Go Article Directory Isle of Man: March 2012

Saturday 31 March 2012

Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer

Pronunciation: TER-bin-a-feen/hye-DROX-ee-PROE-pil/KYE-toe-san
Generic Name: Terbinafine Tablets and Hydroxypropyl-Chitosan
Brand Name: Terbinex

Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer is used for:

Treating certain fungal infections of the fingernails or toenails.

Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer is an antifungal agent. It works by killing sensitive fungi.

Do NOT use Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer if:

you are allergic to any ingredient in Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer

you have severe kidney problems

you have liver problems

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

Before using Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer:

Some medical conditions may interact with Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer. 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 a history of kidney or liver problems, lupus, psoriasis, cirrhosis, or alcohol abuse or dependence

if you have a weakened immune system

Some MEDICINES MAY INTERACT with Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer. Tell your health care provider if you are taking any other medicines, especially any of the following:

Amiodarone, cimetidine, fluconazole, or ketoconazole because they may increase the risk of Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer's side effects

Rifampin because it may decrease Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer's effectiveness

Certain antiarrhythmics (eg, flecainide, propafenone), beta-blockers (eg, metoprolol), monoamine oxidase type B (MAO-B) inhibitors (eg, selegiline), selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), or tricyclic antidepressants (eg, amitriptyline, desipramine) because the risk of their side effects may be increased by Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer

Anticoagulants (eg, warfarin) or cyclosporine because their effectiveness may be decreased or the risk of their side effects may be increased by Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer

This may not be a complete list of all interactions that may occur. Ask your health care provider if Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer 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 Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer:

Use Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer as directed by your doctor. Check the label on the medicine for exact dosing instructions.

To use the tablets: Take by mouth with or without food.

The tablets are usually taken for 6 to 12 weeks, depending on your condition. The full benefit may not be seen for several months after stopping treatment. This includes the time period necessary for healthy nails to grow.

To use the nail lacquer: Use at bedtime, unless your doctor tells you otherwise. Wash and dry the affected nails, then apply a thin coat of medicine.

Do not apply the nail lacquer to a wound, or to broken or damaged skin.

Use the nail lacquer until a new, healthy nail has grown, unless your doctor tells you otherwise. This usually takes 6 to 12 months, depending on your condition.

To clear up your infection completely, take Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer for the full course of treatment. Keep taking it even if you begin to see improvement before the end of your therapy.

If you miss a dose of Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer, 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 Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer.

Important safety information:

Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer only works against fungal infections; it does not treat bacterial or viral infections (eg, the common cold).

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

Be sure to use Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The fungus could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.

Avoid large amounts of food or drink that have caffeine (eg, coffee, tea, cocoa, cola, chocolate) while you are taking Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer.

Taste changes (eg, taste loss) have been reported in patients taking Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer. These effects may resolve within several weeks after you stop taking Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer, but may last for a long time (eg, more than one year). Tell your doctor right away if you experience a taste disturbance.

Rarely, Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer may cause severe or even fatal liver problems. If liver problems occur, they may be more severe in patients who have other active liver problems or a history of long-term liver problems. Discuss any questions or concerns with your doctor.

The nail lacquer is for external use only. Do not get it in your eyes, nose, or mouth. If you get it in any of these areas, rinse right away with cool water.

You may apply nail polish on top of the nail lacquer.

Unless you are washing your hands, use gloves while using water or chemical substances to avoid accidentally washing the nail lacquer off. Wearing cotton under the gloves is preferred.

The nail lacquer is flammable. Do not store or use near an open flame or while smoking.

Lab tests, including liver function and complete blood cell counts, may be performed while you use Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

PREGNANCY and BREAST-FEEDING: Do not use Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer if you are pregnant. If you think you may be pregnant, contact your doctor right away. Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer is found in breast milk. Do not breast-feed while taking Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer.

Possible side effects of Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer:

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:

Diarrhea; headache; indigestion.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); mental or mood changes (eg, depression); mouth sores; new or worsening symptoms of lupus (eg, butterfly-shaped rash on the face, joint pain, seizures, skin color changes, unusual sensitivity to the sun); red, blistered, peeling, or swollen skin; severe muscle pain or tenderness; symptoms of infection (eg, fever, chills, sore throat); symptoms of liver problems (eg, dark urine; loss of appetite; pale stools; stomach pain; unexplained, persistent nausea; unusual tiredness or weakness; vomiting; yellowing of the skin or eyes); taste changes (eg, taste loss); unexpected weight loss; unusual bruising or bleeding; 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.

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 dizziness; frequent urination; nausea; rash; severe or persistent headache; stomach pain; vomiting.

Proper storage of Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer:

Store the tablets at room temperature between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Store the nail lacquer at room temperature between 59 and 86 degrees F (15 and 30 degrees C). Do not store near an open flame. Keep Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer out of the reach of children and away from pets.

General information:

If you have any questions about Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer, please talk with your doctor, pharmacist, or other health care provider.

Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer 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 Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer. 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

More Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer resources

Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer Use in Pregnancy & Breastfeeding
Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer Drug Interactions
Terbinafine Tablets and Hydroxypropyl-Chitosan Nail Lacquer Support Group
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Friday 30 March 2012

Valtrex

Generic Name: Valacyclovir Hydrochloride
Class: Nucleosides and Nucleotides
VA Class: AM800
Chemical Name: 2-[(2-Amino-1,6-dihydro-6-oxo-9H-purin-9-yl)methoxyl]ethyl ester-l-valine monohydrochloride
Molecular Formula: C₁₃H₂₀N₆O₄•ClH
CAS Number: 124832-27-5

Introduction

Antiviral; prodrug of acyclovir, a nucleoside.¹

Uses for Valtrex

Genital Herpes

Treatment of initial episodes of genital herpes in immunocompetent¹ ²⁴ ²⁹ ³⁰ or HIV-infected†²⁴ adults and adolescents.

Episodic treatment of recurrent episodes of genital herpes in immunocompetent¹ ²⁴ ²⁹ ³⁰ or HIV-infected†²⁴ adults and adolescents.

Chronic suppressive therapy of recurrent episodes of genital herpes in immunocompetent or HIV-infected adults and adolescents.¹ ²⁴ ²⁹ ³⁰ ³³ When used for suppressive therapy in immunocompetent individuals, the risk of heterosexual transmission of genital herpes to susceptible partners is reduced;¹ ³⁵ efficacy for reducing transmission not established in those with multiple partners or in non-heterosexual couples.¹

CDC and others recommend oral acyclovir, oral famciclovir, or oral valacyclovir as drug of choice for treatment of initial episodes of genital herpes and for episodic treatment or chronic suppressive therapy of recurrent genital herpes.²⁴ ²⁹ ³⁰

Herpes Labialis

Treatment of herpes labialis (perioral herpes, cold sores, fever blisters) in adults and adolescents.¹ ³⁴

Safety and efficacy not established in immunocompromised patients.¹

Mucocutaneous Herpes Simplex Virus (HSV) Infections

Treatment of recurrent mucocutaneous HSV infections in HIV-infected adults†.²⁶

Chronic suppressive or maintenance therapy (secondary prophylaxis) against recurrence of HSV infections† in HIV-infected individuals who have frequent or severe recurrences.²⁵ ²⁶

Herpes Zoster

Treatment of acute, localized herpes zoster (shingles, zoster) in adults and adolescents.¹ ⁴ ¹⁰ ¹¹

Treatment of localized dermatomal herpes zoster in HIV-infected adults or adolescents†.³⁸ If cutaneous lesions are extensive or there is clinical evidence of visceral involvement, IV acyclovir should be used for initial treatment.³⁸

Safety and efficacy not established in immunocompromised patients.¹

Safety and efficacy not established for treatment of disseminated herpes zoster.¹

Prevention of Cytomegalovirus (CMV) Disease in Transplant Recipients

Prevention of CMV disease in kidney transplant recipients† at high risk (CMV-seropositive donor).²⁷

Not recommended for prevention of CMV disease in hematopoietic stem cell transplant (HSCT) recipients because the drug is presumed to be less effective than ganciclovir.³¹

Not recommended for primary prevention of CMV disease in HIV-infected individuals because of an unexplained trend toward increased mortality in clinical studies.²⁵ ²⁸

Valtrex Dosage and Administration

Administration

Oral Administration

Administer orally without regard to meals.¹

Patients should maintain adequate hydration during treatment.¹

Dosage

Available as valacyclovir hydrochloride;¹ dosage expressed in terms of valacyclovir.¹

Pediatric Patients

Genital Herpes, Herpes Labialis, Mucocutaneous Herpes Simplex Virus (HSV) Infections, and Herpes Zoster

Oral

Adolescents should receive dosage recommended for adults.²⁴ (See Adults under Dosage and Administration.)

Adults

Genital Herpes

Treatment of First Episodes

Oral

Immunocompetent adults: 1 g twice daily for 7–10 days.¹ ²⁴ ²⁹ ³⁰ CDC suggests duration of treatment may be extended if healing is incomplete after 10 days.²⁴

HIV-infected adults: 1 g twice daily for 7–14 days recommended by CDC and others.³⁸

Initiate therapy within 48 hours of onset of signs and symptoms;¹ efficacy not established if initiated >72 hours after onset of signs or symptoms.¹

Episodic Treatment of Recurrent Episodes

Oral

Immunocompetent adults: 500 mg twice daily for 3 days.¹ ²⁴ ²⁹ ³⁰ Alternatively, CDC recommends 1 g once daily for 5 days†.²⁴

HIV-infected adults: CDC recommends 1 g twice daily for 5–10 days;²⁴ may be continued for 7–14 days.³⁸

Initiate therapy at first sign or symptom of an episode;¹ efficacy not established if initiated >24 hours after onset of signs or symptoms.¹

Suppressive Therapy of Recurrent Episodes

Oral

Immunocompetent adults: 1 g once daily.¹ ²⁴ ³⁰ Alternatively, 500 mg once daily for those with a history of ≤9 recurrences per year.¹ ²⁴ ³⁰

HIV-infected adults: 500 mg twice daily.¹ ²⁴

Manufacturer states safety and efficacy not established beyond a duration of 1 year in immunocompetent or 6 months in HIV-infected individuals.¹

Because frequency of recurrent episodes diminishes over time in many patients, CDC and others recommend suppressive antiviral therapy be discontinued periodically (e.g., once yearly) to assess the need for continued therapy.²⁴ ²⁹ ³⁰

Reduction of Transmission

Oral

500 mg once daily in source partner with a history of ≤9 recurrences per year.¹

Efficacy for reducing transmission not established beyond a duration of 8 months in discordant couples.¹

Herpes Labialis

Oral

Immunocompetent adults: 2 g every 12 hours for 1 day;¹ treatment for cold sores should not exceed 1 day.¹

Initiate treatment at earliest symptom of cold sore (e.g., tingling, itching, burning);¹ efficacy not established if initiated after development of clinical signs of cold sore (e.g., papule, vesicle, ulcer).¹

Mucocutaneous Herpes Simplex Virus (HSV) Infections

Chronic Suppression of Recurrent Episodes

Oral

HIV-infected adults: 500 mg twice daily for chronic suppressive or maintenance therapy (secondary prophylaxis) of HSV infections in those who have frequent or severe recurrences.²⁵

Herpes Zoster

Oral

Immunocompetent adults: 1 g 3 times daily for 7 days.¹

Local dermatomal herpes zoster in HIV-infected adults or adolescents†: 1 g 3 times daily for 7–10 days recommended by CDC and others.³⁸

Initiate therapy at earliest sign or symptom (preferably within 48 hours of rash onset);¹ efficacy not established if initiated >72 hours after rash onset.¹

Special Populations

Hepatic Impairment

Dosage adjustments not recommended for patients with cirrhosis.¹

Renal Impairment

Genital Herpes

Oral

Table 1. Dosage for Treatment of Genital Herpes in Renal Impairment1
Cl_cr (mL/min)	Daily Dosage
First Episodes
≥50	1 g every 12 hours
30–49	1 g every 12 hours
10–29	1 g once every 24 hours
<10	500 mg once every 24 hours
Episodic Treatment of Recurrent Episodes
≥50	500 mg every 12 hours
30–49	500 mg every 12 hours
10–29	500 mg once every 24 hours
<10	500 mg once every 24 hours
Suppressive Therapy of Recurrent Episodes (Immunocompetent with >9 Episodes/Year)
≥50	1 g once every 24 hours
30–49	1 g once every 24 hours
10–29	500 mg once every 24 hours
<10	500 mg once every 24 hours
Suppressive Therapy of Recurrent Episodes (Immunocompetent with <9 Episodes/Year)
≥50	500 mg once every 24 hours
30–49	500 mg once every 24 hours
10–29	500 mg once every 48 hours
<10	500 mg once every 48 hours
Suppressive Therapy of Recurrent Episodes (HIV-infected Individuals)
≥50	500 mg every 12 hours
30–49	500 mg every 12 hours
10–29	500 mg once every 24 hours
<10	500 mg once every 24 hours

Herpes Labialis

Oral

Table 2. Dosage for Treatment of Herpes Labialis in Renal Impairment1
Cl_cr (mL/min)	Daily Dosage
≥50	2 g every 12 hours for 1 day
30–49	1 g every 12 hours for 1 day
10–29	500 mg every 12 hours for 1 day
<10	A single dose of 500 mg

Herpes Zoster

Oral

Table 3. Dosage for Treatment of Herpes Zoster in Renal Impairment1
Cl_cr (mL/min)	Daily Dosage
≥50	1 g every 8 hours
30–49	1 g every 12 hours
10–29	1 g once every 24 hours
<10	500 mg once every 24 hours

Hemodialysis

Usual dose should be administered after hemodialysis.²³

Peritoneal Dialysis

Supplemental doses unnecessary following CAPD or CAVHD.¹

Geriatric Patients

No dosage adjustments except those related to renal impairment.¹ ²³

Cautions for Valtrex

Contraindications

Known hypersensitivity or intolerance to valacyclovir, acyclovir, or any component of the formulation.¹

Warnings/Precautions

Warnings

Hematologic Effects

Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (sometimes fatal) reported in patients with advanced HIV infection and in allogeneic bone marrow or renal transplant recipients receiving high dosages (8 g daily).¹ ²³

General Precautions

Renal Effects

Use of inappropriately high dosage for the level of renal function has resulted in acute renal failure in patients with underlying renal disease.¹

Acyclovir may precipitate in renal tubules if solubility (2.5 mg/mL) is exceeded in intratubular fluid.¹ Maintain adequate hydration.¹

If acute renal failure and anuria occur, hemodialysis recommended until normal renal function returns.¹

CNS Effects

Use of inappropriately high dosage for the level of renal function has resulted in CNS symptoms in patients with underlying renal disease.¹

Genital Herpes

Valacyclovir is not a cure for genital herpes.¹

Avoid sexual contact while lesions and/or symptoms are present due to risk of infecting sexual partners.¹ Infection can be transmitted in the absence of symptoms through asymptomatic viral shedding.¹

Although use for suppressive therapy in immunocompetent individuals with genital herpes decreases the risk for heterosexual transmission, safer sex practices also should be used.¹ Efficacy for reducing transmission not established in individuals with multiple partners or in non-heterosexual couples.¹

Type-specific serologic testing of asymptomatic partners of individuals with genital herpes can determine whether risk for HSV-2 acquisition exists.¹

Valacyclovir has not been shown to reduce transmission of sexually transmitted infections other than HSV-2.¹

Recommended by CDC and others for episodic treatment of genital herpes or chronic suppressive therapy of recurrent episodes in HIV-infected adults and adolescents,¹ ²⁵ ²⁶ but manufacturer says efficacy not established for treatment of genital herpes in HIV-infected individuals and safety and efficacy not established for chronic suppressive therapy in those with advanced HIV disease (CD4⁺ T-cell count <100/mm³).¹

Herpes Labialis

Valacyclovir is not a cure for cold sores.¹

Treatment should not exceed a single day;¹ therapy beyond 1 day does not provide additional clinical benefits.¹

Because of high dosage, use caution when prescribing valacyclovir for treatment of cold sores in geriatric individuals or those with renal impairment.¹ (See Special Populations under Dosage and Administration.)

Safety and efficacy not established for treatment of cold sores in immunocompromised individuals.¹

Herpes Zoster

Safety and efficacy not established for treatment of disseminated herpes zoster or for treatment of herpes zoster in immunocompromised individuals.¹

Specific Populations

Pregnancy

Category B.¹

Lactation

Acyclovir distributed into human milk following oral administration of valacyclovir.¹ Use valacyclovir with caution.¹

Pediatric Use

Safety and efficacy not established in prepubertal children.¹

Geriatric Use

Increased risk of adverse renal or CNS effects.¹ CNS effects reported more frequently in geriatric adults than in younger adults include agitation, hallucinations, confusion, delirium, and encephalopathy.¹

In herpes zoster, longer duration of pain after healing (post-herpetic neuralgia) than in younger adults.¹

Consider age-related decreases in renal function when selecting dosage and adjust dosage if necessary.¹ ²³ (See Renal Impairment under Dosage and Administration.)

Renal Impairment

Decreased clearance; increased risk of adverse renal and CNS effects in patients with underlying renal disease receiving high dosages.¹

Adjust dosage as necessary.¹ (See Renal Impairment under Dosage and Administration.)

Common Adverse Effects

Headache, nausea, vomiting.¹

Interactions for Valtrex

Neither valacyclovir nor acyclovir metabolized by CYP isoenzymes.¹

Specific Drugs

Drug	Interaction	Comments
Antacids (aluminum- or magnesium-containing)	No effect on acyclovir pharmacokinetics¹	Use usual dosages¹
Cimetidine	Potential increased peak plasma concentrations and AUC of acyclovir¹	Not considered clinically important if renal function normal;¹ use usual dosages¹
Digoxin	No effect on pharmacokinetics of acyclovir or digoxin¹	Use usual dosages¹
Probenecid	Potential increased peak plasma concentrations and AUC of acyclovir¹	Not considered clinically important if renal function normal;¹ use usual dosage¹
Thiazide diuretics	No effect on acyclovir pharmacokinetics¹	Use usual dosages¹

Valtrex Pharmacokinetics

Absorption

Bioavailability

Valacyclovir hydrochloride, a prodrug of acyclovir, is rapidly absorbed following oral administration and almost completely converted to acyclovir andl-valine by first-pass intestinal and/or hepatic metabolism.¹ ³⁶

Absolute bioavailability of acyclovir approximately 54% following oral administration of valacyclovir hydrochloride;¹ ³⁶ peak acyclovir plasma concentrations attained within 1.7 hours.³⁶

Food

Administration of valacyclovir with food does not alter acyclovir bioavailability.¹

Distribution

Extent

Although there are no adequate studies using valacyclovir, acyclovir crosses the placenta.¹

Following oral administration of valacyclovir to the mother, acyclovir is distributed into milk.¹

Plasma Protein Binding

13.5–17.9% bound to plasma proteins.¹

Elimination

Metabolism

Valacyclovir hydrochloride rapidly converted to acyclovir and l-valine by first-pass intestinal and/or hepatic metabolism.¹ Acyclovir converted to acyclovir monophosphate, diphosphate, and triphosphate in cells infected with herpesviruses.¹

Neither valacyclovir nor acyclovir metabolized by CYP enzymes.¹

Elimination Route

Valacyclovir principally eliminated as acyclovir;¹ 46 and 47% of an oral dose eliminated in urine and feces, respectively.¹ ³⁶

Half-life

Plasma elimination half-life of acyclovir after oral administration of valacyclovir averages 2.5–3.3 hours.¹ ³⁶

Special Populations

Renal clearance and elimination half-life decreased in patients with renal impairment;¹ half-life averages 14 hours in end-stage renal disease.¹

Pharmacokinetics in geriatric patients vary depending on renal function.¹

Stability

Storage

Oral

Tablets

15–25°C.¹

Actions and SpectrumActions

Valacyclovir is thel-valine ester of acyclovir.¹ ² ³ ⁴ ⁵ ⁶ ⁷ ⁸ ⁹ Prodrug with no antiviral activity until converted in vivo to acyclovir and subsequently to the active acyclovir triphosphate.¹ ² ⁵ ⁶ ⁷

GI absorption of valacyclovir substantially greater than absorption of oral acyclovir resulting in plasma acyclovir concentrations comparable to those achieved with IV acyclovir.³⁶

Active against Herpesviridae including herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella-zoster virus (VZV), and cytomegalovirus (CMV).¹

Acyclovir highly selective for thymidine kinase encoded by HSV and VZV, which converts acyclovir into acyclovir monophosphate, which is further converted to the diphosphate and then to the active triphosphate via other cellular enzymes.¹ Also exhibits activity against viruses that do not code for this enzyme.¹² ¹³ ¹⁴ ¹⁵ ¹⁶ ¹⁷ ¹⁸ ¹⁹ ²⁰

Inhibits viral DNA replication by competitive inhibition of viral DNA polymerase, incorporation and termination of the growing viral DNA chain, and inactivation of the viral DNA polymerase.¹

Resistant strains of HSV and VZV reported.¹

Advice to Patients

Advise patients that valacyclovir is not a cure for genital herpes or herpes labialis (cold sores).¹

Importance of avoiding sexual contact with uninfected partners while genital herpes lesions and/or symptoms are present since there is a risk of transmission.¹ Genital herpes can be transmitted in the absence of symptoms.¹

Importance of using safer sex practices in conjunction with use of valacyclovir for suppressive therapy of genital herpes.¹

Importance of initiating treatment of genital herpes recurrence as soon as possible following onset of signs and symptoms.¹

For treatment of herpes labialis, importance of initiating treatment immediately following onset of symptoms (tingling, itching, burning) and importance of not using valacyclovir for longer than 1 day.¹

Importance of maintaining adequate hydration during treatment.¹

Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.¹

Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, and any concomitant illnesses.¹

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

Preparations

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

Valacyclovir Hydrochloride
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets, film-coated	500 mg (of valacyclovir)	Valtrex Caplets (with povidone)	GlaxoSmithKline
		1 g (of valacyclovir)	Valtrex Caplets (with povidone)	GlaxoSmithKline

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Valacyclovir HCl 1GM Tablets (AUROBINDO PHARMA): 30/$315.99 or 90/$899.97

Valacyclovir HCl 500MG Tablets (MYLAN): 30/$185.99 or 90/$525.97

Valtrex 1GM Tablets (GLAXO SMITH KLINE): 30/$365.87 or 90/$1050.46

Valtrex 500MG Tablets (GLAXO SMITH KLINE): 30/$233.81 or 90/$657.9

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 August 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. GlaxoSmithKline. Valtrex (valacyclovir hydrochloride) caplets prescribing information. Research Triangle Park, NC; 2006 Jul.

2. Jacobson MA, Gallant J, Wang LH et al. Phase I trial of valaciclovir, the l-valyl ester of acyclovir, in patients with advanced human immunodeficiency virus disease. Antimicrob Agents Chemother. 1994; 38:1534-40. [IDIS 332383] [PubMed 7979285]

3. Darby G. Acyclovir—and beyond. J Int Med Res. 1994; 22(Suppl 1):33-42A. [PubMed 8187942]

4. Beutner KR, Friedman DJ, Forszpaniak C et al. Valaciclovir compared with acyclovir for improved therapy for herpes zoster in immunocompetent adults. Antimicrob Agents Chemother. 1995; 39:1546-53. [IDIS 350497] [PubMed 7492102]

5. Gnann JW Jr. New antivirals with activity against varicella-zoster virus. Ann Neurol. 1994; 34(Suppl):S69-72.

6. Easterbrook P, Wood MJ. Successors to acyclovir. J Antimicrob Chemother. 1994; 34:307-11. [IDIS 336425] [PubMed 7829405]

7. Weller S, Blum MR, Doucette M et al. Pharmacokinetics of the acyclovir pro-drug valaciclovir after escalating single- and multiple-dose administration to normal volunteers. Clin Pharmacol Ther. 1993; 54:595-605. [IDIS 324231] [PubMed 8275615]

8. Lampkin TA. Valacyclovir HCl (Valtrex) administration achieves increased acyclovir concentration in multiple populations. Int Pharm Abst. 1994; 31:2291.

9. Shaefer MS. Valacyclovir HCl (Valtrex) provides simplified dosing and increased efficacy in the treatment of herpes virus infections. Int Pharm Abst. 1994; 31:2244-5.

10. The International Valaciclovir Zoster Study Group, Smiley ML. The efficacy and safety of valaciclovir for the treatment of herpes zoster. Proceedings of ICAAC New Orleans 1993. Abstract No. 1203.

11. The International Valaciclovir Zoster Study Group, Smiley ML. Valaciclovir and acyclovir for the treatment of recurrent genital herpes simplex virus infections. Proceedings of ICAAC New Orleans 1993. Abstract No. 1210.

12. Koch-Weser J, Hirsch MS, Swartz MN. Drug therapy: antiviral agents (second of two parts). N Engl J Med. 1980; 302:949-53. [IDIS 113597] [PubMed 6244492]

13. Lerner AM. Acyclovir reaches clinical trial. Ann Intern Med. 1982; 96:370-2. [IDIS 146189] [PubMed 7036819]

14. Weller IV, Carreno V, Fowler MJ et al. Acyclovir inhibits hepatitis B virus replication in man. Lancet. 1982; 1:273. [IDIS 144926] [PubMed 6120286]

15. Colby BM, Furman PA, Shaw JE et al. Phosphorylation of acyclovir [9-(2-hydroxyethoxymethyl)-guanine] in Epstein-Barr virus infected lymphoblastoid cell lines. J Virol. 1981; 38:606-11. [PubMed 6264131]

16. St. Clair MH, Furman PA, Lubbers CM et al. Inhibition of cellular α and virally induced deoxyribonucleic acid polymerases by the triphosphate of acyclovir. Antimicrob Agents Chemother. 1980; 18:741-5. [PubMed 7192534]

17. Tyms AS, Scamans EM, Naim HM. The in vitro activity of acyclovir and related compounds against cytomegalovirus infections. J Antimicrob Chemother. 1981; 8:65-72. [PubMed 6265430]

18. Burns WH, Wingard JR, Bender WJ et al. Thymidine kinase not required for antiviral activity of acyclovir against mouse cytomegalovirus. J Virol. 1981; 30:889-93.

19. McCarthy P (Burroughs Wellcome Co, Research Triangle Park, NC): Personal communication; 1982 Aug.

20. Mar E, Patel PC, Huang E. Effect of 9-(2-hydroxyethoxymethyl) guanine on viral-specific polypeptide synthesis in human cytomegalovirus-infected cell. Am J Med. 1982; 73(Acyclovir symposium):82-5. [IDIS 154027] [PubMed 6285739]

21. Lang DJ, Cheung K. Effectiveness of acycloguanosine and trifluorothymidine as inhibitors of cytomegalovirus infection in vitro. Am J Med. 1982; 73(Acyclovir symposium):49-53. [IDIS 154025] [PubMed 6285732]

22. Pagano JS, Datta AK. Perspectives on interactions of acyclovir with Epstein-Barr and other herpes viruses. Am J Med. 1982; 73(Acyclovir symposium):18-26. [IDIS 156729] [PubMed 6285710]

23. Glaxo Wellcome, Inc, Research Triangle Park, NC: Personal communication.

24. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. 2006; 55(RR-11):1-95.

25. US Public Health Service (USPHS) and Infectious Diseases Society of America (IDSA) Prevention of Opportunistic Infections Working Group. 2001 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons with human immunodeficiency virus. From the US Department of Health and Human Services HIV/AIDS Information Services (AIDSinfo) website ().

26. Balfour HH. Antiviral drugs. N Engl J Med. 1999; 340:1255-68. [IDIS 423356] [PubMed 10210711]

27. Lowance D, Neumayer HH, Legendre CM et al. Valacyclovir for the prevention of cytomegalovirus disease after renal transplantation. N Engl J Med. 1999; 340:1462-70. [IDIS 427339] [PubMed 10320384]

28. Feinberg JE, Hurwitz S, Cooper D et al. A randomized, double-blind trial of valaciclovir prophylaxis for cytomegalovirus disease in patients with advanced human immunodeficiency virus infection. J Infect Dis. 1998; 177:48-56. [IDIS 399239] [PubMed 9419169]

29. Anon. Drugs for sexually transmitted infections. Treat Guidel Med Lett. 2004; 2:67-74. [PubMed 15529116]

30. Anon. Drugs for non-HIV viral infections. Treat Guidel Med Lett. 2005; 3:23-32.

31. Centers for Disease Control and Prevention. Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients: recommendations of CDC, the Infectious Disease Society of America, and the American Society of Blood and Marrow Transplantation. MMWR Recomm Rep. 2000; 49(RR-10):1-125.

32. Leone P, Trottier S, Miller JM. Valacyclovir for episodic treatment of genital herpes: a shorter 3-day treatment course compared with 5-day treatment. Clin Infect Dis. 2002; 34:958-62. [IDIS 480416] [PubMed 11880962]

33. DeJesus E, Wald A, Warren T et al. Valacyclovir for suppression of recurrent genital herpes in human immunodeficiency virus-infected subjects. J Infect Dis. 2003; 188:1009-16. [IDIS 516503] [PubMed 14513421]

34. Spruance SL, Jones TM, Blatter MM et al. High-dose, short-duration, early valacyclovir therapy for episodic treatment of cold sores: results of two randomized, placebo-controlled, multicenter studies. Antimicrob Agents Chemother. 2003; 47:1072-80. [IDIS 495732] [PubMed 12604544]

35. Corey L, Wald A, Patel R et al. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med. 2004; 350:11-20. [IDIS 508984] [PubMed 14702423]

36. Soul-Lawton J, Seaber E, On N et al. Absolute bioavailability and metabolic disposition of valaciclovir, the L-valyl ester of acyclovir, following oral administration to humans. Antimicrob Agents Chemother. 1995; 39:2759-64. [IDIS 358708] [PubMed 8593015]

37. Soul-Lawton J, Seaber E, On N et al. Absolute bioavailability and metabolic disposition of valaciclovir, the L-valyl ester of acyclovir, following oral administration to humans. Antimicrobial Agents and Chemotherapy. 1995; 39:2759-64. [IDIS 358708] [PubMed 8593015]

38. Centers for Disease Control and Prevention. Treating opportunistic infections among HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America. MMWR Recomm Rep. 2004; 53(RR-15):1-112.

39. Centers for Disease Control and Prevention. Treating opportunistic infections among HIV-exposed and infected children: recommendations from CDC, the National Institutes of Health, and the Infectious Diseases Society of America. MMWR Recomm Rep. 2004; 53( RR-14):1-92.

More Valtrex resources

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

Valtrex Prescribing Information (FDA)

Valtrex Consumer Overview

Valtrex Advanced Consumer (Micromedex) - Includes Dosage Information

Valtrex MedFacts Consumer Leaflet (Wolters Kluwer)

Valacyclovir Prescribing Information (FDA)

Compare Valtrex with other medications

Cold Sores
Cytomegalovirus Infection
Herpes Simplex, Mucocutaneous/Immunocompetent Host
Herpes Simplex, Mucocutaneous/Immunocompromised Host
Herpes Simplex, Suppression
Herpes Zoster
Multiple Sclerosis
Varicella-Zoster

Wednesday 21 March 2012

Neosporin Ophthalmic

Generic Name: gramicidin, neomycin, and polymyxin B ophthalmic (gram i SYE din, NEE oh MYE sin, POL ee MIX in B off THAL mik)

Brand Names: Neosporin Ophthalmic, Ocu-Spore-G

What is Neosporin Ophthalmic (gramicidin, neomycin, and polymyxin B ophthalmic)?

Gramicidin, neomycin, and polymyxin B are all antibiotics. They are used to treat bacterial infections.

The ophthalmic form of gramicidin, neomycin, and polymyxin B is used to treat bacterial infections of the eyes.

Gramicidin, neomycin, and polymyxin B ophthalmic may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Neosporin Ophthalmic (gramicidin, neomycin, and polymyxin B ophthalmic)?

Contact your doctor if your symptoms begin to get worse or if you do not see any improvement in your condition after a few days.

Do not touch the dropper to any surface, including your eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in your eye.

Apply light pressure to the inside corner of your eye (near your nose) after each drop to prevent the liquid from draining down your tear duct.

Who should not use Neosporin Ophthalmic (gramicidin, neomycin, and polymyxin B ophthalmic)?

Do not use gramicidin, neomycin, and polymyxin B ophthalmic if you have a viral or fungal infection in your eye. It is used to treat infections caused by bacteria only. It is not known whether gramicidin, neomycin, and polymyxin B ophthalmic will harm an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant. It is not known whether gramicidin, neomycin, and polymyxin B ophthalmic passes into breast milk. Do not use this medication without first talking to your doctor if you are breast-feeding a baby.

How should I use Neosporin Ophthalmic (gramicidin, neomycin, and polymyxin B ophthalmic)?

Use gramicidin, neomycin, and polymyxin B eyedrops exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Wash your hands before and after using your eyedrops.

To apply the eyedrops:

Tilt your head back slightly and pull down on your lower eyelid. Position the dropper above your eye. Look up and away from the dropper. Squeeze out a drop and close your eye. Apply gentle pressure to the inside corner of your eye (near your nose) for about 1 minute to prevent the liquid from draining down your tear duct. If you are using more than one drop in the same eye or drops in both eyes, repeat the process with about 5 minutes between drops.

Do not touch the dropper to any surface, including your eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in your eye. Do not use any eyedrop that is discolored or has particles in it. Store gramicidin, neomycin, and polymyxin B ophthalmic at room temperature away from moisture and heat. Keep the bottle properly capped.

What happens if I miss a dose?

Apply the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the missed dose and apply the next one as directed. Do not use a double dose of this medication.

What happens if I overdose?

An overdose of this medication is unlikely to occur. If you do suspect an overdose, wash the eye with water and call an emergency room or poison control center near you. If the drops have been ingested, drink plenty of fluid and call an emergency center for advice.

What should I avoid while using Neosporin Ophthalmic (gramicidin, neomycin, and polymyxin B ophthalmic)?

Do not touch the dropper to any surface, including your eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in your eye. Use caution when driving, operating machinery, or performing other hazardous activities. Gramicidin, neomycin, and polymyxin B ophthalmic may cause blurred vision. If you experience blurred vision, avoid these activities.

Use caution with contact lenses. Wear them only if your doctor approves. After applying this medication, wait at least 15 minutes before inserting contact lenses.

Avoid other eye medications unless your doctor approves.

Neosporin Ophthalmic (gramicidin, neomycin, and polymyxin B ophthalmic) side effects

Serious side effects are not expected with this medication.

Commonly, some burning, stinging, irritation, itching, redness, blurred vision, eyelid itching, eyelid swelling or crusting, tearing, or sensitivity to light may occur.

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 Neosporin Ophthalmic (gramicidin, neomycin, and polymyxin B ophthalmic)?

Avoid other eye medications unless they are approved by your doctor.

Drugs other than those listed here may also interact with gramicidin, neomycin, and polymyxin B ophthalmic. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

More Neosporin Ophthalmic resources

Neosporin Ophthalmic Side Effects (in more detail)
Neosporin Ophthalmic Use in Pregnancy & Breastfeeding
Neosporin Ophthalmic Support Group
0 Reviews for Neosporin Ophthalmic - Add your own review/rating

Neocidin Prescribing Information (FDA)

Neocidin Advanced Consumer (Micromedex) - Includes Dosage Information

Compare Neosporin Ophthalmic with other medications

Conjunctivitis, Bacterial

Where can I get more information?

Your pharmacist has additional information about gramicidin, neomycin, and polymyxin B written for health professionals that you may read.

See also: Neosporin Ophthalmic side effects (in more detail)

Monday 19 March 2012

Para-Time S. R.

Generic Name: papaverine (pa PAV uh reen)

Brand Names: Papacon, Para-Time S. R., Pavabid Plateau, Pavacot, Pavagen

What is Para-Time S. R. (papaverine)?

Papaverine is in a class of drugs called vasodilators. Papaverine relaxes veins and arteries, which makes them wider and allows blood to pass through them more easily. These actions may help to increase the amount of oxygen-rich blood in your brain, heart, and muscles.

Papaverine may also be useful in treating conditions involving spasms of the intestines and urinary tract.

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

What is the most important information I should know about Para-Time S. R. (papaverine)?

Use caution when driving, operating machinery, or performing other hazardous activities. Papaverine may cause dizziness. If you experience dizziness, avoid these activities. If you experience dizziness, rise slowly from a sitting or lying position to avoid falling. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking papaverine.

Notify your doctor if you experience especially bothersome sweating, rash, flushing, headache, tiredness, yellowing of your skin, nausea, decreased appetite, diarrhea, or constipation.

Who should not take Para-Time S. R. (papaverine)?

Before taking this medication, tell your doctor if you have

heart disease or irregular heartbeats,

liver disease,

glaucoma, or

Parkinson's disease.

You may not be able to take papaverine, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Papaverine is in the FDA pregnancy category C. This means that it is not known whether papaverine will harm an unborn baby. Do not take papaverine without first talking to your doctor if you are pregnant. It is not known whether papaverine passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take Para-Time S. R. (papaverine)?

Take papaverine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

The regular-release form of papaverine is usually taken three to five times a day. The timed-release tablets and capsules are usually taken two or three times a day (every 8 to 12 hours). Follow your doctor's instructions.

Do not crush, chew, break, or open the timed-release tablets or capsules. Swallow them whole. They are specially formulated to release slowly in your body. Store papaverine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a papaverine overdose include drowsiness, weakness, double vision, poor coordination, headache, blue-colored lips or skin, and coma.

What should I avoid while taking Para-Time S. R. (papaverine)?

Para-Time S. R. (papaverine) side effects

Stop taking papaverine and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).

Stop taking papaverine and contact your doctor if your skin or eyes develop a yellow tint.

Other, less serious side effects may be more likely to occur. Continue to take papaverine and talk to your doctor if you experience

nausea, decreased appetite, diarrhea, or constipation;

dizziness or drowsiness;

headache;

sweating and flushing;

a rash; or

irregular heartbeats.

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 Para-Time S. R. (papaverine)?

Papaverine may decrease the effects of levodopa (Dopar, Larodopa) which is used to treat Parkinson's disease. You may need a change in your levodopa dosage if you are taking levodopa.

Drugs other than those listed here may also interact with papaverine or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

More Para-Time S. R. resources

Para-Time S. R. Use in Pregnancy & Breastfeeding
Drug Images
Para-Time S. R. Drug Interactions
Para-Time S. R. Support Group
0 Reviews · Be the first to review/rate this drug

Papaverine MedFacts Consumer Leaflet (Wolters Kluwer)

Papacon Advanced Consumer (Micromedex) - Includes Dosage Information

Papaverine Hydrochloride Monograph (AHFS DI)

Where can I get more information?

Your pharmacist has additional information about papaverine written for health professionals that you may read.

Sunday 18 March 2012

Infantaire Gas Relief

Generic Name: simethicone (sye METH i cone)

Brand Names: Alka-Seltzer Anti-Gas, Equalize Gas Relief Drops, Gas Aide, Gas Free Extra Strength, Gas-X, Gas-X Extra Strength, Gas-X Infant Drops, Gas-X Maximum Strength, Gas-X Thin Strips Cinnamon, Gas-X Thin Strips Peppermint, Gas-X Tongue Twisters Thin Strips Children's, Gas-X Ultra Softgels, Genasyme, Infantaire Gas Relief, Little Tummys, Maalox Anti-Gas, Maalox Anti-Gas Extra Strength, Mi-Acid Gas Relief, Mylanta Gas, Mylanta Gas Maximum Strength, Mylicon, Mytab Gas, Phazyme, Phazyme Maximum Strength, Phazyme Ultra, Phazyme-125, Phazyme-95

What is Infantaire Gas Relief (simethicone)?

Simethicone allows gas bubbles in the stomach and intestines to come together more easily, which allows for easier passage of gas.

Simethicone is used to relieve painful pressure caused by excess gas in the stomach and intestines. Simethicone is for use in babies, children, and adults.

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

What is the most important information I should know about Infantaire Gas Relief (simethicone)?

Never use more than the recommended dose of simethicone.

Ask a doctor or pharmacist if it is safe for you to take this medicine if you are allergic to any drugs, or if you have any type of serious illness (especially one that affects your stomach or intestines).

Simethicone works best if you take it after meals and at bedtime.

Simethicone may be only part of a complete program of treatment that may also include a special diet or increased exercise. It is very important to follow the diet and exercise plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you must avoid to help control your condition.

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

What should I discuss with my healthcare provider before taking Infantaire Gas Relief (simethicone)?

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

Simethicone is not expected to harm an unborn baby. It is not known whether simethicone passes into breast milk or if it could harm a nursing baby. Do not use this medication without medical advice if you are breast-feeding a baby.

The liquid form may contain phenylalanine. Talk to your doctor before using this form of simethicone if you have phenylketonuria (PKU).

How should I take Infantaire Gas Relief (simethicone)?

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.

Do not take more of this medication than is directed.

Simethicone works best if you take it after meals and at bedtime.

The simethicone chewable tablet must be chewed before swallowing.

Measure liquid medicine with a special dose measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose measuring device, ask your pharmacist for one. Clean the medicine dropper after each use. Allow it to air dry.

Simethicone liquid drops can be mixed with water, baby formula, or other liquids to make swallowing easier for an infant or child.

Children should never be given more than the recommended dose of simethicone. Call your doctor if the child's gas symptoms do not improve after treatment with simethicone.

Store at room temperature away from moisture, heat, and light. Do not allow the liquid form of this medicine to freeze.

What happens if I miss a dose?

Since simethicone is used on an as needed basis, you are not likely to miss a dose. Do not use more of this medication than is directed.

What happens if I overdose?

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

What should I avoid while taking Infantaire Gas Relief (simethicone)?

Ask a doctor or pharmacist before using any other stomach medicine or antacid. Simethicone is contained in many combination medicines. Taking certain products together can cause you to get too much simethicone.

Infantaire Gas Relief (simethicone) 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.

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 Infantaire Gas Relief (simethicone)?

More Infantaire Gas Relief resources

Infantaire Gas Relief Side Effects (in more detail)
Infantaire Gas Relief Use in Pregnancy & Breastfeeding
Infantaire Gas Relief Support Group
0 Reviews for Infantaire Gas Relief - Add your own review/rating

Simethicone Professional Patient Advice (Wolters Kluwer)

Simethicone Monograph (AHFS DI)

Alka-Seltzer Anti-Gas Advanced Consumer (Micromedex) - Includes Dosage Information

Bicarsim MedFacts Consumer Leaflet (Wolters Kluwer)

Gas-X Chewable Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

Gas-X Extra Strength MedFacts Consumer Leaflet (Wolters Kluwer)

Gas-X Infant Drops Liquid Drops MedFacts Consumer Leaflet (Wolters Kluwer)

Genasyme Suspension MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Infantaire Gas Relief with other medications

Endoscopy or Radiology Premedication
Functional Gastric Disorder
Gas
Postoperative Gas Pains

Where can I get more information?

Your pharmacist can provide more information about simethicone.

See also: Infantaire Gas Relief side effects (in more detail)

Tuesday 13 March 2012

enalaprilat Intravenous

en-AL-a-pril-at

Intravenous route(Solution)

ACE inhibitors can cause injury or death to the developing fetus when used during the second and third trimesters. Stop therapy as soon as possible when pregnancy is detected .

Commonly used brand name(s)

In the U.S.

Vasotec I.V.

Available Dosage Forms:

Solution

Therapeutic Class: Antihypertensive

Pharmacologic Class: ACE Inhibitor

Uses For enalaprilat

Enalaprilat injection is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled .

Enalaprilat works by blocking an enzyme in the body that is necessary to produce a substance that causes blood vessels to tighten. As a result, the blood vessels relax. This lowers blood pressure and increases the supply of blood and oxygen to the heart .

enalaprilat is available only with your doctor's prescription .

Before Using enalaprilat

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For enalaprilat, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to enalaprilat or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of enalaprilat in the pediatric population. Safety and efficacy have not been established .

Geriatric

No information is available on the relationship of age to the effects of enalaprilat in geriatric patients. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment of dose in patients receiving enalaprilat .

Pregnancy

	Pregnancy Category	Explanation
1st Trimester	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.
2nd Trimester	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.
3rd Trimester	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving enalaprilat, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using enalaprilat with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Allopurinol

Alteplase, Recombinant

Amiloride

Azathioprine

Azilsartan Medoxomil

Candesartan Cilexetil

Canrenoate

Eplerenone

Eprosartan

Interferon Alfa-2a

Losartan

Olmesartan Medoxomil

Potassium

Spironolactone

Telmisartan

Triamterene

Valsartan

Using enalaprilat with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aceclofenac

Acemetacin

Alclofenac

Apazone

Aspirin

Azosemide

Bemetizide

Bendroflumethiazide

Benoxaprofen

Benzthiazide

Bromfenac

Bufexamac

Bumetanide

Bupivacaine

Buthiazide

Capsaicin

Carprofen

Chlorothiazide

Chlorthalidone

Clometacin

Clomipramine

Clonixin

Clopamide

Cyclopenthiazide

Cyclothiazide

Dexketoprofen

Diclofenac

Diflunisal

Dipyrone

Droxicam

Ethacrynic Acid

Etodolac

Etofenamate

Felbinac

Fenbufen

Fenoprofen

Fentiazac

Floctafenine

Flufenamic Acid

Flurbiprofen

Furosemide

Hydrochlorothiazide

Hydroflumethiazide

Ibuprofen

Indapamide

Indomethacin

Indoprofen

Isoxicam

Ketoprofen

Ketorolac

Lornoxicam

Meclofenamate

Mefenamic Acid

Meloxicam

Metformin

Methyclothiazide

Metolazone

Nabumetone

Naproxen

Niflumic Acid

Nimesulide

Oxaprozin

Oxyphenbutazone

Phenylbutazone

Pirazolac

Piretanide

Piroxicam

Pirprofen

Polythiazide

Propyphenazone

Proquazone

Quinethazone

Rifampin

Sulindac

Suprofen

Tenidap

Tenoxicam

Tiaprofenic Acid

Tolmetin

Torsemide

Trichlormethiazide

Trimethoprim

Xipamide

Zomepirac

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of enalaprilat

In addition to the use of enalaprilat, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that enalaprilat will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Precautions While Using enalaprilat

It is very important that your doctor check your progress at regular visits to make sure enalaprilat is working properly and to check for unwanted effects .

Stop using enalaprilat and call your doctor right away if you have swelling of the face, arms, legs, eyes, lips, or tongue, or problems with swallowing or breathing. These are symptoms of a condition called angioedema .

You may experience lightheadedness during the first few days with enalaprilat. If this becomes severe and you faint, talk to your doctor right away .

Tell your doctor immediately if you have any signs of infection such as chills, sore throat, or fever. These may be symptoms of an immune system condition called neutropenia .

Using enalaprilat while you are pregnant can harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away .

Check with your doctor right away if you have symptoms of jaundice (yellow skin or eyes) because these may be signs of a serious liver condition .

enalaprilat may increase the amount of potassium in your blood. Do not use salt substitutes containing potassium without first checking with your doctor .

Make sure any doctor or dentist who treats you knows that you are using enalaprilat. You may need to stop using enalaprilat several days before having surgery or medical tests .

enalaprilat Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common

Blurred vision

confusion

dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly

sweating

unusual tiredness or weakness

Rare

Chest pain or discomfort

nausea

pain or discomfort in arms, jaw, back or neck

shortness of breath

vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Headache

Rare

Difficulty having a bowel movement (stool)

dizziness

fever

rash

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: enalaprilat Intravenous side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More enalaprilat Intravenous resources

Enalaprilat Intravenous Side Effects (in more detail)
Enalaprilat Intravenous Support Group
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Innohep

Generic Name: tinzaparin (Subcutaneous route)

tin-za-PAR-in

Subcutaneous route(Solution)

Epidural or spinal hematomas, which may result in long-term or permanent paralysis, may occur in patients who are anticoagulated with low molecular weight heparins or heparinoids and are receiving neuraxial anesthesia or undergoing spinal puncture. Factors that can increase the risk of developing these hematomas include: use of indwelling epidural catheters, concomitant use of drugs affecting hemostasis such as NSAIDs, platelet inhibitors, or other anticoagulants, or history of traumatic or repeated epidural or spinal puncture, spinal deformity, or spinal surgery. Monitor patients frequently for neurological impairment. If neurological compromise is noted, urgent treatment is necessary. Consider risks/benefits before neuraxial intervention in patients anticoagulated or to be anticoagulated for thromboprophylaxis .

Commonly used brand name(s)

In the U.S.

Innohep

Available Dosage Forms:

Solution

Therapeutic Class: Anticoagulant

Pharmacologic Class: Low Molecular Weight Heparin

Uses For Innohep

Tinzaparin is used for the treatment of deep venous thrombosis, a condition in which harmful blood clots form in the blood vessels of the legs. These blood clots can travel to the lungs and can become lodged in the blood vessels of the lungs, causing a condition called pulmonary embolism. Tinzaparin is used for several days after surgery, while you are unable to walk. It is during this time that blood clots are most likely to form. Tinzaparin also may be used for other conditions as determined by your doctor.

This medicine is available only with your doctor's prescription.

Before Using Innohep

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of tinzaparin in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of tinzaparin in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment in the dose for patients receiving tinzaparin.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	B	Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abciximab

Aceclofenac

Acemetacin

Acenocoumarol

Alclofenac

Alteplase, Recombinant

Anistreplase

Antithrombin, Recombinant

Apazone

Argatroban

Benoxaprofen

Bivalirudin

Bromfenac

Bufexamac

Carprofen

Citalopram

Clometacin

Clonixin

Clopidogrel

Dabigatran Etexilate

Dalteparin

Danaparoid

Dexketoprofen

Dextran

Diclofenac

Diflunisal

Dipyridamole

Dipyrone

Drotrecogin Alfa

Droxicam

Enoxaparin

Eptifibatide

Escitalopram

Etodolac

Etofenamate

Felbinac

Fenbufen

Fenoprofen

Fentiazac

Floctafenine

Flufenamic Acid

Fluoxetine

Flurbiprofen

Fluvoxamine

Ibuprofen

Indomethacin

Indoprofen

Isoxicam

Ketoprofen

Ketorolac

Lepirudin

Lornoxicam

Meclofenamate

Mefenamic Acid

Meloxicam

Nabumetone

Naproxen

Niflumic Acid

Nimesulide

Oxaprozin

Oxyphenbutazone

Paroxetine

Phenindione

Phenprocoumon

Phenylbutazone

Pirazolac

Piroxicam

Pirprofen

Propyphenazone

Proquazone

Reteplase, Recombinant

Rivaroxaban

Sertraline

Streptokinase

Sulindac

Suprofen

Tenecteplase

Tenidap

Tenoxicam

Tiaprofenic Acid

Ticlopidine

Tirofiban

Tolmetin

Urokinase

Warfarin

Zomepirac

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aspirin

Benorilate

Choline Magnesium Trisalicylate

Mesalamine

Olsalazine

Salicylamide

Salicylic Acid

Salsalate

Sodium Salicylate

Sodium Thiosalicylate

Trolamine Salicylate

Interactions with Food/Tobacco/Alcohol

Proper Use of Innohep

A nurse or other trained health professional will give you this medicine. This medicine is given as a shot under your skin, usually in the abdomen.

If you are using tinzaparin at home, your doctor will teach you how to inject yourself with the medicine. Be sure to follow the directions carefully. Check with your doctor if you have any problems using the medicine.

You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. This will help prevent skin problems from the injections.

If the medicine in the vial (glass container) has changed color, or if you see particles in it, do not use it.

Put used syringes in a puncture-resistant, disposable container, or dispose of them as directed by your doctor.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For injection dosage form:
- For prevention of deep venous thrombosis (leg clots) due to surgery:
  - Adults
  - General surgery—3500 International Units (IU) given 2 hours before surgery then 3500 IU once a day for 7 to 10 days.
  - Hip surgery—50 International Units (IU) per kilogram (kg) of body weight given 2 hours before surgery then 50 IU per kg of body weight once a day for 7 to 10 days, or 75 IU per kg of body weight given after surgery once a day for 7 to 10 days.
  - Knee surgery—75 International Units (IU) per kilogram (kg) of body weight given after surgery once a day for 7 to 10 days.
  - Children—Use and dose must be determined by your doctor.
- For treatment of deep venous thrombosis (leg clots) with or without pulmonary embolism (lung clots):
  - Adults—Dose is based on body weight and must be determined by your doctor. The dose is usually 175 International Units (IU) per kilogram (kg) of body weight injected under the skin once a day for 6 to 7 days.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

Call your doctor or pharmacist for instructions.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Precautions While Using Innohep

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests will be needed to check for unwanted effects. Be sure to keep all appointments.

This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash; itching; swelling of the face, tongue, and throat; trouble breathing; or chest pain after you receive this medicine.

Make sure your doctor knows if you have had an allergic reaction to heparin, sulfites, benzyl alcohol, or pork products.

Tinzaparin may increase your chance of bleeding or bruising. This risk is higher if you have a catheter in your back for pain medicine or anesthesia (sometimes called an "epidural"), or if you have kidney problems. The risk of bleeding increases as the severity of your kidney problems increases. Check with your doctor right away if you notice any unusual bleeding or bruising; black, tarry stools; bleeding gums; blood in the urine or stools; or pinpoint red spots on your skin.

You may bleed and bruise more easily while you are using this medicine. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Be careful when using sharp objects, including razors and fingernail clippers. Avoid nose picking and forceful nose blowing.

Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using tinzaparin several days before having surgery or medical tests.

This medicine contains benzyl alcohol which may cause serious reactions to newborn or premature infants. Discuss this with your doctor if you are concerned.

Do not take or discontinue other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines, and herbal or vitamin supplements.

Innohep Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Deep, dark purple bruise, pain, or swelling at the place of injection

Less common

Bladder pain

bleeding gums

blood in the urine

bloody or cloudy urine

blurred vision

chest pain

chest tightness

chills

confusion

cough

coughing up blood

difficulty with breathing or swallowing

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

fast, slow, or irregular heartbeat

fever

frequent urge to urinate

headache

increased menstrual flow or vaginal bleeding

lower back or side pain

nosebleeds

pain or burning while urinating

painful or difficult urination

pale skin

palpitations

paralysis

pounding in the ears

prolonged bleeding from cuts

red or black, tarry stools

red or dark brown urine

severe or continuing dull nervousness

shortness of breath

skin rash

sore throat

sores, ulcers, or white spots on the lips or in the mouth

sweating

swollen glands

troubled breathing, exertional

unexplained pain, swelling, or discomfort, especially in the chest, abdomen or stomach, joints, or muscles

unusual bleeding or bruising

unusual tiredness or weakness

vomiting of blood or material like coffee grounds

Rare

Blue-green to black skin discoloration

bowel or bladder dysfunction

hives

itching

leg weakness

numbness

pain, redness, or sloughing of the skin at the place of injection

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

wheezing

Incidence not known

Abdominal or stomach pain

accumulation of pus

break in the skin, especially associated with blue-black discoloration, swelling, or drainage of fluid

change in vision

clay-colored stools

collection of blood under the skin

diarrhea

excessive thirst

general feeling of discomfort or illness

hoarseness

large, flat, blue or purplish patches in the skin

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

loss of appetite

muscle cramps

numbness and tingling of the face, fingers, or toes

pain in the arms, legs, or lower back, especially pain in the calves or heels upon exertion

pain, redness, or swelling

painful knees and ankles

pale, bluish-colored, or cold hands or feet

problems with vision or hearing

raised, red swellings on the skin, buttocks, legs or ankles

red or irritated eyes

redness, tenderness, burning, blistering, or peeling of the skin (usually on the backs of arms and the fronts of legs, mouth, eyes, hands, or feet)

seeing floating spots before the eyes

swollen, red, or tender area of infection

unpleasant breath odor

weak or absent pulses in the legs

yellow eyes or skin

Less common or rare

Constipation

nausea and vomiting

prolonged, painful, or inappropriate erection of the penis

trouble with sleeping

Incidence not known

Hives or welts

redness of the skin

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Innohep side effects (in more detail)

More Innohep resources

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

Innohep Prescribing Information (FDA)

Innohep Concise Consumer Information (Cerner Multum)

Innohep Monograph (AHFS DI)

Innohep MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Innohep with other medications

Deep Vein Thrombosis