Rescon-GG

Generic Name: guaifenesin and phenylephrine (gwye FEN e sin and FEN il EFF rin)

Brand Names: Aldex G, Aquatab D, Crantex, D-Phen 1000, D-Tab, Deconex, Deconsal II, Deconsal Pediatric, Despec, Donatussin Drops, Duomax, Duraphen 1000, Duraphen II, Duratuss, Dynex LA, ExeTuss, Extendryl G, Fenesin PE IR, Genexa LA, Gentex LA, Gilphex TR, Guaiphen-D 1200, Guaiphen-D 600, Guaiphen-PD, Guiadex PD, Guiatex PE, J-Max, Liquibid D-R, Liquibid-D, Liquibid-PD, Lusonex, Maxiphen, Medent-PE, MontePhen, Mucinex Children's Cold, Mucus Relief Sinus, Mydex, Nariz, Nasex, Nescon-PD, Nexphen PD, Norel EX, PE-Guai, Pendex, Prolex D, Refenesen PE, Reluri, Rescon-GG, Respa-PE, Robitussin Head & Chest Congestion, Simuc, Simuc-GP, Sina-12X, Sinupan, SINUvent PE, Sitrex PD, Sudafed PE Non-Drying Sinus, Sudex, Triaminic Chest & Nasal Congestion, Visonex, Wellbid-D, Xedec, Xedec II, Xpect-PE, Zotex GPX

What is Rescon-GG (guaifenesin and phenylephrine)?

There are many brands and forms of guaifenesin and phenylephrine available and not all brands are listed on this leaflet.

Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of guaifenesin and phenylephrine is used to treat stuffy nose and sinus congestion, and to reduce chest congestion caused by the common cold or flu.

Guaifenesin and phenylephrine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Rescon-GG (guaifenesin and phenylephrine)?

There are many brands and forms of guaifenesin and phenylephrine available and not all brands are listed on this leaflet.

Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Ask a doctor or pharmacist before using any other cough, cold, or allergy medicine. Guaifenesin and phenylephrine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains guaifenesin or phenylephrine.

What should I discuss with my healthcare provider before taking Rescon-GG (guaifenesin and phenylephrine)?

You should not use this medication if you are allergic to guaifenesin or phenylephrine, or to other decongestants, diet pills, stimulants, or ADHD medications. Do not use guaifenesin and phenylephrine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. Serious, life threatening side effects can occur if you use guaifenesin and phenylephrine before the MAO inhibitor has cleared from your body.

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

• 
  

  heart disease or high blood pressure;

  
  


• 
  

  diabetes;

  
  


• 
  

  circulation problems;

  
  


• 
  

  glaucoma;

  
  


• 
  

  overactive thyroid; or

  
  


• 
  

  enlarged prostate or problems with urination.

  
  

It is not known if this medication may be harmful to an unborn baby. Do not use this medication without your doctor's advice if you are pregnant. This medication passes into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Artificially-sweetened liquid forms of cold medicine may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.

How should I take Rescon-GG (guaifenesin and phenylephrine)?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.

Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children.

Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time. Take guaifenesin and phenylephrine with food if it upsets your stomach. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash. Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication. Store at room temperature away from moisture and heat.

What happens if I miss a dose?

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

What happens if I overdose?

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

Overdose symptoms may include nausea, vomiting, numbness or tingly feeling, dizziness, and feeling restless or nervous.

What should I avoid while taking Rescon-GG (guaifenesin and phenylephrine)?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Drinking alcohol can increase certain side effects of guaifenesin and phenylephrine. Ask a doctor or pharmacist before using any other cough, cold, or allergy medicine. Guaifenesin and phenylephrine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains guaifenesin or phenylephrine.

Avoid taking this medication with diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.

Rescon-GG (guaifenesin and phenylephrine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

• 
  

  fast, pounding, or uneven heartbeat;

  
  


• 
  

  severe dizziness, anxiety, restless feeling, or nervousness;

  
  


• 
  

  easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms;

  
  


• 
  

  dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure); or

  
  


• 
  

  nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

  
  

Less serious side effects may include:

• 
  

  vomiting, upset stomach;

  
  


• 
  

  warmth, tingling, or redness under your skin;

  
  


• 
  

  feeling excited or restless (especially in children);

  
  


• 
  

  sleep problems (insomnia);

  
  


• 
  

  skin rash or itching;

  
  


• 
  

  headache; or

  
  


• 
  

  dizziness.

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Rescon-GG (guaifenesin and phenylephrine)?

Ask a doctor or pharmacist if it is safe for you to take guaifenesin and phenylephrine if you are also using any of the following drugs:

• 
  

  medicines to treat high blood pressure;

  
  


• 
  

  a beta-blocker such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Dutoprol, Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others; or

  
  


• 
  

  an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), doxepin (Sinequan, Silenor), desipramine (Norpramin), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), and others.

  
  

This list is not complete and other drugs may interact with guaifenesin and phenylephrine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More Rescon-GG resources

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

• Rescon-GG Liquid MedFacts Consumer Leaflet (Wolters Kluwer)


• Crantex Prescribing Information (FDA)


• Despec Drops MedFacts Consumer Leaflet (Wolters Kluwer)


• Entex LA Sustained-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)


• Gentex LA Sustained-Release Tablets (12 Hour) MedFacts Consumer Leaflet (Wolters Kluwer)


• Guiatex PE Prescribing Information (FDA)


• Lusonex Controlled-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)


• Sina-12X Suspension MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Rescon-GG with other medications

• Cough and Nasal Congestion
• Sinus Symptoms

Where can I get more information?

• Your pharmacist can provide more information about guaifenesin and phenylephrine.

See also: Rescon-GG side effects (in more detail)

Reteplase

Class: Thrombolytic Agents
Chemical Name: 173-l-Serine-174-l-lysine-175-l-glutamine-173-527-plasminogen activator (human tissue-type)
Molecular Formula: C₁₇₃₆H₂₆₅₃N₄₉₉O₅₂₂S₂₂
CAS Number: 133652-38-7
Brands: Retavase

Introduction

Thrombolytic agent; biosynthetic (recombinant DNA origin) form of human tissue-type plasminogen activator (t-PA).¹

Uses for Reteplase

Acute MI

Management of selected cases of acute evolving transmural MI in conjunction with heparin and/or platelet-aggregation inhibitors (i.e., aspirin).^{1 2 3 4 7 15 16} Lysis of coronary artery thrombi associated with acute evolving transmural MI^{1 15 16} and the resulting reperfusion can improve ventricular function and reduce the incidence of CHF, cardiogenic shock, and associated post-MI mortality.^{1 2 3 7 8 16}

Clinical benefit diminishes as the time period from symptom onset to initiation of therapy increases.^{2 3 5 6 15 16 19} If possible, administer thrombolytic therapy within 30 minutes of hospital admission or first contact with the health-care system.^{15 16 19}

The American College of Chest Physicians (ACCP), AHA, and ACC recommend use of any approved thrombolytic agent (e.g., alteplase, reteplase, tenecteplase, streptokinase [no longer commercially available in the US]) in patients having ischemic symptoms for ≤12 hours and ST-segment elevation or new or presumed new left bundle-branch block, unless contraindications exist.^{15 16 19} ACCP states that reteplase may be used in patients with acute MI who can be treated within 6 hours of symptom onset; however, alteplase or tenecteplase is recommended.¹⁶

ACCP suggests thrombolytic therapy in high-risk patients with ischemic symptoms characteristic of an acute MI or hemodynamic compromise present for 12–24 hours who have persistent ST-segment elevation or left bundle-branch block with concomitant ST-segment elevation changes if primary PCI is not readily available.¹⁶ ACC and AHA state that thrombolytic therapy is reasonable within 12–24 hours of symptom onset in patients with persistent ischemic symptoms accompanied by ST-segment elevation, provided no contraindications exist.^{15 19}

Thrombolytic therapy may be reasonable in patients with true posterior MI presenting within 12 hours after onset of symptoms.^{15 16 19}

PE

Thrombolytic therapy suggested by ACCP in patients with acute massive embolism† accompanied by unstable hemodynamics who are not at risk for hemorrhage.¹⁷ However, ACCP states that use of thrombolytic therapy for treatment of PE remains controversial because of the lack of studies supporting this use and the high risk of bleeding.²⁰ (See Effects on Hemostasis under Cautions.)

Generally reserve IV thrombolytic therapy for those with PE accompanied by unstable hemodynamics (e.g., shock) who do not have major contraindications because of bleeding risk²⁰ or those with stable hemodynamics with other poor prognostic factors (e.g., marked dyspnea, anxiety and low oxygen saturation; elevated troponin concentrations indicating right ventricular microinfarction; echocardiographic evidence of right ventricular dysfunction, right ventricular enlargement on a chest computed-tomography scan).²⁰

Perform a rapid risk assessment to determine if thrombolytic therapy is appropriate; irreversible cardiogenic shock may occur if therapy is delayed in patients with evidence of hemodynamic compromise.²⁰

Reteplase Dosage and Administration

General

• 
  

  Institute therapy as soon as possible after acute MI.^{1 3 4 5 6 15 16} (See Acute MI under Uses.)

  
  

Administration

IV Administration

For drug compatibility information, see Drug Compatibility under Stability.

Administer IV.¹

Do not add other IV substances, additives, or other drugs to reteplase solution and do not infuse anything else simultaneously through the same IV line.¹

If administered via an IV administration set that is used for infusing heparin, flush line with 0.9% sodium chloride or 5% dextrose solution prior to and following drug administration.¹

Reconstitution

Reconstitute with 10 mL of sterile water for injection without preservatives to provide a solution containing 1 unit/mL.¹ Use dispensing pin and diluent provided by the manufacturer.^{1 12}

If foaming (usually slight) occurs, leave the vial undisturbed for several minutes.¹ Gently swirl until the contents are completely dissolved; avoid shaking.¹

Rate of Administration

Administer over 2 minutes.¹

Dosage

Expressed in reteplase-specific units, but also may be expressed in mg; each reteplase-specific unit is equivalent to 1.74 mg.¹

Adults

Acute MI

IV

Total dose is 20 units, given as two 10-unit IV injections 30 minutes apart.¹

Lower doses of reteplase (two 5-unit doses 30 minutes apart) have been used in conjunction with a platelet glycoprotein (GP IIb/IIIa)-receptor inhibitor, heparin, and aspirin.^{13 14 15 16} (See Interactions.)

PE†

IV

ACCP suggests a total dose of 20 units, given as two 10-unit IV injections 30 minutes apart.¹⁷

Cautions for Reteplase

Contraindications

• 
  

  Active internal bleeding.^{1 3 9 15 19}

  
  


• 
  

  History of cerebrovascular accident.^{1 8 15 16}

  
  


• 
  

  Recent intracranial or intraspinal surgery or trauma.^{1 9 15 16}

  
  


• 
  

  Intracranial neoplasm.^{1 7 15 19}

  
  


• 
  

  Intracranial vascular disease (i.e., arteriovenous malformation, aneurysm).^{1 7 15 19}

  
  


• 
  

  Known bleeding diathesis.^{1 7 15 19}

  
  


• 
  

  Severe uncontrolled hypertension.^{1 6 7 9 11 15}

  
  


• 
  

  History of intracranial hemorrhage.^{15 16 19}

  
  


• 
  

  Suspected aortic dissection.^{15 19}

  
  


• 
  

  Recent (within 3 months) facial trauma.^{15 19}

  
  

Warnings/Precautions

Warnings

Effects on Hemostasis

Possible bleeding, including internal bleeding at intracranial or retroperitoneal sites or bleeding from the GI, GU, or respiratory tract.¹ Superficial or surface bleeding at vascular puncture and access sites (e.g., venous cutdowns, arterial punctures) or sites of recent surgical intervention also may occur.¹

Weigh increased risks of therapy against anticipated benefits in patients with recent major surgery (e.g., CABG), obstetric delivery, organ biopsy, previous puncture of noncompressible vessels, cerebrovascular disease, hypertension (SBP ≥180 mm Hg and/or DBP ≥110 mm Hg), hemostatic defects (e.g., secondary to severe hepatic or renal disease), recent GI (e.g., active peptic ulcer) or GU bleeding, or recent trauma.^{1 15} Also, weigh risks against benefits of therapy in patients with diabetic hemorrhagic retinopathy or other hemorrhagic ophthalmic conditions.¹ Weigh risks against benefits in patients receiving concurrent oral anticoagulant therapy (e.g., warfarin).^{1 15} Weigh risks against benefits in patients with any condition in which bleeding constitutes a substantial hazard or would be particularly difficult to manage because of its location.¹

Initiate therapy only after careful screening for contraindications.¹

Minimize risk of bleeding by carefully selecting patients and monitoring all potential bleeding sites (e.g., sites of all venous cutdowns, arterial and venous punctures, needle punctures).¹ Avoid IM injections and nonessential handling of patient.¹ Perform invasive venous procedures carefully and as infrequently as possible.¹ Minimize arterial punctures.¹ Avoid arterial and venous invasive procedures in areas that are inaccessible to manual compression (e.g., internal jugular or subclavian punctures).¹ Use of an artery in an upper extremity is preferred if an arterial puncture is essential.¹ Apply pressure to the puncture site for ≥30 minutes followed by a pressure dressing and frequent inspection of the puncture site for bleeding.¹

If serious bleeding occurs, immediately discontinue anticoagulant therapy; heparin anticoagulation can be reversed with protamine sulfate.¹ Do not administer a second injection of reteplase if serious bleeding occurs with the first injection.¹

Cardiovascular Effects

Possible fatal cardiogenic shock, heart failure, cardiac arrest, recurrent myocardial ischemia or infarction, myocardial rupture, AV block, electromechanical dissociation, pericardial effusion, pericarditis, mitral regurgitation, cardiac tamponade, hypotension, pulmonary edema, or thromboembolism.¹

Weigh risks against anticipated benefits of therapy in patients with a high likelihood of left heart thrombus (e.g., mitral stenosis with atrial fibrillation), acute pericarditis, subacute bacterial endocarditis, septic thrombophlebitis, or an occluded arteriovenous cannula at a seriously infected site.¹

Cholesterol Embolization

Possibly fatal cholesterol crystal embolization associated with invasive vascular procedures (e.g., cardiac catheterization, angiography, vascular surgery) and/or thrombolytic agents.¹ Clinical features of cholesterol embolism include livedo reticularis, “purple toe” syndrome, acute renal failure, gangrenous digits, hypertension, pancreatitis, MI, cerebral infarction, spinal cord infarction, retinal artery occlusion, bowel infarction, and rhabdomyolysis.¹

Arrhythmias

Possible reperfusion-related arrhythmias (e.g., sinus bradycardia, accelerated idioventricular rhythm, VPCs, VT).^{1 6 10 11}

Have appropriate antiarrhythmic therapy available during and after administration.^{1 6}

Sensitivity Reactions

Sensitivity Reactions

Allergic-type (e.g., pruritus, rash, urticaria) or anaphylactoid reactions (e.g., dyspnea, hypotension) reported rarely.^{1 7 13}

Institute appropriate therapy if an anaphylactoid reaction occurs.¹

Readministration

Repeat courses not systematically studied.¹ Do not administer second dose if anaphylaxis occurs with first dose.¹

Specific Populations

Pregnancy

Category C.¹

Increases risk of therapy in pregnant women; weigh risks against benefits of therapy in pregnant women.¹

Lactation

Not known whether reteplase is distributed into milk.¹ Caution if used in nursing women.¹

Pediatric Use

Safety and efficacy not established in children <18 years of age.^{1 13}

Geriatric Use

Intracranial hemorrhage more common.^{1 4 5 6} Weigh risks of drug against potential benefits.¹

Hepatic Impairment

Weigh the risks of therapy against the potential benefits in patients with severe hepatic impairment.¹

Renal Impairment

Weigh the risks of therapy against the potential benefits in patients with severe renal impairment.¹

Common Adverse Effects

Bleeding.¹

Interactions for Reteplase

Specific Drugs

Drug	Interaction	Comments
Abciximab	Increased risk of hemorrhage1 14 15 16	Concomitant use not recommended by some clinicians16 Use suggested by other clinicians in selected patients with no risk factors for bleeding15
Aspirin	Increased risk of hemorrhage1 14 15 16	Monitor carefully for bleeding, especially at arterial puncture sites1
Dipyridamole	Increased risk of hemorrhage1 14 15 16
Heparin	Increased risk of hemorrhage1 14 15 16	Monitor carefully for bleeding, especially at arterial puncture sites1
Warfarin	Increased risk of hemorrhage1 15 16	Weigh risks against anticipated benefits1

Reteplase Pharmacokinetics

Distribution

Extent

Not known whether reteplase is distributed into human milk.¹

Elimination

Metabolism

Cleared by the liver and kidney.¹

Half-life

13–16 minutes.¹

Stability

Storage

Parenteral

Powder for Injection

2–25°C; protect from light.¹

Reconstituted solutions contain no preservative.¹ Preferably use solution immediately after preparation; may be used up to 4 hours after reconstitution if stored at 2–30°C.¹ Discard any unused solution after 4 hours.¹

Compatibility

For information on systemic interactions resulting from concomitant use, see Interactions.

Parenteral

Drug Compatibility

Reteplase is incompatible with heparin.¹

Y-Site CompatibilityHID

Incompatible
Bivalirudin

ActionsActions

• 
  

  Binds to fibrin and converts plasminogen to plasmin.¹ Plasmin degrades the fibrin matrix of the thrombus.¹

  
  


• 
  

  Decreased fibrin affinity compared with alteplase.^{2 3 4 7 8 10}

  
  

Advice to Patients

• 
  

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

  
  


• 
  

  Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.^{1 6}

  
  


• 
  

  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.

Reteplase

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Parenteral	For IV use only	10.4 units (18.1 mg)	Retavase (with reconstitution kit containing sterile water for injection diluent and a double-ended sterile dispensing pin)	PDL BioPharma

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 February 2011. 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. PDL BioPharma, Inc. Retavase (reteplase, recombinant) injection prescribing information. Freemont, CA; 2006 Jan.

2. Topol EJ, Ohman M, Armstrong PW et al. Survival outcomes 1 year after reperfusion therapy with either alteplase or reteplase for acute myocardial infarction: results from the Global utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) III trial. Circulation. 2000; 102:1761-5. [IDIS 454027] [PubMed 11023929]

3. The Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO III) Investigators. A comparison of reteplase with alteplase for acute myocardial infarction. N Engl J Med. 1997; 337:118-23.

4. Cairns JA, Kenedy JW, Fuster V. Coronary thrombolysis. Chest. 1998; 114:(Suppl 5S):634-57S.

5. Ryan TJ, Antman EM, Brooks NH et al. ACC/AHA guidelines for the management of patients with acute myocardial infarction: 1999 update: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). J Am Coll Cardiol. 1999; 34:89-911.

6. Internation Liason Committee on Resuscitation. Guidelines 2000 for cardiopulmonary rsuscitation and emergency cardiovascular care: an international consensus on science. Part 7, section 1. Acute coronary syndromes (acute myocardial infarction). Circulation. 2000; 102(Suppl. I):I-172-203.

7. International Joint Efficacy Comparison of Thrombolytics. Randomised, double-blind comparison of reteplase double-bolus administration with streptokinase in acute myocardial infarction (INJECT): trial to investigate equivalence. Lancet. 1995; 346:329-36. [IDIS 351255] [PubMed 7623530]

8. Smalling RW, Bode C, Kalbfleisch J et al et al. More rapid, complete, and stable coronary thrombolysis with bolus administration of reteplase compared with alteplase infusion in acute myocardial infarction. Circulation. 1995; 91:2725-32. [IDIS 348924] [PubMed 7758177]

9. Bode C, Smalling RW, Berg G et al et al. Randomized comparison of coronary thrombolysis achieved with double-bolus reteplase (recombinant plasminogen activator) and front-loaded, accelerated alteplase (recombinant tissue plasminogen activator) in patients with acute myocardial infarction. Circulation. 1996; 94:891-8. [IDIS 372165] [PubMed 8790022]

10. Tebbe U, von Essen R, Smolarz A et al. Open, noncontrolled dose-finding study with a novel recombinant plasminogen activator (BM 06.022) given as a double bolus in patients with acute myocardial infarction. Am J Cardiol. 1993; 72:518-24. [IDIS 319465] [PubMed 8362764]

11. Neuhaus KL, von Essen R, Vogt A et al. Dose finding with a novel recombinant plasminogen activator (BM 06.022) in patients with acute myocardial infarction: results of the German recombinant plasminogen activator study. J Am Coll Cardiol. 1994; 24:55-60. [IDIS 332009] [PubMed 8006283]

12. Boehringer Mannheim Corporation, Gaithersburg, MD: Personal communication.

13. Centocor Inc., Malvern, PA: Personal communication.

14. Topol EJ, GUSTO V Investigators. Reperfusion therapy for acute myocardial infarction with fibrinolytic therapy or combinaiton reduced fibrinolytic therapy and platelet glycoprotein IIb/IIIa inhibition: the GUSTO V randomized trial. Lancet. 2001; 357: 1905-14.

15. Antman EM, Anbe DT, Armstrong PW et al. ACC/AHA guidelines for the management of patients with ST-elevation acute myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction). 2004. From http://www.acc.org/clinical/guidelines/stemi/index.pdf and http://www.americanheart.org.

16. Goodman SG, Menon V, Cannon CP et al. Acute ST-segment elevation myocardial infarction: American College of Chest Physicians evidence-based clinical practice guidelines (8th ed). Chest. 2008; 133:708S-75S. [PubMed 18574277]

17. Buller HR, Agnelli G, Hull RD et al. Antithrombotic therapy for venous thromboembolic disease. Chest. 2004; 126(Suppl):401S-28S. [IDIS 523841] [PubMed 15383479]

19. The American Heart Association. Guidelines 2005 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2005; 112(Suppl I):IV1-211.

20. Kearon C, Kahn SR, Agnelli G et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians evidence-based clinical practice guidelines (8th ed). Chest. 2008; 133 (Suppl): 454S-545S. [PubMed 18574272]

HID. Trissel LA. Handbook on injectable drugs. 14th ed; Bethesda, MD: American Society of Health-System Pharmacists; 2007:1462.

More Reteplase resources

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

• Reteplase MedFacts Consumer Leaflet (Wolters Kluwer)


• Retavase Prescribing Information (FDA)


• Retavase Advanced Consumer (Micromedex) - Includes Dosage Information


• Retavase Concise Consumer Information (Cerner Multum)

Compare Reteplase with other medications

• Heart Attack

Retrovir injection

Generic Name: zidovudine (injection) (zye DOE vyoo deen)

Brand Names: Retrovir

What is Retrovir (zidovudine (injection))?

Zidovudine is an antiviral medication that prevents human immunodeficiency virus (HIV) cells from multiplying in your body.

Zidovudine injection is used to treat HIV, which causes the acquired immunodeficiency syndrome (AIDS). Zidovudine is also given during pregnancy to prevent an HIV-infected woman from passing the virus to her baby. Zidovudine is not a cure for HIV or AIDS.

Zidovudine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Retrovir (zidovudine (injection))?

Zidovudine may cause lactic acidosis (the build up of lactic acid in the body). Lactic acidosis symptoms can start slowly and gradually get worse. Symptoms include unusual muscle pain and weakness, trouble breathing, fast or uneven heart rate, nausea, vomiting, stomach pain, and numbness or cold feeling in your arms or legs. Call your doctor at once if you have any of these symptoms, even if they are only mild. Early signs of lactic acidosis generally get worse over time and this condition can be fatal. Zidovudine can also cause severe or life-threatening effects on your liver. Call your doctor at once if you have any of these symptoms while using zidovudine: nausea and vomiting, diarrhea, loss of appetite, stomach pain, low fever, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). Do not use zidovudine together with other combination drugs that contain zidovudine, such as Combivir or Trizivir.

HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

Using zidovudine will not prevent you from passing HIV to other people through unprotected sex or sharing of needles. Talk with your doctor about safe methods of preventing HIV transmission during sex, such as using a condom and spermicide. Sharing drug or medicine needles is never safe, even for a healthy person.

What should I discuss with my healthcare provider before using Retrovir (zidovudine (injection))?

Do not use this medication if you are allergic to zidovudine, or if you are using any other drugs that contain zidovudine, such as Combivir or Trizivir.

Before using zidovudine, tell your doctor if you are allergic to any drugs, or if you have:

• kidney disease (or if you are on dialysis);


• liver disease; or


• 
  

  bone marrow suppression.

  
  

If you have any of these conditions, you may not be able to use zidovudine or you may need a dosage adjustment or special tests during treatment.

Zidovudine may cause lactic acidosis (the build up of lactic acid in the body). Lactic acidosis symptoms can start slowly and gradually get worse. Symptoms include unusual muscle pain and weakness, trouble breathing, fast or uneven heart rate, nausea, vomiting, stomach pain, and numbness or cold feeling in your arms or legs. Call your doctor at once if you have any of these symptoms, even if they are only mild. Early signs of lactic acidosis generally get worse over time and this condition can be fatal. Zidovudine can also cause severe or life-threatening effects on your liver. Call your doctor at once if you have any of these symptoms while using zidovudine: nausea and vomiting, diarrhea, loss of appetite, stomach pain, low fever, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Use all of your HIV medicines as directed to control your infection while you are pregnant.

Your name may need to be listed on an antiviral pregnancy registry when you start using zidovudine. The purpose of this registry is to track the outcome of the pregnancy and delivery to evaluate whether zidovudine had any effect on the baby.

You should not breast-feed while you are using zidovudine. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.

How should I use Retrovir (zidovudine (injection))?

Use this medication exactly as your doctor has prescribed it for you. Do not use more of the medication than recommended. Do not use zidovudine for longer than your doctor has prescribed. Follow the directions on your prescription label.

Zidovudine is given as an injection through a needle placed into a vein. Your doctor, nurse, or other healthcare provider will give you this injection. You may be given instructions on how to inject your medicine at home. Do not use this medicine at home if you do not fully understand how to give the injection and properly dispose of needles and other items used in giving the medicine.

Zidovudine must be given slowly through an IV infusion, and can take up to an hour to complete.

Use each needle and syringe only one time. Throw away used needles and syringes in a puncture-proof container. If your medicine does not come with such a container, ask your pharmacist where you can get one. Keep this container out of the reach of children and pets. Your pharmacist can tell you how to properly dispose of the container.

It is important to use zidovudine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

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

Zidovudine injection must be mixed with a liquid (diluent) before injecting it.

After mixing the medication, you may store it at room temperature if it is used within 24 hours. You may also store the mixed medication in a refrigerator, but you must use it within 48 hours.

What happens if I miss a dose?

Use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

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

Symptoms of a zidovudine overdose may include nausea, vomiting, drowsiness, headache, or weakness.

What should I avoid while using Retrovir (zidovudine (injection))?

Avoid drinking alcohol while using zidovudine. Alcohol may increase the risk of damage to the liver.

Using zidovudine will not prevent you from passing HIV to other people through unprotected sex or sharing of needles. Talk with your doctor about safe methods of preventing HIV transmission during sex, such as using a condom and spermicide. Sharing drug or medicine needles is never safe, even for a healthy person.

Retrovir (zidovudine (injection)) side effects

Stop using this medication and 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 other serious side effects:

• 
  

  liver damage - nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  
  


• 
  

  lactic acidosis - muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, nausea with vomiting, and fast or uneven heart rate;

  
  


• 
  

  easy bruising or bleeding, unusual weakness, pale skin;

  
  


• 
  

  white patches or sores inside your mouth or on your lips;

  
  


• 
  

  fever, chills, body aches, flu symptoms; or

  
  


• 
  

  any other signs of new infection.

  
  

Less serious side effects may be more likely to occur, such as:

• 
  

  mild nausea, vomiting, constipation;

  
  


• 
  

  sleep problems (insomnia);

  
  


• 
  

  muscle or joint pain;

  
  


• 
  

  headache, tired feeling;

  
  


• 
  

  skin rash;

  
  


• 
  

  pain or irritation where the medicine was injected; or

  
  


• 
  

  changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and trunk).

  
  

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Retrovir (zidovudine (injection))?

Before using zidovudine, tell your doctor if you are also using:

• 
  

  atovaquone (Mepron);

  
  


• 
  

  doxorubicin (Adriamycin);

  
  


• 
  

  fluconazole (Diflucan);

  
  


• 
  

  ganciclovir (Cytovene);

  
  


• 
  

  interferon-alfa (Roferon, Intron, Rebetron);

  
  


• 
  

  methadone (Dolophine, Methadose);

  
  


• 
  

  nelfinavir (Viracept);

  
  


• 
  

  phenytoin (Dilantin);

  
  


• 
  

  probenecid (Benemid);

  
  


• 
  

  ribavirin (Rebetol, Ribasphere, Copegus Virazole);

  
  


• 
  

  ritonavir (Norvir); or

  
  


• 
  

  stavudine (Zerit).

  
  

There may be other drugs that can affect zidovudine. 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 Retrovir resources

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

Compare Retrovir with other medications

• HIV Infection
• Nonoccupational Exposure
• Occupational Exposure
• Reduction of Perinatal Transmission of HIV

Where can I get more information?

• Your pharmacist has information about zidovudine written for health professionals that you may read.

See also: Retrovir side effects (in more detail)

Ralix

Generic Name: chlorpheniramine, methscopolamine, and phenylephrine (KLOR fe NEER a meen, METH skoe POL a meen, FEN il EFF rin)

Brand Names: Aerohist Plus, Ah-Chew, Chlor-Mes, Dallergy (obsolete), Denaze, Duradryl, Durahist PE, DuraTan PE, Extendryl Chews, Histatab PH, Omnihist L.A., Ralix, Redur-PCM, Rescon MX

What is Ralix (chlorpheniramine, methscopolamine, and phenylephrine)?

Chlorpheniramine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Methscopolamine is an anticholinergic (an-tye-kol-in-URJ-ik) that has a drying effect on the nasal passages.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of chlorpheniramine, methscopolamine, and phenylephrine is used to treat runny nose, sneezing, itchy throat, watery eyes, and sinus congestion caused by allergies, the common cold, or the flu.

Chlorpheniramine, methscopolamine, and phenylephrine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Ralix (chlorpheniramine, methscopolamine, and phenylephrine)?

Do not use this medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cold or allergy medicine before the MAO inhibitor has cleared from your body.

Before using this medicine, tell your doctor if you have heart disease, high blood pressure, or a heart rhythm disorder, circulation problems, glaucoma, diabetes, a thyroid disorder, kidney disease, or problems with urination.

Do not use any other over-the-counter cold, cough, or allergy medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of a certain drug. Read the label of any other medicine you are using to see if it contains chlorpheniramine or phenylephrine. Talk with your doctor if your symptoms do not improve after 5 days of treatment, or if you have a fever with a headache, cough, or skin rash.

What should I discuss with my health care provider before taking Ralix (chlorpheniramine, methscopolamine, and phenylephrine)?

Do not take this medication if you are allergic to chlorpheniramine, methscopolamine, phenylephrine, or to other cold or allergy medicines, diet pills, stimulants, or ADHD medications. Do not use this medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take a cold or allergy medicine before the MAO inhibitor has cleared from your body.

Before using this medication, tell your doctor if you are allergic to any drugs, or if you have:

• 
  

  heart disease, high blood pressure, or a heart rhythm disorder;

  
  


• 
  

  a blood vessel disorder or circulation problems;

  
  


• 
  

  glaucoma;

  
  


• 
  

  diabetes;

  
  


• 
  

  a thyroid disorder;

  
  


• 
  

  kidney disease;

  
  


• 
  

  asthma;

  
  


• 
  

  an enlarged prostate; or

  
  


• 
  

  problems with urination.

  
  

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. This medication can decrease breast milk production, and also may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Artificially-sweetened liquid forms of cold medicine may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.

How should I take Ralix (chlorpheniramine, methscopolamine, and phenylephrine)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label. Cold medicine is usually taken for only a short time until your symptoms clear up.

Take this medicine with a full glass of water. It is best to take this medicine with food.

Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. The suspension liquid form should be shaken well just before you measure a dose.

Do not crush, chew, break, or open an extended-release tablet unless your doctor tells you to. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time. However, some extended-release pills can be broken to split the dose. Ask your doctor or pharmacist if you have questions.

The chewable tablet must be chewed completely before you swallow it.

Tell your doctor if your symptoms do not improve after 5 days of treatment, or if you have a fever with a headache, cough, or skin rash.

This medication can cause you to have unusual results with allergy skin tests. Tell any doctor who treats you that you are taking an antihistamine.

Store this medicine at room temperature, away from heat, light, and moisture.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include feeling restless or nervous, nausea, vomiting, extreme drowsiness, confusion, hallucinations, uneven heart rate, fainting, or seizure (convulsions).

What should I avoid while taking Ralix (chlorpheniramine, methscopolamine, and phenylephrine)?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid becoming overheated or dehydrated during exercise and in hot weather.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by chlorpheniramine or methscopolamine. Tell your doctor if you need to use any of these other medicines.

Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice.

Do not use any other over-the-counter cold, cough, or allergy medication without first asking your doctor or pharmacist. Chlorpheniramine and phenylephrine are contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of a certain drug. Read the label of any other medicine you are using to see if it contains chlorpheniramine or phenylephrine. Avoid drinking alcohol. It can add to drowsiness caused by an antihistamine.

Ralix (chlorpheniramine, methscopolamine, and phenylephrine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

• 
  

  fast, pounding, or uneven heartbeat;

  
  


• 
  

  confusion, hallucinations, unusual thoughts or behavior;

  
  


• 
  

  severe dizziness, anxiety, restless feeling, or nervousness;

  
  


• 
  

  urinating less than usual or not at all;

  
  


• 
  

  easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms;

  
  


• 
  

  increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure); or

  
  


• 
  

  nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

  
  

Less serious side effects may include:

• 
  

  blurred vision;

  
  


• 
  

  dry mouth;

  
  


• 
  

  nausea, stomach pain, constipation;

  
  


• 
  

  mild loss of appetite;

  
  


• 
  

  dizziness, drowsiness, headache;

  
  


• 
  

  problems with memory or concentration;

  
  


• 
  

  ringing in your ears;

  
  


• 
  

  restlessness or excitability (especially in children);

  
  


• 
  

  warmth, tingling, or redness under your skin;

  
  


• 
  

  cold feeling in your hands or feet;

  
  


• 
  

  sleep problems (insomnia); or

  
  


• 
  

  skin rash or itching.

  
  

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.

What other drugs will affect Ralix (chlorpheniramine, methscopolamine, and phenylephrine)?

Before taking this medication, tell your doctor if you are using any other antihistamine or decongestant pills, liquids, or nasal sprays. Also tell your doctor if you are using any of the following drugs:

• 
  

  pramlintide (Symlin);

  
  


• 
  

  aspirin or salicylates (such as Disalcid, Doan's Pills, Dolobid, Salflex, Tricosal, and others);

  
  


• 
  

  an antidepressant such as amitriptyline (Elavil, Etrafon) or desipramine (Norpramin);

  
  


• 
  

  bladder or urinary medications such as oxybutynin (Ditropan, Oxytrol) or tolterodine (Detrol);

  
  


• 
  

  a diuretic (water pill), or medicines to treat high blood pressure, angina (chest pain), or other heart conditions;

  
  


• 
  

  medication to treat irritable bowel syndrome;

  
  


• 
  

  medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), risperidone (Risperdal), trazodone (Desyrel);

  
  


• 
  

  migraine headache medication such as sumatriptan (Imitrex), naratriptan (Amerge), zolmitriptan (Zomig), ergotamine (Ergostat, Ergomar); or

  
  


• 
  

  seizure medication such as carbamazepine (Carbatrol) or phenobarbital (Luminal, Solfoton).

  
  

This list is not complete and there may be other drugs that can interact with chlorpheniramine, methscopolamine, and phenylephrine. 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 Ralix resources

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

• AH-Chew Chewable Tablets MedFacts Consumer Leaflet (Wolters Kluwer)


• Aerohist Plus Sustained-Release and Long-Acting Tablets MedFacts Consumer Leaflet (Wolters Kluwer)


• Allergy DN PE Prescribing Information (FDA)


• Dallergy Syrup Prescribing Information (FDA)


• Dehistine Prescribing Information (FDA)


• Duravent-DA Controlled-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)


• Rescon Prescribing Information (FDA)

Compare Ralix with other medications

• Nasal Congestion
• Rhinitis

Where can I get more information?

• Your pharmacist can provide more information about chlorpheniramine, methscopolamine, and phenylephrine.

See also: Ralix side effects (in more detail)

Rauwolfemms

Generic Name: rauwolfia alkaloid (Oral route)

Commonly used brand name(s)

In the U.S.

• Rauwolfemms


• Resa


• Serpalan

Available Dosage Forms:

• Tablet

Uses For Rauwolfemms

Rauwolfia alkaloids belong to the general class of medicines called antihypertensives. They are used to treat high blood pressure (hypertension).

High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Rauwolfia alkaloids work by controlling nerve impulses along certain nerve pathways. As a result, they act on the heart and blood vessels to lower blood pressure.

Rauwolfia alkaloids may also be used to treat other conditions as determined by your doctor.

These medicines are available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, reserpine is used in certain patients with the following medical condition:

• Raynaud's disease

Before Using Rauwolfemms

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group 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

Although there is no specific information comparing use of rauwolfia alkaloids in children with use in other age groups, rauwolfia alkaloids are not expected to cause different side effects or problems in children than they do in adults.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of rauwolfia alkaloids in the elderly with use in other age groups, dizziness or drowsiness may be more likely to occur in the elderly, who are more sensitive to the effects of rauwolfia alkaloids.

Pregnancy

Rauwolfia alkaloids have not been studied in pregnant women. However, too much use of rauwolfia alkaloids during pregnancy may cause unwanted effects (difficult breathing, low temperature, loss of appetite) in the baby. In rats, use of rauwolfia alkaloids during pregnancy causes birth defects and in guinea pigs decreases newborn survival rates. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast Feeding

Rauwolfia alkaloids pass into breast milk and may cause unwanted effects (difficult breathing, low temperature, loss of appetite) in infants of mothers taking large doses of this medicine. Be sure you have discussed this with your doctor before taking this medicine.

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 any of these medicines, 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 medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

• Brofaromine


• Clorgyline


• Furazolidone


• Iproniazid


• Isocarboxazid


• Lazabemide


• Linezolid


• Moclobemide


• Nialamide


• Pargyline


• Phenelzine


• Procarbazine


• Rasagiline


• Selegiline


• Tetrabenazine


• Toloxatone


• Tranylcypromine

Using medicines in this class 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.

• Colchicine

Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

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

• Allergies or other breathing problems such as asthma—Rauwolfia alkaloids can cause breathing problems.

• Epilepsy

• Gallstones or


• Stomach ulcer or


• Ulcerative colitis—Rauwolfia alkaloids increase activity of the stomach, which may make the condition worse.

• Heart disease—Rauwolfia alkaloids can cause heart rhythm problems or slow heartbeat.

• Kidney disease—Some patients may not do well when blood pressure is lowered by rauwolfia alkaloids.

• Mental depression (or history of)—Rauwolfia alkaloids cause mental depression.

• Parkinson's disease—Rauwolfia alkaloids can cause parkinsonism-like effects.

• Pheochromocytoma

Proper Use of rauwolfia alkaloid

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

For patients taking this medicine for high blood pressure:

• In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.


• Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.


• Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

To help you remember to take your medicine, try to get into the habit of taking it at the same time each day.

This medicine is sometimes given together with certain other medicines. If you are using a combination of drugs, make sure that you take each medicine at the proper time and do not mix them. Ask your health care professional to help you plan a way to remember to take your medicines at the right times.

If this medicine upsets your stomach, it may be taken with meals or milk. If stomach upset (nausea, vomiting, stomach cramps or pain) continues or gets worse, check with your doctor.

Dosing

The dose medicines in this class 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 these medicines. 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 deserpidine


• For oral dosage form (tablets):
  
  • For high blood pressure:
    
    • Adults—250 to 500 micrograms (mcg) a day. This may be taken as a single dose or divided into two doses.
    
    
    • Children—Dose must be determined by your doctor.
    
    
  
  

• For rauwolfia serpentina


• For oral dosage form (tablets):
  
  • For high blood pressure:
    
    • Adults—50 to 200 milligrams (mg) a day. This may be taken as a single dose or divided into two doses.
    
    
    • Children—Dose must be determined by your doctor.
    
    
  
  

• For reserpine


• For oral dosage form (tablets):
  
  • For high blood pressure:
    
    • Adults—100 to 250 micrograms (mcg) a day.
    
    
    • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 5 to 20 mcg per kilogram (kg) (2.27 to 9.1 mcg per pound) of body weight a day. This may be taken as a single dose or divided into two doses.
    
    
  
  

Missed Dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

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

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Rauwolfemms

It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly.

For patients taking this medicine for high blood pressure:

• Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine.

In some patients, this medicine may cause mental depression. Tell your doctor right away:

• if you or anyone else notices unusual changes in your mood.


• if you start having early-morning sleeplessness or unusually vivid dreams or nightmares.

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

This medicine may cause some people to become drowsy or less alert than they are normally. This is more likely to happen when you begin to take it or when you increase the amount of medicine you are taking. 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 not alert.

This medicine may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if dry mouth continues for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

This medicine often causes stuffiness in the nose. However, do not use nasal decongestant medicines without first checking with your health care professional.

Rauwolfemms Side Effects

Suggestions that rauwolfia alkaloids may increase the risk of breast cancer occurring later have not been proven. However, rats and mice given 100 to 300 times the human dose had an increased number of tumors.

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

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

Less common

• Drowsiness or faintness


• impotence or decreased sexual interest


• lack of energy or weakness


• mental depression or inability to concentrate


• nervousness or anxiety


• vivid dreams or nightmares or early-morning sleeplessness

Check with your doctor as soon as possible if any of the following side effects occur:

More common

• Dizziness

Less common

• Black, tarry stools


• bloody vomit


• chest pain


• headache


• irregular heartbeat


• shortness of breath


• slow heartbeat


• stomach cramps or pain

Rare

• Painful or difficult urination


• skin rash or itching


• stiffness


• trembling and shaking of hands and fingers


• unusual bleeding or bruising

Symptoms of overdose

• Dizziness or drowsiness (severe)


• flushing of skin


• pinpoint pupils of eyes


• slow pulse

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

More common

• Diarrhea


• dryness of mouth


• loss of appetite


• nausea and vomiting


• stuffy nose

Less common

• Swelling of feet and lower legs

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time check with your doctor immediately if you notice any of the following side effects:

• Drowsiness or faintness


• impotence or decreased sexual interest


• irregular or slow heartbeat


• lack of energy or weakness


• mental depression or inability to concentrate


• nervousness or anxiety


• vivid dreams or nightmares or early-morning sleeplessness

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.

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.

rabies vaccine, purified chick embryo cell

Generic Name: rabies vaccine, purified chick embryo cell (RAY beez vax EEN, PYUR if eyed CHIK EM bree o sel)

Brand Names: RabAvert

What is rabies vaccine?

Rabies is a serious disease caused by a virus. Rabies is mainly a disease of animals. Humans get rabies when they are bitten by an infected animal. There may be no symptoms at first, but weeks or even years after a bite from an infected animal, rabies can cause pain, fatigue, headaches, irritability, fever, seizures, hallucinations, and paralysis. Rabies can be fatal.

You are more likely to be exposed to the rabies virus if you are a veterinarian, animal handler, rabies laboratory worker, or may otherwise come into contact with animals that could possibly carry the virus (including cats, dogs, foxes, skunks, raccoons, bobcats, coyotes, and bats). Travel to certain countries may also increase your risk of exposure to rabies.

Rabies purified chick embryo cell vaccine is used to prevent rabies in people who have been bitten by an animal or otherwise exposed to the rabies virus.

What is the most important information I should know about rabies vaccine?

Keep track of any and all side effects you have after receiving this vaccine. When you receive another vaccine in the future, you will need to tell the doctor if the first shot caused any side effects. Getting rabies disease is much more dangerous to your health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects. The risk of serious side effects is extremely low.

You can still receive a rabies vaccine if you have a cold or other minor illness. If you have a more severe illness with a fever, wait until you recover before receiving this vaccine. However, if you have been bitten by an infected animal or otherwise exposed to the rabies virus, you should receive the rabies vaccine regardless of having another illness.

What should I discuss with my healthcare provider before receiving rabies vaccine?

Do not receive this vaccine if you have ever had an allergic reaction to a rabies vaccine.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely receive this vaccine:

• 
  

  any type of infection or severe illness;

  
  


• 
  

  human immunodeficiency virus (HIV) infection;

  
  


• 
  

  a weak immune system caused by disease or by taking certain medicines or receiving cancer treatments;

  
  


• 
  

  if you are taking medicine to treat or prevent malaria; or

  
  


• 
  

  if you are allergic to pork or chicken.

  
  

You can still receive a rabies vaccine if you have a cold or other minor illness. If you have a more severe illness with a fever, wait until you recover before receiving this vaccine. However, if you have been bitten by an infected animal or otherwise exposed to the rabies virus, you should receive the rabies vaccine regardless of having another illness.

FDA pregnancy category C. It is not known whether this vaccine is harmful to an unborn baby. Before you receive a rabies vaccine, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether rabies vaccine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Rabies vaccine purified chick embryo cell (Rabavert) contains a small amount of albumin from human blood and may contain viruses and other infectious agents that can cause disease. Although donated human blood is screened, tested, and treated to reduce the risk of it containing anything that could cause disease, there is still a small possibility it could transmit disease. Talk with your doctor about the risks and benefits of receiving this vaccine.

How is rabies vaccine given?

Rabies purified chick embryo cell vaccine is given as an injection into a muscle. You will receive this injection in your doctor's office or other clinic setting. A doctor, nurse, or other healthcare provider will give you this injection.

For preventing rabies if you are at risk of exposure, you will need to receive a total of 3 injections. The second injection is usually given 7 days after the first, followed by a third injection 2 or 3 weeks later.

Depending on your risk of exposure to rabies, you may need to receive the rabies vaccine series every 2 years. If you work around live rabies virus, such as in a laboratory or a vaccine production area, you may need to receive a booster rabies vaccine every 6 months.

For treating rabies after you have been bitten or exposed, you will need to receive a total of 5 injections. The injections are usually given on Days 0, 3, 7, 14, and 28. At the beginning of your treatment you may also receive a second injection with an immune globulin (im-YOON GLOB-yoo-lin). This medicine is sometimes injected into or near the bite wound or injury where the rabies virus is likely to have entered your body.

Follow your doctor's instructions for your injection schedule.

What happens if I miss a dose?

Contact your doctor if you will miss a booster dose or if you get behind schedule. The next dose should be given as soon as possible. There is no need to start over.

Be sure to receive all doses of this vaccine recommended by your healthcare provider or by the health department of the state where you live. If you do not receive the full series of vaccines, you may not be fully protected against the disease.

What happens if I overdose?

An overdose of rabies vaccine is unlikely to occur.

What should I avoid before or after getting rabies vaccine?

Follow your doctor's instructions about any restrictions on food, beverages, or activity after you receive rabies vaccine.

Rabies vaccine side effects

Keep track of any and all side effects you have after receiving this vaccine. When you receive another vaccine in the future, you will need to tell the doctor if the first shot caused any side effects. Getting rabies disease is much more dangerous to your health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects. The risk of serious side effects is extremely low.

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:

• 
  

  fever, chills, weakness, body aches, flu symptoms;

  
  


• 
  

  severe headache, problems with your vision;

  
  


• 
  

  numbness or tingly feeling;

  
  


• 
  

  swollen lymph glands; or

  
  


• 
  

  skin rash.

  
  

Less serious side effects may include:

• 
  

  pain, swelling, itching, or redness where the shot was given;

  
  


• 
  

  headache;

  
  


• 
  

  increased heart rate;

  
  


• 
  

  hot flashes;

  
  


• 
  

  muscle pain; or

  
  


• 
  

  nausea, stomach pain.

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

Rabies vaccine, purified chick embryo cell Dosing Information

Usual Adult Dose for Rabies Prophylaxis:

Preexposure Prophylaxis:
1 mL IM for a total of 3 doses on days 0, 7, and 21 or 28.

Postexposure prophylaxis:
Not previously vaccinated:
1 mL IM for a total of 5 doses on days 0, 3, 7, 14, and 28. Rabies immune globulin should also be administered on day 0 at 20 units/kg.

Previously vaccinated:
1 mL IM for a total of 2 doses on days 0 and 3. Do not administer rabies immune globulin.

Booster:
1 mL IM every 2 years or as indicated by antibody titers. People with continuing high risk of exposure such as certain veterinarians, should have their serum tested for rabies antibodies every 2 years; others working with live rabies in laboratories or vaccine production facilities and who are at risk of inapparent exposure should be tested every 6 months.

Usual Pediatric Dose for Rabies Prophylaxis:

Preexposure Prophylaxis:
1 mL IM on days 0,7, and 28.

Postexposure prophylaxis:
Not previously vaccinated:
1 mL IM on days 0, 3, 7, 14, and 28. Rabies immune globulin should also be administered at 20 units/kg.

Previously vaccinated:
1 mL IM on days 0 and 3. Do not administer rabies immune globulin.

Booster:
1 mL IM every 2 years or as indicated by antibody titers. People with continuing high risk of exposure such as certain veterinarians, should have their serum tested for rabies antibodies every 2 years; others working with live rabies in laboratories or vaccine production facilities and who are at risk of inapparent exposure should be tested every 6 months.

What other drugs will affect rabies vaccine?

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

• 
  

  chemotherapy or radiation cancer treatments;

  
  


• 
  

  cyclosporine (Neoral, Sandimmune, Gengraf);

  
  


• 
  

  sirolimus (Rapamune), tacrolimus (Prograf);

  
  


• 
  

  basiliximab (Simulect), efalizumab (Raptiva), muromonab-CD3 (Orthoclone);

  
  


• 
  

  mycophenolate mofetil (CellCept);

  
  


• 
  

  azathioprine (Imuran), leflunomide (Arava), etanercept (Enbrel);

  
  


• 
  

  a steroid medicine such as betamethasone (Celestone), cortisone (Cortone), dexamethasone (Decadron, Dexone), hydrocortisone (Cortef, Hydrocortone), methylprednisolone (Medrol), prednisolone (Prelone, Pediapred), prednisone (Orasone, Deltasone, others), or triamcinolone (Aristocort); or

  
  


• 
  

  an inhaled or nasal steroid such as beclomethasone (Qvar, Beclovent, Beconase, Vanceril, Vancenase), budesonide (Pulmicort, Rhinocort), flunisolide (Aerobid, Nasalide, Nasarel), fluticasone (Flovent, Flonase), mometasone (Nasonex), or triamcinolone (Azmacort, Nasacort).

  
  

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

More rabies vaccine, purified chick embryo cell resources

• Rabies vaccine, purified chick embryo cell Side Effects (in more detail)
• Rabies vaccine, purified chick embryo cell Use in Pregnancy & Breastfeeding
• Rabies vaccine, purified chick embryo cell Drug Interactions
• Rabies vaccine, purified chick embryo cell Support Group
• 0 Reviews for Rabies vaccine, purified chick embryo cell - Add your own review/rating

• RabAvert MedFacts Consumer Leaflet (Wolters Kluwer)


• RabAvert Prescribing Information (FDA)


• Rabavert Advanced Consumer (Micromedex) - Includes Dosage Information


• Rabies Vaccine Monograph (AHFS DI)

Compare rabies vaccine, purified chick embryo cell with other medications

• Rabies Prophylaxis

Where can I get more information?

• Your doctor or pharmacist may have information about this vaccine written for health professionals that you may read. You may also find additional information from your local health department or the Centers for Disease Control and Prevention.

See also: rabies vaccine, purified chick embryo cell side effects (in more detail)