Betamethasone sodium phosphate and betamethasone acetate combination injection provides relief for inflamed areas of the body. It is used to treat a number of different conditions, such as inflammation (swelling), severe allergies, adrenal problems, arthritis, lung or breathing problems, blood or bone marrow problems, eye or vision problems, lupus, serious skin conditions, kidney problems, ulcerative colitis, and flare-ups of multiple sclerosis. Betamethasone sodium phosphate and betamethasone acetate combination is a corticosteroid (cortisone-like medicine or steroid). It works on the immune system to help relieve swelling, redness, itching, and allergic reactions.
Betamethasone sodium phosphate and betamethasone acetate is to be given only by or under the direct supervision of your doctor.
Betamethasone indications
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Betamethasone Suspension is indicated for the treatment of acute and chronic corticosteroid-responsive disorders. Corticosteroid hormone therapy is an adjunct to, and not a replacement for conventional therapy.
Allergic Conditions: Chronic bronchial asthma (including adjunctive therapy for status asthmaticus), hay fever, angioneurotic edema, allergic bronchitis, seasonal or perennial allergic rhinitis, drug reactions, serum sickness and insect bites.
Neoplastic Diseases: Palliative management of leukemias and lymphomas in adults; acute leukemia of childhood.
Other Conditions: Adrenogenital syndrome, ulcerative colitis, regional ileitis, sprue, podiatric conditions (bursitis under heloma durum, hallux rigidus, digiti quinti varus), affections requiring subconjunctival injection, corticosteroid-responsive blood dyscrasias, nephritis and nephrotic syndrome.
Primary or secondary adrenocortical insufficiency may be treated with Betamethasone Suspension but should be supplemented with mineralocorticosteroids, if applicable.
Betamethasone Suspension is recommended for intramuscular injection in conditions responsive to systemic corticosteroids; injection directly into the affected soft tissues where indicated; intra-articular and periarticular injection in arthritides; intralesional injection in various dermatologic conditions; and local injection in certain inflammatory and cystic disorders of the foot.
How should I use Betamethasone?
Use Betamethasone as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Take Betamethasone by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
Use the dropper that comes with Betamethasone to measure your dose. Ask your pharmacist for help if you are unsure of how to measure your dose.
If Betamethasone needs to be stopped (or if a different medicine is added to therapy) by your doctor, this will be done gradually. The risk of side effects may be increased if Betamethasone is suddenly stopped.
If you miss a dose of Betamethasone, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Betamethasone.
Uses of Betamethasone in details
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications
Intramuscular:
Allergic states: Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, serum sickness, transfusion reactions
Endocrine disorders: Congenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsuppurative thyroiditis. Note: Hydrocortisone or cortisone is the drug of choice in primary or secondary adrenocortical insufficiency. Synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance
Gastrointestinal diseases: During acute episodes in regional enteritis and ulcerative colitis
Hematologic disorders: Acquired (autoimmune) hemolytic anemia, Diamond-Blackfan anemia, pure red cell aplasia, selected cases of secondary thrombocytopenia
Neoplastic diseases: Palliative management of leukemias and lymphomas
Nervous system: Acute exacerbations of multiple sclerosis; cerebral edema associated with primary or metastatic brain tumor or craniotomy. Note: Treatment guidelines recommend the use of high-dose IV or oral methylprednisolone for acute exacerbations of multiple sclerosis (AAN [Scott 2011]; NICE 2014).
Ophthalmic diseases:
Sympathetic ophthalmia, temporal arteritis, uveitis and ocular inflammatory conditions unresponsive to topical corticosteroids
Renal diseases: To induce diuresis or remission of proteinuria in idiopathic nephrotic syndrome or that due to lupus erythematosus
Respiratory diseases: Berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis
Rheumatic disorders: Adjunctive therapy for short-term administration in acute gout flares; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy); treatment of dermatomyositis, polymyositis, and systemic lupus erythematosus.
Miscellaneous: Trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used with appropriate antituberculous chemotherapy
Intra-articular or soft tissue administration:
Adjunctive therapy for short-term administration in acute gout flares, acute and subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, rheumatoid arthritis, synovitis of osteoarthritis
Intralesional:
Treatment of alopecia areata; discoid lupus erythematosus; keloids; localized hypertrophic, infiltrated, inflammatory lesions of granuloma annulare, lichen planus, lichen simplex chronicus (neurodermatitis), and psoriatic plaques; necrobiosis lipoidica diabeticorum
Off Label Uses
Accelerate fetal lung maturation
According to systematic reviews of randomized controlled trials using betamethasone or dexamethasone, evidence supports the use of a single course of antenatal corticosteroids to accelerate fetal lung maturation in women at risk for preterm delivery, with no clear advantages found regarding use of one corticosteroid over another.
Betamethasone description
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Each gram of Betamethasone (Betamethasone*) Cream* contains: 640 mcg betamethasone dipropionate (equivalent to 500 mcg betamethasone).
Each gram of Betamethasone (Betamethasone*) Ointment* contains: 640 mcg betamethasone dipropionate (equivalent to 500 mcg betamethasone).
Betamethasone (Betamethasone*) Cream and Ointment contain betamethasone dipropionate, a synthetic corticosteroid with anti-inflammatory activity to be administered topically.
Betamethasone dipropionate is a white to creamy white odorless crystalline powder insoluble in water; freely soluble in acetone and in chloroform; sparingly soluble in alcohol. It has a molecular weight of 504.16 and the empirical formula C28H37FO7; a chemical name of 9-fluoro-11β,17,21-trihydroxy-16β-methylpregna-1,4-diene-3,20-dione,17,21-dipropionate.
Betamethasone dosage
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Kit, Injection:
Pod-Care 100C: Betamethasone sodium phosphate 3 mg and betamethasone acetate 3 mg per 1 mL [contains benzalkonium chloride, disodium edta]
ReadySharp Betamethasone: Betamethasone sodium phosphate 3 mg and betamethasone acetate 3 mg per 1 mL [contains benzalkonium chloride, disodium edta]
Suspension, Injection:
Betamethasone Soluspan: Betamethasone sodium phosphate 3 mg and betamethasone acetate 3 mg per 1 mL (5 mL) [contains benzalkonium chloride, edetate disodium]
Generic: Betamethasone sodium phosphate 3 mg and betamethasone acetate 3 mg per 1 mL (5 mL)
Dosing: Adult
Note: Dosages expressed as combined amount of betamethasone sodium phosphate and betamethasone acetate; 1 mg is equivalent to betamethasone sodium phosphate 0.5 mg and betamethasone acetate 0.5 mg.
Usual dosage range: IM: Initial: 0.25 to 9 mg/day (based on severity of disease and patient response).
Indication-specific dosing:
Antenatal fetal maturation (off-label use): IM: 12 mg every 24 hours for a total of 2 doses (ACOG 171 2016). A single course of betamethasone is recommended for women between 24 and 34 weeks of gestation, including those with ruptured membranes or multiple gestations, who are at risk of delivering within 7 days. A single course may be appropriate in some women beginning at 23 weeks gestation or late preterm (between 34 0/7 weeks and 36 6/7 weeks gestation). A single repeat course may be considered in some women with pregnancies less than 34 weeks gestation at risk for delivery within 7 days and who had a course of antenatal corticosteroids >14 days prior (ACOG 171 2016; ACOG 713 2017, ACOG 188 2018).
Bursitis (other than of foot): Intra-articular: 3 to 6 mg (0.5 to 1 mL) for one dose; additional injections may be required for acute exacerbations or chronic conditions; generally, injections should be separated by a minimum of 4 to 6 weeks and limited to ≤4 injections per year. If symptoms are not improved after 1 or 2 injections, additional injections are unlikely to provide benefit (Cardone 2002); following resolution of acute episodes, reduced doses may be warranted for chronic conditions.
Dermatologic conditions: Intradermal: 1.2 mg/cm displayed a good or excellent response (Chowdri, 1994). Another trial (n=25, age range: 7 weeks to 2 years) used lower doses of 3 to 12 mg (in combination with triamcinolone); 16 patients experienced a marked response (Kushner, 1985).
Concurrent use of phenobarbital, phenytoin, rifampin or ephedrine may enhance the metabolism of corticosteroids, reducing their therapeutic effects.
Patients receiving both a corticosteroid and an estrogen should be observed for excessive corticosteroid effects.
Concurrent use of corticosteroids with potassium-depleting diuretics may enhance hypokalemia. Concurrent use of corticosteroids with cardiac glycosides may enhance the possibility of arrhythmias or digitalis toxicity associated with hypokalemia. Corticosteroids may enhance the potassium depletion caused by amphotericin B. In all patients taking any of these drug therapy combinations, serum electrolyte determinations, particularly potassium levels, should be monitored closely.
Concurrent use of corticosteroids with coumarin-type anticoagulants may increase or decrease the anticoagulant effects, possibly requiring adjustment in dosage.
Combined effects of nonsteroidal anti-inflammatory drugs or alcohol with glucocorticosteroids may result in an increased occurrence or increased severity of gastrointestinal ulceration.
Corticosteroids may decrease blood salicylate concentrations. Acetylsalicylic acid should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia.
Dosage adjustments of an antidiabetic drug may be necessary when corticosteroids are given to diabetics.
Concomitant glucocorticosteroid therapy may inhibit the response to somatotropin. Doses of betamethasone in excess of 300-450 mcg (0.3-0.45 mg)/m2 of body surface per day should be avoided during administration of somatotropin.
Laboratory Tests: Corticosteroids may affect the nitro-blue tetrazolium test for bacterial infection and produce false-negative results.
In addition to its needed effects, some unwanted effects may be caused by betamethasone topical (the active ingredient contained in Betamethasone). In the event that any of these side effects do occur, they may require medical attention.
Major Side Effects
You should check with your doctor immediately if any of these side effects occur when taking betamethasone topical:
More common:
Burning, itching, or stinging at the application site
Less common:
Hair loss
thinning of the hair
Incidence not known:
Blistering, burning, crusting, dryness, or flaking of the skin
irritation
itching, scaling, severe redness, soreness, or swelling of the skin
redness and scaling around the mouth
thinning of the skin with easy bruising, especially when used on where the skin folds together (e.g. between the fingers)
Minor Side Effects
Some of the side effects that can occur with betamethasone topical may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:
Less common:
Acne or pimples
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
Incidence not known:
Burning and itching of the skin with pinhead-sized red blisters
burning, itching, and pain in hairy areas, or pus at the root of the hair
increased hair growth on the forehead, back, arms, and legs
lightening of normal skin color
lightening of treated areas of dark skin
reddish purple lines on the arms, face, legs, trunk, or groin
You should not use this medication if you are allergic to betamethasone, or if you have a fungal infection anywhere in your body.
Before taking betamethasone, tell your doctor about all of your medical conditions, and about all other medicines you are using. There are many other diseases that can be affected by steroid use, and many other medicines that can interact with steroids.
Your steroid medication needs may change if you have any unusual stress such as a serious illness, fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you during treatment.
Steroid medication can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.
Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medication.
Do not receive a "live" vaccine while you are taking betamethasone. Vaccines may not work as well while you are taking a steroid.
Do not stop using betamethasone suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.
Carry an ID card or wear a medical alert bracelet stating that you are taking a steroid, in case of emergency.
What is Gentamicin sulfate?
Treating surface eye infections caused by certain bacteria.
Gentamicin sulfate is a topical antibiotic. It works by slowing the growth of, or killing, sensitive bacteria.
Gentamicin sulfate indications
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Gentamicin sulfate and other antibacterial drugs, Gentamicin sulfate should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Gentamicin sulfate Sulfate Injection, USP is indicated in the treatment of serious infections caused by susceptible strains of the following microorganisms: Pseudomonas aeruginosa, Proteus species (indole-positive and indole-negative), Escherichia coli, Klebsiella-Enterobacter-Serratia species, Citrobacter species, and Staphylococcus species (coagulase-positive and coagulase-negative).
Clinical studies have shown Gentamicin sulfate Sulfate Injection, USP to be effective in bacterial neonatal sepsis; bacterial septicemia; and serious bacterial infections of the central nervous system (meningitis), urinary tract, respiratory tract, gastrointestinal tract (including peritonitis), skin, bone and soft tissue (including burns).
Aminoglycosides, including Gentamicin sulfate, are not indicated in uncomplicated initial episodes of urinary tract infections unless the causative organisms are susceptible to these antibiotics and are not susceptible to antibiotics having less potential for toxicity.
Specimens for bacterial culture should be obtained to isolate and identify causative organisms and to determine their susceptibility to Gentamicin sulfate.
Gentamicin sulfate sulfate may be considered as initial therapy in suspected or confirmed gram-negative infections, and therapy may be instituted before obtaining results of susceptibility testing. The decision to continue therapy with this drug should be based on the results of susceptibility tests, the severity of the infection, and the important additional concepts contained in the “WARNINGS box”. If the causative organisms are resistant to Gentamicin sulfate, other appropriate therapy should be instituted.
In serious infections when the causative organisms are unknown, Gentamicin sulfate sulfate may be administered as initial therapy in conjunction with a penicillin-type or cephalosporin-type drug before obtaining results of susceptibility testing. If anaerobic organisms are suspected as etiologic agents, consideration should be given to using other suitable antimicrobial therapy in conjunction with Gentamicin sulfate. Following identification of the organism and its susceptibility, appropriate antibiotic therapy should then be continued.
Gentamicin sulfate sulfate has been used effectively in combination with carbenicillin for the treatment of life-threatening infections caused by Pseudomonas aeruginosa. It has also been found effective when used in conjunction with a penicillin-type drug for the treatment of endocarditis caused by group D streptococci.
Gentamicin sulfate Sulfate Injection, USP has also been shown to be effective in the treatment of serious staphylococcal infections. While not the antibiotic of first choice, Gentamicin sulfate may be considered when penicillins or other less potentially toxic drugs are contraindicated and bacterial susceptibility tests and clinical judgment indicate its use. It may also be considered in mixed infections caused by susceptible strains of staphylococci and gram-negative organisms.
In the neonate with suspected bacterial sepsis or staphylococcal pneumonia, a penicillin-type drug is also usually indicated as concomitant therapy with Gentamicin sulfate.
In this dosage form, Gentamicin sulfate Sulfate Injection, USP is to be used with an ADD-Vantage antibiotic diluent flexible plastic container..
How should I use Gentamicin sulfate?
Use Gentamicin sulfate as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Gentamicin sulfate may be used around the eye or in the eye, as directed by your doctor. To use Gentamicin sulfate in the eye, first, wash your hands. Using your index finger, pull the lower eyelid away from your eye to form a pouch. Squeeze a thin strip of ointment into the pouch. After using Gentamicin sulfate, gently close your eyes for 1 to 2 minutes. Wash your hands to remove any medicine that may be on them. Wipe the applicator tip with a clean, dry tissue.
To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including the eye. Keep the container tightly closed.
Do not wear contact lenses while you are using Gentamicin sulfate. Take care of your contact lenses as directed by the manufacturer. Check with your doctor before you use them.
Gentamicin sulfate is only for the eye. Do not get it in your nose or mouth.
To clear up your infection completely, use Gentamicin sulfate for the full course of treatment. Keep using it even if you feel better in a few days.
Using Gentamicin sulfate at the same times each day will help you to remember to use it.
If you miss a dose of Gentamicin sulfate, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Gentamicin sulfate.
Uses of Gentamicin sulfate in details
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
This medication is used to treat minor skin infections (such as impetigo, folliculitis) or minor infections related to some skin conditions (such as eczema, psoriasis, minor burns/cuts/wounds). Gentamicin sulfate works by stopping the growth of certain bacteria. It belongs to a class of drugs known as aminoglycoside antibiotics.
This antibiotic only treats bacterial infections. It will not work for virus or fungus infections. Unnecessary use or overuse of any antibiotic can lead to its decreased effectiveness.
How to use Gentamicin sulfate topical
This medication is for use on the skin only.
Wash your hands before using. Clean and dry the affected area as directed. If you are treating impetigo, remove any dried, crusty skin to increase contact between the antibiotic and the infected area. Then gently apply a small amount of medication in a thin layer as directed by your doctor, usually 3 to 4 times a day. You may cover the area with a sterile gauze bandage if so directed. Keep the infected area clean. Wash your hands after use, unless you are using this product to treat the hands.
Avoid getting this medication in your eyes, nose, or mouth. If this occurs, wipe off the medication and rinse thoroughly with water.
Dosage and length of treatment is based on your medical condition and response to treatment.
Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day. Do not apply large amounts of this medication, use it more often, or use it for longer than prescribed. Your condition will not improve any faster, and your risk of side effects may increase.
Continue to use this medication for the full length of treatment prescribed, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a return of the infection.
Tell your doctor if your skin infection persists or if it worsens.
Gentamicin sulfate description
Gentamicin sulfate also contains the following ingredients: Methyl paraben 1.8 mg, propyl paraben 0.2 mg, sodium bisulfite 3.2 mg, disodium ethylenediaminetetraacetate 0.1 mg and water for injection.
Gentamicin sulfate sulfate injection is a sterile solution of Gentamicin sulfate sulfate water for injection. It contains the equivalent of not less than 90% and not more than 125% of the labeled amount of Gentamicin sulfate. It may contain suitable buffers, preservatives, sequestering agents, unless it is intended for intrathecal use, in which case it contains only suitable tonicity agents.
Gentamicin sulfate dosage
Gentamicin sulfate Sulfate Injection, USP is administered by intravenous infusion only after dilution in a 50 or 100 mL ADD-Vantage Flexible Diluent Container of 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP.
The patient’s pretreatment body weight should be obtained for calculation of correct dosage. The dosage of aminoglycosides in obese patients should be based on an estimate of the lean body mass. It is desirable to limit the duration of treatment with aminoglycosides to short term.
Patients with Normal Renal Function
Adults: The recommended dosage of Gentamicin sulfate sulfate for patients with serious infections and normal renal function is 3 mg/kg/day, administered in three equal doses every eight hours (Table 3).
For patients with life-threatening infections, dosages up to 5 mg/kg/day may be administered in three or four equal doses. The dosage should be reduced to 3 mg/kg/day as soon as clinically indicated (Table 3).
It is desirable to measure both peak and trough serum concentrations of Gentamicin sulfate to determine the adequacy and safety of the dosage. When such measurements are feasible, they should be carried out periodically during therapy to assure adequate but not excessive drug levels. When monitoring peak concentrations after intravenous administration, dosage should be adjusted so that prolonged levels above 12 mcg/mL are avoided. When monitoring trough concentrations (just prior to the next dose), dosage should be adjusted so that levels above 2 mcg/mL are avoided. Determination of the adequacy of a serum level for a particular patient must take into consideration the susceptibility of the causative organism, the severity of the infection, and the status of the patient’s host-defense mechanisms. In patients with extensive burns, altered pharmacokinetics may result in reduced serum concentrations of aminoglycosides. In such patients treated with Gentamicin sulfate, measurement of serum concentrations is recommended as a basis for dosage adjustment.
Table 3 Dosage Schedule Guide For Adults With Normal Renal Function
* The dosage of aminoglycosides in obese patients should be based on an estimate of the lean body mass.
** For q6h schedules, dosage should be recalculated.
(Dosage at Eight-Hour Intervals)
Patient’s
Weight*
Usual Dose
for Serious Infections
Dose for Life-Threatening
Infections (Reduce as Soon as Clinically Indicated)
kg
(lb)
1 mg/kg q8h
(3 mg/kg/day)
1.7 mg/kg q8h**
(5 mg/kg/day)
mg/dose
q8h
mg/dose
q8h
40
(88)
40
66
45
(99)
45
75
50
(110)
50
83
55
(121)
55
91
60
(132)
60
100
65
(143)
65
108
70
(154)
70
116
75
(165)
75
125
80
(176)
80
133
85
(187)
85
141
90
(198)
90
150
95
(209)
95
158
100
(220)
100
166
NOTE: For further information concerning the use of Gentamicin sulfate in infants and children, see pediatric Gentamicin sulfate sulfate injection product information.
The usual duration of treatment for all patients is seven to ten days. In difficult and complicated infections, a longer course of therapy may be necessary. In such cases monitoring of renal, auditory, and vestibular functions is recommended, since toxicity is more apt to occur with treatment extended for more than ten days. Dosage should be reduced if clinically indicated.
For
Intravenous Administration
The intravenous administration of Gentamicin sulfate may be particularly useful for treating patients with bacterial septicemia or those in shock. It may also be the preferred route of administration for some patients with congestive heart failure, hematologic disorders, severe burns, or those with reduced muscle mass. For intermittent intravenous administration in adults, a single dose of Gentamicin sulfate sulfate may be diluted in 50 or 100 mL of sterile 0.9% Sodium Chloride Injection, USP or in a sterile solution of 5% Dextrose Injection, USP. The solution may be infused over a period of one-half to two hours.
Gentamicin sulfate sulfate should not be physically premixed with other drugs, but should be administered separately in accordance with the recommended route of administration and dosage schedule.
Patients with Impaired Renal Function
Dosage must be adjusted in patients with impaired renal function to assure therapeutically adequate, but not excessive blood levels. Whenever possible, serum concentrations of Gentamicin sulfate should be monitored. One method of dosage adjustment is to increase the interval between administration of the usual doses. Since the serum creatinine concentration has a high correlation with the serum half-life of Gentamicin sulfate, this laboratory test may provide guidance for adjustment of the interval between doses. The interval between doses (in hours) may be approximated by multiplying the serum creatinine level (mg/100 mL) by 8. For example, a patient weighing 60 kg with a serum creatinine level of 2.0 mg/100 mL could be given 60 mg (1 mg/kg) every 16 hours (2x8).
In patients with serious systemic infections and renal impairment, it may be desirable to administer the antibiotic more frequently but in reduced dosage. In such patients, serum concentrations of Gentamicin sulfate should be measured so that adequate, but not excessive levels result. A peak and trough concentration measured intermittently during therapy will provide optimal guidance for adjusting dosage. After the usual initial dose, a rough guide for determining reduced dosage at eight-hour intervals is to divide the normally recommended dose by the serum creatinine level (Table 4). For example, after an initial dose of 60 mg (1 mg/kg), a patient weighing 60 kg with a serum creatinine level of 2.0 mg/100 mL could be given 30 mg every eight hours (60 ÷ 2). It should be noted that the status of renal function may be changing over the course of the infectious process.
It is important to recognize that deteriorating renal function may require a greater reduction in dosage than that specified in the above guidelines for patients with stable renal impairment.
Table 4 Dosage Adjustment Guide for Patients with Renal Impairment
(Dosage at Eight-Hour Intervals After the Usual Initial Dose)
Serum
Creatinine
(mg%)
Approximate Creatinine
Clearance Rate
(mL/min/1.73M2)
Percent of Usual Doses
Shown in Table 3
≤1.0
>100
100
1.1 — 1.3
70 —100
80
1.4 — 1.6
55 — 70
65
1.7 — 1.9
45 — 55
55
2.0 — 2.2
40 — 45
50
2.3 — 2.5
35 — 40
40
2.6 — 3.0
30 — 35
35
3.1 — 3.5
25 — 30
30
3.6 — 4.0
20 — 25
25
4.1 — 5.1
15 — 20
20
5.2 — 6.6
10 — 15
15
6.7 — 8.0
<10
10
In adults with renal failure undergoing hemodialysis, the amount of Gentamicin sulfate removed from the blood may vary depending upon several factors including the dialysis method used. An eight-hour hemodialysis may reduce serum concentrations of Gentamicin sulfate by approximately 50%. The recommended dose at the end of each dialysis period is 1 to 1.7 mg/kg depending upon the severity of infection.
The above dosage schedules are not intended as rigid recommendations but are provided as guides to dosage when the measurement of Gentamicin sulfate serum levels is not feasible.
A variety of methods are available to measure Gentamicin sulfate concentrations in body fluids; these include microbiologic, enzymatic and radioimmunoassay techniques.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
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: aminoglycoside antibiotics given by injection (such as amikacin, Gentamicin sulfate, tobramycin).
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.
Nephrotoxicity: Adverse renal effects, as demonstrated by the presence of casts, cells or protein in the urine or by rising BUN, NPN, serum creatinine or oliguria, have been reported. They occur more frequently in patients with a history of renal impairment and in patients treated for longer periods or with larger dosages than recommended.
Neurotoxicity: Serious adverse effects on both vestibular and auditory branches of the eighth nerve have been reported, primarily in patients with renal impairment (especially if dialysis is required) and in patients on high doses and/or prolonged therapy. Symptoms include dizziness, vertigo, tinnitus, roaring in the ears and also hearing loss, which, as with the other aminoglycosides, may be irreversible. Hearing loss is usually manifested initially by diminution of high-tone acuity. Other factors which may increase the risk of toxicity include excessive dosage, dehydration and previous exposure to other ototoxic drugs.
Peripheral neuropathy or encephalopathy, including numbness, skin tingling, muscle twitching, convulsions, and a myasthenia gravis-like syndrome, have been reported.
NOTE: The risk of toxic reactions is low in patients with normal renal function who do not receive Gentamicin sulfate Sulfate at higher doses or for longer periods of time than recommended.
Other reported adverse reactions possibly related to Gentamicin sulfate include: Respiratory depression, lethargy, confusion, depression, visual disturbances, decreased appetite, weight loss and hypotension and hypertension; rash, itching, urticaria, generalized burning, laryngeal edema, anaphylactoid reactions, fever, and headache; nausea, vomiting, increased salivation, and stomatitis; purpura, pseudotumor cerebri, acute organic brain syndrome, pulmonary fibrosis, alopecia, joint pain, transient hepatomegaly and splenomegaly.
Laboratory abnormalities possibly related to Gentamicin sulfate include: Increased levels of serum transaminase (SGOT, SGPT), serum LDH and bilirubin; decreased serum calcium, magnesium, sodium and potassium; anemia, leukopenia, granulocytopenia, transient agranulocytosis, eosinophilia, increased and decreased reticulocyte counts and thrombocytopenia. While clinical laboratory test abnormalities may be isolated findings, they may also be associated with clinically related signs and symptoms. For example, tetany and muscle weakness may be associated with hypomagnesemia, hypocalcemia and hypokalemia.
While local tolerance of Gentamicin sulfate Sulfate is generally excellent, there has been an occasional report of pain at the injection site. Subcutaneous atrophy or fat necrosis suggesting local irritation has been reported rarely.
Gentamicin sulfate Sulfate Sterile Ophthalmic Solution is contraindicated in patients with known hypersensitivity to any of the components.
What is Miconazole nitrate?
Miconazole nitrate topical is an antifungal medication. Miconazole nitrate topical prevents fungus from growing on your skin.
Miconazole nitrate topical is used to treat skin infections such as athlete's foot, jock itch, ringworm, tinea versicolor (a fungus that discolors the skin), and yeast infections.
Miconazole nitrate topical may also be used for purposes other than those listed in this medication guide.
Miconazole nitrate indications
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
Adwizole (Miconazole nitrate nitrate) Spray is indicated for the treatment of fungal infections in dogs and cats caused by Microsporum canis, Microsporum gypseum and Trichophyton mentagrophytes.
How should I use Miconazole nitrate?
Use Miconazole nitrate as directed by your doctor. Check the label on the medicine for exact dosing instructions.
An extra patient leaflet is available with Miconazole nitrate. Talk to your pharmacist if you have questions about this information.
Use Miconazole nitrate in the morning after you brush your teeth.
Wash your hands and dry well before handling Miconazole nitrate.
Place the rounded side of the tablet against the upper gum just above the incisor tooth. Check with your doctor or pharmacist if you are not sure where to place Miconazole nitrate.
Apply slight pressure over the upper lip to hold the tablet in place for 30 seconds to make sure that it stays in place. The tablet may be used if it sticks to the cheek, the inside of the lip, or the gum.
After you apply Miconazole nitrate, allow it to dissolve slowly in your mouth. Do not chew, crush, or swallow it whole.
Apply your next dose to the other side of the mouth. Before you apply your next dose, rinse your mouth to be sure none of the previous tablet still remains.
You may eat and drink while the tablet is in place. However, do not chew gum while the tablet is in place.
If the tablet does not stick or falls off within the first 6 hours, replace the same tablet back against the gum immediately. If the tablet still does not stick, remove that tablet and put a new one in place.
If you accidentally swallow Miconazole nitrate within the first 6 hours, drink a glass of water. Then put a new tablet in place. The tablet should only be replaced once. Check with your doctor or pharmacist if you accidentally swallow the tablet and you are not sure what to do.
If the tablet falls off or is accidentally swallowed after it has been in place for 6 hours or more, do not replace that tablet until your next regularly scheduled dose.
To clear up your infection completely, use Miconazole nitrate for the full course of treatment. Keep using it even if your condition improves in a few days.
If you miss a dose of Miconazole nitrate, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Miconazole nitrate.
Uses of Miconazole nitrate in details
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
Miconazole nitrate is an imidazole (organic compound) antifungal agent used to treat fungal and associated bacterial super infections of the skin and nails Miconazole nitrate is also used for oral treatment and prevention of fungal infections of the mouth, throat and food pipe Miconazole nitrate is effectively used in vulvovaginal (vagina and external genital organs) candidiasis (thrush) and other yeast infection of the vagina. Further, Miconazole nitrate is also prescribed for napkin rash and inflammation of the folds of tissue surrounding the nails of toes or fingers (paronychia).
Miconazole nitrate description
Miconazole nitrate: Each mL of solution contains Miconazole nitrate nitrate, in a soothing, cooling solution, which helps to keep the infection site dry.
Miconazole nitrate Tinea: Each gram of cream contains Miconazole nitrate nitrate, dimethicone and phenethyl alcohol in a lanolin-free aqueous soft cream base. It has a pH of 5.
Each gram of powder contains Miconazole nitrate nitrate in a zinc oxide menthol and talc powder base.
All cream products are lanolin-free, propylene glycol-free, colour-free, perfume-free and paraben-free to avoid irritant reactions.
Miconazole nitrate dosage
Miconazole nitrate Dosage
Generic name: Miconazole nitrate nitrate
Dosage form: Cream
See also:
Monistat 3 vaginal cream, vaginal suppositories
Monistat 3 Combination Pack Triple Action cream
Monistat 7 Combination Pack cream
Monistat 7 Cream vaginal cream
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
Sufficient Miconazole nitrate Cream should be applied to cover affected areas twice daily (morning and evening) in patients with tinea pedis, tinea cruris, tinea corporis, and cutaneous candidiasis, and once daily in patients with tinea versicolor. If Miconazole nitrate Cream is used in intertriginous areas, it should be applied sparingly and smoothed in well to avoid maceration effects.
Early relief of symptoms (2 to 3 days) is experienced by the majority of patients and clinical improvement may be seen fairly soon after treatment is begun; however, Candida infections and tinea cruris and corporis should be treated for two weeks and tinea pedis for one month in order to reduce the possibility of recurrence. If a patient shows no clinical improvement after a month of treatment, the diagnosis should be redetermined. Patients with tinea versicolor usually exhibit clinical and mycological clearing after two weeks of treatment.
More about Miconazole nitrate (Miconazole nitrate topical)
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Miconazole nitrate cream
Monistat Derm
Topical (Advanced Reading)
Other brands: Mitrazol, Aloe Vesta, Zeasorb-AF, Baza Antifungal, More (26) »
In addition to its needed effects, some unwanted effects may be caused by Miconazole nitrate topical (the active ingredient contained in Miconazole nitrate). In the event that any of these side effects do occur, they may require medical attention.
Severity: Moderate
If any of the following side effects occur while taking Miconazole nitrate topical, check with your doctor or nurse as soon as possible:
Blistering, burning, redness, skin rash, or other sign of skin irritation not present before use of this medicine
When used by a person taking the anticoagulant medication warfarin, Miconazole nitrate may cause an adverse reaction which can lead to excessive bleeding or bruising.
Active ingredient matches for Betamethasone/Gentamicin sulfate/miconazole nitrate:
DailyMed. "MICONAZOLE: 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. "GENTAMICIN SULFATE: 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. "BETAMETHASONE: 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).
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