ClindaMax Vaginal

Generic Name: clindamycin (Vaginal route)

klin-da-MYE-sin

Commonly used brand name(s)

In the U.S.

• Cleocin Vaginal


• ClindaMax


• Clindesse

Available Dosage Forms:

• Suppository


• Cream

Therapeutic Class: Antibiotic

Chemical Class: Lincosamide

Uses For ClindaMax

Clindamycin is used to treat certain vaginal infections. It works by killing the bacteria. This medicine will not work for vaginal fungus or yeast infections.

Clindamycin is available only with your doctor's prescription.

Before Using ClindaMax

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of vaginal clindamycin in children with use in other age groups.

Geriatric

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 vaginal clindamycin in the elderly with use in other age groups.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	B	Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, 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 this medicine 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.

• Erythromycin

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Atracurium


• Metocurine


• Tubocurarine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

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

• Stomach or intestinal disease, history of (especially colitis, including colitis caused by antibiotics, or enteritis)—Patients with a history of stomach or intestinal disease may have an increased chance of side effects including diarrhea

Proper Use of clindamycin

This section provides information on the proper use of a number of products that contain clindamycin. It may not be specific to ClindaMax. Please read with care.

Wash your hands before and after using this medicine.

Avoid getting this medicine in your eyes. If this medicine does get into your eyes, rinse them immediately with large amounts of cool tap water. If your eyes still burn or are painful, check with your doctor.

Vaginal clindamycin usually comes with patient directions. Read them carefully before using this medicine.

Use clindamycin vaginal cream exactly as directed by your doctor.

• To fill the applicator if you are not using a pre-filled applicator
  
  • Remove cap from the tube.
  
  
  • Screw one of the applicators onto the tube. Always use a new applicator. Never use one that has been used before.
  
  
  • Squeeze the medicine into the applicator slowly until it is full.
  
  
  • Remove the applicator from the tube. Replace the cap on the tube.
  
  


• To insert the vaginal cream using the applicator
  
  • Relax while lying on your back with your knees bent.
  
  
  • Hold the full applicator in one hand. Insert it slowly into the vagina. Stop before it becomes uncomfortable.
  
  
  • Slowly press the plunger until it stops.
  
  
  • Withdraw the applicator. The medicine will be left behind in the vagina.
  
  


• To care for the applicator
  
  • Throw the applicator away after you use it.
  
  

To help clear up your infection completely, it is very important that you keep using this medicine for the full time of treatment , even if your symptoms begin to clear up after a few days. If you stop using this medicine too soon, your symptoms may return. Do not miss any doses. Also, continue using this medicine even if your menstrual period starts during the time of treatment .

Dosing

The dose of this medicine 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 this medicine. 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 vaginal cream dosage form:
  
  • For bacterial vaginosis:
    
    • Adults and teenagers who are not pregnant—One applicatorful (100 milligrams [mg]) inserted into the vagina once a day, usually at bedtime, for three or seven days.
    
    
    • Adults and teenagers who are pregnant—One applicatorful (100 milligrams [mg]) inserted into the vagina once a day, usually at bedtime, for seven days.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  


• For vaginal cream prefilled applicator dosage form:
  
  • For bacterial vaginosis:
    
    • Adults and teenagers—One applicatorful (100 milligrams [mg]) inserted into the vagina one time at any time of the day. This is a one-day treatment.
    
    
    • Children—Use and 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

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using ClindaMax

If your symptoms do not improve within a few days, or if they become worse, check with your doctor.

It is important that you visit your doctor after you have used all your medicine to make sure that the infection is gone.

This medicine may cause some people to become dizzy. 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.

It is important that you tell your doctor right away if diarrhea occurs while you are using this medicine or after you have finished your treatment. It could be a symptom of a serious condition that your doctor will need to diagnose and treat.

Vaginal medicines usually leak out of the vagina during treatment. To keep the medicine from getting on your clothing, wear a minipad or sanitary napkin. Do not use tampons since they may soak up the medicine.

To help clear up your infection completely and make sure it does not return, good health habits are also required.

• Wear cotton panties (or panties or pantyhose with cotton crotches) instead of synthetic (for example, nylon or rayon) panties.


• Wear only freshly washed panties daily.

Do not have sexual intercourse while you are using this medicine. Having sexual intercourse may reduce the strength of the medicine. This may cause the medicine to not work as well.

Do not use latex (rubber) contraceptive products such as condoms, diaphragms, or cervical caps for 72 hours after stopping treatment with vaginal clindamycin cream. The cream contains oils that weaken or harm the latex products, causing them to not work properly to prevent pregnancy. If you have any questions about this, check with your health care professional.

ClindaMax 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 as soon as possible if any of the following side effects occur:

More common

• Itching of the vagina or genital area


• pain during sexual intercourse


• thick, white vaginal discharge with no odor or with mild odor

Less common

• Diarrhea


• dizziness


• headache


• nausea or vomiting


• stomach pain or cramps

Rare

• Burning, itching, rash, redness, swelling or other signs of skin problems not present before use of this medicine

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

• Itching of the vagina or genital area


• pain during sexual intercourse


• thick, white vaginal discharge with no odor or with mild odor

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.

See also: ClindaMax Vaginal side effects (in more detail)

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More ClindaMax Vaginal resources

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

Compare ClindaMax Vaginal with other medications

• Bacterial Vaginitis

Eludril Mouthwash

1. Name Of The Medicinal Product

ELUDRIL mouthwash

2. Qualitative And Quantitative Composition

Actives :	Quantity :	Unit :
Chlorhexidine digluconate	0.100	% W/V
Chlorobutanol	0.500	% W/V

Each 1 ml contains chlorhexidine digluconate solution 0.005 ml (corresponding to 1 mg chlorhexidine digluconate).

The content of chlorhexidine digluconate per ml when diluted as recommended is 0.22 mg/ml – 0.33 mg/ml.

Each ml contains 5 mg of chlorobutanol.

The content of chlorobutanol per ml when diluted as recommended is 1.11 mg/ml – 1.66 mg/ml.

Excipients:Methyl parahydroxybenzoate (E218), Propyl parahydroxybenzoate (E216)

For a full list of excipients, see section 6.1.

3. Pharmaceutical Form

Mouthwash.

Clear colourless Oromucosal solution.

4. Clinical Particulars

4.1 Therapeutic Indications

Eludril mouthwash is an antibacterial solution which inhibits dental plaque formation. It is indicated as an aid in the treatment and prevention of gingivitis, and in maintaining oral hygiene, particularly in situations where toothbrushing is difficult to carry out (eg following oral surgery or in physically or mentally-handicapped patients). It is valuable in the management of aphtous ulceration and oral candidal infections (eg denture stomatitis and thrush) and can be used as an adjuvant treatment for minor infections of the throat.

As a disinfectant solution for the cleansing of removable dentures.

4.2 Posology And Method Of Administration

Eludril is contraindicated in infants and children under six years of age: see section 4.3.

1. As a mouthwash, dilute 10 to 15 ml in the measuring-cup provided for this purpose and fill with lukewarm water to the upper line and use as a mouthwash or a gargle two or three times a day.

2. As a disinfectant for removable dentures, prepare a 1 in 3 dilution of Eludril with water. The dentures previously cleansed should be soaked in the solution for one hour.

Route of administration

Oromucosal use. (This product is not intended to be swallowed)

4.3 Contraindications

- Hypersensitivity to the active substances or to any of the excipients.

- Use in infants and children less than 6 years of age.

- Use with anionic agents (see section 4.5).

4.4 Special Warnings And Precautions For Use

Warnings

For oral use only

Do not swallow

Keep out of the eyes and ears. If the mouthwash comes into contact with the eyes or ears, wash out promptly and thoroughly with water.

Discoloration of the tongue, teeth and silicate or composite restorations may occur. This stain is not permanent and can largely be prevented by brushing with a conventional toothpaste daily before using the mouthwash or, in the case of dentures cleansing with a conventional cleanser: see sections 4.5, 4.8.

In case of soreness, swelling or irritation of the mouth, stop using the product and consult a healthcare professional: see section 4.8

This medicine contains methyl parahydroxybenzoate (E218) and propyl parahydroxybenzoate (E218) which may cause allergic reactions.

Precautions for use

Chlorhexidine is an irritant and should be used with caution. If there is evidence of irritation or aggravation of the condition, a doctor or dentist should be consulted.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

Chlorhexidine is incompatible with anionic agents which are usually present in conventional toothpastes. Therefore, thorough rinsing of the mouth with water, after toothbrushing with toothpaste, should be done before using this medicine: see section 4.3. A short time should elapse between using the two products.

4.6 Pregnancy And Lactation

There is no evidence of any adverse effects in infants arising from the use of Eludril mouthwash during pregnancy or lactation.

Therefore no special precautions are recommended.

4.7 Effects On Ability To Drive And Use Machines

No studies on the effects on the ability to drive and use machines have been performed.

4.8 Undesirable Effects

Body System	Adverse Reactions (frequency not known)
Immune system disorders	Anaphylactic shock, anaphylactic reaction, hypersensitivity
Nervous system disorders	-Dysgeusia: transient disturbance of taste sensation -Mucosal burning sensation: burning sensation of the tongue. These effects may occur on initial use of the product and usually diminish with continued use.
Gastrointestinal disorders	-Tongue discoloration: Superficial discoloration of the dorsum of the tongue, reversible after discontinuing treatment: see section 4.4. -Teeth discoloration: Discoloration of the teeth and silicate or composite restorations: see section 4.4. -Parotid gland enlargement: swelling of the parotid glands reversible after discontinuing treatment. - Oral desquamation: In cases where oral desquamation occurs dilution of 10ml of the mouthwash with water to the upper line of the measuring cup will often allow continued use of the mouthwash

4.9 Overdose

Overdose is not expected under normal conditions of use of this solution as a mouthwash (normal dilution conditions for 10 ml is 7.4 %v/v and for 15 ml is 11.1 %v/v.). However, due to the undiluted product alcohol content (33.25 % v/v) accidental ingestion of large amounts by children requires prompt medical attention for appropriate action.

Symptoms

Chlorhexidine when taken orally is poorly absorbed. Most patients will develop very few symptoms. Local effects like burning sensation in the mouth and throat may occur. Systemic effects are unlikely if large volumes are ingested. However, large amounts may cause digestive disorders (epigastric pain, diarrhoea) and if chlorhexidine passes into the general system, signs of neurological toxicity may develop.

Emergency procedures

- Do not attempt to empty the stomach

- Administration of milk, water to drink, raw egg, gelatin or mild soap may be advisable provided the airway can be protected.

- General supportive measures should be instituted as deemed necessary by the physician.

5. Pharmacological Properties

5.1 Pharmacodynamic Properties

Pharmacotherapeutic group: Anti-infectives and antiseptics for local oral treatment.

ATC code: A01AB03.

CHLORHEXIDINE : broad-spectrum antibacterial (gram + and gram -) and anti-fungal product with extended bactericidal activity on buccal mucosa.

CHLOROBUTANOL: local anaesthetic providing a quick relief from pain, bacteriostatic reinforcing the activity of chlorhexidine.

5.2 Pharmacokinetic Properties

CHLORHEXIDINE:

Oral:Very weak systemic absorption, distribution mainly via liver and kidneys; little metabolism (no degradation of the molecule). Elimination mainly in faeces (99.5 % of the ingested dose).

Permucosal absorption: negligible. Distribution, metabolism and elimination same as oral route

CHLOROBUTANOL:

Systemic absorption after oral administration. Half-life of 9 to 10 days.

5.3 Preclinical Safety Data

No information further to that contained in other sections of the SPC is included.

6. Pharmaceutical Particulars

6.1 List Of Excipients

Poloxamer

Alcohol

Sorbitol solution 70 % (crystallising)

Menthol

Methyl parahydroxybenzoate (E218)

Propyl parahydroxybenzoate (E216)

Peppermint spirit

Purified Water

6.2 Incompatibilities

See section 4.5

6.3 Shelf Life

Unopened: 3 years

6.4 Special Precautions For Storage

Store away from light,

Store at a temperature of 25°C maximum.

6.5 Nature And Contents Of Container

Clear glass bottle with aluminium cap and a measuring cup.

Pack sizes: 90ml, 250ml and 500ml.

Not all pack sizes may be marketed.

6.6 Special Precautions For Disposal And Other Handling

No special requirements

7. Marketing Authorisation Holder

PIERRE FABRE LIMITED

Hyde Abbey House

23 Hyde Street

Winchester

Hampshire

SO23 7DR

UNITED KINGDOM

8. Marketing Authorisation Number(S)

PL 00603/0012R

9. Date Of First Authorisation/Renewal Of The Authorisation

Date of first authorisation: 9^th August 1973

Date of last renewal: 16^th April 2007

10. Date Of Revision Of The Text

27/01/2011

Kapake 15mg / 500mg Tablets.

1. Name Of The Medicinal Product

Kapake 15mg/500mg Tablets.

2. Qualitative And Quantitative Composition

	mg per tablet
Paracetamol	500.0mg
(as Paracetamol DC 96% and Povidone 4%)
Codeine Phosphate Hemihydrate	15.0mg

For a full list of excipients, see Section 6.1

3. Pharmaceutical Form

Tablet.

Oblong, white uncoated tablets marked 'K1' both sides of a score line on one side, the other side is plain and unmarked. The score line is only to facilitate breaking for ease of swallowing and not to divide into equal doses.

4. Clinical Particulars

4.1 Therapeutic Indications

For the relief of moderate pain.

4.2 Posology And Method Of Administration

For oral administration.

Adults and children aged 16 and over:

Two tablets to be taken every four hours as required, up to a maximum of eight tablets in any 24-hour period.

Children aged 12 to 15 years:

One tablet to be taken every four hours as required, up to a maximum of four tablets in any 24-hour period.

Children under 12 years:

Not recommended for children under 12 years of age.

Elderly:

The adult dose is appropriate (please refer to Section 4.4 for additional information on elderly patients).

4.3 Contraindications

Kapake 15mg/500mg Tablets should not be used in patients hypersensitive to codeine phosphate, paracetamol or any of the other ingredients. This product is contraindicated in patients with raised intracranial pressure or head injury, respiratory depression, acute asthma and acute alcoholism. Kapake 15mg/500mg Tablets are also contraindicated in patients receiving monoamine oxidase inhibitors or who have received these agents within the previous two weeks. It is not recommended for children under 12 years of age.

4.4 Special Warnings And Precautions For Use

Codeine is partially metabolised by CYP2D6. If a patient has a deficiency or is completely lacking this enzyme they will not obtain adequate analgesic effects. Estimates indicate that up to 7% of the caucasian population may have this deficiency. However, if the patient is an ultra-rapid metaboliser there is an increased risk of developing side effects of opioid toxicity even at low doses. General symptoms of opioid toxicity include nausea, vomiting, constipation, lack of appetite and somnolence. In severe cases this may include symptoms of circulatory and respiratory depression. Estimates indicate that up to 1 to 2% of the caucasian population may be ultra-rapid metabolisers.

Kapake 15mg/500mg Tablets should be used with caution in the elderly and debilitated as these patients may be more sensitive to the effects of opioids, those with prostatic hypertrophy, inflammatory or obstructive bowel disorders or Addison's disease. Care is advised in the administration of paracetamol to patients with severe renal or severe hepatic impairment. The hazards of overdose are greater in those with non-cirrhotic alcoholic liver disease. Dependence of the morphine type may be produced especially with prolonged use of high doses of codeine.

Prolonged regular use, except under medical supervision, may lead to physical and psychological dependence (addiction) and result in withdrawal symptoms such as restlessness and irritability, once the drug is stopped.

The risk-benefit of continued use should be assessed regularly by the prescriber.

Immediate medical advice should be sought in the event of an overdose, even if the patient feels well, because of the risk of delayed serious liver damage. Patients should be advised not to take other paracetamol- or codeine-containing products concurrently.

The leaflet will state in a prominent position in the 'before taking' section:

• Do not take for longer than directed by your prescriber

• Taking codeine regularly for a long time can lead to addiction, which might cause you to feel restless and irritable when you stop the tablets

• Taking a painkiller for headaches too often or for too long can make them worse.

The label will state (to be displayed prominently on outer pack – not boxed):

• Do not take for longer than directed by your prescriber as taking codeine regularly for a long time can lead to addiction.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

The depressant effects of codeine may be enhanced by other central nervous system depressants: anxiolytics, hypnotics, antidepressants, antipsychotics and alcohol. If combined therapy is necessary, the dose of one or both agents should be reduced. Alcohol should be avoided.

The speed of absorption of paracetamol may be increased by metoclopramide or domperidone and absorption reduced by colestyramine.

The anticoagulant effect of warfarin and other coumarins may be enhanced by prolonged regular use of paracetamol with increased risk of bleeding; occasional doses have no significant effect.

4.6 Pregnancy And Lactation

This product should not be used during pregnancy.

At normal therapeutic doses codeine and its active metabolites may be present in breast milk at very low doses and is unlikely to adversely affect the breast fed infant.

However, if the patient is an ultra-rapid metaboliser of CYP2D6, higher levels of the active metabolites may be present in breast milk and on very rare occasions may result in symptoms of opioid toxicity in the infant.

If symptoms of opioid toxicity develop in either the mother or the infant, then all codeine containing medicines should be stopped and alternative non-opioid analgesics prescribed. In severe cases consideration should be given to prescribing naloxone to reverse these effects.

4.7 Effects On Ability To Drive And Use Machines

Kapake 15mg/500mg may impair mental and/or physical abilities, therefore it may affect the ability to drive and operate machinery.

4.8 Undesirable Effects

The following undesirable effects have been reported following the use of paracetamol: blood dyscrasias including thrombocytopenia and agranulocytosis, but these were not necessarily causally related to paracetamol. Hypersensitivity, including skin rash, may also occur.

The following undesirable effects have been reported following the use of codeine: nausea, vomiting, dizziness and drowsiness. These effects are more likely to be experienced by the ambulatory patient and thus may be alleviated if the patient lies down. Other side effects of codeine, which may occur, include bradycardia, miosis, constipation, abdominal pain (rarely codeine-induced pancreatitis has been reported in patients with a history of cholecystectomy), allergic reactions, light-headedness, confusion, euphoria, dysphoria, urinary retention, and pruritus.

Regular prolonged use of codeine is known to lead to addiction and tolerance. Symptoms of restlessness and irritability may result when treatment is then stopped.

Prolonged use of a painkiller for headaches can make them worse.

4.9 Overdose

Paracetamol Overdose

Liver damage is possible in adults who have taken 10g or more of paracetamol. Ingestion of 5g or more of paracetamol may lead to liver damage if the patient has risk factors (see below).

Risk factors

If the patient

(a) Is on long term treatment with carbamazepine, phenobarbitone, phenytoin, primidone, rifampicin, St John's Wort or other drugs that induce liver enzymes, or

(b) Regularly consumes ethanol in excess of recommended amounts, or

(c) Is likely to be glutathione deplete, e.g. eating disorders, cystic fibrosis, HIV infection, starvation, cachexia.

Symptoms of Paracetamol Overdose

Symptoms of paracetamol overdosage in the first 24 hours are pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may become apparent 12 to 48 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur. In severe poisoning, hepatic failure may progress to encephalopathy, haemorrhage, hypoglycaemia, cerebral oedema, and death. Acute renal failure with acute tubular necrosis, strongly suggested by loin pain, haematuria and proteinuria, may develop even in the absence of severe liver damage. Cardiac arrhythmias and pancreatitis have been reported.

Management of Paracetamol Overdose

Immediate treatment is essential in the management of paracetamol overdose. Despite a lack of significant early symptoms, patients should be referred to hospital urgently for immediate medical attention. Symptoms may be limited to nausea or vomiting and may not reflect the severity of overdose or the risk of organ damage. Management should be in accordance with established treatment guidelines.

Treatment with activated charcoal should be considered if the overdose has been taken within one hour. Plasma paracetamol concentration should be measured at 4 hours or later after ingestion (earlier concentrations are unreliable). Treatment with N-acetylcysteine may be used up to 24 hours after ingestion of paracetamol, however, the maximum protective effect is obtained up to 8 hours post-ingestion. The effectiveness of the antidote declines sharply after this time. If required the patient should be given intravenous N-acetylcysteine, in line with the established dosage schedule. If vomiting is not a problem, oral methionine may be a suitable alternative for remote areas, outside hospital. Management of patients who present with serious hepatic dysfunction beyond 24 hours from ingestion should be discussed with the National Poisons Information Centre (NPIC) or a liver unit.

Codeine Overdose

The effects in overdosage will be potentiated by simultaneous ingestion of alcohol and psychotropic drugs.

Symptoms of Codeine Overdose

Central nervous system depression, including respiratory depression, may develop but is unlikely to be severe unless other sedative agents have been co-ingested, including alcohol, or the overdose is very large. The pupils may be pin-point in size; nausea and vomiting are common. Hypotension and tachycardia are possible but unlikely.

Management of Codeine Overdose

This should include general symptomatic and supportive measures including a clear airway and monitoring of vital signs until stable. Consider activated charcoal if an adult presents within one hour of ingestion of more than 350mg or a child more than 5mg/kg.

Give naloxone if coma or respiratory depression is present. Naloxone is a competitive antagonist and has a short half-life so large and repeated doses may be required in a seriously poisoned patient. Observe for at least four hours after ingestion, or eight hours if a sustained release preparation has been taken.

5. Pharmacological Properties

5.1 Pharmacodynamic Properties

Pharmacotherapeutic Group: Paracetamol, combinations, excluding psycholeptics ATC Code: N02B E51

Paracetamol has analgesic and antipyretic effects that do not differ significantly from those of aspirin. Its anti-inflammatory action is weak and it has practically no anti-platelet effect. The mechanism of action is unclear, although it is believed to exert its action by inhibition of prostaglandin synthesis.

Codeine is an analgesic with uses similar to those of morphine, although it is much less potent as an analgesic and has only mild sedative effects. It is used for the relief of cough and pain. Codeine has a low affinity for opioid receptors, the analgesic effect of codeine may be due to its conversion to morphine; approximately 10% of administered codeine is demethylated to form morphine.

5.2 Pharmacokinetic Properties

Paracetamol is readily absorbed from the gastrointestinal tract with peak plasma concentrations occurring about 30 minutes to two hours after oral administration. 90-100% of administered drug can be recovered in the urine within the first day. Practically none is excreted unchanged, most is conjugated in the liver with glucuronic acid or sulphuric acid.

Codeine and its salts are absorbed rapidly from the gastrointestinal tract with peak plasma levels occurring about one hour after oral administration. Codeine is metabolised in the liver and excreted in the urine mainly as a conjugate of glucuronic acid. Approximately 10% of administered codeine is demethylated to form morphine.

Concurrent administration of both drugs does not interfere with the normal metabolic processes of each agent.

5.3 Preclinical Safety Data

There are no findings of relevance to the prescriber other than those already mentioned elsewhere in the SPC.

6. Pharmaceutical Particulars

6.1 List Of Excipients

Microcrystalline Cellulose

Magnesium Stearate

Sodium Starch Glycolate

Povidone

6.2 Incompatibilities

Not applicable.

6.3 Shelf Life

Three years.

6.4 Special Precautions For Storage

This medicinal product does not require any special storage conditions.

6.5 Nature And Contents Of Container

PVC/ aluminium blisters.

Pack sizes: 4, 30 and 100 tablets. Not all pack sizes may be marketed.

6.6 Special Precautions For Disposal And Other Handling

No special requirements.

7. Marketing Authorisation Holder

Galen Limited

Seagoe Industrial Estate

Craigavon

BT63 5UA

UK

8. Marketing Authorisation Number(S)

PL 27827/0011

9. Date Of First Authorisation/Renewal Of The Authorisation

13 July 2010

10. Date Of Revision Of The Text

03 August 2011

Tritane

Generic Name: trihexyphenidyl (Oral route)

trye-hex-ee-FEN-i-dil

Commonly used brand name(s)

In the U.S.

• Artane


• Trihexane


• Tritane

Available Dosage Forms:

• Tablet


• Capsule, Extended Release


• Elixir

Therapeutic Class: Antiparkinsonian

Pharmacologic Class: Anticholinergic

Uses For Tritane

Trihexyphenidyl is used alone or together with other medicines (e.g., levodopa) to treat Parkinson's disease. By improving muscle control and reducing stiffness, this medicine allows more normal movements of the body as the disease symptoms are reduced.

Trihexyphenidyl is also used to control severe muscle reactions and other side effects from certain medicines that are used to treat severe nausea or nervous, mental, or emotional conditions (e.g., haloperidol [Haldol®], loxapine [Loxitane®], prochlorperazine [Compazine®], promethazine [Phenergan®], thiothixene [Navane®]).

This medicine is available only with your doctor's prescription.

Before Using Tritane

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

No information is available on the relationship of age to the effects of trihexyphenidyl in the pediatric population. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of trihexyphenidyl in geriatric patients. However, elderly men are more likely to have age-related prostate problems, and all elderly patients are more likely to have age-related kidney, liver, or heart problems. These conditions may require caution or an adjustment in the dose for patients receiving trihexyphenidyl.

Breast Feeding

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

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 this medicine, 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 this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Potassium

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Betel Nut


• Chlorpromazine


• Haloperidol


• Perphenazine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

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

• Bowel or stomach blockage or


• Enlarged prostate or


• Glaucoma or


• Hypertension (high blood pressure) or


• Urinary blockage—Use with caution. May make these conditions worse.

• Kidney disease or


• Liver disease—Use with caution. Effects may be increased because of slower removal of the medicine from the body.

Proper Use of trihexyphenidyl

This section provides information on the proper use of a number of products that contain trihexyphenidyl. It may not be specific to Tritane. Please read with care.

Take this medicine every day exactly as ordered by your doctor in order to improve your condition as much as possible. 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.

You may take this medicine before or after food, although it is usually taken with meals.

Dosing

The dose of this medicine 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 this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (elixir or tablets):
  
  • For Parkinson's disease:
    
    • Adults—At first, 1 milligram (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 15 mg per day, given in divided doses 3 or 4 times per day.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  
  • For side effects caused by other medicines:
    
    • Adults—5 to 15 milligrams (mg) per day, given in divided doses 3 or 4 times per day.
    
    
    • Children—Use and 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

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Tritane

It is important that your doctor check your progress at regular visits to allow changes in your dose and to check for any unwanted effects.

Before using this medicine, your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor). Trihexyphenidyl may increase your risk of having glaucoma. Check with your doctor right away if you have blurred vision or any change in vision while taking this medicine.

Trihexyphenidyl may cause dryness of the mouth, nose, and throat. For temporary relief of mouth dryness, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Tritane 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

• Abdominal or stomach cramps or pain


• bloating


• constipation


• delusions of persecution, mistrust, suspiciousness, or combativeness


• excessive dryness of the mouth


• false beliefs that cannot be changed by facts


• loss of appetite


• nausea or vomiting


• seeing, hearing, or feeling things that are not there


• skin rash


• stomach pain


• swollen, painful, or tender lymph glands on the side of the face or neck

Incidence not known

• Anxiety


• blurred vision


• change in vision


• decrease in frequency of urination


• decrease in urine volume


• difficult urination


• difficulty in passing urine (dribbling)


• disturbed behavior


• dry mouth


• enlarged pupils


• eye pain


• fast, pounding, or irregular heartbeat or pulse


• hyperventilation


• irritability


• loss of vision


• mental confusion


• nervousness


• painful urination


• restlessness


• shaking


• shortness of breath


• trouble sleeping

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

• Dizziness


• mild nausea


• nervousness

Incidence not known

• Drowsiness


• weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Tritane side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Tritane resources

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

Compare Tritane with other medications

• Cerebral Spasticity
• Extrapyramidal Reaction
• Parkinson's Disease

cloxacillin

Generic Name: cloxacillin (klox a SILL in)

Brand Names: Cloxapen, Tegopen

What is cloxacillin?

Cloxacillin is an antibiotic in the class of drugs called penicillins. It fights bacteria in your body.

Cloxacillin is used to treat many different types of infections caused by staphylococcus bacteria ("staph" infections).

Cloxacillin may also be used for purposes other than those listed in this medication guide.

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

Take all of the cloxacillin that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated. Do not break, chew, open, or crush the capsules. Swallow them whole. Cloxacillin may decrease the effectiveness of birth control pills. Use a second method of birth control while taking cloxacillin to protect against pregnancy.

Who should not take cloxacillin?

If you have ever had an allergic reaction to another penicillin or to a cephalosporin, do not take cloxacillin unless your doctor is aware of your allergy and monitors your therapy.

Before taking this medication, tell your doctor if you have kidney disease, stomach or intestinal disease, or infectious mononucleosis. You may not be able to take cloxacillin because of an increased risk of side effects.

If you are a diabetic, some glucose urine tests may give false positive results while you are taking cloxacillin.

Cloxacillin is in the FDA pregnancy category B. This means that it is unlikely to harm an unborn baby. Do not, however, take cloxacillin without first talking to your doctor if you are pregnant. It is not known whether cloxacillin passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take cloxacillin?

Take cloxacillin exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Take cloxacillin on an empty stomach 1 hour before or 2 hours after meals.

Do not drink juice or carbonated beverages (soda) with your dose of cloxacillin. These beverages will decrease the effectiveness of the drug.

Cloxacillin should be taken at evenly spaced intervals throughout the day and night to keep the level in your blood high enough to treat the infection.

Do not crush, chew, or open the capsules. Swallow them whole. Shake the suspension well before measuring a dose. To ensure that you get a correct dose, measure the liquid form of cloxacillin with a dose-measuring spoon or cup, not a regular tablespoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. Take all of the cloxacillin that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated. Store the capsules at room temperature and store the suspension in the refrigerator for longer use. The suspension is good for 14 days if it is stored in the refrigerator. Throw away any unused liquid after this amount of time.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and take only your next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor.

If you have only missed one dose, you can take the rest of your scheduled doses for the day at evenly spaced intervals.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of an cloxacillin overdose include muscle spasms or weakness, pain or twitching, pain in the fingers or toes, loss of feeling in the fingers or toes, seizures, confusion, coma, and agitation.

What should I avoid while taking cloxacillin?

Alcohol may irritate your stomach if taken with cloxacillin, so use it with moderation.

Cloxacillin side effects

If you experience any of the following serious side effects, stop taking cloxacillin and seek emergency medical attention:

• 
  

  an allergic reaction (shortness of breath; closing of your throat; hives; swelling of your lips, face, or tongue; rash; or fainting);

  
  


• 
  

  seizures;

  
  


• 
  

  severe watery diarrhea and abdominal cramps; or

  
  


• 
  

  unusual bleeding or bruising.

  
  

Other, less serious side effects maybe more likely to occur. Continue to take cloxacillin and talk to your doctor if you experience

• 
  

  mild nausea, vomiting, diarrhea, or abdominal pain;

  
  


• 
  

  white patches on the tongue (thrush/yeast infection);

  
  


• 
  

  itching or discharge of the vagina (vaginal yeast infection); or

  
  


• 
  

  black, "hairy" tongue or sore mouth or tongue.

  
  

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Cloxacillin Dosing Information

Usual Adult Dose for Upper Respiratory Tract Infection:

250 mg orally every 6 hours for 7 to 14 days, depending on the nature and severity of the infection.

Maximum dose: 4 g/day.

Usual Adult Dose for Pneumonia:

500 mg orally every 6 hours for up to 21 days, depending on the nature and severity of the infection.

Maximum dose: 4 g/day.

Usual Adult Dose for Skin and Structure Infection:

500 mg orally every 6 hours for 7 days, or until 3 days after acute inflammation resolves, depending on the nature and severity of the infection.

Maximum dose: 4 g/day.

Usual Adult Dose for Cystitis:

250 mg orally every 6 hours for 3 to 7 days, depending on the nature and severity of the infection. Cloxacillin is rarely indicated for the treatment of cystitis.

Maximum dose: 4 g/day.

Usual Pediatric Dose for Pneumonia:

The safety and efficacy of cloxacillin in children
>= 1 year to 18 years: 50 to 100 mg/kg/day orally divided every 6 hours.

Maximum dose: 4 g/day.

Usual Pediatric Dose for Upper Respiratory Tract Infection:

The safety and efficacy of cloxacillin in children
>= 1 year to 18 years: 50 to 100 mg/kg/day orally divided every 6 hours.

Maximum dose: 4 g/day.

Usual Pediatric Dose for Skin and Structure Infection:

The safety and efficacy of cloxacillin in children
>= 1 year to 18 years: 50 to 100 mg/kg/day orally divided every 6 hours.

Maximum dose: 4 g/day.

What other drugs will affect cloxacillin?

Some drugs may decrease the effects of cloxacillin and prevent it from properly treating your infection. Before taking cloxacillin, tell your doctor if you are taking any of the following drugs:

• 
  

  cholestyramine (Questran) or colestipol (Colestid); or

  
  


• 
  

  another antibiotic (for the same or for a different infection) such as erythromycin (Ery-Tab, E-Mycin, E.E.S., others), tetracycline (Sumycin, others), minocycline (Minocin), doxycycline (Doryx, Vibramycin, others), or any other.

  
  

Cloxacillin may decrease the effectiveness of birth control pills. Use a second method of birth control while taking cloxacillin to protect against pregnancy.

Cloxacillin increases the effects of methotrexate, and you may need a dose adjustment during therapy with cloxacillin.

Cloxacillin also increases the side effects of allopurinol (Zyloprim) and may cause a rash.

Probenecid (Benemid) increases the effects of cloxacillin. These drugs may be used together for this purpose; however, be sure your doctor is aware if you are taking probenecid. You may need a lower dose of cloxacillin.

Drugs other than those listed here may also interact with cloxacillin. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

More cloxacillin resources

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

• Cloxapen Advanced Consumer (Micromedex) - Includes Dosage Information

Compare cloxacillin with other medications

• Bladder Infection
• Pneumonia
• Skin and Structure Infection
• Upper Respiratory Tract Infection

Where can I get more information?

• Your pharmacist has additional information about cloxacillin written for health professionals that you may read.

What does my medication look like?

Cloxacillin is available generically and with a prescription in 250 and 500 mg capsules and in a suspension formulation of 120 mg per 5 mL (1 teaspoon). Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

See also: cloxacillin side effects (in more detail)

Knee Joint Replacement Medications

There are currently no drugs listed for "Knee Joint Replacement".

Definition of Knee Joint Replacement: Knee joint replacement is surgery to replace a painful damaged or diseased knee joint with an artificial joint (prosthesis).

Learn more about Knee Joint Replacement

Medical Encyclopedia:

• Knee joint replacement

Drug List:

sulfinpyrazone

Generic Name: sulfinpyrazone (sul fin PEER a zone)

Brand Names: Anturane

What is sulfinpyrazone?

Sulfinpyrazone reduces the amount of uric acid in your body by causing more uric acid to be passed out in your urine. Sulfinpyrazone also has other effects in the body that are important in the treatment of gout.

Sulfinpyrazone is used to treat gout and gouty arthritis.

Sulfinpyrazone may also be used for purposes other than those listed in this medication guide.

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

To reduce the risk that kidney stones will form, drink at least 8 to 10 full glasses (8 ounces) of fluid every day, unless your doctor tells you not to. Take sulfinpyrazone with food, milk, or an antacid to lessen stomach upset. Do not take aspirin, salsalate (Disalcid), magnesium salicylate (Magan, Doan's), choline and magnesium salicylate (Trilisate), or other aspirin-like products without the approval of your doctor. These products decrease the effects of sulfinpyrazone. Taking one aspirin a day to reduce the risk of a heart attack is usually acceptable. Talk to your doctor.

Who should not take sulfinpyrazone?

Before taking this medication, tell your doctor if you

• 
  

  have ever had an allergic reaction to sulfinpyrazone,

  
  


• 
  

  have kidney disease or poorly functioning kidneys,

  
  


• 
  

  have kidney stones,

  
  


• 
  

  have an ulcer in your stomach,

  
  


• 
  

  have blood problems, or

  
  


• 
  

  are on high-dose aspirin or salicylate therapy.

  
  

Sulfinpyrazone is in the FDA pregnancy category C. This means that it is not known whether sulfinpyrazone will harm an unborn baby. Do not take sulfinpyrazone without first talking to your doctor if you are pregnant. It is also not known whether sulfinpyrazone passes into breast milk. Do not take sulfinpyrazone without first talking to your doctor if you are breast-feeding a baby.

How should I take sulfinpyrazone?

Take sulfinpyrazone exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose of sulfinpyrazone with a full glass of water. Also, to reduce the risk that kidney stones will form, drink at least 8 to 10 full glasses (8 ounces) of fluid every day, unless your doctor tells you not to. Take sulfinpyrazone with food, milk, or an antacid to lessen stomach upset. If nausea, vomiting, or loss of appetite is severe or persistent, consult your doctor.

Do not stop taking this medication without the approval of your doctor.

Store sulfinpyrazone at room temperature away from moisture and heat.

See also: Sulfinpyrazone dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a sulfinpyrazone overdose include nausea, vomiting, diarrhea, stomach pain, poor coordination, difficulty breathing, seizures, and coma. An overdose of sulfinpyrazone can result in death.

What should I avoid while taking sulfinpyrazone?

Do not take aspirin, salsalate (Disalcid), magnesium salicylate (Magan, Doan's), choline and magnesium salicylate (Trilisate), or other aspirin-like products unless your doctor approves. These products decrease the effects of sulfinpyrazone. Taking one aspirin a day to reduce the risk of a heart attack is usually acceptable.

Follow your doctor's recommendations about diet.

Sulfinpyrazone side effects

Stop taking sulfinpyrazone and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).

Other, less serious side effects may be more likely to occur. Heartburn, nausea, and upset stomach are the most common side effects of sulfinpyrazone therapy. Take each dose with food, milk, or an antacid to decrease these side effects.

Contact your doctor as soon as possible if you experience an acute attack of gouty arthritis.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Sulfinpyrazone Dosing Information

Usual Adult Dose for Gouty Arthritis:

Initial: 200 to 400 mg orally given in 2 equally divided doses, with meals or milk, gradually increasing when necessary to full maintenance dosage in 1 week.

Maintenance: 400 mg daily in 2 equally divided doses; may increase to 800 mg daily or reduce to as low as 200 mg daily after the blood urate level has been controlled. Continue treatment without interruption even in the presence of acute exacerbations, which can be concomitantly treated with colchicine. Patients previously controlled with other uricosuric therapy may be transferred to sulfinpyrazone at full maintenance dosage.

What other drugs will affect sulfinpyrazone?

Do not take aspirin, salsalate (Disalcid), magnesium salicylate (Magan, Doan's), choline and magnesium salicylate (Trilisate), or other aspirin-like products unless your doctor approves. These products decrease the effects of sulfinpyrazone. Taking one aspirin a day to reduce the risk of a heart attack is usually acceptable.

The combination of sulfinpyrazone and acetaminophen (in Tylenol and many other products) can be damaging to your liver. Do not take products that contain acetaminophen unless your doctor approves.

Sulfinpyrazone may increase the effects of the following medicines:

• 
  

  warfarin (Coumadin), which could lead to bleeding; and

  
  


• 
  

  tolbutamide (Orinase), which could lead to low blood sugar levels.

  
  

You may need lower doses of these drugs.

Sulfinpyrazone may decrease the effects of other medicines:

• 
  

  theophylline (Theo-Dur, Theochron, Theolair, Elixophylline, others), which could lead to worsening asthma or chronic obstructive pulmonary disease (COPD); and

  
  


• 
  

  verapamil (Verelan, Calan, Isoptin), which could lead to worsening heart problems such as high blood pressure or an irregular heartbeat.

  
  

You may need higher doses of these drugs.

Niacin (Nicolar, Nicobid, others) may decrease the effects of sulfinpyrazone. A dose adjustment may be necessary.

Drugs other than those listed here may also interact with sulfinpyrazone. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

More sulfinpyrazone resources

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

• sulfinpyrazone Advanced Consumer (Micromedex) - Includes Dosage Information


• Sulfinpyrazone Professional Patient Advice (Wolters Kluwer)


• Sulfinpyrazone Monograph (AHFS DI)


• Anturane Prescribing Information (FDA)

Compare sulfinpyrazone with other medications

• Gouty Arthritis

Where can I get more information?

• Your pharmacist has more information about sulfinpyrazone written for health professionals that you may read.

What does my medication look like?

Sulfinpyrazone is available with a prescription generically and under the brand name Anturane. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• 
  

  Anturane 100 mg--white, round, scored tablets

  
  


• 
  

  Anturane 200 mg--green capsules

  
  

See also: sulfinpyrazone side effects (in more detail)