockville, MD; 2004, Aug 24. From FDA web site (http: / / www.fda.gov / ForIndustry / DevelopingProductsforRareDiseasesConditions / HowtoapplyforOrphanProductDesignation / default.htm).



10. Genzyme Corporation. Ceredase (alglucerase) prescribing information. Cambridge, MA; 1992 Feb.



11. Genzyme Corporation, Cambridge, MA. Personal communication on alglucerase.



12. Reviewers’ comments (personal observations) on alglucerase.



13. Stahl PD, Rodman JS, Miller MJ et al. Evidence for receptor-mediated binding of glycoproteins, glycoconjugates, and lysosomal glycosidases by alveolar macrophages. Proc Natl Acad Sci USA. 1978; 75:1399-1403. [PubMed 274729]



14. Weinreb NJ, Charrow J, Andersson HC et al. Effectiveness of enzyme replacement therapy in 1028 patients with type 1 Gaucher disease after 2 to 5 years of treatment: a report from the Gaucher Register. Am J Med. 2002; 113:112-9. [IDIS 484109] [PubMed 12133749]



15. Niederau C, Haussinger D. Gaucher’s disease: a review for the internist and hepatologist. Hepatogastroenterology. 2000; 47:984-7. [PubMed 11020862]



16. McCormack PL, Goa KL. Miglustat. Drugs. 2003;63:2427-34.



17. Charrow J, Andersson HC, Kaplan P et al. Enzyme replacement therapy and monitoring for children with type 1 Gaucher disease: Consensus recommendations. J Pediatrics. 2003; 144:112-20.



18. Barton NW, Brady RO, Dambrosia JM et al. Replacement therapy for inherited enzyme deficiency—macrophage-targeted glucocerebrosidase for Gaucher’s disease. N Engl J Med. 1991; 324:1464-70. [IDIS 280934] [PubMed 2023606]



19. Rosenthal DI, Doppelt SH, Mankin HL et al. Enzyme therapy for Gaucher disease: skeletal responses to macrophage-targeted glucocerebrosidase. Pediatrics. 1995; 96:629-37. [IDIS 355405] [PubMed 7567322]



20. Beutler E, Kay AC, Saven A et al. Enzyme-replacement therapy for Gaucher’s disease. N Engl J Med. 1991; 325:1809-10. [IDIS 289025] [PubMed 1944489]



21. Beutler E, Kay A, Saven A et al. Enzyme replacement therapy for Gaucher disease. Blood. 1991; 78:1183-9. [IDIS 288172] [PubMed 1878585]



22. Parker RI, Barton NW, Read EJ et al. Hematologic improvement in a patient with Gaucher disease on long-term enzyme replacement therapy: evidence for decreased splenic sequestration and improved red blood cell survival. Am J Hematol. 1991; 38:130-7. [PubMed 1951303]



23. Barton NW, Brady RO, Dambrosia JM et al. Dose-dependent responses to macrophage-targeted glucocerebrosidase in a child with Gaucher disease. J Pediatr. 1992; 120:277-80. [IDIS 292694] [PubMed 1735829]



24. Genzyme Corporation. Ceredase treatment protocol: investigators’ brochure. IND No. 31,345. Boston, MA: 1990 Feb 6.



25. Zimran A, Hadas-Halpern I, Abrahamov A et al. Enzyme-replacement therapy for Gaucher’s disease. N Engl J Med. 1991; 325:1810-1.



26. Barton NW, Brady RO, Murray GJ et al. Enzyme-replacement therapy for Gaucher’s disease. N Engl J Med. 1991; 325:1811. [IDIS 289028] [PubMed 1944490]



27. Grabowski GA, Barton NW, Pastores G et al. Enzyme therapy in type 1 Gaucher disease: comparative efficacy of mannose-terminated glucocerebrosidase from natural and recombinant sources. Ann Intern Med. 1995; 122:33-9. [IDIS 339881] [PubMed 7985893]



28. Actelion Pharmaceuticals. Zavesca (miglustat) capsules prescribing information. South San Francisco, CA; 2003 Jul 31.



29. Elstein D, Abrahamov A, Hadas-Halpern I et al. Low-dose low-frequency imiglucerase as a starting regimen of enzyme replacement therapy for patients with type I Gaucher disease. QJM. 1998; 91:483-8. [PubMed 9797931]



30. Elstein D, Abrahamov A, Hadas-Halpern I et al. Gaucher's disease. Lancet. 2001; 358:324-7. [IDIS 467174] [PubMed 11498237]



31. Genzyme Corporation, Cambridge, MA: Personal communication.



32. Charrow J, Andersson HC, Kaplan P et al. The Gaucher registry: demographics and disease characteristics of 1698 patients with Gaucher disease. Arch Intern Med. 2000; 160:2835-43. [PubMed 11025794]



33. Poll LW, Maas M, Terk MR et al. Response of Gaucher bone disease to enzyme replacement therapy. Br J Radiol. 2002; 75(Suppl 1):A25-36.



a. Genzyme Corporation. Cerezyme (imiglucerase for injection) prescribing information. Cambridge, MA; 2005 Apr.



More Cerezyme resources


  • Cerezyme Side Effects (in more detail)
  • Cerezyme Use in Pregnancy & Breastfeeding
  • Cerezyme Drug Interactions
  • Cerezyme Support Group
  • 0 Reviews for Cerezyme - Add your own review/rating


  • Cerezyme Prescribing Information (FDA)

  • Cerezyme Consumer Overview

  • Cerezyme Advanced Consumer (Micromedex) - Includes Dosage Information

  • Cerezyme MedFacts Consumer Leaflet (Wolters Kluwer)

  • Imiglucerase Professional Patient Advice (Wolters Kluwer)



Compare Cerezyme with other medications


  • Gaucher Disease
  • Thrombocytopenia

Sunday, 11 March 2012

Extendryl G


Generic Name: guaifenesin and phenylephrine (gwye FEN e sin and FEN il EFF rin)

Brand Names: Aldex G, Aquatab D, Crantex, D-Phen 1000, D-Tab, Deconex, Deconsal II, Deconsal Pediatric, Despec, Donatussin Drops, Duomax, Duraphen 1000, Duraphen II, Duratuss, Dynex LA, ExeTuss, Extendryl G, Fenesin PE IR, Genexa LA, Gentex LA, Gilphex TR, Guaiphen-D 1200, Guaiphen-D 600, Guaiphen-PD, Guiadex PD, Guiatex PE, J-Max, Liquibid D-R, Liquibid-D, Liquibid-PD, Lusonex, Maxiphen, Medent-PE, MontePhen, Mucinex Children's Cold, Mucus Relief Sinus, Mydex, Nariz, Nasex, Nescon-PD, Nexphen PD, Norel EX, PE-Guai, Pendex, Prolex D, Refenesen PE, Reluri, Rescon-GG, Respa-PE, Robitussin Head & Chest Congestion, Simuc, Simuc-GP, Sina-12X, Sinupan, SINUvent PE, Sitrex PD, Sudafed PE Non-Drying Sinus, Sudex, Triaminic Chest & Nasal Congestion, Visonex, Wellbid-D, Xedec, Xedec II, Xpect-PE, Zotex GPX


What is Extendryl G (guaifenesin and phenylephrine)?

There are many brands and forms of guaifenesin and phenylephrine available and not all brands are listed on this leaflet.


Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.


Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).


The combination of guaifenesin and phenylephrine is used to treat stuffy nose and sinus congestion, and to reduce chest congestion caused by the common cold or flu.


Guaifenesin and phenylephrine may also be used for purposes not listed in this medication guide.


What is the most important information I should know about Extendryl G (guaifenesin and phenylephrine)?


There are many brands and forms of guaifenesin and phenylephrine available and not all brands are listed on this leaflet.


Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Ask a doctor or pharmacist before using any other cough, cold, or allergy medicine. Guaifenesin and phenylephrine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains guaifenesin or phenylephrine.

What should I discuss with my healthcare provider before taking Extendryl G (guaifenesin and phenylephrine)?


You should not use this medication if you are allergic to guaifenesin or phenylephrine, or to other decongestants, diet pills, stimulants, or ADHD medications. Do not use guaifenesin and phenylephrine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. Serious, life threatening side effects can occur if you use guaifenesin and phenylephrine before the MAO inhibitor has cleared from your body.

Ask a doctor or pharmacist if it is safe for you to take this medication if you have:



  • heart disease or high blood pressure;




  • diabetes;




  • circulation problems;




  • glaucoma;




  • overactive thyroid; or




  • enlarged prostate or problems with urination.




It is not known if this medication may be harmful to an unborn baby. Do not use this medication without your doctor's advice if you are pregnant. This medication passes into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Artificially-sweetened liquid forms of cold medicine may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.


How should I take Extendryl G (guaifenesin and phenylephrine)?


Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.


Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children.

Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.


Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time. Take guaifenesin and phenylephrine with food if it upsets your stomach. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash. Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication. Store at room temperature away from moisture and heat.

What happens if I miss a dose?


Since cough or cold medicine is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, vomiting, numbness or tingly feeling, dizziness, and feeling restless or nervous.


What should I avoid while taking Extendryl G (guaifenesin and phenylephrine)?


This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Drinking alcohol can increase certain side effects of guaifenesin and phenylephrine. Ask a doctor or pharmacist before using any other cough, cold, or allergy medicine. Guaifenesin and phenylephrine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains guaifenesin or phenylephrine.

Avoid taking this medication with diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.


Extendryl G (guaifenesin and phenylephrine) side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

  • fast, pounding, or uneven heartbeat;




  • severe dizziness, anxiety, restless feeling, or nervousness;




  • easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms;




  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure); or




  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).



Less serious side effects may include:



  • vomiting, upset stomach;




  • warmth, tingling, or redness under your skin;




  • feeling excited or restless (especially in children);




  • sleep problems (insomnia);




  • skin rash or itching;




  • headache; or




  • dizziness.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


What other drugs will affect Extendryl G (guaifenesin and phenylephrine)?


Ask a doctor or pharmacist if it is safe for you to take guaifenesin and phenylephrine if you are also using any of the following drugs:



  • medicines to treat high blood pressure;




  • a beta-blocker such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Dutoprol, Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others; or




  • an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), doxepin (Sinequan, Silenor), desipramine (Norpramin), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), and others.



This list is not complete and other drugs may interact with guaifenesin and phenylephrine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More Extendryl G resources


  • Extendryl G Side Effects (in more detail)
  • Extendryl G Use in Pregnancy & Breastfeeding
  • Extendryl G Drug Interactions
  • Extendryl G Support Group
  • 0 Reviews for Extendryl G - Add your own review/rating


  • Crantex Prescribing Information (FDA)

  • Despec Drops MedFacts Consumer Leaflet (Wolters Kluwer)

  • Entex LA Sustained-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)

  • Gentex LA Sustained-Release Tablets (12 Hour) MedFacts Consumer Leaflet (Wolters Kluwer)

  • Guiatex PE Prescribing Information (FDA)

  • Lusonex Controlled-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

  • Rescon-GG Liquid MedFacts Consumer Leaflet (Wolters Kluwer)

  • Sina-12X Suspension MedFacts Consumer Leaflet (Wolters Kluwer)



Compare Extendryl G with other medications


  • Cough and Nasal Congestion
  • Sinus Symptoms


Where can I get more information?


  • Your pharmacist can provide more information about guaifenesin and phenylephrine.

See also: Extendryl G side effects (in more detail)


Friday, 9 March 2012

sodium chloride flush


Generic Name: sodium chloride (flush) (SOE dee um KLOR ide)

Brand Names: Saljet Rinse, Saljet Sterile


What is sodium chloride flush?

Sodium chloride is the chemical name for salt. Sodium chloride can reduce some types of bacteria.


Sodium chloride flush is used to clean out an intravenous (IV) catheter, which helps prevent blockage and removes any medicine left in the catheter area after you have received an IV infusion.


Sodium chloride may also be used for purposes not listed in this medication guide.


What is the most important information I should know about sodium chloride flush?


Call your doctor or tell your caregivers if your catheter, needle, or IV tubing becomes blocked or if the flush or IV medicine is not flowing normally. Stop using sodium chloride flush and call your doctor at once if you have severe irritation, swelling, warmth, redness, oozing, or pain around your catheter while using the flush.

What should I discuss with my health care provider before using sodium chloride flush?


Before using sodium chloride flush, tell your doctor if you are allergic to any drugs.


How should I use sodium chloride flush?


Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or more often than recommended.


You will use sodium chloride flush each time you use your IV catheter. Follow your doctor's instructions about how many times per day to use the flush.


Before using the flush, check the solution container to make sure there are no leaks in it. Do not use the medication if it has changed colors or has particles in it. Call your doctor for a new prescription.


Call your doctor or tell your caregivers if your catheter, needle, or IV tubing becomes blocked or if the flush or IV medicine is not flowing normally.

Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.


Store sodium chloride at room temperature away from moisture and heat. Keep all of your catheter flush supplies in a clean dry place when not in use.

What happens if I miss a dose?


If you use flush your catheter each time you use it, you are not likely to miss a dose.


What happens if I overdose?


An overdose of sodium chloride flush is unlikely to occur.


What should I avoid while using sodium chloride flush?


Follow your doctor's instructions about any restrictions on food, beverages, or activity.


Sodium chloride flush side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Stop using sodium chloride flush and call your doctor at once if you have any of these side effects while using the flush:

  • severe irritation;




  • swelling;




  • warmth;




  • redness;




  • oozing; or




  • pain.



Less serious side effects may include mild irritation around the catheter.


This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


What other drugs will affect sodium chloride flush?


It is not likely that other drugs you take orally or inject will have an effect on sodium chloride used to flush your catheter. But many drugs can interact with each other. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More sodium chloride resources


  • Sodium chloride Support Group
  • 0 Reviews · Be the first to review/rate this drug


Where can I get more information?


  • Your doctor or pharmacist can provide more information about sodium chloride flush.


Chlor-Trimeton Syrup


Pronunciation: klor-fen-IHR-ah-meen
Generic Name: Chlorpheniramine
Brand Name: Examples include Aller-Chlor and Chlor-Trimeton


Chlor-Trimeton Syrup is used for:

Relieving symptoms of sinus congestion, sinus pressure, runny nose, watery eyes, itching of the nose and throat, and sneezing due to upper respiratory infections (eg, colds), allergies, and hay fever. It may also be used for other conditions as determined by your doctor.


Chlor-Trimeton Syrup is an antihistamine. It works by blocking the action of histamine, which helps reduce symptoms such as watery eyes and sneezing.


Do NOT use Chlor-Trimeton Syrup if:


  • you are allergic to any ingredient in Chlor-Trimeton Syrup

  • you are taking sodium oxybate (GHB) or if you have taken furazolidone or a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the last 14 days

Contact your doctor or health care provider right away if any of these apply to you.



Before using Chlor-Trimeton Syrup:


Some medical conditions may interact with Chlor-Trimeton Syrup. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, plan to become pregnant, or are breast-feeding

  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

  • if you have allergies to medicines, foods, or other substances

  • if you have a fast, slow, or irregular heartbeat

  • if you have a history of asthma, lung problems (eg, emphysema), heart problems, high blood pressure, diabetes, heart blood vessel problems, stroke, glaucoma, a blockage of your stomach or intestines, ulcers, a blockage of your bladder, trouble urinating, an enlarged prostate, seizures, or an overactive thyroid

Some MEDICINES MAY INTERACT with Chlor-Trimeton Syrup. Tell your health care provider if you are taking any other medicines, especially any of the following:


  • Furazolidone, MAO inhibitors (eg, phenelzine), sodium oxybate (GHB), or tricyclic antidepressants (eg, amitriptyline) because side effects of Chlor-Trimeton Syrup may be increased

  • Hydantoins (eg, phenytoin) because side effects may be increased by Chlor-Trimeton Syrup

This may not be a complete list of all interactions that may occur. Ask your health care provider if Chlor-Trimeton Syrup may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.


How to use Chlor-Trimeton Syrup:


Use Chlor-Trimeton Syrup as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Chlor-Trimeton Syrup may be taken with or without food.

  • Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.

  • If you miss a dose of Chlor-Trimeton Syrup, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Chlor-Trimeton Syrup.



Important safety information:


  • Chlor-Trimeton Syrup may cause dizziness, drowsiness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Chlor-Trimeton Syrup. Using Chlor-Trimeton Syrup alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.

  • Do NOT exceed the recommended dose or take Chlor-Trimeton Syrup for longer than prescribed without checking with your doctor.

  • If your symptoms do not improve within 5 to 7 days or if they become worse, check with your doctor.

  • Chlor-Trimeton Syrup may cause increased sensitivity to the sun. Avoid exposure to the sun, sunlamps, or tanning booths until you know how you react to Chlor-Trimeton Syrup. Use a sunscreen or protective clothing if you must be outside for a prolonged period.

  • If you are scheduled for allergy skin testing, do not take Chlor-Trimeton Syrup for several days before the test because it may decrease your response to the skin tests.

  • Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Chlor-Trimeton Syrup.

  • Use Chlor-Trimeton Syrup with caution in the ELDERLY because they may be more sensitive to its effects.

  • Caution is advised when using Chlor-Trimeton Syrup in CHILDREN because they may be more sensitive to its effects.

  • PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Chlor-Trimeton Syrup, discuss with your doctor the benefits and risks of using Chlor-Trimeton Syrup during pregnancy. It is unknown if Chlor-Trimeton Syrup is excreted in breast milk. Do not breast-feed while taking Chlor-Trimeton Syrup.


Possible side effects of Chlor-Trimeton Syrup:


All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:



Constipation; diarrhea; dizziness; drowsiness; dry mouth, nose, or throat; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; vomiting; weakness.



Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; seizures; severe dizziness, lightheadedness, or headache; tremor; trouble sleeping; vision changes.



This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.


See also: Chlor-Trimeton side effects (in more detail)


If OVERDOSE is suspected:


Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blurred vision; confusion; hallucinations; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; unusually fast, slow, or irregular heartbeat; and vomiting.


Proper storage of Chlor-Trimeton Syrup:

Store Chlor-Trimeton Syrup at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Chlor-Trimeton Syrup out of the reach of children and away from pets.


General information:


  • If you have any questions about Chlor-Trimeton Syrup, please talk with your doctor, pharmacist, or other health care provider.

  • Chlor-Trimeton Syrup is to be used only by the patient for whom it is prescribed. Do not share it with other people.

  • If your symptoms do not improve or if they become worse, check with your doctor.

  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Chlor-Trimeton Syrup. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.



Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Chlor-Trimeton resources


  • Chlor-Trimeton Side Effects (in more detail)
  • Chlor-Trimeton Use in Pregnancy & Breastfeeding
  • Chlor-Trimeton Drug Interactions
  • Chlor-Trimeton Support Group
  • 9 Reviews for Chlor-Trimeton - Add your own review/rating


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