Trobicin

In the US, Trobicin (spectinomycin systemic) is a member of the drug class miscellaneous antibiotics and is used to treat Gonococcal Infection, Gonococcal Infection - Disseminated and Gonococcal Infection - Uncomplicated.

US matches:

• Trobicin


• Trobicin Intramuscular

Ingredient matches for Trobicin

Spectinomycin

Spectinomycin is reported as an ingredient of Trobicin in the following countries:

• Bulgaria

Spectinomycin dihydrochloride (a derivative of Spectinomycin) is reported as an ingredient of Trobicin in the following countries:

• Belgium


• Colombia


• Georgia


• Hong Kong


• India


• Italy


• Japan


• Latvia


• Luxembourg


• Peru


• Portugal


• Singapore


• South Africa


• United States


• Vietnam

International Drug Name Search

Brevibloc

Generic Name: Esmolol Hydrochloride
Class: beta-Adrenergic Blocking Agents
VA Class: CV100
Chemical Name: 4-[2-Hydroxy-3-[(1-methylethyl)amino]propoxy]benzenepropanoic acid methyl ester hydrochloride
Molecular Formula: C₁₆H₂₅NO₄•ClH
CAS Number: 81161-17-3

Introduction

Short-acting β₁-selective adrenergic blocking agent.^{1 2 17 18 113 167}

Uses for Brevibloc

Supraventricular Tachyarrhythmias (SVT)

Rapid, temporary control of ventricular rate in patients with atrial flutter and/or fibrillation associated with surgical or other manipulative procedures (e.g., cardiac catheterization), or other emergent situations requiring short-term control of ventricular rate.^{1 2 5 51 52 53 54 55 56 57 58 59 68 87 88 100 113 143 152 167}

β-Adrenergic blocking agents, including esmolol, are one of several preferred antiarrhythmic agents for the treatment of stable, narrow-complex supraventricular tachycardias (e.g., paroxysmal supraventricular tachycardia [reentry supraventricular tachycardia], ectopic or multifocal atrial tachycardia, junctional tachycardia) if the rhythm is not controlled by vagal maneuvers or adenosine in patients with preserved left ventricular function and for rate control in atrial fibrillation or flutter in patients with preserved left ventricular function.¹⁶⁷

May be useful in patients with noncompensatory sinus tachycardia for short-term control of rapid heart rate requiring intervention.^{1 2 37 59 60 61 62 63 64 65 66 67 68}

Not intended for chronic use when other more appropriate antiarrhythmic agents would be preferred.^{1 2}

Hypertension

Treatment of intraoperative and postoperative hypertension and/or tachycardia.^a Has been used effectively for prevention or treatment of increases in BP associated with surgical events,^{63 64 71 72 73 74 75 109 113 125 142} including hypertensive crises (i.e., emergencies and urgencies).¹⁴² However, use for prevention of such events is not recommended by the manufacturer.^a

Management of hypertensive urgencies or emergencies in adults.¹⁴²

Rapid reduction of BP in the management of hypertensive urgencies or emergencies in pediatric patients 1–17 years of age†.¹⁵⁴

Treatment to produce controlled hypotension† during anesthesia in order to reduce bleeding resulting from surgical procedures (e.g., orthopedic surgery, neurosurgery).^{75 114 124}

AMI

Has been used for the management of acute tachyarrhythmias complicating AMI†^{15 24 25 167} and to minimize myocardial ischemia following AMI†.^{13 15 24 25 58 113 167}

Unstable Angina and Non-ST-Segment Elevation MI

A β-blocker is used as part of standard therapeutic measures, including aspirin and/or clopidogrel, low-molecular weight or unfractionated heparin, and nitrates followed by either conservative medical management or early aggressive management (e.g., angiographic evaluation and revascularization procedures) as required.^{144 149 150 167}

ACC and AHA recommend an IV β-blocker followed by oral β-blocker therapy for patients with unstable angina at high risk of death or nonfatal MI† who do not have contraindications to these drugs.¹⁴⁹ β-Blockers without intrinsic sympathomimetic activity (e.g., metoprolol, atenolol, propranolol, esmolol) are preferred to manage unstable angina.¹⁴⁹ Oral β-blocker therapy is recommended for lower-risk patients.¹⁴⁹

Brevibloc Dosage and Administration

Administration

Administer by IV infusion.¹

May administer by direct IV injection for immediate control of intraoperative tachyarrhythmia and/or hypertension.^a

Constant infusion is preferred for rapid BP reduction in children† due to short duration of action.¹⁵⁴

IV Administration

For solution and drug compatibility information, see Compatibility under Stability.

IV infusion usually administered via controlled infusion device to facilitate dosage titration.^{52 53 54 61 114 126}

Esmolol hydrochloride concentrate (250 mg/mL) is not for direct IV injection and must be diluted prior to administration.^{1 2 3} Alternatively, use esmolol hydrochloride for injection (10 or 20 mg/mL) in ready-to-use vials or premixed injection (10 or 20 mg/mL) in ready-to-use bags for direct IV injection and infusion.^a

Some clinicians state that an auxiliary label with the indication esmolol hydrochloride concentrate is not for direct injection and must be diluted before administration should be affixed to the ampul containing the concentrate.^{137 138}

Take care to avoid extravasation.^a Avoid using butterfly needles and very small veins for infusion.^{1 114} Use alternate infusion site if local reaction occurs at infusion site.¹ Infusion concentration of 20 mg/mL associated with more serious venous irritation (e.g., thrombophlebitis) than 10-mg/mL solution.^a Extravasation of 20-mg/mL solution may cause serious local reaction and possibly skin necrosis.^{1 2 3}

Do not introduce additives into premixed solutions in ready-to-use bags.^{1 a}

Do not use the premixed injection in series connections with other plastic containers since such use could result in air embolism.¹

Infusion bag for premixed solution contains 2 outlet ports.¹ Use medication port on the bag only for withdrawing an initial loading dose for direct IV injection.^a Sterility cannot be guaranteed with repeated withdrawals; once drug has been withdrawn from the bag, use the solution within 24 hours.^a

Dilution

For IV infusion, dilute esmolol hydrochloride concentrate (250 mg/mL) to a final concentration of 10 mg/mL by adding 5 g of esmolol hydrochloride to a 500-mL container of compatible IV infusion solution (see Compatibility under Stability);^{1 2 3} alternatively, dilute 2.5 g in 250 mL of a compatible IV infusion solution.^a Prior to dilution, remove an appropriate amount of solution (according to overfill) from the diluent container.¹

Use of the concentrate (with propylene glycol in formulation) diluted to a concentration >10 mg/mL has caused a higher incidence of venous irritation with continued infusion;^a however, use of the concentrate diluted to a concentration >10 mg/mL has been well tolerated when administered via central vein.^a

Rate of Administration

Administer 500-mcg/kg loading doses over 1 minute, followed by IV infusion of the drug.^a Rate of IV infusion determined by patient response and tolerance.^{1 51 52 53 54 55 58 59 60 61 64 65 66 67 68}

For immediate control of intraoperative hypertension and/or tachycardia, administer initial 80-mg bolus dose by IV injection over 30 seconds, followed by IV infusion, if necessary.^a

Dosage

Available as esmolol hydrochloride; dosage expressed in terms of the salt.^a

Pediatric Patients

Hypertension

Rapid Reduction of BP in Hypertensive Urgencies or Emergencies†

IV

Children and adolescents 1–17 years of age: 100–500 mcg/kg per minute as constant infusion.¹⁵⁴

Adults

SVT

IV

Loading dose of 500 mcg/kg per minute for 1 minute,^{1 51 52 53 54 55 58 167} followed by maintenance infusion of 50 mcg/kg per minute for 4 minutes.^{1 2 3 51 52 53 54 167}

If desired response is not attained within first 5 minutes, may increase infusion rate in 50-mcg/kg per minute increments (i.e., to 100 mcg/kg per minute, then to 150 mcg/kg per minute) up to a maximum of 200 mcg/kg per minute; maintain each new rate for 4 or more minutes.¹ Alternatively, some experts recommend a second loading dose of 500 mcg/kg per minute for 1 minute, followed by maintenance infusion of 100 mcg/kg per minute (maximum infusion rate is 300 mcg/kg per minute).¹⁶⁷

Adjust rate and duration of infusion carefully according to patient’s tolerance and response (as indicated by ventricular rate and BP).^{1 51 52 53 54 55 58 143 150}

Average maintenance dosage: 100 mcg/kg per minute (range: 50–200 mcg/kg per minute).^{1 2 3 51 52 53 54 55 58} Adequate heart rate control may occur with dosage as low as 25 mcg/kg per minute.^{1 55}

Transfer to alternative antiarrhythmic therapy (e.g., longer-acting β-blocker, digoxin, verapamil) when adequate control of heart rate has been achieved and patient is stabilized.¹

Rapid Dosage Titration (if rapid slowing of ventricular response is required)

IV

Loading dose of 500 mcg/kg per minute for 1 minute,^{1 51 52 53 54 55 58 143 167} followed by maintenance infusion of 50 mcg/kg per minute for 4 minutes.^{1 2 3 51 52 53 54 143 167}

Administer second loading dose of 500 mcg/kg per minute for 1 minute,^{1 2 3 51 52 53 54 143 167} followed by maintenance infusion of 100 mcg/kg per minute for 4 minutes.^{1 2 3 51 52 53 54 143 167}

If necessary, administer a third and final loading dose of 500 mcg/kg per minute for 1 minute, followed by 150 mcg/kg per minute for 4 minutes.^{1 52 55 57 58}

If needed (without a fourth loading dose), increase maintenance dosage to maximum of 200 mcg/kg per minute.^{1 52 55 57 58}

Once the desired ventricular rate¹ or a patient tolerance end point (e.g., reduction in BP)^{52 53 54} has been nearly achieved,^{1 114} omit loading doses and titrate maintenance infusion rate upward (to 200 mcg/kg per minute) or downward as appropriate; may increase interval between dosage increments.¹

Transfer to Alternative Antiarrhythmics

IV

Decrease esmolol infusion rate by 50% 30 minutes after the first dose of the alternative drug; if adequate response is maintained for ≥1 hour after the second dose of the alternative drug, discontinue esmolol.¹

Consider dosing guidelines for the alternative drug when determining the appropriateness of this guideline for transferring therapy.¹

Hypertension

Immediate Control of Intraoperative Hypertension and/or Tachycardia

IV

80 mg (approximately 1 mg/kg) by direct IV injection over 30 seconds; if necessary, follow with IV infusion of 150 mcg/kg per minute.¹

Adjust as required to maintain desired heart rate and/or BP (maximum 300 mcg/kg per minute).¹

Gradual Control of Intraoperative and Postoperative Hypertension and/or Tachycardia

IV

Loading dose of 500 mcg/kg per minute for 1 minute followed by maintenance infusion of 50 mcg/kg per minute for 4 minutes.^a If desired response is not attained within first 5 minutes, administer second loading dose of 500 mcg/kg per minute for 1 minute followed by maintenance infusion of 100 mcg/kg per minute.^a

Adjust dosage using titration schedule recommended for treatment of SVT;¹ however, higher dosages (e.g., 250–300 mcg/kg per minute) may be required for adequate control of BP.¹

Hypertensive Emergency

IV

Loading dose of 250–500 mcg/kg over 1 minute, followed by 50–100 mcg/kg per minute for 4 minutes;¹⁴² may repeat loading dose or increase infusion rate to 300 mcg/kg per minute as tolerated.¹⁵³

Initial goal is ≤25% reduction of mean arterial BP within minutes to 1 hour, followed by further reduction (if stable) toward 160/100–110 mm Hg within next 2–6 hours.¹⁴²

Implement further gradual reductions toward normal over next 24–48 hours if this BP is well tolerated and patient is clinically stable.¹⁵³

Avoid excessive declines in pressure that could precipitate renal, cerebral, or coronary ischemia.¹⁴²

In patients with aortic dissection, reduce SBP to <100 mm Hg if tolerated.¹⁵³

Production of Controlled Hypotension† during Anesthesia

IV

Dosage has been titrated upward to a level necessary to maintain the required reduction in BP (e.g., a 15% reduction in mean arterial pressure) or until maximum rate of 300 mcg/kg per minute is reached.^{75 124 126}

AMI†

IV

Loading dose of 500 mcg/kg per minute for 1 minute, followed by maintenance infusion of 50 mcg/kg per minute for 4 minutes.²⁴

If necessary, gradually titrate upward (using titration regimen similar to that for SVT) until desired response or maximum dosage of 300 mcg/kg per minute is reached or SBP is decreased to <90 mm Hg.²⁴

Unstable Angina or Non-ST-segment Elevation MI†

IV

Initially, 100 mcg/kg per minute followed by increments of 50 mcg/kg per minute every 10–15 minutes as tolerated (by effect on BP) until desired response occurs, limiting symptoms develop, or dosage of 300 mcg/kg per minute is achieved.¹⁴⁹

May administer loading dose of 500 mcg/kg over 2–5 minutes for more rapid onset.¹⁴⁹

Target resting heart rate in unstable angina is 50–60 bpm in the absence of dose-limiting adverse effects.¹⁴⁹

Prescribing Limits

Adults

SVT

IV

Manufacturer recommends maximum maintenance dosage of 200 mcg/kg per minute.^a Maintenance dosages as high as 300 mcg/kg per minute have been used^{1 2 3 51 52 53 54 55 58 167} but provide little added benefit and increase the incidence of adverse effects.^{1 2 51 53 58 114} Safety of maintenance dosages >300 mcg/kg per minute not established.^{1 3}

Administered for ≤24 hours in most patients;^{1 2 55} limited data indicate that infusions may be well tolerated for up to 48 hours.^{1 143}

Hypertension

Intraoperative and Postoperative Hypertension and/or Tachycardia

IV

Maximum 300 mcg/kg per minute.¹

Special Populations

Renal Impairment

Administer with caution, especially in patients with severe renal impairment.^{1 2}

Cautions for Brevibloc

Contraindications

• 
  

  Cardiogenic shock.¹

  
  


• 
  

  Overt cardiac failure.^{1 150}

  
  


• 
  

  Second- or third-degree AV block.^{1 150}

  
  


• 
  

  Sinus bradycardia.¹

  
  

Warnings/Precautions

Warnings

Hypotension

Risk of hypotension,^{1 2 24 50 51 54 55 56 57 58 59 63 100 113 114 122 167} occasionally symptomatic (e.g., manifested as diaphoresis or dizziness).^{1 2 50 51 54 55 58} Can occur at any dose level but usually is dose related.^{1 2 51 53 58} Doses >200 mcg/kg per minute not recommended by manufacturer for SVT management.^{1 2 114}

Dosage reduction or discontinuance of drug usually results in reversal of hypotension within 30 minutes.¹

Monitor BP closely, especially in patients with low pretreatment BP (e.g., SBP <105 mm Hg).^{1 2 55 58 114 143 150}

Intraoperative or Postoperative Hypertension

Do not use when hypertension is principally due to hypothermia-associated vasoconstriction.¹

Cardiac Failure

Possible precipitation of CHF in patients with inadequate cardiac function; use with caution in such patients.^{1 2} Prolonged β-adrenergic blockade may lead to cardiac failure in patients with latent cardiac insufficiency.¹⁰⁴

Avoid use in patients with overt CHF.¹ Use cautiously, if necessary, in patients with compensated heart failure (e.g., those controlled with cardiac glycosides and/or diuretics).¹

Discontinue at first sign or symptom of impending cardiac failure;¹ if necessary, initiate specific therapy (e.g., a cardiac glycoside and/or diuretic).^{1 2} If continued esmolol therapy is necessary, may restart esmolol infusion at a slower rate once manifestations of cardiac failure have subsided.¹¹⁴

Bronchospastic Disease

In general, do not use β-blockers in patients with bronchospastic disease;^{1 2 105 106 107 116 117 143 150 167} however, may use esmolol with caution due to its relative β₁-selective adrenergic blocking activity and short duration of action.^{1 2} Administer lowest effective dose since β₁-selectivity is not absolute.^{1 2}

Discontinue immediately if bronchospasm occurs.¹ May administer a β₂-adrenergic agonist (bronchodilator), but use extreme caution since the patient may have a preexisting rapid ventricular rate.^{1 2}

Diabetes and Hypoglycemia

Possible decreased signs and symptoms of hypoglycemia (e.g., tachycardia, palpitation, BP changes, tremor, feelings of anxiety, but not sweating or dizziness) and increased insulin-induced hypoglycemia.^{1 2 108}

Use with caution in patients with diabetes mellitus or hypoglycemia.^{1 2}

General Precautions

Adverse effects generally resolve more rapidly than with other β-blockers because of esmolol’s short duration of action.^{1 2 3 4 5 113}

Cardiovascular Precautions

Use with caution in patients with SVT who are compromised hemodynamically or are taking drugs that reduce peripheral resistance, myocardial filling, myocardial contractility, and/or electrical impulse propagation in the myocardium.¹

Do not use in patients with acute atrial fibrillation who have severe left ventricular dysfunction,^{150 167} hypotension,^{143 150 167} or an accessory pathway.^{143 152 167}

Deaths have been reported in patients with complex clinical states receiving esmolol (presumably to control ventricular rate).¹

History of Anaphylactic Reactions

Patients with a history of severe anaphylactic reactions to a variety of allergens may be more reactive to repeated, accidental, diagnostic, or therapeutic challenge with such allergens and less responsive to usual doses of epinephrine.¹

Abrupt Withdrawal of Therapy

Abrupt discontinuance has not produced the withdrawal effects (e.g., exacerbation of angina symptoms, precipitation of MI) associated with abrupt discontinuance of other β-adrenergic blocking agents used chronically.¹ However, consider the possibility that such effects could occur with esmolol in patients with coronary artery disease; use caution when esmolol infusions are stopped abruptly in such patients.¹

Extravasation

Avoid extravasation; skin necrosis may occur.¹ (See IV Administration under Dosage and Administration.)

Specific Populations

Pregnancy

Category C.^a

Lactation

Not known whether esmolol is distributed into milk.¹ Use with caution in nursing women.¹

Pediatric Use

Safety and efficacy not established in children <18 years of age.^{1 114}

Use with caution for rapid reduction of BP in pediatric patients 1–17 years of age†; may cause profound bradycardia, and reductions in BP may be modest.¹⁵⁴

Renal Impairment

Use with caution in patients with renal impairment, especially severe impairment; de-esterified metabolite (ASL 8123) is eliminated mainly by the kidneys.^{1 2 47}

Common Adverse Effects

Hypotension,^{1 2 24 50 51 53 54 55 56 57 58 59 63 100 113 114 122} dizziness,^{1 2 51 54 55 58 113 122} diaphoresis,^{1 2 50 51 54 55 58 113 122} headache,^{1 2 51 55 58 59 113} somnolence,^{1 2 50 55 58 113} confusion,^{1 2 55 58 113} agitation,^{1 2 55 58 63 113} nausea,^{1 2 51 55 56 58 59 113} infusion site reactions^{1 2} (e.g., inflammation,^{1 2 54 55 58} induration).^{1 2 55 58 59}

Interactions for Brevibloc

Specific Drugs

Drug	Interaction	Comments
Digoxin	Possible increase in serum digoxin concentrations;1 2 49 113 esmolol pharmacokinetics unaffected1 2 49 113	Used safely and effectively; combined therapy apparently somewhat more effective than esmolol alone in lowering heart rate59 113
Verapamil	Rare but serious adverse reactions (including fatal cardiac arrest) with concomitant IV β-blocker and IV verapamil, especially in patients with severe cardiomyopathy, CHF, or recent MI1 141
Mibefradil (no longer commercially available in US)	Slowing or complete suppression of SA node activity, with slow ventricular rates139 140
Vasoconstrictors or inotropes (e.g., dopamine, epinephrine, norepinephrine)	Potential for blocked cardiac contractility when systemic vascular resistance is high1	Do not use esmolol to control SVT in patients receiving vasoconstrictive or inotropic drugs1
Catecholamine-depleting drugs (e.g., reserpine)	Possible additive effects1	Monitor closely for marked bradycardia or hypotension1
Morphine	Increased esmolol concentrations; morphine pharmacokinetics not affected1 2 49 113	Titrate esmolol dosage carefully1 2 49
Neuromuscular blocking agents (succinylcholine)	Possible prolonged duration of neuromuscular blockade1 2 113	Apparently not clinically important1 2 86 114
Warfarin	Slight increase in esmolol concentrations;1 2 49 113 warfarin concentrations not affected1 2 49 113	Titrate esmolol dosage carefully1

Brevibloc Pharmacokinetics

Absorption

Onset

Following rapid IV injection, 13–18% decrease in heart rate within 1 minute, 11–18% decrease in SBP within 2 minutes, and 13–22% prolongation of PR interval within 4 minutes after IV injection.⁴¹

In patients with SVT, 15–20% reduction in heart rate apparent within 5–22 minutes after initiation of IV infusion.^{59 68}

Duration

Following discontinuance of IV infusion, β-blockade dissipates within about 1–2 minutes, substantial recovery occurs within about 10–20 minutes, and complete reversal occurs within about 20–30 minutes.^{1 2 5 27 34 39 113}

Distribution

Extent

Distributed into liver and kidneys, but only minimally into CSF, spleen, or testes of rats.^{2 28} Rapidly and widely distributed in humans.^{2 39 99 113}

Not known whether esmolol and/or ASL 8123 crosses the placenta in humans, ¹²⁶ but the drug crosses the placenta in animals.^{114 115}

Not known whether esmolol and/or ASL 8123 are distributed into milk.¹

Plasma Protein Binding

Esmolol: 55%^{1 2 28 113} (albumin and α₁-acid glycoprotein).²⁸

Metabolite (ASL 8123): Approximately 10%.^{1 2 113}

Elimination

Metabolism

Hydrolyzed rapidly, principally by esterases (probably arylesterase) in erythrocytic cytosol,^{1 2 39 40 45 46 99 113} to de-esterified (acid) metabolite (ASL 8123) and methanol.^{1 2 39 40 45 46 113} Acid metabolite has no appreciable β-blocking activity in humans.^{1 2 40}

Elimination Route

Excreted principally in urine as the acid metabolite (73–88%); less than 2% excreted unchanged in urine.^{1 2 5 39 47 113} Small amounts (<5%) may be eliminated in feces.^{28 114}

Half-life

Biphasic;^{1 2 39 99 113} distribution half-life of esmolol is about 2 minutes; ^{1 2 39 99} terminal elimination half-life is about 9 minutes (range: 5–23 minutes).^{1 2 39 40 99 114}

Special Populations

In patients with renal impairment, elimination half-life of the metabolite may be increased up to 10-fold, but accumulation is not clinically important since ASL 8123 has only minimal β-blocking activity.^{2 43}

About 24% (as metabolite) is removed by hemodialysis,¹¹⁴ and 21% by peritoneal dialysis;¹¹⁴ amount removed depends on several factors (e.g., dialysis flow-rate, dwell time).^{131 132 133 134}

Stability

Storage

Parenteral

Injection

25°C (may be exposed to 15–30°C).^{1 a} Do not freeze; protect from excessive heat.^{1 a}

Compatibility

For information on systemic interactions resulting from concomitant use, see Interactions.

Parenteral

Solution Compatibility^HID

Compatible
Dextrose 5% in Ringer’s injection
Dextrose 5% in Ringer’s injection, lactated
Dextrose 5% in sodium chloride 0.45 or 0.9%
Dextrose 5% in water
Dextrose 5% in water with potassium chloride 40 mEq/L
Ringer’s injection, lactated
Sodium chloride 0.45 or 0.9%

Drug Compatibility

Admix a compatible drug with esmolol hydrochloride only after diluting the concentrate for injection to a concentration of 10 mg/mL in a compatible IV infusion solution.^{1 2} Manufacturer states that additives should not be introduced into premixed solutions in ready-to-use bags.^a

Admixture CompatibilityHID

Compatible
Aminophylline
Atracurium besylate
Bretylium tosylate
Heparin sodium
Incompatible
Diazepam2
Furosemide2 119
Procainamide HCl
Sodium bicarbonate1 2 3
Thiopental sodium2

Y-Site CompatibilityHID

Compatible
Alcohol 10% in dextrose 5%
Amikacin sulfate
Aminophylline
Amiodarone HCl
Ampicillin sodium
Atracurium besylate
Bivalirudin
Butorphanol tartrate
Calcium chloride
Cefazolin sodium
Ceftazidime
Ceftizoxime sodium
Chloramphenicol sodium succinate
Cimetidine HCl
Clindamycin phosphate
Co-trimoxazole
Dexmedetomidine HCl
Diltiazem HCl
Dopamine HCl
Enalaprilat
Erythromycin lactobionate
Famotidine
Fenoldopam mesylate
Fentanyl citrate
Gentamicin sulfate
Heparin sodium
Hetastarch in lactated electrolyte injection (Hextend)
Hydrocortisone sodium succinate
Labetalol HCl
Linezolid
Magnesium sulfate
Methyldopate HCl
Metronidazole
Midazolam HCl
Morphine sulfate
Nafcillin sodium
Nicardipine HCl
Nitroglycerin
Norepinephrine bitartrate
Pancuronium bromide
Penicillin G potassium
Phenytoin sodium
Polymyxin B sulfate
Potassium chloride
Potassium phosphates
Propofol
Ranitidine HCl
Remifentanil HCl
Sodium acetate
Sodium nitroprusside
Streptomycin sulfate
Tacrolimus
Tobramycin sulfate
Vancomycin HCl
Vecuronium bromide
Incompatible
Amphotericin B cholesteryl sulfate complex
Furosemide
Lansoprazole
Pantoprazole sodium
Warfarin sodium

ActionsActions

• 
  

  Selectively blocks cardiac β₁-adrenergic receptors with little effect on₂-adrenergic receptors of bronchial and vascular smooth muscle.^{1 2 3}

Feldenedi

Feldenedi may be available in the countries listed below.

Ingredient matches for Feldenedi

Piroxicam

Piroxicam is reported as an ingredient of Feldenedi in the following countries:

• Venezuela

International Drug Name Search

Methovate

Methovate may be available in the countries listed below.

Ingredient matches for Methovate

Betamethasone

Betamethasone 17α-valerate (a derivative of Betamethasone) is reported as an ingredient of Methovate in the following countries:

• Bangladesh

International Drug Name Search

Microgynon 50

Microgynon 50 may be available in the countries listed below.

Ingredient matches for Microgynon 50

Ethinylestradiol

Ethinylestradiol is reported as an ingredient of Microgynon 50 in the following countries:

• Netherlands

Levonorgestrel

Levonorgestrel is reported as an ingredient of Microgynon 50 in the following countries:

• Netherlands

International Drug Name Search

Soriatane

In the US, Soriatane (acitretin systemic) is a member of the drug class antipsoriatics and is used to treat Psoriasis.

US matches:

• Soriatane


• Soriatane CK

Ingredient matches for Soriatane

Acitretin

Acitretin is reported as an ingredient of Soriatane in the following countries:

• Canada


• France


• United States

International Drug Name Search

Emedastine

Scheme

Rec.INN

ATC (Anatomical Therapeutic Chemical Classification)

S01GX06

CAS registry number (Chemical Abstracts Service)

0087233-61-2

Chemical Formula

C17-H26-N4-O

Molecular Weight

302

Therapeutic Categories

Antiallergic agent

Histamine, H₁-receptor antagonist

Chemical Name

1-(2-Ethoxyethyl)-2-(hexahydro-4-methyl-1H-1,4-diazepin-1-yl)benzimidazole

Foreign Names

• Emedastinum (Latin)
• Emedastin (German)
• Émédastine (French)
• Emedastina (Spanish)

Generic Names

• Emedastine (OS: BAN)
• Émédastine (OS: DCF)
• Emedastine Difumarate (OS: USAN, JAN)
• Emedastine Fumarate (OS: BANM)
• AL 3432 (IS: Kanebo)
• KB 2413 (IS: Kanebo)
• LY 188695 (IS: Lilly)
• Emedastine Difumarate (PH: Ph. Eur. 6, USP 32)
• Emedastine Fumarate (PH: BP 2010)
• Emedastini difumaras (PH: Ph. Eur. 6)

Brand Names

• Emadine
  Alcon, Bulgaria; Alcon, Bulgaria; Alcon, China; Alcon, Spain; Alcon, Serbia; Alcon, Tunisia



• Daren
  Organon, Japan



• Emadine
  Alcon, Austria; Alcon, Bangladesh; Alcon, Bahrain; Alcon, Canada; Alcon, Switzerland; Alcon, Czech Republic; Alcon, Germany; Alcon, Finland; Alcon, United Kingdom; Alcon, Georgia; Alcon, Greece; Alcon, Hong Kong; Alcon, Hungary; Alcon, Ireland; Alcon, Israel; Alcon, Iceland; Alcon, Italy; Alcon, Luxembourg; Alcon, Netherlands; Alcon, Norway; Alcon, Oman; Alcon, Portugal; Alcon, Romania; Alcon, Sweden; Alcon, Slovenia; Alcon, Slovakia; Alcon, Taiwan; Alcon, United States; Alcon, South Africa; Alcon-Couvreur, Belgium; Liba, Turkey; Alcon Laboratories Inc.US, Denmark



• Emeromin
  Towa Yakuhin, Japan



• Remicut
  Kowa Souyaku, Japan

International Drug Name Search

Glossary

BAN	British Approved Name
BANM	British Approved Name (Modified)
DCF	Dénomination Commune Française
IS	Inofficial Synonym
JAN	Japanese Accepted Name
OS	Official Synonym
PH	Pharmacopoeia Name
Rec.INN	Recommended International Nonproprietary Name (World Health Organization)
USAN	United States Adopted Name

Click for further information on drug naming conventions and International Nonproprietary Names.

Nardil

Nardil is a brand name of phenelzine, approved by the FDA in the following formulation(s):

NARDIL (phenelzine sulfate - tablet; oral)

• 
  Manufacturer: PARKE DAVIS
  
  Approved Prior to Jan 1, 1982
  
  Strength(s): EQ 15MG BASE ^[RLD][AB]

Has a generic version of Nardil been approved?

Yes. The following products are equivalent to Nardil:

phenelzine sulfate tablet; oral

• 
  Manufacturer: NOVEL LABS INC
  
  Approval date: December 8, 2010
  
  Strength(s): EQ 15MG BASE ^[AB]

Note: Fraudulent online pharmacies may attempt to sell an illegal generic version of Nardil. These medications may be counterfeit and potentially unsafe. If you purchase medications online, be sure you are buying from a reputable and valid online pharmacy. Ask your health care provider for advice if you are unsure about the online purchase of any medication.

See also: About generic drugs.

Related Patents

There are no current U.S. patents associated with Nardil.

See also...

• Nardil Consumer Information (Wolters Kluwer)
• Nardil Consumer Information (Cerner Multum)
• Nardil Advanced Consumer Information (Micromedex)
• Nardil AHFS DI Monographs (ASHP)
• Phenelzine Consumer Information (Wolters Kluwer)
• Phenelzine Consumer Information (Cerner Multum)
• Phenelzine Advanced Consumer Information (Micromedex)
• Phenelzine Sulfate AHFS DI Monographs (ASHP)