Pack Content Directory American Samoa

Tuesday, October 18, 2016

M-End DMX

Generic Name: dexbrompheniramine, dextromethorphan, and pseudoephedrine (DEX brom fen IR a meen, DEX troe me THOR fan, and SOO doe ee FED rin)

Brand Names: M-End DMX

What is M-End DMX (dexbrompheniramine, dextromethorphan, and pseudoephedrine)?

Dexbrompheniramine is an antihistamine that reduces the effects of the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Pseudoephedrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of dexbrompheniramine, dextromethorphan, and pseudoephedrine is used to treat runny or stuffy nose, sneezing, itching, watery eyes, cough, and sinus congestion caused by allergies, the common cold, or the flu.

This medicine will not treat a cough that is caused by smoking, asthma, or emphysema.

Dexbrompheniramine, dextromethorphan, and pseudoephedrine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.?

Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. You should not use this medication if you have severe constipation, a blockage in your stomach or intestines, or if you are unable to urinate. Do not use cough or cold medicine if you have untreated or uncontrolled diseases such as glaucoma, asthma or COPD, high blood pressure, heart disease, coronary artery disease, or overactive thyroid. Do not use cough or cold medicine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

What should I discuss with my healthcare provider before taking M-End DMX (dexbrompheniramine, dextromethorphan, and pseudoephedrine)?

Do not use cough or cold medicine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects. You should not use this medication if you have severe constipation, a blockage in your stomach or intestines, or if you are unable to urinate. Do not use cough or cold medicine if you have untreated or uncontrolled diseases such as glaucoma, asthma or COPD, high blood pressure, heart disease, coronary artery disease, or overactive thyroid.

Ask a doctor or pharmacist if it is safe for you to take this medication if you have:

a blockage in your digestive tract (stomach or intestines), a colostomy or ileostomy;

diabetes;

liver or kidney disease;

epilepsy or other seizure disorder;

cough with mucus, or cough caused by emphysema or chronic bronchitis;

enlarged prostate or urination problems;

low blood pressure;

pheochromocytoma (an adrenal gland tumor); or

if you take potassium (Cytra, Epiklor, K-Lyte, K-Phos, Kaon, Klor-Con, Polycitra, Urocit-K).

FDA pregnancy category C. It is not known whether this medication will harm an unborn baby. Do not use cough or cold medicine without medical advice if you are pregnant. This medicine may pass into breast milk and may harm a nursing baby. Antihistamines and decongestants may also slow breast milk production. Do not use cough or cold medicine without medical advice if you are breast-feeding a baby.

How should I take M-End DMX (dexbrompheniramine, dextromethorphan, and pseudoephedrine)?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Cough or cold medicine is usually taken only for a short time until your symptoms clear up.

Do not take for longer than 7 days in a row. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache or skin rash.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

If you need surgery or medical tests, tell the surgeon or doctor ahead of time if you have taken a cough or cold medicine within the past few days. Store at room temperature away from moisture and heat. Do not freeze.

What happens if I miss a dose?

Since cough or cold medicine is taken when needed, you may not be on a dosing schedule. If you are taking the medication regularly, 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 severe forms of some of the side effects listed in this medication guide.

What should I avoid while taking M-End DMX (dexbrompheniramine, dextromethorphan, and pseudoephedrine)?

This medicine may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly. Drinking alcohol can increase certain side effects of this medication. Ask a doctor or pharmacist before using any other cold, allergy, cough, or sleep medicine. Antihistamines, cough suppressants, and decongestants are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains an antihistamine, cough suppressant, or decongestant.

Avoid taking this medication if you also take diet pills, caffeine pills, or other stimulants (such as ADHD medications). Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.

Avoid becoming overheated or dehydrated during exercise and in hot weather. This medication can decrease sweating and you may be more prone to heat stroke.

M-End DMX (dexbrompheniramine, dextromethorphan, and pseudoephedrine) side effects

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

fast, slow, or uneven heart rate;

severe headache, mood changes, hallucinations;

severe dizziness or anxiety, feeling like you might pass out;

tremor, seizure (convulsions);

easy bruising or bleeding, unusual weakness;

fever;

urinating less than usual or not at all;

feeling short of breath; or

dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, uneven heartbeats, seizure).

Less serious side effects may include:

mild headache;

mild dizziness, drowsiness;

dry mouth, nose, or throat;

nausea, diarrhea, constipation, upset stomach;

feeling nervous, restless, or irritable;

blurred vision; or

sleep problems (insomnia).

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.

What other drugs will affect M-End DMX (dexbrompheniramine, dextromethorphan, and pseudoephedrine)?

Ask a doctor or pharmacist before using this medicine if you regularly use other medicines that make you sleepy (such as narcotic pain medication, sedatives, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by dexbrompheniramine or dextromethorphan.

Ask a doctor or pharmacist if it is safe for you to take this medication if you are also using any of the following drugs:

atropine (Atreza, Sal-Tropine);

benztropine (Cogentin);

topiramate (Topamax);

zonisamide (Zonegran);

an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), paroxetine (Paxil, Pexeva), sertraline (Zoloft), venlafaxine (Effexor), and others;

anti-nausea medications such as belladonna (Donnatal), dimenhydrinate (Dramamine), droperidol (Inapsine), methscopolamine (Pamine), or scopolamine (Transderm Scop);

bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), solifenacin (Vesicare), tolterodine (Detrol), or Urogesic Blue;

bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine); or

ulcer medicine such as glycopyrrolate (Robinul) or mepenzolate (Cantil).

This list is not complete and other drugs may interact with dexbrompheniramine, dextromethorphan, and pseudoephedrine. 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 M-End DMX resources

M-End DMX Side Effects (in more detail)
M-End DMX Use in Pregnancy & Breastfeeding
M-End DMX Drug Interactions
0 Reviews for M-End DMX - Add your own review/rating

M-END DMX Liquid MedFacts Consumer Leaflet (Wolters Kluwer)

Compare M-End DMX with other medications

Cough and Nasal Congestion

Where can I get more information?

Your pharmacist can provide more information about dexbrompheniramine, dextromethorphan, and pseudoephedrine.

See also: M-End DMX side effects (in more detail)

Mentax

Generic Name: butenafine topical (byoo TEN ah fine)

Brand Names: Mentax

What is Mentax (butenafine topical)?

Butenafine topical is an antifungal medication. Butenafine topical prevents fungus from growing on your skin.

Butenafine topical is used to treat athlete's foot, jock itch, and ringworm.

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

What is the most important information I should know about Mentax (butenafine topical)?

Use this medication for the full amount of time prescribed by your doctor even if you begin to feel better. Your symptoms may improve before the infection is completely healed.

Do not use bandages or dressings that do not allow air to circulate to the affected area (occlusive dressings) unless otherwise directed by your doctor. Wear loose-fitting clothing (preferably cotton).

Avoid getting this medication in your eyes, nose, or mouth.

Who should not use Mentax (butenafine topical)?

Do not use butenafine topical if you have had an allergic reaction to it in the past.

It is not known whether butenafine topical will harm an unborn baby. Do not use butenafine topical without first talking to your doctor if you are pregnant. It is not known whether butenafine passes into breast milk. Do not use this medication without first talking to your doctor if you are breast-feeding a baby.

How should I use Mentax (butenafine topical)?

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

Wash your hands before and after using this medication.

Clean and dry the affected area. Apply the cream once daily as directed by your doctor for the specified length of time.

Use this medication for the full amount of time prescribed by your doctor or recommended in the package even if you begin to feel better. Your symptoms may improve before the infection is completely healed.

If the infection does not clear up in 4 weeks, or if it appears to get worse, see your doctor.

Do not use bandages or dressings that do not allow air circulation over the affected area (occlusive dressings) unless otherwise directed by your doctor. A light cotton-gauze dressing may be used to protect clothing.

Avoid getting this medication in your eyes, nose, or mouth. Store butenafine topical at room temperature away from moisture and heat.

What happens if I miss a dose?

Apply the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the dose you missed and apply only the regular amount of butenafine topical. Do not use a double dose unless otherwise directed by your doctor.

What happens if I overdose?

An overdose of butenafine topical is unlikely to occur. If you do suspect that a much larger than normal dose has been used or that butenafine topical has been ingested, contact an emergency room or a poison control center.

What should I avoid while using Mentax (butenafine topical)?

Avoid wearing tight-fitting, synthetic clothing that doesn't allow air circulation. Wear loose-fitting clothing made of cotton and other natural fibers until the infection is healed.

Mentax (butenafine topical) side effects

Serious side effects of butenafine topical use are not expected. Stop using butenafine topical and see your doctor if you experience unusual or severe blistering, itching, redness, peeling, dryness, swelling, or irritation of the skin.

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. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Mentax (butenafine topical)?

Avoid using other topicals at the same time unless your doctor approves. Other skin medications may affect the absorption or effectiveness of butenafine topical

More Mentax resources

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

Mentax Prescribing Information (FDA)

Mentax Topical Advanced Consumer (Micromedex) - Includes Dosage Information

Mentax Cream MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Mentax with other medications

Tinea Corporis
Tinea Cruris
Tinea Pedis

Where can I get more information?

Your pharmacist has additional information about butenafine topical written for health professionals that you may read.

See also: Mentax side effects (in more detail)

Mesalamine

Class: Anti-inflammatory Agents
VA Class: GA900
Chemical Name: 5-Amino-2-hydroxybenzoic acid
Molecular Formula: C₇H₇NO₃
CAS Number: 89-57-6
Brands: Asacol, Canasa, Lialda, Pentasa, Rowasa

Introduction

The 5-amino derivative of salicylic acid; a GI anti-inflammatory agent.¹ ³ ⁴ ⁶ ¹⁵

Uses for Mesalamine

Ulcerative Colitis

Used for management of ulcerative colitis (as oral delayed-release tablets or extended-release capsules)²²⁸ ²²⁹ ²³¹ ²³² ²³³ ²³⁶ and to induce (as extended-release capsules and as 1.2-g delayed-release tablets)²²⁹ ²³⁶ ⁴⁴⁸ and maintain (as 400-mg delayed-release tablets)²²⁸ ²³⁴ ²³⁵ clinical remission in adults with mildly to moderately active disease.

Management of mildly to moderately active distal ulcerative colitis (as rectal suspension) ¹ ² ³ ⁷ ⁷¹ ⁷² ⁷⁴ ⁷⁸ ⁹³ ⁹⁴ ¹⁰⁴ ¹⁵⁴ ¹⁷⁵ ¹⁷⁶ ¹⁷⁷ ²⁰³ ²⁰⁴ ²⁰⁵ including ulcerative proctosigmoiditis ¹ ² ⁷ ¹⁵ ⁹⁷ ⁹⁹ ¹⁰⁰ ¹⁰² ¹²⁰ ¹²² ¹⁵³ ¹⁵⁴ ¹⁷³ ¹⁷⁵ and ulcerative proctitis.¹ ² ⁷ ⁷¹ ⁷² ⁹⁷ ⁹⁸ ¹²² ¹⁵⁴

Management of active ulcerative proctitis (as rectal suppositories).²¹⁷ ²²⁷ ²³⁰ ²³⁷

Oral preparations of the drug may be preferable to rectal preparations in patients with extensive inflammatory bowel disease, since efficacy of rectal preparations may be limited to disease distal to the splenic flexure.⁸⁶ ¹⁵⁶

Crohn’s Disease

Has been used (as extended-release oral preparations) for the management of active Crohn’s disease†¹⁰⁶ ²⁶¹ ³³⁹ ³⁴¹ ³⁴² ³⁴³ ³⁴⁴ ³⁴⁵ and to induce³⁰⁰ ³³⁹ ³⁴¹ and maintain clinical remission²⁴¹ ²⁴⁵ ²⁴⁸ ²⁵⁰ ³³⁹ ³⁴⁸ ³⁴⁹ ³⁵⁰ ³⁵¹ ³⁵² ³⁵³ ³⁵⁴ ³⁵⁵ ³⁵⁶ ³⁵⁷ in adults with mildly to moderately active disease.

Has been used (as rectal preparations) in a limited number of patients for the management of active Crohn’s disease†,⁷⁰ but the role of such therapy in this condition is not as well defined as in the management of ulcerative colitis.⁸⁸ ¹⁹⁹ ²⁰⁰

Mesalamine Dosage and Administration

Administration

Administer orally⁶⁶ ⁷³ ⁸⁰ ⁸¹ ⁸³ ⁸⁵ ⁹⁰ ⁹¹ ⁹⁶ ¹³⁶ ¹⁵⁶ ¹⁶⁴ ¹⁷² ¹⁷⁴ ²²⁸ ²²⁹ ²³¹ ²³³ ²³⁴ ²³⁵ ²³⁶ ⁴⁴⁸ or rectally.¹ ² ⁷ ⁷¹ ⁷² ⁷⁴ ⁸⁶ ⁹³ ⁹⁴ ⁹⁹ ¹⁰⁰ ¹⁰² ¹⁰³ ¹⁰⁴ ¹⁰⁵ ¹ ²²⁷

Oral Administration

Administer orally as delayed-release tablets (Asacol, Lialda)²²⁸ ²³¹ ²³³ ²³⁴ ⁴⁴⁸ or extended-release capsules (Pentasa).²²⁹ ²³⁵ ²³⁶

Delayed-release tablets should be swallowed whole without breaking the outer coating, since the coating is designed to maintain the integrity of the tablets prior to entering the colon, where the drug is released.²²⁸ ⁴⁴⁸ Intact or partially intact tablets may be present in stools; if this occurs repeatedly, patients should notify their clinician.²²⁸

1.2-g delayed-release tablets (Lialda): Administer orally with food.⁴⁴⁸

Rectal Administration

Administer rectally as a suspension retention enema¹ ² ⁷ ⁷¹ ⁷² ⁷⁴ ⁸⁶ ⁹³ ⁹⁴ ⁹⁹ ¹⁰⁰ ¹⁰² ¹⁰³ ¹⁰⁴ ¹⁰⁵ or suppositories.²²⁷ ²³⁰

Administer rectal suspension preferably at bedtime and retain for about 8 hours.¹ Best results are achieved if the bowel is emptied just prior to enema administration.² Administer according to manufacturer’s instructions.¹

Retain rectal suppositories for ≥1–3 hours, if possible, to achieve maximum benefit.⁷⁰ ²¹⁷ ²²⁷ ²³⁰

Dosage

Pediatric Patients

Ulcerative Colitis† or Crohn’s Disease†

Oral

Delayed-release tablets have been given in an initial dosage of 20–30 mg/kg daily and then increased up to 60 mg/kg daily.³³³ ³³⁵

Adults

Ulcerative Colitis

Management of Mildly to Moderately Active Ulcerative Colitis

Oral

Delayed-release tablets: Usually, 2.4 g daily (given as two 400-mg delayed-release tablets 3 times daily) for 6 weeks.²²⁸

Induction of Remission of Mildly to Moderately Active Ulcerative Colitis

Oral

Extended-release capsules: Usually, 4 g daily in equally divided doses (given as four 250-mg extended-release capsules or two 500-mg extended-release capsules 4 times daily) for up to 8 weeks.²²⁹ Lower dosages (e.g., 2–4 g daily [in divided doses]) have been used†.²⁵⁰

Delayed-release tablets: 2.4 or 4.8 g once daily (given as two or four 1.2-g delayed-release tablets).⁴⁴⁸ Safety and efficacy beyond 8 weeks of treatment have not been established.⁴⁴⁸

Maintenance of Remission

Oral

Delayed-release tablets: Usually, 1.6 g daily (four 400-mg delayed-release tablets) given in divided doses for 6 months.²²⁸ Dosages of 800 mg to 4.8 g daily (in divided doses) also have been used.²⁵⁰

Extended-release capsules: Dosages of 1.5–3 g daily (in divided doses) have been used.²⁵⁰

Advise patients that ulcerative colitis rarely remits completely, and continued use of maintenance dosages of mesalamine may substantially decrease the risk of relapse.²²⁸

Distal Ulcerative Colitis

Rectal

Suppositories: 1 g (using 1-g suppositories) once daily at bedtime.²²⁷ ²³⁰

Enema suspension: Usually, 4 g once daily (preferably at bedtime).¹ ² ⁷² ⁷⁸ ⁸⁶ ⁹³ ⁹⁴ ²⁰⁵

Although clinical response may be apparent within 3–21 days, therapy with rectal mesalamine usually is continued for 3–6 weeks or until clinical and/or sigmoidoscopic remission is achieved.¹ ²²⁷ ²³⁰

Efficacy of rectal therapy (in terms of modification of relapse rates) beyond 6 weeks has not been established,¹ ²²⁷ but mesalamine has been used rectally for prolonged periods (e.g., >1 year) in some patients.⁹³

Lower dosages⁷ ⁷¹ ⁹⁹ ¹⁰⁰ ¹⁰² ¹⁰⁴ ¹⁰⁵ ¹⁷⁶ ²⁰³ ²⁰⁴ ²⁰⁸ or less frequent administration⁹³ ²⁰⁴ of the rectal drug has been used in some patients†, particularly after initial remission is achieved.

In some patients with distal ulcerative colitis in whom clinical remission occurred following daily administration of 4-g doses of the rectal suspension, dosage was reduced to 4 g every 2 or 3 nights or, occasionally, to less frequent administration.⁹³ ²⁰⁴ If clinical relapse occurred with such administration, dosage was increased to more frequent use.⁹³ In some patients with distal ulcerative colitis or ulcerative proctosigmoiditis, the rectal suspension also has been used in dosages of 1–3 g daily.⁷ ⁷¹ ⁹⁹ ¹⁰⁰ ¹⁰² ¹⁰⁴ ¹⁰⁵ ¹⁷⁶ ²⁰³ ²⁰⁴ ²⁰⁸

Crohn’s Disease†

Management of Mildly to Moderately Active Crohn’s Disease†

Oral

Adults have received dosages of 3.2–4.8 g daily (as delayed-release tablets)²⁴¹ ²⁴³ ²⁴⁸ ²⁵⁰ ³³⁹ ³⁴⁰ ³⁴² or 4 g daily (as extended-release capsules), generally in divided doses.³⁰⁰ ³³⁹ Lower dosages do not appear to be effective.¹⁰⁶ ³⁰⁰ ³³⁹ ³⁶⁷ ³⁴¹

Prescribing Limits

Pediatric Patients

Ulcerative Colitis† or Crohn’s Disease†

Oral

Maximum 60 mg/kg daily.³³³ ³³⁵

Adults

Ulcerative Colitis

Management of Mildly to Moderately Active Ulcerative Colitis

Oral

Delayed-release tablets (400 mg; Asacol): Maximum 4.8 g daily in divided doses.²⁵⁰

Extended-release capsules: Maximum 4 g daily in divided doses.²²⁹ ²⁵⁰

Induction of Remission of Mildly to Moderately Active Ulcerative Colitis

Oral

Extended-release capsules: Maximum 4 g daily in divided doses.²²⁹

Delayed-release tablets (1.2 g; Lialda): Safety and efficacy beyond 8 weeks of therapy not established.⁴⁴⁸

Maintenance of Remission

Oral

Delayed-release tablets (400 mg; Asacol): Maximum 4.8 g daily, in divided doses.²⁵⁰

Extended-release capsules†: Maximum 3 g daily in divided doses.²⁵⁰

Distal Ulcerative Colitis

Rectal

Enema suspension: Maximum 4 g once daily.¹ ² ⁷² ⁷⁸ ⁸⁶ ⁹³ ⁹⁴ ²⁰⁵

The drug has been used rectally for >1 year.⁹³

Crohn’s Disease†

Management of Mildly to Moderately Active Crohn’s Disease

Oral

Delayed-release tablets (400 mg; Asacol): Maximum 4.8 g daily in divided doses.²⁵⁰

Extended-release capsules: Maximum 4 g daily in divided doses.²⁵⁰

Maintenance of Remission

Oral

Delayed-release tablets (400 mg; Asacol): Maximum 4.8 g daily in divided doses. ²⁵⁰

Extended-release capsules: Maximum 3 g daily in divided doses.²⁵⁰

Special Populations

Geriatric Patients

Careful dosage selection recommended due to possible age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.²²⁸ ²³⁰ ⁴⁴⁸

Cautions for Mesalamine

Contraindications

Extended-release capsules (Pentasa), delayed-release tablets (1.2-g; Lialda), rectal suppositories (Canasa): Known hypersensitivity to salicylates (including aspirin, mesalamine)²²⁹ ²³⁰ ⁴⁴⁸ or any ingredient in the respective formulation.¹ ²²⁷ ²²⁸ ²²⁹ ²³⁰ ⁴⁴⁸

Warnings/Precautions

Sensitivity Reactions

Possible acute intolerance (sensitivity reaction) syndrome (e.g., cramping, abdominal pain, bloody diarrhea, fever, headache, malaise, conjunctivitis, pruritus, rash); may require prompt discontinuance.¹ ² ⁷⁸ ¹¹² ¹¹⁴ ¹²¹ ¹⁵⁶ ¹⁸⁰ ¹⁹⁸ ²¹³ ²²⁷ ²²⁸ ²²⁹ ²³⁰ ⁴⁴⁸ A history of sulfasalazine intolerance, if any, should be reevaluated.¹ ² ¹⁹⁸ ²²⁷ ²²⁸ ²³⁰

Use with caution in patients with a history of hypersensitivity to sulfasalazine.¹ ²²⁷ ²²⁸ ²³⁰ ⁴⁴⁸

Sulfite Sensitivity

Rectal suspension contains a sulfite, which may cause allergic-type reactions (including anaphylaxis and life-threatening or less severe asthmatic episodes) in certain susceptible individuals.¹

General Precautions

Renal Impairment

Renal impairment (e.g., minimal change nephropathy, acute and chronic interstitial nephritis, renal failure) and increases in BUN and S_cr reported.²²⁸ ²²⁹

Use with caution and only if the benefits outweigh the risks⁴⁴⁸ in patients with renal impairment.¹ ²²⁸ ²²⁹ ²³⁰ ⁴⁴⁸

Renal function should be evaluated prior to initiation of therapy and periodically thereafter.¹ ²²⁸ ⁴⁴⁸

GI Effects

Pancolitis reported rarely in patients receiving rectal mesalamine.¹ ² ²²⁷ ²³⁰

Possible worsening colitis or symptoms of inflammatory bowel disease (e.g., melena, hematochezia) in patients receiving rectal mesalamine.¹

Potential for prolonged gastric retention of oral delayed-release tablets in patients with pyloric stenosis.²²⁸ ⁴⁴⁸

The possibility of acute pancreatitis should be considered in any patient who develops new abdominal complaints while receiving mesalamine therapy.²²⁰

Cardiac Effects

Use with caution in patients with conditions predisposing them to the development of myocarditis or pericarditis.⁴⁴⁸ The possibility of pericarditis should be considered in any patient who develops chest pain or dyspnea during mesalamine therapy.¹ Discontinuance may be needed.²²⁷

Specific Populations

Pregnancy

Category B.¹ ²²⁸ ²²⁹ ²³⁰ ⁴⁴⁸

Lactation

Distributed into milk following oral administration.²²⁸ ²²⁹ Use with caution.²²⁸ ²²⁹ ⁴⁴⁸

Not known whether the rectal drug is distributed into milk.¹ ²²⁷ ²³⁰ Use of rectal mesalamine usually not recommended,¹ ²²⁷ although one manufacturer of rectal suppositories states the preparation may be used with caution.²³⁰

Pediatric Use

Safety and efficacy not established in children.¹ ²²⁸ ²²⁹ ²³⁰ ⁴⁴⁸

Has been used (as oral delayed-release tablets) for the management of inflammatory bowel disease (i.e., mild ileal, ileocecal, ileocolonic, or colonic disease) and (as rectal mesalamine suspension) in those with left-sided colitis in a limited number of pediatric patients†.⁵⁹ ¹⁹⁹ ²⁰⁰ ³³³ ³³⁵ (See Pediatric Patients under Dosage.)

Geriatric Use

Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger patients.²²⁸ ²³⁰ ⁴⁴⁸ Response does not appear to differ from that in younger adults; however, drug dosage should be selected cautiously.²³⁰ ⁴⁴⁸

Possibility of increased incidence of blood dyscrasias (i.e., agranulocytosis, neutropenia, pancytopenia); CBCs should be monitored closely.²²⁸

Because mesalamine is substantially eliminated by kidneys, assess renal function prior to initiation of therapy and periodically thereafter since geriatric patients more likely to have decreased renal function.²²⁸

Hepatic Impairment

Use with caution in patients with hepatic impairment.²²⁹ ⁴⁴⁸

Renal Impairment

Use with caution in patients with renal impairment.¹ ²²⁸ ²²⁹ ²³⁰

Common Adverse Effects

Oral therapy: Headache, rash, vomiting, diarrhea, flatulence, constipation, nausea, dyspepsia, abdominal pain, fever, arthralgia, flu syndrome.²²⁸ ²²⁹ ⁴⁴⁸

Rectal therapy: Headache, abdominal pain, nausea, diarrhea, gas/flatulence, fever, dizziness, rectal pain, rash, leg/joint pain, flu syndrome.¹ ²²⁷ ²³⁰

Interactions for Mesalamine

No known drug interactions.²²⁸ ²²⁹

Specific Drugs

Drug	Interaction
Azathioprine	Possible increased risk of hematologic toxicity⁴⁴⁸
Digoxin	Decreased GI absorption of digoxin with concomitant sulfasalazine or aminosalicylic acid;¹¹⁵ ¹⁴³ ¹⁹⁵ not known whether mesalamine alters digoxin absorption¹⁹⁹ ²⁰⁰
Mercaptopurine	Possible increased risk of hematologic toxicity⁴⁴⁸
Nephrotoxic drugs (e.g., NSAIAs)	Possible increased nephrotoxicity⁴⁴⁸

Mesalamine Pharmacokinetics

Absorption

Bioavailability

Following oral administration of the 400-mg delayed-release tablets (Asacol), approximately 28% of mesalamine is absorbed and the remainder of the dose is available for topical activity and fecal excretion.²²⁸

Following oral administration of extended-release capsules (Pentasa), about 20–30% of the drug is absorbed.²²⁹

Following oral administration of the 1.2-g delayed-release tablets (Lialda), about 21–22% of the drug is absorbed.⁴⁴⁸

Rectally administered suspension is poorly absorbed from the GI tract (about 15% [range: 5–35%]).¹ ² ¹⁵ ⁴³ ⁴⁷ ⁴⁹ ⁶⁵ ⁶⁸ ²¹⁰ ²²⁷ The rectal suspension usually is retained for about 3.5–12 hours after administration as an enema;¹ ² ⁴² ⁴⁷ prolonged retention may increase absorption of the drug.¹⁹⁹ ²⁰⁰

Variably absorbed following rectal administration of the suppositories.²³⁰ Rectal suppositories usually are retained for 1–3 hours after administration.²²⁷

Food

Food does not appear to affect absorption of the 400-mg delayed-release tablets (Asacol).²²⁸

Food decreases rate of absorption and increases extent of absorption of the 1.2-g delayed-release tablets (Lialda).⁴⁴⁸

Distribution

Extent

Following oral or IV (IV preparation currently not available in the US) administration, the drug may be distributed into kidneys.¹ ¹⁹⁹

Rectal suspension distributes from the rectum into the colon, generally reaching the splenic flexure⁷ ⁴² ⁹⁵ ²⁰⁷ and possibly the ascending colon.²⁰⁷ Rectal suppositories distribute to some extent in rectal tissues.²³⁰

Oral mesalamine crosses the placenta;³ ⁴⁷ ¹⁰⁸ ²²⁹ ⁴⁴⁸ serum concentrations of mesalamine in umbilical cord and amniotic fluid are very low.¹⁰⁸

Not known whether rectal mesalamine crosses the placenta.³

Oral mesalamine is distributed into milk.²²⁸ ²²⁹

Not known whether rectal mesalamine is distributed into milk.¹ ² ⁶

Plasma Protein Binding

Approximately 44–55% (as unchanged drug).³ ⁵⁴ ⁶⁰

Approximately 43% at a concentration of 2.5 mcg/mL.⁴⁴⁸

Elimination

Metabolism

Rapidly metabolized, principally in the liver to form N-acetyl-5-aminosalicylic acid.³ ⁴⁷ ⁶³ ⁷⁰ ²²⁸ ⁴⁴⁸

Elimination Route

Following oral administration, excreted in urine (about 20%) mainly as metabolites⁴⁶ ²²⁸ ²²⁹ and in feces.²²⁹

Following rectal administration, principally excreted in feces (about 50%),⁴⁷ ⁷¹ as unchanged drug and metabolites,¹ ⁶ and in urine¹ ² ³ ⁶ ⁴² (about 10–35%).¹ ² ³ ⁶ ⁴² ⁶⁸ ⁷¹

Half-life

400-mg delayed-release tablets (Asacol): 12 hours (range: 2–15 hours).²²⁸

1.2-g delayed-release tablets (Lialda): 7–9 hours (for mesalamine) and 8–12 hours (for N-acetyl-5-aminosalicylic acid metabolite).⁴⁴⁸

Rectal suspension: 0.5–1.5 hours (for mesalamine) and 5–10 hours (for N-acetyl-5-aminosalicylic acid metabolite).¹ ³ ⁴⁷ ⁵⁶ ⁶⁰ ⁶³

Rectal suppositories: 0.5–7 hours (for mesalamine) and 5–10 hours (for N-acetyl-5-aminosalicylic acid metabolite).²²⁷ ²³⁰

Stability

Storage

Oral

Extended-release Capsules

25°C (may be exposed to 15–30°C).²²⁹

Delayed-release Tablets

400-mg tablets: 20–25°C.²²⁸

1.2-g tablets: 15–25°C (may be exposed to 30°C).⁴⁴⁸

Rectal

Suppositories

<25°C.²³⁰ Do not freeze; keep out of reach of children.²³⁰

Suspension

20–25°C (may be exposed to 15–30°C); keep out of reach of children.¹ ⁶ May darken with time once the container has been removed from the foil wrap;¹ dark brown suspensions should be discarded.¹ ¹⁹⁹

ActionsActions

Exerts local (rather than systemic)¹ ² ³ ⁵ ⁷ ⁴² ⁴⁷ ⁴⁹ ⁶⁵ ⁶⁸ ⁶⁹ ⁷⁰ ⁹⁵ ¹⁵⁶ ¹⁷³ ²²⁸ ²²⁹ ²³⁰ ⁴⁴⁸ anti-inflammatory effects in the GI tract.¹ ² ³ ⁴ ⁵ ⁷ ⁹ ¹⁰ ¹³ ²⁶ ⁷⁶ ¹⁶⁸ ¹⁸³

May reduce inflammation in the colon by inhibiting cyclooxygenase and lipoxygenase,¹ ² ³ ¹⁰ ¹² ¹³ ¹⁴ ¹⁶⁸ ²²⁸ ²²⁹ which catalyze the formation of prostaglandin precursors (endoperoxides) and of leukotrienes¹ ² ³ ⁵ ⁹ ¹⁰ ¹² ¹³ ²⁶ ³⁹ ⁷⁶ ¹⁶⁸ ¹⁸³ ²¹⁰ and hydroxyeicosatetraenoic acids, respectively, from arachidonic acid and/or its metabolites.⁵ ¹⁰ ¹³ ²¹⁰

Advice to Patients

Importance of swallowing delayed-release tablets whole without breaking the outer coating.²²⁸ ⁴⁴⁸

Importance of taking 1.2-g delayed-release tablets with food.⁴⁴⁸

Importance of informing patients that intact or partially intact tablets may be present in stools and if this occurs repeatedly, they should notify their clinician.²²⁸

Importance of informing patients that the rectal suspension and suppositories will cause staining of direct contact surfaces, including, but not limited to, fabrics, flooring, painted surfaces, marble, granite, vinyl, and enamel¹ and therefore, they should carefully choose a suitable location for administration of the rectal suspension.¹ ²³⁰

Importance of informing patients with sulfasalazine sensitivity¹ ² ⁷⁸ ⁸⁷ ¹²¹ ¹⁸⁰ ²²⁸ ²³⁰ to discontinue mesalamine therapy and contact their clinician if signs of sensitivity (e.g., rash, fever) develop¹ ² ¹⁹⁸ ²³⁰ or increased diarrhea or rectal bleeding occurs.²⁰⁰

Importance of informing clinicians of existing pancreatitis.²³⁰

Importance informing patients that ulcerative colitis rarely remits completely and that continued use of maintenance dosages of mesalamine may substantially decrease the risk of relapse.²²⁸

Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.¹

Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.

Importance of informing patients of other important precautionary information. (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Mesalamine
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Capsules, extended-release	250 mg	Pentasa	Shire
		500 mg	Pentasa	Shire
	Tablets, delayed-release	400 mg	Asacol	Procter & Gamble
		1.2 g	Lialda	Shire
Rectal	Suppositories	1 g	Canasa	Axcan
	Suspension	4 g/60 mL	Mesalamine Suspension Enema
			Rowasa Suspension Enema	Alaven

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Apriso 0.375GM 24-hr Capsules (SALIX PHARMACEUTICALS INC.): 120/$271.38 or 360/$781.93

Asacol 400MG Enteric-coated Tablets (WARNER CHILCOTT PHARMA): 30/$70.6 or 90/$180.72

Asacol HD 800MG Enteric-coated Tablets (WARNER CHILCOTT PHARMA): 90/$338.85 or 180/$656.48

Canasa 1000MG Suppositories (AXCAN PHARMA US): 30/$488.34 or 90/$1437.86

Lialda 1.2GM Enteric-coated Tablets (SHIRE US INC.): 120/$725.99 or 360/$2089.94

Mesalamine 4GM Enema (TEVA PHARMACEUTICALS USA): 60/$35.99 or 120/$59.98

Pentasa 250MG Controlled-release Capsules (SHIRE US INC.): 240/$290.98 or 720/$835.97

Pentasa 500MG Controlled-release Capsules (SHIRE US INC.): 30/$82.07 or 90/$222.45

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions August 2009. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

1. Alaven Pharmaceutical LLC. Rowasa (mesalamine) rectal suspension enema prescribing information. Marietta, GA; 2008 Aug.

2. Reid-Rowell. Rowasa (mesalamine): a product profile. Marietta, GA; 1988 Mar.

3. Bondesen S, Rasmussen SN, Rask-Madsen J et al. 5-Aminosalicylic acid in the treatment of inflammatory bowel disease. Acta Med Scand. 1987; 221:227-42. [IDIS 232774] [PubMed 3296672]

4. Weintraub M, Evans P. 5-Aminosalicylic acid: an old, ″new″ treatment for inflammatory bowel disease. Hosp Formul. 1987; 22:528-33.

5. Peppercorn MA. Sulfasalazine and related new drugs. J Clin Pharmacol. 1987; 260-5. (IDIS 228622)

6. Reid-Rowell. Rowasa (mesalamine) product information form for the American Hospital Formulary Service. Marietta, GA; 1988 Apr.

7. Anon. Mesalamine for ulcerative colitis. Med Lett Drugs Ther. 1988; 30:53-6. [PubMed 3283508]

8. Allgayer H, Sonnenbichler J, Kruis W et al. Determination of the pK values of 5-aminosalicylic acid and N-acetylaminosalicylic acid and comparison of the pH dependent lipid-water partition coefficients of sulphasalazine and its metabolites. Arzneimittelforschung. 1985; 35:1457-9. [PubMed 2867770]

9. Ligumsky M, Karmeli F, Sharon P et al. Enhanced thromboxane A₂ and prostacyclin production by cultured rectal mucosa in ulcerative colitis and its inhibition by steroids and sulfasalazine. Gastroenterology. 1981; 81:444-9. [IDIS 139848] [PubMed 6114012]

10. Sharon P, Ligumsky M, Rachmilewitz D et al. Role of prostaglandins in ulcerative colitis. Gastroenterology. 1978; 75:638-40. [PubMed 30669]

11. Azad Khan AK, Piris J, Truelove SC. An experiment to determine the active therapeutic moiety of sulphasalazine. Lancet. 1977; 2:892-5. [IDIS 76335] [PubMed 72239]

12. Lauritsen K, Laursen LS, Bukhave K et al. Effects of topical 5-aminosalicylic acid and prednisolone on prostaglandin E₂ and leukotriene B₄ levels determined by equilibrium in vivo dialysis of rectum in relapsing ulcerative colitis. Gastroenterology. 1986; 91:837-44. [IDIS 221448] [PubMed 3017804]

13. Donowitz M. Arachidonic acid metabolites and their role in inflammatory bowel disease: update requiring addition of a pathway. Gastroenterology. 1985; 88:580-7. [IDIS 196055] [PubMed 2856909]

14. Isselbacher KJ. The role of arachidonic acid metabolites in gastrointestinal homeostasis: biochemical, histological and clinical gastrointestinal effects. Drugs. 1987; 33(Suppl 1):38-46. [IDIS 230964] [PubMed 2885170]

15. Lewis JH. Summary of the 31st meeting of the Food and Drug Administration Gastrointestinal Drugs Advisory Committee December 8-9, 1986. Am J Gastroenterol. 1987; 82:443-7.

16. Sharon P, Stenson WF. Metabolism of arachidonic acid in acetic acid colitis in rats. Gastroenterology. 1985; 88:55-63. [PubMed 3917261]

17. Dull BJ, Salata K, van Langenhove A et al. 5-Aminosalicylate: oxidation by activated leukocytes and protection of cultured cells from oxidative damage. Biochem Pharmacol. 1987; 36:2467-72. [PubMed 3038125]

18. Molin L, Stendahl O. The effect of sulfasalazine and its active components on human polymorphonuclear leukocyte function in relation to ulcerative colitis. Acta Med Scand. 1979; 206:451-7. [IDIS 108764] [PubMed 43662]

19. Hillier K, Mason PI, Pacheco S et al. Ulcerative colitis: effect of sulphasalazine, its metabolites and indomethacin on the ability of human colonic mucosa to metabolize prostaglandins in vitro. Br J Pharmacol. 1982; 76:157-61. [IDIS 150404] [PubMed 6123357]

20. Rhodes JM, Jewell DP. Inhibition of leucocyte motility by drugs used in inflammatory bowel disease. Gut. 1980; 21:A452-3. [PubMed 6450718]

21. Hoult JRS, Page H. 5-Aminosalicylic acid, a co-factor for colonic prostacyclin synthesis? Lancet. 1981; 2:255. Letter. (IDIS 136287)

22. Holdstock G, Chastenay BF, Krawitt EL. Increased prostaglandin producing suppressor cells in inflammatory bowel disease not sensitive to sulfasalazine. Gastroenterology. 1981; 80:1177.

23. Das K, Zapp B, Rubinstein A. In vivo and in vitro effect of sulfasalazine on lymphocyte in inflammatory bowel disease (IBD): systemic immunological parameters in idiopathic proctitis (IP). Gastroenterology. 1976; 70:A17.

24. Smith PR, Dawson DJ, Swan CHJ. Prostaglandins and sulphasalazine. Lancet. 1978; 2:260.

25. Sharon P, Stenson WF. Enhanced synthesis of leukotriene B₄ by colonic mucosa in inflammatory bowel disease. Gastroenterology. 1984; 86:453-60. [PubMed 6319219]

26. Kirsner JB, Shorter RG. Recent developments in ″nonspecific″ inflammatory bowel disease: first of two parts. N Engl J Med. 1982; 306:775-85. [IDIS 146719] [PubMed 7038488]

27. Anon. Sulphasalazine:

Meruvax II

Pronunciation: roo-BELL-a
Generic Name: Rubella Virus Vaccine
Brand Name: Meruvax II

Meruvax II is used for:

Preventing rubella (German measles).

Meruvax II is a vaccine. It works by stimulating the body to produce antibodies to rubella.

Do NOT use Meruvax II if:

you are allergic to any ingredient in Meruvax II

you have a weakened immune system (eg, advanced HIV, AIDS, decreased gammaglobulin levels), blood problems, or tuberculosis (TB)

you are pregnant

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

Before using Meruvax II:

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

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

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

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

if you are allergic to neomycin

if you have a fever, a tumor, HIV, or a family history of weak immune systems

if you have had a recent blood or plasma transfusion, or have received immune globulin or a tuberculin test

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

Corticosteroids (eg, prednisone) because the effectiveness of Meruvax II may be decreased, or risk of infection may be increased

Immunosuppressants (eg, cyclosporine) because the effectiveness of Meruvax II may be decreased

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

How to use Meruvax II:

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

Meruvax II is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Meruvax II at home, carefully follow the injection procedures taught to you by your health care provider.

If Meruvax II contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.

Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.

If you miss a dose of Meruvax II, contact your doctor to set up a new dosing schedule.

Ask your health care provider any questions you may have about how to use Meruvax II.

Important safety information:

Meruvax II may cause dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Meruvax II.

Adult women may experience joint pain 2 to 4 weeks after receiving this injection. This usually lasts only a short time. However, these symptoms have persisted for months or, rarely, years.

Meruvax II may decrease the effectiveness of tuberculin tests. If you are scheduled to have a TB test within 6 weeks after receiving this vaccination, contact your doctor. You may need to reschedule your TB test.

Keep written documentation of all vaccinations received to help avoid unnecessary doses.

Use of Meruvax II is not recommended in CHILDREN younger than 12 months of age. Safety and effectiveness in this age group have not been confirmed.

PREGNANCY and BREAST-FEEDING: Do not use Meruvax II if you are pregnant. If you suspect that you could be pregnant, contact your doctor immediately. Avoid becoming pregnant for at least 3 months after receiving Meruvax II. Meruvax II is excreted in breast milk. If you are or will be breast-feeding while you are using Meruvax II, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of Meruvax II:

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

Burning or stinging at the injection site; diarrhea; dizziness; fever; general feeling of being unwell; headache; irritability; muscle or joint ache; nausea; tiredness; vomiting.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; red, swollen, blistered, or peeling skin; unusual bruising or bleeding; vision or hearing changes.

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

See also: Meruvax II side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Meruvax II:

Meruvax II is usually handled and stored by a health care provider. If you are using Meruvax II at home, store Meruvax II as directed by your pharmacist or health care provider. Keep Meruvax II out of the reach of children and away from pets.

General information:

If you have any questions about Meruvax II, please talk with your doctor, pharmacist, or other health care provider.

Meruvax II is to be used only by the patient for whom it is prescribed. Do not share it with other people.

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

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

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

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Meruvax II resources

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

Meruvax II Concise Consumer Information (Cerner Multum)

Meruvax II Advanced Consumer (Micromedex) - Includes Dosage Information

Compare Meruvax II with other medications

Rubella Prophylaxis

Maxi-Tuss HCG Liquid

Pronunciation: gwye-FEN-e-sin/hye-droe-KOE-done
Generic Name: Guaifenesin/Hydrocodone
Brand Name: Examples include CodiCLEAR DH and Maxi-Tuss HCG

Maxi-Tuss HCG Liquid is used for:

Relieving cough and throat and airway irritation due to colds, flu, or hay fever. It may also be used for other conditions as determined by your doctor.

Maxi-Tuss HCG Liquid is a cough suppressant and expectorant combination. It works by loosening mucus and lung secretions in the chest, and making coughs more productive. The cough suppressant works in the brain to help decrease the cough reflex to reduce a dry cough.

Do NOT use Maxi-Tuss HCG Liquid if:

you are allergic to any ingredient in Maxi-Tuss HCG Liquid or any other codeine or morphine-related medicine (eg, oxycodone)

you are taking sodium oxybate (GHB)

you have increased pressure in the brain, trouble breathing, or diarrhea due to antibiotic use

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

Before using Maxi-Tuss HCG Liquid:

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

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

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

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

if you have a history of glaucoma, an enlarged prostate gland or other prostate problems, heart problems, diabetes, high blood pressure, blood vessel problems, stroke, adrenal gland problems, or an underactive thyroid

if you have a history of stomach problems, bowel problems (eg, chronic inflammation or ulceration of the bowel), or gallbladder problems (eg, gallstones), or if you have had recent abdominal surgery

if you have breathing or lung problems (eg, asthma, chronic bronchitis, emphysema), or chronic obstructive pulmonary disease (COPD), or if cough occurs with large amounts of mucus

if you have recently had any head injury, brain injury or tumor, infection of the brain or nervous system, epilepsy, or seizures

if you have a history of alcohol abuse, drug abuse, or suicidal thoughts or behavior

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

Cimetidine because it may increase the risk of Maxi-Tuss HCG Liquid's side effects

Barbiturates (eg, phenobarbital) or sodium oxybate (GHB) because the risk of severe drowsiness or breathing problems may be increased

Naltrexone because it may decrease Maxi-Tuss HCG Liquid's effectiveness

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

How to use Maxi-Tuss HCG Liquid:

Use Maxi-Tuss HCG Liquid as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take Maxi-Tuss HCG Liquid by mouth with or without food.

Drink plenty of water while taking Maxi-Tuss HCG Liquid.

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

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

Ask your health care provider any questions you may have about how to use Maxi-Tuss HCG Liquid.

Important safety information:

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

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

If your symptoms do not get better within 5 to 7 days or if they get worse, check with your doctor.

Maxi-Tuss HCG Liquid may interfere with certain lab test results. Be sure your doctor and lab personnel know you are taking Maxi-Tuss HCG Liquid.

Tell your doctor or dentist that you take Maxi-Tuss HCG Liquid before you receive any medical or dental care, emergency care, or surgery.

Use Maxi-Tuss HCG Liquid with caution in the ELDERLY; they may be more sensitive to its effects.

Maxi-Tuss HCG Liquid should be used with extreme caution in CHILDREN younger than 6 years old; safety and effectiveness in these children have not been confirmed.

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

Possible side effects of Maxi-Tuss HCG Liquid:

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

Constipation; dizziness; drowsiness; excitability; headache; nausea; nervousness or anxiety; trouble sleeping; weakness.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); anxiety; change in amount of urine; difficulty urinating; hearing change or loss; mental or mood changes; severe drowsiness.

See also: Maxi-Tuss HCG side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blurred vision; confusion; hallucinations; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; unusually fast, slow, or irregular heartbeat; vomiting.

Proper storage of Maxi-Tuss HCG Liquid:

Store Maxi-Tuss HCG Liquid at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Maxi-Tuss HCG Liquid out of the reach of children and away from pets.

General information:

If you have any questions about Maxi-Tuss HCG Liquid, please talk with your doctor, pharmacist, or other health care provider.

Maxi-Tuss HCG Liquid is to be used only by the patient for whom it is prescribed. Do not share it with other people.

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

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

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

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Maxi-Tuss HCG resources

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

Compare Maxi-Tuss HCG with other medications

Cough

Methoxsalen Lotion

Pronunciation: meth-OX-ah-len
Generic Name: Methoxsalen
Brand Name: Oxsoralen

Methoxsalen Lotion is powerful and could produce severe burns if improperly used. Methoxsalen Lotion must never be dispensed to a patient. A doctor using special light conditions must apply Methoxsalen Lotion.

Methoxsalen Lotion is used for:

Treating vitiligo in combination with controlled doses of ultraviolet A (UVA) or sunlight. It may also be used for other conditions as determined by your doctor.

Methoxsalen Lotion is a psoralen used in combination with light therapy. It works by making the skin more sensitive to UV light. It appears that this sensitivity results in damage to the skin cells when UV light treatment is given. Damaged skin cells grow more slowly and the rate of tissue growth is reduced.

Do NOT use Methoxsalen Lotion if:

you are allergic to any ingredient in Methoxsalen Lotion or to similar medicines

you have a light-sensitive disease (eg, the blood disease porphyria, lupus, xeroderma pigmentosum)

you have a history of melanoma or certain types of skin cancer

your skin is sensitive to the sun or light

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

Before using Methoxsalen Lotion:

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

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

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

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

if you are fair-skinned, have a history of coal tar UV treatment, or ionizing radiation, or have taken arsenic compounds or oral psoralen UVA treatment

if you have other skin conditions, an infection, or a history of heart or blood vessel disease

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

Hydantoins (eg, phenytoin) because the effectiveness of Methoxsalen Lotion may be decreased

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

How to use Methoxsalen Lotion:

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

Methoxsalen Lotion is usually applied at your doctor's office or a clinic.

Methoxsalen Lotion is applied only in small well-defined lesions and preferably on lesions that can be protected by clothing or sunscreen from later exposure to UVA.

If you miss a dose of Methoxsalen Lotion, contact your doctor right away.

Ask your health care provider any questions you may have about how to use Methoxsalen Lotion.

Important safety information:

After you begin Methoxsalen Lotion and light therapy, several weeks to months may pass before you see an improvement in your condition.

Do not sunbathe for at least 24 hours before receiving Methoxsalen Lotion and light therapy. After your treatment, avoid any exposure to sunlight for at least 8 hours. This includes indirect light through a window or on cloudy days. If you can not avoid exposure to sunlight, wear protective clothing, or use a sunscreen with a sun protective factor (SPF) of 15 or greater, as directed by your doctor. Protect all areas of the body, including lips, from sun exposure. Do not sunbathe or use a tanning booth without checking with your doctor and wait at least 48 hours after your treatment.

Serious burns from either UV light or sunlight (even through a window glass) can occur if the recommended doses of Methoxsalen Lotion or exposure schedules are not maintained.

The treated area may be highly sensitive to sunlight for several days and may cause severe burning if exposed to additional UV or sunlight. Protect the treated areas with clothing or sunscreen.

Return of skin color may begin after a few weeks, but significant color may require 6 to 9 months of treatment.

Exposure to sunlight or UV radiation may cause early aging of the skin.

During treatment with Methoxsalen Lotion and UVA light, wear total UVA absorbing/blocking goggles designed to provide maximal protection of the eyes.

Protect stomach skin, breasts, genitals, and other sensitive areas for about one third of the exposure time until tanning occurs.Unless affected by disease, male genitals should be shielded.

Be careful using Methoxsalen Lotion with other light-sensitizing medicines. Tell your doctor if you are taking any of the following medicines: anthralin, coal tar and derivatives, griseofulvin, phenothiazines, nalidixic acid, fluoroquinolone antibiotics, halogenated salicylanilides, bacteriostatic soaps, staining dyes (eg, methylene blue, toluidine blue, rose bengal, methyl orange), sulfonamides, tetracyclines, or thiazide diuretics.

LAB TESTS may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.

Use Methoxsalen Lotion with caution in the ELDERLY because they may be more sensitive to its effects.

Methoxsalen Lotion is not recommended for use in CHILDREN younger than 12 years of age. Safety and effectiveness in this age group have not been confirmed.

PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Methoxsalen Lotion during pregnancy. It is unknown if Methoxsalen Lotion is excreted in breast milk. If you are or will be breast-feeding while you are using Methoxsalen Lotion, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of Methoxsalen Lotion:

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

Dryness or redness of the skin; itching.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blistering; burns on the treated area from overexposure to UVA or sunlight; severe swelling or redness of the skin; swelling of the feet or lower legs; tenderness.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blisters; burns. Methoxsalen Lotion may be harmful if swallowed.

Proper storage of Methoxsalen Lotion:

Methoxsalen Lotion is usually handled and stored by a health care provider. If you are using Methoxsalen Lotion at home, store Methoxsalen Lotion as directed by your pharmacist or health care provider. Keep Methoxsalen Lotion out of the reach of children and away from pets.

General information:

If you have any questions about Methoxsalen Lotion, please talk with your doctor, pharmacist, or other health care provider.

Methoxsalen Lotion is to be used only by the patient for whom it is prescribed. Do not share it with other people.

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

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

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

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Methoxsalen resources

Methoxsalen Use in Pregnancy & Breastfeeding
Methoxsalen Drug Interactions
Methoxsalen Support Group
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