tenecteplase (Rx)

Brand and Other Names:TNK tPA, TNKase
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • 50mg

Acute MI

Administer ASAP (within 30 minutes) after onset of acute MI

30-50 mg IV bolus over 5 sec once (based on weight)

  • <60 kg: 30 mg
  • 60-70 kg: 35 mg
  • 70-80 kg: 40 mg
  • 80-90 kg: 45 mg
  • >90 kg: 50 mg

Restore Function to Hemodialysis Catheters (Orphan)

Indicated to restore function to hemodialysis catheters

Orphan indication sponsor

  • Genentech, Inc; 1 DNA Way; South San Francisco, CA 94080-4990

Safety & efficacy not established

Next:

Interactions

Interaction Checker

and tenecteplase

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (2)

            • defibrotide

              defibrotide increases effects of tenecteplase by pharmacodynamic synergism. Contraindicated. Coadministration of defibrotide is contraindicated with antithrombotic/fibrinolytic drugs. This does not include use for routine maintenance or reopening of central venous lines.

            • prothrombin complex concentrate, human

              tenecteplase, prothrombin complex concentrate, human. pharmacodynamic antagonism. Contraindicated.

            Serious - Use Alternative (4)

            • apixaban

              tenecteplase and apixaban both increase anticoagulation. Avoid or Use Alternate Drug.

            • caplacizumab

              caplacizumab, tenecteplase. Either increases effects of the other by anticoagulation. Avoid or Use Alternate Drug.

            • reteplase

              reteplase and tenecteplase both increase anticoagulation. Avoid or Use Alternate Drug.

            • zanubrutinib

              tenecteplase, zanubrutinib. Either increases effects of the other by anticoagulation. Avoid or Use Alternate Drug. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.

            Monitor Closely (77)

            • agrimony

              tenecteplase and agrimony both increase anticoagulation. Modify Therapy/Monitor Closely.

            • alfalfa

              tenecteplase and alfalfa both increase anticoagulation. Modify Therapy/Monitor Closely.

            • alteplase

              alteplase and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • American ginseng

              tenecteplase and American ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.

            • anamu

              tenecteplase and anamu both increase anticoagulation. Use Caution/Monitor.

            • antithrombin alfa

              antithrombin alfa and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • antithrombin III

              antithrombin III and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • argatroban

              argatroban and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • aspirin

              aspirin, tenecteplase. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.

            • aspirin rectal

              aspirin rectal and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • aspirin/citric acid/sodium bicarbonate

              aspirin/citric acid/sodium bicarbonate, tenecteplase. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.

            • azficel-T

              azficel-T, tenecteplase. Other (see comment). Use Caution/Monitor. Comment: Coadministration with anticoagulants or antiplatelets may increase bruising or bleeding at biopsy and/or injection sites; concomitant use not recommended. Decisions regarding continued use or cessation of anticoagulants or antiplatelets should be made by a physician.

            • bivalirudin

              bivalirudin and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • celecoxib

              celecoxib and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • choline magnesium trisalicylate

              choline magnesium trisalicylate and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • cinnamon

              tenecteplase and cinnamon both increase anticoagulation. Modify Therapy/Monitor Closely.

            • cordyceps

              tenecteplase and cordyceps both increase anticoagulation. Modify Therapy/Monitor Closely.

            • dabigatran

              dabigatran and tenecteplase both increase anticoagulation. Use Caution/Monitor. Both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.

            • dalteparin

              dalteparin and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • danshen

              tenecteplase and danshen both increase anticoagulation. Use Caution/Monitor.

            • devil's claw

              tenecteplase and devil's claw both increase anticoagulation. Use Caution/Monitor.

            • diclofenac

              diclofenac and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • diflunisal

              diflunisal and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • dong quai

              tenecteplase and dong quai both increase anticoagulation. Modify Therapy/Monitor Closely.

            • enoxaparin

              enoxaparin and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • epoprostenol

              tenecteplase and epoprostenol both increase anticoagulation. Modify Therapy/Monitor Closely.

            • etodolac

              etodolac and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • fennel

              tenecteplase and fennel both increase anticoagulation. Modify Therapy/Monitor Closely.

            • fenoprofen

              fenoprofen and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • feverfew

              tenecteplase and feverfew both increase anticoagulation. Modify Therapy/Monitor Closely.

            • fish oil

              fish oil, tenecteplase. Other (see comment). Use Caution/Monitor. Comment: Patients taking fish oil and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

            • fish oil triglycerides

              fish oil triglycerides will increase the level or effect of tenecteplase by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.

            • flurbiprofen

              flurbiprofen and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • fondaparinux

              fondaparinux and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • forskolin

              tenecteplase and forskolin both increase anticoagulation. Modify Therapy/Monitor Closely.

            • garlic

              tenecteplase and garlic both increase anticoagulation. Modify Therapy/Monitor Closely.

            • ginger

              tenecteplase and ginger both increase anticoagulation. Modify Therapy/Monitor Closely.

            • ginkgo biloba

              tenecteplase and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.

            • green tea

              green tea, tenecteplase. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of bleeding.

            • heparin

              heparin and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • horse chestnut seed

              tenecteplase and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.

            • ibrutinib

              ibrutinib will increase the level or effect of tenecteplase by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding.

            • ibuprofen

              ibuprofen and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • ibuprofen IV

              ibuprofen IV and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • imatinib

              imatinib, tenecteplase. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: Imatinib may cause thrombocytopenia; bleeding risk increased when imatinib is coadministered with anticoagulants, NSAIDs, platelet inhibitors, and thrombolytic agents.

            • indomethacin

              indomethacin and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • ketoprofen

              ketoprofen and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • ketorolac

              ketorolac and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • ketorolac intranasal

              ketorolac intranasal and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

            • meclofenamate

              meclofenamate and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • mefenamic acid

              mefenamic acid and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • melatonin

              melatonin increases effects of tenecteplase by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

            • meloxicam

              meloxicam and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • mistletoe

              tenecteplase increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • nabumetone

              nabumetone and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • naproxen

              naproxen and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • nettle

              tenecteplase increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • nitroglycerin rectal

              nitroglycerin rectal decreases effects of tenecteplase by Other (see comment). Use Caution/Monitor. Comment: Caution should be observed in patients receiving nitroglycerin during t-PA therapy. IV administration of nitroglycerin decreases the thrombolytic effect of tissue-type plasminogen activator (t-PA). Plasma levels of t-PA are reduced when coadministered with nitroglycerin. .

            • omega 3 carboxylic acids

              omega 3 carboxylic acids, tenecteplase. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3 acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding.

            • omega 3 fatty acids

              omega 3 fatty acids, tenecteplase. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

            • oxaprozin

              oxaprozin and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • panax ginseng

              tenecteplase and panax ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.

            • pau d'arco

              tenecteplase and pau d'arco both increase anticoagulation. Modify Therapy/Monitor Closely.

            • phytoestrogens

              tenecteplase and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.

            • piroxicam

              piroxicam and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • reishi

              tenecteplase and reishi both increase anticoagulation. Modify Therapy/Monitor Closely.

            • rivaroxaban

              rivaroxaban, tenecteplase. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Avoid concurrent use of rivaroxaban with other anticoagulants due to increased bleeding risk other than during therapeutic transition periods where patients should be observed closely. Monitor for signs/symptoms of blood loss.

            • salicylates (non-asa)

              salicylates (non-asa) and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • salsalate

              salsalate and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • Siberian ginseng

              tenecteplase and Siberian ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.

            • sulindac

              sulindac and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • ticagrelor

              ticagrelor, tenecteplase. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Increased risk of bleeding during concomitant use of medications that increase potential for bleeding.

            • tolmetin

              tolmetin and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

            • tranexamic acid oral

              tranexamic acid oral, tenecteplase. Either decreases effects of the other by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.

            • vorapaxar

              tenecteplase, vorapaxar. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Coadministration of anticoagulants, antiplatelets, or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding.

            • vortioxetine

              tenecteplase, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.

            • warfarin

              tenecteplase increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.

            Minor (1)

            • ceftaroline

              ceftaroline increases effects of tenecteplase by Other (see comment). Minor/Significance Unknown. Comment: Cephalosporins with a methylthiotetrazole (MTT) side ring (eg, cefotetan, cefoperazone) are more frequently associated with hypoprothrombinemic activity.

            Previous
            Next:

            Adverse Effects

            >10%

            Minor bleeding (22%)

            Frequency Not Defined

            Reperfusion arrhythmias

            MI

            Fever

            Nausea

            Vomiting

            Cholesterol embolization

            Allergic reaction

            Previous
            Next:

            Warnings

            Contraindications

            Hypersensitivity

            Active bleeding, history of CVA, recent (within 2 months) intracranial or intraspinal surgery or trauma, intracranial neoplasm, AVM, aneurysm, bleeding diathesis, severe uncontrolled HTN, recent (within 3 mth) facial trauma, suspected aortic dissection

            Cautions

            Hypersensitivity, including urticarial/anaphylactic reactions, reported after administration of TNKase (eg, anaphylaxis, angioedema, laryngeal edema, rash, and urticaria); monitor patients treated with TNKase during and for several hours after infusion; if symptoms of hypersensitivity occur, initiate appropriate therapy

            Standard management of myocardial infarction should be implemented concomitantly with TNKase treatment; arterial and venous punctures should be minimized; noncompressible arterial puncture must be avoided and internal jugular and subclavian venous punctures should be avoided to minimize bleeding from the non-compressible sites

            The use of thrombolytics can increase the risk of thrombo-embolic events in patients with high likelihood of left heart thrombus, such as patients with mitral stenosis or atrial fibrillation

            Readministration of plasminogen activators, including TNKase, to patients who have received prior plasminogen activator therapy has not been systematically studied; although sustained antibody formation in patients receiving one dose of TNKase has not been documented,readministration should be undertaken with caution

            Cholesterol embolism

            • Cholesterol embolism has been reported rarely in patients treated with all types of thrombolytic agents; the true incidence is unknown; this serious condition, which can be lethal, is also associated with invasive vascular procedures (eg, cardiac catheterization, angiography, vascular surgery) and/or anticoagulant therapy
            • Clinical features of cholesterol embolism may include livedo reticularis, “purple toe” syndrome, acute renal failure, gangrenous digits, hypertension, pancreatitis, myocardial infarction, cerebral infarction, spinal cord infarction, retinal artery occlusion, bowel infarction, and rhabdomyolysis

            Arrhythmias

            • Coronary thrombolysis may result in arrhythmias associated with reperfusion; these arrhythmias (such as sinus bradycardia, accelerated idioventricular rhythm, ventricular premature depolarizations, ventricular tachycardia) are not different from those seen in ordinary course of acute myocardial infarction and may be managed with standard anti-arrhythmic measures
            • Recommended that anti-arrhythmic therapy for bradycardia and/or ventricular irritability be available when TNKase is administered

            Bleeding

            • The type of bleeding associated with thrombolytic therapy can be divided into two broad categories, internal bleeding, involving intracranial and retroperitoneal sites, or gastrointestinal, genitourinary, or respiratory tracts and superficial or surface bleeding, observed mainly at vascular puncture and access sites (eg, venous cutdowns, arterial punctures) or sites of recent surgical intervention
            • Should serious bleeding (not controlled by local pressure) occur, any concomitant heparin and antiplatelet agents should be discontinued immediately; heparin effects can be reversed by protamine
            • In clinical studies of TNKase, patients were treated with both aspirin and heparin; heparin may contribute to bleeding risks associated with TNKase; the safety of the use of TNKase with other antiplatelet agents has not been adequately studied
            • Intramuscular injections and nonessential handling of the patient should be avoided for the first few hours following treatment with TNKase; venipunctures should be performed and monitored carefully
            • Should an arterial puncture be necessary during first few hours following TNKase therapy, it is preferable to use an upper extremity vessel that is accessible to manual compression; pressure should be applied for at least 30 minutes, a pressure dressing applied, and the puncture site checked frequently for evidence of bleeding
            • Each patient being considered for therapy with TNKase should be carefully evaluated and anticipated benefits weighed against potential risks associated with therapy
            • In the following conditions, the risk of TNKase therapy may be increased and should be weighed against the anticipated benefits
              • Recent major surgery, eg, coronary artery bypass graft, obstetrical delivery, organ biopsy, previous puncture of noncompressible vessels
              • Cerebrovascular disease
              • Recent gastrointestinal or genitourinary bleeding
              • Recent trauma
              • Hypertension: systolic BP ≥ 180 mm Hg and/or diastolic BP ≥ 110 mm Hg
              • Acute pericarditis
              • Subacute bacterial endocarditis
              • Hemostatic defects, including those secondary to severe hepatic or renal disease
              • Severe hepatic dysfunction
              • Pregnancy
              • Diabetic hemorrhagic retinopathy or other hemorrhagic ophthalmic conditions
              • Septic thrombophlebitis or occluded AV cannula at seriously infected site
              • Advanced age (see PRECAUTIONS: Geriatric Use)
              • Patients currently receiving oral anticoagulants, e.g., warfarin sodium
              • Recent administration of GP IIb/IIIa inhibitors
              • Any other condition in which bleeding constitutes a significant hazard or would be particularly difficult to manage because of its location

            Drug interaction overview

            • Formal interaction studies of TNKase with other drugs have not been performed; patients studied in clinical trials of TNKase were routinely treated with heparin and aspirin; anticoagulants (such as heparin and vitamin K antagonists) and drugs that alter platelet function (such as acetylsalicylic acid, dipyridamole, and GP IIb/IIIa inhibitors) may increase risk of bleeding if administered prior to, during, or after therapy

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy

            There are no adequate and well-controlled studies in pregnant women; therapy should be given to pregnant women only if potential benefits justify potential risk to fetus

            Animal data

            • This drug has been shown to elicit maternal and embryo toxicity in rabbits given multiple IV administrations; embryonic deaths were secondary to maternal hemorrhage and no fetal anomalies were observed; this drug does not elicit maternal and embryo toxicity in rabbits following a single IV administration
            • The no observable effect level (NOEL) of a single IV administration on maternal or developmental toxicity was approximately 7 times human exposure (based on AUC) at the dose for AM

            Lactation

            Not known if this drug is excreted in human milk; because many drugs are excreted in human milk, exercise caution when this drug is administered to a nursing woman

            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.

            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Genetically engineered variant of alteplase with multiple point mutations of tPA molecule resulting in longer plasma half-life, enhanced fibrin specificity, & increased resistance to inactivation by plasminogen activator inhibitor 1 (PAI-1) compared to alteplase

            Promotes thrombolysis by converting plasminogen to plasmin which degrades fibrin & fibrinogen

            Pharmacokinetics

            Half-Life: 90-130 min

            Onset: 30 min

            Metabolism: Liver

            Metabolites: Degradation products (constituent amino acids of tenecteplase)

            Total Body Clearance: 99-119 mL/min

            Previous
            Next:

            Administration

            IV Preparation

            Add 10 mL SWI to a 50 mg vial using TwinPak® device directing stream of diluent into powder. If foaming (usually slight) occurs, leave vial undisturbed for several minutes to allow dissipation of any large bubbles. Gently swirl (do not shake) until contents are completely dissolved.

            Do not discard shield assembly

            Use immediately or may be refrigerated up to 8 hr

            Previous
            Next:

            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            TNKase intravenous
            -
            50 mg vial
            TNKase intravenous
            -
            50 mg vial
            TNKase intravenous
            -
            50 mg kit

            Copyright © 2010 First DataBank, Inc.

            Previous
            Next:

            Patient Handout

            A Patient Handout is not currently available for this monograph.
            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            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.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.