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Prep-Hem rectal Dosage |
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Usual Adult Dose for Hypotension:
IM or subcutaneous: 2 to 5 mg every 1 to 2 hours as needed.
IV bolus: 0.2 mg/dose (range: 0.1 to 0.5 mg/dose) every 10 to 15 minutes as needed (initial dose should not exceed 0.5 mg)
IV infusion: 100 to 180 mcg/min initially. The usual maintenance dose is 40 to 60 mcg/min.
Alternatively, 0.5 mcg/kg/minute; titrate to desired response. Dosing ranges between 0.4 to 9.1 mcg/kg/minute have been reported.
Usual Adult Dose for Shock:
IM or subcutaneous: 2 to 5 mg every 1 to 2 hours as needed.
IV bolus: 0.2 mg/dose (range: 0.1 to 0.5 mg/dose) every 10 to 15 minutes as needed (initial dose should not exceed 0.5 mg)
IV infusion: 100 to 180 mcg/min initially. The usual maintenance dose is 40 to 60 mcg/min.
Alternatively, 0.5 mcg/kg/minute; titrate to desired response. Dosing ranges between 0.4 to 9.1 mcg/kg/minute have been reported.
Usual Adult Dose for Supraventricular Tachycardia:
0.25 to 0.5 mg IV over 30 seconds.
Usual Adult Dose for Nasal Congestion:
Tablets or oral liquid: 10 to 20 mg orally every 4 hours as needed.
Prep-Hem rectal 7.5 mg/5 mL oral liquid:
15 mg orally every 6 hours not to exceed 60 mg daily.
Prep-Hem rectal 10 mg oral tablet:
10 mg orally every 4 to 6 hours not to exceed 4 doses daily.
Prep-Hem rectal 10 mg oral disintegrating strip:
10 mg orally every 4 hours not to exceed 6 doses daily.
Prep-Hem rectal 10 mg/5 mL oral suspension, extended release:
10 to 20 mg orally every 12 hours.
Prep-Hem rectal tannate 10 mg oral tablet, chewable, extended release:
10 to 20 mg orally every 12 hours.
Prep-Hem rectal tannate 7.5 mg/5 mL oral suspension, extended release
7.5 to 15 mg orally every 12 hours.
Usual Pediatric Dose for Hypotension:
IM or subcutaneous: 0.1 mg/kg every 1 to 2 hours as needed. Maximum dose: 5 mg.
IV bolus: 5 to 20 mcg/kg/dose every 10 to 15 minutes as needed.
IV: 0.1 to 0.5 mcg/kg/min titrated to effect.
Usual Pediatric Dose for Shock:
IM or subcutaneous: 0.1 mg/kg every 1 to 2 hours as needed. Maximum dose: 5 mg.
IV bolus: 5 to 20 mcg/kg/dose every 10 to 15 minutes as needed.
IV: 0.1 to 0.5 mcg/kg/min titrated to effect.
Usual Pediatric Dose for Supraventricular Tachycardia:
5 to 10 mcg/kg IV over 30 seconds.
Usual Pediatric Dose for Nasal Congestion:
Prep-Hem rectal 1.25 mg/0.8 mL oral liquid:
2 years to 5 years: 1.6 mL orally every 4 hours not to exceed 6 doses daily.
Chewable tablets or oral liquid:
6 years to 11 years: 10 mg orally every 4 hours as needed.
12 years or older: 10 to 20 mg orally every 4 hours as needed.
Prep-Hem rectal 7.5 mg/5 mL oral liquid:
2 years to 5 years: 3.75 mg orally every 6 hours not to exceed 15 mg daily.
6 years to 11 years: 7.5 mg orally every 6 hours not to exceed 30 mg daily.
12 years or older: 15 mg orally every 6 hours not to exceed 60 mg daily.
Prep-Hem rectal 10 mg oral tablet:
12 years or older: 10 mg orally every 4 to 6 hours not to exceed 4 doses daily.
Prep-Hem rectal 10 mg oral tablet, disintegrating:
2 years to 5 years: 5 mg orally every 4 hours as needed.
6 years to 11 years: 10 mg orally every 4 hours as needed.
12 years or older: 10 to 20 mg orally every 4 hours as needed.
Prep-Hem rectal 10 mg/5 mL oral suspension, extended release:
12 years or older: 10 to 20 mg orally every 12 hours.
6 years to 11 years: 5 to 10 mg orally every 12 hours.
Prep-Hem rectal 10 mg oral disintegrating strip:
12 years or older: 10 mg orally every 4 hours not to exceed 6 doses daily.
Prep-Hem rectal tannate 10 mg oral tablet, chewable, extended release:
6 years to 11 years: 5 to 10 mg orally every 12 hours.
12 years or older: 10 to 20 mg orally every 12 hours.
Prep-Hem rectal tannate 7.5 mg/5 mL oral suspension, extended release
2 years to 5 years: 1.25 to 2.5 mL orally every 12 hours.
6 years to 11 years: 2.5 to 5 mL orally every 12 hours.
12 years or older: 5 to 10 mL orally every 12 hours.
Prep-Hem rectal 1.25 mg oral disintegrating strip:
2 years to 3 years: 2.5 mg orally every 4 hours, not to exceed 15 mg in 24 hours.
Prep-Hem rectal 2.5 mg oral disintegrating strip:
2 years to 5 years: 2.5 mg orally every 4 hours, not to exceed 15 mg in 24 hours.
6 years to 11 years: 5 mg orally every 4 hours, not to exceed 30 mg in 24 hours.
Prep-Hem rectal 1.25 mg oral tablet, chewable:
12 years or older: 5 mg orally every 4 hours not to exceed 6 doses daily.
Prep-Hem rectal 2.5 mg/5 mL oral liquid:
4 years to 5 years: 5 mL orally every 4 hours, not to exceed 6 doses in 24 hours.
6 years to 11 years: 10 mL orally every 4 hours, not to exceed 6 doses in 24 hours.
Ask a doctor or pharmacist if it is safe for you to use Prep-Hem rectal rectal if you are also using any of the following drugs:
an antidepressant; or
blood pressure medication.
This list is not complete and other drugs may interact with Prep-Hem rectal rectal. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Acetaminophen: May increase the serum concentration of Prep-Hem rectal (Systemic). Monitor therapy
Alpha1-Blockers: May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1-Agonists may antagonize Alpha1-Blocker vasodilation. Monitor therapy
AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Benzylpenicilloyl Polylysine: Alpha1-Agonists may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Consider use of a histamine skin test as a positive control to assess a patient's ability to mount a wheal and flare response. Consider therapy modification
Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol. Monitor therapy
Chloroprocaine: May enhance the hypertensive effect of Prep-Hem rectal (Systemic). Monitor therapy
CloZAPine: May diminish the therapeutic effect of Prep-Hem rectal (Systemic). Monitor therapy
Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Consider therapy modification
Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Monitor therapy
Ergot Derivatives: May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates; Nicergoline. Avoid combination
FentaNYL: Alpha1-Agonists may decrease the serum concentration of FentaNYL. Specifically, fentanyl nasal spray serum concentrations may decrease and onset of effect may be delayed. Monitor therapy
Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Monitor therapy
Hyaluronidase: May enhance the vasoconstricting effect of Prep-Hem rectal (Systemic). Management: Avoid the use of hyaluronidase to enhance dispersion or absorption of Prep-Hem rectal. Use of hyaluronidase for other purposes in patients receiving Prep-Hem rectal may be considered as clinically indicated. Avoid combination
Iobenguane Radiopharmaceutical Products: Alpha1-Agonists may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Avoid combination
Ioflupane I 123: Prep-Hem rectal (Systemic) may diminish the diagnostic effect of Ioflupane I 123. Monitor therapy
Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Consider therapy modification
Monoamine Oxidase Inhibitors: May enhance the hypertensive effect of Alpha1-Agonists. While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details. Exceptions: Linezolid. Avoid combination
Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Management: Concomitant use of ozanimod with sympathomimetic agents is not recommended. If combined, monitor patients closely for the development of hypertension, including hypertensive crises. Consider therapy modification
Propacetamol: May increase the serum concentration of Prep-Hem rectal (Systemic). Management: Monitor patients closely for increased side effects of Prep-Hem rectal if propacetamol is used concomitantly. Patients with underlying blood pressure issues or arrhythmias may need closer monitoring and may warrant consideration of alternative therapies. Monitor therapy
Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Monitor therapy
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy
Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Tricyclic Antidepressants: May enhance the therapeutic effect of Alpha1-Agonists. Tricyclic Antidepressants may diminish the therapeutic effect of Alpha1-Agonists. Monitor therapy
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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