Thursday, 29 September 2016

Cetirizinhydrochlorid Stada




Cetirizinhydrochlorid Stada may be available in the countries listed below.


Ingredient matches for Cetirizinhydrochlorid Stada



Cetirizine

Cetirizine dihydrochloride (a derivative of Cetirizine) is reported as an ingredient of Cetirizinhydrochlorid Stada in the following countries:


  • Germany

International Drug Name Search

Wednesday, 28 September 2016

Artexal




Artexal may be available in the countries listed below.


Ingredient matches for Artexal



Tertatolol

Tertatolol hydrochloride (a derivative of Tertatolol) is reported as an ingredient of Artexal in the following countries:


  • Ireland

International Drug Name Search

Gatifloxacin


Class: Quinolones
VA Class: AM900
Chemical Name: (±-1-Cyclopropyl-6-fluoro-1,4-dihydro-8-methoxy-7-(3-methyl-1-piperazinyl)-4-oxo-3-quinoline- carboxylic acid sesquihydrate
Molecular Formula: C19H22FN3O4
CAS Number: 112811-59-3
Brands: Tequin

Introduction

Antibacterial; 8-methoxy fluoroquinolone.1 2


Uses for Gatifloxacin


Respiratory Tract Infections


Acute bacterial sinusitis caused by Streptococcus pneumoniae or Haemophilus influenzae.1 8 12


Acute bacterial exacerbations of chronic bronchitis caused by susceptible S. pneumoniae, H. influenzae, H. parainfluenzae, Moraxella catarrhalis, or Staphylococcus aureus (oxacillin-susceptible [methicillin-susceptible] strains).1 8 11 b


Community-acquired pneumonia (CAP) caused by susceptible S. pneumoniae (including multidrug-resistant strains), H. influenzae, H. parainfluenzae, M. catarrhalis, S. aureus, Mycoplasma pneumoniae, Chlamydophila pneumoniae (formerly Chlamydia pneumoniae), or Legionella pneumophila.1 8 13 14 15 b


Skin and Skin Structure Infections


Uncomplicated skin and skin structure infections (i.e., simple abscesses, furuncles, folliculitis, wound infections, cellulitis) caused by susceptible S. aureus (oxacillin-susceptible [methicillin-susceptible] strains) or S. pyogenes (group A β-hemolytic streptococci).1 b


Urinary Tract Infections (UTIs)


Uncomplicated UTIs caused by susceptible Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis.1


Complicated UTIs caused by susceptible E. coli, K. pneumoniae, or P. mirabilis.1


Pyelonephritis caused by susceptible E. coli.1 8


Endocarditis


Alternative for treatment of native or prosthetic valve endocarditis caused by fastidious gram-negative bacilli known as the HACEK group (Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Haemophilus aphrophilus, H. influenzae, H. parainfluenzae, H. paraphrophilus, Kingella denitrificans, K. kingae).c AHA and IDSA recommend ceftriaxone or ampicillin-sulbactam as drugs of choice,c but a fluoroquinolone (ciprofloxacin, gatifloxacin, levofloxacin, moxifloxacin) may be considered when β-lactam anti-infectives cannot be used.c Consultation with an infectious disease specialist is recommended.c


Gonorrhea


Uncomplicated urethritis and cervicitis caused by susceptible Neisseria gonorrhoeae.1


Acute, uncomplicated rectal infections caused by susceptible N. gonorrhoeae in women.1


Should not be used for treatment of gonococcal infections acquired in Asia or Pacific islands (including Hawaii); use may be inadvisable in other areas where N. gonorrhoeae with quinolone resistance has been reported (including California).18 20


Anthrax


Alternative for postexposure prophylaxis following suspected or confirmed exposure to aerosolized anthrax spores (inhalational anthrax) when oral ciprofloxacin and oral doxycycline are unavailable.21


Alternative for treatment of inhalational anthrax when a parenteral regimen is unavailable (e.g., supply or logistic problems because large numbers of individuals require treatment in a mass casualty setting).21


Mycobacterial Infections


Alternative for use in multiple-drug regimens for treatment of active tuberculosis in patients with relapse, treatment failure, or Mycobacterium tuberculosis resistant to isoniazid and/or rifampin or when first-line drugs cannot be tolerated.28


Gatifloxacin Dosage and Administration


Administration


Administer orally or by slow IV infusion; not for IM, rapid IV, intrathecal, intraperitoneal, or sub-Q use.1


No dosage adjustment needed when switching from IV to oral administration, or vice versa.1


Administer once daily every 24 hours.1


Oral Administration


Administer tablets without regard to meals, including milk or dietary supplements containing calcium.1 (See Interactions: Specific Drugs.)


IV Administration


Gatifloxacin injection concentrate must be diluted prior to administration.1 (See Solution Compatibility under Stability.)


No further dilution necessary for gatifloxacin premixed injection.1


Manufacturer states that additives or other drugs should not be added to gatifloxacin solutions or infused simultaneously through the same IV line1 .


Dilution

Dilute gatifloxacin injection concentrate to concentration of 2 mg/mL with a compatible IV solution before administration (see Solution Compatibility under Stability).1 Do not use water for injection as a diluent;1 a hypotonic solution results.1


Use strict aseptic technique since drug product contains no preservative.1


Rate of Administration

Administer by IV infusion over 1 hour.1


Dosage


Adults


Respiratory Tract Infections

Oral or IV

400 mg once daily.1 Usual duration is 5 days for acute bacterial exacerbation of chronic bronchitis, 10 days for acute sinusitis, and 7–14 days for CAP.1


Skin and Skin Structure Infections

Oral or IV

400 mg once daily for 7–10 days.1


UTIs

Oral or IV

400 mg as a single dose or 200 mg once daily for 3 days in patients with uncomplicated UTIs; 400 mg once daily for 7–10 days in those with complicated UTIs or pyelonephritis.1


Gonorrhea

Oral or IV

400 mg as a single dose in men with uncomplicated urethral gonorrhea or in women with endocervical or rectal gonorrhea.1


Anthrax

Oral

400 mg once daily for ≥60 days for postexposure prophylaxis or treatment of inhalational anthrax.21 22 23


Mycobacterial Infections

Active Tuberculosis

Oral

400 mg once daily.28 Must be used in conjunction with other antituberculosis agents.28


Multiple-drug regimen usually given for 12–18 months when rifampin-resistant M. tuberculosis are involved; for 18–24 months when isoniazid- and rifampin-resistant strains are involved; or for 24 months when the strain is resistant to isoniazid, rifampin, ethambutol, and/or pyrazinamide.28


Special Populations


Hepatic Impairment


Dosage adjustment not necessary in patients with moderate (Child-Pugh class B) cirrhosis.1


Not studied to date in patients with severe (Child-Pugh class C) impairment;1 manufacturer makes no recommendations regarding dosage in such patients.16


Renal Impairment


Adjust dosage in patients with Clcr <40 mL/minute, including those who require hemodialysis or CAPD: initial dose of 400 mg, followed by 200 mg daily beginning on day 2 of therapy.1 Administer dose in hemodialysis patients after dialysis session.1


Dosage adjustment not required for single-dose regimen (for uncomplicated UTIs or gonorrhea) or 3-day regimen (for uncomplicated UTIs).1


Renal impairment increases risk of dysglycemia.b (See Hypoglycemia and Hyperglycemia under Cautions.)


Geriatric Patients


Select dosage with caution and closely monitor renal function because of age-related decreases in renal function.b (See Renal Impairment under Dosage and Administration.)


Cautions for Gatifloxacin


Contraindications



  • Known hypersensitivity to gatifloxacin, other quinolones, or any ingredient in the formulation.1




  • Diabetes mellitus.b



Warnings/Precautions


Warnings


Hypoglycemia and Hyperglycemia

Symptomatic hypoglycemia or hyperglycemia reported.1 Usually have occurred in patients with diabetes, but blood glucose disturbances (especially hyperglycemia) have occurred in patients without a history of diabetes.1


Serious (sometimes fatal) disturbances of glucose homeostasis (e.g., hyperosmolar nonketotic hyperglycemic coma, diabetic ketoacidosis, hypoglycemic coma, seizures, loss of consciousness) reported rarely during postmarketing surveillance.b


In addition to diabetes, risk factors for dysglycemia during gatifloxacin therapy include advanced age, renal insufficiency, and concurrent use of glucose-altering medication (especially oral hypoglycemic agents).b


Closely monitor blood glucose concentrations in patients with risk factors for developing dysglycemia.1 If signs and symptoms of hypoglycemia or hyperglycemia occur, discontinue gatifloxacin and immediately initiate appropriate therapy.1


Musculoskeletal Effects

Arthropathy and chondrodysplasia in weight-bearing joints of in immature animals reported with fluoroquinolones, including gatifloxacin.1 b Permanent lesions in cartilage reported in immature dogs; clinical relevance to humans unknown.1 Safety and efficacy not established in children and adolescents <18 years of age or in pregnant or lactating women.1


Rupture of the shoulder, hand, Achilles, or other tendons that required surgical repair or resulted in prolonged disability reported in patients receiving fluoroquinolones, including gatifloxacin.b Tendon rupture can occur during or after treatment; tendinitis or tendon rupture may occur more frequently in those receiving corticosteroids, especially geriatric patients.b


Discontinue gatifloxacin if pain, inflammation, or tendon rupture occurs.b Patient should rest and refrain from exercise until the diagnosis of tendinitis or tendon rupture excluded.b


Prolongation of QT Interval

Prolonged QT interval leading to ventricular arrhythmias, including torsades de pointes, reported with some fluoroquinolones, including gatifloxacin.1


QT interval prolongation is dose related; do not exceed recommended dosage or infusion rate.b


Increased torsades de pointes risk with advanced age (>60 years of age), female gender, underlying cardiac disease, and/or concurrent use of multiple medications.b


Avoid use in patients with prolonged QTc interval or uncorrected hypokalemia. Also avoid use in those receiving class IA (e.g., quinidine, procainamide) or class III (e.g., amiodarone, sotalol) antiarrhythmic agents.b Use with caution in patients receiving drugs that prolong QT interval (e.g., cisapride,17 erythromycin, antipsychotic agents, tricyclic antidepressants) and in patients with ongoing proarrhythmic conditions, such as clinically important bradycardia or acute myocardial ischemia.1


CNS Effects

Seizures, increased intracranial pressure, and psychoses reported with fluoroquinolones, including gatifloxacin.1 CNS stimulation leading to tremors, restlessness, lightheadedness, confusion, hallucinations, paranoia, depression, nightmares, insomnia, nervousness, agitation, or anxiety also reported.1


Use with caution in patients with known or suspected CNS disorders (e.g., severe cerebral arteriosclerosis, epilepsy) or other risk factors predisposing to seizures.1


If CNS effects occur, discontinue gatifloxacin and institute appropriate measures.1


Peripheral Neuropathy

Sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons resulting in paresthesias, hypoesthesias, dysesthesias, and weakness reported with fluoroquinolones.b


Discontinue gatifloxacin if symptoms of neuropathy (e.g., pain, burning, tingling, numbness, and/or weakness) occur.b


Superinfection/Clostridium difficile-associated Colitis

Possible emergence and overgrowth of nonsusceptible bacteria or fungi.1


Consider Clostridium difficile-associated diarrhea and colitis (antibiotic-associated pseudomembranous colitis) if diarrhea develops and manage accordingly.1


Sensitivity Reactions


Hypersensitivity Reactions

Serious and occasionally fatal hypersensitivity and/or anaphylactic reactions reported in patients receiving fluoroquinolones.1 These reactions may occur with first dose.1


Some hypersensitivity reactions have been accompanied by cardiovascular collapse, hypotension or shock, seizures, loss of consciousness, tingling, angioedema (e.g., edema or swelling of the tongue, larynx, throat, or face), airway obstruction (e.g., bronchospasm, shortness of breath, acute respiratory distress), urticaria, pruritus, and other severe skin reactions.1


In addition, other possible severe and potentially fatal reactions (may be hypersensitivity reactions or of unknown etiology) have been reported most frequently after multiple doses.1 These include fever, rash or other severe dermatologic reactions (e.g., toxic epidermal necrolysis, Stevens-Johnson syndrome), vasculitis, arthralgia, myalgia, serum sickness, allergic pneumonitis, interstitial nephritis, acute renal insufficiency or failure, hepatitis, jaundice, acute hepatic necrosis or failure, anemia (including hemolytic and aplastic), thrombocytopenia (including thrombotic thrombocytopenic purpura), leukopenia, agranulocytosis, pancytopenia, and/or other hematologic effects.1


Discontinue gatifloxacin at first appearance of rash or any other sign of hypersensitivity.1 Institute appropriate therapy as indicated (e.g., epinephrine, corticosteroids, and maintenance of an adequate airway and oxygen).1


Photosensitivity Reactions

Phototoxicity reported with some other quinolones.1 Potential for photosensitivity reaction may be lower with gatifloxacin than with some other fluoroquinolones (e.g., ciprofloxacin, levofloxacin).1


Avoid excessive sunlight or artificial UV light (e.g., tanning beds).1


General Precautions


Selection and Use of Anti-infectives

To reduce development of drug-resistant bacteria and maintain effectiveness of gatifloxacin and other antibacterials, use only for treatment or prevention of infections proven or strongly suspected to be caused by susceptible bacteria.b


When selecting or modifying anti-infective therapy, use results of culture and in vitro susceptibility testing.b In the absence of such data, consider local epidemiology and susceptibility patterns when selecting anti-infectives for empiric therapy.b


Specific Populations


Pregnancy

Category C.1


Lactation

Distributed into milk in rats.1 Use with caution.1 16


Pediatric Use

Safety and efficacy not established in children <18 years of age.1


Geriatric Use

No substantial differences in safety and efficacy relative to younger adults, but increased sensitivity cannot be ruled out.1


Patients ≥65 years of age with unrecognized diabetes, age-related decreases in renal function, underlying medical problems, or receiving concomitant therapy associated with alterations of blood glucose concentration may be at particular risk for serious dysglycemia.a (See Hypoglycemia and Hyperglycemia under Cautions.)


Age-related decline in renal function may increase risk of adverse reactions.1


Hepatic Impairment

Effects of severe hepatic impairment on gatifloxacin pharmacokinetics not determined.1 Use with caution.1


Renal Impairment

Decreased clearance.1 Dosage adjustment recommended.1 (See Renal Impairment under Dosage and Administration.)


Renal impairment increases risk of dysglycemia.b (See Hypoglycemia and Hyperglycemia under Cautions.)


Common Adverse Effects


Nausea, vaginitis, redness at injection site, diarrhea, headache, dizziness.1


Interactions for Gatifloxacin


Does not inhibit CYP isoenzymes 3A4, 2D6, 2C9, 2C19, or 1A2 in vitro and is not an enzyme inducer.1 Pharmacokinetic interactions with drugs metabolized by CYP isoenzymes unlikely.1


Drugs Affecting Glucose Metabolism


Potential pharmacologic interaction (possible additive hypoglycemic or hyperglycemic effect); monitor blood glucose.a (See Hypoglycemia and Hyperglycemia under Cautions.)


Drugs That Prolong QT Interval


Potential pharmacologic interaction (additive effect on QT interval prolongation).1 (See Prolongation of QT Interval under Cautions.)


Specific Drugs










































Drug



Interaction



Comments



Antacids (aluminum- or magnesium-containing)



Decreased absorption of gatifloxacin1



Administer gatifloxacin at least 4 hours before such antacids1



Antacids (calcium-containing); calcium supplements, milk



No clinically important pharmacokinetic interactions 1



Antidiabetic agents (e.g., glyburide)



Hypoglycemia and hyperglycemia reportedb


Glyburide: Pharmacokinetic interaction unlikely1



Closely monitor blood glucose; discontinue gatifloxacin and initiate appropriate therapy if hypoglycemia or hyperglycemia occurs1



Didanosine



Decreased absorption of gatifloxacin with buffered didanosine preparations1 16



Administer gatifloxacin at least 4 hours before buffered didanosine preparations1 16



Digoxin



Potential increase in serum digoxin concentration and toxicity1



Monitor for digoxin toxicity; determine serum digoxin concentrations and adjust digoxin dosage as appropriate1



Iron preparations



Decreased absorption of gatifloxacin1



Administer gatifloxacin at least 4 hours before ferrous sulfate and dietary supplements containing iron1



Multivitamins and mineral supplements



Decreased absorption of gatifloxacin1



Administer gatifloxacin at least 4 hours before supplements containing zinc, magnesium, or iron1



NSAIAs



Possible increased risk of CNS stimulation, seizures1



Omeprazole



Pharmacokinetic interaction unlikelyb



Probenecid



Increased systemic exposure to gatifloxacin1



Sucralfate



Potential pharmacokinetic interaction16



Warfarin



Potential for enhanced warfarin effect1 16



Careful monitoring recommended1


Gatifloxacin Pharmacokinetics


Absorption


Bioavailability


Well absorbed from the GI tract following oral administration.1 40 Absolute bioavailability is 96%.1 37 41 When administered orally in fasting individuals, peak plasma concentrations usually occur 1–2 hours following a dose.1 b


Pharmacokinetics are similar after oral or IV (1-hour infusion) administration.1 41


Food


Administration with food does not affect peak plasma concentration or extent or rate of absorption.39


Distribution


Extent


Rapidly and widely distributed into most body tissues and fluids.1 37 38 41


Distributed into milk in rats; not known whether distributed into milk in humans.1


Plasma Protein Binding


Approximately 20%.1 41


Elimination


Metabolism


Undergoes limited biotransformation.1


Elimination Route


Excreted principally in urine as unchanged drug;1 37 38 41 <1% of a dose is excreted in urine as metabolites,1 and 5% is recovered in feces as unchanged drug.1 40


Half-life


7–14 hours.1 37 40


Special Populations


In patients with moderate to severe renal insufficiency, clearance is decreased and systemic exposure is increased.1


Stability


Storage


Oral


Tablets

Tightly sealed containers at 25°C (may be exposed to 15–30°C).1


Parenteral


Injection Concentrate for IV infusion

25°C (may be exposed to 15–30°C).1


Following dilution to concentration of 2 mg/mL with compatible IV fluid, solution is stable for 14 days at room temperature (20–25°C) or under refrigeration (2–8°C).1


Following dilution to concentration of 2 mg/mL with compatible IV fluid (except 5% sodium bicarbonate injection), solution may be stored for up to 6 months at -25 to -10°C.1 Thaw at controlled room temperature;1 stable for 14 days at room temperature or under refrigeration after thawing.1 Do not refreeze.1


Premixed Injection for IV infusion

25°C (may be exposed to 15–30°C);1 do not freeze.1


Compatibility


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


Parenteral


Solution Compatibility

For dilution of gatifloxacin injection concentrate:














Compatible1 g



Dextrose 5% in Ringer’s injection, lactated



Dextrose 5% in sodium chloride 0.45% with potassium chloride 20 mEq/L



Dextrose 5% in sodium chloride 0.9%



Dextrose 5% in water



Plasma-Lyte 56 and dextrose 5%



Sodium bicarbonate 5%



Lactated Ringer’s and dextrose 5%



Sodium bicarbonate 5%



Sodium chloride 0.9%



Sodium lactate (1/6)M


Drug Compatibility















































































































Y-Site Compatibilityg

Compatible



Acyclovir sodium



Alfentanil HCl



Amikacin sulfate



Aminophylline



Ampicillin sodium



Ampicillin sodium-sulbactam sodium



Aztreonam



Bretylium tosylate



Buprenorphine HCl



Butorphanol tartrate



Calcium chloride



Calcium gluconate



Carboplatin



Cefazolin sodium



Cefotetan disodium



Ceftazidime



Ceftizoxime sodium



Ceftriaxone sodium



Chlorpromazine HCl



Cimetidine HCl



Cisplatin



Clindamycin phosphate



Co-trimoxazole



Cyclophosphamide



Cyclosporine



Cytarabine



Dexamethasone sodium phosphate



Dexmedetomidine HCl



Digoxin



Diphenhydramine HCl



Dobutamine HCl



Dopamine HCl



Doxorubicin HCl



Droperidol



Enalaprilat



Esmolol HCl



Etoposide phosphate



Famotidine



Fenoldopam mesylate



Fentanyl citrate



Fluconazole



Fluorouracil



Ganciclovir sodium



Gemcitabine HCl



Gentamicin sulfate



Granisetron HCl



Haloperidol lactate



Hydrocortisone sodium succinate



Hydromorphone HCl



Hydroxyzine HCl



Ifosfamide



Imipenem-cilastatin sodium



Labetalol HCl



Leucovorin calcium



Lidocaine HCl



Lorazepam



Magnesium sulfate



Mannitol



Meperidine HCl



Mesna



Methotrexate sodium



Methylprednisolone sodium succinate



Metoclopramide HCl



Metronidazole



Midazolam HCl



Mitoxantrone HCl



Morphine sulfate



Nalbuphine HCl



Naloxone HCl



Nicardipine HCl



Nitroglycerin



Ondansetron HCl



Paclitaxel



Pentamidine isethionate



Pentobarbital sodium



Phenobarbital sodium



Potassium chloride



Prochlorperazine edisylate



Promethazine HCl



Propranolol HCl



Ranitidine HCl



Remifentanil HCl



Sodium bicarbonate



Sodium phosphates



Sufentanil citrate



Theophylline



Ticarcillin disodium



Ticarcillin disodium-clavulanate potassium



Tobramycin sulfate



Trimethoprim-sulfamethoxazole



Vecuronium bromide



Verapamil HCl



Vinblastine sulfate



Vincristine sulfate



Vinorelbine tartrate



Zidovudine



Incompatible



Amphotericin B



Amphotericin B cholesteryl sulfate complex



Cefoperazone sodium



Cefoxitin sodium



Diazepam



Furosemide



Heparin sodium



Phenytoin sodium



Piperacillin sodium-tazobactam sodium



Potassium phosphates



Vancomycin HCl


Actions



  • Like other fluoroquinolone antibacterials, gatifloxacin inhibits bacterial DNA gyrase and topoisomerase IV.1 2 29




  • Spectrum of activity includes gram-positive aerobic bacteria, some gram-negative bacteria, a few anaerobic bacteria, and some other organisms (e.g., Mycobacterium, Chlamydia, Mycoplasma).1




  • More active in vitro than ciprofloxacin or levofloxacin against Streptococcus pneumoniae (including penicillin-resistant strains) and anaerobic bacteria (i.e., Clostridium and Bacteroides),3 6 7 while retaining in vitro activity of ciprofloxacin and levofloxacin against gram-negative organisms3 6 and etiologic agents of atypical pneumonia (e.g., C. pneumoniae, M. pneumoniae, Legionella).3




  • Gram-positive aerobes: Active in vitro and in clinical infections against S. aureus (oxacillin-susceptible [methicillin-susceptible] strains only),1 b S. pneumoniae (including multidrug-resistant strains),1 b and S. pyogenes (group A β-hemolytic streptococci).1 Also active in vitro against some other staphylococci (e.g., S. epidermidis, S. saprophyticus) and some other streptococci (e.g., S. agalactiae [group B streptococci], S. pneumoniae [penicillin-resistant strains], viridans streptococci).1




  • Gram-negative aerobes: Active in vitro and in clinical infections against E. coli,1 H. influenzae,1 H. parainfluenzae,1 K. pneumoniae,1 M. catarrhalis,1 N. gonorrhoeae,1 and P. mirabilis.1 Also active in vitro against some strains of Acinetobacter, Citrobacter, Enterobacter, K. oxytoca, Morganella, and P. vulgaris.1




  • Other organisms: Active in vitro and in clinical infections against Chlamydophila pneumonia (formerly Chlamydia pneumoniae),1 L. pneumophila,1 M. pneumoniae,1 and M. tuberculosis.30 32



Advice to Patients



  • Advise patients that antibacterials (including gatifloxacin) should only be used to treat bacterial infections and not used to treat viral infections (e.g., the common cold).b




  • Importance of completing full course of therapy, even if feeling better after a few days.b




  • Advise patients that skipping doses or not completing the full course of therapy may decrease effectiveness and increase the likelihood that bacteria will develop resistance and will not be treatable with gatifloxacin or other antibacterials in the future.b




  • Importance of taking gatifloxacin at least 4 hours before multivitamins containing iron, magnesium, or zinc; aluminum- or magnesium-containing antacids; or didanosine chewable/dispersible buffered tablets, buffered powder for oral solution, or pediatric powder for oral solution prepared as an admixture with antacid.1 16




  • Importance of notifying clinician of persistent or worsening symptoms of infection.1




  • Potential for gatifloxacin to impair mental alertness or physical coordination; need for caution when operating machinery or driving a motor vehicle until effects of drug on individual are known.1 16




  • Potential for gatifloxacin to cause other CNS effects, including confusion, tremor, hallucinations, and depression.b




  • Importance of informing clinician if medical history includes palpitations, convulsions, or fainting spells or if any of these events occur during therapy.1




  • Importance of discontinuing therapy and of informing clinician if an allergic or hypersensitivity reaction occurs.1




  • Potential for hypoglycemia or hyperglycemia, usually in patients with diabetes or in patients at risk for dysglycemia, but also in those without diabetes.b Importance of monitoring blood sugar concentrations.b Importance of initiating appropriate therapy immediately, discontinuing gatifloxacin, and contacting clinician if symptoms of high or low blood sugar occur.b (See Hypoglyecemia and Hyperglycemia under Cautions.)




  • Importance of informing clinician of personal or family history of QT interval prolongation or proarrhythmic conditions (e.g., hypokalemia, bradycardia, recent myocardial ischemia).1 b




  • Importance of discontinuing therapy and consulting clinician if symptoms of peripheral neuropathy (e.g., pain, burning, tingling, numbness, and/or weakness) develop.b




  • Advise patients of risk of adverse musculoskeletal effects and importance of discontinuing gatifloxacin, resting, refraining from exercise, and consulting clinician if pain, inflammation, or rupture of a tendon occurs.1




  • Importance of informing clinician of existing or contemplated concomitant therapy, including prescription and OTC drugs, especially drugs that may affect the QT interval (e.g., cisapride, erythromycin, antipsychotic agents, tricyclic antidepressants), antiarrhythmic agents (e.g., amiodarone, quinidine, procainamide, sotalol), diuretics (e.g., furosemide, hydrochlorothiazide), or drugs that may affect blood sugar concentrations.1 b




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




























Gatifloxacin

Routes



Dosage Forms



Strengths



Brand Names



Manufacturer



Oral



Tablets, film-coated



200 mg



Tequin



Bristol-Myers Squibb



400 mg



Tequin



Bristol-Myers Squibb



Parenteral



For injection concentrate, for IV infusion



10 mg/mL (400 mg)



Tequin Injection



Bristol-Myers Squibb



Injection, for IV infusion



2 mg/mL (200 and 400 mg) in 5% dextrose



Tequin Injection Premixed (in flexible containers)



Bristol-Myers Squibb



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, 1959-2010, Selected Revisions June 2006. 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. Bristol-Myers Squibb Company. Tequin (gatifloxacin) tablets and injection prescribing information. Princeton, NJ; 2002 Dec.



2. Zhanel GC, Ennis K, Vercaigne L et al. A critical review of the fluoroquinolones: focus on respiratory tract infections. Drugs. 2002; 62:13-59. [PubMed 11790155]



3. Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther. 1999; 21:3-40. [IDIS 424194] [PubMed 10090423]



4. Nakashima M, Uematsu T, Kosuge K et al. Single- and multiple-dose pharmacokinetics of AM-1155, a new 6-fluoro-8-methoxy quinolone, in humans. Antimicrob Agents Chemother. 1995; 39:2635-40. [IDIS 358702] [PubMed 8592993]



5. Lober S, Ziege S, Rau M et al. Pharmacokinetics of gatifloxacin and interaction with an antacid containing aluminum and magnesium. Antimicrob Agents Chemother. 1999; 43:1067-71. [IDIS 426804] [PubMed 10223915]



6. Bauernfeind A. Comparison of the antibacterial activities of the quinolones Bay 12-8039, gatifloxacin (AM-1155), trovafloxacin, clinafloxacin, levofloxacin and ciprofloxacin. J Antimicrob Chemother. 1997; 40:639-51. [IDIS 398240] [PubMed 9421311]



7. Blondeau JM. A review of the comparative in-vitro activities of 12 antimicrobial agents, with a focus on five new ’respiratory quinolones’. J Antimicrob Chemother. 1999; 43(Suppl):1B-11B.



8. Perry CM, Barman Balfour JA, Lamb HM. Gatifloxacin. Drugs. 1999; 58:683-96. [PubMed 10551438]



9. Bayer Corporation. Avelox (moxifloxacin) tablets and I.V. prescribing information. West Haven, CT; 2003 Mar.



10. Andriole VT. The future of the quinolones. Drugs. 1999; 58(Suppl 2): 1-5. [PubMed 10553697]



11. DeAbate CA, McIvor RA, Di Bartolo C et al. Gatifloxacin vs. cefuroxime axetil in patients with acute exacerbations of chronic bronchitis. J Respir Dis. 1999; 20(Suppl 11A):23-9.



12. Fogarty C, McAdoo M, Paster RZ et al. Gatifloxacin vs. clarithromycin in the management of acute sinusitis. J Respir Dis. 1999; 20(Suppl 11A):17-22.



13. Fogarty C, Powell ME, Ellison T et al. Treating community-acquired pneumonia in hospitalized patients: gatifloxacin vs. ceftriaxone/clarithromycin. J Respir Dis. 1999; 20(Suppl 11A):60-9.



14. Ramirez J, Nguyen TH, Tellier G et al. Treating community-acquired pneumonia with once-daily gatifloxacin vs. twice-daily clarithromycin. J Respir Dis. 1999; 20(Suppl 11A):40-8.



15. Sullivan JG, McElroy AD, Hunsinger RW et al. Treating community-acquired pneumonia with once-daily gatifloxacin vs. once-daily levofloxacin. J Respir Dis. 1999; 20(Suppl 11A):49-59.



16. Manufacturer’s comments (personal observations).



17. US Food and Drug Administration. Janssen Pharmaceutica stops marketing cisapride in the U.S. FDA Talk Paper. Rockville, MD; 2000 March 23.



18. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2002. MMWR Morb Mortal Wkly Rep. 2002; 51(No. RR-6):1-78.



19. Centers for Disease Control and Prevention. Decreased susceptibility of Neisseria gonorrhoeae to fluoroquinolones—Ohio and Hawaii, 1992–1994. MMWR Morb Mortal Wkly Rep. 1994; 43:325-7. [IDIS 329259] [PubMed 8164636]



20. Centers for Disease Control and Prevention. Fluoroquinolone-resistance in Neisseria gonorrhoeae, Hawaii, 1999, and decreased susceptibility to azithromycin in N. gonorrhoeae, Missouri, 1999. MMWR Morb Mortal Wkly Rep. 2000; 49:833-7. [IDIS 453336] [PubMed 11012233]



21. Inglesby TV, O’Toole T, Henderson DA et al for the Working Group on Civilian Biodefense. Anthrax as a biological weapon, 2002: updated recommendations for management. JAMA. 2002; 287:2236-52. [IDIS 480001] [PubMed 11980524]



22. Centers for Disease Control and Prevention. Update: investigation of anthrax associated with intentional exposure and interim public health guidelines, October 2001. MMWR Morb Mortal Wkly Rep. 2001; 50:889-93. [IDIS 471389] [PubMed 11686472]



23. Centers for Disease Control and Prevention. Update: investigation of bioterrorism-related anthrax and interim guidelines for exposure management and antimicrobial therapy, October 2001. MMWR Morb Mortal Wkly Rep. 2001; 50:909-19. [IDIS 471910] [PubMed 11699843]



24. Bartlett JG, Dowell SF, Mandell LA et al. Practice guidelines for the management of community-acquired pneumonia in adult. Clin Infect Dis. 2000; 31:347-82. [IDIS 454042] [PubMed 10987697]



25. Heffelfinger JD, Dowell SF, Jorgensen JH et al. Management of community-acquired pneumonia in the era of pneumococcal resistance: a report from the drug-resistance streptococcus pneumoniae therapeutic working group. Arch Intern Med. 2000; 160:1399-1408. [IDIS 448719] [PubMed 10826451]



26. American Thoracic Society. Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Resp Crit Care Med. 2001; 163:1730-54. [IDI

Domperin




Domperin may be available in the countries listed below.


Ingredient matches for Domperin



Domperidone

Domperidone is reported as an ingredient of Domperin in the following countries:


  • Japan

International Drug Name Search

Tuesday, 27 September 2016

Alfaprostol




In some countries, this medicine may only be approved for veterinary use.

Scheme

Rec.INN

CAS registry number (Chemical Abstracts Service)

0074176-31-1

Chemical Formula

C24-H38-O5

Molecular Weight

406

Therapeutic Category

Prostaglandin analogue

Chemical Name

5-Heptenoic acid, 7-[2-(5-cyclohexyl-3-hydroxy-1-pentynyl)-3,5-dihydroxycyclopentyl]-, methyl ester, [1R-[1α(Z),2ß(S*),3α,5α]]-

Foreign Names

  • Alfaprostolum (Latin)
  • Alfaprostol (German)
  • Alfaprostol (French)
  • Alfaprostol (Spanish)

Generic Names

  • Alfaprostol (OS: BAN, USAN)
  • Alfaprostololo (OS: DCIT)
  • K 11941 (IS)
  • Ro 22-9000 (IS: Roche)

Brand Names

  • Alfabédyl (veterinary use)
    Ceva, France


  • Alfavet (veterinary use)
    Vetem, United States


  • Gabbrostim (veterinary use)
    Ceva, Belgium; Ceva, Netherlands; Ceva, Portugal; Vetem, Italy

International Drug Name Search

Glossary

BANBritish Approved Name
DCITDenominazione Comune Italiana
ISInofficial Synonym
OSOfficial Synonym
Rec.INNRecommended International Nonproprietary Name (World Health Organization)
USANUnited States Adopted Name

Click for further information on drug naming conventions and International Nonproprietary Names.

Monday, 26 September 2016

Gas-X Chewable Tablets


Pronunciation: sih-METH-ih-cone
Generic Name: Simethicone
Brand Name: Examples include Gas-X and Maalox Anti-Gas


Gas-X Chewable Tablets are used for:

Relieving pressure, bloating, and gas in the digestive tract. It may also be used for other conditions as determined by your doctor.


Gas-X Chewable Tablets are an antiflatulent. It works by breaking up gas bubbles, which makes gas easier to eliminate.


Do NOT use Gas-X Chewable Tablets if:


  • you are allergic to any ingredient in Gas-X Chewable Tablets

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



Before using Gas-X Chewable Tablets:


Some medical conditions may interact with Gas-X Chewable Tablets. 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 phenylketonuria

Some MEDICINES MAY INTERACT with Gas-X Chewable Tablets. However, no specific interactions with Gas-X Chewable Tablets are known at this time.


This may not be a complete list of all interactions that may occur. Ask your health care provider if Gas-X Chewable Tablets 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 Gas-X Chewable Tablets:


Use Gas-X Chewable Tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Take Gas-X Chewable Tablets as needed after meals and at bedtime, unless otherwise directed by your doctor.

  • Chew thoroughly before swallow.

  • If you miss a dose of Gas-X Chewable Tablets and you are using it regularly, 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 Gas-X Chewable Tablets.



Important safety information:


  • Do not exceed the recommended dose without checking with your doctor.

  • If your condition persists, contact your health care provider.

  • Phenylketonuria patients - Some versions of this product contain phenylalanine. Ask your doctor or pharmacist if Gas-X Chewable Tablets contains phenylalanine.

  • PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Gas-X Chewable Tablets, discuss with your doctor the benefits and risks of using Gas-X Chewable Tablets during pregnancy. It is unknown if Gas-X Chewable Tablets are excreted in breast milk. If you are or will be breast-feeding while you are taking Gas-X Chewable Tablets, check with your doctor or pharmacist to discuss the risks to your baby.


Possible side effects of Gas-X Chewable Tablets:


All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no COMMON side effects have been reported with this product. Seek medical attention right away if any of these SEVERE side effects occur:



Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).



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


See also: Gas-X side effects (in more detail)


If OVERDOSE is suspected:


Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.


Proper storage of Gas-X Chewable Tablets:

Store Gas-X Chewable Tablets at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Avoid temperatures above 104 degrees F (40 degrees C). Keep Gas-X Chewable Tablets out of the reach of children and away from pets.


General information:


  • If you have any questions about Gas-X Chewable Tablets, please talk with your doctor, pharmacist, or other health care provider.

  • Gas-X Chewable Tablets are 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 Gas-X Chewable Tablets. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.



Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Gas-X resources


  • Gas-X Side Effects (in more detail)
  • Gas-X Use in Pregnancy & Breastfeeding
  • Gas-X Support Group
  • 2 Reviews for Gas-X - Add your own review/rating


Compare Gas-X with other medications


  • Gas

Anksen




Anksen may be available in the countries listed below.


Ingredient matches for Anksen



Dipotassium Clorazepate

Dipotassium Clorazepate is reported as an ingredient of Anksen in the following countries:


  • Turkey

International Drug Name Search