Thursday, September 29, 2016

Efam




Efam may be available in the countries listed below.


Ingredient matches for Efam



Tocopherol, α-

Tocopherol, α- acetate (a derivative of Tocopherol, α-) is reported as an ingredient of Efam in the following countries:


  • Venezuela

International Drug Name Search

Natelle Complete





Dosage Form: capsule, gelatin coated
natelle® COMPLETE All-in-one Rx prenatal vitamin with plant-based DHA

Natelle Complete Description


Natelle® Complete capsules for oral administration are supplied as oblong pink soft gelatin capsules, imprinted with "nComplete" in white ink.


Each capsule contains:


Docosahexaenoic Acid (DHA) from Algal Oil.........................................................250 mg


Eicosapentaenoic Acid (EPA) ....................................................... Not more than 0.625 mg


Calcium (Tricalcium Phosphate).................................................................................100 mg


Iron (Ferrous Fumarate) .................................................................................................30 mg


Vitamin C (Ascorbic Acid) ............................................................................................30 mg


Vitamin B-6 (Pyridoxine HCl) .........................................................................................25 mg


Vitamin E (D-Alpha Tocopherol)...................................................................................... 30 IU


Folic Acid ...........................................................................................................................1 mg


Vitamin D (Cholecalciferol) ........................................................................................... 400 IU


DHA is an omega-3 fatty acid. The DHA in Natelle® Complete is derived from Algal Oil (C. cohnii).


Inactive Ingredients: Gelatin (Bovine), Beeswax, Glycerine, Soybean Oil, Lecithin, Titanium Dioxide, Ethyl Vanillin, D&C Red #33, FD&C Red#40.



Indications and Usage for Natelle Complete


Natelle® Complete is indicated to provide vitamin/mineral and DHA omega-3 fatty acid supplementation to women throughout pregnancy, during the postnatal period for both lactating and non–lactating mothers, and throughout the childbearing years. Natelle® Complete may be beneficial in improving the nutritional status of women prior to conception.



Contraindications


This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.




WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6.


Keep this product out of the reach of children. In case of accidental overdose, call a doctor or poison control center immediately.



Warnings

Ingestion of more than 3 grams of omega-3 fatty acids per day has been shown to have potential antithrombotic effects, including increased bleeding time and INR. Administration of omega-3 fatty acids should be avoided in patients on anticoagulants and in those known to have an inherited or acquired bleeding diathesis.



Precautions


Folic acid in doses above 0.1 mg daily may obscure pernicious anemia in that hematologic remission can occur while neurological manifestations remain progressive. Other sources of folic acid are leafy vegetables, fortified cereals and bread. Causes of neural tube defect are multifactorial and folic acid supplements alone may not prevent these birth defects.


Pediatric Use: Safety and effectiveness in pediatric patients have not been established.


Geriatric Use: Clinical studies on this product have not been performed to determine whether elderly subjects respond differently from younger subjects.



Adverse Reactions


Allergic sensitization has been reported following both oral and parenteral administration of folic acid.



Natelle Complete Dosage and Administration


One capsule daily, or as directed by a physician.



How is Natelle Complete Supplied


Supplied in child resistant bottles of 30 capsules (NDC 18860-652-01).


Store at controlled room temperature 15°-30°C (59°-86°F).


 


KEEP THIS AND ALL DRUGS OUT OF THE REACH OF CHILDREN.


Distributed by: AZUR PHARMA, INC. •1818 Market Street, Suite 2350 • Philadelphia, PA 19103 • www.azurpharma.com


 


To report a serious adverse event or obtain product information, contact (800) 890 3098.



life’sDHA™ is a trademark of Martek Biosciences Corporation.


Natelle® is a registered trademark of Pharmelle.


 


Rx Only


NTCMw-10-01



PACKAGE/LABEL PRINCIPAL DISPLAY PANEL - Physician Starter Kit Front Carton Label


Physician Starter Kit Front Carton Label



natelle® COMPLETE


All-in-one Rx prenatal vitamin with


plant-based DHA


A complete formulation for you and your baby.


Distributed by: AZUR PHARMA, INC.


1818 Market Street, Suite 2350 ∙ Philadelphia, PA 19103


www.azurpharma.com


Manufactured by: Accucaps Industries Ltd.


Windsor, Ontario, Canada


Natelle® is a registered trademark of Pharmelle.


life'sDHA™ is a trademark of Martek Biosciences Corporation.




PACKAGE/LABEL PRINCIPAL DISPLAY PANEL - Physician Starter Kit Left-Side Carton Label


Physician Starter Kit Left-Side Carton Label



natelle® COMPLETE


All-in-one Rx prenatal vitamin with


plant-based DHA


NDA 18860-652-00


ONE PHYSICIAN SAMPLING KIT


Contains 10 Patient Starter Kits,


each containing 3 capsules


NOT FOR SALE


RX ONLY



PACKAGE/LABEL PRINCIPAL DISPLAY PANEL - Bottle Label


Bottle Label



30 CAPSULES


18860-652-01


Rx Only


natelle®


COMPLETE


All-in-one Rx prenatal vitamin with


plant-based DHA


Dist by: AZUR PHARMA, INC.


1818 Market Street, Suite 2350


Philadelphia, PA 19103


www.azurpharma.com


Mfg by: Accucaps Industries, Ltd.


Windsor, Ontario, Canada


To report a serious adverse event or obtain


product information, contact (800) 890 3098.


Natelle® is a registered trademark of Pharmelle.


life'sDHA™ is a trademark of Martek Biosciences Corporation.










Natelle Complete 
docosahexaenoic acid, eicosapentaenoic acid, calcium, iron, vitamin c, vitamin b-6, vitamin e, folic acid and vitamin d  capsule, gelatin coated










Product Information
Product TypeHUMAN PRESCRIPTION DRUGNDC Product Code (Source)18860-652
Route of AdministrationORALDEA Schedule    
































Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
DOCONEXENT (DOCONEXENT)DOCONEXENT250 mg
ICOSAPENT (ICOSAPENT)ICOSAPENT0.625 mg
TRICALCIUM PHOSPHATE (CALCIUM)TRICALCIUM PHOSPHATE100 mg
FERROUS FUMARATE (IRON)FERROUS FUMARATE30 mg
ASCORBIC ACID (ASCORBIC ACID)ASCORBIC ACID30 mg
PYRIDOXINE HYDROCHLORIDE (PYRIDOXINE)PYRIDOXINE HYDROCHLORIDE25 mg
ALPHA-TOCOPHEROL (ALPHA-TOCOPHEROL)ALPHA-TOCOPHEROL30 [iU]
FOLIC ACID (FOLIC ACID)FOLIC ACID1 mg
CHOLECALCIFEROL (CHOLECALCIFEROL)CHOLECALCIFEROL400 [iU]






















Inactive Ingredients
Ingredient NameStrength
GELATIN 
GLYCERIN 
SOYBEAN OIL 
LECITHIN, SOYBEAN 
TITANIUM DIOXIDE 
ETHYL VANILLIN 
YELLOW WAX 
D&C RED NO. 33 
FD&C RED NO. 40 


















Product Characteristics
ColorPINKScoreno score
ShapeCAPSULE (oblong)Size20mm
FlavorImprint CodenComplete
Contains      


















Packaging
#NDCPackage DescriptionMultilevel Packaging
118860-652-0130 CAPSULE In 1 BOTTLENone
218860-652-0010 BLISTER PACK In 1 CARTONcontains a BLISTER PACK
23 CAPSULE In 1 BLISTER PACKThis package is contained within the CARTON (18860-652-00)










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
Unapproved drug other06/24/2011


Labeler - Azur Pharma, Inc. (805611071)









Establishment
NameAddressID/FEIOperations
Accucaps Industries Limited248441727MANUFACTURE
Revised: 07/2011Azur Pharma, Inc.

More Natelle Complete resources


  • Natelle Complete Use in Pregnancy & Breastfeeding
  • Drug Images
  • Natelle Complete Drug Interactions
  • Natelle Complete Support Group
  • 21 Reviews for Natelle Complete - Add your own review/rating


Compare Natelle Complete with other medications


  • Vitamin/Mineral Supplementation during Pregnancy/Lactation

Wednesday, September 28, 2016

Glimepiride Teva




Glimepiride Teva may be available in the countries listed below.


Ingredient matches for Glimepiride Teva



Glimepiride

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


  • Italy

International Drug Name Search

Gastrogard




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

Ingredient matches for Gastrogard



Omeprazole

Omeprazole is reported as an ingredient of Gastrogard in the following countries:


  • Austria

  • Belgium

  • Finland

  • France

  • Germany

  • Italy

  • Luxembourg

  • Netherlands

  • Portugal

  • Sweden

  • United Kingdom

  • United States

International Drug Name Search

Isosorbidedinitraat PCH




Isosorbidedinitraat PCH may be available in the countries listed below.


Ingredient matches for Isosorbidedinitraat PCH



Isosorbide Dinitrate

Isosorbide Dinitrate is reported as an ingredient of Isosorbidedinitraat PCH in the following countries:


  • Netherlands

International Drug Name Search

hydroxyurea



Generic Name: hydroxyurea (hye DROX ee yoo REE a)

Brand names: Droxia, Hydrea, Mylocel


What is hydroxyurea?

Hydroxyurea affects certain cells in the body, such as cancer cells or sickled red blood cells.


Hydroxyurea is used to treat chronic myelocytic leukemia, ovarian cancer, and certain types of skin cancer (melanoma and primary squamous cell cancer of the head and neck).


Hydroxyurea is also used to reduce pain episodes and the need for blood transfusions in people with sickle cell anemia. Hydroxyurea will not cure sickle cell anemia.


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


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


Do not use hydroxyurea if you are pregnant. It could harm the unborn baby. You should not use hydroxyurea if you are allergic to it, or if you have severe bone marrow suppression, severe anemia, or low levels of platelets in your blood.

Before using hydroxyurea, tell your doctor if you have bone marrow suppression, HIV or AIDS, liver or kidney disease, or if you are receiving chemotherapy or radiation.


Wash your hands before and after you handle a hydroxyurea capsule or the bottle that contains the pills. For best protection, wear disposable gloves when handling the pills. Do not open the hydroxyurea capsule. Do not use a pill that has been accidentally opened or broken. The medicine from an open capsule can be dangerous if it gets in your eyes, mouth, or nose, or on your skin. If this occurs, wash your skin with soap and water or rinse your eyes with water.

If any powder from an open capsule is spilled, wipe it up at once with a damp paper towel and throw the towel away in a sealed plastic bag where children and pets cannot get to it.


Hydroxyurea can lower blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Your blood may need to be tested often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.


What should I discuss with my healthcare provider before taking hydroxyurea?


You should not use hydroxyurea if you are allergic to it, or if you have:

  • severe bone marrow suppression;




  • severe anemia; or




  • low levels of platelets in your blood.



To make sure you can safely take hydroxyurea, tell your doctor if you have any of these other conditions:



  • bone marrow suppression;




  • HIV or AIDS;



  • liver disease;

  • kidney disease; or


  • if you are receiving chemotherapy or radiation.




FDA pregnancy category D. Do not use hydroxyurea if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. This medication may affect fertility (your ability to have children), whether you are a man or a woman. Hydroxyurea can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are taking hydroxyurea. Older adults may be more likely to have side effects from this medicine.

How should I take hydroxyurea?


Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.


Drink 8 to 10 glasses of liquid per day while you are taking hydroxyurea. You may take the medicine with or without food.

Hydroxyurea is either taken once per day or once every third day, depending on the condition being treated. On each of your dosing days, take the medicine at the same time of day. Your doctor may also want you to take a folic acid supplement. Follow your doctor's instructions very carefully.


Wash your hands before and after you handle a hydroxyurea capsule or the bottle that contains the pills. For best protection, wear disposable gloves when handling the pills. Do not open the hydroxyurea capsule. Do not use a pill that has been accidentally opened or broken. The medicine from an open capsule can be dangerous if it gets in your eyes, mouth, or nose, or on your skin. If this occurs, wash your skin with soap and water or rinse your eyes with water.

If any powder from an open capsule is spilled, wipe it up at once with a damp paper towel and throw the towel away in a sealed plastic bag where children and pets cannot get to it.


Hydroxyurea can lower blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill.


To make sure this medication is helping your condition and not causing harmful effects, your blood will need to be tested often. Your treatments may be delayed based on the results of these tests. Do not miss any follow-up visits to your doctor.


Use hydroxyurea regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.


Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

See also: Hydroxyurea dosage (in more detail)

What happens if I miss a dose?


Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


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

Overdose symptoms may include drowsiness, mouth sores, and swelling with pain and purple discoloration in your hands and feet.


What should I avoid while taking hydroxyurea?


Do not handle hydroxyurea pills or the medicine bottle without skin protection (disposable gloves).


Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.


Hydroxyurea 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:

  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;




  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;




  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;




  • skin redness, skin ulcers, or open sores;




  • painful or difficult urination;




  • confusion, hallucinations, seizure; or




  • nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of your skin or eyes).



Less serious side effects may include:



  • hair loss;




  • skin peeling or discoloration, mild rash;




  • upset stomach, constipation, diarrhea;




  • headache, dizziness; or




  • weight gain.



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.


Hydroxyurea Dosing Information


Usual Adult Dose for Solid Tumors:

Solid Tumors:
Intermittent Therapy: 80 mg/kg administered orally as a single dose every third day.

Continuous Therapy: 20 to 30 mg/kg administered orally as a single dose daily.

Concomitant Therapy with Irradiation: Carcinoma of the head and neck: 80 mg/kg administered orally as a single dose every third day.

Administration of hydroxyurea should be begun at least seven days before initiation of irradiation and continued during radiotherapy as well as indefinitely afterwards provided that the patient may be kept under adequate observation and there is no evidence of unusual or severe reactions.

Pain or discomfort from inflammation of the mucous membranes at the irradiated site (mucositis) is usually controlled by measures such as topical anesthetics and orally administered analgesics. If the reaction is severe, hydroxyurea therapy may be temporarily interrupted; if it is extremely severe, irradiation dosage may, in addition, be temporarily postponed. However, it has rarely been necessary to terminate these therapies.

Severe gastric distress, such as nausea, vomiting, and anorexia, resulting from combined therapy may usually be controlled by temporary interruption of hydroxyurea administration.

Usual Adult Dose for Sickle Cell Anemia:

Initial Dose: 15 mg/kg (10-20 mg/kg) once a day. The dose may be increased in 5 mg/kg/day increments every 12 weeks to a maximum dose of 35 mg/kg/day.

Usual Adult Dose for Chronic Myelogenous Leukemia:

Resistant Chronic Myelocytic Leukemia: Until the intermittent therapy regimen has been evaluated, continuous therapy at 20 to 30 mg/kg administered orally as a single dose daily is recommended.

An adequate trial period for determining the antineoplastic effectiveness of hydroxyurea is six weeks of therapy. When there is regression in tumor size or arrest in tumor growth, therapy should be continued indefinitely.

Therapy should be interrupted if the white blood cell count drops below 2500/mm3, or the platelet count below 100,000/mm3. In these cases, the counts should be rechecked after three days, and therapy resumed when the counts rise significantly toward normal values. Since the hematopoietic rebound is prompt, it is usually necessary to omit only a few doses. If prompt rebound has not occurred during combined hydroxyurea tablets and irradiation therapy, irradiation may also be interrupted. However, the need for postponement of irradiation has been rare. Radiotherapy has usually been continued using the recommended dosage and technique. If severe anemia occurs, it should be corrected without interrupting hydroxyurea therapy. Because hematopoiesis may be compromised by extensive irradiation or by other antineoplastic agents, it is recommended that hydroxyurea be administered cautiously to patients who have recently received extensive radiation therapy or chemotherapy with other cytotoxic drugs.

Pain or discomfort from inflammation of the mucous membranes at the irradiated site (mucositis) is usually controlled by measures such as topical anesthetics and orally administered analgesics. If the reaction is severe, hydroxyurea therapy may be temporarily interrupted; if it is extremely severe, irradiation dosage may, in addition, be temporarily postponed. However, it has rarely been necessary to terminate these therapies.

Severe gastric distress, such as nausea, vomiting, and anorexia, resulting from combined therapy may usually be controlled by temporary interruption of hydroxyurea administration.


What other drugs will affect hydroxyurea?


Some medicines can increase your risk of certain side effects while taking hydroxyurea. Tell your doctor if you are also using:



  • didanosine (Videx);




  • stavudine (Zerit); or




  • an interferon such as Actimmune, Alferon, Avonex, Betaseron, Extavia, Infergen, Intron, Rebetron, Rebif, or Roferon.



This list is not complete and other drugs may interact with hydroxyurea. 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 hydroxyurea resources


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


  • hydroxyurea Advanced Consumer (Micromedex) - Includes Dosage Information

  • Hydroxyurea Prescribing Information (FDA)

  • Hydroxyurea Professional Patient Advice (Wolters Kluwer)

  • Hydroxyurea Monograph (AHFS DI)

  • Hydroxyurea MedFacts Consumer Leaflet (Wolters Kluwer)

  • Droxia Prescribing Information (FDA)

  • Droxia MedFacts Consumer Leaflet (Wolters Kluwer)

  • Hydrea Prescribing Information (FDA)



Compare hydroxyurea with other medications


  • Anemia, Sickle Cell
  • Chronic Myelogenous Leukemia
  • Polycythemia Vera
  • Psoriasis
  • Psoriatic Arthritis
  • Solid Tumors


Where can I get more information?


  • Your pharmacist can provide more information about hydroxyurea.

See also: hydroxyurea side effects (in more detail)


Tuesday, September 27, 2016

Gastro




Gastro may be available in the countries listed below.


Ingredient matches for Gastro



Famotidine

Famotidine is reported as an ingredient of Gastro in the following countries:


  • Israel

International Drug Name Search

Glimepirida




Glimepirida may be available in the countries listed below.


Ingredient matches for Glimepirida



Glimepiride

Glimepiride is reported as an ingredient of Glimepirida in the following countries:


  • Venezuela

International Drug Name Search

GF




GF may be available in the countries listed below.


Ingredient matches for GF



Gatifloxacin

Gatifloxacin is reported as an ingredient of GF in the following countries:


  • Bangladesh

International Drug Name Search

Glimepirida Alter




Glimepirida Alter may be available in the countries listed below.


Ingredient matches for Glimepirida Alter



Glimepiride

Glimepiride is reported as an ingredient of Glimepirida Alter in the following countries:


  • Portugal

  • Spain

International Drug Name Search

Metvixia


Metvixia is a brand name of methyl aminolevulinate topical, approved by the FDA in the following formulation(s):


METVIXIA (methyl aminolevulinate hydrochloride - cream; topical)



  • Manufacturer: GALDERMA LABS LP

    Approval date: July 27, 2004

    Strength(s): EQ 16.8% BASE [RLD]

Has a generic version of Metvixia been approved?


No. There is currently no therapeutically equivalent version of Metvixia available.


Note: Fraudulent online pharmacies may attempt to sell an illegal generic version of Metvixia. These medications may be counterfeit and potentially unsafe. If you purchase medications online, be sure you are buying from a reputable and valid online pharmacy. Ask your health care provider for advice if you are unsure about the online purchase of any medication.

See also: About generic drugs.




Related Patents


Patents are granted by the U.S. Patent and Trademark Office at any time during a drug's development and may include a wide range of claims.




  • Esters of 5-aminolevulinic acid as photosensitizing agents in photochemotherapy
    Patent 6,034,267
    Issued: March 7, 2000
    Inventor(s): Gierskcky; Karl E. & Moan; Johan & Peng; Qian & Steen; Harald & Warloe; Trond & Bjorseth; Alf
    Assignee(s): PhotoCure AS
    The invention provides a pharmaceutical compositions comprising a compound of formula I: EQU R.sub.2.sup.2 N--CH.sub.2 COCH.sub.2 --CH.sub.2 CO--OR.sup.1(I) wherein, R.sup.1 and R.sup.2 have any of the values defined in the specification; or a salt thereof; and a pharmaceutically acceptable carrier or excipient. The invention also provides a method for the diagnosis or photochemotherapeutic treatment of disorders or abnormalities of external or internal surfaces of the body using such compounds or salts.
    Patent expiration dates:

    • March 8, 2016
      ✓ 
      Patent use: TREATMENT OF ACTINIC KERATOSES BY PHOTODYNAMIC THERAPY



Related Exclusivities

Exclusivity is exclusive marketing rights granted by the FDA upon approval of a drug and can run concurrently with a patent or not. Exclusivity is a statutory provision and is granted to an NDA applicant if statutory requirements are met.

  • Exclusivity expiration dates:
    • June 26, 2011 - USE IN COMBINATION WITH THE NEW AKTILITE CL128 LAMP FOR THE TREATMENT OF THIN AND MODERATELY THICK, NON-HYPERKERATOTIC, NON-PIGMENTED ACTINIC KERATOSES OF THE FACE AND SCALP IN IMMUNOCOMPETENT PATIENTS

See also...

  • Metvixia Consumer Information (Drugs.com)
  • Metvixia Cream Consumer Information (Wolters Kluwer)
  • Metvixia topical Consumer Information (Cerner Multum)
  • Metvixia Advanced Consumer Information (Micromedex)
  • Methyl Aminolevulinate Cream Consumer Information (Wolters Kluwer)
  • Methyl aminolevulinate topical Consumer Information (Cerner Multum)
  • Methyl aminolevulinate Topical application Advanced Consumer Information (Micromedex)

Rheohes




Rheohes may be available in the countries listed below.


Ingredient matches for Rheohes



Hetastarch

Hetastarch is reported as an ingredient of Rheohes in the following countries:


  • Germany

International Drug Name Search

Gabapentin-biomo




Gabapentin-biomo may be available in the countries listed below.


Ingredient matches for Gabapentin-biomo



Gabapentin

Gabapentin is reported as an ingredient of Gabapentin-biomo in the following countries:


  • Germany

International Drug Name Search

Ultrazole




Ultrazole may be available in the countries listed below.


Ingredient matches for Ultrazole



Lansoprazole

Lansoprazole is reported as an ingredient of Ultrazole in the following countries:


  • Oman

International Drug Name Search

Monday, September 26, 2016

Testosterone




Generic Name: Testosterone cypionate

Dosage Form: injection, solution
Testosterone Cypionate Injection, USP

100 mg/mL and 200 mg/mL

Testosterone Description


Testosterone cypionate injection, USP, for intramuscular injection, contains Testosterone cypionate which is the oil-soluble 17 (beta)-cyclopentylpropionate ester of the androgenic hormone Testosterone.


Testosterone cypionate is a white or creamy white crystalline powder, odorless or nearly so and stable in air. It is insoluble in water, freely soluble in alcohol, chloroform, dioxane, ether, and soluble in vegetable oils.


The chemical name for Testosterone cypionate is androst-4-en-3-one,17-(3-cyclopentyl-1-oxopropoxy)-, (17β)-. Its molecular formula is C27H40O3, and the molecular weight 412.61.


The structural formula is represented below:



Testosterone cypionate injection, USP is available in two strengths, 100 mg/mL and 200 mg/mL Testosterone cypionate.


Each mL of the 100 mg/mL solution contains:











Testosterone cypionate100 mg
Benzyl benzoate0.1 mL
Cottonseed oil736 mg
Benzyl alcohol (as preservative)9.45 mg

Each mL of the 200 mg/mL solution contains:











Testosterone cypionate200 mg
Benzyl benzoate0.2 mL
Cottonseed oil560 mg
Benzyl alcohol (as preservative)9.45 mg

Testosterone - Clinical Pharmacology


Endogenous androgens are responsible for normal growth and development of the male sex organs and for maintenance of secondary sex characteristics. These effects include growth and maturation of the prostate, seminal vesicles, penis, and scrotum; development of male hair distribution, such as beard, pubic, chest, and axillary hair; laryngeal enlargement, vocal cord thickening, and alterations in body musculature and fat distribution. Drugs in this class also cause retention of nitrogen, sodium, potassium, and phosphorous, and decreased urinary excretion of calcium. Androgens have been reported to increase protein anabolism and decrease protein catabolism. Nitrogen balance is improved only when there is sufficient intake of calories and protein.


Androgens are responsible for the growth spurt of adolescence and for eventual termination of linear growth, brought about by fusion of the epiphyseal growth centers. In children, exogenous androgens accelerate linear growth rates, but may cause disproportionate advancement in bone maturation. Use over long periods may result in fusion of the epiphyseal growth centers and termination of the growth process. Androgens have been reported to stimulate production of red blood cells by enhancing production of erythropoietic stimulation factor.


During exogenous administration of androgens, endogenous Testosterone release is inhibited through feedback inhibition of pituitary luteinizing hormone (LH). At large doses of exogenous androgens, spermatogenesis may also be suppressed through feedback inhibition of pituitary follicle stimulating hormone (FSH).


There is a lack of substantial evidence that androgens are effective in fractures, surgery, convalescence, and functional uterine bleeding.



Pharmacokinetics


Testosterone esters are less polar than free Testosterone. Testosterone esters in oil injected intramuscularly are absorbed slowly from the lipid phase; thus, Testosterone cypionate can be given at intervals of two to four weeks.


Testosterone in plasma is 98 percent bound to a specific Testosterone-estradiol binding globulin, and about 2 percent is free. Generally, the amount of this sex-hormone binding globulin in the plasma will determine the distribution of Testosterone between free and bound forms, and the free Testosterone concentration will determine its half-life.


About 90 percent of a dose of Testosterone is excreted in the urine as glucuronic and sulfuric acid conjugates of Testosterone and its metabolites; about 6 percent of a dose is excreted in the feces, mostly in the conjugated form. Inactivation of Testosterone occurs primarily in the liver. Testosterone is metabolized to various 17-keto steroids through two different pathways.


The half-life of Testosterone cypionate when injected intramuscularly is approximately eight days.


In many tissues the activity of Testosterone appears to depend on reduction to dihydroTestosterone, which binds to cytosol receptor proteins. The steroid-receptor complex is transported to the nucleus where it initiates transcription events and cellular changes related to androgen action.



Indications and Usage for Testosterone


Testosterone cypionate injection, USP is indicated for replacement therapy in the male in conditions associated with symptoms of deficiency or absence of endogenous Testosterone.


  1. Primary hypogonadism (congenital or acquired) testicular failure due to cryptorchidism, bilateral torsion, orchitis, vanishing testis syndrome; or orchidectomy.

  2. Hypogonadotropic hypogonadism (congenital or acquired) idiopathic gonadotropin or LHRH deficiency, or pituitary-hypothalamic injury from tumors, trauma, or radiation.


Contraindications


  1. Known hypersensitivity to the drug

  2. Males with carcinoma of the breast

  3. Males with known or suspected carcinoma of the prostate gland

  4. Women who are or who may become pregnant

  5. Patients with serious cardiac, hepatic or renal disease


Warnings


Hypercalcemia may occur in immobilized patients. If this occurs, the drug should be discontinued.


Prolonged use of high doses of androgens (principally the 17-α alkyl-androgens) has been associated with development of hepatic adenomas, hepatocellular carcinoma, and peliosis hepatis – all potentially life-threatening complications.


Geriatric patients treated with androgens may be at an increased risk of developing prostatic hypertrophy and prostatic carcinoma although conclusive evidence to support this concept is lacking.


Edema, with or without congestive heart failure, may be a serious complication in patients with pre-existing cardiac, renal or hepatic disease.


Gynecomastia may develop and occasionally persists in patients being treated for hypogonadism.


This product contains benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants.


Androgen therapy should be used cautiously in healthy males with delayed puberty. The effect on bone maturation should be monitored by assessing bone age of the wrist and hand every 6 months. In children, androgen treatment may accelerate bone maturation without producing compensatory gain in linear growth. This adverse effect may result in compromised adult stature. The younger the child the greater the risk of compromising final mature height.


This drug has not been shown to be safe and effective for the enhancement of athletic performance. Because of the potential risk of serious adverse health effects, this drug should not be used for such purpose.



Precautions



General


Patients with benign prostatic hypertrophy may develop acute urethral obstruction. Priapism or excessive sexual stimulation may develop. Oligospermia may occur after prolonged administration or excessive dosage. If any of these effects appear, the androgen should be stopped and if restarted, a lower dosage should be utilized.


Testosterone cypionate should not be used interchangeably with Testosterone propionate because of differences in duration of action.


Testosterone cypionate is not for intravenous use.



Information for Patients


Patients should be instructed to report any of the following: nausea, vomiting, changes in skin color, ankle swelling, too frequent or persistent erections of the penis.



Laboratory Tests


Hemoglobin and hematocrit levels (to detect polycythemia) should be checked periodically in patients receiving long-term androgen administration.


Serum cholesterol may increase during androgen therapy.



Drug Interactions


Androgens may increase sensitivity to oral anticoagulants. Dosage of the anticoagulant may require reduction in order to maintain satisfactory therapeutic hypoprothrombinemia.


Concurrent administration of oxyphenbutazone and androgens may result in elevated serum levels of oxyphenbutazone.


In diabetic patients, the metabolic effects of androgens may decrease blood glucose and, therefore, insulin requirements.


Drug/Laboratory Test Interferences

Androgens may decrease levels of thyroxine­binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however, and there is no clinical evidence of thyroid dysfunction.



Carcinogenesis


Animal Data

Testosterone has been tested by subcutaneous injection and implantation in mice and rats. The implant induced cervical-uterine tumors in mice, which metastasized in some cases. There is suggestive evidence that injection of Testosterone into some strains of female mice increases their susceptibility to hepatoma. Testosterone is also known to increase the number of tumors and decrease the degree of differentiation of chemically induced carcinomas of the liver in rats.


Human Data

There are rare reports of hepatocellular carcinoma in patients receiving long-term therapy with androgens in high doses. Withdrawal of the drugs did not lead to regression of the tumors in all cases.


Geriatric patients treated with androgens may be at an increased risk of developing prostatic hypertrophy and prostatic carcinoma although conclusive evidence to support this concept is lacking.



Pregnancy


Teratogenic Effects

Pregnancy Category X. (See CONTRAINDICATIONS.)



Nursing Mothers


Testosterone cypionate injection, USP is not recommended for use in nursing mothers.



Pediatric Use


Safety and effectiveness in pediatric patients below the age of 12 years have not been established.



Adverse Reactions


The following adverse reactions in the male have occurred with some androgens:



Endocrine and Urogenital


Gynecomastia and excessive frequency and duration of penile erections. Oligospermia may occur at high dosages.



Skin and Appendages


Hirsutism, male pattern of baldness, seborrhea, and acne.



Fluid and Electrolyte Disturbances


Retention of sodium, chloride, water, potassium, calcium, and inorganic phosphates.



Gastrointestinal


Nausea, cholestatic jaundice, alterations in liver function tests, rarely hepatocellular neoplasms and peliosis hepatis (see WARNINGS).



Hematologic


Suppression of clotting factors II, V, VII, and X, bleeding in patients on concomitant anticoagulant therapy, and polycythemia.



Nervous System


Increased or decreased libido, headache, anxiety, depression, and generalized paresthesia.



Allergic


Hypersensitivity, including skin manifestations and anaphylactoid reactions.



Miscellaneous


Inflammation and pain at the site of intramuscular injection.



Drug Abuse and Dependence



Controlled Substance Class


Testosterone is a controlled substance under the Anabolic Steroid Control Act, and Testosterone cypionate injection, USP has been assigned to Schedule III.



Overdosage


There have been no reports of acute overdosage with the androgens.



Testosterone Dosage and Administration


Testosterone cypionate injection, USP is for intramuscular use only.


It should not be given intravenously. Intramuscular injections should be given deep in the gluteal muscle.


The suggested dosage for Testosterone cypionate injection, USP varies depending on the age, sex, and diagnosis of the individual patient. Dosage is adjusted according to the patient’s response and the appearance of adverse reactions.


Various dosage regimens have been used to induce pubertal changes in hypogonadal males; some experts have advocated lower dosages initially, gradually increasing the dose as puberty progresses, with or without a decrease to maintenance levels. Other experts emphasize that higher dosages are needed to induce pubertal changes and lower dosages can be used for maintenance after puberty. The chronological and skeletal ages must be taken into consideration, both in determining the initial dose and in adjusting the dose.


For replacement in the hypogonadal male, 50 to 400 mg should be administered every two to four weeks.


Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Warming and shaking the vial should redissolve any crystals that may have formed during storage at temperatures lower than recommended.



How is Testosterone Supplied


Testosterone cypionate injection, USP is available as follows:


100 mg/mL:


NDC 0781-3073-70 – 10 mL multidose vial


200 mg/mL:


NDC 0781-3074-71 – 1 mL vial


NDC 0781-3074-70 – 10 mL multidose vial



Store at 20°-25°C (68°-77°F) (see USP Controlled Room Temperature). Protect from light.



03-2009M


U1006824


Manufactured in Canada by


Sandoz Canada Inc. for


Sandoz Inc., Princeton, NJ 08540




mg/mL 10 mL Label


NDC 0781-3073-70


Testosterone CIII


Cypionate


Injection, USP


1,000 mg/10 mL


(100 mg/mL)


FOR INTRAMUSCULAR USE ONLY


Sterile. Protect from light.


Rx only 10 mL Multidose Vial


SANDOZ





mg/mL 10 mL Carton


NDC 0781-3073-70


CIII


Testosterone


Cypionate


Injection, USP


1,000 mg/10 mL


(100 mg/mL)


FOR INTRAMUSCULAR


USE ONLY


Sterile


Rx only


10 mL


Multidose Vial


SANDOZ





mg/mL 1 mL Label


NDC 0781-3074-71


Testosterone CIII


Cypionate


Injection, USP


200 mg/mL


FOR IM USE ONLY. Sterile.


Rx only


1 mL Vial


Manufactured in Canada by


Sandoz Canada Inc. for


Sandoz Inc.,


Princeton, NJ 08540





mg/mL 1 mL Carton


NDC 0781-3074-71


CIII


Testosterone


Cypionate


Injection, USP


200 mg/mL


FOR INTRAMUSCULAR


USE ONLY


Sterile


Rx only


1 mL Vial


SANDOZ





mg/mL 10 mL Label


NDC 0781-3074-70


Testosterone CIII


Cypionate


Injection, USP


2,000 mg/10 mL


(200 mg/mL)


FOR INTRAMUSCULAR USE ONLY


Sterile. Protect from light.


Rx only 10 mL Multidose Vial


SANDOZ





mg/mL 10 mL Carton


NDC 0781-3074-70


CIII


Testosterone


Cypionate


Injection, USP


2,000 mg/10 mL


(200 mg/mL)


FOR INTRAMUSCULAR


USE ONLY


Sterile


Rx only


10 mL


Multidose Vial


SANDOZ










Testosterone CYPIONATE 
Testosterone cypionate  injection, solution










Product Information
Product TypeHUMAN PRESCRIPTION DRUGNDC Product Code (Source)0781-3073
Route of AdministrationINTRAMUSCULARDEA ScheduleCIII    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
Testosterone CYPIONATE (Testosterone)Testosterone CYPIONATE100 mg  in 1 mL










Inactive Ingredients
Ingredient NameStrength
BENZYL ALCOHOL9.45 mg  in 1 mL
BENZYL BENZOATE0.1 mL  in 1 mL
COTTON SEED736 mg  in 1 mL


















Product Characteristics
Color    Score    
ShapeSize
FlavorImprint Code
Contains      














Packaging
#NDCPackage DescriptionMultilevel Packaging
10781-3073-701 VIAL In 1 CARTONcontains a VIAL, MULTI-DOSE
110 mL In 1 VIAL, MULTI-DOSEThis package is contained within the CARTON (0781-3073-70)










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
ANDAANDA04061508/10/2006







Testosterone CYPIONATE 
Testosterone cypionate  injection, solution










Product Information
Product TypeHUMAN PRESCRIPTION DRUGNDC Product Code (Source)0781-3074
Route of AdministrationINTRAMUSCULARDEA ScheduleCIII    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
Testosterone CYPIONATE (Testosterone)Testosterone CYPIONATE200 mg  in 1 mL










Inactive Ingredients
Ingredient NameStrength
BENZYL ALCOHOL9.45 mg  in 1 mL
BENZYL BENZOATE0.2 mL  in 1 mL
COTTON SEED560 mg  in 1 mL


















Product Characteristics
Color    Score    
ShapeSize
FlavorImprint Code
Contains      






















Packaging
#NDCPackage DescriptionMultilevel Packaging
10781-3074-701 VIAL In 1 CARTONcontains a VIAL, MULTI-DOSE
110 mL In 1 VIAL, MULTI-DOSEThis package is contained within the CARTON (0781-3074-70)
20781-3074-711 VIAL In 1 CARTONcontains a VIAL
21 mL In 1 VIALThis package is contained within the CARTON (0781-3074-71)










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
ANDAANDA04061508/10/2006


Labeler - Sandoz Inc (110342024)









Establishment
NameAddressID/FEIOperations
Sandoz Canada Inc244062071MANUFACTURE
Revised: 01/2010Sandoz Inc

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Midazolam DeltaSelect




Midazolam DeltaSelect may be available in the countries listed below.


Ingredient matches for Midazolam DeltaSelect



Midazolam

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


  • Austria

  • Germany

  • Netherlands

International Drug Name Search

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Gastirin may be available in the countries listed below.


Ingredient matches for Gastirin



Cimetidine

Cimetidine is reported as an ingredient of Gastirin in the following countries:


  • Japan

International Drug Name Search

Azrogen




Azrogen may be available in the countries listed below.


Ingredient matches for Azrogen



Lorazepam

Lorazepam is reported as an ingredient of Azrogen in the following countries:


  • Japan

International Drug Name Search

Glimepirida Teva




Glimepirida Teva may be available in the countries listed below.


Ingredient matches for Glimepirida Teva



Glimepiride

Glimepiride is reported as an ingredient of Glimepirida Teva in the following countries:


  • Spain

International Drug Name Search

Friday, September 23, 2016

Pig Scour




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

Ingredient matches for Pig Scour



Roxarsone

Roxarsone is reported as an ingredient of Pig Scour in the following countries:


  • United States

International Drug Name Search

Hartil HCT




Hartil HCT may be available in the countries listed below.


Ingredient matches for Hartil HCT



Hydrochlorothiazide

Hydrochlorothiazide is reported as an ingredient of Hartil HCT in the following countries:


  • Bulgaria

  • Hungary

Ramipril

Ramipril is reported as an ingredient of Hartil HCT in the following countries:


  • Bulgaria

  • Hungary

International Drug Name Search

Fioricet


Generic Name: butalbital and acetaminophen combination (Oral route)


Commonly used brand name(s)

In the U.S.


  • Anolor 300

  • Cephadyn

  • Dolgic LQ

  • Esgic

  • Esgic-Plus

  • Ezol

  • Fioricet

  • Geone

  • Margesic

  • Medigesic

  • Phrenilin

  • Phrenilin Forte

Available Dosage Forms:


  • Tablet

  • Capsule

  • Solution

Uses For Fioricet


Butalbital and acetaminophen combination is a pain reliever and relaxant. It is used to treat tension headaches. Butalbital belongs to the group of medicines called barbiturates. Barbiturates act in the central nervous system (CNS) to produce their effects.


When you take butalbital for a long time, your body may get used to it so that larger amounts are needed to produce the same effects. This is called tolerance to the medicine. Also, butalbital may become habit-forming (causing mental or physical dependence) when it is used for a long time or in large doses. Physical dependence may lead to withdrawal side effects when you stop taking the medicine. In patients who get headaches, the first symptom of withdrawal may be new (rebound) headaches.


Some butalbital and acetaminophen combinations also contain caffeine. Caffeine may help to relieve headaches. However, caffeine can also cause physical dependence when it is used for a long time. This may lead to withdrawal (rebound) headaches when you stop taking it.


Butalbital and acetaminophen combination may also be used for other kinds of headaches or other kinds of pain as determined by your doctor.


These medicines are available only with your doctor's prescription.


Before Using Fioricet


Allergies


Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group 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


For butalbital:


  • Although barbiturates such as butalbital often cause drowsiness, some children become excited after taking them.

For acetaminophen:


  • Acetaminophen has been tested in children and, in effective doses, has not been shown to cause different side effects or problems than it does in adults.

For caffeine:


  • There is no specific information comparing use of caffeine in children up to 12 years of age with use in other age groups. However, caffeine is not expected to cause different side effects or problems in children than it does in adults.

Geriatric


For butalbital:


  • Certain side effects, such as confusion, excitement, or mental depression, may be especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of the butalbital in this combination medicine.

For acetaminophen:


  • Acetaminophen has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

For caffeine:


  • Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of caffeine in the elderly with use in other age groups.

Pregnancy


For butalbital:


  • Barbiturates such as butalbital have been shown to increase the chance of birth defects in humans. Also, one study in humans has suggested that barbiturates taken during pregnancy may increase the chance of brain tumors in the baby.

  • Butalbital may cause breathing problems in the newborn baby if taken just before or during delivery.

For acetaminophen:


  • Although studies on birth defects with acetaminophen have not been done in pregnant women, it has not been reported to cause birth defects or other problems.

For caffeine:


  • Studies in humans have not shown that caffeine (contained in some of these combination medicines) causes birth defects. However, use of large amounts of caffeine during pregnancy may cause problems with the heart rhythm and the growth of the fetus. Also, studies in animals have shown that caffeine causes birth defects when given in very large doses (amounts equal to those present in 12 to 24 cups of coffee a day).

Breast Feeding


For butalbital:


  • Barbiturates such as butalbital pass into the breast milk and may cause drowsiness, unusually slow heartbeat, shortness of breath, or troubled breathing in nursing babies.

For acetaminophen:


  • Although acetaminophen has not been shown to cause problems in nursing babies, it passes into the breast milk in small amounts.

For caffeine:


  • Caffeine (present in some butalbital and acetaminophen combinations) passes into the breast milk in small amounts. Taking caffeine in the amounts present in these medicines has not been shown to cause problems in nursing babies. However, studies have shown that nursing babies may appear jittery and have trouble in sleeping when their mothers drink large amounts of caffeine-containing beverages. Therefore, breast-feeding mothers who use caffeine-containing medicines should probably limit the amount of caffeine they take in from other medicines or from beverages.

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 any of these medicines, 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 medicines in this class 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.


  • Adinazolam

  • Alfentanil

  • Alprazolam

  • Amobarbital

  • Anileridine

  • Anisindione

  • Aprobarbital

  • Bromazepam

  • Brotizolam

  • Butabarbital

  • Butalbital

  • Carisoprodol

  • Chloral Hydrate

  • Chlordiazepoxide

  • Chlorzoxazone

  • Clobazam

  • Clonazepam

  • Clorazepate

  • Codeine

  • Dantrolene

  • Diazepam

  • Dicumarol

  • Estazolam

  • Ethchlorvynol

  • Fentanyl

  • Flunitrazepam

  • Flurazepam

  • Halazepam

  • Hydrocodone

  • Hydromorphone

  • Ketazolam

  • Levorphanol

  • Lorazepam

  • Lormetazepam

  • Medazepam

  • Meperidine

  • Mephenesin

  • Mephobarbital

  • Meprobamate

  • Metaxalone

  • Methocarbamol

  • Methohexital

  • Midazolam

  • Morphine

  • Morphine Sulfate Liposome

  • Nitrazepam

  • Nordazepam

  • Oxazepam

  • Oxycodone

  • Oxymorphone

  • Pentobarbital

  • Phenindione

  • Phenobarbital

  • Phenprocoumon

  • Prazepam

  • Primidone

  • Propoxyphene

  • Quazepam

  • Quetiapine

  • Remifentanil

  • Secobarbital

  • Sodium Oxybate

  • Sufentanil

  • Temazepam

  • Thiopental

  • Triazolam

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.


Using medicines in this class 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 your medicine, or give you special instructions about the use of food, alcohol, or tobacco.


  • Ethanol

Other Medical Problems


The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:


  • Alcohol abuse (or history of) or

  • Drug abuse or dependence (or history of)—Dependence on butalbital may develop. Also, acetaminophen may cause liver damage in people who abuse alcohol.

  • Asthma (or history of), emphysema, or other chronic lung disease or

  • Hepatitis or other liver disease or

  • Hyperactivity (in children) or

  • Kidney disease—The chance of serious side effects may be increased.

  • Type 2 diabetes mellitus or

  • Mental depression or

  • Overactive thyroid or

  • Porphyria (or history of)—Butalbital can make these conditions worse.

  • Heart disease (severe)—The caffeine in some butalbital and acetaminophen combinations can make some kinds of heart disease worse.

Proper Use of butalbital and acetaminophen combination

This section provides information on the proper use of a number of products that contain butalbital and acetaminophen combination. It may not be specific to Fioricet. Please read with care.


Take this medicine only 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. If butalbital and acetaminophen combination is taken regularly (for example, every day), it may become habit-forming (causing mental or physical dependence). The caffeine in some butalbital and acetaminophen combinations can also increase the chance of dependence. Dependence is especially likely to occur in patients who take these medicines to relieve frequent headaches. Taking too much of this medicine may also lead to liver damage or other medical problems.


This medicine will relieve a headache best if you take it as soon as the headache begins. If you get warning signs of a migraine, take this medicine as soon as you are sure that the migraine is coming. This may even stop the headache pain from occurring. Lying down in a quiet, dark room for a while after taking the medicine also helps to relieve headaches.


People who get a lot of headaches may need to take a different medicine to help prevent headaches. It is important that you follow your doctor's directions about taking the other medicine, even if your headaches continue to occur. Headache-preventing medicines may take several weeks to start working. Even after they do start working, your headaches may not go away completely. However, your headaches should occur less often, and they should be less severe and easier to relieve than before. This will reduce the amount of headache relievers that you need. If you do not notice any improvement after several weeks of headache-preventing treatment, check with your doctor.


Dosing


The dose medicines in this class 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 these medicines. 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 forms (capsules or tablets):
    • For tension headaches:
      • Adults—One or 2 capsules or tablets every four hours as needed. If your medicine contains 325 or 500 milligrams (mg) of acetaminophen in each capsule or tablet, you should not take more than six capsules or tablets a day. If your medicine contains 650 mg of acetaminophen in each capsule or tablet, you should not take more than four capsules or tablets a day.

      • Children—Dose must be determined by your doctor.



Missed Dose


If you miss a dose of this medicine, 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


Keep out of the reach of children.


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.


Do not keep outdated medicine or medicine no longer needed.


Precautions While Using Fioricet


Check with your doctor:


  • If the medicine stops working as well as it did when you first started using it. This may mean that you are in danger of becoming dependent on the medicine. Do not try to get better pain relief by increasing the dose.

  • If you are having headaches more often than you did before you started taking this medicine. This is especially important if a new headache occurs within 1 day after you took your last dose of this medicine, headaches begin to occur every day, or a headache continues for several days in a row. This may mean that you are dependent on the medicine. Continuing to take this medicine will cause even more headaches later on. Your doctor can give you advice on how to relieve the headaches.

Check the labels of all nonprescription (over-the-counter [OTC]) or prescription medicines you now take. If any contain a barbiturate or acetaminophen, check with your health care professional. Taking them together with this medicine may cause an overdose.


The butalbital in this medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; other prescription pain medicine; narcotics; other barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Also, drinking large amounts of alcoholic beverages regularly while taking this medicine may increase the chance of liver damage, especially if you take more of this medicine than your doctor ordered or if you take it regularly for a long time. Therefore, do not drink alcoholic beverages, and check with your doctor before taking any of the medicines listed above, while you are using this medicine.


This medicine may cause some people to become drowsy, dizzy, or lightheaded. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert and clearheaded.


Before you have any medical tests, tell the person in charge that you are taking this medicine. Caffeine (present in some butalbital and acetaminophen combinations) interferes with the results of certain tests that use dipyridamole (e.g., Persantine) to help show how well blood is flowing to your heart. Caffeine should not be taken for 8 to 12 hours before the test. The results of other tests may also be affected by butalbital and acetaminophen combinations.


Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine. Serious side effects can occur if your medical doctor or dentist gives you certain medicines without knowing that you have taken butalbital.


If you have been taking large amounts of this medicine, or if you have been taking it regularly for several weeks or more, do not suddenly stop taking it without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are taking before stopping completely in order to lessen the chance of withdrawal side effects.


If you think you or anyone else may have taken an overdose of this medicine, get emergency help at once. Taking an overdose of this medicine or taking alcohol or CNS depressants with this medicine may lead to unconsciousness or possibly death. Signs of butalbital overdose include severe drowsiness, confusion, severe weakness, shortness of breath or unusually slow or troubled breathing, slurred speech, staggering, and unusually slow heartbeat. Signs of severe acetaminophen poisoning may not occur until 2 to 4 days after the overdose is taken, but treatment to prevent liver damage or death must be started within 24 hours or less after the overdose is taken.


Fioricet 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:


Rare
  • Bleeding or crusting sores on lips

  • chest pain

  • fever with or without chills

  • hive-like swellings (large) on eyelids, face, lips, and/or tongue

  • muscle cramps or pain

  • red, thickened, or scaly skin

  • shortness of breath, troubled breathing, tightness in chest, or wheezing

  • skin rash, itching, or hives

  • sores, ulcers, or white spots in mouth (painful)

Symptoms of overdose
  • Anxiety, confusion, excitement, irritability, nervousness, restlessness, or trouble in sleeping (severe, especially with products containing caffeine)

  • convulsions (seizures) (for products containing caffeine)

  • diarrhea, especially if occurring together with increased sweating, loss of appetite, and stomach cramps or pain

  • dizziness, lightheadedness, drowsiness, or weakness, (severe)

  • frequent urination (for products containing caffeine)

  • hallucinations (seeing, hearing, or feeling things that are not there)

  • increased sensitivity to touch or pain (for products containing caffeine)

  • muscle trembling or twitching (for products containing caffeine)

  • nausea or vomiting, sometimes with blood

  • ringing or other sounds in ears (for products containing caffeine)

  • seeing flashes of "zig-zag" lights (for products containing caffeine)

  • shortness of breath or unusually slow or troubled breathing

  • slow, fast, or irregular heartbeat

  • slurred speech

  • staggering

  • swelling, pain, or tenderness in the upper abdomen or stomach area

  • unusual movements of the eyes

Check with your doctor as soon as possible if any of the following side effects occur:


Less common
  • Confusion (mild)

  • mental depression

  • unusual excitement (mild)

Rare
  • Bloody or black, tarry stools

  • bloody urine

  • pinpoint red spots on skin

  • swollen or painful glands

  • unusual bleeding or bruising

  • unusual tiredness or weakness (mild

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
  • Bloated or "gassy" feeling

  • dizziness or lightheadedness (mild)

  • drowsiness (mild)

  • nausea, vomiting, or stomach pain (occurring without other symptoms of overdose)

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.



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