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

Gastrocrom Concentrate


Pronunciation: KROE-moe-lin
Generic Name: Cromolyn
Brand Name: Gastrocrom


Gastrocrom Concentrate is used for:

Treating mastocytosis, including improvement of symptoms such as diarrhea, flushing, headaches, vomiting, hives, stomach pain, nausea, and itching in some patients. It may also be used for other conditions as determined by your doctor.


Gastrocrom Concentrate is a mast cell stabilizer. It works by preventing the mast cells of the body from releasing substances that cause symptoms of mastocytosis.


Do NOT use Gastrocrom Concentrate if:


  • you are allergic to any ingredient in Gastrocrom Concentrate

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



Before using Gastrocrom Concentrate:


Some medical conditions may interact with Gastrocrom Concentrate. 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 liver or kidney problems

Some MEDICINES MAY INTERACT with Gastrocrom Concentrate. However, no specific interactions with Gastrocrom Concentrate are known at this time.


This may not be a complete list of all interactions that may occur. Ask your health care provider if Gastrocrom Concentrate 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 Gastrocrom Concentrate:


Use Gastrocrom Concentrate as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Gastrocrom Concentrate comes with an additional patient leaflet. Read it carefully and reread it each time you get Gastrocrom Concentrate refilled.

  • Take Gastrocrom Concentrate 30 minutes before meals and at bedtime unless directed otherwise by your doctor.

  • To use Gastrocrom Concentrate, break open the number of ampules prescribed by your doctor and squeeze the medicine into a glass of water. Stir and then drink all of the liquid.

  • Do not use Gastrocrom Concentrate if it contains particles, is cloudy, or becomes discolored.

  • Continue to use Gastrocrom Concentrate even if you feel well.

  • Gastrocrom Concentrate works best if it is used at regular intervals throughout the day as directed. Do not miss any doses. If you miss a dose of Gastrocrom Concentrate, 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 Gastrocrom Concentrate.



Important safety information:


  • Caution is advised when using Gastrocrom Concentrate in CHILDREN younger than 2 years of age because they may be more sensitive to its effects.

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


Possible side effects of Gastrocrom Concentrate:


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



Diarrhea; headache; nausea.



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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fast or irregular heartbeat; hoarseness; mental or mood changes; seizures.



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: Gastrocrom 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 Gastrocrom Concentrate:

Store Gastrocrom Concentrate 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. Store ampules in pouch until ready to use. Keep Gastrocrom Concentrate out of the reach of children and away from pets.


General information:


  • If you have any questions about Gastrocrom Concentrate, please talk with your doctor, pharmacist, or other health care provider.

  • Gastrocrom Concentrate is to be used only by the patient for whom it is prescribed. Do not share it with other people.

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

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

This information is a summary only. It does not contain all information about Gastrocrom Concentrate. 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 Gastrocrom resources


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


Compare Gastrocrom with other medications


  • Inflammatory Bowel Disease
  • Systemic Mastocytosis

Penicillin-V-Wolff




Penicillin-V-Wolff may be available in the countries listed below.


Ingredient matches for Penicillin-V-Wolff



Phenoxymethylpenicillin

Phenoxymethylpenicillin potassium (a derivative of Phenoxymethylpenicillin) is reported as an ingredient of Penicillin-V-Wolff in the following countries:


  • Germany

International Drug Name Search

Friday, 23 September 2016

Garamycin Eye Ointment



gentamicin sulfate

Dosage Form: ophthalmic ointment
Garamycin brand of Gentamicin Sulfate Ophthalmic Ointment, USP Sterile Rx Only

DESCRIPTION:




Gentamicin sulfate is a water soluble antibiotic of the aminoglycoside group.


Gentamicin Sulfate Ophthalmic Ointment USP is a sterile ointment for topical ophthalmic use.  Each gram contains gentamicin sulfate (equivalent to 3 mg gentamicin) in a base of white petrolatum and mineral oil.


Gentamicin is obtained from cultures of Micromonospora purpurea.  Gentamicin sulfate is a mixture of the sulfate salts of gentamicin C1, C2 and C1A.  All three components appear to have similar antimicrobial activities.  Gentamicin sulfate occurs as a white powder and is soluble in water and insoluble in alcohol.  The structural formula is as follows:





CLINICAL PHARMACOLOGY:


Microbiology:  Gentamicin sulfate is active in vitro against many strains of the following microorganisms:


    Staphylococcus aureus, Staphylococcus epidermidis,


    Streptococcus pyogenes, Streptococcus pneumoniae,


    Enterobacter aerogenes, Escherichia coli, Haemophilus influenzae,


    Klebsiella pneumoniae, Neisseria gonorrhoeae,


    Pseudomonas aeruginosa, and Serratia marcescens.



INDICATIONS AND USAGE:


GARAMYCIN Ophthalmic Ointment is indicated in the topical treatment of ocular bacterial infections, including conjunctivitis, keratitis, keratoconjunctivitis, corneal ulcers, blepharitis, blepharoconjunctivitis, acute meibomianitis, and dacryocystitis caused by susceptible strains of the following microorganisms:


    Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus pneumoniae, Enterobacter aerogenes, Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Neisseria gonorrhoeae, Pseudomonas aeruginosa, and Serratia marcescens.



CONTRAINDICATIONS:


GARAMYCIN Ophthalmic Ointment is contraindicated in patients with known hypersensitivity to any of the components.



WARNINGS:


NOT FOR INJECTION INTO THE EYE.  Gentamicin Sulfate Ophthalmic Ointment is not for injection.  It should never be injected subconjunctivally, nor should it be directly introduced into the anterior chamber of the eye.



Precautions





General:


Prolonged use of topical antibiotics may give rise to overgrowth of non-susceptible organisms including fungi.  Bacterial resistance to gentamicin may also develop.  If purulent discharge, inflammation or pain becomes aggravated, the patient should discontinue use of the medication and consult a physician.


If irritation or hypersensitivity to any component of the drug develops, the patient should discontinue use of this preparation, and appropriate therapy should be instituted.


Ophthalmic ointments may retard corneal healing.



Information For Patients:


To avoid contamination, do not touch tip of container to the eye, eyelid, or any surface.



Carcinogenesis, Mutagenesis and Impairment of Fertility:


There are no published carcinogenicity or impairment of fertility studies on gentamicin.  Aminoglycoside antibiotics have been found to be non-mutagenic.



Pregnancy:


Teratogenic effects - Pregnancy Category C.  Gentamicin has been shown to depress body weights, kidney weights, and median glomerular counts in newborn rats when administered systemically to pregnant rats in daily doses approximately 500 times the maximum recommended ophthalmic human dose.  There are no adequate and well-controlled studies in pregnant women.  Gentamicin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.



Pediatric Use:


Safety and effectiveness in neonates have not been established.



ADVERSE REACTIONS:


Bacterial and fungal corneal ulcers have developed during treatment with gentamicin ophthalmic preparations.


The most frequently reported adverse reactions are ocular burning and irritation upon drug instillation, non-specific conjunctivitis, conjunctival epithelial defects, and conjunctival hyperemia.


Other adverse reactions which have occurred rarely are allergic reactions, thrombocytopenic purpura, and hallucinations.


To report SUSPECTED ADVERSE REACTIONS, contact Fera Pharmaceuticals, LLC at (414) 434-6604, Monday - Friday 9am-5pm EST, or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.



DOSAGE AND ADMINISTRATION:


Apply a small amount (about 1/2 inch) to the affected eye(s) two to three times a day.



HOW SUPPLIED:


GARAMYCIN Ophthalmic Ointment (equivalent to 3 mg gentamicin) is supplied as follows:


NDC 48102-009-35                  3.5 gram tubes


Store at 25oC (77oF); excursions permitted to 15-30oC (59-86oF)


[see USP Controlled Room Temperature].


GARAMYCIN is a Trademark of Fera Pharmaceuticals, LLC.



Mfd. for:


Fera Pharmaceuticals, LLC


Locust Valley, NY  11560



PRINCIPAL DISPLAY PANEL - CARTON












NDC 48102-009-35

STERILE      Rx only


GaramycinTM


brand of


GENTAMICIN


SULFATE


OPHTHALMIC


OINTMENT, USP


Gentamicin Sulfate,


USP equivalent to 3 mg


gentamicin per gram.



Net Wt. 3.5g (1/8 Oz)

PRINCIPAL DISPLAY PANEL - TUBE






NDC 48102-009-35



STERILE      Rx only


GaramycinTM


brand of


GENTAMICIN


SULFATE


OPHTHALMIC


OINTMENT, USP


Gentamicin Sulfate,


USP equivalent to 3 mg


gentamicin per gram.


Each gram contains:


Gentamicin sulfate,


USP equivalent to 3 mg


gentamicin base, in a


base of white petrolatum


and mineral oil.


Net Wt. 3.5 g (1/8 Oz)









GARAMYCIN 
gentamicin sulfate  ointment










Product Information
Product TypeHUMAN PRESCRIPTION DRUGNDC Product Code (Source)48102-009
Route of AdministrationOPHTHALMICDEA Schedule    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
GENTAMICIN SULFATE (GENTAMICIN)GENTAMICIN SULFATE3 mg  in 1 g








Inactive Ingredients
Ingredient NameStrength
MINERAL OIL 
PETROLATUM 


















Product Characteristics
Color    Score    
ShapeSize
FlavorImprint Code
Contains      














Packaging
#NDCPackage DescriptionMultilevel Packaging
148102-009-351 TUBE In 1 CARTONcontains a TUBE
13.5 g In 1 TUBEThis package is contained within the CARTON (48102-009-35)










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
ANDAANDA06502410/08/2010


Labeler - Fera Pharmaceuticals, LLC (831023713)

Registrant - Fera Pharmaceuticals, LLC (831023713)
Revised: 09/2010Fera Pharmaceuticals, LLC




More Garamycin Eye Ointment resources


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


Compare Garamycin Eye Ointment with other medications


  • Conjunctivitis, Bacterial

ganirelix Subcutaneous


ga-ni-REL-ix


Commonly used brand name(s)

In the U.S.


  • Antagon

Available Dosage Forms:


  • Solution

Therapeutic Class: Endocrine-Metabolic Agent


Pharmacologic Class: Luteinizing Hormone Releasing Hormone Antagonist


Uses For ganirelix


Ganirelixis used as a fertility medicine to prevent premature luteinizing hormone (LH) surges in women undergoing the fertility procedure of controlled ovarian hyperstimulation. LH is involved in ovulation, which is the development of eggs in the ovaries. Ganirelix may help reduce the need for follicle-stimulating hormone (FSH) , which is also involved in ovulation.


Ganirelix is available only with your doctor's prescription.


Before Using ganirelix


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 ganirelix, the following should be considered:


Allergies


Tell your doctor if you have ever had any unusual or allergic reaction to ganirelix 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.


Pregnancy








Pregnancy CategoryExplanation
All TrimestersXStudies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.

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. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.


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 ganirelix. Make sure you tell your doctor if you have any other medical problems.


Proper Use of ganirelix


To make using ganirelix as safe and reliable as possible, you should understand how and when to use ganirelix and what effects may be expected. A paper with information for the patient will be given to you with your filled prescription and will provide many details concerning the use of ganirelix. Read this paper carefully and ask your health care professional for any additional information or explanation.


Sometimes ganirelix can be given by injection at home. If you are using ganirelix at home:


  • Understand and use the proper method of safely preparing the medicine if you are going to prepare your own medicine.

  • Wash your hands with soap and water and use a clean work area to prepare your injection.

  • Make sure you clearly understand and carefully follow your doctor's instructions on how to give yourself an injection, including using the proper needle and syringe.

  • Do not inject more or less of the medicine than your doctor ordered.

  • Remember to move the site of injection to different areas to prevent skin problems from developing.

  • Throw away needles, syringes, bottles, and unused medicine after the injection in a safe manner.

  • Tell your doctor when you use your last dose of ganirelix. Your doctor will give you another medicine called human chorionic gonadotrophin (hCG) or arrange for you to get ganirelix at the right time.

Dosing


The dose of ganirelix 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 ganirelix. If your dose is different, do not change it unless your doctor tells you to do so.


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


  • For injection dosage form:
    • For treatment of female infertility:
      • Adults—After receiving FSH treatment on Day 2 or 3 of your menstrual cycle, 250 micrograms (mcg) of ganirelix is injected under the skin once a day during the early to midfollicular phase (about Day 7 or Day 8 of your menstrual cycle).



Missed Dose


Call your doctor or pharmacist for instructions.


Storage


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


Keep out of the reach of children.


Do not keep outdated medicine or medicine no longer needed.


Precautions While Using ganirelix


It is very important that your doctor check your progress often at regular visits to make sure that the medicine is working properly and to check for unwanted effects. Your doctor will probably want to follow the developing eggs inside the ovaries by doing an ultrasound examination and measuring hormones in your blood stream.


If your doctor has asked you to record your basal body temperatures (BBTs) daily, make sure that you do this every day. Using a BBT record or some other method, your doctor will help you decide when you are most fertile and when ovulation occurs. It is important that sexual intercourse take place around the time when you are most fertile to give you the best chance of becoming pregnant. Follow your doctor's directions carefully.


If severe abdominal pain occurs with use of ganirelix, discontinue treatment and report the problem to your doctor immediately. Do not receive the injection of human chorionic gonadotropin (hCG) and avoid sexual intercourse.


ganirelix Side Effects


Side Effects of ganirelix

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.


Stop taking ganirelix and get emergency help immediately if any of the following effects occur:


Less common
  • Abdominal pain (severe)

  • nausea and vomiting

  • weight gain (rapid)

Check with your doctor as soon as possible if any of the following side effects occur:


Less common
  • Nausea

  • vaginal bleeding

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


Less common
  • Headache

  • redness, pain or swelling at injection site

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: ganirelix Subcutaneous side effects (in more detail)



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Thursday, 22 September 2016

Gainpro





Dosage Form: FOR ANIMAL USE ONLY
Gainpro 10

FRONT PANEL


Gainpro 10


For increased rate of weight gain and

improved feed efficiency in cattle fed in

confinement for slaughter. For increased rate

of weight gain in pasture cattle (slaughter,

stocker and feeder cattle, and dairy and beef

replacement heifers).


ACTIVE INGREDIENTS

Bambermycins 10 grams per pound (22

grams per kilogram)


INGREDIENTS

Roughage products and/or calcium carbonate,

dried bambermycins fermentation product,

mineral oil.


MIXING DIRECTIONS AND PERMITTED

CLAIMS ON REVERSE SIDE.

FOR USE IN MANUFACTURED FEEDS ONLY.

NOT FOR HUMAN USE

Restricted Drug (California)-

use only as directed


Net Weight—50 pounds (22.68 kg)


Distributed by:

HUVEPHARMA, INC.

Peachtree City, GA 30269

NADA # 141-034, Approved by FDA

MIXING DIRECTIONS AND PERMITTED CLAIMS


Type A

Medicated Article


PERMITTED CLAIMS AND LIMITATIONS


Species                 Drug                 Level                 Claim(s)                 Limitations

Cattle Fed in          Bambermycins 10 to 20               Increased rate        None

Confinement for                             mg/hd/day**        of weight gain,

Slaughter*                                                               improved feed

                                                                              efficiency

Pasture                Bambermycins   10 to 40              Increased rate        None

Cattle*                                           mg/hd/day***      of weight gain


*Only a single level of bambermycins (i.e. 2 grams bambermycins/ton) can be

indicated on a feed tag. A different feed tag must be submitted for each level of

bambermycins needed for your complete feeding program.


CATTLE FED IN CONFINEMENT FOR SLAUGHTER:

**THE APPROVED DOSAGE IN CATTLE FED IN CONFINEMENT FOR SLAUGHTER IS 10

TO 20 MG OF BAMBERMYCINS/HD/DAY. The amount of bambermycins will range between

1 and 4 grams per ton of feed depending upon the daily feed consumption of the cattle fed in

confinement for slaughter. The amount of Type A Medicated Article added to the complete

ration (Type C Medicated Feed) must be based on daily feed consumption, the number of

animals in the pen and the level (10-20 mg/hd/day) of bambermycins being fed. From this

information the grams of bambermycins per ton of feed can be calculated in order to fulfill

feed assay requirements. No Type C Medicated Feed should be manufactured with less than

1 g bambermycins/ton. Feed assays for bambermycins with expected levels below 1 g/t may

not be accurate. See the following table for conversions from mg/hd/day to g/t.


EXAMPLE OF CONVERTING THE BAMBERMYCINS CATTLE DOSAGE FROM

                        MG/HEAD/DAY TO GRAMS/TON*



                                                                                                Mg

                   Average Feed            Grams                Bambermycinx

Cattle         Consumption/         Bambermycins/         Fed Daily to

Weight         Head/Day             Ton of Feed               each Animal

Lbs.     Kg         Lbs.1                Low         High         Low             High

400     181.4     10.0                 2.00         4.00         10.0             20.0

500     226.8     14.0                 1.50         2.80         10.5             19.6

600     272.2     17.0                 1.25         2.30         10.6             19.6

700     317.5     20.0                 1.00         2.00         10.0             20.0

800     362.9     22.0                 1.00         1.80         11.0             19.8

900     408.2     23.0                 1.00         1.70         11.5             19.6

1000   453.6     24.0                 1.00         1.60         12.0             19.2

1100   499.0     25.0                 1.00         1.60         12.5             20.0

1200   544.3     26.0                 1.00         1.50         13.0             19.5

1300   589.7     27.0                 1.00         1.40         13.5             18.9

*Dosage range is 10 to 20 mg/head/day             1Assumes as fed ad libitum

consumption and average daily gain

of 2.0 to 3.0 lbs./day


Example Calculation—Amount of Gainpro®-10 premix added to feed for a pen of cattle.

Given: Average Weight—800 lbs.; Number in pen—100 hd.; Dosage—20 mg/hd/day; Daily

Feed Consumption—22 lbs./day.

• 100 hd x 20 mg = 2,000 mg or 2 grams bambermycins.

• Gainpro®-10 contains 10 grams bambermycins/lb., therefore add 0.2 pound of

Gainpro®-10 premix to the daily feed for this pen of 100 animals.

• 22 lbs./day x 100 hd = 2,200 lbs. total feed consumption.

• 2 grams bambermycins ÷ 2,200 lbs. = .000909 g/lb.

• .000909 x 2,000 lbs. = 1.82 g bambermycins/ton of feed.



MIXING DIRECTIONS:

It is recommended that Gainpro®-10 be diluted with a suitable grain carrier before addition

to the final feed. A dilution of 1 part of Gainpro®-10 and 9 parts grain carrier is the

suggested working premix. The table below shows premix and working premix addition levels

for various commonly used feeds.


                                                                    Pounds Premix To Be Added Per Ton

Feed             Bambermycins Level         Gainpro®-1   1-9 Working Premix

Cattle Fed in         1 gram/ton                                0.1                                1

Confinement         2 grams/ton                              0.2                                 2

for Slaughter         3 grams/ton                              0.3                                 3

                            4 grams/ton                              0.4                                 4

     


Thoroughly mix both working premix and finished feed to ensure complete and uniform

distribution of the Gainpro®-10.


FEEDING DIRECTIONS:

Feeds containing Gainpro®-10 should be fed continuously in a complete feed. Complete

feed for cattle fed in confinement for slaughter must be fed continuously at a rate of 10-20 mg

bambermycins/hd/day from Type C Medicated Feed containing 1-4 g bambermycins/ton.



TYPE B LIQUID FEEDS INTENDED FOR ADDITION TO DRY FEEDS FOR

CONFINEMENT CATTLE

•Type B Liquid Feeds should be in a pH range of 3.8 to 7.5 and should have a moisture

content between 30 and 45%.

•Type B Liquid Feeds must be mixed into the dry feed within 8 weeks of manufacture.

•Type B Liquid Feeds can be manufactured containing 40.0 to 800.0 g of bambermycins/ton.

Mixing directions into dry feed are as follows:


Before feeding, the Type B Medicated Liquid feed must be thoroughly mixed with other feed

materials to make a complete feed (Type C Medicated Feed). Examples of addition rates to

complete feeds are shown in the following table.


                                                    Addition Rate of Type B     Bambermycins (g/ton) in

Bambermycins (g/ton) in         Liquid Feed (pounds/ton) to     Final Complete Feed

Type B Liquid Feed                     Complete Feed                     (Type C Medicated Feed)

40.0                                                         50.0                                          1.0

40.0                                                         200.0                                         4.0


100.0                                                        20.0                                          1.0

100.0                                                        80.0                                           4.0


400.0                                                         5.0                                           1.0

400.0                                                       20.0                                           4.0


800.0                                                         2.5                                           1.0

800.0                                                       10.0                                           4.0

The complete dry feed (Type C Medicated Feed) may only be fed to cattle in confinement for

slaughter and must be fed within one week after mixing.


PASTURE CATTLE:

***THE APPROVED DOSAGE IN PASTURE CATTLE IS 10 TO 40 MG OF BAMBERMYCINS/

HD/DAY. Daily intakes of bambermycins in excess of 20 mg/head/day have not

been shown to be more effective than 20mg/head/day. Blend 0.8 pound of Gainpro®-10

with 1999.2 pounds of suitable grain carrier. This supplemental feed will contain 4 mg bambermycins

per pound (8 g/ton). This supplemental feed can be fed at a rate of 2.5 to 10

pounds per head per day to achieve a daily intake of 10 to 40 mg bambermycins/head/day.

See the following table for additional examples of conversion from mg/hd/day to g/t.


MIXING DIRECTIONS:

It is recommended that Gainpro®-10 be diluted with a suitable grain carrier to provide a

supplemental feed. The table below shows examples of premix addition levels.


                                                                Pounds

                                                            Gainpro®-10

Feed         Bambermycins Level    To Be Added Per Ton        Feeding Rate

Pasture             2 grams/ton                         0.2                         10.0 lb./hd/day

Cattle                4 grams/ton                         0.4                         5.0-10.0 lb./hd/day

                        8 grams/ton                         0.8                         2.5-10.0 lb./hd/day

                       20 grams/ton                        2.0                         1.0-4.0 lb./hd/day

                       40 grams/ton                        4.0                         1.0-2.0 lb./hd/day

                       80 grams/ton                        8.0                         1.0 lb./hd/day


Thoroughly mix both working premix and supplemental feed to ensure complete and uniform

distribution of the Gainpro®-10.


FEEDING DIRECTIONS:

Feed for Pasture Cattle must be fed continuously at a rate of 10-40 mg bambermycins/hd/day

in at least one pound and not more than 10 pounds of Type C Medicated Feed containing 2-

40 g bambermycins/ton. Daily intakes of bambermycins in excess of 20 mg/head/day have

not been shown to be more effective than 20 mg/head/day.


FREE-CHOICE (SELF-FED) SUPPLEMENT:

Free-choice supplements must be formulated to provide not less than 10 mg nor more than

40 mg bambermycins per head per day. An FDA approved formula must be used to manufacture

free-choice medicated feeds containing bambermycins. Feed mills that use a proprietary formula

are required to be licensed.

Bag Label Image


Bag Label Image










Gainpro  10
bambermycins  powder










Product Information
Product TypeOTC TYPE A MEDICATED ARTICLE ANIMAL DRUGNDC Product Code (Source)23243-2070
Route of AdministrationORALDEA Schedule    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
BAMBERMYCINS (BAMBERMYCINS)BAMBERMYCINS22 g  in 1 kg






Inactive Ingredients
Ingredient NameStrength
MINERAL OIL 


















Product Characteristics
Colorbrown ((Off White to Tan))Score    
ShapeSize
FlavorImprint Code
Contains      










Packaging
#NDCPackage DescriptionMultilevel Packaging
123243-2070-522.68 kg In 1 BAGNone










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
NADANADA14103406/29/2009


Labeler - Huvepharma, Inc. (619153559)

Registrant - Huvepharma AD (552691651)









Establishment
NameAddressID/FEIOperations
Huvepharma, Inc.619153559manufacture, analysis, label, pack
Revised: 03/2010Huvepharma, Inc.