Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local, or emergency room immediately. Acnetoin solution may be harmful if swallowed.
Proper storage of Acnetoin solution:
Store Acnetoin solution at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), in a tightly-closed container. Store away from heat and light. Keep Acnetoin solution out of the reach of children and away from pets.
Overdose of Acnetoin in details
When a dose is taken in higher dose than the recommended doses, it is called Overdose. Overdose always needs a clinical supervision. Any medicine or drug when consumed in Overdose produces untoward side effects on one or various organs in the body. A medicine is excreted in the kidney or metabolized in the liver most of the times. This process goes without any hurdles when taken in normal dose, but when taken in an overdose, the body is not able to metabolize it or send it out properly which causes the effects of anoverdose.
In case of overdosage, Acnetoin should be discontinued. Overdosage should be handled with the prompt elimination of unabsorbed drug and all other appropriate measures should be instituted.
Acnetoin is not removed by peritoneal dialysis or hemodialysis.
What should I avoid while taking Acnetoin?
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking Acnetoin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
Warnings are a mix of Precautions. Contraindications and interactions and serious harmful effects associated with the medicine intake. A diabetic or Hypertensive patient need to be warned about few drug interactions. A known hypersensitivity patient needs to be careful about the reactions or anaphylactic shock. A pregnant woman or a breastfeeding woman should be warned of certain medications. A Hepatitis [liver disease] patient or a cardiac patient should avoid few drugs.
There have been reports of hepatic dysfunction, including increased liver enzymes, and hepatocellular and/or cholestatic hepatitis, with or without jaundice, occurring in patients receiving oral Acnetoin products.
Acnetoin has been associated with prolongation of the QT interval and infrequent cases of arrhythmia. Cases of torsades de pointes have been spontaneously reported during postmarketing surveillance in patients receiving Acnetoin. Fatalities have been reported. Acnetoin should be avoided in patients with known prolongation of the QT interval, patients with ongoing proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia, and in patients receiving Class IA (quinidine, procainamide) or Class III (dofetilide, aminodarone, sotalol) antiarrhythmic agents. Elderly patients may be more susceptible to drug-associated effects on the QT interval.
Syphilis in pregnancy
There have been reports suggesting that Acnetoin does not reach the fetus in adequate concentration to prevent congenital syphilis. Infants born to women treated during pregnancy with oral Acnetoin for early syphilis should be treated with an appropriate penicillin regimen.
Clostridium difficile-associated diarrhea
Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including Acnetoin Capsules, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
Serious adverse reactions have been reported in patients taking Acnetoin concomitantly with CYP3A4 substrates. These include colchicine toxicity with colchicine; rhabdomyolysis with simvastatin, lovastatin, and atorvastatin; and hypotension with calcium channel blockers metabolized by CYP3A4 (for example, verapamil, amlodipine, diltiazem).
There have been post-marketing reports of colchicine toxicity with concomitant use of Acnetoin and colchicine. This interaction is potentially life-threatening, and may occure while using both drugs at their recommended doses.
Rhabdomyolysis with or without renal impairment has been reported in seriously ill patients receiving Acnetoin concomitantly with lovastatin. Therefore, patients receiving concomitant lovastatin and Acnetoin should be carefully monitored for creatine kinase (CK) and serum transaminase levels.
What should I discuss with my healthcare provider before taking Acnetoin?
Some medical conditions may interact with Acnetoin pad. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
if you are pregnant, planning to become pregnant, or are breast-feeding
if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
if you have allergies to medicines, foods, or other substances
if you have liver disease or you have a blood disorder called porphyria
Some MEDICINES MAY INTERACT with Acnetoin pad. Tell your health care provider if you are taking any other medicines, especially any of the following:
Efavirenz or rifampin because they may decrease Acnetoin pad's effectiveness
Arsenic, cimetidine,diltiazem,dofetilide,HIV protease inhibitors (eg, ritonavir), imidazoles (eg, ketoconazole), pimozide, QT-prolonging agents (eg, quinidine, sotalol), quinolones (eg, ciprofloxacin), streptogramins (eg, quinupristin/dalfopristin), or verapamil because side effects, such as heart toxicity or irregular heartbeat, may occur
Anticoagulants (eg, warfarin), aldosterone blockers (eg, spironolactone), alfentanil, arsenic, astemizole, benzodiazepines (eg, alprazolam), bromocriptine, buspirone, carbamazepine, cilostazol, cisapride, clozapine, corticosteroids (eg, hydrocortisone), cyclosporine, digitoxin, digoxin, disopyramide, ergot alkaloids (eg, ergotamine, felodipine, H antagonists (eg, diphenhydramine), HMG-CoA reductase inhibitors (eg, simvastatin), imatinib, macrolide immunosuppressants (eg, tacrolimus), meglitinide antidiabetics (eg, repaglinide), midazolam, phosphodiesterase type 5 inhibitors (eg, sildenafil), pimozide, QT-prolonging agents (eg, quinidine, sotalol), quinolones (eg, ciprofloxacin, rifampin, serotonin reuptake inhibitors (eg, fluoxetine), sumatriptan theophyllines, tricyclic antidepressants (eg, amitriptyline), valproic acid, or vinca alkaloids (eg, vincristine) because the risk of their side effects may be increased by Acnetoin pad
This may not be a complete list of all interactions that may occur. Ask your health care provider if Acnetoin pad may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Certain people who are very sick or very old or who are sensitive show an exacerbation of side effect of the drug which can turn dangerous at times. So, it is very important to remember the precautions while taking the medicine. Pregnancy and Breastfeeding are also special categories wherein extra care or precaution is needed when taking a drug. Few patients may have a hypersensitivity reaction to few medications, and that can be life-threatening rarely. Penicillin hypersensitivity is one example. Diarrhea, rashes are few other symptoms which need a watch. A patient with other co-existing diseases like liver disease, heart disease, kidney disease should take special precautions.
General: Prescribing Acnetoin Base Filmtab (Acnetoin tablets) tablets in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
Since Acnetoin is principally excreted by the liver, caution should be exercised when Acnetoin is administered to patients with impaired hepatic function.
There have been reports that Acnetoin may aggravate the weakness of patients with myasthenia gravis.
There have been reports of infantile hypertrophic pyloric stenosis (IHPS) occurring in infants following Acnetoin therapy. In one cohort of 157 newborns who were given Acnetoin for pertussis prophylaxis, seven neonates (5%) developed symptoms of non-bilious vomiting or irritability with feeding and were subsequently diagnosed as having IHPS requiring surgical pyloromyotomy. A possible dose-response effect was described with an absolute risk of IHPS of 5.1% for infants who took Acnetoin for 8-14 days and 10% for infants who took Acnetoin for 15-21 days. Since Acnetoin may be used in the treatment of conditions in infants which are associated with significant mortality or morbidity (such as pertussis or neonatal Chlamydia trachomatis infections), the benefit of Acnetoin therapy needs to be weighed against the potential risk of developing IHPS. Parents should be informed to contact their physician if vomiting or irritability with feeding occurs.
Prolonged or repeated use of Acnetoin may result in an overgrowth of nonsusceptible bacteria or fungi. If superinfection occurs, Acnetoin should be discontinued and appropriate therapy instituted.
When indicated, incision and drainage or other surgical procedures should be performed in conjunction with antibiotic therapy.
Carcinogenesis, Mutagenesis, Impairment of Fertility: Long-term (2-year) oral studies conducted in rats with Acnetoin base did not provide evidence of tumorigenicity. Mutagenicity studies have not been conducted. There was no apparent effect on male or female fertility in rats fed Acnetoin (base) at levels up to 0.25 percent of diet.
Pregnancy: Teratogenic effects. Pregnancy Category B: There is no evidence of teratogenicity or any other adverse effect on reproduction in female rats fed Acnetoin base (up to 0.25 percent of diet) prior to and during mating, during gestation, and through weaning of two successive litters. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Labor and Delivery: The effect of Acnetoin on labor and delivery is unknown.
Nursing Mothers: Acnetoin is excreted in human milk. Caution should be exercised when Acnetoin is administered to a nursing woman.
Pediatric Use: See INDICATIONS and DOSAGE AND ADMINISTRATION.
4. Honein, M.A., et. al.: Infantile hypertrophic pyloric stenosis after pertussis prophylaxis with Acnetoin: a case review and cohort study. The Lancet 1999; 354 (9196): 2101-5.
What happens if I miss a dose of Acnetoin?
When you miss a dose, you should take it as soon as you remember, but you should take care that it should be well spaced from the next dose. You should not take an extra dose at the time of the second dose as it will become a double dose. The double dose can give unwanted side effects, so be careful. In chronic conditions or when you have a serious health issue, if you miss a dose, you should inform your health care provider and ask his suggestion.
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
DailyMed. "ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PHYTONADIONE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN 5'-PHOSPHATE SODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
DailyMed. "ERYTHROMYCIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).