phentolamine (Rx)

Brand and Other Names:Regitine, OraVerse
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

powder for injection

  • 5mg

injectable solution

  • 0.4mg/1.7mL

Pheochromocytoma

Diagnosis: 5 mg IV/IM

Test for pheochromocytoma is positive if decrease SBP >35 mmHg & decrease DBP >25 mmHg

Pheochromocytoma Surgery Use

Treatment of hypertension during pheochromocytoma surgery

5 mg IV/IM 1-2 hr preoperative, repeat if necessary q2-4hr

Extravasation Treatment

Epinephrine or norepinephrine extravastation treatment

Treatment: 5-10 mg in 10 mL NS local injection within 12 hr

Prevention: 10 mg for each liter of IV fluids (pressor effect of NE is unaffected)

Dental Anesthesia Reversal (OraVerse)

Indicated for reversal of soft-tissue anesthesia associated with functional deficits from intraoral local anesthesia containing a vasoconstrictor

Dose based on amount of local anesthetic administered

Administer using same locations and techniques (infiltration or block injection) as local anesthetic

1/2 cartridge local anesthetic: OraVerse 1/2 cartridge (0.2 mg)

1 cartridge local anesthetic: OraVerse 1 cartridge (0.4 mg)

2 cartridges local anesthetic: OraVerse 2 cartridges (0.8 mg)

Hypertensive Crises (Off-label)

Secondary to catecholamine excess: 5-15 mg IV

Other Indications & Uses

Pheochromocytoma diagnosis, HTN in pheochromocytoma surgery, dermal necrosis due to epinephrine/NE extravasation

Off-label: hypertensive crises (pheochromocytoma, other catecholamine excess situations); erectile dysfunction (intracavernous)

Dosage Forms & Strengths

powder for injection

  • 5mg

injectable solution

  • 0.4mg/1.7mL

Pheochromocytoma, Diagnosis

0.1-0.2 mg/kg IV/IM, OR 1 mg IV OR 3 mg IM  

Pheochromocytoma Surgery Use

Treatment of hypertension during surgery

0.05-0.1 mg/kg/dose OR 1 mg IV/IM 1-2 hr preoperative, repeat q2-4hr until hypertension is controlled; not to exceed 5 mg/dose  

Dental Anesthesia Reversal (OraVerse)

Indicated for reversal of soft-tissue anesthesia associated with functional deficits from intraoral local anesthesia containing a vasoconstrictor

<6 years or <15 kg: Safety and efficacy not established

Dose based on amount of local anesthetic administered

Administer using same locations and techniques (infiltration or block injection) as local anesthetic

6-12 years (15-30 kg)

  • For 1/2 cartridge local anesthetic, use OraVerse 1/2 cartridge (0.2 mg)

6-12 years (>30 kg)

  • 1/2 cartridge local anesthetic: OraVerse 1/2 cartridge (0.2 mg)
  • 1 cartridge local anesthetic: OraVerse 1 cartridge (0.4 mg)

Other Information

Extravasation of epinephrine/norepinephrine:0.1-0.2 mg/kg to no more than 10 mg

Pheochromocytoma

Diagnosis: 5 mg IV/IM

Test for pheochromocytoma is positive if decrease SBP >35 mmHg & decrease DBP >25 mmHg

Pheochromocytoma surgery use

Treatment of hypertension during pheochromocytoma surgery

5 mg IV/IM 1-2 hr preoperative, repeat if necessary q2-4hr

Extravasation treatment

Epinephrine or norepinephrine extravastation treatment

Treatment: 5-10 mg in 10 mL NS local injection within 12 hr

Prevention: 10 mg for each liter of IV fluids (pressor effect of NE is unaffected)

Dental anesthesia reversal (OraVerse)

Indicated for reversal of soft-tissue anesthesia associated with functional deficits from intraoral local anesthesia containing a vasoconstrictor

Dose based on amount of local anesthetic administered

Administer using same locations and techniques (infiltration or block injection) as local anesthetic

1/2 cartridge local anesthetic: OraVerse 1/2 cartridge (0.2 mg)

1 cartridge local anesthetic: OraVerse 1 cartridge (0.4 mg)

2 cartridges local anesthetic: OraVerse 2 cartridges (0.8 mg)

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Interactions

Interaction Checker

and phentolamine

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      Serious - Use Alternative

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            Contraindicated (0)

              Serious - Use Alternative (5)

              • lofexidine

                lofexidine, phentolamine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.

              • sildenafil

                sildenafil increases effects of phentolamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of hypotension; separate sildenafil >25mg from alpha blocker by 4hr.

              • tamsulosin

                phentolamine, tamsulosin. Either increases effects of the other by additive vasodilation. Avoid or Use Alternate Drug. Risk of hypotension.

              • vardenafil

                vardenafil increases effects of phentolamine by pharmacodynamic synergism. Contraindicated. Risk of hypotension.

              • yohimbe

                yohimbe increases effects of phentolamine by pharmacodynamic synergism. Contraindicated.

              Monitor Closely (93)

              • acebutolol

                phentolamine and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • aceclofenac

                aceclofenac decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • acemetacin

                acemetacin decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • aldesleukin

                aldesleukin increases effects of phentolamine by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • alfuzosin

                alfuzosin and phentolamine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • amifostine

                amifostine, phentolamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.

              • amlodipine

                phentolamine and amlodipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • asenapine

                asenapine and phentolamine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • aspirin

                aspirin decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • aspirin rectal

                aspirin rectal decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • atenolol

                phentolamine and atenolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • avanafil

                avanafil increases effects of phentolamine by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • benazepril

                benazepril, phentolamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • betaxolol

                phentolamine and betaxolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • bisoprolol

                phentolamine and bisoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • bretylium

                phentolamine, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.

              • captopril

                captopril, phentolamine. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response. Both drugs lower blood pressure. Monitor blood pressure.

              • carbidopa

                carbidopa increases effects of phentolamine by pharmacodynamic synergism. Use Caution/Monitor. Monitor for hypotension.

              • carvedilol

                phentolamine and carvedilol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • celecoxib

                celecoxib decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • celiprolol

                phentolamine and celiprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • choline magnesium trisalicylate

                choline magnesium trisalicylate decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • clevidipine

                phentolamine and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • diclofenac

                diclofenac decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • diflunisal

                diflunisal decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • diltiazem

                phentolamine and diltiazem both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • dopexamine

                phentolamine, dopexamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.

              • doxazosin

                doxazosin and phentolamine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • enalapril

                enalapril, phentolamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • ephedrine

                phentolamine, ephedrine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.

              • epinephrine

                phentolamine, epinephrine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.

              • epinephrine racemic

                phentolamine, epinephrine racemic. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.

              • esmolol

                phentolamine and esmolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • etodolac

                etodolac decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • felodipine

                phentolamine and felodipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • fenoprofen

                fenoprofen decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • flurbiprofen

                flurbiprofen decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • fosinopril

                fosinopril, phentolamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • ibuprofen

                ibuprofen decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • ibuprofen IV

                ibuprofen IV decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • iloperidone

                iloperidone increases effects of phentolamine by pharmacodynamic synergism. Use Caution/Monitor.

              • imidapril

                imidapril, phentolamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • indomethacin

                indomethacin decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • isradipine

                phentolamine and isradipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • ketoprofen

                ketoprofen decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • ketorolac

                ketorolac decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • ketorolac intranasal

                ketorolac intranasal decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • labetalol

                phentolamine and labetalol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • levodopa

                levodopa increases effects of phentolamine by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.

              • lisinopril

                lisinopril, phentolamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • lornoxicam

                lornoxicam decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • meclofenamate

                meclofenamate decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • mefenamic acid

                mefenamic acid decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • meloxicam

                meloxicam decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • methylphenidate

                methylphenidate will decrease the level or effect of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.

              • metoprolol

                phentolamine and metoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • moexipril

                moexipril, phentolamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • moxisylyte

                moxisylyte and phentolamine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • nabumetone

                nabumetone decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • nadolol

                phentolamine and nadolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • naproxen

                naproxen decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • nebivolol

                phentolamine and nebivolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • nicardipine

                phentolamine and nicardipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • nifedipine

                phentolamine and nifedipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • nisoldipine

                phentolamine and nisoldipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • norepinephrine

                phentolamine, norepinephrine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.

              • oxaprozin

                oxaprozin decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • oxymetazoline topical

                oxymetazoline topical increases and phentolamine decreases sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • parecoxib

                parecoxib decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • penbutolol

                phentolamine and penbutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • perindopril

                perindopril, phentolamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • phenoxybenzamine

                phenoxybenzamine and phentolamine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • pindolol

                phentolamine and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • piroxicam

                piroxicam decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • prazosin

                phentolamine and prazosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • propranolol

                phentolamine and propranolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • quinapril

                quinapril, phentolamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • ramipril

                ramipril, phentolamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • salicylates (non-asa)

                salicylates (non-asa) decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • salsalate

                salsalate decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • silodosin

                phentolamine and silodosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • sotalol

                phentolamine and sotalol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • sulfasalazine

                sulfasalazine decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • sulindac

                sulindac decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • tadalafil

                tadalafil increases effects of phentolamine by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • terazosin

                phentolamine and terazosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • timolol

                phentolamine and timolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • tolfenamic acid

                tolfenamic acid decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • tolmetin

                tolmetin decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • trandolapril

                trandolapril, phentolamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • verapamil

                phentolamine and verapamil both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • zotepine

                phentolamine and zotepine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              Minor (7)

              • brimonidine

                brimonidine increases effects of phentolamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • butcher's broom

                phentolamine, butcher's broom. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Minor/Significance Unknown.

              • ethanol

                phentolamine, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension, esp. in Asian pts.

              • phenylephrine

                phentolamine, phenylephrine. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Minor/Significance Unknown.

              • phenylephrine PO

                phentolamine, phenylephrine PO. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Minor/Significance Unknown.

              • tizanidine

                tizanidine increases effects of phentolamine by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.

              • treprostinil

                treprostinil increases effects of phentolamine by pharmacodynamic synergism. Minor/Significance Unknown.

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              Adverse Effects

              1-10%

              Nasal congestion (10% )

              Post-treatment pain (up to 10% )

              Injection site pain (4% to 6% )

              Diarrhea (<3% )

              Frequency Not Defined

              Cardiac dysrhythmia

              Chest pain

              Hypotension

              Myocardial infarction

              CVA - cerebrovascular accident due to cerebral artery occlusion

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              Warnings

              Contraindications

              Hypersensitivity; MI or other CAD

              Cautions

              First dose effect may occur, causing a sudden and drastic fall in blood pressure after administering the first dose.

              Hypotension/syncope with first few doses or with increase in dose

              Minimize by using small first dose at bedtime

              Increase dose slowly

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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: not known if excreted in breast milk; not recommended

              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

              Has positive inotropic and chronotropic effect on the heart

              Blocks alph-adrenergic receptors to briefly antagonize circulating epinephrine and norepinephrine to reduce hypertension caused by alpha effects of the endogenous catecholamines

              Pharmacokinetics

              Half-Life:19 min (IV)

              Duration: 30-45 min (IM); 15-30 min (IV)

              Excretion: Urine (13%) as unchanged drug

              Metabolism: Hepatic

              Onset of action: Immediate (IV); 15-20 min (IM)

              Peak effect: 10-20 min (OraVerse)

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              Administration

              IV Compatibilities

              Additive: cibenzoline succinate, dobutamine, verapamil

              Syringe: papaverine

              Y-site: amiodarone

              IV Preparation

              Reconstitute with 1 mL SWI (5 mg/mL solution)

              IV/IM Administration

              Administer by IV or IM injection

              Rapid IV

              Storage

              Store at controlled room temperature

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              phentolamine injection
              -
              5 mg vial
              phentolamine injection
              -
              5 mg vial
              phentolamine injection
              -
              5 mg vial
              phentolamine injection
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              5 mg vial

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              phentolamine injection

              NO MONOGRAPH AVAILABLE AT THIS TIME

              USES: Consult your pharmacist.

              HOW TO USE: Consult your pharmacist.

              SIDE EFFECTS: Consult your 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: Consult your pharmacist.

              DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

              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.

              NOTES: No monograph available at this time.

              MISSED DOSE: Consult your pharmacist.

              STORAGE: Consult your pharmacist.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 July 2016. 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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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              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.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              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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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.