colestipol (Rx)

Brand and Other Names:Colestid
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

granules, bottle

  • 5g

granules, packets

  • 5g

tablet

  • 1g

Hyperlipidemia

Tablets: 2 g PO qDay or q12hr; increases of 2 g should occur at 1- or 2-month intervals; titrate not to exceed 16 g/day

Granules: 5 g PO qDay; increases of 5 g should occur at 1- or 2-month intervals; titrate not to exceed 30 g/day

Overdose Management

Generally considered safe in acute overdose although not formally studied

Adverse drug reactions in overdose may include peripheral neuropathy, diarrhea, increase K+, myopathy , rhabdomyolysis, acute renal failure, elevated liver function tests, eye lens opacities)

Check renal function tests, urine myoglobin, CPK, LFT's

Administration

Mix dry form in water/fluids to avoid inhalation or esophageal distress

Mix granules in fluids or food; take before meals

Do not crush, chew, or cut tablets

Take 1 tablet at a time; swallow with water or other fluids

Other Information

Monitor: Serum cholesterol, triglycerides

Other Indications & Uses

Used in relief of pruritus associated with elevated levels of bile

Used to decrease plasma half-life of digoxin in toxicity

Hypercholesterolemia (adjunct to diet for Type IIa & IIb hyperlipidemia)

Safety & efficacy not established

Tablets: 2 g PO qDay or q12hr; increases of 2 g should occur at 1- or 2-month intervals; titrate not to exceed 16 g/day

Granules: 5 g PO qDay; increases of 5 g should occur at 1- or 2-month intervals; titrate not to exceed 30 g/day

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Interactions

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            Contraindicated (1)

            • mycophenolate

              colestipol will decrease the level or effect of mycophenolate by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Colestipol binds bile acids and reduces mycophenolic acid exposure

            Serious - Use Alternative (0)

              Monitor Closely (10)

              • cholic acid

                colestipol will decrease the level or effect of cholic acid by drug binding in GI tract. Use Caution/Monitor. Take cholic acid at least 1 hr before or 4-6 hr (or as great an interval as possible) after a bile acid binding resin.

              • digoxin

                colestipol decreases levels of digoxin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • doxercalciferol

                colestipol decreases levels of doxercalciferol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. (Vitamin D analog).

              • lomitapide

                colestipol decreases levels of lomitapide by drug binding in GI tract. Use Caution/Monitor. Separate lomitapide and administration of bile acid sequestrants by at least 4 hours; bile acid sequestrants can interfere with the absorption of oral medications.

              • obeticholic acid

                colestipol will decrease the level or effect of obeticholic acid by drug binding in GI tract. Modify Therapy/Monitor Closely. Administer obeticholic acid at least 4 hr before or 4 hr after taking a bile acid binding resins.

              • odevixibat

                colestipol will decrease the level or effect of odevixibat by drug binding in GI tract. Modify Therapy/Monitor Closely. Administer bile acid sequestrants 4 hr before or after odevixibat.

              • omadacycline

                colestipol will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Monitor for decreased effects of tetracyclines if coadministered with a bile acid sequestrant. Separate doses 2 or more hours if these agents are used concomitantly.

              • paricalcitol

                colestipol decreases levels of paricalcitol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. (Vitamin D analog).

              • sarecycline

                colestipol will decrease the level or effect of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Monitor for decreased effects of tetracyclines if coadministered with a bile acid sequestrant. Separate doses by 2 or more hours if coadministered.

              • vitamin D

                colestipol will decrease the level or effect of vitamin D by Other (see comment). Use Caution/Monitor. Bile acid sequestrants may decrease the absorption of fat-soluble vitamins. Administer vitamin supplementation at least 4 hours prior to colestipol.

              Minor (61)

              • acetaminophen

                colestipol decreases levels of acetaminophen by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • acetaminophen IV

                colestipol decreases levels of acetaminophen IV by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • acetaminophen rectal

                colestipol decreases levels of acetaminophen rectal by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • ampicillin

                colestipol decreases levels of ampicillin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • atorvastatin

                colestipol decreases levels of atorvastatin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • bendroflumethiazide

                colestipol decreases levels of bendroflumethiazide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • chenodiol

                colestipol decreases levels of chenodiol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • chlorothiazide

                colestipol decreases levels of chlorothiazide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • chlorthalidone

                colestipol decreases levels of chlorthalidone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • clobetasone

                colestipol decreases levels of clobetasone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • cortisone

                colestipol decreases levels of cortisone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • cyanocobalamin

                colestipol decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • deflazacort

                colestipol decreases levels of deflazacort by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • demeclocycline

                colestipol decreases levels of demeclocycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • dexamethasone

                colestipol decreases levels of dexamethasone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • diclofenac

                colestipol decreases levels of diclofenac by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • dicloxacillin

                colestipol decreases levels of dicloxacillin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • doxycycline

                colestipol decreases levels of doxycycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • fenofibrate

                colestipol decreases levels of fenofibrate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • fenofibrate micronized

                colestipol decreases levels of fenofibrate micronized by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • fenofibric acid

                colestipol decreases levels of fenofibric acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • fludrocortisone

                colestipol decreases levels of fludrocortisone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • fluvastatin

                colestipol decreases levels of fluvastatin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • folic acid

                colestipol decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • furosemide

                colestipol decreases levels of furosemide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • gemfibrozil

                colestipol decreases levels of gemfibrozil by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • hydrochlorothiazide

                colestipol decreases levels of hydrochlorothiazide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • hydrocortisone

                colestipol decreases levels of hydrocortisone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • imipramine

                colestipol decreases levels of imipramine by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • indapamide

                colestipol decreases levels of indapamide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • L-methylfolate

                colestipol decreases levels of L-methylfolate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • levothyroxine

                colestipol decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • liothyronine

                colestipol decreases levels of liothyronine by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • lovastatin

                colestipol decreases levels of lovastatin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • meloxicam

                colestipol decreases levels of meloxicam by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • methotrexate

                colestipol decreases levels of methotrexate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Patients should take other drugs at least 1 hour before or 4 hours after colestipol to avoid impeding their absorption.

              • methyclothiazide

                colestipol decreases levels of methyclothiazide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • methylprednisolone

                colestipol decreases levels of methylprednisolone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • metolazone

                colestipol decreases levels of metolazone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • minocycline

                colestipol decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • niacin

                colestipol decreases levels of niacin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • oxacillin

                colestipol decreases levels of oxacillin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • oxytetracycline

                colestipol decreases levels of oxytetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • piroxicam

                colestipol decreases levels of piroxicam by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pitavastatin

                colestipol decreases levels of pitavastatin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pivmecillinam

                colestipol decreases levels of pivmecillinam by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pravastatin

                colestipol decreases levels of pravastatin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • prednisolone

                colestipol decreases levels of prednisolone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • prednisone

                colestipol decreases levels of prednisone by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • rosuvastatin

                colestipol decreases levels of rosuvastatin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • simvastatin

                colestipol decreases levels of simvastatin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • temocillin

                colestipol decreases levels of temocillin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • tetracycline

                colestipol decreases levels of tetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • thyroid desiccated

                colestipol decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • ticarcillin

                colestipol decreases levels of ticarcillin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • triamcinolone acetonide injectable suspension

                colestipol decreases levels of triamcinolone acetonide injectable suspension by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • ursodiol

                colestipol decreases effects of ursodiol by pharmacodynamic antagonism. Minor/Significance Unknown.

              • valproic acid

                colestipol decreases levels of valproic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • vitamin A

                colestipol decreases levels of vitamin A by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. (Vitamin A).

              • vitamin K1 (phytonadione)

                colestipol decreases levels of vitamin K1 (phytonadione) by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. (Vitamin K).

              • warfarin

                colestipol decreases levels of warfarin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              Gastrointestinal (mostly)

              Constipation

              1-10%

              Stomach pain

              Belching

              Nausea/vomiting

              Flatulance

              Diarrhea

              Dizziness

              Anxiety

              Vertigo

              Fatigue

              Drowsiness

              Frequency Not Defined

              Heartburn

              Steatorrhea

              Malabsorption of fat-soluble vitamins

              Gallstones

              Dysphagia

              GI bleeding

              Cholecystitis

              Peptic ulceration

              Transient esophageal obstruction

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              Warnings

              Contraindications

              Hypersensitivity to colestipol

              Bowel obstruction

              Cautions

              Increased risk of bleeding due to hypoprothrombinemia from vitamin K deficiency

              May interfere with fat absorption, and decrease absorption of fat-soluble vitamins (A, D, E, K)

              May worsen pre-existing constipation

              Take other medications 1 hr before or 4 hr after colestipol

              If significant increase in triglycerides, consider dose reduction, discontinuation or alternatives

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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: use caution; may interfere with vitamin absorption in infants

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Forms a soluble complex after binding to bile acid, increasing fecal loss of bile acid-bound low-density lipoprotein cholesterol

              Pharmacokinetics

              Onset: initial effect: 24-48 hr; max effect: 1 wk

              Bioavailability: Not absorbed

              Metabolism: Not metabolized

              Excretion: feces 100%

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              colestipol oral
              -
              1 gram tablet
              colestipol oral
              -
              5 gram granules
              colestipol oral
              -
              5 gram miscellaneous
              colestipol oral
              -
              5 gram miscellaneous
              colestipol oral
              -
              1 gram tablet
              colestipol oral
              -
              5 gram granules
              colestipol oral
              -
              5 gram miscellaneous
              colestipol oral
              -
              5 gram miscellaneous
              Colestid oral
              -
              1 gram tablet
              Colestid oral
              -
              5 gram granules
              Colestid oral
              -
              5 gram miscellaneous
              Colestid oral
              -
              5 gram granules
              Colestid oral
              -
              5 gram miscellaneous
              Colestid Flavored oral
              -
              5 gram granules
              Colestid Flavored oral
              -
              7.5 gram miscellaneous

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              colestipol oral

              COLESTIPOL TABLET - ORAL

              (koe-LES-ti-pol)

              COMMON BRAND NAME(S): Colestid

              USES: Colestipol is used along with a proper diet to lower cholesterol in the blood. Lowering cholesterol helps decrease the risk for strokes and heart attacks.In addition to a proper diet (such as a low-cholesterol/low-fat diet), other lifestyle changes that may help this medication work better include exercising, losing weight if overweight, and stopping smoking. Consult your doctor for more details.This medication is known as a bile acid-binding resin. It works by removing bile acid from the body. In people with high cholesterol, this causes the liver to make more bile acid by using cholesterol in the blood. This helps to lower the cholesterol levels.

              HOW TO USE: Take this medication by mouth as directed by your doctor, usually 1 to 2 times a day. If your dose is more than 1 tablet, take the tablets one at a time. Do not try to swallow more than one tablet at once. Take each tablet with plenty of liquid (such as water, juice). Swallow each tablet whole. Do not crush, chew, or break the tablets. If you have difficulty swallowing the tablet whole, consult your doctor.The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. It may take several weeks before you get the full benefit of this drug.Colestipol may decrease your absorption of other medications. Take your other medications as directed by your doctor, usually at least 1 hour before or 4 to 6 hours after colestipol. Ask your doctor or pharmacist for more information or if you have any questions.Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day. Keep taking this medication even if you feel well. Most people with high cholesterol do not feel sick.

              SIDE EFFECTS: Constipation, stomach/abdominal pain, gas, nausea, and vomiting may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.Remember that this medication has been prescribed because your doctor 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.Tell your doctor right away if any of these rare but serious side effect occurs: difficulty swallowing, chest pain/pressure, severe stomach/abdominal pain, unusual bleeding/bruising, rapid breathing, confusion.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: 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 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking colestipol, 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: swallowing problems, constipation, hemorrhoids, kidney disease.Because this drug can interfere with the absorption of certain nutrients (such as folic acid, fat-soluble vitamins including A, D, E, K), your doctor may direct you to take a multivitamin supplement. Consult your doctor for more information.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially constipation.During pregnancy, this medication should be used only when clearly needed. It may affect the absorption of certain nutrients. Discuss the risks and benefits with your doctor.This medication is unlikely to pass into breast milk. However, it may affect the absorption of certain nutrients. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: See also How to Use section.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.Some products that may interact with this drug include: "blood thinners" (such as warfarin), mycophenolate, raloxifene.This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe stomach/abdominal pain.

              NOTES: Do not share this medication with others.Laboratory and/or medical tests (such as blood cholesterol/triglyceride levels, vitamin levels) should 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, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. 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 August 2021. Copyright(c) 2021 First Databank, Inc.

              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.

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              Formulary

              FormularyPatient Discounts

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              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
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              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
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              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
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              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.