bromfenac

brompheniramine

Bromfenac, Dimetapp Allergy, Lodrane 24, LoHist 12D, Nasahist B, ND-Stat, TanaCof-XR, Vazol

Pharmacologic class: Histamine antagonist

Therapeutic class: Antihistamine

Pregnancy risk category C

Action

Antagonizes effects of histamine at histamine1-receptor sites, but doesn't bind to or inactivate histamine. Also shows anticholinergic, antipruritic, and sedative activity.

Availability

Capsules (liquigels): 4 mg

Elixir: 2 mg/5 ml

Suspension: 12 mg/5 ml

Tablets: 4 mg, 8 mg, 12 mg

Tablets (extended-release): 8 mg, 12 mg

Indications and dosages

Symptomatic relief of allergic symptoms caused by histamine release; severe allergic or hypersensitivity reactions

Adults and children ages 12 and older: 4 to 8 mg P.O. three to four times daily, or 8 to 12 mg extended-release tablets P.O. two or three times daily. Maximum dosage is 36 mg/day.

Children ages 6 to 12: 2 mg P.O. q 4 to 6 hours as needed, not to exceed 12 mg/day

Children ages 2 to 6: 1 mg P.O. q 4 to 6 hours p.r.n., not to exceed 6 mg/day

Contraindications

• Hypersensitivity to drug

• Coronary artery disease

• Urinary retention

• Pyloroduodenal obstruction

• Peptic ulcer

• MAO inhibitor use within past 14 days

• Breastfeeding

Precautions

Use cautiously in:

• angle-closure glaucoma, hepatic disease, hyperthyroidism, hypertension, bronchial asthma

• elderly patients

• pregnant patients.

Administration

• Give with food if GI upset occurs.

• Don't break or crush extended-release tablets.

• Shake oral suspension well before measuring dose.

Check elixir and suspension doses carefully, because the mg/ml varies widely between the two liquids.

Adverse reactions

CNS: drowsiness, sedation, dizziness, excitation, irritability, syncope, tremor

CV: hypertension, hypotension, palpitations, tachycardia, extrasystole, arrhythmias, bradycardia

EENT: blurred vision, nasal congestion or dryness, dry or sore throat

GI: nausea, vomiting, constipation, dry mouth

GU: urinary retention or hesitancy, dysuria, early menses, decreased libido, impotence

Hematologic: hemolytic anemia, hypoplastic anemia, thrombocytopenia, agranulocytosis, leukopenia, pan-cytopenia

Respiratory: thickened bronchial secretions, chest tightness, wheezing

Skin: urticaria, rash

Other: increased or decreased appetite, weight gain

Interactions

Drug-drug. CNS depressants (including opioids and sedative-hypnotics): additive CNS depression

MAO inhibitors: intensified, prolonged anticholinergic effects

Drug-diagnostic tests. Allergy tests: false results

Granulocytes, platelets: decreased counts

Drug-behaviors. Alcohol use: increased CNS depression

Patient monitoring

• Monitor respiratory status.

• Stay alert for urinary retention, urinary frequency, and painful or difficult urination. Discontinue drug if these problems occur.

• With long-term use, monitor CBC.

• Monitor elderly patient for dizziness, sedation, and hypotension.

• If patient takes over-the-counter antihistamines, monitor him closely to avoid potential overdose.

Patient teaching

• Advise patient to take drug with meals if GI upset occurs.

• Instruct patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• Caution patient to avoid alcohol while taking drug.

• Urge patient to tell all prescribers which drugs and over-the-counter preparations he's taking.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.

bromfenac

An analgesic NSAID used for acute pain management, which was withdrawn from the market following multiple reports of liver failure.
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References in periodicals archive ?
Alembic Pharmaceuticals Limited announced that the Company has received approval from the US Food & Drug Administration (USFDA) for its Abbreviated New Drug Application (ANDA) Bromfenac Oph0thalmic Solution 0.09%.
Ophthalmic utility of topical bromfenac, a twice-daily nonsteroidal anti-inflammatory agent.
Although some studies have not reported differences in effectiveness, others have stated that fenamates (mefenamic acid, tolfenamic acid, flufenamic acid, meclofenamate, bromfenac) may have slightly better efficacy than phenylproprionic acid derivatives (ibuprofen, naproxen).
Healthcare company Perrigo Company plc (NYSE:PRGO) (TASE:PRGO) disclosed on Wednesday the receipt of the tentative approval from the US Food and Drug Administration for the generic version of Prolensa (bromfenac ophthalmic solution) 0.07% for treating ocular pain in patients.
(fenfluramine), Posicor (mibefradil), and Duract (bromfenac) in 1997,
When CME was diagnosed postoperatively, topical bromfenac (Bronuck[R], Senju, Pharmaceutical Co., Osaka, Japan) and sub-Tenon injection of triamcinolone acetonide (MaQaid[R]; Wakamoto Pharmaceutical Co., Tokyo, Japan) were immediately applied.
Warsi, "Chondroitin sulfatechitosan nanoparticles for ocular delivery of bromfenac sodium: Improved permeation, retention, and penetration," International Journal of Pharmaceutical Investigation, vol.
Several other drugs can cause dose-related hepatotoxicity as in bromfenac, cyclophosphamide, methotrexate etc.
In vivo pharmacokinetics and in vitro pharmacodynamics of nepafenac, amfenac, ketorolac, and bromfenac. J Cataract Refract Surg.
Other compounds, such as E330 and the NSAID bromfenac, exhibit oxidative stress protection and antiangiogenic properties by stimulating the Nrf2/HO-1 axis.
A number of drugs such as troglitazone, trovafloxacin and bromfenac (oral formulation) were withdrawn from the market due to the formation of reactive hepatotoxic metabolites (12) and other drugs that are still on the market such as acetaminophen and amiodarone, etc., can cause hepatotoxicity when used at high doses (12).