Blog Indiana

Wednesday, October 5, 2016

Doxazosin Mesylate

Class: alpha-Adrenergic Blocking Agents
VA Class: CV150
Chemical Name: 1-(4-Amino-6,7-dimethoxy-2-quinazolinyl)-4-[(2,3-dihydro-1,4-benzodioxin-2-yl)carbonyl]piperazine monomethanesulfonate
Molecular Formula: C₂₃H₂₅N₅O₅•CH₄O₃S
CAS Number: 77883-43-3
Brands: Cardura

Introduction

Postsynaptic α₁-adrenergic blocking agent; quinazoline derivative.¹ ² ³ ⁴ ⁵ ⁶ ⁷

Uses for Doxazosin Mesylate

Hypertension

Management of hypertension (alone or in combination with other classes of antihypertensive agents).¹ ² ³ ⁴ ⁶ ⁷

Current antihypertensive and urology guidelines (e.g., JNC 7) no longer recommend α₁-blockers as preferred first-line therapy for patients with hypertension.⁶⁶ ⁷⁰ ⁸²

May have potential favorable effects in hypertensive patients with benign prostatic hyperplasia or other urinary outflow obstruction.⁷⁰ ⁸²

Benign Prostatic Hyperplasia (BPH)

Reduction of urinary obstruction and relief of associated manifestations in hypertensive or normotensive patients with symptomatic BPH.¹ ²¹ ³³ ³⁵ ³⁷ ⁴⁰ ⁴¹ ⁴² ⁴³ ⁴⁴ ⁴⁶

Although drug therapy usually is not as effective as surgical therapy, it may provide adequate symptomatic relief with fewer and less serious adverse effects compared with surgery.⁶⁶

May consider combined therapy with an α₁-adrenergic blocker and 5α-reductase inhibitor for men with bothersome moderate to severe BPH and demonstrable prostatic enlargement.⁶⁶ ⁸⁴ ⁸⁵ Has been more effective than therapy with either drug alone in preventing long-term BPH symptom progression.⁶⁶ Men at risk for BPH progression are most likely to benefit from combination therapy.⁶⁶ ⁸⁴

Doxazosin Mesylate Dosage and Administration

Administration

Oral Administration

Administer orally once daily in the morning or evening.¹ Effect of food on maximum plasma concentration and AUC is not clinically important.¹

Dosage

Available as doxazosin mesylate; dosage expressed in terms of doxazosin.¹

Individualize dosage according to patient response and tolerance.¹ ⁷ Initiate at low dosage to minimize frequency of postural hypotension and syncope.¹

Postural effects are most likely to occur 2–6 hours after a dose; monitor BP during this period after first dose and with any dosage increases.¹

If therapy is interrupted for several days, restart using initial dosage regimen.¹

Pediatric Patients

Hypertension†

Oral

Initially, 1 mg once daily.¹⁰⁶ Increase dosage as necessary up to a maximum of 4 mg once daily.¹⁰⁶

Adults

Hypertension

Oral

Initially, 1 mg once daily.¹ ⁷ ⁷⁰ Do not initiate with higher dosages.¹

Depending on patient response (standing BP 2–6 and 24 hours after initial dose), may increase dosage to 2 mg once daily; make subsequent dosage adjustments by doubling dose at intervals of 2 weeks–1 month until desired BP control is achieved, drug is not tolerated, or maximum daily dosage of 16 mg is reached.¹ ⁷ ⁷⁰

Increased likelihood of excessive postural effects (e.g., syncope, postural dizziness/vertigo, postural hypotension) with dosages >4 mg daily; substantial risk of postural effects with dosages >16 mg daily.¹

Careful monitoring of BP is recommended during initial titration or subsequent upward dosage adjustment;⁵³ ⁷⁰ avoid large or abrupt reductions in BP.⁵³

BPH

Oral

Initially, 1 mg once daily in the morning or evening;¹ ⁴¹ ⁴⁴ some clinicians recommend administration at bedtime to minimize postural effects.³⁵ ³⁶ Do not initiate with higher dosages.¹

To achieve desired improvement in symptoms and urodynamics, may increase dosage in a stepwise manner to 2, 4, and 8 mg daily as necessary, at intervals ≥1–2 weeks.¹ ⁴¹ ⁴² ⁴³ ⁴⁴ Do not exceed 8 mg daily.

Evaluate BP routinely, particularly with initiation of therapy and subsequent dosage adjustment.¹

Prescribing Limits

Pediatric Patients

Hypertension†

Oral

Maximum 4 mg daily.⁷⁶

Adults

Hypertension

Oral

Maximum 16 mg daily.¹

BPH

Oral

Maximum 8 mg daily.¹

Special Populations

Geriatric Patients

Hypertension

Select dosage carefully, usually initiating therapy at the low end of the dosage range, because of possible age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy;¹ generally, increase dosage more slowly in geriatric patients than in younger adults.⁷

Cautions for Doxazosin Mesylate

Contraindications

Known hypersensitivity to doxazosin, quinazolines (e.g., prazosin, terazosin), or any ingredient in the formulation.¹

Warnings/Precautions

Warnings

Postural Hypotension

Marked hypotension, especially in the upright position, can occur; may be accompanied by syncope and other postural effects (e.g., dizziness, lightheadedness, vertigo).¹

Postural effects are most common after initial dose but may also occur when dosage is increased or when therapy is resumed after an interruption exceeding a few days.¹

To decrease risk of excessive hypotension and syncope, initiate therapy at a low dosage (i.e., 1 mg daily) and titrate slowly; initiate concomitant antihypertensive agents with caution.¹

If syncope or hypotension occurs, place patient in a recumbent position and institute supportive therapy as necessary; a transient hypotensive response is not a contraindication to further doses.¹

Use with particular caution in patients in occupations in which orthostatic hypotension could be dangerous.¹

Priapism

Priapism reported rarely; may lead to permanent impotence if not treated promptly.¹

General Precautions

Prostate Cancer

Exclude possibility of prostate cancer before initiation of therapy for BPH.¹

Hematologic Effects

Possible decreases in leukocyte and neutrophil counts in patients receiving α₁-adrenergic blocking agents, including doxazosin.¹

Specific Populations

Pregnancy

Category C.¹

Lactation

Distributed into milk in rats; not known whether distributed into human milk.¹ Caution if used in nursing women.¹

Pediatric Use

Safety and efficacy not established in children <18 years of age.¹

Geriatric Use

Geriatric patients may be particularly susceptible to postural effects.⁷

BPH: Safety and efficacy were similar in those ≥65 years of age compared with younger patients.¹

Hypertension: Clinical studies did not include sufficient numbers of patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults; other clinical experience has not revealed age-related differences in response.¹ Select dosage with caution.¹ (See Geriatric Patients under Dosage and Administration.)

Hepatic Impairment

Use with caution in patients with hepatic impairment and those who are receiving other agents known to influence hepatic metabolism.¹ (See Interactions.)

Common Adverse Effects

Dizziness, headache, drowsiness, fatigue, edema, nausea, dyspnea, somnolence, abdominal pain, diarrhea.¹ ² ³ ⁴ ⁶ ⁷

Interactions for Doxazosin Mesylate

No formal drug interaction studies to date, but no interactions observed in patients receiving various agents concomitantly during clinical trials.¹ (See Specific Drugs and Laboratory Tests.)

Antihypertensive Agents

Potential pharmacodynamic interaction (additive hypotensive effects; initiate additional antihypertensive agents with caution).¹

Drugs Affecting Hepatic Metabolism

Potential pharmacokinetic interaction; use concomitantly with caution.¹

Protein-bound Drugs

Potential pharmacokinetic interaction (displacement of doxazosin or other protein-bound drug); no information available to date on effect of other highly protein-bound drugs on doxazosin binding.¹ Doxazosin has no effect on protein binding of certain drugs in vitro.¹ (See Specific Drugs and Laboratory Tests.)

Specific Drugs and Laboratory Tests

Drug or Test	Interaction	Comments
Acetaminophen	No interaction observed in clinical trials¹
Amoxicillin	No interaction observed in clinical trials¹
Antacids	No interaction observed in clinical trials¹
β-Adrenergic blocking agents (e.g., atenolol, propranolol)	No interaction observed in clinical trials¹
Chlorpheniramine	No interaction observed in clinical trials¹
Cimetidine	Increased AUC (10%) of doxazosin¹	Clinical importance unknown¹
Codeine	No interaction observed in clinical trials¹
Corticosteroids	No interaction observed in clinical trials¹
Co-trimoxazole	No interaction observed in clinical trials¹
Diazepam	No interaction observed in clinical trials¹
Digoxin	No effect on digoxin protein binding in vitro¹
Diuretics, thiazide (e.g., hydrochlorothiazide)	No interaction observed in clinical trials¹
Erythromycin	No interaction observed in clinical trials¹
Finasteride	Adverse effects with concomitant use generally reflect combined toxicity profile of each drug alone⁶⁶ ⁸⁴
Hypoglycemic	No interaction observed in clinical trials¹
NSAIAs (e.g., aspirin, ibuprofen, indomethacin)	No interaction observed in clinical trials; no effect on indomethacin protein binding in vitro¹
Phenytoin	No effect on phenytoin protein binding in vitro¹
Test for prostate specific antigen (PSA)	No effect on plasma PSA concentrations in patients receiving doxazosin for up to 3 years¹
Warfarin	No effect on warfarin protein binding in vitro¹

Doxazosin Mesylate Pharmacokinetics

Absorption

Bioavailability

Peak plasma concentrations attained within about 2–3 hours.¹

Bioavailability is approximately 65%.¹

Onset

In patients with hypertension, maximum reduction in BP usually occurs 2–6 hours after administration.¹

In patients with BPH, decreased severity of symptoms and improved urinary flow rate observed within 1–2 weeks.¹

Food

Food decreases mean maximum plasma concentrations and AUC by 18 and 12%, respectively; not statistically or clinically significant.¹

Distribution

Extent

Crosses the placenta and is distributed into milk in animals; not known whether distributed into human milk.¹

Plasma Protein Binding

Approximately 98%.¹

Elimination

Metabolism

Extensively metabolized, principally in the liver by O-demethylation of quinazoline nucleus or hydroxylation of benzodioxan moiety, to several active metabolites; pharmacokinetics of metabolites not characterized.¹

Elimination Route

Excreted in feces (63%) and urine (9%) mainly as metabolites; only 4.8% and trace amounts excreted unchanged in feces and urine, respectively.¹

Half-life

Biphasic; terminal half-life is approximately 22 hours.¹

Special Populations

In patient with cirrhosis (Child-Pugh class A), systemic exposure was increased by 40% after a single 2-mg dose.¹ Effect of hepatic impairment on disposition not established in controlled clinical studies.¹

In geriatric patients and patients with renal impairment, clinically important alterations in pharmacokinetics not observed to date.¹

Stability

Storage

Oral

Tablets

<30°C.¹

ActionsActions

Reduces peripheral vascular resistance and BP as a result of vasodilating effects; produces both arterial and venous dilation.¹ ² ³ ⁴ ⁶ ⁷

Binds to α-adrenergic receptors on the prostate capsule, prostate adenoma, and the bladder trigone, resulting in decreased urinary outflow resistance in men.¹ ⁵

May improve to limited extent the serum lipid profile (e.g., small increases in HDL and HDL/total cholesterol ratio; small decreases in LDL, total cholesterol, and triglyceride concentrations).¹ ² ³ ⁷

Advice to Patients

Possible syncopal and orthostatic symptoms, especially at initiation of therapy; importance of avoiding driving or other hazardous tasks where injury could occur for 24 hours after first dose, a dosage increase, or when resumed after therapy interruption.¹

Importance of sitting or lying down when symptoms of lowered BP occur, and of rising carefully from a sitting or lying position.¹

Importance of informing clinician if bothersome dizziness, lightheadedness, or palpitations occur.¹

Possible drowsiness or somnolence; use caution when operating machinery or driving a motor vehicle until effects on individual are known.¹

Importance of men seeking immediate medical attention if painful or sustained (for hours) erection occurs.¹

Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.¹

Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as concomitant illnesses.¹

Importance of informing patients of other important precautionary information.¹ (See Cautions.)

Preparations

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

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Doxazosin Mesylate
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets	1 mg (of doxazosin)*	Cardura (scored)	Pfizer
		2 mg (of doxazosin)*	Cardura (scored)	Pfizer
		4 mg (of doxazosin)*	Cardura (scored)	Pfizer
		8 mg (of doxazosin)*	Cardura (scored)	Pfizer

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.

Cardura 1MG Tablets (PFIZER U.S.): 30/$52.99 or 90/$158.96

Cardura 2MG Tablets (PFIZER U.S.): 30/$61.14 or 90/$153.95

Cardura 4MG Tablets (PFIZER U.S.): 30/$63.33 or 90/$159.39

Cardura 8MG Tablets (PFIZER U.S.): 30/$63.32 or 90/$172.5

Cardura XL 4MG 24-hr Tablets (PFIZER U.S.): 30/$60.99 or 90/$170.97

Doxazosin Mesylate 1MG Tablets (MYLAN): 30/$17.99 or 90/$47.97

Doxazosin Mesylate 2MG Tablets (TEVA PHARMACEUTICALS USA): 30/$19.99 or 90/$43.98

Doxazosin Mesylate 4MG Tablets (MYLAN): 30/$21.99 or 90/$59.97

Doxazosin Mesylate 8MG Tablets (TEVA PHARMACEUTICALS USA): 30/$23.99 or 90/$62.99

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 May 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

1. Pfizer. Cardura (doxazosin mesylate) tablets prescribing information. New York, NY; 2002 Apr.

2. Babamoto KS, Hirokawa WT. Doxazosin: a new α₁-adrenergic antagonist. Clin Pharm. 1992; 11:415-27. [IDIS 294778] [PubMed 1349855]

3. Young RA, Brogden RN. Doxazosin: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in mild or moderate hypertension. Drugs. 1988; 35:525-41. [IDIS 243128] [PubMed 2899495]

4. Khoury AF, Kaplan NM. α-Blocker therapy of hypertension. JAMA. 1991; 266:394-8. [IDIS 283041] [PubMed 1676077]

5. Monda JM, Oesterling JE. Medical treatment of benign prostatic hyperplasia: 5α-reductase inhibitors and α-adrenergic antagonists. Mayo Clin Proc. 1993; 68:670-9. [IDIS 316185] [PubMed 7688840]

6. Itskovitz HD. Alpha₁ blockers: safe, effective treatment for hypertension. Postgrad Med. 1991; 89:89-112. [IDIS 283690] [PubMed 1674822]

7. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Arch Intern Med. 1993; 153:154-83. [IDIS 309043] [PubMed 8422206]

8. Oliver RM, Upward JW, Dewhurst AG et al. The pharmacokinetics of doxazosin in patients with hypertension and renal impairment. Br J Clin Pharm. 1990; 29:417-22.

9. de Planque BA. A double-blind comparative study of doxazosin and prazosin when administered with β-blockers or diuretics. Am Heart J. 1991; 121:304-11. [IDIS 276237] [PubMed 1670744]

10. Englert RG, Barlage U. The addition of doxazosin to the treatment regimen of patients with hypertension not adequately controlled by β-blockers. Am Heart J. 1991; 121:311-6. [IDIS 276238] [PubMed 1670745]

11. DiBianco R, Parker JO, Chakko S et al. Doxazosin for the treatment of chronic congestive heart failure: results of a randomized double-blind and placebo-controlled study. Am Heart J. 1991; 121:372-80. [IDIS 276249] [PubMed 1670746]

12. Miura Y, Yoshinaga K. Doxazosin: a newly developed, selective α₁-inhibitor in the management of patients with pheochromocytoma. Am Heart J. 1988; 116:1785. [IDIS 313494] [PubMed 2904751]

13. Holme JB, Husted SE, Jacobsen F et al. Doxazosin: A new, efficient and safe drug in the treatment of benign prostatic obstruction. J Urol. 1990; 143:267A.

14. Chapple R, Carter P, Christmas TJ et al. A three month double-blind placebo controlled study of doxazosin as treatment for benign prostatic bladder outlet obstruction. J Urol. 1992; 147:366A.

15. 1988 Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The 1988 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med. 1988; 148:1023-38. [IDIS 242588] [PubMed 3365073]

16. Weber MA, Laragh JH. Hypertension: steps forward and steps backward. The Joint National Committee fifth report. Arch Intern Med. 1993; 153:149-52. [PubMed 8422205]

17. Pfizer Roerig, New York, NY: Personal communication.

18. Wilde MI, Fitton A, Sorkin EM. Terazosin: a review of its pharmacodynamic properties, and therapeutic potential in benign prostatic hyperplasia. Drugs and Aging. 1993; 3:258-77. [PubMed 7686794]

19. Lindner UK, von Manteuffel GE, Stafunsky M. The addition of doxazosin to the treatment regimen of hypertensive patients not responsive to nifedipine. Am Heart J. 1988; 116:1814-20. [IDIS 313499] [PubMed 2904756]

20. Englert RG, Mauersberger H. A single-blind study of doxazosin in the treatment of essential hypertension when added to nonresponders to angiotensin-converting enzyme inhibitor therapy. Am Heart J. 1988; 116:1826-32. [IDIS 313501] [PubMed 2904758]

21. Chapple C. Medical treatment for benign prostatic hyperplasia. BMJ. 1992; 304:1198-9. [IDIS 296671] [PubMed 1381250]

22. Kirby RS. Alpha-adrenoceptor inhibitors in the treatment of benign prostatic hyperplasia. Am J Med. 1989; 87(Suppl 2A):26-30S.

23. Lepor H. The emerging role of alpha antagonists in the therapy of benign prostatic hyperplasia. J Androl. 1991; 12:389-94. [PubMed 1722795]

24. Wilde MI, Fitton A, Sorkin EM. Terazosin: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in benign prostatic hyperplasia. Drugs Aging. 1993; 3:258-77. [PubMed 7686794]

25. Lepor H, Meretyk S, Knapp-Maloney G. The safety, efficacy and compliance of terazosin therapy for benign prostatic hyperplasia. J Urol. 1992; 147:1554-7. [IDIS 297430] [PubMed 1375659]

26. Chapple CR, Christmas TJ, Milroy EJG. A twelve-week placebo-controlled study of prazosin in the treatment of prostatic obstruction. Urol Int. 1990; 45(Suppl 1):47-55. [PubMed 1690482]

27. Andersson KE. Current concepts in the treatment of disorders of micturition. Drugs. 1988; 35:477-94. [IDIS 240964] [PubMed 3292211]

28. Lepor H. Role of long-acting selective alpha-1 blockers in the treatment of benign prostatic hyperplasia. Urol Clin North Am. 1990; 17:651-9. [PubMed 1695785]

29. Chisholm GD. Benign prostatic hyperplasia: the best treatment. BMJ. 1989; 299:215-6. [IDIS 257552] [PubMed 2475197]

30. Geller J. Nonsurgical treatment of prostatic hyperplasia. Cancer. 1992; 70(Suppl 1):339-45. [IDIS 298353] [PubMed 1376202]

31. Bostwick DG, Cooner WH, Denis L et al. The association of benign prostatic hyperplasia and cancer of the prostate. Cancer. 1992; 70(Suppl 1):291-301. [PubMed 1376199]

32. Merck & Co., Inc. Proscar (finasteride) tablets prescribing information. Whitehouse Station, NJ; 2006 Jan.

33. Garraway WM, Collins GN, Lee RJ. High prevalence of benign prostatic hypertrophy in the community. Lancet. 1991; 338:469-71. [PubMed 1714529]

34. Oesterling JE. Benign prostatic hyperplasia: medical and minimally invasive treatment options. N Engl J Med. 1995; 332:99-109. [IDIS 340651] [PubMed 7527494]

35. Hill SJ, Lawrence SL, Lepor H. New use for alpha blockers: benign prostatic hyperplasia. Am Fam Physician. 1994; 49:1885-8. [IDIS 330970] [PubMed 7515555]

36. Moul JW. Benign prostatic hyperplasia: new concepts in the 1990s. Postgrad Med. 1993; 94:141-52. [IDIS 322455] [PubMed 7694269]

37. Monda JM, Oesterling JE. Subspecialty clinics: urology: medical treatment of benign prostatic hyperplasia: 5α-reductase inhibitors and α-adrenergic antagonists. Mayo Clin Proc. 1993; 68:670-9. [IDIS 316185] [PubMed 7688840]

38. Brendler CB. Diseases of the prostate. In: Wyngaarden JB, Smith LH Jr, Bennett JC, eds. Cecil textbook of medicine. 19th ed. Philadelphia: W.B. Saunders Company; 1992:1351-5.

39. Bruskewitz RC. Benign prostatic hyperplasia: drug and nondrug therapies. Geriatrics. 1992; 47:39-45. [IDIS 306255] [PubMed 1280242]

40. Kaplan SA, Soldo KA, Olsson CA. Effect of dosing regimen on efficacy and safety of doxazosin in normotensive men with symptomatic prostatism: a pilot study. Urology. 1994; 44:348-52. [PubMed 7521090]

41. Chapple CR, Carter P, Christmas TJ et al. A three month double-blind study of doxazosin as treatment for benign prostatic bladder outlet obstruction. Br J Urol. 1994; 74:50-6. [PubMed 7519112]

42. Holme JB, Christensen MM, Rasmussen PC et al. 29-week doxazosin treatment in patients with symptomatic benign prostatic hyperplasia: a double-blind placebo-controlled study. Scand J Urol Nephrol. 1994; 28:77-82. [PubMed 7516576]

43. Christensen MM, Holme JB, Rasmussen PC et al. Doxazosin treatment in patients with prostatic obstruction: a double-blind placebo-controlled study. Scand J Urol Nephrol. 1993; 27:39-44. [PubMed 7684157]

44. Janknegt RA, Chapple CR for the Doxazosin Study Groups. Efficacy and safety of the alpha-1 blocker doxazosin in the treatment of benign prostatic hyperplasia: analysis of 5 studies. Eur Urol. 1993; 24:319-26. [PubMed 7505224]

45. Roberts RG. Novel idea in BPH guideline: the patient as decision maker. Am Fam Physician. 1994; 49:1044-51. [PubMed 7512307]

46. Chapple CR, Carter P, Christmas TJ et al. A three month double-blind placebo controlled study of doxazosin as treatment for benign prostatic bladder outlet obstruction. J Urol. 1992; 147:366A.

47. National Heart, Lung, and Blood Institute. NHLBI panel reviews safety of calcium channel blockers. Rockville, MD; 1995 Aug 31. Press release.

48. National Heart, Lung, and Blood Institute. New analysis regarding the safety of calcium-channel blockers: a statement for health professionals from the National Heart, Lung, and Blood Institute. Rockville, MD; 1995 Sep 1.

49. Psaty BM, Heckbert SR, Koepsell TD et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. 1995; 274:620-5. [IDIS 352203] [PubMed 7637142]

50. Yusuf S. Calcium antagonists in coronary artery disease and hypertension: time for reevaluation? Circulation. 1995; 92:1079-82. Editorial.

51. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Arch Intern Med. 1993; 153:154-83. [IDIS 309043] [PubMed 8422206]

52. Anon. Drugs for hypertension. Med Lett Drugs Ther. 1993; 35:55-60. [PubMed 8099706]

53. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). Bethesda, MD: National Institutes of Health; 1997 Nov. (NIH publication No. 98-4080.)

54. Whelton PK, Appel LJ, Espeland MA et al. for the TONE Collaborative Research Group. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA. 1998; 279:839-46. [PubMed 9515998]

55. Upjohn Company. Caverject (alprostadil) injection for intracavernosal use prescribing information. Kalamazoo, MI; 1995 Jul.

56. Krane RJ, Goldstein I, Saenz de Tejada I. Impotence. N Engl J Med. 1989; 321:1648-59. [PubMed 2685600]

57. The ALLHAT collaborative research group. Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: the Antihypertensive and Lipid-Lowering treatment to prevent Heart Attack Trial (ALLHAT). JAMA. 2000; 283:1967-75. [IDIS 444771] [PubMed 10789664]

58. Lasagna L. Diuretics vs α-blockers for treatment of hypertension: lessons from ALLHAT. JAMA. 2000; 283:2013-4. [IDIS 444774] [PubMed 10789671]

59. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. 2000; 35:1021-4. [PubMed 10818056]

60. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. 2000; 35:1019-20. [PubMed 10818055]

61. Bakris GL, Williams M, Dworkin L et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000; 36:646-61. [IDIS 452007] [PubMed 10977801]

62. Associated Press (American Diabetes Association). Diabetics urged: drop blood pressure. Chicago, IL; 2000 Aug 29. Press Release from web site.

63. Appel LJ. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002; 288:3039-60. [IDIS 490723] [PubMed 12479770]

64. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:2981-97. [IDIS 490721] [PubMed 12479763]

65. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs usual care: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack (ALLHAT). JAMA. 2002; 288:2998-3007. [IDIS 490722] [PubMed 12479764]

66. American Urological Association Practice Guideline Committee. AUA guidelines on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations. J Urol. 2003; 170:530-47. [PubMed 12853821]

67. Kaplan NM. Initial treatment of adult patients with essential hypertension. Part 2: alternating monotherapy is the preferred treatment. Pharmacotherapy. 1985; 5:195-200. [IDIS 394161] [PubMed 4034407]

68. Bauer JH. Stepped-care approach to the treatment of hypertension: is it obsolete? (unpublished observations)

69. 1988 Joint National Committee. The 1988 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med. 1988; 148:1023-38. [IDIS 242588] [PubMed 3365073]

70. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) Express. Bethesda, MD: May 14 2003. From NIH website. (Also published in JAMA. 2003; 289.

71. Neal B, MacMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs. Lancet. 2000;356:1955-64.

72. Cushman WC, Ford CE, Cutler JA, et al. Success and predictors of blood pressure control in diverse North American settings: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). J Clin Hypertens (Greenwich). 2002;4:393-404.

73. Black HR, Elliott WJ, Neaton JD et al. Baseline characteristics and elderly blood pressure control in the CONVINCE trial. Hypertension. 2001; 37:12-18. [PubMed 11208750]

74. Black HR, Elliott WJ, Grandits G, et al. Principal results of the Controlled Onset Verapamil Investigation of Cardiovascular End Points (CONVINCE) trial. JAMA. 2003;289:2073-2082.

75. Dahlof B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint Reduction in Hypertension Study (LIFE). Lancet. 2002;359:995-1003.

76. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000;342:145-153.

77. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet. 2001;358:1033-41.

78. Wing LMH, Reid CM, Ryan P, et al, for Second Australian National Blood Pressure Study Group. A comparison of outcomes with angiotensin-converting-enzyme inhibitors and diuretics for hypertension in the elderly. N Engl J Med. 2003;348:583-92.

79. Psaty BM, Smith NL, Siscovich DS et al. Health outcomes associated with antihypertensive therapies used as first-line agents: a systematic review and meta-analysis. JAMA. 1997; 277:739-45. [IDIS 380501] [PubMed 9042847]

80. American Diabetes Association. Treatment of hypertension in adults with diabetes. Diabetes Care. 2003; 26(Suppl 1):S80-2.

81. Hunt SA, Baker DW, Chin MH, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult. J Am Coll Cardiol. 2001;38:2101-2113.

82. Guidelines Committee. 2003 European Society of Hypertension–European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertension. 2003; 21:1011-53.

83. The Guidelines Subcommittee of the WHO/ISH Mild Hypertension Liaison Committee. 1999 guidelines for the management of hypertension. J Hypertension. 1999; 17:392-403.

84. McConnell JD, Roehrborn CG, Bautista OM et al for the Medical Therapy of Prostatic Symptoms (MTOPS) Research Group. The long-term effect of doxazosin, finasteride, and combination theprapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med. 2003; 349:2387-98. [IDIS 508413] [PubMed 14681504]

85. Vaughan ED. Medical management of benign prostatic hyperplasia—are two drugs better than one? N Engl J Med. 2003; 349:2440-51. Editorial.

86. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII) Complete Version. Bethesda, MD: 2003 Nov 5. Hypertension. 2003; 42:1206-52. [PubMed 14656957]

87. Milroy E. Clinical overview of prazosin in the treatment of prostatic obstruction. Urol Int. 1990; 45(Suppl 1):1-3. [PubMed 1690474]

88. Kondo A, Gotoh M, Saito M et al. The efficacy of prazosin HCl in the treatment of urinary flow obstruction due to prostatic hypertrophy. Urol Int. 1990; 45(Suppl 1):4-17. [PubMed 1690480]

89. Aoki H, Ohninata M, Tsuzuki T et al. Clinical studies on the effectiveness of prazosin HCl (Minipress tablets) in the treatment of dysuria accompanying benign prostatic hyperplasia. Urol Int. 1990; 45(Suppl 1):18-25. [PubMed 1690476]

90. Shapiro E. Embryologic development of the prostate. Insights into the etiology and treatment of benign prostatic hyperplasia. Urol Clin North Am. 1990; 17:487-93. [PubMed 1695777]

91. Rowden AM, Mowers RM. Prazosin in benign prostatic hypertrophy. DICP Ann Pharmacother. 1989; 23:474-5.

92. Lepor H. Alpha adrenergic antagonists for the treatment of symptomatic BPH. Int J Clin Pharmacol Ther Toxicol. 1989; 27:151-5. [PubMed 2469658]

93. Lepor H. Role of alpha-adrenergic blockers in the treatment of benign prostatic hyperplasia. Prostate Suppl. 1990; 3:75-84. [PubMed 1689172]

94. Chapple CR, Aubry ML, James S et al. Characterisation of human prostatic adrenoceptors using pharmacology receptor binding and localisation. Br J Urol. 1989; 63:487-96. [PubMed 2471572]

95. Staub WR, Staub JS. Phenoxybenzamine in benign prostatic obstruction. JAMA. 1988; 260:2220. [IDIS 246399] [PubMed 2459421]

96. Hieble JP, Caine M, Zalaznik E. In vitro characterization of the alpha-adrenoceptors in human prostate. Eur J Pharmacol. 1985; 107:111-7. [PubMed 2579826]

97. Caine M. Alpha-adrenergic mechanisms in dynamics of benign prostatic hypertrophy. Urology. 1988; 32(Suppl 6):16-20. [PubMed 2462300]

98. Abrams PH, Shah PJ, Stone R et al. Bladder outflow obstruction treated with phenoxybenzamine. Prog Clin Biol Res. 1981; 78:269-75. [PubMed 6174998]

99. Barry MJ. Phenoxybenzamine in benign prostatic obstruction. JAMA. 1988; 260:2220.

100. Gerstenberg T, Blaabjerg J, Nielsen ML et al. Phenoxybenzamine reduces bladder outlet obstruction in benign prostatic hyperplasia: a urodynamic investigation. Invest Urol. 1980; 18:29-31. [IDIS 118319] [PubMed 6157651]

101. Caine M, Perlberg S, Meretyk S. A placebo-controlled double-blind study of the effect of phenoxybenzamine in benign prostatic obstruction. Br J Urol. 1978; 50:551-4. [PubMed 88984]

102. Caine M. Clinical experience with alpha-adrenoceptor antagonists in benign prostatic hypertrophy. Fed Proc. 1986; 45:2604-8. [PubMed 2428670]

103. Griffiths DJ, Schröder FH. Phenoxybenzamine in prostatic obstruction. Urol Int. 1984; 39:241-2. [PubMed 6207651]

104. Caine M, Perlberg S, Shapiro A. Phenoxybenzamine for benign prostatic obstruction: review of 200 cases. Urology. 1981; 17:542-6. [PubMed 6166111]

105. Reviewers’ comments (personal observations) on prazosin.

106. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004; 114(Suppl 2):555-76. [PubMed 15286277]

More Doxazosin Mesylate resources

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

Doxazosin Prescribing Information (FDA)

Cardura Prescribing Information (FDA)

Cardura Consumer Overview

Cardura Advanced Consumer (Micromedex) - Includes Dosage Information

Cardura MedFacts Consumer Leaflet (Wolters Kluwer)

Cardura XL Prescribing Information (FDA)

Cardura XL Extended-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Doxazosin

difluprednate Ophthalmic

dye-floo-PRED-nate

Commonly used brand name(s)

In the U.S.

Durezol

Available Dosage Forms:

Emulsion

Therapeutic Class: Anti-Inflammatory

Pharmacologic Class: Adrenal Glucocorticoid

Uses For difluprednate

Difluprednate is used to treat eye pain and inflammation (redness and swelling) caused by eye surgery. difluprednate belongs to the group of medicines known as corticosteroids (steroids or cortisone-like medicines) .

difluprednate is available only with your doctor's prescription .

Before Using difluprednate

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 difluprednate, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to difluprednate 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 have not been performed on the relationship of age to the effects of difluprednate in the pediatric population. Safety and efficacy have not been established .

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of difluprednate in the elderly .

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal 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. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

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 difluprednate

Your doctor will tell you how much of difluprednate to use and how often. Do not use more medicine or use it more often than your doctor tells you to. difluprednate is not for long-term use .

To use the eye drops:

First, wash your hands. Tilt your head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 1 or 2 minutes to allow the medicine to be absorbed by the eye.

If you think you did not get the drop of medicine into your eye properly, use another drop.

Immediately after using the eye drops, wash your hands to remove any medicine that may be on them.

To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Always keep the container tightly closed .

Do not wear contact lenses while you are using difluprednate .

Dosing

The dose of difluprednate 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 difluprednate. 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 ophthalmic dosage form (eye drops):
- For eye pain or inflammation:
  - Adults—Use one drop in the affected eye(s) four times a day. Start using the medicine 24 hours after surgery, and keep using it until your doctor tells you to stop. Your doctor may adjust your dose if needed.
  - Children—Use and dose must be determined by your doctor .

Missed Dose

If you miss a dose of difluprednate, apply 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.

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 difluprednate

Your eye doctor will want to examine your eye(s) at regular visits to make sure the medicine is working properly and is not causing unwanted effects .

Difluprednate eye drops are not for long-term use. Steroid eye drops may cause glaucoma (increased pressure inside the eye) or posterior subcapsular cataracts (a rare type of cataract) if used too long .

If you hurt your eye or develop an eye infection, talk with your doctor right away. You may need to change your medicine or stop using it .

If your symptoms do not improve or if your condition becomes worse, check with your doctor .

difluprednate 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:

More common

Blurred vision

change in color vision

decreased vision or other changes in vision

difficulty seeing at night

eye discomfort

eye pain

eye redness

increase in blood flow to the whites of the eyes

increased sensitivity of the eyes to sunlight

sensitivity of the eyes to light

swelling or redness of the eye and lining of the eyelid

Less common

Eyelid irritation and crusting

painful irritation of the front clear part of the eye

tearing

throbbing eye pain

watering of the eyes

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:

Rare

Burning, itching, or soreness of the eye

feeling of having something in the eye

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: difluprednate Ophthalmic 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 difluprednate Ophthalmic resources

Difluprednate Ophthalmic Side Effects (in more detail)
Difluprednate Ophthalmic Use in Pregnancy & Breastfeeding
Difluprednate Ophthalmic Support Group
0 Reviews for Difluprednate Ophthalmic - Add your own review/rating

Durezol Prescribing Information (FDA)

Durezol Monograph (AHFS DI)

Durezol Emulsion MedFacts Consumer Leaflet (Wolters Kluwer)

Durezol Consumer Overview

Compare difluprednate Ophthalmic with other medications

Postoperative Ocular Inflammation

doxorubicin

Generic Name: doxorubicin (DOX oh ROO bi sin)

Brand names: Adriamycin, Adriamycin RDF, Rubex, Adriamycin PFS

What is doxorubicin?

Doxorubicin is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Doxorubicin is used to treat different types of cancers that affect the breast, bladder, ovary, thyroid, stomach, lungs, bones, nerve tissues, bones, muscles, joints, and soft tissues. Doxorubicin is also used to treat Hodgkin's disease and certain types of leukemia.

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

What is the most important information I should know about doxorubicin?

You should not use this medication if you are allergic to doxorubicin or similar medications (Cerubidine, Ellence, Idamycin, Novantrone), or if you have an untreated or uncontrolled infection, severe liver disease, severe heart problems, or if you have recently had a heart attack. Doxorubicin can have serious side effects on your heart. Before you are treated with doxorubicin, tell your doctor if you have a history of heart disease, heart rhythm disorder, congestive heart failure, or heart attack.

Also tell your doctor about all other medicines you use, especially about any other cancer medications or treatments you have received (including radiation).

Do not use doxorubicin if you are pregnant. It could harm the unborn baby. Doxorubicin can lower blood cells that help your body fight infections. Your blood may need to be tested often. Avoid being near people who are sick or have infections. Avoid activities that may increase your risk of bleeding injury. Tell your doctor at once if you develop signs of infection. Do not receive a "live" vaccine while using doxorubicin, or you could develop a serious infection.

Using doxorubicin may increase your risk of developing other types of cancer, such as leukemia. Talk with your doctor about your specific risk.

What should I discuss with my healthcare provider before taking doxorubicin?

Before you are treated with doxorubicin, tell your doctor about all other cancer medications and treatments you have received, including radiation. You should not use this medication if you are allergic to doxorubicin or similar medications (Cerubidine, Ellence, Idamycin, Novantrone), or if you have:

an untreated or uncontrolled infection (including mouth sores);

severe liver disease;

severe heart problems; or

if you have recently had a heart attack.

To make sure you can safely receive doxorubicin, tell your doctor if you have any of these other conditions:

liver or kidney disease;

a weak immune system caused by prior cancer treatments;

heart disease, a heart rhythm disorder, congestive heart failure; or

if you have ever had a heart attack.

Using doxorubicin may increase your risk of developing other types of cancer, such as leukemia. Talk with your doctor about your specific risk. FDA pregnancy category D. Do not use doxorubicin if you are pregnant. It could harm the unborn baby. Tell your doctor if you become pregnant or plan to become pregnant. Use birth control to prevent pregnancy while you are receiving doxorubicin. Doxorubicin can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using doxorubicin.

How should I take doxorubicin?

Doxorubicin is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting.

Doxorubicin is sometimes given together with other cancer medications. You may be given other medications to prevent nausea, vomiting, or infections.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when doxorubicin is injected.

If any of this medication accidentally gets on your skin, wash it thoroughly with soap and warm water.

Doxorubicin can lower blood cells that help your body fight infections. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests. Visit your doctor regularly.

See also: Doxorubicin dosage (in more detail)

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your doxorubicin injection.

What happens if I overdose?

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

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid while taking doxorubicin?

Do not receive a "live" vaccine while using doxorubicin, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), H1N1 influenza, and nasal flu vaccine.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Doxorubicin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Tell your caregivers at once if you have a serious side effect such as:

pain, burning, irritation, or skin changes where the injection was given;

feeling short of breath, even with mild exertion;

swelling, rapid weight gain (especially in your face and midsection);

nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

fast, slow, or uneven heartbeats;

anxiety, sweating, severe shortness of breath, wheezing, gasping for breath;

chest pain, sudden cough, cough with foamy mucus, rapid breathing, coughing up blood;

nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

lower back pain, blood in your urine, urinating less than usual or not at all;

numbness or tingly feeling around your mouth, weak pulse, overactive reflexes, confusion, fainting;

muscle weakness, tightness, or contraction;

fever, chills, body aches, flu symptoms, sores in your mouth and throat;

pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or

easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.

Less serious side effects may include:

missed menstrual periods;

darkening of your skin or nails;

temporary hair loss;

feeling weak or tired;

mild nausea, diarrhea; or

eye redness, puffy eyelids.

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.

Doxorubicin Dosing Information

Usual Adult Dose for Breast Cancer:

When used in combination with other chemotherapy drugs, the most commonly used dosage of doxorubicin is 40 to 60 mg/m2 IV every 21 to 28 days. Alternatively, 60 to 75 mg/m2 IV once every 21 days. The lower doses are recommended for patients with inadequate marrow reserves due to old age, prior therapy, or neoplastic marrow infiltration.

Usual Adult Dose for Neuroblastoma:

Usual Adult Dose for Hodgkin's Disease:

Usual Adult Dose for Ovarian Cancer:

Usual Adult Dose for Wilms' Tumor:

Usual Adult Dose for Stomach Cancer:

Usual Adult Dose for Acute Lymphoblastic Leukemia:

Usual Adult Dose for Lymphoma:

Usual Adult Dose for Osteosarcoma:

Usual Adult Dose for Bladder Cancer:

Usual Adult Dose for Acute Myeloblastic Leukemia:

Usual Adult Dose for Thyroid Cancer:

Usual Adult Dose for Bronchogenic Carcinoma:

Usual Adult Dose for Soft Tissue Sarcoma:

Usual Adult Dose for Multiple Myeloma:

(In combination with other chemotherapeutic agents as a part of the VAD regimen)
9 mg/m2/day IV continuous infusion on days 1 through 4

Usual Pediatric Dose for Malignant Disease:

35 to 75 mg/m2 as a single dose repeated every 21 days, or 20 to 30 mg/m2 once weekly, or 60 to 90 mg/m2 given as a continuous infusion over 96 hours every 3 to 4 weeks.

What other drugs will affect doxorubicin?

Many drugs can interact with doxorubicin. Below is just a partial list. Tell your doctor if you are using:

acetaminophen (Tylenol);

an antibiotic or antifungal medication;

auranofin (Ridaura) or gold injections to treat arthritis;

cyclosporine (Gengraf, Neoral, Sandimmune);

dexrazoxane (Totect, Zinecard);

progesterone (Prometrium);

rosiglitazone (Avandia, Avandamet, Avandaryl);

an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), doxepin (Sinequan, Silenor), nortriptyline (Pamelor), and others;

birth control pills or hormone replacement therapy;

cholesterol medications such as atorvastatin (Lipitor, Caduet), simvastatin (Zocor, Simcor, Vytorin), and others;

drugs that weaken your immune system, such as adalimumab (Humira), certolizumab (Cimzia), clozapine (Clozaril, FazaClo), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), and others;

heart rhythm or blood pressure medicine such as amiodarone (Cordarone, Pacerone), benazepril (Lotensin), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), enalapril (Vasotec), labetalol (Normodyne, Trandate), lisinopril (Prinivil, Zestril), methyldopa (Aldomet), quinapril (Accupril), ramipril (Altace), verapamil (Calan, Covera, Isoptin, Verelan, Tarka), and others;

HIV/AIDS medications;

non-steroidal anti-inflammatory drugs (NSAIDs) such as (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others;

other cancer medications, especially cyclophosphamide Cytoxan, Cytoxan Lyophilized, Neosar), cytarabine (Cytosar, DepoCyt, Tarabine), etoposide (Etopophos, VePesid), paclitaxel (Taxol, Onxol), sorafenib (Nexavar); or

seizure medications such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), divalproex (Depakote), phenobarbital (Solfoton), phenytoin (Dilantin), valproic acid (Depakene, Stavzor).

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

More doxorubicin resources

Doxorubicin Dosage
Doxorubicin Use in Pregnancy & Breastfeeding
Doxorubicin Drug Interactions
Doxorubicin Support Group
2 Reviews for Doxorubicin - Add your own review/rating

doxorubicin Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information

Adriamycin Prescribing Information (FDA)

Doxorubicin MedFacts Consumer Leaflet (Wolters Kluwer)

Doxorubicin Prescribing Information (FDA)

Doxorubicin Hydrochloride Monograph (AHFS DI)

Rubex Prescribing Information (FDA)

Compare doxorubicin with other medications

Acute Lymphoblastic Leukemia
Acute Myeloblastic Leukemia
Bladder Cancer
Breast Cancer
Cancer
Hodgkin's Lymphoma
Lung Cancer
Lymphoma
Multiple Myeloma
Neuroblastoma
Osteosarcoma
Ovarian Cancer
Soft Tissue Sarcoma
Stomach Cancer
Thyroid Cancer
Wilms' Tumor

Where can I get more information?

Your doctor or pharmacist can provide more information about doxorubicin.

Doctors Foster and Smith Dental Cleans Pad

Dosage Form: FOR ANIMAL USE ONLY

Drs. Foster and Smith Dental Cleans Pads help promote healthy teeth and gums through regular use. Also reduce bad breath and plaque build up. For Dogs and Cats.

DIRECTIONS FOR USE

Hold animal's head steady with one hand and gently wipe teeth and gums with pad. Use additional pads as needed until entire mouth has been cleaned.

ACTIVE INGREDIENT

0.1% Chlorhexidine Gluconate

OTHER INGREDIENTS

Water, Glycerin, Polysorbate 80, Peppermint Flavor, carmine Color.

Item# 8523

For Questions or to Reorder:

1-800-562-7169 or www.drsfostersmith.com

Doctors

Foster and smith

DentalClens

Pads

Cleans teeth and gums

Freshens breath

90 pads

Formulated by our veterinarians

DOCTORS FOSTER AND SMITH
chlorhexidine gluconate cloth

Product Information
Product Type	OTC ANIMAL DRUG	NDC Product Code (Source)	65713-902
Route of Administration	DENTAL	DEA Schedule

Active Ingredient/Active Moiety
Ingredient Name	Basis of Strength	Strength
Chlorhexidine Gluconate (CHLORHEXIDINE)	Chlorhexidine Gluconate	0.55 g in 103.6 g

Inactive Ingredients
Ingredient Name	Strength
WATER
GLYCERIN
POLYSORBATE 80

Product Characteristics
Color	brown (carmine color)	Score
Shape		Size
Flavor	PEPPERMINT (peppermint flavor)	Imprint Code
Contains

Packaging
#	NDC	Package Description	Multilevel Packaging
1	65713-902-05	103.6 g In 1 JAR	None

Marketing Information
Marketing Category	Application Number or Monograph Citation	Marketing Start Date	Marketing End Date
unapproved drug other		02/23/2010

Labeler - Doctors Foster and Smith (122135148)

Registrant - United Pet Group (931135730)

Establishment
Name	Address	ID/FEI	Operations
JUNGLE LABORATORIES CORPORATION		032615270	manufacture

Revised: 02/2010Doctors Foster and Smith

Depakene

Generic Name: valproic acid (Oral route)

val-PROE-ik AS-id

Oral route(Syrup;Capsule, Liquid Filled;Capsule, Delayed Release)

Hepatic failure resulting in fatalities has occurred in patients receiving valproic acid and its derivatives. Children under the age of two years are at a considerably increased risk of developing fatal hepatotoxicity. Patients should be monitored closely and liver function tests should be performed prior to therapy and at frequent intervals thereafter, especially during the first six months. Life-threatening pancreatitis has been reported in both children and adults receiving valproate. If pancreatitis is diagnosed, valproate should ordinarily be discontinued. Valproate can produce teratogenic effects such as neural tube defects (eg, spina bifida). Accordingly, the use of valproate products in women of childbearing potential requires that the benefits of its use be weighed against the risk of injury to the fetus .

Oral route(Tablet, Enteric Coated;Tablet, Extended Release;Capsule, Delayed Release)

Hepatotoxicity (some cases fatal), usually occurring during the first 6 months of treatment, has been reported in patients receiving valproic acid and its derivatives. Children under the age of two years are at a considerably increased risk of developing fatal hepatotoxicity. Monitor patients closely, and perform liver function tests prior to therapy and at frequent intervals thereafter. Valproate can produce teratogenic effects such as neural tube defects (eg, spina bifida). Accordingly, the use of divalproex sodium in women of childbearing potential requires that the benefits of its use be weighed against the risk of injury to the fetus. Life-threatening pancreatitis has been reported in both children and adults receiving valproate. If pancreatitis is diagnosed, valproate should ordinarily be discontinued .

Commonly used brand name(s)

In the U.S.

Depakene

Depakote

Depakote DR

Depakote ER

Depakote Sprinkles

Stavzor

In Canada

Alti-Valproic

Available Dosage Forms:

Capsule, Delayed Release

Syrup

Capsule, Liquid Filled

Tablet, Extended Release

Tablet, Enteric Coated

Tablet, Delayed Release

Therapeutic Class: Antimanic

Pharmacologic Class: Histone Deacetylase Inhibitor

Chemical Class: Valproic Acid (class)

Uses For Depakene

Valproic acid is used alone or together with other medicines to control certain types of seizures (convulsions) in the treatment of epilepsy. This medicine is an anticonvulsant that works in the brain tissue to stop seizures.

Valproic acid is also used to treat the manic phase of bipolar disorder (manic-depressive illness), and helps prevent migraine headaches.

This medicine is available only with your doctor's prescription.

Before Using Depakene

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 this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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 valproic acid in children. However, safety and efficacy have not been established in children with epilepsy below 10 years of age; and in children with migraine below 12 years of age. Because of valproic acid's toxicity, use in children below 2 years of age requires extreme caution.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of valproic acid in the elderly. However, elderly patients are more likely to have unwanted effects (e.g., tremors or unusual drowsiness), which may require an adjustment in the dose for patients receiving valproic acid.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

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 this medicine, 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 this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Doripenem

Ertapenem

Imipenem

Ketorolac

Lamotrigine

Meropenem

Naproxen

Primidone

Vorinostat

Warfarin

Using this medicine 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.

Acyclovir

Aspirin

Betamipron

Carbamazepine

Cholestyramine

Clomipramine

Erythromycin

Ethosuximide

Felbamate

Fosphenytoin

Ginkgo

Lopinavir

Lorazepam

Mefloquine

Nimodipine

Nortriptyline

Olanzapine

Oxcarbazepine

Panipenem

Phenobarbital

Phenytoin

Rifampin

Rifapentine

Risperidone

Ritonavir

Rufinamide

Topiramate

Zidovudine

Interactions with Food/Tobacco/Alcohol

Proper Use of valproic acid

This section provides information on the proper use of a number of products that contain valproic acid. It may not be specific to Depakene. Please read with care.

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a medication guide and patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

Swallow the delayed-release capsules and oral capsules whole with a full glass of water. Do not split, crush, or chew it. You may take this medicine with food.

Dosing

The dose of this medicine 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 this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

For oral dosage forms (capsules, delayed-release capsules, and solution):
- For seizures:
  - Adults and children 10 years of age or older—Dose is based on body weight and must be determined by your doctor. At first, the usual dose is 10 to 15 milligrams (mg) per kilogram (kg) of body weight a day to start. Your doctor may increase your dose gradually every week by 5 to 10 mg per kg of body weight if needed. However, the dose is usually not more than 60 mg per kg of body weight a day. If the total dose a day is greater than 250 mg, it is usually divided into smaller doses and taken two or more times during the day.
  - Children below 10 years of age—Use and dose must be determined by your doctor.

For oral dosage form (delayed-release capsules):
- For mania:
  - Adults—At first, 750 milligrams (mg) once a day, usually divided in smaller doses. Your doctor may increase your dose as needed.
  - Children—Use and dose must be determined by your doctor.
- For migraine:
  - Adults—At first, 250 milligrams (mg) two times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 1000 mg a day.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, 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 Depakene

It is very important that your doctor check your progress closely while you are using this medicine to see if it is working properly and to allow for a change in the dose. Blood tests may be needed to check for any unwanted effects.

Using this medicine while you are pregnant (especially during first trimester) can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

It is very important to take folic acid before getting pregnant and during early pregnancy to lower chances of harmful side effects to your unborn baby. Ask your doctor or pharmacist for help if you are not sure how to choose a folic acid product.

Liver problems may occur while you are using this medicine. Stop using this medicine and check with your doctor right away if you are having more than one of these symptoms: abdominal pain or tenderness; clay-colored stools; dark urine; decreased appetite; fever; headache; itching; loss of appetite; nausea and vomiting; skin rash; swelling of the feet or lower legs; unusual tiredness or weakness; or yellow eyes or skin.

Pancreatitis may occur while you are using this medicine. Tell your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

Check with your doctor right away if you are having unusual drowsiness, dullness, tiredness, weakness or feelings of sluggishness, changes in mental status, or vomiting. These may be symptoms of a serious condition called hyperammonemic encephalopathy.

Valproic acid may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.

Do not stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping completely.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Valproic acid may cause serious allergic reactions that affect several parts of the body (e.g., liver or kidney). Check with your doctor right away if you have more than one of the following symptoms: fever; dark urine; headache; rash; stomach pain; swollen lymph glands in the neck, armpit, or groin; unusual tiredness; or yellow eyes or skin.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates or medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are taking this medicine.

Check with your doctor if you have unusual drowsiness, dullness, tiredness, weakness; or feeling of sluggishness; confusion; low body temperature; or loss of consciousness while taking this medicine.

Valproic acid may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you notice any of these adverse effects, tell your doctor right away.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Depakene 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:

More common

Black, tarry stools

bleeding gums

bloating or swelling of the face, arms, hands, lower legs, or feet

blood in the urine or stools

confusion

cough or hoarseness

crying

delusions

dementia

depersonalization

diarrhea

difficult or labored breathing

dysphoria

euphoria

fever or chills

general feeling of discomfort or illness

headache

joint pain

loss of appetite

lower back or side pain

mental depression

muscle aches and pains

nausea

nervousness

painful or difficult urination

paranoia

pinpoint red spots on the skin

quick to react or overreact emotionally

rapid weight gain

rapidly changing moods

runny nose

shakiness in the legs, arms, hands, or feet

shivering

shortness of breath

sleepiness or unusual drowsiness

sore throat

sweating

tightness in the chest

tingling of the hands or feet

trembling or shaking of the hands or feet

trouble with sleeping

unusual bleeding or bruising

unusual tiredness or weakness

unusual weight gain or loss

vomiting

wheezing

Less common

Abnormal dreams

absence of or decrease in body movement

anxiety

bloody nose

bloody or cloudy urine

blurred vision

bruising burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

change in personality

change in walking and balance

changes in patterns and rhythms of speech

chest pain

chills

clumsiness or unsteadiness

cold sweats

constipation

darkened urine

degenerative disease of the joint

difficult, burning, or painful urination

difficulty with moving

discouragement

dizziness

dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly

dry mouth

excessive muscle tone

fast, irregular, pounding, or racing heartbeat or pulse

fear

feeling of warmth or heat

feeling sad or empty

flushing or redness of the skin, especially on the face and neck

frequent urge to urinate

heavy non-menstrual vaginal bleeding

hyperventilation

increased need to urinate

indigestion

irritability

lack of appetite

lack of coordination

large, flat, blue, or purplish patches in the skin

leg cramps

lip smacking or puckering

loss of bladder control

loss of interest or pleasure

loss of strength or energy

multiple swollen and inflamed skin lesions

muscle pain or stiffness

muscle tension or tightness

normal menstrual bleeding occurring earlier, possibly lasting longer than expected

pains in the stomach, side, or abdomen, possibly radiating to the back

passing urine more often

pounding in the ears

puffing of the cheeks

rapid or worm-like movements of the tongue

rapid weight gain

restlessness

seeing, hearing, or feeling things that are not there

shakiness and unsteady walk

slurred speech

small red or purple spots on the skin

sweating

swollen joints

tiredness

trouble with concentrating

trouble with speaking

twitching

uncontrolled chewing movements

uncontrolled movements of the arms and legs

unsteadiness, trembling, or other problems with muscle control or coordination

vomiting of blood or material that looks like coffee grounds

yellow eyes or skin

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

Symptoms of overdose

Change in consciousness

fainting

loss of consciousness

slow or irregular heartbeat

More common

Acid or sour stomach

belching

body aches or pain

change in vision

congestion

continuing ringing or buzzing or other unexplained noise in the ears

hair loss or thinning of the hair

hearing loss

heartburn

impaired vision

lack or loss of strength

loss of memory

problems with memory

rash

seeing double

sleeplessness

tender, swollen glands in the neck

trouble with swallowing

unable to sleep

uncontrolled eye movements

voice changes

weight gain

weight loss

Less common

Absent, missed, or irregular menstrual periods

back pain

burning, dry, or itching eyes

change in taste or bad unusual or unpleasant (after) taste

coin-shaped lesions on the skin

cough producing mucus

cramps

dandruff

discharge or excessive tearing

dry skin

earache

excess air or gas in the stomach or intestines

eye pain

feeling of constant movement of self or surroundings

full feeling

heavy bleeding

increased appetite

itching of the vagina or genital area

itching skin

loss of bowel control

neck pain

oily skin

pain

pain during sexual intercourse

pain or tenderness around the eyes and cheekbones

passing gas

rash with flat lesions or small raised lesions on the skin

redness or swelling in the ear

redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid

redness, swelling, or soreness of the tongue

sensation of spinning

sneezing

stiff neck

stopping of menstrual bleeding

thick, white vaginal discharge with no odor or with a mild odor

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: Depakene side effects (in more detail)

More Depakene resources

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

Depakene Prescribing Information (FDA)

Depakene MedFacts Consumer Leaflet (Wolters Kluwer)

Valproic Acid Monograph (AHFS DI)

Depacon MedFacts Consumer Leaflet (Wolters Kluwer)

Depacon Prescribing Information (FDA)

Stavzor Prescribing Information (FDA)

Stavzor Delayed-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)

Stavzor Consumer Overview

Compare Depakene with other medications

Bipolar Disorder
Hyperekplexia
Schizoaffective Disorder
Seizure Prevention
Seizures