Wednesday, 28 September 2016

Ondeton




Ondeton may be available in the countries listed below.


Ingredient matches for Ondeton



Ondansetron

Ondansetron hydrochloride dihydrate (a derivative of Ondansetron) is reported as an ingredient of Ondeton in the following countries:


  • Greece

International Drug Name Search

Omaflaxina




Omaflaxina may be available in the countries listed below.


Ingredient matches for Omaflaxina



Ciprofloxacin

Ciprofloxacin hydrochloride (a derivative of Ciprofloxacin) is reported as an ingredient of Omaflaxina in the following countries:


  • Argentina

International Drug Name Search

Kaopectate Caplet



Generic Name: loperamide (loe PER a mide)

Brand Names: Diamode, Imodium A-D, Imodium A-D EZ Chews, Imodium A-D New Formula, Kao-Paverin, Kaopectate 1-D, Maalox Anti-Diarrheal


What is Kaopectate Caplet (loperamide)?

Loperamide slows the rhythm of digestion so that the small intestines have more time to absorb fluid and nutrients from the foods you eat.


Loperamide is used to treat diarrhea. Loperamide is also used to reduce the amount of stool in people who have an ileostomy (re-routing of the bowel through a surgical opening in the stomach).


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


What is the most important information I should know about Kaopectate Caplet (loperamide)?


You should not use this medication if you are allergic to loperamide, or if you have stools that are bloody, black, or tarry, or if you have diarrhea that is caused by taking an antibiotic.

Before taking loperamide, tell your doctor if you have a fever, mucus in your stools, a history of liver disease, or if you are taking an antibiotic.


Drink plenty of liquids while you are taking loperamide. It may take up to 48 hours before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 10 days of treatment. Loperamide may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What should I discuss with my healthcare provider before taking Kaopectate Caplet (loperamide)?


You should not use this medication if you are allergic to loperamide, or if you have:

  • stools that are bloody, black, or tarry; or




  • if you have diarrhea that is caused by taking an antibiotic.



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



  • a fever;




  • mucus in your stools;



  • a history of liver disease; or


  • if you are taking an antibiotic.




FDA pregnancy category C. It is not known whether loperamide will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Loperamide can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using loperamide. Do not give this medicine to a child without medical advice.

How should I take Kaopectate Caplet (loperamide)?


Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.


Take loperamide with a full glass of water. Drink extra water while you are taking this medication to keep from getting dehydrated.

Loperamide is usually taken at the first sign of diarrhea, and again if diarrhea comes back. The first dose of loperamide is usually twice as much as the following doses. Do not take this medication more than 3 times in 24 hours without your doctor's advice.


The loperamide chewable tablet must be chewed before swallowing.


Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose measuring device, ask your pharmacist for one.

Immodium A-D Liquid and New Immodium A-D Liquid contain two different strengths of loperamide. If you switch from using one brand to using the other, follow the dosing instructions carefully. Immodium A-D Liquid also contains a small amount of alcohol, but New Immodium A-D Liquid does not.


It may take up to 48 hours before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 10 days of treatment. Store at room temperature away from moisture and heat. Do not freeze liquid loperamide.

What happens if I miss a dose?


Since loperamide is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


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

Overdose symptoms may include dizziness, drowsiness, urinating less than usual, severe stomach cramps or bloating, and vomiting.


What should I avoid while taking Kaopectate Caplet (loperamide)?


Loperamide may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink.


Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you are taking an antibiotic and you have diarrhea that is watery or has blood in it, call your doctor. Do not use loperamide to stop the diarrhea unless your doctor has told you to.


Kaopectate Caplet (loperamide) 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 taking loperamide and call your doctor at once if you have a serious side effect such as:

  • stomach pain or bloating;




  • ongoing or worsening diarrhea;




  • diarrhea that is watery or bloody; or




  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.



Less serious side effects may include:



  • dizziness;




  • drowsiness, tired feeling;




  • constipation;




  • mild stomach pain; or




  • mild skin rash or itching.



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 Kaopectate Caplet (loperamide)?


Tell your doctor about all other medicines you use, especially saquinavir (Invirase).


This list is not complete and other drugs may interact with loperamide. 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 Kaopectate Caplet resources


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


Compare Kaopectate Caplet with other medications


  • Diarrhea
  • Diarrhea, Acute
  • Diarrhea, Chronic
  • Lymphocytic Colitis
  • Traveler's Diarrhea


Where can I get more information?


  • Your pharmacist can provide more information about loperamide.

See also: Kaopectate Caplet side effects (in more detail)


Anticholinesterase Poisoning Medications


Drugs associated with Anticholinesterase Poisoning

The following drugs and medications are in some way related to, or used in the treatment of Anticholinesterase Poisoning. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

Topics under Anticholinesterase Poisoning

  • Anticholinesterase Overdose (1 drug)





Drug List:

Glucosamina




Glucosamina may be available in the countries listed below.


Ingredient matches for Glucosamina



Glucosamine

Glucosamina (DCIT) is known as Glucosamine in the US.

International Drug Name Search

Glossary

DCITDenominazione Comune Italiana

Click for further information on drug naming conventions and International Nonproprietary Names.

Kaletra




Generic Name: lopinavir and ritonavir

Dosage Form: tablet, film coated
FULL PRESCRIBING INFORMATION

Indications and Usage for Kaletra


Kaletra is indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection.


The following points should be considered when initiating therapy with Kaletra:


  • The use of other active agents with Kaletra is associated with a greater likelihood of treatment response [see Clinical Pharmacology (12.4) and Clinical Studies (14)].

  • Genotypic or phenotypic testing and/or treatment history should guide the use of Kaletra [see Clinical Pharmacology (12.4)]. The number of baseline lopinavir resistance-associated substitutions affects the virologic response to Kaletra [see Clinical Pharmacology (12.4)].

  • Once daily administration of Kaletra is not recommended for any pediatric patients.


Kaletra Dosage and Administration


Kaletra tablets may be taken with or without food. The tablets should be swallowed whole and not chewed, broken, or crushed.


Kaletra oral solution must be taken with food.



Adult Patients


  •  Kaletra tablets 400/100 mg (given as two 200/50 mg tablets) twice daily.

  •  Kaletra oral solution 400/100 mg (5 mL) twice daily.

  •  Kaletra tablets 800/200 mg (given as four 200/50 mg tablets) once daily in patients with less than three lopinavir resistance-associated substitutions.

  •  Kaletra oral solution 800/200 mg (10 mL) once daily in patients with less than three lopinavir resistance-associated substitutions.

 Once daily administration of Kaletra is not recommended for adult patients with three or more of the following lopinavir resistance-associated substitutions: L10F/I/R/V, K20M/N/R, L24I, L33F, M36I, I47V, G48V, I54L/T/V, V82A/C/F/S/T, and I84V [see Clinical Pharmacology ( 12.4)].


 Kaletra should not be administered once daily in combination with carbamazepine, phenobarbital, or phenytoin [see Drug Interactions (7)].


Concomitant Therapy: Efavirenz, Nevirapine, Amprenavir or Nelfinavir


[see Clinical Pharmacology (12.3) and [Drug Interactions (7.3)]


Kaletra tablets and oral solution should not be administered as a once daily regimen in combination with efavirenz, nevirapine, amprenavir, or nelfinavir.


  • A dose increase is recommended for all patients who use Kaletra tablets. The recommended dose of Kaletra tablets is 500/125 mg (such as two 200/50 tablets and one 100/25 mg tablet) twice daily in combination with efavirenz, nevirapine, amprenavir or nelfinavir.

  • A dose increase is recommended for all patients who use Kaletra oral solution. The recommended dose of Kaletra oral solution is 533/133 mg (6.5 mL) twice daily when used in combination with efavirenz, nevirapine, amprenavir or nelfinavir.


Pediatric Patients


Kaletra tablets and oral solution should not be administered once daily in pediatric patients < 18 years of age.


 Kaletra oral solution should not be administered to neonates before a postmenstrual age (first day of the mother’s last menstrual period to birth plus the time elapsed after birth) of 42 weeks and a postnatal age of at least 14 days has been attained [see Warnings and Precautions (5.2)].


 Kaletra oral solution contains 42.4% (v/v) alcohol and 15.3% (w/v) propylene glycol. Special attention should be given to accurate calculation of the dose of Kaletra, transcription of the medication order, dispensing information and dosing instructions to minimize the risk for medication errors, and overdose. This is especially important for infants and young children. Total amounts of alcohol and propylene glycol from all medicines that are to be given to pediatric patients 14 days to 6 months of age should be taken into account in order to avoid toxicity from these excipients [see Warnings and Precautions (5.2) and Overdosage (10)].


 Prescribers should calculate the appropriate dose of Kaletra for each individual child based on body weight (kg) or body surface area (BSA) to avoid underdosing or exceeding the recommended adult dose.


Body surface area (BSA) can be calculated as follows:



The Kaletra dose can be calculated based on weight or BSA:


Based on Weight:


Patient Weight (kg) × Prescribed lopinavir dose (mg/kg) = Administered lopinavir dose (mg)


Based on BSA:


Patient BSA (m2) × Prescribed lopinavir dose (mg/m2) = Administered lopinavir dose (mg)


If Kaletra oral solution is used, the volume (mL) of Kaletra solution can be determined as follows:


Volume of Kaletra solution (mL) = Administered lopinavir dose (mg) ÷ 80 (mg/mL)


The dose of the oral solution should be administered using a calibrated dosing syringe.


Before prescribing Kaletra 100/25 mg tablets, children should be assessed for the ability to swallow intact tablets. If a child is unable to reliably swallow a Kaletra tablet, the Kaletra oral solution formulation should be prescribed.


14 Days to 6 Months:


In pediatric patients 14 days to 6 months of age, the recommended dosage of lopinavir/ritonavir using Kaletra oral solution is 16/4 mg/kg or 300/75 mg/m2 twice daily. Prescribers should calculate the appropriate dose based on body weight or body surface area.


Because no data exists for dosage when administered with efavirenz, nevirapine, amprenavir, or nelfinavir, it is recommended that Kaletra not be administered in combination with these drugs in patients < 6 months of age.


6 Months to 18 Years:


Without Concomitant Efavirenz, Nevirapine, Amprenavir or Nelfinavir


Dosing recommendations using oral solution


In children 6 months to 18 years of age, the recommended dosage of lopinavir/ritonavir using Kaletra oral solution without concomitant efavirenz, nevirapine, amprenavir, or nelfinavir is 230/57.5 mg/m2 given twice daily, not to exceed the recommended adult dose (400/100 mg [5 mL] twice daily). If weight-based dosing is preferred, the recommended dosage of lopinavir/ritonavir for patients < 15 kg is 12/3 mg/kg given twice daily and the dosage for patients ≥ 15 kg to 40 kg is 10/2.5 mg/kg given twice daily.


Dosing recommendations using tablets


Table 1 provides the dosing recommendations for pediatric patients 6 months to 18 years of age based on body weight or body surface area for Kaletra tablets.

















Table 1. Pediatric Dosing Recommendations for Patients 6 Months to 18 Years of Age Based on Body Weight or Body Surface Area for Kaletra Tablets Without Concomitant Efavirenz, Nevirapine, Amprenavir, or Nelfinavir
Body Weight (kg)Body Surface Area (m2)*Recommended number of

100/25 mg Tablets Twice Daily
15 to 25≥0.6 to < 0.92
>25 to 35≥0.9 to < 1.43
>35≥1.44 (or two 200/50 mg tablets)
* Kaletra oral solution is available for children with a BSA less than 0.6 m2 or those who are unable to reliably swallow a tablet.

Concomitant Therapy: Efavirenz, Nevirapine, Amprenavir, or Nelfinavir


Dosing recommendations using oral solution


A dose increase of Kaletra to 300/75 mg/m2 using Kaletra oral solution is needed when co-administered with efavirenz, nevirapine, amprenavir, or nelfinavir in children (both treatment-naïve and treatment-experienced) 6 months to 18 years of age, not to exceed the recommended adult dose (533/133 mg [6.5 mL] twice daily). If weight-based dosing is preferred, the recommended dosage for patients <15 kg is 13/3.25 mg/kg given twice daily and the dosage for patients >15 kg to 45 kg is 11/2.75 mg/kg given twice daily.


Dosing recommendations using tablets


Table 2 provides the dosing recommendations for pediatric patients 6 months to 18 years of age based on body weight or body surface area for Kaletra tablets when given in combination with efavirenz, nevirapine, amprenavir, or nelfinavir.




















Table 2. Pediatric Dosing Recommendations for Patients 6 Months to 18 Years of Age Based on Body Weight or Body Surface Area for Kaletra Tablets With Concomitant Efavirenz†, Nevirapine, Amprenavir† or Nelfinavir†
Body Weight (kg)Body Surface Area (m2)*Recommended number of

100/25 mg Tablets Twice Daily
15 to 20≥0.6 to < 0.82
>20 to 30≥0.8 to < 1.23
>30 to 45≥1.2 to <1.74 (or two 200/50 mg tablets)
>45≥1.75 [see Dosage and Administration, Adult Patients (2.1)]
* Kaletra oral solution is available for children with a BSA less than 0.6 m2 or those who are unable to reliably swallow a tablet.

† Please refer to the individual product labels for appropriate dosing in children.

Dosage Forms and Strengths


  • Kaletra Tablets, 200 mg lopinavir/50 mg ritonavir

    Yellow, film-coated, ovaloid tablets debossed with the corporate Abbott “A” logo and the Abbo-Code KA providing 200 mg lopinavir/50 mg ritonavir.

  • Kaletra Tablets, 100 mg lopinavir/25 mg ritonavir

    Pale yellow, film-coated, ovaloid tablets debossed with the corporate Abbott “A” logo and the Abbo-Code KC providing 100 mg lopinavir/25 mg ritonavir.

  • Kaletra Oral Solution

    Light yellow to orange colored liquid containing 400 mg lopinavir/100 mg ritonavir per 5 mL (80 mg lopinavir/20 mg ritonavir per mL).


Contraindications


  •  Kaletra is contraindicated in patients with previously demonstrated clinically significant hypersensitivity (e.g., toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme) to any of its ingredients, including ritonavir.

  • Co-administration of Kaletra is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life-threatening reactions.

  • Co-administration of Kaletra is contraindicated with potent CYP3A inducers where significantly reduced lopinavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance and cross-resistance. These drugs are listed in Table 3.


































Table 3. Drugs That Are Contraindicated With Kaletra
Drug ClassDrugs Within Class That Are Contraindicated With KaletraClinical comments
 Alpha 1- Adrenoreceptor antagonist Alfuzosin Potentially increased alfuzosin concentrations can result in hypotension.
AntimycobacterialRifampinMay lead to loss of virologic response and possible resistance to Kaletra or to the class of protease inhibitors or other co-administered antiretroviral agents [see Drug Interactions (7)].
Ergot DerivativesDihydroergotamine, ergonovine, ergotamine, methylergonovinePotential for acute ergot toxicity characterized by peripheral vasospasm and ischemia of the extremities and other tissues.
GI motility agentCisapridePotential for cardiac arrhythmias.
Herbal ProductsSt. John's Wort (hypericum perforatum)May lead to loss of virologic response and possible resistance to Kaletra or to the class of protease inhibitors.
HMG-CoA Reductase InhibitorsLovastatin, simvastatinPotential for myopathy including rhabdomyolysis.
PDE5 enzyme inhibitorSildenafila (Revatio®) when used for the treatment of pulmonary arterial hypertensionA safe and effective dose has not been established when used with Kaletra. There is an increased potential for sildenafil-associated adverse events, including visual abnormalities, hypotension, prolonged erection, and syncope [see Drug Interactions (7)].
NeurolepticPimozidePotential for cardiac arrhythmias.
Sedative/HypnoticsTriazolam;

orally administered midazolamb
Prolonged or increased sedation or respiratory depression.
a see Drug Interactions (7) for coadministration of sildenafil in patients with erectile dysfunction.

bsee Drug Interactions, Table 9 for parenterally administered midazolam.

Warnings and Precautions



Drug Interactions - CYP3A Enzyme Inhibition


 Kaletra is a CYP3A inhibitor. Initiating treatment with Kaletra in patients receiving medications metabolized by CYP3A or initiating medications metabolized by CYP3A in patients already maintained on Kaletra may result in increased plasma concentrations of concomitant medications. Higher plasma concentrations of concomitant medications can result in increased or prolonged therapeutic or adverse effects, potentially leading to severe, life-threatening or fatal events. The potential for drug-drug interactions must be considered prior to and during therapy with Kaletra. Review of other medications taken by patients and monitoring of patients for adverse effects is recommended during therapy with Kaletra.


See Tables 3 and 9 for listing of drugs that are contraindicated for use with Kaletra due to potentially life-threatening adverse events, significant drug interactions, or loss of virologic activity [see Contraindications (4) and Drug Interactions (7)].



Toxicity in Preterm Neonates


 Kaletra oral solution contains the excipients alcohol (42.4% v/v) and propylene glycol (15.3% w/v). When administered concomitantly with propylene glycol, ethanol competitively inhibits the metabolism of propylene glycol, which may lead to elevated concentrations. Preterm neonates may be at increased risk of propylene glycol-associated adverse events due to diminished ability to metabolize propylene glycol, thereby leading to accumulation and potential adverse events. Postmarketing life-threatening cases of cardiac toxicity (including complete AV block, bradycardia, and cardiomyopathy), lactic acidosis, acute renal failure, CNS depression and respiratory complications leading to death have been reported, predominantly in preterm neonates receiving Kaletra oral solution.


 Kaletra oral solution should not be used in preterm neonates in the immediate postnatal period because of possible toxicities. A safe and effective dose of Kaletra oral solution in this patient population has not been established. However, if the benefit of using Kaletra oral solution to treat HIV infection in infants immediately after birth outweighs the potential risks, infants should be monitored closely for increases in serum osmolality and serum creatinine, and for toxicity related to Kaletra oral solution including: hyperosmolality, with or without lactic acidosis, renal toxicity, CNS depression (including stupor, coma, and apnea), seizures, hypotonia, cardiac arrhythmias and ECG changes, and hemolysis. Total amounts of alcohol and propylene glycol from all medicines that are to be given to infants should be taken into account in order to avoid toxicity from these excipients [see Dosage and Administration (2.2) and Overdosage (10)].



Pancreatitis


Pancreatitis has been observed in patients receiving Kaletra therapy, including those who developed marked triglyceride elevations. In some cases, fatalities have been observed. Although a causal relationship to Kaletra has not been established, marked triglyceride elevations are a risk factor for development of pancreatitis [see Warnings and Precautions (5.10)]. Patients with advanced HIV-1 disease may be at increased risk of elevated triglycerides and pancreatitis, and patients with a history of pancreatitis may be at increased risk for recurrence during Kaletra therapy.


Pancreatitis should be considered if clinical symptoms (nausea, vomiting, abdominal pain) or abnormalities in laboratory values (such as increased serum lipase or amylase values) suggestive of pancreatitis occur. Patients who exhibit these signs or symptoms should be evaluated and Kaletra and/or other antiretroviral therapy should be suspended as clinically appropriate.



Hepatotoxicity


Patients with underlying hepatitis B or C or marked elevations in transaminase prior to treatment may be at increased risk for developing or worsening of transaminase elevations or hepatic decompensation with use of Kaletra.


There have been postmarketing reports of hepatic dysfunction, including some fatalities. These have generally occurred in patients with advanced HIV-1 disease taking multiple concomitant medications in the setting of underlying chronic hepatitis or cirrhosis. A causal relationship with Kaletra therapy has not been established.


 Elevated transaminases with or without elevated bilirubin levels have been reported in HIV-1 mono-infected and uninfected patients as early as 7 days after the initiation of Kaletra in conjunction with other antiretroviral agents. In some cases, the hepatic dysfunction was serious; however, a definitive causal relationship with Kaletra therapy has not been established.


Appropriate laboratory testing should be conducted prior to initiating therapy with Kaletra and patients should be monitored closely during treatment. Increased AST/ALT monitoring should be considered in the patients with underlying chronic hepatitis or cirrhosis, especially during the first several months of Kaletra treatment [see Use In Specific Populations (8.6)].



Diabetes Mellitus/Hyperglycemia


New onset diabetes mellitus, exacerbation of pre-existing diabetes mellitus, and hyperglycemia have been reported during post-marketing surveillance in HIV-1 infected patients receiving protease inhibitor therapy. Some patients required either initiation or dose adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, diabetic ketoacidosis has occurred. In those patients who discontinued protease inhibitor therapy, hyperglycemia persisted in some cases. Because these events have been reported voluntarily during clinical practice, estimates of frequency cannot be made and a causal relationship between protease inhibitor therapy and these events has not been established.



PR Interval Prolongation


Lopinavir/ritonavir prolongs the PR interval in some patients. Cases of second or third degree atrioventricular block have been reported. Kaletra should be used with caution in patients with underlying structural heart disease, pre-existing conduction system abnormalities, ischemic heart disease or cardiomyopathies, as these patients may be at increased risk for developing cardiac conduction abnormalities.


The impact on the PR interval of co-administration of Kaletra with other drugs that prolong the PR interval (including calcium channel blockers, beta-adrenergic blockers, digoxin and atazanavir) has not been evaluated. As a result, co-administration of Kaletra with these drugs should be undertaken with caution, particularly with those drugs metabolized by CYP3A. Clinical monitoring is recommended [see Clinical Pharmacology (12.3)].



QT Interval Prolongation


Postmarketing cases of QT interval prolongation and torsade de pointes have been reported although causality of Kaletra could not be established. Avoid use in patients with congenital long QT syndrome, those with hypokalemia, and with other drugs that prolong the QT interval [see Clinical Pharmacology (12.3)].



Immune Reconstitution Syndrome


Immune reconstitution syndrome has been reported in patients treated with combination antiretroviral therapy, including Kaletra. During the initial phase of combination antiretroviral treatment, patients whose immune system responds may develop an inflammatory response to indolent or residual opportunistic infections (such as Mycobacterium avium infection, cytomegalovirus, Pneumocystis jirovecii pneumonia [PCP], or tuberculosis) which may necessitate further evaluation and treatment.



Fat Redistribution


Redistribution/accumulation of body fat including central obesity, dorsocervical fat enlargement (buffalo hump), peripheral wasting, facial wasting, breast enlargement, and "cushingoid appearance" have been observed in patients receiving antiretroviral therapy. The mechanism and long-term consequences of these events are currently unknown. A causal relationship has not been established.



Lipid Elevations


Treatment with Kaletra has resulted in large increases in the concentration of total cholesterol and triglycerides [see Adverse Reactions (6.1)]. Triglyceride and cholesterol testing should be performed prior to initiating Kaletra therapy and at periodic intervals during therapy. Lipid disorders should be managed as clinically appropriate, taking into account any potential drug-drug interactions with Kaletra and HMG-CoA reductase inhibitors [see Contraindications (4) and Drug Interactions (7.3)].



Patients with Hemophilia


Increased bleeding, including spontaneous skin hematomas and hemarthrosis have been reported in patients with hemophilia type A and B treated with protease inhibitors. In some patients additional factor VIII was given. In more than half of the reported cases, treatment with protease inhibitors was continued or reintroduced. A causal relationship between protease inhibitor therapy and these events has not been established.



Resistance/Cross-resistance


Because the potential for HIV cross-resistance among protease inhibitors has not been fully explored in Kaletra-treated patients, it is unknown what effect therapy with Kaletra will have on the activity of subsequently administered protease inhibitors [see Clinical Pharmacology (12.4)].



Adverse Reactions


The following adverse reactions are discussed in greater detail in other sections of the labeling.


  • PR Interval Prolongation, QT Interval Prolongation [see Warnings and Precautions (5.6, 5.7)]

  • Drug Interactions [see Warnings and Precautions (5.1)]

  • Pancreatitis [see Warnings and Precautions (5.3)]

  • Hepatotoxicity [see Warnings and Precautions (5.4)]

Because clinical trials are conducted under widely varying conditions, adverse reactions rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.



Adults - Clinical Trials Experience


The safety profile of Kaletra in adults is primarily based on 1964 HIV-1 infected patients in clinical trials.


The most common adverse reaction was diarrhea, which was generally of mild to moderate severity. In study 730, the incidence of diarrhea of any severity during 48 weeks of therapy was 60% in patients receiving Kaletra tablets once daily compared to 57% in patients receiving Kaletra tablets twice daily. More patients receiving Kaletra tablets once daily (14, 4.2%) had ongoing diarrhea at the time of discontinuation as compared to patients receiving Kaletra tablets twice daily (6, 1.8%). In study 730, discontinuations due to any adverse reaction were 4.8% in patients receiving Kaletra tablets once daily as compared to 3% in patients receiving Kaletra tablets twice daily. In study 802, the incidence of diarrhea of any severity during 48 weeks of therapy was 50% in patients receiving Kaletra tablets once daily compared to 39% in patients receiving Kaletra tablets twice daily. Moderate or severe drug-related diarrhea occurred in 14% of patients receiving Kaletra tablets once daily as compared to 11% in patients receiving Kaletra tablets twice daily. At the time of discontinuation, 19 (6.3%) patients receiving Kaletra tablets once daily had ongoing diarrhea, as compared to 11 (3.7%) patients receiving Kaletra tablets twice daily. Discontinuations due to any adverse reaction occurred in 4.3% of patients receiving Kaletra tablets once daily compared to 7.0% in patients receiving Kaletra tablets twice daily. In study 863, discontinuations of randomized therapy due to adverse reactions were 3.4% in Kaletra-treated and 3.7% in nelfinavir-treated patients.


Treatment-emergent clinical adverse reactions of moderate or severe intensity in ≥ 2% of patients treated with combination therapy for up to 48 weeks (Studies 863 and 730) and for up to 360 weeks (Study 720) are presented in Table 4 (treatment-naïve patients); and for up to 48 weeks (Studies 888 and 802), 84 weeks (Study 957) and 144 weeks (Study 765) in Table 5 (protease inhibitor-experienced patients).






























































































































































































Table 4. Percentage of Adult Patients with Selected Treatment-Emergent1 Adverse Reactions of Moderate or Severe Intensity Reported in ≥ 2% of Adult Antiretroviral-Naïve Patients
 Study 863

(48 Weeks)
Study 720

(360 Weeks)
Study 730

(48 Weeks)
 Kaletra 400/100 mg Twice Daily + d4T + 3TC

(N = 326)
Nelfinavir 750 mg Three Times Daily + d4T + 3TC

(N = 327)
Kaletra Twice Daily2 + d4T + 3TC

(N = 100)
Kaletra 800/200 mg Once Daily + TDF +FTC (N=333)Kaletra 400/100 mg Twice Daily + TDF +FTC (N=331)
Endocrine Disorders    
Hypogonadism0%0%2%0%0%
Gastrointestinal Disorders     
Diarrhea16%17%28%17%15%
Nausea7%5%16%7%5%
Vomiting2%2%6%3%4%
Abdominal Pain4%3%11%1%1%
Dyspepsia2%<1%6%0%0%
Flatulence2%1%4%1%1%
General Disorders and Administration Site Conditions    
Asthenia4%3%9%<1%<1%
Infections and Infestations    
Bronchitis0%0%2%0%<1%
Investigations    
Weight decreased1%<1%2%0%<1%
Metabolism and Nutrition Disorders     
Anorexia1%<1%2%<1%1%
Musculoskeletal and Connective Tissue Disorders     
Myalgia1%1%2%0%0%
Nervous System Disorders     
Headache2%2%6%2%2%
Paresthesia1%1%2%0%0%
Psychiatric Disorders    
Insomnia2%1%3%1%0%
Depression1%2%0%0%0%
Libido decreased<1%<1%2%0%<1%
Skin and Subcutaneous Tissue Disorders     
Rash1%2%5%<1%1%
Vascular Disorders     
Vasodilation0%0%3%0%0%
1   Includes adverse reactions of possible or probable relationship to study drug.

2   Includes adverse reaction data from dose group I (200/100 mg twice daily [N = 16] and 400/100 mg twice daily [N = 16]) and dose group II (400/100 mg twice daily [N = 35] and 400/200 mg twice daily [N = 33]). Within dosing groups, moderate to severe nausea of probable/possible relationship to Kaletra occurred at a higher rate in the 400/200 mg dose arm compared to the 400/100 mg dose arm in group II.

Definitions: d4T = Stavudine; 3TC = Lamivudine; TDF = Tenofovir Disoproxil Fumarate; FTC = Emtricitabine
























































































































































































Table 5. Percentage of Adult Patients with Selected Treatment-Emergent1 Adverse Reactions of Moderate or Severe Intensity Reported in ≥ 2% of Adult Protease Inhibitor-Experienced Patients
 Study 888

(48 Weeks)
Study 9572 and Study 7653

(84-144 Weeks)
Study 802

(48 Weeks)
 Kaletra 400/100 mg Twice Daily + NVP + NRTIs

(N = 148)
Investigator-selected protease inhibitor(s) + NVP + NRTIs

(N = 140)
Kaletra Twice Daily + NNRTI + NRTIs

(N = 127)
Kaletra 800/200 mg Once Daily +NRTIs

(N=300)
Kaletra 400/100 mg Twice Daily + NRTIs

(N=299)
Gastrointestinal Disorders     
Diarrhea7%9%23%14%11%
Nausea7%16%5%3%7%
Vomiting4%12%2%2%3%
Abdominal Pain2%2%4%2%<1%
Abdominal Pain UpperN/AN/AN/A1%2%
Dyspepsia1%1%2%1%<1%
Flatulence1%2%2%1%1%
Dysphasia2%1%0%0%0%
General Disorders and Administration Site Conditions     
Asthenia3%6%9%<1%<1%
Pyrexia2%1%2%0%<1%
Chills2%0%0%0%0%
Investigations     
Weight decreased0%1%3%<1%<1%
Metabolism and Nutrition Disorders     
Anorexia1%3%0%0%1%
Musculoskeletal and Connective Tissue Disorders     
Myalgia1%1%2%0%0%
Nervous System Disorders     
Headache2%3%2%<1%0%
Paresthesia0%1%2%0%0%
Psychiatric Disorders     
Depression1%2%3%<1%0%
Insomnia0%2%2%0%<1%
Skin and Subcutaneous Tissue Disorders     
Rash2%1%2%0%0%
Vascular Disorders     
Hypertension0%0%2%0%

Tuesday, 27 September 2016

Kerafoam Foam


Pronunciation: ue-REE-a
Generic Name: Urea
Brand Name: Kerafoam


Kerafoam Foam is used for:

Treating dry, rough, scaly skin caused by certain conditions (eg, dermatitis, psoriasis, eczema, cracked skin, calluses). It may also be used for certain other skin or nail conditions as determined by your doctor.


Kerafoam Foam is a debriding agent. It works by helping the breakdown of dead skin, which helps to loosen and shed hard and scaly skin. It also softens and moisturizes the skin.


Do NOT use Kerafoam Foam if:


  • you are allergic to any ingredient in Kerafoam Foam

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



Before using Kerafoam Foam:


Some medical conditions may interact with Kerafoam Foam. 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 the affected area is broken or severely irritated

Some MEDICINES MAY INTERACT with Kerafoam Foam. Because little, if any, of Kerafoam Foam is absorbed into the blood, the risk of it interacting with another medicine is low.


Ask your health care provider if Kerafoam Foam 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 Kerafoam Foam:


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


  • Wash your hands immediately before and after using Kerafoam Foam unless your hands are part of the treated area.

  • Prime the container before the first use. To do this, point the container away from yourself and others. Hold it upright. Press down on the actuator for 3 to 5 seconds, or until foam begins to appear.

  • Shake well before each use.

  • To use Kerafoam Foam, hold the container upright. Apply Kerafoam Foam to the affected skin as directed by your doctor. Rub in gently until the medicine is completely absorbed.

  • After you use Kerafoam Foam, wipe any excess foam off of the container.

  • If you miss a dose of Kerafoam Foam and you are using it regularly, use 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 use 2 doses at once.

Ask your health care provider any questions you may have about how to use Kerafoam Foam.



Important safety information:


  • Kerafoam Foam is for external use only. Do not get it in your eyes, nose, mouth, or on your lips. If you get Kerafoam Foam in your eyes, rinse them right away with cool water.

  • Do not apply to broken or severely irritated skin.

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

  • Do not use Kerafoam Foam for other skin conditions at a later time.

  • PREGNANCY and BREAST-FEEDING: It is not known if Kerafoam Foam can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Kerafoam Foam while you are pregnant. It is not known if Kerafoam Foam is found in breast milk. If you are or will be breast-feeding while you use Kerafoam Foam, check with your doctor. Discuss any possible risks to your baby.


Possible side effects of Kerafoam Foam:


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:



Mild, temporary burning, itching, irritation, or stinging.



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); redness; severe or persistent burning or irritation.



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: Kerafoam 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 ( http://www.aapcc.org), or emergency room immediately.


Proper storage of Kerafoam Foam:

Store Kerafoam Foam at room temperature, between 59 and 77 degrees F (15 and 25 degrees C). Avoid temperatures above 120 degrees F (49 degrees C). Do not freeze. Store upright away from heat and direct sunlight. Do not puncture, break, or burn the canister even if it appears to be empty. Keep Kerafoam Foam out of the reach of children and away from pets.


General information:


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

  • Kerafoam Foam 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 Kerafoam Foam. 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 Kerafoam resources


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


Compare Kerafoam with other medications


  • Dermatological Disorders
  • Dry Skin
  • Pityriasis rubra pilaris