Crestor

Generic Name: Rosuvastatin Calcium
Class: HMG-CoA Reductase Inhibitors
VA Class: CV350
Chemical Name: 7 - [4 - (4 - fluorophenyl) - 6 - (1 - methylethyl) - 2 - [methylsulfonyl)amino] - 5 - pyrimi - dinyl] - 3,5 - dihydroxy - 6 - heptenoic acid calcium
Molecular Formula: 2C₂₂H₂₇FN₃O₆S•Ca
CAS Number: 147098-20-2

Special Alerts:

[Posted 09/30/2008] An FDA analysis provides new evidence that the use of statins does not increase incidence of amyotrophic lateral sclerosis (ALS), a neurodegenerative disease often referred to as “Lou Gehrig's Disease.” The FDA analysis, undertaken after the agency received a higher than expected number of reports of ALS in patients on statins, is based on data from 41 long-term controlled clinical trials. The results showed no increased incidence of the disease in patients treated with a statin compared with placebo.

The FDA is anticipating the completion of a case-control or epidemiological study of ALS and statin use. Results from this study should be available within 6-9 months. FDA is also examining the feasibility of conducting additional epidemiologic studies to examine the incidence and clinical course of ALS in patients taking statins.

Based on currently available information, health care professionals should not change their prescribing practices for statins and patients should not change their use of statins. For more information visit the FDA website at: and .

Introduction

Antilipemic agent; hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitor (i.e., statin).¹

Uses for Crestor

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.

Dyslipidemias

Adjunct to dietary therapy in adults to decrease elevated serum total cholesterol, LDL-cholesterol, apolipoprotein B (apo B), non-HDL-cholesterol, and triglyceride concentrations and to increase HDL-cholesterol concentrations in the management of primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia.¹

Reduction of elevated serum total cholesterol, LDL-cholesterol, and apo B concentrations in patients with homozygous familial hypercholesterolemia as an adjunct to other lipid-lowering therapies (e.g., plasma LDL-apheresis) or when such therapies are not available.¹

Adjunct to dietary therapy in the management of patients with elevated serum triglyceride concentrations.¹

Produces greater reductions in LDL-cholesterol concentrations than atorvastatin, pravastatin, or simvastatin on a mg-for-mg basis.¹

Crestor Dosage and Administration

General

• 
  

  Patients should be placed on a standard lipid-lowering diet before initiation of rosuvastatin therapy and should remain on this diet during treatment with the drug.^{1 7}

  
  

Administration

Oral Administration

Administer orally at any time of day without regard to meals.¹

If used with cyclosporine or gemfibrozil, adjustment in the treatment regimen recommended.¹ (See Specific Drugs under Interactions.)

Dosage

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.

Available as rosuvastatin calcium; dosage expressed in terms of rosuvastatin.¹

When initiating statin therapy or switching from another statin, select appropriate initial dosage, then carefully adjust dosage according to individual requirements and response.¹

Adults

Dyslipidemias

Primary Hypercholesterolemia and Mixed Dyslipidemia

Oral

Usual initial dosage is 10 mg once daily.¹ Initiate at 5 mg once daily in patients requiring less aggressive LDL-cholesterol reductions, patients with predisposing factors for myopathy, or patients at risk of increased exposure to rosuvastatin (e.g., Asian patients, patients receiving concomitant cyclosporine therapy, patients with severe renal impairment).¹ (See Special Populations under Dosage and Administration and see Specific Drugs under Interactions.)¹ Initiate at 20 mg once daily in patients with marked hypercholesterolemia (LDL-cholesterol >190 mg/dL) and aggressive lipid targets.¹

Determine serum lipoprotein concentrations within 2–4 weeks after initiating and/or titrating therapy and adjust dosage accordingly.¹ Usual maintenance dosage is 5–40 mg once daily.¹

Reserve 40-mg daily dosage for patients who have not achieved their LDL-cholesterol goal with the 20-mg daily dosage.¹

Homozygous Familial Hypercholesterolemia

Oral

Initially, 20 mg once daily.¹ Dosage can be increased up to 40 mg once daily.¹

Hypertriglyceridemia

Oral

Initially, 10 mg once daily.¹¹ Usual maintenance dosage is 5–40 mg once daily.¹¹

Prescribing Limits

Adults

Dyslipidemias

Oral

Maximum 40 mg once daily.¹

Special Populations

Asian Patients

Initially, 5 mg once daily.¹ When contemplating dosage escalation in patients experiencing inadequate response with 5, 10, or 20 mg daily, consider potential for increased systemic exposure in Asian patients relative to Caucasian patients.¹ (See Special Populations under Pharmacokinetics.)

Renal Impairment

Dosage modification not necessary in patients with mild to moderate renal impairment.¹

Patients with severe renal impairment (Cl_cr <30 mL/minute) not undergoing hemodialysis: Initially, 5 mg once daily; dosage can be increased up to 10 mg once daily.¹

Cautions for Crestor

Contraindications

• 
  

  Active liver disease or unexplained, persistent elevations of serum aminotransferases.¹

  
  


• 
  

  Pregnancy or lactation.¹ (See Fetal/Neonatal Morbidity and Mortality under Cautions.)

  
  


• 
  

  Known hypersensitivity to rosuvastatin or any ingredient in the formulation.¹

  
  

Warnings/Precautions

Warnings

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.

Fetal/Neonatal Morbidity and Mortality

Suppression of cholesterol biosynthesis could cause fetal harm.¹ Congenital anomalies following intrauterine exposure to statins reported rarely.

Administer to women of childbearing age only when such patients are highly unlikely to conceive and have been informed of the potential hazards.¹ If the patient becomes pregnant while taking the drug, discontinue therapy and apprise the patient of the potential hazard to the fetus.¹

Hepatic Effects

Associated with increases in serum aminotransferase (AST, ALT) concentrations.¹

Pancreatitis, hepatitis, jaundice, increased serum alkaline phosphatase concentrations, increased γ-glutamyl transpeptidase concentrations, and increased bilirubin concentrations reported.¹ Fatty change in liver and rarely, cirrhosis, fulminant hepatic necrosis, and hepatoma reported with other statins.

Perform liver function tests before and at 12 weeks after initiation of therapy or any increase in dosage and periodically (e.g., semiannually) thereafter.¹

Patients who develop increased serum AST/ALT concentrations or manifestations of liver disease should receive frequent liver function tests thereafter until the abnormalities return to normal.¹ If increases in AST or ALT concentrations of >3 times the ULN persist, reduce dosage or discontinue therapy.¹

Musculoskeletal Effects

Myopathy (manifested as muscle pain, tenderness, or weakness and serum CK concentration increases >10 times the ULN) reported occasionally.¹

Rhabdomyolysis (characterized by muscle pain or weakness with marked increases [>10 times the ULN] in serum CK concentrations and increases in S_cr [usually accompanied by brown urine and urinary myoglobinuria]) reported rarely.¹ Rhabdomyolysis occurs more frequently with 40-mg daily dosage compared with lower dosages.¹ However, risk of rhabdomyolysis is similar between rosuvastatin and other statins.¹² In clinical studies, incidence of myopathy and rhabdomyolysis increased with dosages >40 mg daily.¹

Risk of myopathy increased in patients receiving higher doses of statins; in patients with multisystem disease (e.g., renal or hepatic impairment); in patients with concurrent serious infections or hypothyroidism; in patients (particularly women) of advanced age (≥65 years of age); in patients at risk of increased exposure to rosuvastatin (e.g., Asian patients); in patients with small body frame and frailty; and in patients undergoing surgery (i.e., during perioperative periods).¹ Risk also may be increased by concomitant administration of cyclosporine, niacin, or fibric acid derivatives (e.g., gemfibrozil).¹

Measure baseline serum CK concentrations prior to initiation of therapy, particularly in black men and patients receiving concomitant therapy with fibric acid derivatives.

Obtain serum CK concentrations and compare with baseline concentrations in patients presenting with musculoskeletal symptoms suggestive of myopathy; because hypothyroidism may be a predisposing factor, TSH concentrations also should be obtained in such patients.

Discontinue if serum CK concentrations increase markedly or if myopathy is diagnosed or suspected.¹

Monitor patients weekly if myalgia (muscle pain, tenderness) is present with either no CK elevation or a moderate elevation (3–10 times the ULN) until manifestations improve; discontinue if manifestations worsen.

Dosage reduction or temporary discontinuance may be prudent in patients with muscle discomfort and/or weakness in the presence of progressive elevation of CK concentrations on serial measurements.

Temporarily withhold or discontinue therapy in any patient experiencing an acute or serious condition suggestive of a myopathy.¹

Temporarily withhold or discontinue therapy in any patient experiencing an acute or serious condition predisposing to the development of renal failure secondary to rhabdomyolysis (e.g., sepsis; hypotension; major surgery; trauma; severe metabolic, endocrine, or electrolyte disorders; uncontrolled seizures).¹

Sensitivity Reactions

Hypersensitivity Reactions

Face edema, vesiculobullous rash, urticaria, and angioedema reported.¹

General Precautions

Role as Adjunct Therapy

Prior to institution of antilipemic therapy, vigorously attempt to control serum cholesterol by appropriate dietary regimens, weight reduction, exercise, and treatment of any underlying disorder that might be the cause of lipid abnormality.¹

CNS Effects

CNS vascular lesions (e.g., perivascular hemorrhages and edema, mononuclear cell infiltration of perivascular spaces) observed in animals receiving other statins.¹

Ocular Effects

Optic nerve degeneration observed in animals receiving other statins.¹

Specific Populations

Pregnancy

Category X.¹ (See Contraindications and also see Fetal/Neonatal Morbidity and Mortality under Cautions.)

Lactation

Distributed into milk in rats; not known whether distributed into human milk.¹ Discontinue nursing or the drug. (See Contraindications under Cautions.)

Pediatric Use

Safety and efficacy not established in pediatric patients.¹

Geriatric Use

No substantial differences in safety and efficacy relative to younger adults.¹

Caution in patients (particularly women) of advanced age (≥65 years of age) and in those with small body frame and frailty.

Hepatic Impairment

Use with caution in patients who consume substantial amounts of alcohol and/or have a history of liver disease.¹ (See Contraindications under Cautions.)

Renal Impairment

Dosage adjustments necessary in patients with severe renal impairment.¹ (See Renal Impairment under Dosage and Administration.)

Common Adverse Effects

Myalgia, constipation, asthenia, abdominal pain, nausea.¹

Interactions for Crestor

Minimally metabolized by CYP2C9.¹

Specific Drugs

Drug	Interaction	Comments
Antacids (aluminum- and magnesium hydroxide-containing)	Decreased absorption of rosuvastatin1	Administer antacid at least 2 hours after rosuvastatin1
Anticoagulants, oral (e.g., warfarin)	Increased INR1	Closely monitor PT until stabilized if rosuvastatin is initiated or dosage is adjusted in patients receiving a coumarin anticoagulant.1 Thereafter, monitor PT at intervals usually recommended for patients receiving coumarin anticoagulants1
Antifungals, azoles	Fluconazole: Increased rosuvastatin concentrations1 Ketoconazole: Pharmacokinetic interaction unlikely1 Itraconazole: Increased rosuvastatin concentrations1	Fluconazole: Pharmacokinetic interaction not considered clinically important1 Itraconazole: Pharmacokinetic interaction not considered clinically important1
Bile acid sequestrants	Enhanced effect on total and LDL-cholesterol1
Cyclosporine	Increased rosuvastatin concentrations1 Increased risk of myopathy1	If used concomitantly, rosuvastatin dosage should not exceed 5 mg daily1
Digoxin	Pharmacokinetic interaction unlikely1
Erythromycin	Decreased rosuvastatin concentrations1	Not considered clinically important1
Fibric acid derivatives (fenofibrate, gemfibrozil)	Increased risk of myopathy and/or rhabdomyolysis1 Gemfibrozil: Increased rosuvastatin concentrations1 Fenofibrate: Pharmacokinetic interaction unlikely1	Gemfibrozil: Concomitant use generally should be avoided1 If used concomitantly with gemfibrozil, rosuvastatin dosage should not exceed 10 mg daily1
Niacin	Increased risk of myopathy and/or rhabdomyolysis1	Weigh benefits against potential risks1
Oral contraceptives	Increased concentrations of ethinyl estradiol and norgestrel1

Crestor Pharmacokinetics

Absorption

Bioavailability

Absolute bioavailability is approximately 20%.¹

Peak plasma concentrations attained within 3–5 hours.¹

Onset

Maximal response occurs within 4 weeks.¹

Duration

Response maintained during continued therapy.¹

Food

Food decreases rate but not extent of absorption.¹

Special Populations

Race: Clinically important differences in pharmacokinetics among white, Hispanic, African American, or Afro-Caribbean groups not demonstrated.¹ Compared with Caucasian patients residing in the US, rosuvastatin concentrations are higher in Asian patients (of Filipino, Chinese, Japanese, Korean, Vietnamese, or Asian-Indian ancestry).¹ (See Asian Patients under Dosage and Administration.)

Patients with severe renal impairment (Cl_cr <30 mL/minute) and those undergoing chronic hemodialysis: Rosuvastatin plasma concentrations increased 3-fold.¹

Patients with mild to moderate renal impairment (Cl_cr ≥30 mL/minute): Plasma concentrations not altered.¹

Patients with hepatic impairment (Child-Pugh class A and B, chronic alcohol-induced liver disease): Plasma concentrations increased.¹

Distribution

Extent

Crosses the placenta.¹ Distributed into milk in rats; not known whether distributed into human milk.¹

Plasma Protein Binding

88% (mainly albumin).¹

Elimination

Metabolism

Not extensively metabolized; only 10% of dose is recovered as metabolite.¹

Metabolized by CYP2C9 to active metabolite.¹

Elimination Route

Excreted principally in feces (90%) as unchanged drug and metabolites.¹

Half-life

Approximately 19 hours.¹

Stability

Storage

Oral

Tablets

20–25°C.¹ Protect from moisture.¹

ActionsActions

• 
  

  Inhibits HMG-CoA reductase, causing subsequent reduction in hepatic cholesterol synthesis.^{1 2} Reduces serum concentrations of total cholesterol, LDL-cholesterol, VLDL-cholesterol, non-HDL-cholesterol, apo B, and triglycerides; increases HDL-cholesterol concentrations.¹

  
  


• 
  

  Statins may slow progression of and/or induce regression of atherosclerosis in coronary and/or carotid arteries, modulate BP in hypercholesterolemic patients with hypertension, and possess anti-inflammatory activity.

  
  

Advice to Patients

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.

• 
  

  Importance of informing patients about risks, especially rhabdomyolysis, associated with statins alone or combined with other drugs.¹ Importance of patients promptly reporting muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever,¹ brown urine, and flu-like symptoms.

  
  


• 
  

  Importance of adhering to nondrug therapies and measures, including dietary management, weight control, physical activity, and management of potentially contributory disease (e.g., diabetes mellitus).

  
  


• 
  

  Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed.¹ Necessity for clinicians to advise women to avoid pregnancy (i.e., using effective and appropriate contraceptive methods) during therapy and to advise pregnant women of risk to the fetus.¹

  
  


• 
  

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

  
  


• 
  

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

  
  

Preparations

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

Rosuvastatin Calcium

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets	5 mg (of rosuvastatin)	Crestor	AstraZeneca
		10 mg (of rosuvastatin)	Crestor	AstraZeneca
		20 mg (of rosuvastatin)	Crestor	AstraZeneca
		40 mg (of rosuvastatin)	Crestor	AstraZeneca

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Crestor 10MG Tablets (ASTRAZENECA): 30/$154.99 or 90/$426.96

Crestor 20MG Tablets (ASTRAZENECA): 30/$155.98 or 90/$427.99

Crestor 40MG Tablets (ASTRAZENECA): 30/$156.99 or 90/$427.95

Crestor 5MG Tablets (ASTRAZENECA): 30/$154.99 or 90/$426.96

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 October 2008. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

1. AstraZeneca Pharmaceuticals. Crestor (rosuvastatin calcium) tablets prescribing information. Wilmington, DE. 2005 Mar.

2. Davidson M, Ma P, Stein EA. Comparison of effects on low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with rosuvastatin versus atorvastatin in patients with type IIa or IIb hypercholesterolemia. Am J Cardiol. 2003; 89:268-75.

3. Jones PH, Davidson MH, Stein EA et al. Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR trial). Am J Cardiol. 2003; 92:152-60. [IDIS 502119] [PubMed 12860216]

4. Schneck DW, Knopp RH, Ballantyne CM. Comparative effects of rosuvastatin and atorvastatin across their dose ranges in patients with hypercholesterolemia and without active arterial disease. Am J Cardiol. 2003; 91:33-41. [IDIS 491642] [PubMed 12505568]

5. Capuzzi DM, Morgan JM, Weiss RJ. Beneficial effects of rosuvastatin alone and in combination with extended-release niacin in patients with combined hyperlipidemia and low high-density lipoprotein cholesterol levels. Am J Cardiol. 2003; 91:1304-10. [IDIS 500482] [PubMed 12767421]

6. Carswell CI, Plosker GL, Jarvis B. Rosuvastatin. Drugs. 2002; 62:2075-85.

7. National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Adult Treatment Panel III Report. From AHA web site.

8. Pasternak RC, Smith SC Jr, Bairey-Merz CN et al. ACC/AHA/NHLBI clinical advisory on the use and safety of statins. American College of Cardiology/American Heart Association/National Heart, Lung and Blood Institute. Circulation. 2002;106:1024-8.

9. Anon. Bayer voluntarily withdraws Baycol. FDA Talk Paper. Rockville, MD: Food and Drug Administration; 2001 Aug 8.

10. Pasternak RC, Smith SC Jr, Bairey-Merz CN et al. ACC/AHA/NHLBI clinical advisory on the use and safety of statins. American College of Cardiology/American Heart Association/National Heart, Lung and Blood Institute. Circulation. 2002;106:1024-8.

11. AstraZeneca, Wilmington, DE: Personal communication.

12. Anon. Rosuvastatin (marketed as Crestor). FDA Alert for Healthcare Professionals. Rockville, MD. From FDA website; accessed 2005 Mar 2.

More Crestor resources

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

• Crestor Prescribing Information (FDA)


• Crestor Advanced Consumer (Micromedex) - Includes Dosage Information


• Crestor MedFacts Consumer Leaflet (Wolters Kluwer)


• Crestor Consumer Overview

Compare Crestor with other medications

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• High Cholesterol
• High Cholesterol, Familial Heterozygous
• High Cholesterol, Familial Homozygous
• Hyperlipoproteinemia
• Hyperlipoproteinemia Type IIa, Elevated LDL
• Hyperlipoproteinemia Type IIb, Elevated LDL VLDL
• Hyperlipoproteinemia Type III, Elevated beta-VLDL IDL
• Hyperlipoproteinemia Type IV, Elevated VLDL
• Prevention of Cardiovascular Disease

cromolyn sodium nasal

Generic Name: cromolyn sodium (nasal) (KRO mo lin SO dee um)

Brand names: Nasalcrom, Nasalcrom Child

What is cromolyn sodium nasal?

Cromolyn sodium is an anti-inflammatory medication. It works by preventing the release of substances in the body that cause inflammation.

Cromolyn sodium nasal is used to prevent allergy symptoms such as runny nose, stuffy nose, sneezing, itching, and post-nasal drip.

Cromolyn sodium nasal will not treat allergy symptoms that have already begun. The medication works best if used at least 1 week before you come into contact with things you are allergic to (pollen, dust, pets, etc).

Cromolyn sodium nasal will not treat the symptoms of asthma, sinus infections, or the common cold.

Cromolyn sodium nasal may also be used for purposes not listed in this medication guide.

What is the most important information I should know about cromolyn sodium nasal?

You should not use this medication if you are allergic to cromolyn sodium.

Before you use cromolyn sodium nasal, tell your doctor if you have asthma, drug allergies, or polyps in your nose.

Cromolyn sodium nasal will not treat allergy symptoms that have already begun. The medication works best if used at least 1 week before you come into contact with things you are allergic to (pollen, dust, pets, etc).

Stop using this medication and call your doctor if you have severe burning, stinging, or irritation in your nose, nosebleeds, sinus pain, sores in your nose, wheezing, chest tightness, fever, or green/yellow mucus from your nose.

Do not use cromolyn sodium nasal more than 6 times in a 24-hour period. Do not use this medication for longer than 12 weeks unless your doctor has told you to.

What should I discuss with my healthcare provider before using cromolyn sodium nasal?

You should not use this medication if you are allergic to cromolyn sodium.

To make sure you can safely use cromolyn sodium nasal, tell your doctor if you have any of these other conditions:

• 
  

  asthma;

  
  


• 
  

  drug allergies; or

  
  


• 
  

  polyps in your nose.

  
  

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether cromolyn sodium 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.

How should I use cromolyn sodium nasal?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

This medicine is usually given as 1 spray into each nostril every 4 to 6 hours during allergy season or within 1 week before you will be exposed to an allergen. Follow your doctor's instructions.

Do not use cromolyn sodium nasal more than 6 times in a 24-hour period. Do not use this medication for longer than 12 weeks unless your doctor has told you to.

To use the nasal spray:

• 
  

  Blow your nose gently before each use.

  
  


• 
  

  Keeping your head upright, insert just the tip of the spray bottle into your nostril. Hold your other nostril closed with one finger. Spray the medicine into the nostril while inhaling, then sniff deeply a few times to make sure the medicine gets up into your nasal passages.

  
  


• 
  

  Repeat these steps in your other nostril.

  
  


• 
  

  After using the nasal spray, rinse the tip with hot water or wipe it with a clean tissue and recap. Avoid getting water into the nasal spray tip.

  
  

It may take up to 2 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 2 weeks of treatment.

Store at room temperature away from moisture, heat, and light. Keep the bottle capped when not in use.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use 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.

What should I avoid while using cromolyn sodium nasal?

Avoid getting this medication in your eyes. If this does happen, rinse with water.

Cromolyn sodium nasal side effects

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

• 
  

  severe burning, stinging, or irritation in your nose;

  
  


• 
  

  nosebleeds, sinus pain, or sores in your nose;

  
  


• 
  

  wheezing, tight feeling in your chest; or

  
  


• 
  

  fever, green or yellow mucus from the nose.

  
  

Less serious side effects may include mild burning or stinging inside your nose after use.

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.

Cromolyn sodium Dosing Information

Usual Adult Dose for Allergic Rhinitis:

1 spray in each nostril 3 to 6 times a day at regular intervals.

Usual Pediatric Dose for Allergic Rhinitis:

>= 6 years: 1 spray in each nostril 3 to 6 times daily at regular intervals.

What other drugs will affect cromolyn sodium nasal?

There may be other drugs that can interact with cromolyn sodium nasal. 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 cromolyn sodium resources

• Cromolyn sodium Use in Pregnancy & Breastfeeding
• Cromolyn sodium Support Group
• 0 Reviews for Cromolyn sodium - Add your own review/rating

Compare cromolyn sodium with other medications

• Hay Fever

Where can I get more information?

• Your pharmacist can provide more information about cromolyn sodium nasal.

Cozaar

Pronunciation: loe-SAR-tan
Generic Name: Losartan
Brand Name: Cozaar

Cozaar may cause injury or death to the fetus if taken after the third month of pregnancy. If you think you may be pregnant, contact your doctor right away.

Cozaar is used for:

Treating high blood pressure alone or with other medicines. It is used in certain patients to decrease the risk of stroke. It is used in certain patients to treat kidney problems caused by diabetes (diabetic nephropathy). It may also be used for other conditions as determined by your doctor.

Cozaar is an angiotensin II receptor blocker (ARB). It works by relaxing blood vessels. This helps to lower blood pressure.

Do NOT use Cozaar if:

• you are allergic to any ingredient in Cozaar


• you are in your second or third trimester of pregnancy


• the patient is a child with severe kidney problems

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

Before using Cozaar:

Some medical conditions may interact with Cozaar. Tell your health care provider if you have any medical conditions, especially if any of the following apply to you:

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


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


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


• if you are able to become pregnant


• if you have a history of angioedema (swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness), including angioedema caused by treatment with an angiotensin-converting enzyme (ACE) inhibitor (eg, lisinopril)


• if you have a history of heart problems (eg, heart failure), blood vessel problems, blood flow problems, or liver or kidney problems


• if you have a history of stroke or recent heart attack


• if you are dehydrated or have low blood volume


• if you have electrolyte problems (eg, high blood potassium levels, low blood sodium levels) or are on a low-salt (sodium) diet


• if you have diabetes, especially if you are also taking aliskiren


• if you are on dialysis or are scheduled to have major surgery

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

• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood pressure may be increased


• Aliskiren, potassium-sparing diuretics (eg, spironolactone, triamterene), or potassium supplements because the risk of high blood potassium levels may be increased


• ACE inhibitors (eg, lisinopril) because the risk of kidney problems and high blood potassium levels may be increased


• Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, indomethacin, celecoxib) or rifampin because they may decrease Cozaar's effectiveness


• Lithium because the risk of its side effects may be increased by Cozaar

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cozaar may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Cozaar:

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

• Take Cozaar by mouth with or without food.


• Take Cozaar on a regular schedule to get the most benefit from it. Taking Cozaar at the same time each day will help you remember to take it.


• Continue to take Cozaar even if you feel well. Do not miss any doses.


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

Ask your health care provider any questions you may have about how to use Cozaar.

Important safety information:

• Cozaar may cause dizziness, lightheadedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use Cozaar with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Cozaar may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.


• Cozaar may cause a serious side effect called angioedema. Contact your doctor at once if you develop swelling of the hands, face, lips, eyes throat, or tongue; difficulty swallowing or breathing; or hoarseness.


• Cozaar may not work as well to reduce the risk of stroke in black patients. Discuss any questions or concerns with your doctor.


• Dehydration, excessive sweating, vomiting, or diarrhea may increase the risk of low blood pressure. Contact your health care provider at once if any of these occur.


• Check with your doctor before you use a salt substitute or a product that has potassium in it.


• Tell your doctor or dentist that you take Cozaar before you receive any medical or dental care, emergency care, or surgery.


• Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.


• If you have high blood pressure, do not use nonprescription products that contain stimulants. These products may include diet pills or cold medicines. Contact your doctor if you have any questions or concerns.


• Patients taking Cozaar for kidney problems caused by diabetes have developed low blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine. Contact your doctor immediately if you experience symptoms of low blood sugar, including fast heartbeat, headache, chills, sweating, tremor, increased hunger, changes in vision, nervousness, weakness, dizziness, drowsiness, or fainting.


• Lab tests, including blood pressure, blood electrolyte levels, and heart, kidney, or liver function, may be performed while you use Cozaar. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Cozaar should not be used in CHILDREN younger than 6 years old; safety and effectiveness in these children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: Cozaar may cause birth defects or fetal death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. It is not known if Cozaar is found in breast milk. Do not breast-feed while taking Cozaar.

Possible side effects of Cozaar:

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

Diarrhea; dizziness; tiredness.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; hoarseness); change in the amount of urine produced; chest pain; dark urine; difficulty swallowing; fast, slow, or irregular heartbeat; muscle pain or cramps; severe or persistent stomach pain (with or without nausea or vomiting); symptoms of low blood pressure (eg, fainting, severe dizziness, lightheadedness); unusual bruising or bleeding; vision changes; yellowing of the eyes or skin.

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

See also: Cozaar side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Cozaar:

Store Cozaar at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Cozaar out of the reach of children and away from pets.

General information:

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


• Cozaar is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Cozaar. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Cozaar resources

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

• Cozaar Prescribing Information (FDA)


• Cozaar Consumer Overview


• Cozaar Monograph (AHFS DI)


• Cozaar Advanced Consumer (Micromedex) - Includes Dosage Information


• Losartan Prescribing Information (FDA)

Compare Cozaar with other medications

• Diabetic Kidney Disease
• High Blood Pressure

Cubicin

Generic Name: daptomycin (Intravenous route)

dap-toe-MYE-sin

Commonly used brand name(s)

In the U.S.

• Cubicin

Available Dosage Forms:

• Powder for Solution

Therapeutic Class: Antibiotic

Uses For Cubicin

Daptomycin injection is used to treat complicated skin and skin structure infections (cSSSI). It is also used to treat infections in the bloodstream, including right-sided infective endocarditis.

Daptomycin belongs to the class of medicines known as antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.

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

Before Using Cubicin

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

Allergies

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

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of daptomycin injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of daptomycin injection in the elderly. However, elderly patients are more likely to have increased unwanted side effects, which may require caution in patients receiving daptomycin injection.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	B	Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

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

Interactions with Medicines

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

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

• Atorvastatin


• Fluvastatin


• Lovastatin


• Pravastatin


• Rosuvastatin


• Simvastatin

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 this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Diarrhea or


• Muscle problems or


• Nerve problems (e.g., neuropathy)—Use with caution. May make these conditions worse.

• Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

• Staphylococcus infection, persisting or relapsing—Patients with this condition should have repeated blood tests.

Proper Use of Cubicin

A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins. This medicine is given slowly, so the needle will remain in place for about 30 minutes.

To help clear up your infection completely, keep using this medicine for the full time of treatment, even if you begin to feel better after a few days. Also, this medicine works best when there is a constant amount in the blood. To help keep the amount constant, you must receive this medicine on a regular schedule.

Precautions While Using Cubicin

Your doctor will check your progress closely while you are receiving this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it.

If your symptoms do not improve within a few days or if they become worse, check with your doctor.

Call your doctor right away if you develop chest pain, dry cough, fever, general feeling of tiredness or weakness, rapid breathing, shortness of breath, skin rash, or wheezing after receiving this medicine. These maybe symptoms of a serious condition called eosinophilic pneumonia.

Daptomycin injection may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop receiving this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. If you have any questions or if mild diarrhea continues or gets worse, check with your doctor.

If you have unexplained muscle pain, tenderness, or weakness while receiving this medicine, check with your doctor right away.

Check with your doctor right away if you are having burning, numbness, tingling, or painful sensations in the arms, hands, legs, or feet after receiving this medicine. These could be symptoms of a condition called peripheral neuropathy.

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

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

Cubicin Side Effects

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

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

More common

• Bloating or swelling of the face, arms, hands, lower legs, or feet


• fever


• rapid weight gain


• tingling of the hands or feet


• unusual weight gain or loss

Less common

• Abdominal or stomach pain


• agitation


• black, tarry stools


• bladder pain


• bloody or cloudy urine


• blurred vision


• chest pain or discomfort


• chills


• coma


• confusion


• convulsions


• cough


• decreased frequency or amount of urine


• decreased urine output


• depression


• diarrhea


• difficult or labored breathing


• difficult, burning, or painful urination


• dilated neck veins


• dizziness


• dry mouth


• extreme fatigue


• fainting


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


• fast heartbeat


• frequent urge to urinate


• headache


• hostility


• increased blood pressure


• increased thirst


• irregular breathing


• irregular heartbeat


• irritability


• itching in the genital or other skin areas


• itching, pain, redness, swelling, tenderness, or warmth on the skin


• lethargy


• lightheadedness


• loss of appetite


• lower back or side pain


• mood changes


• muscle pain or cramps


• muscle twitching


• nausea


• nervousness


• numbness or tingling in the hands, feet, or lips


• pale skin


• pounding in the ears


• rapid weight gain


• rapid, shallow breathing


• scaling


• seizures


• shortness of breath


• slow or fast heartbeat


• sneezing


• sore throat


• stupor


• sweating


• swelling of the face, fingers, ankles, or hands


• tightness in the chest


• troubled breathing with exertion


• unusual bleeding or bruising


• usual tiredness or weakness


• vomiting of blood or material that looks like coffee grounds


• weight gain


• wheezing

Rare

• Bleeding gums


• blood in the urine or stools


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


• clay-colored stools


• dark urine


• difficulty with moving


• drowsiness


• eye pain


• feeling of warmth


• feeling unusually cold


• general feeling of illness


• headache


• hives


• hoarseness


• increase in bone pain


• irritation


• itching


• joint pain, stiffness, or swelling


• loss of appetite


• mood or mental changes


• muscle aching or cramping


• muscle spasms (tetany) or twitching


• no blood pressure or pulse


• pain in the joints


• pinpoint red spots on the skin


• rapid or irregular heartbeat


• rash


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


• redness of the skin


• redness, blistering, peeling, or loosening of the skin


• shivering


• skin rash, encrusted, scaly and oozing


• sore throat


• sores, ulcers, or white spots on the lips or in the mouth


• stopping of heart


• swelling of the eyelids, face, lips, hands, or feet


• swollen glands


• swollen joints


• swollen, painful, or tender lymph glands in the neck, armpit, or groin


• trembling


• troubled breathing or swallowing


• twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs


• unconsciousness


• unpleasant breath odor


• unusual bleeding or bruising


• vomiting of blood


• yellow eyes or skin

Incidence not known

• Abdominal or stomach cramps


• abdominal or stomach tenderness


• diarrhea, watery and severe, which may also be bloody


• difficulty with swallowing


• dry cough


• pain


• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue


• unusual weight loss

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

• Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site


• diarrhea, mild


• difficulty having a bowel movement (stool)

Less common

• Anxiety


• back pain


• blurred vision


• cold sweats


• coma


• cool, pale skin


• decreased appetite


• depression


• flushed, dry skin


• fruit-like breath odor


• increased hunger


• increased urination


• itching of the vagina or outside genitals


• lack or loss of strength


• limb pain


• nervousness


• nightmares


• pain during sexual intercourse


• shakiness


• skin rash


• sleeplessness


• slurred speech


• sweating


• thick, white, curd-like vaginal discharge without odor or with mild odor


• trouble sleeping


• unable to sleep


• unexplained weight loss

Rare

• Acid or sour stomach


• bad, unusual, or unpleasant (after) taste


• belching


• change in taste


• continuing ringing or buzzing or other unexplained noise in the ears


• excess air or gas in the stomach or intestines


• feeling of constant movement of self or surroundings


• full feeling


• hearing loss


• heartburn


• indigestion


• pain or discomfort in the chest, upper stomach, or throat


• passing gas


• pressure in the stomach


• red, sore eyes


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


• sensation of spinning


• sore mouth or tongue


• swelling of the abdominal or stomach area


• swelling or inflammation of the mouth


• weakness


• white patches in the mouth or on the tongue

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

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

See also: Cubicin side effects (in more detail)

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

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

More Cubicin resources

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

• Cubicin Prescribing Information (FDA)


• Cubicin Consumer Overview


• Cubicin Monograph (AHFS DI)


• Cubicin MedFacts Consumer Leaflet (Wolters Kluwer)


• Daptomycin Professional Patient Advice (Wolters Kluwer)

Compare Cubicin with other medications

• Bacteremia
• Endocarditis
• Methicillin-Resistant Staphylococcus Aureus Infection
• Skin and Structure Infection
• Skin Infection

crotamiton topical

Generic Name: crotamiton topical (crow TA mi ton)

Brand Names: Eurax

What is crotamiton topical?

Crotamiton is a scabicide. The exact way that crotamiton works is unknown.

Crotamiton topical is used to treat scabies and to reduce itching associated with certain conditions.

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

What is the most important information I should know about crotamiton topical?

Do not take this medication by mouth.

Do not use more of this medication than is recommended.

Avoid application to the mouth, nose, or eyes.

Treat sexual and other close contacts who are also infected.

To prevent reinfection, wash all clothing, hats, bed clothes, bed linens, hair brushes, and combs with a strong cleanser in hot water to remove any mites or eggs.

Who should not use crotamiton topical?

Do not use this medication if you have ever had an allergic reaction to it. Crotamiton topical is in the pregnancy category C. This means that it is not known whether crotamiton topical will harm an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant. It is also not known whether crotamiton passes into breast milk. Do not use crotamiton topical without first talking to your doctor if you are breast-feeding a baby.

How should I use crotamiton topical?

Use crotamiton topical exactly as directed by your doctor, or follow the directions that accompany the package. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Never use more of this medication than is recommended.

To treat scabies:

• 
  

  Shake the lotion well before use. Apply a thin layer of the cream or lotion to all body parts from the neck down to the soles of your feet (scabies does not usually infect the head). Apply the medication to dry skin and rub it in well. Leave the medication on for 24 hours, then, without washing, apply a second dose. Thoroughly wash off the medication 48 hours after the last application.

  
  

To treat itching:

• 
  

  Massage the medication into the affected areas until it is completely absorbed. Repeat as necessary or as directed.

  
  

Do not apply this medication to the eyes, nose, or mouth. Flush with water if you get medication in any of these areas.

Do not apply crotamiton topical to open cuts or wounds. Doing so could cause too much medication to be absorbed by your body, which could be very dangerous.

To prevent reinfection, wash all clothing, hats, bed clothes, bed linens, hair brushes, and combs with a strong cleanser in hot water to remove any mites or eggs.

Store crotamiton topical at room temperature away from moisture and heat.

What happens if I miss a dose?

Two doses of crotamiton topical, 24 hours apart, are recommended. If the second dose is messed, retreatment may be necessary. Contact your doctor or pharmacist if you miss a dose.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a crotamiton topical overdose (after ingestion) include a burning feeling in the mouth; irritation or inflammation of the mouth, throat, and stomach lining; nausea; vomiting; and abdominal pain.

What should I avoid while taking crotamiton?

Avoid sexual or intimate contact with others until the infection has been cured. Also avoid sharing hair combs, hair accessories, hats, clothing, bed linens, and other articles of personal use. The infections are highly contagious.

Do not use more of this medication than is directed, and do not apply it to the facial area. Using too much of this medication could be very dangerous.

Do not apply crotamiton topical to open cuts or wounds. Doing so could cause too much medication to be absorbed by your body, which could be very dangerous.

Crotamiton side effects

Serious side effects are not likely to occur. Stop using crotamiton topical and seek emergency medical attention if you experience an allergic reaction (shortness of breath; closing of your throat; swelling of your lips, face, or tongue; or hives).

Mild itching, burning, or stinging may occur upon application.

Notify your doctor if your condition worsens or if unusual itching, redness, swelling, burning, or a rash occurs.

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.

Crotamiton topical Dosing Information

Usual Adult Dose for Scabies:

Apply topically to entire body starting at the chin and working downwards. Be certain to apply to all folds and creases. Repeat application 24 hours after initial application. Change clothing and bed linen the following morning. Take a cleansing bath 48 hours after final application.

Usual Adult Dose for Pruritus:

Apply topically to affected area(s) massaging gently until completely absorbed. Repeat application as necessary.

What other drugs will affect crotamiton?

Do not apply other topical preparations to the affected area during treatment with crotamiton topical.

Drugs other than those listed here may also interact with crotamiton topical. Ask your doctor and pharmacist before taking any prescription or over-the-counter medicines.

More crotamiton topical resources

• Crotamiton topical Side Effects (in more detail)
• Crotamiton topical Dosage
• Crotamiton topical Use in Pregnancy & Breastfeeding
• Crotamiton topical Support Group
• 1 Review for Crotamiton - Add your own review/rating

• Eurax Prescribing Information (FDA)


• Eurax Monograph (AHFS DI)


• Eurax Topical Advanced Consumer (Micromedex) - Includes Dosage Information


• Eurax Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Eurax Consumer Overview

Compare crotamiton topical with other medications

• Pruritus
• Scabies

Where can I get more information?

• Your pharmacist has additional information about crotamiton topical written for health professionals that you may read.

See also: crotamiton side effects (in more detail)

Cuvposa

Generic Name: glycopyrrolate (Oral route)

glye-koe-PIR-oh-late

Commonly used brand name(s)

In the U.S.

• Cuvposa


• Robinul


• Robinul Forte

Available Dosage Forms:

• Tablet


• Solution

Therapeutic Class: Gastrointestinal Agent

Pharmacologic Class: Antimuscarinic

Uses For Cuvposa

Glycopyrrolate is used to treat peptic ulcers in adults. It is also used to treat chronic, severe drooling caused by certain neurologic disorders (e.g., cerebral palsy) in children 3 to 16 years of age. This medicine is an anticholinergic.

Glycopyrrolate may also be used for other conditions as determined by your doctor.

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

Before Using Cuvposa

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

Allergies

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

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of glycopyrrolate in children 3 to 16 years of age. However, safety and efficacy have not been established in children younger than 3 years of age.

Geriatric

No information is available on whether the risk of glycopyrrolate-induced adverse effects are increased in the elderly; however, it should be used with caution because elderly patients are more likely to have age related liver disease, kidney disease, heart disease, or prostate problems. This may require a dosage adjustment or careful monitoring in elderly patients receiving glycopyrrolate.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

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

Interactions with Medicines

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

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

• Potassium

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 this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Colostomy (bowel surgical procedure) or


• Congestive heart failure or


• Heart disease or


• Heart rhythm problems or


• Hiatal hernia with gastroesophageal reflux disease (GERD) or


• Hypertension (high blood pressure) or


• Hyperthyroidism (overactive thyroid) or


• Ileostomy (bowel surgical procedure) or


• Liver disease or


• Nerve problems (e.g., neuropathy) or


• Prostatic hypertrophy (enlarged prostate) or


• Ulcerative colitis—Use with caution. May make these conditions worse.

• Glaucoma or


• Myasthenia gravis (severe muscle weakness) or


• Obstructive uropathy (urinary blockage due to enlarged prostate or other condition) or


• Paralytic ileus (bowel blockage) or


• Stomach or intestinal problems (e.g., ulcerative colitis, toxic megacolon, bowel obstruction), severe or


• Trouble urinating—Should not be used in patients with these conditions.

• Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of glycopyrrolate

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

Your doctor will tell you how much of this medicine to use and how often. The dose may need to be changed several times in order to find out what works best for you or your child. Do not use more medicine or use it more often than your doctor tells you to.

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

Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.

You should take this medicine at least one hour before or two hours after meals.

Dosing

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

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

• For oral dosage form (solution):
  
  • For severe drooling:
    
    • Children 3 to 16 years of age—Dose is based on body weight and must be determined by your child's doctor. The dose is 0.02 milligram (mg) per kilogram (kg) of body weight three times a day. Your child's doctor may increase your child's dose as needed. However, the dose is usually not more than 1.5 to 3 mg per dose.
    
    
    • Children younger than 3 years of age—Use and dose must be determined by your child's doctor.
    
    
  
  


• For oral dosage form (tablet):
  
  • For peptic ulcers:
    
    • Adults and children 12 years of age and older—The initial dose is 1 mg three times daily. Your doctor will adjust the dose as needed. However, the dose is usually not more than 8 mg per day.
    
    
    • Children younger than 12 years of age—Use is not recommended.
    
    
  
  

Missed Dose

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

Storage

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

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

Precautions While Using Cuvposa

It is very important that your doctor or your child's doctor check your progress at regular visits. This will allow your doctor to make sure that this medicine is working properly and to check for unwanted effects.

You should not take potassium chloride tablets or other potassium supplements (in tablet or capsule forms) while is using this medicine. Using these medicines together may cause delayed movement of the potassium supplement through the esophagus and stomach.

This medicine may cause constipation or diarrhea. Constipation or diarrhea can be an early symptom of a serious bowel problem. Stop using this medicine and check with your doctor if you or your child has constipation, diarrhea, abdominal or stomach distention (swelling), pain, nausea, or vomiting.

Stop using this medicine and check with your doctor right away if your child is unable to urinate, has dry diapers or undergarments, or has the following symptoms while using this medicine: crying, irritability, decrease in the frequency of urine, or difficult or painful urination.

If you or your child develops a skin rash, hives, or any allergic reaction to this medicine, stop taking the medicine and check with your doctor as soon as possible.

This medicine may make you or your child sweat less, causing your body temperature to increase. Use extra care to avoid becoming overheated during exercise or hot weather while you are taking this medicine, since overheating may result in heat stroke.

This medicine may make you or your child drowsy or cause blurred vision. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.

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

Cuvposa Side Effects

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

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

More common

• Body aches or pain


• chills


• constipation


• cough


• decrease in the frequency of urination


• decrease in urine volume


• difficulty in passing urine (dribbling)


• difficulty with breathing


• ear congestion


• feeling of warmth


• fever


• headache


• loss of voice


• nasal congestion


• painful urination


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


• runny nose


• sneezing


• sore throat


• unusual tiredness or weakness

Less common

• Abdominal or stomach discomfort or pain


• abdominal or stomach distension


• chest pain


• confusion


• convulsions


• dizziness


• dry heaves


• dry mouth


• fainting


• increase in heart rate


• lightheadedness


• pain or tenderness around the eyes and cheekbones


• rapid breathing


• shortness of breath or troubled breathing


• stuffy nose


• sunken eyes


• thirst


• tightness in the chest


• vomiting


• wheezing


• wrinkled skin

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

• low blood pressure


• muscle weakness


• trouble breathing

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:

Less common

• Altered mood


• anxiety


• attack, assault, or force


• bloated


• change in taste


• chapped lips


• crying


• dry skin


• dry tongue


• excess air or gas in the stomach or intestines


• full feeling


• hyperventilation


• irregular heartbeats


• irritability


• loss of taste


• moaning


• nervousness


• pain


• paleness of the skin


• passing gas


• rash


• restlessness


• shaking


• trouble with sleeping


• uncontrolled eye movements

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

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

See also: Cuvposa side effects (in more detail)

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

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

More Cuvposa resources

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

• Cuvposa Prescribing Information (FDA)


• Cuvposa Consumer Overview


• Cuvposa Solution MedFacts Consumer Leaflet (Wolters Kluwer)


• Glycopyrrolate Professional Patient Advice (Wolters Kluwer)


• Glycopyrrolate Monograph (AHFS DI)


• Glycopyrrolate MedFacts Consumer Leaflet (Wolters Kluwer)


• Robinul Prescribing Information (FDA)


• Robinul Forte MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Cuvposa with other medications

• Excessive Salivation

crotamiton Topical

kroe-TAM-i-ton

Commonly used brand name(s)

In the U.S.

• Eurax

Available Dosage Forms:

• Cream


• Lotion

Therapeutic Class: Scabicide

Uses For crotamiton

Crotamiton is used to treat scabies infection. It is also used to relieve the itching of certain skin conditions.

crotamiton is available only with your doctor's prescription.

Before Using crotamiton

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

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to crotamiton 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

Studies on crotamiton have been done only in adult patients, and there is no specific information comparing use of crotamiton in children with use in other age groups.

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 or if they cause different side effects or problems in older people. There is no specific information comparing use of crotamiton in the elderly with use in other age groups.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

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

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

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

• Severely inflamed skin or raw oozing areas of the skin—Use of crotamiton on these areas may make the condition worse

Proper Use of crotamiton

Keep crotamiton away from the mouth. It may be harmful if swallowed.

Use crotamiton only as directed. Do not use it more often than your doctor ordered. To do so may increase the chance of side effects.

Keep crotamiton away from the eyes and other mucous membranes, such as the inside of the nose. It may cause irritation. If you should accidentally get some in your eyes, flush them thoroughly with water at once.

crotamiton usually comes with patient directions. Read them carefully before using.

If you take a bath or shower before using crotamiton, dry the skin well before applying crotamiton.

For patients using crotamiton for scabies:

• Apply enough medicine to cover the entire skin surface from the chin down, and rub in well. This applies especially to folds and creases in the skin and to the hands, feet (including the soles), between fingers and toes, and moist areas (such as underarms and groin).


• Do not wash off the first coat of crotamiton.


• Apply a second coat of crotamiton 24 hours after the first one.


• The next day, put on freshly washed or dry-cleaned clothing and change bedding in order to prevent reinfection.


• Then, 48 hours after the second application of crotamiton, take a cleansing bath to remove the medicine.


• Your sexual partners, especially, and all members of your household may need to be treated also, since the infection may spread to persons in close contact. If these persons are not being treated or if you have any questions about this, check with your doctor.

Dosing

The dose of crotamiton 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 crotamiton. 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 topical dosage forms (cream and lotion):
  
  • For scabies:
    
    • Adults—Use two times. Apply one time the first day, and one time the second day. For severe cases, treatment may be repeated one time after one week.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  
  • For pruritus:
    
    • Adults—Use when necessary according to the directions on the label or your doctor's instructions.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  

Storage

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using crotamiton

If your condition does not improve or if it becomes worse, check with your doctor.

For patients using crotamiton for scabies:

• To prevent reinfection or spreading of the infection to other people, good health habits are also required. These include machine washing all underwear, pajamas, sheets, pillowcases, towels, and washcloths in very hot water and drying them using the hot cycle of a dryer. Clothing or bedding that cannot be washed in this way should be dry cleaned.

crotamiton Side Effects

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

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

Rare

• Skin irritation or rash not present before use of crotamiton

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

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

See also: crotamiton Topical side effects (in more detail)

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

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

More crotamiton Topical resources

• Crotamiton Topical Side Effects (in more detail)
• Crotamiton Topical Use in Pregnancy & Breastfeeding
• Crotamiton Topical Support Group
• 1 Review for Crotamiton Topical - Add your own review/rating

• Eurax Prescribing Information (FDA)


• Eurax Monograph (AHFS DI)


• Eurax Cream MedFacts Consumer Leaflet (Wolters Kluwer)


• Eurax Consumer Overview

Compare crotamiton Topical with other medications

• Pruritus
• Scabies