Sample PLR Articles Directory Northern Mariana Islands

Tuesday, October 25, 2016

Thioguanine Tabloid

Generic Name: Thioguanine
Class: Antineoplastic Agents
VA Class: AN300
CAS Number: 154-42-7

Introduction

Antineoplastic agent; antimetabolite, synthetic purine antagonist.¹⁰³ ^b

Uses for Thioguanine Tabloid

Acute Myeloid Leukemia (AML)

Remission induction (in combination with other antineoplastic agents) in acute myeloid (myelogenous, nonlymphocytic) leukemia (AML, ANLL).¹⁰³ ¹⁰⁴ ¹¹⁵ ¹¹⁶

Has been used with other antineoplastic agents in regimens of consolidation therapy for AML following induction of a complete remission; optimal regimen of such therapy in prolonging remissions remains to be established but is typically administered short-term.¹¹⁵ ^b

Not recommended for maintenance or long-term continuous therapy.¹⁰³ (See Hepatic Effects under Cautions.)

Thioguanine Tabloid Dosage and Administration

General

Consult specialized references for procedures for proper handling and disposal of antineoplastic drugs.¹⁰³ ^b

Individualize dosage according to clinical and hematologic response and tolerance of the patient.¹⁰³

Administration

Oral Administration

Calculate total daily dose to the nearest multiple of 20 mg and administer orally once daily.^b

Dosage

Consult currently published protocols for dosages used in combination regimens and method and sequence of administration.¹⁰³

Dosage reduction may be necessary if used concomitantly with other myelosuppressive agents.¹⁰³ (See Specific Drugs under Interactions.)

When initiating thioguanine therapy, patients with inherited deficiency of thiopurine S-methyl transferase (TPMT) activity are at increased risk of life-threatening myelotoxicity; substantial dosage reduction may be required.¹⁰³ (See Hematologic Effects under Cautions.)

Pediatric Patients

Acute Myeloid Leukemia

Induction and Consolidation Therapy

Oral

If monotherapy is appropriate, initially, approximately 2 mg/kg daily.¹⁰³ If there is no clinical improvement and no leukocyte or platelet count depression after 4 weeks on initial dosage, dosage may be cautiously increased to 3 mg/kg daily.¹⁰³

Thioguanine should not be part of maintenance therapy.¹⁰³ (See Hepatic Effects under Cautions.)

Adults

Acute Myeloid Leukemia

Induction and Consolidation Therapy

Oral

Thioguanine should not be part of maintenance therapy.¹⁰³ (See Hepatic Effects under Cautions.)

Special Populations

Hepatic Impairment

Consider dosage reduction; however, no specific dosage recommendations at this time.¹⁰³ (See Hepatic Effects under Cautions.)

Renal Impairment

Consider dosage reduction; however, no specific dosage recommendations at this time.¹⁰³

Geriatric Patients

Select dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.¹⁰³

Cautions for Thioguanine Tabloid

Contraindications

If a diagnosis of AML has not been adequately established and there is no responsible clinician knowledgeable in assessing response to chemotherapy.¹⁰³

Patients whose disease was resistant to prior therapy with the drug.¹⁰³ Consider that there is complete cross-resistance between thioguanine and mercaptopurine.¹⁰³

Warnings/Precautions

Warnings

Toxicity

Highly toxic; low therapeutic index; therapeutic response is unlikely without some evidence of toxicity.^b Administer only under supervision of qualified clinicians experienced in use of cytotoxic therapy.¹⁰³ ^b

Hepatic Effects

Risk of hepatotoxicity associated with vascular endothelial damage; usually manifested as hepatic veno-occlusive disease (e.g., hyperbilirubinemia, hepatomegaly, ascites) or portal hypertension (e.g., splenomegaly, thrombocytopenia out of proportion with neutropenia, esophageal varices).¹⁰³

Possible jaundice and increases in serum aminotransferases (AST, ALT), alkaline phosphatase, and γ glutamyl transferase concentrations.¹⁰³ Hepatoportal sclerosis, nodular regenerative hyperplasia, peliosis hepatitis, and periportal fibrosis reported.¹⁰³

Discontinue immediately if evidence of hepatotoxicity (e.g., jaundice) occurs; signs and symptoms generally reversible after discontinuance of the drug.¹⁰³

Hepatic function must be carefully monitored.¹⁰³ Serum transaminase, alkaline phosphatase, and bilirubin concentrations should be determined weekly during initiation of therapy and monthly thereafter.¹⁰³ More frequent testing in patients with preexisting liver disease and in those receiving other hepatotoxic drugs.¹⁰³

Hematologic Effects

Risk of myelosuppression (manifested as anemia, leukopenia, and/or thrombocytopenia); usually dose related.¹⁰³ Hematologic status must be carefully monitored.¹⁰³

Discontinue temporarily at the first sign of an abnormally large or rapid decrease in leukocytes, platelets, or hemoglobin concentration or abnormal depression of bone marrow, unless induction of bone marrow hypoplasia is desired.¹⁰³ ^b Bone marrow examination (aspiration and/or biopsy) may be helpful in distinguishing between progression of leukemia, resistance to therapy, and marrow hypoplasia induced by therapy.¹⁰³ ^b

Perform CBC, including platelet count and leukocyte differential, at least once weekly during therapy; more frequent blood counts may be required, particularly during remission induction therapy and with concomitant therapy with other antineoplastic agents.¹⁰³ ^b

When initiating thioguanine therapy, patients with inherited deficiency of thiopurine S-methyl transferase (TPMT) activity are at increased risk for life-threatening myelotoxicity; substantial dosage reduction may be required.¹⁰³ Concomitant use with drugs that inhibit TPMT (e.g., olsalazine, mesalamine, sulfasalazine) may exacerbate such toxicity.¹⁰³ Consider testing for TPMT deficiency prior to initiating therapy.¹⁰³

Infectious Complications and Hemorrhagic Complications

Life-threatening infections due to granulocytopenia may occur.¹⁰³ Anti-infectives or granulocyte transfusions may be needed.¹⁰³

Bleeding due to thrombocytopenia may occur.¹⁰³ Platelet transfusions may be needed.¹⁰³

Fetal/Neonatal Morbidity and Mortality

May cause fetal harm; teratogenicity demonstrated in animals.¹⁰³

Avoid pregnancy during therapy.¹⁰³ If used during pregnancy or if patient becomes pregnant, apprise of potential fetal hazard.¹⁰³

Major Toxicities

GI Effects

Possible nausea, vomiting, anorexia, and stomatitis.¹⁰³

General Precautions

Hyperuricemia

Hyperuricemia occurs frequently because of extensive purine catabolism accompanying rapid cellular destruction.¹⁰³ Hyperuricemia may be minimized or prevented by adequate hydration, alkalinization of urine, and/or administration of allopurinol.¹⁰³

Immunization

Effects of thioguanine on immunocompetence are unknown.¹⁰³ Avoid live virus vaccines in immunocompromised patients.¹⁰³

Specific Populations

Pregnancy

Category D.¹⁰³ (See Fetal/Neonatal Morbidity and Mortality under Cautions.)

Lactation

Not known whether thioguanine is distributed into milk.¹⁰³ Discontinue nursing or the drug.¹⁰³

Geriatric Use

Clinical studies did not include sufficient numbers of patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults; select dosage with caution.¹⁰³

Common Adverse Effects

Myelosuppression, hyperuricemia, hepatotoxicity.¹⁰³

Interactions for Thioguanine Tabloid

Specific Drugs

Drug	Interaction	Comments
Allopurinol	Pharmacokinetic interactions not expected¹⁰³	Dosage adjustments not required¹⁰³
Aminosalicylates (e.g., olsalazine, mesalamine, sulfasalazine)	Potential pharmacokinetic interaction; increased risk of thioguanine myelotoxicity¹⁰³ (see Hematologic Effects under Cautions)	Use concomitantly with caution¹⁰³
Myelosuppressive agents	Possible additive myelosuppressive effects¹⁰³	Reduced thioguanine dosage may be necessary with concomitant therapy¹⁰³

Thioguanine Tabloid Pharmacokinetics

Absorption

Bioavailability

Absorption from GI tract is variable and incomplete; approximately 30% of an oral dose may be absorbed.¹⁰³

Distribution

Extent

Incorporated into the DNA and RNA of bone marrow cells.¹⁰³

Does not reach therapeutic concentrations in the CSF.¹⁰³

Thioguanine crosses the placenta; not known whether distributed into milk.¹⁰³

Elimination

Metabolism

Rapidly and extensively metabolized in the liver and other tissues, principally to the less toxic and less active methylated derivative 2-amino-6-methylthiopurine.¹⁰³

Elimination Route

Excreted principally in urine as metabolites.¹⁰³ ^b

Half-life

Biphasic; terminal half-life averages 11 hours.^b

Stability

Storage

Oral

Tablets

15–25°C.¹⁰³

ActionsActions

Converted intracellularly to ribonucleotides that result in a sequential blockade of the synthesis and utilization of purine and guanine nucleotides.¹⁰³ ^b

Thioguanine ribonucleotides incorporate into DNA and RNA; cytotoxic effects may be related primarily to substitution of ribonucleotides into DNA.¹⁰³ ^b

Usually complete cross-resistance between thioguanine and mercaptopurine.¹⁰³ ^b

Advice to Patients

Advise patients that the major toxicities of the drug are related to myelosuppression, hepatotoxicity, and GI toxicity.¹⁰³

Importance of taking the drug only under medical supervision.¹⁰³

Importance of patients informing their clinicians if fever, sore throat, jaundice, nausea, vomiting, signs of local infection, bleeding from any site, or symptoms suggestive of anemia occur.¹⁰³

Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed; necessity for clinicians to advise women to avoid pregnancy during therapy and advise pregnant women of risk to the fetus.¹⁰³

Importance of informing patients of other important precautionary information. (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Thioguanine
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets	40 mg	Thioguanine Tabloid (scored)	GlaxoSmithKline

Comparative Pricing

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.

Tabloid 40MG Tablets (GLAXO SMITH KLINE): 25/$235.91 or 50/$466.57

Disclaimer

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 March 2009. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

100. Griner PF, Elbadawi A, Packman CH. Veno-occlusive disease of the liver after chemotherapy of acute leukemia. Ann Intern Med. 1976; 85:578-82. [IDIS 65468] [PubMed 1068643]

101. Gill RA, Onstad GR, Cardamone JM et al. Hepatic veno-occlusive disease caused by 6-thioguanine. Ann Intern Med. 1982; 96:58-60. [IDIS 142618] [PubMed 7053705]

102. Krivoy N, Raz R, Carter A et al. Reversible hepatic veno-occlusive disease and 6-thioguanine. Ann Intern Med. 1982; 96:788. [IDIS 152653] [PubMed 7091946]

103. GlaxoSmithKline. Tabloid brand thioguanine 40-mg scored tablets prescribing information. Research Triangle Park, NC; 2004 Dec.

104. Childhood acute myeloid leukemia/other myeloid malignancies. From: PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2007 Aug 22.

105. Thiersch JB. Effect of 2-6 diaminopurine (2-6 DP): 6 chlorpurine (CIP) and thioguanine (ThG) on rat litter in utero. Proc Soc Exp Biol Med. 1957; 94:40-3. [PubMed 13400865]

107. Key NS, Kelly PMA, Emerson PM et al. Oesophageal varices associated with busulphan-thioguanine combination therapy for chronic myeloid leukaemia. Lancet. 1987; 2:1050-2. [IDIS 235711] [PubMed 2889964]

109. Shepherd PC, Fooks J, Gray R et al. Thioguanine used in maintenance therapy of chronic myeloid leukaemia causes non-cirrhotic portal hypertension. Br J Haematol. 1991; 79:185-92. [PubMed 1958475]

110. McCauley DL. Treatment of adult acute leukemia. Clin Pharm. 1992; 11:767-96. [IDIS 300402] [PubMed 1521402]

111. Arlin Z, Case DC Jr, Moore J et al. Randomized multicenter trial of cytosine arabinoside with mitoxantrone or daunorubicin in previously untreated adult patients with acute nonlymphocytic leukemia (ANLL). Leukemia. 1990; 4:177-83. [PubMed 2179638]

112. Feldman EJ. Acute myelogenous leukemia in the older patient. Semin Oncol. 1995; 22(Suppl 1):21-4. [PubMed 7532322]

113. Pavlovsky S, Gonzalez Llaven J, Garcia Martinez MA et al. A randomized study of mitoxantrone plus cytarabine versus daunomycin plus cytarabine in the treatment of previously untreated adult patients with acute nonlymphocytic leukemia. Ann Hematol. 1994; 69:11-5. [PubMed 8061102]

114. Wahlin A, Hornsten P, Hedenus M et al. Mitoxantrone and cytarabine versus daunorubicin and cytarabine in previously untreated patients with acute myeloid leukemia. Cancer Chemother Pharmacol. 1991; 28:480-3. [PubMed 1934252]

115. Adult acute myeloid leukemia. From: PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2007 Jul 17.

116. Anon. Drugs of choice for cancer. Treat Guidel Med Lett. 2003; 1:41-52.

b. AHFS drug information 2008. McEvoy GK, ed. Thioguanine. Bethesda, MD: American Society of Health-System Pharmacists, Inc; 2008:1232-3.

More Thioguanine Tabloid resources

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

Compare Thioguanine Tabloid with other medications

Acute Nonlymphocytic Leukemia

Indometacina Iqfarma

Indometacina Iqfarma may be available in the countries listed below.

Ingredient matches for Indometacina Iqfarma

Indometacin

Indometacin is reported as an ingredient of Indometacina Iqfarma in the following countries:

Peru

International Drug Name Search

Itrahexal

Itrahexal may be available in the countries listed below.

Ingredient matches for Itrahexal

Itraconazole

Itraconazole is reported as an ingredient of Itrahexal in the following countries:

Brazil

International Drug Name Search

Tusscough DHC

dihydrocodeine bitartrate, phenylephrine hydrochloride and chlorpheniramine maleate

Dosage Form: oral syrup
Tusscough DHC™

Syrup

Rx Only

CIII

Tusscough DHC Description

A sugar-free, alcohol-free, dye-free syrup for oral administration. Each teaspoonful (5 mL) contains:

* (WARNING: May be habit forming)
Dihydrocodeine Bitartrate*	3 mg
Phenylephrine Hydrochloride	20 mg
Chlorpheniramine Maleate	5 mg

Inactive Ingredients: Methyl Paraben, Propyl Paraben, Benzoic Acid, Citric Acid, Saccharin Sodium, Grape Flavor, Natural Masking Flavor, Propylene Glycol, Glycerin, Sorbitol, and Purified Water.

Dihydrocodeine Bitartrate is an opioid analgesic and antitussive with the chemical name: Morphinan-6-ol, 4,5-epoxy-3-methoxy-17-methyl-, (5α, 6α)-2,3-dihydroxybutanedioate (1:1) (salt). Its structure is as follows:

C18H23NO3 • C4H6O6 M.W. 451.47

Phenylephrine Hydrochloride is a mydriatic and a decongestant with the chemical name: Benzenemethanol, 3-hydroxy-α-[(methylamino)methyl]-, hydrochloride. Its structure is as follows:

C9H13NO2 • HCl M.W. 203.67

Chlorpheniramine Maleate is an antihistaminic with the chemical name: 2-Pyridinepropanamine, γ-(4-chlorphenyl)-N,N-dimethyl-, (Z)-2-butenedioate (1:1). Its structure is as follows:

C16H19ClN2 • C4H4O4 M.W. 390.86

Tusscough DHC - Clinical Pharmacology

Dihydrocodeine Bitartrate is a semi-synthetic narcotic analgesic and antitussive related to codeine, with multiple actions qualitatively similar to those of codeine; the most prominent of these involve the central nervous system and organs with smooth muscle components.

Phenylephrine acts predominantly by a direct action on alpha adrenergic receptors. In therapeutic doses, the drug has no significant stimulant effect on the beta adrenergic receptors of the heart and cause little, if any, central nervous system stimulation. Following oral administration, constriction of blood vessels in the nasal mucosa may relieve nasal congestion.

Chlorpheniramine competitively antagonizes most of the smooth muscle stimulating actions of histamine on the H1 receptors of the GI tract, uterus, large blood vessels and bronchial muscle. It also antagonizes the action of histamine that results in increased capillary permeability and the formation of edema.

INDICATIONS

Tusscough DHC™ temporarily relieves nasal congestion, runny nose, sneezing, itching of the nose or throat, and itchy, watery eyes, also alleviates cough due to minor throat and bronchial irritation associated with a cold.

Contraindications

Tusscough DHC™ is contraindicated in patients with known hypersensitivity to any of the ingredients. Do not use in patients with severe hypertension, severe coronary artery disease, prostatic hypertrophy, patients on MAO inhibitor therapy (or for 14 days after stopping MAOI therapy), ventricular tachycardia, pheochromocytoma, or breast-feeding mothers. Also contraindicated in newborns, premature infants, patients with narrow angle glaucoma, stenosing peptic ulcer, asthma, bladder neck obstruction, or pyloroduodenal obstruction. Because of its drying effect on lower secretions, this product is not recommended in the treatment of bronchial asthma.

Warnings

Do not exceed recommended dosage. If nervousness, dizziness, or sleeplessness occurs, discontinue use and consult a doctor. If symptoms do not improve within 7 days or are accompanied by a fever, consult a doctor.

May cause drowsiness; alcohol, sedatives, and tranquilizers may increase the drowsiness effect. Avoid alcoholic beverages while taking this product. Do not take this product if you are taking sedatives or tranquilizers, without first consulting your doctor. Use caution when driving a motor vehicle or operating machinery.

Do not take this product for persistent or chronic cough such as occurs with smoking, asthma, or emphysema, or if cough is accompanied by excessive phlegm (mucus) unless directed by a doctor. A persistent cough may be a sign of a serious condition. If cough persists for more than 1 week, tends to recur, or is accompanied by fever, rash, or persistent headache, consult a doctor.

Do not take this product if you have a chronic pulmonary disease or shortness of breath unless directed by your doctor.

Dihydrocodeine should be prescribed and administered with the same degree of caution as all oral medications containing a narcotic analgesic. Patients should be warned that dihydrocodeine bitartrate is potentially habit forming. Extreme caution should be exercised in the use of dihydrocodeine in patients with severe respiratory impairment or patients with impaired respiratory drive.

If pregnant, or planning to become pregnant or are currently breast-feeding please contact your physician, or health-care provider before using or continuing use.

Use in Elderly

The elderly (60 years and older) are more likely to have adverse reactions to sympathomimetics. Overdosage of sympathomimetics in this age group may cause hallucinations, convulsions, CNS depression and death.

Respiratory Depression

At high doses or in sensitive patients. Dihydrocodeine may produce dose-related respiratory depression by acting directly on the brain stem respiratory center. Dihydrocodeine also affects the center that controls respiratory rhythm, and may produce irregular and periodic breathing.

Head Injury and Increased Intracranial Pressure

The respiratory depressant effects of narcotics and their capacity to elevate cerebrospinal fluid pressure may be markedly exaggerated in the presence of head injury, other intracranial lesions, or preexisting increase in intracranial pressure. Furthermore, narcotics produce adverse reactions which may obscure the clinical course of patients with head injuries.

Acute Abdominal Conditions

The administration of narcotics may obscure the diagnosis or clinical course of patients with acute abdominal conditions.

Sympathomimetic amines should be used judiciously and sparingly in patients with hypertension, diabetes mellitus, ischemic heart disease, increased intraocular pressure, hyperthyroidism, or prostatic hypertrophy. Sympathomimetics may produce central nervous system stimulation with convulsions or cardiovascular collapse with accompanying hypotension.

Antihistamines may impair mental and physical abilities required for the performance of potentially hazardous tasks, such as driving a vehicle or operating machinery, and may impair mental alertness in children. Chlorpheniramine has an atropine-like action and should be used with caution in patients with increased intraocular pressure, increased intraocular pressure, cardiovascular disease, hypertension, or in patients with a history of bronchial asthma. Do not exceed recommended dosage.

Precautions

General

Use caution in the presence of hypertension, cardiovascular disease, hyperthyroidism, diabetes, bronchial asthma, emphysema, chronic pulmonary disease, heart disease, thyroid disease, increased intraocular pressure, or prostatic hypertrophy.

Information for Patients

Tusscough DHC™, like all narcotics, may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery; patients should be cautioned accordingly.

Stimulants, such as phenylephrine, are banned and tested for by the U.S. Olympic Committee (USOC) and the National Collegiate Athletic Association (NCAA).

Cough Reflex

Dihydrocodeine suppresses the cough reflex. As with all narcotics, caution should be exercised when Tusscough DHC™ is used postoperatively and in patients with pulmonary disease.

Drug Interactions

Patients receiving other narcotic analgesics, antipsychotics, antianxiety agents, or other CNS depressants (including alcohol) concomitantly with Tusscough DHC™ may exhibit an additive CNS depression. When combined therapy is contemplated, the dose of one or both agents should be reduced. The use of MAO inhibitors (or for 14 days after stopping MAOI therapy), or tricyclic antidepressants with dihydrocodeine preparations may increase the effect of either the antidepressant or dihydrocodeine. The concurrent use of anticholinergics with dihydrocodeine may produce paralytic ileus.

Antihistamines may cause drowsiness and ambulatory patients who operate machinery or motor vehicles should be cautioned accordingly.

MAO inhibitors (or for 14 days after stopping MAOI therapy) and beta adrenergic blockers increase the effect of sympathomimetics. Sympathomimetics may reduce the antihypertensive effects of methyldopa, mecamylamine, reserpine and veratrum alkaloids.

Usage in Pregnancy

Teratogenic Effects

Pregnancy Category C

There are no adequate and well-controlled studies in pregnant women. Tusscough DHC™ should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Non-Teratogenic Effects

Babies born to mothers who have been taking opioids regularly prior to delivery will be physically dependent. The withdrawal signs include irritability and excessive crying, tremors, hyperactive reflexes, increased respiratory rate, increased stools, sneezing, yawning, vomiting, and fever. The intensity of the syndrome does not always correlate with the duration of maternal opioid use or dose. There is no consensus on the best method of managing withdrawal. Chlorpromazine 0.7 to 1 mg/kg q 6h, and paregoric 2 to 4 drops/kg q 4h, have been used to treat withdrawal symptoms in infants. The duration of therapy is 4 to 28 days, with the dosage decreased as tolerated.

Labor and Delivery

As with all narcotics, administration of Tusscough DHC™ to the mother shortly before delivery may result in some degree of respiratory depression in the newborn, especially if higher doses are used.

Nursing Mothers

It is not known whether Tusscough DHC™ is excreted in human milk. Because many drugs are excreted in human milk and because potential for serious adverse reactions in nursing infants from Tusscough DHC™, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Codeine Warning

When physicians prescribe codeine-containing drugs to nursing women, they should inform their patients about the potential risks and the signs of morphine overdose. Nursing women taking codeine need to carefully watch their infants for signs of morphine overdose and seek medical attention immediately if the infant develops increased sleepiness (more than usual), difficulty breastfeeding or breathing, or decreased tone (limpness). Nursing mothers may also experience overdose symptoms such as extreme sleepiness, confusion, shallow breathing or severe constipation. When prescribing codeine to nursing mothers, physicians should choose the lowest effective dose over the shortest period of time and should closely monitor mother-infant pairs.

Drug metabolism is a complex process involving multiple genetic, environmental and physiologic factors. Limited evidence suggests that individuals who are ultra-rapid metabolizers (those with a specific CYP2D6 genotype) may convert codeine to its active metabolite, morphine, more rapidly and completely than other people. In nursing mothers, this metabolism can result in higher than expected serum and breast milk morphine levels. One published case report of an infant death raises concern that nursing babies may be at increased risk of morphine overdose if their mothers are taking codeine and are ultra-rapid metabolizers of the drug.

Pediatric Use

Safety and effectiveness in the pediatric population, under 12, have not been established.

Adverse Reactions

The most frequently observed reactions with dihydrocodeine include lightheadedness, dizziness, drowsiness, sedation, nausea and vomiting. These effects seem to be more prominent in ambulatory than in nonambulatory patients and some of these adverse reactions may be alleviated if the patient lies down. Patients sensitive to antihistamines may experience mild sedation. Possible side effects, of antihistamines are drowsiness, restlessness, dizziness, weakness, dry mouth, anorexia, nausea, vomiting, headache, nervousness, blurring of vision, polyuria, heartburn, dysuria and, very rarely, dermatitis. Individuals hyperreactive to sympathomimetic amines may display ephedrine-like reactions such as tachycardia, palpitations, headache, dizziness, or nausea. Sympathomimetics have been associated with certain untoward reactions including restlessness, tremor, weakness, pallor, respiratory difficulty, dysuria, insomnia, hallucinations, convulsions, CNS depression, arrhythmias and cardiovascular collapse with hypotension. Other adverse reactions include:

Central Nervous System: Drowsiness, mental clouding, lethargy, impairment of mental and physical performance, anxiety, fear, dysphoria, psychic dependence, mood changes.

Gastrointestinal System: The antiemetic phenothiazines are useful suppressing the nausea and vomiting which may occur, however, some phenothiazine derivatives seem to be anti analgesic and tend to increase the amount of narcotic required to produce pain relief, while other phenothiazines reduce the amount of narcotic required to produce a given level of analgesia.

Genitourinary System: Ureteral spasm, spasm of vesical sphincters and urinary retention have been reported.

Respiratory Depression: If significant respiratory depression occurs, it may be antagonized by the use of naloxone hydrochloride. Apply other supportive measures when indicated.

Drug Abuse and Dependence

Tusscough DHC™ is subject to Federal Controlled Substance Act (Schedule III). May be habit forming. Dihydrocodeine can produce drug dependence of the morphine type and, therefore, has the potential for being abused. Psychic dependence, physical dependence and tolerance may develop upon repeated administration of Tusscough DHC™ and it should be prescribed and administered with the same degree of caution appropriate to the use of other narcotic drugs.

Overdosage

Dihydrocodeine Bitartrate; Signs and Symptoms

Serious overdose with dihydrocodeine is characterized by respiratory depression (a decrease in respiratory rate and/or tidal volume, Cheyne-Stokes respiration, cyanosis), extreme somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, and sometimes bradycardia or hypotension. In severe overdosage, apnea, circulatory collapse, cardiac arrest and death may occur.

Treatment

Primary attention should be given to the reestablishment of adequate respiratory exchange through provision of a patent airway and the institution of assisted or controlled ventilation. The narcotic antagonist naloxone is a specific antidote against respiratory depression which may result from overdosage or unusual sensitivity to narcotics, including dihydrocodeine. Therefore, an appropriate dose of naloxone hydrochloride (see package insert) should be administered, preferably by the intravenous route, and simultaneously with efforts at respiratory resuscitation. Since the duration of action of dihydrocodeine may exceed that of the antagonist, the patient should be kept under continued surveillance and repeated doses of the antagonist should be administered as needed to maintain adequate respiration. An antagonist should not be administered in the absence of clinically significant respiratory or cardiovascular depression. Oxygen, intravenous fluids, vasopressors and other supportive measures should be employed as indicated. Gastric emptying may be useful in removing unabsorbed drug.

Tusscough DHC Dosage and Administration

Adults and children 12 years of age and older

1 teaspoonful (5 mL) every 4 to 6 hours.

This product is not indicated for use in children under 12 years of age. (see PRECAUTIONS, Pediatric Use.)

How is Tusscough DHC Supplied

Tusscough DHC™ is a clear, grape-flavored syrup, available in one pint (473 mL) bottles, NDC 51991-608-16.

Store at 25°C (77°F): excursions permitted to 15° - 30°C (59° - 86°F). See USP Controlled Room Temperature. Protect from freezing.

Dispense in a tight, light-resistant container as defined in the USP/NF.

WARNING: KEEP THIS AND ALL MEDICATIONS OUT OF THE REACH OF CHILDREN. IN CASE OF ACCIDENTAL OVERDOSE, SEEK PROFESSIONAL ASSISTANCE OR CONTACT A POISON CONTROL CENTER IMMEDIATELY.

Rx Only

All prescription substitutions using this product shall be pursuant to state statutes as applicable. This is not an Orange Book product.

Distributed by:

Breckenridge Pharmaceutical Inc.

Boca Raton, FL 33487

Manufactured by:

Provident Pharmaceuticals, LLC

Colorado Springs, CO 80919

lss. 06/09

PRINCIPAL DISPLAY PANEL - 473 mL Bottle Label

Breckenridge

Pharmaceutical, Inc.

NDC 51991-608-16

Tusscough DHC™

Syrup

Antitussive • Decongestant • Antihistamine

Each 5 mL (1 teaspoonful) contains:
Dihydrocodeine Bitartrate*	3 mg
*(WARNING: May be habit forming)
Phenylephrine Hydrochloride	20 mg
Chlorpheniramine Maleate	5 mg

SUGAR FREE • ALCOHOL FREE • DYE FREE

Rx Only

ONE PINT (473 mL)

Tusscough DHC
dihydrocodeine bitartrate, phenylephrine hydrochloride, and chlorpheniramine maleate syrup

Product Information
Product Type	HUMAN PRESCRIPTION DRUG	NDC Product Code (Source)	51991-608
Route of Administration	ORAL	DEA Schedule	CIII

Active Ingredient/Active Moiety
Ingredient Name	Basis of Strength	Strength
Dihydrocodeine Bitartrate (Codeine)	Dihydrocodeine Bitartrate	3 mg in 5 mL
Phenylephrine Hydrochloride (Phenylephrine)	Phenylephrine Hydrochloride	20 mg in 5 mL
Chlorpheniramine Maleate (Chlorpheniramine)	Chlorpheniramine Maleate	5 mg in 5 mL

Inactive Ingredients
Ingredient Name	Strength
Methylparaben
Propylparaben
Benzoic Acid
Citric Acid Monohydrate
Saccharin Sodium
grape
Propylene Glycol
Glycerin
Sorbitol
Water

Product Characteristics
Color		Score
Shape		Size
Flavor	GRAPE	Imprint Code
Contains

Packaging
#	NDC	Package Description	Multilevel Packaging
1	51991-608-16	473 mL In 1 BOTTLE, PLASTIC	None

Marketing Information
Marketing Category	Application Number or Monograph Citation	Marketing Start Date	Marketing End Date
UNAPPROVED DRUG OTHER		08/01/2009	06/30/2011

Labeler - Breckenridge Pharmaceutical, Inc. (150554335)

Establishment
Name	Address	ID/FEI	Operations
Provident Pharms Inc		171901445	MANUFACTURE

Revised: 01/2011Breckenridge Pharmaceutical, Inc.

More Tusscough DHC resources

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

Chlorpheniramine/Dihydrocodeine/Phenylephrine Liquid MedFacts Consumer Leaflet (Wolters Kluwer)

Novahistine DH Liquid MedFacts Consumer Leaflet (Wolters Kluwer)

Pancof-PD Concise Consumer Information (Cerner Multum)

Compare Tusscough DHC with other medications

Cough and Nasal Congestion

testosterone injection

Generic Name: testosterone injection (tes TOS ter one)

Brand Names: Andro LA 200, Delatestryl, Depandro 100, Depo-Testosterone, Testosterone Cypionate, Testosterone Enanthate

What is testosterone injection?

Testosterone is a naturally occurring sex hormone that is produced in a man's testicles. Small amounts of testosterone are also produced in a woman's ovaries and adrenal system.

Testosterone injection is used in men and boys to treat conditions caused by a lack of this hormone, such as delayed puberty, impotence, or other hormonal imbalances. Testosterone injection is also used in women to treat breast cancer that has spread to other parts of the body.

Testosterone injection may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about testosterone injection?

This medication can cause birth defects in an unborn baby if it is used by a woman during pregnancy. Do not receive testosterone injection if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. Do not receive this medication if you have prostate cancer, male breast cancer, if you are pregnant, or if you have ever had an allergic reaction to a hormone treatment.

Before receiving testosterone injection, tell your doctor if you have benign prostatic hypertrophy (BPH), a bleeding or blood clotting disorder, high cholesterol, any type of cancer, liver or kidney disease, or heart disease, coronary artery disease, or a history of heart attack.

What should I discuss with my healthcare provider before receiving testosterone injection?

You should not receive this medication if you have:

prostate cancer;

male breast cancer;

if you are pregnant; or

if you have ever had an allergic reaction to a hormone treatment.

Before receiving testosterone injection, tell your doctor if you are allergic to any drugs, or if you have:

benign prostatic hypertrophy (BPH);

any type of cancer;

high cholesterol;

a bleeding or blood clotting disorder;

liver or kidney disease; or

heart disease, coronary artery disease (hardened arteries), congestive heart failure, or a history of heart attack.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use testosterone injection.

FDA pregnancy category X. This medication can cause birth defects. Do not receive testosterone injection if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are receiving this medication. It is not known whether testosterone injection passes into breast milk or if it could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.

How is testosterone injection given?

Testosterone injection is given as an shot into a muscle of your buttocks. Your doctor, nurse, or other healthcare provider will give you this injection. Testosterone injection is usually given every 2 to 4 weeks.

The number of months you need to use testosterone injection will depend on the condition being treated.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

Testosterone injection can affect bone growth in boys who are treated for delayed puberty. Bone development may need to be checked with x-rays every 6 months during treatment.

What happens if I miss a dose?

Call your doctor if you miss an appointment for your testosterone injection.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine.

An overdose of testosterone injection is not expected to produce life-threatening symptoms.

What should I avoid while receiving testosterone injection?

Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are using testosterone injection.

Testosterone injection 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. Call your doctor at once if you have any of these serious side effects:

swelling, rapid weight gain;

increased or ongoing erection of the penis;

bone pain, increased thirst, memory problems, restless feeling, confusion, nausea, loss of appetite, increased urination, weakness, muscle twitching; or

nausea, vomiting, stomach pain, loss of appetite, and jaundice (yellowing of the skin or eyes).

Women receiving testosterone injection may develop male characteristics, which could be irreversible if testosterone treatment is continued. Call your doctor as soon as possible if you notice any of these signs of excess testosterone:

acne;

changes in your menstrual periods;

male-pattern hair growth (such as on the chin or chest);

male pattern baldness;

enlarged clitoris; or

increase or decrease in sex drive.

Less serious side effects may include:

breast swelling in men;

headache, anxiety, depressed mood;

numbness or tingly feeling; or

pain or swelling where the medicine was injected.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Testosterone injection Dosing Information

Usual Adult Dose for Hypogonadism -- Male:

Parenteral: Short-acting (testosterone solution and propionate): 25 mg to 50 mg IM 2 to 3 times a week.
Long-acting (enanthate and cypionate): 50 to 400 mg IM every 2 to 4 weeks.
Subcutaneous implant: 2 to 6 pellets (75 mg each) implanted subcutaneously every 3 to 6 months.

Topical:
Transdermal Film: 2.5 to 5 mg applied to the back, abdomen, upper arm, or upper thigh once a day, preferably at night.
Gel (in tubes, packets or spray): 5 grams applied once daily, preferably in the morning. May increase as needed to a maximum of 10 grams once a day.

Buccal: 30 mg patch to the gum region twice daily; morning and evening (about 12 hours apart). Patch should be placed just above the incisor tooth. With each application, the patch should be rotated to alternate sided of the mouth.

Testosterone 30 mg/1.5 mL transdermal solution:
Starting dose is 60 mg of testosterone (1 pump actuation of 30 mg of testosterone to each axilla), applied once daily, at the same time each morning. The dose of testosterone may be decreased from 60 mg (2 pump actuations) to 30 mg (1 pump actuation) or increased from 60 mg to 90 mg (3 pump actuations) or from 90 mg to 120 mg (4 pump actuations) based on the serum testosterone concentration from a single blood draw 2 to 8 hours after applying the solution and at least 14 days after starting treatment or following dose adjustment.

Testosterone 10 mg/0.5 g transdermal gel:
Starting dose is 40 mg of testosterone (4 pump actuations of 30 mg to clean, dry intact skin of the front and inner thighs), applied once daily, at the same time each morning. Let application site dry before putting on pants or shorts. The dose can be adjusted between a minimum of 10 mg of testosterone (1 pump actuation) and a maximum of 70 mg of testosterone (7 pump actuations) on the basis of total serum testosterone concentrations 2 hours post application. The dose should be titrated based on the serum testosterone concentration from a single blood draw 2 hours after applying and at approximately 14 days and 35 days after starting treatment or following dose adjustment. In addition, serum testosterone concentration should be assessed periodically thereafter.

Testosterone 20.25 mg/1.25 g transdermal gel:
Starting dose 40.5 mg of testosterone (2 pump actuations), applied topically to the shoulders and upper arms once daily in the morning. The dose can be adjusted between a minimum of 20.25 mg of testosterone (1 pump actuation) and a maximum of 81 mg of testosterone (4 pump actuations). The dose should be titrated based on the pre dose morning serum testosterone concentration at approximately 14 days and 28 days after starting treatment or following dose adjustment. Additionally, serum testosterone concentration should be assessed periodically thereafter.

Usual Adult Dose for Breast Cancer--Palliative:

Parenteral: Short-acting (testosterone solution and propionate): 50 mg to 100 mg IM 2 to 3 times a week.
Long-acting (enanthate and cypionate): 200 to 400 mg IM every 2 to 4 weeks.
Subcutaneous implant: 2 to 6 pellets (75 mg each) implanted subcutaneously every 3 to 6 months

Testosterone is approved by the FDA for the palliation of androgen responsive metastatic breast cancer in women who are 1 to 5 years postmenopausal or who are proven to have a hormone-dependent tumor noted by previous beneficial response to castration.

Female patients should be observed for signs of virilization. Women should be instructed to report any hoarseness, acne, changes in menstrual periods, or increases in facial hair. Discontinuation of drug therapy at the time of evidence of mild virilism is necessary to prevent irreversible virilization. A decision may be made by the patient and the physician that some virilization will be tolerated during the treatment for malignant disease.

Usual Adult Dose for Postpartum Breast Pain:

Parenteral: Short-acting (testosterone solution and propionate): 25 mg to 50 mg IM for 3 to 4 days, starting at the time of delivery.

Usual Pediatric Dose for Delayed Puberty -- Male:

Parenteral:
Initiation of pubertal growth: Long-acting (enanthate and cypionate): 40 to 50 mg/square meter IM monthly until the growth rate falls to prepubertal levels.
Terminal growth phase: Long-acting (enanthate and cypionate): 100 mg/square meter IM monthly until the growth ceases.
Maintenance virilizing dose: Long-acting (enanthate and cypionate): 100 mg/square meter intramuscular twice monthly.

Subcutaneous implant: 2 to 6 pellets (75 mg each) implanted subcutaneously every 3 to 6 months.

Dosages used to treat delayed puberty are generally started at the lower end of the dosing range and titrated according to patient response and tolerance. The duration of therapy should be limited to 4 to 6 months. Serum concentrations of testosterone should be determined following 3 to 4 weeks of daily use. If desired results have not been achieved at 6 to 8 weeks an alternative testosterone regimen should be considered.

Wrist and hand bone age should be assessed prior to initiation of testosterone therapy and every 6 months to monitor bone maturation. Exogenous androgen therapy can accelerate bone maturation without producing a compensatory gain in linear growth. Use over long periods can result in fusion of the epiphyseal growth centers and termination of the growth process.

What other drugs will affect testosterone injection?

Before receiving testosterone injection, tell your doctor if you are using any of the following drugs:

the blood thinner warfarin (Coumadin);

insulin or diabetes medication you take by mouth such as glimepiride (Amaryl, Duetact, Avandaryl), glipizide (Glucotrol), glyburide (Diabeta, Micronase, Glynase), metformin (Actoplus Met, Avandamet, Fortamet, Glucophage Janumet), rosiglitazone (Avandia), and others; or

steroid medicine such as methylprednisolone (Depo-Medrol, Medrol, Solu-Medrol), prednisone (Deltasone, Orasone, others), and others.

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

More testosterone injection resources

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

Compare testosterone injection with other medications

Breast Cancer, Palliative
Delayed Puberty, Male
Hypogonadism, Male
Postpartum Breast Pain

Where can I get more information?

Your doctor or pharmacist can provide more information about testosterone injection.

See also: testosterone side effects (in more detail)

Monday, October 24, 2016

thyroid

THYE-roid

Oral route(Tablet)

In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects .

Commonly used brand name(s)

In the U.S.

Armour Thyroid

Nature-Throid NT-1

Nature-Throid NT-1/2

Nature-Throid NT-2

Nature-Throid NT-3

Nature-Thyroid

Westhroid

Available Dosage Forms:

Tablet

Capsule

Therapeutic Class: Thyroid Supplement

Uses For thyroid

Thyroid is used to treat hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone. It is also used to help decrease the size of enlarged thyroid glands (known as goiter) and to treat thyroid cancer .

Thyroid is also used in some medical tests to help diagnose problems with the thyroid gland .

thyroid is available only with your doctor's prescription .

Before Using thyroid

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 thyroid, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to thyroid 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 pediatrics-specific problems that would limit the usefulness of thyroid in children .

Geriatric

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

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	A	Adequate studies in pregnant women have not shown an increased risk of fetal abnormalities.

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 thyroid, 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 thyroid with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acenocoumarol

Anisindione

Dicumarol

Kelp

Phenindione

Phenprocoumon

Warfarin

Interactions with Food/Tobacco/Alcohol

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

Proper Use of thyroid

thyroid usually needs to be taken for life. Do not stop taking thyroid or change your doses without first checking with your doctor. It may take several weeks before you start to notice an improvement in your symptoms .

Dosing

The dose of thyroid 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 thyroid. 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 oral dosage form (tablet):
- For the treatment of hypothyroidism:
  - Adults—At first, 30 milligrams (mg) once a day. Then, your doctor may increase your dose a little at a time up to the usual maintenance dose of 60 to 120 mg a day. A lower starting dose of 15 mg/day may be given to patients for certain conditions.
  - Children 0 to 6 months of age—The dose is based on body weight and must be determined by your doctor. The usual dose is 15 to 30 mg once a day.
  - Children 6 to 12 months of age—The dose is based on body weight and must be determined by your doctor. The usual dose is 30 to 45 mg once a day.
  - Children 1 to 5 years of age—The dose is based on body weight and must be determined by your doctor. The usual dose is 45 to 60 mg once a day.
  - Children 6 to 12 years of age—The dose is based on body weight and must be determined by your doctor. The usual dose is 60 to 90 mg once a day.
  - Children over 12 years of age—The dose is based on body weight and must be determined by your doctor. The usual dose is over 90 mg once a day .

Missed Dose

If you miss a dose of thyroid, 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

DRUG: GENERAL, STORAGE DRUG: GENERAL, STORAGE

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

Keep out of the reach of children.

Precautions While Using thyroid

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests will be needed to check for unwanted effects .

Thyroid should not be used for the treatment of obesity or for the purpose of losing weight. thyroid is ineffective for weight reduction and when taken in larger amount, it may cause more serious medical conditions .

Hypothyroidism can sometimes cause infertility in men and women. Thyroid should not be used for the treatment of infertility unless it is caused by hypothyroidism .

Call your doctor right away if you start to have chest pain, fast, irregular, pounding, or racing heartbeat or pulse, excessive sweating, heat intolerance, nervousness, or any other unusual medical condition .

For patients with diabetes, it is very important that you keep track of your blood or urine sugar levels as instructed by your doctor. Check with your doctor immediately if you notice any changes in your sugar levels .

A temporary loss of hair may occur during the first few months of thyroid therapy. Ask your doctor about this if you have any concerns .

thyroid 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.

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

Changes in appetite

changes in menstrual periods

chest pain

diarrhea

fast or irregular heartbeat

fever

hand tremors

headache

irritability

leg cramps

nervousness

sensitivity to heat

shortness of breath

sweating

trouble sleeping

vomiting

weight loss

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: thyroid side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More thyroid resources

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

Armour Thyroid Prescribing Information (FDA)

Armour Thyroid Concise Consumer Information (Cerner Multum)

Armour Thyroid MedFacts Consumer Leaflet (Wolters Kluwer)

Compare thyroid with other medications

Hashimoto's disease
Hypothyroidism, After Thyroid Removal
Thyroid Cancer
TSH Suppression
Underactive Thyroid

Lospre

Lospre may be available in the countries listed below.

Ingredient matches for Lospre

Losartan

Losartan potassium salt (a derivative of Losartan) is reported as an ingredient of Lospre in the following countries:

Bangladesh

International Drug Name Search