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the exact opposite Cariprazine Generic Name: Cariprazine (kar IP ra zeen) Brand Name: Vraylar Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Warning There is a higher chance of death in older adults who take cariprazine for mental problems caused by dementia. Most of the deaths were linked to heart disease or infection. This medicine is not approved to treat mental problems caused by dementia. Uses of Cariprazine: It is used to treat schizophrenia. It is used to treat bipolar problems. Slideshow A Friend In Need: Getting Smart With Mental Illness What do I need to tell my doctor BEFORE I take Cariprazine? If you have an allergy to this medicine or any part of cariprazine. If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs. If you have any of these health problems: Kidney disease or liver disease. If you are taking carbamazepine. If you are taking rifampin. This is not a list of all drugs or health problems that interact with this medicine. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take cariprazine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor. What are some things I need to know or do while I take Cariprazine? Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists. Avoid driving and doing other tasks or actions that call for you to be alert until you see how cariprazine affects you. To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs. Have blood work checked as you have been told by the doctor. Talk with the doctor. Do not take this medicine for longer than you were told by your doctor. Be careful in hot weather or while being active. Drink lots of fluids to stop fluid loss. High blood sugar or diabetes, high cholesterol, and weight gain have happened with drugs like this one. These changes may raise the chance of heart and brain blood vessel disease. Talk with the doctor. Check your blood sugar as you have been told by your doctor. Low white blood cell counts have happened with drugs like this one. This may lead to a higher chance of getting an infection. Deadly infections have rarely happened. Tell your doctor if you have ever had a low white blood cell count. Call your doctor right away if you have signs of infection like fever, chills, or sore throat. Talk with your doctor. This medicine may cause seizures in some patients. Talk with the doctor. Dizziness, sleepiness, and feeling less stable may happen with cariprazine. These may lead to falling. Broken bones or other health problems can happen from falling. Talk with the doctor. Older adults with dementia taking drugs like this one have had a higher number of strokes. Sometimes these strokes have been deadly. This drug is not approved to treat mental problems caused by dementia. Talk with your doctor. Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this medicine while you are pregnant. Taking cariprazine in the third trimester of pregnancy may lead to muscle movements that cannot be controlled and withdrawal in the newborn. Talk with the doctor. Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby. How is this medicine (Cariprazine) best taken? Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely. Take with or without food. To gain the most benefit, do not miss doses. Keep taking cariprazine as you have been told by your doctor or other health care provider, even if you feel well. What do I do if I miss a dose? Take a missed dose as soon as you think about it. If it is close to the time for your next dose, skip the missed dose and go back to your normal time. Do not take 2 doses at the same time or extra doses. Dosage Information (comprehensive) What are some side effects that I need to call my doctor about right away? WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect: Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat. Signs of high blood sugar like confusion, feeling sleepy, more thirst, more hungry, passing urine more often, flushing, fast breathing, or breath that smells like fruit. Signs of high or low blood pressure like very bad headache or dizziness, passing out, change in eyesight. Shakiness, trouble moving around, or stiffness. Seizures. Trouble swallowing. Feeling agitated. A very bad and sometimes deadly health problem called neuroleptic malignant syndrome (NMS) may happen. Call your doctor right away if you have any fever, muscle cramps or stiffness, dizziness, very bad headache, confusion, change in thinking, fast heartbeat, heartbeat that does not feel normal, or are sweating a lot. Some people who take this medicine may get a very bad muscle problem called tardive dyskinesia. This muscle problem may not go away even if cariprazine is stopped. Sometimes, signs may lessen or go away over time after this medicine is stopped. The risk of tardive dyskinesia may be greater in people with diabetes and in older adults, especially older women. The risk is also greater the longer you take cariprazine or with higher doses. Muscle problems may also occur after short-term use with low doses. Call your doctor right away if you have trouble controlling body movements or if you have muscle problems with your tongue, face, mouth, or jaw like tongue sticking out, puffing cheeks, mouth puckering, or chewing. What are some other side effects of Cariprazine? All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away: Weight gain. Belly pain. Hard stools (constipation). Loose stools (diarrhea). Upset stomach or throwing up. Tooth pain. Headache. Feeling sleepy. Dizziness. Not able to sleep. Restlessness. Anxiety. Feeling tired or weak. These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch. Side Effects (complete list) If OVERDOSE is suspected: If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened. How do I store and/or throw out Cariprazine? Store at room temperature. Protect from light. Store in a dry place. Do not store in a bathroom. Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets. Check with your pharmacist about how to throw out unused drugs. Consumer Information Use and Disclaimer If your symptoms or health problems do not get better or if they become worse, call your doctor. Do not share your drugs with others and do not take anyone else's drugs. Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor. Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins. Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this medicine, please talk with your doctor, nurse, pharmacist, or other health care provider. If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened. This information should not be used to decide whether or not to take cariprazine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to cariprazine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine. Review Date: December 6, 2017 Next Side Effects Print this page Add to My Med List More about cariprazine Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 92 Reviews Add your own review/rating Drug class: atypical antipsychotics Consumer resources Cariprazine Cariprazine (Advanced Reading) Other brands: Vraylar Professional resources Cariprazine Hydrochloride (AHFS Monograph) Cariprazine (Wolters Kluwer) Related treatment guides Bipolar Disorder Schizophrenia} Drug Status Rx Availability Prescription only N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Cariprazine Rating 92 User Reviews 6.7 /10 92 User Reviews 6.7 Rate it! Drug Class Atypical antipsychotics Related Drugs Bipolar Disorder Seroquel , lithium , quetiapine , lamotrigine , Abilify , Lamictal , Depakote , risperidone , carbamazepine , olanzapine , divalproex sodium , Risperdal , More... Schizophrenia Seroquel , quetiapine , Abilify , risperidone , olanzapine , Risperdal , aripiprazole , Zyprexa , Latuda , Geodon , ziprasidone , clozapine , More... Related: Bipolar Disorder (Manic Depressive Illness or Manic Depression)} } immediately


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Photo :Alomide
our kids Alomide Generic Name: lodoxamide tromethamine Dosage Form: ophthalmic solution Overview Side Effects Dosage Professional Pregnancy More Breastfeeding Warnings User Reviews Support Group Q & A Compare Alternatives Pricing & Coupons DESCRIPTION Alomide (lodoxamide tromethamine ophthalmic solution) 0.1% is a sterile ophthalmic solution containing the mast cell stabilizer lodoxamide tromethamine for topical administration to the eyes. Lodoxamide tromethamine is a white, crystalline, water-soluble powder with a molecular weight of 553.91. The chemical structure is presented below: Structural Formula: Chemical Name: N,N'-(2-chloro-5-cyano-m-phenylene)dioxamic acid tromethamine salt Molecular Formula: C 19 H 28 O 12 N 5 Cl Each mL of Alomide (lodoxamide tromethamine ophthalmic solution) 0.1% contains: Active: 1.78 mg lodoxamide tromethamine equivalent to 1 mg lodoxamide. Preservative: benzalkonium chloride 0.007%. Inactive: mannitol, hypromellose 2910, sodium citrate, citric acid, edetate disodium, tyloxapol, hydrochloric acid and/or sodium hydroxide (adjust pH), and purified water. Slideshow Insomnia and Sleep Deprivation: The Case For A Good Night's Sleep CLINICAL PHARMACOLOGY Lodoxamide tromethamine is a mast cell stabilizer that inhibits the in vivo Type I immediate hypersensitivity reaction. Lodoxamide therapy inhibits the increases in cutaneous vascular permeability that are associated with reagin or IgE and antigen-mediated reactions. In vitro studies have demonstrated the ability of lodoxamide to stabilize rodent mast cells and prevent antigen-stimulated release of histamine. In addition, lodoxamide prevents the release of other mast cell inflammatory mediators (i.e., SRS-A, slow-reacting substances of anaphylaxis, also known as the peptidoleukotrienes) and inhibits eosinophil chemotaxis. Although lodoxamide's precise mechanism of action is unknown, the drug has been reported to prevent calcium influx into mast cells upon antigen stimulation. Lodoxamide has no intrinsic vasoconstrictor, antihistaminic, cyclooxygenase inhibition, or other anti-inflammatory activity. The disposition of 14 C-lodoxamide was studied in six healthy adult volunteers receiving a 3 mg (50 μCi) oral dose of lodoxamide. Urinary excretion was the major route of elimination. The elimination half-life of 14 C-lodoxamide was 8.5 hours in urine. In a study conducted in twelve healthy adult volunteers, topical administration of Alomide (lodoxamide tromethamine ophthalmic solution) 0.1%, one drop in each eye four times per day for ten days, did not result in any measurable lodoxamide plasma levels at a detection limit of 2.5 ng/mL. INDICATIONS AND USAGE Alomide (lodoxamide tromethamine ophthalmic solution) 0.1% is indicated in the treatment of the ocular disorders referred to by the terms vernal keratoconjunctivitis, vernal conjunctivitis, and vernal keratitis. CONTRAINDICATIONS Hypersensitivity to any component of this product. WARNINGS FOR TOPICAL OPHTHALMIC USE ONLY. NOT FOR INJECTION. As with all ophthalmic preparations containing benzalkonium chloride, patients should be instructed not to wear soft contact lenses during treatment with Alomide Ophthalmic Solution. Do not touch the dropper tip to any surface, as this may contaminate the solution. PRECAUTIONS General Patients may experience a transient burning or stinging upon instillation of Alomide Ophthalmic Solution. Should these symptoms persist, the patient should be advised to contact the prescribing physician. Carcinogenesis, Mutagenesis, Impairment of Fertility A long-term study with lodoxamide tromethamine in rats (two-year oral administration) showed no neoplastic or tumorigenic effects at doses 100 mg/kg/day (more than 5000 times the proposed human clinical dose). No evidence of mutagenicity or genetic damage was seen in the Ames Salmonella Assay, Chromosomal Aberration in CHO Cells Assay, or Mouse Forward Lymphoma Assay. In the BALB/c-3T3 Cells Transformation Assay, some increase in the number of transformed foci was seen at high concentrations (greater than 4000 μg/mL). No evidence of impairment of reproductive function was shown in laboratory animal studies. Pregnancy: Pregnancy Category B Reproduction studies with lodoxamide tromethamine administered orally to rats and rabbits in doses of 100 mg/kg/day (more than 5000 times the proposed human clinical dose) produced no evidence of developmental toxicity. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, Alomide (lodoxamide tromethamine ophthalmic solution) 0.1% should be used during pregnancy only if clearly needed. Nursing Mothers It is not known whether lodoxamide tromethamine is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Alomide Ophthalmic Solution 0.1% is administered to nursing women. Pediatric Use Safety and effectiveness in pediatric patients below the age of 2 years have not been established. Geriatric Use No overall differences in safety or effectiveness have been observed between elderly and younger patients. ADVERSE REACTIONS During clinical studies of Alomide (lodoxamide tromethamine ophthalmic solution) 0.1%, the most frequently reported ocular adverse experiences were transient burning, stinging, or discomfort upon instillation, which occurred in approximately 15% of the subjects. Other ocular events occurring in 1 to 5% of the subjects included ocular itching/pruritus, blurred vision, dry eye, tearing/discharge, hyperemia, crystalline deposits, and foreign body sensation. Events that occurred in less than 1% of the subjects included corneal erosion/ulcer, scales on lid/lash, eye pain, ocular edema/swelling, ocular warming sensation, ocular fatigue, chemosis, corneal abrasion, anterior chamber cells, keratopathy/keratitis, blepharitis, allergy, sticky sensation, and epitheliopathy. Nonocular events reported were headache (1.5%) and (at less than 1%) heat sensation, dizziness, somnolence, nausea, stomach discomfort, sneezing, dry nose, and rash. OVERDOSAGE There have been no reports of Alomide (lodoxamide tromethamine ophthalmic solution) 0.1% overdose following topical ocular application. Accidental overdose of an oral preparation of 120 to 180 mg of lodoxamide resulted in a temporary sensation of warmth, profuse sweating, diarrhea, light-headedness, and a feeling of stomach distension; no permanent adverse effects were observed. Side effects reported following systemic oral administration of 0.1 mg to 10.0 mg of lodoxamide include a feeling of warmth or flushing, headache, dizziness, fatigue, sweating, nausea, loose stools, and urinary frequency/urgency. The physician may consider emesis in the event of accidental ingestion. DOSAGE AND ADMINISTRATION The dose for adults and children greater than two years of age is one to two drops in each affected eye four times daily for up to 3 months. HOW SUPPLIED Alomide (lodoxamide tromethamine ophthalmic solution) 0.1% is supplied in plastic ophthalmic DROP-TAINER dispenser as follows: 10 mL: NDC 0065-0345-10 Storage: Store at 15 C - 25 C (59 F - 77 F). Rx Only 2002, 2003, 2015 Novartis a Novartis company ALCON LABORATORIES, INC. Fort Worth, Texas 76134 USA Printed in USA 9012548-1115 PRINCIPAL DISPLAY PANEL NDC 0065-0345-10 Alcon Alomide 0.1% (lodoxamide tromethamine ophthalmic solution) 10 mL Sterile EACH mL CONTAINS: lodoxamide tromethamine 1.78 mg, equivalent to 1 mg lodoxamide with benzalkonium chloride 0.007 %, mannitol, hypromellose 2910, sodium citrate, tyloxapol, citric acid, edetate disodium, sodium hydroxide and/or hydrochloric acid (to adjust pH), and purified water. Rx Only DROP-TAINER Dispenser STORAGE: Store at 15 -25 C (59 -77 F). FOR TOPICAL OPHTHALMIC USE ONLY. USUAL DOSAGE: Instill one to two drops in affected eye(s) four times daily. PRECAUTION: Do not touch dropper tip to any surface, as this may contaminate the solution. Alcon a Novartis Company ALCON LABORATORIES, INC. Fort Worth, Texas 76134 USA Printed in USA 2001, 2003, 2013, 2015 Novartis 9012549-1115 LOT: EXP.: NDC 0065-0345-10 Alcon Alomide 0.1% (lodoxamide tromethamine ophthalmic solution) Sterile 10 mL Rx Only EACH mL CONTAINS: lodoxamide tromethamine 1.78 mg, equivalent to 1 mg lodoxamide STORAGE: Store at 15 -25 C (59 -77 F). FOR TOPICAL OPHTHALMIC USE ONLY. PRECAUTION: Do not touch dropper tip to any surface, as this may contaminate the solution. USUAL DOSAGE: Instill one to two drops in affected eye(s) four times daily. ALCON LABORATORIES, INC. Fort Worth, Texas 76134 USA 2001, 2004, 2015 Novartis LOT: EXP.: H14106-1115 Alomide lodoxamide tromethamine solution/ drops Product Information Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:0065-0345 Route of Administration OPHTHALMIC DEA Schedule Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength LODOXAMIDE TROMETHAMINE (LODOXAMIDE) LODOXAMIDE 1 mg in 1 mL Inactive Ingredients Ingredient Name Strength BENZALKONIUM CHLORIDE MANNITOL HYPROMELLOSE 2910 (4000 MPA.S) SODIUM CITRATE CITRIC ACID MONOHYDRATE EDETATE DISODIUM TYLOXAPOL HYDROCHLORIC ACID SODIUM HYDROXIDE WATER Packaging # Item Code Package Description 1 NDC:0065-0345-10 1 BOTTLE, PLASTIC in 1 CARTON 1 10 mL in 1 BOTTLE, PLASTIC Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date NDA NDA020191 09/30/1993 Labeler - Alcon Laboratories, Inc. (008018525) Registrant - Alcon Laboratories, Inc. (008018525) Establishment Name Address ID/FEI Operations Alcon Research Ltd 007672236 MANUFACTURE(0065-0345) Revised: 11/2016 Alcon Laboratories, Inc. Next Pregnancy Warnings Print this page Add to My Med List More about Alomide (lodoxamide ophthalmic) Side Effects During Pregnancy or Breastfeeding Dosage Information Compare Alternatives Support Group Pricing & Coupons En Español 0 Reviews Add your own review/rating Drug class: ophthalmic antihistamines and decongestants Consumer resources Alomide Alomide (Advanced Reading) Professional resources Alomide (AHFS Monograph) Related treatment guides Conjunctivitis Keratitis Keratoconjunctivitis} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only B Pregnancy Category No proven risk in humans N/A CSA Schedule Not a controlled drug 10 + years Approval History FDA approved 1993 Manufacturer Novartis Pharmaceuticals Corporation Drug Class Ophthalmic antihistamines and decongestants Related Drugs ophthalmic antihistamines and decongestants azelastine ophthalmic , Pataday , Patanol , phenylephrine ophthalmic , olopatadine ophthalmic , Zaditor Conjunctivitis triamcinolone , diclofenac ophthalmic , dexamethasone ophthalmic , ceftriaxone , Rocephin , Lotemax , cortisone , gatifloxacin ophthalmic , More... Keratitis prednisone , triamcinolone , prednisolone ophthalmic , dexamethasone , Decadron , Lotemax , Deltasone , More... Keratoconjunctivitis diclofenac ophthalmic , Maxitrol , cromolyn ophthalmic , Blephamide , Pred-G , Voltaren Ophthalmic , More... Alomide Rating No Reviews - Be the first! 2.0 /10 No Reviews - Be the first! 2.0 Rate it!} } land up


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Photo :Dextrose and Sodium Chloride Injection
suitable Dextrose and Sodium Chloride Injection Dosage Form: injection, solution Overview Side Effects Professional Reviews Q & A More Pricing & Coupons Dextrose and Sodium Chloride Injection Description (See chart below for quantitative information.) Dextrose and Sodium Chloride Injections USP are sterile, nonpyrogenic and contain no bacteriostatic or antimicrobial agents. These products are intended for intravenous administration. The formulas of the active ingredients are: Ingredients Molecular Formula Molecular Weight Sodium Chloride USP NaCl 58.44 Hydrous Dextrose USP 198.17 Composition Each 100 mL contains: Concentration of Electrolytes (mEq/liter) Hydrous Dextrose USP Sodium Chloride USP Calories per liter Calculated Osmolarity mOsmol/liter pH Solution Sodium Chloride Water for Injection USP qs 2.5% Dextrose and 0.45% Sodium Chloride Injection USP 2.5 g 0.45 g 77 77 85 280 4.6 (3.5 6.5) 3.3% Dextrose and 0.30% Sodium Chloride Injection USP 3.3 g 0.3 g 51 51 110 270 4.5 (3.5 6.5) 5% Dextrose and 0.9% Sodium Chloride Injection USP 5 g 0.9 g 154 154 170 560 4.4 (3.5 6.5) 5% Dextrose and 0.45% Sodium Chloride Injection USP 5 g 0.45 g 77 77 170 405 4.4 (3.5 6.5) 5% Dextrose and 0.33% Sodium Chloride Injection USP 5 g 0.33 g 56 56 170 365 4.4 (3.5 6.5) 5% Dextrose and 0.20% Sodium Chloride Injection USP 5 g 0.2 g 34 34 170 320 4.4 (3.5 6.5) 10% Dextrose and 0.45% Sodium Chloride Injection USP 10 g 0.45 g 77 77 340 660 4.3 (3.5 6.5) 10% Dextrose and 0.20% Sodium Chloride Injection USP 10 g 0.2 g 34 34 340 575 4.3 (3.5 6.5) Not made with natural rubber latex, PVC or DEHP. The plastic container is made from a multilayered film specifically developed for parenteral drugs. It contains no plasticizers and exhibits virtually no leachables. The solution contact layer is a rubberized copolymer of ethylene and propylene. The container is nontoxic and biologically inert. The container-solution unit is a closed system and is not dependent upon entry of external air during administration. The container is overwrapped to provide protection from the physical environment and to provide an additional moisture barrier when necessary. Addition of medication should be accomplished using complete aseptic technique. The closure system has two ports; the one for the administration set has a tamper evident plastic protector and the other is a medication addition site. Refer to the Directions for Use of the container. Slideshow Type 1 Diabetes: Symptoms, Treatments, and Breakthroughs Dextrose and Sodium Chloride Injection - Clinical Pharmacology Dextrose and Sodium Chloride Injections USP provide electrolytes and calories and are a source of water for hydration. All are capable of inducing diuresis depending on the clinical condition of the patient. Sodium, the major cation of the extracellular fluid, functions primarily in the control of water distribution, fluid balance, and osmotic pressure of body fluids. Sodium is also associated with chloride and bicarbonate in the regulation of the acid-base equilibrium of body fluid. Chloride, the major extracellular anion, closely follows the metabolism of sodium, and changes in the acid-base balance of the body are reflected by changes in the chloride concentration. Dextrose provides a source of calories. Dextrose is readily metabolized, may decrease losses of body protein and nitrogen, promotes glycogen deposition and decreases or prevents ketosis if sufficient doses are provided. Indications and Usage for Dextrose and Sodium Chloride Injection These intravenous solutions are indicated for use in adults and pediatric patients as sources of electrolytes, calories and water for hydration. Contraindications These solutions are contraindicated where the administration of sodium or chloride could be clinically detrimental. Solutions containing dextrose may be contraindicated in patients with hypersensitivity to corn products. Warnings The administration of intravenous solutions can cause fluid and/or solute overload resulting in dilution of serum electrolyte concentrations, overhydration, congested states or pulmonary edema. The risk of dilutional states is inversely proportional to the electrolyte concentration. The risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentration. Solutions containing sodium ions should be used with great care, if at all, in patients with congestive heart failure, severe renal insufficiency, and in clinical states in which there is sodium retention with edema. In patients with diminished renal function, administration of solutions containing sodium ions may result in sodium retention. Infusion of isotonic (0.9%) sodium chloride during or immediately after surgery may result in excessive sodium retention. Use the patient's circulatory system status as a guide. Excessive administration of potassium-free dextrose solutions may result in significant hypokalemia. Serum potassium levels should be maintained and potassium supplemented as required. Solutions containing dextrose and low electrolyte concentrations should not be administered simultaneously with blood through the same infusion set because of pseudoagglutination or hemolysis. Precautions General These solutions should be used with care in patients with hypervolemia, renal insufficiency, urinary tract obstruction, or impending or frank cardiac decompensation. Extraordinary electrolyte losses such as may occur during protracted nasogastric suction, vomiting, diarrhea or gastrointestinal fistula drainage may necessitate additional electrolyte supplementation. Additional essential electrolytes, minerals and vitamins should be supplied as needed. Sodium-containing solutions should be administered with caution to patients receiving corticosteroids or corticotropin, or to other salt-retaining patients. Care should be exercised in administering solutions containing sodium to patients with renal or cardiovascular insufficiency, with or without congestive heart failure, particularly if they are postoperative or elderly. Infusion of more than one liter of isotonic (0.9%) sodium chloride per day may supply more sodium and chloride than normally found in serum, and can exceed normal tolerance, resulting in hypernatremia; this may also cause a loss of bicarbonate ions, resulting in an acidifying effect. Solutions containing dextrose should be used with caution in patients with overt or known subclinical diabetes mellitus, or carbohydrate intolerance for any reason. Hypokalemia may develop during parenteral administration of hypertonic dextrose solutions. Sufficient amounts of potassium should be added to dextrose solutions administered to fasting patients with good renal function, especially those on digitalis therapy. To minimize the risk of possible incompatibilities arising from mixing any of these solutions with other additives that may be prescribed, the final infusate should be inspected for cloudiness or precipitation immediately after mixing, prior to administration and periodically during administration. Do not use plastic containers in series connection. If administration is controlled by a pumping device, care must be taken to discontinue pumping action before the container runs dry or air embolism may result. If administration is not controlled by a pumping device, refrain from applying excessive pressure (>300mmHg) causing distortion to the container such as wringing or twisting. Such handling could result in breakage of the container. These solutions are intended for intravenous administration using sterile equipment. It is recommended that intravenous administration apparatus be replaced at least once every 24 hours. Use only if solution is clear and container and seals are intact. Laboratory Tests Clinical evaluation and periodic laboratory determinations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid-base balance during prolonged parenteral therapy or whenever the condition of the patient warrants such evaluation. Significant deviations from normal concentrations may require tailoring of the electrolyte pattern, in these or alternative solutions. Carcinogenesis, Mutagenesis, Impairment of Fertility Studies with Dextrose and Sodium Chloride Injections USP have not been performed to evaluate carcinogenic potential, mutagenic potential, or effects on fertility. Pregnancy Teratogenic Effects Pregnancy Category C. Animal reproduction studies have not been conducted with Dextrose and Sodium Chloride Injections USP. It is also not known whether Dextrose and Sodium Chloride Injections USP can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Dextrose and Sodium Chloride Injections USP should be given to a pregnant woman only if clearly needed. Labor and Delivery The effects of Dextrose and Sodium Chloride Injections USP on the duration of labor or delivery, on the possibility that forceps delivery or other intervention or resuscitation of the newborn will be necessary, and on the later growth, development, and functional maturation of the child are unknown. As reported in the literature, sodium and dextrose containing solutions have been administered during labor and delivery. Caution should be exercised, and the fluid balance, glucose and electrolyte concentrations, and acid-base balance, of both mother and fetus should be evaluated periodically or whenever warranted by the condition of the patient or fetus. Nursing Mothers It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Dextrose and Sodium Chloride Injections USP are administered to a nursing woman. Pediatric Use Safety and effectiveness of Dextrose and Sodium Chloride Injections USP in pediatric patients have not been established by adequate and well-controlled studies. Dextrose is safe and effective for the stated indications in pediatric patients (see INDICATIONS AND USAGE ). As reported in the literature, the dosage selection and constant infusion rate of intravenous dextrose must be selected with caution in pediatric patients, particularly neonates and low birth weight infants, because of the increased risk of hyperglycemia/hypoglycemia. Frequent monitoring of serum glucose concentrations is required when dextrose is prescribed to pediatric patients, particularly neonates and low birth weight infants. In neonates or in very small infants even small volumes of fluid may affect fluid and electrolyte balance. Care must be exercised in treatment of neonates, especially pre-term neonates, whose renal function may be immature and whose ability to excrete fluid and solute loads may be limited. Fluid intake, urine output, and serum electrolytes should be monitored closely. See WARNINGS and DOSAGE AND ADMINISTRATION . Geriatric Use Clinical studies of Dextrose and Sodium Chloride Injections USP did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. These drugs are known to be substantially excreted by the kidney, and the risk of toxic reactions to these drugs may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. See WARNINGS . Adverse Reactions Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation and hypervolemia. Too rapid infusion of hypertonic solutions may cause local pain and venous irritation. Rate of administration should be adjusted according to tolerance. Use of the largest peripheral vein and a small bore needle is recommended. (See DOSAGE AND ADMINISTRATION .) Symptoms may result from an excess or deficit of one or more of the ions present in the solution; therefore, frequent monitoring of electrolyte levels is essential. Hypernatremia may be associated with edema and exacerbation of congestive heart failure due to the retention of water, resulting in an expanded extracellular fluid volume. If infused in large amounts, chloride ions may cause a loss of bicarbonate ions, resulting in an acidifying effect. The physician should also be alert to the possibility of adverse reactions to drug additives diluted and administered from the plastic container. Prescribing information for drug additives to be administered in this manner should be consulted. If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures, and save the remainder of the fluid for examination if deemed necessary. Overdosage In the event of a fluid or solute overload during parenteral therapy, reevaluate the patient's condition and institute appropriate corrective treatment. Dextrose and Sodium Chloride Injection Dosage and Administration These solutions are for intravenous use only. Dosage is to be directed by a physician and is dependent upon age, weight, clinical condition of the patient and laboratory determinations. Frequent laboratory determinations and clinical evaluation are essential to monitor changes in blood glucose and electrolyte concentrations, and fluid and electrolyte balance during prolonged parenteral therapy. When a hypertonic solution is to be administered peripherally, it should be slowly infused through a small bore needle, placed well within the lumen of a large vein to minimize venous irritation. Carefully avoid infiltration. In the average adult, daily requirements of sodium and chloride are met by the infusion of one liter of fluid containing 0.9% sodium chloride (154 mEq each of sodium and chloride). Fluid administration should be based on calculated maintenance or replacement fluid requirements for each patient. Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Pediatric Use There is no specific pediatric dose. The dose is dependent on weight, clinical condition, and laboratory results. See WARNINGS and PRECAUTIONS . How is Dextrose and Sodium Chloride Injection Supplied Dextrose and Sodium Chloride Injections USP are supplied sterile and nonpyrogenic in EXCEL Containers. The 1000 mL containers are packaged 12 per case; the 500 mL and 250 mL containers are packaged 24 per case. Canada DIN NDC REF Size 2.5% Dextrose and 0.45% Sodium Chloride Injection USP 0264-7605-00 L6050 1000 mL 3.3% Dextrose and 0.30% Sodium Chloride Injection USP 01927981 0264-7608-00 L6080-00 1000 mL 0264-7608-10 L6081-00 500 mL 5% Dextrose and 0.9% Sodium Chloride Injection USP 01924435 0264-7610-00 L6100 1000 mL 0264-7610-10 L6101 500 mL 5% Dextrose and 0.45% Sodium Chloride Injection USP 01927531 0264-7612-00 L6120 1000 mL 0264-7612-10 L6121 500 mL 0264-7612-20 L6122 250 mL 5% Dextrose and 0.33% Sodium Chloride Injection USP 0264-7614-00 L6140 1000 mL 0264-7614-10 L6141 500 mL 5% Dextrose and 0.20% Sodium Chloride Injection USP 01927558 0264-7616-00 L6160 1000 mL 0264-7616-10 L6161 500 mL 0264-7616-20 L6162 250 mL 10% Dextrose and 0.45% Sodium Chloride Injection USP 0264-7622-00 L6220 1000 mL 10% Dextrose and 0.20% Sodium Chloride Injection USP 0264-7623-20 L6232 250 mL Exposure of pharmaceutical products to heat should be minimized. Avoid excessive heat. Protect from freezing. It is recommended that the product be stored at room temperature (25 C); however, brief exposure up to 40 C does not adversely affect the product. Rx only Revised: February 2015 EXCEL is a registered trademark of B. Braun Medical Inc. Directions for Use of EXCEL Container Caution: Do not use plastic containers in series connection. To Open Tear overwrap down at notch and remove solution container. Check for minute leaks by squeezing solution container firmly. If leaks are found, discard solution as sterility may be impaired. If supplemental medication is desired, follow directions below before preparing for administration. NOTE : Before use, perform the following checks: Inspect each container. Read the label. Ensure solution is the one ordered and is within the expiration date. Invert container and carefully inspect the solution in good light for cloudiness, haze, or particulate matter. Any container which is suspect should not be used. Use only if solution is clear and container and seals are intact. Preparation for Administration 1. Remove plastic protector from sterile set port at bottom of container. 2. Attach administration set. Refer to complete directions accompanying set. To Add Medication Warning: Some additives may be incompatible. To Add Medication Before Solution Administration 1. Prepare medication site. 2. Using syringe with 18 22 Ga. needle, puncture medication port and inner diaphragm and inject. 3. Squeeze and tap ports while ports are upright and mix solution and medication thoroughly. To Add Medication During Solution Administration 1. Close clamp on the set. 2. Prepare medication site. 3. Using syringe with 18 22 Ga. needle of appropriate length (at least 5/8 inch), puncture resealable medication port and inner diaphragm and inject. 4. Remove container from IV pole and/or turn to an upright position. 5. Evacuate both ports by tapping and squeezing them while container is in the upright position. 6. Mix solution and medication thoroughly. 7. Return container to in use position and continue administration. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 In Canada, distributed by: B. Braun of Canada, Ltd. Scarborough, Ontario M1H 2W4 Y36-002-889 LD-197-3 PRINCIPAL DISPLAY PANEL - 1000 mL Container Label 2.5% Dextrose and 0.45 Sodium Chloride Injection USP REF L6050 NDC 0264-7605-00 HK 22568 1000 mL EXCEL CONTAINER Each 100 mL contains: Hydrous Dextrose USP 2.5 g; Sodium Chloride USP 0.45 g; Water for Injection USP qs pH: 4.6 (3.5-6.5); Calc. Osmolarity: 280 mOsmol/liter Electrolytes (mEq/liter): Na + 77; Cl 77 Sterile, nonpyrogenic. Single dose container. Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact. WARNINGS: Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Recommended Storage: Room temperature (25 C). Avoid excessive heat. Protect from freezing. See Package Insert. Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired. Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 Y94-003-251 LD-164-3 EXP LOT PRINCIPAL DISPLAY PANEL - 1000 mL Container Label 3.3% Dextrose and 0.30% Sodium Chloride Injection USP REF L6080-00 NDC 0264-7608-00 DIN 01927981 1000 mL EXCEL CONTAINER Each 100 mL contains: Hydrous Dextrose USP 3.3 g; Sodium Chloride USP 0.3 g; Water for Injection USP qs pH: 4.5 (3.5-6.5); Calc. Osmolarity: 270 mOsmol/liter Electrolytes (mEq/liter): Na + 51; Cl 51 Sterile, nonpyrogenic. Single dose container. Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact. WARNINGS: Do Not Administer Simultaneously With Blood. Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Recommended Storage: Room temperature (25 C). Avoid excessive heat. Protect from freezing. See Package Insert. Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired. Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 In Canada, distributed by: B. Braun of Canada, Ltd. Scarborough, Ontario M1H 2W4 Y94-003-252 LD-183-3 EXP LOT PRINCIPAL DISPLAY PANEL - 500 mL Container Label 3.3% Dextrose and 0.30% Sodium Chloride Injection USP REF L6081-00 NDC 0264-7608-10 DIN 01927981 500 mL EXCEL CONTAINER Each 100 mL contains: Hydrous Dextrose USP 3.3 g; Sodium Chloride USP 0.3 g; Water for Injection USP qs pH: 4.5 (3.5-6.5); Calc. Osmolarity: 270 mOsmol/liter Electrolytes (mEq/liter): Na + 51; Cl 51 Sterile, nonpyrogenic. Single dose container. Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact. WARNINGS: Do Not Administer Simultaneously With Blood. Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Recommended Storage: Room temperature (25 C). Avoid excessive heat. Protect from freezing. See Package Insert. Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired. Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 In Canada, distributed by: B. Braun of Canada, Ltd. Scarborough, Ontario M1H 2W4 Y94-003-246 LD-184-3 EXP LOT PRINCIPAL DISPLAY PANEL - 1000 mL Container Label 5% Dextrose and 0.9% Sodium Chloride Injection USP REF L6100 NDC 0264-7610-00 DIN 01924435 HK 22608 1000 mL EXCEL CONTAINER Each 100 mL contains: Hydrous Dextrose USP 5 g; Sodium Chloride USP 0.9 g; Water for Injection USP qs pH: 4.4 (3.5-6.5); Calc. Osmolarity: 560 mOsmol/liter, hypertonic Electrolytes (mEq/liter): Na + 154; Cl 154 Sterile, nonpyrogenic. Single dose container. Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact. WARNINGS: Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Recommended Storage: Room temperature (25 C). Avoid excessive heat. Protect from freezing. See Package Insert. Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired. Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 In Canada, distributed by: B. Braun of Canada, Ltd. Scarborough, Ontario M1H 2W4 Y94-003-253 LD-177-3 EXP LOT PRINCIPAL DISPLAY PANEL - 500 mL Container Label 5% Dextrose and 0.9% Sodium Chloride Injection USP REF L6101 NDC 0264-7610-10 DIN 01924435 HK 22608 500 mL EXCEL CONTAINER Each 100 mL contains: Hydrous Dextrose USP 5 g; Sodium Chloride USP 0.9 g; Water for Injection USP qs pH: 4.4 (3.5-6.5); Calc. Osmolarity: 560 mOsmol/liter, hypertonic Electrolytes (mEq/liter): Na + 154; Cl 154 Sterile, nonpyrogenic. Single dose container. Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact. WARNINGS: Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Recommended Storage: Room temperature (25 C). Avoid excessive heat. Protect from freezing. See Package Insert. Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired. Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 In Canada, distributed by: B. Braun of Canada, Ltd. Scarborough, Ontario M1H 2W4 Y94-003-247 LD-176-3 EXP LOT PRINCIPAL DISPLAY PANEL - 1000 mL Container Label 5% Dextrose and 0.45% Sodium Chloride Injection USP REF L6120 NDC 0264-7612-00 DIN 01927531 HK 22607 1000 mL EXCEL CONTAINER Each 100 mL contains: Hydrous Dextrose USP 5 g; Sodium Chloride USP 0.45 g; Water for Injection USP qs pH: 4.4 (3.5-6.5); Calc. Osmolarity: 405 mOsmol/liter, hypertonic Electrolytes (mEq/liter): Na + 77; Cl 77 Sterile, nonpyrogenic. Single dose container. Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact. WARNINGS: Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Recommended Storage: Room temperature (25 C). Avoid excessive heat. Protect from freezing. See Package Insert. Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired. Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 In Canada, distributed by: B. Braun of Canada, Ltd. Scarborough, Ontario M1H 2W4 Y94-003-254 LD-108-3 EXP LOT PRINCIPAL DISPLAY PANEL - 500 mL Container Label 5% Dextrose and 0.45% Sodium Chloride Injection USP REF L6121 NDC 0264-7612-10 DIN 01927531 HK 22607 500 mL EXCEL CONTAINER Each 100 mL contains: Hydrous Dextrose USP 5 g; Sodium Chloride USP 0.45 g; Water for Injection USP qs pH: 4.4 (3.5-6.5); Calc. Osmolarity: 405 mOsmol/liter, hypertonic Electrolytes (mEq/liter): Na + 77; Cl 77 Sterile, nonpyrogenic. Single dose container. Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact. WARNINGS: Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Recommended Storage: Room temperature (25 C). Avoid excessive heat. Protect from freezing. See Package Insert. Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired. Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 In Canada, distributed by: B. Braun of Canada, Ltd. Scarborough, Ontario M1H 2W4 Y94-003-248 LD-113-3 EXP LOT PRINCIPAL DISPLAY PANEL - 250 mL Container Label 5% Dextrose and 0.45% Sodium Chloride Injection USP REF L6122 NDC 0264-7612-20 DIN 01927531 HK 22607 250 mL EXCEL CONTAINER Each 100 mL contains: Hydrous Dextrose USP 5 g; Sodium Chloride USP 0.45 g; Water for Injection USP qs pH: 4.4 (3.5-6.5); Calc. Osmolarity: 405 mOsmol/liter, hypertonic Electrolytes (mEq/liter): Na + 77; Cl 77 Sterile, nonpyrogenic. Single dose container. Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact. WARNINGS: Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Recommended Storage: Room temperature (25 C). Avoid excessive heat. Protect from freezing. See Package Insert. Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired. Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 In Canada, distributed by: B. Braun of Canada, Ltd. Scarborough, Ontario M1H 2W4 Y94-003-245 LD-114-3 EXP LOT PRINCIPAL DISPLAY PANEL - 1000 mL Container Label 5% Dextrose and 0.33% Sodium Chloride Injection USP REF L6140 NDC 0264-7614-00 1000 mL EXCEL CONTAINER Each 100 mL contains: Hydrous Dextrose USP 5 g; Sodium Chloride USP 0.33 g; Water for Injection USP qs pH: 4.4 (3.5-6.5); Calc. Osmolarity: 365 mOsmol/liter, hypertonic Electrolytes (mEq/liter): Na + 56; Cl 56 Sterile, nonpyrogenic. Single dose container. Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact. WARNINGS: Do Not Administer Simultaneously With Blood. Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Recommended Storage: Room temperature (25 C). Avoid excessive heat. Protect from freezing. See Package Insert. Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired. Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 Y94-003-255 LD-115-3 EXP LOT PRINCIPAL DISPLAY PANEL - 500 mL Container Label 5% Dextrose and 0.33% Sodium Chloride Injection USP REF L6141 NDC 0264-7614-10 500 mL EXCEL CONTAINER Each 100 mL contains: Hydrous Dextrose USP 5 g; Sodium Chloride USP 0.33 g; Water for Injection USP qs pH: 4.4 (3.5-6.5); Calc. Osmolarity: 365 mOsmol/liter, hypertonic Electrolytes (mEq/liter): Na + 56; Cl 56 Sterile, nonpyrogenic. Single dose container. Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact. WARNINGS: Do Not Administer Simultaneously With Blood. Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Recommended Storage: Room temperature (25 C). Avoid excessive heat. Protect from freezing. See Package Insert. Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired. Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 Y94-003-249 LD-174-3 EXP LOT PRINCIPAL DISPLAY PANEL - 1000 mL Container Label 5% Dextrose and 0.20% Sodium Chloride Injection USP REF L6160 NDC 0264-7616-00 DIN 01927558 HK 22606 1000 mL EXCEL CONTAINER Each 100 mL contains: Hydrous Dextrose USP 5 g; Sodium Chloride USP 0.2 g; Water for Injection USP qs pH: 4.4 (3.5-6.5); Calc. Osmolarity: 320 mOsmol/liter Electrolytes (mEq/liter): Na + 34 ; Cl 34 Sterile, nonpyrogenic. Single dose container. Do not use in series connection. For intravenous use only. Use only if solution is clear and container and seals are intact. WARNINGS: Do Not Administer Simultaneously With Blood. Some additives may be incompatible. Consult with pharmacist. When introducing additives, use aseptic techniques. Mix thoroughly. Do not store. Recommended Storage: Room temperature (25 C). Avoid excessive heat. Protect from freezing. See Package Insert. Do not remove overwrap until ready for use. After removing the overwrap, check for minute leaks by squeezing container firmly. If leaks are found, discard solution as sterility may be impaired. Not made with natural rubber latex, PVC or DEHP. Rx only EXCEL is a registered trademark of B. Braun Medical Inc. B. Braun Medical Inc. Bethlehem, PA 18018-3524 USA 1-800-227-2862 In Canada, distributed by: B. Braun of Canada, Ltd. Scarborough, Ontario M1H 2W4 Y94-003-256 LD-172-3 EXP LOT PRINCIPAL DISPLAY PANEL most advantageous


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apologize Dialyvite 3000 Generic Name: ascorbic acid, thiamine mononitrate, riboflavin, niacinamide, pyridoxine hydrochloride, folic acid, cobalamin, biotin, calcium pantothenate, zinc citrate, .alpha.-tocopherol succinate, d- and selenocysteine Dosage Form: tablet, coated Side Effects Dosage Professional Interactions Reviews More Drug Images Pricing & Coupons Disclaimer: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA. For further information about unapproved drugs, click here. Dialyvite 3000 Description Dialyvite 3000 is a prescription folic acid supplement with additional nutrients for kidney dialysis patients. Dialyvite 3000 is a small, round, light brown, clear-coated tablet, with debossed "H" on one side. Each tablet contains: Folic Acid.....3 mg Vitamin E (d-alpha Tocopheryl Acid Succinate).....30 IU Vitamin C (Ascorbic Acid).....100 mg Thiamine (Thiamine Mononitrate).....1.5 mg Riboflavin.....1.7 mg Niacinamide.....20 mg Vitamin B6 (Pyridoxine HCl).....25 mg Vitamin B12 (Methylcobalamin).....1 mg Biotin.....300 mcg Pantothenic Acid (Calcium Pantothenate).....10 mg Zinc (Zinc Citrate).....15 mg Selenium (Selenium Amino Acid Chelate).....70 mcg Inactive ingredients: Microcrystalline Cellulose, Croscarmellose Sodium, Mono-and Diglycerides, Wheat Germ (color), Pharmaceutical Glaze, Starch, Calcium Stearate, Silicon Dioxide. Contains Wheat. Slideshow Sports And Dietary Supplements: From Creatine To Whey Indications and Usage for Dialyvite 3000 Dialyvite 3000 is a prescription folic acid supplement with additional nutrients indicated for use in improving the nutritional status of renal dialysis patients. Contraindications This product is contraindicated in patients with known hypersensitivity to any of the ingredients. Precautions Folic acid supplementation may obscure pernicious anemia, in that hematologic remission can occur while neurological manifestations progress. Keep out of reach of children. Adverse Reactions Allergic sensitizations have been reported following oral administration of folic acid. Consult your physician immediately if adverse side effects occur. Dialyvite 3000 Dosage and Administration Take one tablet per day or use as directed by your physician, orally. PRINCIPAL DISPLAY PANEL NDC 10542-014-09 Dialyvite 3000 Multivitamin Supplement for Dialysis Patients 90 Tablets Dialyvite 3000 ascorbic acid, tocopheryl acid succinate, thiamine, riboflavin, niacinamide, pyridoxine, folic acid, cobalamin, biotin, pantothenic acid, zinc, selenium tablet, coated Product Information Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:10542-014 Route of Administration ORAL DEA Schedule Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength Ascorbic Acid (Ascorbic Acid) Ascorbic Acid 100 mg Thiamine Mononitrate (Thiamine Ion) Thiamine 1.5 mg Riboflavin (Riboflavin) Riboflavin 1.7 mg Niacinamide (Niacinamide) Niacinamide 20 mg Pyridoxine Hydrochloride (Pyridoxine) Pyridoxine 25 mg Folic Acid (Folic Acid) Folic Acid 3 mg Cobalamin (Cobalamin) Cobalamin 1 mg Biotin (Biotin) Biotin 300 ug Calcium Pantothenate (Pantothenic Acid) Pantothenic Acid 10 mg Zinc Citrate (Zinc Cation) Zinc Cation 15 mg .alpha.-tocopherol succinate, d- (.alpha.-tocopherol, d-) .alpha.-tocopherol, d- 30 [iU] Selenocysteine (Selenium) Selenium 70 ug Inactive Ingredients Ingredient Name Strength Cellulose, microcrystalline Croscarmellose Sodium Glyceryl Monostearate Wheat Germ Shellac Starch, Corn Calcium Stearate Silicon Dioxide Product Characteristics Color brown Score no score Shape ROUND Size 11mm Flavor Imprint Code H Contains Packaging # Item Code Package Description 1 NDC:10542-014-09 90 TABLET, COATED in 1 BOTTLE, PLASTIC 2 NDC:10542-014-02 7 TABLET, COATED in 1 BOTTLE, PLASTIC Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date Unapproved drug other 02/01/2004 Labeler - Hillestad Pharmaceuticals USA (029291085) Establishment Name Address ID/FEI Operations Hillestad Pharmaceuticals USA 029291085 manufacture(10542-014), label(10542-014) Revised: 12/2015 Hillestad Pharmaceuticals USA Next Interactions Print this page Add to My Med List More about Dialyvite 3000 (multivitamin with minerals) Side Effects Dosage Information Drug Images Drug Interactions Pricing & Coupons 0 Reviews Add your own review/rating Drug class: vitamin and mineral combinations Consumer resources Professional resources Calcium-Folic Acid Plus D (FDA) Other brands: Strovite One , Centratex , MagneBind 400 Rx , Tozal , ... +7 more Other Formulations Dialyvite Dialyvite Supreme D Dialyvite 5000 Related treatment guides Vitamin/Mineral Supplementation and Deficiency FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx OTC Availability Rx and/or OTC N Pregnancy Category Not classified N/A CSA Schedule Not a controlled drug Manufacturer Hillestad Pharmaceuticals, Inc. Drug Class Vitamin and mineral combinations Related Drugs vitamin and mineral combinations multivitamin , Citracal + D Vitamin / Mineral Supplementation and Deficiency folic acid , ferrous sulfate , ergocalciferol , Vitamin D2 , Zinc , thiamine , Drisdol , selenium , chromium picolinate , Feosol Original , riboflavin , Iron-150 , Dialyvite , zinc sulfate , More... Dialyvite 3000 Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! Dialyvite 3000 Images Dialyvite 3000 multivitamin with minerals (H ) View larger images as a result of


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they carry May 19, 2015 By Andrea Blanch, Ph.D. and David Shern, Ph.D. Two weeks ago, Liberia was officially declared Ebola free. Liberia was ground zero of the Ebola epidemic, with confirmed cases in all 15 counties and almost 5,000 Ebola-related deaths. Chronic poverty and years of civil war had devastated the country s health care system. At the height of the epidemic, containing the disease seemed almost impossible. But the last reported case was in March. What led to this turnaround? Several factors contributed. Donor nations and international aid groups poured expert assistance into the country. President Ellen Sirleaf-Johnson also provided important national leadership. While admitting to early mistakes - including the imposition of a tough security crackdown that fed public fears her government led a highly effective public education campaign that played a key role. But commentators have been consistent in giving another group the biggest share of the credit Liberian citizens themselves. Neighborhood groups rooted out the virus by going house by house, locating individuals who were sick. They worked to change behaviors, like washing bodies after death, long-rooted in cultural traditions. It was their action that ultimately turned the tide on the outbreak. As in Liberia, communities across the United States are mobilizing to fight another type of epidemic . We have recently summarized research showing how toxic stress and trauma are affecting the health and wellbeing of the U.S. population. These problems are reflected in declining academic performance, high levels of violence, the highest incarceration rate in the world, mental health and substance abuse problems, and many other indicators of declining human capital. This week, the Substance Abuse and Mental Health Services Administration took an important step in recognizing this epidemic and identifying potential solutions. They convened a meeting of citizen teams from six communities that are mobilizing for action. The passion, commitment and creativity these individuals bring to their task is beyond inspiring. Most are working as volunteers or are doing this work in addition to their paid employment. All understand the lesson from Liberia that turning the tide on violence and trauma will require widespread citizen involvement in concert with professional expertise. Each community has unique strengths and problems, and each has taken different initial steps. In Kansas City, police are eagerly embracing a program to address the trauma they experience in their lives and work, and the Chamber of Commerce is encouraging members to become trauma-informed. In Philadelphia, inner city residents are rebuilding community cohesion through citizen public art, and gang violence is being reduced through prevention and intervention. San Francisco is training the entire public health department (all 9,000 staff) in cultural humility and trauma-informed approaches. Walla Walla has demonstrated how using a trauma-informed approach can turn around a failing school, dramatically reducing suspensions and improving academic performance. Tarpon Springs has organized hundreds of citizens to work towards a safer and healthier community, and is helping former prisoners succeed in the community by addressing childhood trauma. In Worcester, people in recovery from mental illness, substance abuse, and trauma have led a community-wide effort to increase compassion and to celebrate differences. These efforts and others like them - need to be expanded and replicated as quickly as possible. Communities all across the country are reeling from racially charged incidents, outbreaks of violence, and mass shootings. A participant from Baltimore noted that although the city currently looks calm, some neighborhoods have been flooded with drugs and have seen a steep spike in homicides since the end of the riots. These problems are not unrelated. They reflect our failure to address social conditions that create toxic levels of stress for many of our most vulnerable citizens. David Nabarro, UN special envoy, said about Liberia: Fundamentally, this is about the extent to which societies change their behaviors, how they change them, and the speed at which they change them. In Liberia, once people understood they were faced with a devastating infectious threat, they changed quickly and dramatically. Ultimately, untold thousands of lives were saved. The threat facing us may not be as dramatic as Ebola, but it is just as deadly. If we are going to put an end to the current epidemic of toxic stress, violence and trauma, we have to change just as quickly and dramatically as Liberia did. The federal government took a welcome step in this direction this past week. Additional resources: http://www.mentalhealthamerica.net/issues/toxic-stress-behavioral-health-and-next-major-era-public-health http://www.samhsa.gov/ http://www.mentalhealthamerica.net/blog/kansas-city-gets-it-right http://www.philaceasefire.com/ http://www.leapsf.org/pdf/Trauma-Informed-Systems-Initative-2014.pdf http://communityresiliencecookbook.org/tastes-of-success/the-walla-walla-washington-story/ http://www.peace4tarpon.org/ https://www.youtube.com/watch?v=EQhqkZSvKs8&feature=youtu.be Andy Blanch, PhD, has been an advocate for the development of trauma-informed public policies and programs for the past 30 years. Dr. David Shern is the Senior Science Advisor at Mental Health America having served as its President/CEO from 2006-2014. He also has a faculty appointment in the Department of Mental Health at the Hopkins Bloomberg School of Public Health and previously was a Dean and Professor at the University of South Florida. Tags: Upstream New Public Health Mental Health America Blog seems


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registration number plate Share 14 +1 1 Pin 2 Stumble Reddit 1 Shares 18 Nuvigil and Provigil are both drugs that were approved by the FDA for the treatment of excessive daytime sleepiness. Both drugs act as eugeroics and are considered wakefulness-promoting agents in that they are distinct from more potent, habit-forming psychostimulants (e.g. Adderall). Provigil was initially approved in the late 1990s to help treat narcolepsy. Although the drug was successful in treating narcolepsy, many individuals sought out the drug as a performance enhancing agent, particularly as a nootropic. A series of patent issues for Cephalon Inc. (the manufacturer of Provigil) lead the company to engineer an upgraded version of Provigil called Nuvigil. Nuvigil contains solely the R-enantiomer of modafinil whereas Provigil contains both the R and S enantiomers of modafinil. Nuvigil was approved by the FDA in 2007 for the treatment of excessive daytime sleepiness associated with narcolepsy. Despite the fact that Nuvigil was intended to be a more effective successor to Provigil, there is no evidence to suggest superior efficacy. Preferences for one drug over the other are generally subject to individual variation. Nuvigil vs. Provigil Comparison Chart Below is a chart comparing the eugeroics Nuvigil and Provigil. Provigil is an older medication and has been subject to more off-label usage as a result. The two medications are thought to be very similar in their mechanism of action and wakefulness-promoting effect. Nuvigil Provigil Drug type Eugeroic Eugeroic Approved uses Narcolepsy. Obstructive sleep apnea. Shift work sleep disorder. Narcolepsy. Obstructive sleep apnea. Shift work sleep disorder. Ingredients Armodafinil Modafinil Formats Tablet Tablet Dosages 50 mg/150 mg/200 mg/250 mg 100 mg/200 mg Manufacturer Cephalon Inc. Cephalon Inc. Legal Status Schedule IV (US) Schedule IV (US) Mechanism of action Functions by inhibiting reuptake of dopamine and is thought to act as an indirect D2 receptor partial agonist. It is believed to also elevate histamine levels in the hypothalamus and increase concentrations of other neurotransmitters such as norepinephrine and serotonin. It may activate orexin peptides via stimulation of orexin receptors (OX1 and OX2). It may also increase glutamatergic concentrations / decrease GABAergic activation and increase electronic coupling. Functions by inhibiting reuptake of dopamine and elevating histamine levels in the hypothalamus. It also increases levels of other monoamines such as norepinephrine / serotonin / and activation of orexin peptides. Specifically it may stimulate orexin receptors (OX1 and OX2) to promote wakefulness. The drug may also activate glutamatergic circuits / inhibit GABA neurotransmission / and enhance electronic coupling. Generic version? No. Yes. Half life 15 hours 12 hours Common side effects Dizziness. Headache. Insomnia. Nausea. Nervousness. Dizziness. Headache. Insomnia. Nausea. Nervousness. Date approved June (2007) (1998) Effect duration 8 hours 6 to 8 hours Investigational uses ADHD. Cognitive enhancement. Chronic fatigue syndrome. Depression. Drug addiction. Jet lag. Negative symptoms of schizophrenia . ADHD. Cognitive enhancement. Chronic fatigue syndrome. Delayed sleep phase syndrome. Depersonalization. Depression. Drug addiction. Fibromyalgia. Jet lag. Multiple sclerosis. Parkinson's disease. Weight loss. Nuvigil vs. Provigil: What s the difference? The primary difference between Nuvigil and Provigil is that Nuvigil contains just the R enantiomer of modafinil and Provigil contains both the S and the R enantiomers. They are both manufactured by Cephalon Inc. and both are thought to have nearly identical mechanisms of action. If you re knowledgeable about antidepressants, a good analogy is that: Nuvigil is to Provigil what Lexapro is to Celexa. It s just an upgraded version of an older drug that s been repackaged in a more efficient formula. The reason it has been repackaged is largely a result of the fact that the patent for Provigil had expired, allowing other companies to manufacture generic versions. By creating Nuvigil, Cephalon Inc. was able to promote a new version of their older drug at a premium price, thus increasing their earning potential. Nuvigil is thought to elicit a slightly longer duration of effect (2 more hours) than Provigil as a result of containing only the R-enantiomer. The S-enantiomer found in Provigil has a much shorter half-life than its R-enantiomer counterpart, meaning Provigil s effect may not be as potent, efficient, or long-lasting when compared to Nuvigil. Abuse Potential Both Nuvigil and Provigil are considered Schedule IV substances in the United States. Under this classification, the drugs are regarded as having a low potential for abuse relative to other drugs or substances in Schedule III. Furthermore, the drugs in the Schedule IV class have medically accepted uses in the United States. That said, it is possible that Nuvigil and Provigil may be subject to abuse. Abuse of either of these drugs could lead to psychological or physical dependence more likely the former than the latter. Due to their low potential for abuse, prescriptions for these drugs can be refilled up to 5 times within a 6 month term. Most people don t take eugeroics as party drugs and therefore they are unlikely to be abused. Although they do elicit dopamine reuptake inhibition (DRI) effects, the degree to which they inhibit dopamine is considered significantly weaker than psychostimulants. Many people have compared their effects to high doses of caffeine as opposed to psychostimulants like Adderall. The abuse potential increases when these substances are used on an off-label basis without medical supervision. For example, some people use Provigil for weight loss , enhancement of academic performance, or optimize occupational productivity. These unapproved uses may be more likely to result in abuse and dependence upon the drug for functioning. Cost: Which is more expensive? Those looking to take a eugeroic to treat a condition associated with excessive daytime sleepiness (e.g. narcolepsy), may want to compare prescription prices. Due to similarities between Provigil and Nuvigil, most insurance companies will want you to take whichever one is cheaper. If you are paying out of pocket or don t have very good insurance, you ll probably also want to take the cheaper of the two. Provigil is an older drug that s been on the market since 1998 and is available as a generic (modafinil). The generic version of Provigil (modafinil) will cost anywhere from $150 to $305 for a 30 day supply. The brand name Provigil is one of the more expensive drugs on the market, costing between $790 and $805 for a 30 count of 100 mg pills and well over $1000 for a 30 count of 200 mg pills. Nuvigil is considered a newer drug and is not yet available as a generic. The lowest 50 mg dose of Nuvigil costs between $195 and $210 for a 30 count, and between $570 and $600 for a 30 count of any other dosing option (i.e. 150 mg, 200 mg, 250 mg). The cheapest format is generic modafinil, followed by brand name Nuvigil, with the most expensive option being brand name Provigil. Dosage & Formats Nuvigil and Provigil are manufactured in tablet format and are absorbed rapidly after oral administration. The peak effect of each drug is thought to be achieved within 2 hours of consumption, though this may be delayed slightly with food consumption or enhanced via fasting. Nuvigil is manufactured in doses of 50 mg, 150 mg, 200 mg, and 250 mg. Provigil is only manufactured in doses of 100 mg and 200 mg. The starting dose of Provigil for most wakefulness-related disorders is 200 mg taken once in the morning. Due to individual sensitivities, some people may prefer a lower dose of 100 mg over the 200 mg. There is no evidence that doses exceeding 200 mg offer additional therapeutic benefit. Nuvigil is manufactured in a greater number of dosing increments compared to Provigil. It is typically administered at a starting dose of 150 mg, taken once in the morning for wakefulness-related disorders. The drug is considered by some as being twice as potent as Provigil due to the fact that it solely consists of the R enantiomer. There is no evidence that exceeding doses of 150 mg offers additional therapeutic benefit. By comparison, Nuvigil has more dosing options, but many people don t care due to the fact that some users cut Provigil in half for smaller doses. Some individuals may like the fact that Nuvigil is manufactured with double the dosing options compared to Provigil. Efficacy: Which drug is more effective? There is no clear evidence that Nuvigil is superior in efficacy to Provigil as a wakefulness-promoting agent or vice-versa. Nuvigil is a newer substance and is considered more potent than Provigil, but the degree to which it is more potent is unknown. Some speculate that Nuvigil is nearly twice as potent as Provigil due to the fact that it contains solely the R enantiomer of modafinil, whereas Provigil (modafinil) is comprised of a mix of the R and S enantiomers. The S enantiomer of modafinil is known to have a shorter duration of effect, and is considered less potent than the R enantiomer. Anecdotal evidence suggests that lower doses of Nuvigil may be equal in efficacy than higher doses of Provigil. Both drugs seem to hit a therapeutic ceiling, meaning that beyond certain doses, no additional benefits can be attained. The therapeutic ceiling for Provigil is thought to be 200 mg per day and the therapeutic ceiling for Nuvigil is thought to be 150 mg per day. Nuvigil s onset of action peaks at 2 hours, whereas Provigil s onset of action peaks between 2 to 4 hours. Additionally, Nuvigil is thought to provide symptomatic relief for up to 2 hours longer than Provigil. From a perspective of duration of effect and potency, Nuvigil may be advantageous. However, there remains no head-to-head comparison of efficacy between these drugs. Some research suggests that Nuvigil may deliver superior wakefulness to Provigil. Source: http://www.ncbi.nlm.nih.gov/pubmed/19663523 Mechanisms of action Due to the fact that both drugs are very similar, there isn t thought to be significant discrepancies in their respective mechanisms of action. There may be subtle differences due to the fact that Nuvigil only contains the R enantiomer and Provigil contains both the R and the S enantiomers. The specific mechanisms of action for each drug are poorly understood by the medical community. Provigil is thought to inhibit reuptake of the dopamine transporter, thus increasing extracellular levels of dopamine. Its dopaminergic effect is thought to be significantly less than amphetamines and other psychostimulants. Research also shows that Provigil increases levels of both norepinephrine in the hypothalamus and ventrolateral preoptic nucleus, and levels of serotonin in the amygdala and prefrontal cortex. Some studies suggest that Provigil also activates peptides in the brain called orexins. These peptides are responsible for promoting wakefulness and deficiencies can result in excessive sleepiness. In animal models, Provigil was confirmed to stimulate orexin receptor 1 (OX1) and orexin receptor 2 (OX2). It also may also stimulate glutamatergic circuits, while inhibiting GABAergic neurotransmission. Another effect of Provigil is its ability to enhance electronic coupling, thereby increasing efficiency of neural communication. This enhancement of electronic coupling this believed to increase gamma brain waves , which may also aid in promotion of wakefulness and cognitive function. Nuvigil is thought to have the same mechanism of action as Provigil. The R and S enantiomers of modafinil elicit similar effects in animals, but the R enantiomer is more potent and delivers a longer effect. The R enantiomer is thought to have nearly three-fold the binding activity for dopamine and norepinephrine transporters than the S enantiomer. Other than differences in enantiomer composition, there shouldn t be major differences in Nuvigil and Provigil with regards to mechanisms of action. Source: http://www.ncbi.nlm.nih.gov/pubmed/19197004 Source: http://www.ncbi.nlm.nih.gov/pubmed/17920581 Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654794/ Medical Uses Nuvigil and Provigil are approved by the FDA for the treatment of sleep-wakefulness disorders such as narcolepsy. Both were initially approved for the treatment of narcolepsy, and were since approved for the treatment of obstructive sleep apnea (OSA) and shift work sleep disorder (SWSD). Due to the fact that Provigil hit the market (1998) earlier than Nuvigil (2007), it has been more heavily investigated as a non-traditional (off-label) treatment for an array of conditions. Provigil has been investigated for the treatment of attention-deficit/hyperactivity disorder, chronic fatigue syndrome, delayed sleep phase syndrome, depersonalization disorder, depression, drug addiction, fibromyalgia, jet lag, multiple sclerosis, Parkinson s disease, and weight loss. Despite the fact that it isn t officially approved for these conditions, it is still commonly prescribed. Nuvigil has been investigated for many of the same conditions such as ADHD, chronic fatigue syndrome, drug addiction, and jet lag. One different investigational use for Nuvigil over Provigil is as an adjunct to treat schizophrenia, particularly the negative symptoms (e.g. avolition). Some sources estimate that a majority of the prescriptions for these eugeroic drugs are for off-label purposes such as cognitive enhancement. By comparison, the approved medical uses for these drugs are the same and investigational uses are similar. Popularity The fact that Provigil has been around longer than Nuvigil and is available under the generic name of modafinil has contributed to its popularity. There remains a grey-market for Provigil sales online from unauthorized third-party sources, generally based in foreign countries (outside the United States). The mystique surrounding Provigil s off-label use as a nootropic has lead many people to actively seek out the drug to enhance cognitive function and productivity. As of 2014, profits from Nuvigil sales were thought to exceed $400 million, while in 2007 sales of Provigil exceeded $800 million. Provigil has been around since the 1990s and has remained the most popular eugeroic on the market. Nuvigil is being heavily promoted by Cephalon Inc. as a result of Provigil s generic availability. Sales of Nuvigil and its popularity is expected to grow in coming years. Most people that are knowledgeable of Provigil (Modafinil) are not necessarily knowledgeable of Nuvigil (Armodafinil). Those that know of Nuvigil generally know that it is the successor to Provigil. Provigil is universally regarded as the more popular eugeroic drug, and Nuvigil is a newer, lesser-known spin-off of Provigil with a similar name. Side Effects The side effects resulting from Nuvigil and Provigil are thought to be similar. For some people less side effects may be experienced as a result of solely ingesting the R enantiomer (Armodafinil) whereas others may find less side effects from a racemic mix of the R and S enantiomers (Modafinil). Common side effects associated with both drugs include: dizziness, headache, insomnia, nausea, and nervousness. Perhaps the side effects from Nuvigil may be longer-lasting due to the fact that the drug itself is thought to elicit a greater duration of effect. Additionally, lower doses of Nuvigil may trigger side effects comparable to higher doses of Provigil as a result of its increased potency. In some cases, users of these drugs may experience serious skin reactions (e.g. Stevens-Johnson syndrome). Neither is thought to have a favorable side effect profile over the other. The severity and number of side effects experienced may be related to the dosage of either drug as well as individual physiology. Withdrawal Neither Nuvigil nor Provigil is thought to have any withdrawal symptoms. Many reports claim that regardless of dosing and duration of usage, these drugs can be stopped abruptly without any discontinuation symptoms. Whether there is a withdrawal period or not is largely a matter of medical debate and subjectivity. In the past, many drugs were thought to have no discontinuation effects. It wasn t until decades later that researchers discovered that there were in fact discontinuation effects and drug companies admitted these symptoms. Due to the fact that these are highly potent drugs that promote wakefulness and there s no biological free lunch , most people should expect withdrawal symptoms. Common symptoms of Nuvigil withdrawal and Provigil withdrawal include: cognitive impairment, fatigue, sleepiness, and resurgence of original condition (e.g. narcolepsy). It may take days, weeks, or even months for the brain to restore homeostatic functioning following eugeroic usage. Similarities (Recap): Nuvigil vs. Provigil Based on ingredient composition, Nuvigil and Provigil are very similar drugs. Abuse potential : Both drugs are considered to have a low potential for abuse when used as medically suggested. Abuse potential increases when individuals begin using the drugs on an off-label basis or with the intention of taking supratherapeutic doses in attempt to attain a high. Drug type : Each of these drugs is classified as a eugeroic or wakefulness-promoting agent. Efficacy : Evidence suggests that both Nuvigil and Provigil are significantly more effective than a placebo in double-blind, randomized clinical trials for the treatment of excessive daytime sleepiness. Formats : Both drugs are available in tablet format. Interactions : These drugs are thought to have similar contraindications due to similar ingredients. That said, contraindications may be subject to variation and you should always consult a medical professional to discuss interactions. Investigational uses : Each of these substances has similar investigative uses including: ADHD, chronic fatigue syndrome, and jet lag. Manufacturer : Cephalon Inc. is responsible for the creation of both Nuvigil and Provigil. Medical uses : The drugs are approved for the treatment of excessive daytime sleepiness associated with narcolepsy, obstructive sleep apnea, and shift work sleep disorder. Legal status : Each are classified as a Schedule IV controlled substance. This means there is a low potential for abuse, but they are refillable up to 5 times in 6 months. Neurotransmission : These substances are thought to have similar mechanisms of action in regards to how they affect neurotransmission. Side effects : Common side effects associated with each drug are similar and include: dizziness, headaches, insomnia, nausea, and nervousness. Withdrawal : Most medical experts suggest that there is no withdrawal associated with either drug, and that if there are withdrawal symptoms, they quickly dissipate. The most common withdrawal symptoms are increased fatigue and sleepiness. Differences (Recap): Nuvigil vs. Provigil Below are some general differences between Nuvigil and Provigil. Cost : The cost of Nuvigil for a 30 day supply ranges between $195 and $210 (for 50 mg) and between $570 and $600 (for all higher doses). The cost of generic Provigil (modafinil) is within the range of $150 and $305 for a 30 day supply. Brand name Provigil remains expensively priced between $800 and $1200 for a 30 day supply. Duration of effect : Nuvigil is thought to have a longer duration of effect than Provigil. It is believed that Nuvigil kicks-in quicker (in 2 hours) compared to Provigil (in 2 to 4 hours) and produces an effect lasting up to 2 hours longer than Provigil. Generic availability : Provigil is sold as generic modafinil, but Nuvigil is not yet available as a generic. Half-life : The elimination half-life differs between the two drugs due to the fact that S -enantiomer in Provigil is cleared quicker than the R -enantiomer. Since Nuvigil doesn t contain the S -enantiomer, its half-life is an estimated 15 hours compared to an estimated 12 hour half-life for Provigil. Ingredients : Provigil is comprised of a racemic mix of S -modafinil and R -modafinil whereas Nuvigil only contains R -modafinil. Popularity : Provigil remains the most popular drug compared to Nuvigil and other eugeroics. Which drug is better? Nuvigil vs. Provigil. Many people have attempted to determine whether Nuvigil is better than Provigil or vice-versa. From an efficacy standpoint, neither drug has been proven to be superior over the other. Some reports suggest that Nuvigil may possess less side effects than Provigil and be more potent in smaller doses. The fact that Nuvigil is considered a newer, updated formulation of Provigil has lead many people to conclude that it must be better. Nuvigil is believed to have a quicker onset of action and longer duration of effect. Nuvigil also has four dosing increments (50 mg, 150 mg, 200 mg, 250 mg) and Provigil only has two dosing options (100 mg or 200 mg). While Nuvigil is hypothesized to be a more potent successor to Provigil, there s no evidence to substantiate this hypothesis. Which drug do you prefer: Nuvigil or Provigil? If you ve had the opportunity to try both Nuvigil and Provigil, be sure to share whether you prefer one over the other in the comments section below. Did you find Nuvigil to produce a quicker onset of action, have a longer duration of effect, or have less side effects than Provigil (or vice-versa)? Were the differences between the two drugs obvious to you or did they seem relatively similar in their effect? Share 14 +1 1 Pin 2 Stumble Reddit 1 Shares 18 Related Posts: Provigil (Modafinil) vs. Adderall: Comparison Armour Thyroid vs. Synthroid (Comparison) Dexedrine vs. Adderall: Comparison Concerta vs. Vyvanse: Comparison Focalin vs. Adderall: Comparison immediately


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prescribed drugs Share 2 +1 Pin 1 Stumble Reddit Shares 3 Geodon (Ziprasidone) is an atypical antipsychotic that was approved by the FDA in 2001 for the treatment of schizophrenia. It has since been approved to manage both manic and mixed states of bipolar disorder. In some cases, the drug is used as an antidepressant augmentation strategy for the treatment of refractory depression, as well as for various types of anxiety disorders. In comparison to other antipsychotics, studies demonstrate that it is less effective than Zyprexa, but roughly the same efficacy as Seroquel. The drug functions primarily as an antagonist of the D2 dopamine receptor, but also tends to inhibit the 5-HT2A receptor. Its effects on the D2 receptors result in reduced positive symptoms of schizophrenia. It also inhibits the reuptake of the neurotransmitters norepinephrine and serotonin, which may help with negative symptoms. Geodon and Weight Changes Geodon differs from other antipsychotics in that it is very unlikely to cause weight gain. This is likely due to the fact that the drug doesn t affect the muscarinic acetylcholine receptors (mACh), resulting in no anticholinergic side effects. The most likely side effects that you ll experience while taking this medication include: sedation and orthostatic hypotension. A majority of medical professionals regard this drug as being weight neutral in that no studies link this drug to significant weight gain. Geodon is a weight neutral antipsychotic Many people that are concerned about gaining weight on an antipsychotic end up trying Geodon. Although a small percentage of individuals may still end up gaining weight, another small percentage of individuals actually end up losing weight. The majority of people do not report any significant weight change throughout treatment with the drug, therefore it should be considered weight neutral. The hormone leptin has been found to not increase after 4-week trials of Geodon. The hormone leptin is responsible for appetite stimulation and regulation. When taking other atypical antipsychotics, it tends to increase, resulting in significant appetite increase as well as weight gain. Since Geodon doesn t tend to increase leptin levels, this is likely reason (in part) as to why weight gain is uncommon. Could Geodon Cause Weight Gain? Despite the fact that research suggests Geodon is unlikely to cause weight gain, some people still end up gaining weight throughout their treatment. Even though the medication isn t likely to cause a weight increase, some people still end up gaining weight Below is a list of reasons as to why you may still gain weight. Appetite increase : If the drug increases your appetite, you may end up eating more overall food than you did before. It can be difficult to control yourself when a drug significantly increases your appetite. This tends to be more of a problem with other antipsychotics, but could still happen while on Geodon. Cravings : The drug-induced changes to neurochemical processes in the brain can lead some people to crave food. If you start craving foods while on Geodon, it s probably an individualized reaction (and may be temporary). These cravings make it difficult to resist unhealthy foods and often lead to overeating. Eating out : If the medication is working well to control your symptoms, you may end up feeling more comfortable in public and may be more likely to dine out with friends or family. Feeling more comfortable in social situations could lead to more frequent meals with friends. Eating out is typically a cause of weight gain due to the fact that portions tend to be larger and foods are usually unhealthier. Hormones : This drug may affect various levels of hormones throughout the body, which could cause weight gain. It may increase the hormone prolactin, while decreasing testosterone levels in men, leading to muscle loss and an increase in body-fat. If you start gaining weight, it could be a result of a medication-induced hormone alteration. Sedation : At some doses (generally lower ones), Geodon can be very sedating. If you feel sedated, it can be difficult to get out of bed, let alone get proper exercise. Assuming your diet has remained stable (and/or increased), you are likely to gain weight as a result of the sedation. Slowed metabolism : This medication is unlikely to slow your metabolism, but may have different effects based on the individual. If you notice that your exercise habits and portion sizes are the same during treatment as they were prior to taking the drug, and you ve gained weight it could be a result of metabolic slowing. Taste improvement : You may notice that your taste improves as a result of taking this medication. Some people respond to the neurotransmitter tweaks made by Geodon with an increased appetite and improved taste. When food tastes better, you re probably going to end up eating more. Could Geodon Cause Weight Loss? In some cases, people may end up losing weight throughout their treatment with Geodon. Weight is most commonly lost when a person switches to this medication from a different antipsychotic like Zyprexa, a drug that is known to cause weight gain. Even if you aren t switching from another medication, you may experience various side effects that lead to temporary weight loss. Appetite decrease : Some people may notice that their appetite decreases while taking this drug. If your appetite decreases, you probably aren t going to eat as much food, leading to weight loss. Although it s not that common for appetite to significantly decrease, it does happen to some people. Diarrhea : This is a side effect that some people experience while taking this drug. It s not a common side effect, but if you end up with diarrhea, you ll likely lose some weight. Once your body adapts to the drug and the diarrhea subsides, the weight loss shouldn t continue. Energy increase : At certain dosages, this drug tends to be more activating than sedating. This could lead to more physical activity and productivity. If you have increased energy, you re more likely to engage in some sort of exercise. Exercise helps keep your metabolism high and is known to burn excess calories. Nausea : If the drug makes you feel nauseous, it may be difficult to eat enough food. Nausea tends to subside after several weeks of treatment, but while occurring, may interfere with your ability to eat. If you are overly nauseous, your appetite is likely to temporarily decrease resulting in weight loss. Vomiting : A side effect associated with psychotropic drugs is that of vomiting. If you start vomiting while on this medication, you re going to lose some weight. Fortunately most weight loss as a result of vomiting is short-term. Vomiting generally subsides once your body has adapted to the effects of the drug; this can take several weeks. Factors that influence weight changes on Geodon There are several other factors that may be responsible for weight changes you experience while taking Geodon. These include things such as: genetics, your personal habits, how long you ve been taking the drug, your dosage, as well whether you take other medications. 1. Genetics Realize that each person has different reactions to medications in part due to their genetics. Although most people aren t going to experience major weight changes while taking Geodon, those that do may have certain genetics that trigger these changes. Fortunately there are now tests like GeneSight available that analyze your genetics and predict your ability to tolerate psychiatric drugs like Geodon. 2. Lifestyle Before you assume that the drug is causing your weight to fluctuate, evaluate your lifestyle and habits. Do you make an effort to eat healthy and/or get regular physical activity? Do you get enough sleep at night? Are you overstressed from work or relationships? All of these factors can influence weight changes independent of the medication. It is important to consider something as simple as lack of sufficient sleep can cause certain people to gain weight. Always take an objective look at your lifestyle and determine whether your habits are contributing to weight gain. Also keep in mind that some people change their routine after they start this medication, which may result in weight change. 3. Duration of treatment The duration over which you ve been taking Geodon may play a role in determining weight gain. Those that have been on the drug for an extended period of time are more likely to experience some degree of weight change. This is due to the fact that after a long-term of being medicated, the drug will have altered various homeostatic physiological functions within the body. Many of these physiological functions may help regulate appetite, hormones, and metabolism. If you notice that you ve lost or gained weight over the long-term, it may be due to the fact that you are further from your baseline, homeostatic functioning. Also keep in mind that some people may experience weight changes over the short-term as their body adapts to the drug. Short-term weight changes tend to subside once a person stabilizes on the medication. 4. Dosage For medications that cause weight change, there is often a relationship between degree of weight change and dosage strength. For some medications, the greater the dose, the more inclined a person will be to gain weight. On other medications, there is no apparent relationship between dosing and weight change. With Geodon, it is believed that different doses have different effects based on the individual. Low doses : Some have suggested that lower doses of Geodon tend to be more sedating than higher ones. If the sedation causes you to become lazier and you end up maintaining your current appetite, metabolism may slow, ultimately leading to weight gain. Others would argue that the lower the dose, the easier it is to prevent weight change of any type. This is because at lower doses, the drug has less influence over your physiology. Therefore, it is always recommended to take the minimal effective dose . Higher doses : At higher doses of Geodon, the drug can be activating in that it provides the user with more energy. Increased energy can give people fuel to exercise, move around, and keep their metabolism high. On the other hand, at higher doses, the chemical has more influence over physiological functions. Some would argue that higher doses are more likely to cause weight changes. 5. Other drugs Do you currently take any other medications with Geodon? If you are on a stack of several medications, it is important to consider the possibility that the other drugs may be contributing to weight change. As a rule of thumb, most stimulatory drugs tend to promote weight loss, while sedating agents and various antidepressants (e.g. SSRIs ) can cause weight gain. If you are unsure as to how other drugs you are taking could be affecting your weight, talk to your doctor. Also keep in mind that the other medications you take could interact with Geodon s mechanism of action to provoke weight change. How much weight change will you experience on Geodon? Most people will not experience any noticeable weight change from taking this medication. If you meticulously weigh yourself, you may notice very small changes as a result of treatment, but for a majority of people, they tend to be minimal. For those that do experience weight change, it may occur early in treatment when the body hasn t yet adapted to the effect of the drug. Once the body adapts to its effect, your weight should stabilize. In other cases, those taking the medication for a long-term may notice weight change stemming from physiological tolerance. If you do experience weight gain or loss, it will likely range between 5 lbs. and 15 lbs. it shouldn t be anything too extreme. Geodon s therapeutic effects vs. side effects If you are taking this medication, it is important to evaluate how well it is working, and compare the therapeutic effects with the side effects. If the side effects become unbearable, you ll probably want to consider Geodon withdrawal and/or another medication. Assuming the drug is working well to treat your psychiatric condition, you may be able to put up with some minor weight gain (or loss) throughout treatment. Did you experience weight changes on Geodon? If you took (or are currently taking) Geodon, feel free to share whether you gained (or lost) weight in the comments section below. For those that experienced any type of weight changes on this drug, feel free to mention how many pounds you gained (or lost). To help others get a better understanding of your experience, include additional details such as: your dosage, how long you were taking this drug, whether you were on other medications, and any other factors that may have elicited weight change. Share 2 +1 Pin 1 Stumble Reddit Shares 3 Related Posts: Does Viibryd Cause Weight Loss or Gain? Individual Causes & Factors. Latuda Unlikely To Cause Weight Gain; Considered Weight Neutral Zyprexa and Weight Gain: How It Causes You To Get Fat Seroquel and Weight Gain: What Are The Causes? Pristiq: Weight Gain or Weight Loss? Causes & Individual Factors. discover ways to


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