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pride Alglucosidase alfa Pregnancy and Breastfeeding Warnings Alglucosidase alfa is also known as: Lumizyme , Myozyme Overview Side Effects Dosage Professional Pregnancy More Breastfeeding Warnings User Reviews Support Group Q & A Alglucosidase alfa Pregnancy Warnings Animal studies have failed to reveal evidence of impaired fertility or embryofetal toxicity at daily doses up to 0.4 to 0.5 times the human steady-state AUC at recommended human biweekly dose during organogenesis; however, increase in mouse pup mortality observed when dose was given every other day during organogenesis through lactation at 0.4 times the human steady-state AUC at recommended human biweekly dose. There are no controlled data in human pregnancy. The Pompe Registry monitors the effect of this drug on pregnant women and their offspring. For additional information and enrollment: pomperegistry.com AU TGA pregnancy category B1: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have not shown evidence of an increased occurrence of fetal damage. US FDA pregnancy category B: Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. This drug should be used during pregnancy only if clearly needed and the benefit outweighs the risk to the fetus. AU TGA pregnancy category: B1 US FDA pregnancy category: -Lumizyme(R): C -Myozyme(R): B See references Alglucosidase alfa Breastfeeding Warnings The Pompe Registry collects data on breastfeeding women treated with this drug. For additional information and enrollment: pomperegistry.com In 1 woman, alglucosidase alfa activity was evident in breast milk for only 24 hours after a dose. At 3 and 77 days of age, anti-alglucosidase alfa antibodies were negligible in the serum of an infant born to a mother receiving alglucosidase alfa 20 mg/kg IV every 2 weeks during pregnancy and lactation. This infant was examined regularly up to 1 year of age and showed normal development; extent of breastfeeding was not reported. LactMed: As a precaution, breastfeeding should be withheld for 24 hours after each dose. -AU: Use is recommended only if clearly needed and after careful benefit/risk analysis for mother and child. -UK: Breastfeeding should be stopped when this drug is used. -US: Caution is recommended; to minimize infant exposure, the nursing mother may pump and discard breast milk produced during the 24 hours after drug administration. Excreted into human milk: Yes Comments: -The effects in the nursing infant are unknown. -This drug is a large protein molecule (molecular weight about 110,000); the amount in milk is likely to be very low; absorption unlikely as it is probably destroyed in the infant gastrointestinal tract. See references References for pregnancy information Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 Cerner Multum, Inc. "Australian Product Information." O 0 "Product Information. Myozyme (alglucosidase alfa)." Genzyme Corporation, Cambridge, MA. "Product Information. Lumizyme (alglucosidase alfa)." Genzyme Corporation, Cambridge, MA. References for breastfeeding information Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 "Product Information. Myozyme (alglucosidase alfa)." Genzyme Corporation, Cambridge, MA. Cerner Multum, Inc. "Australian Product Information." O 0 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 -]): "Product Information. Lumizyme (alglucosidase alfa)." Genzyme Corporation, Cambridge, MA. Print this page See Also... Alglucosidase Alfa use while Breastfeeding (in more detail) alglucosidase alfa injection 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 Pregnancy Category Risk depends on usage N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Alglucosidase alfa Rating No Reviews - Be the first! 1.0 /10 No Reviews - Be the first! 1.0 Rate it! Drug Class Lysosomal enzymes Help and Support Looking for answers? Ask a question or go join the alglucosidase alfa support group to connect with others who have similar interests. make money working from home


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premiere [1000/mm:<75,000/mm 3 , and hemoglobin 17 g/dL; subsequent doses may be delayed if ANC> <1000/mm 3 , platelets> <50,000/mm 3 , and hemoglobin 17 g/dL. Do not reduce dose. Castleman disease, multicentric (in patients who are HIV negative and HHV-8 negative): IV: 11 mg/kg over 1 hour every 3 weeks until treatment failure Dosing: Geriatric Refer to adult dosing. Dosing: Renal Impairment CrCl 15 mL/minute: No initial dosage adjustment is necessary. CrCl> <15 mL/minute: There are no dosage adjustments provided in the manufacturer s labeling (has not been studied). End-stage renal disease (ESRD): There are no dosage adjustments provided in the manufacturer s labeling (has not been studied). Dosing: Hepatic Impairment Mild to moderate impairment (Child Pugh class A or B): No initial dosage adjustment is necessary. Severe impairment (Child Pugh class C): There are no dosage adjustments provided in the manufacturer s labeling (has not been studied). Dosing: Adjustment for Toxicity Hematologic toxicity: ANC> <1000/mm 3 , platelets> <50,000/mm 3 , and hemoglobin 17 g/dL: Consider delaying treatment until ANC 1000/mm 3 , platelets 50,000/mm 3 , and hemoglobin> <17 g/dL Anaphylaxis, cytokine release syndromes, and/or severe infusion-related or allergic reactions: Discontinue permanently. Infection, severe: Withhold treatment until infection resolves. Reconstitution Allow intact vials to come to room temperature (~30 minutes) and remain at room temperature for the duration of preparation. Reconstitute with 5.2 mL (100 mg vial) or 20 mL (400 mg vial) SWFI to a final concentration of 20 mg/mL; gently swirl to fully dissolve powder (usually takes> <60 minutes). Do not shake or swirl vigorously. Must further dilute within 2 hours to 250 mL with D5W (infusion bag must be made of polyvinyl chloride [PVC], polyolefin [PO], polypropylene [PP], or polyethylene [PE], or PE bottles may be used. After all solids are completely dissolved, remove a volume equal to the total calculated dose volume of reconstituted siltuximab from the bag of D5W; slowly add the appropriate volume of reconstituted siltuximab solution to the infusion bag and gently invert to mix. Complete infusion within 4 hours of dilution of the reconstituted solution to the infusion bag. Administration Administer IV over 1 hour using administration sets lined with polyvinyl chloride (PVC), polyurethane (PU), or polyethylene (PE), which contain a 0.2 micron inline polyethersulfone (PES) filter. Do not infuse in the same line with other medications. Complete infusion within 4 hours of dilution of the reconstituted solution to the infusion container. Storage Store intact vials at 2 C to 8 C (36 F to 46 F); protect from light. Reconstituted solution should be further diluted in D5W for infusion within 2 hours; complete infusion within 4 hours of dilution of the reconstituted solution to the infusion container. Discard any unused portion of the reconstituted solution or solution diluted for infusion. Drug Interactions BCG (Intravesical): Immunosuppressants may diminish the therapeutic effect of BCG (Intravesical). Avoid combination Belimumab: Monoclonal Antibodies may enhance the adverse/toxic effect of Belimumab. Avoid combination Coccidioides immitis Skin Test: Immunosuppressants may diminish the diagnostic effect of Coccidioides immitis Skin Test. Monitor therapy CYP3A4 Substrates (High risk with Inducers): Siltuximab may decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Monitor therapy Denosumab: May enhance the adverse/toxic effect of Immunosuppressants. Specifically, the risk for serious infections may be increased. Monitor therapy Echinacea: May diminish the therapeutic effect of Immunosuppressants. Consider therapy modification Fingolimod: Immunosuppressants may enhance the immunosuppressive effect of Fingolimod. Management: Avoid the concomitant use of fingolimod and other immunosuppressants when possible. If combined, monitor patients closely for additive immunosuppressant effects (eg, infections). Consider therapy modification Leflunomide: Immunosuppressants may enhance the adverse/toxic effect of Leflunomide. Specifically, the risk for hematologic toxicity such as pancytopenia, agranulocytosis, and/or thrombocytopenia may be increased. Management: Consider not using a leflunomide loading dose in patients receiving other immunosuppressants. Patients receiving both leflunomide and another immunosuppressant should be monitored for bone marrow suppression at least monthly. Consider therapy modification Natalizumab: Immunosuppressants may enhance the adverse/toxic effect of Natalizumab. Specifically, the risk of concurrent infection may be increased. Avoid combination Nivolumab: Immunosuppressants may diminish the therapeutic effect of Nivolumab. Consider therapy modification Ocrelizumab: May enhance the immunosuppressive effect of Immunosuppressants. Monitor therapy Pidotimod: Immunosuppressants may diminish the therapeutic effect of Pidotimod. Monitor therapy Pimecrolimus: May enhance the adverse/toxic effect of Immunosuppressants. Avoid combination Roflumilast: May enhance the immunosuppressive effect of Immunosuppressants. Consider therapy modification Sipuleucel-T: Immunosuppressants may diminish the therapeutic effect of Sipuleucel-T. Monitor therapy Tacrolimus (Topical): May enhance the adverse/toxic effect of Immunosuppressants. Avoid combination Tertomotide: Immunosuppressants may diminish the therapeutic effect of Tertomotide. Monitor therapy Tofacitinib: Immunosuppressants may enhance the immunosuppressive effect of Tofacitinib. Management: Concurrent use with antirheumatic doses of methotrexate or nonbiologic disease modifying antirheumatic drugs (DMARDs) is permitted, and this warning seems particularly focused on more potent immunosuppressants. Consider therapy modification Trastuzumab: May enhance the neutropenic effect of Immunosuppressants. Monitor therapy Vaccines (Inactivated): Immunosuppressants may diminish the therapeutic effect of Vaccines (Inactivated). Management: Vaccine efficacy may be reduced. Complete all age-appropriate vaccinations at least 2 weeks prior to starting an immunosuppressant. If vaccinated during immunosuppressant therapy, revaccinate at least 3 months after immunosuppressant discontinuation. Consider therapy modification Vaccines (Live): Immunosuppressants may enhance the adverse/toxic effect of Vaccines (Live). Immunosuppressants may diminish the therapeutic effect of Vaccines (Live). Management: Avoid use of live organism vaccines with immunosuppressants; live-attenuated vaccines should not be given for at least 3 months after immunosuppressants. Avoid combination Adverse Reactions> 10%: Cardiovascular: Peripheral edema (16%) Central nervous system: Fatigue (21%; long-term exposure) Dermatologic: Pruritus (28%), skin rash (28%) Endocrine & metabolic: Weight gain (19%), hyperuricemia (11%) Gastrointestinal: Diarrhea (32%; long-term exposure), abdominal pain (12%) Neuromuscular & skeletal: Arthralgia (21%; long-term exposure), limb pain (21%; long-term exposure) Respiratory: Upper respiratory tract infection (26%; long-term exposure: 63%) 1% to 10%: Cardiovascular: Hypotension (4% to 6%; grades 3/4: 2% [anaphylactic reaction]) Central nervous system: Headache (8%) Dermatologic: Eczema (4%), psoriasis (4%), skin hyperpigmentation (4%), xeroderma (4%) Endocrine & metabolic: Hypertriglyceridemia (8%), dehydration (4%), hypercholesterolemia (4%) Gastrointestinal: Constipation (8%), decreased appetite (4%) Hematologic & oncologic: Thrombocytopenia (9%) Renal: Renal insufficiency (8%) Respiratory: Lower respiratory tract infection (8%), oropharyngeal pain (8%) Miscellaneous: Infusion related reaction (5%) <1% (Limited to important or life-threatening): Anaphylaxis Warnings/Precautions Concerns related to adverse effects: Gastrointestinal perforation: Gastrointestinal perforation has been observed in clinical trials. Use with caution in patients at risk for perforation; promptly evaluate concerning symptoms. Hemoglobin levels: Siltuximab administration may result in elevated hemoglobin levels in patients with multicentric Castleman disease; monitor blood counts prior to each dose for the first 12 months and every 3 dosing cycles thereafter, or as clinically necessary. May require therapy interruption. Infection: Siltuximab may mask signs and symptoms of infection, including signs of acute inflammation (eg, fever, C-reactive protein elevation). Do not administer to patients with severe infections (until infection resolves); monitor closely for infections and initiate appropriate anti-infective therapy if needed. If infection develops, withhold therapy until resolved. Infusion-related/hypersensitivity reactions: Discontinue infusion immediately (and permanently) if signs of anaphylaxis occur; do not reinitiate therapy. Discontinue in patients with severe infusion reaction, severe allergic reactions, or cytokine release syndromes. If a mild to moderate infusion reaction develops, temporarily discontinue the infusion; if the reaction resolves, may reinitiate at a lower infusion rate. Consider premedication with acetaminophen, antihistamines, and corticosteroids. If infusion-related reactions recur despite appropriate premedication and infusion rate reduction, discontinue therapy. Administer in a setting equipped to provide resuscitation equipment; medications for the treatment of hypersensitivity reactions (eg, bronchodilators, epinephrine, antihistamines, and corticosteroids) should be readily available. Concurrent drug therapy issues: Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information. Other warnings/precautions: Appropriate use: Approved for use only in patients who are HIV negative and HHV-8 negative. Siltuximab was not studied in patients positive for these disease states due to the lack of drug binding to virally produced IL-6 in a nonclinical study. Vaccinations: Do not administer live vaccines to patients receiving siltuximab; IL-6 inhibition may interfere with immune response to vaccination. Monitoring Parameters Monitor complete blood count with differential prior to each dose for the first 12 months and every 3 dosing cycles thereafter, or as clinically necessary; monitor for anaphylaxis and signs/symptoms of infusion-related, allergic, or cytokine release reactions; monitor for infection and signs/symptoms of gastrointestinal perforation. Pregnancy Risk Factor C Pregnancy Considerations Adverse events were not observed in animal reproduction studies. However, decreased globulin levels were detected in the pregnant animals and their offspring. Infants born to pregnant women treated with siltuximab may be at increased risk for infection. Use during pregnancy only if the potential benefit outweighs the possible risk to the fetus. Women of childbearing potential should use effective contraception during and for 3 months following treatment discontinuation. Patient Education Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?) Patient may experience constipation, diarrhea, headache, loss of strength and energy, joint pain, pharyngitis, abdominal pain, common cold symptoms, or weight gain. Have patient report immediately to prescriber signs of infection, signs of kidney problems (urinary retention, hematuria, change in amount of urine passed, or weight gain), dizziness, passing out, severe abdominal pain, severe nausea, vomiting, back pain, angina, abnormal heartbeat, flushing, edema, bruising, or bleeding (HCAHPS). Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions. Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients. Next Interactions Print this page Add to My Med List More about siltuximab Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 0 Reviews Add your own review/rating Drug class: interleukin inhibitors Consumer resources Siltuximab Siltuximab Intravenous (Advanced Reading) Professional resources Siltuximab (AHFS Monograph) Other brands: Sylvant Related treatment guides Multicentric Castleman s Disease> ]} Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Siltuximab Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! Drug Class Interleukin inhibitors Related Drugs interleukin inhibitors Stelara , Actemra , Cosentyx , Dupixent , tocilizumab , Taltz Multicentric Castleman s Disease Sylvant , More...} } this sort of


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various Copper Mate Generic Name: cupric sulfate, zinc sulfate monohydrate and citric acid monohydrate powder, for solution 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. Copper Mate Drug Facts Label Active Ingredients: Cupric Sulfate, Zinc Sulfate, Citric Acid [Powder for use in solution] Directions: It is recommended for use in a 1% to 3% solution strength (by weight) with immersion lasting between 5 and 20 minutes, once or twice daily, for a period of time as prescribed by your veterinarian. Warnings: Copper and Zinc can be toxic to sheep. Do not allow animals to eat or drink the Copper Mate powder or hoof bath solution. Know the volume of the hoof bath and calculate the amount of Copper Mate carefully. DO NOT OVER DOSE by using more Copper Mate than what is recommended by your veterinarian. For External Use Only Keep out of reach of children. Purpose: Copper Mate powder is used as an aid in hoof rot management under veterinary guidance. Use: Copper Mate powder is used in hoof baths for cattle and sheep. When Using this Product: By placing a clean water bath ahead of the treatment bath, animals will clean their hooves to some extent and keep the treatment bath clean longer. Hoof baths should only be part of an overall program that includes proper nutrition, regular hoof trimming, and hoof injury prevention. Questions?: 1-800-567-7455 (24/7-Emergency Spill Line) or 1-905-878-8432 Copper Mate Bag Label Copper Mate HOOF TREATMENT Contains a Proprietary Blend of Copper and Zinc Salts in an Acidified Medium FIRST AID MEASURES SKIN: IMMEDIATELY REMOVE CONTAMINATED CLOTHING AND FLUSH SKIN WITH RUNNING WATER FOR AT LEAST 15 MINUTES. WASH SKIN WITH SOAP AND WATER. LAUNDER CLOTHING BEFORE REUSE. EYES: FLUSH CONTINUOUSLY WITH WATER FOR 15 MINUTES. FORCIBLY HOLD EYELIDS APART TO ENSURE IRRIGATION OF ALL EYE TISSUE. SEEK PROMPT MEDICAL ATTENTION. INHALATION: REMOVE TO FRESH AIR. APPLY ARTIFICIAL RESPIRATION OR ADMINISTER OXYGEN IF NECESSARY. SEEK PROMPT MEDICAL ATTENTION IF SYMPTOMS PERSIST. INGESTION: NEVER GIVE ANYTHING BY MOUTH IF VICTIM IS RAPIDLY LOSING CONSCIOUSNESS OR IS UNCONCIOUS OR CONVULSING. HAVE VICTIM RINSE MOUTH THROUGHLY WITH WATER. IF CONSIOUS GIVE 100 ML OF WATER AND INDUCE VOMITING. SEEK MEDICAL ATTENTION IMMEDIATELY. PRECAUTIONARY MEASURES AVOID CONTACT WITH SKIN AND EYES. AVOID BREATHING VAPOURS. WEAR ADEQUATE PROTECTIVE CLOTHES PRECAUTIONARY EQUIPMENT GLOVES/TYPE: WEAR IMPERVIOUS GLOVES IN NEOPRENE OR RUBBER. RESPIRATOR TYPE: WHERE VAPOURS OR MIST ARE PRESENT, USE AN APPROVED NIOSH/MHSA APPROVED RESPIRATOR FOR THE INDICATED COMPONENTS, OR USE AN APPROVED AIR SUPPLIED RESPIRATOR. A RESPIRATOR WITH DUST/MIST FILTER IS REQUIRED UNDER DUSTY OR MISTY CONDITIONS. EYE/TYPE: CHEMICAL GOOGLES. FOOTWEAR/TYPE: SAFETY BOOTS. RISK PHRASES WARNING! THIS PRODUCT IS CONSIDERED TOXIC. IS A SKIN AND EYE IRRITANT. USE PROPER PROTECTIVE MEASURES. FOR MORE INFORMATION SEE MSDS. FONDEL Chemicals Ltd. 9688 Regional Rd. 25, Milton, Ontario, CANADA L9T 2X7 Tel: 905/878-8432 Fax: 905/878-7262 E-mail: Canada@fondel.com Emergency Spill Line: North America 24/7 NEWALTA- (800) 567-7455 PRODUCT OF CANADA 50 LBS. 25 KG. Copper Mate acidified cupric and zinc sulfate powder, for solution Product Information Product Type OTC ANIMAL DRUG Item Code (Source) NDC:51044-401 Route of Administration TOPICAL DEA Schedule Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength Cupric Sulfate (Cupric Cation) Cupric Cation 0.25 kg in 1.6 kg ZINC SULFATE MONOHYDRATE (Zinc Cation) Zinc Cation 0.1 kg in 1.6 kg CITRIC ACID MONOHYDRATE (CARBON DIOXIDE) CARBON DIOXIDE 0.05 kg in 1.6 kg Packaging # Item Code Package Description 1 NDC:51044-401-25 25 kg in 1 BAG Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date unapproved drug other 12/15/2010 Labeler - Fondel Chemical Ltd. (201786790) Registrant - Fondel Chemical Ltd. (201786790) Establishment Name Address ID/FEI Operations Fondel Chemical Ltd. 201786790 manufacture, label Revised: 12/2010 Fondel Chemical Ltd. 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 suddenly


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the child [1:1 year) of high doses of vitamin E ( 400 units daily) may increase all-cause mortality. 166 d Specific Populations Pregnancy Category A. c Lactation Distributed into human milk. c Common Adverse Effects Usually nontoxic at therapeutic doses. a Interactions for Aquasol E Specific Drugs Drug Interaction Comments Anticoagulants, oral Risk of hemorrhage with large doses of vitamin E a Iron supplements Vitamin E dosages 10 units/kg daily may delay response to iron therapy in children a Mineral oil Possible impaired absorption of vitamin E a Orlistat Possible impaired absorption of fat-soluble vitamins, including vitamin E 150 Administer orlistat 2 hours before or after vitamin E 150 152 156 158 Vitamin A Potential increase in absorption, utilization, and storage of vitamin A a Aquasol E Pharmacokinetics Absorption Bioavailability Absorption from the GI tract depends on biliary and pancreatic secretions, micelle formation, uptake into erythrocytes, and chylomicron secretion. a b Not well absorbed; 20 60% absorbed from dietary sources. a Fraction absorbed decreases as dosage increases. a Distribution Extent Readily distributed into all tissues and stored in adipose tissue. a Crosses the placenta. c Distributed into human milk. c Secreted from the liver in very-low-density lipoproteins (VLDLs); only the R -stereoisomer of α-tocopherol is secreted by the liver. 159 Elimination Metabolism Extensively metabolized, principally in the liver, to glucuronides of tocopheronic acid and its γ-lactone. a Elimination Route Excreted principally in the feces via biliary excretion; also excreted in urine. a 159 Stability Storage Oral Cool dry place. e Actions Chain-breaking antioxidant that prevents propagation of free-radical reactions (e.g., lipid peroxidation); 159 scavenges peroxyl radicals; 159 protects polyunsaturated fatty acids (PUFAs) and other oxygen-sensitive substances such as vitamin A and ascorbic acid from oxidation. a 159 Has been suggested that the antioxidant effects of the vitamin may have beneficial effects in delaying the onset or slowing the progress of Alzheimer s changes. 118 146 147 149 May enhance immune response in healthy geriatric individuals. 142 143 159 Advice to Patients Importance of informing clinicians of existing or contemplated therapy, including prescription and OTC drugs and dietary or herbal supplements, as well as concomitant illnesses. a Importance of proper dietary habits, including taking appropriate AI or RDA of vitamin E. a Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. a Importance of informing patients of other important precautionary information. (See Cautions.) Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. * available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name Vitamin E Routes Dosage Forms Strengths Brand Names Manufacturer Bulk oil* Oral Capsules, liquid-filled 100 units* 200 units* 400 units* 600 units* 1000 units* Capsules, water-miscible 100 units* 200 units* 400 units* Liquid, dye-free 4600 units/5 mL* Solution, water-miscible 50 units/mL Solution, aqueous drops 15 units/0.3 mL Aquasol E Drops (as dl -α-tocopheryl acetate; with propylene glycol) Hospira Tablets 100 units* 200 units* 400 units* 500 units* 600 units* 1000 units* Vitamin E is also commercially available in combination with other vitamins, minerals, protein supplements, and infant formulas. AHFS DI Essentials. Copyright 2017, Selected Revisions January 1, 2009. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. Use is not currently included in the labeling approved by the US Food and Drug Administration. References Only references cited for selected revisions after 1984 are available electronically. 100. American Academy of Pediatrics Committee on Fetus and Newborn. Vitamin E and the prevention of retinopathy of prematurity. Pediatrics . 1985; 76:315-6. [PubMed 3895151] 101. Lorch V, Murphy MD, Hoersten LR et al. Unusual syndrome among premature infants: association with a new intravenous vitamin E product. Pediatrics . 1985; 75:598-602. [PubMed 3975131] 102. Bove KE, Kosmetatos N, Wedig KE et al. Vasculopathic hepatotoxicity associated with E-Ferol syndrome in low-birth-weight infants. JAMA . 1985; 254:2422-30. [PubMed 3930760] 103. Centers for Disease Control. Unusual syndrome with fatalities among premature infants: association with a new intravenous vitamin E product. MMWR Morb Mortal Wkly Rep . 1984; 33:198-9. [PubMed 6423951] 104. Butler J, Hutchison M, Sandlin M. Deaths in preterm infants associated with intravenous vitamin E supplement. Am J Hosp Pharm . 1984; 41:1514-6. [PubMed 6475969] 105. Bodenstein CJ. Intravenous vitamin E and deaths in the intensive care unit. Pediatrics . 1984; 73:733. [PubMed 6718133] 106. Phelps DL. E-Ferol: what happened and what now? Pediatrics . 1984; 74:1114-6. Editorial. 107. Lemons JA, Maisels MJ. Vitamin E how much is too much? Pediatrics . 1985; 76:625-7. Editorial. 108. American Academy of Pediatrics Committee on Nutrition. Pediatric nutrition handbook. 5th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2004:35. 109. Committee on Dietary Allowances, Food and Nutrition Board, National Research Council. Recommended dietary allowances. 9th rev ed. Washington, DC: National Academy of Sciences; 1980:63-9. 110. Finer NN, Peters KL, Hayek Z et al. Vitamin E and necrotizing enterocolitis. Pediatrics . 1984; 73:387-93. [PubMed 6546616] 111. Bhat R. Serum, retinal, choroidal vitreal vitamin E concentrations in human infants. Pediatrics . 1986; 78:866-70. [PubMed 3763301] 112. Conyers RAJ, Bais R, Rofe AM. Oxalosis and the E-Ferol toxicity syndrome. JAMA . 1986; 256:2677-8. [PubMed 3773173] 113. Brown RE, Alade SL, Krouse MA. Polysorbates and renal oxalate crystals in the E-Ferol syndrome. JAMA . 1986; 255:2445. [PubMed 3701955] 114. Alade SL, Brown RE, Paquet A Jr. Polysorbate 80 and E-Ferol toxicity. Pediatrics . 1986; 77:593-7. [PubMed 3960626] 115. Balistreri WF, Farrel MK, Bove KE. Lessons from the E-Ferol tragedy. Pediatrics . 1986; 78:503-6. [PubMed 3748688] 116. Phelps DL, Rosenbaum AL, Isenberg SJ et al. Tocopherol efficacy and safety for preventing retinopathy of prematurity: a randomized, controlled, double-masked trial. Pediatrics . 1987; 79:489-500. [PubMed 3547300] 117. National Research Council Food and Nutrition Board Subcommittee on the Tenth Edition of the RDAs. Recommended dietary allowances. 10th ed. Washington, DC: National Academy Press; 1989:99-107. 118. Parnetti L, Senin U, Mecocci P. Cognitive enhancement therapy for Alzheimer s disease: the way forward. Drugs . 1997; 53:752-68. [PubMed 9129864] 119. Diaz MN, Frei B, Vita JA et al. Antioxidants and atherosclerotic heart disease. N Engl J Med . 1997; 337:408-16. [PubMed 9241131] 120. Jha P, Flather M, Lonn E et al. The antioxidant vitamins and cardiovascular disease. Ann Intern Med . 1995; 123:860-72. [PubMed 7486470] 121. Stampfer MJ, Hennekens CH, Manson JE et al. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med . 1993; 328:1444-9. [PubMed 8479463] 122. Rimm EB, Stampfer MJ, Ascherio A et al. Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med . 1993; 328:1450-6. [PubMed 8479464] 123. Kushi LH, Folsom AR, Prineas RJ et al. Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med . 1996; 334:1156-62. [PubMed 8602181] 124. Stephens NG, Parsons A, Schofield PM et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet . 1996; 347:781-6. [PubMed 8622332] 125. Hennekens CH. Platelet inhibitors and antioxidant vitamins in cardiovascular disease. Am Heart J . 1994; 128:1333-6. [PubMed 7977015] 126. Mosca L, Rubenfire M, Mandel C et al. Antioxidant nutrient supplementation reduces the susceptibility of low density lipoprotein to oxidation in patients with coronary artery disease. J Am Coll Cardiol . 1997; 30:392-9. [PubMed 9247510] 127. Freedman JE, Farhat JH, Loscalzo J et al. α-Tocopherol inhibits aggregation of human platelets by a protein kinase C-dependent mechanism. Circulation . 1996; 94:2434-40. [PubMed 8921785] 128. Hodis HN, Mack WJ, LaBree L et al. Serial coronary angiographic evidence that antioxidant vitamin intake reduces progression of coronary artery atherosclerosis. JAMA . 1995; 273:1849-54. [PubMed 7776501] 129. Tardif JC, Cote G, Lesperance J et al. Probucol and multivitamins in the prevention of restenosis after coronary angioplasty. N Engl J Med . 1997; 337:365-72. [PubMed 9241125] 130. Libby P, Ganz P. Restenosis revisited new targets, new therapies. N Engl J Med . 1997; 337:418-9. [PubMed 9241132] 131. Stephens N. Anti-oxidant therapy for ischaemic heart disease: where do we stand? Lancet . 1997; 349:1710-1. Editorial. 132. Rapola JM, Virtamo J, Ripatti S et al. Randomised trial of α-tocopherol and β-carotene supplements on incidence of major coronary events in men with previous myocardial infarction. Lancet . 1997; 349:1715-20. [PubMed 9193380] 133. Greenberg ER. Antioxidant vitamins, cancer, and cardiovascular disease. N Engl J Med . 1996; 334:1189-90. [PubMed 8602188] 134. National Research Council, Committee on Diet and Health, Food and Nutrition Board, Commission on Life Sciences. Diet and health: implications for reducing chronic disease risk. Washington, D.C.: National Academy Press, 1989. 135. The Alpha-tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med . 1994; 330:1029-35. [PubMed 8127329] 136. Greenberg ER, Baron JA, Tosteson TD et al. A clinical trial of antioxidant vitamins to prevent colorectal adenoma. N Engl J Med . 1994; 331:141-7. [PubMed 8008027] 137. Hunter DJ, Manson JE, Colditz GA et al. A prospective study of the intake of vitamins C, E, and A and the risk of breast cancer. N Engl J Med . 1993; 329:234-40. [PubMed 8292129] 138. Blot WJ, Li JY, Taylor PR et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst . 1993; 85:1483-92. [PubMed 8360931] 139. Blot WJ, Li JY, Taylor PR et al. Lung cancer and vitamin supplementation. N Engl J Med . 1994; 331:614. [PubMed 8047094] 140. Hennekens CH, Buring JE, Peto R. Beta carotene, vitamin E, and lung cancer. N Engl J Med . 1994; 331:613-4. 141. Meydani SN, Meydani M, Verdon CP et al. Vitamin E supplementation suppresses prostaglandin E 2 synthesis and enhances the immune response of aged mice. Mech Ageing Dev . 1986; 34:191-201. [PubMed 3487685] 142. Meydani SN, Meydani M, Blumberg J et al. Vitamin E supplementation and in vivo immune response in healthy elderly subjects: a randomized controlled trial. JAMA . 1997; 277:1380-6. [PubMed 9134944] 143. Meydani SN, Barklund PM, Liu S et al. Effect of vitamin E supplementation on immune responsiveness of healthy elderly subjects. Am J Clin Nutr . 1990; 52:557-63. [PubMed 2203257] 144. Food and Drug Administration. Drug products for the treatment and/or prevention of nocturnal leg muscle cramps for over-the-counter human use. 21 CFR Part 310. [Docket No. 77N-0094]. Fed Regist . 1994; 59:43234-52. 145. Ryan TJ, Antman EM, Brooks NH et al. ACC/AHA guidelines for management of patients with acute myocardial infarction: 1999 update: report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). From website. 146. Sano M, Ernesto C, Thomas RG et al. A controlled trial of selegiline, alpha- tocopherol, or both as treatment for Alzheimer s disease. N Engl J Med . 1997; 336:1216-22. [PubMed 9110909] 147. Drachman DA, Leber P. Treatment of Alzheimer s disease searching or a breakthrough, settling for less. N Engl J Med . 1997; 336:1245-7. [PubMed 9110915] 148. Small GW, Rabins PV, Barry PP et al. Diagnosis and treatment of Alzheimer disease and related disorders: consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer s Association, and the American Geriatric Society. JAMA . 1997; 278:1363-71. [PubMed 9343469] 149. American Psychiatric Association. Practice guideline for the treatment of patients with Alzheimer s disease and other dementias of late life. Am J Psychiatry . 1997; 154(Suppl):1-39. 150. Roche Laboratories Inc. Xenical (orlistat) capsules prescribing information. Nutley, NJ; 1999 April. 151. Sjöström L, Rissanen A, Andersen T et al. Randomized placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. Lancet . 1998; 352:167-72. [PubMed 9683204] 152. Davidson MH, Hauptman J, DiGirolamo M et al. Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat. JAMA . 1999; 281:235-42. [PubMed 9918478] 153. Hollander PA, Elbein SC, Hirsch IB et al. Role of orlistat in the treatment of obese patients with type 2 diabetes: a 1-year randomized double-blind study. Diabetes Care . 1998; 21:1288-94. [PubMed 9702435] 154. Melia AT, Koss-Twardy SG, Zhi J. The effect of orlistat, an inhibitor of dietary fat absorption, on the absorption of vitamins A and E in healthy volunteers. J Clin Pharmacol . 1996; 36:647-53. [PubMed 8844448] 155. Zhi J, Melia AT, Koss-Twardy SG et al. The effect of orlistat, an inhibitor of dietary fat absorption, on the pharmacokinetics of β-carotene in healthy volunteers. J Clin Pharmacol . 1996; 36:152-9. [PubMed 8852391] 156. Roche Laboratories Inc. Xenical (orlistat) capsules patient information. Nutley, NJ; 1999 April. 157. James WP, Avenell A, Broom J et al. A one-year trial to assess the value of orlistat in the management of obesity. Int J Obes Relat Metab Disord . 1997; 21(Suppl 3):S24-30. [PubMed 9225173] 158. Roche Laboratories Inc, Nutley, NJ: Personal communication on Orlistat 56:40. 159. Committee on the Scientific Evaluation of Dietary Reference Intakes of the Food and Nutrition Board, Institute of Medicine, National Academy of Sciences. Dietary reference intakes for Vitamin C, Vitamin E, selenium, and carotenoids. Washington, DC: National Academy Press; 2000. 160. The Heart Prevention Evaluation Study Investigators. Vitamin E supplementation and cardiovascular events in high-risk patients. N Engl J Med . 2000; 342:154-60. [PubMed 10639540] 161. GISSI-Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet . 1999; 354:447-55. [PubMed 10465168] 162. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes of the Food and Nutrition Board, Institute of Medicine, National Academy of Sciences. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: National Academy Press; 1997. (Uncorrected proofs.) 163. Doody RS, Stevens JC, Beck C et al. Practice parameter: management of dementia (an evidence-based review). Report of the quality standards subcommittee of the American Academy of Neurology. Neurology . 2001; 56:1154-66. [PubMed 11342679] 164. Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss. Arch Ophthalmol . 2001; 119:1417-36. [PubMed 11594942] 165. Jampol LM. Antioxidants, zinc, and age-related macular degeneration. Arch Ophthalmol . 2001; 119:1533-4. [PubMed 11594957] 166. Miller ER, Pastor-Barriuso R, Dalal D, et al. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med . 2005:142. From Annals of Internal Medicine website (). Accessed 11 Nov 2004. 167. Peterson RC, Thomas RG, Grundman M et al. Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med . 2005; 352:2379-88. [PubMed 15829527] 168. Gualler E, Hanley DF, Miller ER. An editorial update: Annus horribilis for vitamin E. Ann Intern Med . 2005; 143:143-5. [PubMed 16027457] 169. Lee IM, Cook NR, Gaziano JM et al. Vitamin E in the primary prevention of cardiovascular disease and cancer The Women's Health Study: a randomized controlled trial. JAMA . 2005; 294:56-65. [PubMed 15998891] 170. Ford ES, Ajani UA, Mokdad AH. Brief communication: The prevalence of high intake of vitamin E from the use of supplements among U.S. adults. Ann Intern Med . 2005: 143:116-20. 171. The HOPE and HOPE-TOO trial investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: A randomized trial. JAMA . 2005; 293:1338-47. [PubMed 15769967] 172. Brown BG, Crowley J. Is there any hope for vitamin E? JAMA . 2005; 293:1387-90. Editorial. 173. American Psychiatric Association. Practice guideline for the treatment of patients with schizophrenia. Am J Psychiatr . 2004; 161(Suppl):1-56. 174. Klein EA, Thompson IM, Lippman SM et al. SELECT: the selenium and vitamin E cancer prevention trial: rationale and design. Prostate Cancer Prostatic Dis . 2000: 3:145-51 175. National Cancer Institute. Selenium and vitamin E cancer prevention trial (SELECT). 2008 Oct 31. From . Accessed 2008 Nov 21. a. AHFS drug information 2007. McEvoy GK, ed. Vitamin E. Bethesda, MD: American Society of Health-System Pharmacists; 2007:3645-9. b. Dietary reference intakes: the essential guide to nutrient requirements. Institute of Medicine of the National Academies. Washington, D.C.: National Academies Press, 2006: 235 43. c. Vitamin E. In: Briggs GG, Freeman RK, Yaffe SJ, eds. Drug in pregnancy and lactation: a reference guide to fetal and neonatal risk. 7th ed.Philadelphia: Lippincott, Williams & Wilkins; 2005:1735-7. d. Bjelakovic F, Nikolova D, Gluud LL et al. Mortality in randomized trials of antioxidant supplements for primary or secondary prevention: systematic review and meta-analysis. JAMA . 2007; 297:842-57. [PubMed 17327526] e. Nature's Bounty 100% natural vitamin E 400 IU, softgels product information. From Walgreen's website. Accessed 24 Mar 2008. f. American Psychiatric Association. Practice Guideline for the treatment of patients with Alzheimer's disease and other dementias. 2007 Oct. From the American Psychiatric Association website. Next Interactions Print this page Add to My Med List More about Aquasol E (vitamin e) Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 0 Reviews Add your own review/rating Drug class: vitamins Consumer resources Aquasol E Aquasol E (Advanced Reading) Professional resources Vitamin E (AHFS Monograph) Related treatment guides Alzheimer's Disease Anemia, Sickle Cell Cystic Fibrosis Dietary Supplementation ... +4 more]} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx OTC Availability Rx and/or OTC C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Drug Class Vitamins Related Drugs Dietary Supplementation biotin , multivitamin , Fish Oil , ascorbic acid , More... Alzheimer's Disease Aricept , Exelon , donepezil , Namenda , memantine , vitamin e , More... 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imaginable Aquasol E of moral

treatments Love, Lust or Addiction?

what should be blamed for Love, Lust or Addiction? wonderful
 
Photo :Love, Lust or Addiction?
they convey Wonder whether you re in love or in lust? Whether your obsession about someone is a sign of love or addiction? Whether you re staying in a troubled relationship because you re addicted or in love? It s complicated, and lust and love and addiction don t always exclude one another. Endless analyzing doesn t help or change our feelings, because we re often driven by forces outside our conscious awareness. Initial attraction stirs up neurotransmitters and hormones that create the excitement of infatuation and a strong desire to be close and sexual with the person. These chemicals and our emotional and psychological makeup can cause us to obfuscate reality and idealize the object of our attraction. Time spent in fantasy fuels our craving to be with him or her. This is normal when it doesn t take over our lives. When it s purely lust, we re not too interested in spending time together without sex or the expectation of it. We don t want to discuss real-life problems and may not even want to spend the night. Fantasies are mostly sexual or about the person s appearance and body, and we aren t interested in meeting the person s needs outside the bedroom or maybe even inside! Sex releases oxytocin, the love chemical that makes us want to nest with our partner. As we get to know our lover, we may want to spend more or less time together, depending on what we learn. At this juncture, our brain chemicals as well as our attachment style and psychological issues can lead us to become codependently attached through a romance or love addiction that feels like love, but is more driven by our need for the chemical rush to avoid feelings of abandonment, depression and low self-esteem. Excitement and desire may be heightened by intrigue or our partner s unpredictability or unavailability. We may remain attached and even crave our partner, but our discomfort or unhappiness grows. Instead of focusing on that, our hunger to be with him or her takes center stage, despite the fact that disturbing facts or character traits arise that are hard to ignore. We may feel controlled or neglected, unsafe or disrespected, or discover that our partner is unreliable, or lies, manipulates, rages, has secrets, or has a major problem, such as drug addiction or serious legal or financial troubles. Nonetheless, we stay and don t heed our better judgment to leave. Increasingly, we hide our worries and doubts and rely on sex, romance, and fantasy to sustain the relationship. Out of sympathy, we might even be drawn to help and rescue our partner or try to change him or her back into the ideal we fell for. These are signs of addiction. But lust also can lead to true love as we become attached to and get to know our sexual partner, and lust doesn t always fade. I ve seen couples married for decades who enjoy a vibrant sex life. However, true love does require that we recognize our separateness and love our mate for who he or she truly is. There s always some idealization in a new relationship, but true love endures when that fades. As the relationship grows, we develop trust and greater closeness. Instead of trying to change our partner, we accept him or her. We want to share more of our time and life together, including our problems and friends and family. Our lover s needs, feelings, and happiness become important to us, and we think about planning a future together. When the passion is still there, we re lucky to have both love and lust. Love and codependency may coexist or be hard to differentiate, because codependents idealize and often happily self-sacrifice for their partner. When differences and serious problems are largely ignored, minimized, or rationalized, it looks more like codependency, because we re not really seeing or loving the whole person. Facing the truth would create inner conflict about our fear of emptiness and loneliness. Similarly, when our emphasis is on how our partner makes us feel or how he or she feels about us, our love is based on our self-centered, codependent need. Healthy relationships and codependent, addictive ones have very different trajectories. Healthy partners don t fall in love; they grow in love. They re not as driven by overwhelming, unconscious fears and needs. Compare: Codependent Relationships Intense attraction feel anxious Idealize each other, ignoring differences Fall in love and make commitments Get to know each other Become disappointed Cling to fantasy of love Try to change our partner into our ideal Feel resentful and unloved Healthy Relationships Attraction and friendship begin feel comfortable Attraction grows as they know each other Acknowledge differences (or leave) Grow to love each other Make commitments Compromise needs Love and acceptance of each other deepens Feel supported and loved Codependency is an addiction and underlies all other addictions, including sex addiction, and romance, relationship, and love addiction. Lust and love and love and addiction can overlap. When we heal our codependency, we can see whether love remains. We might even leave an unhealthy relationship and still love our ex. Meanwhile, some things are knowable: It takes time to love someone. Love at first sight may be triggered by many things, but it s not love. Having sex with strangers or frequent multiple partners is a sign of sexual addiction. Compulsive activity, whether sexual or romantic, that feels out of control, such as compulsive sex, stalking, spying, constant calling or texting is a sign of addiction. Ignoring your partner s boundaries, and abusing, controlling or manipulating him or her (including people-pleasing or rescuing) are signs of addiction. Using sex or a relationship to cope with emptiness, depression, anger, shame, or anxiety is a sign of addiction. Using sex or romance to substitute for vulnerable, authentic intimacy is a symptom of addiction. Staying in a painful relationship out of fear of abandonment or loneliness is a sign of codependency and addiction, not love. Inability to commit to a relationship or staying involved with someone who is emotionally unavailable shows a fear of intimacy a symptom of addiction. Trusting too much or too little are signs of addiction. Sacrificing your values or standards to be with someone is a sign of addiction. Healing from codependency and addiction require effort and the support of a 12-step program or psychotherapy . It s very hard to abstain from compulsive, addictive behavior without support because the unconscious forces driving us and the pain of abstinence are overwhelming. There is hope and a way out. Recovery includes: Learning more about the symptoms of codependency. Healing the shame and abandonment pain of your childhood. Building your self-esteem. Learning to be assertive. Learning to honor and meet your needs and nurture yourself. Risking being authentic about your feelings and needs. To learn more and start healing, do the exercises in my books Codependency for Dummies and Conquering Shame and Codependency: 8 Steps to Freeing the True You and ebooks 10 Steps to Self-Esteem and How to Speak Your Mind: Become Assertive and Set Limits . Darlene Lancer 2014 Related Articles About Darlene Lancer, JD, MFT Darlene Lancer is a Licensed Marriage and Family Therapist and expert on relationships and codependency. She s the author of Conquering Shame and Codependency: 8 Steps to Freeing the True You and Codependency for Dummies and six ebooks, including: 10 Steps to Self-Esteem , How To Speak Your Mind - Become Assertive and Set Limits , Dealing with a Narcissist: 8 Steps to Raise Self-Esteem and Set Boundaries with Difficult People , and Freedom from Guilt and Blame - Finding Self-Forgiveness , available on her website, http://www.whatiscodependency.com and Amazon. Ms. Lancer has counseled individuals and couples for 28 years and coaches internationally. She s a sought-after speaker in media and at professional conferences. Her articles appear in professional journals and Internet mental health websites, including on her own, where you can get a free copy of 14 Tips for Letting Go. Find her on Youtube.com, Soundcloud, Twitter @darlenelancer, and at www.Facebook.com/codependencyrecovery. View all posts by Darlene Lancer, JD, MFT Hot Topics Today 1 5 Types of People Who Are Naturally Attracted to Each Other 2 PTSD Patients Show Heightened Sensitivity to Deviant Sounds 3 Developing the Evidence Base for Mindfulness Therapies 4 Dominant Hand May Begin in Womb 5 Why Empaths and Sensitives Must Take Special Care of Their Energies Most Popular News Dominant Hand May Begin in Womb PTSD Patients Show Heightened Sensitivity to Deviant Sounds Developing the Evidence Base for Mindfulness Therapies Bipolar or Depression? Heart Test May Help Tell the Difference Avatar Therapy May Ease Schizophrenia Symptoms Join Over 195,000 Subscribers to Our Weekly Newsletter Find a Therapist Enter ZIP or postal code a chosen


a good idea Love, Lust or Addiction? tourists

trudging away Enzalutamide could be

to be able to Enzalutamide seems
 
Photo :Enzalutamide
eventually [30:<30 mL/minute) or end-stage renal disease. 1 Common Adverse Effects Asthenia/fatigue, 1 2 5 back pain, 1 diarrhea, 1 2 arthralgia, 1 hot flush, 1 2 peripheral edema, 1 musculoskeletal pain, 1 2 headache, 1 2 upper respiratory tract infection, 1 muscular weakness, 1 dizziness, 1 insomnia, 1 lower respiratory tract infection, 1 spinal cord compression and cauda equina syndrome, 1 hematuria, 1 paresthesia, 1 anxiety, 1 hypertension. 1 Interactions for Enzalutamide Metabolized by CYP2C8 and CYP3A4; formation of major active metabolite ( N -desmethylenzalutamide) is mediated by CYP2C8. 1 Enzalutamide is a potent inducer of CYP3A4 and a moderate inducer of CYP2C9 and CYP2C19 in vivo. 1 Not expected to induce CYP1A2 at clinically relevant concentrations. 1 In vitro, enzalutamide and its 2 major metabolites (active N -desmethyl metabolite and inactive carboxylic acid metabolite) inhibit CYP isoenzymes 2B6, 2C8, 2C9, 2C19, 2D6, and 3A4/5; enzalutamide causes time-dependent inhibition of CYP1A2 in vitro. 1 Neither enzalutamide nor its 2 major metabolites are substrates of P-glycoprotein (P-gp) in vitro; enzalutamide and N -desmethylenzalutamide inhibit P-gp. 1 Drugs Affecting Hepatic Microsomal Enzymes Potent CYP2C8 inhibitors: Possible increased AUC of major active forms of enzalutamide (parent drug plus N -desmethyl metabolite). 1 Avoid concomitant use if possible. 1 If concomitant use cannot be avoided, reduce enzalutamide dosage to 80 mg once daily. 1 If concomitant use of the potent CYP2C8 inhibitor is discontinued, return enzalutamide dosage to the dosage used prior to initiation of the potent CYP2C8 inhibitor. 1 Potent CYP3A4 inhibitors: Possible increased AUC of major active forms of enzalutamide (parent drug plus N -desmethyl metabolite). 1 Initial dosage adjustment not necessary. 1 Potent or moderate CYP2C8 inducers: In vivo effects of CYP2C8 inducers not established to date; possible alteration of enzalutamide AUC. 1 Avoid concomitant use, if possible, and select alternative agent with minimal or no CYP2C8 induction potential. 1 Potent or moderate CYP3A4 inducers: In vivo effects of CYP3A4 inducers not established to date; possible decreased plasma concentrations of enzalutamide. 1 Avoid concomitant use, if possible, and select alternative agent with minimal or no CYP3A4 induction potential. 1 Drugs Metabolized by Hepatic Microsomal Enzymes Substrates of CYP 3A4, 2C9, or 2C19: Possible decreased plasma concentrations of the substrate drug. 1 Avoid concomitant use of enzalutamide and CYP 3A4, 2C9, or 2C19 substrates with narrow therapeutic indices. 1 CYP2C8 substrates: No substantial change in plasma concentrations of a probe substrate for CYP2C8. 1 Dosage adjustment not necessary. 1 Specific Drugs Drug Interaction Comments Anticonvulsants (carbamazepine, phenobarbital, phenytoin) In vivo effects of CYP inducers not established to date; possible decreased plasma concentrations of enzalutamide 1 Possible decreased plasma concentrations of phenytoin 1 Avoid concomitant use, if possible, and select alternative agent with minimal or no CYP3A4 induction potential 1 Avoid concomitant use of phenytoin 1 Antimycobacterials (rifabutin, rifampin, rifapentine) In vivo effects of CYP inducers not established to date; possible alterations in plasma concentrations of enzalutamide 1 Avoid concomitant use, if possible, and select alternative agent with minimal or no CYP2C8 or CYP3A4 induction potential 1 Bosentan Possible decreased plasma concentrations of enzalutamide 1 Avoid concomitant use, if possible, and select alternative agent with minimal or no CYP3A4 induction potential 1 Efavirenz Possible decreased plasma concentrations of enzalutamide 1 Avoid concomitant use, if possible, and select alternative agent with minimal or no CYP3A4 induction potential 1 Ergot derivatives (e.g., dihydroergotamine, ergotamine) Possible decreased concentrations of the ergot derivative 1 Avoid concomitant use 1 Etravirine Possible decreased plasma concentrations of enzalutamide 1 Avoid concomitant use, if possible, and select alternative agent with minimal or no CYP3A4 induction potential 1 Gemfibrozil Increased AUC of major active forms of enzalutamide (parent drug plus N -desmethyl metabolite) 1 Avoid concomitant use; if concomitant use cannot be avoided, reduce enzalutamide dosage to 80 mg once daily 1 Immunosuppressive agents (cyclosporine, sirolimus, tacrolimus) Possible decreased concentrations of the immunosuppressive agent 1 Avoid concomitant use 1 Itraconazole Increased AUC of major active forms of enzalutamide (parent drug plus N -desmethyl metabolite) 1 No initial dosage adjustment required 1 Midazolam Decreased AUC and peak plasma concentration of midazolam 1 13 Modafinil Possible decreased plasma concentrations of enzalutamide 1 Avoid concomitant use, if possible, and select alternative agent with minimal or no CYP3A4 induction potential 1 Nafcillin Possible decreased plasma concentrations of enzalutamide 1 Avoid concomitant use, if possible, and select alternative agent with minimal or no CYP3A4 induction potential 1 Omeprazole Decreased AUC and peak plasma concentration of omeprazole 1 13 Opiate agonists (alfentanil, fentanyl) Possible decreased concentrations of the opiate agonist 1 Avoid concomitant use 1 Pimozide Possible decreased concentrations of pimozide 1 Avoid concomitant use 1 Pioglitazone No substantial change in AUC or peak plasma concentration of pioglitazone 1 No dosage adjustment required 1 Quinidine Possible decreased concentrations of quinidine 1 Avoid concomitant use 1 St. John's wort ( Hypericum perforatum ) Possible decreased plasma concentrations of enzalutamide 1 Avoid concomitant use, if possible, and select alternative agent with minimal or no CYP3A4 induction potential 1 Warfarin Decreased AUC of S -warfarin 1 13 Avoid concomitant use 1 If concomitant use cannot be avoided, additional INR monitoring recommended 1 Enzalutamide Pharmacokinetics Absorption Bioavailability Following oral administration, peak plasma concentrations are attained in about 1 hour. 1 Food High-fat meal does not substantially affect bioavailability. 1 Special Populations Mild or moderate hepatic impairment (Child-Pugh class A or B) does not substantially alter AUC of major active forms of enzalutamide (parent drug plus N -desmethyl metabolite) following single dose. 1 Age and body weight do not substantially affect exposure to enzalutamide. 1 Distribution Extent Not known whether enzalutamide is distributed into human milk. 1 Plasma Protein Binding Enzalutamide: 97 98% (mainly albumin). 1 N -desmethylenzalutamide: 95%. 1 Elimination Metabolism Metabolized in the liver by CYP2C8 and CYP3A4. 1 Major metabolites are N -desmethylenzalutamide (active) and a carboxylic acid derivative (inactive); formation of N -desmethyl metabolite is mediated principally by CYP2C8. 1 Elimination Route Excreted in urine (71%) and feces (14%); only trace to minimal amounts of dose are recovered in urine and feces as unchanged drug and N -desmethyl metabolite. 1 Half-life Enzalutamide: 5.8 days. 1 N -desmethylenzalutamide: Approximately 7.8 8.6 days. 1 Special Populations Mild to moderate renal impairment (Cl cr 30 89 mL/minute) does not appear to substantially alter clearance of enzalutamide. 1 Stability Storage Oral Capsules 20 25 C (may be exposed to 15 30 C). 1 Actions Competitively inhibits androgen binding to androgen receptors. 1 6 Inhibition of the androgen receptor results in growth arrest or apoptosis through inhibition of nuclear translocation of the androgen receptor and androgen-dependent DNA binding. 4 6 7 9 Binding affinity of enzalutamide at the androgen receptor is 5 8 times greater than that of bicalutamide. 3 5 Main circulating metabolite, N -desmethylenzalutamide, has activity similar to that of enzalutamide in vitro. 1 Unlike conventional antiandrogens (e.g., bicalutamide, flutamide, nilutamide), enzalutamide appears to lack agonistic effects on the androgen receptor in cells that overexpress the androgen receptor, which may result in retained antagonism of the receptor. 2 3 5 8 Advice to Patients Importance of taking enzalutamide as directed and at the same time each day. 1 If a dose is missed, importance of administering the missed dose on the same day as soon as it is remembered; do not take 2 doses on the same day to make up for a missed dose. 1 Importance of swallowing enzalutamide capsules whole; do not chew, dissolve, or open the capsules. 1 For patients currently receiving gonadotropin-releasing hormone (GnRH) agonist therapy, importance of continuing this therapy during enzalutamide therapy. 1 Risk of seizures. 1 Importance of avoiding activities where sudden loss of consciousness could cause serious harm to self or others. 1 Risk of dizziness, mental impairment, paresthesia, hypoesthesia, and falls. 1 Risk of fetal harm. 1 Necessity of advising men receiving the drug to use a condom during sexual encounters with pregnant women and to use a condom in conjunction with another effective contraceptive method during sexual encounters with women of childbearing potential; these contraceptive measures are required during therapy and for 3 months after drug discontinuance. 1 Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription (e.g., drugs that lower seizure threshold) and OTC drugs and herbal supplements, as well as any concomitant illnesses or conditions that might predispose to seizures. 1 Importance of informing patients of other important precautionary information. 1 (See Cautions.) Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Enzalutamide Routes Dosage Forms Strengths Brand Names Manufacturer Oral Capsules, liquid-filled 40 mg Xtandi Astellas AHFS DI Essentials. Copyright 2017, Selected Revisions September 17, 2013. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. References 1. Astellas Pharma US, Inc. Xtandi (enzalutamide) capsules prescribing information. Northbrook, IL; 2012 Nov. 2. Scher HI, Fizazi K, Saad F et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med . 2012; 367:1187-97. [PubMed 22894553] 3. Golshayan AR, Antonarakis ES. Enzalutamide: an evidence-based review of its use in the treatment of prostate cancer. Core Evid . 2013; 8:27-35. [PubMed 23589709] 4. Sternberg CN. Novel hormonal therapy for castration-resistant prostate cancer. Ann Oncol . 2012; 23 Suppl 10:x259-63. [PubMed 22987973] 5. Scher HI, Beer TM, Higano CS et al. Antitumour activity of MDV3100 in castration-resistant prostate cancer: a phase 1-2 study. Lancet . 2010; 375:1437-46. [PubMed 20398925] 6. Vogelzang NJ. Enzalutamide--a major advance in the treatment of metastatic prostate cancer. N Engl J Med . 2012; 367:1256-7. [PubMed 23013078] 7. US Food and Drug Administration. Center for Drug Evaluation and Research. Application number 203415Orig1s000: Summary review. From FDA website. 8. Tran C, Ouk S, Clegg NJ et al. Development of a second-generation antiandrogen for treatment of advanced prostate cancer. Science . 2009; 324:787-90. [PubMed 19359544] 9. Abdulla A, Kapoor A. Emerging novel therapies in the treatment of castrate-resistant prostate cancer. Can Urol Assoc J . 2011; 5:120-33. [PubMed 21470540] 10. Small EJ, Halabi S, Dawson NA et al. Antiandrogen withdrawal alone or in combination with ketoconazole in androgen-independent prostate cancer patients: a phase III trial (CALGB 9583). J Clin Oncol . 2004; 22:1025-33. [PubMed 15020604] 11. Taplin ME, Bubley GJ, Shuster TD et al. Mutation of the androgen-receptor gene in metastatic androgen-independent prostate cancer. N Engl J Med . 1995; 332:1393-8. [PubMed 7723794] 12. Nieh PT. Withdrawal phenomenon with the antiandrogen casodex. J Urol . 1995; 153:1070-2; discussion 1072-3. [PubMed 7531785] 13. US Food and Drug Administration. Center for Drug Evaluation and Research. Application number 203415Orig1s000: Clinical pharmacology and biopharmaceutics review(s). From FDA website. 14. Cookson MS, Roth BJ, Dahm P et al. Castration-Resistant Prostate Cancer: AUA Guideline. J Urol . 2013; :. 15. Astellas Pharma Europe. Xtandi (enzalutamide) capsules. Annex I: Summary of product characteristics. Leiden, Netherlands. (undated) Next Interactions Print this page Add to My Med List More about enzalutamide Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 4 Reviews Add your own review/rating Drug class: antiandrogens Consumer resources Enzalutamide Enzalutamide (Advanced Reading) Professional resources Enzalutamide (Wolters Kluwer) Other brands: Xtandi Related treatment guides Prostate Cancer> ]} 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 X Pregnancy Category Not for use in pregnancy N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Antiandrogens Hormones / antineoplastics Related Drugs Prostate Cancer estradiol , Premarin , Estrace , bicalutamide , Casodex , Eligard , Xtandi , Zytiga , leuprolide , Taxotere , Lupron Depot , conjugated estrogens , docetaxel , Firmagon , Trelstar , Zoladex , abiraterone , degarelix , Menest , flutamide , flax , Delestrogen , Xofigo , More... Enzalutamide Rating 4 User Reviews 1.0 /10 4 User Reviews 1.0 Rate it!} } left out


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information Valchlor Generic Name: Mechlorethamine (Topical) (me klor ETH a meen) Brand Name: Valchlor Overview Side Effects Dosage Professional Pregnancy More User Reviews Support Group Q & A Pricing & Coupons Uses of Valchlor: It is used to treat a type of lymphoma that affects the skin. Slideshow Men's Health Month And Movember: Raising The Profile Of Men's Health One Stache At A Time What do I need to tell my doctor BEFORE I take Valchlor? If you have an allergy to mechlorethamine or any other part of Valchlor (mechlorethamine (topical)). 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. Do not breast-feed while you take this medicine. 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 Valchlor with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor. What are some things I need to know or do while I take Valchlor? Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists. If you get Valchlor in your eyes, it may cause eye problems like very bad eye pain, swelling, or blurred eyesight. Sometimes blindness and long-last injury may happen. Do not touch your eyes while using this medicine. If you get Valchlor in your eyes, flush with water and call your doctor. Talk with your doctor before you use other drugs or products on your skin. Do not let your skin where the gel was used touch anyone else's skin while wearing the gel. Cover the treated skin with clothes. If anyone else touches the gel, wash the skin with soap and water for at least 15 minutes and take off any clothing that gets gel on it. This medicine may add to the chance of getting other skin cancers. Talk with the doctor. This medicine may catch on fire. Do not use near an open flame or while smoking. Avoid fire, flames, or smoking until the gel has dried. If you are 65 or older, use this medicine with care. You could have more side effects. This medicine may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking Valchlor, call your doctor right away. How is this medicine (Valchlor) best taken? Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely. Do not take Valchlor by mouth. Use on your skin only. Keep out of your mouth, nose, and eyes (may burn). Wash your hands before and after use. Do not wash your hands after use if putting this on your hand. Caregivers need to wear special gloves when putting on this medicine and wash hands after use. Put on right away or within 30 minutes after taking Valchlor out of the refrigerator. Put back in the refrigerator right after each use. Put on clean, dry skin. Put a thin layer on the affected skin. Avoid putting on healthy skin. Let gel dry before covering with clothing. Do not bathe, shower, or swim for 4 hours after putting on. Wait at least 30 minutes after you bathe or shower before putting on this medicine. Do not use coverings (bandages, dressings, make-up) unless told to do so by the doctor. Use as you have been told, even if your signs get better. What do I do if I miss a dose? Put on 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 put on 2 doses 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. Blisters or sores. Redness. Swelling. Signs of skin infection like oozing, heat, swelling, redness, or pain. Skin ulcers. A skin lump or growth. Change in color or size of a mole. What are some other side effects of Valchlor? 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: Itching. Change in color of skin. 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 Valchlor? Store in a refrigerator. Do not freeze. Store in original container. Protect from heat or open flame. Check with your pharmacist if drug is left at room temperature for more than 1 hour a day. Throw away any part not used after 3 months. Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets. Check with your pharmacist about how to throw out unused drugs. Consumer Information Use and Disclaimer If your symptoms or health problems do not get better or if they become worse, call your doctor. Do not share your drugs with others and do not take anyone else's drugs. Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor. Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins. This medicine comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time Valchlor (mechlorethamine (topical)) is refilled. If you have any questions about this medicine, please talk with the doctor, pharmacist, or other health care provider. If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened. This information should not be used to decide whether or not to take Valchlor 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 Valchlor. 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 Valchlor (mechlorethamine topical) Side Effects During Pregnancy Dosage Information Support Group Pricing & Coupons En Español 0 Reviews Add your own review/rating Drug class: topical antineoplastics Consumer resources Valchlor Valchlor (Advanced Reading) Professional resources Valchlor (AHFS Monograph) Valchlor Gel (FDA) Related treatment guides Mycosis Fungoides} Drug Status Rx Availability Prescription only D Pregnancy Category Positive evidence of risk N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Valchlor Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! Manufacturer Actelion Pharmaceuticals US, Inc. Drug Class Topical antineoplastics Related Drugs Mycosis Fungoides prednisone , methotrexate , dexamethasone , Decadron , Deltasone , Trexall , Sterapred , vinblastine , Dexasone , Adcetris , brentuximab , Prednicot , Dexpak Taperpak , Sterapred DS , Baycadron , Velban , Dexacen-4 , More...} } truly fizzling out


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which will Genentech, Inc. Address Genentech, Inc., 1 DNA Way South San Francisco, CA 94080-4990 Contact Details Phone: (650) 225-1000 Website: www.gene.com Careers: www.gene.com/careers Drugs Associated with Genentech, Inc. Genentech, Inc. manufactures, markets and/or distributes more than 38 drugs in the United States. Medications listed here may also be marketed under different names in different countries. Non-US country and region specific information is not available on this page. Brand/Generic Name Average User Rating Actemra generic name: tocilizumab class: interleukin inhibitors 8.0 Activase generic name: alteplase class: thrombolytics N/A Alecensa generic name: alectinib class: multikinase inhibitors N/A Avastin generic name: bevacizumab class: VEGF/VEGFR inhibitors 8.2 Boniva generic name: ibandronate class: bisphosphonates 5.3 Cathflo Activase generic name: alteplase class: thrombolytics N/A CellCept generic name: mycophenolate mofetil class: selective immunosuppressants 8.4 Copegus generic name: ribavirin class: inhaled anti-infectives, purine nucleosides 8.0 Cotellic generic name: cobimetinib class: multikinase inhibitors N/A Cytovene generic name: ganciclovir class: purine nucleosides N/A Erivedge generic name: vismodegib class: hedgehog pathway inhibitors N/A Esbriet generic name: pirfenidone class: miscellaneous uncategorized agents N/A Fuzeon generic name: enfuvirtide class: miscellaneous antivirals 7.2 Gazyva generic name: obinutuzumab class: CD20 monoclonal antibodies N/A Hemlibra generic name: emicizumab class: N/A N/A Herceptin generic name: trastuzumab class: HER2 inhibitors 9.5 Invirase generic name: saquinavir class: protease inhibitors 1.0 Kadcyla generic name: ado-trastuzumab emtansine class: HER2 inhibitors N/A Klonopin generic name: clonazepam class: benzodiazepine anticonvulsants, benzodiazepines 8.7 Lucentis generic name: ranibizumab class: anti-angiogenic ophthalmic agents 7.1 Nutropin AQ generic name: somatropin class: growth hormones 10 Ocrevus generic name: ocrelizumab class: CD20 monoclonal antibodies N/A Pegasys generic name: peginterferon alfa-2a class: antiviral interferons 6.5 Perjeta generic name: pertuzumab class: HER2 inhibitors N/A Pulmozyme generic name: dornase alfa class: miscellaneous respiratory agents 10 Rituxan generic name: rituximab class: antirheumatics, CD20 monoclonal antibodies 8.0 Rituxan Hycela generic name: hyaluronidase/rituximab class: CD20 monoclonal antibodies N/A Tamiflu generic name: oseltamivir class: neuraminidase inhibitors 6.8 Tarceva generic name: erlotinib class: EGFR inhibitors 8.9 Tecentriq generic name: atezolizumab class: Anti-PD-1 monoclonal antibodies N/A TNKase generic name: tenecteplase class: thrombolytics N/A Valcyte generic name: valganciclovir class: purine nucleosides 8.0 Valium generic name: diazepam class: benzodiazepine anticonvulsants, benzodiazepines 8.7 Venclexta generic name: venetoclax class: miscellaneous antineoplastics N/A Xeloda generic name: capecitabine class: antimetabolites 7.2 Xenical generic name: orlistat class: peripherally acting antiobesity agents 8.4 Xolair generic name: omalizumab class: other immunosuppressants 8.3 Zelboraf generic name: vemurafenib class: multikinase inhibitors 6.6 Latest Drug Information Updates Ozempic Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) analog administered once-weekly for the treatment... Juluca Juluca (dolutegravir and rilpivirine) is a single-tablet, two-drug regimen of the approved drugs dolutegravir... Hemlibra Hemlibra (emicizumab-kxwh) is a bispecific factor IXa- and factor X-directed antibody indicated to prevent... Prevymis Prevymis (letermovir) a CMV DNA terminase complex inhibitor indicated for prophylaxis of cytomegalovirus... Fasenra Fasenra (benralizumab) is an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody indicated... Calquence Calquence (acalabrutinib) is a highly selective, potent, Bruton tyrosine kinase (BTK) inhibitor for the... More drug information updates commonly


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occasion Gammagard S/D Generic Name: immune globulin (Intramuscular route, Intravenous route, Subcutaneous route) i-MUNE GLOB-ue-lin Intravenous route(Powder for Solution;Solution) Thrombosis may occur with or without known risk factors, including advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, estrogen use, indwelling central vascular catheters, hyperviscosity, and cardiovascular risk factors . For patients at risk of thrombosis, administer immune globulin at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration; monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity . Renal dysfunction, acute renal failure, osmotic nephrosis, and death may occur in predisposed patients who receive immune globulin IV (IGIV) products. Patients predisposed to renal dysfunction include those with any degree of pre-existing renal insufficiency, diabetes mellitus, age greater than 65, volume depletion, sepsis, paraproteinemia, or patients receiving known nephrotoxic drugs. Higher rates of renal failure were associated with IGIV products that contain sucrose . The following products do not contain sucrose: Gammaplex(R), Bivigam(R), Octagam(R) 10%, Gamunex(R)-C, Gammagard Liquid(R), Gammagard S/D, Gammaked(TM), Flebogamma(R) 5% DIF, Flebogamma(R) 10% DIF, Privigen(R), and Hizentra(R) . Overview Side Effects Dosage Interactions Pregnancy More User Reviews Support Group Q & A Compare Alternatives Pricing & Coupons Commonly used brand name(s) In the U.S. Baygam Bivigam Carimune Cuvitru Flebogamma 10% DIF Flebogamma 5% Flebogamma 5% DIF Gamastan S/D Gamimune N Gammagard Gammagard S/D Gammaplex Gammaplex 10% Gammar-P Gamunex Hizentra Iveegam EN Octagam Octagam 10% Panglobulin NF Polygam S/D Privigen Sandoglobulin Venoglobulin-S Vivaglobin Available Dosage Forms: Solution Powder for Solution Therapeutic Class: Immune Serum Slideshow 2016 New Drug Approvals: The Year That Was Uses For Gammagard S/D Immune globulin injection is used to prevent or treat diseases that occur when your body has a weak immune system. Immune globulin contains antibodies that make your immune system stronger. It is used for patients who have primary humoral immunodeficiency (PI), idiopathic thrombocytopenic purpura (ITP), chronic immune thrombocytopenic purpura, or chronic inflammatory demyelinating polyneuropathy (CIDP). It is also used to improve muscle strength and disability in patients with multifocal motor neuropathy (MMN). Immune globulin injection belongs to a group of medicines known as immunizing agents. This medicine is to be given only by or under the supervision of your doctor. Before Using Gammagard S/D In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of immune globulin injection in children. Some of the products are only used in children who are 2 or 3 years of age and older, and other products are not approved for use in children. Immune globulin injection is used to treat primary humoral immunodeficiency (PI), idiopathic thrombocytopenic purpura (ITP), and chronic immune thrombocytopenic purpura in children. Safety and efficacy have not been established for use in chronic inflammatory demyelinating polyneuropathy (CIDP) or multifocal motor neuropathy (MMN). Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of immune globulin injection in the elderly. However, elderly patients are more likely to have age-related blood clotting problems, kidney disease, or heart disease, which may require caution for patients receiving immune globulin injection. Pregnancy Pregnancy Category Explanation All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women. Breast Feeding Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine. Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. Other Medical Problems The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially: Allergy to corn Use with caution. May cause an allergic reaction to occur again. Anemia, history of or Bleeding problems, history of or Hyponatremia (low sodium in the blood) or Kidney problems Use with caution. May make these conditions worse. Atherosclerosis (hardening of the arteries), history of or Blood clotting problems, history of or Diabetes or Heart attack or stroke, recent or Heart or blood vessel disease or Hyperproteinemia (high protein in the blood) or Hyperviscosity (thick blood), known or suspected or Hypovolemia (low blood volume or major loss of body fluids) or IgA (immunoglobulin A) deficiency with antibodies against IgA or Paraproteinemia (paraproteins in the blood) or Sepsis (serious infection in the body) Use with caution. May cause side effects to become worse. Hereditary intolerance to fructose or sucrose or IgA (immunoglobulin A) deficiency with antibodies against IgA Gammaplex should not be used in patients with these conditions. Hyperprolinemia (too much proline in the blood) or IgA (immunoglobulin A) deficiency with antibodies against IgA Hizentra should not be used in patients with these conditions. IgA (immunoglobulin A) deficiency with antibodies against IgA Octagam should not be used in patients with this condition. Proper Use of immune globulin This section provides information on the proper use of a number of products that contain immune globulin. It may not be specific to Gammagard S/D. Please read with care. A doctor or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins, as a shot into one of your muscles, or as a shot under your skin. This medicine comes with a patient information insert. Read and follow the instructions carefully. Ask your doctor if you have any questions. While you are being treated with immune globulin injection, do not have any immunizations (vaccines) without your doctor's approval . Live virus vaccines should not be given for 3 months after receiving immune globulin. The Gammagard Liquid, Gammaked , Gamunex -C, and Hizentra products may be given at home to patients who do not need to be in the hospital or clinic. They are given as an infusion under your skin once every week. The Hizentra product may also be given once every 2 weeks. If you are using this medicine at home, your doctor will teach you how to prepare and infuse the medicine. You will be shown the body areas where the medicine can be given. Use a different body area for each infusion. Keep track of where you give an infusion to make sure you rotate sites. This will help prevent skin problems. Do not change the brand or type of your immune globulin unless your doctor tells you to. If you must change the brand of medicine, talk to your doctor before giving yourself an infusion. Make sure you understand the instructions on how to use the new brand. Allow the Gammagard Liquid, Gammaked , or Gamunex -C brand to reach room temperature before using it. To use Gammagard Liquid, Gammaked , Gamunex -C, or Hizentra : First, gather the items you will need on a clean, flat surface using a cloth or towel in a well-lighted area. Wash your hands with soap and water before and after using this medicine. If you have been told to wear gloves when preparing your infusion, put the gloves on. Check the liquid in the vial (glass container). It should be clear and slightly yellow to light brown in color. If it is cloudy, discolored, or contains large flecks (particles), do not use the vial. Select another vial. If the liquid is clear, place it on the clean, flat surface. Do not heat up or shake the medicine. Follow your doctor's instructions on how to prepare the correct amount of medicine. Choose an injection site on your body (eg, abdomen or stomach area, thigh, upper arm, upper leg, hip). Clean the injection site with a fresh alcohol wipe, and let it dry. With two fingers, pinch together the skin at the injection site. Insert the needle with the tube under the skin. Put sterile gauze and tape over the injection site to keep the needle from coming out. Before starting the infusion, make sure no blood is flowing into the infusion tube. If blood is present, remove and throw away the used needle and tube. Follow your doctor's instructions on how to use the infusion pump. Remove the peel-off portion of the label from the used vial. Place this label in your treatment diary or log book. Write down the amount of medicine you used, the date, and the time of your treatment. It usually takes about 60 minutes for each infusion. When all of the medicine has been infused, turn off the pump. Take the gauze off and remove the needle and tube from your skin. Clean and store the infusion pump. Throw away used needles and tubes in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets. Missed Dose This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions. Storage Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Store the Hizentra product at room temperature, away from heat and moisture, for up to 30 months. Keep from freezing. Protect the product from direct light. Keep the medicine in the original package until you are ready to use it. Store the Gamunex -C product in the original container and in the refrigerator, but do not freeze it. You may store the Gammagard Liquid or Gammaked product in the refrigerator or at room temperature. Check the box or label of the vials for expiration dates. Store it in the original container. Do not freeze. Talk with your pharmacist if you have questions about storage of this product. Precautions While Using Gammagard S/D It is very important that your doctor check your progress at regular visits for any problems that may be caused by this medicine. Blood and urine tests may be needed to check for unwanted effects. Patients with idiopathic thrombocytopenic purpura (ITP) should not be treated with Gammaked or Gamunex -C that is injected under the skin (subcutaneously). Doing so may increase the risk of having a hematoma (buildup of blood under the skin). This medicine may cause fever, chills, flushing, headaches, nausea, and vomiting, especially if you are receiving it for the first time or if you have not received it for more than 8 weeks. Check with your doctor or nurse right away if you have any of these symptoms. This medicine is made from donated human blood. Some human blood products have transmitted certain viruses to people who have received them, although the risk is low. Human donors and donated blood are both tested for viruses to keep the transmission risk low. Talk with your doctor about this risk if you are concerned. This medicine may cause a serious type of allergic reaction, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hives, chest pain, dizziness or lightheadedness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine. Certain people, including those with IgA (an immunoglobulin) deficiency and antibodies against IgA and a history of hypersensitivity to human immunoglobulin products should not use this medicine . Check with your doctor right away if you start to have a stiff neck, drowsiness, fever, severe headache, nausea or vomiting, painful eye movements, or eye sensitivity to light. These could be symptoms of a serious condition called aseptic meningitis syndrome (AMS). This medicine may cause bleeding (hemolysis) or hemolytic anemia. Tell your doctor right away if you have stomach or back pain, dark urine, decreased urination, difficulty with breathing, an increased heart rate, tiredness, or yellow eyes or skin after you receive the medicine. Check with your doctor right away if you start having chest pain, difficult, fast, or noisy breathing, sometimes with wheezing, blue lips and fingernails, fever, pale skin, increased sweating, coughing that sometimes produces a pink frothy sputum, shortness of breath, or swelling of the legs and ankles after receiving this medicine. These may be symptoms of a serious lung problem. This medicine may cause blood clots. This is more likely to occur if you have a history of blood clotting problems, heart disease, or atherosclerosis (hardening of the arteries), or if you are obese, take medicines containing estrogen, or must stay in bed for a long time because of surgery or illness. Check with your doctor right away if you suddenly have chest pain, shortness of breath, a severe headache, leg pain, or problems with vision, speech, or walking. Check with your doctor right away if you start having red or dark brown urine, lower back or side pain, a sudden weight gain, a swollen face, arms, or legs, decreased urine output, or any problems with urination after you receive this medicine. These may be symptoms of a serious kidney problem. Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests. Gammagard S/D Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor or nurse immediately if any of the following side effects occur: More common Chills cough fast, pounding, or irregular heartbeat or pulse fever noisy breathing tightness in the chest troubled breathing unusual tiredness or weakness Less common Bluish coloring of the lips or nail beds burning sensation in the head faintness or lightheadedness Rare Difficulty with swallowing hives or welts itching, especially of the feet or hands reddening of the skin, especially around the ears swelling of the eyes, face, or inside of the nose Incidence not known Back, leg, or stomach pains blistering, peeling, or loosening of the skin change in vision changes in urination chest pain or discomfort cold, clammy, or pale skin confusion convulsions dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position fever headache that is severe and occurs suddenly light-colored stools loss of consciousness low blood pressure or pulse muscle spasm or jerking of all extremities nausea or vomiting pains in the chest, groin, or legs, especially calves of the legs shakiness in the legs, arms, hands, or feet skin blisters slow breathing slurred speech that occurs suddenly sores, ulcers, or white spots in the mouth or on the lips sudden, severe weakness or numbness in the arm or leg sweating swelling in the legs and ankles tightness in the chest unusual bleeding or bruising yellow eyes or skin Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Diarrhea dizziness headache joint pain muscle pain redness, swelling, itching, or pain at the injection site skin rash Less common Hip pain leg cramps Incidence not known Feeling of warmth redness of the face, neck, arms, and occasionally, upper chest stomach pain swollen glands tiredness weakness Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Side Effects (complete list) The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products. Copyright 2017 Truven Health Analytics, Inc. All Rights Reserved. Next Side Effects Print this page Add to My Med List More about Gammagard S/D (immune globulin intravenous) Side Effects During Pregnancy Dosage Information Drug Interactions Compare Alternatives Support Group Pricing & Coupons 0 Reviews Add your own review/rating Drug class: immune globulins Consumer resources Other brands: Privigen , Gamunex , Octagam , Carimune , ... +10 more Professional resources Other Formulations Gammagard Related treatment guides Autoimmune Neutropenia Bone Marrow Transplantation Chronic Lymphocytic Leukemia Evan's Syndrome ... +5 more} Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Manufacturer Shire US, Inc. Drug Class Immune globulins Related Drugs Chronic Lymphocytic Leukemia Rituxan , rituximab , cyclophosphamide , Imbruvica , Cytoxan , ibrutinib , More... Primary Immunodeficiency Syndrome Gammagard , Hizentra , Gamunex , Privigen , Octagam , Gamunex-C , More... Autoimmune Neutropenia Octagam , Carimune , Flebogamma , Gammaplex , immune globulin intravenous , Sandoglobulin , More... Bone Marrow Transplantation fluconazole , Diflucan , cisplatin , Neupogen , filgrastim , Zarxio , More... 3 more conditions... Gammagard S / D Rating No Reviews - Be the first! 5.0 /10 No Reviews - Be the first! 5.0 Rate it! Help and Support Looking for answers? Ask a question or go join the Gammagard S / D support group to connect with others who have similar interests.} } to utilize


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