Wednesday, January 28, 2009

dexmethylphenidate


dex-meth-il-FEN-i-date


Oral route(Capsule, Extended Release;Tablet)

Give cautiously to patients with a history of drug dependence or alcoholism. Chronic, abusive use can lead to marked tolerance and psychological dependence with varying degrees of abnormal behavior. Frank psychotic episodes can occur, especially with parenteral abuse. Careful supervision is required during drug withdrawal from abusive use since severe depression may occur .



Commonly used brand name(s)

In the U.S.


  • Focalin

  • Focalin XR

Available Dosage Forms:


  • Tablet

  • Capsule, Extended Release

Therapeutic Class: CNS Stimulant


Chemical Class: Amphetamine Related


Uses For dexmethylphenidate


Dexmethylphenidate belongs to the group of medicines called central nervous system (CNS) stimulants. It is used to treat attention deficit hyperactivity disorder (ADHD) in patients 6 years of age and older.


Dexmethylphenidate increases attention and decreases restlessness in children and adults who are hyperactive, cannot concentrate for very long, or are easily distracted and impulsive. dexmethylphenidate is used as part of a total treatment program that also includes social, educational, and psychological treatment.


dexmethylphenidate is available only with your doctor's prescription.


Before Using dexmethylphenidate


In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For dexmethylphenidate, the following should be considered:


Allergies


Tell your doctor if you have ever had any unusual or allergic reaction to dexmethylphenidate or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Pediatric


Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of dexmethylphenidate in children. Safety and efficacy have not been established in children younger than 6 years of age.


Geriatric


Appropriate studies on the relationship of age to the effects of dexmethylphenidate have not been performed in the geriatric population.


Pregnancy








Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding


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


Interactions with Medicines


Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking dexmethylphenidate, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.


Using dexmethylphenidate with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.


  • Brofaromine

  • Clorgyline

  • Furazolidone

  • Iproniazid

  • Isocarboxazid

  • Lazabemide

  • Linezolid

  • Moclobemide

  • Nialamide

  • Pargyline

  • Phenelzine

  • Procarbazine

  • Rasagiline

  • Selegiline

  • Toloxatone

  • Tranylcypromine

Interactions with Food/Tobacco/Alcohol


Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.


Other Medical Problems


The presence of other medical problems may affect the use of dexmethylphenidate. Make sure you tell your doctor if you have any other medical problems, especially:


  • Agitation, severe or

  • Anxiety, severe or

  • Glaucoma or

  • Motor tics (repeated muscle movements) or

  • Tension, severe or

  • Tourette's syndrome, or family history of—Should not be used in patients with these conditions.

  • Alcohol abuse, history of or

  • Drug abuse and dependence, history of—Dependence may be more likely to develop.

  • Bipolar disorder (manic-depressive illness), history of or

  • Blood vessel problems or

  • Coronary artery disease or

  • Depression, or a family history of or

  • Heart attack, recent or

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

  • Heart failure or

  • Heart rhythm problems, or a family history of or

  • Hypertension (high blood pressure) or

  • Hyperthyroidism (overactive thyroid) or

  • Psychosis (mental illness), history of or

  • Seizures, history of or

  • Stroke, history of or

  • Tachycardia (increased heart rate)—May make these conditions worse.

Proper Use of dexmethylphenidate


dexmethylphenidate may be habit-forming. If you or your child feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.


dexmethylphenidate should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.


dexmethylphenidate may be taken with or without food.


You should take the extended-release capsule only once a day and in the morning. If you take dexmethylphenidate in the afternoon or evening, it might be harder for you to fall asleep. If your doctor tells you to take the medicine at a certain time, take it exactly as directed.


The extended-release capsule should be swallowed whole and not crushed, divided, or chewed.


If you or your child are unable to swallow the capsule whole, carefully open the capsule and sprinkle the small beads over a spoonful of applesauce. The mixture of drug and applesauce should be taken right away without chewing. The medicine and applesauce can not be stored for future use.


Dosing


The dose of dexmethylphenidate will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of dexmethylphenidate. If your dose is different, do not change it unless your doctor tells you to do so.


The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.


  • For attention deficit hyperactivity disorder (ADHD):
    • For oral dosage form (extended-release capsules):
      • Adults:
        • Patients not taking dexmethylphenidate, methylphenidate, or patients taking stimulant medicines other than methylphenidate—10 milligrams (mg) once a day in the morning. If needed, your doctor may increase the dose once a week by 10 mg per day until symptoms improve or a maximum dose of 20 mg is reached.

        • Patients taking methylphenidate—The dose per day will be half the dose of methylphenidate you are taking now, once a day. If needed, your doctor will adjust your dose once a week to a maximum dose of 20 mg once a day.

        • Patients using the regular dexmethylphenidate tablets will use the same number of milligrams per day as a single dose for the extended-release capsules.


      • Children 6 years of age and older:
        • Patients not taking dexmethylphenidate, methylphenidate, or patients taking stimulant medicines other than methylphenidate—5 milligrams (mg) once a day in the morning. If needed, your doctor may increase the dose once a week by 5 mg per day until symptoms improve or a maximum dose of 20 mg is reached.

        • Patients taking methylphenidate—The dose per day will be half the dose of methylphenidate you are taking now, once a day. If needed, your doctor will adjust your dose once a week to a maximum dose of 20 mg once a day.

        • Patients using the regular dexmethylphenidate tablets will use the same number of milligrams per day as a single dose for the extended-release capsules.


      • Children younger than 6 years of age—Use and dose must be determined by your doctor.


    • For oral dosage form (tablets):
      • Adults, teenagers, and children 6 years of age and older:
        • Patients not taking methylphenidate or patients taking stimulant medicines other than methylphenidate—2.5 milligrams (mg) two times a day, at least 4 hours apart. If needed, your doctor may increase the dose once a week by 2.5 or 5 mg per day until symptoms improve or a maximum dose of 10 mg two times a day is reached.

        • Patients taking methylphenidate—The dose per day will be half the dose of methylphenidate you are taking now, divided and taken two times a day at least 4 hours apart. If needed, your doctor will adjust your dose once a week to a maximum dose of 10 mg two times a day.


      • Children younger than 6 years of age—Use and dose must be determined by your doctor.



Missed Dose


If you miss a dose of dexmethylphenidate, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


Storage


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.


Keep out of the reach of children.


Do not keep outdated medicine or medicine no longer needed.


Ask your healthcare professional how you should dispose of any medicine you do not use.


Precautions While Using dexmethylphenidate


It is very important that your doctor check your or your child's progress at regular visits to make sure the dose is right and the medicine is helping you. Your doctor might need to check your blood, heart, and blood pressure for any unwanted effects.


You should not use dexmethylphenidate if you have used a medicine for depression called a monoamine oxidase inhibitor (MAOI) in the past 14 days. Some examples of MAOI are isocarboxazid (Marplan®), phenelzine (Nardil®), selegiline (Eldepryl®, Zelapar®), or tranylcypromine (Parnate®).


Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines, such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, allergies, or sinus problems.


dexmethylphenidate may cause some people to have vision changes or to become drowsy, dizzy, or less alert than they are normally. Make sure you know how you react to dexmethylphenidate before you drive, use machines, or do anything else that could be dangerous if you are dizzy, not alert, or not able to see well.


Dexmethylphenidate may cause serious heart or blood vessel problems. This may be more likely to occur in patients who have a family history of heart disease. Check with your doctor right away if you have chest pain, shortness of breath, or fainting while taking dexmethylphenidate.


Tell your doctor right away if you or your family notice any unusual changes in behavior, such as an increase in aggression, hostility, agitation, irritability, or suicidal thinking or behavior. Also tell your doctor if you or your child have hallucinations or any unusual thoughts, especially if they are new or getting worse quickly.


dexmethylphenidate may cause slow growth. If your child is using dexmethylphenidate, the doctor will need to keep track of your child's height and weight to make sure that your child is growing properly.


dexmethylphenidate Side Effects


Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.


Check with your doctor immediately if any of the following side effects occur:


Less common
  • Fast, pounding, or irregular heartbeat or pulse

Rare
  • Blurred vision

  • change in near or distance vision

  • difficulty in focusing the eyes

Incidence not known
  • Convulsions

  • muscle spasm or jerking of the arms and legs

  • sudden loss of consciousness

Get emergency help immediately if any of the following symptoms of overdose occur:


Symptoms of overdose
  • Anxiety

  • bigger, dilated, or enlarged pupils (black part of the eye)

  • blurred vision

  • change in consciousness

  • chest pain or discomfort

  • confusion as to time, place, or person

  • dizziness

  • dry mouth

  • dryness of the mucous membranes

  • fainting

  • false or unusual sense of well-being

  • fast, slow, or irregular heartbeat

  • feeling of warmth

  • fever

  • hallucinations

  • headache

  • holding false beliefs that cannot be changed by fact

  • hyperventilation

  • increased sensitivity of the eyes to light

  • irritability

  • lightheadedness

  • loss of consciousness

  • mood or mental changes

  • muscle twitching

  • nervousness

  • overactive reflexes

  • pounding in the ears

  • pounding or rapid pulse

  • redness of the face, neck, arms and occasionally, upper chest

  • restlessness

  • seeing, hearing, or feeling things that are not there

  • seizures

  • shaking

  • shortness of breath

  • sweating

  • tremors such as shakiness

  • trouble with sleeping

  • unusual excitement

  • vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:


More common
  • Acid or sour stomach

  • belching

  • heartburn

  • indigestion

  • loss of appetite

  • nausea

  • stomach discomfort, upset, or pain

  • throat pain

  • weight loss

Less common
  • Sleeplessness

  • twitching

  • unable to sleep

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: dexmethylphenidate side effects (in more detail)



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More dexmethylphenidate resources


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


  • Dexmethylphenidate MedFacts Consumer Leaflet (Wolters Kluwer)

  • Dexmethylphenidate Prescribing Information (FDA)

  • Dexmethylphenidate Hydrochloride Monograph (AHFS DI)

  • Focalin Prescribing Information (FDA)

  • Focalin Consumer Overview

  • Focalin XR Prescribing Information (FDA)

  • Focalin XR Extended-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)



Compare dexmethylphenidate with other medications


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Sunday, January 25, 2009

Atedurex




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Friday, January 23, 2009

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Wednesday, January 21, 2009

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Saturday, January 17, 2009

Rynatuss Pediatric Suspension


Pronunciation: car-beta-PEN-tane/klor-fen-EER-a-meen/e-FED-rin/fen-ill-EF-rin
Generic Name: Carbetapentane/Chlorpheniramine/Ephedrine/Phenylephrine
Brand Name: Examples include Quad-Tuss and Rynatuss Pediatric


Rynatuss Pediatric Suspension is used for:

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


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


Do NOT use Rynatuss Pediatric Suspension if:


  • you are allergic to any ingredient in Rynatuss Pediatric Suspension

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

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

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

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



Before using Rynatuss Pediatric Suspension:


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


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

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

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

  • if you have a fast, slow, or irregular heartbeat

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

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

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


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

  • Digoxin or droxidopa because risk of irregular heartbeat or heart attack may be increased

  • Bromocriptine or hydantoins (eg, phenytoin) because side effects may be increased by Rynatuss Pediatric Suspension

  • Guanadrel, guanethidine, mecamylamine, methyldopa, or reserpine because effectiveness may be decreased by Rynatuss Pediatric Suspension

This may not be a complete list of all interactions that may occur. Ask your health care provider if Rynatuss Pediatric Suspension 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 Rynatuss Pediatric Suspension:


Use Rynatuss Pediatric Suspension as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Rynatuss Pediatric Suspension may be taken with or without food.

  • Shake well before using.

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

  • If you miss a dose of Rynatuss Pediatric Suspension, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Rynatuss Pediatric Suspension.



Important safety information:


  • Rynatuss Pediatric Suspension may cause dizziness, drowsiness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Rynatuss Pediatric Suspension. Using Rynatuss Pediatric Suspension alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.

  • Do not take diet or appetite control medicines while you are taking Rynatuss Pediatric Suspension without checking with your doctor.

  • Rynatuss Pediatric Suspension contains phenylephrine. Before you begin taking any new prescription or nonprescription medicine, read the ingredients to see if it also contains phenylephrine. If it does or if you are uncertain, contact your doctor or pharmacist.

  • Do NOT exceed the recommended dose or take Rynatuss Pediatric Suspension for longer than prescribed without checking with your doctor.

  • If your symptoms do not improve within 5 to 7 days or if they become worse, check with your doctor.

  • Rynatuss Pediatric Suspension may cause increased sensitivity to the sun. Avoid exposure to the sun, sunlamps, or tanning booths until you know how you react to Rynatuss Pediatric Suspension. Use a sunscreen or protective clothing if you must be outside for a prolonged period.

  • If you are scheduled for allergy skin testing, do not take Rynatuss Pediatric Suspension for several days before the test because it may decrease your response to the skin tests.

  • Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Rynatuss Pediatric Suspension.

  • Use Rynatuss Pediatric Suspension with caution in the ELDERLY because they may be more sensitive to its effects.

  • Caution is advised when using Rynatuss Pediatric Suspension in CHILDREN because they may be more sensitive to its effects.

  • PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Rynatuss Pediatric Suspension, discuss with your doctor the benefits and risks of using Rynatuss Pediatric Suspension during pregnancy. It is unknown if Rynatuss Pediatric Suspension is excreted in breast milk. Do not breast-feed while taking Rynatuss Pediatric Suspension.


Possible side effects of Rynatuss Pediatric Suspension:


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



Constipation; diarrhea; dizziness; drowsiness; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; vomiting; weakness.



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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; seizures; severe dizziness, lightheadedness, or headache; tremor; trouble sleeping; vision changes.



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


See also: Rynatuss Pediatric side effects (in more detail)


If OVERDOSE is suspected:


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


Proper storage of Rynatuss Pediatric Suspension:

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


General information:


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

  • Rynatuss Pediatric Suspension 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 Rynatuss Pediatric Suspension. 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 Rynatuss Pediatric resources


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


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