Saturday, 31 March 2012

simethicone



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, ...show all 45 brand names.


What is 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 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 simethicone?


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

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.


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 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.


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.


Simethicone Dosing Information


Usual Adult Dose for Flatulence:

40 to 125 mg orally after meals and at bedtime, not to exceed 500 mg/24 hours.

Usual Adult Dose for Functional Gastric Disorder:

40 to 125 mg orally after meals and at bedtime, not to exceed 500 mg/24 hours.

Usual Adult Dose for Postoperative Gas Pains:

40 to 125 mg orally after meals and at bedtime, not to exceed 500 mg/24 hours.

Usual Adult Dose for Endoscopy or Radiology Premedication:

67 mg as an oral suspension in 2.5 mL of water given shortly before the procedure.

Usual Pediatric Dose for Flatulence:

0 to
2 to 12 years: 40 mg orally 4 times a day. For the 40 mg strips, allow 1 strip to dissolve on the tongue as needed after meals and at bedtime. Do not exceed 6 strips in 24 hours except under the advice and supervision of a physician.


12 to 18 years: 40 to 125 mg orally after meals and at bedtime as needed, not to exceed 500 mg/24 hours.

Usual Pediatric Dose for Endoscopy or Radiology Premedication:

Child >12 years: 67 mg as an oral suspension in 2.5 mL of water given shortly before the procedure.


What other drugs will affect simethicone?


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.



More simethicone resources


  • Simethicone Use in Pregnancy & Breastfeeding
  • Drug Images
  • Simethicone Support Group
  • 2 Reviews for Simethicone - Add your own review/rating


  • simethicone Advanced Consumer (Micromedex) - Includes Dosage Information

  • Simethicone Professional Patient Advice (Wolters Kluwer)

  • Simethicone Monograph (AHFS DI)

  • Simethicone MedFacts Consumer Leaflet (Wolters Kluwer)

  • Bicarsim MedFacts Consumer Leaflet (Wolters Kluwer)

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

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

  • Genasyme Suspension MedFacts Consumer Leaflet (Wolters Kluwer)



Compare simethicone 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.


Tuesday, 27 March 2012

Chlorpromazine 100mg Tablets





1. Name Of The Medicinal Product



Chlorpromazine 100mg Tablets


2. Qualitative And Quantitative Composition



Each tablet contains 100mg of Chlorpromazine Hydrochloride B.P.



3. Pharmaceutical Form



Round, white, film- coated tablets intended for oral administration to human beings.



4. Clinical Particulars



4.1 Therapeutic Indications



Chlorpromazine is a phenothiazine neuroleptic and is indicated in the following conditions:



1) Psychotic conditions (especially paranoid), including schizophrenia, mania and hypomania.



2) As an adjunct in the short-term management of anxiety psychomotor agitation excitement, violent or dangerously impulsive behaviour.



3) Nausea or vomiting associated with terminal illness, where other agents are ineffective or unavailable.



4) Intractable hiccup.



5) Childhood schizophrenia and autism.



4.2 Posology And Method Of Administration



Method of administration: Oral.



Dosage



Dosage varies both with the individual and with the purpose for which the drug is being used. The dosage should be low to begin with and increased, gradually, under close supervision until the optimum level of control is achieved.



Dosage in schizophrenia, other psychoses, anxiety and agitation etc.



Adults: Initially 25mg three times daily or 75mg at bedtime, increasing by daily amounts of 25mg to the effective maintenance dose. The usual maintenance dose is in the range of 75 to 300mg daily, although some patients may require up to 1.0g daily.



Children:Aged under 1 year: Chlorpromazine should generally not be used unless the need is life-saving.



Age 1 to 5 years: 0.5mg/kg every 4 to 6 hours to a maximum daily dosage of 40mg.



Age 6 to 12 years: 1/3 to 1/2 the adult dose to a maximum daily dosage of 75mg.



Elderly or debilitated patients: Initially 1/3 to 1/2 the usual adult dose with a more gradual increase in dosage.



Dosage in Hiccup



Adults: 25 - 50mg three to four times daily.



Children: No information available.



Dosage in nausea and vomiting of terminal illness :



Adults: 10-25mg every 4 to 6 hours.



Children: Age under 1 year: Chlorpromazine should generally not be used unless the need is life-saving.



Age 1 to 5 years: 0.5 mg/kg every 4 to 6 hours. The maximum daily dosage should not exceed 40mg.



Aged 6 to 12 years: 0.5 mg/kg every 4 to 6 hours. The maximum daily dosage should not exceed 75mg.



Elderly or debilitated patients: Initially 1/3 to ½ the adult dose. The subsequent dosage should be adjusted under close supervision to obtain control.



4.3 Contraindications



Chlorpromazine is contraindicated in patients with a known hypersensitivity to the drug. Chlorpromazine is also contraindicated in comatose patients, including those under the influence of alcohol or other central nervous system depressants.



4.4 Special Warnings And Precautions For Use



Chlorpromazine should be avoided whenever possible in patients with hepatic or renal dysfunction, cardiac failure, phaeochromocytoma, hypothyroidism, bone marrow depression, epilepsy, Parkinson's disease, myasthenia gravis, prostatic hypertrophy or a history of narrow angle glaucoma.



Cases of venous thromboembolism (VTE) have been reported with antipsychotic drugs. Since patients treated with antipsychotics often present with acquired risk factor for VTE, all possible risk factors for VTE should be identified before and during treatment with Chlorpromazine and preventive measures undertaken.



Chlorpromazine should be used with caution in the elderly, especially during very hot or very cold weather because of the risk of hyper - or hypothermia.



Increased Mortality in Elderly people with Dementia



Data from two large observational studies showed that elderly people with dementia who are treated with antipsychotics are at a small increased risk of death compared with those who are not treated. There are insufficient data to give a firm estimate of the precise magnitude of the risk and the cause of the increased risk is not known.



Chlorpromazine is not licensed for the treatment of dementia-related behavioural disturbances.



4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction



Alcohol, barbiturates and other sedatives may intensify the CNS depressant effects of chlorpromazine and respiratory depression may occur.



The hypotensive effect of most antihypertensive agents, especially alpha-adrenoceptor blocking agents, may be exaggerated by chlorpromazine.



Chlorpromazine has mild anticholinergic activity which may be enhanced by other anticholinergic drugs.



Anticholinergic drugs may decrease the antipsychotic effect of chlorpromazine. Chlorpromazine may oppose the action of some drugs, including amphetamine, levodopa, adrenaline, clonidine and guanethidine.



Some drugs interfere with the absorption of neuroleptic agents, e.g. antacids, lithium, anti-Parkinsonian agents. Although increases or decreases have been observed in the plasma concentrations of a number of drugs, including propranolol and phenobarbitone, these were not of clinical significance.



At high dosage, chlorpromazine reduces the response to hypoglycaemic agents, which may require an increase in dosage of the latter.



Clinically significant adverse drug interactions with alcohol, guanethidine and hypoglycaemic agents are documented. Adrenaline must not be used in cases of overdosage with chlorpromazine. Other interactions are of theoretical interest and are not of a serious nature. Concomitant administration of desferrioxamine and prochlorperazine has been reported to cause a transient metabolic encephalopathy with loss of consciousness for 48 to 72 hours. The possibility of a similar occurrence with chlorpromazine exists, because it shares many of the pharmacological activities of prochlorperazine.



4.6 Pregnancy And Lactation



The safety of chlorpromazine in pregnancy has not been established, although the drug has been in wide use for many years without apparent ill consequence. There is evidence of harmful effects in animals. As with other drugs, chlorpromazine should be avoided during pregnancy unless it is considered essential by the physician. Labour may occasionally be prolonged by chlorpromazine and therapy should be delayed until the cervix is dilated 3 to 4cms. Possible effects on the neonate include lethargy, paradoxical hyperexcitability, tremor and low Apgar score. Chlorpromazine is excreted in breast milk and breast feeding should be suspended during treatment.



4.7 Effects On Ability To Drive And Use Machines



Chlorpromazine may cause drowsiness, especially during the early days of therapy, and patients should be warned not to drive or operate machinery if affected.



4.8 Undesirable Effects



Minor side effects include nasal stuffiness, dry mouth, insomnia and agitation.



Cardiovascular : Hypotension, especially postural, is relatively common and elderly patients or subjects with volume depletion are particularly susceptible. Cardiac arrhythmias have been reported in patients receiving neuroleptic agents and may be dose-related. They include atrial arrhythmia, A-V block, ventricular tachycardia and fibrillation. Pre-existing cardiac disease, hypokalaemia, concurrent use of tricyclic antidepressants and old age may predispose to development of arrhythmia. E.C.G. changes may occur, including widened QT interval, ST depression, U waves and T wave changes.



Blood : Mild leucopenia may occur in up to 30% of patients on prolonged high dosage. Agranulocytosis may occur rarely and is not dose-related. Unexplained infections or pyrexia require immediate haematological investigations.



Respiratory: Clinical doses of the neuroleptics usually have little effect on respiration. However, respiratory depression may occur in susceptible patients.



Hepatic: A very small percentage of patients may develop jaundice, which is usually transient and which may be preceded by sudden pyrexia after one to three weeks of treatment. The jaundice is obstructive in type and is frequently accompanied by an eosinophilia, indicating the allergic nature of the event. Chlorpromazine therapy should be withdrawn if jaundice occurs.



Extrapyramidal: Acute dystonic or dyskinetic reactions may occur. These are usually transitory, are commoner in children and young adults and are more likely to occur within the first four days of treatment or after dosage increases. Akathisia may occur, characteristically following large initial doses.



Neuroleptic - induced parkinsonism is commoner in adults and the elderly and usually takes weeks or months of treatment to develop. Tremor is a common sign but rigidity, akinesia or other features of parkinsonism may also occur.



If tardive dyskinesia occurs, it is usually although not always associated with prolonged or high dosage. It may occur after treatment has been discontinued. To reduce the likelihood of tardive dyskinesia, the dosage should be kept low whenever possible.



Skin and Eyes: Various skin rashes may occur during therapy with chlorpromazine. Photosensitivity eruptions may occur and patients receiving high dosage should be advised to avoid exposure to direct sunlight. Contact skin sensitisation is a rare but serious complication in persons who frequently handle chlorpromazine preparations and particular care should be taken to avoid contact of the drug with the skin.



Ocular changes and a metallic greyish-mauve discolouration of exposed skin have been reported in some patients, mainly females, who received chlorpromazine continuously for long periods of between four and eight years.



Endocrine: Hyperprolactinaemia has been reported and may result in galactorrhoea, gynaecomastia or amenorrhoea; impotence has been reported.



Neuroleptic malignant syndrome: The syndrome may occur with use of any neuroleptic agent. Symptoms include clouding of consciousness, rigidity and other extrapyramidal effects, and autonomic dysfunction, most importantly hyperpyrexia. Treatment involves the immediate cessation of neuroleptic therapy and symptomatic management as appropriate.



Cases of venous thromboembolism, including cases of pulmonary embolism and cases of deep vein thrombosis have been reported with antipsychotic drugs- Frequency unknown



4.9 Overdose



Symptoms of overdosage may include drowsiness or loss of consciousness, hypotension, tachycardia, ventricular arrhythmias, acute extrapyramidal reactions and hypothermia. There is no specific antidote and treatment is essentially symptomatic and supportive. The stomach should be emptied by aspiration and lavage and activated charcoal should be given. Circulatory collapse may respond to elevation of the lower limbs, although volume expansion with intravenous fluids may be required. Use of a positive inotropic agent such as dopamine may be considered if circulatory collapse does not respond to volume expansion; peripheral vasoconstrictor agents are not generally recommended and adrenaline should be avoided.



Tachyarrhythmias usually respond to restoration of normal body temperature and correction of circulatory or metabolic disturbances. Anti-arrhythmic therapy may be considered for persistent or life-threatening arrhythmias; lignocaine should be avoided and, as far as possible, so should long-acting anti-arrhythmic drugs.



If severe dystonic reactions occur, they usually respond to procyclidine 5 to 10mg or orphenadrine 20 to 40mg given intramuscularly or intravenously. Intravenous diazepam may be used to treat convulsions.



Dantrolene sodium together with cooling and general supportive measures may be used to treat the neuroleptic malignant syndrome.



An open airway should be maintained and artificial respiration may be required in severe cases of central nervous system depression.



5. Pharmacological Properties



5.1 Pharmacodynamic Properties



Chlorpromazine is a dimethylamine derivative of phenothiazine. Although the precise mechanism where by the therapeutic effects of chlorpromazine are produced is not known, the principal pharmacological action are neuroleptic, resulting in the favourable modification of psychotic symptoms. Chlorpromazine also exerts sedative and anti-emetic activity. It has alpha-adrenergic blocking and weaker anticholinergic activities. It is an inhibitor of dopamine and it inhibits prolactine-release-inhibitory factor (considered to be dopamine), thus stimulating the release of prolactin. Chlorpromazine has serotonin blocking and weak antihistaminic properties. It inhibits the heat-regulating centre so that the subject tends to acquire the ambient temperature.



5.2 Pharmacokinetic Properties



Although chlorpromazine is readily absorbed from the gastrointestinal tract, it undergoes first-pass metabolism in the gut wall and is also extensively metabolised in the liver. Intramuscular administration avoids much of the first-pass metabolism of the drug. Paths of metabolism include hydroxylation and conjugation with glucuronic acid, N-oxidation, oxidation of a sulphur atom and dealkylation. Chlorpromazine is extensively bound to plasma proteins. It is widely distributed in the body and across the blood-brain barrier to achieve higher concentration in the brain than in the plasma. Chlorpromazine and its metabolism also cross the placental barrier and are excreted in breast milk. Although the plasma half-life of chlorpromazine has been reported to be only a few hours, elimination of metabolism may be very prolonged. Chlorpromazine is excreted in the urine and faeces in the form of numerous active and inactive metabolites.



5.3 Preclinical Safety Data



No further relevant information other than that which is included in other sections of the Summary of Product Characteristics.



6. Pharmaceutical Particulars



6.1 List Of Excipients



Lactose B.P.



Maize Starch B.P.



Povidone B.P.



Sodium Starch Glycollate B.P.



Magnesium Stearate B.P.



Opadry Y-I-7000



6.2 Incompatibilities



None.



6.3 Shelf Life



4 years (48 months).



6.4 Special Precautions For Storage



Store in a cool dry place.



Protect from light and heat.



Keep out of reach of children.



6.5 Nature And Contents Of Container



Polypropylene securitainers with tamper evident polypropylene caps.



Pack sizes: 28, 50, 100, 250, 500, 1000 and 5000 tablets.



6.6 Special Precautions For Disposal And Other Handling



Not applicable.



Administrative Data


7. Marketing Authorisation Holder



Goldshield Pharmaceutical Ltd



NLA Tower



12-16 Addiscombe Road



Croydon



CRO OXT



United Kingdom



8. Marketing Authorisation Number(S)



PL 12762/0110



9. Date Of First Authorisation/Renewal Of The Authorisation



25 July 2001



10. Date Of Revision Of The Text



24/2/2010




Friday, 23 March 2012

Nitrozone





Dosage Form: FOR ANIMAL USE ONLY
Nitrozone Soluble Dressing (nitrofurazone) First Companion Veterinary Products NADA 122-447, Approved by FDA

Indications


For the prevention or treatment of surface bacterial infections of wounds, burns and cutaneous ulcers.  For use only on dogs, cats and horses.



Administration


Apply directly on the lesion with a spatula or first place on a piece of gauze.  Application of a bandage is optional.


This preparation should be in contact with the lesion for at least 24 hours.  The dressing may be changed several times daily or left on the lesion for a longer period.



Caution


In case of deep or puncture wounds or serious burns, consult a veterinarian.  If redness, irritation or swelling persists or increase, discontinue use and consult a veterinarian.


Avoid exposure to excessive heat or direct sunlight and strong fluorescent lighting.




Human Warnings: Carcinogenesis


Nitrofurazone, the active ingredient of Nitrozone Dressing has been shown to produce mammary tumors in rats and ovarian tumors in mice.


Additionally, some people may be hypersensitive to this product.  Either wear gloves when applying, or wash hands afterwards.


Not to be used on animals intended for food purposes.



Storage and Handling


Store at 20 degrees to 25 degrees C (68 degrees to 77 degrees F); excursions permited to 15 degrees to 30 degrees C (59 degrees to 86 degrees F)


(See USP Controlled Room Temperature)


FOR ANIMAL USE ONLY


KEEP OUT OF REACH OF CHILDREN



Package Label Display Panel


Nitrozone


(Brand of Nitrofurazone Soluble Dressing)


FOR USE ONLY ON DOGS, CATS AND HORSES


WARNING:  DO NOT USE IN HORSES INTENDED FOR HUMAN CONSUPTION.


AN ANTIBACTERIAL PREPARATION FOR TOPICAL APPLICATION


Federal law prohibits the extralabel use of this drug in food-producing animals.


CONTENTS:  0.2% Nitrofurazone in a Water Soluble base of Polyethylene Glycols.


NADA 122-447, Approved by FDA


Net Weight:  1 Pound










Nitrozone 
nitrofurazone  dressing










Product Information
Product TypeOTC ANIMAL DRUGNDC Product Code (Source)64556-900
Route of AdministrationTOPICALDEA Schedule    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
Nitrofurazone (Nitrofurazone)Nitrofurazone0.907 g  in 453.6 g





Inactive Ingredients
Ingredient NameStrength
No Inactive Ingredients Found


















Product Characteristics
Color    Score    
ShapeSize
FlavorImprint Code
Contains      










Packaging
#NDCPackage DescriptionMultilevel Packaging
164556-900-01453.6 g In 1 JARNone










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
NADANADA12244710/01/2009


Labeler - First Companion Veterinary Products (059580480)
Revised: 12/2009First Companion Veterinary Products



Wednesday, 21 March 2012

tocainide


Generic Name: tocainide (toe CANE ide)

Brand Names: Tonocard


What is tocainide?

Tocainide affects the way that your heart beats.


Tocainide is used to treat serious irregularity in heartbeat patterns.


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


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


Call your doctor immediately if you experience wheezing, coughing, difficulty breathing, chest pain, chest discomfort, worsening irregular heartbeats, a fever, a sore throat, a throat infection, a sore mouth, mouth ulcers, a rash, or unusual bruising or bleeding.


Do not skip doses or change your dosing schedule without talking to your doctor. Changing your schedule could make your condition much worse. Use caution when driving, operating machinery, or performing other hazardous activities. Tocainide may cause dizziness, drowsiness, or blurred vision. If you experience dizziness, drowsiness, or blurred vision, avoid these activities.

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


Before taking tocainide, tell your doctor if you have



  • any other type of heart disease or heart problem,



  • liver disease, or

  • kidney disease.

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


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

How should I take tocainide?


Take tocainide 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. Tocainide may be taken with food to lessen stomach upset. Do not skip doses or change your dosing schedule without talking to your doctor. Changing your schedule could make your condition much worse. Store tocainide at room temperature away from moisture and heat.

See also: Tocainide dosage (in more detail)

What happens if I miss a dose?


Try not to miss any doses of this medication. Missing doses could be very dangerous.


If you do miss a dose, take it 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. A double dose could be dangerous.


What happens if I overdose?


Seek emergency medical attention.

Symptoms of a tocainide overdose include tiredness, dizziness, confusion, tremor, nausea, vomiting, seizures, and a worsening irregular heartbeat.


What should I avoid while taking tocainide?


Use caution when driving, operating machinery, or performing other hazardous activities. Tocainide may cause dizziness, drowsiness, or blurred vision. If you experience dizziness, drowsiness, or blurred vision, avoid these activities.

Follow any other special instructions given by your doctor regarding food, beverages or activities.


Tocainide side effects


If you experience any of the following serious side effects, stop taking tocainide and seek emergency medical attention:

  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);




  • a new or a worsening irregular heartbeat pattern;




  • wheezing, coughing, chest pain, or chest discomfort;




  • unusual bruising or bleeding; or




  • fever, sore throat, a sore mouth, mouth ulcers, or an infection.



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



  • dizziness or tiredness;




  • upset stomach, vomiting, decreased appetite, or diarrhea;




  • headache or blurred vision;




  • confusion; or




  • numbness, tingling, or tremor (shaking).



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.


Tocainide Dosing Information


Usual Adult Dose for Arrhythmias:

Initial dose: 400 mg orally every 8 hours.
Maintenance dose: 1200-1800 mg/day in 3 divided doses.


What other drugs will affect tocainide?


The effects of tocainide may be decreased by rifampin (Rimactane, Rifadin). Your doctor may want to adjust your tocainide dosage if you are taking this medicine.


The beta-blocker metoprolol (Lopressor) may increase the effects of tocainide. Your doctor may need to lower your dose of tocainide if you are taking this medication.


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



More tocainide resources


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


  • tocainide Advanced Consumer (Micromedex) - Includes Dosage Information



Compare tocainide with other medications


  • Arrhythmia


Where can I get more information?


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

What does my medication look like?


Tocainide is available with a prescription under the brand name Tonocard. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.



  • Tonocard 400 mg--yellow, oval, film-coated, scored tablets




  • Tonocard 600 mg--yellow, oblong, film-coated, scored tablets



See also: tocainide side effects (in more detail)


Tuesday, 20 March 2012

Solage



mequinol and tretinoin

Dosage Form: topical solution
FULL PRESCRIBING INFORMATION

Indications and Usage for Solage


(To understand fully the indication for this product, please read the entire Indications and Usage section of the labeling).


Solagé® (mequinol 2%, tretinoin 0.01%) Topical Solution is indicated for the treatment of solar lentigines.


Solagé should only be used under medical supervision as an adjunct to a comprehensive skin care and sun avoidance program where the patient should primarily either avoid the sun or use protective clothing.


Neither the safety nor effectiveness of Solagé for the prevention or treatment of melasma or postinflammatory hyperpigmentation has been established.


The efficacy of using Solagé daily for greater than 24 weeks has not been established.



Solage Dosage and Administration


Patients require detailed instruction to obtain maximal benefits and to understand all the precautions necessary to use this product with greatest safety. The physician should review the Patient Information. Apply Solagé to the solar lentigines using the applicator tip while avoiding application to the surrounding skin. Use twice daily, morning and evening at least 8 hours apart, or as directed by a physician. Patients should not shower or bathe the treatment areas for at least 6 hours after application of Solagé. Special caution should be taken when applying Solagé to avoid the eyes, mouth, paranasal creases, and mucous membranes.


Application of Solagé may cause transitory stinging, burning or irritation.


Improvement continues gradually through the course of therapy and should be apparent by 24 weeks. Patients should avoid exposure to sunlight (including sunlamps) or wear protective clothing while using Solagé. Data are not available to establish how or whether Solagé is degraded (either by sunlight or by normal interior lighting) following application to the skin.


With discontinuation of Solagé therapy, a majority of patients will experience some repigmentation over time of their lesions.


Applications of larger amounts of medication or more frequently than recommended will not lead to more rapid or better results, and marked redness, peeling, irritation, or hypopigmentation (abnormal lightening) of the skin may occur.


Patients treated with Solagé may use cosmetics but should wait 30 minutes before applying.


Not for oral, ophthalmic or intravaginal use.



Dosage Forms and Strengths


Mequinol 2% and tretinoin 0.01%, by weight, in a solution base of ethyl alcohol (77.8% v/v)



Contraindications


No adequate or well-controlled trials have been conducted with Solagé in pregnant women. The combination of mequinol and tretinoin may cause fetal harm when administered to a pregnant woman. Due to the known effects of these active ingredients, Solagé should not be used in women of childbearing potential.


In a dermal teratology study in New Zealand White rabbits, there were no statistically significant differences among treatment groups in fetal malformation data; however, marked hydrocephaly with visible doming of the head was observed in one mid-dose litter (12 and 0.06 mg/kg or 132 and 0.66 mg/m2 of mequinol and tretinoin, respectively) and two fetuses in one high dose litter (40 and 0.2 mg/kg or 440 and 2.2 mg/m2 of mequinol and tretinoin, respectively) of Solagé, and two high-dose tretinoin (0.2 mg/kg, 2.2 mg/m2) treated litters. These malformations were considered to be treatment related and due to the known effects of tretinoin. This was further supported by coincident appearance of other malformations associated with tretinoin, such as cleft palate and appendicular skeletal defects. No effects attributed to treatment were observed in rabbits in that study treated topically with mequinol alone (dose 40 mg/kg, 440 mg/m2). A no-observed-effect level (NOEL) for teratogenicity in rabbits was established at 4 and 0.02 mg/kg (44 and 0.22 mg/m2 mequinol and tretinoin, respectively) for Solagé which is approximately the maximum possible human daily dose, based on clinical application to 5% of total body surface area. Plasma tretinoin concentrations were not raised above endogenous levels, even at teratogenic doses. Plasma mequinol concentrations in rabbits at the NOEL at one hour after application were 124 ng/mL or approximately twelve times the mean peak plasma concentrations of that substance seen in human subjects in a clinical pharmacokinetic study.


In a repeated study in pregnant rabbits administered the same dose levels as the study described above, additional precautionary measures were taken to prevent ingestion, although there is no evidence to confirm that ingestion occurred in the initial study. Precautionary measures additionally limited transdermal absorption to a six hour exposure period, or approximately one-fourth of the human clinical daily continuous exposure time. This study did not show any significant teratogenic effects at doses up to approximately 13 times the human dose on a mg/m2 basis. However, a concurrent tretinoin dose group (0.2 mg/kg/day) did include two litters with limb malformations.


In a published study in albino rats (J. Am. Coll. Toxicology 4(5):31–63, 1985), topical application of 5% of mequinol in a cream vehicle during gestation was embryotoxic and embryolethal. Embryonic loss prior to implantation was noted in that study where animals were treated throughout gestation. Coincidentally, mean preimplantation embryonic loss was increased in the first rabbit study in all mequinol treated groups, relative to control, and in the high dose mequinol/tretinoin and tretinoin only treated groups in the second study. In those studies, dosing began at gestation day 6, when implantation is purported to occur. Increased preimplantation loss was also noted at the high combination dose in a study of early embryonic effects in rats, as was decreased body weight in male pups; these findings are consistent with the published study.


Solagé was not teratogenic in Sprague-Dawley rats when given in topical doses of 80 and 0.4 mg/kg mequinol and tretinoin, respectively (480 and 2.4 mg/m2 or 11 times the maximum human daily dose). The maximum human dose is defined as the amount of solution applied daily to 5% of the total body surface area.


With widespread use of any drug, a small number of birth defect reports associated temporally with the administration of the drug would be expected by chance alone. Thirty cases of temporally-associated congenital malformations have been reported during two decades of clinical use of another formulation of topical tretinoin. Although no definite pattern of teratogenicity and no casual association has been established from these cases, 6 of the reports describe the rare birth defect category holoprosencephaly (defects associated with incomplete midline development of the forebrain). The significance of these spontaneous reports in terms of risk to the fetus is not known.



Warnings and Precautions



Augmented Phototoxicity


Solagé should not be administered if the patient is also taking drugs known to be photosensitizers (e.g., thiazides, tetracyclines, fluoroquinolones, phenothiazines, sulfonamides) because of the possibility of augmented phototoxicity. Because of heightened burning susceptibility, exposure to sunlight (including sunlamps) to treated areas should be avoided or minimized during the use of Solagé. Patients must be advised to use protective clothing and comply with a comprehensive sun avoidance program when using Solagé. Data are not available to establish how or whether Solagé is degraded (either by sunlight or by normal interior lighting) following application to the skin. Patients with sunburn should be advised not to use Solagé until fully recovered. Patients who may have considerable sun exposure due to their occupation and those patients with inherent sensitivity to sunlight should exercise particular caution when using Solagé and ensure that the precautions outlined in the Patient Information are observed.


Solagé should be kept out of the eyes, mouth, paranasal creases, and mucous membranes.



Local Events


Solagé is a dermal irritant and the results of continued irritation of the skin for greater than 52 weeks in chronic, long-term use are not known. Tretinoin has been reported to cause severe irritation on eczematous skin and should be used only with utmost caution in patients with this condition.


Solagé may cause skin irritation, erythema, burning, stinging or tingling, peeling, and pruritis. If the degree of such local irritation warrants, patients should be directed to use less medication, decrease the frequency of application, discontinue use temporarily, or discontinue use altogether. The efficacy at reduced frequencies of application has not been established.



Precautions: General


Solagé should only be used as an adjunct to a comprehensive skin care and sun avoidance program. (see Indications and Usage [1]).


If a drug sensitivity, chemical irritation, or a systemic adverse reaction develops, use of Solagé should be discontinued.


Weather extremes, such as wind or cold, may be more irritating to patients using Solagé.


Solagé should be used with caution by patients with a history, or family history, of vitiligo. One patient in the trials, whose brother had vitiligo, experienced hypopigmentation in areas that had not been treated with study medication. Some of these areas continued to worsen for at least one month post treatment with Solagé. Six weeks later the severity of the hypopigmentation had decreased from moderate to mild and 106 days post treatment, the patient had resolution of some but not all lesions.


Application of larger amounts of medication than recommended will not lead to more rapid or better results, and marked redness, peeling, discomfort, or hypopigmentation of the skin may occur.



Flammable Contents


Keep away from heat and open flame.



Adverse Reactions



Adverse Reactions in Clinical Trials


Because clinical trials are conducted under widely varying conditions, adverse reaction rate observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.


In the pivotal clinical trials, adverse reactions were primarily mild to moderate in intensity, occurring in 66% and 30% of patients, respectively. The majority of these events were limited to the skin and 64% had an onset of a skin related adverse reaction early in treatment (by week 8). The most frequent adverse reactions in patients treated with Solagé were erythema (49% of patients), burning, stinging, or tingling (26%), desquamation (14%), pruritus (12%), and skin irritation (5%). Some patients experienced temporary hypopigmentation of treated lesions (5%) or of the skin surrounding treated lesions (7%). Ninety-four of 106 patients (89%) had resolution of hypopigmentation upon discontinuation of treatment to the lesion, and/or re-instruction on proper application to the lesion only. Another 8% (9/106) of patients with hypopigmentation events had resolution within 120 days after the end of treatment. Three of the 106 patients (2.8%) had persistence of hypopigmentation beyond 120 days. Approximately 6% of patients discontinued study participation with Solagé due to adverse reactions. These discontinuations were due primarily to skin redness (erythema) or related cutaneous adverse reactions. Rare cases of depigmentation at sites distant from the application have been reported in Post Marketing Surveillance.

















































































































































Adverse Events Occurring in >1% of the Population – All Studies

*

In study RD.06.SRE.18091 irritant dermatitis included signs & symptoms of scaling, dryness, stinging/burning, and erythema.

Body SytstemSolagé (mequinol 2%, tretinoin 0.01%)Tretinoin, 0.01%

Mequinol,


2%,
Vehicle

Skin and Appendages


N%N%N%N%
Erythema61341.126155.3135.184.6
Burning/Stinging/ Tingling27018.117336.72610.22011.4
Desquamation17111.59319.772.821.1
Pruritus1489.96614.0124.731.7
Irritation Skin*906.0255.310.410.6
Halo Hypopigmentation966.4163.420.821.1
Hypopigmentation624.281.720.800.0
Skin Dry463.1183.831.210.6
Rash312.0214.400.010.6
Crusting302.0183.800.010.6
Rash Vesicular Bullae181.281.700.000.0
Dermatitis291.900.000.000.0
Discomfort Skin523.500.000.000.0
Irritant Dermatitis171.100.000.000.0

 



Post-marketing Experience


The following adverse reactions have been reported during post-approval use of Solagé: skin discoloration, erythema, skin exfoliation, skin irritation, and skin burning sensation. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.



Drug Interactions


Concomitant topical products with a strong skin drying effect, products with high concentrations of alcohol, astringents, spices or lime, medicated soaps or shampoos, permanent wave solutions, electrolysis, hair depilatories or waxes, or other preparations that might dry or irritate the skin should be used with caution in patients being treated with Solagé because they may increase irritation when used with Solagé.


Solagé should not be administered if the patient is also taking drugs known to be photosensitizers (e.g., thiazides, tetracyclines, fluoroquinolones, phenothiazines, sulfonamides) because of the possibility of augmented phototoxicity.



USE IN SPECIFIC POPULATIONS



Pregnancy


TERATOGENIC EFFECTS: PREGNANCY CATEGORY X.


Although the magnitude of the potential for teratogenicity may not be well-defined, Solagé is labeled as a pregnancy category “X” because the potential risk of the use of this drug to treat this particular indication (solar lentigines) in a pregnant woman clearly outweighs any possible benefit (see Contraindications [4]). Solagé should not be used in women of childbearing potential.



Nursing Mothers


It is not known to what extent mequinol and/or tretinoin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Solagé is administered to a nursing woman.



Pediatric Use


The safety and effectiveness of this product have not been established in pediatric patients. Solagé should not be used on children.



Geriatric Use


Of the total number of patients in clinical studies of Solagé, approximately 43% were 65 and older, while approximately 8% were 75 and over. No overall differences in effectiveness or safety were observed between these patients and younger patients.



Overdosage


If Solagé is applied excessively, no more rapid or better results will be obtained and marked redness, peeling, discomfort, or discoloration, including hypopigmentation, may occur. Oral ingestion of the drug may lead to the same adverse effects as those associated with excessive oral intake of vitamin A (hypervitaminosis A). If oral ingestion occurs, the patient should be monitored, and appropriate supportive measures should be administered as necessary. The maximal no-effect level for oral administration of Solagé in rats was 5.0 mL/kg (30 mg/m2). Clinical signs observed were attributed to the high alcohol content (77%) of the drug formulation.



Solage Description


Solagé contains mequinol 2% and tretinoin 0.01%, by weight, in a solution base of ethyl alcohol (77.8% v/v), polyethylene glycol 400, butylated hydroxytoluene, ascorbic acid, citric acid, ascorbyl palmitate, edetate disodium, and purified water.


Mequinol is 4-hydroxyanisole, the monomethyl ether of hydroquinone or 1-hydroxy-4-methoxybenzene. It has the chemical formula, C7H8O2, a molecular weight of 124.14, and the structural formula:



The chemical name for tretinoin, a retinoid, is (all-E)-3,7-dimethyl-9-(2,6,6-trimethyl-1-cyclohexen-1-yl)-2,4,6,8-nonatetraenoic acid, also referred to as all-trans-retinoic acid. It has the chemical formula, C20H28O2, a molecular weight of 300.44, and the structural formula:




Solage - Clinical Pharmacology


Solar lentigines are localized, pigmented, macular lesions of the skin on the areas of the body which have been chronically exposed to sunlight. Biopsy specimens of solar lentigines were collected in a clinical study with Solagé at baseline, at the end of a 24 week treatment period, and at the end of a subsequent 24 week, no treatment, follow-up period. The end of treatment specimens showed a decrease in melanin pigmentation in both melanocytes and keratinocytes, and an increased lymphocytic infiltration, which may have been the result of irritation or an immunologic reaction. The end of follow-up period specimens showed repigmentation of the melanocytes and keratinocytes to a state similar to the baseline specimens. These results indicate that there is no assurance that any improvement obtained would persist upon discontinuation of drug therapy.



Mechanism of Action


The mechanism of action of mequinol is unknown. Although mequinol is a substrate for the enzyme tyrosinase and acts as a competitive inhibitor of the formation of melanin precursors, the clinical significance of these findings is unknown. The mechanism of action of tretinoin as a depigmenting agent also is unknown.



Pharmacokinetics


The percutaneous absorption of tretinoin and the systemic exposure to tretinoin and mequinol were assessed in healthy subjects (n=8) following two weeks of twice daily topical treatment of Solagé. Approximately 0.8 mL of Solagé was applied to a 400 cm2 area of the back, corresponding to a dose of 37.3 μg/cm2 for mequinol and 0.23 μg/cm2 for tretinoin. The percutaneous absorption of tretinoin was approximately 4.4%, and systemic concentrations did not increase over endogenous levels. The mean Cmax for mequinol was 9.92 ng/mL (range 4.22 to 23.62 ng/mL) and the Tmax was 2 hours (range 1 to 2 hours).



Nonclinical Toxicology



Carcinogenesis, Mutagenesis, Impairment of Fertility


Although a dermal carcinogenicity study in CD-1 mice indicated that Solagé applied topically at daily doses up to 80 and 0.4 mg/kg (240 and 1.2 mg/m2) of mequinol and tretinoin, respectively, representing approximately 5 times the maximum possible systemic human exposure was not carcinogenic, in a photocarcinogenicity study utilizing Crl:Skh-1(hr/hr BR) hairless albino mice, median time to onset of tumors decreased. Also, the number of tumors increased in all dose groups administered 1.4, 4.3, or 14 μl of Solagé /cm2 of skin (24 and 0.12, 72 and 0.36, or 240 and 1.2 mg/m2 of mequinol and tretinoin, respectively; 0.6, 1.9, or 6.5 times the daily human dose on a mg/m2 basis) following chronic topical dosing with intercurrent exposure to ultraviolet radiation for up to 40 weeks. Similar animal studies have shown an increased tumorigenic risk with the use of retinoids when followed by ultraviolet radiation. Although the significance of these studies to human use is not clear, patients using this product should be advised to avoid or minimize exposure to either sunlight or artificial ultraviolet irradiation sources.


Mequinol was non-mutagenic in the Ames/Salmonella assay using strains TA98, TA100, TA1535, and TA1537, all of which are insensitive to mutagenic effects of structurally-related quinones. Solagé was non-genotoxic in an in vivo dermal micronucleus assay in rats, but exposure of bone marrow to drug was not demonstrated.


A dermal reproduction study with Solagé in Sprague-Dawley rats at a daily dose of 80 and 0.4 mg/kg (480 and 2.4 mg/m2) of mequinol and tretinoin, respectively, approximately 11 times the corresponding maximum possible human exposure, assuming 100% bioavailability following topical application to 5% of the total body surface area, showed no impairment of fertility.



Clinical Studies


Two adequate and well-controlled trials evaluated changes in treated hyperpigmented lesions on the face, forearms/back of hands in 421 patients treated with Solagé, 422 patients treated with tretinoin topical solution, 209 patients treated with mequinol topical solution and 107 patients treated with vehicle for up to 24 weeks. In these studies, patients were to avoid sun exposure and use protective clothing, and use of suncreens was prohibited. Patients were allowed to apply Moisturel® Lotion 30 minutes after application of Solagé. Physicians assessed the extent of improvement or worsening of all the treated lesions from the baseline condition on a 7 point scale. The results of these evaluations are shown below.




























*

Includes the following grades: Moderate Improvement, Marked Improvement, Almost Clear, Completely Clear. Moderate Improvement or greater was considered clinically meaningful.


Includes the following grades: No Change, Worse (less than 1% of patients treated with Solagé were rated as worse).

FaceForearms/Back of Hands
Solagé SolutionVehicleSolagé SolutionVehicle 

Moderate Improvement


or greater*

57%


15%54%14%
Slight Improvement

28%


36%26%33%
No Change

15%


49%20%53%

Improvement (lightening) of the solar lentigines occurred gradually over time during the 24 week treatment period. At 24 weeks of treatment, 57% and 54% of patients experienced moderate improvement or greater, and 3% and 1% of patients were completely clear of all treated lesions for the face and forearms/back of hands, respectively. It should be noted that approximately 9% of patients, from both treatment areas in these studies, with moderate improvement or greater also experienced hypopigmentation of the skin surrounding at least one treated lesion. There are no vehicle-controlled effectiveness data on the course of lesions treated beyond 24 weeks.


After 24 weeks of treatment, for the forearm/back of hands treatment site, the percentage of patients treated with tretinoin topical solution with moderate improvement or greater, slight improvement, or no change, were 38%, 37%, and 26%, respectively, and for mequinol topical solution were 24%, 40%, and 36%, respectively. For the face treatment site, the percentage of patients treated with tretinoin topical solution with moderate improvement or greater, slight improvement, or no change, were 46%, 33%, and 21%, respectively, and for mequinol topical solution were 33%, 30%, and 37% respectively.


The duration of effect was investigated during a period of up to 24 weeks following the discontinuation of treatment. Results from these studies showed that patients may maintain the level of clinical improvement of their treated lesions from the end of treatment through the 24 week follow-up period. However, some degree of repigmentation of treated lesions was observed over time, demonstrating reversibility of the depigmenting action of Solagé.


In the pivotal clinical trials of 24 weeks duration, some patients experienced temporary hypopigmentation of treated lesions (5%) or of the skin surrounding treated lesions (7%). Hypopigmentation of the skin surrounding treated lesions occurs even in the setting of proper application of the drug within the lesion border. The majority (94/106 - 89%) resolved upon discontinuation of treatment to the lesion, and/or re-instruction on proper application to the lesion only. Another 8% (9/106) of patients with hypopigmentation events had resolution within 120 days after the end of treatment.


Three of the 106 patients (2.8%) had persistence of hypopigmentation beyond 120 days. This further demonstrates the reversibility of the depigmenting action of Solagé.


Over 150 patients used Solagé twice daily for 52 weeks in an open label clinical study. The safety profile for Solagé in this long-term study was similar to that seen in the 24 week studies although burning/stinging/tingling, desquamation, pruritis, and irritation of the skin occurred at lower rates and halo hypopigmentation and hypopigmentation occurred at a slightly greater rate.


Over 90 patients used Solagé twice daily and a concomitant sunscreen (PreSun® 29) daily for up to 24 weeks in an open label clinical study. The safety profile for Solagé in this study was similar to that seen in studies which prohibited sunscreen use although desquamation, pruritis, and halo hypopigmentation occurred at slightly lower rates.


The initial clinical trials for Solagé included 1794 individuals of Skin Type I-V, 94.5% of whom were Caucasian. The trials also included 5% of individuals who were Asian/Pacific Islander (1.2%), African-American (0.8%), and Hispanic/Latino (3.5%). An additional open label study was conducted in 259 patients in the Asian (24.3%), Hispanic/Latino (62.2%), and African American (13.5%) ethnic groups with skin types II to V. This number reflects approximately three times as many subjects in this population as were represented in the initial clinical trials. In this study, as in the earlier studies, Solagé was used twice daily for a period of 24 weeks. The overall safety profile in this study was generally consistent with the initial clinical trials although erythema, desquamation, and pruritis occurred at lower rates and halo hypopigmentation occurred at a higher rate (7.7% versus 6.2%). The safety of Solagé in women of childbearing potential has not been established (see Contraindications [4]).



How Supplied/Storage and Handling



How Supplied


Solagé (mequinol 2%, tretinoin 0.01%) Topical Solution is available in 30mL plastic bottles with an applicator.


NDC 13478-001-01



Storage Conditions


The bottle should be protected from light by continuing to store in the carton after opening. Store at 25°C (77°F); excursions permitted to 15° - 30°C (59° - 86°F).


FLAMMABLE. Keep away from heat and open flame.


Keep out of reach of children.



Patient Counseling Information



FDA APPROVED PATIENT LABELING


-SEE BELOW-


PATIENT INFORMATION


SOLAGÉ® (so-la-jay) Topical Solution


(mequinol 2%, tretinoin 0.01%)


Important: For skin use only


Read the Patient Information that comes with Solagé before you start using it and each time you get a refill. There may be new information. This leaflet does not take the place of talking to your doctor about your medical condition or treatment.


What is Solagé?


Solagé is a prescription medicine used on the skin to treat solar lentigines. Solar lentigines are also called “brown spots”, “age spots”, or “liver spots”. Solar lentigines can happen on areas of skin that have been exposed to too much sunlight over time.


Do not use for greater than 24 weeks unless you are directed to do so by your doctor.


Solagé should only be used under medical care along with a skin care and sun avoidance program. The patient should avoid the sun or use protective clothing.


Who should not use Solagé?


Do not use Solagé if you are:


  • a woman who is pregnant, planning to become pregnant, or is able to become pregnant. Solagé may harm a fetus (unborn baby).

  • allergic to anything in Solagé. See the end of this leaflet for a list of ingredients in Solagé.

Solagé has not been studied in children and  should not be used on children.


Solagé may not be right for you. Before starting Solagé, tell your doctor about all of your health conditions, including, if you:


  • have eczema

  • have skin irritation

  • have vitiligo or a family history of vitiligo. Vitiligo is a condition where color is lost on areas of the skin and white patches appear.

  • have a sunburn

  • have skin that is sensitive to sunlight

  • are exposed to sunlight often because of your job

  • are breastfeeding. It is not known if Solagé passes into breast milk and to your baby.

Tell your doctor about all of the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Solagé should not be used with other medicines that can make your skin sensitive to sunlight including:


  • blood pressure medicines called “thiazides”

  • some antibiotic medicines (tetracyclines, fluoroquinolones, or sulfonamides)

  • antipsychotic medicines called “phenothiazines”

Know the medicines you take. Keep a list of your medicines with you to show your doctor. Your doctor will decide if you can use Solagé with your other medicines.


Tell your doctor about all of the skin products you use.  Your doctor will tell you which skin products you can use with Solagé. You must be careful about using skin products that can dry or irritate your skin because dryness and irritation are increased with Solagé.  Skin products that can dry and irritate your skin include:


  • products that contain alcohol, astringents, spices, or limes

  • medicated soaps or shampoos

  • hair “perms”

  • hair removal products such as electrolysis, depilatories, or waxes

How should I use Solagé?


  • Solagé is for skin use only.

  • Apply Solagé exactly as prescribed and instructed by your doctor. Solagé is usually applied twice a day, at least 8 hours apart. Do not use more Solagé or use it more often than prescribed.

  • Apply Solagé to the “spots” to be treated using the applicator tip of the Solagé bottle. Be careful and do not apply Solagé to “normal” skin.

  • Do not use Solagé around your eyes, mouth, crease of your nose, or on mucous membranes. Solagé can cause severe redness, itching, burning, stinging, and peeling if applied to these areas. If Solagé gets in your eyes, rinse them well with water and call your doctor right away. If you get Solagé in your mouth or swallow any, get medical treatment right away.

  • Do not bathe or shower for at least 6 hours after applying Solagé.

  • Cosmetics may be applied 30 minutes after using Solagé. Talk to your doctor about cosmetics and other skin care products that are okay to use with Solagé.

  • You must avoid sun exposure (including the use of sunlamps.). Always wear protective clothing when you go outside. If your skin gets sunburned, stop Solagé until the sunburn has healed.

  • Wind or cold weather may cause more irritation when using Solagé.

What are the possible side effects of Solagé?


Common side effects of Solagé include changes in skin color, redness, stinging, burning, tingling, peeling, itching, or irritation on areas of the skin where it is applied. If any of these occur, discontinue use and contact your doctor.


Solagé may cause the treated age spots or surrounding skin to become lighter than your normally colored skin, especially if too much Solagé is used or it is used for too long. Hyperpigmentation (darkening of skin) has also been reported as a possible side effect. Call your doctor if changes in your skin color occur . Skin color may return when Solagé is stopped.


These are not all of the side effects of Solagé. Ask your doctor or pharmacist for more information.


How should I store Solagé?


  • Store Solagé at 59ºF to 86ºF (15º to 30ºC). Protect Solagé from light by returning the bottle to the carton after each use.

  • Solagé is flammable. Keep away from heat and flames.

  • Keep Solagé and all medicines out of the reach of children.

General information about Solagé.


Medicines can be prescribed for conditions that are not in patient information leaflets. Use Solagé only for what your doctor prescribed.  Do not give it to other people, even if they have the same symptoms that you have. It may harm them.


This leaflet gives the most important information about Solagé. For more information about Solagé, talk with your doctor or pharmacist. For more information call 1-866-440-5508 or visit www.Solage.com.


What are the ingredients in Solagé?


Active ingredients: mequinol and tretinoin


Inactive ingredients: ethyl alcohol (77.8% v/v), polyethylene glycol 400, butylated hydroxytoluene, ascorbic acid, citric acid, ascorbyl palmitate, edetate disodium, and purified water.


This Patient Information leaflet has been approved by the U.S. Food and Drug Administration.


The Patient Information leaflet was last revised: 07 December 2009.


Rx Only


Marketed by:


Stiefel Laboratories, Inc.


255 Alhambra Circle


Coral Gables, FL 33134


Manufactured by:


Contract Pharmaceutical Laboratories, Buffalo, NY 14213 USA


Questions? Call 1-866-440-5508. Serious side effects associated with use of this product may be reported to this number.


Revised December 2009


SAP


FG No


P/N


SOLAGÉ, STIEFEL, and STIEFEL & Design are registered trademarks of Stiefel Laboratories, Inc.


© 2009 Stiefel Laboratories, Inc.


STIEFEL®



Principal Display Panel


NDC 13478-001-01







Solage 
mequinol and tretinoin  solution










Product Information
Product TypeHUMAN PRESCRIPTION DRUGNDC Product Code (Source)13478-001
Route of AdministrationTOPICALDEA Schedule    











Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
MEQUINOL (MEQUINOL)MEQUINOL20 mg  in 1 mL
TRETINOIN (TRETINOIN)TRETINOIN0.1 mg  in 1 mL










Inactive Ingredients
Ingredient NameStrength
ALCOHOL 
POLYETHYLENE GLYCOL 400 
BUTYLATED HYDROXYTOLUENE 
ASCORBIC ACID

Thursday, 15 March 2012

Pima


Generic Name: potassium iodide (Oral route)


poe-TAS-ee-um EYE-oh-dide


Oral route(Solution)

When used in a nuclear radiation emergency, instruct patients on the proper dosage and usage. Should be used along with other emergency measures that will be recommended by public officials .



Commonly used brand name(s)

In the U.S.


  • Pima

  • SSKI

  • ThyroShield

Available Dosage Forms:


  • Solution

  • Syrup

Therapeutic Class: Antithyroid Agent


Uses For Pima


Potassium iodide is used to treat overactive thyroid and to protect the thyroid gland from the effects of radiation from inhaled or swallowed radioactive iodine. It may be used before and after administration of medicine containing radioactive iodine or after accidental exposure to radioactive iodine (for example, from nuclear power plant accidents that involved release of radioactivity to the environment). It may also be used for other problems as determined by your doctor.


Potassium iodide is taken by mouth. It may be taken as an oral solution, syrup, uncoated tablet, or enteric-coated delayed-release tablet. However, the delayed-release tablet form may cause serious side effects and its use is generally not recommended.


Some brands of the oral solution are available without a prescription.


Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, potassium iodide is used in certain patients with the following medical conditions:


  • To prepare the thyroid gland before a thyroid operation

  • Iodine deficiency

  • Certain skin conditions caused by fungus

In addition to the above information, for patients taking this medicine for a fungus infection:


  • Keep taking it for the full course of treatment , even if you begin to feel better after a few days. This will help clear up your infection completely. Do not miss any doses .

Before Using Pima


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


Potassium iodide may cause skin rash and thyroid problems in infants.


Geriatric


Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of potassium iodide in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than in younger adults.


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 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.


  • Acenocoumarol

  • Anisindione

  • Dicumarol

  • Phenindione

  • Phenprocoumon

  • Warfarin

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.


Other Medical Problems


The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:


  • High blood levels of potassium (hyperkalemia) or

  • Myotonia congenita or

  • Tuberculosis—Potassium iodine may make these conditions worse

  • Kidney disease—May cause an increase of potassium in the blood

  • Overactive thyroid (unless you are taking this medicine for this medical problem)—Prolonged use of potassium iodine may be harmful to the thyroid gland

Proper Use of potassium iodide

This section provides information on the proper use of a number of products that contain potassium iodide. It may not be specific to Pima. Please read with care.


If potassium iodide upsets your stomach, take it after meals or with food or milk unless otherwise directed by your doctor. If stomach upset (nausea, vomiting, stomach pain, or diarrhea) continues, check with your doctor.


For patients taking this medicine for radiation exposure :


  • Take this medicine only when directed to do so by state or local public health authorities.

  • Take this medicine once daily until the risk of significant exposure to radiation no longer exists.Do not take more of it and do not take it more often than directed. Taking more of the medicine will not protect you better and may result in a greater chance of side effects.

For patients taking the oral solution form of this medicine:


  • This medicine is to be taken by mouth even if it comes in a dropper bottle.

  • Do not use if solution turns brownish yellow.

  • Take potassium iodide in a full glass (8 ounces) of water or in fruit juice, milk, or broth to improve the taste and lessen stomach upset. Be sure to drink all of the liquid to get the full dose of medicine.

  • If crystals form in potassium iodide solution, they may be dissolved by warming the closed container of solution in warm water and then gently shaking the container.

For patients taking the uncoated tablet form of this medicine:


  • Before taking, dissolve each tablet in ½ glass (4 ounces) of water or milk. Be sure to drink all of the liquid to get the full dose of medicine.

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 solution dosage form:
    • To treat overactive thyroid (hyperthyroidism):
      • Adults and teenagers—250 milligrams (mg) (0.25 milliliters [mL]) three times a day.

      • Children—Use and dose must be determined by your doctor.


    • To protect the thyroid gland against radiation exposure:
      • Adults or teenagers approaching adult weight (greater than 70 kg or 154 lbs of body weight)—130 mg once a day, until significant risk of exposure to radioiodines no longer exists.

      • Children through 1 month of age—16 mg once a day, until significant risk of exposure to radioiodines no longer exists.

      • Children over 1 month through 3 years of age—32 mg once a day, until significant risk of exposure to radioiodines no longer exists.

      • Children and teenagers over 3 years through 18 years of age (less than 70 kg or 154 lbs of body weight) —65 mg once a day, until significant risk of exposure to radioiodines no longer exists.



  • For syrup dosage form:
    • To protect the thyroid gland against radiation exposure:
      • Adults or teenagers approaching adult weight (70 kg or 154 lbs of body weight) greater)—130 mg once a day, until significant risk of exposure to radioiodines no longer exists.

      • Children through 1 month of age—16 mg once a day, until significant risk of exposure to radioiodines no longer exists.

      • Children over 1 month through 3 years of age—32 mg once a day, until significant risk of exposure to radioiodines no longer exists.

      • Children and teenagers over 3 years through 18 years of age (less than 70 kg or 154 lbs of body weight)—65 mg once a day, until significant risk of exposure to radioiodines no longer exists.



  • For tablet dosage form:
    • To protect the thyroid gland against radiation exposure:
      • Adults or teenagers approaching adult weight (70 kg or 154 lbs of body weight)—130 mg once a day, until significant risk of exposure to radioiodines no longer exists.

      • Children through 1 month of age—16 mg once a day, until significant risk of exposure to radioiodines no longer exists.

      • Children over 1 month through 3 years of age—32 mg once a day, until significant risk of exposure to radioiodines no longer exists.

      • Children and teenagers over 3 years through 18 years of age (less than 70 kg or 154 lbs of body weight)—65 mg once a day, until significant risk of exposure to radioiodines no longer exists.



Missed Dose


If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


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.


Precautions While Using Pima


Your doctor should check your progress at regular visits to make sure that this medicine does not cause unwanted effects.


For patients on a low-potassium diet:


  • This medicine contains potassium. Check with your health care professional before you take this medicine.

Pima 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 as soon as possible if any of the following side effects occur:


Less common
  • Hives

  • joint pain

  • swelling of arms, face, legs, lips, tongue, and/or throat

  • swelling of lymph glands

With long-term use
  • Burning of mouth or throat

  • confusion

  • headache (severe)

  • increased watering of mouth

  • irregular heartbeat

  • metallic taste

  • numbness, tingling, pain or weakness in hands or feet

  • soreness of teeth and gums

  • sores on skin

  • symptoms of head cold

  • unusual tiredness

  • weakness or heaviness of legs

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
  • Diarrhea

  • nausea or vomiting

  • stomach pain

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: Pima 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 Pima resources


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


  • Pima Syrup MedFacts Consumer Leaflet (Wolters Kluwer)

  • Pima Concise Consumer Information (Cerner Multum)

  • Potassium Iodide Monograph (AHFS DI)

  • Potassium Iodide MedFacts Consumer Leaflet (Wolters Kluwer)

  • ThyroShield Solution MedFacts Consumer Leaflet (Wolters Kluwer)

  • Thyroshield Prescribing Information (FDA)



Compare Pima with other medications


  • Cough
  • Cutaneous Sporotrichosis
  • Hyperthyroidism
  • Radiation Emergency