New medicines
Cholestagel
Composition: Colesevelam hydrochloride.
Presentation: Film-coated tablet.
Class: Bile acid sequestrant.
Indications: In conjunction with a statin as adjunctive therapy to diet
to provide additive reduction in LDL-cholesterol levels for patients
with primary hypercholesterolaemia who are not adequately controlled
with a statin alone. As monotherapy, adjunctive to diet, for reduction
in total and LDL-cholesterol levels for patients with isolated primary
hypercholesterolaemia in whom statin therapy is inappropriate or poorly
tolerated.
Dosage: Tablets should be taken with meals. As combination therapy with
statins the recommended dose is four to six tablets per day. The maximum
recommended dose is three tablets twice a day or six tablets once a day.
For monotherapy, the recommended starting dose is three tablets twice
a day or six tablets once a day. The maximum recommended dose for monotherapy
is seven tablets per day.
Contraindications: Bowel or biliary obstruction.
Precautions: Secondary causes of hypercholesterolaemia
(eg, poorly controlled diabetes, hypothyroidism, nephrotic syndrome,
dysproteinaemias, obstructive
liver disease, alcoholism, other drug therapies) should be excluded before
starting Cholestagel.
Patients with triglyceride levels greater than
3.4mmol/L should be treated with caution because of the triglyceride-increasing
effect of Cholestagel.
Caution should be exercised when treating patients
with dysphagia, swallowing disorders, severe gastrointestinal motility
disorders, inflammatory bowel disease, liver failure or previous major
gastrointestinal surgery
Cholestagel can induce or worsen constipation — this
risk should be considered especially for patients with coronary heart
disease or angina.
Bile acid sequestrants have been shown to reduce absorption
of vitamin K and interfere with the anticoagulant effect of warfarin — patients
receiving warfarin or similar medicines should have their anticoagulation
monitored closely.
Side effects: Common or very common (>=1/100) vomiting,
abnormal stools, headache, nausea, diarrhoea, abdominal pain, dyspepsia,
constipation,
flatulence.
Legal category: POM.
Net price: 180 x 625mg, £92.66.
Contact details: Genzyme, 4620 Kingsgate, Cascade Way, Oxford Business
Park South, Oxford OX4 2SU (tel
01865 405200).
Ecalta
Composition: Anidulafungin.
Presentation: Powder and solvent for concentrate for solution for infusion.
Class: Echinocandin antimycotic.
Indications: Treatment of invasive candidiasis in adult non-neutropenic
patients.
Dosage: A single loading dose of 200mg should be administered on day
1 followed by 100mg daily thereafter. It is recommended that treatment
with Ecalta is continued for at least 14 days after the last positive
culture. Ecalta should be administered at a rate not exceeding 1.1mg/minute.
Precautions: Ecalta should not be administered as a
bolus injection.
There are insufficient data to support treatment for
longer than 35 days.
Ecalta is not recommended for patients under 18
years of age.
The efficacy
of Ecalta for neutropenic patients with candidaemia and for patients
with deep tissue candidal infections or intra-abdominal abscess and peritonitis
has not been established.
Each 100mg dose of Ecalta also contains 6g
of ethanol, which should be considered when treating women who are pregnant
or breastfeeding, children, alcoholics and people with liver disease
or epilepsy.
Side effects: Common (>=1/100, <1/10) coagulopathy, convulsions,
headache, diarrhoea, vomiting, nausea, rash, pruritus, hypokalaemia,
flushing, increases in blood creatinine, alanine aminotransferase, alkaline
phosphatase, aspartate aminotransferase, bilirubin and gamma-glutamyltransferase.
Legal category: POM.
Net price: 1 x 100mg, £299.99.
Contact details: Pfizer Ltd, Ramsgate Road, Sandwich, Kent CT13 9NJ (tel
01304 616161).
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