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probabilities Didanosine Oral Solution Generic Name: Didanosine Oral Solution (dye DAN oh seen) Brand Name: Videx Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings Breastfeeding Warnings User Reviews Drug Images Support Group Q & A Pricing & Coupons Warning This medicine may rarely cause swollen liver and an acid health problem in the blood. This may be deadly in some cases. The chance may be higher in women, in overweight people, and in people who have taken drugs like this one for a long time. Talk with your doctor. Deadly acid health problems have happened in pregnant women when didanosine oral solution was used along with stavudine and other drugs. Talk with the doctor. This medicine may cause very bad and sometimes deadly pancreas problems (pancreatitis). This may happen soon after use as well as many years after use. Signs of pancreatitis include belly pain, upset stomach, throwing up, or not feeling hungry. Call your doctor right away if you have any of these signs. Uses of Didanosine Oral Solution: It is used to treat HIV infection. What do I need to tell my doctor BEFORE I take Didanosine Oral Solution? If you have an allergy to didanosine or any other part of this medicine. 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 are taking any of these drugs: Allopurinol or ribavirin. If you are taking hydroxyurea. If you are breast-feeding. Do not breast-feed while you take didanosine oral solution. 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 didanosine oral solution with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor. Slideshow Save Your Blushes - The FAQ's On STDs What are some things I need to know or do while I take Didanosine Oral Solution? Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists. Have blood work checked as you have been told by the doctor. Talk with the doctor. Have an eye exam as you have been told by your doctor. This medicine does not stop the spread of diseases like HIV or hepatitis that are passed through blood or having sex. Do not have any kind of sex without using a latex or polyurethane condom. Do not share needles or other things like toothbrushes or razors. Talk with your doctor. This medicine is not a cure for HIV. Stay under the care of your doctor. Avoid drinking alcohol while taking didanosine oral solution. Liver problems have happened with this medicine. Sometimes, this has been very bad and has led to the need for a liver transplant or death. Liver problems may happen in people with or without liver disease. Talk with the doctor. This medicine may prevent other drugs taken by mouth from getting into the body. If you take other drugs by mouth, you may need to take them at some other time than didanosine oral solution. Talk with your doctor. If you are 65 or older, use this medicine with care. You could have more side effects. Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using didanosine oral solution while you are pregnant. How is this medicine (Didanosine Oral Solution) best taken? Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely. Keep taking didanosine oral solution as you have been told by your doctor or other health care provider, even if you feel well. It is important that you do not miss or skip a dose of this medicine during treatment. Take on an empty stomach. Take at least 30 minutes before or 2 hours after a meal. Shake well before use. Measure liquid doses carefully. Use the measuring device that comes with didanosine oral solution. If there is none, ask the pharmacist for a device to measure this medicine. 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. If you are not sure what to do if you miss a dose, call your doctor. 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 too much lactic acid in the blood (lactic acidosis) like fast breathing, fast heartbeat, a heartbeat that does not feel normal, very bad upset stomach or throwing up, feeling very sleepy, shortness of breath, feeling very tired or weak, very bad dizziness, feeling cold, or muscle pain or cramps. Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes. Swelling of belly. Very bad dizziness or passing out. A burning, numbness, or tingling feeling that is not normal. Any unexplained bruising or bleeding. Change in eyesight. Change in body fat. This medicine may help the immune system work. If you have an infection that you did not know you had, it may show up when you take didanosine oral solution. Tell your doctor right away if you notice any signs of infection like fever, sore throat, weakness, cough, or shortness of breath after you start this medicine. What are some other side effects of Didanosine Oral Solution? 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: Headache. Belly pain. Upset stomach or throwing up. Loose stools (diarrhea). 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 Didanosine Oral Solution? Store in a refrigerator. Do not freeze. Throw away any unused portion after 30 days. Keep lid tightly closed. 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. This medicine comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time didanosine oral solution is refilled. If you have any questions about this medicine, please talk with the doctor, 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 didanosine oral solution 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 didanosine oral solution. 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: November 1, 2017 Next Side Effects Print this page Add to My Med List More about didanosine Side Effects During Pregnancy or Breastfeeding Dosage Information Drug Images Drug Interactions Support Group Pricing & Coupons En Español 0 Reviews Add your own review/rating Drug class: nucleoside reverse transcriptase inhibitors (NRTIs) Consumer resources Didanosine Didanosine Delayed-Release Enteric-Coated Capsules Didanosine (Advanced Reading) Other brands: Videx , Videx EC Professional resources Didanosine (AHFS Monograph) ... +4 more Related treatment guides HIV Infection Nonoccupational Exposure} Drug Status Rx Availability Prescription only B Pregnancy Category No proven risk in humans N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Didanosine Rating No Reviews - Be the first! 9.0 /10 No Reviews - Be the first! 9.0 Rate it! Manufacturers Mylan Pharmaceuticals Inc. Teva Pharmaceuticals USA, Inc. Aurobindo Pharma Limited Drug Class Nucleoside reverse transcriptase inhibitors (NRTIs) Related Drugs HIV Infection Truvada , Atripla , Norvir , Viread , Isentress , Prezista , Stribild , lamivudine , abacavir , tenofovir , Reyataz , Epzicom , More... Nonoccupational Exposure Truvada , Atripla , Viread , lamivudine , abacavir , tenofovir , Reyataz , Epzicom , zidovudine , emtricitabine , Kaletra , Sustiva , More... Didanosine Images Didanosine systemic 200 mg (barr 200mg 588) View all images Related: HIV/AIDS} } many differing types


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save money it may P-Care M Generic Name: bupivacaine hydrochloride, sodium chloride, povidone-iodine, isopropyl alcohol Dosage Form: kit Marcaine Marcaine Bupivacaine Hydrochloride Injection, USP Marcaine With Epinephrine 1:200,000 (as bitartrate) Bupivacaine Hydrochloride and Epinephrine Injection, USP Rx only P-Care M Description Bupivacaine hydrochloride is 2-Piperidinecarboxamide, 1-butyl- N -(2,6-dimethylphenyl)-, monohydrochloride, monohydrate, a white crystalline powder that is freely soluble in 95 percent ethanol, soluble in water, and slightly soluble in chloroform or acetone. It has the following structural formula: Marcaine Structure Epinephrine is (-)-3,4-Dihydroxy-α-[(methylamino)methyl] benzyl alcohol. It has the following structural formula: Epinephrine Structure MARCAINE is available in sterile isotonic solutions with and without epinephrine (as bitartrate) 1:200,000 for injection via local infiltration, peripheral nerve block, and caudal and lumbar epidural blocks. Solutions of MARCAINE may be autoclaved if they do not contain epinephrine. Solutions are clear and colorless. Bupivacaine is related chemically and pharmacologically to the aminoacyl local anesthetics. It is a homologue of mepivacaine and is chemically related to lidocaine. All three of these anesthetics contain an amide linkage between the aromatic nucleus and the amino, or piperidine group. They differ in this respect from the procaine-type local anesthetics, which have an ester linkage. MARCAINE Sterile isotonic solutions containing sodium chloride. In multiple-dose vials, each mL also contains 1 mg methylparaben as antiseptic preservative. The pH of these solutions is adjusted to between 4 and 6.5 with sodium hydroxide or hydrochloric acid. MARCAINE with epinephrine 1:200,000 (as bitartrate) Sterile isotonic solutions containing sodium chloride. Each mL contains bupivacaine hydrochloride and 0.0091 mg epinephrine bitartrate, with 0.5 mg sodium metabisulfite, 0.001 mL monothioglycerol, and 2 mg ascorbic acid as antioxidants, 0.0017 mL 60% sodium lactate buffer, and 0.1 mg edetate calcium disodium as stabilizer. In multiple-dose vials, each mL also contains 1 mg methylparaben as antiseptic preservative. The pH of these solutions is adjusted to between 3.4 and 4.5 with sodium hydroxide or hydrochloric acid. The specific gravity of MARCAINE 0.5% with epinephrine 1:200,000 (as bitartrate) at 25 C is 1.008 and at 37 C is 1.008. P-Care M - Clinical Pharmacology Local anesthetics block the generation and the conduction of nerve impulses, presumably by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse, and by reducing the rate of rise of the action potential. In general, the progression of anesthesia is related to the diameter, myelination, and conduction velocity of affected nerve fibers. Clinically, the order of loss of nerve function is as follows: (1) pain, (2) temperature, (3) touch, (4) proprioception, and (5) skeletal muscle tone. Systemic absorption of local anesthetics produces effects on the cardiovascular and central nervous systems (CNS). At blood concentrations achieved with normal therapeutic doses, changes in cardiac conduction, excitability, refractoriness, contractility, and peripheral vascular resistance are minimal. However, toxic blood concentrations depress cardiac conduction and excitability, which may lead to atrioventricular block, ventricular arrhythmias, and cardiac arrest, sometimes resulting in fatalities. In addition, myocardial contractility is depressed and peripheral vasodilation occurs, leading to decreased cardiac output and arterial blood pressure. Recent clinical reports and animal research suggest that these cardiovascular changes are more likely to occur after unintended intravascular injection of bupivacaine. Therefore, incremental dosing is necessary. Following systemic absorption, local anesthetics can produce central nervous system stimulation, depression, or both. Apparent central stimulation is manifested as restlessness, tremors and shivering progressing to convulsions, followed by depression and coma progressing ultimately to respiratory arrest. However, the local anesthetics have a primary depressant effect on the medulla and on higher centers. The depressed stage may occur without a prior excited state. Pharmacokinetics: The rate of systemic absorption of local anesthetics is dependent upon the total dose and concentration of drug administered, the route of administration, the vascularity of the administration site, and the presence or absence of epinephrine in the anesthetic solution. A dilute concentration of epinephrine (1:200,000 or 5 mcg/mL) usually reduces the rate of absorption and peak plasma concentration of MARCAINE, permitting the use of moderately larger total doses and sometimes prolonging the duration of action. The onset of action with MARCAINE is rapid and anesthesia is long lasting. The duration of anesthesia is significantly longer with MARCAINE than with any other commonly used local anesthetic. It has also been noted that there is a period of analgesia that persists after the return of sensation, during which time the need for strong analgesics is reduced. The onset of action following dental injections is usually 2 to 10 minutes and anesthesia may last two or three times longer than lidocaine and mepivacaine for dental use, in many patients up to 7 hours. The duration of anesthetic effect is prolonged by the addition of epinephrine 1:200,000. Local anesthetics are bound to plasma proteins in varying degrees. Generally, the lower the plasma concentration of drug the higher the percentage of drug bound to plasma proteins. Local anesthetics appear to cross the placenta by passive diffusion. The rate and degree of diffusion is governed by (1) the degree of plasma protein binding, (2) the degree of ionization, and (3) the degree of lipid solubility. Fetal/maternal ratios of local anesthetics appear to be inversely related to the degree of plasma protein binding, because only the free, unbound drug is available for placental transfer. MARCAINE with a high protein binding capacity (95%) has a low fetal/maternal ratio (0.2 to 0.4). The extent of placental transfer is also determined by the degree of ionization and lipid solubility of the drug. Lipid soluble, nonionized drugs readily enter the fetal blood from the maternal circulation. Depending upon the route of administration, local anesthetics are distributed to some extent to all body tissues, with high concentrations found in highly perfused organs such as the liver, lungs, heart, and brain. Pharmacokinetic studies on the plasma profile of MARCAINE after direct intravenous injection suggest a three-compartment open model. The first compartment is represented by the rapid intravascular distribution of the drug. The second compartment represents the equilibration of the drug throughout the highly perfused organs such as the brain, myocardium, lungs, kidneys, and liver. The third compartment represents an equilibration of the drug with poorly perfused tissues, such as muscle and fat. The elimination of drug from tissue distribution depends largely upon the ability of binding sites in the circulation to carry it to the liver where it is metabolized. After injection of MARCAINE for caudal, epidural, or peripheral nerve block in man, peak levels of bupivacaine in the blood are reached in 30 to 45 minutes, followed by a decline to insignificant levels during the next three to six hours. Various pharmacokinetic parameters of the local anesthetics can be significantly altered by the presence of hepatic or renal disease, addition of epinephrine, factors affecting urinary pH, renal blood flow, the route of drug administration, and the age of the patient. The half-life of MARCAINE in adults is 2.7 hours and in neonates 8.1 hours. In clinical studies, elderly patients reached the maximal spread of analgesia and maximal motor blockade more rapidly than younger patients. Elderly patients also exhibited higher peak plasma concentrations following administration of this product. The total plasma clearance was decreased in these patients. Amide-type local anesthetics such as MARCAINE are metabolized primarily in the liver via conjugation with glucuronic acid. Patients with hepatic disease, especially those with severe hepatic disease, may be more susceptible to the potential toxicities of the amide-type local anesthetics. Pipecoloxylidine is the major metabolite of MARCAINE. The kidney is the main excretory organ for most local anesthetics and their metabolites. Urinary excretion is affected by urinary perfusion and factors affecting urinary pH. Only 6% of bupivacaine is excreted unchanged in the urine. When administered in recommended doses and concentrations, MARCAINE does not ordinarily produce irritation or tissue damage and does not cause methemoglobinemia. Indications and Usage for P-Care M MARCAINE is indicated for the production of local or regional anesthesia or analgesia for surgery, dental and oral surgery procedures, diagnostic and therapeutic procedures, and for obstetrical procedures. Only the 0.25% and 0.5% concentrations are indicated for obstetrical anesthesia. (See WARNINGS .) Experience with nonobstetrical surgical procedures in pregnant patients is not sufficient to recommend use of 0.75% concentration of MARCAINE in these patients. MARCAINE is not recommended for intravenous regional anesthesia (Bier Block). See WARNINGS . The routes of administration and indicated MARCAINE concentrations are: local infiltration 0.25% peripheral nerve block 0.25% and 0.5% retrobulbar block 0.75% sympathetic block 0.25% lumbar epidural 0.25%, 0.5%, and 0.75% (0.75% not for obstetrical anesthesia) caudal 0.25% and 0.5% epidural test dose 0.5% with epinephrine 1:200,000 dental blocks 0.5% with epinephrine 1:200,000 (See DOSAGE AND ADMINISTRATION for additional information.) Standard textbooks should be consulted to determine the accepted procedures and techniques for the administration of MARCAINE. Contraindications MARCAINE is contraindicated in obstetrical paracervical block anesthesia. Its use in this technique has resulted in fetal bradycardia and death. MARCAINE is contraindicated in patients with a known hypersensitivity to it or to any local anesthetic agent of the amide-type or to other components of MARCAINE solutions. Warnings THE 0.75% CONCENTRATION OF MARCAINE IS NOT RECOMMENDED FOR OBSTETRICAL ANESTHESIA. THERE HAVE BEEN REPORTS OF CARDIAC ARREST WITH DIFFICULT RESUSCITATION OR DEATH DURING USE OF MARCAINE FOR EPIDURAL ANESTHESIA IN OBSTETRICAL PATIENTS. IN MOST CASES, THIS HAS FOLLOWED USE OF THE 0.75% CONCENTRATION. RESUSCITATION HAS BEEN DIFFICULT OR IMPOSSIBLE DESPITE APPARENTLY ADEQUATE PREPARATION AND APPROPRIATE MANAGEMENT. CARDIAC ARREST HAS OCCURRED AFTER CONVULSIONS RESULTING FROM SYSTEMIC TOXICITY, PRESUMABLY FOLLOWING UNINTENTIONAL INTRAVASCULAR INJECTION. THE 0.75% CONCENTRATION SHOULD BE RESERVED FOR SURGICAL PROCEDURES WHERE A HIGH DEGREE OF MUSCLE RELAXATION AND PROLONGED EFFECT ARE NECESSARY. LOCAL ANESTHETICS SHOULD ONLY BE EMPLOYED BY CLINICIANS WHO ARE WELL VERSED IN DIAGNOSIS AND MANAGEMENT OF DOSE-RELATED TOXICITY AND OTHER ACUTE EMERGENCIES WHICH MIGHT ARISE FROM THE BLOCK TO BE EMPLOYED, AND THEN ONLY AFTER INSURING THE IMMEDIATE AVAILABILITY OF OXYGEN, OTHER RESUSCITATIVE DRUGS, CARDIOPULMONARY RESUSCITATIVE EQUIPMENT, AND THE PERSONNEL RESOURCES NEEDED FOR PROPER MANAGEMENT OF TOXIC REACTIONS AND RELATED EMERGENCIES. (See also ADVERSE REACTIONS, PRECAUTIONS , and OVERDOSAGE .) DELAY IN PROPER MANAGEMENT OF DOSE-RELATED TOXICITY, UNDERVENTILATION FROM ANY CAUSE, AND/OR ALTERED SENSITIVITY MAY LEAD TO THE DEVELOPMENT OF ACIDOSIS, CARDIAC ARREST AND, POSSIBLY, DEATH. Local anesthetic solutions containing antimicrobial preservatives, i.e., those supplied in multiple-dose vials, should not be used for epidural or caudal anesthesia because safety has not been established with regard to intrathecal injection, either intentionally or unintentionally, of such preservatives. Intra-articular infusions of local anesthetics following arthroscopic and other surgical procedures is an unapproved use, and there have been post-marketing reports of chondrolysis in patients receiving such infusions. The majority of reported cases of chondrolysis have involved the shoulder joint; cases of glenohumeral chondrolysis have been described in pediatric and adult patients following intra-articular infusions of local anesthetics with and without epinephrine for periods of 48 to 72 hours. There is insufficient information to determine whether shorter infusion periods are not associated with these findings. The time of onset of symptoms, such as joint pain, stiffness and loss of motion can be variable, but may begin as early as the 2nd month after surgery. Currently, there is no effective treatment for chondrolysis; patients who experienced chondrolysis have required additional diagnostic and therapeutic procedures and some required arthroplasty or shoulder replacement. It is essential that aspiration for blood or cerebrospinal fluid (where applicable) be done prior to injecting any local anesthetic, both the original dose and all subsequent doses, to avoid intravascular or subarachnoid injection. However, a negative aspiration does not ensure against an intravascular or subarachnoid injection. MARCAINE with epinephrine 1:200,000 or other vasopressors should not be used concomitantly with ergot-type oxytocic drugs, because a severe persistent hypertension may occur. Likewise, solutions of MARCAINE containing a vasoconstrictor, such as epinephrine, should be used with extreme caution in patients receiving monoamineoxidase inhibitors (MAOI) or antidepressants of the triptyline or imipramine types, because severe prolonged hypertension may result. Until further experience is gained in pediatric patients younger than 12 years, administration of MARCAINE in this age group is not recommended. Mixing or the prior or intercurrent use of any other local anesthetic with MARCAINE cannot be recommended because of insufficient data on the clinical use of such mixtures. There have been reports of cardiac arrest and death during the use of MARCAINE for intravenous regional anesthesia (Bier Block). Information on safe dosages and techniques of administration of MARCAINE in this procedure is lacking. Therefore, MARCAINE is not recommended for use in this technique. MARCAINE with epinephrine 1:200,000 contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people. Single-dose ampuls and single-dose vials of MARCAINE without epinephrine do not contain sodium metabisulfite. Precautions General: The safety and effectiveness of local anesthetics depend on proper dosage, correct technique, adequate precautions, and readiness for emergencies. Resuscitative equipment, oxygen, and other resuscitative drugs should be available for immediate use. (See WARNINGS, ADVERSE REACTIONS, and OVERDOSAGE. ) During major regional nerve blocks, the patient should have IV fluids running via an indwelling catheter to assure a functioning intravenous pathway. The lowest dosage of local anesthetic that results in effective anesthesia should be used to avoid high plasma levels and serious adverse effects. The rapid injection of a large volume of local anesthetic solution should be avoided and fractional (incremental) doses should be used when feasible. Epidural Anesthesia: During epidural administration of MARCAINE, 0.5% and 0.75% solutions should be administered in incremental doses of 3 mL to 5 mL with sufficient time between doses to detect toxic manifestations of unintentional intravascular or intrathecal injection. Injections should be made slowly, with frequent aspirations before and during the injection to avoid intravascular injection. Syringe aspirations should also be performed before and during each supplemental injection in continuous (intermittent) catheter techniques. An intravascular injection is still possible even if aspirations for blood are negative. During the administration of epidural anesthesia, it is recommended that a test dose be administered initially and the effects monitored before the full dose is given. When using a continuous catheter technique, test doses should be given prior to both the original and all reinforcing doses, because plastic tubing in the epidural space can migrate into a blood vessel or through the dura. When clinical conditions permit, the test dose should contain epinephrine (10 mcg to 15 mcg has been suggested) to serve as a warning of unintended intravascular injection. If injected into a blood vessel, this amount of epinephrine is likely to produce a transient epinephrine response within 45 seconds, consisting of an increase in heart rate and/or systolic blood pressure, circumoral pallor, palpitations, and nervousness in the unsedated patient. The sedated patient may exhibit only a pulse rate increase of 20 or more beats per minute for 15 or more seconds. Therefore, following the test dose, the heart rate should be monitored for a heart rate increase. Patients on beta-blockers may not manifest changes in heart rate, but blood pressure monitoring can detect a transient rise in systolic blood pressure. The test dose should also contain 10 mg to 15 mg of MARCAINE or an equivalent amount of another local anesthetic to detect an unintended intrathecal administration. This will be evidenced within a few minutes by signs of spinal block (e.g., decreased sensation of the buttocks, paresis of the legs, or, in the sedated patient, absent knee jerk). The Test Dose formulation of MARCAINE contains 15 mg of bupivacaine and 15 mcg of epinephrine in a volume of 3 mL. An intravascular or subarachnoid injection is still possible even if results of the test dose are negative. The test dose itself may produce a systemic toxic reaction, high spinal or epinephrine-induced cardiovascular effects. Injection of repeated doses of local anesthetics may cause significant increases in plasma levels with each repeated dose due to slow accumulation of the drug or its metabolites, or to slow metabolic degradation. Tolerance to elevated blood levels varies with the status of the patient. Debilitated, elderly patients and acutely ill patients should be given reduced doses commensurate with their age and physical status. Local anesthetics should also be used with caution in patients with hypotension or heartblock. Careful and constant monitoring of cardiovascular and respiratory (adequacy of ventilation) vital signs and the patient s state of consciousness should be performed after each local anesthetic injection. It should be kept in mind at such times that restlessness, anxiety, incoherent speech, lightheadedness, numbness and tingling of the mouth and lips, metallic taste, tinnitus, dizziness, blurred vision, tremors, twitching, depression, or drowsiness may be early warning signs of central nervous system toxicity. Local anesthetic solutions containing a vasoconstrictor should be used cautiously and in carefully restricted quantities in areas of the body supplied by end arteries or having otherwise compromised blood supply such as digits, nose, external ear, or penis. Patients with hypertensive vascular disease may exhibit exaggerated vasoconstrictor response. Ischemic injury or necrosis may result. Because amide-local anesthetics such as MARCAINE are metabolized by the liver, these drugs, especially repeat doses, should be used cautiously in patients with hepatic disease. Patients with severe hepatic disease, because of their inability to metabolize local anesthetics normally, are at a greater risk of developing toxic plasma concentrations. Local anesthetics should also be used with caution in patients with impaired cardiovascular function because they may be less able to compensate for functional changes associated with the prolongation of AV conduction produced by these drugs. Serious dose-related cardiac arrhythmias may occur if preparations containing a vasoconstrictor such as epinephrine are employed in patients during or following the administration of potent inhalation anesthetics. In deciding whether to use these products concurrently in the same patient, the combined action of both agents upon the myocardium, the concentration and volume of vasoconstrictor used, and the time since injection, when applicable, should be taken into account. Many drugs used during the conduct of anesthesia are considered potential triggering agents for familial malignant hyperthermia. Because it is not known whether amide-type local anesthetics may trigger this reaction and because the need for supplemental general anesthesia cannot be predicted in advance, it is suggested that a standard protocol for management should be available. Early unexplained signs of tachycardia, tachypnea, labile blood pressure, and metabolic acidosis may precede temperature elevation. Successful outcome is dependent on early diagnosis, prompt discontinuance of the suspect triggering agent(s) and prompt institution of treatment, including oxygen therapy, indicated supportive measures and dantrolene. (Consult dantrolene sodium intravenous package insert before using.) Use in Head and Neck Area: Small doses of local anesthetics injected into the head and neck area, including retrobulbar, dental, and stellate ganglion blocks, may produce adverse reactions similar to systemic toxicity seen with unintentional intravascular injections of larger doses. The injection procedures require the utmost care. Confusion, convulsions, respiratory depression, and/or respiratory arrest, and cardiovascular stimulation or depression have been reported. These reactions may be due to intra-arterial injection of the local anesthetic with retrograde flow to the cerebral circulation. They may also be due to puncture of the dural sheath of the optic nerve during retrobulbar block with diffusion of any local anesthetic along the subdural space to the midbrain. Patients receiving these blocks should have their circulation and respiration monitored and be constantly observed. Resuscitative equipment and personnel for treating adverse reactions should be immediately available. Dosage recommendations should not be exceeded. (See DOSAGE AND ADMINISTRATION .) Use in Ophthalmic Surgery: Clinicians who perform retrobulbar blocks should be aware that there have been reports of respiratory arrest following local anesthetic injection. Prior to retrobulbar block, as with all other regional procedures, the immediate availability of equipment, drugs, and personnel to manage respiratory arrest or depression, convulsions, and cardiac stimulation or depression should be assured (see also WARNINGS and Use In Head and Neck Area , above). As with other anesthetic procedures, patients should be constantly monitored following ophthalmic blocks for signs of these adverse reactions, which may occur following relatively low total doses. A concentration of 0.75% bupivacaine is indicated for retrobulbar block; however, this concentration is not indicated for any other peripheral nerve block, including the facial nerve, and not indicated for local infiltration, including the conjunctiva (see INDICATIONS AND USAGE and PRECAUTIONS , General ). Mixing MARCAINE with other local anesthetics is not recommended because of insufficient data on the clinical use of such mixtures. When MARCAINE 0.75% is used for retrobulbar block, complete corneal anesthesia usually precedes onset of clinically acceptable external ocular muscle akinesia. Therefore, presence of akinesia rather than anesthesia alone should determine readiness of the patient for surgery. Use in Dentistry: Because of the long duration of anesthesia, when MARCAINE 0.5% with epinephrine is used for dental injections, patients should be cautioned about the possibility of inadvertent trauma to tongue, lips, and buccal mucosa and advised not to chew solid foods or test the anesthetized area by biting or probing. Information for Patients: When appropriate, patients should be informed in advance that they may experience temporary loss of sensation and motor activity, usually in the lower half of the body, following proper administration of caudal or epidural anesthesia. Also, when appropriate, the physician should discuss other information including adverse reactions in the package insert of MARCAINE. Patients receiving dental injections of MARCAINE should be cautioned not to chew solid foods or test the anesthetized area by biting or probing until anesthesia has worn off (up to 7 hours). Clinically Significant Drug Interactions: The administration of local anesthetic solutions containing epinephrine or norepinephrine to patients receiving monoamine oxidase inhibitors or tricyclic antidepressants may produce severe, prolonged hypertension. Concurrent use of these agents should generally be avoided. In situations when concurrent therapy is necessary, careful patient monitoring is essential. Concurrent administration of vasopressor drugs and of ergot-type oxytocic drugs may cause severe, persistent hypertension or cerebrovascular accidents. Phenothiazines and butyrophenones may reduce or reverse the pressor effect of epinephrine. Carcinogenesis, Mutagenesis, Impairment of Fertility: Long-term studies in animals to evaluate the carcinogenic potential of bupivacaine hydrochloride have not been conducted. The mutagenic potential and the effect on fertility of bupivacaine hydrochloride have not been determined. Pregnancy Category C: There are no adequate and well-controlled studies in pregnant women. MARCAINE should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Bupivacaine hydrochloride produced developmental toxicity when administered subcutaneously to pregnant rats and rabbits at clinically relevant doses. This does not exclude the use of MARCAINE at term for obstetrical anesthesia or analgesia. (See Labor and Delivery ) Bupivacaine hydrochloride was administered subcutaneously to rats at doses of 4.4, 13.3, & 40 mg/kg and to rabbits at doses of 1.3, 5.8, & 22.2 mg/kg during the period of organogenesis (implantation to closure of the hard palate). The high doses are comparable to the daily maximum recommended human dose (MRHD) of 400 mg/day on a mg/m2 body surface area (BSA) basis. No embryo-fetal effects were observed in rats at the high dose which caused increased maternal lethality. An increase in embryo-fetal deaths was observed in rabbits at the high dose in the absence of maternal toxicity with the fetal No Observed Adverse Effect Level representing approximately 1/5th the MRHD on a BSA basis. In a rat pre- and post-natal development study (dosing from implantation through weaning) conducted at subcutaneous doses of 4.4, 13.3, & 40 mg/kg, decreased pup survival was observed at the high dose.The high dose is comparable to the daily MRHD of 400 mg/day on a BSA basis. Labor and Delivery: SEE BOXED WARNING REGARDING OBSTETRICAL USE OF 0.75% MARCAINE. MARCAINE is contraindicated for obstetrical paracervical block anesthesia. Local anesthetics rapidly cross the placenta, and when used for epidural, caudal, or pudendal block anesthesia, can cause varying degrees of maternal, fetal, and neonatal toxicity. (See CLINICAL PHARMACOLOGY , Pharmacokinetics .) The incidence and degree of toxicity depend upon the procedure performed, the type, and amount of drug used, and the technique of drug administration. Adverse reactions in the parturient, fetus, and neonate involve alterations of the central nervous system, peripheral vascular tone, and cardiac function. Maternal hypotension has resulted from regional anesthesia. Local anesthetics produce vasodilation by blocking sympathetic nerves. Elevating the patient s legs and positioning her on her left side will help prevent decreases in blood pressure. The fetal heart rate also should be monitored continuously and electronic fetal monitoring is highly advisable. Epidural, caudal, or pudendal anesthesia may alter the forces of parturition through changes in uterine contractility or maternal expulsive efforts. Epidural anesthesia has been reported to prolong the second stage of labor by removing the parturient s reflex urge to bear down or by interfering with motor function. The use of obstetrical anesthesia may increase the need for forceps assistance. The use of some local anesthetic drug products during labor and delivery may be followed by diminished muscle strength and tone for the first day or two of life. This has not been reported with bupivacaine. It is extremely important to avoid aortocaval compression by the gravid uterus during administration of regional block to parturients. To do this, the patient must be maintained in the left lateral decubitus position or a blanket roll or sandbag may be placed beneath the right hip and gravid uterus displaced to the left. Nursing Mothers: Bupivacaine has been reported to be excreted in human milk suggesting that the nursing infant could be theoretically exposed to a dose of the drug. Because of the potential for serious adverse reactions in nursing infants from bupivacaine, a decision should be made whether to discontinue nursing or not administer bupivacaine, taking into account the importance of the drug to the mother. Pediatric Use: Until further experience is gained in pediatric patients younger than 12 years, administration of MARCAINE in this age group is not recommended. Continuous infusions of bupivacaine in children have been reported to result in high systemic levels of bupivacaine and seizures; high plasma levels may also be associated with cardiovascular abnormalities. (See WARNINGS, PRECAUTIONS, and OVERDOSAGE .) Geriatric Use: Patients over 65 years, particularly those with hypertension, may be at increased risk for developing hypotension while undergoing anesthesia with MARCAINE. (See ADVERSE REACTIONS .) Elderly patients may require lower doses of MARCAINE. (See PRECAUTIONS , Epidural Anesthesia and DOSAGE AND ADMINISTRATION .) In clinical studies, differences in various pharmacokinetic parameters have been observed between elderly and younger patients. (See CLINICAL PHARMACOLOGY .) This product is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug 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 CLINICAL PHARMACOLOGY .) Adverse Reactions Reactions to MARCAINE are characteristic of those associated with other amide-type local anesthetics. A major cause of adverse reactions to this group of drugs is excessive plasma levels, which may be due to overdosage, unintentional intravascular injection, or slow metabolic degradation. The most commonly encountered acute adverse experiences which demand immediate counter-measures are related to the central nervous system and the cardiovascular system. These adverse experiences are generally dose related and due to high plasma levels which may result from overdosage, rapid absorption from the injection site, diminished tolerance, or from unintentional intravascular injection of the local anesthetic solution. In addition to systemic dose-related toxicity, unintentional subarachnoid injection of drug during the intended performance of caudal or lumbar epidural block or nerve blocks near the vertebral column (especially in the head and neck region) may result in underventilation or apnea ( Total or High Spinal ). Also, hypotension due to loss of sympathetic tone and respiratory paralysis or underventilation due to cephalad extension of the motor level of anesthesia may occur. This may lead to secondary cardiac arrest if untreated. Patients over 65 years, particularly those with hypertension, may be at increased risk for experiencing the hypotensive effects of MARCAINE. Factors influencing plasma protein binding, such as acidosis, systemic diseases which alter protein production, or competition of other drugs for protein binding sites, may diminish individual tolerance. Central Nervous System Reactions: Th pattern


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perhaps Share +1 Pin Stumble Reddit Shares 0 DayQuil is an over-the-counter (OTC) medication sold by Procter & Gamble under the brand Vicks. It is manufactured in approximately 5 formulations, each of which contain a unique set of ingredients aimed to target a specific symptom (e.g. coughing) or multiple symptoms as one would experience with the common cold and/or influenza. DayQuil is considered similar to its sister compound NyQuil, but unlike NyQuil which is intended for nighttime usage, DayQuil is meant to be taken during waking hours. Common ingredients within DayQuil formulations include: dextromethorphan (DXM), acetaminophen, phenylephrine, guaifenesin, and oxymetazoline. Some formulations solely contain dextromethorphan, while others contain a specific mixture of two, three, or four of the aforementioned chemicals. Dextromethorphan is effective as an antitussive (cough suppressant), acetaminophen acts as an analgesic and reduces fevers, guaifenesin increases mucus expulsion, while both phenylephrine and oxymetazoline act as decongestants. The popularity of DayQuil has continued to increase due to the fact that it alleviates unwanted symptoms [associated with a variety of sicknesses] without significantly compromising alertness, cognitive function, and vigilance. However, many users may still experience some slight brain fog or report side effects even after they ve stopped DayQuil for a few days. This has lead some individuals to question how long DayQuil stays in their system upon cessation. How long does DayQuil stay in your system? If you recently stopped taking DayQuil and are over your sickness, you may notice that some side effects you experienced while taking DayQuil continue to linger. As a result of these lingering effects, you may suspect that DayQuil is still in your system. To determine whether DayQuil is likely in your system, you ll first need to determine the specific DayQuil formulation that you had utilized. Below is a list of various DayQuil formulations. DayQuil Cough (Dextromethorphan) DayQuil Cold & Flu (Acetaminophen, Dextromethorphan, Phenylephrine) DayQuil Severe Cold & Flu (Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine) DayQuil Mucus Control DM (Dextromethorphan, Guaifenesin) Dayquil Sinex (Acetaminophen, Phenylephrine, or Oxymetazoline) As you can see, some formulations such as DayQuil Cough only contain the ingredient dextromethorphan, whereas others such as DayQuil Severe Cold & Flu contain several ingredients including acetaminophen, dextromethorphan, guaifenesin, and phenylephrine. To accurately determine how long each DayQuil formulation stays in your system, it is necessary to examine the elimination half-lives of the full set of ingredients. Below is a list of each ingredient with its respective elimination half-life. Acetaminophen: 1 to 4 hours Dextromethorphan: 3 to 6 hours Guaifenesin: ~1 hour Oxymetazoline: 1.72 to 2.32 hours Phenylephrine: 2 to 3 hours Knowing the elimination half-lives of DayQuil ingredients, we can estimate that formulations containing dextromethorphan may take the longest to eliminate. This is because dextromethorphan may exhibit an elimination half-life of 3 to 6 hours, indicating that it may take up to 33 hours to completely clear it from the plasma. Another popular ingredient within certain DayQuil formulations is that of acetaminophen which has a half-life from 1 to 4 hours. This suggests that systemic elimination of acetaminophen could take up to 22 hours. Of all potential DayQuil ingredients, Guaifenesin has the shortest elimination half-life of ~1 hour, meaning it will be out of your system in less than 6 hours post-ingestion. Oxymetazoline is also eliminated quickly in under 13 hours (on average) and Phenylephrine should be out of a DayQuil user s system within 16.5 hours. Knowing the approximate elimination times of DayQuil ingredients, we can conclude that most users should have cleared DayQuil from their systems within 24 to 48 hours of their final dose. Much of the elimination speed among formulations containing dextromethorphan will be contingent upon CYP2D6 isoenzyme function. Individuals who are CYP2D6 poor metabolizers may take considerably longer than usual to eliminate this ingredient within DayQuil. That said, only a small percentage of the population are classified as CYP2D6 poor metabolizers. Therefore we can expect a majority of DayQuil users (assuming no other health problems) to eliminate the ingredients from their systems within 1 to 2 days of their final dose. Source: https://pubchem.ncbi.nlm.nih.gov/compound/dextromethorphan Source: https://pubchem.ncbi.nlm.nih.gov/compound/acetaminophen Source: https://pubchem.ncbi.nlm.nih.gov/compound/phenylephrine Source: https://pubchem.ncbi.nlm.nih.gov/compound/guaifenesin Source: http://www.ncbi.nlm.nih.gov/pubmed/22855901 Variables that influence how long DayQuil stays in your system Most DayQuil users should expect to have eliminated the pharmacologically active ingredients from their systems within 24 to 48 hours of taking their final dose. Though 24 to 48 hours is considered an average elimination timeframe, some users may eliminate DayQuil at a faster or slower pace than this average. Variables that often influence how long DayQuil stays in a person s system include: individual factors, dosage, frequency of administration, and simultaneously administered drugs. Individual factors Two individuals could simultaneously administer the same single dose of DayQuil Cold & Flu, yet one user may metabolize and eliminate the ingredients from his/her system faster than the other. Though most users will likely eliminate the ingredients from their respective systems in a similar amount of time, individual factors may alter elimination times. These factors include things like: a person s age, body mass, food intake, genetics, glutathione levels, hepatic function, and renal function. Age : The age of a DayQuil user may affect how long it ll take to metabolize and eliminate pharmacological ingredients from systemic circulation. Elderly individuals (over the age of 65) tend to have poorer overall physiologic function and exhibit altered distribution of DayQuil ingredients upon ingestion (compared to younger adults). This altered disposition leads to an increase in plasma concentrations of ingredients like acetaminophen and impairs clearance. Elderly individuals also are likely to exhibit declining hepatic and renal function, both of which may extend the elimination half-life of DayQuil compared to other users. An array of other potential health conditions, concomitant medications, and decreased glutathione levels can also prolong systemic elimination of DayQuil. For these reasons, it should be expected that younger adults will likely clear DayQuil from systemic circulation faster than elderly. Source: http://www.ncbi.nlm.nih.gov/pubmed/7056022 Body mass + Fat (%) : A user s body mass and fat percentage may impact how long DayQuil is likely to remain in systemic circulation. Individuals with a high BMI (especially relative to the dosage ingested) are likely to eliminate DayQuil quicker from their systems than those with a low BMI. This is due to the fact that larger individuals can handle and metabolize larger doses with greater efficiency than smaller individuals. Since most of the ingredients within DayQuil are hydrophilic, body fat percentage could also influence elimination speed. Individuals with a high percentage of body fat are less likely to accumulate or retain hydrophilic ingredients of DayQuil because they likely have less muscle and ultimately fewer water stores; this may force lipophobic ingredients to leave the body at a quicker rate. Users with low body fat and more muscle may retain certain ingredients for a longer duration within tissue because they re holding more water. Genetics : A person s genes can influence the hepatic function of CYP450 (cytochrome P450) isoenzymes that are responsible for metabolizing various components of DayQuil. Although most ingredients are unlikely to be affected by genetic polymorphisms, dextromethorphan metabolism may be altered among those with CYP2D6 polymorphisms. Specifically, individuals with alleles that decrease CYP2D6 isoenzyme function may retain dextromethorphan for a substantially longer term than those with normative CYP2D6 function. Research suggests that elimination half-life of dextromethorphan among those considered CYP2D6 poor metabolizers may be around 19 hours. If you are a CYP2D6 poor metabolizer (3% to 10% of the population), you may be unable to clear dextromethorphan (within DayQuil) from your system for up to 5 days after ingestion. On the other hand, if you are a CYP2D6 rapid metabolizer, you may eliminate the dextromethorphan (within DayQuil) from your system in less than 2 days. Source: http://www.ncbi.nlm.nih.gov/pubmed/8841152 Glutathione levels : The pharmacokinetics of DayQuil formulations with acetaminophen may be affected by an individual s glutathione levels. Acetaminophen is metabolized via conjugation with glucuronides and sulfates prior to elimination. When taken at high doses, the conjugation processes are overwhelmed and it requires CYP450 isoenzyme metabolism, converting acetaminophen to a toxic metabolite NAPQI. NAPQI isn t a major problem among those with sufficient levels of the antioxidant glutathione. This is because is undergoes conjugation with glutathione and the NAPQI is neutralized and eliminated. However, among high-dose DayQuil users with low glutathione, it is possible that elimination of acetaminophen and its NAPQI intermediary metabolites will be impaired. For this reason, those with low glutathione should be expected to eliminate acetaminophen slower than those with high levels. Source: http://www.ncbi.nlm.nih.gov/pubmed/3829578 Hepatic function : Though not all of the ingredients within DayQuil undergo extensive hepatic metabolism, it is necessary to consider that hepatic impairment may prolong elimination of certain ingredients. Research shows that among individuals with hepatic impairment, its elimination half-life may exceed 4 hours. This means that it could take longer than a full day to fully eliminate acetaminophen from systemic circulation. Elimination of dextromethorphan within DayQuil is likely to be prolonged to a greater extent than acetaminophen among those with hepatic impairment. This is due to the fact that dextromethorphan is metabolized primarily by CYP2D6 isoenzymes and the function of these enzymes may decrease in respect to the degree of impairment. Elimination of dextromethorphan among those with severe hepatic impairment could exceed 5 days. Source: http://www.ncbi.nlm.nih.gov/pubmed/499292 Metabolic rate : Your BMR (basal metabolic rate) can affect how quickly various drugs are metabolized and excreted from systemic circulation. Individuals with high BMRs are burning more energy at rest, and ultimately eliminate exogenous substances faster from their plasma than those with low BMRs. This is evidenced by those with hyperthyroidism, a condition that radically amplifies BMR, leading to rapid metabolism of drugs. Those with a low BMR are burning less energy at rest, and are less physiologically primed to metabolize and eliminate the ingredients within DayQuil. Though BMR may affect elimination speed of DayQuil, it is unlikely to be of notable significance unless a user has hyper- or hypo-thyroidism. That said, if you have a high BMR, you may eliminate DayQuil slightly quicker than someone with a lower BMR. Renal function : Upon ingestion of DayQuil, its ingredients such as acetaminophen and dextromethorphan are metabolized and the metabolites are conjugated into glucuronides and/or sulfates prior to elimination. These conjugated metabolites are processed by the kidneys and eliminated primarily through the urine. Among those with suboptimal kidney function and/or renal impairment, it is possible that clearance speed and elimination half-life could be prolonged. Renal impairment often leads to accumulation of metabolites within the kidneys, followed by reabsorption and recirculation throughout the system. If you have normative renal function, the clearance and urinary excretion of metabolites should be efficient. However, those with impairment may exhibit compromised efficiency of renal excretion leading to longer systemic retention of DayQuil. Urinary flow rate : Your urinary flow rate could also influence how quickly DayQuil gets eliminated from your system. Individuals with a high urinary flow rate will likely excrete a greater amount of acetaminophen in a shorter duration than those with a low urinary flow rate. Since hydration is known to have an impact on urinary flow rate, perhaps the degree to which you stay hydrated while using DayQuil will determine how long it remains in your system upon discontinuation. Someone who maintains optimal hydration should excrete DayQuil with greater efficiency than an individual who is dehydrated or suboptimally hydrated. Though urinary flow rate can influence the excretion of acetaminophen, it is unknown as to whether it affects excretion of other DayQuil ingredients such as dextromethorphan. Source: http://www.ncbi.nlm.nih.gov/pubmed/2257860 Daily dosage The total daily dosage that you take of DayQuil will likely affect how long it remains in your system after your final dose. Let s assume that you decided to take DayQuil Cold & Flu which contains: 325 mg acetaminophen, 10 mg dextromethorphan, and 5 mg phenylephrine per dose. If you were to take 4 doses within 24 hours, your body would need to metabolize and eliminate 1300 mg acetaminophen, 40 mg dextromethorphan, and 20 mg phenylephrine. On the other hand, if you were to only take 2 doses, you would only have ingested 650 mg acetaminophen, 20 mg dextromethorphan, and 10 mg phenylephrine. When dosages are increased, the metabolism and elimination of various ingredients becomes less efficient. This is because with high doses, hepatic enzymes are taxed to a greater extent; there s a greater quantity of an exogenous substances that needs to be metabolized. Furthermore, there are a greater number of metabolites formed in the process, possibly leading to increased accumulation within plasma. As a result of the increased plasma concentrations and metabolite formation among high dose users, efficiency of renal excretion is reduced. The kidneys are only capable of eliminating a certain amount of the DayQuil ingredient metabolites at a time. Low dose users are unlikely to tax metabolic pathways to the same extent as high dose users and exhibit lower plasma concentrations. Additionally, renal excretion should remain efficient among low dose users because there s a reduced amount of the exogenous substance that necessitates excretion. Therefore if you are a low dose DayQuil user, you may clear its ingredients faster from your system than a high dose user. Frequency/Term of administration The term and frequency of DayQuil administration may be necessary to consider when determining how long it is likely to stay in your system. If you simply used a single dose of DayQuil one day when you were sick, it is likely to get eliminated efficiently from your system. However, if you were frequently administering DayQuil several times per day for a long-term (e.g. several weeks), it may take longer for your body to eliminate it. A high-frequency user such as someone ingesting DayQuil several times per day is forcing their body to metabolize an additional dosage before the previous one has been metabolized and cleared from the plasma. This means that a frequent user is likely to accumulate DayQuil ingredients (as well as metabolites) within plasma, leading to slower hepatic metabolism and renal excretion. Conversely, an infrequent user is unlikely to accumulate DayQuil ingredients within his/her system because there are gaps between doses. These longer gaps between doses among infrequent users allows the body to fully eliminate the previous dose before another one is introduced. Therefore if you use DayQuil on an inconsistent basis, expect a faster elimination than someone using it every day, several times per day. The term of administration or total duration over which DayQuil was taken may also affect its elimination speed. A frequent user of DayQuil that has been taking it daily for a full year is likely to have accumulated a greater amount of the ingredients in his/her system than a short-term user. In part this is because long-term users build up tolerance to lower doses of ingredients over time, leading to usage of higher doses. The higher doses among long-term users are thought to increase ingredient accumulation and prolong elimination. Co-administered drugs (CYP2D6) It is likely that co-administration of various drugs can affect how long DayQuil stays in your system. In particular, the pharmacokinetics of DayQuil formulations containing dextromethorphan are likely to be altered by co-administration of drugs that affect function of CYP2D6 isoenzymes. Drugs that interfere with CYP2D6 isoenzyme function are known as inhibitors, and are thought to prolong elimination of the dextromethorphan within DayQuil. Examples of such CYP2D6 inhibitors include: Bupropion, Cinacalcet, Fluoxetine, Paroxetine, Quinidine, and Ritonavir. Should you have taken any of these agents along with DayQuil formulations, realize that it ll take longer to clear dextromethorphan from your system. This is because CYP2D6 inhibitors downregulate function of CYP2D6 isoenzymes. If you took a drug that enhanced CYP2D6 isoenzyme function, you should eliminate dextromethorphan (within DayQuil) faster than average. Drugs known as CYP2D6 inducers increase activity of CYP2D6 isoenzymes within the liver, leading to faster metabolism and quicker systemic elimination. Examples of CYP2D6 inducers include: Dexamethasone, Glutethimide, and Rifampicin. DayQuil: Absorption, Metabolism, Excretion (Details) Since DayQuil formulations may contain any variety of ingredients, it is necessary to analyze the pharmacokinetics of all potential DayQuil ingredients. Ingredients within any given DayQuil formulation may include: acetaminophen, dextromethorphan, guaifenesin, oxymetazoline, and phenylephrine. Below is a brief pharmacokinetic description of each aforementioned ingredient. Acetaminophen Following administration of acetaminophen within DayQuil, it is rapidly absorbed within the gastrointestinal (GI) tract and undergoes hepatic metabolism. Hepatic metabolism consists primarily of glucuronidation and sulfation of the parent acetaminophen. Metabolites formed in the process include: APAP-gluc (acetaminophen glucuornide) and APAP-sulf (acetaminophen sulfate). A small percentage of NAPQI may also form if glutathione levels are low and/or high doses of DayQuil are ingested. The standard elimination half-life of acetaminophen ranges from 1 to 4 hours, indicating that it is usually out of your system within 22 hours. An estimated 90% of an acetaminophen dosage will be eliminated within urine in under 24 hours, primarily as APAP-glucuronides and APAP-sulfates. Only a minimal amount of acetaminophen will be excreted unchanged (unmetabolized) within the urine. Dextromethorphan The dextromethorphan within DayQuil will be rapidly absorbed via the gastrointestinal (GI) tract. After dextromethorphan is absorbed by the GI tract, it is subject to extensive hepatic metabolism, primarily via CYP2D6 isoenzymes. Hepatic metabolism (catalyzed via CYP2D6) converts dextromethorphan to its principal metabolite dextrorphan. Peak serum concentrations of dextromethorphan are attained approximately 2.5 hours post-ingestion. Concentrations of the dextrorphan metabolite peak within the bloodstream in around 1.7 hours after dextromethorphan ingestion. Among those with CYP2D6 polymorphisms as to compromise CYP2D6 isoenzyme function, metabolism of dextromethorphan is reduced and ultimately less dextrorphan is formed. Among extensive CYP2D6 metabolizers approximately 15% of a dextromethorphan dose forms minor metabolites such as D-methoxymorphinane. Dextromethorphan and its metabolites are then subject to renal excretion. Depending on CYP2D6 expression, up to 11% of a dose may be excreted unchanged as dextromethorphan, while in others, up to 100% of a dose may consist of metabolites. Only a small amount of the dose is eliminated via feces (0.1%). The elimination half-life of 3 to 6 hours suggests that dextromethorphan is likely to be out of a users system in under 33 hours. Most users will have excreted the entire dosage within 24 hours of ingestion. Guaifenesin Guaifenesin is efficiently absorbed from the gastrointestinal tract and acts as an expectorant via maximizing volume and minimizing viscosity of trachea and bronchi secretions. Following ingestion, approximately 60% of a dose is hydrolyzed within 7 hours. It is converted primarily into the metabolite beta-(2-methoxyphenoxy)-lactic acid which appears within urine upon excretion. Due to the fact that guaifenesin has a plasma elimination half-life of just 1 hour, it can be expected to be out of a users system much quicker than other ingredients within DayQuil. Most of the guaifenesin ingested from DayQuil is eliminated as glucuronides and sulfates. Therefore you should expect this ingredient out of your plasma in less than 12 hours. Phenylephrine Upon administration of DayQuil containing phenylephrine, the phenylephrine is completely absorbed and undergoes first pass metabolism within the intestinal wall and liver. It is then rapidly distributed throughout the body to peripheral tissues. Some speculate that phenylephrine could accumulate within organs, especially if administered frequently. It has an estimated oral bioavailability of 38%, with its serum concentrations peaking within 45 minutes to 2 hours post-ingestion. Metabolism of phenylephrine occurs primarily via sulfate conjugation (within the intestinal wall) and oxidative deamination (via monoamine oxidase enzymes). To a minor extent, phenylephrine undergoes glucuronidation. The elimination half-life of phenylephrine is thought to range between 2 and 3 hours, indicating that it is out of the plasma in under 17 hours. Phenylephrine is processed by the kidneys and subject to urinary excretion. In less than 48 hours, most individuals should have eliminated over 80% of a phenylephrine dose within urine; 2.6% of which is unchanged phenylephrine and the majority of which is phenylephrine metabolites. Source: https://pubchem.ncbi.nlm.nih.gov/compound/dextromethorphan Source: https://pubchem.ncbi.nlm.nih.gov/compound/acetaminophen Source: https://pubchem.ncbi.nlm.nih.gov/compound/phenylephrine Source: https://pubchem.ncbi.nlm.nih.gov/compound/guaifenesin Source: http://www.ncbi.nlm.nih.gov/pubmed/22855901 Tips to clear DayQuil from your system If you ve recently stopped taking DayQuil and want to ensure that it is eliminated from your system as quickly as possible, below are some suggestions that may be helpful. Prior to implementing any of these suggestions, be sure to verify safety and alleged efficacy with a medical professional. Realize that not everyone will derive significant benefit from these tips in regards to expediting the elimination of DayQuil. Activated charcoal : A supplement that binds to unmetabolized chemicals and other endotoxins circulating throughout your body is activated charcoal. If you are concerned that any DayQuil may be lingering in systemic circulation, especially the acetaminophen component or its toxic metabolite NAPQI, you may want to take some activated charcoal. Activated charcoal carries a negative electrical charge allowing it to bind to any DayQuil remnants in your body that warrant elimination. Calcium-D-Glucarate : Based on the pharmacokinetic data from the ingredients of DayQuil, it is apparent that most ingredients are eliminated via renal pathways. If renal pathways are overtaxed as a result of environmental, dietary, or chemical toxins accumulation of DayQuil may occur. To help out your kidneys, supplementation with calcium-d-glucarate may provide benefit. Calcium-d-glucarate acts as a beta-glucuronidase inhibitor which releases molecules (e.g. ingredients of DayQuil) from detoxification pathways. Glutathione : Anyone taking large doses of DayQuil with acetaminophen should supplement with exogenous glutathione. Glutathione is generated by your liver and aids in the conjugation of acetaminophen metabolite NAPQI. Without enough glutathione to conjugate NAPQI, your liver may endure some damage and/or fail to eliminate acetaminophen in a timely manner. Urinary flow rate : Evidence suggests that elimination of acetaminophen (and possibly other DayQuil ingredients) may be influenced by urinary flow rate. The greater an individual s urinary flow rate, the faster acetaminophen will be eliminated, whereas the lesser a person s urinary flow rate, the slower the acetaminophen will be excreted. Urinary flow rate can be manipulated in large part via hydration. If you stay optimally hydrated, you may excrete DayQuil quicker than if you were dehydrated. How long has DayQuil stayed in your system after stopping? If you ve used DayQuil to treat symptoms of a common cold, influenza, nasal congestion, etc. mention the dosage you were taking and the number of consecutive days over which you took it. Share a comment mentioning whether you believe the DayQuil stayed in your system for more or less than 24 hours after your final dose. If you believe it took a considerably longer duration than 24 hours to eliminate ingredients of DayQuil, support your hypothesis by sharing variables that may have prolonged elimination (e.g. renal impairment). Realize that DayQuil formulations with dextromethorphan are likely to stay in a users system for a longer duration than average only if that individual happens to be a poor CYP2D6 metabolizer. In this case, elimination could take up to 5 days, whereas among a normative metabolizer, elimination should take between 17 and 33 hours. The bottom line though is that nearly every ingredient within common DayQuil formulations should be out of your system within 48 hours of your last dose. Share +1 Pin Stumble Reddit Shares 0 Related Posts: How Long Does NyQuil Stay In Your System? How Long Does Lortab Stay In Your System? How Long Does Percocet Stay In Your System? How Long Does Nortriptyline Stay In Your System? How Long Does Amitriptyline Stay In Your System? is legendary


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the plain carmustine (Implantation route) kar-MUS-teen Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Commonly used brand name(s) In the U.S. Gliadel Available Dosage Forms: Implant Therapeutic Class: Antineoplastic Agent Pharmacologic Class: Alkylating Agent Chemical Class: Nitrosourea Slideshow Multiple Myeloma: Has Crowd Control Ever Been As Important? Uses For carmustine Carmustine implant is used together with surgery and radiation therapy to treat malignant glioma and glioblastoma multiforme. These are types of brain cancer. Carmustine belongs to the group of cancer medicines known as alkylating agents. It interferes with the growth of cancer cells, which are eventually destroyed. carmustine is to be given only by or under the direct supervision of your doctor. Before Using carmustine In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For carmustine, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to carmustine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies have not been performed on the relationship of age to the effects of carmustine implant in the pediatric population. Safety and efficacy have not been established. Geriatric Although appropriate studies on the relationship of age to the effects of carmustine implant have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. Breast Feeding There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving carmustine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using carmustine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Measles Virus Vaccine, Live Mumps Virus Vaccine, Live Rotavirus Vaccine, Live Rubella Virus Vaccine, Live Varicella Virus Vaccine Using carmustine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Adenovirus Vaccine Bacillus of Calmette and Guerin Vaccine, Live Cholera Vaccine, Live Cimetidine Influenza Virus Vaccine, Live Phenobarbital Poliovirus Vaccine, Live Smallpox Vaccine Typhoid Vaccine Yellow Fever Vaccine Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. Other Medical Problems The presence of other medical problems may affect the use of carmustine. Make sure you tell your doctor if you have any other medical problems, especially: Intracranial hypertension (increased pressure in the head) or Seizures Use with caution. May make these conditions worse. Proper Use of carmustine Medicines used to treat cancer are very strong and can have many side effects. Before receiving carmustine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment. A doctor will place carmustine in your brain during a surgical procedure. It is in the form of a small wafer. The wafer will dissolve and slowly release the medicine in the tumor. Precautions While Using carmustine It is important that your doctor check your progress closely while you are receiving carmustine. This will allow your doctor to see if the medicine is working properly and to check for unwanted effects. Using carmustine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant after receiving the medicine. If you think you have become pregnant while using carmustine, tell your doctor right away. carmustine may cause seizures after the surgical procedure. Call your doctor if you have symptoms of seizures after receiving carmustine. carmustine may cause increased pressure in the head (intracranial hypertension). Tell your doctor right away if you have a severe headache, nausea, vomiting, blurred vision, or any change in vision after receiving the implant. carmustine may cause a brain infection called meningitis. Tell your doctor right away if you have a severe headache, confusion, drowsiness, nausea, a general feeling of illness, or a stiff neck. Some men using carmustine have become infertile (unable to have children). If you plan to have children, talk to your doctor before receiving carmustine. carmustine Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor or nurse immediately if any of the following side effects occur: More common Blurred vision change in ability to see colors, especially blue or yellow confusion fever headache nausea and vomiting problems with movement, walking, or speech seizures trouble healing Less common Drowsiness general feeling of illness severe headache stiff neck or back Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Abdominal or stomach pain back pain bladder pain bloody or cloudy urine difficult, burning, or painful urination difficulty having a bowel movement (stool) discouragement feeling sad or empty frequent urge to urinate irritability lack of appetite lack or loss of strength loss of interest or pleasure lower back or side pain tiredness trouble concentrating trouble sleeping Less common Chest pain Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Side Effects (complete list) The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products. Copyright 2017 Truven Health Analytics, Inc. All Rights Reserved. Next Side Effects Print this page Add to My Med List More about carmustine Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 0 Reviews Add your own review/rating Drug class: alkylating agents Consumer resources Carmustine Carmustine Injection Carmustine Intracranial Implant Carmustine Intravenous (Advanced Reading) Other brands: Gliadel , BiCNU Professional resources Carmustine (AHFS Monograph) Carmustine (Wolters Kluwer) Related treatment guides Brain Tumor Glioblastoma Multiforme Hodgkin's Lymphoma Malignant Glioma Multiple Myeloma Non-Hodgkin's Lymphoma} Drug Status Rx Availability Prescription only D Pregnancy Category Positive evidence of risk N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Alkylating agents Related Drugs Hodgkin's Lymphoma Opdivo , Keytruda , cyclophosphamide , nivolumab , Cytoxan , etoposide , More... Non-Hodgkin's Lymphoma methotrexate , Rituxan , rituximab , cyclophosphamide , Imbruvica , Cytoxan , More... Glioblastoma Multiforme Avastin , bevacizumab , Temodar , temozolomide , carmustine , Gliadel , More... Brain Tumor cisplatin , lomustine , carmustine , Gliadel , Platinol , Gleostine , More... 2 more conditions... Carmustine Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! Help and Support Looking for answers? Ask a question or go join the carmustine support group to connect with others who have similar interests.} } massive


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speeds up Alphanate (Intravenous) Generic Name: antihemophilic factor viii and von willebrand factor (Intravenous route) an-tee-hee-moe-FIL-ik FAK-tor ATE HUE-man, Von WILL-a-brand FAK-tor HUE-man Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Pricing & Coupons Commonly used brand name(s) In the U.S. Alphanate Humate-P Wilate Available Dosage Forms: Powder for Solution Therapeutic Class: Antihemophilic Agent Slideshow FDA-Approved Weight Loss Drugs: Can They Help You? Uses For Alphanate Antihemophilic factor VIII and von Willebrand factor injection is a combination product that is used to treat serious bleeding episodes in patients with a bleeding problem called von Willebrand disease (VWD). The bleeding episode may be related to an injury (trauma) or a surgical procedure. This medicine may also be used to stop bleeding in patients with hemophilia A. Antihemophilic factor VIII and von Willebrand factor are normally produced in the body. They help clot the blood when an injury occurs. Patients with von Willebrand disease or hemophilia A do not make enough of these substances to prevent bleeding, so this product is given to increase the levels of these substances in the blood. This medicine is available only with your doctor's prescription. Before Using Alphanate In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of antihemophilic factor VIII and von Willebrand factor injection in children 5 to 16 years of age. Geriatric Adequate and well-controlled studies have not been done on the relationship of age to the effects of antihemophilic factor VIII and von Willebrand factor injection in geriatric patients. Pregnancy Pregnancy Category Explanation All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women. Breast Feeding Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine. Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. Other Medical Problems The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially: Blood clots, history of or Deep vein thrombosis (blood clot in leg), history of or Pulmonary embolism (blood clot in lung), history of or Stroke, history of Use with caution. May make these conditions worse. Proper Use of antihemophilic factor viii and von willebrand factor This section provides information on the proper use of a number of products that contain antihemophilic factor viii and von willebrand factor. It may not be specific to Alphanate. Please read with care. A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins. This medicine may also be given at home to patients who do not need to be in a hospital or clinic. If you are using this medicine at home, your doctor or nurse will teach you how to prepare and inject the medicine. Make sure you understand all of the instructions before giving yourself an injection . Your dose may change based on where you are bleeding. Do not use more medicine or use it more often than your doctor tells you to. Precautions While Using Alphanate It is very important that your doctor check you closely while you are receiving this medicine to make sure it is working properly. Blood tests may be needed to check for unwanted effects. This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a cough, difficulty with swallowing, dizziness, a fast heartbeat, wheezing, shortness of breath, trouble breathing, chest tightness, swelling in your face, hands, tongue, or throat, a fever, chills, a runny nose or sneezing, itching or hives, or lightheadedness or faintness after you get the injection. This medicine may increase your chance of having blood clots. Tell your doctor right away if you have a sudden or severe headache, problems with vision or speech, chest pain, shortness of breath, or numbness or weakness with this medicine. This medicine is made from donated human blood. Some human blood products have transmitted certain viruses to people who have received them. The risk of getting a virus from medicines made from human blood has been greatly reduced in recent years. This is the result of required testing of human donors for certain viruses, and testing during the making of these medicines. Although the risk is low, talk with your doctor if you have concerns. Alphanate Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor or nurse immediately if any of the following side effects occur: More common Difficulty with breathing or swallowing dizziness fast heartbeat fever hives or welts itching nausea reddening of the skin, especially around the ears shortness of breath skin rash swelling of the face, throat, or tongue unusual tiredness or weakness Incidence not known Cough tightness in the chest vomiting wheezing Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Side Effects (complete list) The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products. Copyright 2017 Truven Health Analytics, Inc. All Rights Reserved. Next Side Effects Print this page Add to My Med List More about Alphanate (antihemophilic factor / von willebrand factor) Side Effects During Pregnancy Dosage Information Drug Interactions Support Group Pricing & Coupons En Español 0 Reviews Add your own review/rating Drug class: miscellaneous coagulation modifiers Consumer resources Alphanate Other brands: Humate-P , Wilate Professional resources Alphanate (FDA) Related treatment guides Hemophilia A von Willebrand's Disease} Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Manufacturer Grifols USA, LLC Drug Class Miscellaneous coagulation modifiers Related Drugs Hemophilia A desmopressin , tranexamic acid , DDAVP , Advate , Cyklokapron , Eloctate , Stimate , Humate-P , NovoSeven RT , Adynovate , Hemofil-M , Kogenate , More... von Willebrand's Disease desmopressin , DDAVP , Stimate , Humate-P , Wilate , Vonvendi , More... Alphanate Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! Help and Support Looking for answers? Ask a question or go join the Alphanate support group to connect with others who have similar interests.} } a delegated


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person that [400:<50 copies/mL, are on their original study medication (except stavudine-zidovudine switches), and have not experienced an AIDS-defining event. Table 15: Outcomes of Randomized Treatment Through Week 48, AI454-148 Week 48 Status Percent of Patients with HIV-1 RNA less than 400 copies/mL (less than 50 copies/mL) didanosine/stavudine/nelfinavir n=503 lamivudine/zidovudine/nelfinavir n=253 * p less than 0.05 for the differences between treatment groups, by Cochran-Mantel-Haenszel test. a Patients achieved virologic response [two consecutive viral loads less than 400 (less than 50) copies/mL] and maintained it to Week 48. b Includes viral rebound and failing to achieve confirmed less than 400 (less than 50) copies/mL by Week 48. c Includes lost to follow-up, noncompliance, withdrawal, and pregnancy. Responder a 50* (34*) 59 (47) Virologic failure b 36 (57) 32 (48) Death or disease progression less than 1 (less than 1) 1 (less than 1) Discontinued due to adverse events 4 (2) 2 (less than 1) Discontinued due to other reasons c 6 (3) 4 (2) Never initiated treatment 4 (4) 2 (2) Monotherapy The efficacy of didanosine was demonstrated in two randomized, double-blind studies comparing didanosine, given on a twice-daily schedule, to zidovudine, given three times daily, in 617 (ACTG 116A, conducted 1989 to 1992) and 913 (ACTG 116B/117, conducted 1989 to 1991) patients with symptomatic HIV infection or AIDS who were treated for more than one year. In treatment-naive patients (ACTG 116A), the rate of HIV disease progression or death was similar between the treatment groups; mortality rates were 26% for patients receiving didanosine and 21% for patients receiving zidovudine. Of the patients who had received previous zidovudine treatment (ACTG 116B/117), those treated with didanosine had a lower rate of HIV disease progression or death (32%) compared to those treated with zidovudine (41%); however, survival rates were similar between the treatment groups. Studies have demonstrated that the clinical benefit of monotherapy with antiretrovirals, including didanosine, was time limited. Pediatric Patients Efficacy in pediatric patients was demonstrated in a randomized, double-blind, controlled study (ACTG 152, conducted 1991 to 1995) involving 831 patients 3 months to 18 years of age treated for more than 1.5 years with zidovudine (180 mg/m 2 every 6 hours), didanosine (120 mg/m 2 every 12 hours), or zidovudine (120 mg/m 2 every 6 hours) plus didanosine (90 mg/m 2 every 12 hours). Patients treated with didanosine or didanosine plus zidovudine had lower rates of HIV-1 disease progression or death compared with those treated with zidovudine alone. How Supplied/Storage and Handling Didanosine Tablets for Oral Suspension USP, 100 mg are white to off-white, slightly mottled, round, flat faced beveled edge tablets with debossing D on one side and 45 on other side. The tablets are packaged in bottles with child-resistant closures. Bottles of 60 NDC 65862-092-60 Didanosine Tablets for Oral Suspension USP, 150 mg are white to off-white, slightly mottled, round, flat faced beveled edge tablets with debossing D on one side and 46 on other side. The tablets are packaged in bottles with child-resistant closures. Bottles of 60 NDC 65862-093-60 Didanosine Tablets for Oral Suspension USP, 200 mg are white to off-white, slightly mottled, round, flat faced beveled edge tablets with debossing D on one side and 47 on other side. The tablets are packaged in bottles with child-resistant closures. Bottles of 60 NDC 65862-094-60 Storage Store in tightly closed bottles at 20 to 25 C (68 to 77 F); excursions permitted to 15 to 30 C (59 to 86 F) [see USP Controlled Room Temperature]. If dispersed in water, the dose may be held for up to 1 hour at ambient temperature. Patient Counseling Information See Medication Guide . Pancreatitis Patients should be informed that a serious toxicity of didanosine, used alone and in combination regimens, is pancreatitis, which may be fatal. Peripheral Neuropathy Patients should be informed that peripheral neuropathy, manifested by numbness, tingling, or pain in hands or feet, may develop during therapy with didanosine. Patients should be counseled that peripheral neuropathy occurs with greatest frequency in patients with advanced HIV-1 disease or a history of peripheral neuropathy, and that discontinuation of didanosine may be required if toxicity develops. Lactic Acidosis and Severe Hepatomegaly with Steatosis Patients should be informed that lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including didanosine and other antiretrovirals. Hepatic Toxicity Patients should be informed that hepatotoxicity including fatal hepatic adverse events were reported in patients with preexisting liver dysfunction. The safety and efficacy of didanosine have not been established in HIV-infected patients with significant underlying liver disease. Non-cirrhotic Portal Hypertension Patients should be informed that non-cirrhotic portal hypertension has been reported in patients taking didanosine, including cases leading to liver transplantation or death. Retinal Changes and Optic Neuritis Patients should be informed that retinal changes and optic neuritis have been reported in adult and pediatric patients. Fat Redistribution Patients should be informed that redistribution or accumulation of body fat may occur in patients receiving antiretroviral therapy and that the cause and long-term health effects of these conditions are not known at this time. Concomitant Therapy Patients should be informed that when didanosine is used in combination with other agents with similar toxicities, the incidence of adverse events may be higher than when didanosine is used alone. These patients should be followed closely. Patients should be cautioned about the use of medications or other substances, including alcohol, which may exacerbate didanosine toxicities. General Information Didanosine is not a cure for HIV-1 infection, and patients may continue to experience illnesses associated with HIV-1 infection, including opportunistic infections. Therefore, patients should remain under the care of a physician when using didanosine. Patients should be advised to avoid doing things that can spread HIV-1 infection to others. Do not share needles or other injection equipment. Do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades. Do not have any kind of sex without protection. Always practice safe sex by using a latex or polyurethane condom or other barrier method to lower the chance of sexual contact with semen, vaginal secretions, or blood. Do not breastfeed. It is not known if didanosine can be passed to your baby in your breast milk and whether it could harm your baby. Also, mothers with HIV-1 should not breastfeed because HIV-1 can be passed to the baby in breast milk. Patients should be informed that the preferred dosing frequency of didanosine is twice daily because there is more evidence to support the effectiveness of this dosing frequency. Once-daily dosing should be considered only for patients whose management requires once-daily dosing of didanosine. Patients should be instructed to not miss a dose but if they do, patients should take didanosine as soon as possible. Patients should be told that if it is almost time for the next dose, they should skip the missed dose and continue with the regular dosing schedule. Patients should be advised that to ensure proper acid neutralization in the stomach they must take at least two of the appropriate strength didanosine tablets at each dose. To reduce the risk of gastrointestinal side effects from excess antacid, patients should take no more than four didanosine tablets at each dose. Patients should be instructed to contact a poison control center or emergency room right away in case of an overdose. Manufactured for: Aurobindo Pharma USA, Inc. 2400 Route 130 North Dayton, NJ 08810 Manufactured by: Aurobindo Pharma Limited Hyderabad-500 072, India Issued: November 2011 Medication Guide Didanosine Tablets for Oral Suspension, USP (didanosine, also known as ddI) Phenylketonurics Phenylalanine is a component of aspartame. Each Didanosine Tablets for Oral Suspension USP, 100 mg, 150 mg, and 200 mg contains phenylalanine 73 mg per 2 tablet dose. Read this Medication Guide before you start taking didanosine tablets for oral suspension and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or your treatment. You and your healthcare provider should talk about your treatment with didanosine tablets for oral suspension before you start taking them and at regular check-ups. You should stay under your healthcare provider s care when taking didanosine tablets for oral suspension. What is the most important information I should know about didanosine tablets for oral suspension? Didanosine tablets for oral suspension may cause serious side effects, including: 1. Swelling of your pancreas (pancreatitis) that may cause death. Pancreatitis can happen at any time during your treatment with didanosine tablets for oral suspension. Before you start taking didanosine tablets for oral suspension, tell your healthcare provider if you: have had pancreatitis have advanced HIV (human immunodeficiency virus) infection have kidney problems drink alcoholic beverages take a medicine called ZERIT (stavudine) It is important to call your healthcare provider right away if you have: stomach pain swelling of your stomach nausea and vomiting fever 2. Build-up of acid in your blood (lactic acidosis). Lactic acidosis must be treated in the hospital as it may cause death. The risk for lactic acidosis may be higher if you: have liver problems are pregnant. There have been deaths reported in pregnant women who get lactic acidosis after taking didanosine tablets for oral suspension and ZERIT (stavudine). are overweight have been treated for a long time with other medicines to treat HIV It is important to call your health care provider right away if you: feel weak or tired have unusual (not normal) muscle pain have trouble breathing have stomach pain with nausea and vomiting feel cold, especially in your arms and legs feel dizzy or light-headed have a fast or irregular heartbeat 3. Liver problems. Some people (including pregnant women) who have taken didanosine tablets for oral suspension have had serious liver problems. These problems include liver enlargement (hepatomegaly), fat in the liver (steatosis), liver failure, and high blood pressure in the large vein of the liver (portal hypertension). Severe liver problems can lead to liver transplantation or death in some people taking didanosine tablets for oral suspension. Your healthcare provider should check your liver function while you are taking didanosine tablets for oral suspension. You should be especially careful if you have a history of heavy alcohol use or liver problems. It is important to call your healthcare provider right away if you have: yellowing of your skin or the white of your eyes (jaundice) dark urine pain on the right side of your stomach swelling of your stomach easy bruising or bleeding loss of appetite nausea or vomiting vomiting blood or dark colored stools (bowel movements) What are didanosine tablets for oral suspension? Didanosine tablets for oral suspension are a prescription medicine used with other antiretroviral medicines to treat human immunodeficiency virus (HIV) infection in children and adults. Didanosine tablets for oral suspension belong to a class of drugs called nucleoside analogues. Didanosine tablets for oral suspension will not cure your HIV infection. At present there is no cure for HIV infection. Even while taking didanosine tablets for oral suspension, you may continue to have HIV-related illnesses, including infections with other disease-producing organisms. Continue to see your healthcare provider regularly and report any medical problems that occur. Who should not take didanosine tablets for oral suspension? Do not take didanosine tablets for oral suspension if you take: ZYLOPRIM , LOPURIN , ALOPRIM (allopurinol) COPEGUS , REBETOL , RIBASPHERE , RIBAVIRIN , VIRAZOLE (ribavirin) What should I tell my healthcare provider before taking didanosine tablets for oral suspension? Before you take didanosine tablets for oral suspension, tell your healthcare provider if you: have or had kidney problems have or had liver problems (such as hepatitis) have or had persistent numbness, tingling, or pain in the hands or feet (neuropathy) have any other medical conditions are pregnant or plan to become pregnant. It is not known if didanosine tablets for oral suspension will harm your unborn baby. Tell your healthcare provider right away if you become pregnant while taking didanosine tablets for oral suspension. You and your healthcare provider will decide if you should take didanosine tablets for oral suspension while you are pregnant. Pregnancy Registry: There is a pregnancy registry for women who take antiviral medicines during pregnancy. The purpose of the registry is to collect information about the health of you and your baby. Talk to your doctor about how you can take part in this registry. are breastfeeding or plan to breastfeed. Do not breastfeed. It is not known if didanosine can be passed to your baby in your breast milk and whether it could harm your baby. Also, mothers with HIV-1 should not breastfeed because HIV-1 can be passed to the baby in the breast milk. Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Didanosine tablets for oral suspension may affect the way other medicines work, and other medicines may affect how didanosine tablets for oral suspension work. Especially tell your healthcare provider if you take: VIREAD (tenofovir disoproxil fumarate) DROXIA , HYDREA (hydroxyurea) RESCRIPTOR (delavirdine mesylate) CYTOVENE , VALCYTE (ganciclovir) CRIXIVAN (indinavir) DOLOPHINE HYDROCHLORIDE, METHADOSE (methadone) VIRACEPT (nelfinavir) antacids antifungal medicines such as NIZORAL (ketoconazole) or SPORANOX (itraconazole) quinolone antibiotics such as CIPRO , PROQUIN XR (ciprofloxacin) tetracycline antibiotics such as BRISTACYCLINE , SUMYCIN (tetracycline) alcoholic beverages Know the medicines you take. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine. Ask your healthcare provider if you are not sure if you take one of the medicines listed above. How should I take didanosine tablets for oral suspension? Take didanosine tablets for oral suspension exactly as your healthcare provider tells you to take them. Your healthcare provider will tell you how much didanosine tablets for oral suspension to take and when to take them. Your healthcare provider may change your dose. Do not change your dose of didanosine tablets for oral suspension without talking to your healthcare provider. Do not take didanosine tablets for oral suspension with food. Take didanosine tablets for oral suspension on an empty stomach at least 30 minutes before or 2 hours after you eat. Try not to miss a dose, but if you do, take it as soon as possible. If it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Some medicines should not be taken at the same time of day that you take didanosine tablets for oral suspension. Check with your healthcare provider. If your kidneys are not working well, your healthcare provider will need to do regular blood and urine tests to check how they are working while you take didanosine tablets for oral suspension. Your healthcare provider may also lower your dosage of didanosine tablets for oral suspension if your kidneys are not working well. If you take too much didanosine tablets for oral suspension, contact a poison control center or emergency room right away. What should I avoid while taking didanosine tablets for oral suspension? Alcohol. Do not drink alcohol while you take didanosine tablets for oral suspension. Alcohol may increase your risk of getting pain and swelling of your pancreas (pancreatitis) or may damage your liver. What are the possible side effects of didanosine tablets for oral suspension? Didanosine tablets for oral suspension can cause pancreatitis, lactic acidosis, and liver problems. See What is the most important information I should know about didanosine tablets for oral suspension? at the beginning of this Medication Guide. Vision changes. You should have regular eye exams while you take didanosine tablets for oral suspension. Peripheral neuropathy. Symptoms include: numbness, tingling, or pain in your hands or feet. This condition is more likely to happen in people who have had it before, in patients taking medicines that affect the nerves, and in people with advanced HIV disease. A child may not notice these symptoms. Ask your child s healthcare provider for the signs and symptoms of peripheral neuropathy in children. Changes in your immune system (immune reconstitution syndrome). Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider if you start having new or worse symptoms of infection after you start taking HIV medicine. Changes in body fat (fat redistribution). Changes in body fat have been seen in people who take antiretroviral medicines. These changes may include: more fat in or around your - upper back and neck (buffalo hump) - breasts or chest - trunk less fat in your - legs - arms - face Tell your healthcare provider if you have any of the symptoms listed above. The most common side effects of didanosine tablets for oral suspension include: diarrhea stomach pain nausea vomiting headache rash Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of didanosine tablets for oral suspension. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at l-800-FDA-1088. How should I store didanosine tablets for oral suspension? Store didanosine tablets for oral suspension in tightly closed bottles at 20 to 25 C (68 to 77 F); excursions permitted to 15 to 30 C (59 to 86 F). If dispersed in water, the dose may be held for up to 1 hour at ambient temperature. Safely throw away any unused didanosine tablets for oral suspension after 30 days. Keep didanosine tablets for oral suspension and all medicines out of the reach of children and pets. General information about the safe and effective use of didanosine tablets for oral suspension Avoid doing things that can spread HIV-1 infection to others. Do not share needles or other injection equipment. Do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades. Do not have any kind of sex without protection. Always practice safe sex by using a latex or polyurethane condom or other barrier method to lower the chance of sexual contact with semen, vaginal secretions, or blood. Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use didanosine tablets for oral suspension for a condition for which it was not prescribed. Do not give didanosine tablets for oral suspension to other people, even if they have the same symptoms as you have. They may harm them. Do not keep medicine that is out of date or that you no longer need. Dispose of unused medicines through community take-back disposal programs when available or place didanosine tablets for oral suspension in an unrecognizable closed container in the household trash. This Medication Guide summarizes the most important information about didanosine tablets for oral suspension. If you would like more information, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for information about didanosine tablets for oral suspension that is written for health professionals. For more information, call 1-866-850-2876. What are the ingredients in didanosine tablets for oral suspension? Active Ingredient: didanosine Inactive Ingredients: Each tablet is buffered with calcium carbonate and magnesium hydroxide. Didanosine tablets also contain aspartame, crospovidone, magnesium stearate, microcrystalline cellulose, orange flavor, and sorbitol. All brands listed are the trademarks of their respective owners and are not trademarks of Aurobindo Pharma Limited. Manufactured for: Aurobindo Pharma USA, Inc. 2400 Route 130 North Dayton, NJ 08810 Manufactured by: Aurobindo Pharma Limited Hyderabad-500 072, India Issued: November 2011 This Medication Guide has been approved by the U.S. Food and Drug Administration. PACKAGE LABEL-PRINCIPAL DISPLAY PANEL - 100 mg (60 Tablet Bottle) NDC 65862-092-60 Didanosine Tablets for Oral Suspension, USP [Formerly: Didanosine Tablets (Chewable, Dispersible, Buffered)] 100 mg PHARMACIST: Dispense the accompanying Medication Guide to each patient. Rx only 60 Tablets AUROBINDO PACKAGE LABEL-PRINCIPAL DISPLAY PANEL - 150 mg (60 Tablet Bottle) NDC 65862-093-60 Didanosine Tablets for Oral Suspension, USP [Formerly: Didanosine Tablets (Chewable, Dispersible, Buffered)] 150 mg PHARMACIST: Dispense the accompanying Medication Guide to each patient. Rx only 60 Tablets AUROBINDO PACKAGE LABEL-PRINCIPAL DISPLAY PANEL - 200 mg (60 Tablet Bottle) NDC 65862-094-60 Didanosine Tablets for Oral Suspension, USP [Formerly: Didanosine Tablets (Chewable, Dispersible, Buffered)] 200 mg PHARMACIST: Dispense the accompanying Medication Guide to each patient. Rx only 60 Tablets AUROBINDO DIDANOSINE Didanosine Tablet, for suspension Product Information Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:65862-092 Route of Administration ORAL DEA Schedule Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength DIDANOSINE (DIDANOSINE) DIDANOSINE 100 mg Inactive Ingredients Ingredient Name Strength CALCIUM CARBONATE MAGNESIUM HYDROXIDE ASPARTAME CROSPOVIDONE MAGNESIUM STEARATE CELLULOSE, MICROCRYSTALLINE ORANGE SORBITOL Product Characteristics Color WHITE (White to Off-white) Score no score Shape ROUND (Flat Faced Beveled Edge) Size 20mm Flavor ORANGE Imprint Code D;45 Contains Packaging # Item Code Package Description 1 NDC:65862-092-60 60 TABLET, FOR SUSPENSION in 1 BOTTLE Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date ANDA ANDA077275 08/14/2012 DIDANOSINE Didanosine Tablet, for suspension Product Information Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:65862-093 Route of Administration ORAL DEA Schedule Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength DIDANOSINE (DIDANOSINE) DIDANOSINE 150 mg Inactive Ingredients Ingredient Name Strength CALCIUM CARBONATE MAGNESIUM HYDROXIDE ASPARTAME CROSPOVIDONE MAGNESIUM STEARATE CELLULOSE, MICROCRYSTALLINE ORANGE SORBITOL Product Characteristics Color WHITE (White to Off-white) Score no score Shape ROUND (Flat Faced Beveled Edge) Size 20mm Flavor ORANGE Imprint Code D;46 Contains Packaging # Item Code Package Description 1 NDC:65862-093-60 60 TABLET, FOR SUSPENSION in 1 BOTTLE Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date ANDA ANDA077275 08/14/2012 DIDANOSINE Didanosine Tablet, for suspension Product Information Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:65862-094 Route of Administration ORAL DEA Schedule Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength DIDANOSINE (DIDANOSINE) DIDANOSINE 200 mg Inactive Ingredients Ingredient Name Strength CALCIUM CARBONATE MAGNESIUM HYDROXIDE ASPARTAME CROSPOVIDONE MAGNESIUM STEARATE CELLULOSE, MICROCRYSTALLINE ORANGE SORBITOL Product Characteristics Color WHITE (White to Off-white) Score no score Shape ROUND (Flat Faced Beveled Edge) Size 20mm Flavor ORANGE Imprint Code D;47 Contains Packaging # Item Code Package Description 1 NDC:65862-094-60 60 TABLET, FOR SUSPENSION in 1 BOTTLE Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date ANDA ANDA077275 08/14/2012 Labeler - Aurobindo Pharma Limited (650082092) Establishment Name Address ID/FEI Operations Aurobindo Pharma Limited 918917642 ANALYSIS(65862-092, 65862-093, 65862-094), MANUFACTURE(65862-092, 65862-093, 65862-094) Establishment Name Address ID/FEI Operations Aurobindo Pharma Limited 918917662 API MANUFACTURE(65862-092, 65862-093, 65862-094) Revised: 08/2012 Aurobindo Pharma Limited Next Interactions Print this page Add to My Med List More about didanosine Side Effects During Pregnancy or Breastfeeding Dosage Information Drug Images Drug Interactions Support Group Pricing & Coupons En Español 0 Reviews Add your own review/rating Drug class: nucleoside reverse transcriptase inhibitors (NRTIs) Consumer resources Didanosine ... +3 more Professional resources Didanosine (AHFS Monograph) Didanosine (FDA) Didanosine Oral Solution (FDA) Didanosine (Wolters Kluwer) Other brands: Videx , Videx EC Related treatment guides HIV Infection Nonoccupational Exposure> ]} 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 Approval History Drug history at FDA Manufacturers Mylan Pharmaceuticals Inc. Teva Pharmaceuticals USA, Inc. Aurobindo Pharma Limited Drug Class Nucleoside reverse transcriptase inhibitors (NRTIs) Related Drugs nucleoside reverse transcriptase inhibitors (NRTIs) Viread , lamivudine , abacavir , entecavir , tenofovir , Baraclude HIV Infection Truvada , Atripla , Norvir , Viread , Isentress , Prezista , Stribild , lamivudine , abacavir , tenofovir , Reyataz , Epzicom , More... Nonoccupational Exposure Truvada , Atripla , Viread , lamivudine , abacavir , tenofovir , Epzicom , Reyataz , zidovudine , emtricitabine , Kaletra , Sustiva , More... Didanosine Rating No Reviews - Be the first! 9.0 /10 No Reviews - Be the first! 9.0 Rate it! Didanosine Images Didanosine systemic 200 mg (barr 200mg 588) View all images} } fees


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