Jul
26
Bicalutamide
July 26, 2009 | Leave a Comment
Generic Name
Bicalutamide (bye-kal-UTE-uh-mide)
Brand tjSMb Casodex
The information in this profile also applies to the following drug:
Generic Ingredient: Nilutamide Nilandron
Type of Drug Antiandrogen.
Prescribed For Prostate cancer.
General Information
Antiandrogens are prescribed together with another hormone product for prostate cancer. Bicalutamide competes with testosterone and other natural androgens (male hormones) by binding to the same places in body tissue where androgens normally bind. Prostate cancer is androgen sensitive and responds to treatments that counteract the effects of androgen or remove the sources of androgen.
Cautions and Warnings
Do not take this drug if you are allergic or sensitive to it or any of its ingredients.
People taking this medication may develop severe liver injury. People with liver disease may be at greater risk for serious side effects.
Almost 40% of men taking bicalutamide as single therapy for prostate cancer develop breast pain and enlargement. Bicalutamide may also reduce sperm count.
Two of every 100 people taking nilutamide develop interstitial pneumonitis (symptoms include cough, chest pain, fever, and breathing difficulties). People with lung disease and Asians may be at greater risk. Report any breathing difficulty or worsening of pre-existing breathing difficulty to your doctor immediately.
Isolated cases of aplastic anemia (a potentially fatal blood disorder) have been reported in people taking nilutamide, but the relationship between the drug and the disease is not established.
Possible Side Effects
♦ Most common’. hot dashes, hot flushes, general pain, headache, weakness, back pain, nausea, constipation, sleeplessness, breathing difficulties, and swollen breasts. Nilutamide–difficulty seeing in the dark and loss of testicle function.
V Common: diarrhea and pelvic pain.
Possible Side Effects (continued)
♦ Less common: vomiting, abdominal pains, chest pain, flu-like symptoms, high blood pressure, swelling in the ankles or lower legs, high blood sugar, weight loss, dizziness, tingling in the hands or feet, sweating, rash, nighttime urination, blood in the urine, urinary or other infection, loss of libido, impotence, breast pain, painful urination, anemia, and bone pain.
♦ Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Bicalutamide and nilutamide increase the effect of oral anticoagulant (blood-thinning) drugs such as warfarin. Dosage adjustment may be necessary.
• Nilutamide may increase the risk of the potentially serious side effects of phenytoin, theophylline, or vitamin K antagonists.
Food Interactions
None known. Usual Dose
Bicalutamide
Adult: 50 mg once a day, morning or night.
Nilutamide
Adult: 300 mg a day, reduced to 150 mg a day after 30 days.
Overdosage
Symptoms of overdose may include nausea, vomiting, tiredness, headache and dizziness. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the presc6pktm bottle or container,
Special Information
Report anything unusual to your doctor, especially pain or tenderness in the upper right abdomen, yellowing of skin or whites of eyes, severe itching, dark urine, persistent appetite loss, and unexplained flu-like symptoms. These may be signs of severe liver toxicity. Also report any breathing difficulties, cough, chest pain,
orfever.
Up to half of people taking nilutamide can take from a few sec-
onds to a few minutes to adapt to darkness. This can be a problem especially when driving at night or through tunnels. Wearing tinted glasses will minimize this effect.
Up to 5% of people taking nilutamide may experience intolerance to alcohol. Symptoms include flushing, tiredness, and lightheadedness. If you experience this reaction, you should avoid alcohol.
Bicalutamide should be taken at the same time each day for best results. If you forget a dose of bicalutamide, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Call your doctor if you forget to take more than 1 dose.
Special Populations
PregnancylBreast-feeding: Antiandrogens are not intended for use by women.
Seniors: Seniors may take this drug without special precaution.
Jul
26
Betaxolol
July 26, 2009 | Leave a Comment
Generic Name
Betaxolol (bay-TAX-0-101) IN
Brand Names
Betoptic Kerlone Betoptic S
The information in this profile also applies to the following drugs:
Generic Ingredient: Carteolol Ocupress
Generic Ingredient: Levobunolol 92
AK Beta Betagan
Generic Ingredient: Metipranolol Optipranolol
Type of Drug
Beta-adrenergic blocking agent. Prescribed For
High blood pressure and glaucoma.
General Information
betaxololhydrochloride is one of many beta-adrenergic blocking drugs, or beta blockers, which interfere with the action of a specific part of the nervous system. Beta receptors are found all over the body and affect many body functions. Each beta blocker has particular characteristics that make it more suitable for certain conditions or people. Beta-blocker eyedrops reduce ocular pressure (pressure inside the eye) by slowing the production of eye fluids and by slightly increasing the rate at which these fluids flow through and leave the eye. Small amounts of these drugs are absorbed into the general blood circulation after they are instilled in the eye and may affect areas of the body other than the eye.
Cautions and Warnings
Q(3 M *e betaxolol if you are allergic or sensitive to any of its ingredients. You should be cautious about taking betaxolol if you have asthma, chronic bronchitis, emphysema, severe heart failure, a very slow heart rate, or heart block (disruption of the electrical impulses that control heart rate) because the drug may aggravate these conditions.
People with angina risk aggravating their angina if they suddenly stop taking the drug. These people should have their betablocker eyedrops dosage reduced gradually over 1-2 weeks.
Liver or kidney problems may reduce your ability to eliminate beta-blocker eyedrops from your body.
Beta-blocker eyedrops may mask the physical signs of hypoglycemia (low blood sugar). People with diabetes who must take insulin or oral medications to lower blood sugar and those subject to hypoglycemia should use beta-blocker eyedrops with caution.
Beta-blocker eyedrops may reduce the amount of blood your heart pumps with each beat. This reduction in blood flow may aggravate the condition of people with poor circulation or circulatory disease.
If you are undergoing major surgery, your doctor may want you to stop using beta-blocker eyedrops at least 2 days before surgery.
Betaxolol eyedrops should be avoided by people who cannot take oral beta-blocking drugs such as propranolol.
People with a history of severe anaphylactic reaction to allergens may be unresponsive to usual doses of epinephrine while taking beta blockers.
Possible Side Effects
Side effects are relatively uncommon and usually mild.
✓ Common: discomfort in the eye.
✓ Less common: blurred vision, inflammation of the cornea, sensation of having something in the eye, sensitivity to light, tearing, itching, dry eye, redness, inflammation, discharge, eye pain, cloudy vision, and crusting of the lashes.
✓ Rare: unusual tiredness or weakness, slow heartbeat, heart failure, dizziness, breathing difficulties, bronchospasm, depression, rash, and hair loss. Contact your doctor if you experience any side effect not listed above.
I
OMg ITAGractions
Beta-blocker eyedrops may interact with surgical anesthetics to increase the risk of heart problems during surgery. Some anesthesiologists recommend gradually stopping the drug Combining beta-blocker eyedrops and oral beta blockers will increase the effects of each drug. These drugs should be combined cautiously.
• Cocaine may reduce the effectiveness of all beta-blocker eyedrops.
• Betaxolol will counteract thyroid hormone replacements.
• Calcium channel blockers, reserpine, phenothiazine compounds, and quinidine may increase the amount of betablocker eyedrops in the bloodstream and lead to low blood pressure and heart rate disturbances.
• Betaxolol should not be taken within 2 weeks of taking a monoamine oxidase inhibitor (MAOI) antidepressant.
• Combining betaxolol with digitalis drugs can result in ex-
cessive slowing of the heart, possibly causing heart block.
• If you use other glaucoma eye medications, separate your doses to avoid physically combining them.
• Small amounts of beta-blocker eyedrops are absorbed into the bloodstream and may interact with other drugs in the same way as oral beta blockers, although this is unlikely.
• Beta blockers may block the effects of epinephrine.
• If you stop smoking while taking betaxolol, your dose may have to be reduced because your liver will break down the drug more slowly afterward.
Food Interactions
None known. Usual Dose
Adult
Glaucoma: 1-2 drops in the affected eye twice a day.
Hypertension: 10 mg tablet a day. May increase to 20 mg a day after 7-14 days. For seniors or people with severe kidney impairment, starting dose is 5 mg.
Child: not recommended. Overdosage
If Q\4tCqOSZ Occurs in the eye, flush it with water or saline. If accidentally ingested, symptoms of overdose of beta-blockers taken orally may occur. These include changes in heartbeat—unusually slow, unusually fast, or irregular—severe dizziness or fainting, breathing difficulties, bluish-colored fingernails or palms, low blood pressure, heart failure, shock, and seizures. If these symptoms occur, the victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container with you.
Special Information
Call your doctor at once if you develop back or joint pain, breathing difficulties, cold hands or feet, depression, rash, or changes in heartbeat. Beta-blocker eyedrops may produce an undesirable lowering of blood pressure, leading to dizziness or fainting; call your doctor if this happens to you. Also call your doctor if you experience persistent or bothersome anxiety, diarrhea, constipation, impotence, headache, itching, nausea or vomiting, nightmares or vivid dreams, upset stomach, trouble sleeping, stuffy nose, frequent urination, unusual tiredness, or weakness.
Do not use with your contact lenses in your eye. Do not touch the dropper to any surface.
If you forget a dose of beta-blocker eyedrops, administer it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: In animal studies, betaxolol given orally at doses much higher than is absorbed through administration in the eye was associated with miscarriage. There is little information about the effects of betaxolol in pregnant women. Betaxolol should be used during pregnancy only if the benefit outweighs the risk.
Some beta blockers pass into breast milk. Nursing mothers taking beta-blocker eyedrops should use infant formula.
Seniors: Seniors may take betaxolol without special precautions.
Jul
26
Becaplermin
July 26, 2009 | Leave a Comment
If you forget a dose, apply it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Special Populations
Pregnancy/Breast-feeding
The safety of using becaplermin during pregnancy is not known. The drug should only be used during pregnancy if it is absolutely necessary.
It is not known if becaplermin passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors
Seniors may take this drug without special precaution.Generic Name
Becaplermin (beh-CAP-ler-min)
Brand Name Regranex
Type of Drug Human growth factor.
Prescribed For
Diabetic foot and leg wounds.
General Information
Becaplermin is a type of human growth factor produced in a laboratory. While it is not a substitute for good wound care, becaplermin can stimulate wound tissue to heal taster. Studies of the drug have produced mixed results. In some studies, people using becaplermin were 111.–2 times more likely to have complete healing of their wounds. In another study, the results with becaplermin were the same as those with good wound care alone.
Cautions and Warnings
Do not use becaplermin if you are allergic or sensitive to any of its ingredients.
Becaplermin should not be used to speed the healing of wounds that are healing by themselves.
Becaplermin should not be applied to skin cancer or tumors or exposed bones, joints, tendons, or ligaments because its effect on these body structures is not known.
Becaplermin should not be used for wounds that do not extend to subcutaneous tissue or are caused by poor circulation.
Drug and Food Interactions None known.
Usual•Dose
Adult and Child (age 16 and over): Apply a thin layer to the wound and leave in place for 12 hours. Then, remove the becaplermin bandage, rinse the wound, and cover it with a plain saline-soaked bandage for the rest of the day. Continue this process until the wound has healed completely.
Child (under age 16): not recommended.
Overdosage
Little is known about the effects of accidental ingestion. Call your local poison control center or a hospital emergency room for information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
Call your doctor if your wound worsens or is irritated by becaplermin.
Wash your hands bet43ve -applying becaplermin.
Do not allow the tip of the becaplermin tube to touch any surface, including the wound being treated.
Your doctor should reassess your treatment if the wound is not 30% smaller in 10 weeks and completely healed in 20 weeks.
Applying more becaplermin than recommended will not make your wound heal better or faster.
alone. plus wound care had a eveloping a rash than those who re-
e.
Possible Side Effects
People treated with becaplermin larger risk of developing wound care.
Jul
26
Baclofen
July 26, 2009 | Leave a Comment
Generic Name
Baclofen (BAK-loe-fen)
Brand Name Kemstro
Type of Drug
Skeletal muscle relaxant.
Prescribed For
Muscle spasms associated with multiple sclerosis (MS), spinal cord injury or disease, or other nervous system conditions; may also be used to treat trigeminal neuralgia (tic douloureux), hiccups, acid reflux, and as migraine prevention.
QeCttt!b% %iftTimation
Baclofen may work by interfering with nervous system reflexes at the spinal cord, although it may also have some effect outside the spinal cord. Baclofen is chemically similar to a natural nerve transmitter known as GABA; baclofen’s effect on muscle spasm may be related to its effect on GABA nerve receptors.
cautions and Warnings
Do not take baclofen if you are allergic or sensitive to any of its ingredients. It should not be taken for muscle spasm resulting from rheumatic disease, stroke, cerebral palsy, or Parkinson’s disease because its benefit in these situations has not been proven. The condition of people with epilepsy or psychotic disorders may worsen while taking baclofen.
About 4% of women with MS who take baclofen for less than 1 year develop ovarian cysts that usually disappear on their own. This is within the normal range for all women-1-5%—for developing ovarian cysts.
Baclofen is excreted primarily through the kidneys, so patients with kidney disease or impaired kidney function should use baclofen with caution.
Abruptly stopping baclofen can lead to hallucinations and seizure. Dosage should always be gradually reduced, except in cases of severe side effects.
Possible Side Effects
Baclofen may affect lab tests for liver function and can raise blood sugar levels.
♦ Most common: drowsiness, low blood pressure, weakness, dizziness, lightheadedness, nausea and vomiting, headache, and sleeplessness.
♦ Less common: frequent urination, fatigue or lethargy, confusion, euphoria, excitement, depression, hallucinations, tingling in the hands or feet, muscle pain, ringing or buzzing in the ears, coordination difficulties, tremors, rigidity, weakness, loss of muscle tone, unusual eye movement and other muscle-control problems, double vision, pinpoint or wide-open pupils, breathing difficulties, heart palpitations, dry mouth, appetite loss, changes in sense of taste, abdominal pain, diarrhea, bedwetting, difficulty u6- nating, painful urination, impotence, gash, Itching, swelling of the ankle, excessive sweating, weight gain, and stuffy
MSe.
• Rare: slurred speech, blurred vision, seizure, fainting, chest pain, blood in the urine, and testing positive for blood in the stool. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Avoid alcoholic beverages and other nervous system depressants such as antihistamines, sedatives, or narcotic pain relievers while taking baclofen.
• Combining a monoamine oxidase inhibitor (MA01) antidepressant with baclofen may cause drowsiness, nervous system depression, and low blood pressure.
• Combining a tricyclic antidepressant with baclofen may lead to severe muscle weakness.
• Baclofen may increase blood sugar. Diabetics may need to increase their dosage of antidiabetic drugs to account for this effect.
• Combining blood-pressure-lowering drugs with baclofen may lead to dizziness or fainting due to severe lowering of blood pressure.
Food Interactions
This drug may be taken without regard to food or meals.
Usual Dose
Adult and Child: 5 mg 3 times a day for 3 days, gradually increased every 3 days until the desired effect is achieved, usually at 40-80 mg a day. People with kidney disease require lower doses.
Overdosage
Symptoms of baclofen overdose include vomiting, loss of muscle tone, twitching, convulsions, pinpoint or wide-open pupils, drowsiness, blurred or double vision, breathing difficulties, seizure, and coma. Overdose victims should be taken to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Baclofen is a nervous system depressant. Take care when driving or doing anything that requires concentration and physical coordination.
Call your doctor if you develop persistent symptoms such as a frequent u((;e, t0 %,miwale, painful urination, constipation, nausea, headache, sleeplessness, or confusion.
Do not stop taking baclofen on your own. Abruptly stopping this drug may lead to hallucinations or seizure.
Your pharmacist may prepare a baclofen liquid. This mixture should be kept in the refrigerator and must be thrown away after I month.
If you forget a dose of baclofen and remember within 1 hour of your scheduled time, take it immediately. If you do not remember until more than 1 hour later or it 1()u JoTgetft completely. skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Baclofen increases the chances of certain birth defects in lab animals. Pregnant women should only take baclofen after carefully weighing its possible benefits against its risks.
Baclofen taken by mouth passes into breast milk. Nursing mothers who must take this drug should use infant formula or receive the drug by injection directly into the spinal cord, because baclofen administered by injection does not pass into breast milk.
Seniors: Seniors may be more sensitive to nervous system side effects including hallucinations, depression, drowsiness, and confusion.
Jul
26
Azole Antifungals
July 26, 2009 | Leave a Comment
Type of Drug
Azole Antifungals
Brand Names
Generic Ingredient: Fluconazole 91 Diflucan
Generic Ingredient: Itraconazole Sporanox
Generic Ingredient: Ketoconazole 0
Extina Nizoral
Ketozole Xolegel
Generic Ingredient: Posaconazole Noxafil
Generic Ingredient: Voriconazole Wend
PlIM-fibed For
Fungal infections of the blood, mouth, throat, vagina, or central nervous system.
Fluconazole, posaconazole, and itraconazole can be used to treat opportunistic fungal infections that inflict many people with HIV or cancer whose immune systems have been compromised.
General Information
Azole antifungals are used to treat a variety of fungal organisms, including Candida, aspergillus, cryptococcus, blastomycosis, fusarium, histoplasmosis, and Scedosporium. They work by inhibiting important enzyme systems in the organisms they attack. These drugs are broken down in the liver.
Cautions and Warnings
Do not take azole antifungals if you are allergic or sensitive to any of their ingredients. People who are allergic to similar antifungals may also be allergic to these drugs, but cross-reactions are not common and serious allergic reaction is rare.
Azole antifungals can affect heart rhythm and should be used with caution if you have a history of abnormal heart rhythms.
Rarely, azole antifungals can cause liver damage. The drugs should be used with caution in people with liver disease. At least one in every 10,000 people who take ketOGonazole develop liver inflammation. The inflammation generally subsides when the drug is discontinued.
Voriconazole tablets contain lactose. They should not be taken by patients with rare hereditary problems of galactose intolerance, Lapp-lactase deficiency, or glucose-galactose malabsorption.
Rash may be an important sign of drug toxicity, especially in people with HIV or others with compromised immune function. Report any rashes, especially ones that do not heal readily, to your doctor.
These drugs can have very serious effects if combined with other medicines. See “Drug Interactions” for specific information.
Possible Side Effects
Side effects are generally more common among people with HIV.
Fluconazole
V Most common *wa)jsea, headache, rash, vomiting, ab- dominal pain, and diarrhea.
V Less common: liver toxicity, as measured by increases in specific lab tests. These changes in lab values are more common in people with HIV or cancer, who are more likely to be taking several drugs.
Possible Side Effects (continued)
V Rare: seizures and exfoliative skin disorders. People with
HIV or cancer who take fluconazole for fungal infections
may develop severe liver or skin problems. Contact your
doctor if you experience any side effect not listed above.
Itraconazole
• Most common: nausea, vomiting, and rash.
♦ Less common: diarrhea, abdominal pain, appetite loss, swelling in the legs or feet, fatigue, fever, feeling unwell, itching, headache, dizziness, reduced sex drive, tiredness, high blood pressure, liver or kidney function abnormalities, low blood potassium, and impotence.
♦ Rare: gas, sleeplessness, depression, ringing or buzzing in the ears, bronchitis, chest pain, coughing, and swollen or painful breasts in men or women. Contact your doctor if you experience any side effect not listed above.
Ketoconazole
✓ Common: nausea, vomiting, upset stomach, abdominal pain or discomfort, itching, and swollen breasts in men. Most of these side effects are mild and only a small number of people-1.5%—have to stop taking the drug because of severe side effects.
Posaconazole
✓ Most common: fever, headache, chills, swelling in the legs, appetite loss, dizziness, fluid accumulation, weakness, blood pressure changes, anemia, low white-blood-cell counts with or without fever, vaginal bleeding, diarrhea, nausea, vomiting, abdominal pain, constipation, upset stomach, mucous membrane irritation, rapid heart beat, bacteria in the blood, herpes infection, CMV infection, infection, sore throat, low blood potassium, low blood magnesium, high blood sugar, muscle and joint pain, back pain, low blood-platelet levels, ‘,-A-&ZVanO -blue marks, sleep%’Mess, cough, difficulty breathing, nosebleeds, and rash and itching.
♦ Common: upper respiratory infection, low blood calcium, and anxiety.
✓ Less common: tiredness, weakness, blurred vision, taste changes, and heart rhythm changes.
Drug Interactions
• Do not mix astemizole, cisapride, halofantrine, pimozide. quinidine, or terfenadine with itraconazole, ketoconazole, or posaconazole. Severe cardiac side effects may occur. Similarly, combining fluconazole with cisapride may cause cardiac events. Do not mix these medicines.
• Antacids interfere with the absorption of ketoconazole and itraconazole. Take antacids more than 2 hours after taking these drugs.
• Fluconazole and ketoconazole may increase the amount of the sulfonylurea-type antidiabetes drugs (eg. tolbutamide, glyburide, and glipizide) in the blood, causing low blood sugar. Cyclosporine, phenytoin, theophyiline, warfarin, and zidovudine (an HIV drug—also known as AZT) are similarly affected. Dosage adjustments of these drugs and monitoring may be required.
• Ketoconazole may also increase blood levels of HIV drugs including protease inhibitors and didanosine (ddl).
• Use caution when combining fluconazole with rifabutin, rifampin, tacromilus, and terfenadine. Dose adjustments may be necessary.
• Fluconazole and ketoconazole may interfere with contraceptive drugs. Consider using an alternative form of birth control.
• Hydrochlorothiazide may increase blood levels of fluconazole up to 40%.
• Do not mix ketoconazole with triazolam.
• Ketoconazole increases the effects of benzodiazepk”-_ se0atives, buspirone, carbamaze, ime. corticosteroids, digoxin, do(I8ptl15, Wodipine, nisoldipine, tacrolimus, tricyclic antidepressants, vinca-type alkaloids, and zolpidem. Dosage adjustments may be required.
• Do not mix itraconazole with dofetilide, ergot alkaloids, midazolam, or triazolam.
• Use caution when combining itraconazole with alfentanil, aripiprazole, buspirone, calcium channel blockers,
Possible Side Effects (continued) Voriconazole
✓ Most common: visual disturbances.
♦ Common: fever, rash, nausea, in blood infections, swelling the arms or legs, and
respiratory disorder.
carbamazepine, cilostazol, clarithromycin, corticosteroids, digoxin, erythromycin, halofantrine, haloperidol, sirolimus, tacrolimus, verapamil, vinca-type alkaloids, warfarin, and zolpidem. Dose adjustments may be necessary.
• Rarely, people who combine itraconazole or posaconazole with a statin-type blood-fat lowering drug experience muscle pain and destruction. The statin drug dose should be reduced. Some people who have experienced this interaction were also taking cyclosporine. cyclosporine dosages should be lowered when combined with itraconazole and a statin drug. Do not combine itraconazole with lovastatin or simvastin.
• Cimetidine, didanosine, famotidine, isoniazid, nizatidine, phenytoin, protease inhibitors, ranitidine, rifabutin, rifampin, and rifapentine may interfere with the effectiveness of itraconazole and posaconazole.
• Voriconazole should not be combined with astemizole, barbiturates, carbamazepine, cisapride, efavirenz, ergot drugs for migraines, pirnozide, quinidine, rifabutin, rifampin, sirolimus, and terfenadine.
• Serious increases in levels of cyclosporine and tacrolimus have been reported when mixed with posaconazole. Dosage adjustments are required.
• Posaconazole and an ergot drug should not be mixed.
• Voriconazole and posaconazole should be used with caution with benzodiazepine sedatives, calcium channel blockers, cyclosporine, methadone, statin-type drugs, sulfonylureatype antidiabetes drugs, tacrolimus, vinca-type anti-cancer drugs, and warfarin. Dosage adjustments of these drugs may be needed to avoid side effects.
• Combining voriconazole and contraceptive drugs, omeprazole, phenytoin, or a protease inhibitor (excluding indinavir) may require dose adjustments and frequent monitoring for drug toxicity.
• Combining voriconazole with an NNRTI for HIV can either increase or decrease blood levels of voriconazole and increase blood levels Qt the NNM~.Drug side effects may occur.
Food Interactions
Take voriconazole at least 1 hour before or 2 hours after a meal. Take ketoconazole and itraconazole with food or meals. Posaconazole must be taken with food or a nutritional supplement. Another treatment should be considered if this requirement cannot be met.
Usual Dose
6uconazole
Adult and Child (age 14 and over): 100-400 mg once a day. Child: 1.3-5.5 mg per lb. of body weight once a day; no more
than 400 mg a day.
Itraconazole
Adult: 200-600 mg once a day.
Child (age 3-16): 100 mg a day has been prescribed, but the long-term effects of itraconazole in children are not known.
Ketoconazole
Oral
Adult: 200-400 mg once a day. Treatment may continue for several months, depending on the type of infection being treated.
Child (age 2 and over): 1.5-3 mg per lb. of body weight once a day.
Child (under age 2): not recommended.
Topical: Apply to affected and immediately surrounding areas 12 times a day for 2-6 weeks, depending on the type of infection being treated.
Posaconazole
Adult and Child (age 13 and over): 200 mg (5 ml) 3 times a day. This product includes a measuring spoon. Child (under age 13): not recommended.
Voriconazole
Adult: 100-300 mg every 12 hours. Child: not recommended.
Overdosage
Overdose is likely to result in exaggerated drug side effects. Doses of posaconazole up to 1600 mg a day have been taken without any adverse reactions. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special WIMMation
When taking fluconazole, regular doctor visits are necessary to monitor liver function and general progress. Call your doctor if you develop severe diarrhea; vomiting; reddening, loosening, blistering, or peeling of the skin; darkening of the urine; jaundice (yellowing of the skin or whites of the eyes); loss of appetite; or abdominal pain, especially on the right side. Report other symptoms that are bothersome or persistent.
Itraconazole must be taken for at least 3 months to determine its effectiveness; otherwise, the infection may return.
If you forget a dose of one of these medicines, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Animal studies with these medicines show effects on the fetus that have not been seen in humans. Pregnant women should not use azole antifungals unless the possible benefits outweigh the risks.
These drugs pass into breast milk. Nursing mothers who must these drugs should use infant formula.
Seniors: Seniors may require a reduced dosage of fluconazole due to age-related loss of kidney function. No dosage adjustments are necessary with other azole antifungals.