The
Pharmaceutical Journal
Vol 280 No 7503 p621
24 May 2008
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New medicines Composition: Loteprednol etabonate. Steroids should be used with caution in the presence of glaucoma. Prolonged use of corticosteroids may suppress the host response and increase the possibility of secondary ocular infections. In diseases causing thinning of the cornea or sclera, perforations can occur with the use of topical steroids. In acute purulent conditions of the eye, steroids may mask infection or enhance existing infection. The use of steroids after cataract surgery may delay healing and increase the incidence of bleb formation. Long-term treatment with corticosteroids can allow fungal disease to occur, which should be considered in the differential diagnosis when a corneal ulcer persists. Lotemax contains benzalkonium chloride, which may cause eye irritation. Contact with soft contact lenses should be avoided. Patients should be advised to remove contact lenses prior to application and wait at least 15 minutes before reinsertion. If signs
and symptoms fail to improve after two days, the patient should be re-evaluated
and if Lotemax is used for 10 days or longer intraocular pressure should
be monitored.
Composition: Nilotinib. Complete blood counts should be performed every two weeks for the first two months and then monthly thereafter, or as clinically indicated. For grade 3–4 serum lipase elevations or grade 3–4 bilirubin elevations treatment should be reduced to 400mg once daily or interrupted. Patients with hepatic impairment should be treated with caution. Tasigna has been shown to prolong cardiac ventricular repolarisation, as measured by the QT interval, in a concentration-dependent manner. Significant prolongation of the QT interval, which could be fatal, may occur when nilotinib is inappropriately taken with strong CYP3A4 inhibitors, with medicinal products with a known potential to prolong QT, or with food. Hypokalaemia and hypomagnesaemia may further enhance this effect. Tasigna should be used with caution for patients who have or who are at significant risk of developing QT prolongation. Concomitant use of Tasigna with medicinal products that are potent inducers of CYP3A4 is likely to reduce levels of nilotinib to a clinically relevant extent. Concomitant
use of antacids, H2 blockers, or proton pump inhibitors with Tasigna
is not recommended. Common
(>=1/100, <1/10)
vomiting, abdominal pain, alopecia, myalgia, arthralgia, muscle spasms,
bone pain, anorexia, asthenia, peripheral oedema, palpitations, electrocardiogram
QT prolonged, febrile neutropenia, pancytopenia, dizziness, paraesthesia,
vertigo, dyspnoea, exertional dyspnoea, cough, dysphonia, abdominal discomfort,
dyspepsia, flatulence, night sweats, eczema, urticaria, erythema, hyperhidrosis,
dry skin, musculoskeletal chest pain, musculoskeletal pain, hypomagnesaemia,
hyperkalaemia, hyperglycaemia, hypertension, flushing, pyrexia, insomnia;
increased blood amylase, alanine aminotransferase, aspartate aminotransferase,
bilirubin, alkaline phosphatase, gamma-glutamyltransferase and creatinine
phosphokinase; increased and decreased weight. |
