Tuesday, October 25, 2016

Cyperguard




Cyperguard may be available in the countries listed below.


In some countries, this medicine may only be approved for veterinary use.

Ingredient matches for Cyperguard



Cypermethrin

Cypermethrin is reported as an ingredient of Cyperguard in the following countries:


  • Ireland

International Drug Name Search

denosumab


Generic Name: denosumab (Xgeva) (den OH sue mab)

Brand Names: Xgeva


What is denosumab (Xgeva)?

Denosumab is a monoclonal antibody. Monoclonal antibodies are made to target and destroy only certain cells in the body. This may help to protect healthy cells from damage.


The Xgeva brand of denosumab is used to prevent bone fractures and other skeletal conditions in people with tumors that have spread to the bone. Xgeva is not for use in people with multiple myeloma (bone marrow cancer).


This medication guide provides information about the Xgeva brand of denosumab. Prolia is another brand of denosumab used to treat osteoporosis in postmenopausal women who have high risk of bone fracture.


Denosumab may also be used for purposes not listed in this medication guide.


What is the most important information I should know about Xgeva?


This medication guide provides information about the Xgeva brand of denosumab. Prolia is another brand of denosumab used to treat osteoporosis in postmenopausal women who have high risk of bone fracture.


You should not receive denosumab if you are allergic to it, or if you have low levels of calcium in your blood (hypocalcemia).

Before you receive this medication, tell your doctor if you have kidney disease or if you are on dialysis.


Some people using denosumab have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums. You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.


If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are receiving denosumab. You may need to stop using the medicine for a short time.

What should I discuss with my healthcare provider before receiving Xgeva?


You should not receive denosumab if you are allergic to it, or if you have low levels of calcium in your blood (hypocalcemia).

To make sure you can safely use Xgeva, tell your doctor if you have kidney disease or if you are on dialysis.


FDA pregnancy category C. It is not known whether denosumab will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of denosumab on the baby. It is not known whether denosumab passes into breast milk or if it could harm a nursing baby. However, this medication may slow the production of breast milk. You should not breast-feed while receiving denosumab.

Some people using denosumab have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums. You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.


How is Xgeva given?


Denosumab is injected under the skin of your stomach, upper thigh, or upper arm. A healthcare provider will give you this injection.


Xgeva is usually given once every 4 weeks. Follow your doctor's instructions.


Your doctor may have you take extra calcium and vitamin D while you are being treated with denosumab. Take only the amount of calcium and vitamin D that your doctor has prescribed.


Pay special attention to your dental hygiene. Brush and floss your teeth regularly while receiving this medication. You may need to have a dental exam before you begin treatment with Xgeva. Follow your doctor's instructions.


If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are receiving denosumab. You may need to stop using the medicine for a short time. If you keep your medication at home, store it in the original container in a refrigerator. Protect from light and do not freeze.

You may take the medicine out of the refrigerator and allow it to reach room temperature before giving the injection. Do not heat the medicine before using.


After you have taken Xgeva out of the refrigerator, you may keep it at room temperature and use it within 14 days. Store in the original container away from heat and light. Do not shake the medication bottle or you may ruin the medicine. Prepare your dose in a syringe only when you are ready to give yourself an injection. Do not use the medication if it looks cloudy or has particles in it. Call your doctor for a new prescription.

Each single use vial (bottle) of this medicine is for one use only. Throw away after one use, even if there is still some medicine left in it after injecting your dose.


What happens if I miss a dose?


Call your doctor for instructions if you miss an appointment for your Xgeva injection.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving Xgeva?


Follow your doctor's instructions about any restrictions on food, beverages, or activity.


Xgeva side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

  • numbness or tingly feeling around your mouth or in your fingers or toes, fast or slow heart rate, muscle cramps or contraction, overactive reflexes; or




  • trouble breathing.



Less serious side effects may include:



  • feeling weak or tired;




  • diarrhea, nausea; or




  • headache.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Denosumab Dosing Information


Usual Adult Dose for Osteoporosis:

For the treatment of postmenopausal women with osteoporosis at high risk for fracture, defined as a history of osteoporotic fracture, or multiple risk factors for fracture; or patients who have failed or are intolerant to other available osteoporosis therapy, treatment to increase bone mass in women at high risk for fracture
receiving adjuvant aromatase inhibitor therapy for breast cancer, and treatment to increase bone mass in men at high risk for fracture receiving androgen deprivation therapy for nonmetastatic prostate cancer:

60 mg administered as a single subcutaneous injection in the upper arm, the upper thigh, or the abdomen once every 6 months. All patients should receive calcium 1000 mg daily and at least 400 IU vitamin D daily

Usual Adult Dose for Hypercalcemia of Malignancy:

For the prevention of skeletal related events in patients with bone metastases from solid tumors:

120 mg as a subcutaneous injection in the upper arm, upper thigh, or abdomen every 4 weeks.

Administer calcium and vitamin D as necessary to treat or prevent hypocalcemia.


What other drugs will affect Xgeva?


There may be other drugs that can interact with Xgeva. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More denosumab resources


  • Denosumab Side Effects (in more detail)
  • Denosumab Use in Pregnancy & Breastfeeding
  • Denosumab Drug Interactions
  • Denosumab Support Group
  • 0 Reviews for Denosumab - Add your own review/rating


Compare denosumab with other medications


  • Hypercalcemia of Malignancy
  • Osteolytic Bone Metastases of Solid Tumors
  • Osteoporosis


Where can I get more information?


  • Your doctor or pharmacist can provide more information about denosumab (Xgeva).

See also: denosumab side effects (in more detail)


Alaceril




Alaceril may be available in the countries listed below.


Ingredient matches for Alaceril



Alacepril

Alacepril is reported as an ingredient of Alaceril in the following countries:


  • Japan

International Drug Name Search

Monday, October 24, 2016

Didanosine Delayed-Release Enteric-Coated Capsules


Pronunciation: dye-DAN-oh-seen
Generic Name: Didanosine
Brand Name: Videx EC

Didanosine Delayed-Release Enteric-Coated Capsules may cause serious and sometimes fatal inflammation of the pancreas (pancreatitis). This has occurred in patients who have just started taking Didanosine Delayed-Release Enteric-Coated Capsules and in patients who have already been taking it. Contact your doctor right away if you experience sudden stomach or back pain, swelling of the stomach, fever or chills, nausea or vomiting, or fast heartbeat.


Didanosine Delayed-Release Enteric-Coated Capsules may cause severe and sometimes fatal lactic acidosis and liver problems. Fatal lactic acidosis has also occurred in pregnant women who have used Didanosine Delayed-Release Enteric-Coated Capsules along with certain other medicines for HIV (eg, stavudine). Tell your doctor if you are taking stavudine and you are pregnant or planning to become pregnant.





Didanosine Delayed-Release Enteric-Coated Capsules are used for:

Treating HIV infection when used in combination with other medicines.


Didanosine Delayed-Release Enteric-Coated Capsules are a nucleoside analogue reverse transcriptase inhibitor. It works by stopping the growth of HIV-1, the virus that causes AIDS.


Do NOT use Didanosine Delayed-Release Enteric-Coated Capsules if:


  • you are allergic to any ingredient in Didanosine Delayed-Release Enteric-Coated Capsules

  • you have pancreas inflammation (pancreatitis), certain liver problems (eg, enlarged liver, portal hypertension), abnormal liver function tests, or lactic acidosis

  • you are taking allopurinol or ribavirin

Contact your doctor or health care provider right away if any of these apply to you.



Before using Didanosine Delayed-Release Enteric-Coated Capsules:


Some medical conditions may interact with Didanosine Delayed-Release Enteric-Coated Capsules. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, planning to become pregnant, or are breast-feeding

  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

  • if you have allergies to medicines, foods, or other substances

  • if you have a history of heart problems (eg, heart attack)

  • if you have advanced HIV infection (AIDS), kidney problems, liver problems (eg, hepatitis), gallstones, nerve problems (neuropathy), high blood cholesterol or lipid levels, or high blood amylase levels

  • if you are overweight or you have a history of alcohol abuse

Some MEDICINES MAY INTERACT with Didanosine Delayed-Release Enteric-Coated Capsules. Tell your health care provider if you are taking any other medicines, especially any of the following:


  • Hydroxyurea because the risk of pancreatitis may be increased

  • Allopurinol, ganciclovir, nucleotide reverse transcriptase inhibitors (eg, tenofovir), or ribavirin because they may increase the risk of Didanosine Delayed-Release Enteric-Coated Capsules's side effects

  • Methadone because it may decrease Didanosine Delayed-Release Enteric-Coated Capsules's effectiveness

  • Aluminum salts (eg, aluminum hydroxide) because the risk of their side effects may be increased by Didanosine Delayed-Release Enteric-Coated Capsules

  • Azole antifungals (eg, itraconazole, ketoconazole), delavirdine, HIV protease inhibitors (eg, indinavir, lopinavir, nelfinavir), lithium, quinolones (eg, ciprofloxacin, levofloxacin), sulfones (eg, dapsone), or tetracyclines (eg, doxycycline) because their effectiveness may be decreased by Didanosine Delayed-Release Enteric-Coated Capsules

  • Stavudine because the risk of pancreatitis or fatal lactic acidosis in pregnant women may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Didanosine Delayed-Release Enteric-Coated Capsules may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.


How to use Didanosine Delayed-Release Enteric-Coated Capsules:


Use Didanosine Delayed-Release Enteric-Coated Capsules as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Didanosine Delayed-Release Enteric-Coated Capsules comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Didanosine Delayed-Release Enteric-Coated Capsules refilled.

  • Take Didanosine Delayed-Release Enteric-Coated Capsules by mouth on an empty stomach at least 1 hour before or 2 hours after eating.

  • Swallow Didanosine Delayed-Release Enteric-Coated Capsules whole. Do not break, crush, or chew before swallowing.

  • Didanosine Delayed-Release Enteric-Coated Capsules may reduce the effectiveness of certain other medicines when taken together. Ask your doctor or pharmacist if you should separate Didanosine Delayed-Release Enteric-Coated Capsules from any other medicine that you are taking.

  • Continue to take Didanosine Delayed-Release Enteric-Coated Capsules even if you feel well. Do not miss any doses.

  • If you miss a dose of Didanosine Delayed-Release Enteric-Coated Capsules, take it as soon as you remember. If it is within 2 hours of your next dose, skip the missed dose and go back to your regular dosing schedule. It is important not to miss doses of Didanosine Delayed-Release Enteric-Coated Capsules. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Didanosine Delayed-Release Enteric-Coated Capsules.



Important safety information:


  • Do not drink alcohol while you are taking Didanosine Delayed-Release Enteric-Coated Capsules.

  • Didanosine Delayed-Release Enteric-Coated Capsules are not a cure for HIV infection. Patients may still get illnesses and infections associated with HIV. Remain under the care of your doctor.

  • Didanosine Delayed-Release Enteric-Coated Capsules does not stop the spread of HIV to others through blood or sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection. Do not share needles, injection supplies, or items like toothbrushes or razors.

  • When your medicine supply is low, get more from your doctor or pharmacist as soon as you can. Do not stop taking Didanosine Delayed-Release Enteric-Coated Capsules, even for a short period of time. If you do, the virus may grow resistant to the medicine and become harder to treat.

  • Tell your doctor or dentist that you take Didanosine Delayed-Release Enteric-Coated Capsules before you receive any medical or dental care, emergency care, or surgery.

  • The risk of severe side effects (eg, lactic acidosis, severe liver problems) may be greater in women, patients who are overweight (obese), and patients who have taken reverse transcriptase inhibitors (eg, emtricitabine, tenofovir) for a long time. Talk with your doctor if you have questions about your risk of severe side effects from Didanosine Delayed-Release Enteric-Coated Capsules.

  • Changes in body fat (eg, an increased amount of fat in the upper back, neck, breast, and trunk, and loss of fat from the legs, arms, and face) may occur in some patients taking Didanosine Delayed-Release Enteric-Coated Capsules. The cause and long-term effects of these changes are unknown. Discuss any concerns with your doctor.

  • Didanosine Delayed-Release Enteric-Coated Capsules may improve immune system function. This may reveal hidden infections in some patients. Tell your doctor right away if you notice symptoms of infection (eg, fever, sore throat, weakness, cough, shortness of breath) after you start Didanosine Delayed-Release Enteric-Coated Capsules.

  • Lab tests, including eye exams, liver function, complete blood cell counts, and blood clotting (eg, international normalized ratio [INR]), may be performed while you use Didanosine Delayed-Release Enteric-Coated Capsules. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

  • Use Didanosine Delayed-Release Enteric-Coated Capsules with caution in the ELDERLY; they may be more sensitive to its effects.

  • Use Didanosine Delayed-Release Enteric-Coated Capsules with extreme caution in CHILDREN weighing less than 44 lb; safety and effectiveness in these children have not been confirmed.

  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Didanosine Delayed-Release Enteric-Coated Capsules while you are pregnant. It is not known if Didanosine Delayed-Release Enteric-Coated Capsules are found in breast milk. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or Didanosine Delayed-Release Enteric-Coated Capsules to the baby.


Possible side effects of Didanosine Delayed-Release Enteric-Coated Capsules:


All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:



Breast enlargement; changes in body fat; darkened complexion with purple markings; diarrhea; dry mouth; headache; itching; muscle pain; skin and facial wasting.



Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; blood in the vomit or vomit that looks like coffee grounds; blurred vision or other vision changes; chest pain or discomfort, numbness of an arm or leg, or shortness of breath; confusion; dark urine; dizziness; fainting; fast, shallow breathing; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; lightheadedness; low body temperature; nausea or vomiting; numbness, tingling, or pain in the hands or feet; pale stools; seizures; severe muscle pain or cramping; stomach pain or swelling; tiredness; unusual bruising or bleeding; weakness; yellowing of the skin or eyes.



This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.


See also: Didanosine side effects (in more detail)


If OVERDOSE is suspected:


Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include dark urine; diarrhea; pale stools; severe stomach pain with nausea and vomiting; tingling, burning, or numbness in the hands or feet; unusual fatigue; yellowing of the skin or eyes.


Proper storage of Didanosine Delayed-Release Enteric-Coated Capsules:

Store Didanosine Delayed-Release Enteric-Coated Capsules at room temperature, between 59 and 77 degrees F (15 and 25 degrees C), in a tightly closed container. Brief storage at temperatures of up to 86 degrees F (30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Didanosine Delayed-Release Enteric-Coated Capsules out of the reach of children and away from pets.


General information:


  • If you have any questions about Didanosine Delayed-Release Enteric-Coated Capsules, please talk with your doctor, pharmacist, or other health care provider.

  • Didanosine Delayed-Release Enteric-Coated Capsules are to be used only by the patient for whom it is prescribed. Do not share it with other people.

  • If your symptoms do not improve or if they become worse, check with your doctor.

  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Didanosine Delayed-Release Enteric-Coated Capsules. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.



Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Didanosine resources


  • Didanosine Side Effects (in more detail)
  • Didanosine Use in Pregnancy & Breastfeeding
  • Drug Images
  • Didanosine Drug Interactions
  • Didanosine Support Group
  • 0 Reviews for Didanosine - Add your own review/rating


Compare Didanosine with other medications


  • HIV Infection
  • Nonoccupational Exposure

Cabergolin Teva




Cabergolin Teva may be available in the countries listed below.


Ingredient matches for Cabergolin Teva



Cabergoline

Cabergoline is reported as an ingredient of Cabergolin Teva in the following countries:


  • Denmark

  • Malta

International Drug Name Search

Deprozol




Deprozol may be available in the countries listed below.


Ingredient matches for Deprozol



Secnidazole

Secnidazole is reported as an ingredient of Deprozol in the following countries:


  • Brazil

International Drug Name Search

Friday, October 21, 2016

Opipram




Opipram may be available in the countries listed below.


Ingredient matches for Opipram



Opipramol

Opipramol dihydrochloride (a derivative of Opipramol) is reported as an ingredient of Opipram in the following countries:


  • Germany

International Drug Name Search

Julab




Julab may be available in the countries listed below.


Ingredient matches for Julab



Selegiline

Selegiline hydrochloride (a derivative of Selegiline) is reported as an ingredient of Julab in the following countries:


  • Hong Kong

International Drug Name Search

Eryrox




Eryrox may be available in the countries listed below.


Ingredient matches for Eryrox



Erythromycin

Erythromycin is reported as an ingredient of Eryrox in the following countries:


  • Bangladesh

International Drug Name Search

Pranactin Citric





Dosage Form: powder, for solution

Introduction and Test Instructions


Note: This “Introduction and Test Instructions” contains information for:









Test Collection KitBreath Test Instrument
BreathTek™

UBT for H. pylori
1. UBiT®-IR 300 Infrared Spectrophotometer
2. POCone™ Infrared Spectrophotometer 

I. Intended Use


The BreathTek™ UBT Collection Kit is intended for use in the qualitative detection of urease associated with Helicobacter pylori in the human stomach and as an aid in the initial diagnosis and post-treatment monitoring of Helicobacter pylori infection in adult patients. The test may be used for monitoring treatment if used at least four (4) weeks following completion of therapy. For these purposes, the system utilizes an Infrared Spectrophotometer for the measurement of the ratio of 13CO2 to 12CO2 in breath samples.


For administration by health care professionals. To be administered under a physician’s supervision.



II. Summary and Explanation


Since the isolation of the spiral urease-producing Helicobacter pylori bacteria (H. pylori) in 1983 by Drs. Marshall and Warren1, a significant body of evidence has accumulated indicating that the bacteria is an important pathogen in the upper GI tract of humans.2.3 The causal relationship between H. pylori and chronic active gastritis, duodenal ulcer, and gastric ulcer is well documented.4.5 Methods available for detecting current infection of the human stomach by H. pylori are generally divided into two (2) general types: Invasive and Non-invasive.


Invasive methods are so named because they include, as a first step, an esophagogastroduodenoscopy (“EGD”) with collection of gastric biopsies. These biopsies are then examined by one or more detection methods: histological examination of stained tissue, microbiological culture of the organism, or direct detection of urease activity in the tissue (for example, the CLOtest®). Biopsy based methods are expensive, entail some patient risk and discomfort and may give false negative results due to sampling errors when colonization of the gastric mucosa is patchy.6


The non-invasive, non-radioactive method for detecting current H. pylori infection is based on the BreathTek™ UBT which is described in the next section. Several serological tests that detect serum antibodies to H. pylori are commercially available. A positive result with these tests cannot distinguish between current infection and past exposure to infection and, therefore, is not a conclusive indicator of current gastrointestinal colonization by H. pylori.



III. Principle of the BreathTek™ UBT for H. pylori


  1. Description of the Pranactin®-Citric Diagnostic Drug Component

    The diagnostic drug component of the kit is 13C-urea, a synthetic urea contained in a granulated powder (Pranactin®-Citric) for reconstitution with potable water to provide a clear solution for oral administration. The carbon in the drug component is predominantly Carbon-13, a stable, naturally occurring, non-radioactive isotope of carbon; the relative abundance of Carbon-13 is greater than or equal to 99%. Each three (3) gram dose of Pranactin®-Citric is supplied in a polyethylene-lined foil pouch and contains 75 mg of 13C-urea, citric acid7, aspartame and mannitol. 13C-urea is the diamide of 13C-carbonic acid and is highly soluble in water (1 gram per mL at 25°C). It has the following chemical formula: 13CH4N2O. An average adult body normally contains about 9 grams of urea, which is a product of protein metabolism. Urea in the body is referred to as natural isotopic abundance urea since it is composed of 98.9% 12C-urea and 1.1% 13C-urea.


  2. Principle of the Test

    Pranactin®-Citric drug product is a component of the BreathTek™ UBT for H. pylori kit. Three (3) g of reconstituted Pranactin®-Citric containing 75 mg of 13C-urea is ingested by the patient. In the presence of urease associated with gastric H. pylori, 13C-urea is decomposed to 13CO2 and NH4 + according to the following equation:







    (NH2)213CO + H2O + 2H+     HP Urease    13CO2 + 2NH4+13C-urea
                →

    The 13CO2, is absorbed in the blood, then exhaled in the breath. This results in an increase in the ratio of 13CO2 to 12CO2 in a POST-DOSE breath sample taken after the Pranactin®-Citric solution was consumed, compared to a BASELINE sample taken before the Pranactin®-Citric solution was consumed. Analysis of the breath samples is performed by UBiT®-IR300 Infrared Spectrophotometer or POCone™ Infrared Spectrophotometer [located at your testing laboratory, physician office or hospital].

    The BreathTek™ UBT can detect very low levels of H. pylori colonization and, by assessing the entire gastric mucosa, avoids the risk of sampling errors inherent in biopsy based methods. In the absence of gastric H. pylori, the 13C-urea does not produce 13CO2 in the stomach. The ratio of 13CO2 in the POST-DOSE breath sample remains essentially the same as the BASELINE.


IV. Warnings and Precautions


  1. For in vitro diagnostic use only. The Pranactin®-Citric drug solution is taken orally as part of the diagnostic procedure.

  2. Phenylketonurics: Contains Phenylalanine (one of the protein components of Aspartame), 84 mg per dosage unit. (For reference, 12 ounces of typical diet cola soft drinks contain approximately 80 mg of Phenylalanine.)

  3. A negative result does not rule out the possibility of Helicobacter pylori infection. False negative results do occur with this procedure. If clinical signs are suggestive of H. pylori infection, retest with a new sample or an alternate method.

  4. Antimicrobials, proton pump inhibitors, and bismuth preparations are known to suppress H. pylori. Ingestion of these within two (2) weeks prior to performing the BreathTek™ UBT may give false negative results.

  5. A false positive test may occur due to urease associated with other gastric spiral organisms observed in humans such as Helicobacter heilmannii.

  6. Premature POST-DOSE breath collection time can lead to a false negative diagnosis for a patient with a marginally positive BreathTek™ UBT result.

  7. A false positive test could occur in patients who have achlorhydria.8

  8. If particulate matter is visible in the reconstituted Pranactin®-Citric solution after thorough mixing, the solution should not be used.


V. Shelf Life and Storage


The BreathTek™ UBT Collection Kit should be stored at 15°-30°C (59°-86°F). Pranactin®-Citric has an expiration date. Do not use beyond the expiration date stated on the label.



VI. Patient Preparation


  1. Remind the patient that Pranactin®-Citric contains phenylalanine (one of the protein components of Aspartame). Phenylketonurics restrict dietary phenylalanine.

  2. The patient should have fasted at least one (1) hour before administering the BreathTek™ UBT.

  3. The patient should not have taken antimicrobials, proton pump inhibitors, or bismuth preparations within two (2) weeks prior to administering the BreathTek™ UBT.


VII. Procedure for Collecting Breath Samples Using BreathTek™ UBT Kit, for Analysis by Infrared Spectrophotometer


A.

Materials
  1. Materials provided

    Each sealed single-patient BreathTek™ UBT Collection Kit contains:
    • One (1) plastic kit tray containing
      -

      One (1) “How To” guide

      -

      Test instructions

      -

      One (1) pouch of Pranactin®-Citric powder (3 g)

      -

      A set of four (4) self-adhesive bar-code stickers. All bar-codes should bear the same number.

      -

      Two (2) breath collection bags, one (1) blue bag for the BASELINE sample and one (1) pink bag for the POST-DOSE sample.

      -

      One (1) sample transport bag

      -

      One (1) plastic straw

      -

      One (1) plastic drinking cup



  2. Materials needed but not provided
    • A timer capable of timing an interval up to fifteen (15) minutes.

    • Scissors for opening the Pranactin®-Citric pouch.



Note: An Infrared Spectrophotometer (UBiT®-IR3000 or POCone™, Otsuka Pharmaceutical Co., Ltd.) is required for analysis of breath samples.


B.

Step-By-Step Procedure
 

Time intervals listed in the following step-by-step procedure are critical. They are highlighted by the timer icon:
  1. Verify that the patient has been prepared for the test as specified in Section VI.

  2. Open the BreathTek™ UBT Collection Kit, which should contain all the materials listed in Step VII. Slide out the kit tray. Label each breath collection bag to maintain patient identification using the bar-code labels provided, or according to your laboratory or office procedure.

  3. Collect the BASELINE breath sample according to the following procedure:
    1. Remove the blue breath collection bag from the kit tray.

    2. Remove the pull-off cap from the mouthpiece of the breath collection bag.

    3. Instruct the patient to: (1) breathe normally; (2) take a deep breath then pause momentarily; (3) exhale into the mouthpiece of the bag.

    4. Replace the cap firmly until it clicks on the mouthpiece of the bag.


  4. Prepare the Pranactin®-Citric solution no more than sixty (60) minutes before administering it to the patient. Urea slowly decomposes in water.
    1. Remove the Pranactin®-Citric pouch from the kit tray. Tap the upright packet of Pranactin®-Citric to settle the contents in the bottom half.

    2. With clean scissors, cut off the top of the packet and carefully empty the contents into the drinking cup provided, making sure to transfer all of the contents by tapping on the bottom of the pouch.

    3. Add potable water to the fill line indicated on the outside of the cup by a raised plastic ridge.

    4. Replace the lid securely and swirl the mixture for up to two (2) minutes to dissolve the packet contents; typically, only one (1) minute is required for complete dissolution. The resulting solution should be clear with no particulate matter. If particulate matter is present after thorough mixing, the solution should not be used.


  5. Instruct the patient to drink all of the solution with the straw provided, without stopping. Advise the patient NOT to ‘rinse’ the inside of his/her mouth with the solution before swallowing. Discard the straw.

  6. Set the timer for fifteen (15) minutes. The patient should sit quietly and should not eat, drink or smoke during the fifteen (15) minute interval.

  7. After fifteen (15) minutes have elapsed, remove the pink breath collection bag from the kit tray. Collect the POST-DOSE breath sample according to the procedure described in Steps VII B.3.b through B.3.d.

  8. Store the specimens at 15°-30°C (59°-86°F) until analysis is performed.

  9. Perform breath sample analysis within seven (7) days of breath sample collection. If desired, use the plastic sample transport bag for transport of the breath samples.




VIII. Quality Control


Complete operating information, including self-diagnostic instrument routines and user maintenance procedures, is provided in the Instruction Manuals for the UBiT®-IR300 Spectrophotometer, the UBiT®-AS10 Autosampler and the POCone™ Spectrophotometer, respectively. Additionally, each office laboratory or test facility should follow its own internal procedures for quality control.



IX. Test Results


  1. The Test Method

    The ratio of 13CO2 to 12CO2 in breath samples is determined by Infrared Spectrophotometer, (i.e., UBiT®-IR300 or POCone™).

  2. Calculation of Results

    The result of the BreathTek™ UBT is provided as the Delta Over Baseline. No calculations are required by the user. Delta Over Baseline is the difference between the ratio (13CO2 / 12CO2) in the POST-DOSE sample and the corresponding ratio in the BASELINE sample.

  3. Determination of the Cutoff Point

    The cutoff point is the level of BreathTek™ UBT result used to discriminate between H. pylori infected and uninfected individuals. For the BreathTek™ UBT, the Delta Over Baseline cutoff point was determined to be 2.4 in a controlled study of twenty-six (26) infected, and twenty-three (23) uninfected adult volunteers. Test subjects were judged to be in acceptable health based on the results of a medical history and physical examination and demonstrated no uncontrolled clinically significant abnormality other than, for some, symptoms of peptic ulcer. The previous version of the Meretek urea breath test, the Meretek UBT® was used as the reference standard. The cutoff point was calculated by determining the BreathTek™ UBT result level at which negative and positive subjects were best distinguished by co-optimization of relative sensitivity and specificity. The 2.4 cutoff point for the BreathTek™ UBT was verified in an independent study by retrospective analysis of Clinical Field Trial data collected on 145 H. pylori negative and 105 H. pylori positive test subjects, again using the original Meretek UBT® as reference. Asymptomatic subjects and those with dyspepsia were included in the validation study. Figure 1a depicts graphically the BreathTek™ UBT Delta Over Baseline cutoff point which distinguishes H. pylori positive and negative subjects. For the Meretek UBT® Breath Test, the Delta Over Baseline cutoff point was determined to be 2.4 in a controlled study of sixty-six (66) infected and fifty-three (53) uninfected asymptomatic, apparently healthy volunteers. Histological examination of biopsy tissue was used as the reference standard. The cutoff point was evaluated by determining the Meretek UBT® Breath Test result level at which histologically negative and positive subjects were best distinguished. Figure 1b graphically depicts the Meretek UBT® Breath Test Delta Over Baseline cutoff point which distinguishes histologically positive and negative subjects. Note that in Figures 1a and 1b, the Delta Over Baseline scales are logarithmic.


  4. Interpretation of Results

    For the BreathTek™ UBT, a result greater than or equal to 2.4 Delta Over Baseline is interpreted as diagnostically positive indicating the presence of urease associated with H. pylori. A BreathTek™ UBT result less than 2.4 Delta Over Baseline is interpreted as diagnostically negative indicating the absence of urease associated with H. pylori. The 2.4 Delta Over Baseline cutoff point applies to both initial diagnosis and post-treatment monitoring of H. pylori infection.


X. Limitations of the Test


  1. The BreathTek™ UBT should not be used until four (4) weeks or more after the end of treatment for the eradication of H. pylori as earlier post-treatment assessment may give false negative results.

  2. The performance characteristics for persons under the age of eighteen (18) have not been established for this test.

  3. The specimen integrity of breath samples and reference gases stored in breath bags under ambient conditions has not been determined beyond seven (7) days.

  4. A correlation between the number of H. pylori organisms in the stomach and the BreathTek™ UBT result has not been established.

  5. The predicate device (Meretek UBT®) was standardized in asymptomatic healthy volunteers and subsequently validated in clinical trials limited to patients with documented duodenal ulcer disease.


XI. Expected Values


Delta Over Baseline values for the BreathTek™ UBT were determined in a controlled clinical study of twenty-six (26) infected and twenty-three (23) uninfected adult volunteers. The Meretek UBT® Breath Test was used as the reference method in the diagnosis of infection. The range of BreathTek™ UBT Delta Over Baseline values for the uninfected group was determined to be 0.0 to 1.0. A histogram for the distribution of Delta Over Baseline values from the uninfected subjects is shown in Figure 2a.



Values for the Meretek UBT® Breath Test were determined in a controlled clinical study of sixty-six (66) infected and fifty-three (53) uninfected asymptomatic, apparently healthy volunteers. Histological examination of biopsy tissue was used as the reference method in the determination of infection in this study. The range of Meretek UBT® Delta Over Baseline values for the uninfected group was determined to be 0.0 to 2.2. A histogram for the distribution of Delta Over Baseline values from the uninfected subjects is shown in Figure 2b.



XII. Performance Characteristics


  1. Performance Characteristics for the UBiT®-IR300 Spectrophotometer. Refer to the Instruction Manual for the instrument.

  2. Performance Characteristics for the POCone™ Spectrophotometer. Refer to the Instruction Manual for the instrument.

  3. Method Comparisons in Clinical Trials
    1. Comparison of the BreathTek™ UBT with the Meretek UBT®
      1. Experimental Design

        The method comparison data presented here were collected from a prospective, cross-over clinical field trial designed to validate the BreathTek™ UBT test procedure and to examine the effect of pre-test fasting time on test performance. The study included two hundred fifty-two (252) adult test subjects from Houston and Galveston, Texas. Subjects were judged to be in acceptable health based on the results of a medical history and physical examination and demonstrated no uncontrolled clinically significant abnormality other than, for some, symptoms of dyspepsia. Test subjects were tested for H. pylori infection using the Meretek UBT® Breath Test according to established procedure and with the BreathTek™ UBT under differing conditions of pre-test fasting times. Otherwise, no special instructions were given to subjects beyond those listed in the step-by-step procedures for administration of the Meretek UBT® and BreathTek™ UBT®. To minimize potential bias due to test order, the sequence of urea breath tests administered to each subject was randomized. All breath tests were administered to a given individual within fourteen (14) days of one another, most often and at a minimum, on successive days.

      2. Results

        It was demonstrated in the field trial that the BreathTek™ UBT may be administered at any time beyond one (1) hour after consuming solid and/or liquid food.


        Method comparison results are presented in a two-way contingency table on the following page (Table 1).


        Point estimates of Percent Agreement of the BreathTek™ UBT with Meretek UBT® positive and negative results are listed in the contingency table (Table 1). The comparative method for determining the true diagnosis was the predicate device (Meretek UBT®) rather than endoscopic methods. The exact binomial distribution was used to calculate the lower and upper limits of the 95% confidence intervals of the performance statistics. The confidence intervals are entered in parentheses following the point estimate of the statistic.




















        Table 1. Comparison of BreathTek™ UBT (≥ 1-hour fast) with Meretek UBT®
        BreathTek™ UBT Results
        Meretek UBT®PositiveNegativeTotal
        Positive1051106
        Negative1145146
        Total106146252


        Percent Agreement with Meretek UBT® positive subjects: 99.1 % [95% CI: (94.9, 1.00.0)]

        Percent Agreement with Meretek UBT® negative subjects: 99.3% [95% CI: (96.2, 100.0)]



    2. Comparison of Gas Isotope Ratio Mass Spectrometry (GIRMS) and UBiT®-IR300 Infrared Spectrophotometry Method

      A multi-center prospective clinical trial was conducted to compare the UBiT®-IR300 method with the traditional GIRMS method. The study included a total of three hundred twenty (320) adult test subjects enrolled at four (4) physicans’ office laboratory (POL) settings and at a clinical laboratory. The results of the clinical trial are provided in the Instructional Manual for the UBiT®-IR300 Infrared Spectrophotometer (refer to the Application Note, 13C-Urea Breath Test using the UBiT®-IR300 Infrared Spectrophotometry System).


      Table 2 shows the percent agreement of the UBiT®-IR300 results as compared to the GIRMS method. Overall agreement was excellent at 99.06 percent.




















      Table 2. Agreement of UBiT®-IR300 and GIRMS for 13C urea breath test
      GIRMS Results
      UBiT®-IR 300 ResultsPositiveNegativeTotal
      Positive1151116
      Negative2202204
      Total117203320

      %Overall Agreement: 99.06% [95% CI: (97.35, 99.74)]

      %Positive Agreement: 98.29% [95% CI: (94.26, 99.70)]

      %Negative Agreement: 99.51% [95% CI: (97.49, 99.97)]


    3. Comparison of UBiT®-IR300 and POCone™ Infrared Spectrophotometry Methods


      A multi-center, prospective study was conducted to compare the POCone™ Infrared Spectrophotometer to the UBiT®-IR300 Infrared Spectrophotometer for measuring 13CO2 enrichment in breath. The study included a total of two hundred twenty (220) adult test subjects enrolled at five (5) physicians’ office laboratory (POL) and point of care (POC) settings. The results of the clinical trial are provided in the Instruction Manual for the POCone™ Infrared Spectrophotometer (refer to the Application Note, 13C-Urea Breath Test using the POCone™ Infrared Spectrophotometry System).


      Table 3 shows the percent agreement of the POCone™ results with the UBiT®-IR300 results. Overall agreement was 99.55 percent




















      Table 3. Agreement of POCone™ and UBiT®-IR300 for the 13C urea breath test
      UBiT ® -IR 300 Results
      POCone™ResultsPositiveNegativeTotal
      Positive86187
      Negative0133133
      Total86134220


      %Overall Agreement: 99.55% [95% CI: (97.67, 99.98)]

      %Positive Agreement: 100.00% [95% CI: (95.90, 100.00)]

      %Negative Agreement: 99.25% [95% CI: (96.27, 99.96)]


    4. Comparison of Meretek UBT® with Endoscopic Methods
      1. Experimental Design

        The method comparison data presented here were collected from two (2) independent double blind clinical field trials which involved treatment of H. pylori infection. The studies included four hundred ninety-nine (499) adult patients with duodenal ulcer disease at seventy-five (75) clinical sites in the United States. Patients were tested for H. pylori infection initially (using histopathology, microbiological culture, CLOtest®, and the Meretek UBT®), and at various post-treatment intervals through out the study (using histopathology, microbiological culture, and the Meretek UBT®). In these clinical trials, patients were treated with various combinations of clarithromycin, omeprazole and placebo. Note, however, that there is no evidence that differing treatment regimens affect the performance of the Meretek UBT®.
        1)

        Histopathology

        Biopsy specimens, fixed with 10% buffered formalin were cut into 4-mm sections, stained with Genta stain and examined by an experienced pathologist.

        2)

        Microbiologic culture

        Culture was performed using fresh blood-based media, both selective and non-selective, at 37°C in 12% CO2 in air with 98% humidity. H. pylori were identified by Gram stain, typical colony morphology, and biochemical properties (production of oxidase, catalase and urease).

        3)

        CLOtest® (Delta West, Limited, Bently, West Australia)

        A biopsy specimen was tested for urease activity with the CLOtest® according to the instructions in its package insert.

        4)

        The Meretek UBT® Breath Test for H. pylori

        The diagnostic Meretek UBT® Breath Test was performed in accordance with procedures described in its package insert.


      2. Results

        Method comparison results are presented in two-way contingency tables. In Tables 4, 5, and 6, the Meretek UBT® Breath Test results are compared with the CLOtest®, histology, and with the combined endoscopic method results (CLOtest®, histology, and culture) for the initial patient visit9. In Table 7, the Meretek UBT® Breath Test results are compared with the combined endoscopic method results (histology and culture) for the post-treatment visits which occurred four (4) weeks or more after end of treatment. The exact binomial distribution was used to calculate the lower and upper limits of the 95% confidence intervals of the performance statistics. The confidence intervals are entered in parentheses following the point estimate of the statistic.




  4. Performance Characteristics For Initial Diagnosis




















    Table 4. Comparison with CLOtest® for Initial Visit
    Meretek™ UBT Results
    CLOtest® ResultsPositiveNegativeTotal
    Positive39731428
    Negative11617
    Total39847445

    Relative Sensitivity: 92.8% [95% CI: (90, 95)]

    Relative Specificity: 94.1% [95% CI: (71, l00)]




















    Table 5. Comparison with Histology for Initial Visit
    Meretek™ UBT Results
    HistologyPositiveNegativeTotal
    Positive39420414
    Negative32730
    Total39747444

    Sensitivity: 95.2% [95% CI: (93, 97)]

    Relative Specificity: 90.0% [95% CI: (74, 98)]





















    Table 6. Comparison with Combined Endoscopic Methods for Initial Visit
    Combined endoscopic methods used were CLOtest®, histology, and culture per DAIDP guidelines8 for pre-treatment diagnosis.
    Meretek™ UBT Results
    EndoscopyPositiveNegativeTotal
    Positive39520414
    Negative32629
    Total39846444

    Sensitivity: 95.2% [95 % CI: (93, 97)]

    Specificity: 89.7% [95% CI: (73, 98)]


    E. Performance Characteristics for Post-Treatment Monitoring




















































    Table 7. Comparison with Combined Endoscopic Methods* for Post-Treatment Visits (four weeks or more after End of Treatment (EOT))
    Meretek UBT® Breath Test Results
     1 Month

    EOT
    3 Months

    EOT
    6 Months

    EOT
    1-6 Months

    ComBined
    EndoscopyPosNegPosNegPosNegPosNeg
    Positive1876123891540119
    Negative59748728011264
         
    Sensitivity

    (95% CI)
    96.9

    (93, 99)
    93.9

    (88, 97)
    94.8

    (88, 98)
    95.5

    (93, 97)
    Specificity

    (95% CI)
    95.1

    (89, 98)
    95.6

    (89, 99)
    97.6

    (92, 100)
    96.0

    (93, 98)
    *Combined endoscopic methods used were histology and culture per DAIDP guidelines8 for post-treatment monitoring.



    Please note that the post-treatment performance characteristics at 1, 3 and 6 months after therapy are not statistically different. Therefore, the single best estimates of sensitivity and specificity are presented in the 1-6 Months Combined column.


    Negative Predictive Value (NPV) for Post-Treatment Monitoring


    Given the post-treatment sensitivity (95.5%) and specificity (96.0%) observed in these studies, and assuming a treatment efficacy of 90% (10% prevalence of residual H. pylori infection), the NPV of the Meretek UBT® is greater than 99%. When efficacy of treatment drops to 50%, the NPV is still greater than 95%.


XIII. Bibliography


  1. Marshall, B.J., Warren, J.R. Unidentified curved bacilli on gastric epithelium in active chronic gastritis, Lancet, June 4: 1273-1275; 1983.

  2. Northfield T.C., Mendall M., Goggin P.M., (Eds), Helicobacter pylori infection. Pathophysiology, Epidemiology and Management. Kluwer Academic Publisher (1993).

  3. Rathbone B.J., Heatley R.V., (Eds) Helicobacter pylori and Gastroduodenal Disease, Blackwell Scientific Publications, 2nd edition (1992).

  4. Helicobacter pylori in Peptic Ulcer Diseases, Program and Abstracts. NIH Consensus Development Conference, February 7-9, 1994, Bethesda, MD.

  5. NIH Consensus Development Panel, H. pylori in Peptic Ulcer Disease, JAMA, July 6, 1994 - Vol. 272, No.1, 65-69.

  6. Reference 2, page 113.

  7. Graham, D.Y., Runke, D., Anderson, S., Malaty, H.M., and Klein, P.D. Citric Acid as the Test Meal for the 13C-Urea Breath Test. American Journal of Gastroenterology, 5, 1214-1217; 1999.

  8. Borriello, S.P., Reed, P.J., Dolby, J.M., Barclay, F.E. and Webster, A.D.B. Microbial and metabolic profile of achlorhydric stomach: comparison of pernicious anemia and hypogammaglobulinaemia. J. Chin. Pathol. 38, 946-953; 1985.

  9. FDA, Center for Drug Evaluation and Research, Division of Anti-Infective Drug Products, DAIDP Points to consider document - Helicobacter pylori-associated Peptic Ulcer Disease. Indication #25. (March 1995 Addendum to March 15, 1995 Draft).


XIV. Name and Place of Business


The BreathTek™ UBT for H. pylori Collection Kit is manufactured for Meretek Diagnostics Group of Otsuka America Pharmaceutical, Inc., 2440 Research Boulevard, Rockville, MD 20850.



XV. Labeling Revision Information


Revision: September 2008

Print Code: 0508L-0177

Part Number: 002215AC


Directions For Use:

The PranactinR-Citric in this container

is intended for use only as a

componet of a BreathTekTM UBT for

H. pylori. See package insert for

instructions on how to prepare the

solution and directions for use.


Phenylketonurics: Contains

Phenylalanine, 84 mg Per Pouch


Part No. 002201AA

Print Code: 0508L-0155

US PATENT 4,830,010



NDC 59148-023-33


PranactinR-Citric


Contains: 13C-Urea, 75mg


For in vitro diagnostic use only.

The PranactinR-Citric drug is

taken orally as part of the

BreathTekTM UBT for H. pylori.


Store at 15o-30oC (59o-86oF)


Manufactured for

Otsuka America Pharmaceutical, Inc.

Rockville, MD 20850


002204AA








PRANACTIN-CITRIC 
urea c-13  powder, for solution










Product Information
Product TypeHUMAN PRESCRIPTION DRUGNDC Product Code (Source)59148-023
Route of AdministrationORALDEA Schedule    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
UREA C-13 (UREA C-13)UREA C-1375 mg  in 3000 mg










Inactive Ingredients
Ingredient NameStrength
ANHYDROUS CITRIC ACID2000 mg  in 3000 mg
MANNITOL775 mg  in 3000 mg
ASPARTAME150 mg  in 3000 mg


















Product Characteristics
Color    Score    
ShapeSize
FlavorImprint Code
Contains      










Packaging
#NDCPackage DescriptionMultilevel Packaging
159148-023-3375 mg In 1 KITNone










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
NDANDA02058605/10/2001


Labeler - Otsuka America Pharmaceutical (008314390)

Registrant - Otsuka America Pharmaceutical (008314390)
Revised: 08/2009Otsuka America Pharmaceutical



Thursday, October 20, 2016

Dercome




Dercome may be available in the countries listed below.


Ingredient matches for Dercome



Benzoyl Peroxide

Benzoyl Peroxide is reported as an ingredient of Dercome in the following countries:


  • Croatia (Hrvatska)

  • Estonia

  • Serbia

International Drug Name Search

Doxytex Liquid


Pronunciation: dox-IL-a-meen
Generic Name: Doxylamine
Brand Name: Doxytex


Doxytex Liquid is used for:

Treating symptoms of allergies, such as runny nose, sneezing, nose or throat itching, or itchy, watery eyes. It may also be used for other conditions as determined by your doctor.


Doxytex Liquid is an antihistamine. It works by blocking the action of histamine, which reduces the symptoms of an allergic reaction. It also depresses the central nervous system (brain) to produce drowsiness.


Do NOT use Doxytex Liquid if:


  • you are allergic to any ingredient in Doxytex Liquid or to any other similar medicine

  • you are taking sodium oxybate (GHB) or you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) in the past 2 weeks

  • you are breast-feeding

Contact your doctor or health care provider right away if any of these apply to you.



Before using Doxytex Liquid:


Some medical conditions may interact with Doxytex Liquid. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, planning to become pregnant, or are breast-feeding

  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

  • if you have allergies to medicines, foods, or other substances

  • if you have asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema, lung disease, shortness of breath, or sleep apnea

  • if you have blockage of the stomach, intestine, or urinary tract; difficulty urinating; or a history of diabetes, ulcers, enlargement of the prostate, glaucoma, heart disease, high blood pressure, the blood disease porphyria, seizures, stroke, or thyroid disease

Some MEDICINES MAY INTERACT with Doxytex Liquid. Tell your health care provider if you are taking any other medicines, especially any of the following:


  • Sodium oxybate (GHB) because an increase in sleep duration and a decrease in the ability to breathe are likely to occur

  • Furazolidone or MAOIs (eg, phenelzine) because serious side effects, such as high blood pressure and seizures, may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Doxytex Liquid may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.


How to use Doxytex Liquid:


Use Doxytex Liquid as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Take Doxytex Liquid by mouth with or without food.

  • Use Doxytex Liquid exactly as directed on the package, unless instructed differently by your doctor.

  • Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.

  • If you miss a dose of Doxytex Liquid and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Doxytex Liquid.



Important safety information:


  • Doxytex Liquid may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Doxytex Liquid with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

  • Avoid drinking alcohol while you are taking Doxytex Liquid. Talk with your doctor before using other medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Doxytex Liquid; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.

  • Doxytex Liquid may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.

  • Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.

  • Do not become overheated in hot weather or while you are being active; heatstroke may occur.

  • Doxytex Liquid has doxylamine in it. Before you start any new medicine, including one used on the skin, check the label to see if it has doxylamine in it too. If it does or if you are not sure, check with your doctor or pharmacist.

  • Doxytex Liquid may interfere with skin allergy tests. If you are scheduled for a skin test, talk to your doctor. You may need to stop taking Doxytex Liquid for a few days before the tests.

  • Use Doxytex Liquid with caution in the ELDERLY; they may be more sensitive to its effects, especially dizziness, sedation, and lightheadedness upon standing.

  • Do not use Doxytex Liquid in CHILDREN younger than 2 years old without talking with the child's doctor; safety and effectiveness in these children have not been confirmed.

  • Caution is advised when using Doxytex Liquid in CHILDREN; they may be more sensitive to its effects, especially excitability.

  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Doxytex Liquid while you are pregnant. Doxytex Liquid is found in breast milk. Do not breast-feed while taking Doxytex Liquid.


Possible side effects of Doxytex Liquid:


All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:



Dizziness; drowsiness; dry mouth, throat, and nose.



Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); convulsions; decreased alertness; decreased urination; excitability; fast heartbeat; hallucinations; seizures; severe drowsiness; tightness or pounding in the chest; tremor; wheezing.



This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.


See also: Doxytex side effects (in more detail)


If OVERDOSE is suspected:


Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include coma; excitement; hallucinations; loss of consciousness; muscle twitching; seizures; tremor; weakness.


Proper storage of Doxytex Liquid:

Store Doxytex Liquid at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), or according to the directions on the package label. Store in the original package or container away from heat, moisture, and light. Do not store in the bathroom. Keep Doxytex Liquid out of the reach of children and away from pets.


General information:


  • If you have any questions about Doxytex Liquid, please talk with your doctor, pharmacist, or other health care provider.

  • Doxytex Liquid is to be used only by the patient for whom it is prescribed. Do not share it with other people.

  • If your symptoms do not improve or if they become worse, check with your doctor.

  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Doxytex Liquid. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.



Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Doxytex resources


  • Doxytex Side Effects (in more detail)
  • Doxytex Use in Pregnancy & Breastfeeding
  • Doxytex Drug Interactions
  • Doxytex Support Group
  • 0 Reviews for Doxytex - Add your own review/rating


Compare Doxytex with other medications


  • Allergies
  • Conjunctivitis, Allergic
  • Hay Fever
  • Insomnia
  • Nasal Congestion
  • Rhinorrhea
  • Upper Respiratory Tract Infection

Vexol




In some countries, this medicine may only be approved for veterinary use.


In the US, Vexol (rimexolone ophthalmic) is a member of the drug class ophthalmic steroids and is used to treat Postoperative Ocular Inflammation and Uveitis.

US matches:

  • Vexol

UK matches:

  • Vexol 1%
  • Vexol 1% Eye Drops, Suspension (SPC)

Ingredient matches for Vexol



Rimexolone

Rimexolone is reported as an ingredient of Vexol in the following countries:


  • Austria

  • Brazil

  • Canada

  • Denmark

  • Finland

  • France

  • Germany

  • Greece

  • Ireland

  • Italy

  • Mexico

  • Netherlands

  • Norway

  • Portugal

  • Spain

  • Sweden

  • Switzerland

  • Turkey

  • United Kingdom

  • United States

International Drug Name Search

Glossary

SPC Summary of Product Characteristics (UK)

Click for further information on drug naming conventions and International Nonproprietary Names.

Algoremin




Algoremin may be available in the countries listed below.


Ingredient matches for Algoremin



Metamizole

Metamizole sodium anhydrous (a derivative of Metamizole) is reported as an ingredient of Algoremin in the following countries:


  • Romania

International Drug Name Search

Covonia Vapour Drops





1. Name Of The Medicinal Product



Covonia Vapour Drops


2. Qualitative And Quantitative Composition



Covonia Vapour Drops contains the following active ingredients:



Menthol BP natural or Menthol BP synthetic 17.5% w/v



Peppermint Oil BP 0.2% v/v



For excipients, see 6.1



3. Pharmaceutical Form



Inhalation vapour, solution.



A clear yellow liquid.



4. Clinical Particulars



4.1 Therapeutic Indications



For the symptomatic relief of catarrh, hay fever and nasal congestion.



4.2 Posology And Method Of Administration



Adults, the elderly and children over 3 months:



Sprinkle a few drops on a handkerchief and inhale the vapour.



Children under 3 months:



Not recommended for children under 3 months.



4.3 Contraindications



Hypersensitivity to any of the ingredients.



Not recommended for children under 3 months.



4.4 Special Warnings And Precautions For Use



In young children, menthol can cause spasm of the glottis and cases of collapse have been reported in children following local application.



The label states:



1 If symptoms persist, consult your doctor.



2 Avoid contact with the eyes.



3 Not to be taken internally.



4 Keep all medicines out of the sight and reach of children.



4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction



None stated.



4.6 Pregnancy And Lactation



The safety of Covonia Vapour Drops in pregnancy and lactation has not been established, but is not thought to constitute a hazard.



4.7 Effects On Ability To Drive And Use Machines



No or negligible influence.



4.8 Undesirable Effects



Occasional hypersensitivity reactions are a possibility.



4.9 Overdose



Following oral ingestion, the following symptoms may be expected: insomnia, unsteady gait, tremor of hands, nausea and vomiting, delirium, epileptiform convulsions, depression and coma. Treatment should consist of gastric lavage and aspiration. A saline purgative such as 30g of sodium sulphate in 250ml of water may be given and any convulsions controlled by intravenous diazepam.



5. Pharmacological Properties



5.1 Pharmacodynamic Properties



R01A X – Other nasal preparations, combinations



Menthol, a frequent constituent of inhalation preparations, produces a sensation of decreased nasal congestion, possibly by virtue of its local anaesthetic action on the nasal mucosal surface. Peppermint Oil possesses the physiological actions and therapeutic uses of menthol.



5.2 Pharmacokinetic Properties



Not applicable.



5.3 Preclinical Safety Data



No data of relevance to the prescriber, which is additional to that included in other sections of the SPC.



6. Pharmaceutical Particulars



6.1 List Of Excipients



Eucalyptus Oil Ph. Eur



Cajuput Oil BPC 1973



Spike Lavender Fragrance Oil HSE



Industrial Methylated Spirit BP



6.2 Incompatibilities



None stated.



6.3 Shelf Life



10ml: 36 months



15ml: 36 months



30ml: 36 months



6.4 Special Precautions For Storage



Do not store above 25°C



6.5 Nature And Contents Of Container



10ml, 15ml & 30ml pack - amber glass bottle with polyethylene screw cap with integral polyethylene dropper.



6.6 Special Precautions For Disposal And Other Handling



Not applicable.



7. Marketing Authorisation Holder



Thornton & Ross Limited



Linthwaite



Huddersfield



West Yorkshire



HD7 5QH



United Kingdom



8. Marketing Authorisation Number(S)



PL 00240/0073



9. Date Of First Authorisation/Renewal Of The Authorisation



19 June 2002



10. Date Of Revision Of The Text



19/09/03



11 DOSIMETRY (IF APPLICABLE)


Not Applicable



12 INSTRUCTIONS FOR PREPARATION OF RADIOPHARMACEUTICALS (IF APPLICABLE)


Not Applicable




Polyethylene Glycol Drug Facts




Generic Name: polyethylene glycol 3350

Dosage Form: powder, for solution
Drug Facts

Active ingredient


Polyethylene Glycol 3350, 17 grams (cap filled to line)



Purpose


Laxative



Uses


  • relieves occasional constipation (irregularity)

  • generally produces a bowel movement in 1 to 3 days


Warnings


Allergy alert: Do not use if you are allergic to polyethylene glycol



Do not use


if you have kidney disease, except under the advice


and supervision of a doctor



Ask a doctor before use if you have


  • nausea, vomiting or abdominal pain

  • a sudden change in bowel habits that lasts over 2 weeks

  • irritable bowel syndrome


Ask a doctor or pharmacist before use if you are


taking a prescription drug



When using this product


you may have loose, watery, more frequent stools



Stop use and ask a doctor if


  • you have rectal bleeding or your nausea, bloating, cramping or

    abdominal pain gets worse. These may be signs of a serious


    condition.



  • you get diarrhea

  • you need to use a laxative for longer than 1 week


If pregnant or breast feeding


ask a health professional before use.


Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.



Directions


  • do not take more than directed unless advised by your doctor

  • the bottle top is a measuring cap marked to contain 17 grams of powder when filled to the indicated line

  • adults and children 17 years of age and older:
    • fill to 17 grams line in cap for the correct dose

    • stir and dissolve in any 4 to 8 ounces of beverage (cold, hot or room temperature) then drink

    • use once daily

    • use no more than 7 days


  • children 16 years of age or under: ask a doctor


Other information


  • store at 20° - 25°C (68° - 77°F)

  • tamper-evident: do not use if printed foil seal under cap is missing, open or broken


Inactive ingredients


none



Questions or comments?


1-800-477-7877


Distributed by


Kremers Urban, LLC


Princeton, NJ 08540 USA


Rev. 1E



Principal Display Panel


Original Prescription Strength


  • Relieves Occasional Constipation

  • Softens Stool


  • 4.1 oz Label. Drug Facts on ECL.





  • 8.9 oz Label. Drug Facts on ECL.





  • 18.5 oz Label. Drug Facts on ECL.











POLYETHYLENE GLYCOL 3350 
polyethylene glycol 3350  powder, for solution










Product Information
Product TypeHUMAN OTC DRUGNDC Product Code (Source)62175-195
Route of AdministrationORALDEA Schedule    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
POLYETHYLENE GLYCOL 3350 (POLYETHYLENE GLYCOL 3350)POLYETHYLENE GLYCOL 335017 g  in 17 g





Inactive Ingredients
Ingredient NameStrength
No Inactive Ingredients Found


















Product Characteristics
Color    Score    
ShapeSize
FlavorImprint Code
Contains      


















Packaging
#NDCPackage DescriptionMultilevel Packaging
162175-195-07119 g In 1 BOTTLENone
262175-195-15255 g In 1 BOTTLENone
362175-195-31527 g In 1 BOTTLENone










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
ANDAANDA09060010/06/2009


Labeler - Kremers Urban (015411751)
Revised: 03/2010Kremers Urban




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