Prescription Products
Ebixa tablets and oral drops
Composition: Memantine hydro-chloride
tablets 10mg, oral drops 10mg/g.
Presentation: Film-coated tablets and oral drops.
Class: N-methyl-D-aspartate (NMDA) receptor antagonist.
Indications: Treatment of moderately severe to severe stages of Alzheimer’s
disease.
Dosage: Treatment should be started with 5mg (10 drops) daily for the
first week, followed by 10mg daily for the second week and 15mg daily
for the third week. The recommended maintenance dose, from the fourth
week, is 20mg daily. Maximum daily dose is 20mg.
Major cautions: Memantine is not recommended in patients with severe renal
impairment. Caution is recommended in patients with epilepsy. Some factors
that may raise urine pH may necessitate careful monitoring of the patient.
Concomitant use of NMDA-antagonists such as amantadine, ketamine or dextromethorphan
should be avoided. Interactions between memantine and the following drugs
may occur: L-dopa, dopaminergic agonists, anticholinergics, cimetidine,
ranitidine, procainamide, quinidine, quinine, nicotine, hydrochlorothiazide.
Memantine should not be used during pregnancy unless clearly necessary.
Women taking memantine should not breast-feed. Safety and efficacy in
children and adolescents under the age of 18 years have not been established.
Side effects: Common (1–10 per cent) adverse reactions are hallucinations,
confusion, dizziness, headache and tiredness.
Legal category: POM.
Net price: Tablets 28 £37.10, 56 £74.20, 112 £148.40;
oral drops 50g £66.25, 100g £132.50.
Contact details: Lundbeck, Lundbeck House, Caldecotte Lake Business Park,
Caldecotte, Milton Keynes MK7 8LF. Tel 01908 649966, fax 01908 647888.
See SPC for further details.
Tracleer tablets
Composition: Bosentan 62.5mg and 125mg.
Presentation: Film-coated tablets.
Class: Endothelial receptor antagonist.
Indications: Treatment of pulmonary hypertension to improve exercise capacity
and symptoms in patients with grade III functional status.
Dosage: Treatment should be initiated at a dose of 62.5mg twice daily
for four weeks and then increased to a maintenance dose of 125mg twice
daily.
Major cautions and contra-indications: Bosentan should only be initiated
if the systolic blood
pressure is higher than 85mmHg. Bosentan is contraindicated in the following:
moderate to severe hepatic impairment (Child-Pugh Class B or C); baseline
values of liver aminotransferases (aspartate aminotransferases and/or
alanine amino-
transferases) greater than three times the upper limit of normal; concomitant
use of ciclosporin A; pregnancy; women of childbearing potential who are
not using a reliable method of contraception. Liver aminotransferase levels
must be measured and it is recommended that haemoglobin concentrations
be checked. Bosentan should not be used concomitantly with glibenclamide
and concomitant use with fluconazole, a CYP3A4 inhibitor (such as ketoconazole,
itraconazole and ritonavir) or a CYP2CP inhibitor (such as voriconazole)
is not recommended. Nursing mothers taking bosentan should be advised
to discontinue breast-feeding. Safety and efficacy in patients under 12
years have not been established.
Side effects: Adverse reactions that occurred more frequently in patients
taking bosentan (Ž3 per cent) than in those taking placebo are headache,
flushing, abnormal hepatic function, leg oedema and anaemia.
Legal category: POM.
Net price: Both strengths 56 £1,615.
Contact details: Actelion Pharmaceuticals, 500 Chiswick High Road, Chiswick,
London W4 5RG. Tel 020 8956 2601, fax 020 8956 2512.
See SPC for further details.
Elidel cream
Composition: Pimecrolimus 10mg/g.
Presentation: Cream.
Action: Blocks synthesis of inflammatory cytokines in T cells.
Indications: For short-term treatment of signs and symptoms, and intermittent
long-term treatment for prevention of progression to flares, in patients
with mild to moderate atopic dermatitis (eczema) aged two years and over.
Dosage: A thin layer of pimecrolimus cream should be applied to the affected
skin twice daily.
Major cautions and contra-indications: Pimecrolimus should not be applied
to areas affected by acute cutaneous viral infections (herpes simplex,
chickenpox). Before starting treatment, clinically infected atopic dermatitis
treatment sites should be cleared of infections. In the presence of herpes
simplex skin infections, pimecrolimus should be discontinued at the site
of the infection until the infection has cleared. Pimecrolimus can not
be recommended in patients with erythroderma and is not recommended in
patients with Netherton’s syndrome. Pimecrolimus should not be used
concomitantly with topical corticosteroids or other topical anti-inflammatory
products. Excessive exposure of the skin to ultraviolet light should be
avoided. Pimecrolimus should not be used during pregnancy. Breast-feeding
mothers may use pimecrolimus but should not apply it to the breast.
Side effects: Very common (Ž10 per cent) adverse event is application
site burning. Common adverse events are application site reactions (irritation,
pruritus and erythema), skin infections (folliculitis).
Legal category: POM.
Net price: 30g £19.69.
Contact details: Novartis Pharmaceuticals, Frimley Business Park, Frimley,
Camberley, Surrey GU16 7SR. Tel medical information 01276 698370; customer
care (for orders) 0845 741 9442.
See SPC for further details.
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