Drugs Details

Drugs Info of Vexol
Drugs Details
  • Drugs Type  : FDA
  • Date : 24th Mar 2015 02:06 am
  • Brand Name : Vexol
  • Generic Name : rimexolone ophthalmic (Pronunciation: rye MEX oh lone off THAL mik)
Descriptions

VEXOL® 1% Ophthalmic Suspension is a sterile, multi-dose topical ophthalmic suspension containing the corticosteroid, rimexolone. Rimexolone is a white, water-insoluble powder with an empirical formula of C24H34O3 and a molecular weight of 370.53. Its chemical name is 11α-Hydroxy-16β, 17β-dimethyl-17-propionylandrosta-l,4-diene-3-one. The chemical structure of rimexolone is presented below:

VEXOL (rimexolone) structural formula illustration

Each mL Contains: Active ingredient: rimexolone 10 mg (1%). Preservative: benzalkonium chloride 0.01%. Inactive ingredients: carbomer 974P, polysorbate 80, sodium chloride, edetate disodium, sodium hydroxide and/or hydrochloric acid (to adjust pH) and purified water.

The pH of the suspension is 6.0 to 8.0 and the tonicity is 260 to 320 mOsmol/kg.

What are the possible side effects of rimexolone ophthalmic (Vexol)?

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.

Stop using rimexolone ophthalmic and call your doctor at once if you have a serious side effect such as:

  • vision changes, eye pain, or seeing halos around lights;
  • pain behind your eyes;
  • feeling like something is in your eye; or
  • eye swelling, redness, itching, severe discomfort, crusting or drainage (may be signs of infection).

Less serious side effects may...

Read All Potential Side Effects and See Pictures of Vexol »

What are the precautions when taking rimexolone (Vexol)?

Before using rimexolone, 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, especially of: eye infections, cataracts, glaucoma (open-angle type), severe nearsightedness (myopia), diabetes.

After you apply this drug, your vision may become temporarily blurred. Do not drive, use machinery, or do any activity that requires clear vision until you are sure you can perform such activities safely.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs,...

Read All Potential Precautions of Vexol »

This monograph has been modified to include the generic and brand name in many instances.

Indications

VEXOL® 1% (rimexolone ophthalmic suspension) is indicated for the treatment of postoperative inflammation following ocular surgery and in the treatment of anterior uveitis.

Dosage Administration

Post-Operative Inflammation

Apply one - two drops of VEXOL® 1% Ophthalmic Suspension into the conjunctival sac of the affected eye four times daily beginning 24 hours after surgery and continuing throughout the first 2 weeks of the postoperative period.

Anterior Uveitis

Apply one - two drops of VEXOL® 1% Ophthalmic Suspension into the conjunctival sac of the affected eye every hour during waking hours for the first week, one drop every two hours during waking hours of the second week, and then taper until uveitis is resolved.

How Supplied

5 mL and 10 mL in plastic DROP-TAINER® dispensers. VEXOL® 1% Ophthalmic Suspension is supplied in natural (clear) low density polyethylene (LDPE) bottles, with a natural LDPE dispensing plug and pink polypropylene closures. Fill volumes are 5 mL in an 8 mL bottle and 10 mL in a 10 mL bottle.

5 mL: NDC 0065-0627-07
10 mL: NDC 0065-0627-03

STORAGE: Store upright between 2°-25°C (36°-77°F).

DO NOT FREEZE.

SHAKE WELL BEFORE USING.

Alcon Laboratories, Inc., Fort Worth, Texas 76134 USA.

This monograph has been modified to include the generic and brand name in many instances.

Side Effects

Reactions associated with ophthalmic steroids include elevated intraocular pressure, which may be associated with optic nerve damage, visual acuity and field defects, posterior subcapsular cataract formation, secondary ocular infection from pathogens including herpes simplex, and perforation of the globe where there is thinning of the cornea or sclera.

Ocular adverse reactions occurring in 1 - 5% of patients in clinical studies of VEXOL® 1% (rimexolone ophthalmic suspension) included blurred vision, discharge, discomfort, ocular pain, increased intraocular pressure, foreign body sensation, hyperemia and pruritus.

Other ocular adverse reactions occurring in less than 1% of patients included sticky sensation, increased fibrin, dry eye, conjunctival edema, corneal staining, keratitis, tearing, photophobia, edema, irritation, corneal ulcer, browache, lid margin crusting, corneal edema, infiltrate, and corneal erosion.

Non-ocular adverse reactions occurred in less than 2% of patients. These included headache, hypotension, rhinitis, pharyngitis, and taste perversion.

Read the Vexol (rimexolone) Side Effects Center for a complete guide to possible side effects

Learn More »

Interactions

No information provided.

This monograph has been modified to include the generic and brand name in many instances.

Warnings

FOR TOPICAL OPHTHALMIC USE ONLY. Not for injection. Use in the treatment of herpes simplex infection requires great caution and frequent slit-lamp examinations. Prolonged use may result in ocular hypertension /glaucoma, damage to the optic nerve, defects in visual acuity and visual fields, and posterior subcapsular cataract formation.

Prolonged use may also result in secondary ocular infections due to suppression of host response.

Acute purulent infections of the eye may be masked or exacerbated by the presence of corticosteroid medication. In those diseases causing thinning of the cornea or sclera, perforation has been known to occur with topical steroids. It is advisable that the intraocular pressure be checked frequently.

Precautions

General

Fungal infections of the cornea are particularly prone to develop coincidentally with long-term local steroid application. Fungal invasion must be considered in any persistent corneal ulceration where a steroid has been or is in use.

For ophthalmic use only. Use of the same bottle for both eyes is not recommended with topical eye drops that are used in association with surgery.

The initial prescription and renewal of the medication order beyond 14 days should be made by a physician only after examination of the patient with the aid of magnification, such as slit lamp biomicroscopy and where appropriate, fluorescein staining. If signs and symptoms fail to improve after two days, the patient should be reevaluated. If this product is used for 10 days or longer, intraocular pressure should be monitored even though it may be difficult in children and uncooperative patients (see WARNINGS).

Carcinogenesis, mutagenesis, impairment of fertility

Rimexolone has been shown to be non-mutagenic in a battery of in vitro and in vivo mutagenicity assays.

Fertility and reproductive capability were not impaired in a study in rats with plasma levels (42 ng/mL) approximately 200 times those obtained in clinical studies after topical administration ( < 0.2 ng/mL). Long-term studies have not been conducted in animals or humans to evaluate the carcinogenic potential of rimexolone.

Pregnancy

Pregnancy Category C

Rimexolone has been shown to be teratogenic and embryotoxic in rabbits following subcutaneous administration at the lowest dose tested (0.5 mg/kg/day, approximately 2 times the recommended human ophthalmic dose). Corticosteroids are recognized to cause fetal resorptions and malformations in animals. There are no adequate and well-controlled studies in pregnant women. VEXOL® 1% (rimexolone ophthalmic suspension) should be used in pregnant women only if the potential benefit to the mother justifies the potential risk to the fetus.

Nursing Mothers

It is not known whether topical ophthalmic administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human breast milk. Nevertheless, caution should be exercised when topical corticosteroids are administered to a nursing woman; a decision should be made whether to discontinue nursing or discontinue therapy, taking into consideration the importance of the drug to the mother.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established.

Geriatric Use

No overall differences in safety or effectiveness have been observed between elderly and younger patients.

This monograph has been modified to include the generic and brand name in many instances.

OverDose

No information provided.

ContrainDications

VEXOL® 1% (rimexolone ophthalmic suspension) is contraindicated in epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, and most other viral diseases of the cornea and conjunctiva; mycobacterial infection of the eye; fungal diseases of the eye; acute purulent untreated infections which, like other diseases caused by microorganisms, may be masked or enhanced by the presence of the steroid; and in those persons with hypersensitivity to any component of the formulation.

This monograph has been modified to include the generic and brand name in many instances.

Clinical Pharamacology

Corticosteroids suppress the inflammatory response to a variety of inciting agents of a mechanical, chemical, or immunological nature. They inhibit edema, cellular infiltration, capillary dilatation, fibroblastic proliferation, deposition of collagen and scar formation associated with inflammation. Placebo-controlled clinical studies demonstrated that VEXOL® 1% Ophthalmic Suspension is efficacious for the treatment of anterior chamber inflammation following cataract surgery.

In two controlled clinical trials, VEXOL® 1% Ophthalmic Suspension demonstrated clinical equivalence to 1% prednisolone acetate in reducing uveitic inflammation. In a controlled 6-week study of steroid responsive subjects, the time to raise intraocular pressure was similar for VEXOL® 1% Ophthalmic Suspension and 0.1% fluorometholone given four times daily.

As with other topically administered ophthalmic drugs, VEXOL® 1% (rimexolone ophthalmic suspension) is absorbed systemically. Studies in normal volunteers dosed bilaterally once every hour during waking hours for one week have demonstrated serum concentrations ranging from less than 80 pg/mL to 470 pg/mL. The mean serum concentrations were approximately 130 pg/mL. Serum concentrations were at or near steady state after 5 to 7 hourly doses. After decreasing the dosing frequency to once every two hours while awake during the second week of administration, mean serum concentrations were approximately 100 pg/mL.

The serum half-life of rimexolone could not be reliably estimated due to the large number of samples below the quantitation limit of the assay (80 pg/mL). However, based on the time required to reach steady-state, the half-life appears to be short (1-2 hours).

Based upon in vivo and in vitro preclinical metabolism studies, and on in vitro results with human liver preparations, rimexolone undergoes extensive metabolism. Following IV administration of radio-labelled rimexolone to rats, greater than 80% of the dose is excreted via the feces as rimexolone and metabolites. Metabolites have been shown to be less active than parent drug, or inactive in human glucocorticoid receptor binding assays.

This monograph has been modified to include the generic and brand name in many instances.

Patient Information

Do not touch dropper tip to any surface, as this may contaminate the suspension.

This monograph has been modified to include the generic and brand name in many instances.

Consumer Overview Uses

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.

 

RIMEXOLONE SUSPENSION - OPHTHALMIC

 

(ri-MEX-oh-lone)

 

COMMON BRAND NAME(S): Vexol

 

USES: This medication is used to treat certain eye conditions due to inflammation or injury. It is also used after eye surgery. Rimexolone works by relieving symptoms such as swelling and redness. It belongs to a class of drugs known as corticosteroids.

 

HOW TO USE: Unless otherwise directed by your doctor, do not wear contact lenses while you are using this medicine. Sterilize contact lenses according to the manufacturer's directions, and check with your doctor before you begin using them again.

If your doctor does approve the wearing of contact lenses during treatment with this medication, remove the lenses before using the eye drops. The preservative in this product may be absorbed by contact lenses. Wait at least 15 minutes after each dose of the eye drop before wearing the lenses again.

To apply eye drops, wash your hands first. Shake the bottle well before using. To avoid contamination, do not touch the dropper tip or let it touch your eye or any other surface.

Tilt your head back, look upward, and pull down the lower eyelid to make a pouch. Hold the dropper directly over your eye and place 1 drop into the pouch. Look downward and gently close your eyes for 1 to 2 minutes. Place one finger at the corner of your eye (near the nose) and apply gentle pressure. This will prevent the medication from draining out. Try not to blink and do not rub your eye. Repeat these steps for your other eye if so directed and if your dose is for more than 1 drop.

Apply as often as directed by your doctor. Do not rinse the dropper. Replace the dropper cap after each use.

If you are using another kind of eye medication (for example, other drops or ointments), wait at least 5 to 10 minutes before applying other medications. Use eye drops before eye ointments to allow the drops to enter the eye.

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

The dosage and length of treatment are based on your medical condition and response to treatment. Do not use this medication more often or for longer than prescribed because doing so may increase your risk of side effects.

Continue to use this medication for the full time prescribed. Do not stop using this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.

Do not use this product if it becomes contaminated (for example, drops turn cloudy or a dark color). Use of contaminated eye medication can cause infection, serious damage to the eye, and loss of vision. Contact your doctor or pharmacist for more information.

Tell your doctor if your condition does not improve after 2 days or if it worsens.

Consumer Overview Side Effect

SIDE EFFECTS: Stinging/burning of the eyes for 1 to 2 minutes and temporary blurred vision may occur when you apply this medication. 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.

Use of this medication for prolonged periods or in high doses may cause serious eye problems (such as high pressure inside the eyes and cataracts). Tell your doctor immediately if any of these unlikely but serious side effects occur: vision problems, eye pain.

This medication may mask the signs of an eye infection. It may also put you at greater risk of developing an eye infection, especially with prolonged use. Report any new or worsening symptoms such as eye discharge/swelling/redness, vision problems, or no improvement of your current eye condition. Your doctor will need to adjust your treatment.

Tell your doctor immediately if any of these unlikely but serious side effects occur: headache, dizziness.

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 Vexol (rimexolone) Side Effects Center for a complete guide to possible side effects

Learn More »

PRECAUTIONS: Before using rimexolone, 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, especially of: eye infections, cataracts, glaucoma (open-angle type), severe nearsightedness (myopia), diabetes.

After you apply this drug, your vision may become temporarily blurred. Do not drive, use machinery, or do any activity that requires clear vision until you are sure you can perform such activities safely.

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

If you develop a new eye infection or injury, or require eye surgery, ask your doctor if you should continue to use your current bottle of rimexolone eye drops or start a new bottle.

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

It is not known if the medication in this product passes into breast milk. Consult your doctor before breast-feeding.

Consumer Overview Missed Dose

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 medicine may be harmful if swallowed. If swallowing or overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can 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 eye condition unless told to do so by your doctor. A different medication may be necessary in that case.

Laboratory and/or medical tests (such as eye exams, measurement of the pressure inside the eyes) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

 

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 the US product between 36-77 degrees F (2-25 degrees C).

Store the Canadian product between 36-86 degrees F (2-30 degrees C).

Store away from light and moisture. Do not freeze. Do not store in the bathroom. Keep the bottle upright and tightly closed when not in use. 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 March 2013. Copyright(c) 2013 First Databank, Inc.

Patient Detailed Side Effect

Brand Names: Vexol

Generic Name: rimexolone ophthalmic (Pronunciation: rye MEX oh lone off THAL mik)

  • What is rimexolone ophthalmic (Vexol)?
  • What are the possible side effects of rimexolone ophthalmic (Vexol)?
  • What is the most important information I should know about rimexolone ophthalmic (Vexol)?
  • What should I discuss with my healthcare provider before using rimexolone ophthalmic (Vexol)?
  • How should I use rimexolone ophthalmic (Vexol)?
  • What happens if I miss a dose (Vexol)?
  • What happens if I overdose (Vexol)?
  • What should I avoid while using rimexolone ophthalmic (Vexol)?
  • What other drugs will affect rimexolone ophthalmic (Vexol)?
  • Where can I get more information?

What is rimexolone ophthalmic (Vexol)?

Rimexolone ophthalmic is a steroid. It prevents the release of substances in the body that cause inflammation.

Rimexolone ophthalmic (for the eyes) is used to treat eye inflammation caused by infections, injury, surgery, or other conditions.

Rimexolone ophthalmic may also be used for purposes other than those listed in this medication guide.

What are the possible side effects of rimexolone ophthalmic (Vexol)?

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.

Stop using rimexolone ophthalmic and call your doctor at once if you have a serious side effect such as:

  • vision changes, eye pain, or seeing halos around lights;
  • pain behind your eyes;
  • feeling like something is in your eye; or
  • eye swelling, redness, itching, severe discomfort, crusting or drainage (may be signs of infection).

Less serious side effects may include:

  • blurred vision;
  • dry or watery eyes;
  • eyes being more sensitive to light;
  • headache;
  • runny nose, sore throat; or
  • unusual or unpleasant taste in your mouth.

Serious side effects are not expected with this medication. Rarely, an increase in the pressure inside of the eye, formation of cataracts, or perforation of the cornea have been reported. Talk to your doctor about any possible side effects.

More commonly, some burning, stinging, irritation, itching, redness, blurred vision, or sensitivity to light may occur.

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.

Read the Vexol (rimexolone) Side Effects Center for a complete guide to possible side effects

Learn More »

What is the most important information I should know about rimexolone ophthalmic (Vexol)?

You should not use this medication if you are allergic to rimexolone, or if you have a bacterial, viral, or fungal infection in your eye without also receiving proper anti-infective treatment.

You should not breast-feed while you are using rimexolone ophthalmic.

Your doctor may prescribe two separate bottles of rimexolone ophthalmic, one to use in each eye. This is to keep from passing infection from one eye to the other. Be sure to mark each bottle for the right or left eye, and use the eye drops from that bottle only in that eye.

Do not allow the tip of the dropper to touch any surface, including your eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.

Stop using rimexolone ophthalmic and call your doctor at once if you have vision changes, eye pain, seeing halos around lights, pain behind your eyes, feeling like something is in your eye, or any signs of infection (eye swelling, redness, itching, severe discomfort, crusting or drainage).

This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Side Effects Centers
  • Vexol

Patient Detailed How Take

What should I discuss with my healthcare provider before using rimexolone ophthalmic (Vexol)?

You should not use this medication if you are allergic to rimexolone, or if you have a bacterial, viral, or fungal infection in your eye without also receiving proper anti-infective treatment.

FDA pregnancy category C. It is not known whether rimexolone ophthalmic will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether rimexolone ophthalmic passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using rimexolone ophthalmic.

How should I use rimexolone ophthalmic (Vexol)?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Do not use this medication while wearing contact lenses. Rimexolone ophthalmic may contain a preservative that can discolor soft contact lenses. Wait at least 15 minutes after using rimexolone ophthalmic before putting your contact lenses in.

The usual dose of rimexolone ophthalmic is 1 or 2 drops into each affected eye. How often you use this medication will depend on the condition you are treating. Follow your doctor's instructions.

Your doctor may prescribe two separate bottles of rimexolone ophthalmic, one to use in each eye. This is to keep from passing infection from one eye to the other. Be sure to mark each bottle for the right or left eye, and use the eye drops from that bottle only in that eye.

Shake the medicine well just before using a dose.

Wash your hands before using eye medication.

To apply the eye drops:

  • Tilt your head back slightly and pull down your lower eyelid to create a small pocket. Hold the dropper above the eye with the tip down. Look up and away from the dropper as you squeeze out a drop, then close your eye.
  • Use only the number of drops your doctor has prescribed.
  • Gently press your finger to the inside corner of the eye (near your nose) for about 1 minute to keep the liquid from draining into your tear duct.
  • If you use more than one drop in the same eye, wait about 5 minutes before putting in the next drop.
  • Also wait at least 10 minutes before using any other eye drops that your doctor has prescribed.

Do not allow the tip of the dropper to touch any surface, including your eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.

Do not use the eye drops if the liquid has changed colors or has particles in it. Call your doctor for a new prescription.

Store in an upright position at room temperature, away from moisture and heat. Do not freeze. Keep the bottle tightly closed when not in use.

Side Effects Centers
  • Vexol

Patient Detailed Avoid Taking

What happens if I miss a dose (Vexol)?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose (Vexol)?

An overdose of rimexolone ophthalmic is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

What should I avoid while using rimexolone ophthalmic (Vexol)?

Do not use other eye medications during treatment with rimexolone ophthalmic unless your doctor tells you to.

This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

If you wear contact lenses, ask your doctor if you should wear them during treatment with rimexolone ophthalmic.

What other drugs will affect rimexolone ophthalmic (Vexol)?

Tell your doctor about all other medicines you use, especially an oral, nasal, inhaled, or injectable steroid medicine.

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

Where can I get more information?

Your doctor or pharmacist can provide more information about rimexolone ophthalmic.


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.

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