Dospertine 5 Overdose

How do you administer this medicine?
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What happens if I overdose Dospertine 5?

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include agitation; confusion; drowsiness; muscle restlessness; unusual movement of the eyes, face, or limbs.

Proper storage of Dospertine 5:

Store Dospertine 5 at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Dospertine 5 out of the reach of children and away from pets.

Overdose of Dospertine 5 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.
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Notes

Missed Dose

Storage

What should I avoid while taking Dospertine 5?

Avoid drinking alcohol. It can increase some of the side effects of Dospertine 5.

Dospertine 5 may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Dospertine 5 warnings

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.

You should not take this medication if you are allergic to Dospertine 5, or if you have bleeding or blockage in your stomach or intestines, epilepsy or other seizure disorder, or an adrenal gland tumor (pheochromocytoma).

Before taking Dospertine 5, tell your doctor if you have kidney or liver disease, congestive heart failure, diabetes, or a history of depression.

Avoid drinking alcohol. It can increase some of the side effects of Dospertine 5. There are many other medicines that can interact with Dospertine 5.

Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Do not take it in larger amounts than recommended, or for longer than 3 months. High doses or long-term use of Dospertine 5 may cause tremors or other uncontrollable muscle movements, especially in older women.

Stop using Dospertine 5 and call your doctor at once if you have tremors or uncontrolled muscle movements, fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing, depressed mood, thoughts of suicide or hurting yourself, hallucinations, anxiety, agitation, seizure, or jaundice (yellowing of your skin or eyes).

After you stop taking Dospertine 5, you may have unpleasant withdrawal symptoms such as headache, dizziness, or nervousness. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

You should not take this medication if you are allergic to Dospertine 5, or if you have:

bleeding or blockage in your stomach or intestines;

a perforation (hole) in your stomach or intestines;

epilepsy or other seizure disorder; or

an adrenal gland tumor (pheochromocytoma).

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take Dospertine 5:

kidney disease;

liver disease (especially cirrhosis);

congestive heart failure;

high blood pressure;

Parkinson’s disease;

diabetes (your insulin dose may need adjusting); or

a history of depression.

FDA pregnancy category B. Dospertine 5 is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Dospertine 5 can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Avoid drinking alcohol. It can increase some of the side effects of Dospertine 5. Dospertine 5 can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my healthcare provider before taking Dospertine 5?

Some medical conditions may interact with Dospertine 5. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

Some MEDICINES MAY INTERACT with Dospertine 5. Tell your health care provider if you are taking any other medicines, especially any of the following:

This may not be a complete list of all interactions that may occur. Ask your health care provider if Dospertine 5 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.

Dospertine 5 precautions

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.
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Concerns related to adverse effects:

• CNS depression: May cause CNS depression, which may impair physical or mental abilities; patients must be cautioned about performing tasks that require mental alertness (eg, operating machinery or driving).

• Depression: Depression has occurred (in patients with and without a history of depression); symptoms have included suicidal ideation and suicide; avoid use in patients with a history of depression.

• Extrapyramidal symptoms (EPS): May cause extrapyramidal symptoms, generally manifested as acute dystonic reactions within the initial 24 to 48 hours of use at the usual adult dose (30 to 40 mg/day). Risk of these reactions is increased at higher than recommended doses, and in patients <30 years of age. Symptoms may include involuntary limb movements, facial grimacing, torticollis, oculogyric crisis, rhythmic tongue protrusion, bulbar type speech, trismus, or dystonic reactions resembling tetanus. May also rarely present as stridor and dyspnea (may be due to laryngospasm). Dystonic symptoms may be managed with IM diphenhydramine or benztropine. Pseudoparkinsonism (eg, bradykinesia, tremor, cogwheel rigidity, mask-like facies) may also occur (usually within first 6 months of therapy but also after longer periods) and is generally reversible within 2 to 3 months following discontinuation. Motor restlessness (eg, anxiety, agitation, jitteriness, insomnia) may occur; if symptoms resolve, consider restarting at a lower dosage. Avoid Dospertine 5 in patients receiving other drugs that are likely to cause EPS (eg, antipsychotics).

• Hyperprolactinemia: Dospertine 5 elevates prolactin levels. Hyperprolactinemia may suppress hypothalamic GnRH, resulting in reduced pituitary gonadotropin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis. Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported. Hyperprolactinemia may potentially stimulate prolactin-dependent breast cancer. However, some clinical studies and epidemiology studies have not shown an association between administration of dopamine D receptor antagonists and tumorigenesis in humans.

• Hypertension: May elevate blood pressure; avoid use in patients with hypertension (IV administration was shown to release catecholamines). There are reports of hypertensive crises in patients with undiagnosed pheochromocytoma; use is contraindicated in patients with pheochromocytoma or other catecholamine-releasing paragangliomas. Discontinue therapy in any patient with a rapid rise in blood pressure.

• Neuroleptic malignant syndrome: Use may be associated with neuroleptic malignant syndrome (NMS); may be fatal. Monitor for manifestations of NMS, which include hyperpyrexia, muscle rigidity, altered mental status, and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis, and cardiac arrhythmias); additional signs may include elevated creatine phosphokinase, myoglobinuria, and acute renal failure. Discontinue immediately if signs/symptoms of NMS appear and begin intensive symptomatic management and monitoring.

• Proarrhythmic effects: Dospertine 5 has been known to cause sinus arrest (usually with rapid IV administration or higher doses) (Bentsen 2002; Malkoff 1995). The torsadogenic potential for Dospertine 5 is considered to be low (Claassen 2005). Based on case reports, however, Dospertine 5 may cause QT prolongation and torsades de pointes in certain individuals (eg, heart failure patients with renal impairment) (Siddique 2009). There is data in healthy male volunteers to show that Dospertine 5 actually shortens the QT interval while at the same time increasing QT variance (Ellidokuz 2003). No human data other than case reports, however, has demonstrated a consistent QT prolonging effect with Dospertine 5 nor is there any substantiated evidence to show a direct association with the development of torsades de pointes.

• Tardive dyskinesia: [US Boxed Warning]: May cause tardive dyskinesia, a serious movement disorder that is often irreversible with no known treatment; the risk of developing tardive dyskinesia increases with duration of treatment and total cumulative dose. Discontinue Dospertine 5 in patients who develop signs/symptoms of tardive dyskinesia; in some patients, symptoms may lessen or resolve after Dospertine 5 is stopped. Avoid treatment with Dospertine 5 for longer than 12 weeks because of the increased risk of developing tardive dyskinesia with longer-term use. Avoid Dospertine 5 in patients receiving other drugs that are likely to cause tardive dyskinesia (eg, antipsychotics). Tardive dyskinesia is characterized by disfiguring involuntary movements of the face, tongue, and sometimes of the trunk and/or extremities; movements may be choreoathetotic in appearance. Dospertine 5 may mask underlying tardive disease by suppressing or partially suppressing tardive dyskinesia signs; the effect of this symptomatic suppression upon the long-term course of tardive dyskinesia is unknown. The risk of developing tardive dyskinesia is increased in the elderly, especially elderly women, and diabetics, although it is not possible to predict which patients will develop tardive dyskinesia. Discontinue Dospertine 5 immediately in patients who develop signs/symptoms of tardive dyskinesia. There is no known effective treatment for established cases of tardive dyskinesia, although in some patients, tardive dyskinesia may remit (partially or completely) within several weeks to months after Dospertine 5 is withdrawn.

Disease-related concerns:

• Cardiovascular disease: Use with caution in patients with heart failure and concomitant renal impairment; may be at risk for development of QT prolongation and torsades de pointes (Siddique 2009).

• Edematous conditions: Use with caution in patients who are at risk of fluid overload (HF, cirrhosis). Dospertine 5 causes a transient increase in serum aldosterone and increases the risk for fluid retention and volume overload. Discontinue if adverse events or signs/symptoms appear.

• Hepatic impairment: Use caution in patients with moderate to severe hepatic impairment; risk of adverse reactions may be increased due to increased systemic exposure; dosage adjustment recommended.

• Nicotinamide adenine dinucleotide hydrogen (NADH)-cytochrome b5 reductase deficiency: Patients with NADH-cytochrome b5 reductase deficiency are at increased risk of methemoglobinemia and/or sulfhemoglobinemia.

• Parkinson disease: Symptoms of Parkinson disease may be exacerbated; avoid use in patients with Parkinson disease and other patients being treated with antiparkinsonian drugs.

• Renal impairment: Use with caution in patients with moderate to severe renal impairment; risk of adverse reactions may be increased due to increased systemic exposure; dosage adjustment recommended.

• Surgical anastomosis/closure: Use with caution following surgical anastomosis/closure; promotility agents may theoretically increase pressure in suture lines.

Concurrent drug therapy issues:

• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.

Special populations:

• CYP2D6 poor metabolizers: Elimination of Dospertine 5 may be slowed possibly increasing the risk of dystonic and other adverse reactions; dosage reduction recommended.

Elderly: Risk of tardive dyskinesia may be increased in elderly, especially in elderly women.

• Pediatric: Not recommended for use (oral formulation) due to increased risk of tardive dyskinesia and other extrapyramidal symptoms as well as the risk of methemoglobinemia in neonates (neonates may have decreased levels of NADH-cytochrome b5 reductase, which increases the risk of methemoglobinemia).

Dosage form specific issues:

• Benzyl alcohol and derivatives: Some dosage forms may contain sodium benzoate/benzoic acid; benzoic acid (benzoate) is a metabolite of benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity (“gasping syndrome”) in neonates; the “gasping syndrome” consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse (AAP ["Inactive" 1997]; CDC 1982); some data suggest that benzoate displaces bilirubin from protein binding sites (Ahlfors 2001); avoid or use dosage forms containing benzyl alcohol derivative with caution in neonates. See manufacturer's labeling.

What happens if I miss a dose of Dospertine 5?

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.

Skip the dose and use your next dose at the regular time. Do not use two doses at one time.

If you aren't sure you got a full dose while spraying the medicine into your nose, do not use a second dose. Wait until your next scheduled dose to use the medicine again.


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References

  1. DrugBank. "metoclopramide". http://www.drugbank.ca/drugs/DB01233 (accessed September 17, 2018).
  2. MeSH. "Antiemetics". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
  3. FDA Medication Guides. "Reglan: FDA Medication Guides are paper handouts that come with many prescription medicines. The guides address issues that are specific to particular drugs and drug classes, and they contain FDA-approved information that can help patients avoid serious adverse events. ". https://www.fda.gov/downloads/Drugs/... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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