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Experience with 1, 25-dihydroxycholecalciferol therapy in hemodialysis patients with progressive vitamin D2-treated osteodystrophy
brand Of tictynafh z:S Before prescribiig, see complete prescribing literature. The following is a brief summary.
information
in
SK&F
indications: Hypertension, with or wlthout elevated uric acid levels. Salt and water retention states associated with congestive cardiac failure. Conlraindications: Anuria, severe or progressive renal disease, hypersensitivityto the drug, known renal uric acid calculi Warnings: Potentiates the action of oral anticoagulants; caution should be exercised when these agents are used with’Selacryn’; reduce anticoagulant dosage to l/4 or l/2 of the maintenance dose, and carefully monitor prothrombin time until stabilized.
Concomitant use with triamterene is not recommended marked elevation of BUN and creatinine may occur.
since a
Not appropriate in hepatic ascites. May precipitate azotemia in progressive oradvanced renal disease; therefore, frequent electrolyte. creatinine and BUN determinations should be performed early in therapy and periodically thereafter. Discontinue the drug if renal impairment progresses. Pregnancy, NufSing: ‘Selacryn’crosses the placental barrier in animals. Routine use of diuretics during normal pregnancy is inappropriate and exposes mother and fetus to unnecessary hazard. Use in pregnancy requires weighing anticipated benefits against possible hazards. Generally, nursing should not be undertaken while a patient is on a drug. Precautions: Substantial uricosurla occurs within hours after the first dose of ‘Selacryn’: for this reason, hypertensive patients switching from other diuretics should discontinue diuretics for 3 days before starting ‘Selacryn’; where feasible, diuretics should be discontinued for 1 to 2 days in patients with congestive cardiac failure. Fluid intake should be increased to approximately 1500 cc. per day for up to 3 days before and 3 days after initiation of ‘Seiacryn’ therapy in patients switched to ‘Selacryn’ from other diuretics and in patients who may be dehydrated, particularly if the patients are hyperuricemic. Acute attacks of gout may be precipitated; Continue’Selacryn (brand of ticrynafen). add coichicine. Observe patients for signs of electrolyte imbalance, i.e., hypokalemia, hyponatremia, hypechloremic aikaiosis. Periodic determinations of electrolytes to detect possible imbalance should be performed. Concomitant use with cytotoxic agents requires caution and individualization of dosage and management. Effectson glucose metabolism are similar to those seen with thiazides. Insulin requirements may be affected; hyperglycemia and glycosuria may occur in patients with latent diabetes. Elevation of BUN and/or serum Creatinine can occur during diuretic therapy.
Children: Safety and effectiveness in children have not been established Drug interadionr: Exercise caution when administering with other highly protein-bound drugs, especially anticoagulants; reduce anticoagulant dose to l/4 or i/2 of the maintenance dose and carefully monitorprothrombintimeuntiistabiiized. (SeeWarnings.) Concomitant use with triamterene is not recommended since a marked elevation of BUN and creatinine may occur. The drug causes a decrease in excretion of saiicylates and organic acids, e.g., penicillin. Diuretics reduce renal clearance of lithium and increase the risk of lithium toxicity. Adverse Reactions: Adverse reactions seen with ‘Selacryn’ (brand of ticrynafen) in controlled studies were approximately the same as those seen with hydrochiorothiazide. Except where noted. the following adverse effects seen with ‘Seiacryn’ have been reported in a small number of pabents,e.g.. approximately 1 in 100: anorexia, nausea, vomiting, dyspepsia, cramping, diarrhea, constipation, headache (approximately 4 in 100). dizziness/lightheadedness (approximately 9 in 1OO), paresthesia, somnolence, insomnia, syncope, vertigo, orthostatic hypotension, palpitation, rash, urticaria, pruritus, rare casesof fever and interstitial nephritis. Tiredness/fatigue (approximately 4 in 100). hyperglycemia, glycosuria. muscle cramps, weakness, bitter taste and dryness in mouth, exacerbation of gout, renal colic or costovertebral pain. Abnormal liver function testsand jaundice have been reported in a few patients. The following adverse reactions have not been reported to date with ‘Selacryn’ but have occurred with thiazides or other diuretics: pancreatitis, siaiadenitis. xanthopsia, purpura. photosensitivity, necrotizing angiitis, StevensJohnson syndrome, respiratorydistress, anaphyiactic reaction, leukopenia, agranulocytosis. thrombocytopenia. aplastic anemia, restlessness and transient blurred vision. Supplied:
Light blue, round,
scored,
monogrammed
tablets of
250 mg. in bottlesof 100, and in Single Unit Packages of 100 (intended for institutional use only). Date of issuance June 1979
Smith Kline Wrench Philadelphia, Pa. A44
Laboratories
information
in
SK&F
indications: Hypertension, with or wlthout elevated uric acid levels. Salt and water retention states associated with congestive cardiac failure. Conlraindications: Anuria, severe or progressive renal disease, hypersensitivityto the drug, known renal uric acid calculi Warnings: Potentiates the action of oral anticoagulants; caution should be exercised when these agents are used with’Selacryn’; reduce anticoagulant dosage to l/4 or l/2 of the maintenance dose, and carefully monitor prothrombin time until stabilized.
Concomitant use with triamterene is not recommended marked elevation of BUN and creatinine may occur.
since a
Not appropriate in hepatic ascites. May precipitate azotemia in progressive oradvanced renal disease; therefore, frequent electrolyte. creatinine and BUN determinations should be performed early in therapy and periodically thereafter. Discontinue the drug if renal impairment progresses. Pregnancy, NufSing: ‘Selacryn’crosses the placental barrier in animals. Routine use of diuretics during normal pregnancy is inappropriate and exposes mother and fetus to unnecessary hazard. Use in pregnancy requires weighing anticipated benefits against possible hazards. Generally, nursing should not be undertaken while a patient is on a drug. Precautions: Substantial uricosurla occurs within hours after the first dose of ‘Selacryn’: for this reason, hypertensive patients switching from other diuretics should discontinue diuretics for 3 days before starting ‘Selacryn’; where feasible, diuretics should be discontinued for 1 to 2 days in patients with congestive cardiac failure. Fluid intake should be increased to approximately 1500 cc. per day for up to 3 days before and 3 days after initiation of ‘Seiacryn’ therapy in patients switched to ‘Selacryn’ from other diuretics and in patients who may be dehydrated, particularly if the patients are hyperuricemic. Acute attacks of gout may be precipitated; Continue’Selacryn (brand of ticrynafen). add coichicine. Observe patients for signs of electrolyte imbalance, i.e., hypokalemia, hyponatremia, hypechloremic aikaiosis. Periodic determinations of electrolytes to detect possible imbalance should be performed. Concomitant use with cytotoxic agents requires caution and individualization of dosage and management. Effectson glucose metabolism are similar to those seen with thiazides. Insulin requirements may be affected; hyperglycemia and glycosuria may occur in patients with latent diabetes. Elevation of BUN and/or serum Creatinine can occur during diuretic therapy.
Children: Safety and effectiveness in children have not been established Drug interadionr: Exercise caution when administering with other highly protein-bound drugs, especially anticoagulants; reduce anticoagulant dose to l/4 or i/2 of the maintenance dose and carefully monitorprothrombintimeuntiistabiiized. (SeeWarnings.) Concomitant use with triamterene is not recommended since a marked elevation of BUN and creatinine may occur. The drug causes a decrease in excretion of saiicylates and organic acids, e.g., penicillin. Diuretics reduce renal clearance of lithium and increase the risk of lithium toxicity. Adverse Reactions: Adverse reactions seen with ‘Selacryn’ (brand of ticrynafen) in controlled studies were approximately the same as those seen with hydrochiorothiazide. Except where noted. the following adverse effects seen with ‘Seiacryn’ have been reported in a small number of pabents,e.g.. approximately 1 in 100: anorexia, nausea, vomiting, dyspepsia, cramping, diarrhea, constipation, headache (approximately 4 in 100). dizziness/lightheadedness (approximately 9 in 1OO), paresthesia, somnolence, insomnia, syncope, vertigo, orthostatic hypotension, palpitation, rash, urticaria, pruritus, rare casesof fever and interstitial nephritis. Tiredness/fatigue (approximately 4 in 100). hyperglycemia, glycosuria. muscle cramps, weakness, bitter taste and dryness in mouth, exacerbation of gout, renal colic or costovertebral pain. Abnormal liver function testsand jaundice have been reported in a few patients. The following adverse reactions have not been reported to date with ‘Selacryn’ but have occurred with thiazides or other diuretics: pancreatitis, siaiadenitis. xanthopsia, purpura. photosensitivity, necrotizing angiitis, StevensJohnson syndrome, respiratorydistress, anaphyiactic reaction, leukopenia, agranulocytosis. thrombocytopenia. aplastic anemia, restlessness and transient blurred vision. Supplied:
Light blue, round,
scored,
monogrammed
tablets of
250 mg. in bottlesof 100, and in Single Unit Packages of 100 (intended for institutional use only). Date of issuance June 1979
Smith Kline Wrench Philadelphia, Pa. A44
Laboratories