Cyklokapron

tranexamic acid

Dosage Form: injection, solution
Cyklokapron®

tranexamic acid injection

Antifibrinolytic agent

Cyklokapron Description

Each mL of the sterile solution for intravenous injection contains 100 mg tranexamic acid and Water for Injection to 1 mL.

FORMULATION

Chemical Name: trans-4-(aminomethyl)cyclohexanecarboxylic acid

Structural Formula:

Tranexamic acid is a white crystalline powder. The aqueous solution for injection has a pH of 6.5 to 8.0.

Cyklokapron - Clinical Pharmacology

Tranexamic acid is a competitive inhibitor of plasminogen activation, and at much higher concentrations, a noncompetitive inhibitor of plasmin, i.e., actions similar to aminocaproic acid. Tranexamic acid is about 10 times more potent in vitro than aminocaproic acid.

Tranexamic acid binds more strongly than aminocaproic acid to both the strong and weak receptor sites of the plasminogen molecule in a ratio corresponding to the difference in potency between the compounds. Tranexamic acid in a concentration of 1 mg per mL does not aggregate platelets in vitro.

Tranexamic acid in concentrations up to 10 mg per mL blood has no influence on the platelet count, the coagulation time, or various coagulation factors in whole blood or citrated blood from normal subjects. On the other hand, tranexamic acid in concentrations of 10 mg and 1 mg per mL blood prolongs the thrombin time.

The plasma protein binding of tranexamic acid is about 3% at therapeutic plasma levels and seems to be fully accounted for by its binding to plasminogen. Tranexamic acid does not bind to serum albumin.

After an intravenous dose of 1 g, the plasma concentration time curve shows a triexponential decay with a half-life of about 2 hours for the terminal elimination phase. The initial volume of distribution is about 9 to 12 liters. Urinary excretion is the main route of elimination via glomerular filtration. Overall renal clearance is equal to overall plasma clearance (110 to 116 mL/min), and more than 95% of the dose is excreted in the urine as unchanged drug. Excretion of tranexamic acid is about 90% at 24 hours after intravenous administration of 10 mg per kg body weight.

An antifibrinolytic concentration of tranexamic acid remains in different tissues for about 17 hours, and in the serum, up to seven or eight hours.

Tranexamic acid passes through the placenta. The concentration in cord blood after an intravenous injection of 10 mg per kg to pregnant women is about 30 mg per liter, as high as in the maternal blood. Tranexamic acid diffuses rapidly into joint fluid and the synovial membrane. In the joint fluid, the same concentration is obtained as in the serum. The biological half-life of tranexamic acid in the joint fluid is about three hours.

The concentration of tranexamic acid in a number of other tissues is lower than in blood. In breast milk, the concentration is about one hundredth of the serum peak concentration. Tranexamic acid concentration in cerebrospinal fluid is about one tenth of that of the plasma. The drug passes into the aqueous humor, the concentration being about one tenth of the plasma concentration.

Tranexamic acid has been detected in semen where it inhibits fibrinolytic activity but does not influence sperm migration.

Indications and Usage for Cyklokapron

Cyklokapron Injection is indicated in patients with hemophilia for short-term use (two to eight days) to reduce or prevent hemorrhage and reduce the need for replacement therapy during and following tooth extraction.

Contraindications

Cyklokapron Injection is contraindicated:

1. In patients with acquired defective color vision, since this prohibits measuring one endpoint that should be followed as a measure of toxicity (see WARNINGS).


2. In patients with subarachnoid hemorrhage. Anecdotal experience indicates that cerebral edema and cerebral infarction may be caused by Cyklokapron in such patients.


3. In patients with active intravascular clotting.


4. In patients with hypersensitivity to tranexamic acid or any of the ingredients.

Warnings

Focal areas of retinal degeneration have developed in cats, dogs, and rats following oral or intravenous tranexamic acid at doses between 250 to 1600 mg/kg/day (6 to 40 times the recommended usual human dose) from 6 days to 1 year. The incidence of such lesions has varied from 25% to 100% of animals treated and was dose-related. At lower doses, some lesions have appeared to be reversible.

Limited data in cats and rabbits showed retinal changes in some animals with doses as low as 126 mg/kg/day (only about 3 times the recommended human dose) administered for several days to two weeks.

No retinal changes have been reported or noted in eye examinations in patients treated with tranexamic acid for weeks to months in clinical trials.

However, visual abnormalities, often poorly characterized, represent the most frequently reported postmarketing adverse reaction in Sweden. For patients who are to be treated continually for longer than several days, an ophthalmological examination, including visual acuity, color vision, eye-ground, and visual fields, is advised, before commencing and at regular intervals during the course of treatment. Tranexamic acid should be discontinued if changes in examination results are found.

Convulsions have been reported in association with tranexamic acid treatment.

Precautions

General

The dose of Cyklokapron Injection should be reduced in patients with renal insufficiency because of the risk of accumulation. (See DOSAGE AND ADMINISTRATION.)

Ureteral obstruction due to clot formation in patients with upper urinary tract bleeding has been reported in patients treated with Cyklokapron.

Venous and arterial thrombosis or thromboembolism has been reported in patients treated with Cyklokapron. In addition, cases of central retinal artery and central retinal vein obstruction have been reported.

Patients with a previous history of thromboembolic disease may be at increased risk for venous or arterial thrombosis.

Cyklokapron should not be administered concomitantly with Factor IX Complex concentrates or Anti-inhibitor Coagulant concentrates, as the risk of thrombosis may be increased.

Patients with disseminated intravascular coagulation (DIC), who require treatment with Cyklokapron, must be under strict supervision of a physician experienced in treating this disorder.

Tranexamic acid may cause dizziness and therefore may influence the ability to drive or use machines.

Drug Interactions

No studies of interactions between Cyklokapron and other drugs have been conducted.

Carcinogenesis, Mutagenesis, Impairment of Fertility

An increased incidence of leukemia in male mice receiving tranexamic acid in food at a concentration of 4.8% (equivalent to doses as high as 5 g/kg/day) may have been related to treatment. Female mice were not included in this experiment.

Hyperplasia of the biliary tract and cholangioma and adenocarcinoma of the intrahepatic biliary system have been reported in one strain of rats after dietary administration of doses exceeding the maximum tolerated dose for 22 months. Hyperplastic, but not neoplastic, lesions were reported at lower doses. Subsequent long-term dietary administration studies in a different strain of rat, each with an exposure level equal to the maximum level employed in the earlier experiment, have failed to show such hyperplastic / neoplastic changes in the liver. No mutagenic activity has been demonstrated in several in vitro and in vivo test systems.

There are no clinical or nonclinical data to assess the effects of tranexamic acid on fertility.

Pregnancy (Category B)

Reproduction studies performed in mice, rats, and rabbits have not revealed any evidence of impaired fertility or adverse effects on the fetus due to tranexamic acid.

There are no adequate and well-controlled studies in pregnant women. However, tranexamic acid is known to pass the placenta and appears in cord blood at concentrations approximately equal to maternal concentration. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Labor and Delivery

See above under Pregnancy.

Nursing Mothers

Tranexamic acid is present in the mother's milk at a concentration of about a hundredth of the corresponding serum levels. Caution should be exercised when Cyklokapron is administered to a nursing woman.

Pediatric Use

The drug has had limited use in pediatric patients, principally in connection with tooth extraction. The limited data suggest that dosing instructions for adults can be used for pediatric patients needing Cyklokapron therapy.

Geriatric Use

Clinical studies of Cyklokapron did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function (see CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION).

Adverse Reactions

Gastrointestinal disturbances (nausea, vomiting, diarrhea) may occur but disappear when the dosage is reduced. Allergic dermatitis, giddiness, and hypotension have been reported occasionally. Hypotension has been observed when intravenous injection is too rapid. To avoid this response, the solution should not be injected more rapidly than 1 mL per minute.

Worldwide Postmarketing Reports

Thromboembolic events (e.g., deep vein thrombosis, pulmonary embolism, cerebral thrombosis, acute renal cortical necrosis, and central retinal artery and vein obstruction) have been rarely reported in patients receiving tranexamic acid for indications other than hemorrhage prevention in patients with hemophilia. Convulsion, chromatopsia, and visual impairment have also been reported. However, due to the spontaneous nature of the reporting of medical events and the lack of controls, the actual incidence and causal relationship of drug and event cannot be determined.

Overdosage

Cases of overdosage of Cyklokapron have been reported. Based on these reports, symptoms of overdosage may be gastrointestinal, e.g., nausea, vomiting, diarrhea; hypotensive, e.g., orthostatic symptoms; thromboembolic, e.g., arterial, venous, embolic; visual impairment; convulsions, mental status changes; myoclonus, and rash.

Cyklokapron Dosage and Administration

Immediately before tooth extraction in patients with hemophilia, administer 10 mg per kg body weight of Cyklokapron intravenously together with replacement therapy (see PRECAUTIONS). Following tooth extraction, intravenous therapy, at a dose of 10 mg per kg body weight three to four times daily, may be used for 2 to 8 days.

Note: For patients with moderate to severe impaired renal function, the following dosages are recommended:

Serum Creatinine (µmol/L)	Tranexamic Acid I.V. Dosage
120 to 250 (1.36 to 2.83 mg/dL)	10 mg/kg BID
250 to 500 (2.83 to 5.66 mg/dL)	10 mg/kg daily
>500 (>5.66 mg/dL)	10 mg/kg every 48 hours or 5 mg/kg every 24 hours

For intravenous infusion, Cyklokapron Injection may be mixed with most solutions for infusion such as electrolyte solutions, carbohydrate solutions, amino acid solutions, and Dextran solutions. The mixture should be prepared the same day the solution is to be used. Heparin may be added to Cyklokapron Injection. Cyklokapron Injection should NOT be mixed with blood. The drug is a synthetic amino acid, and should NOT be mixed with solutions containing penicillin.

How is Cyklokapron Supplied

Cyklokapron Injection 100 mg/mL

NDC 0013-1114-10 10 × 10 mL ampules

STORAGE

Store at 25°C (77°F); excursions permitted to 15°–30°C (59°–86°F) [see USP Controlled Room Temperature].

Rx only

LAB-0258-6.0

January 2011

PRINCIPAL DISPLAY PANEL - 10 mL Ampule Carton

100 mg/mL

NDC 0013-1114-10

Contains 10 of NDC 0013-1114-01

Rx only

10 × 10 mL ampules

Cyklokapron®

tranexamic acid injection

(1000 mg/10 mL)

Solution for intravenous injection

Cyklokapron  tranexamic acid  injection, solution

Product Information Product Type HUMAN PRESCRIPTION DRUG NDC Product Code (Source) 0013-1114 Route of Administration INTRAVENOUS DEA Schedule

Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength tranexamic acid (tranexamic acid) tranexamic acid 100 mg  in 1 mL

Inactive Ingredients Ingredient Name Strength water

Product Characteristics Color      Score      Shape Size Flavor Imprint Code Contains

Packaging # NDC Package Description Multilevel Packaging 1 0013-1114-10 10 AMPULE In 1 BOX contains a AMPULE 1 10 mL In 1 AMPULE This package is contained within the BOX (0013-1114-10)

Marketing Information
Marketing Category	Application Number or Monograph Citation	Marketing Start Date	Marketing End Date
NDA	NDA019281	12/30/1986

Labeler - Pharmacia and Upjohn Company (829076566)

Establishment
Name	Address	ID/FEI	Operations
CMIC CMO Co., Ltd.		690846636	API MANUFACTURE

Establishment
Name	Address	ID/FEI	Operations
Pfizer Manufacturing Belgium NV		370156507	MANUFACTURE

Revised: 02/2011Pharmacia and Upjohn Company

More Cyklokapron resources

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

• Cyklokapron Advanced Consumer (Micromedex) - Includes Dosage Information


• Cyklokapron MedFacts Consumer Leaflet (Wolters Kluwer)


• Tranexamic Acid Professional Patient Advice (Wolters Kluwer)


• Lysteda Advanced Consumer (Micromedex) - Includes Dosage Information


• Lysteda MedFacts Consumer Leaflet (Wolters Kluwer)


• Lysteda Consumer Overview

Compare Cyklokapron with other medications

• Bleeding Disorder
• Factor IX Deficiency
• Hemophilia A

Halaven

Generic Name: eribulin (e RIB ue lin)

Brand Names: Halaven

What is eribulin?

Eribulin is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Eribulin is used to treat breast cancer that has spread to other parts of the body.

Eribulin is usually given after at least 2 other combinations of chemotherapy medications have been tried without successful treatment of symptoms.

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

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

Do not use eribulin if you are pregnant. It could harm the unborn baby.

Before you receive eribulin, tell your doctor if you have liver or kidney disease, congestive heart failure, a heart rhythm disorder, a personal or family history of Long QT syndrome, or an electrolyte imbalance (such as low levels of potassium or magnesium in your blood).

Eribulin can lower blood cells that help your body fight infections. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests. Visit your doctor regularly.

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

Call your doctor at once if you have a serious side effect such as fever, chills, body aches, flu symptoms, mouth sores, pain or burning when you urinate, pale skin, feeling light-headed or short of breath, fast or uneven heart rate, severe numbness or tingling in your hands and feet, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling.

Tell your doctor about all other medicines you use.

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

You should not use eribulin if you are allergic to it.

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

• 
  

  liver disease;

  
  


• 
  

  kidney disease;

  
  


• 
  

  slow heartbeats, congestive heart failure;

  
  


• 
  

  heart rhythm disorder;

  
  


• 
  

  personal or family history of Long QT syndrome; or

  
  


• 
  

  an electrolyte imbalance (such as low levels of potassium or magnesium in your blood).

  
  

FDA pregnancy category D. Do not use eribulin if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. It is not known whether eribulin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using eribulin.

How is eribulin given?

Eribulin is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting.

Eribulin is usually given once per week for 2 weeks in a row, on days 1 and 8 of a 21-day treatment cycle. This 21-day cycle is then repeated until your doctor decides that eribulin is no longer an appropriate treatment for your condition. Follow your doctor's instructions.

Eribulin can lower blood cells that help your body fight infections. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests. Your heart function may also need to be checked using an electrocardiograph or ECG (sometimes called an EKG). Visit your doctor regularly.

What happens if I miss a dose?

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

What happens if I overdose?

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

Overdose symptoms may include some of the serious side effects listed in this medication guide.

What should I avoid while receiving eribulin?

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

Eribulin 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. Call your doctor at once if you have a serious side effect such as:

• 
  

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

  
  


• 
  

  pain or burning when you urinate;

  
  


• 
  

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

  
  


• 
  

  severe numbness or tingling in your hands and feet;

  
  


• 
  

  low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling);

  
  

Less serious side effects may include:

• 
  

  weakness, tired feeling;

  
  


• 
  

  hair loss;

  
  


• 
  

  nausea, constipation, loss of appetite;

  
  


• 
  

  headache; or

  
  


• 
  

  muscle or joint pain.

  
  

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 eribulin?

Tell your doctor about all other medicines you use, especially:

• 
  

  arsenic trioxide (Trisenox);

  
  


• 
  

  tacrolimus (Prograf);

  
  


• 
  

  an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), levofloxacin (Levaquin), moxifloxacin (Avelox), or pentamidine (NebuPent, Pentam);

  
  


• 
  

  an antidepressant such as amitriptylline (Elavil, Vanatrip, Limbitrol), clomipramine (Anafranil), or desipramine (Norpramin);

  
  


• 
  

  anti-malaria medications such as chloroquine (Aralen), or mefloquine (Lariam);

  
  


• 
  

  heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), ibutilide (Corvert), procainamide (Procan, Pronestyl), propafenone (Rythmol), quinidine (Quin-G), or sotalol (Betapace);

  
  


• 
  

  medicine to prevent or treat nausea and vomiting such as dolasetron (Anzemet), droperidol (Inapsine), or ondansetron (Zofran);

  
  


• 
  

  medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (FazaClo, Clozaril), haloperidol (Haldol), pimozide (Orap), thioridazine (Mellaril), or ziprasidone (Geodon);

  
  


• 
  

  migraine headache medicine such as sumatriptan (Imitrex, Treximet) or zolmitriptan (Zomig);

  
  


• 
  

  narcotic medication such as methadone (Methadose, Diskets, Dolophine).

  
  

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

More Halaven resources

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

• Halaven Prescribing Information (FDA)


• Halaven Advanced Consumer (Micromedex) - Includes Dosage Information


• Halaven MedFacts Consumer Leaflet (Wolters Kluwer)


• Halaven Consumer Overview

Compare Halaven with other medications

• Breast Cancer
• Breast Cancer, Metastatic

Where can I get more information?

• Your pharmacist can provide more information about eribulin.

See also: Halaven side effects (in more detail)

Histex HC Liquid

Pronunciation: car-bihn-OCKS-ah-meen/hye-droe-KOE-done/sue-do-eh-FED-rin
Generic Name: Carbinoxamine/Hydrocodone/Pseudoephedrine
Brand Name: Examples include Histex HC and Mintex HC

Histex HC Liquid is used for:

Relieving symptoms of sinus congestion, runny nose, sneezing, and cough due to colds, upper respiratory tract infections, and allergies. It may also be used for other conditions as determined by your doctor.

Histex HC Liquid is a decongestant, antihistamine, and cough suppressant combination. The decongestant works by constricting blood vessels and reducing swelling in the nasal passages. The antihistamine works by blocking the action of histamine, which helps reduce symptoms, such as watery eyes and sneezing. The cough suppressant works in the brain to help decrease the cough reflex, which reduces a dry cough.

Do NOT use Histex HC Liquid if:

• you are allergic to any ingredient in Histex HC Liquid or any other codeine- or morphine-related medicine (eg, codeine)


• you have severe high blood pressure, severe heart blood vessel disease, rapid heartbeat, or severe heart problems


• you are unable to urinate or are having an asthma attack


• you are taking sodium oxybate (GHB) or you have taken furazolidone or a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the last 14 days

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

Before using Histex HC Liquid:

Some medical conditions may interact with Histex HC 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 fast, slow, or irregular heartbeat, blood vessel problems, or other heart problems


• if you have a history of adrenal gland problems (eg, adrenal gland tumor); high blood pressure; diabetes; stroke; glaucoma; a blockage of your bladder, stomach, or intestines; ulcers; trouble urinating; an enlarged prostate or other prostate problems; or an overactive thyroid


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


• if you have a history of head or brain injury, brain tumor, increased pressure in the brain, infection of the brain or nervous system, epilepsy, or seizures


• if you have a history of stomach problems (eg, ulcers), 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 a history of alcohol or substance abuse or suicidal thoughts or behavior

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

• Beta-blockers (eg, propranolol), catechol-O-methyltransferase (COMT) inhibitors (eg, tolcapone), furazolidone, indomethacin, MAO inhibitors (eg, phenelzine), sodium oxybate (GHB), or tricyclic antidepressants (eg, amitriptyline) because the side effects of Histex HC Liquid may be increased


• Cimetidine, digoxin, droxidopa, or sodium oxybate (GHB) because the risk of severe drowsiness, breathing problems, seizures, irregular heartbeat, or heart attack may be increased


• Naltrexone because it may decrease Histex HC Liquid's effectiveness


• Bromocriptine or hydantoins (eg, phenytoin) because their side effects may be increased by Histex HC Liquid


• Guanadrel, guanethidine, mecamylamine, methyldopa, or reserpine because their effectiveness may be decreased by Histex HC Liquid

This may not be a complete list of all interactions that may occur. Ask your health care provider if Histex HC 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 Histex HC Liquid:

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

• Take Histex HC Liquid by mouth with or without food.


• 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 Histex HC 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 Histex HC Liquid.

Important safety information:

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


• Do not take diet or appetite control medicines while you are taking Histex HC Liquid without checking with your doctor.


• Histex HC Liquid has pseudoephedrine in it. Before you start any new medicine, check the label to see if it has pseudoephedrine in it too. If it does or if you are not sure, check with your doctor or pharmacist.


• 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.


• Histex HC Liquid may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Histex HC Liquid. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.


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


• Tell your doctor or dentist that you take Histex HC Liquid before you receive any medical or dental care, emergency care, or surgery.


• Use Histex HC Liquid with caution in the ELDERLY; they may be more sensitive to its effects.


• Caution is advised when using Histex HC Liquid in CHILDREN; they may be more sensitive to its effects.


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

When used for long periods of time or at high doses, Histex HC Liquid may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Histex HC Liquid stops working well. Do not take more than prescribed.

When used for long periods of time or at high doses, some people develop a need to continue taking Histex HC Liquid. This is known as DEPENDENCE or addiction.

If you suddenly stop taking Histex HC Liquid, you may experience WITHDRAWAL symptoms including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing, or feeling things that are not there; shivering or tremors; sweating; trouble sleeping.

Possible side effects of Histex HC 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; diarrhea; dizziness; drowsiness; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; vomiting; 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); difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; tremor; trouble sleeping; vision 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: Histex HC 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 Histex HC Liquid:

Store Histex HC 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 Histex HC Liquid out of the reach of children and away from pets.

General information:

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


• Histex HC 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 Histex HC Liquid. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Histex HC resources

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

Compare Histex HC with other medications

• Cold Symptoms
• Cough
• Nasal Congestion
• Sinus Symptoms

Herceptin

Generic Name: trastuzumab (Intravenous route)

tras-TOOZ-oo-mab

Intravenous route(Powder for Solution)

Trastuzumab can result in subclinical and clinical cardiac failure, with greatest risk when administered concurrently with anthracyclines. Evaluate cardiac function prior to and during treatment. Discontinue trastuzumab for cardiomyopathy. Serious and fatal infusion reactions and pulmonary toxicity may occur. Discontinue trastuzumab for anaphylaxis, angioedema, interstitial pneumonitis, or acute respiratory distress syndrome. Exposure during pregnancy can result in oligohydramnios, in some cases complicated by pulmonary hypoplasia and neonatal death .

Commonly used brand name(s)

In the U.S.

• Herceptin

Available Dosage Forms:

• Powder for Solution

Therapeutic Class: Immunological Agent

Pharmacologic Class: Monoclonal Antibody

Uses For Herceptin

Trastuzumab is a monoclonal antibody. It is used to treat new cases of breast cancer or disease that has spread to other parts of the body. Trastuzumab may prevent the growth of some breast tumors that produce extra amounts of a certain substance known as the HER2 protein. Trastuzumab should only be used in patients whose breast tumors have been shown to produce extra amounts of this protein. It can be used alone or with other cancer medicines (chemotherapy) such as doxorubicin, cyclophosphamide, paclitaxel, docetaxel, and carboplatin.

Trastuzumab is also used in combination with cisplatin and capecitabine or 5-fluorouracil to treat malignant tumor of the stomach and esophagogastric (esophagus and stomach) cancer, metastatic, HER2 overexpression.

Trastuzumab interferes with the growth of cancer cells, which are eventually destroyed by the body. Since the growth of normal body cells may also be affected by trastuzumab, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, such as a skin rash, may not be serious but may cause concern. Some effects do not occur until months or years after the medicine is used.

Before you begin treatment with trastuzumab, you and your doctor should talk about the benefits this medicine will do as well as the risks of using it.

This medicine is to be administered only by or under the immediate supervision of your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, trastuzumab is used in certain patients with the following medical conditions:

• Breast cancer, HER2-overexpressing disease, primary treatment in combination with chemotherapy, before surgery.

Before Using Herceptin

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

Appropriate studies have not been performed on the relationship of age to the effects of trastuzumab in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of trastuzumab in the elderly. However, elderly patients are more likely to have age-related heart problems, which may require caution in patients receiving trastuzumab.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

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

• Aclarubicin


• Cyclophosphamide


• Daunorubicin


• Daunorubicin Citrate Liposome


• Doxorubicin Hydrochloride


• Doxorubicin Hydrochloride Liposome


• Epirubicin


• Idarubicin


• Pirarubicin

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.

• Warfarin

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:

• Heart disease (e.g., cardiomyopathy, heart failure) or


• Heart rhythm problems (e.g., arrhythmia) or


• Hypertension (high blood pressure) or


• Lung disease (e.g., interstitial pneumonitis, pulmonary fibrosis)—Use with caution. May make these conditions worse.

• Infection—May decrease your body's ability to fight infection.

Proper Use of Herceptin

Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

A doctor or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins.

Trastuzumab must be given slowly, so the IV tube must remain in place for at least 90 minutes.

Precautions While Using Herceptin

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for any unwanted effects.

Your doctor may test your heart before you start receiving trastuzumab and while you are getting treatments with this medicine. Contact your doctor right away if you experience any chest pain, increased coughing, trouble with breathing, a sudden difficulty with breathing at night, rapid weight gain, or abnormal swelling in your ankles or legs. These could be symptoms of serious heart problems.

Using this medicine while you are pregnant may cause very serious birth defects (e.g., decreased amniotic fluid, bone problems). Use an effective form of birth control to keep from getting pregnant during treatment and for 6 months after the last dose of this medicine. If you think you have become pregnant while using the medicine, tell your doctor right away. Your doctor may want you to join a pregnancy registry for patients receiving this medicine.

Trastuzumab may cause a serious side effect called an infusion reaction. This can be life-threatening and requires immediate medical attention. Tell your doctor or nurse right away if you have a fever, chills, chest pain, lightheadedness, dizziness, fainting, headache, rash, pain, nausea, vomiting, trouble with breathing, or weakness within a few hours after you receive it.

This medicine can temporarily lower the number of white blood cells in your blood, which increases the chance of getting an infection. If this occurs, there are certain precautions you can take to reduce the risk of infection:

• If you can, avoid people with infections. Check with your doctor right away if you think you are getting an infection or if you get a fever or chills, a cough or hoarseness, lower back or side pain, or have painful or difficult urination.


• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.

Tell your doctor right away if you are having shortness of breath, chest tightness, or any type of breathing problem while receiving this medicine.

Cancer medicines can cause nausea or vomiting in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these side effects.

Herceptin 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 or nurse immediately if any of the following side effects occur:

More common

• Dizziness


• fever or chills


• headache


• muscle aches


• nausea or vomiting


• shortness of breath


• skin rash


• sore throat


• stuffy or runny nose


• unusual tiredness or weakness

Less common

• Bloody nose


• cough


• diarrhea


• difficult or labored breathing


• ear congestion or pain


• fast or irregular heartbeat


• general feeling of discomfort or illness


• head congestion


• hoarseness or other voice changes


• increased cough


• joint pain


• loss of appetite


• nasal congestion


• pain or tenderness around the eyes and cheekbones


• shivering


• sneezing


• sweating


• swelling of the feet or lower legs


• tightness in the chest


• trouble with sleeping


• vomiting


• wheezing

Rare

• Blue lips and fingernails


• blurred vision


• chest pain


• confusion


• cough or hoarseness, accompanied by fever or chills


• faintness or lightheadedness when getting up suddenly from a lying or sitting position suddenly


• itching


• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, feet, or sex organs


• lower back or side pain, accompanied by fever or chills


• painful or difficult urination, accompanied by fever or chills


• pale skin


• redness of the skin


• trouble with breathing

Incidence not known

• Black, tarry stools


• bloody or cloudy urine


• sores, ulcers, or white spots in the mouth


• unusual bleeding or bruising


• weight gain

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

• Pain

Less common

• Numbness or tingling of the hands or feet

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: Herceptin 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 Herceptin resources

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

• Herceptin Prescribing Information (FDA)


• Herceptin Consumer Overview


• Herceptin Monograph (AHFS DI)


• Herceptin MedFacts Consumer Leaflet (Wolters Kluwer)


• Trastuzumab Professional Patient Advice (Wolters Kluwer)

Compare Herceptin with other medications

• Breast Cancer
• Breast Cancer, Adjuvant
• Breast Cancer, Metastatic
• Esophageal Carcinoma
• Gastric Cancer
• Salivary Gland Cancer

Reese's Pinworm Medicine

Pronunciation: pi-RAN-tel
Generic Name: Pyrantel Pamoate
Brand Name: Reese's Pinworm Medicine

Reese's Pinworm Medicine is used for:

Treating certain worm infections (eg, pinworm, roundworm).

Reese's Pinworm Medicine is an anthelmintic agent. It works by paralyzing the nervous system of intestinal parasites (worms). The parasite is then passed in the stool.

Do NOT use Reese's Pinworm Medicine if:

• you are allergic to any ingredient in Reese's Pinworm Medicine


• you have liver problems

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

Before using Reese's Pinworm Medicine:

Some medical conditions may interact with Reese's Pinworm Medicine. 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 worms other than pinworms


• if others in your home also have pinworms

Some MEDICINES MAY INTERACT with Reese's Pinworm Medicine. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Piperazine because the effectiveness of Reese's Pinworm Medicine may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Reese's Pinworm Medicine 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 Reese's Pinworm Medicine:

Use Reese's Pinworm Medicine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Reese's Pinworm Medicine may be taken on an empty stomach or with food, milk, or juice.


• Wear tight underwear both day and night while taking Reese's Pinworm Medicine.


• Reese's Pinworm Medicine is usually prescribed as a single dose.


• Only one dose of Reese's Pinworm Medicine is required. If you forget to take Reese's Pinworm Medicine, take it as soon as you remember.

Ask your health care provider any questions you may have about how to use Reese's Pinworm Medicine.

Important safety information:

• Reese's Pinworm Medicine may cause drowsiness or dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Reese's Pinworm Medicine. Using Reese's Pinworm Medicine alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.


• This infection spreads easily to family members and close contacts. To prevent reinfection: Disinfect toilet and change and wash underwear, bed linens, towels, clothes, and pajamas daily. Wash hands with soap often during the day, especially before eating and after using the toilet. Do not scratch the infected area or place your fingers in your mouth.


• The entire household should be treated with Reese's Pinworm Medicine if one individual in the household has pinworms.


• After treatment with Reese's Pinworm Medicine, clean the bedroom floor by vacuuming or damp mopping.


• If any worms other than pinworms are visible after treatment with Reese's Pinworm Medicine, contact your doctor.


• Use Reese's Pinworm Medicine with extreme caution in CHILDREN younger than 2 years of age. Safety and effectiveness in this age group have not been confirmed.


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

Possible side effects of Reese's Pinworm Medicine:

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:

Diarrhea; dizziness; drowsiness; headache; loss of appetite; nausea; stomach cramps; trouble sleeping; 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).

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: Reese's Pinworm Medicine 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 Reese's Pinworm Medicine:

Store Reese's Pinworm Medicine 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 Reese's Pinworm Medicine out of the reach of children and away from pets.

General information:

• If you have any questions about Reese's Pinworm Medicine, please talk with your doctor, pharmacist, or other health care provider.


• Reese's Pinworm Medicine 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 Reese's Pinworm Medicine. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Reese's Pinworm Medicine resources

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

Compare Reese's Pinworm Medicine with other medications

• Ascariasis
• Enterobiasis
• Hookworm Infection, Necator or Ancylostoma
• Moniliformis Infection
• Pinworm Infection, Enterobius vermicularis
• Trichostrongylosis

Camptosar

Generic Name: irinotecan (EYE ri noe TEE kan)

Brand Names: Camptosar

What is irinotecan?

Irinotecan is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Irinotecan is used to treat cancers of the colon and rectum. It is usually given with other cancer medicines in a combination chemotherapy.

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

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

Do not use irinotecan if you are pregnant. It could harm the unborn baby. Irinotecan can cause severe diarrhea, which can be life-threatening if it leads to dehydration. Diarrhea can occur soon after your injection or more than 24 hours later.

Your doctor may recommend you have an anti-diarrhea medicine such as loperamide (Imodium) available at all times while you are receiving irinotecan. Take the anti-diarrhea medication at the first sign of loose or frequent bowel movements.

Call your doctor if you still have diarrhea after 24 hours of taking anti-diarrhea medicine.

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

Do not receive a "live" vaccine while using irinotecan, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you.

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

You should not use irinotecan if you are allergic to it.

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

• 
  

  liver or kidney disease;

  
  


• 
  

  diabetes;

  
  


• 
  

  asthma, chronic obstructive pulmonary disease (COPD), sleep apnea, or other breathing disorder;

  
  


• 
  

  an intestinal disorder or obstruction;

  
  


• 
  

  Gilbert's syndrome;

  
  


• 
  

  fructose intolerance (irinotecan contains sorbitol); or

  
  


• 
  

  if you are receiving radiation treatment to your abdomen or pelvic area.

  
  

FDA pregnancy category D. Do not use irinotecan if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. It is not known whether irinotecan passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using irinotecan.

How is irinotecan given?

Your doctor may recommend a DNA test before your first dose of irinotecan. Some people are genetically more likely to have certain side effects from irinotecan.

Irinotecan is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Irinotecan must be given slowly, and the IV infusion can take up to 90 minutes to complete.

You may be given other medications to prevent nausea, vomiting, diarrhea, and other side effects while you are receiving irinotecan. You may need to keep using these medications for at least a day after your irinotecan injection.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when irinotecan is injected. If any of the medicine gets on your skin, wash right away with soap and water. Irinotecan can cause severe diarrhea, which can occur soon after your injection or more than 24 hours later. You can easily become dehydrated if you have ongoing diarrhea. You may also develop a severe infection or a serious electrolyte imbalance.

Your doctor may recommend you have an anti-diarrhea medicine such as loperamide (Imodium) available at all times while you are receiving irinotecan. Take the anti-diarrhea medication at the first sign of loose or frequent bowel movements.

Call your doctor if you still have diarrhea after 24 hours of taking anti-diarrhea medicine. Do not take loperamide for longer than 2 full days without your doctor's advice.

To be sure this medication is not causing harmful effects, your blood may need to be tested often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.

If you need surgery, tell the surgeon ahead of time that you are using irinotecan.

What happens if I miss a dose?

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

What happens if I overdose?

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

Overdose symptoms may include some of the serious side effects listed in this medication guide.

What should I avoid while using irinotecan?

Avoid using a laxative or stool softener during treatment with irinotecan.

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

Do not receive a "live" vaccine while using irinotecan, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), oral polio, typhoid, chickenpox (varicella), BCG (Bacillus Calmette and Guérin), and nasal flu vaccine. Irinotecan may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Irinotecan 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. Call your doctor at once if you have a serious side effect such as:

• 
  

  wheezing, feeling short of breath;

  
  


• 
  

  chest pain, dry cough;

  
  


• 
  

  pale skin, feeling light-headed, rapid heart rate, trouble concentrating;

  
  


• 
  

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

  
  


• 
  

  runny nose, watery eyes, increased sweating, stomach cramps, and flushing (warmth, redness, or tingly feeling);

  
  


• 
  

  black, bloody, or tarry stools;

  
  


• 
  

  nausea or vomiting that keeps you from drinking enough fluids;

  
  


• 
  

  burning, pain, or swelling around the IV needle;

  
  


• 
  

  sudden numbness or weakness, problems with vision, speech, or balance;

  
  


• 
  

  swelling, rapid weight gain; or

  
  


• 
  

  feeling very thirsty or hot, being unable to urinate, heavy sweating, feeling light-headed, or hot and dry skin.

  
  

Less serious side effects may include:

• 
  

  dizziness;

  
  


• 
  

  temporary hair loss.

  
  


• 
  

  loss of appetite, constipation;

  
  


• 
  

  mild skin rash; or

  
  


• 
  

  redness or peeling of the skin on your hands and feet.

  
  

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 irinotecan?

Before you are treated with irinotecan, tell your doctor about all other cancer medicines you have recently used.

Tell your doctor about all other medicines you use, especially:

• 
  

  atazanavir (Reyataz);

  
  


• 
  

  a diuretic (water pill);

  
  


• 
  

  ketoconazole (Extina, Ketozole, Nizoral, Xolegal);

  
  


• 
  

  rifabutin (Mycobutin);

  
  


• 
  

  rifampin (Rifadin, Rifater, Rifamate, Rimactane);

  
  


• 
  

  St. John's wort; or

  
  


• 
  

  seizure medicine such as carbamazepine (Carbatrol, Tegretol), phenobarbital (Solfoton), or phenytoin (Dilantin).

  
  

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

• Camptosar Side Effects (in more detail)
• Camptosar Dosage
• Camptosar Use in Pregnancy & Breastfeeding
• Camptosar Drug Interactions
• Camptosar Support Group
• 1 Review for Camptosar - Add your own review/rating

• Camptosar Prescribing Information (FDA)


• Camptosar Consumer Overview


• Camptosar Monograph (AHFS DI)


• Camptosar MedFacts Consumer Leaflet (Wolters Kluwer)


• Camptosar Advanced Consumer (Micromedex) - Includes Dosage Information


• Irinotecan Prescribing Information (FDA)


• Irinotecan Professional Patient Advice (Wolters Kluwer)

Compare Camptosar with other medications

• Colorectal Cancer

Where can I get more information?

• Your doctor or pharmacist can provide more information about irinotecan.

See also: Camptosar side effects (in more detail)

Canges-XP

Generic Name: guaifenesin and hydrocodone (gwye FEN e sin and HYE droe KOE done)

Brand Names: A-Cof DH, Canges-XP, Codiclear DH, Condasin, Cotuss V, Execlear, Extendryl HC, Hycotuss Expectorant, Hydrocod-GF, Kwelcof, Monte-G HC, Narcof, Pancof XP, Pneumotussin 2.5, Relasin-HCX, Touro HC, Tussicle, Tusso-DF, Vi-Q-Tuss, Vitussin Expectorant, Xpect-HC, Z-Cof HCX

What is Canges-XP (guaifenesin and hydrocodone)?

Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.

Hydrocodone is a narcotic cough suppressant.

Guaifenesin and hydrocodone is used to treat cough and reduce chest congestion caused by the common cold, flu, or allergies.

Guaifenesin and hydrocodone may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Canges-XP (guaifenesin and hydrocodone)?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Drinking alcohol can increase certain side effects of guaifenesin and hydrocodone. Tell your doctor if you regularly use other medicines that make you sleepy (such as other cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by guaifenesin and hydrocodone. Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Keep the medication in a secure place where others cannot get to it.

What should I discuss with my healthcare provider before taking Canges-XP (guaifenesin and hydrocodone)?

Hydrocodone may be habit forming and should be used only by the person it was prescribed for. Never share this medication with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Do not use this medicine if you are allergic to hydrocodone or guaifenesin.

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

• 
  

  liver or kidney disease;

  
  


• 
  

  asthma;

  
  


• 
  

  urination problems;

  
  


• 
  

  an enlarged prostate;

  
  


• 
  

  a thyroid disorder;

  
  


• 
  

  seizures or epilepsy;

  
  


• 
  

  gallbladder disease;

  
  


• 
  

  a head injury; or

  
  


• 
  

  Addison's disease.

  
  

FDA pregnancy category C. It is not known whether this medication will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Guaifenesin and hydrocodone can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take Canges-XP (guaifenesin and hydrocodone)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Guaifenesin and hydrocodone can be taken with or without food.

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

Call your doctor if your symptoms do not improve, or if they get worse. Store at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Guaifenesin and hydrocodone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

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

What happens if I overdose?

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

Overdose symptoms may include extreme drowsiness, sweating, pinpoint pupils, nausea, vomiting, dry mouth, confusion, cold and clammy skin, muscle weakness, fainting, weak pulse, slow heart rate, seizure (convulsions), weak or shallow breathing, or breathing that stops.

What should I avoid while taking Canges-XP (guaifenesin and hydrocodone)?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Drinking alcohol can increase certain side effects of guaifenesin and hydrocodone.

Ask a doctor or pharmacist before using any other cough, cold, allergy, pain, or sleep medicine. Guaifenesin is contained in many combination medicines. Taking certain products together can cause you to get too much guaifenesin. Check the label to see if a medicine contains guaifenesin.

Canges-XP (guaifenesin and hydrocodone) side effects

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

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  slow heart rate, weak or shallow breathing;

  
  


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  feeling like you might pass out;

  
  


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  confusion, fear, unusual thoughts or behavior;

  
  


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  seizure (convulsions); or

  
  


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  urinating less than usual or not at all.

  
  

Less serious side effects may include:

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  dizziness, drowsiness;

  
  


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  nausea, vomiting, upset stomach;

  
  


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  blurred vision;

  
  


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  constipation;

  
  


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  dry mouth; or

  
  


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  sweating.

  
  

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 Canges-XP (guaifenesin and hydrocodone)?

Tell your doctor if you regularly use other medicines that make you sleepy (such as other cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by guaifenesin and hydrocodone.

Tell your doctor about all other medicines you use, especially:

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  antidepressants such as amitriptyline (Elavil, Vanatrip, Limbitrol), doxepin (Sinequan), nortriptyline (Pamelor), and others;

  
  


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  atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), glycopyrrolate (Robinul), mepenzolate (Cantil), methscopolamine (Pamine), or scopolamine (Transderm-Scop);

  
  


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

  
  


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  a bronchodilator such as ipratropium (Atrovent) or tiotropium (Spiriva); or

  
  


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  irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine).

  
  

This list is not complete and other drugs may interact with guaifenesin and hydrocodone. 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 Canges-XP resources

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

• CodiCLEAR DH Liquid MedFacts Consumer Leaflet (Wolters Kluwer)


• Entuss Liquid MedFacts Consumer Leaflet (Wolters Kluwer)


• Tusso-HC Sustained-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Canges-XP with other medications

• Cough

Where can I get more information?

• Your pharmacist can provide more information about guaifenesin and hydrocodone.

See also: Canges-XP side effects (in more detail)