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virtually Anxiety TFLN Generic Name: sodium borate, matricaria recutita, phosphorus, rhododendron aureum leaf and theridion curassavicum liquid Dosage Form: FOR ANIMAL USE ONLY Print this page Disclaimer: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA. For further information about unapproved drugs, click here. Anxiety TFLN Homeopathic remedy provides relief from fear of: Thunderstorms, fireworks, wind, loud noises, gunshots, hurricanes, windstorms, and tornado. Restless, anxious and unwanted behavior can be helped with this fast acting, non-sedating liquid. Dosage: 1-20lbs/5 drops per dose. 21-60lbs/10 drops per dose. 61-100lbs/15 drops per dose. Over 100lbs/20 drops per dose. A full dose may be given every 15 minutes up to 4 doses if needed, before or during storms or fireworks. For pets home alone, put doses in water bowl, as they drink they will receive a dose. Dosing may be repeated as recommended above, throughout the day if multiple storms or stressful situations occur. For pets under 1lb, put 2 drops in water, following dosing instructions above. Remedy may be dosed directly into mouth, on food/treat or in water. Remedy only needs to be used if pet is anxious. Visit www.homeopet.com for detailed dosing and information. Contact Veterinarian if problems persist. Ingredients HPUS: Phosphorus, Rhododendron, Borax, Theridion Curassavicum, Chamomilla 6c,30c Alcohol and Purified Water Anxiety TFLN phosphorus, rhododendron, borax, theridion curassavicum, chamomilla liquid Product Information Product Type OTC ANIMAL DRUG Item Code (Source) NDC:61571-542 Route of Administration ORAL DEA Schedule Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength SODIUM BORATE (SODIUM CATION) SODIUM BORATE 6 [hp_C] in 15 mL MATRICARIA RECUTITA (MATRICARIA RECUTITA) MATRICARIA RECUTITA 6 [hp_C] in 15 mL PHOSPHORUS (PHOSPHORUS) PHOSPHORUS 6 [hp_C] in 15 mL RHODODENDRON AUREUM LEAF (RHODODENDRON AUREUM LEAF) RHODODENDRON AUREUM LEAF 6 [hp_C] in 15 mL THERIDION CURASSAVICUM (THERIDION CURASSAVICUM) THERIDION CURASSAVICUM 6 [hp_C] in 15 mL Inactive Ingredients Ingredient Name Strength ALCOHOL WATER Packaging # Item Code Package Description 1 NDC:61571-542-01 15 mL in 1 BOTTLE, DROPPER Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date unapproved homeopathic 04/15/1995 Labeler - HomeoPet, LLC (121272657) Registrant - HomeoPet, LLC (121272657) Establishment Name Address ID/FEI Operations Washington Homeopathic Products 084929389 manufacture Revised: 12/2010 HomeoPet, LLC FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Recently Approved Lonhala Magnair Lonhala Magnair (glycopyrrolate) is a long-acting muscarinic antagonist (LAMA) bronchodilator for... Ozempic Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) analog administered once-weekly for the... Ogivri Ogivri (trastuzumab-dkst) is a HER2 / neu receptor antagonist biosimilar to Herceptin indicated for... Sublocade Sublocade (buprenorphine) is a once-monthly injectable partial opioid agonist formulation for the... More and mock


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well-deserved Home Pregnancy Problems Complications with Baby First Trimester Bleeding Pregnancy Bleeding - First Trimester Vaginal bleeding during pregnancy is a scary thing - regardless the cause. Vaginal bleeding is any bleeding coming from the vagina but usually refers to abnormal bleeding that is not associated with a regular menstrual period. First Trimester Bleeding First trimester bleeding is considered to be any bleeding that occurs during the first three months of gestation. It may vary from light spotting to heavy bleeding complete with clots. It occurs commonly in early pregnancies, causing complications in 20 to 30 percent of all pregnancies. Sometimes a woman will have light bleeding during the first month of her pregnancy, after conception. It is nothing to be very worried about, but it still causes concern. Often it is implantation bleeding and occurs about the time her normal menstrual cycle would start. Second and Third Trimester Bleeding Second and third trimester bleeding (from the third month to the end of pregnancy) has concerns other than what are involved in first trimester bleeding. Any type of bleeding in this period is considered to be abnormal and cause for concern. If bleeding occurs after the 28 th week of pregnancy, it is a serious concern and an emergency in the true sense of the word. Whether very mild or extremely intense, accompanied by abdominal pain or not, bleeding at this point is dangerous. Hemorrhage complicates four percent of all pregnancies and is the most common cause of death in mothers at this stage in the US. Blighted Ovum Along with the implantation bleeding and postcoital bleeding in the first trimester, there are other causes of bleeding. Blighted ovum, also called an embryonic failure, is when the embryo fails to develop as it should in the proper location in the uterus. If the embryo or fetus is abnormal in some way, this is often the result. It isn't anybody's fault and it isn't anything you did or didn't do - it just is. Intrauterine Fetal Demise Intrauterine fetal demise (IUFD) can occur at any point in a pregnancy, however, it often happens in the first trimester. An ultrasound confirms the diagnosis. The reasons for an IUFD are essentially the same as they are for a threatened miscarriage that occurs during the early stages of pregnancy. It is uncommon for IUFD to occur past the first trimester. However, if it does occur later, it includes placental separation from the uterine wall ( placenta abruption ) or happens because the placenta didn't receive enough blood flow. Ectopic Pregnancy Ectopic pregnancy, also referred to as tubal pregnancy, is another reason for first trimester bleeding. This type of bleeding is very dangerous and occurs as a result of the fertilized egg implanting in the fallopian tube. There isn't room for the baby to grow in such a small space and as a result it can rupture the tube, causing life-threatening bleeding. Most frequently the pregnancy ends before the 10 th week. The fetus cannot develop and will die because of the lack of nutrients. Ectopic pregnancy occurs in about three percent of all pregnancies. There are definite risk factors for ectopic pregnancy, including: history of a prior ectopic pregnancy history of pelvic inflammatory disease (PID) history of Fallopian tube surgery or ligation history of infertility for more than two years having an IUD (intrauterine device) in place smoking frequent (daily) douching Nearly half of all women who experience an ectopic pregnancy have risk factors - the other half does not. Molar Pregnancy A molar pregnancy, technically called gestational trophoblastic disease, is evidenced by an ultrasound that shows the presence of abnormal tissue inside the uterus rather than a developing fetus. Actually, this is a type of tumor that is a result of the hormones present during pregnancy and is not usually life threatening. In rare cases, the tumor is malignant and can potentially penetrate the uterine wall and spread to other parts of the body. The cause of molar pregnancies is unknown. First trimester bleeding can be caused by reasons that are not related to pregnancy. Trauma or tears to the vaginal wall can cause bleeding as can some infections. To learn more about pregnancy bleeding, see our article in this section. Login to comment Log in or sign up Forgot Password? Username: Password: CANCEL (0 Comments) Login to add a comment Post a comment You must be logged in to comment. professional


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humorist Doxorubicin (Liposomal) Generic Name: Doxorubicin (Liposomal) (doks oh ROO bi sin lye po SO mal) Brand Name: Doxil, Lipodox 50, Lipodox Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Pricing & Coupons Warning This medicine may cause very bad heart problems like heart failure. This can happen during care or months to years after you get doxorubicin (liposomal). Sometimes, these heart problems will not go away or may be deadly. The chance of heart problems may be raised if you are using other drugs that may cause heart problems or if you have ever had heart problems or radiation to the chest area, or if you have ever had this medicine or other drugs like this one. Ask your doctor if you are not sure if any drugs you take may cause heart problems. Your chance of heart problems depends on your dose of doxorubicin and your health problem. Heart problems may happen even if you do not have any risk factors. In children, the chance of heart problems later in life is raised. Call your doctor right away if you have cough, fast or slow heartbeat, a heartbeat that does not feel normal, swelling in the arms or legs, shortness of breath, sudden weight gain, or feeling very tired or weak. Side effects like flushing, shortness of breath, wheezing, swelling of the face, headache, chills, back pain, chest pain, chest or throat tightness, fever, fast heartbeat, itching, blue or gray skin, very bad dizziness, or passing out have happened with this medicine during the infusion. Most of the time, these side effects happen with the first infusion and go away within a few hours to a day after the infusion is stopped. Sometimes, these reactions have been very bad and even life-threatening or deadly. Tell your doctor right away if you have any of these signs. Uses of Doxorubicin: It is used to treat cancer. What do I need to tell my doctor BEFORE I take Doxorubicin? If you have an allergy to doxorubicin or any other part of doxorubicin. 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 breast-feeding or plan to breast-feed. This medicine may interact with other drugs or health problems. 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 this medicine 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 2016 New Drug Approvals: The Year That Was What are some things I need to know or do while I take Doxorubicin? Tell all of your health care providers that you take doxorubicin. This includes your doctors, nurses, pharmacists, and dentists. Have blood work checked as you have been told by the doctor. Talk with the doctor. You will need to have your heart checked before starting this medicine. This includes an ECG. Talk with your doctor. You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu. You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor. If you have upset stomach, throwing up, loose stools (diarrhea), or are not hungry, talk with your doctor. There may be ways to lower these side effects. To help with mouth sores, use a soft toothbrush or cotton swabs and rinse the mouth. Do not use mouth rinses that have alcohol in them. If you have had daunorubicin, doxorubicin, epirubicin, idarubicin, or mitoxantrone before, talk with your doctor. This medicine may add to the chance of getting some types of cancer. Talk with the doctor. Cases of mouth cancer have happened in people who have used doxorubicin long-term (more than 1 year). These cancers have happened during care with this medicine and up to 6 years after the last dose. Your doctor will check your mouth during care with doxorubicin. Call your doctor right away if you have mouth pain, sores, or ulcers. Talk with your doctor before getting any vaccines. Use with this medicine may either raise the chance of an infection or make the vaccine not work as well. This medicine may affect being able to father a child. In some people, this may go back to normal but may take some time. Talk with the doctor. If you are a man and have sex with a female who could get pregnant, protect her from pregnancy during care and for 6 months after care ends. Use birth control that you can trust. If you are a man and your sex partner gets pregnant while you take doxorubicin or within 6 months after your last dose, call your doctor right away. Periods may stop in women treated with this medicine. This may not go back to normal. Women treated with doxorubicin (liposomal) may go through menopause at a younger age than normal. Talk with your doctor. This medicine may cause fertility problems. This may affect being able to have children. Talk with the doctor. This medicine may cause harm to the unborn baby if you take it while you are pregnant. Use birth control that you can trust during care and for 6 months after care ends. If you get pregnant while taking this medicine or within 6 months after your last dose, call your doctor right away. How is this medicine (Doxorubicin) best taken? Use doxorubicin as ordered by your doctor. Read all information given to you. Follow all instructions closely. It is given as an infusion into a vein over a period of time. Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor. What do I do if I miss a dose? Call your doctor to find out what to do. 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 infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal. Signs of bleeding like throwing up blood or throw up that looks like coffee grounds; coughing up blood; blood in the urine; black, red, or tarry stools; bleeding from the gums; vaginal bleeding that is not normal; bruises without a reason or that get bigger; or any bleeding that is very bad or that you cannot stop. Chest pain or pressure. Very upset stomach or throwing up. A big weight loss. Bone pain. Night sweats. A burning, numbness, or tingling feeling that is not normal. Redness or irritation of the palms of hands or soles of feet. Mouth irritation or mouth sores. Feeling very tired or weak. Blood in the urine. This medicine may irritate the vein. It may burn the skin if the drug leaks from the vein when it is given. Tell your nurse if you have any redness, burning, pain, swelling, or leaking of fluid where the drug is going into your body. What are some other side effects of Doxorubicin? 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: Feeling tired or weak. Hard stools (constipation). Loose stools (diarrhea). Upset stomach or throwing up. Not hungry. Back pain. Headache. Hair loss. Throat irritation. Weight loss. Urine and other body fluids may change to an orange or red color. This is normal. 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 Doxorubicin? If you need to store this medicine at home, talk with your doctor, nurse, or pharmacist about how to store it. 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. 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. Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about doxorubicin, please talk with your doctor, nurse, pharmacist, or other health care provider. If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened. This information should not be used to decide whether or not to take this medicine 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 doxorubicin. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. 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 doxorubicin. Review Date: November 1, 2017 Next Side Effects Print this page Add to My Med List More about doxorubicin liposomal Side Effects During Pregnancy Dosage Information Drug Interactions Support Group Pricing & Coupons En Espaรฑol 0 Reviews Add your own review/rating Drug class: antibiotics/antineoplastics Consumer resources Doxorubicin liposomal Doxorubicin liposome Intravenous (Advanced Reading) Other brands: Doxil , Lipodox , Lipodox 50 Professional resources DOXOrubicin (Liposomal) (Wolters Kluwer) Related treatment guides Ovarian Cancer Kaposi's Sarcoma Multiple Myeloma} Drug Status Rx Availability Prescription only D Pregnancy Category Positive evidence of risk N/A CSA Schedule Not a controlled drug Doxorubicin liposomal Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! Manufacturer Sun Pharmaceutical Industries Inc. Drug Class Antibiotics / antineoplastics Related Drugs Ovarian Cancer Avastin , carboplatin , Taxol , cisplatin , cyclophosphamide , paclitaxel , gemcitabine , Gemzar , More... Multiple Myeloma dexamethasone , Decadron , Revlimid , cyclophosphamide , Cytoxan , Adriamycin , doxorubicin , More... Kaposi's Sarcoma Taxol , paclitaxel , Doxil , vinblastine , Intron A , doxorubicin liposomal , More... Related: Ovarian Cancer} } new edition


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finishing up For news media inquiries, contact the appropriate media relations team member as outlined below. For all other inquiries, please visit our Contact page. CVS Health Carolyn Castel carolyn.castel@cvshealth.com CVS Pharmacy Retail Products and Services, ExtraCare, Digital Erin Pensa erin.pensa@cvshealth.com CVS Caremark PBM Services, CVS Specialty Christine Cramer christine.cramer@cvshealth.com MinuteClinic Amy Lanctot amy.lanctot@cvshealth.com Corporate Social Responsibility Joe Goode joseph.goode@cvshealth.com most recent


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wrestle Insulin glargine / lixisenatide Pregnancy and Breastfeeding Warnings Insulin glargine / lixisenatide is also known as: Soliqua Overview Side Effects Dosage Interactions Pregnancy More User Reviews Support Group Q & A Insulin glargine / lixisenatide Pregnancy Warnings Benefit should outweigh risk US FDA pregnancy category: Not Assigned Risk Summary: Based on animal studies, there may be a risk to the fetus from exposure to lixisenatide. Comment: There are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy; insulin therapy is considered a drug of choice during pregnancy. Animal studies with lixisenatide have shown reproductive toxicity. Studies in pregnant rats and rabbits at doses of 1 and 6 times the recommended human dose, respectively, were associated with visceral closure and skeletal defects. Published studies with insulin glargine have not reported a clear association with major birth defects or miscarriage risk. Poorly controlled diabetes in pregnancy increases the maternal risk for diabetic ketoacidosis, pre-eclampsia, spontaneous abortions, preterm delivery, still birth, and macrosomia related morbidity. There are no controlled data in human pregnancy. Patients with diabetes or a history of gestational diabetes should maintain good metabolic control before conception and during pregnancy. Insulin requirements may decrease during the first trimester; generally, increase during the second and third trimesters, and rapidly decline after delivery. Careful monitoring of glucose control is essential. US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out. See references Insulin glargine / lixisenatide Breastfeeding Warnings Benefit should outweigh risk Excreted into human milk: Insulin glargine (yes); Lixisenatide (unknown) Excreted into animal milk: Yes (lixisenatide) Exogenous insulins, including insulin glargine appear to be excreted into breast milk. Insulin is a protein that is inactivated if taken by mouth. If absorbed, it would be destroyed in the digestive tract of the infant. There is no information on the presence of lixisenatide in human milk. In lactating rats, milk transfer of lixisenatide and its metabolites were low (9.4%) and levels of unchanged drug in the gastric contents of weaning offspring was negligible (0.01%). There is no information on the effects on the breastfed infant, or the effects on milk production with this combination drug, although use of insulin therapy should be considered compatible with breastfeeding. See references References for pregnancy information "Product Information. Soliqua 100/33 (insulin glargine-lixisenatide)." sanofi-aventis, Bridgewater, NJ. References for breastfeeding information "Product Information. Soliqua 100/33 (insulin glargine-lixisenatide)." sanofi-aventis, Bridgewater, NJ. United States National Library of Medicine "Toxnet. Toxicology Data Network. Available from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." ([cited 2013 -]): Print this page See Also... insulin glargine and lixisenatide Consumer Information Pregnancy Support Group FDA Pregnancy Categories Medicine use during Pregnancy Medicine use while Breastfeeding Safe Medications during Breastfeeding Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Wolters Kluwer Health and Drugs.com is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2008 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist. Drug Status Rx Availability Prescription only N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Insulin glargine / lixisenatide Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! Drug Class Antidiabetic combinations Help and Support Looking for answers? Ask a question or go join the insulin glargine / lixisenatide support group to connect with others who have similar interests.


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caused Cleocin Pediatric Generic Name: clindamycin palmitate hydrochloride Dosage Form: granule, for oral solution Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings Breastfeeding Warnings User Reviews Support Group Q & A Pricing & Coupons To reduce the development of drug-resistant bacteria and maintain the effectiveness of Cleocin Pediatric and other antibacterial drugs, Cleocin Pediatric should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. Not for Injection Warning Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including clindamycin and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C.difficile . Because clindamycin therapy has been associated with severe colitis which may end fatally, it should be reserved for serious infections where less toxic antimicrobial agents are inappropriate, as described in the INDICATIONS AND USAGE section. It should not be used in patients with nonbacterial infections such as most upper respiratory tract infections. C.difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C.difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C.difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C.difficile , and surgical evaluation should be instituted as clinically indicated. Cleocin Pediatric Description Clindamycin palmitate hydrochloride is a water soluble hydrochloride salt of the ester of clindamycin and palmitic acid. Clindamycin is a semisynthetic antibiotic produced by a 7(S)-chloro-substitution of the 7(R)-hydroxyl group of the parent compound lincomycin. The structural formula is represented below: The chemical name for clindamycin palmitate hydrochloride is Methyl 7-chloro-6, 7, 8-trideoxy-6-(1-methyl- trans -4-propyl-L-2-pyrrolidinecarboxamido)-1-thio-L- threo -ฮฑ-D- galacto -octopyranoside 2-palmitate monohydrochloride. Cleocin Pediatric Flavored Granules contain clindamycin palmitate hydrochloride for reconstitution. Each 5 mL contains the equivalent of 75 mg clindamycin. Inactive ingredients: artificial cherry flavor, dextrin, ethylparaben, pluronic F68, simethicone, sucrose. Slideshow The Shocking Truth About Antibiotic Resistance Cleocin Pediatric - Clinical Pharmacology Human Pharmacology Absorption Blood level studies comparing clindamycin palmitate HCl with clindamycin hydrochloride show that both drugs reach their peak active serum levels at the same time, indicating a rapid hydrolysis of the palmitate to the clindamycin. Serum level studies with clindamycin palmitate HCl in normal pediatric patients weighing 50-100 lbs given 2, 3 or 4 mg/kg every 6 hours (8, 12 or 16 mg/kg/day) demonstrated mean peak clindamycin serum levels of 1.24, 2.25 and 2.44 mcg/mL respectively, one hour after the first dose. By the fifth dose, the 6-hour serum concentration had reached equilibrium. Peak serum concentrations after this time would be about 2.46, 2.98 and 3.79 mcg/mL with doses of 8, 12 and 16 mg/kg/day, respectively. Serum levels have been uniform and predictable from person to person and dose to dose. Distribution Multiple-dose studies in neonates and infants up to 6 months of age show that the drug does not accumulate in the serum and is excreted rapidly. Serum levels exceed the MICs for most indicated organisms for at least six hours following administration of the usually recommended doses of Cleocin Pediatric in adults and pediatric patients. Clindamycin is widely distributed in body fluids and tissues (including bones). No significant levels of clindamycin are attained in the cerebrospinal fluid, even in the presence of inflamed meninges. Metabolism In vitro studies in human liver and intestinal microsomes indicated that clindamycin is predominantly metabolized by Cytochrome P450 3A4 (CYP3A4), with minor contribution from CYP3A5, to form clindamycin sulfoxide and a minor metabolite, N-desmethylclindamycin. Excretion Approximately 10% of the bioactivity is excreted in the urine and 3.6% in the feces; the remainder is excreted as bioinactive metabolites. The average serum half-life after doses of Cleocin Pediatric is approximately two hours in pediatric patients. Special Populations Renal Impairment Serum half-life of clindamycin is increased slightly in patients with markedly reduced renal function. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum. Use in Elderly Pharmacokinetic studies in elderly volunteers (61-79 years) and younger adults (18-39 years) indicate that age alone does not alter clindamycin pharmacokinetics (clearance, elimination half-life, volume of distribution, and area under the serum concentration-time curve) after IV administration of clindamycin phosphate. After oral administration of clindamycin hydrochloride, elimination half-life is increased to approximately 4.0 hours (range 3.4 5.1 h) in the elderly compared to 3.2 hours (range 2.1 4.2 h) in younger adults; administration of clindamycin palmitate HCl resulted in a similar elimination half-life value of about 4.5 hours in elderly subjects. However, the extent of absorption is not different between age groups and no dosage alteration is necessary for the elderly with normal hepatic function and normal (age-adjusted) renal function 1 . Microbiology Mechanism of Action Clindamycin inhibits bacterial protein synthesis by binding to the 23S RNA of the 50S subunit of the ribosome. Clindamycin is bacteriostatic. Resistance Resistance to clindamycin is most often caused by modification of specific bases of the 23S ribosomal RNA. Cross-resistance between clindamycin and lincomycin is complete. Because the binding sites for these antibacterial drugs overlap, cross-resistance is sometimes observed among lincosamides, macrolides and streptogramin B. Macrolide-inducible resistance to clindamycin occurs in some isolates of macrolide-resistant bacteria. Macrolide-resistant isolates of staphylococci and beta-hemolytic streptococci should be screened for induction of clindamycin resistance using the D-zone test. Antimicrobial Activity Clindamycin has been shown to be active against most of the isolates of the following microorganisms, both in vitro and in clinical infections, as described in the INDICATIONS AND USAGE section. Gram-positive Bacteria Staphylococcus aureus (methicillin-susceptible strains) Streptococcus pneumoniae (penicillin-susceptible strains) Streptococcus pyogenes Anaerobic Bacteria Clostridium perfringens Fusobacterium necrophorum Fusobacterium nucleatum Peptostreptococcus anaerobius Prevotella melaninogenica At least 90% of the microorganisms listed below exhibit in vitro minimum inhibitory concentrations (MICs) less than or equal to the clindamycin susceptible MIC breakpoint for organisms of a similar type to those shown in Table 1. However, the efficacy of clindamycin in treating clinical infections due to these microorganisms has not been established in adequate and well-controlled clinical trials. Gram-positive Bacteria Staphylococcus epidermidis (methicillin-susceptible strains) Streptococcus agalactiae Streptococcus anginosus Streptococcus mitis Streptococcus oralis Anaerobic Bacteria Actinomyces israelii Clostridium clostridioforme Eggerthella lenta Finegoldia (Peptostreptococcus) magna Micromonas (Peptostreptococcus) micros Prevotella bivia Prevotella intermedia Propionibacterium acnes Susceptibility Testing Methods When available, the clinical microbiology laboratory should provide cumulative in vitro susceptibility test results for antimicrobial drugs used in local hospitals and practice areas to the physician as periodic reports that describe the susceptibility profile of nosocomial and community-acquired pathogens. These reports should aid the physician in selecting an antibacterial drug for treatment. Dilution Techniques Quantitative methods are used to determine antimicrobial minimum inhibitory concentrations (MICs). These MICs provide estimates of the susceptibility of bacteria to antimicrobial compounds. The MICs should be determined using a standardized test method 2,3 (broth and/or agar). The MIC values should be interpreted according to the criteria provided in Table 1. Diffusion Techniques Quantitative methods that require the measurement of zone diameters can also provide reproducible estimates of the susceptibility of bacteria to antimicrobial compounds. The zone size should be determined using a standardized method 2,5 . This procedure uses paper disks impregnated with 2 mcg of clindamycin to test the susceptibility of bacteria to clindamycin. The disk diffusion breakpoints are provided in Table 1. Anaerobic Techniques For anaerobic bacteria, the susceptibility to clindamycin can be determined by a standardized test method 2,4 . The MIC values obtained should be interpreted according to the criteria provided in Table 1. Table 1. Susceptibility Test Interpretive Criteria for Clindamycin Pathogen Susceptibility Interpretive Criteria Minimal Inhibitory Concentrations (MIC in mcg/mL) Disk Diffusion (Zone Diameters in mm) S I R S I R NA=not applicable Staphylococcus spp. 0.5 1 2 4 21 15 20 14 Streptococcus pneumoniae and other Streptococcus spp. 0.25 0.5 1 19 16 18 15 Anaerobic Bacteria 2 4 8 NA NA NA A report of Susceptible (S) indicates that the antimicrobial drug is likely to inhibit growth of the pathogen if the antimicrobial drug reaches the concentration usually achievable at the site of infection. A report of Intermediate (I) indicates that the result should be considered equivocal, and, if the microorganism is not fully susceptible to alternative, clinically feasible drugs, the test should be repeated. This category implies possible clinical applicability in body sites where the drug is physiologically concentrated or in situations where high dosage of drug can be used. This category also provides a buffer zone that prevents small, uncontrolled technical factors from causing major discrepancies in interpretation. A report of Resistant (R) indicates that the antimicrobial drug is not likely to inhibit growth of the pathogen if the antimicrobial drug reaches the concentration usually achievable at the infection site; other therapy should be selected. Quality Control Standardized susceptibility test procedures require the use of laboratory controls to monitor and ensure the accuracy and precision of the supplies and reagents used in the assay, and the techniques of the individuals performing the test. 2,3,4,5 Standard clindamycin powder should provide the MIC ranges in Table 2. For the disk diffusion technique using the 2 mcg clindamycin disk the criteria provided in Table 2 should be achieved. Table 2. Acceptable Quality Control Ranges for Clindamycin QC Strain Acceptable Quality Control Ranges Minimum Inhibitory Concentration Range (mcg/mL) Disk Diffusion Range (Zone Diameters in mm) NA=Not applicable ATCC is a registered trademark of the American Type Culture Collection * Enterococcus faecalis has been included in this table for quality control purposes only. Quality control for C. difficile is performed using the agar dilution method only, all other obligate anaerobes may be tested by either broth microdilution or agar dilution methods. Enterococcus faecalis * ATCC 29212 4 16 NA Staphylococcus aureus ATCC 29213 0.06 0.25 NA Staphylococcus aureus ATCC 25923 NA 24 30 Streptococcus pneumoniae ATCC 49619 0.03 0.12 19 25 Bacteroides fragilis ATCC 25285 0.5 2 NA Bacteroides thetaiotaomicron ATCC 29741 2 8 NA Clostridium difficile ATCC 700057 2 8 NA Eggerthella lenta ATCC 43055 0.06 0.25 NA Indications and Usage for Cleocin Pediatric Cleocin Pediatric (clindamycin palmitate HCl) is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of colitis, as described in the BOXED WARNING , before selecting clindamycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (e.g., erythromycin). Anaerobes: Serious respiratory tract infections such as empyema, anaerobic pneumonitis and lung abscess; serious skin and soft tissue infections; septicemia; intra-abdominal infections such as peritonitis and intra-abdominal abscess (typically resulting from anaerobic organisms resident in the normal gastrointestinal tract); infections of the female pelvis and genital tract such as endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis and postsurgical vaginal cuff infection. Streptococci: Serious respiratory tract infections; serious skin and soft tissue infections. Staphylococci: Serious respiratory tract infections; serious skin and soft tissue infections. Pneumococci: Serious respiratory tract infections. Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Cleocin Pediatric and other antibacterial drugs, Cleocin Pediatric should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Contraindications This drug is contraindicated in individuals with a history of hypersensitivity to preparations containing clindamycin or lincomycin. Warnings See BOXED WARNING . Clostridium difficile Associated Diarrhea Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including Cleocin Pediatric (Clindamycin Palmitate HCL) , and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile . C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile , and surgical evaluation should be instituted as clinically indicated. Anaphylactic and Severe Hypersensitivity Reactions Anaphylactic shock and anaphylactic reactions have been reported (see ADVERSE REACTIONS ). Severe hypersensitivity reactions, including severe skin reactions such as toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), and Stevens-Johnson syndrome (SJS), some with fatal outcome, have been reported (see ADVERSE REACTIONS ). In case of such an anaphylactic or severe hypersensitivity reaction, discontinue treatment permanently and institute appropriate therapy. A careful inquiry should be made concerning previous sensitivities to drugs and other allergens. Usage in Meningitis Since clindamycin does not diffuse adequately into the cerebrospinal fluid, the drug should not be used in the treatment of meningitis. Precautions General Review of experience to date suggests that a subgroup of older patients with associated severe illness may tolerate diarrhea less well. When clindamycin is indicated in these patients, they should be carefully monitored for change in bowel frequency. Cleocin Pediatric (clindamycin palmitate HCl) should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis. Cleocin Pediatric should be prescribed with caution in atopic individuals. Indicated surgical procedures should be performed in conjunction with antibiotic therapy. The use of Cleocin Pediatric occasionally results in overgrowth of nonsusceptible organisms-particularly yeasts. Should superinfections occur, appropriate measures should be taken as indicated by the clinical situation. Clindamycin dosage modification may not be necessary in patients with renal disease. In patients with moderate to severe liver disease, prolongation of clindamycin half-life has been found. However, it was postulated from studies that when given every eight hours, accumulation should rarely occur. Therefore, dosage modification in patients with liver disease may not be necessary. However, periodic liver enzyme determinations should be made when treating patients with severe liver disease. Prescribing Cleocin Pediatric in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Information for Patients Patients should be counseled that antibacterial drugs including Cleocin Pediatric should only be used to treat bacterial infections. They do not treat viral infections (e.g., the common cold). When Cleocin Pediatric is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may (1) decrease the effectiveness of the immediate treatment and (2) increase the likelihood that bacteria will develop resistance and will not be treatable by Cleocin Pediatric or other antibacterial drugs in the future. Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools (with or without stomach cramps and fever) even as late as two or more months after having taken the last dose of the antibiotic. If this occurs, patients should contact their physician as soon as possible. Laboratory Tests During prolonged therapy, periodic liver and kidney function tests and blood counts should be performed. Drug Interactions Clindamycin has been shown to have neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents. Therefore, it should be used with caution in patients receiving such agents. Clindamycin is metabolized predominantly by CYP3A4, and to a lesser extent by CYP3A5, to the major metabolite clindamycin sulfoxide and minor metabolite N-desmethylclindamycin. Therefore inhibitors of CYP3A4 and CYP3A5 may increase plasma concentrations of clindamycin and inducers of these isoenzymes may reduce plasma concentrations of clindamycin. In the presence of strong CYP3A4 inhibitors, monitor for adverse reactions. In the presence of strong CYP3A4 inducers such as rifampicin, monitor for loss of effectiveness. In vitro studies indicate that clindamycin does not inhibit CYP1A2, CYP2C9, CYP2C19, CYP2E1 or CYP2D6 and only moderately inhibits CYP3A4. Carcinogenesis, Mutagenesis, Impairment of Fertility Long term studies in animals have not been performed with clindamycin to evaluate carcinogenic potential. Genotoxicity tests performed included a rat micronucleus test and an Ames Salmonella reversion test. Both tests were negative. Fertility studies in rats treated orally with up to 300 mg/kg/day (approximately 1.6 times the highest recommended adult human oral dose based on mg/m 2 ) revealed no effects on fertility or mating ability. Pregnancy: Teratogenic Effects Clindamycin should be used during the first trimester of pregnancy only if clearly needed. There are no adequate and well-controlled studies in pregnant women during the first trimester of pregnancy. Because animal reproduction studies are not always predictive of the human response, this drug should be used during pregnancy only if clearly needed. Reproduction studies performed in rats and mice using oral doses of clindamycin up to 600 mg/kg/day (3.2 and 1.6 times the highest recommended adult human dose based on mg/m2, respectively) or subcutaneous doses of clindamycin up to 250 mg/kg/day (1.3 and 0.7 times the highest recommended adult human dose based on mg/m 2 , respectively) revealed no evidence of teratogenicity. Nursing Mothers Clindamycin has been reported to appear in breast milk in the range of 0.7 to 3.8 mcg/mL. Clindamycin has the potential to cause adverse effects on the breastfed infant's gastrointestinal flora. If oral or intravenous clindamycin is required by a nursing mother, it is not a reason to discontinue breastfeeding, but an alternate drug may be preferred. Monitor the infant for possible adverse effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for clindamycin and any potential adverse effects on the breastfed child from clindamycin or from the underlying maternal condition. Pediatric Use When Cleocin Pediatric is administered to the pediatric population (birth to 16 years), appropriate monitoring of organ system functions is desirable. Geriatric Use Clinical studies of clindamycin did not include sufficient numbers of patients age 65 and over to determine whether they respond differently from younger patients. However, other reported clinical experience indicates that antibiotic-associated colitis and diarrhea (due to Clostridium difficile ) seen in association with most antibiotics occur more frequently in the elderly (>60 years) and may be more severe. These patients should be carefully monitored for the development of diarrhea. Pharmacokinetic studies with clindamycin have shown no clinically important differences between young subjects (18 39 years) and elderly subjects (61 79 years) with normal hepatic function and normal (age-adjusted) renal function after oral or intravenous administration. Adverse Reactions The following reactions have been reported with the use of clindamycin. Infections and infestations: Clostridium difficile colitis Gastrointestinal: Abdominal pain, pseudomembranous colitis, esophagitis, nausea, vomiting and diarrhea (see BOXED WARNING ). The onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment (see WARNINGS ). An unpleasant or metallic taste has been reported after oral administration. Hypersensitivity Reactions: Generalized mild to moderate morbilliform-like (maculopapular) skin rashes are the most frequently reported adverse reactions. Vesiculobullous rashes, as well as urticaria, have been observed during drug therapy. Severe skin reactions such as Toxic Epidermal Necrolysis, some with fatal outcome, have been reported (See WARNINGS ). Cases of Acute Generalized Exanthematous Pustulosis (AGEP), erythema multiforme, some resembling Stevens-Johnson syndrome, anaphylactic shock, anaphylactic reaction and hypersensitivity have also been reported. Skin and Mucous Membranes: Pruritus, vaginitis, angioedema, and rare instances of exfoliative dermatitis have been reported. (See Hypersensitivity Reactions .) Liver: Jaundice and abnormalities in liver function tests have been observed during clindamycin therapy. Renal: Although no direct relationship of clindamycin to renal damage has been established, renal dysfunction as evidenced by azotemia, oliguria, and/or proteinuria has been observed. Hematopoietic: Transient neutropenia (leukopenia) and eosinophilia have been reported. Reports of agranulocytosis and thrombocytopenia have been made. No direct etiologic relationship to concurrent clindamycin therapy could be made in any of the foregoing. Immune system : Drug reaction with eosinophilia and systemic symptoms (DRESS) cases have been reported. Musculoskeletal: Cases of polyarthritis have been reported. Overdosage Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum. Cleocin Pediatric Dosage and Administration If significant diarrhea occurs during therapy, this antibiotic should be discontinued (see BOXED WARNING ). Concomitant administration of food does not adversely affect the absorption of clindamycin palmitate HCl contained in Cleocin Pediatric Flavored Granules. Serious infections: 8 12 mg/kg/day (4 6 mg/lb/day) divided into 3 or 4 equal doses. Severe infections: 13 16 mg/kg/day (6.5 8 mg/lb/day) divided into 3 or 4 equal doses. More severe infections: 17 25 mg/kg/day (8.5 12.5 mg/lb/day) divided into 3 or 4 equal doses. In pediatric patients weighing 10 kg or less, teaspoon (37.5 mg) three times a day should be considered the minimum recommended dose. Serious infections due to anaerobic bacteria are usually treated with CLEOCIN PHOSPHATE Sterile Solution. However, in clinically appropriate circumstances, the physician may elect to initiate treatment or continue treatment with Cleocin Pediatric. NOTE: In cases of ฮฒ-hemolytic streptococcal infections, treatment should be continued for at least 10 days. Reconstitution Instructions: When reconstituted with water as follows, each 5 mL (teaspoon) of solution contains clindamycin palmitate HCl equivalent to 75 mg clindamycin. Reconstitute bottles of 100 mL with 75 mL of water. Add a large portion of the water and shake vigorously; add the remainder of the water and shake until the solution is uniform. Storage Conditions: Store at controlled room temperature 20 to 25 C (68 to 77 F) [see USP]. Do NOT refrigerate the reconstituted solution; when chilled, the solution may thicken and be difficult to pour. The solution is stable for 2 weeks at room temperature. How is Cleocin Pediatric Supplied Cleocin Pediatric Flavored Granules for oral solution is available in bottles of 100 mL (NDC 0009-0760-04). When reconstituted as directed, each bottle yields a solution containing 75 mg of clindamycin per 5 mL. Rx only References Smith RB, Phillips JP: Evaluation of CLEOCIN HCl and CLEOCIN Phosphate in an Aged Population. Upjohn TR 8147-82-9122-021, December 1982. CLSI. Performance Standards for Antimicrobial Susceptibility Testing: 26 th ed CLSI supplement M 100S. Wayne, PA: Clinical and Laboratory Standards Institute; 2016. CLSI. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically; Approved Standard Tenth Edition. CLSI document M07-A10. Wayne, PA: Clinical and Laboratory Standards Institute; 2015. . CLSI. Methods for Antimicrobial Susceptibility Testing of Anaerobic Bacteria; Approved Standard Eighth Edition. CLSI document M11-A8. Wayne, PA: Clinical and Laboratory Standards Institute; 2012. CLSI. Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard Twelfth Edition. CLSI document M02-A12. Wayne, PA: Clinical and Laboratory Standards Institute; 2015. This product's label may have been updated. For current full prescribing information, please visit www.pfizer.com. LAB-0041-16.0 September 2017 PRINCIPAL DISPLAY PANEL - 100 mL Bottle Label NDC 0009-0760-04 Pfizer Cleocin Pediatric clindamycin palmitate hydrochloride for oral solution, USP When reconstituted each 5 mL contains 75 mg* 100 mL (when mixed) Rx only PRINCIPAL DISPLAY PANEL - 100 mL Bottle Carton NDC 0009-0760-04 Pfizer Cleocin Pediatric clindamycin palmitate hydrochloride for oral solution, USP When reconstituted each 5 mL contains 75 mg* 100 mL (when mixed) Rx only Cleocin Pediatric clindamycin palmitate hydrochloride granule, for solution Product Information Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:0009-0760 Route of Administration ORAL DEA Schedule Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength CLINDAMYCIN PALMITATE HYDROCHLORIDE (CLINDAMYCIN) CLINDAMYCIN 75 mg in 5 mL Inactive Ingredients Ingredient Name Strength ETHYLPARABEN DIMETHICONE POLOXAMER 188 SUCROSE ICODEXTRIN Product Characteristics Color Score Shape Size Flavor CHERRY Imprint Code Contains Packaging # Item Code Package Description 1 NDC:0009-0760-04 1 BOTTLE in 1 CARTON 1 100 mL in 1 BOTTLE Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date ANDA ANDA062644 04/17/1986 Labeler - Pharmacia and Upjohn Company LLC (618054084) Establishment Name Address ID/FEI Operations Pharmacia and Upjohn Company LLC 618054084 ANALYSIS(0009-0760), API MANUFACTURE(0009-0760), LABEL(0009-0760), PACK(0009-0760) Revised: 09/2017 Pharmacia and Upjohn Company LLC Next Interactions Print this page Add to My Med List More about Cleocin Pediatric (clindamycin) Side Effects During Pregnancy or Breastfeeding Dosage Information Drug Interactions Support Group Pricing & Coupons En Espaรฑol 0 Reviews Add your own review/rating Drug class: lincomycin derivatives Consumer resources Cleocin Pediatric oral/injection Cleocin Pediatric Cleocin Pediatric Oral (Advanced Reading) Professional resources Clindamycin Phosphate (AHFS Monograph) Clindamycin in Dextrose Injection (FDA) Other Formulations Cleocin ... +5 more Related treatment guides Bacterial Vaginitis Aspiration Pneumonia Babesiosis Bacteremia ... +18 more} 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 Drug Class Lincomycin derivatives Related Drugs lincomycin derivatives clindamycin , Cleocin , Lincocin , lincomycin Bacterial Vaginitis metronidazole , clindamycin , Cleocin , tinidazole , More... Bacterial Infection ciprofloxacin , amoxicillin , azithromycin , doxycycline , cephalexin , More... Sinusitis prednisone , ciprofloxacin , amoxicillin , azithromycin , Augmentin , More... 19 more conditions... Cleocin Pediatric Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first!} } idea


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obsessed with Cleocin Pediatric Generic Name: Clindamycin Oral Solution (KLIN da MYE sin) Brand Name: Cleocin Pediatric Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings Breastfeeding Warnings User Reviews Support Group Q & A Pricing & Coupons Warning It is common to have diarrhea when taking Cleocin Pediatric (clindamycin oral solution). Rarely, a very bad form of diarrhea called Clostridium difficile (C diff) associated diarrhea (CDAD) may occur. Sometimes, this has led to a deadly bowel problem (colitis). CDAD may happen while you are taking this medicine or within a few months after you stop taking it. Call your doctor right away if you have stomach pain or cramps, very loose or watery stools, or bloody stools. Do not try to treat loose stools without first checking with your doctor. Uses of Cleocin Pediatric: It is used to treat or prevent bacterial infections. What do I need to tell my doctor BEFORE I take Cleocin Pediatric? If you have an allergy to lincomycin, clindamycin, or any other part of Cleocin Pediatric. If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs. If you have meningitis. This medicine is not used to treat meningitis. This medicine may interact with other drugs or health problems. 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 this medicine 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 Flagyl Side Effects and What You Can Do About Them What are some things I need to know or do while I take Cleocin Pediatric? Tell all of your health care providers that you take Cleocin Pediatric. This includes your doctors, nurses, pharmacists, and dentists. Have your blood work checked if you are on this medicine for a long time. Talk with your doctor. This medicine does not treat the common cold. Do not use longer than you have been told. A second infection may happen. A very bad and sometimes deadly reaction has happened with Cleocin Pediatric. Most of the time, this reaction has signs like fever, rash, or swollen glands with problems in body organs like the liver, kidney, blood, heart, muscles and joints, or lungs. Talk with the 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 Cleocin Pediatric while you are pregnant. Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby. How is this medicine (Cleocin Pediatric) best taken? Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely. To gain the most benefit, do not miss doses. Keep taking Cleocin Pediatric as you have been told by your doctor or other health care provider, even if you feel well. Take with or without food. Take with food if it causes an upset stomach. Shake well before use. Measure liquid doses carefully. Use the measuring device that comes with this medicine. If there is none, ask the pharmacist for a device to measure Cleocin Pediatric. What do I do if I miss a dose? Take a missed dose as soon as you think about it. If it is close to the time for your next dose, skip the missed dose and go back to your normal time. Do not take 2 doses at the same time or extra doses. Dosage Information (comprehensive) What are some side effects that I need to call my doctor about right away? WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect: Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat. Joint pain or swelling. Not able to pass urine or change in how much urine is passed. Yellow skin or eyes. Vaginal itching or discharge. A very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes. What are some other side effects of Cleocin Pediatric? 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: 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 Cleocin Pediatric? Store at room temperature. Do not refrigerate or freeze. Store in a dry place. Do not store in a bathroom. Throw away any part not used after 2 weeks. Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets. Check with your pharmacist about how to throw out unused drugs. Consumer Information Use and Disclaimer If your symptoms or health problems do not get better or if they become worse, call your doctor. Do not share your drugs with others and do not take anyone else's drugs. Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor. Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins. Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this medicine, please talk with your doctor, nurse, pharmacist, or other health care provider. If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened. This information should not be used to decide whether or not to take Cleocin Pediatric (clindamycin 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 Cleocin Pediatric. 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 Cleocin Pediatric (clindamycin) Side Effects During Pregnancy or Breastfeeding Dosage Information Drug Interactions Support Group Pricing & Coupons En Espaรฑol 0 Reviews Add your own review/rating Drug class: lincomycin derivatives Consumer resources Cleocin Pediatric oral/injection Cleocin Pediatric Oral (Advanced Reading) Professional resources Cleocin Pediatric (FDA) Clindamycin Phosphate (AHFS Monograph) Other Formulations Cleocin (Clindamycin Capsules) ... +5 more Related treatment guides Bacterial Vaginitis Aspiration Pneumonia Babesiosis Bacteremia ... +18 more} Drug Status Rx Availability Prescription only B Pregnancy Category No proven risk in humans N/A CSA Schedule Not a controlled drug Cleocin Pediatric Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! Drug Class Lincomycin derivatives Related Drugs Bacterial Vaginitis metronidazole , clindamycin , Cleocin , tinidazole , More... Bacterial Infection ciprofloxacin , amoxicillin , azithromycin , doxycycline , cephalexin , More... Sinusitis prednisone , ciprofloxacin , amoxicillin , azithromycin , Augmentin , More... Skin or Soft Tissue Infection ciprofloxacin , amoxicillin , azithromycin , doxycycline , cephalexin , More... 18 more conditions... Related: Bacterial Vaginosis (Gardnerella Vaginitis)} } sometimes


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daily SF Generic Name: fluoride topical (FLOR ide TOP i kal) Brand Name: ACT Fluoride Rinse, Biotene, Clinpro 5000, Control Rx, Denta 5000 Plus, Dentagel, Fluoridex, Fluorigard, Fluorinse, Gel-Kam, NaFrinse Daily/Acidulated, Nafrinse Solution, Neutracare Gel, Neutragard, Neutral Sodium Fluoride Rinse, Omnii Gel Just For Kids, Oral B Anti-Cavity, OrthoWash, Perfect Choice, Perio Med, Prevident, Prevident Dental Rinse, SF Overview Side Effects Dosage Pregnancy Reviews More Pricing & Coupons What is SF (fluoride topical)? Fluoride is a substance that strengthens tooth enamel. This helps to prevent dental cavities. Fluoride topical is used as a medication to prevent tooth decay in patients that have a low level of fluoride topical in their drinking water. Fluoride topical is also used to prevent tooth decay in patients who undergo radiation of the head and/or neck, which may cause dryness of the mouth and an increased incidence of tooth decay. Fluoride may also be used for purposes not listed in this medication guide. Slideshow Type 1 Diabetes: Symptoms, Treatments, and Breakthroughs What is the most important information I should know about SF (fluoride topical)? Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use. Fluoride topical should not be used if the level of fluoride in the drinking water is greater than 0.7 parts per million (ppm). What should I discuss with my healthcare provider before using SF (fluoride topical)? Fluoride topical should not be used if the level of fluoride in the drinking water is greater than 0.7 parts per million (ppm). To make sure fluoride topical is safe for you, tell your doctor if you are on a low salt or a salt free diet If you have gum disease, some forms of fluoride topical may be irritating to your gums. Talk to your dentist or doctor if you have bothersome mouth irritation while using fluoride topical. Talk to your doctor and dentist before using fluoride topical if you are pregnant. Talk to your doctor and dentist before using fluoride topical if you are breast-feeding. The use of fluoride is particularly important in children to protect against tooth decay. The American Dental Association's Council on Dental Therapeutics recommends the use of fluoride by children up to 13 years of age. The American Academy of Pediatrics recommends fluoride supplementation in children until the age of 16 years old. Do not allow a child to swallow fluoride topical or serious overdose symptoms could result. How should I use SF (fluoride topical)? Use this medication exactly as directed on the label, or as it was prescribed by your dentist or doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label. Fluoride topical should be used immediately after brushing or flossing your teeth. For best results, use the medication just before bedtime, unless your doctor tells you otherwise. Swish this medication in your mouth without swallowing. Then spit it out. Do not eat, drink, or rinse your mouth for 30 minutes after using fluoride topical. Store fluoride topical at room temperature away from moisture and heat. What happens if I miss a dose? Use the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may result if you swallow large amounts of fluoride while using it. Overdose symptoms may include nausea, vomiting, stomach pain, diarrhea, drooling, numbness or tingling, loss of feeling anywhere in your body, muscle stiffness, or seizure (convulsions). What should I avoid while using SF (fluoride topical)? Do not swallow fluoride topical. Spit it out after use. SF (fluoride topical) side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor if you have any of the following side effects: discolored teeth; weakened tooth enamel; or any changes in the appearance of your teeth. Common side effects may include: stomach upset; headache; or weakness. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Side Effects (complete list) What other drugs will affect SF (fluoride topical)? It is not likely that other drugs you take orally or inject will have an effect on topically applied fluoride. But many drugs can interact with each other. Tell each of your health care providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products. Next Side Effects Print this page Add to My Med List More about SF (fluoride topical) Side Effects During Pregnancy Dosage Information Pricing & Coupons En Espaรฑol 0 Reviews Add your own review/rating Drug class: minerals and electrolytes Consumer resources Other brands: Biotene , Prevident , Denta 5000 Plus , Fluoridex , ... +20 more Professional resources Stannous Fluoride Oral Rinse (FDA) Related treatment guides Prevention of Dental Caries Where can I get more information? Your pharmacist can provide more information about fluoride topical. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Copyright 1996-2012 Cerner Multum, Inc. Version: 3.07. Date modified: December 03, 2017 Last reviewed: February 13, 2014 Drug Status Rx OTC Availability Rx and/or OTC N Pregnancy Category Not classified N/A CSA Schedule Not a controlled drug Drug Class Minerals and electrolytes Related Drugs Prevention of Dental Caries Biotene , Prevident , fluoride topical , Prevident 5000 Plus , Denta 5000 Plus , SF 5000 Plus , Fluoridex , Dentagel , Clinpro 5000 , PreviDent 5000 Booster , Gelato X , Prevident 5000 Sensitive , Zooby , ACT Fluoride Rinse , Neutral Sodium Fluoride Rinse , Flura-Drops , Prevident Mouthwash , Perio Med , Colgate Total Advanced Clean , Luride , Omnii Gel Just For Kids , More... SF 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 bank


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different Anusol-HC Cream 2.5% ANUSOL-HC 2.5% (Monarch) (Hydrocortisone Cream, USP) Rx only Description The topical corticosteroids constitute a class of primarily synthetic steroids used as antiinflammatory and antipruritic agents. Anusol-HC 2.5% (Hydrocortisone Cream, USP) is a topical corticosteroid with hydrocortisone 2.5% (active ingredient) in a water-washable cream containing the following inactive ingredients: benzyl alcohol. petrolatum, stearyl alcohol, propylene glycol. isopropyl myristate, polyoxyl 40 stearate, carbomer 934, sodium lauryl sulfate, edetate disodium, sodium hydroxide to adjust the pH, and purified water. Hydrocortisone has the chemical name Pregn-4-ene-3,20-dione, 11,17,21, trihydroxy-,(11(beta)) and the following chemical structure: MOLECULAR FORMULA C 21 H 30 O 5 MOLECULAR WEIGHT 362.47 CAS REGISTRY NUMBER 50-23-7 Clinical Pharmacology Topical corticosteroids share antiinflammatory, antipruritic and vasoconstrictive actions. The mechanism of antiinflammatory activity of the topical corticosteroids is unclear. Various laboratory methods, including vasoconstrictor assays, are used to compare and predict potencies and/or clinical efficacies of the topical corticosteroids. There is some evidence to suggest that a recognizable correlation exists between vasoconstrictor potency and therapeutic efficacy in man. Pharmacokinetics: The extent of percutaneous absorption of topical corticosteroids is determined by many factors including the vehicle, the integrity of the epidermal barrier, and the use of occlusive dressings. Topical corticosteroids can be absorbed from normal intact skin. Inflammation and/or other disease processes in the skin increase percutaneous absorption. Occlusive dressings substantially increase the percutaneous absorption of topical corticosteroids. Thus, occlusive dressings may be a valuable therapeutic adjunct for treatment of resistant dermatoses (see DOSAGE AND ADMINISTRATION ). Once absorbed through the skin, topical corticosteroids are handled through pharmacokinetic pathways similar to systemically administered corticosteroids. Corticosteroids are bound to plasma proteins in varying degrees. Corticosteroids are metabolized primarily in the liver and are then excreted by the kidneys. Some of the topical corticosteroids and their metabolites are also excreted into the bile. Indications and Usage Topical corticosteroids are indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. Contraindications Topical corticosteroids are contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation. Precautions General: Systemic absorption of topical corticosteroids has produced reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing's syndrome, hyperglycemia, and glucosuria in some patients. Conditions which augment systemic absorption include the application of the more potent steroids, use over large surface areas, prolonged use, and the addition of occlusive dressings. If HPA axis suppression is noted (by using the urinary free cortisol and ACTH stimulation tests) an attempt should be made to withdraw the drug or to reduce the frequency of application. Recovery of HPA axis function is generally prompt and complete upon discontinuation of the drug. Infrequently, signs and symptoms of steroid withdrawal may occur, requiring supplemental systemic corticosteroids. Pediatric patients may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity (see PRECAUTIONS --Use in Pediatric Patients). If irritation develops, topical corticosteroids should be discontinued and appropriate therapy instituted. In the presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted. If a favorable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled. Information for the Patient: Patients using topical corticosteroids should receive the following information and instructions: This medication is to be used as directed by the physician. It is for external use only. Avoid contact with the eyes. Patients should be advised not to use this medication for any disorder other than for which it has been prescribed. The treated skin area should not be bandaged or otherwise covered or wrapped as to be occlusive unless directed by the physician. Patients should report any signs of local adverse reactions especially under occlusive dressing. Parents of pediatric patients should be advised not to use tight-fitting diapers or plastic pants on a child being treated in the diaper area, as these garments may constitute occlusive dressings. Laboratory Tests: The urinary free cortisol test and the ACTH stimulation test may be helpful in evaluating the HPA axis suppression. Carcinogenesis, Mutagenesis, and Impairment of Fertility: Long-term animal studies have not been performed to evaluate the carcinogenic potential or the effect on fertility of topical corticosteroids. Studies to determine mutagenicity with hydrocortisone have revealed negative results. Pregnancy Category C: Corticosteroids are generally teratogenic in laboratory animals when administered systemically at relatively low dosage levels. The more potent corticosteroids have been shown to be teratogenic after dermal application in laboratory animals. There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Drugs of this class should not be used extensively on pregnant patients, in large amounts, or for prolonged periods of time. Nursing Mothers: It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Systemically administered corticosteroids are secreted into breast milk in quantities not likely to have a deleterious effect on the infant. Nevertheless, caution should be exercised when topical corticosteroids are administered to a nursing woman. Use in Pediatric Patients: PEDIATRIC PATIENTS MAY DEMONSTRATE GREATER SUSCEPTIBILITY TO TOPICAL CORTICOSTEROID-INDUCED HPA AXIS SUPPRESSION AND CUSHING'S SYNDROME THAN MATURE PATIENTS BECAUSE OF A LARGER SKIN SURFACE AREA TO BODY WEIGHT RATIO. Hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, and intracranial hypertension have been reported in pediatric patients receiving topical corticosteroids. Manifestations of adrenal suppression in pediatric patients include linear growth retardation, delayed weight gain, low plasma cortisol levels, and absence of response to ACTH stimulation. Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema. Administration of topical corticosteroids to pediatric patients should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of pediatric patients. Adverse Reactions The following local adverse reactions are reported infrequently with topical corticosteroids, but may occur more frequently with the use of occlusive dressings. These reactions are listed in an approximate decreasing order of occurrence: Burning Itching Irritation Dryness Folliculitis Hypertrichosis Acneiform eruptions Hypopigmentation Perioral dermatitis Allergic contact dermatitis Maceration of the skin Secondary infection Skin atrophy Striae Miliaria Overdosage Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects. (See PRECAUTIONS ). Dosage and Administration Anusol-HC 2.5% (Hydrocortisone Cream, USP) should be applied to the affected area two to four times daily depending on the severity of the condition. Occlusive dressings may be used for the management of psoriasis or recalcitrant conditions. If an infection develops, the use of occlusive dressings should be discontinued and appropriate antimicrobial therapy instituted. How Supplied Anusol-HC 2.5% (Hydrocortisone Cream, USP) is supplied in 30 gram tubes NDC 61570-313-11. Store at controlled room temperature 15 -30 C (59 -86 F). Store away from heat. Protect from freezing. Rev. 11/98 0932999 Manufactured by: King Pharmaceuticals, Inc., Bristol, TN 37620 Distributed by: Monarch Pharmaceuticals, Inc. Bristol, TN 37620 PRODUCT PHOTO(S): NOTE: These photos can be used only for identification by shape, color, and imprint. They do not depict actual or relative size. The product samples shown here have been supplied by the manufacturer. While every effort has been made to assure accurate reproduction, please remember that any visual identification should be considered preliminary. In cases of poisoning or suspected overdosage, the drug's identity should be verified by chemical analysis. Print this page} FDA Consumer Updates Depression: FDA-Approved Medications May Help Dealing with ADHD: What You Need to Know Making Decisions for Your Health: Getting the Info You Need FDA: Cutting-Edge Technology Sheds Light on Antibiotic Resistance More FDA updates} } once in a while


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charge Home Pregnancy Problems Complications with Baby Low Cord pH Umbilical Cord Blood Test According to research conducted by Birmingham, England scientists, an infant's risk for mortality, brain damage, or cerebral palsy can be determined by checking the pH of his umbilical cord at birth. A low pH suggests a higher risk for these events. The study, which has been published in the British Medical Journal (BMJ), is the first collaborative project between BMJ and Cleveland Clinic to earn a continuing medical education credit (CME). Intensive Monitoring The research team believes their findings warrant intensive monitoring for babies born with low cord pH. In addition, they feel that more research is needed to discover whether newborn babies should all undergo testing of their umbilical cord blood. Adverse Outcomes Doctors have long suspected that there may be some linkage between the pH of the umbilical artery and adverse infant outcomes since babies who are deprived of oxygen (hypoxia) during their mothers' labors ; tend to have a low pH in the blood of their umbilical cords. Babies with growth restriction and premature infants both have a very high risk for hypoxia which is a leading cause of brain damage in infants. Inconsistent Data But the data has been inconsistent on this topic. The current guidelines express doubt as to whether the umbilical cord blood pH can give an accurate prediction of complications such as infant death or the later childhood development of cerebral palsy. Therefore, the Birmingham team decided to evaluate the results of 51 studies. The studies included a total of almost half a million babies. The aim of the researchers was to discover whether the evidence of umbilical cord blood pH could be an accurate predictor of complications. Though the studies varied in terms of quality, the overall results seemed unaffected by this fact. In short, the researchers discovered a very strong, consistent correlation between brain damage, infant death, and childhood cerebral palsy with low arterial umbilical cord pH. As a result, the researchers are calling for an increased monitoring of babies born with low pH umbilical cord blood and for more research to be done on whether or not it would be cost effective to test all babies. Stated Aim In an editorial accompanying the report, James Neilson, a professor of obstetrics and gynecology at the University of Liverpool stated that according to these findings, " we should aim to reduce the number of babies born with a low cord pH, without increasing unnecessary obstetric intervention." Login to comment Log in or sign up Forgot Password? Username: Password: CANCEL (0 Comments) Login to add a comment Post a comment You must be logged in to comment. one of these


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nice 08.03.17 The opioid abuse epidemic claims the lives of thousands of Americans each year. Here are five facts about opioid abuse, along with what we're doing about each one. 1. The U.S. is the world s top consumer of prescription opioids. Although the U.S. represents just five percent of the world s population, we use 99 percent of the world s hydrocodone (also known as Vicodin) and 80 percent of its oxycodone (also known as Percocet or Oxycontin). While acknowledging that there are many patients in real need of pain medication, CVS Health CEO Larry Merlo has stated , We believe it is time to institute limits on the quantity of opioids dispensed to patients who are receiving an opioid for the first time and to ensure that the prescription fits the medical condition. Learn more. 2. About two thirds of teens who say they abuse prescription drugs get them from family members, friends and acquaintances. 1 To help prevent prescription drugs from falling into the wrong hands, we created the Medication Disposal for Safer Communities program. Through this program, police departments can apply to receive a drug collection unit to help their communities safely discard unwanted medications, including controlled substances. Since 2014, we have donated a total of 800 drug collection units to police departments in 43 states, and has collected more than 100 metric tons of prescription drugs. Learn more. 3. In 2015, more than 50,000 people in the U.S. died from drug overdoses. 2 More than 60 percent of cases involved an opioid. 3 Naloxone, also known by the brand name Narcan, is a lifesaving drug that blocks opioid receptor sites to reverse the effects of an overdose, offering people a second chance to get the help they need. CVS Pharmacy now dispenses naloxone to patients without an individual prescription in 43 states. Learn more. 4. CVS Health pharmacists have educated nearly 300,000 students about the dangers of prescription drug abuse. Peer pressure, ease of access to prescription medications and a general lack of knowledge about the risks of opioid use can make for a deadly combination. Our Pharmacists Teach program provides teens with the facts about prescription drug abuse. Our pharmacists visit high school health classes on a volunteer basis, where they give a powerful presentation that includes stories of real youths whose lives were changed forever by their choice to abuse prescription painkillers. Learn more. 5. Increasing access to naloxone saves lives. Expanding access to naloxone gives more people a chance to get the help they need: according to the National Bureau of Economic Research, five states that have adopted Naloxone Access Laws have seen a nine to 11 percent reduction in opioid-related deaths. Over the past two years, CVS Health has worked to expand access to naloxone without individual prescriptions in 43 states. Learn more. For more information about our efforts in the fight against opioid abuse, visit our Prescription Drug Abuse information center. And to stay informed about the most talked-about topics in health care, register for content alerts and our bi-weekly health care newsletter . This article was originally published on August 3, 2017, and was updated to reflect current data on September 21, 2017. 1 Partnership for Drug-Free Kids, 2016 2 https://www.cdc.gov/drugoverdose/data/statedeaths.html 3 https://www.cdc.gov/drugoverdose/epidemic/index.html Naloxone availability across the United States 4 6 See States Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin CVS Pharmacy patients in 46 states now have access to the opioid overdose-reversal drug, naloxone. Follow our commitment to drug abuse prevention as we increase access to the life-saving opioid overdose reversal drug. Related Articles CVS Health and POLITICO Examine the Opioid Crisis A quick and easy-to-understand explanation of one of the most pressing challenges in public health: the opioid epidemic. Tackling the Nation s Opioid Crisis: POLITICO Pro Health Care Briefing Experts weigh in with personal experiences and multifaceted solutions to addressing the opioid crisis in America. A State of Emergency: Integrative Approaches to Addiction and the Opioid Epidemic Moriarty discusses the power of partnerships in tackling the opioid epidemic. Related Press Releases 10.26.17 CVS Health Recognizes President s Declaration of Public Health Emergency to Help End Opioid Epidemic 09.21.17 CVS Health Fighting National Opioid Abuse Epidemic With Enterprise Initiatives 09.12.17 CVS Health Makes Overdose-Reversal Drug Available Without Individual Prescription at CVS Pharmacy Locations in Kansas 07.27.17 CVS Health Makes Overdose-Reversal Drug Available Without Individual Prescription at CVS Pharmacy Locations in South Dakota 06.07.17 CVS Pharmacy Now Using Time Delay Safes in Ohio for Controlled Substances to Combat Opioid Epidemic, Reduce Robbery Incidents 05.23.17 Attorney General Brnovich, Rep. Carter Join CVS Health to Announce Availability of Naloxone at All CVS Pharmacy Locations in Arizona to enclose


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and in fact Soliqua Side Effects Generic Name: insulin glargine / lixisenatide Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Pricing & Coupons Note: This document contains side effect information about insulin glargine / lixisenatide. Some of the dosage forms listed on this page may not apply to the brand name Soliqua. For the Consumer Applies to insulin glargine / lixisenatide: subcutaneous solution Along with its needed effects, insulin glargine / lixisenatide 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 immediately if any of the following side effects occur while taking insulin glargine / lixisenatide: Incidence not known Abdominal or stomach pain agitation bloating blurred vision chills cold sweats cold, clammy skin coma confusion constipation convulsions cool, pale skin cough decreased urine output difficulty swallowing dizziness dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position dry mouth fast heartbeat fast, weak pulse fever flushed, dry skin fruit-like breath odor headache hives, itching, or rash hostility increased hunger increased thirst increased urination indigestion irregular heartbeat irritability large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs lethargy lightheadedness loss of appetite muscle pain or cramps muscle twitching nausea or vomiting nightmares noisy breathing numbness or tingling in the hands, feet, or lips pains in the stomach, side, or abdomen, possibly radiating to the back puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue rapid weight gain slurred speech stupor sweating tightness in the chest troubled breathing unexplained weight loss unusual tiredness or weakness yellow eyes or skin Some side effects of insulin glargine / lixisenatide 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 Body aches or pain diarrhea ear congestion loss of voice muscle aches sneezing sore throat stuffy or runny nose Incidence not known Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site For Healthcare Professionals Applies to insulin glargine / lixisenatide: subcutaneous solution General The most commonly occurring adverse reactions with this combination drug include hypoglycemia, allergic reactions, nausea, nasopharyngitis, diarrhea, upper respiratory tract infection, and headache. [ Ref ] Metabolic The rates of hypoglycemia depend on the definition of hypoglycemia. For clinical trials with this drug, severe hypoglycemia was defined as an event requiring assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. Symptomatic hypoglycemia was defined as an event with typical symptoms of hypoglycemia accompanied by a self-monitored plasma glucose value of 70 mg/dL or less. Incidence of severe symptomatic hypoglycemia in 2 trials (n=469 and n=365) was 0% and 1.1% while documented symptomatic hypoglycemia was 25.6% and 40%, respectively. [ Ref ] Very common (10% or more): Hypoglycemia (up to 40%) [ Ref ] Renal Postmarketing reports of acute kidney injury and worsening renal failure, some requiring hemodialysis, have been received in patients treated with GLP-1 receptor agonists. [ Ref ] GLP-1 receptor agonists Postmarketing reports: Acute kidney injury [ Ref ] Gastrointestinal Insulin-glargine-lixisenatide: Very common (10% or more): Nausea (10%) Common (1% to 10%): Diarrhea Frequency not reported: Vomiting, constipation, dyspepsia, gastritis, abdominal pain, flatulence, gastroesophageal reflux disease, abdominal distension, decreased appetite Lixisenatide: Frequency not reported: Pancreatitis [ Ref ] Twenty-one cases of pancreatitis were reported during clinical trials with lixisenatide compared with 14 cases in comparator-treated patients. Cases included acute pancreatitis (n=3), pancreatitis (n=12), chronic pancreatitis (n=5), and edematous pancreatitis (n=1). Some patients had risk factors for pancreatitis, such as a history of cholelithiasis or alcohol abuse. GLP-1 receptor agonists have been associated with acute pancreatitis including fatal and non-fatal hemorrhagic or necrotizing pancreatitis. Gastrointestinal events occur more frequently at the beginning of therapy. [ Ref ] Hypersensitivity Insulins: Frequency not reported: Severe, life-threatening, generalized allergy including anaphylaxis; generalized skin reactions, angioedema, bronchospasm, hypotension, shock Lixisenatide: Uncommon (0.1% to 1%): Anaphylaxis, allergic reactions Frequency not reported: Angioedema [ Ref ] In lixisenatide clinical trials, a higher incidence of allergic reactions occurred in antibody positive patients. [ Ref ] Local Common (1% to 10%): Injection site reactions Frequency not reported: Lipodystrophy, lipohypertrophy [ Ref ] Injection site reactions occurred in 1.7% of patients during clinical trials. Injection site reactions included injection-site hematoma, pain, hemorrhage, erythema, nodules, swelling, discoloration, pruritus, warmth, and injection-site mass. [ Ref ] Immunologic Insulin-glargine-lixisenatide: Very common (10% or more): Antibody formation (up to 43%) Lixisenatide: Common (1% to 10%): High antibody concentrations with attenuated glycemic response [ Ref ] Following 30 weeks of treatment with insulin glargine-lixisenatide, the incidence of anti-insulin glargine antibodies and anti-lixisenatide antibodies was up to 26.2% and approximately 43%, respectively. In about 93% of patients, anti-insulin glargine antibodies showed cross-reactivity to human insulin. In lixisenatide clinical trials, pooled analysis has shown that 70% of lixisenatide-treated patients were antibody positive at 24 weeks. A subset (2.4%) with the highest antibody concentration showed an attenuated glycemic response. A higher incidence of allergic reactions and injection-site reactions occurred in antibody positive patients. [ Ref ] Cardiovascular Insulin Glargine: Frequency not reported: Peripheral edema [ Ref ] Some patients have experienced edema while taking insulin glargine, especially if previously poor metabolic control was improved by intensified insulin therapy. [ Ref ] Nervous system Common (1% to 10%): Headache [ Ref ] Respiratory Common (1% to 10%): Nasopharyngitis, upper respiratory tract, infection [ Ref ] References 1. "Product Information. Soliqua 100/33 (insulin glargine-lixisenatide)." sanofi-aventis, Bridgewater, NJ. Some side effects of Soliqua may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA . Next Dosage Print this page More about Soliqua (insulin glargine / lixisenatide) Side Effects During Pregnancy Dosage Information Drug Interactions Support Group Pricing & Coupons En Espaรฑol 0 Reviews Add your own review/rating Drug class: antidiabetic combinations Consumer resources Soliqua Soliqua 100/33 Professional resources Soliqua 100/33 (FDA) Related treatment guides Diabetes, Type 2 Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.} Drug Status Rx Availability Prescription only N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Manufacturer Sanofi-Aventis U.S. LLC Drug Class Antidiabetic combinations Related Drugs Diabetes, Type 2 metformin , insulin aspart , glipizide , glimepiride , Januvia , pioglitazone , Victoza , Actos , Tradjenta , Glucophage , glyburide , Janumet , Invokana , Amaryl , Welchol , Onglyza , sitagliptin , Trulicity , Jardiance , Lantus , Farxiga , Levemir , Tresiba , Glucotrol , Bydureon , More... Soliqua Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first!} } in the present day


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