Friday, September 9, 2016

Aloxi Capsules


Pronunciation: PAL-oh-NOE-se-tron
Generic Name: Palonosetron
Brand Name: Aloxi


Aloxi Capsules is used for:

Preventing nausea and vomiting caused by cancer chemotherapy. It may also be used for other conditions as determined by your doctor.


Aloxi Capsules is 5-HT3 receptor blocker. It works by blocking the action of serotonin in certain parts of the brain and nervous system, which helps reduce or prevent nausea and vomiting.


Do NOT use Aloxi Capsules if:


  • you are allergic to any ingredient in Aloxi Capsules

  • you are taking apomorphine

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



Before using Aloxi Capsules:


Some medical conditions may interact with Aloxi Capsules. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, planning to become pregnant, 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 allergic to other 5-HT3 receptor antagonists (eg, ondansetron)

  • if you have a history of heart problems (eg, irregular heartbeat, prolonged QT), an abnormal heart function test (eg, electrocardiogram [ECG]), or low blood levels of potassium or magnesium

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


  • Apomorphine because side effects such as severely low blood pressure or loss of consciousness may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Aloxi Capsules 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 Aloxi Capsules:


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


  • An extra patient leaflet is available with Aloxi Capsules. Talk to your pharmacist if you have questions about this information.

  • Take Aloxi Capsules by mouth with or without food.

  • If you miss a dose of Aloxi Capsules, contact your doctor right away.

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



Important safety information:


  • Aloxi Capsules may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Aloxi Capsules with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

  • Aloxi Capsules should be used with extreme caution in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.

  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Aloxi Capsules while you are pregnant. It is not known if Aloxi Capsules is found in breast milk. Do not breast-feed while you are using Aloxi Capsules.


Possible side effects of Aloxi Capsules:


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:



Constipation; headache; 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); chest pain; fainting; fast, slow, or irregular heartbeat; fever, chills, or sore throat; trouble urinating; unusual muscle movement.



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: Aloxi 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 Aloxi Capsules:

Store Aloxi Capsules 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 Aloxi Capsules out of the reach of children and away from pets.


General information:


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

  • Aloxi Capsules 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 Aloxi Capsules. 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 Aloxi resources


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


Compare Aloxi with other medications


  • Nausea/Vomiting, Chemotherapy Induced
  • Nausea/Vomiting, Postoperative

Aloxi


Generic Name: Palonosetron Hydrochloride
Class: 5-HT3 Receptor Antagonists
VA Class: GA700
Chemical Name: (3aS)-2,3,3a,4,5,6-Hexahydro-2-[(3S)-3-quinuclidinyl]-1H-benz[de]isoquinolin-1-one monohydrochloride
Molecular Formula: C19H24N2O•HCl
CAS Number: 135729-62-3

Introduction

Antiemetic; selective inhibitor of type 3 serotonergic (5-HT3) receptors.1 17


Uses for Aloxi


Cancer Chemotherapy-induced Nausea and Vomiting


Prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy.1


Prevention of acute nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy.1


Aloxi Dosage and Administration


Administration


IV Administration


Administer by direct IV injection.1


Do not mix with other drugs; flush tubing with 0.9% sodium chloride injection before and after administration.1


Rate of Administration

Inject over a period of 30 seconds.1


Dosage


Available as palonosetron hydrochloride; dosage expressed in terms of palonosetron.1


Adults


Cancer Chemotherapy-induced Nausea and Vomiting

IV

0.25 mg as a single dose administered approximately 30 minutes before administration of emetogenic chemotherapy.1


An additional dose within a 7-day period is not recommended; safety and efficacy of repeat doses (e.g., on consecutive or alternate days) not established.1


Prescribing Limits


Adults


Cancer Chemotherapy-induced Nausea and Vomiting

IV

Maximum of one 0.25-mg dose within 7 days.1


Special Populations


Hepatic Impairment


No dosage adjustments required.1


Renal Impairment


No dosage adjustments required.1


Geriatric Patients


No dosage adjustments required.1


Cautions for Aloxi


Contraindications



  • Known hypersensitivity to palonosetron or any ingredient in the formulation.1



Warnings/Precautions


Sensitivity Reactions


Sensitivity reactions may occur in patients with history of hypersensitivity to other 5-HT3 receptor antagonists.1


General Precautions


Cardiovascular Effects

Prolongation of QT interval reported.1


Use with caution in patients who have or may develop prolongation of cardiac conduction intervals (particularly QTc), including those with congenital QT syndrome, those with uncorrected hypokalemia or hypomagnesemia, patients receiving diuretics that may induce electrolyte abnormalities, patients receiving antiarrhythmic agents or other drugs that alter cardiac conduction (e.g., prolong QT interval), and those receiving cumulative high-dose anthracycline therapy.1


Specific Populations


Pregnancy

Category B.1


Lactation

Not known whether palonosetron is distributed into milk.1 Discontinue nursing or the drug.1


Pediatric Use

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


Geriatric Use

No substantial differences in safety and efficacy relative to younger adults, but increased sensitivity cannot be ruled out.1


Common Adverse Effects


Headache, constipation.1


Interactions for Aloxi


Approximately 50% metabolized, principally by CYP2D6 and to a lesser extent by CYP3A and CYP1A2;1 however, pharmacokinetics are not substantially different between poor and extensive CYP2D6 substrate metabolizers.1


Does not inhibit activity of isoenzymes 1A2, 2A6, 2B6, 2C9, 2D6, 2E1, or 3A4/5; effect on isoenzyme 2C19 activity undetermined.1 Does not induce activity of isoenzymes 1A2, 2D6, or 3A4/5.1


Drugs Affecting or Metabolized by Hepatic Microsomal Enzymes


Clinically important pharmacokinetic interactions are unlikely.1


Drugs that Prolong QT Interval


Possible additive effect of QT-interval prolongation.1 Use concomitantly with caution.1


Specific Drugs


Palonosetron has been administered safely with analgesics, anticholinergic agents, antiemetics, antispasmodics, and corticosteroids in clinical studies.1






























Drug



Interaction



Comments



Anthracyclines (e.g., doxorubicin)



Potential QTc interval prolongation with cumulative high-dose anthracycline therapy1


Antineoplastic activity of doxorubicin not inhibited in animal tumor models1



Use with caution1



Antiarrhythmics



Possible additive effect of QT-interval prolongation1



Use with caution1



Cisplatin



Antineoplastic activity not inhibited in animal tumor models1



Cyclophosphamide



Antineoplastic activity not inhibited in animal tumor models1



Cytarabine



Antineoplastic activity not inhibited in animal tumor models1



Diuretics



May induce electrolyte abnormalities and increase risk of QTc interval prolongation1



Use with caution1



Metoclopramide



Pharmacokinetic interaction unlikely1



Mitomycin



Antineoplastic activity not inhibited in animal tumor models1


Aloxi Pharmacokinetics


Distribution


Plasma Protein Binding


Approximately 62%.1


Elimination


Metabolism


Approximately 50% metabolized (principally by CYP2D6 and to a lesser extent by CYP3A and CYP1A2) to 2 metabolites with <1% of the 5-HT3 receptor inhibitor activity of palonosetron.1 However, pharmacokinetics are not substantially different between poor and extensive CYP2D6 substrate metabolizers.1


Elimination Route


Eliminated principally in urine (80% in 144 hours, 40% as palonosetron).1


Half-life


Approximately 40 hours.1


Stability


Storage


Parenteral


Injection

20–25°C (may be exposed to 15–30°C).1 Protect from light; do not freeze.1


ActionsActions



  • Antiemetic activity for acute nausea and vomiting appears to be mediated via inhibition of serotonin activity both centrally (in area postrema and chemoreceptor trigger zone) and peripherally (in GI tract).2 3 4 5 6 8 11 18 19 20




  • Alternative mechanisms to peripheral and CNS stimulation by serotonin appear to be responsible for delayed nausea and vomiting.2 3 5 6 7 8 9 10 11 12 13 14 15 16 Risk of delayed nausea and vomiting may be decreased by effective prevention of acute nausea and vomiting in the same chemotherapy cycle.13 20 Palonosetron’s potency and long plasma half-life may contribute to its efficacy in delayed nausea and vomiting.7 11 17 21



Advice to Patients



  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1 26




  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, especially other drugs that may affect the QT interval (e.g., antiarrhythmic agents, diuretics, anthracyclines).1 26




  • Importance of informing clinician of any concomitant illnesses (e.g., cardiac conditions, electrolyte disturbances).26




  • Importance of informing patients of other important precautionary information.1 26 (See Cautions.)



Preparations


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













Palonosetron Hydrochloride

Routes



Dosage Forms



Strengths



Brand Names



Manufacturer



Parenteral



Injection, for IV use



0.05 mg (of palonosetron) per mL



Aloxi



MGI Pharma


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.


Aloxi 0.25MG/5ML Solution (EISAI): 5/$406.98 or 15/$1116.03



Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.


The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions May 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.




References



1. MGI Pharma. Aloxi (palonosetron hydrochloride) injection prescribing information. Bloomington, MN; 2006 Jan.



2. McKeage MJ. Comparative adverse effect profile of platinum drugs. Drug Saf. 1995; 13:228-44. [PubMed 8573296]



3. Cubeddu LX, Hoffmann IS. Participation of serotonin on early and delayed emesis induced by initial and subsequent cycles of cisplatinum-based chemotherapy: effects of antiemetics. J Clin Pharmacol. 1993; 33:691-7. [IDIS 319277] [PubMed 7691898]



4. Hesketh PJ, Gandara DR. Serotonin antagonists: a new class of antiemetic agents. J Natl Cancer Inst. 1991; 83:613-20. [PubMed 1850806]



5. Gralla RJ. Adverse effects of treatment: antiemetic therapy. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds. Cancer: principles and practice of oncology. 4th ed. Philadelphia: J.B. Lippincott Company; 1993:2338-48.



6. Plosker GL, Goa KL. Granisetron: a review of its pharmacological properties and therapeutic use as an antiemetic. Drugs. 1991; 42:805-24. [PubMed 1723376]



7. Di Vall MV, Cersosimo RJ. Palonosetron. A novel 5-HT3 receptor antagonist for chemotherapy-associated nausea and vomiting. Formulary. 2003; 38:414-30.



8. Barger AM, Clark-Snow RA. Adverse effects of treatment. In: DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: principles & practice of oncology. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2001: 2869-80



9. De Mulder PHM, Seynaeve C, Vermorken JB et al. Ondansetron compared with high-dose metoclopramide in prophylaxis of acute and delayed cisplatin-induced nausea and vomiting: a multicenter, randomized, double-blind, crossover study. Ann Intern Med. 1990; 113:834-40. [IDIS 274419] [PubMed 2146911]



10. Gebbia V, Cannata G, Testa A et al. Ondansetron versus granisetron in the prevention of chemotherapy- induced nausea and vomiting. Results of a prospective randomized trial. Cancer. 1994; 74:1945-52. [IDIS 336138] [PubMed 8082100]



11. , Donnerer J, Beubler E. 5-HT3 receptor antgaonists in antiemetic therapy. In: Donnerer J (ed.): Antiemetic therapy. Basel:Karger; 2003: 22-32.



12. Kris MG, Pisters KM, Hinkley L. Delayed emesis following anticancer chemotherapy. Support Care Cancer. 1994; 2:297- 300. [PubMed 8000726]



13. Gregory RE, Ettinger DS. 5-HT3 receptor antagonists for the prevention of chemotherapy-induced nausea and vomiting. Drugs. 1998; 55: 173-89. [PubMed 9506240]



14. Merck. Emend (aprepitant) capsules prescribing information. Whitehouse Station, NJ; 2003 Mar.



15. Sorbera LA, Castaner J, Bayes M at al. Aprepitant and L758298. Drugs Fut. 2002; 27:211-22.



16. Merck. Emend (aprepitant) product information form for the American Hospital Formulary Service. 2003.



17. Eglen RM, Lee CH, Smith WL at al. Pharmacological characterization of RS 25259-17, a novel and selective 5-HT3 receptor antagonist, in vivo. Br J Pharmacol. 1995; 114:860-6 [PubMed 7773547]



18. Perez EA. Review of the preclinical pharmacology and comparative efficacy of 5-Hydroxytryptamine-3 receptor antagonists for chemotherapy-induced emesis. J Clin Oncol. 1995; 13:1036-43. [IDIS 344879] [PubMed 7707101]



19. Lindley C, Blower P. Oral serotonin type 3-recpetor antagonists for prevention of chemotherapy-induced emesis. Am J Health-Syst Pharm. 2000; 57:1685-97. [IDIS 452881] [PubMed 11006796]



20. Schnell FM. Chemotherapy-induced nausea and vomiting: the importance of acute antiemetic control. The Oncologist. 2003; 8:187-98. [PubMed 12697943]



21. MGI Pharma. Aloxi (palonosetron hydrochloride) injection. Overview. Bloomington, MN; [2003 Aug 28]. From MGI Pharma web site (http://www.mgipharma.com).



22. Wong EH, Clark R, Leung E et al. The interaction of RS-25259-197, a potent and selective antagonist, with 5-HT3 receptos. Br J Pharmacol. 1995; 114:851-9. [PubMed 7773546]



23. Clark RD, Miller AB, Berger J et al. 2 (Quinuclidin-3-yl) pyrido [4,3-b]indol-1-ones and isoquinolin-1-ones. Potent conformationally restricted 5-HT3 receptor antagonists. J Med Chem. 1993; 36:2645-57. [PubMed 8410977]



24. Gralla R, Lichinitster M, Van Der Vegt S et al. Palonosetron improves prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: results of a double-blind randomized phase III trial comparing single doses of palonosetron with andansetron. Ann Oncol. 2003; 14:570-7. [PubMed 12649103]



25. MGI Pharma, Bloomington, MN: Personal communication.



26. MGI Pharma. Aloxi (palonosetron hydrochloride) patient information. Bloomington, MN. Undated. Available at: . Accessed 2006 Dec 6.



More Aloxi resources


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


  • Aloxi Prescribing Information (FDA)

  • Aloxi Consumer Overview

  • Aloxi Advanced Consumer (Micromedex) - Includes Dosage Information

  • Aloxi MedFacts Consumer Leaflet (Wolters Kluwer)

  • palonosetron Advanced Consumer (Micromedex) - Includes Dosage Information



Compare Aloxi with other medications


  • Nausea/Vomiting, Chemotherapy Induced
  • Nausea/Vomiting, Postoperative

Alprazolam



Pronunciation: al-PRA-zoe-lam
Generic Name: Alprazolam
Brand Name: Xanax


Alprazolam is used for:

Treating anxiety and panic disorder. It may also be used to treat other conditions as determined by your doctor.


Alprazolam is a benzodiazepine. It works in the brain to decrease anxiety.


Do NOT use Alprazolam if:


  • you are allergic to any ingredient in Alprazolam or other benzodiazepines (eg, diazepam)

  • you have acute narrow-angle glaucoma

  • you are taking delavirdine, itraconazole, ketoconazole, or sodium oxybate (GHB)

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



Video: Treatment for Depression







Treatments for depression are getting better everyday and there are things you can start doing right away.






Before using Alprazolam:


Some medical conditions may interact with Alprazolam. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


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

  • if you are able to become pregnant

  • 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 have a history of seizures, glaucoma or increased pressure in the eye, kidney or liver problems, lung or breathing problems (eg, chronic obstructive pulmonary disease [COPD], sleep apnea), myasthenia gravis, or a blood disorder known as porphyria

  • if you have a history of other mental or mood problems (eg, depression), alcohol or other substance abuse or dependence, or suicidal thoughts or actions

  • if you are in poor health, are very overweight, or are experiencing abnormal muscle movements

  • if you drink alcoholic beverages or you smoke

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


  • Methadone because it may increase the risk of serious and sometimes fatal breathing problems

  • Amiodarone, azole antifungals (eg, itraconazole, ketoconazole), cimetidine, cyclosporine, delavirdine, diltiazem, ergot alkaloids (eg, ergotamine), fluoxetine, fluvoxamine, isoniazid, macrolide antibiotics (eg, clarithromycin, erythromycin), nefazodone, nicardipine, nifedipine, omeprazole, oral contraceptives (birth control pills), paroxetine, propoxyphene, protease inhibitors (eg, boceprevir, ritonavir), sodium oxybate (GHB), telithromycin, or valproic acid because they may increase the risk of Alprazolam's side effects

  • Carbamazepine, rifamycins (eg, rifampin), or St. John's wort because they may decrease Alprazolam's effectiveness

  • Hydantoins (eg, phenytoin) because the risk of their side effects may be increased and they may decrease Alprazolam's effectiveness

  • Clozapine or tricyclic antidepressants (eg, desipramine, imipramine) because the risk of their side effects may be increased by Alprazolam

This may not be a complete list of all interactions that may occur. Ask your health care provider if Alprazolam 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 Alprazolam:


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


  • Alprazolam may be taken with or without food. If stomach upset occurs, take with food to reduce stomach irritation.

  • If you are taking Alprazolam regularly, do not suddenly stop taking it without checking with your doctor. You may have an increased risk of side effects, including seizure. If you need to stop Alprazolam, your doctor will gradually lower your dose.

  • Check with your doctor before eating grapefruit or drinking grapefruit juice while you use Alprazolam.

  • If you miss a dose of Alprazolam and you are using it regularly, 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 Alprazolam.



Important safety information:


  • Alprazolam may cause drowsiness, dizziness, light-headedness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Alprazolam. Using Alprazolam alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.

  • Do not drink alcohol while you are using Alprazolam.

  • Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Alprazolam; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.

  • Do not take more than the recommended dose or use for longer than prescribed without checking with your doctor.

  • Smoking may decrease Alprazolam's effectiveness. Tell your doctor if you smoke or if you have recently stopped smoking.

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

  • Use Alprazolam with caution in the ELDERLY; they may be more sensitive to its effects, especially decreased coordination and drowsiness.

  • Alprazolam should be used with extreme caution in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.

  • PREGNANCY and BREAST-FEEDING: Alprazolam may cause harm to the fetus. If you think you may be pregnant, discuss with your doctor the benefits and risks of using Alprazolam during pregnancy. Alprazolam is found in breast milk. Do not breast-feed while taking Alprazolam.

When used for long periods of time or at high doses, Alprazolam may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Alprazolam stops working well. Do not take more than prescribed.


Some people who use Alprazolam may develop a need to continue taking it. People who take higher doses (eg, some patients with panic disorder) or use Alprazolam for a long time have a greater risk. This is known as DEPENDENCE or addiction. If you stop taking Alprazolam suddenly, you may have WITHDRAWAL symptoms. These may include blurred vision; burning, numbness, or tingling; changes in smell or other senses; decreased appetite; decreased awareness of your surroundings; decreased concentration; diarrhea; muscle cramps or twitches; seizures; or weight loss.



Possible side effects of Alprazolam:


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:



Changes in appetite; constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; light-headedness; nausea; tiredness; weight changes.



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; unusual hoarseness); behavior changes; blurred vision; burning, numbness, or tingling; chest pain; confusion; dark urine; decreased coordination; decreased urination; fainting; fast or irregular heartbeat; hallucinations; loss of balance or muscle control; memory or attention problems; menstrual changes; muscle twitching; new or worsening mental or mood changes (eg, depression, irritability, anxiety; exaggerated feeling of wellbeing); overstimulation; red, swollen blistered, or peeling skin; severe or persistent dizziness, drowsiness, or light-headedness; shortness of breath or trouble breathing; suicidal thoughts or actions; tremor; trouble speaking; 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: Alprazolam 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. Symptoms may include confusion; loss of consciousness; loss of coordination; severe drowsiness or deep sleep; slow reflexes.


Proper storage of Alprazolam:

Store Alprazolam at room temperature, between 68 and 77 degrees F (20 and 25 degrees C) away from heat, moisture, and light. Do not store in the bathroom. Keep Alprazolam out of the reach of children and away from pets.


General information:


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

  • Alprazolam 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 Alprazolam. 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 Alprazolam resources


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


  • Alprazolam Prescribing Information (FDA)

  • Alprazolam Monograph (AHFS DI)

  • Alprazolam Professional Patient Advice (Wolters Kluwer)

  • Niravam Prescribing Information (FDA)

  • Xanax Consumer Overview

  • Xanax Prescribing Information (FDA)

  • Xanax XR Prescribing Information (FDA)

  • Xanax XR Consumer Overview

  • alprazolam Advanced Consumer (Micromedex) - Includes Dosage Information



Compare Alprazolam with other medications


  • Anxiety
  • Depression
  • Dysautonomia
  • Panic Disorder
  • Tinnitus

Alprazolam Orally Disintegrating Tablets



Pronunciation: al-PRA-zoe-lam
Generic Name: Alprazolam
Brand Name: Niravam


Alprazolam Orally Disintegrating Tablets are used for:

Treating anxiety and panic disorder. It may also be used to treat other conditions as determined by your doctor.


Alprazolam Orally Disintegrating Tablets are a benzodiazepine. It works in the brain to decrease anxiety.


Do NOT use Alprazolam Orally Disintegrating Tablets if:


  • you are allergic to any ingredient in Alprazolam Orally Disintegrating Tablets or other benzodiazepines (eg, diazepam)

  • you have acute narrow-angle glaucoma

  • you are taking delavirdine, itraconazole, ketoconazole, or sodium oxybate (GHB)

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



Video: Treatment for Depression







Treatments for depression are getting better everyday and there are things you can start doing right away.






Before using Alprazolam Orally Disintegrating Tablets:


Some medical conditions may interact with Alprazolam Orally Disintegrating Tablets. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


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

  • if you are able to become pregnant

  • 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 have a history of seizures, glaucoma or increased pressure in the eye, kidney or liver problems, lung or breathing problems (eg, chronic obstructive pulmonary disease [COPD], sleep apnea), myasthenia gravis, or a blood disorder known as porphyria

  • if you have a history of other mental or mood problems (eg, depression), alcohol or other substance abuse or dependence, or suicidal thoughts or actions

  • if you are in poor health, are very overweight, or are experiencing abnormal muscle movements

  • if you drink alcoholic beverages or you smoke

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


  • Methadone because it may increase the risk of serious and sometimes fatal breathing problems

  • Amiodarone, azole antifungals (eg, itraconazole, ketoconazole), cimetidine, cyclosporine, delavirdine, diltiazem, ergot alkaloids (eg, ergotamine), fluoxetine, fluvoxamine, isoniazid, macrolide antibiotics (eg, clarithromycin, erythromycin), nefazodone, nicardipine, nifedipine, omeprazole, oral contraceptives (birth control pills), paroxetine, propoxyphene, protease inhibitors (eg, boceprevir, ritonavir), sodium oxybate (GHB), telithromycin, or valproic acid because they may increase the risk of Alprazolam Orally Disintegrating Tablets's side effects

  • Carbamazepine, rifamycins (eg, rifampin), or St. John's wort because they may decrease Alprazolam Orally Disintegrating Tablets's effectiveness

  • Hydantoins (eg, phenytoin) because the risk of their side effects may be increased and they may decrease Alprazolam Orally Disintegrating Tablets's effectiveness

  • Clozapine or tricyclic antidepressants (eg, desipramine, imipramine) because the risk of their side effects may be increased by Alprazolam Orally Disintegrating Tablets

This may not be a complete list of all interactions that may occur. Ask your health care provider if Alprazolam Orally Disintegrating Tablets 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 Alprazolam Orally Disintegrating Tablets:


Use Alprazolam Orally Disintegrating Tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Alprazolam Orally Disintegrating Tablets may be taken with or without food. If stomach upset occurs, take with food to reduce stomach irritation.

  • Do not remove the blister from the outer pouch until you are ready to take Alprazolam Orally Disintegrating Tablets. Make sure that your hands are dry when you open the blister pack. Do not push the tablet through the foil. Peel back the foil on the blister pack and place the tablet on your tongue. The tablet dissolves quickly and can be swallowed with saliva. Alprazolam Orally Disintegrating Tablets may be taken with or without water. Take the tablet immediately after opening the blister pack. Do not store the removed tablet for future use. If you are only taking a half tablet for your dose, throw away the other half. Do not save it for later use.

  • If you are taking Alprazolam Orally Disintegrating Tablets regularly, do not suddenly stop taking it without checking with your doctor. You may have an increased risk of side effects (eg, seizures). If you need to stop Alprazolam Orally Disintegrating Tablets or add a new medicine, your doctor will gradually lower your dose.

  • Eating grapefruit or drinking grapefruit juice may affect the amount of Alprazolam Orally Disintegrating Tablets in your blood. Talk with your doctor before including grapefruit or grapefruit juice in your diet.

  • If you miss a dose of Alprazolam Orally Disintegrating Tablets and you are using it regularly, 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 Alprazolam Orally Disintegrating Tablets.



Important safety information:


  • Alprazolam Orally Disintegrating Tablets may cause drowsiness, dizziness, light-headedness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Alprazolam Orally Disintegrating Tablets. Using Alprazolam Orally Disintegrating Tablets alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.

  • Do not drink alcohol while you are using Alprazolam Orally Disintegrating Tablets.

  • Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Alprazolam Orally Disintegrating Tablets; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.

  • Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.

  • Smoking may decrease Alprazolam Orally Disintegrating Tablets's effectiveness. Tell your doctor if you smoke or if you have recently stopped smoking.

  • Tell your doctor or dentist that you take Alprazolam Orally Disintegrating Tablets before you receive any medical or dental care, emergency care, or surgery.

  • Use Alprazolam Orally Disintegrating Tablets with caution in the ELDERLY; they may be more sensitive to its effects, especially decreased coordination and drowsiness.

  • Use Alprazolam Orally Disintegrating Tablets with extreme caution in CHILDREN younger than 18 years of age; safety and effectiveness in these children have not been confirmed.

  • PREGNANCY and BREAST-FEEDING: Alprazolam Orally Disintegrating Tablets may cause harm to the fetus. If you think you may be pregnant, discuss with your doctor the benefits and risks of using Alprazolam Orally Disintegrating Tablets during pregnancy. Alprazolam Orally Disintegrating Tablets are found in breast milk. Do not breast-feed while taking Alprazolam Orally Disintegrating Tablets.

When used for long periods of time or at high doses, Alprazolam Orally Disintegrating Tablets may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Alprazolam Orally Disintegrating Tablets stops working well. Do not take more than prescribed.


Some people who use Alprazolam Orally Disintegrating Tablets may develop a need to continue taking it. People who take higher doses (eg, some patients with panic disorder) or use Alprazolam Orally Disintegrating Tablets for a long time have a greater risk. This is known as DEPENDENCE or addiction. If you stop taking Alprazolam Orally Disintegrating Tablets suddenly, you may have WITHDRAWAL symptoms. These may include blurred vision; burning, numbness, or tingling; changes in smell or other senses; decreased appetite; decreased awareness of your surroundings; decreased concentration; diarrhea; muscle cramps or twitches; seizures; or weight loss.



Possible side effects of Alprazolam Orally Disintegrating Tablets:


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:



Changes in appetite; constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; light-headedness; nausea; tiredness; weight changes.



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; unusual hoarseness); behavior changes; blurred vision; burning, numbness, or tingling; chest pain; confusion; dark urine; decreased coordination; decreased urination; fainting; fast or irregular heartbeat; hallucinations; loss of balance or muscle control; memory or attention problems; menstrual changes; muscle twitching; new or worsening mental or mood changes (eg, depression, irritability, anxiety; exaggerated feeling of well-being); overstimulation; red, swollen blistered, or peeling skin; severe or persistent dizziness, drowsiness, or light-headedness; shortness of breath or trouble breathing; suicidal thoughts or actions; tremor; trouble speaking; 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: Alprazolam 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. Symptoms may include confusion; loss of consciousness; loss of coordination; severe drowsiness or deep sleep; slow reflexes.


Proper storage of Alprazolam Orally Disintegrating Tablets:

Store Alprazolam Orally Disintegrating Tablets at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Alprazolam Orally Disintegrating Tablets out of the reach of children and away from pets.


General information:


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

  • Alprazolam Orally Disintegrating Tablets are 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 Alprazolam Orally Disintegrating Tablets. 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 Alprazolam resources


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


Compare Alprazolam with other medications


  • Anxiety
  • Depression
  • Dysautonomia
  • Panic Disorder
  • Tinnitus

Alpha-1 Proteinase Inhibitor (Human) Solution


Pronunciation: AL-fa PROE-teen-ase in-HIB-i-ter
Generic Name: Alpha-1 Proteinase Inhibitor (Human)
Brand Name: Glassia


Alpha-1 Proteinase Inhibitor (Human) Solution is used for:

Treating emphysema caused by alpha-1 proteinase inhibitor deficiency (also known as alpha-1 antitrypsin deficiency).


Alpha-1 Proteinase Inhibitor (Human) Solution is an alpha-1 protease inhibitor. It works by blocking substances in the lungs that break down lung tissue and sometimes causes emphysema.


Do NOT use Alpha-1 Proteinase Inhibitor (Human) Solution if:


  • you are allergic to any ingredient in Alpha-1 Proteinase Inhibitor (Human) Solution or other alpha-1 protease inhibitor products

  • you have an immunoglobulin A (IgA) deficiency with antibodies against IgA

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



Before using Alpha-1 Proteinase Inhibitor (Human) Solution:


Some medical conditions may interact with Alpha-1 Proteinase Inhibitor (Human) Solution. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:


  • if you are pregnant, planning to become pregnant, 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 have chronic obstructive pulmonary disease (COPD)

Some MEDICINES MAY INTERACT with Alpha-1 Proteinase Inhibitor (Human) Solution. However, no specific interactions with Alpha-1 Proteinase Inhibitor (Human) Solution are known at this time.


Ask your health care provider if Alpha-1 Proteinase Inhibitor (Human) Solution 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 Alpha-1 Proteinase Inhibitor (Human) Solution:


Use Alpha-1 Proteinase Inhibitor (Human) Solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.


  • Alpha-1 Proteinase Inhibitor (Human) Solution is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Alpha-1 Proteinase Inhibitor (Human) Solution at home, carefully follow the injection procedures taught to you by your health care provider.

  • Do not use Alpha-1 Proteinase Inhibitor (Human) Solution if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged in any way.

  • Use Alpha-1 Proteinase Inhibitor (Human) Solution at room temperature within 3 hours after preparing Alpha-1 Proteinase Inhibitor (Human) Solution for use. Throw away any unused medicine.

  • Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.

  • Do not miss any doses. If you miss a dose of Alpha-1 Proteinase Inhibitor (Human) Solution, contact your doctor.

Ask your health care provider any questions you may have about how to use Alpha-1 Proteinase Inhibitor (Human) Solution.



Important safety information:


  • Alpha-1 Proteinase Inhibitor (Human) Solution may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Alpha-1 Proteinase Inhibitor (Human) Solution with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

  • Alpha-1 Proteinase Inhibitor (Human) Solution contains albumin, which comes from human blood. There is a very rare risk of getting a viral disease or a central nervous system disease called Creutzfeldt-Jakob disease from products with albumin. No cases of these problems have been found in patients who have used Alpha-1 Proteinase Inhibitor (Human) Solution.

  • Alpha-1 Proteinase Inhibitor (Human) Solution should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

  • PREGNANCY and BREAST-FEEDING: It is not known if Alpha-1 Proteinase Inhibitor (Human) Solution can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Alpha-1 Proteinase Inhibitor (Human) Solution while you are pregnant. It is not known if Alpha-1 Proteinase Inhibitor (Human) Solution is found in breast milk. If you are or will be breast-feeding while you use Alpha-1 Proteinase Inhibitor (Human) Solution, check with your doctor. Discuss any possible risks to your baby.


Possible side effects of Alpha-1 Proteinase Inhibitor (Human) Solution:


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:



Dizziness; headache; joint swelling; pain, swelling, or redness at the injection site; sluggishness.



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); chest tightness or discomfort; dark urine; fainting; new or worsening lung or breathing problems or cough; severe or persistent headache or dizziness; stomach pain; symptoms of infection (eg, fever, chills, muscle aches, sore throat); unusual bruising or bleeding; wheezing; yellowing of the skin or eyes.



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: Alpha-1 Proteinase Inhibitor (Human) 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 Alpha-1 Proteinase Inhibitor (Human) Solution:

Alpha-1 Proteinase Inhibitor (Human) Solution is usually handled and stored by a health care provider. If you are using Alpha-1 Proteinase Inhibitor (Human) Solution at home, store Alpha-1 Proteinase Inhibitor (Human) Solution as directed by your pharmacist or health care provider. Keep Alpha-1 Proteinase Inhibitor (Human) Solution, as well as needles and syringes, out of the reach of children and away from pets.


General information:


  • If you have any questions about Alpha-1 Proteinase Inhibitor (Human) Solution, please talk with your doctor, pharmacist, or other health care provider.

  • Alpha-1 Proteinase Inhibitor (Human) Solution 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 Alpha-1 Proteinase Inhibitor (Human) Solution. 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 Alpha-1 Proteinase Inhibitor (Human) resources


  • Alpha-1 Proteinase Inhibitor (Human) Side Effects (in more detail)
  • Alpha-1 Proteinase Inhibitor (Human) Use in Pregnancy & Breastfeeding
  • Alpha-1 Proteinase Inhibitor (Human) Support Group
  • 2 Reviews for Alpha-1 Proteinase Inhibitor (Human) - Add your own review/rating


Compare Alpha-1 Proteinase Inhibitor (Human) with other medications


  • Alpha-1 Proteinase Inhibitor Deficiency

Alphanine SD


Generic Name: coagulation factor IX (koh AG yoo LAY shun FAK tor)

Brand Names: AlphaNine SD, BeneFIX, Mononine


What is Alphanine SD (coagulation factor IX)?

Coagulation factor IX is a man-made protein that is similar to a natural protein in the body that helps the blood to clot.


Coagulation factor IX is used to treat or prevent bleeding in people with hemophilia B. This medication is not for treating people with hemophilia A factor VII deficiency.


Coagulation factor IX may also be used for purposes other than those listed here.


What is the most important information I should know about Alphanine SD (coagulation factor IX)?


Do not use this medication if you have ever had an allergic reaction to a clotting factor medication, or if you are allergic to hamster proteins.

Before using this medication, tell your doctor if you are allergic to latex rubber, or if you have liver disease, coronary artery disease (hardening of the arteries), or a history of stroke or heart attack.


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


Carry an ID card or wear a medical alert bracelet stating that you have a bleeding disorder in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know about your condition.

What should I discuss with my healthcare provider before using Alphanine SD (coagulation factor IX)?


Do not use this medication if you have ever had an allergic reaction to a clotting factor medication, or if you are allergic to hamster proteins.

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



  • liver disease;




  • coronary artery disease (hardening of the arteries); or




  • history of stroke or heart attack.




FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether coagulation factor IX 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 Alphanine SD (coagulation factor IX)?


Coagulation factor IX is given as an injection through a needle placed into a vein. Your doctor, nurse, or other healthcare provider will give you this injection. You may be given instructions on how to use your injections at home.


Do not use this medicine at home if you do not fully understand how to give the injection and properly dispose of needles and other items used in giving the medicine.

Use each disposable needle only one time. Throw away used needles and syringes in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.


Coagulation factor IX is a powder medication that must be mixed with a liquid (diluent) before injecting it. Use the injection within 3 hours after mixing your dose.


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


Carry an ID card or wear a medical alert bracelet stating that you have a bleeding disorder in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know about your condition. If you store this medication at home, keep the powder medicine in the refrigerator. Do not freeze. Avoid exposing the medication to sunlight. The diluent can be stored at room temperature. You may also coagulation factor IX powder at cool room temperature for up to 6 months.

What happens if I miss a dose?


Contact your doctor if you miss a dose of this medication.


What happens if I overdose?


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

An overdose of coagulation factor IX is not expected to produce life-threatening symptoms.


What should I avoid while using Alphanine SD (coagulation factor IX)?


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


Alphanine SD (coagulation factor IX) side effects


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

  • fever or chills;




  • continued bleeding after treatment;




  • feeling like you might pass out;




  • sudden numbness or weakness, especially on one side of the body;




  • sudden headache, confusion, problems with vision, speech, or balance; or




  • swelling in your feet or ankles, weight gain, loss of appetite.



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



  • headache;




  • warmth, redness, or tingly feeling under your skin;




  • nausea, vomiting;




  • dizziness; or




  • pain, redness, or swelling where the medicine was injected.



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


What other drugs will affect Alphanine SD (coagulation factor IX)?


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



More Alphanine SD resources


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


  • Alphanine SD Prescribing Information (FDA)

  • Alphanine SD Advanced Consumer (Micromedex) - Includes Dosage Information

  • AlphaNine SD MedFacts Consumer Leaflet (Wolters Kluwer)

  • BeneFIX Prescribing Information (FDA)

  • BeneFIX Monograph (AHFS DI)

  • BeneFix MedFacts Consumer Leaflet (Wolters Kluwer)

  • Mononine Prescribing Information (FDA)

  • Mononine MedFacts Consumer Leaflet (Wolters Kluwer)



Compare Alphanine SD with other medications


  • Factor IX Deficiency
  • Hemophilia B


Where can I get more information?


  • Your pharmacist can provide more information about coagulation factor IX.

See also: Alphanine SD side effects (in more detail)


Alpha-E


Generic Name: vitamin e (Oral route)


VYE-ta-min E


Commonly used brand name(s)

In the U.S.


  • Alpha-E

  • Aqua Gem-E

  • Aquasol E

  • D-Alpha Gems

  • E-400

  • E-600

  • E-Gems

  • Formula E 400

  • Gamma E-Gems

  • Gamma E Plus

  • Key-E

  • Natural Vitamin Blend E-400IU

  • Nutr-E-Sol

Available Dosage Forms:


  • Liquid

  • Solution

  • Tablet

  • Capsule, Liquid Filled

  • Tablet, Chewable

  • Powder for Solution

  • Capsule

Therapeutic Class: Nutritive Agent


Pharmacologic Class: Vitamin E (class)


Uses For Alpha-E


Vitamins are compounds that you must have for growth and health. They are needed in only small amounts and are available in the foods that you eat. Vitamin E prevents a chemical reaction called oxidation, which can sometimes result in harmful effects in your body. It is also important for the proper function of nerves and muscles.


Some conditions may increase your need for vitamin E. These include:


  • Intestine disease

  • Liver disease

  • Pancreas disease

  • Surgical removal of stomach

Increased need for vitamin E should be determined by your health care professional.


Infants who are receiving a formula that is not fortified with vitamin E may be likely to have a vitamin E deficiency. Also, diets high in polyunsaturated fatty acids may increase your need for vitamin E.


Claims that vitamin E is effective for treatment of cancer and for prevention or treatment of acne, aging, loss of hair, bee stings, liver spots on the hands, bursitis, diaper rash, frostbite, stomach ulcer, heart attacks, labor pains, certain blood diseases, miscarriage, muscular dystrophy, poor posture, sexual impotence, sterility, infertility, menopause, sunburn, and lung damage from air pollution have not been proven. Although vitamin E is being used to prevent certain types of cancer, there is not enough information to show that this is effective.


Lack of vitamin E is extremely rare, except in people who have a disease in which it is not absorbed into the body.


Vitamin E is available without a prescription.


Importance of Diet


For good health, it is important that you eat a balanced and varied diet. Follow carefully any diet program your health care professional may recommend. For your specific dietary vitamin and/or mineral needs, ask your health care professional for a list of appropriate foods. If you think that you are not getting enough vitamins and/or minerals in your diet, you may choose to take a dietary supplement.


Vitamin E is found in various foods including vegetable oils (corn, cottonseed, soybean, safflower), wheat germ, whole-grain cereals, and green leafy vegetables. Cooking and storage may destroy some of the vitamin E in foods.


Vitamin supplements alone will not take the place of a good diet and will not provide energy. Your body also needs other substances found in food such as protein, minerals, carbohydrates, and fat. Vitamins themselves often cannot work without the presence of other foods. For example, small amounts of fat are needed so that vitamin E can be absorbed into the body.


The daily amount of vitamin E needed is defined in several different ways.


  • For U.S.—

  • Recommended Dietary Allowances (RDAs) are the amount of vitamins and minerals needed to provide for adequate nutrition in most healthy persons. RDAs for a given nutrient may vary depending on a person's age, sex, and physical condition (e.g., pregnancy).

  • Daily Values (DVs) are used on food and dietary supplement labels to indicate the percent of the recommended daily amount of each nutrient that a serving provides. DV replaces the previous designation of United States Recommended Daily Allowances (USRDAs).

  • For Canada—

  • Recommended Nutrient Intakes (RNIs) are used to determine the amounts of vitamins, minerals, and protein needed to provide adequate nutrition and lessen the risk of chronic disease.

Vitamin E is available in various forms, including d- or dl-alpha tocopheryl acetate, d- or dl-alpha tocopherol, and d- or dl-alpha tocopheryl acid succinate. In the past, the RDA for vitamin E have been expressed in Units. This term has been replaced by alpha tocopherol equivalents (alpha-TE) or milligrams (mg) of d-alpha tocopherol. One Unit is equivalent to 1 mg of dl-alpha tocopherol acetate or 0.6 mg d-alpha tocopherol. Most products available in stores continue to be labeled in Units.


Normal daily recommended intakes in milligrams (mg) of alpha tocopherol equivalents (mg alpha-TE) and Units for vitamin E are generally defined as follows:











































































     
     
     
     
     
PersonsU.S.Canada
mg

alpha-TE
Unitsmg

alpha-TE
Units 
Infants and children

Birth to 3 years of

age
3–65–103–45–6.7
4 to 6 years of age711.758.3
7 to 10 years of age711.76–810–13
Adolescent and adult

males
1016.76–1010–16.7
Adolescent and adult

females
8135–78.3–11.7
Pregnant females1016.78–913–15
Breast-feeding

females
11–1218–209–1015–16.7

Before Using Alpha-E


If you are taking this dietary supplement without a prescription, carefully read and follow any precautions on the label. For this supplement, 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


Problems in children have not been reported with intake of normal daily recommended amounts. You should check with your health care professional if you are giving your baby an unfortified formula. In that case, the baby must get the vitamins needed some other way. Some studies have shown that premature infants may have low levels of vitamin E. Your health care professional may recommend a vitamin E supplement.


Geriatric


Problems in older adults have not been reported with intake of normal daily recommended amounts.


Pregnancy








Pregnancy CategoryExplanation
All TrimestersAAdequate studies in pregnant women have not shown an increased risk of fetal abnormalities.

Breast Feeding


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


Interactions with Medicines


Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this dietary supplement, 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 dietary supplement 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.


  • Dicumarol

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


  • Warfarin

Interactions with Food/Tobacco/Alcohol


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


Other Medical Problems


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


  • Bleeding problems—Vitamin E, when taken in doses greater than 800 Units a day for long periods of time, may make this condition worse

Proper Use of vitamin e

This section provides information on the proper use of a number of products that contain vitamin e. It may not be specific to Alpha-E. Please read with care.


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 solution dosage form:
    • To prevent the following deficiencies in infants:
      • Infants receiving a formula high in polyunsaturated fatty acids—15 to 25 Units per day or 7 Units per 32 ounces of formula.

      • Infants with certain colon problems—15 to 25 Units per kilogram (kg) (6.8 to 11 Units per pound) of body weight per day. The water-soluble form of vitamin E must be used.

      • Infants of normal birthweight—5 Units per 32 ounces of formula.



  • For oral dosage forms (capsules, tablets, oral solution):
    • To prevent deficiency for individuals (other than infants), the amount taken by mouth is based on normal daily recommended intakes:
      • For the U.S.

      • Adult and teenage males—10 milligrams (mg) of alpha tocopherol equivalents (mg alpha-TE) or 16.7 Units per day.

      • Adult and teenage females—8 mg alpha-TE or 13 Units per day.

      • Pregnant females—10 mg alpha-TE or 16.7 Units per day.

      • Breast-feeding females—11 to 12 mg alpha-TE or 18 to 20 Units per day.

      • Children 4 to 10 years of age—7 mg alpha-TE or 11.7 Units per day.

      • Children birth to 3 years of age—3 to 6 mg alpha-TE or 5 to 10 Units per day.

      • For Canada

      • Adult and teenage males—6 to 10 mg alpha-TE or 10 to 16.7 Units per day.

      • Adult and teenage females—5 to 7 mg alpha-TE or 8.3 to 11.7 Units per day.

      • Pregnant females—8 to 9 mg alpha-TE or 13 to 15 Units per day.

      • Breast-feeding females—9 to 10 mg alpha-TE or 15 to 16.7 Units per day.

      • Children 7 to 10 years of age—6 to 8 mg alpha-TE or 10 to 13 Units per day.

      • Children 4 to 6 years of age—5 mg alpha-TE or 8.3 Units per day.

      • Children birth to 3 years of age—3 to 4 mg alpha-TE or 5 to 6.7 Units per day.


    • To treat deficiency:
      • Adults, teenagers, and children—Treatment dose is determined by prescriber for each individual based on the severity of deficiency.



For individuals taking the oral liquid form of this dietary supplement:


  • This preparation should be taken by mouth even though it comes in a dropper bottle.

  • This dietary supplement may be dropped directly into the mouth or mixed with cereal, fruit juice, or other food.

Missed Dose


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


Storage


Store the dietary supplement 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.


Alpha-E 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:


With doses greater than 400 Units a day and long-term use
  • Blurred vision

  • diarrhea

  • dizziness

  • headache

  • nausea or stomach cramps

  • unusual tiredness or weakness

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: Alpha-E 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 Alpha-E resources


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


Compare Alpha-E with other medications


  • Alzheimer's Disease
  • Anemia, Sickle Cell
  • Cystic Fibrosis
  • Dietary Supplementation
  • Nocturnal Leg Cramps
  • Retinopathy Prophylaxis
  • Tardive Dyskinesia
  • Vitamin E Deficiency

Alpha Lipoic


Generic Name: alpha-lipoic acid (AL fa lye POE ik AS id)

Brand Names: Alpha Lipoic, Alpha Lipoic Acid, Alpha-Lipoic-Acid-300


What is Alpha Lipoic (alpha-lipoic acid)?

Alpha-lipoic acid is a naturally occurring fatty acid that can be found in many foods such as yeast, spinach, broccoli, potatoes, and organ meats such as liver or kidney.


Alpha-lipoic acid has been used as a nutritional supplement and antioxidant.


Not all uses for alpha-lipoic acid have been approved by the FDA. Alpha-lipoic acid should not be substituted for medications prescribed for you by your doctor.

Alpha-lipoic acid is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.


Alpha-lipoic acid may also be used for purposes not listed in this product guide.


What is the most important information I should know about Alpha Lipoic (alpha-lipoic acid)?


Not all uses for alpha-lipoic acid have been approved by the FDA. Alpha-lipoic acid should not be substituted for medications prescribed for you by your doctor.

Alpha-lipoic acid is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.


Talk with a doctor, pharmacist, herbalist, or other healthcare provider before using alpha-lipoic acid if you have kidney or liver disease, diabetes, low blood sugar (hypoglycemia), or a thyroid disorder.


Use alpha-lipoic acid as directed on the label, or as your healthcare provider has prescribed. Do not use this product in larger amounts or for longer than recommended.


Taking alpha-lipoic acid may lower your blood sugar. Tell your doctor, pharmacist, herbalist, or other healthcare provider if you have symptoms such as hunger, weakness, nausea, irritability, dizziness, headache, blurred vision, confusion, sweating, fast heart rate, or fainting.

Less serious side effects are more likely to occur, and you may have none at all.


What should I discuss with my health care provider before taking Alpha Lipoic (alpha-lipoic acid)?


Ask a doctor, pharmacist, herbalist, or other healthcare provider if it is safe for you to use this product if you have:



  • liver disease;




  • kidney disease;




  • diabetes;




  • low blood sugar (hypoglycemia); or




  • a thyroid disorder.




It is not known whether alpha-lipoic acid will harm an unborn baby. Tell your healthcare provider if you are pregnant or plan to become pregnant while using this product. Alpha-lipoic acid can pass into breast milk and may harm a nursing baby. Do not use this product without telling your healthcare provider if you are breast-feeding a baby. Do not give any herbal/health supplement to a child without the advice of a doctor.

How should I take Alpha Lipoic (alpha-lipoic acid)?


When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.


If you choose to take alpha-lipoic acid, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of alpha-lipoic acid than is recommended on the label.


Some brands of alpha-lipoic acid may work best if you take it with food. Check the product label or ask your healthcare provider if you should take alpha-lipoic acid with food.

Your healthcare provider may occasionally change your dose to make sure you get the best results. The recommended dietary allowance of alpha-lipoic acid increases with age. Follow your healthcare provider's instructions. You may also consult the National Academy of Sciences "Dietary Reference Intake" or the U.S. Department of Agriculture's "Dietary Reference Intake" (formerly "Recommended Daily Allowances" or RDA) listings for more information.


Store at room temperature away from moisture and heat.

What happens if I miss a dose?


Consult your healthcare provider for instructions if you miss a 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 taking Alpha Lipoic (alpha-lipoic acid)?


Follow your healthcare provider's instructions about any restrictions on food, beverages, or activity.


Alpha Lipoic (alpha-lipoic acid) side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your healthcare provider if you have any of these signs of low blood sugar while taking alpha-lipoic acid:



  • hunger, weakness, nausea, irritability, tremors;




  • drowsiness, dizziness, headache, blurred vision;




  • confusion, trouble concentrating;




  • sweating, fast heart rate; or




  • feeling like you might pass out.



Less serious side effects may include:



  • upset stomach;




  • numbness or tingly feeling;




  • dizziness, tired feeling;




  • headache, muscle cramps; or




  • mild skin rash.



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


What other drugs will affect Alpha Lipoic (alpha-lipoic acid)?


Do not take alpha-lipoic acid without medical advice if you are using any of the following medications:

  • levothyroxine (Synthroid) and other thyroid medications; or




  • insulin or oral diabetes medications such as metformin (Glucophage), glyburide (DiaBeta, Glynase), and others.



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



More Alpha Lipoic resources


  • Alpha Lipoic Drug Interactions
  • Alpha Lipoic Support Group
  • 2 Reviews for Alpha Lipoic - Add your own review/rating


  • Alpha Lipoic Acid Natural MedFacts for Professionals (Wolters Kluwer)



Compare Alpha Lipoic with other medications


  • Dietary Supplementation


Where can I get more information?


  • Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.