Adsena may be available in the countries listed below.
Ingredient matches for Adsena
Mefenamic Acid is reported as an ingredient of Adsena in the following countries:
- Chile
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Adsena may be available in the countries listed below.
Mefenamic Acid is reported as an ingredient of Adsena in the following countries:
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Thiamini hydrochloridum Darnitsa may be available in the countries listed below.
Thiamine hydrochloride (a derivative of Thiamine) is reported as an ingredient of Thiamini hydrochloridum Darnitsa in the following countries:
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Cefotaxima Jet may be available in the countries listed below.
Cefotaxime sodium salt (a derivative of Cefotaxime) is reported as an ingredient of Cefotaxima Jet in the following countries:
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Neuroswift may be available in the countries listed below.
Mecobalamin is reported as an ingredient of Neuroswift in the following countries:
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Class: Integrase Inhibitors
Chemical Name: N - [(4 - Fluorophenyl)methyl] - 1,6 - dihydro - 5 - hydroxy - 1 - methyl - 2 - {1 - methyl - 1 - [[(5 - methyl - 1,3,4 - oxadiazol - 2 - yl)carbonyl]amino]ethyl} - 6 - oxo - 4 - pyrimidinecarboxamide monopotassium salt
Molecular Formula: C20H20FKN6O5
CAS Number: 871038-72-1
Brands: Isentress
Antiretroviral; HIV integrase inhibitor.1 2 3 4 5
Treatment of HIV-1 infection in conjunction with other antiretrovirals.1 8 14
Safety and efficacy not established in pediatric patients <16 years of age.1 13
Administer orally1 without regard to food.1 5
Available as raltegravir potassium; dosage expressed in terms of raltegravir.1
If used with rifampin, dosage adjustment of raltegravir is necessary.1
Must be given in conjunction with other antiretrovirals.1
Adolescents ≥16 years of age: 400 mg twice daily.1
Adolescents ≥16 years of age receiving rifampin concomitantly 800 mg twice daily.1
400 mg twice daily.1 5
Adults receiving rifampin: 800 mg twice daily.1
Dosage adjustment not necessary in patients with mild to moderate hepatic impairment;1 5 data not available in patients with severe hepatic impairment.1 (See Hepatic Impairment under Cautions.)
Dosage adjustment not necessary.1 5 Avoid administering drug before dialysis session.1 (See Renal Impairment under Cautions.)
Select dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.1
Manufacturer states none known.1
During initial treatment, patients who respond to antiretroviral therapy may develop an inflammatory response to indolent or residual opportunistic infections (e.g., Mycobacterium avium complex [MAC], M. tuberculosis, cytomegalovirus [CMV], Pneumocystis jiroveci [formerly P. carinii], varicella-zoster virus [VZV]); this may necessitate further evaluation and treatment.1
Concomitant use with drugs that are potent inducers of uridine diphosphate-glucuronosyltransferase (UGT) 1A1 (e.g., rifampin) may result in decreased plasma concentrations of raltegravir.1 (See Interactions and see Dosage and Administration.)
Hypersensitivity reactions (e.g., diffuse rash with fever, facial edema) reported.1 b
Increased serum CK concentrations observed.1
Myopathy and rhabdomyolysis reported rarely; relationship to drug not known.1 Use caution in patients at increased risk of myopathy or rhabdomyolysis, including those receiving concomitant therapy with a drug associated with myopathy or rhabdomyolysis.1
Category C.1
Antiretroviral Pregnancy Registry at 800-258-4263.1
Some experts state that safety and pharmacokinetic data are insufficient to recommend raltegravir in pregnant women.7
Distributed into milk in rats; not known whether distributed into human milk.1
Instruct HIV-infected women not to breast-feed because of risk of HIV transmission and risk of adverse effects in the infant.1 5 7
Safety and efficacy not established in pediatric patients <16 years of age.1 13
Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults.1
Use with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.1
Risk for further elevations in hepatic enzyme concentrations in patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection.1 (See Hepatic Impairment under Dosage and Administration.)
Not known if removed by dialysis; avoid administering drug before dialysis session.1 (See Renal Impairment under Dosage and Administration.)
Insomnia, headache, nausea, asthenia, fatigue.1
Metabolized by UGT 1A1.1 Does not inhibit UGT 1A1 or UGT 2B7 in vitro.1
Not a substrate for CYP isoenzymes.1 Does not inhibit CYP isoenzymes 1A2, 2B6, 2C8, 2C9, 2C19, 2D6, or 3A or induce CYP1A2, 2B6, or 3A4.1
Does not inhibit P-glycoprotein-mediated transport.1
Potential pharmacokinetic interactions with drugs that are potent inducers of UGT 1A1 (decreased plasma concentrations of raltegravir)1 5 or inhibitors of UGT 1A1 (increased plasma concentrations of raltegravir).1
Not expected to affect pharmacokinetics of drugs that are substrates for UGT 1A1 or UGT 2B7.1
Pharmacokinetic interactions unlikely with drugs that are substrates for CYP isoenzymes 1A2, 2B6, 2C8, 2C9, 2C19, 2D6, or 3A.1
Pharmacokinetic interactions unlikely with drugs that are substrates for P-glycoprotein.1
Drug | Interaction | Comments |
---|---|---|
Abacavir | In vitro evidence of additive to synergistic antiretroviral effects1 | |
Amprenavir | In vitro evidence of additive to synergistic antiretroviral effects1 | |
Anticonvulsants (phenobarbital, phenytoin) | Phenytoin and/or phenobarbital potentially may affect the UGT 1A1 pathway;11 effect on raltegravir pharmacokinetics unknown1 | Concomitant use of phenytoin and/or phenobarbital prohibited in expanded-access program11 |
Antimycobacterials, rifamycins (rifabutin, rifampin, rifapentine) | Rifabutin: Possible decreased raltegravir concentrations5 Rifampin: Decreased peak plasma concentrations and AUC of raltegravir1 5 11 | Rifabutin: Consider possibility of pharmacokinetic interaction if optimal virologic response not achieved5 Rifampin: Dosage adjustment needed of raltegravir; use raltegravir 800 mg twice daily1 Rifapentine: Concomitant use not recommended5 |
Atazanavir | Atazanavir or ritonavir-boosted atazanavir: Increased raltegravir concentrations;1 clinical importance unknown; however, combination of ritonavir-boosted atazanavir and raltegravir reportedly well tolerated1 11 In vitro evidence of additive to synergistic antiretroviral effects1 | Ritonavir-boosted atazanavir: Dosage adjustment of raltegravir not needed1 |
Benzodiazepines (e.g., midazolam) | Raltegravir not expected to affect pharmacokinetics of midazolam 1 10 | |
Delavirdine | In vitro evidence of additive to synergistic antiretroviral effects1 | |
Didanosine | In vitro evidence of additive to synergistic antiretroviral effects1 | |
Efavirenz | Decreased raltegravir concentrations;1 11 clinical importance unknown11 In vitro evidence of additive to synergistic antiretroviral effects1 | Consider possibility of a pharmacokinetic interaction if optimal virologic response not achieved5 |
Enfuvirtide | In vitro evidence of additive to synergistic antiretroviral effects1 | |
Etravirine | Decreased raltegravir concentrations; no change in etravirine concentrations. Clinical importance unknown1 | |
Hormonal contraceptives | Raltegravir not expected to affect pharmacokinetics of hormonal contraceptives1 | |
Indinavir | In vitro evidence of additive to synergistic antiretroviral effects1 | |
Lamivudine | Raltegravir not observed to have a clinically meaningful effect on pharmacokinetics of lamivudine1 In vitro evidence of additive to synergistic antiretroviral effects1 | |
Lopinavir | In vitro evidence of additive to synergistic antiretroviral effects1 | |
Methadone | Raltegravir not expected to affect pharmacokinetics of methadone1 | |
Nelfinavir | In vitro evidence of additive to synergistic antiretroviral effects1 | |
Nevirapine | In vitro evidence of additive to synergistic antiretroviral effects1 | |
Omeprazole | Increased raltegravir concentrations1 | Dosage adjustment not necessary1 |
Ritonavir | Pharmacokinetic interaction with low-dose ritonavir unlikely11 In vitro evidence of additive to synergistic antiretroviral effects1 | Consider possibility of drug interactions between raltegravir and other protease inhibitors (PIs) when low-dose ritonavir is used to boost PI concentrations11 |
Saquinavir | In vitro evidence of additive to synergistic antiretroviral effects1 | |
Stavudine | In vitro evidence of additive to synergistic antiretroviral effects1 | |
Tenofovir | Increased raltegravir concentrations; no change in concentrations of tenofovir1 In vitro evidence of additive to synergistic antiretroviral effects1 | |
Tipranavir | Ritonavir-boosted tipranavir: Decreased raltegravir concentrations; however, no effect on efficacy of raltegravir observed in small study1 | Ritonavir-boosted tipranavir: Dosage adjustment of raltegravir not needed1 Consider possibility of pharmacokinetic interaction if optimal virologic response not achieved5 |
Zidovudine | In vitro evidence of additive to synergistic antiretroviral effects1 |
Absolute bioavailability not established.1
Following oral administration in the fasted state, peak plasma concentrations attained in approximately 3 hours.1
AUC increased by approximately 13% when administered with a moderate-fat meal compared with administration in the fasting state.1
Distributed into milk in rats; not known whether distributed into human milk.1
Not known whether crosses the placenta.1
83%.1
Metabolized mainly by UGT 1A1-mediated glucuronidation in the liver.1 5
Excreted in feces (51%) and urine (32%).1
Not known if removed by dialysis.1
9 hours.1
Moderate hepatic impairment: No clinically important pharmacokinetic differences between patients with moderate hepatic impairment and healthy individuals observed.1
Severe hepatic impairment: Pharmacokinetics not studied.1
Severe renal impairment: No clinically important pharmacokinetic differences between patients with severe renal impairment and healthy individuals observed.1
Pediatric patients: Pharmacokinetics not established.1
20–25°C (may be exposed to 15–30°C).1
Inhibits catalytic activity of HIV-1 integrase, an enzyme that integrates HIV DNA into the host cell genome.1 4
Inhibition of integrase prevents propagation of viral infection.1 4
Active against some strains of HIV-1 resistant to nucleoside reverse transcriptase inhibitors (NRTIs) and PIs.1
Resistant HIV-1 strains have been produced in vitro and have emerged during raltegravir therapy.1 b
Critical nature of compliance with HIV therapy.1 Used in conjunction with other antiretrovirals; do not use for monotherapy.1
Antiretroviral therapy is not a cure for HIV infection, and opportunistic infections still may occur.1 HIV transmission via sexual contact or sharing needles is not prevented by antiretrovirals.1
Importance of reading patient information provided by the manufacturer.1
Importance of informing clinician if unusual symptoms (e.g., muscle pain, tenderness, weakness) develop or known symptoms persist or worsen.1
If a dose is missed, administer as soon as it is remembered; however, if a dose is skipped, a double dose should not be taken to make up for the missed dose.1
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and herbal products, and any concomitant illnesses (e.g., chronic HBV or HCV).1
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1
Importance of advising patients of other important precautionary information.1 (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
---|---|---|---|---|
Oral | Tablet, film-coated | 400 mg (of raltegravir) | Isentress | Merck |
This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.
Isentress 400MG Tablets (MERCK SHARP & DOHME): 60/$994.9 or 180/$2874.45
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions November 2009. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
1. Merck. Isentress (raltegravir) tablets prescribing information. Whitehouse Station, NJ; 2009 Jul.
2. Cooper D, Gatell J, Rockstroh J et al. Results of BENCHMRK-1, a phase III study evaluating the efficacy and safety of MK-0518, a novel HIV-1 integrase inhibitor, in patients with triple-class resistant virus. 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles, CA. 2007 Feb 25-28. Abstract 105aLB. From website.
3. Steigbigel R, Kumar P, Eron J et al. Results of BENCHMRK-2, a phase III study evaluating the efficacy and safety of MK-0518, a novel HIV-1 integrase inhibitor, in patients with triple-class resistant virus. 14th Conference on Retroviruses and Opportunistic Infections, Los Angeles, CA. 2007 Feb 25-28. Abstract 105bLB. From website.
4. Grinsztejn B, Nguyen BY, Katlama C et al for Protocol 005 team. Safety and efficacy of the HIV-1 integrase inhibitor raltegravir (MK-0518) in treatment-experienced patients with multidrug-resistant virus: a phase II randomised controlled trial. Lancet. 2007; 369:1261-9. [PubMed 17434401]
5. Panel on Antiretroviral Guidelines for Adults and Adolescents of the Department of Health and Human Services (DHHS). Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents (November 3, 2008). From the US Department of Health and Human Services HIV/AIDS Information Services (AIDSinfo) website.
6. Hammer SM, Saag MS, Schechter M et al. Treatment for adult HIV infection: 2006 recommendations of the International AIDS Society–USA panel. JAMA. 2006; 296:827-43. [PubMed 16905788]
7. Perinatal HIV Guidelines Working Group. Public Health Service task force recommendations for use of antiretroviral drugs in pregnant HIV-infected women for maternal health and interventions to reduce perinatal HIV-1 transmission in the United States (April 29, 2009). From the US Department of Health and Human Services HIV/AIDS Information Services (AIDSinfo) website.
8. Markowitz M, Nguyen BY, Gotuzzo E et al. Rapid and durable antiretroviral effect of the HIV-1 integrase inhibitor raltegravir as part of combination therapy in treatment-naive patients with HIV-1 infection: results of a 48-week controlled study. J Acquir Immune Defic Syndr. 2007; 46:125-33. [PubMed 17721395]
9. Anon. Two new drugs for HIV infection. Med Lett Drugs Ther. 2008; 50:2-4.
10. Iwamoto M, Kassahun K, Troyer MD et al. Lack of a pharmacokinetic effect of raltegravir on midazolam: in vitro/in vivo correlation. J Clin Pharmacol. 2008; 48:209-14. [PubMed 18077730]
11. Correll T, Klibanov OM. Integrase inhibitors: a new treatment option for patients with human immunodeficiency virus infection. Pharmacotherapy. 2008: 28:90-101.
12. Merck, North Wales, Pa. Personal communication.
13. Working Group on Antiretroviral Therapy and Medical Management of HIV-infected Children of the National Resource Center at the François-Xavier Bagnoud Center, Health Resources and Services Administration (HRSA), and National Institutes of Health (NIH). Guidelines for the use of antiretroviral agents in pediatric HIV infection (February 23, 2009). From the US Department of Health and Human Services HIV/AIDS Information Services (AIDSinfo) website.
14. Steigbigel RT, Cooper DA, Kumar PN et al. Raltegravir with optimized background therapy for resistant HIV-1 infection. N Engl J Med. 2008; 359:339-54. [PubMed 18650512]
b. Merck, North Wales, PA: Personal communication.
Generic Name: cholecalciferol (vitamin D3) (KOE le kal SIF e role)
Brand Names: D 1000 IU, D3-5, D3-50, Delta D3, Vitamin D3
Cholecalciferol is a vitamin D3. Vitamin D is important for the absorption of calcium from the stomach and for the functioning of calcium in the body.
Cholecalciferol is used to treat or prevent many conditions caused by a lack of vitamin D, especially conditions of the skin or bones.
Cholecalciferol may also be used for other purposes not listed in this medication guide.
Before taking cholecalciferol, tell your doctor if you are allergic to any drugs, or if you have heart disease, kidney disease, or an electrolyte imbalance.
Avoid using calcium supplements or antacids without your doctor's advice. Use only the specific type of supplement or antacid your doctor recommends. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.
Overdose symptoms may include headache, weakness, drowsiness, dry mouth, nausea, vomiting, constipation, muscle or bone pain, metallic taste in the mouth, weight loss, itchy skin, changes in heart rate, loss of interest in sex, confusion, unusual thoughts or behavior, severe pain in your upper stomach spreading to your back, or fainting.
high levels of calcium in your blood (hypercalcemia);
high levels of vitamin D in your body (hypervitaminosis D); or
any condition that makes it hard for your body to absorb nutrients from food (malabsorption).
If you have any of these other conditions, you may need a dose adjustment or special tests to safely use cholecalciferol:
heart disease;
kidney disease; or
an electrolyte imbalance.
Take this medication exactly as directed on the label, or as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended.
Your doctor may occasionally change your dose to make sure you get the best results from this medication.
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.
Cholecalciferol is only part of a complete program of treatment that may also include a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you must eat or avoid to help control your condition.
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.
Overdose symptoms may include headache, weakness, drowsiness, dry mouth, nausea, vomiting, constipation, muscle or bone pain, metallic taste in the mouth, weight loss, itchy skin, changes in heart rate, loss of interest in sex, confusion, unusual thoughts or behavior, severe pain in your upper stomach spreading to your back, or fainting.
Avoid using calcium supplements or antacids without your doctor's advice. Use only the specific type of supplement or antacid your doctor recommends.
thinking problems, changes in behavior, feeling irritable;
urinating more than usual;
chest pain, feeling short of breath; or
early signs of vitamin D overdose (weakness, metallic taste in your mouth, weight loss, muscle or bone pain, constipation, nausea, and vomiting).
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.
Before taking cholecalciferol, tell your doctor if you are taking any of the following medicines:
seizure medication;
cholestyramine (Prevalite, Questran);
colestipol (Colestid);
steroids (prednisone and others);
digoxin (digitalis, Lanoxin); or
a diuretic (water pill) such as chlorothiazide (Diuril), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic), chlorthalidone (Hygroton, Thalitone), indapamide (Lozol), metolazone (Mykrox, Zaroxolyn), and others.
This list is not complete and there may be other drugs that can interact with cholecalciferol. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.
See also: D3-50 side effects (in more detail)
In the US, Aldex (doxylamine systemic) is a member of the drug class upper respiratory combinations and is used to treat Cough and Nasal Congestion and Sinus Symptoms.
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Albendazole is reported as an ingredient of Aldex in the following countries:
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Doxicrisol may be available in the countries listed below.
Doxycycline hyclate (a derivative of Doxycycline) is reported as an ingredient of Doxicrisol in the following countries:
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Reisetabletten-1A Pharma may be available in the countries listed below.
Dimenhydrinate is reported as an ingredient of Reisetabletten-1A Pharma in the following countries:
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