Loprox Gel (Ciclopirox Gel)
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Loprox Gel (Ciclopirox Gel)

Loprox® Gel
(ciclopirox) 0.77%

DRUG DESCRIPTION

LOPROX® Gel (ciclopirox) 0.77% contains a synthetic antifungal agent, ciclopirox. It is intended for topical dermatologic use only.

Each gram of LOPROX® Gel contains 7.70 mg of ciclopirox in a gel consisting of Purified Water USP, Isopropyl Alcohol USP, Octyldodecanol NF, Dimethicone Copolyol 190, Carbomer 980, Sodium Hydroxide NF, and Docusate Sodium USP.

LOPROX® Gel (ciclopirox gel) is a white, slightly fluid gel.

The chemical name for ciclopirox is 6-cyclohexyl-1-hydroxy-4-methyl-2(1H)- pyridinone, with the empirical formula C12H17NO2 and a molecular weight of 207.27. The CAS Registry Number is [29342-05-0]. The chemical structure is:

LOPROX Gel (ciclopirox) Structural Formula Illustration

What are the possible side effects of ciclopirox topical (Loprox, Penlac Nail Lacquer)?

Serious side effects of ciclopirox topical use are not expected to occur. Stop using ciclopirox topical and contact your doctor if you experience unusual or severe itching, redness, burning, dryness, or irritation of the skin or discoloration or other changes in the nails.

Mild burning, itching, or redness may occur with use of ciclopirox topical shampoo.

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...

Read All Potential Side Effects and See Pictures of Loprox Gel »

What are the precautions when taking ciclopirox gel (Loprox Gel)?

Before using ciclopirox, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history.

Before having surgery, tell your doctors or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before...

Read All Potential Precautions of Loprox Gel »

Last reviewed on RxList: 11/5/2008
This monograph has been modified to include the generic and brand name in many instances.

INDICATIONS

Superficial Dermatophyte Infections

LOPROX® GeI is indicated for the topical treatment of interdigital tinea pedis and tinea corporis due to Trichophyton rubrum, Trichophyton mentagrophytes, or Epidermophyton floccosum.

Seborrheic Dermatitis

LOPROX® Gel (ciclopirox gel) is indicated for the topical treatment of seborrheic dermatitis of the scalp.

DOSAGE AND ADMINISTRATION

Superficial Dermatophyte Infections

Gently massage LOPROX® Gel (ciclopirox gel) into the affected areas and surrounding skin twice daily, in the morning and evening immediately after cleaning or washing the areas to be treated. Interdigital tinea pedis and tinea corporis should be treated for 4 weeks. If a patient shows no clinical improvement after 4 weeks of treatment, the diagnosis should be reviewed.

Seborrheic Dermatitis of the Scalp

Apply LOPROX Gel (ciclopirox gel) to affected scalp areas twice daily, in the morning and evening for 4 weeks. Clinical improvement usually occurs within the first week with continuing resolution of signs and symptoms through the fourth week of treatment. If a patient shows no clinical improvement after 4 weeks of treatment, the diagnosis should be reviewed.

HOW SUPPLIED

LOPROX® Gel (ciclopirox) 0.77% is supplied in 30 g tubes (NDC 99207-013-30), and 45 g tubes (NDC 99207-013-45).

Store at 15° - 30°C (59° - 86°F).

Prescribing Information as of September 2001. Manufactured for: MEDICIS, The Dermatology Company® Scottsdale, AZ 85258. By: Aventis Pharma Deutschland GmbH, D-65926 Frankfurt am Main. Made in Germany. FDA Rev date: 3/26/2003

Last reviewed on RxList: 11/5/2008
This monograph has been modified to include the generic and brand name in many instances.

SIDE EFFECTS

In clinical trials, 140 (39%) of 359 subjects treated with LOPROX® Gel (ciclopirox gel) reported adverse experiences, irrespective of relationship to test materials, which resulted in 8 subjects discontinuing treatment. The most frequent experience reported was skin burning sensation upon application, which occurred in approximately 34% of seborrheic dermatitis patients and 7% of tinea pedis patients. Adverse experiences occurring between 1% to 5% were contact dermatitis and pruritus. Other reactions that occurred in less than 1% included dry skin, acne, rash, alopecia, pain upon application, eye pain, and facial edema.

Read the Loprox Gel (ciclopirox gel) Side Effects Center for a complete guide to possible side effects »

DRUG INTERACTIONS

No information provided.

Last reviewed on RxList: 11/5/2008
This monograph has been modified to include the generic and brand name in many instances.

WARNINGS

LOPROX® Gel (ciclopirox gel) is not for ophthalmic, oral, or intravaginal use.

Keep out of reach of children.

PRECAUTIONS

If a reaction suggesting sensitivity or chemical irritation should occur with the use of LOPROX® Gel (ciclopirox gel) , treatment should be discontinued and appropriate therapy instituted. A transient burning sensation may occur, especially after application to sensitive areas. Avoid contact with eyes. Efficacy of LOPROX® Gel in immunosuppressed individuals has not been studied. Seborrheic dermatitis in association with acne, atopic dermatitis, Parkinsonism, psoriasis and rosacea has not been studied with LOPROX® Gel (ciclopirox gel) . Efficacy in the treatment of plantar and vesicular types of tinea pedis has not been established.

Carcinogenesis, Mutagenesis, Impairment of Fertility

A carcinogenicity study of ciclopirox (1% and 5% solutions in polyethylene glycol 400) in female mice dosed cutaneously twice per week for 50 weeks followed by a 6-month drug-free observation period prior to necropsy revealed no evidence of tumors at the application site.

The following battery of in vitro genotoxicity tests was conducted with ciclopirox: evaluation of gene mutation in the Ames Salmonella and E. coli assays (negative); chromosome aberration assays in V79 Chinese hamster cells, with and without metabolic activation (positive); gene mutation assays in the HGPRT-test with V79 Chinese hamster cells (negative); and a primary DNA damage assay (i.e., unscheduled DNA synthesis assay in A549 human cells) (negative). An in vitro cell transformation assay in BALB/c 3T3 cells was negative for cell transformation. In an in vivo Chinese hamster bone marrow cytogenetic assay, ciclopirox was negative for chromosome aberrations at 5000 mg/kg.

Pregnancy

Teratogenic effects: Pregnancy Category B

Reproduction studies of ciclopirox revealed no significant evidence of impaired fertility in rats exposed orally up to 5 mg/kg body weight (approximately 5 times the maximum recommended topical human dose based on surface area). No fetotoxicity was shown due to ciclopirox in the mouse, rat, rabbit, and monkey at oral doses up to 100, 30, 30, and 50 mg/kg body weight, respectively (approximately 37.5, 30, 44, and 77 times the maximum recommended topical human dose based on surface area). By the dermal route of administration, no fetotoxicity was shown due to ciclopirox in the rat and rabbit at doses up to 120 and 100 mg/kg body weight, respectively (approximately 121 and 147 times, respectively, the maximum recommended topical human dose based on surface area).

There are no adequate or well-controlled studies of topically applied ciclopirox in pregnant women. LOPROX® Gel (ciclopirox gel) should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nursing Mothers

It is not known whether this drug is excreted in human milk. Since many drugs are excreted in human milk, caution should be exercised when LOPROX® Gel (ciclopirox gel) is administered to a nursing woman.

Pediatric Use

The efficacy and safety of LOPROX® Gel (ciclopirox gel) in pediatric patients below the age of 16 years have not been established.

Last reviewed on RxList: 11/5/2008
This monograph has been modified to include the generic and brand name in many instances.

OVERDOSE

No information provided.

CONTRAINDICATIONS

LOPROX® Gel (ciclopirox gel) is contraindicated in individuals who have shown hypersensitivity to any of its components.

Last reviewed on RxList: 11/5/2008
This monograph has been modified to include the generic and brand name in many instances.

CLINICAL PHARMACOLOGY

Mechanism of Action

Ciclopirox acts by chelation of polyvalent cations (Fe3+ or Al3+) resulting in the inhibition of the metal-dependent enzymes that are responsible for the degradation of peroxides within the fungal cell.

In vitro studies showed that ciclopirox inhibited the formation of 5-lipoxygenase inflammatory mediators (5-HETE and LTB4) and also inhibited PGE2 release in a cell culture model. In vivo, ciclopirox inhibited inflammation in an arachidonic acid-induced murine ear edema model. The clinical significance of these findings is unknown.

Pharmacokinetics

A comparative study of the pharmacokinetics of LOPROX® GeI and LOPROX® Cream (ciclopirox olamine) 0.77% in 18 healthy males indicated that systemic absorption of ciclopirox from LOPROX® Gel (ciclopirox gel) was higher than that of LOPROX® Cream. A 5 gm dose of LOPROX® Gel (ciclopirox gel) produced a mean (±SD) peak serum concentration of 25.02 (±20.6) ng/mL total ciclopirox and 5 gm of LOPROX® Cream produced 18.62 (±13.56) ng/mL total ciclopirox. Approximately 3% of the applied ciclopirox was excreted in the urine within 48 hours after application, with a renal elimination half-life of about 5.5 hours.

In a study of LOPROX® Gel (ciclopirox gel) , 16 men with moderate to severe tinea cruris applied approximately 15 grams/day of the gel for 14.5 days. The mean (±SD) dose-normalized values of Cmax for total ciclopirox in serum were 100 (±42) ng/mL on Day 1 and 238 (±144) ng/mL on Day 15. During the 10 hours after dosing on Day 1, approximately 10% of the administered dose was excreted in the urine.

Microbiology

Ciclopirox is a hydroxypyridinone antifungal agent that inhibits the growth of pathogenic dermatophytes. Ciclopirox has been shown to be active against most strains of the following microorganisms both in vitro and in clinical infections as described in the INDICATIONS AND USAGE section:

Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum.

Last reviewed on RxList: 11/5/2008
This monograph has been modified to include the generic and brand name in many instances.

PATIENT INFORMATION

The patient should be told the following:

  1. Use LOPROX® Gel (ciclopirox gel) as directed by the physician. Avoid contact with the eyes and mucous membranes. LOPROX® Gel (ciclopirox gel) is for external use only.
  2. Use the medication for fungal infections for the full treatment time even though symptoms may have improved, and notify the physician if there is no improvement after 4 weeks.
  3. A transient burning/stinging sensation may be felt. This may occur in approximately 15% to 20% of cases, when LOPROX® Gel (ciclopirox gel) is used to treat seborrheic dermatitis of the scalp.
  4. Inform the physician if the area of application shows signs of increased irritation or possible sensitization (redness with itching, burning, blistering, swelling, and/or oozing).
  5. Avoid the use of occlusive dressings.
  6. Do not use this medication for any disorder other than that for which it is prescribed.

Last reviewed on RxList: 11/5/2008
This monograph has been modified to include the generic and brand name in many instances.

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PATIENT INFORMATION

The patient should be told the following:

  1. Use LOPROX® Gel (ciclopirox gel) as directed by the physician. Avoid contact with the eyes and mucous membranes. LOPROX® Gel (ciclopirox gel) is for external use only.
  2. Use the medication for fungal infections for the full treatment time even though symptoms may have improved, and notify the physician if there is no improvement after 4 weeks.
  3. A transient burning/stinging sensation may be felt. This may occur in approximately 15% to 20% of cases, when LOPROX® Gel (ciclopirox gel) is used to treat seborrheic dermatitis of the scalp.
  4. Inform the physician if the area of application shows signs of increased irritation or possible sensitization (redness with itching, burning, blistering, swelling, and/or oozing).
  5. Avoid the use of occlusive dressings.
  6. Do not use this medication for any disorder other than that for which it is prescribed.

Last reviewed on RxList: 11/5/2008
This monograph has been modified to include the generic and brand name in many instances.

Disclaimer

Loprox Gel Consumer

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

CICLOPIROX GEL - TOPICAL

(cyc-low-PIE-rocks)

COMMON BRAND NAME(S): Loprox

USES: This medication is used to treat certain fungal skin infections such as ringworm and athlete's foot between the toes. It is also used to treat a certain scalp condition (seborrheic dermatitis). Ciclopirox is an antifungal medication that works by stopping the growth of fungus.

HOW TO USE: Use this medication on the skin only. Clean and dry the area to be treated. Apply a thin layer of the medication on and around the affected area and gently rub into the skin or scalp, usually twice daily or as directed by your doctor. Wash your hands after using unless the area being treated includes the hands. Do not wrap, cover, or bandage the area unless directed to do so by your doctor.

Do not apply the medication in the eyes, nose, or mouth, or inside the vagina. If you do get the medication in those areas, rinse with plenty of water.

Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day.

Continue to use this medication for the full time prescribed, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.

Tell your doctor if your condition worsens or does not improve after 4 weeks.

Disclaimer

Loprox Gel Consumer (continued)

SIDE EFFECTS: Burning, stinging, redness, or itching at the application site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: blistering/swelling/oozing at the application site.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

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

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Read the Loprox Gel (ciclopirox gel) Side Effects Center for a complete guide to possible side effects »

PRECAUTIONS: Before using ciclopirox, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history.

Before having surgery, tell your doctors or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Disclaimer

Loprox Gel Consumer (continued)

DRUG INTERACTIONS: The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.

To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.

Keep a list of all the products you use. Share the list with your doctor and pharmacist to reduce your risk for serious medication problems.

OVERDOSE: This medication may be harmful if swallowed. If overdose or swallowing is suspected, contact a poison control center or emergency room immediately. US residents should call the US National Poison Hotline at 1-800-222-1222. Canada residents should call a provincial poison control center.

NOTES: Do not share this medication with others.

This medication has been prescribed for your current condition only. Do not use it later for another skin infection unless told to do so by your doctor. A different medication may be necessary in that case.

If you are treating athlete's foot, make sure to wear well-fitting, ventilated shoes. Also, change socks at least once daily.

MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE: Store at room temperature between 59-86 degrees F (15-30 degrees C) away from heat. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Information last revised May 2010. Copyright(c) 2010 First Databank, Inc.

Loprox Gel Patient Information Including Side Effects

Brand Names: Loprox, Penlac Nail Lacquer

Generic Name: ciclopirox topical (Pronunciation: sye kloe PEER ox)

What is ciclopirox topical (Loprox Gel)?

Ciclopirox is an antifungal medication. Ciclopirox topical prevents fungus from growing.

Ciclopirox topical cream and lotion formulations are used to treat skin infections such as athlete's foot, jock itch, ringworm, and yeast infections. Ciclopirox shampoo is used to treat seborrheic dermatitis (inflammatory skin condition) of the scalp. Ciclopirox topical nail lacquer is used to treat fungal infections of the toenails and fingernails.

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

What are the possible side effects of ciclopirox topical (Loprox Gel)?

Serious side effects of ciclopirox topical use are not expected to occur. Stop using ciclopirox topical and contact your doctor if you experience unusual or severe itching, redness, burning, dryness, or irritation of the skin or discoloration or other changes in the nails.

Mild burning, itching, or redness may occur with use of ciclopirox topical shampoo.

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.

Read the Loprox Gel (ciclopirox gel) Side Effects Center for a complete guide to possible side effects »

What is the most important information I should know about ciclopirox topical (Loprox Gel)?

Avoid getting ciclopirox topical in the eyes, nose, or mouth.

Do not use bandages or dressings that do not allow air to circulate (occlusive dressings) on areas treated with ciclopirox cream or lotion, unless otherwise directed by your doctor. Wear loose-fitting clothing (preferably cotton).

Use ciclopirox topical nail lacquer on nails and immediately surrounding skin only.

Ciclopirox topical nail lacquer is flammable, keep it away from heat and flame.

Use ciclopirox topical for the full amount of time prescribed by your doctor. Your symptoms may improve before the infection is completely healed however, it is important to use the medication for the full amount of time.

Loprox Gel Patient Information including How Should I Take

What should I discuss with my healthcare provider before using ciclopirox topical (Loprox Gel)?

Do not use ciclopirox topical if you have had an allergic reaction to it in the past.

Before using ciclopirox topical, tell your doctor if you

  • have diabetes;
  • are immunosuppressed (e.g., have received an organ transplant or have AIDS);
  • take medication to control epilepsy or another seizure disorder;
  • use a topical corticosteroid on a regular basis; or
  • use a steroid inhaler on a regular basis.

You may not be able to use ciclopirox topical nail lacquer or you may require a dosage adjustment or special monitoring during your treatment .

Ciclopirox topical is the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not use ciclopirox topical without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether ciclopirox passes into breast milk. Do not use ciclopirox topical without first talking to your doctor if you are breast-feeding a baby.

How should I use ciclopirox topical (Loprox Gel)?

Use ciclopirox topical exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

To use ciclopirox topical cream or lotion:

  • Wash your hands before and after using this medication, unless you are using ciclopirox topical to treat a hand condition.
  • Clean and dry the affected area. Apply a small amount of the cream (usually twice daily) for 2 to 4 weeks. Follow your doctor's instructions.
  • Do not use bandages or dressings that do not allow air to circulate (occlusive dressings) on areas treated with ciclopirox cream or lotion, unless otherwise directed by your doctor. Wear loose-fitting clothing (preferably cotton).
  • If the infection does not clear up in 4 weeks, or if it appears to get worse, see your doctor.

To use ciclopirox shampoo:

  • Wet the hair and apply approximately 1 teaspoon (5 mL) of the shampoo to the scalp. Up to 2 teaspoons (10 mL) may be used for long hair. Lather and leave on the hair and scalp for 3 minutes. A timer may be used. Rinse off the shampoo after 3 minutes have passed.
  • Avoid contact with the eyes, nose, and inside of the mouth.
  • Treatment should be repeated twice per week for 4 weeks, with a minimum of 3 days between applications. If no improvement is seen after 4 weeks of treatment, contact your doctor.

To use ciclopirox topical nail lacquer:

  • Remove any loose nail or nail material using nail clippers or a nail file.
  • Apply ciclopirox topical nail lacquer once daily (preferably at bedtime) to all affected nails with the applicator brush provided. Apply the lacquer evenly over the entire nail. Where possible, apply the nail laquer to the underside of the nail and to the skin beneath it. Allow the lacquer to dry (approximately 30 seconds) before putting on socks or stockings. After applying the medication, wait 8 hours before taking a bath or shower.
  • Apply ciclopirox topical nail lacquer daily over the previous coat. Once a week, remove ciclopirox topical nail lacquer with alcohol. Remove as much as possible of the damaged nail using nail clippers or nail a file.
  • Use ciclopirox topical nail lacquer on nails and immediately surrounding skin only. Avoid contact with other areas.
  • Treatment with ciclopirox topical nail lacquer may require six months or more before initial improvement of symptoms is noticed. Up to 48 weeks of daily application of the nail lacquer, monthly removal of the unattached infected nail by a health care professional, and weekly trimming by the patient may be required for complete treatment.
  • To prevent the screw cap from sticking to the bottle, do not allow the solution to get into the bottle treads. To prevent the solution from drying out, close the bottle tightly after every use.

Use ciclopirox topical for the full amount of time prescribed by your doctor. Your symptoms may improve before the infection is completely healed however, it is important to use the medication for the full amount of time.

Avoid getting ciclopirox topical in the eyes, nose, or mouth.

Store ciclopirox topical at room temperature away from moisture and heat. Ciclopirox topical nail lacquer is flammable, keep it away from heat and flame. Protect the ciclopirox topical nail lacquer from light by storing the bottle in the carton after every use. Once a bottle of ciclopirox topical shampoo is opened, it should be used within 8 weeks.

Loprox Gel Patient Information including If I Miss a Dose

What happens if I miss a dose (Loprox Gel)?

Apply the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the dose you missed and apply only the regular amount of ciclopirox topical. Do not use a double dose unless otherwise directed by your doctor.

What happens if I overdose (Loprox Gel)?

An overdose of ciclopirox topical is unlikely to occur. If you do suspect that a much larger than normal dose has been used or that ciclopirox topical has been ingested, contact an emergency room or a poison control center.

What should I avoid while using ciclopirox topical (Loprox Gel)?

Avoid wearing tight-fitting, synthetic clothing that doesn't allow air circulation. Wear loose-fitting clothing made of cotton and other natural fibers until the infection is healed.

Do not use nail polish, artificial nails, or other cosmetic nail products on the nails treated with ciclopirox topical nail lacquer.

What other drugs will affect ciclopirox topical (Loprox Gel)?

Avoid using other topical products at the same time unless directed otherwise by your doctor. Other skin medications may affect the absorption or effectiveness of ciclopirox topical formulations.

Do not use nail polish, artificial nails, or other cosmetic nail products on the nails treated with ciclopirox topical nail lacquer.

Drugs other than those listed here may also interact with ciclopirox topical. Talk to your doctor and pharmacist before taking or using any other prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

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


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.04. Revision date: 12/15/2010.

Your use of the content provided in this service indicates that you have read,understood and agree to the End-User License Agreement,which can be accessed by clicking on this link.

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