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picks Intrauterine insemination, or IUI, is a common fertility treatment that may help you conceive. One of four types of artificial insemination, IUI is a fairy simple procedure, and IUI side effects are generally minor, although some can be serious. Understanding what IUI is, how it works, and the risks associated with it can help you make the best decision when it s time to explore your options for fertility treatments. What Is Artificial Insemination? Artificial insemination was originally used on livestock, but it s now one of the most common solutions to infertility for many couples and involves inserting sperm directly into cervix, uterus, or fallopian tubes. Artificial insemination is most commonly used when: A couple is unable to have intercourse due to erectile dysfunction or another condition. A woman s cervical mucus doesn t allow sperm to pass through, or it contains an antibody to sperm, which kills the sperm before they can reach the egg. A woman has mild to moderate endometriosis. A woman or man has a sperm allergy. A man produces too few sperm, or the sperm isn t mobile enough to reach the egg. A same-sex couple wishes to conceive with donor sperm. No cause of infertility can be found, but the couple has tried unsuccessfully to conceive. Four Types of Artificial Insemination IUI is the most common insemination procedure used today. During IUI, up to one milliliter of sperm from a woman s partner or a donor are washed in a lab to isolate the sperm from the solution surrounding it. The washed sperm is injected directly into the uterus. The other three types of artificial insemination are: Intracervical insemination, or ICI, which is less expensive than IUI but not quite as effective. The ICI procedure involves placing the semen directly into the cervix. Intratubal insemination, or ITI, during which washed sperm are injected directly into the fallopian tube or near the entrance. ITI is more invasive than IUI, and its success rate isn t much higher, making it the least-used method of artificial insemination. Intravaginal insemination, or IVI, which is also known as self-insemination because it can be done by couples trying to conceive. During IVI, semen is injected into the vaginal canal near the cervix. This method is far less effective than IUI, but it s virtually free. A Closer Look at IUI An IUI is scheduled just after ovulation, when you re the most fertile. If you have a 28-day menstrual cycle, this will be around day 14. If your menstrual cycle is irregular, you ll probably use an ovulation prediction kit that detects hormones in the saliva or urine and accurately predicts when you ll ovulate. If donor sperm is used for the IUI, it will be obtained from the sperm bank and tested for transmittable diseases. If your partner s sperm will be used, the sperm sample will be collected through masturbation. If your partner is unable to ejaculate due to a medical condition, the sperm will be surgically removed directly from the testicles or epididymis. The sperm is washed to separate them from the fluid that surrounds them. The fastest, healthiest sperm are then collected for the IUI. During the procedure, a speculum is used to open the vaginal walls and expose the cervix. A catheter is inserted through the cervix and into the uterus, and the sperm are injected through the catheter. After the procedure, you ll rest for a short time and then go home and wait six to fourteen days before taking a home pregnancy test, which should be followed up by a blood test to confirm the results either way. Intrauterine Tuboperitoneal Insemination Intrauterine tuboperitoneal insemination, or IUTPI, is a newer method of IUI that uses a larger quantity of prepared sperm. The larger volume fills up the uterus and forces it into the fallopian tube as it overflows. During an IUTPI, a special device known as a double-nut bivalve, or DNB, speculum is used to clamp the cervix closed to prevent the excess sperm from flowing back out. IUTPI has a higher success rate than IUI, according to a study published in the journal Sterility and Fertility, but it s more expensive. IUI Side Effects The side effects of the IUI procedure itself are minimal. Some women report mild cramping during and after the IUI, but many report little to no pain during the procedure. In some cases, a vaginal infection may occur due to the introduction of bacteria. This may cause burning or itching, discharge, and a foul odor. In rare cases, bleeding or spotting may occur if the cervix is injured during the procedure. Fertility Drugs and IUI In some cases, such as when the cause of infertility is unknown, fertility drugs may be used along with IUI to increase the chances of success by stimulating your ovaries to produce more eggs, a process known as superovulation. The most common fertility drugs used with IUI include: Clomid , or clomipene citrate, which is an oral drug that works by blocking estrogen receptors in the brain, stimulating the release of follicle simulating hormone (FSH) and luteinizing hormone (LH) to promote egg development. Gonadotropins like hMG, which is administered daily by injection for a week or two to promote the development of eggs in fluid-filled sacs known as ovarian follicles. Blood tests and ultrasounds monitor their development, and when the follicles are big enough, a shot of hCG triggers the follicles to release the eggs into the fallopian tubes. Aromatase inhibitors , such as letrozole, which inhibit the enzyme aromatase to suppress estrogen levels and increase the output of FSH. While IUI side effects are typically mild, the side effects of the fertility drugs can be more intense. Common side effects of Clomid include: Hot flashes Breast tenderness Dizziness Headache Mood swings Insomnia Restlessness Fatigue Serious side effects that require a call to your doctor include vision problems, yellowed skin or eyes, bloating, and stomach or pelvic pain. Common side effects of gonadotropins include irritation at the injection site, headaches, and fatigue. Serious side effects include vomiting, breathing difficulties, and abdominal swelling. Common side effects of letrozole include nausea and hot flashes, but negative effects are unusual due to the speed with which this drug is cleared from the body. All three of these drugs increase your risk of a multiple pregnancy, although letrozole carries the lowest risk of multiples. IUI and Multiple Births If you re not taking fertility drugs in conjunction with your IUI, your chances of having multiples are the same as if you conceived naturally. But most women who undergo IUI do take fertility drugs, and depending on the drug, this increases your chances of having twins, triplets, or other multiples. Around 10 percent of women taking clomid or letrozole and 30 percent of those taking gonadotropins will become pregnant with multiples. While multiple pregnancies are a cause for celebration for couples struggling with infertility, multiple pregnancies increase the risk of complications, including: Premature birth. Most single pregnancies last 39 weeks, while most twin pregnancies last 36 weeks and triplet pregnancies last 32 weeks. Nearly 60 percent of twins are born prematurely, while nearly 90 percent of triplets are delivered pre-term, according to the March of Dimes. Low birth weight. Babies who are less than 5.5 pounds are considered to have low birth weight, which increases the risk of a range of problems, including vision and hearing loss and developmental problems. Intrauterine growth restriction. The growth rate of multiples begins to slow around 30 weeks for twins, 27 weeks for triplets, and 25 weeks for quadruplets. This may either be due to the inability of the placenta to grow any larger or to the babies competing for nutrients. Preeclampsia, a complication that can cause high blood pressure, damage to the kidneys, and seizures. Gestational diabetes. A multiple pregnancy increases your risk of gestational diabetes , which can lead to high blood pressure and pre-term birth or stillbirth. Gestational diabetes also puts your babies at risk for breathing problems, jaundice, childhood obesity, and diabetes later on in life. Placental abruption, a serious condition in which the placenta separates completely or partially from the uterus, potentially depriving the baby of oxygen and nutrients and causing severe bleeding that can dangerous to both you and your baby. Birth defects. According to the University of Rochester Medical Center, multiple-birth babies are at twice the risk of birth defects like spina bifida and heart abnormalities. Cesarean birth. While twins are often delivered vaginally, triplets and larger numbers of multiples are more often delivered by cesarean section. Twin-to-twin transfusion syndrome, or TTTS. This condition occurs in about 15 percent of twins who share a placenta, and treating it requires surgery or early delivery. In TTTS, the blood vessels that connect in the placenta sends blood from one of the babies to the other, and over time, the recipient baby may receive too much blood. Bed rest. In some cases of multiple pregnancies, bed rest is needed to stabilize the mother or the babies. Bed rest can help reduce or prevent stress on your heart, kidneys, and other organs, and it increases the flow of blood to the uterus and improves the delivery of nutrients to the babies. It can also help prevent early contractions by taking the pressure off the cervix. Birth complications. Complications at birth may include cord entanglement, where the babies umbilical cords get tangled, and postpartum hemorrhage of the mother due to the over-distended uterus and the large placental area. Each additional baby you carry increases your risk of complications. Your doctor will monitor your pregnancy closely and take steps to prevent or immediately treat these problems to help ensure a safe, healthy pregnancy and delivery. Factors Affecting IUI Success A study published in the Journal of Human Reproductive Sciences found that the pregnancy rates per IUI cycle range from eight to 22 percent. Researchers cite a number of factors affect the success of IUI cycles: The IUI success rate in women over 40 is as low as 1.4 percent, according to the study. Duration of infertility. The longer the duration of infertility, the less effective an IUI may be. Type of infertility. The study found the success rate slightly higher in unexplained fertility cases than in endometriosis and male-factor infertility cases. Endometrial thickness. With endometrial thickness of 6 millimeters and greater, the success rate was higher, but not significantly so. Total motile fraction, or TMF, of sperm. When the TMF, or the number of good sperm in a sample, was in the range of 10 to 20 million, the success rate was highest, at a little over 18 percent. When the TMF was between five and 10 million, the pregnancy rate was a little over five percent. A motility rate of less than five million was associated with a 2.7 percent success rate. Number of dominant follicles. A higher number of preovulatory follicles is associated with higher success rates. When fertility drugs are used to promote superovulation, the success rate is as high as 33 percent. What if IUI Doesn t Work? Most doctors recommend three to six cycles of IUI. If you still haven t become pregnant after six cycles, your doctor will likely recommend an alternative fertility treatment like in-vitro fertilization , or IVF. During IVF, eggs are extracted from the woman and fertilized manually with the male s sperm in a laboratory dish. The resulting embryo is transferred into the uterus. Infertility can be stressful. It takes a toll on your body, mind, and spirit, and getting plenty of support and keeping your stress levels down is important for your wellbeing and, according to many experts, for helping you conceive. While you re undergoing artificial insemination and other infertility procedures, spend time nurturing your relationship with your spouse or significant other. Engage in hobbies and other enjoyable activities to help you stay active and engaged with other areas of your life. Join a support group to help you maintain good mental health and keep you feeling positive and hopeful for the future. Remember that the majority of couples struggling with infertility will eventually conceive, and those who don t have other options available, including surrogacy and adoption. all and sundry


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slugging away elvitegravir, cobicistat, emtricitabine, and tenofovir (Oral route) el-vi-TEG-ra-vir, koe-BIK-i-stat, em-trye-SYE-ta-been, ten-OF-oh-vir dye-soe-PROX-il FUE-ma-rate Oral route(Tablet) Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues in combination with other antiretrovirals. The elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate combination is not approved for the treatment of chronic hepatitis B virus (HBV) infection and the safety and efficacy have not been established in patients coinfected with HBV and HIV-1. Severe acute exacerbations of hepatitis B have been reported in patients coinfected with HBV and HIV-1 who have discontinued emtricitabine or tenofovir disoproxil fumarate. Monitor hepatic function upon discontinuation of therapy in patients coinfected with HIV-1 and HBV and follow-up for at least several months thereafter. Anti-hepatitis B therapy may be warranted . Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Commonly used brand name(s) In the U.S. Stribild Available Dosage Forms: Tablet Therapeutic Class: Anti-Infective Agent Pharmacologic Class: Integrase Inhibitor Slideshow Hep C and Harvoni: 11 Facts About Your Treatment Uses For elvitegravir, cobicistat, emtricitabine, and tenofovir Elvitegravir, cobicistat, emtricitabine, and tenofovir combination is used to treat human immunodeficiency virus (HIV) infection. HIV is the virus that causes acquired immune deficiency syndrome (AIDS). elvitegravir, cobicistat, emtricitabine, and tenofovir is usually given to adult patients who have yet not received any medicine for HIV infection. Elvitegravir, cobicistat, emtricitabine, and tenofovir combination will not cure or prevent HIV infection or AIDS. It helps keep HIV from reproducing and appears to slow down the destruction of the immune system. This may help delay problems that are usually related to AIDS or HIV disease from occurring. elvitegravir, cobicistat, emtricitabine, and tenofovir will not keep you from spreading HIV to other people. People who receive elvitegravir, cobicistat, emtricitabine, and tenofovir may continue to have other problems usually related to AIDS or HIV disease. elvitegravir, cobicistat, emtricitabine, and tenofovir is available only with your doctor's prescription. Before Using elvitegravir, cobicistat, emtricitabine, and tenofovir 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 elvitegravir, cobicistat, emtricitabine, and tenofovir, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to elvitegravir, cobicistat, emtricitabine, and tenofovir or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies have not been performed on the relationship of age to the effects of elvitegravir, cobicistat, emtricitabine, and tenofovir combination in children younger than 12 years of age or weighing less than 35 kilograms. Safety and efficacy have not been established. Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of elvitegravir, cobicistat, emtricitabine, and tenofovir combination in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution for patients receiving elvitegravir, cobicistat, emtricitabine, and tenofovir. Pregnancy Pregnancy Category Explanation All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus. Breast Feeding There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking elvitegravir, cobicistat, emtricitabine, and tenofovir, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using elvitegravir, cobicistat, emtricitabine, and tenofovir with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Alfuzosin Carbamazepine Cisapride Colchicine Conivaptan Crizotinib Dihydroergotamine Doxorubicin Doxorubicin Hydrochloride Liposome Dronedarone Eletriptan Eliglustat Eplerenone Ergonovine Ergotamine Fosphenytoin Isavuconazonium Sulfate Ivabradine Lomitapide Lovastatin Lurasidone Maraviroc Methylergonovine Midazolam Naloxegol Pazopanib Phenobarbital Phenytoin Pimozide Primidone Ranolazine Rifampin Riociguat Romidepsin Sildenafil Silodosin Simvastatin St John's Wort Tolvaptan Triazolam Venetoclax Using elvitegravir, cobicistat, emtricitabine, and tenofovir with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Ado-Trastuzumab Emtansine Afatinib Alprazolam Aluminum Carbonate, Basic Aluminum Hydroxide Aluminum Phosphate Amiodarone Amprenavir Apixaban Aprepitant Aripiprazole Atazanavir Avanafil Bedaquiline Betrixaban Boceprevir Bosentan Bosutinib Brigatinib Bromocriptine Budesonide Cabazitaxel Cabozantinib Calcifediol Calcium Carbonate Cariprazine Ceritinib Cilostazol Clarithromycin Cobimetinib Cyclophosphamide Cyclosporine Dabrafenib Daclatasvir Darunavir Dasatinib Deflazacort Delamanid Delavirdine Dexamethasone Diazepam Didanosine Digoxin Dihydroxyaluminum Aminoacetate Dihydroxyaluminum Sodium Carbonate Disopyramide Docetaxel Domperidone Donepezil Erlotinib Erythromycin Eslicarbazepine Acetate Eszopiclone Etravirine Everolimus Fentanyl Flecainide Fluoxetine Fluticasone Fosamprenavir Fosaprepitant Haloperidol Hydrocortisone Ibrutinib Idelalisib Ifosfamide Iloperidone Irinotecan Irinotecan Liposome Itraconazole Ivacaftor Ketoconazole Lapatinib Ledipasvir Levomilnacipran Lidocaine Lopinavir Macitentan Magaldrate Magnesium Carbonate Magnesium Hydroxide Magnesium Oxide Magnesium Trisilicate Manidipine Methadone Mexiletine Midostaurin Mifepristone Morphine Morphine Sulfate Liposome Netupitant Nevirapine Nifedipine Nilotinib Nimodipine Nisoldipine Olaparib Orlistat Oxcarbazepine Oxycodone Palbociclib Panobinostat Pimavanserin Piperaquine Pixantrone Ponatinib Prednisone Propafenone Quetiapine Quinidine Reboxetine Regorafenib Retapamulin Ribociclib Rifabutin Rifapentine Ritonavir Rivaroxaban Rosuvastatin Ruxolitinib Salmeterol Saquinavir Simeprevir Sirolimus Sodium Bicarbonate Sunitinib Suvorexant Tacrolimus Tadalafil Tamoxifen Tamsulosin Telithromycin Temsirolimus Thiotepa Ticagrelor Tipranavir Topotecan Toremifene Trabectedin Tramadol Trazodone Valbenazine Vardenafil Vemurafenib Vilanterol Vilazodone Vinblastine Vincristine Vincristine Sulfate Liposome Vinflunine Vorapaxar Voriconazole Warfarin Zolpidem Using elvitegravir, cobicistat, emtricitabine, and tenofovir with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Aripiprazole Lauroxil Atazanavir Darunavir Indinavir Lopinavir Nelfinavir Ritonavir Tipranavir 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 elvitegravir, cobicistat, emtricitabine, and tenofovir. Make sure you tell your doctor if you have any other medical problems, especially: Bone problems (eg, fracture, osteomalacia), history of or Fanconi syndrome (kidney disease), history of or Hepatitis B infection, history of or Kidney failure, history of Use with caution. May make these conditions worse. Kidney disease, moderate to severe or Liver disease, severe Use is not recommended in patients with these conditions. Proper Use of elvitegravir, cobicistat, emtricitabine, and tenofovir Take elvitegravir, cobicistat, emtricitabine, and tenofovir exactly as directed by your doctor . Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. elvitegravir, cobicistat, emtricitabine, and tenofovir comes with a patient information leaflet. Read and follow these instructions carefully. Read it again each time you refill your prescription in case there is new information. You should talk to your doctor if you have any questions. elvitegravir, cobicistat, emtricitabine, and tenofovir should be taken with food. Do not change the dose or stop using elvitegravir, cobicistat, emtricitabine, and tenofovir without checking first with your doctor . When your supply of elvitegravir, cobicistat, emtricitabine, and tenofovir is running low, contact your doctor or pharmacist ahead of time. Do not allow yourself to run out of elvitegravir, cobicistat, emtricitabine, and tenofovir. If you are taking aluminum or magnesium-containing antacids (eg, Maalox , Mylanta , Tums ), do not take them at the same time that you take elvitegravir, cobicistat, emtricitabine, and tenofovir. It is best to take these medicines at least 2 hours before or after taking Stribild . These medicines may keep Stribild from working properly. Dosing The dose of elvitegravir, cobicistat, emtricitabine, and tenofovir will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of elvitegravir, cobicistat, emtricitabine, and tenofovir. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For oral dosage form (tablets): For treatment of HIV infection: Adults and children 12 years of age and older and weighs at least 35 kilograms (kg) One tablet once a day. Children younger than 12 years of age or weighs less than 35 kg Use and dose must be determined by your doctor. Missed Dose If you miss a dose of elvitegravir, cobicistat, emtricitabine, and tenofovir, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Do not use elvitegravir, cobicistat, emtricitabine, and tenofovir if the seal on the bottle is broken or missing. Keep the bottle tightly closed. Keep the medicine in the original bottle that you were given at the pharmacy. Precautions While Using elvitegravir, cobicistat, emtricitabine, and tenofovir Your doctor will want to check your or your child's progress at regular visits , especially during the first few weeks that you take elvitegravir, cobicistat, emtricitabine, and tenofovir. Blood and urine tests may be needed to check for any unwanted effects. The medicines in this combination tablet are also available as Atripla , Complera , Descovy , Emtriva , Genvoya , Odefsey , Truvada , Tybost , Viread , or Vitekta . Do not take the elvitegravir, cobicistat, emtricitabine, and tenofovir combination with any of these medicines . elvitegravir, cobicistat, emtricitabine, and tenofovir should not be used together with adefovir (Hepsera ), alfuzosin (Uroxatral ), carbamazepine (Tegretol ), cisapride (Propulsid ), lamivudine (Combivir , Epivir , Epivir-HBV , Epzicom , Triumeq , Trizivir ), lovastatin (Mevacor ), lurasidone (Latuda ), midazolam (Versed ), phenobarbital (Luminal ), phenytoin (Dilantin ), pimozide (Orap ), rifampin (Rifadin , Rimactane ), ritonavir (Kaletra , Norvir ), sildenafil (Revatio ), simvastatin (Zocor ), triazolam (Halcion ), St John's wort, ergotamine medicines (eg, dihydroergotamine, ergotamine, methylergonovine, Cafergot , Ergomar , Wigraine ), certain other antiviral medications (eg, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir), aminoglycoside antibiotics, or high-dose or multiple NSAID pain medicines. Two rare but serious reactions to elvitegravir, cobicistat, emtricitabine, and tenofovir are lactic acidosis (too much acid in the blood) and liver toxicity. These reactions are more common if you are female, obese, or have been taking anti-HIV medicines for a long time. Call your doctor right away if you or your child have abdominal or stomach pain, nausea, vomiting, decreased appetite, muscle cramping or pain, unusual tiredness or weakness, trouble breathing, or yellow skin or eyes. elvitegravir, cobicistat, emtricitabine, and tenofovir may also increase your risk of developing fractures (broken bones). Ask your doctor about this if you or your child have any concerns. elvitegravir, cobicistat, emtricitabine, and tenofovir does not decrease the risk of transmitting the HIV infection to others through sexual contact or by contaminated blood. Make sure you understand and practice safe sex, even if your partner also has HIV. Avoid sharing needles with anyone. Your immune system may get stronger when you start taking HIV medicines. Tell your doctor right away if you or your child notice any changes in your health. Sometimes the immune system will start to fight infections that were hidden in your body, such as pneumonia, herpes, or tuberculosis. Autoimmune disorders (such as Graves' disease, polymyositis, and Guillain-Barrรฉ syndrome) may also occur. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. elvitegravir, cobicistat, emtricitabine, and tenofovir 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 immediately if any of the following side effects occur: More common Cloudy urine Incidence not known Abdominal or stomach discomfort or pain bloody urine bone fractures bone pain change in urination convulsions cough dark-colored urine decreased appetite difficulty with swallowing dizziness dry mouth fast or irregular heartbeat fast, shallow breathing fever general feeling of discomfort increased thirst large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs light-colored stools lower back or side pain mood changes muscle pain, cramps, or stiffness nausea, vomiting or diarrhea numbness or tingling in the hands, feet, or lips puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue skin rash, hives, or itching sleepiness swelling of the face, fingers, or lower legs tightness in the chest trouble breathing unusual tiredness or weakness weight gain yellow eyes and 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 Abnormal dreams headache Less common Bloated full feeling passing gas trouble sleeping unusual drowsiness Incidence not known Chills constipation indigestion lack or loss of strength pains in the stomach, side, or abdomen, possibly radiating to the back 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 cobicistat/elvitegravir/emtricitabine/tenofovir Side Effects During Pregnancy Dosage Information Drug Interactions Support Group 86 Reviews Add your own review/rating Drug class: antiviral combinations Consumer resources Cobicistat, elvitegravir, emtricitabine, and tenofovir Elvitegravir, Cobicistat, Emtricitabine, and Tenofovir Disoproxil Fumarate Other brands: Stribild Professional resources Elvitegravir, Cobicistat, Emtricitabine, and tenofovir Disoproxil Fumarate (AHFS Monograph) Elvitegravir, Cobicistat, Emtricitabine, and Tenofovir Disoproxil Fumarate (Wolters Kluwer) Related treatment guides HIV Infection} Drug Status Rx Availability Prescription only B Pregnancy Category No proven risk in humans N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Antiviral combinations Related Drugs HIV Infection Truvada , Atripla , Norvir , Viread , Isentress , Prezista , Stribild , lamivudine , abacavir , tenofovir , Epzicom , Reyataz , ritonavir , Complera , emtricitabine , darunavir , Kaletra , Intelence , Sustiva , Epivir , efavirenz , nevirapine , atazanavir , raltegravir , Selzentry , More... Cobicistat / elvitegravir / emtricitabine / tenofovir Rating 86 User Reviews 9.4 /10 86 User Reviews 9.4 Rate it! Help and Support Looking for answers? Ask a question or go join the cobicistat / elvitegravir / emtricitabine / tenofovir support group to connect with others who have similar interests.} } newest


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high quality Maryland 21202 United States Manufactured by: Lupin Limited Pithampur (M.P.) - 454 775 India November 2017 ID#: 253420 Patient Information WYMZYA TM Fe [WYM-zee-yah EFF-EE] [norethindrone and ethinyl estradiol tablets (chewable) and ferrous fumarate tablets] What is the most important information I should know about Wymzya FE? Do not use Wymzya FE if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects (heart and blood vessel problems) from birth control pills can most likely


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came across Medications for Constipation, Acute Health Guide Disease Reference Care Notes Medication List Encyclopedia Q & A More What is Constipation, Acute: Acute constipation is a condition in which bowel movements are infrequent or incomplete, usually of rapid onset and which may be severe. Medications to treat Constipation, Acute The following list of medications are in some way related to, or used in the treatment of this condition. Drug Class (show all) - laxatives (26) Rx OTC Off Label Only Generics Drug name Rx / OTC Preg nancy CSA Alcohol Reviews Rating Popularity MiraLax Rx/OTC C N 10 reviews 8.0 Generic name: polyethylene glycol 3350 systemic Drug class: laxatives For consumers: dosage , interactions , side effects For professionals: Prescribing Information lactulose Rx B N 16 reviews 7.0 Generic name: lactulose systemic Brand names: Generlac, Enulose, Kristalose, Constulose Drug class: laxatives For consumers: dosage , interactions , side effects For professionals: A-Z Drug Facts , AHFS DI Monograph , Prescribing Information Senna S OTC N N 1 review 4.0 Generic name: docusate / senna systemic Drug class: laxatives For consumers: dosage , interactions , side effects docusate / senna OTC N N 13 reviews 8.0 Generic name: docusate / senna systemic Brand names: Senna S, Senokot S, Senna Plus, Peri-Colace, Doculax, Senexon-S, Sennalax-S, Doc-Q-Lax, Dok Plus, Gentlax S, SenoSol-SS Drug class: laxatives For consumers: dosage , interactions , side effects Senokot S OTC N N 4 reviews 9.0 Generic name: docusate / senna systemic Drug class: laxatives For consumers: dosage , interactions , side effects Senna Plus OTC N N 2 reviews 8.0 Generic name: docusate / senna systemic Drug class: laxatives For consumers: dosage , interactions , side effects polyethylene glycol 3350 Rx/OTC C N 11 reviews 8.0 Generic name: polyethylene glycol 3350 systemic Brand names: MiraLax, GlycoLax, ClearLax, Purelax, GaviLAX, Gialax, PEG3350, SunMark ClearLax Drug class: laxatives For consumers: dosage , interactions , side effects For professionals: A-Z Drug Facts , Prescribing Information Peri-Colace OTC N N 1 review 10 Generic name: docusate / senna systemic Drug class: laxatives For consumers: dosage , interactions , side effects Doculax OTC N N 1 review 5.0 Generic name: docusate / senna systemic Drug class: laxatives For consumers: dosage , interactions , side effects Generlac Rx B N Add review Rate Generic name: lactulose systemic Drug class: laxatives For consumers: dosage , interactions , side effects For professionals: Prescribing Information GlycoLax Rx/OTC C N Add review Rate Generic name: polyethylene glycol 3350 systemic Drug class: laxatives For consumers: dosage , interactions , side effects ClearLax Rx/OTC C N 1 review 9.0 Generic name: polyethylene glycol 3350 systemic Drug class: laxatives For consumers: dosage , interactions , side effects For professionals: Prescribing Information Enulose Rx B N Add review Rate Generic name: lactulose systemic Drug class: laxatives For consumers: dosage , interactions , side effects For professionals: Prescribing Information Senexon-S OTC N N Add review Rate Generic name: docusate / senna systemic Drug class: laxatives For consumers: dosage , interactions , side effects Sennalax-S OTC N N Add review Rate Generic name: docusate / senna systemic Drug class: laxatives For consumers: dosage , interactions , side effects Kristalose Rx B N Add review 3.0 Generic name: lactulose systemic Drug class: laxatives For consumers: dosage , interactions , side effects For professionals: Prescribing Information Purelax Rx/OTC C N Add review Rate Generic name: polyethylene glycol 3350 systemic Drug class: laxatives For consumers: dosage , interactions , side effects For professionals: Prescribing Information Constulose Rx B N Add review Rate Generic name: lactulose systemic Drug class: laxatives For consumers: dosage , interactions , side effects For professionals: Prescribing Information GaviLAX Rx/OTC C N Add review Rate Generic name: polyethylene glycol 3350 systemic Drug class: laxatives For consumers: dosage , interactions , side effects For professionals: Prescribing Information Gialax Rx/OTC C N Add review Rate Generic name: polyethylene glycol 3350 systemic Drug class: laxatives For consumers: dosage , interactions , side effects PEG3350 Rx/OTC C N Add review Rate Generic name: polyethylene glycol 3350 systemic Drug class: laxatives For consumers: dosage , interactions , side effects SunMark ClearLax Rx/OTC C N Add review Rate Generic name: polyethylene glycol 3350 systemic Drug class: laxatives For consumers: dosage , interactions , side effects Doc-Q-Lax OTC N N 1 review 8.0 Generic name: docusate / senna systemic Drug class: laxatives For consumers: dosage , interactions , side effects Dok Plus OTC N N Add review Rate Generic name: docusate / senna systemic Drug class: laxatives For consumers: dosage , interactions , side effects Gentlax S OTC N N Add review Rate Generic name: docusate / senna systemic Drug class: laxatives For consumers: dosage , interactions , side effects Page 1 2 Next Legend Off Label This medication may not be approved by the FDA for the treatment of this condition. Prescription Only / Over the Counter Rx Prescription Only OTC Over the Counter Rx/OTC Prescription or Over the Counter Pregnancy A Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters). 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. 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 in pregnant women despite potential risks. D There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks. X Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits. N FDA has not classified the drug. Controlled Substances Act Schedule N Is not subject to the Controlled Substances Act. 1 Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision. 2 Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence. 3 Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence. 4 Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3. 5 Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4. Alcohol X Interacts with Alcohol. Browse Drugs by Condition A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Help and Support Looking for answers? Ask a question or go join the constipation - acute support group to connect with others who have similar interests. bloodbath


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time for supper dasatinib (Oral route) da-SA-ti-nib Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Commonly used brand name(s) In the U.S. Sprycel Available Dosage Forms: Tablet Therapeutic Class: Antineoplastic Agent Pharmacologic Class: Tyrosine Kinase Inhibitor Slideshow Leukemia Symptoms And Lessons: Is A Solution In Sight? Uses For dasatinib Dasatinib is used to treat different types of leukemia. Leukemia is a type of cancer where the body makes too many abnormal white blood cells. It belongs to the general group of medicines known as antineoplastics or cancer medicines. Dasatinib interferes with the growth of cancer cells, which are eventually destroyed by the body. dasatinib is available only with your doctor's prescription. Before Using dasatinib 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 dasatinib, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to dasatinib or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies have not been performed on the relationship of age to the effects of dasatinib in the pediatric population. Safety and efficacy have not been established. Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of dasatinib in the elderly. However, some elderly patients may be more sensitive than younger adults to the unwanted effects of dasatinib. Breast Feeding There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking dasatinib, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using dasatinib with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Amifampridine Amisulpride Bepridil Cisapride Dronedarone Fluconazole Measles Virus Vaccine, Live Mesoridazine Mumps Virus Vaccine, Live Nelfinavir Pimozide Piperaquine Posaconazole Rotavirus Vaccine, Live Rubella Virus Vaccine, Live Saquinavir Sparfloxacin Thioridazine Varicella Virus Vaccine Ziprasidone Using dasatinib with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Adenovirus Vaccine Alfuzosin Amiodarone Amitriptyline Amoxapine Anagrelide Apomorphine Aprepitant Aripiprazole Aripiprazole Lauroxil Arsenic Trioxide Asenapine Astemizole Atazanavir Azithromycin Bacillus of Calmette and Guerin Vaccine, Live Buserelin Carbamazepine Ceritinib Chloroquine Chlorpromazine Cholera Vaccine, Live Cimetidine Ciprofloxacin Citalopram Clarithromycin Clomipramine Clozapine Cobicistat Conivaptan Crizotinib Dabrafenib Degarelix Delamanid Desipramine Deslorelin Deutetrabenazine Dexamethasone Disopyramide Dofetilide Dolasetron Domperidone Donepezil Droperidol Efavirenz Erythromycin Escitalopram Esomeprazole Famotidine Fingolimod Flecainide Fluoxetine Fosaprepitant Foscarnet Fosphenytoin Gatifloxacin Gemifloxacin Gonadorelin Goserelin Granisetron Halofantrine Haloperidol Histrelin Hydroxychloroquine Hydroxyzine Ibutilide Idelalisib Iloperidone Imipramine Indinavir Influenza Virus Vaccine, Live Itraconazole Ivabradine Ketoconazole Lansoprazole Lapatinib Leuprolide Levofloxacin Lopinavir Lumacaftor Lumefantrine Mefloquine Methadone Metronidazole Mifepristone Moxifloxacin Nafarelin Nefazodone Nilotinib Nizatidine Norfloxacin Nortriptyline Octreotide Ofloxacin Omeprazole Ondansetron Paliperidone Panobinostat Pantoprazole Pasireotide Pazopanib Phenytoin Pimavanserin Pitolisant Poliovirus Vaccine, Live Procainamide Prochlorperazine Promethazine Propafenone Protriptyline Quetiapine Quinidine Quinine Rabeprazole Ranitidine Ranolazine Ribociclib Rifabutin Rifampin Ritonavir Salmeterol Sevoflurane Smallpox Vaccine Sodium Phosphate Sodium Phosphate, Dibasic Sodium Phosphate, Monobasic Solifenacin Sorafenib Sotalol St John's Wort Sulpiride Sunitinib Tacrolimus Telithromycin Tetrabenazine Toremifene Trazodone Trifluoperazine Trimipramine Triptorelin Typhoid Vaccine Vandetanib Vardenafil Vemurafenib Vinflunine Voriconazole Yellow Fever Vaccine Zuclopenthixol Using dasatinib with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Aluminum Carbonate, Basic Aluminum Hydroxide Aluminum Phosphate Calcium Calcium Carbonate Dihydroxyaluminum Aminoacetate Dihydroxyaluminum Sodium Carbonate Magaldrate Magnesium Carbonate Magnesium Hydroxide Magnesium Oxide Magnesium Trisilicate Simvastatin Sodium Bicarbonate 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. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using dasatinib with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use dasatinib, or give you special instructions about the use of food, alcohol, or tobacco. Grapefruit Juice Other Medical Problems The presence of other medical problems may affect the use of dasatinib. Make sure you tell your doctor if you have any other medical problems, especially: Anemia or Arrhythmia (heart rhythm problem) or Bleeding problems or Congenital long QT syndrome (heart rhythm problem) or Edema (fluid retention or swelling) or Neutropenia (low white blood cells) or Palpitations (fast heart rate) or Stomach bleeding or Thrombocytopenia (low platelets in the blood) Use with caution. May make these conditions worse. Infection Dasatinib may decrease your body's ability to fight an infection. Lactose intolerance Use with caution. dasatinib contains lactose. Proper Use of dasatinib Take dasatinib exactly as directed by your doctor . Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of unwanted effects. Medicines used to treat cancer are very strong and can have many side effects. Before receiving dasatinib, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment. dasatinib comes with a patient information insert. Follow the instructions carefully. Ask your doctor if you have any questions. You may take dasatinib with or without food. Swallow the tablet whole. Do not break, cut, crush, or chew it. Pregnant women should avoid handling crushed or broken tablets. If a tablet is broken or crushed, wear disposable gloves to avoid exposure to the medicine. If you are taking an antacid (eg, aluminum hydroxide, magnesium hydroxide, Maalox , Rolaids , or Tums ), take it at least 2 hours before or 2 hours after you take dasatinib. Dosing The dose of dasatinib will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of dasatinib. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For oral dosage form (tablets): For the treatment of chronic phase CML: Adults At first, 100 milligrams (mg) once a day given either in the morning or in the evening. Your doctor may adjust your dose as needed. Children Use and dose must be determined by your doctor. For the treatment of accelerated or blast crisis CML or Ph+ ALL: Adults At first, 140 milligrams (mg) once a day given either in the morning or in the evening. Your doctor may adjust your dose as needed. Children Use and dose must be determined by your doctor. Missed Dose If you miss a dose of dasatinib, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Precautions While Using dasatinib It is very important that your doctor check your progress at regular visits to make sure that dasatinib is working properly. Blood tests will be needed to check for unwanted effects. Be sure to keep all appointments. Using dasatinib while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant during treatment and for 30 days after your last dose. If you think you have become pregnant while using the medicine, tell your doctor right away. Dasatinib can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding: If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination. Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin. Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done. Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime. Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters. Avoid contact sports or other situations where bruising or injury could occur. Dasatinib may cause fluid retention. Check with your doctor right away if you have a decrease in amount of urine, noisy or rattling breathing, shortness of breath, swelling of the fingers, hands, feet, or lower legs, troubled breathing at rest, or weight gain. dasatinib can cause changes in the heart rhythm, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Check with your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats. Check with your doctor right away if you have the following symptoms: chest discomfort or pain, decreased urine output, fast, irregular or pounding heartbeat, shortness of breath, swelling of the feet or lower legs, troubled breathing, or unusual tiredness or weakness. These could be symptoms of a serious heart problem. Using dasatinib may cause headache, muscle or joint pain, skin rash, or unusual tiredness or weakness. If these symptoms persist and become worse, check with your doctor. dasatinib may increase your risk of having a condition called pulmonary arterial hypertension (high blood pressure in the lungs). This may occur at anytime during treatment with dasatinib. Check with your doctor right away if you have the following symptoms: shortness of breath, troubled breathing, tiredness, or swelling all over your body (fluid retention). Serious skin reactions can occur with dasatinib. Check with your doctor right away if you have blistering, peeling, or loose skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using dasatinib. dasatinib may cause a serious type of reaction called tumor lysis syndrome. Your doctor may give you a medicine to help prevent this. Call your doctor right away if you have a decrease or change in urine amount, joint pain, stiffness, or swelling, lower back, side, or stomach pain, a rapid weight gain, swelling of the feet or lower legs, or unusual tiredness or weakness. Do not drink grapefruit juice while you are using dasatinib. Grapefruit juice may change the amount of medicine that is absorbed in the body. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements. dasatinib 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 immediately if any of the following side effects occur: More common Bloody or black, tarry stools body aches or pain burning, tingling, numbness or pain in the hands, arms, feet, or legs chest pain constipation cough or hoarseness coughing up blood decrease in the amount of urine dizziness ear congestion fainting fast, slow, or irregular heartbeat fever or chills full or bloated feeling headache loss of voice lower back or side pain nasal congestion noisy or rattling breathing painful or difficult urination pale skin paralysis pressure in the stomach runny nose sensation of pins and needles severe stomach pain sneezing sore throat stabbing pain swelling of the abdominal or stomach area swelling of the face, fingers, hands, feet, or lower legs tightness in the chest troubled breathing ulcers, sores, or white spots in the mouth unsteadiness or awkwardness unusual bleeding or bruising unusual tiredness or weakness vomiting of blood or material that looks like coffee grounds weakness in the arms, hands, legs, or feet weight gain Less common Bloating blue lips and fingernails chest discomfort coughing that sometimes produces a pink frothy sputum decreased urine output difficult or fast breathing dilated neck veins increased sweating irregular breathing irregular heartbeat nausea swelling swelling in the legs and ankles Incidence not known Anxiety pain, redness, or swelling in the arm or leg sudden shortness of breath or troubled breathing tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over the affected area Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Abdominal or stomach pain bleeding gums cracked lips diarrhea difficulty with moving difficulty with swallowing increased menstrual flow or vaginal bleeding itching skin or rash lack or loss of strength loss of appetite muscle aching or cramping muscle or bone pain muscle stiffness nose bleeds pain pain in the joints prolonged bleeding from cuts red or dark brown urine swollen joints vomiting weight loss 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 dasatinib Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Espaรฑol 17 Reviews Add your own review/rating Drug class: BCR-ABL tyrosine kinase inhibitors Consumer resources Dasatinib Other brands: Sprycel Professional resources Dasatinib (AHFS Monograph) Dasatinib (Wolters Kluwer) Related treatment guides Acute Lymphoblastic Leukemia Chronic Myelogenous Leukemia Leukemia} Drug Status Rx Availability Prescription only D Pregnancy Category Positive evidence of risk N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class BCR-ABL tyrosine kinase inhibitors Related Drugs Chronic Myelogenous Leukemia hydroxyurea , Hydrea , Gleevec , cyclophosphamide , imatinib , Sprycel , Tasigna , cytarabine , More... Acute Lymphoblastic Leukemia methotrexate , Gleevec , mercaptopurine , imatinib , Adriamycin , doxorubicin , Sprycel , More... Leukemia prednisone , triamcinolone , dexamethasone , Decadron , Deltasone , Sprycel , Kenalog-40 , More... Dasatinib Rating 17 User Reviews 8.6 /10 17 User Reviews 8.6 Rate it! Related Questions & Answers What is the dosage most used for Sprycel for 2nd round CML patients? What is the best thing to take with dasatinib for sleeplessness? I'm a cml patient, can I quit taking dasatinib after two years? Read more questions} } the general public


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was resolute [4%:<500/mm 3 or platelets> <50,000/mm 3 , withhold treatment until ANC 1000/mm 3 and platelets 50,000/mm 3 ; then resume treatment at the original starting dose if recovery occurs in 7 days. If platelets> <25,000/mm 3 or recurrence of ANC> <500/mm 3 for> 7 days, withhold treatment until ANC 1000/mm 3 and platelets 50,000/mm 3 ; then resume treatment at 80 mg once daily (second episode). For third episode, further reduce dose to 50 mg once daily (for newly diagnosed patients) or discontinue (for patients resistant or intolerant to prior therapy) Accelerated or blast phase CML and Ph+ ALL (140 mg once daily starting dose): For ANC <500/mm 3 or platelets> <10,000/mm 3 , if cytopenia unrelated to leukemia, withhold treatment until ANC 1000/mm 3 and platelets 20,000/mm 3 ; then resume treatment at the original starting dose. If cytopenia recurs, withhold treatment until ANC 1000/mm 3 and platelets 20,000/mm 3 ; then resume treatment at 100 mg once daily (second episode) or 80 mg once daily (third episode). For cytopenias related to leukemia (confirm with marrow aspirate or biopsy), consider dose escalation to 180 mg once daily. Nonhematologic toxicity: Withhold treatment until toxicity improvement or resolution; if appropriate, resume treatment at a reduced dose based on the event severity and recurrence. Dermatologic toxicities : Manage rash with antihistamines or topical or systemic steroids (Khoury 2009), or treatment interruption, dose reduction, or discontinuation. Discontinue if dasatinib-related severe mucocutaneous reaction occurs. Fluid retention: Manage with diuretics, short courses of corticosteroids, and/or supportive care. Severe pleural effusions may require thoracentesis and oxygen therapy; consider dose reduction or treatment interruption. For grade 3 pleural effusion, withhold treatment until resolves to grade 1 or lower and consider corticosteroids (eg, prednisone 20 to 40 mg/day for 3 to 4 days), diuretics, thoracentesis and/or pleurodesis; may resume dasatinib at a decreased dose when effusion resolves (Khoury 2009). Pulmonary arterial hypertension: Discontinue with confirmed pulmonary arterial hypertension. Extemporaneously Prepared An oral suspension may be prepared by dissolving dasatinib tablet(s) for one dose in 30 mL chilled orange or apple juice (without preservatives). After 5 minutes, swirl the contents for 3 seconds and repeat the process every 5 minutes for a total of 20 minutes following addition of tablet(s). Minimize time between end of 20 minutes and administration since suspension will taste more bitter if allowed to stand longer. Swirl contents of container one last time, then administer immediately. To ensure the full dose is administered, rinse container with 15 mL juice and administer residue. May be administered orally (or by nasogastric tube). Discard any unused portion after 60 minutes. Sprycel data on file, Bristol-Myers Squibb Administration Administer once daily (morning or evening). May be taken without regard to food. Swallow whole; do not break, crush, or chew tablets. Take with a meal if GI upset occurs (Khoury 2009). Dietary Considerations Avoid grapefruit juice. Storage Store at 20 C to 25 C (68 F to 77 F); excursions permitted to 15 C to 30 C (59 F to 86 F). Drug Interactions Acetaminophen: May enhance the hepatotoxic effect of Dasatinib. Dasatinib may increase the serum concentration of Acetaminophen. Consider therapy modification Agents with Antiplatelet Properties (e.g., P2Y12 inhibitors, NSAIDs, SSRIs, etc.): Dasatinib may enhance the anticoagulant effect of Agents with Antiplatelet Properties. Monitor therapy Antacids: May decrease the absorption of Dasatinib. Consider therapy modification Anticoagulants: Dasatinib may enhance the anticoagulant effect of Anticoagulants. Monitor therapy Aprepitant: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapy ARIPiprazole: CYP3A4 Inhibitors (Weak) may increase the serum concentration of ARIPiprazole. Management: Monitor for increased aripiprazole pharmacologic effects. Aripiprazole dose adjustments may or may not be required based on concomitant therapy and/or indication. Consult full interaction monograph for specific recommendations. Monitor therapy BCG (Intravesical): Immunosuppressants may diminish the therapeutic effect of BCG (Intravesical). Avoid combination BCG (Intravesical): Myelosuppressive Agents may diminish the therapeutic effect of BCG (Intravesical). Avoid combination Bosentan: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Monitor therapy CloZAPine: Myelosuppressive Agents may enhance the adverse/toxic effect of CloZAPine. Specifically, the risk for neutropenia may be increased. Monitor therapy Coccidioides immitis Skin Test: Immunosuppressants may diminish the diagnostic effect of Coccidioides immitis Skin Test. Monitor therapy Conivaptan: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Avoid combination CYP3A4 Inducers (Moderate): May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Monitor therapy CYP3A4 Inducers (Strong): May decrease the serum concentration of Dasatinib. Management: Avoid when possible. If such a combination cannot be avoided, consider increasing dasatinib dose and monitor clinical response and toxicity closely. Consider therapy modification CYP3A4 Inhibitors (Moderate): May decrease the metabolism of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapy CYP3A4 Inhibitors (Strong): May increase the serum concentration of Dasatinib. Management: Use of this combination should be avoided; consider reducing dasatinib dose if a strong CYP3A4 inhibitor must be used. If using dasatinib 100 mg/day, consider reduction to 20 mg/day; if using dasatinib 140 mg/day, consider reduction to 40 mg/day. Consider therapy modification CYP3A4 Substrates (High risk with Inhibitors): Dasatinib may increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapy Dabrafenib: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Seek alternatives to the CYP3A4 substrate when possible. If concomitant therapy cannot be avoided, monitor clinical effects of the substrate closely (particularly therapeutic effects). Consider therapy modification Deferasirox: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Monitor therapy Deferiprone: Myelosuppressive Agents may enhance the neutropenic effect of Deferiprone. Avoid combination Denosumab: May enhance the adverse/toxic effect of Immunosuppressants. Specifically, the risk for serious infections may be increased. Monitor therapy Dexamethasone (Systemic): May decrease the serum concentration of Dasatinib. Management: Avoid when possible. If such a combination cannot be avoided, consider increasing dasatinib dose and monitoring clinical response and toxicity closely. Consider therapy modification Dipyrone: May enhance the adverse/toxic effect of Myelosuppressive Agents. Specifically, the risk for agranulocytosis and pancytopenia may be increased Avoid combination Echinacea: May diminish the therapeutic effect of Immunosuppressants. Consider therapy modification Enzalutamide: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Concurrent use of enzalutamide with CYP3A4 substrates that have a narrow therapeutic index should be avoided. Use of enzalutamide and any other CYP3A4 substrate should be performed with caution and close monitoring. 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 Flibanserin: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Flibanserin. Monitor therapy Fosaprepitant: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapy Fusidic Acid (Systemic): May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Avoid combination Histamine H2 Receptor Antagonists: May decrease the absorption of Dasatinib. Management: Antacids (taken 2 hours before or after dasatinib administration) can be used in place of H2-antagonists if some acid-reducing therapy is needed. Avoid combination HYDROcodone: CYP3A4 Inhibitors (Weak) may increase the serum concentration of HYDROcodone. Monitor therapy Idelalisib: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Avoid combination 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 Lomitapide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Lomitapide. Management: Patients on lomitapide 5 mg/day may continue that dose. Patients taking lomitapide 10 mg/day or more should decrease the lomitapide dose by half. The lomitapide dose may then be titrated up to a max adult dose of 30 mg/day. Consider therapy modification MiFEPRIStone: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Management: Minimize doses of CYP3A4 substrates, and monitor for increased concentrations/toxicity, during and 2 weeks following treatment with mifepristone. Avoid cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus. Consider therapy modification MiFEPRIStone: May enhance the QTc-prolonging effect of QTc-Prolonging Agents (Indeterminate Risk and Risk Modifying). Management: Though the drugs listed here have uncertain QT-prolonging effects, they all have some possible association with QT prolongation and should generally be avoided when possible. Consider therapy modification Mitotane: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Doses of CYP3A4 substrates may need to be adjusted substantially when used in patients being treated with mitotane. Consider therapy modification Natalizumab: Immunosuppressants may enhance the adverse/toxic effect of Natalizumab. Specifically, the risk of concurrent infection may be increased. Avoid combination Netupitant: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapy NiMODipine: CYP3A4 Inhibitors (Weak) may increase the serum concentration of NiMODipine. Monitor therapy Nivolumab: Immunosuppressants may diminish the therapeutic effect of Nivolumab. Consider therapy modification Ocrelizumab: May enhance the immunosuppressive effect of Immunosuppressants. Monitor therapy Palbociclib: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapy Pidotimod: Immunosuppressants may diminish the therapeutic effect of Pidotimod. Monitor therapy Pimecrolimus: May enhance the adverse/toxic effect of Immunosuppressants. Avoid combination Pimozide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Pimozide. Avoid combination Pitolisant: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Management: Combined use of pitolisant with a CYP3A4 substrate that has a narrow therapeutic index should be avoided. Other CYP3A4 substrates should be monitored more closely when used with pitolisant. Consider therapy modification Promazine: May enhance the myelosuppressive effect of Myelosuppressive Agents. Monitor therapy Propacetamol: Dasatinib may enhance the hepatotoxic effect of Propacetamol. Dasatinib may increase serum concentrations of the active metabolite(s) of Propacetamol. Specifically, acetaminophen concentrations may increase. Consider therapy modification Proton Pump Inhibitors: May decrease the serum concentration of Dasatinib. Management: Antacids (taken 2 hours before or after dasatinib administration) can be used in place of the proton pump inhibitor if some acid-reducing therapy is needed. Avoid combination QTc-Prolonging Agents (Highest Risk): QTc-Prolonging Agents (Indeterminate Risk and Risk Modifying) may enhance the QTc-prolonging effect of QTc-Prolonging Agents (Highest Risk). Management: Avoid such combinations when possible. Use should be accompanied by close monitoring for evidence of QT prolongation or other alterations of cardiac rhythm. Consider therapy modification QTc-Prolonging Agents (Moderate Risk): QTc-Prolonging Agents (Indeterminate Risk and Risk Modifying) may enhance the QTc-prolonging effect of QTc-Prolonging Agents (Moderate Risk). Monitor therapy Roflumilast: May enhance the immunosuppressive effect of Immunosuppressants. Consider therapy modification Sarilumab: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Monitor therapy Siltuximab: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). Monitor therapy Simeprevir: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Monitor therapy Sipuleucel-T: Immunosuppressants may diminish the therapeutic effect of Sipuleucel-T. Monitor therapy St John's Wort: May decrease the serum concentration of Dasatinib. Avoid combination Stiripentol: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Management: Use of stiripentol with CYP3A4 substrates that are considered to have a narrow therapeutic index should be avoided due to the increased risk for adverse effects and toxicity. Any CYP3A4 substrate used with stiripentol requires closer monitoring. Consider therapy modification Tacrolimus (Topical): May enhance the adverse/toxic effect of Immunosuppressants. Avoid combination Tertomotide: Immunosuppressants may diminish the therapeutic effect of Tertomotide. Monitor therapy Tocilizumab: May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers). 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 Voriconazole: May enhance the QTc-prolonging effect of Dasatinib. Voriconazole may increase the serum concentration of Dasatinib. Management: This combination should be avoided; consider reducing dasatinib dose if voriconazole must be used. If using dasatinib 100 mg/day, consider reduction to 20 mg/day; if using dasatinib 140 mg/day, consider reduction to 40 mg/day. Monitor ECG closely. Consider therapy modification Adverse Reactions 10%: Cardiovascular: Facial edema, peripheral edema Central nervous system: Headache (12% to 33%), fatigue (8% to 26%), pain (11%) Dermatologic: Skin rash (11% to 21%; includes drug eruption, erythema, erythema multiforme, erythematous rash, erythrosis, exfoliative rash, follicular rash, heat rash, macular rash, maculopapular rash, milia, papular rash, pruritic rash, pustular rash, skin exfoliation, skin irritation, urticaria vesiculosa, vesicular rash), pruritus (12%) Endocrine & metabolic: Fluid retention (19% to 48%; grades 3/4: 1% to 8%; cardiac-related: 9%) Gastrointestinal: Diarrhea (17% to 31%), nausea (8% to 24%), vomiting (5% to 16%), abdominal pain (7% to 12%) Hematologic & oncologic: Thrombocytopenia (grades 3/4: 22% to 85%), neutropenia (grades 3/4: 29% to 79%), anemia (grades 3/4: 13% to 74%), hemorrhage (8% to 26%; grades 3/4: 1% to 9%), febrile neutropenia (4% to 12%; grades 3/4: 4% to 12%) Infection: Infection (9% to 14%; includes bacterial, fungal, viral) Local: Localized edema (3% to 22%; grades 3/4: 1%; superficial) Neuromuscular & skeletal: Musculoskeletal pain (> <22%), myalgia (7% to 13%), arthralgia ( 13%) Respiratory: Pleural effusion (5% to 28%; grades 3/4: 7%), dyspnea (3% to 24%) Miscellaneous: Fever (6% to 18%) 1% to> <10%: Cardiovascular: Cardiac conduction disturbance (7%), ischemic heart disease (4%), cardiac disease ( 4%; includes cardiac failure, cardiomyopathy, diastolic dysfunction, ejection fraction decreased, left ventricular dysfunction, ventricular failure), edema ( 4%; generalized), pericardial effusion ( 4%; grades 3/4: 1%), prolonged Q-T interval on ECG ( 1%), cardiac arrhythmia, chest pain, flushing, hypertension, palpitations, tachycardia Central nervous system: Intracranial hemorrhage ( 3%; grades 3/4: 3%), chills, depression, dizziness, drowsiness, insomnia, myasthenia, neuropathy, peripheral neuropathy Dermatologic: Acne vulgaris, alopecia, dermatitis, eczema, hyperhidrosis, urticaria, xeroderma Endocrine & metabolic: Hyperuricemia, weight gain, weight loss Gastrointestinal: Constipation (10%), gastrointestinal hemorrhage (2% to 9%; grades 3/4: 1% to 7%), abdominal distention, change in appetite, colitis (including neutropenic colitis), dysgeusia, dyspepsia, enterocolitis, gastritis, mucositis, stomatitis Hematologic & oncologic: Bruise Hepatic: Increased serum bilirubin (grades 3/4: 6%), increased serum ALT (grades 3/4: 5%), increased serum AST (grades 3/4: 4%), ascites ( 1%) Infection: Herpes virus infection, sepsis Neuromuscular & skeletal: Muscle spasm (5%), stiffness, weakness Ophthalmic: Blurred vision, decreased visual acuity, dry eye syndrome, visual disturbance Otic: Tinnitus Renal: Increased serum creatinine (grades 3/4: 8%) Respiratory: Pulmonary hypertension ( 5%; grades 3/4: 1%), pulmonary edema ( 4%; grades 3/4: 3%), cough, pneumonia (bacterial, viral, or fungal), pneumonitis, pulmonary infiltrates, upper respiratory tract infection Miscellaneous: Soft tissue injury (oral)> <1% (Limited to important or life-threatening): Abnormal gait, abnormal platelet aggregation, abnormal T waves on ECG, acute coronary syndrome, acute pancreatitis, acute respiratory distress, amnesia, anal fissure, angina pectoris, anxiety, arthritis, asthma, ataxia, atrial fibrillation, atrial flutter, bronchospasm, bullous skin disease, cardiomegaly, cerebrovascular accident, cholecystitis, cholestasis, confusion, conjunctivitis, coronary artery disease, cor pulmonale, cranial nerve palsy (facial), decreased libido, deep vein thrombosis, dehydration, dementia, dermal ulcer, diabetes mellitus, dyschromia, dysphagia, embolism, emotional lability, epistaxis, equilibrium disturbance, erythema nodosum, esophagitis, fibrosis (dermal), fistula (anal), gastroesophageal reflux disease, gastrointestinal disease (protein wasting), gingival hemorrhage, gynecomastia, hearing loss, hematoma, hematuria, hemoptysis, hemorrhage (ocular), hepatitis, hypercholesterolemia, hypersensitivity reaction, hypersensitivity angiitis, hyperthyroidism, hypoalbuminemia, hypotension, hypothyroidism, increased creatine phosphokinase, increased gamma-glutamyl transferase, increased lacrimation, increased pulmonary artery pressure, increased troponin, inflammation (panniculitis), interstitial pulmonary disease, intestinal obstruction, livedo reticularis, lymphadenopathy, lymphocytopenia, malaise, menstrual disease, myocarditis, nail disease, nephrotic syndrome, optic neuritis, osteonecrosis, ototoxicity (hemorrhage), palmar-plantar erythrodysesthesia, pancreatitis, pericarditis, petechia, photophobia, pleuropericarditis, prolongation P-R interval on ECG, proteinuria, pulmonary embolism, pure red cell aplasia, reactivation of HBV, renal failure, renal insufficiency, rhabdomyolysis, seizure, skin photosensitivity, Stevens-Johnson syndrome, Sweet syndrome, syncope, tendonitis, thrombophlebitis, thrombosis, thyroiditis, transient ischemic attacks, tremor, tumor lysis syndrome, upper gastrointestinal tract ulcer, urinary frequency, uterine hemorrhage, vaginal hemorrhage, ventricular arrhythmia, ventricular tachycardia, vertigo, voice disorder Warnings/Precautions Concerns related to adverse effects: Bone marrow suppression: Severe dose-related bone marrow suppression (thrombocytopenia, neutropenia, anemia) is associated with treatment (usually reversible); dosage adjustment and/or temporary interruption may be required for severe myelosuppression; the incidence of myelosuppression is higher in patients with advanced chronic myeloid leukemia (CML) and Ph+ acute lymphoblastic leukemia (ALL). Monitor blood counts every 2 weeks for 12 weeks and then every 3 months thereafter or as clinically indicated (for chronic phase CML) or weekly for the first 2 months, then monthly thereafter or as clinically necessary (for accelerated or blast phase CML or for ALL). Cardiovascular adverse events: Cardiac ischemic events, cardiac fluid retention-related events, and conduction abnormalities (arrhythmia and palpitations) have been reported. Monitor for signs and symptoms of cardiac dysfunction. Dermatologic toxicity: Cases of severe mucocutaneous dermatologic reactions (including Stevens-Johnson syndrome and erythema multiforme) have been reported with dasatinib. Discontinue dasatinib if severe mucocutaneous reaction occurs and other etiologies have been ruled out. Fluid retention: Dasatinib may cause fluid retention, including pleural and pericardial effusions, pulmonary hypertension, and generalized or superficial edema. A prompt chest x-ray (or other appropriate diagnostic imaging) is recommended for symptoms suggestive of effusion (new or worsening dyspnea on exertion or at rest, pleuritic chest pain, or dry cough). Fluid retention may be managed with supportive care (diuretics or corticosteroids); thoracentesis and oxygen therapy may be necessary for severe fluid retention; consider dose reduction or treatment interruption. Utilizing once-daily dosing is associated with a decreased frequency of fluid retention. The risk for pleural effusion is increased in patients with hypertension, prior cardiac history and a twice a day administration schedule; interrupt treatment for grade 2 effusion; may consider reinitiating at a reduced dose after resolution (Quintรกs-Cardama 2007). Use with caution in patients where fluid accumulation may be poorly tolerated, such as in cardiovascular disease (HF or hypertension) and pulmonary disease. Hemorrhage: Fatal intracranial and GI hemorrhage have been reported in association with dasatinib use; severe hemorrhage (including CNS, GI) may occur due to thrombocytopenia. In addition to thrombocytopenia, dasatinib may also cause platelet dysfunction. Concomitant medications that inhibit platelet function or anticoagulants may increase the risk of bleeding. Pulmonary arterial hypertension: Dasatinib may increase the risk for pulmonary arterial hypertension (PAH). PAH may occur at any time after starting treatment, including after> 12 months of therapy. Evaluate for underlying cardiopulmonary disease prior to therapy initiation and during therapy; evaluate and rule out alternative etiologies in patients with symptoms suggestive of PAH (eg, dyspnea, fatigue, hypoxia, fluid retention) and interrupt therapy if symptoms are severe. Discontinue permanently with confirmed PAH diagnosis (may be reversible upon discontinuation). QT prolongation: May prolong QT interval; there are reports of patients with QTcF >500 msec. Use caution in patients at risk for QT prolongation, including patients with long QT syndrome, patients taking antiarrhythmic medications or other medications that lead to QT prolongation or potassium-wasting diuretics, patients with cumulative high-dose anthracycline therapy, and conditions which cause hypokalemia or hypomagnesemia. Correct hypokalemia and hypomagnesemia prior to and during dasatinib therapy. Tumor lysis syndrome: Tumor lysis syndrome (TLS) has been reported in patients with resistance to imatinib therapy, usually in patients with advanced phase disease. Risk for TLS is higher in patients with advanced stage disease and/or a high tumor burden; monitor patients at risk more frequently. Maintain adequate hydration and correct uric acid levels prior to treatment; monitor electrolyte levels. Disease-related concerns: Hepatic impairment: Use with caution in patients with hepatic impairment due to extensive hepatic metabolism. 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. Use with caution in patients taking anticoagulants or medications interfering with platelet function; not studied in clinical trials. Avoid concomitant use with CYP3A4 inducers and inhibitors; if concomitant use cannot be avoided, consider dasatinib dosage adjustments. Drugs that affect gastric pH: Elevated gastric pH may reduce dasatinib bioavailability; avoid concomitant use with proton pump inhibitors and H 2 blockers. If needed, may consider antacid administration at least 2 hours before or 2 hours after the dasatinib dose. Special populations: Elderly: Patients 65 years of age and older are more likely to experience toxicity (compared with younger patients). Monitoring Parameters CBC with differential every 2 weeks for 12 weeks and then every 3 months thereafter or as clinically indicated (for chronic phase chronic myeloid leukemia [CML]) or weekly for 2 months, then monthly or as clinically necessary (for accelerated or blast phase CML or for acute lymphoblastic leukemia [ALL]); bone marrow biopsy; liver function tests, electrolytes including calcium, phosphorus, magnesium; monitor for fluid retention; monitor for signs/symptoms of cardiac dysfunction; ECG monitoring if at risk for QT c prolongation; chest x-ray is recommended for symptoms suggestive of pleural effusion (eg, cough, dyspnea); signs/symptoms of tumor lysis syndrome and dermatologic reactions. Thyroid function testing recommendations (Hamnvik 2011): Preexisting levothyroxine therapy: Obtain baseline TSH levels, then monitor every 4 weeks until levels and levothyroxine dose are stable, then monitor every 2 months Without preexisting thyroid hormone replacement: TSH at baseline, then monthly for 4 months, then every 2 to 3 months Pregnancy Considerations Dasatinib crosses the placenta, with fetal plasma and amniotic concentrations comparable to maternal concentrations. Adverse effects, including hydrops fetalis and fetal leukopenia and thrombocytopenia have been reported following maternal exposure to dasatinib. Women of reproductive potential should use effective contraception during and for 30 days after the final dose to avoid becoming pregnant. Pregnant women are advised to avoid contact with crushed or broken tablets. 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 muscle pain, joint pain, constipation or headache. Have patient report immediately to prescriber signs of infection, signs of bleeding (vomiting blood or vomit that looks like coffee grounds; coughing up blood; hematuria; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a reason or that get bigger; or any severe or persistent bleeding); shortness of breath; excessive weight gain; swelling of arms or legs; cough; angina; tachycardia; passing out; abnormal heartbeat; severe dizziness; severe abdominal pain; severe nausea; vomiting; severe diarrhea; severe loss of strength and energy; signs of Stevens-Johnson syndrome/toxic epidermal necrolysis (red, swollen, blistered, or peeling skin [with or without fever]; red or irritated eyes; or sores in mouth, throat, nose, or eyes); or signs of tumor lysis syndrome (tachycardia or abnormal heartbeat; any passing out; urinary retention; muscle weakness or cramps; nausea, vomiting, diarrhea or lack of appetite; or feeling sluggish) (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 dasatinib Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Espaรฑol 17 Reviews Add your own review/rating Drug class: BCR-ABL tyrosine kinase inhibitors Consumer resources Dasatinib Dasatinib (Advanced Reading) Professional resources Dasatinib (AHFS Monograph) Other brands: Sprycel Related treatment guides Acute Lymphoblastic Leukemia Chronic Myelogenous Leukemia Leukemia ]} 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 Dasatinib Rating 17 User Reviews 8.6 /10 17 User Reviews 8.6 Rate it! Drug Class BCR-ABL tyrosine kinase inhibitors Related Drugs BCR-ABL tyrosine kinase inhibitors Gleevec , imatinib , Sprycel , Tasigna , nilotinib , bosutinib Chronic Myelogenous Leukemia hydroxyurea , Hydrea , Gleevec , cyclophosphamide , imatinib , Sprycel , Tasigna , cytarabine , More... Acute Lymphoblastic Leukemia methotrexate , Gleevec , mercaptopurine , imatinib , Adriamycin , doxorubicin , Sprycel , More... Leukemia prednisone , triamcinolone , dexamethasone , Decadron , Deltasone , Sprycel , Kenalog-40 , More...} } traditional


on the way to Dasatinib the masses
life-style Alcohol and Pregnancy person who

life-style Alcohol and Pregnancy person who

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day without work Can you drink alcohol while pregnant? There is a difference of opinion among experts regarding whether it is safe to drink even the smallest amount of alcohol during pregnancy. Some of your friends will ask you not to take the unnecessary risk of exposing your unborn child to alcohol, while others may tell you it is fine to indulge in an occasional glass of champagne. But in truth, drinking alcohol while pregnant can lead to a number of birth defects and other problems in a newborn baby, with the risks of complications depending on various factors including the stage of pregnancy as well as the amount of alcohol consumed and the frequency of drinking. Many women continue drinking during the first few weeks (before noticing a missed period) of pregnancy without being aware that they are pregnant. Modern medical guidelines are recommending giving up drinking as soon as you plan having a baby or at least as soon as you find out you are pregnant. Alcohol is currently included in the FDA pregnancy category D [19] as there are evidences of its harmful effects on the fetus. Does drinking alcohol reduce the chances of getting pregnant? Alcohol leads to imbalances in female hormones that control reproduction, thus damaging fertility and reducing the chances of conceiving [17] . But, that does not mean drinking can prevent pregnancy. When does alcohol affect most in pregnancy? It is believed to be most harmful during the first trimester (the initial three months), the negative effects are not limited only to the initial weeks after conception. It can cause major damage to the baby later in pregnancy as well (when the brain and other important organs develop) [1] . Why is alcohol considered more harmful in early pregnancy? Drinking during the first 12 weeks of pregnancy greatly increases the risks of birth defects as this is the time the major organs and systems begin to form [2] . The neural tube (later forms the brain and spinal cord), heart, digestive system, circulatory system, sensory organs and skeletal system all start developing [3] shortly after the implantation of the zygote. How does alcohol consumption during pregnancy affect the baby? Alcohol is a toxic substance for your baby, which quickly enters your bloodstream and passes through the placenta to reach the fetus [1] . It is not possible for the fetus s under-developed liver to break down alcohol as fast as you can. As a result, the fetus has higher blood alcohol levels than you which cause serious cell damage [5] . Cooking with alcohol in pregnancy? Adding a bit of wine or vodka to certain recipes does not generally cause any harm to you or your baby as most of the alcohol gets burnt off in the cooking process. What are the effects of drinking alcohol during pregnancy? Fetal alcohol spectrum disorders (FASD) are a group of birth defects that occur as a result of alcohol consumption by the mother during pregnancy. It is classified into [6] : Alcohol-Related Birth Defects (ARBD) Alcohol-Related Neurodevelopmental Disorder (ARND) Fetal Alcohol Syndrome (FAS) Partial FAS These congenital conditions are characterized by various physical and mental defects in the baby with the principal symptoms including: Physical Effects Abnormal facial features [7] Small head size indicating an underdeveloped brain Growth retardation Central Nervous System (CNS) damage Low birth-weight Below average weight and height [8] (as the child grows up) Poor muscle tone Organ defects (heart, kidney) Mental Effects Mental retardation Cognition problems Short attention span and learning difficulties [9] Lack of coordination Language delays and speech problems Hyperactive behavior [10] Poor social skills [11] ADHD (attention deficit hyperactivity disorder) Other more serious complications of alcohol abuse during pregnancy may include: Cerebral palsy [12] Autism [20] Premature labor Miscarriage [9] Stillbirth How much alcohol is safe during pregnancy? Researchers cannot establish any safe amount to drink while pregnant until they find out the potential effects of specific amounts of alcohol at certain stages in pregnancy [7] . But, drinking alcohol during the first trimester should be avoided due to the high risk of birth defects. According to older government guidelines, a couple of standard drinks in a week during the second and third trimesters should not be harmful [1] . However, currently the American Congress of Obstetricians and Gynecologists (ACOG) suggests pregnant women to refrain from alcohol until the baby is born to eliminate any risk of complication [13] . Can pregnant women drink wine? According to several recent studies, an occasional glass of red wine does not cause any harm to the fetus [21] . Some even claim that children born to mothers who drank a few glasses of wine during their pregnancy are better behaved than those born to mothers who abstained completely [22] . However, there is still much debate over the topic of drinking wine in pregnancy as many believe having one glass may make one want another, which may hurt the baby. So despite all the researches and studies, many doctors recommend avoiding any amount of wine just to stay safe. How much alcohol has been proved harmful in pregnancy? Scientists have proved drinking over 6-7 units (1 unit = 10 ml pure alcohol [14] ) in a week to increase the risks of FASD in the baby [1] . Women in the habit of frequent binge drinking (consuming over 5 units on a single occasion) are more likely to have a baby with fetal alcohol syndrome (FAS) compared to those who drink the same amount over a longer time [5] . Can alcohol affect a home pregnancy test? Home pregnancy tests (HPT) are based on the hCG (human chorionic gonadotrophin) hormone levels in your urine. Drinking alcohol cannot affect an HPT as it does not interfere with the production of functioning of this hormone [15] . Tips to Avoid Drinking in Pregnancy Asking your partner to remind you of the potential effects of alcohol consumption on your baby whenever you consider a drink You can even ask your partner and other family members to abstain from alcohol, at least at home, to help you stay away from it [16] Avoiding going to parties and bars where you are more likely to get a drink Finding a safe non-alcoholic alternative to your favorite alcoholic beverage, like non-alcoholic beer and wine [8] Consulting your health care provider regarding the best ways to give up drinking If alcohol helps you relax, you can try substituting it with other relaxation methods like listening to music, reading or taking a warm bath [8] You can also contact support groups that help people with drinking problems abstain from alcohol [18] [ref] http://www.babycenter.com.au/a3542/alcohol-during-pregnancy http://www.conceiveeasy.com/get-pregnant/drinking-alcohol-during-the-first-trimester-of-pregnancy/ http://www.hopkinsmedicine.org/healthlibrary/conditions/pregnancy_and_childbirth/first_trimester_85,P01218/ http://www.mayoclinic.com/health/fetal-alcohol-syndrome/DS00184/DSECTION=causes http://www.babycenter.com/0_drinking-alcohol-during-pregnancy_3542.bc http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Fetal_alcohol_spectrum_disorder http://www.webmd.com/baby/features/drinking-alcohol-during-pregnancy http://www.babycentre.co.uk/a3542/alcohol-during-pregnancy http://www.nhs.uk/conditions/pregnancy-and-baby/pages/alcohol-medicines-drugs-pregnant.aspx#close http://www.cdc.gov/features/fasd/ http://www.patient.co.uk/health/fetal-alcohol-syndrome# http://www.nlm.nih.gov/medlineplus/ency/article/007454.htm http://www.whattoexpect.com/pregnancy/ask-heidi/wine-on-occasion.aspx# https://www.drinkaware.co.uk/check-the-facts/what-is-alcohol/what-is-an-alcohol-unit http://womenshealth.gov/publications/our-publications/fact-sheet/pregnancy-tests.cfm#h http://www.marchofdimes.com/pregnancy/alcohol-during-pregnancy.aspx https://www.drinkaware.co.uk/check-the-facts/health-effects-of-alcohol/fertility-and-pregnancy/alcohol-and-reproduction/#fertility http://www.nct.org.uk/pregnancy/drinking-pregnancy#Tips on cutting down on alcohol in pregnancy http://www.wellness.com/reference/conditions/fda-pregnancy-categories http://www.topnews.in/health/drinking-alcohol-during-pregnancy-may-trigger-autism-babies-21583 http://www.nydailynews.com/life-style/health/pregnant-women-glass-wine-day-fine-study-article-1.1375559 http://atlanta.cbslocal.com/2014/01/04/study-moms-who-drink-wine-while-pregnant-have-better-behaved-kids/ [/ref] seeking


price Alcohol and Pregnancy flattening