Ciprofloxacino Vir may be available in the countries listed below.
Ciprofloxacin hydrochloride (a derivative of Ciprofloxacin) is reported as an ingredient of Ciprofloxacino Vir in the following countries:
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Zestril is a brand name of lisinopril, approved by the FDA in the following formulation(s):
Yes. The following products are equivalent to Zestril:
Note: Fraudulent online pharmacies may attempt to sell an illegal generic version of Zestril. These medications may be counterfeit and potentially unsafe. If you purchase medications online, be sure you are buying from a reputable and valid online pharmacy. Ask your health care provider for advice if you are unsure about the online purchase of any medication.
See also: About generic drugs.
There are no current U.S. patents associated with Zestril.
Gemfi-1A Pharma may be available in the countries listed below.
Gemfibrozil is reported as an ingredient of Gemfi-1A Pharma in the following countries:
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In the US, Ponstel (mefenamic acid systemic) is a member of the drug class nonsteroidal anti-inflammatory agents and is used to treat Pain and Period Pain.
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Mefenamic Acid is reported as an ingredient of Ponstel in the following countries:
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In the US, Panokase (pancrelipase systemic) is a member of the drug class digestive enzymes and is used to treat Chronic Pancreatitis, Cystic Fibrosis and Pancreatic Exocrine Dysfunction.
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Epinephrine is reported as an ingredient of Lidocain-Epinephrin Streuli in the following countries:
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Lévanol may be available in the countries listed below.
In some countries, this medicine may only be approved for veterinary use.
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Class: Enzymes
ATC Class: V03AF07
VA Class: GA500
Chemical Name: urate (Aspergillus flavus clone 9C/9A reduced) oxidase
Molecular Formula: C1523H2383N417O462S7 (monomer)
CAS Number: 134774-45-1
Brands: Elitek
Risk of severe hypersensitivity reactions (e.g., anaphylaxis).a (See Hypersensitivity Reactions under Cautions.)
Immediately and permanently discontinue if clinical evidence of hypersensitivity reaction develops.a
Risk of severe hemolysis in patients with a glucose-6-phosphate dehydrogenase (G-6-PD) deficiency.a (See Hemolysis under Cautions.)
Immediately and permanently discontinue if hemolysis develops.a
Screen patients at higher risk (e.g., patients of African or Mediterranean ancestry) prior to starting therapy.a
Methemoglobinemia reported; immediately and permanently discontinue if methemoglobinemia develops.a (See Methemoglobinemia under Cautions.)
Enzymatic degradation of uric acid occurs within blood samples left at room temperature, resulting in spuriously low uric acid levels.a
Collect blood in prechilled tubes containing heparin anticoagulant and immediately immerse and maintain in an ice-water bath; assay plasma samples within 4 hours of collection.a (See Specific Drugs and Laboratory Tests under Interactions.)
Biosynthethic (recombinant DNA origin) form of urate oxidase prepared from a genetically modified strain of Saccharomyces cerevisiae.1 4 5 6
Initial management of plasma uric acid concentrations in pediatric patients with leukemia, lymphoma, or solid tumors who are receiving chemotherapy expected to result in tumor lysis and subsequent elevation of plasma uric acid concentrations.1 2 3 4 5 6
Initiate chemotherapy 4–24 hours after administering first dose of rasburicase.1
Administer concomitantly with IV hydration according to standard medical practice for management of plasma uric acid in patients at risk for tumor lysis syndrome.1
Administer by IV infusion.1
Do not administer as a rapid IV injection (e.g., IV push or bolus).1
Do not use filters during administration.1
Infuse through a different line than that used for other concomitant drugs; if not possible, flush the line with at least 15 mL of 0.9% sodium chloride injection prior to and after infusion of rasburicase solutions.1
Reconstitute prior to administration.1
Determine number of vials needed to achieve the proper dosage based on the patient’s weight and the dose per kg.1
Reconstitute vial containing 1.5 mg of rasburicase lyophilized powder with 1 mL of provided diluent (sterile water for injection and poloxamer 188) to provide a solution containing 1.5 mg of rasburicase per mL.1
Mix by swirling very gently.1 Do not shake or form a vortex.1
Must be diluted further before IV administration.a
Use strict aseptic technique since drug product contains no preservatives.1
Withdraw appropriate dose from reconstituted vials and add to the appropriate volume of 0.9% sodium chloride injection to achieve a final volume of 50 mL.1
Administer diluted solution by IV infusion over 30 minutes.1
Infants and children 1 month to 17 years of age: 0.15 or 0.2 mg/kg once daily for 5 days.1
Safety and efficacy established only for a single course of treatment.1 (See Sensitivity Reactions under Cautions.)
Infants and children 1 month to 17 years of age: Safety and efficacy of twice daily dosing, dosing for >5 days, or administration of >1 course of therapy not established.1
No special populations dosing recommendations at this time.1
G-6-PD deficiency.1 (See Hemolysis under Cautions.)
Known hemolytic reactions to rasburicase or any ingredient in the formulation.1 (See Hemolysis under Cautions.)
Known methemoglobinemia reactions to rasburicase or any ingredient in the formulation.1 (See Methemoglobinemia under Cautions.)
Known hypersensitivity to rasburicase or any ingredient in the formulation.1
Potential for severe (e.g., grade 3 or 4) hemolytic reactions associated with G-6-PD deficiency; reported within 2–4 days of initiation of therapy.1
Immediately and permanently discontinue the drug if evidence of hemolysis appears; initiate appropriate patient monitoring and supportive measures (e.g., transfusion support).1
Contraindicated in patients with G-6-PD deficiency because hydrogen peroxide is a major product of the conversion of uric acid to allantoin.1
Prior to initiating therapy, screen patients at increased risk of G-6-PD deficiency (e.g., patients of African or Mediterranean descent).1
Risk of methemoglobinemia, resulting in serious hypoxemia requiring medical intervention.1
Immediately and permanently discontinue if methemoglobinemia develops and implement supportive measures (e.g., transfusion support, methylene blue administration).1
Unknown whether a deficiency of cytochrome b5 reductase (methemoglobin reductase) or of other antioxidant enzymes increases risk for methemoglobinemia or hemolytic anemia.1
Risk of severe hypersensitivity reactions (e.g., anaphylaxis); may occur any time during treatment, even during the first dose.1
If a serious hypersensitivity reaction occurs(e.g., bronchospasm, chest pain and tightness, dyspnea, hypoxia, hypotension, shock, and/or urticaria), immediately and permanently discontinue drug and initiate appropriate therapy.1
Safety in patients with atopic allergy or asthma is unknown.2 3 6
Maintain adequate hydration according to standard medical practice for the management of plasma uric acid in patients at risk for tumor lysis syndrome.1 Alkalinization of the urine is not needed.6 9
Antibodies to rasburicase may develop; may be associated with inhibition of rasburicase activity.1
Category C.1
Not known whether rasburicase is distributed into milk; discontinue nursing or the drug.1
Safety and efficacy not established in infants <1 month of age.a
Insufficient experience in those ≥65 years of age to determine whether they respond differently than pediatric patients.a
Insufficient experience in adults to determine whether they respond differently than pediatric patients.a
Vomiting, fever, nausea, headache, abdominal pain, constipation, diarrhea, mucositis, rash.1
Does not substantially induce or inhibit CYP isoenzymes including 1A, 2A, 2B, 2C, 2E, or 3A in vivo; clinically relevant pharmacokinetic interactions unlikely.1
Drug or Test | Interaction | Comments |
|---|---|---|
Allopurinol | Pharmacokinetic interactions unlikely1 | |
Antineoplastic agents (cyclophosphamide, cytarabine, daunorubicin, etoposide, mercaptopurine, methotrexate, thioguanine, vincristine) | Pharmacokinetic interactions unlikely1 | |
Methylprednisolone | Pharmacokinetic interactions unlikely1 | |
Test for uric acid | Interference with uric acid measurements due to enzymatic degradation of uric acid in blood/plasma/serum samples left at room temperature, resulting in spuriously low uric acid concentrations1 | Collect blood samples in prechilled test tubes containing heparin and immediately immerse in an ice water bath1 Analyze uric acid concentrations in plasma; prepare plasma samples from whole blood by centrifugation in a precooled centrifuge (4°C) and assay within 4 hours of sample collection1 |
Pharmacokinetics evaluated in pediatric patients; insufficient data available to evaluate pharmacokinetics in adults.1
Age-adjusted target plasma uric acid concentrations (i.e., ≤6.5 mg/dL in children <13 years of age or ≤7.5 mg/dL in those ≥13 years of age) achieved within 48 hours following initiation of rasburicase therapy.1 3
Target plasma uric acid concentrations maintained for 24 hours after the last administered rasburicase dose.1 3
Not known whether rasburicase is distributed into milk.a
18 hours.a
2–8°C.1 Do not freeze; protect from light.a
Catalyzes oxidation of uric acid into an inactive and soluble metabolite (allantoin).1
Active only at the end of the purine catabolic pathway that produces uric acid.1
Risk of hypersensitivity reactions (e.g., anaphylaxis).1 Importance of immediately seeking medical attention if symptoms of severe sensitivity (e.g., chest pain, dyspnea, hypotension, urticaria) occur.1
Risk of adverse hematologic effects (e.g., hemolysis, methemoglobinemia).1
Importance of women informing clinicians immediately 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.a
Importance of informing patients of other important precautionary information. (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Parenteral | For IV infusion | 1.5 mg | Elitek | Sanofi-Aventis |
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions March 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
1. Sanofi-Aventis Inc. Elitek (rasburicase) injection for intravenous use prescribing information. New York, NY; 2002 Jul 22.
2. Goldman SC, Holcenberg JS, Finklestein JZ et al. A randomized comparison between rasburicase and allopurinol in children with lymphoma or leukemia at high risk for tumor lysis. Blood. 2001; 97:2998-3003. [IDIS 463743] [PubMed 11342423]
3. Pui CH, Mahmoud HH, Wiley JM et al. Recombinant urate oxidase for the prophylaxis or treatment of hyperuricemia in patients with leukemia or lymphoma. J Clin Oncol. 2001; 19:697-704. [IDIS 460147] [PubMed 11157020]
4. Easton J, Noble S, Jarvis B. Rasburicase. Pediatr Drugs. 2001; 3:433-9
5. Anon. Rasburicase (Elitek) for hyperuricemia. Med Letter Drug Ther. 2002; 44:96-7.
6. Lohr LK. Rasburicase, a new, recombinate form of urate oxidase, treats hyperuricemia in tumor lysis syndrome. Hem/Onc Today. October 2002. From the Hem/Onc Today website. Accessed 2003 Jan 23.
7. Smalley RV, Guaspari A, Haase-Statz S et al. Allopurinol: intravenous use for prevention and treatment of hyperuricemia. J Clin Oncol. 2000; 18:1758-63. [IDIS 447152] [PubMed 10764437]
8. Nabi Biopharmaceuticals. Aloprim (allopurinol sodium) for injection, for intravenous infusion prescribing information (dated 1999 Jun). In: Physicians’ desk reference. From the PDR electronic library website. Accessed 2003 Jan 27.
9. Sanofi-Aventis Inc., New York, NY: Personal communication.
a. Sanofi-Aventis Inc. Elitek (rasburicase) injection for intravenous use prescribing information. New York, NY; 2005 Mar.
Morfinesulfaat Actavis may be available in the countries listed below.
Morphine sulphate pentahydrate (a derivative of Morphine) is reported as an ingredient of Morfinesulfaat Actavis in the following countries:
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