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Wednesday, October 5, 2016

Guaifen PE

Generic Name: guaifenesin and phenylephrine (gwye FEN e sin and FEN il EFF rin)

Brand Names: Aldex G, Aquatab D, Crantex, D-Phen 1000, D-Tab, Deconex, Deconsal II, Deconsal Pediatric, Despec, Donatussin Drops, Duomax, Duraphen 1000, Duraphen II, Duratuss, Dynex LA, ExeTuss, Extendryl G, Fenesin PE IR, Genexa LA, Gentex LA, Gilphex TR, Guaiphen-D 1200, Guaiphen-D 600, Guaiphen-PD, Guiadex PD, Guiatex PE, J-Max, Liquibid D-R, Liquibid-D, Liquibid-PD, Lusonex, Maxiphen, Medent-PE, MontePhen, Mucinex Children's Cold, Mucus Relief Sinus, Mydex, Nariz, Nasex, Nescon-PD, Nexphen PD, Norel EX, PE-Guai, Pendex, Prolex D, Refenesen PE, Reluri, Rescon-GG, Respa-PE, Robitussin Head & Chest Congestion, Simuc, Simuc-GP, Sina-12X, Sinupan, SINUvent PE, Sitrex PD, Sudafed PE Non-Drying Sinus, Sudex, Triaminic Chest & Nasal Congestion, Visonex, Wellbid-D, Xedec, Xedec II, Xpect-PE, Zotex GPX

What is Guaifen PE (guaifenesin and phenylephrine)?

There are many brands and forms of guaifenesin and phenylephrine available and not all brands are listed on this leaflet.

Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of guaifenesin and phenylephrine is used to treat stuffy nose and sinus congestion, and to reduce chest congestion caused by the common cold or flu.

Guaifenesin and phenylephrine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Guaifen PE (guaifenesin and phenylephrine)?

There are many brands and forms of guaifenesin and phenylephrine available and not all brands are listed on this leaflet.

Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Ask a doctor or pharmacist before using any other cough, cold, or allergy medicine. Guaifenesin and phenylephrine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains guaifenesin or phenylephrine.

What should I discuss with my healthcare provider before taking Guaifen PE (guaifenesin and phenylephrine)?

You should not use this medication if you are allergic to guaifenesin or phenylephrine, or to other decongestants, diet pills, stimulants, or ADHD medications. Do not use guaifenesin and phenylephrine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. Serious, life threatening side effects can occur if you use guaifenesin and phenylephrine before the MAO inhibitor has cleared from your body.

Ask a doctor or pharmacist if it is safe for you to take this medication if you have:

heart disease or high blood pressure;

diabetes;

circulation problems;

glaucoma;

overactive thyroid; or

enlarged prostate or problems with urination.

It is not known if this medication may be harmful to an unborn baby. Do not use this medication without your doctor's advice if you are pregnant. This medication passes into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Artificially-sweetened liquid forms of cold medicine may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.

How should I take Guaifen PE (guaifenesin and phenylephrine)?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.

Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children.

Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time. Take guaifenesin and phenylephrine with food if it upsets your stomach. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash. Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication. Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since cough or cold medicine is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, 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.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, vomiting, numbness or tingly feeling, dizziness, and feeling restless or nervous.

What should I avoid while taking Guaifen PE (guaifenesin and phenylephrine)?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Drinking alcohol can increase certain side effects of guaifenesin and phenylephrine. Ask a doctor or pharmacist before using any other cough, cold, or allergy medicine. Guaifenesin and phenylephrine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains guaifenesin or phenylephrine.

Avoid taking this medication with diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.

Guaifen PE (guaifenesin and phenylephrine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

fast, pounding, or uneven heartbeat;

severe dizziness, anxiety, restless feeling, or nervousness;

easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms;

dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure); or

nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

vomiting, upset stomach;

warmth, tingling, or redness under your skin;

feeling excited or restless (especially in children);

sleep problems (insomnia);

skin rash or itching;

headache; or

dizziness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Guaifen PE (guaifenesin and phenylephrine)?

Ask a doctor or pharmacist if it is safe for you to take guaifenesin and phenylephrine if you are also using any of the following drugs:

medicines to treat high blood pressure;

a beta-blocker such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Dutoprol, Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others; or

an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), doxepin (Sinequan, Silenor), desipramine (Norpramin), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), and others.

This list is not complete and other drugs may interact with guaifenesin and phenylephrine. 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.

More Guaifen PE resources

Guaifen PE Side Effects (in more detail)
Guaifen PE Use in Pregnancy & Breastfeeding
Guaifen PE Drug Interactions
Guaifen PE Support Group
0 Reviews for Guaifen PE - Add your own review/rating

Crantex Prescribing Information (FDA)

Despec Drops MedFacts Consumer Leaflet (Wolters Kluwer)

Entex LA Sustained-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)

Gentex LA Sustained-Release Tablets (12 Hour) MedFacts Consumer Leaflet (Wolters Kluwer)

Guiatex PE Prescribing Information (FDA)

Lusonex Controlled-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

Rescon-GG Liquid MedFacts Consumer Leaflet (Wolters Kluwer)

Sina-12X Suspension MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Guaifen PE with other medications

Cough and Nasal Congestion
Sinus Symptoms

Where can I get more information?

Your pharmacist can provide more information about guaifenesin and phenylephrine.

See also: Guaifen PE side effects (in more detail)

Griseofulvin Microsize Oral Suspension

Pronunciation: GRIS-ee-oh-FUL-vin
Generic Name: Griseofulvin
Brand Name: Generic only. No brands available.

Griseofulvin Microsize Oral Suspension is used for:

Treating certain fungal infections (eg, ringworm) of the hair, skin, and nails. It may also be used for other conditions as determined by your doctor.

Griseofulvin Microsize Oral Suspension is an antifungal agent. It works by making the skin more resistant to fungal growth.

Do NOT use Griseofulvin Microsize Oral Suspension if:

you are allergic to any ingredient in Griseofulvin Microsize Oral Suspension

you have liver failure or the blood disease porphyria

you are pregnant

Contact your doctor or health care provider right away if any of these apply to you.

Before using Griseofulvin Microsize Oral Suspension:

Some medical conditions may interact with Griseofulvin Microsize Oral Suspension. 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 had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to a penicillin antibiotic (eg, amoxicillin)

if you have liver disease or lupus

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

Barbiturates (eg, phenobarbital) because they may decrease Griseofulvin Microsize Oral Suspension's effectiveness

Anticoagulants (eg, warfarin), cabazitaxel, cyclosporine, oral contraceptives (birth control pills), or ulipristal because their effectiveness may be decreased by Griseofulvin Microsize Oral Suspension

This may not be a complete list of all interactions that may occur. Ask your health care provider if Griseofulvin Microsize Oral Suspension 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.

How to use Griseofulvin Microsize Oral Suspension:

Use Griseofulvin Microsize Oral Suspension as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take Griseofulvin Microsize Oral Suspension by mouth with or without food.

Shake well before each use.

Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.

To clear up your infection completely, use Griseofulvin Microsize Oral Suspension for the full course of treatment. Keep using it even if you feel better in a few days.

If you miss a dose of Griseofulvin Microsize Oral Suspension, 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 Griseofulvin Microsize Oral Suspension.

Important safety information:

Griseofulvin Microsize Oral Suspension may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Griseofulvin Microsize Oral Suspension with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Be sure to take Griseofulvin Microsize Oral Suspension for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The fungus could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.

Do not drink alcohol while you are taking Griseofulvin Microsize Oral Suspension.

Griseofulvin Microsize Oral Suspension may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Griseofulvin Microsize Oral Suspension. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.

It is important to practice good hygiene during and after use to prevent reinfection.

Hormonal birth control (eg, birth control pills) may not work as well while you are using Griseofulvin Microsize Oral Suspension. To prevent pregnancy, use an extra form of birth control (eg, condoms).

Lab tests, including complete blood cell counts, liver function, and kidney function, may be performed while you use Griseofulvin Microsize Oral Suspension. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Griseofulvin Microsize Oral Suspension should be used with extreme caution in CHILDREN younger than 3 years old; safety and effectiveness in these children have not been confirmed.

PREGNANCY and BREAST-FEEDING: Do not take Griseofulvin Microsize Oral Suspension if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. If you are or will be breast-feeding while you use Griseofulvin Microsize Oral Suspension, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Griseofulvin Microsize Oral Suspension:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; headache; nausea; stomach upset; tiredness; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); butterfly-shaped rash on the face; confusion; fever, chills, or sore throat; flu-like symptoms (eg, headache, joint pain); mental or mood changes; numbness, burning, or tingling of the hands or feet; red, swollen, blistered or peeling skin; symptoms of liver problems (dark urine, pale stools, severe or persistent stomach pain, yellowing of the skin or eyes); white patches in the mouth.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Griseofulvin side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Griseofulvin Microsize Oral Suspension:

Store Griseofulvin Microsize Oral Suspension at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Keep Griseofulvin Microsize Oral Suspension out of the reach of children and away from pets.

General information:

If you have any questions about Griseofulvin Microsize Oral Suspension, please talk with your doctor, pharmacist, or other health care provider.

Griseofulvin Microsize Oral Suspension is to be used only by the patient for whom it is prescribed. Do not share it with other people.

If your symptoms do not improve or if they become worse, check with your doctor.

Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Griseofulvin Microsize Oral Suspension. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Griseofulvin resources

Griseofulvin Side Effects (in more detail)
Griseofulvin Use in Pregnancy & Breastfeeding
Drug Images
Griseofulvin Drug Interactions
Griseofulvin Support Group
5 Reviews for Griseofulvin - Add your own review/rating

Compare Griseofulvin with other medications

Dermatophytosis
Onychomycosis, Fingernail
Onychomycosis, Toenail
Tinea Barbae
Tinea Capitis
Tinea Corporis
Tinea Cruris
Tinea Pedis

Griseofulvin

Class: Antifungals, Miscellaneous
VA Class: AM700
CAS Number: 126-07-8
Brands: Grifulvin V, Gris-PEG

Introduction

Antifungal antibiotic produced by Penicillium.¹⁰⁴ ¹²⁵

Uses for Griseofulvin

Dermatophytoses

Treatment of dermatophytoses of the skin, scalp, and nails, including tinea barbae (ringworm of bearded areas of face and neck), tinea capitis (scalp ringworm), tinea corporis (ringworm of the body), tinea cruris (jock itch; groin ringworm), tinea pedis (athlete’s foot, foot ringworm), and tinea unguium (onychomycosis; nail ringworm) caused by Trichophyton, Microsporum, or Epidermophyton floccosum.¹⁰⁴ ¹²⁵

A drug of choice for treatment of tinea capitis;¹²⁴ ¹³¹ ¹³² ¹³³ ¹³⁵ ¹⁴⁰ ¹⁴¹ prolonged therapy usually is necessary to cure the infection and poor compliance may affect response to the drug.¹³¹ ¹³⁵ ¹³⁸ ¹⁴⁰ ¹⁴¹ Tinea barbae and tinea capitis generally require treatment with an oral antifungal.¹²⁴ ¹³¹ ¹³⁵ ¹³⁷ ¹⁴⁰

Tinea corporis and tinea cruris generally can be effectively treated using a topical antifungal; an oral antifungal may be necessary if the disease is extensive, dermatophyte folliculitis is present, the infection does not respond to topical therapy, or the patient is immunocompromised or has coexisting disease (e.g., diabetes mellitus).¹²⁴ ¹³⁰ ¹³¹ ¹³² ¹³³ ¹³⁴ ¹³⁶ ¹⁴⁰

While topical antifungals usually are effective for treatment of acute, uncomplicated tinea manuum and tinea pedis,¹²⁴ ¹³¹ ¹³² ¹³⁴ ¹³⁶ ¹⁴⁰ an oral antifungal usually is necessary for treatment of severe, chronic, or recalcitrant tinea pedis,¹²⁴ chronic moccasin-type (dry-type) tinea pedis, and for treatment of tinea unguium (onychomycosis).¹³¹ ¹³⁴ ¹³⁶ ¹⁴⁰

Griseofulvin Dosage and Administration

Administration

Oral Administration

Administer orally.¹⁰⁴ ¹²⁵

When microsize griseofulvin (Grifulvin V) tablets are used, absorption may be improved if given after a high-fat meal.¹²⁵

Dosage

Dosage varies depending on whether the drug is administered as griseofulvin microsize (Grifulvin V) or griseofulvin ultramicrosize (Gris-PEG).¹⁰⁴ ¹²⁴ ¹²⁵

Dosage and duration of treatment should be individualized according to the requirements and response of the patient.¹⁰⁴ ¹⁰⁴ Griseofulvin generally should be continued for ≥4–12 weeks for treatment of tinea capitis;¹⁰⁴ ¹²⁴ ¹²⁵ ¹³² ¹³³ ¹³⁵ ¹⁴⁰ ¹⁴¹ ≥2–4 weeks for treatment of tinea corporis;¹⁰⁴ ¹²⁴ ¹²⁵ ≥4–8 weeks for tinea pedis; and from 4–6 months to a year or longer for tinea unguium.¹⁰⁴ ¹²⁴ ¹²⁵

Pediatric Patients

Dermatophytoses

Microsize (Grifulvin V)

Oral

10–11 mg/kg daily, although dosages up to 20–25 mg/kg daily have been used.¹²⁴ ¹²⁵ ¹⁴⁰

Manufacturer suggests that those weighing approximately 14–23 kg may receive 125–250 mg daily and that those weighing >23 kg may receive 250–500 mg daily.¹²⁵

AAP recommends 10–20 mg/kg (maximum 1 g) daily in 1 or 2 doses.¹²⁴ For tinea capitis, AAP recommends 15–20 mg/kg once daily.¹²⁴

Ultramicrosize (Gris-PEG)

Oral

Children >2 years of age: Usually 7.3 mg/kg daily,¹⁰⁴ although dosages up to 10–15 mg/kg daily have been used.¹⁴⁰

Manufacturer suggests that those weighing approximately 16–27 kg may receive 125–187.5 mg daily and those weighing >27 kg may receive 187.5–375 mg daily.¹⁰⁴

AAP recommends 5–10 mg/kg (maximum 750 mg) once daily.¹²⁴

Adults

Dermatophytoses

Microsize (Grifulvin V)

Oral

500 mg daily for treatment of tinea capitis, tinea corporis, or tinea cruris.¹²⁵ For more difficult infections (e.g., tinea pedis, tinea unguium), 1 g daily.¹²⁵

Ultramicrosize (Gris-PEG)

Oral

375 mg once daily or in divided doses for treatment of tinea capitis, tinea corporis, or tinea cruris.¹⁰⁴ For more difficult infections (e.g., tinea pedis, tinea unguium), 750 mg daily given in divided doses.¹⁰⁴

Cautions for Griseofulvin

Contraindications

Hypersensitivity to griseofulvin.¹⁰⁴ ¹²⁵

Porphyria or hepatocellular failure.¹⁰⁴ ¹²⁵

Pregnant women.¹⁰⁴ ¹²⁵ (See Fetal/Neonatal Morbidity and Mortality under Cautions.)

Warnings/Precautions

Warnings

Fetal/Neonatal Morbidity and Mortality

May cause fetal toxicity when administered to pregnant women.¹⁰¹ ¹⁰⁴ ¹¹¹ ¹¹⁷ ¹¹⁸ ¹²⁵

Some animal studies indicate that griseofulvin may be embryotoxic and teratogenic.¹⁰¹ ¹⁰⁴ ¹⁰⁶ ¹¹³ ¹¹⁴ ¹¹⁵ ¹¹⁶ ¹²⁵ There have been 2 cases of conjoined twins born to women who received griseofulvin during the first trimester of pregnancy; some women who received the drug during pregnancy reportedly have had spontaneous abortions or delivered infants with other congenital malformations.¹⁰¹ ¹⁰⁴ ¹¹¹ ¹¹⁷ ¹¹⁸ ¹⁰⁴ ¹²⁵

Griseofulvin should not be used in women who are pregnant¹⁰⁴ ¹²⁵ or intend to become pregnant within 1 month after treatment.¹²⁵

Women should use additional contraceptive precautions during griseofulvin treatment and for 1 month after the drug is discontinued.¹²⁵ One manufacturer recommends that men wait at least 6 months after completing griseofulvin treatment before fathering a child.¹²⁵

If a patient becomes pregnant while receiving griseofulvin, they should be advised of the potential hazard to the fetus.¹⁰⁴

Sensitivity Reactions

Hypersensitivity Reactions

Hypersensitivity reactions (e.g., rash, urticaria, erythema multiforme-like reactions, angioneurotic edema) have been reported.¹⁰⁴

Because griseofulvin is derived from Penicillium, there is a possibility of cross-sensitivity with penicillin.¹⁰⁴ ¹²⁵ Patients with known penicillin hypersensitivity have received griseofulvin without such reactions.¹⁰⁴ ¹²⁵

If hypersensitivity reaction occurs, discontinue griseofulvin and initiate appropriate therapy.¹⁰⁴

Photosensitivity Reactions

Photosensitivity reactions have been reported.¹⁰⁴ ¹²⁵ Lupus erythematosus may be aggravated if a photosensitivity reaction occurs.¹²⁵

Avoid exposure to intense natural or artificial sunlight during griseofulvin treatment.¹⁰⁴

General Precautions

Selection and Use of Antifungals

Prior to administration of griseofulvin for dermatophytoses, diagnosis should be confirmed either by direct microscopic examination of scrapings from infected tissue mounted in potassium hydrochloride (KOH) or by culture.¹⁰⁴ ¹²⁵

Should not be used for treatment of minor or trivial dermatophytoses that may respond to topical antifungals alone.¹⁰⁴ ¹²⁵

General hygiene measures should be observed to control sources of infection or reinfection.¹⁰⁴ ¹²⁵ Concomitant use of topical antifungals or antibacterials may be required, particularly for treatment of tinea pedis (athlete’s foot, foot ringworm).¹⁰⁴ ¹²⁵ In some forms of tinea pedis, yeasts and bacteria may also be involved and griseofulvin is ineffective against these organisms.¹⁰⁴ ¹²⁵

Not effective and should not be used for treatment of pityriasis (tinea) versicolor or cutaneous Candida infections.¹⁰⁴ ¹²⁵ ^a

Not effective and should not be used for treatment of systemic fungal infections, including blastomycosis, candidiasis, chromoblastomycosis, coccidioidomycosis, cryptococcosis, histoplasmosis, or sporotrichosis.¹⁰⁴ ¹²⁵ ^a Safety and efficacy not established for prevention of fungal infections.¹⁰⁴ ¹²⁵

Not effective and should not be used for treatment of bacterial infections, including actinomycosis or nocardiosis.¹⁰⁴ ¹²⁵

Laboratory Monitoring

Periodically assess organ system functions, including renal, hepatic, and hematopoietic, during prolonged therapy.¹⁰⁴ ¹²⁵

Specific Populations

Pregnancy

Category C.^b (See Fetal/Neonatal Morbidity and Mortality under Cautions.)

Pediatric Use

Safety and efficacy of ultramicrosize griseofulvin not established in children ≤2 years of age.¹⁰⁴ Microsize griseofulvin has been used in children as young as 3 months of age.¹³⁸

Hepatic Impairment

Contraindicated in patients with hepatocellular failure.¹⁰⁴

Common Adverse Effects

Hypersensitivity reactions (rash, urticaria); GI effects (oral thrush, nausea, vomiting, epigastric distress, diarrhea); CNS effects (headache, fatigue, dizziness, insomnia, mental confusion, impaired performance of routine activities).¹⁰⁴ ¹²⁵

Interactions for Griseofulvin

Specific Drugs

Drug	Interaction	Comments
Alcohol	Tachycardia, flushing, and potentiation of alcohol effects has been reported in patients receiving griseofulvin¹⁰⁴ ^a	Although clinical importance is unclear, some clinicians suggest that patients be warned of a possible reaction and to avoid alcohol during griseofulvin therapy^a
Anticoagulants, oral (warfarin)	Decreased PT reported¹⁰⁴ ¹²⁵ ^a	Use concomitantly with caution; adjust anticoagulant dosage if needed during and after griseofulvin treatment¹⁰⁴ ¹²⁵ ^a
Aspirin	Possible decreased plasma salicylate concentrations¹²⁷
Barbiturates	Possible decreased antifungal activity¹⁰⁴ ¹²⁵ Phenobarbital: Possible decreased griseofulvin concentrations^a	Dosage adjustment of griseofulvin may be necessary¹⁰⁴ ¹²⁵ Phenobarbital: Avoid concomitant use;^a if concomitant use is necessary, administer griseofulvin in 3 divided doses daily to maximize absorption, monitor griseofulvin concentrations, and adjust dosage of the antifungal if necessary^a
Cyclosporine	Possible decreased concentrations of cyclosporine¹²⁸
Hormonal contraceptives (oral contraceptives)	Amenorrhea, increased breakthrough bleeding, and possibility of decreased contraceptive efficacy reported with concomitant use¹⁰⁰ ¹⁰⁴ ¹⁰⁵ ¹²⁵	The possibility of decreased contraceptive efficacy should be considered if griseofulvin is used concomitantly¹⁰⁰ ¹⁰⁵ ¹²⁹
Theophylline	Increased clearance and decreased theophylline half-life reported in some patients; extent of this interaction appears to vary and increased clearance of theophylline is not evident in all individuals who receive the drugs concomitantly¹²⁶

Griseofulvin Pharmacokinetics

Absorption

Bioavailability

Absorption of microsize griseofulvin is variable¹²⁵ and unpredictable and ranges from 25–70% of an oral dose;^a peak serum concentrations attained 4 hours after a dose.¹²⁵

Ultramicrosize griseofulvin is almost completely absorbed following oral administration.^a

Food

Absorption of microsize griseofulvin may be enhanced by administration after a high-fat meal.¹²⁵ ^a

Distribution

Extent

Following oral absorption, griseofulvin is concentrated in skin, hair, nails, liver, fat, and skeletal muscles.^a The drug can be detected in the outer layers of the stratum corneum soon after ingestion.^a

Griseofulvin is deposited in keratin precursor cells and has greater affinity for diseased tissue.¹⁰⁴ The drug is tightly bound to new keratin.¹⁰⁴

Griseofulvin concentrations in skin are higher in warm climates than in cold, possibly because the drug is dissolved in perspiration and deposited in the horny layer of skin when perspiration evaporates.^a This explanation has also been used to account for the reversed concentration gradient of the drug in skin; highest concentrations are found in the outermost horny layer, while concentrations are much lower in deeper layers.^a

Elimination

Metabolism

Oxidatively demethylated and conjugated with glucuronic acid, principally in the liver.^a The major metabolite, 6-desmethylgriseofulvin, is microbiologically inactive.^a

Elimination Route

About 30% of a single oral dose of microsize griseofulvin is excreted in urine within 24 hours as 6-desmethylgriseofulvin and its glucuronide conjugate; 50% of the dose is excreted in urine within 5 days.^a Unchanged griseofulvin in the urine accounts for <1% of the administered drug.^a Approximately one-third of a single dose of microsize griseofulvin is excreted in feces within 5 days.^a Griseofulvin also is excreted in perspiration.^a

Half-life

9–24 hours.^a

Stability

Storage

Oral

Tablets

Microsize or ultramicrosize: 15–30°C in tight, light-resistant container.¹⁰⁴ ¹²⁵

Suspension

Microsize: Room temperature in tight, light-resistant container.¹²⁵

Actions and SpectrumActions

Structurally unrelated to other antifungals (e.g., allylamines, azoles, echinocandins, polyenes, pyrimidines).^a

Usually fungistatic in action.¹⁰⁴ ¹²⁵ ^a

Antifungal activity principally involves disruption of the fungal cell’s mitotic spindle structure.^a Although the effect on mitosis is similar to that caused by colchicine, a different mechanism is probably involved.^a Griseofulvin may cause production of defective DNA which is unable to replicate.^a

Griseofulvin is deposited in keratin precursor cells and is tightly bound to new keratin, resulting in an environment unfavorable for fungal invasion.¹⁰⁴ ¹²⁵ ^a Infected skin, hair, or nails are then replaced with tissue not infected with the dermatophyte.¹²⁵ ^a

Limited spectrum of antifungal activity.¹⁰⁴ ¹²⁵ ^a Active against most dermatophytes, but not active against yeasts or other fungi, including Aspergillus, Blastomyces, Candida, Cryptococcus, Coccidioides, Histoplasma, Saccharomyces, Sporotrichum, or Malassezia furfur (Pityrosporum orbiculare).¹⁰⁴ ¹²⁵ ^a

Dermatophytes: Active against Epidermophyton floccosum, Microsporum audouini, M. canis, M. gypseum, Trichophyton crateriform, T. gallinae, T. interdigitalis, T. megnini, T. mentagrophytes, T. rubrum, T. schoenleinii, T. sulphureum, T. tonsurans, and T. verrucosum.¹⁰⁴ ¹²⁵

Advice to Patients

Importance of using griseofulvin for the full, prescribed treatment period, even if symptoms improve; importance of consulting with clinician if the condition does not improve after a full course of therapy.

Advise patients to avoid exposure to intense natural or artificial sunlight during griseofulvin treatment since photosensitivity reactions can occur.¹⁰⁴ ¹²⁵

Importance of discontinuing use and contacting clinician if signs or symptoms of sensitization occur (e.g., rash, urticaria).¹⁰⁴ ¹²⁵

Importance of informing clinicians of existing or contemplated therapy, including prescription and OTC drugs, as well as any concomitant illnesses.

Importance of women informing clinicians if they are or plan to become pregnant or to breast-feed. (See Fetal/Neonatal Morbidity and Mortality under Cautions.)

Importance of informing patients of other important precautionary information. (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Griseofulvin Microsize
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Suspension	125 mg/5 mL	Grifulvin V (with alcohol 0.2% parabens and propylene glycol)	Ortho-Neutrogena
	Tablets	500 mg	Grifulvin V (scored)	Ortho-Neutrogena

Griseofulvin Ultramicrosize
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets, film-coated	125 mg	Gris-PEG (with methylparaben; scored)	Pedinol
		250 mg	Gris-PEG (with methylparaben and povidone; scored)	Pedinol

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Grifulvin V 500MG Tablets (ORTHO DERM): 30/$139.98 or 90/$395.99

Griseofulvin Microsize 125MG/5ML Suspension (PATRIOT PHARMACEUTICALS LLC): 120/$42.99 or 360/$115.98

Gris-PEG 125MG Tablets (PEDINOL): 90/$196 or 270/$555.97

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions July 2006. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

100. van Dijke CPH, Weber JCP. Interaction between oral contraceptives and griseofulvin. BMJ. 1984; 288:1125-6.

101. Rosa FW, Hernandez C, Carlo WA. Griseofulvin teratology, including two thoracopagus conjoined twins. Lancet. 1987; 1:171. [IDIS 225528] [PubMed 2880014]

102. Madhok R, Zoma A, Capell H. Fatal exacerbation of systemic lupus erythematosus after treatment with griseofulvin. BMJ. 1985; 291:249-50. [IDIS 203029] [PubMed 3926142]

103. Schering Corporation. Fulvicin P/G 165 and 330 (ultramicrosize griseofulvin) tablets prescribing information (dated 1996 Jun). In: Physicians’ desk reference. 53rd ed. Montvale, NJ: Medical Economics Company Inc; 1999:2844-5.

104. Pedinol Pharmacal. Gris-PEG (griseofulvin ultramicrosize) tablets prescribing information. In: Physician’s desk reference. 56th ed. Montvale, NJ: Medical Economics Company Inc; 2002:2661-2.

105. Catalano PM, Blank H. Griseofulvin–oral contraceptive interaction. Arch Dermatol. 1985; 121:1381. [IDIS 209312] [PubMed 4051524]

106. De Carli L, Larizza L. Griseofulvin. Mutat Res. 1988; 195:91-126. [PubMed 3277037]

107. Curry PT, Reed RN, Martino RM et al. Induction of sister-chromatid exchanges in vivo in mice by the mycotoxins sterigmatocystin and griseofulvin. Mutat Res. 1984; 137:111-5. [PubMed 6472322]

108. Taylor B, Duffill M. Toxic epidermal necrolysis from griseofulvin. J Am Acad Dermatol. 1988; 19:565-7. [PubMed 3170817]

109. Kojima T, Hasegawa T, Ishida H et al. Griseofulvin-induced photodermatitis—report of six cases. J Dermatol (Tokyo). 1988; 15:76-82.

110. Yang DJ, Rankin GO. Nephrotoxicity to antifungal agents. Adverse Drug React Acute Poisoning Rev. 1985; 4:37-47. [PubMed 3890481]

111. Metneki J, Czeizel A. Griseofulvin teratology. Lancet. 1987; 1:1042. [IDIS 229388] [PubMed 2883385]

112. Knudsen LB. No association between griseofulvin and conjoined twinning. Lancet. 1987; 2:1097. [PubMed 2890014]

113. Klein MF, Beall JR. Griseofulvin: a teratogenic study. Science. 1972; 175:1483-4. [PubMed 5013681]

114. Siracusa G, Whittingham DG, DeFelici M. The effect of microtubule- and microfilament-disrupting drugs on preimplantation mouse embryos. J Embryol Exp Morphol. 1980; 60:71-82. [PubMed 7198136]

115. Steelman RL, Kocsis JJ. Determination of the teratogenic and mutagenic potential of griseofulvin. Toxicol Appl Pharmacol. 1978; 45:343.

116. Slonitskaya NN. [Teratogenic effect of griseofulvin-forte on rat fetus.] Antibiotiki. 1969; 14:44-8.

117. Rosa FW. Twins, conjoined, teratogenicity. In: Buyse ML, ed. Birth defects encyclopedia. Birth Defects Information Service: Dover, MA. (in press)

118. Rosa FW. (Food and Drug Administration, Rockville, MD): Personal communication; 1989 Jan 13.

119. Day TW, Mendoza F. Pharmacologic management of Raynaud’s phenomenon. South Med J. 1984; 77:1160-4. [IDIS 191056] [PubMed 6385288]

120. Lecky BRF. Griseofulvin-induced neuropathy. Lancet. 1990; 335:230-1.

121. Mion G, Verdon R, Le Gulluche Y et al. Fatal toxic epidermal necrolysis after griseofulvin. Lancet. 1989; 2:1331. [IDIS 261340] [PubMed 2574272]

122. Ayerst. Grisactin (griseofulvin microsize) prescribing information. New York, NY; 1990 Jun 15.

123. Schering. Fulvicin P/G (ultramicrosize griseofulvin) tablets prescribing information (dated 1996 Feb). In: Physicians’ desk reference. 53rd ed. Montvale, NJ: Medical Economics Company Inc; 1999:2843-4.

124. Committee on Infectious Diseases, American Academy of Pediatrics. 2000 Red book: report of the Committee on Infectious Diseases. 25th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2000:569-74.

125. Ortho Dermatological. Grifulvin V (griseofulvin) tablets microsize and oral suspension microsize prescribing information (dated 1997 Jan). In: Physicians’ desk reference. 56th ed. Montvale, NJ: Medical Economics Company Inc; 2002:2518-9.

126. Rasmussen BB, Jeppesen U, Gaist D et al. Griseofulvin and fluvoxamine interactions with the metabolism of theophylline. Ther Drug Monit. 1997; 19:56-62. [IDIS 381144] [PubMed 9029748]

127. Phillips KR, Wideman SD, Cochran EB et al. Griseofulvin significantly decreases serum salicylate concentrations. Pediatr Infect Dis J. 1993; 12:350-2. [PubMed 8483633]

128. Abu-Romeh SH, Rashed A. Ciclosporin A and griseofulvin: another drug interactions. Nephron. 1991; 58:237. [PubMed 1830935]

129. Cote J. Interaction of griseofulvin and oral contraceptives. J Am Acad Dermatol. 1990; 22:124-5. [PubMed 2298948]

130. Gupta AK, Einarson TR, Summerbell RC et al. An overview of topical antifungal therapy in dermatomycoses: a North American perspective. Drugs. 1998; 55:645-74. [PubMed 9585862]

131. Piérard GE, Arrese JE, Piérard-Franchimont C. Treatment and prophylaxis of tinea infections. Drugs. 1996; 52:209-24. [PubMed 8841739]

132. Lesher JL. Recent developments in antifungal therapy. Dermatol Clin. 1996; 14:163-9. [PubMed 8821170]

133. Hay RJ. Dermatophytosis and other superficial mycoses. In: Mandel GL, Douglas RG Jr, Bennett JE, eds. Principles and practices of infectious disease. 4th ed. New York: Churchill Livingston; 1995: 2375-86.

134. Drake LA, Dincehart SM, Farmer ER et al. Guidelines of care for superficial mycotic infections of the skin: tinea corporis, tinea cruris, tinea faciei, tinea manuum, and tinea pedis. J Am Acad Dermatol. 1996; 34:282-6. [IDIS 363962] [PubMed 8642094]

135. Elewski B. Tinea capitis. Dermatol Clin. 1996; 14:23-31. [PubMed 8821154]

136. Crissey JT. Common dermatophyte infections: a simple diagnostic test and current management. Postgrad Med. 1998; 103:191-205. [IDIS 401902] [PubMed 9479316]

137. Drake LA, Dincehart SM, Farmer ER et al. Guidelines of care for superficial mycotic infections of the skin: tinea capitis and tinea barbae. J Am Acad Dermatol. 1996; 34:290-4. [IDIS 363964] [PubMed 8642096]

138. Abdel-Rahman SM, Nahata MC, Powell DA. Response to initial griseofulvin therapy in pediatric patients with tinea capitis. Ann Pharmacother. 1997; 31:406-10. [IDIS 382641] [PubMed 9100999]

139. Rademaker M, Havill S. Griseofulvin and terbinafine in the treatment of tinea capitis in children. N Z Med J. 1998; 111:55-7. [IDIS 402970] [PubMed 9539918]

140. Howard RM, Frieden IJ. Dermatophyte infections in children. Adv Pediatr Infect Dis. 1999; 14:73-107. [PubMed 10079850]

141. Elewski BE. Treatment of tinea capitis: beyond griseofulvin. J Am Acad Dermatol. 1999; 40:S27-30.

142. Faergemann J, Mork NJ, Haglund A et al. A multicentre (double-blind) comparative study to assess the safety and efficacy of fluconazole and griseofulvin in the treatment of tinea corporis and tinea cruris. Br J Dermatol. 1997; 136:575-7. [IDIS 384787] [PubMed 9155961]

a. AHFS Drug Information 2004. McEvoy GK, ed. Griseofulvin. Bethesda, MD: American Society of Health-System Pharmacists; 2004:532-4.

b. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 6th ed. Philadelphia; PA: Lippincott Wiliams & Wilkins; 2002:.

More Griseofulvin resources

Griseofulvin Side Effects (in more detail)
Griseofulvin Dosage
Griseofulvin Use in Pregnancy & Breastfeeding
Drug Images
Griseofulvin Drug Interactions
Griseofulvin Support Group
5 Reviews for Griseofulvin - Add your own review/rating

Griseofulvin Prescribing Information (FDA)

Griseofulvin Professional Patient Advice (Wolters Kluwer)

Griseofulvin Microsize Oral Suspension MedFacts Consumer Leaflet (Wolters Kluwer)

griseofulvin Concise Consumer Information (Cerner Multum)

griseofulvin Advanced Consumer (Micromedex) - Includes Dosage Information

Gris-PEG Prescribing Information (FDA)

Gris-PEG Ultramicrosize Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

Grisactin 250 Concise Consumer Information (Cerner Multum)

Compare Griseofulvin with other medications

Dermatophytosis
Onychomycosis, Fingernail
Onychomycosis, Toenail
Tinea Barbae
Tinea Capitis
Tinea Corporis
Tinea Cruris
Tinea Pedis

Granul-Derm Spray

Pronunciation: BAL-sum pe-ROO/KAS-tor oil/TRIP-sin
Generic Name: Balsam Peru/Castor Oil/Trypsin
Brand Name: Granulex

Granul-Derm Spray is used for:

Treating skin wounds and promoting wound healing.

Granul-Derm Spray is a wound agent. It works by stimulating blood vessel activity and removal of unhealthy tissue. The castor oil works as a lubricant to protect the tissue.

Do NOT use Granul-Derm Spray if:

you are allergic to any ingredient in Granul-Derm Spray

Contact your doctor or health care provider right away if any of these apply to you.

Before using Granul-Derm Spray:

Some medical conditions may interact with Granul-Derm Spray. 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 a wound that contains a certain type of fresh blood clot

Some MEDICINES MAY INTERACT with Granul-Derm Spray. Because little, if any, of Granul-Derm Spray is absorbed into the blood, the risk of it interacting with another medicine is low.

Ask your health care provider if Granul-Derm Spray 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.

How to use Granul-Derm Spray:

Use Granul-Derm Spray as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Shake well before each use.

Clean the wound before applying Granul-Derm Spray.

Hold the can upright about 12 inches from the area to be treated. Spray to cover the area quickly. The area may be left uncovered. It also can be covered with a dressing if your doctor directs you to do so.

To remove, wash gently with water.

Wash your hands immediately after using Granul-Derm Spray, unless your hands are part of the treated area.

Granul-Derm Spray is for external use only. Avoid spraying in the eyes, nostrils, or mouth.

If you miss a dose of Granul-Derm Spray, 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 Granul-Derm Spray.

Important safety information:

Granul-Derm Spray may cause harm if it is swallowed. If you may have taken it by mouth, contact your poison control center or emergency room right away.

It may take several days for Granul-Derm Spray to work. Do not stop using Granul-Derm Spray without checking with your doctor.

If your wound does not improve or becomes worse, check with your doctor.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Granul-Derm Spray while you are pregnant. It is not known if Granul-Derm Spray is found in breast milk. If you are or will be breast-feeding while you use Granul-Derm Spray, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Granul-Derm Spray:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Temporary stinging.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).

See also: Granul-Derm side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Granul-Derm Spray may be harmful if swallowed.

Proper storage of Granul-Derm Spray:

Store Granul-Derm Spray at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Do not store above 120 degrees F (49 degrees C). Store away from heat and direct sunlight. Do not puncture, break, or burn the canister even if it appears to be empty. Do not store in the bathroom. Keep Granul-Derm Spray out of the reach of children and away from pets.

General information:

If you have any questions about Granul-Derm Spray, please talk with your doctor, pharmacist, or other health care provider.

Granul-Derm Spray is to be used only by the patient for whom it is prescribed. Do not share it with other people.

If your symptoms do not improve or if they become worse, check with your doctor.

Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Granul-Derm Spray. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Granul-Derm resources

Granul-Derm Side Effects (in more detail)
Granul-Derm Use in Pregnancy & Breastfeeding
Granul-Derm Drug Interactions
Granul-Derm Support Group
0 Reviews for Granul-Derm - Add your own review/rating

Compare Granul-Derm with other medications

Dermatologic Lesion

gotu kola

Generic Name: gotu kola (GO too KOE la)

Brand Names:

What is gotu kola?

Gotu kola is also known by many other names, including brahmi, centella, Indian pennywort, marsh penny, thick-leaved pennywort, white rot, hydrocotyle, Indian water navelwort, and talepetrako. Gotu kola is not related to kola (cola) nut.

Gotu kola has been used orally (by mouth) in alternative medicine as an aid to treating anxiety, depression, fatigue, memory loss, colds and flu, upset stomach, diarrhea, ulcer, bladder infections, liver problems, and diabetes. Gotu kola has also been used to treat circulation problems, varicose veins, anemia, lupus, menstrual problems, and birth control.

Topical forms of gotu kola have been used in alternative medicine to aid in wound healing and reducing scars.

Not all uses for gotu kola have been approved by the FDA. Gotu kola should not be substituted for medications prescribed for you by your doctor.

Gotu kola is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Gotu kola may also be used for other purposes not listed in this product guide.

What is the most important information I should know about gotu kola?

Not all uses for gotu kola have been approved by the FDA. Gotu kola should not be substituted for medications prescribed for you by your doctor. You should not use gotu kola if you have liver disease.

Before you use this product, tell your doctor, pharmacist, herbalist, or other healthcare provider if you have diabetes or high cholesterol.

Use gotu kola as directed on the label, or as your healthcare provider has prescribed. Do not use this product in larger amounts or for longer than recommended.

What should I discuss with my health care provider before using gotu kola?

You should not use gotu kola if you have liver disease.

If you have certain conditions, you may need a dose adjustment or special tests to safely use gotu kola. Before you use this product, tell your doctor, pharmacist, herbalist, or other healthcare provider if you have:

diabetes; or

high cholesterol.

It is not known whether gotu kola is harmful to an unborn baby. Do not use this product without talking to a healthcare provider if you are pregnant or plan to become pregnant during treatment. It is not known whether gotu kola passes into breast milk or if it may harm a nursing baby. Ask your healthcare provider before using gotu kola if you are breast-feeding a baby. Do not give any herbal/health supplement to a child without the advice of a doctor.

How should I use gotu kola?

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use gotu kola, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

Different formulations of gotu kola are available to be taken by mouth (orally) or applied to the skin (topically).

Do not use different formulations of gotu kola (such as tablets and topical forms) at the same time, unless your healthcare provider has told you to. Using different formulations together can increase your risk of an overdose of gotu kola. Store gotu kola at room temperature away from moisture and heat.

What happens if I miss a dose?

Consult your doctor, pharmacist, herbalist, or other healthcare provider for instructions if you miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using gotu kola?

Follow your healthcare provider's instructions about any restrictions on food, beverages, or activity while you are using gota kola.

Gotu kola side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives, itching, redness, or burning of your skin; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using gotu kola and call your healthcare provider at once if you have any signs of liver problems, such as nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

nausea;

upset stomach; or

drowsiness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect gotu kola?

Gotu kola can be harmful to the liver, and these effects are increased when gotu kola is used together with medications that can harm the liver. Before using gotu kola, tell your doctor if you are using any of the following drugs:

amiodarone (Cordarone, Pacerone);

zileuton (Zyflo);

acetaminophen (Tylenol);

cancer medications

tuberculosis medications;

birth control pills or hormone replacement therapy;

arthritis medications such as auranofin (Ridaura);

an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), quinapril (Accupril), and others;

medications to treat infections, such as dapsone, erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), nitrofurantoin (Macrodantin), rifampin (Rifadin, Rifamate), or terbinafine (Lamisil);

cholesterol medications such as niacin (Advicor), atorvastatin (Lipitor), lovastatin (Altocor, Mevacor), simvastatin (Zocor), and others;

diabetes medications such as acarbose (Precose), pioglitazone (Actos), rosiglitazone (Avandia);

HIV/AIDS medications such as lamivudine (Combivir, Epivir), abacavir/lamivudine/zidovudine (Trizivir), nevirapine (Viramune), ritonavir (Norvir), tenofovir (Viread), zidovudine (Retrovir);

an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), and others; or

seizure medications such as carbamazepine (Carbatrol, Tegretol), phenytoin (Dilantin), felbamate (Felbatol), valproic acid (Depakene).

Herbal or alternative medicine products that may also be harmful to the liver include:

herbal or alternative medicine products such as androstenedione, chaparral, comfrey, DHEA, germander, pennyroyal oil, red yeast, and others.

This list is not complete and there may be other drugs or alternative medicine products that can interact with gotu kola. Tell your healthcare provider about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your healthcare provider.

More gotu kola resources

Gotu kola Side Effects (in more detail)
Gotu kola Use in Pregnancy & Breastfeeding
Gotu kola Support Group
0 Reviews for Gotu kola - Add your own review/rating

Gotu Kola Natural MedFacts for Professionals (Wolters Kluwer)

Gotu Kola Natural MedFacts for Consumers (Wolters Kluwer)

Gotu Kola MedFacts Consumer Leaflet (Wolters Kluwer)

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Anxiety
Depression
Diabetes, Type 1
Diabetes, Type 2
Herbal Supplementation
Infectious Gastroenteritis
Influenza
Mild Cognitive Impairment
Premenstrual Dysphoric Disorder
Systemic Lupus Erythematosus
Upper Respiratory Tract Infection
Urinary Tract Infection

Where can I get more information?

Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.

See also: gotu kola side effects (in more detail)

Granulex Spray

Pronunciation: BAL-sum pe-ROO/KAS-tor oil/TRIP-sin
Generic Name: Balsam Peru/Castor Oil/Trypsin
Brand Name: Granulex

Granulex Spray is used for:

Treating skin wounds and promoting wound healing.

Granulex Spray is a wound agent. It works by stimulating blood vessel activity and removal of unhealthy tissue. The castor oil works as a lubricant to protect the tissue.

Do NOT use Granulex Spray if:

you are allergic to any ingredient in Granulex Spray

Contact your doctor or health care provider right away if any of these apply to you.

Before using Granulex Spray:

Some medical conditions may interact with Granulex Spray. 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 a wound that contains a certain type of fresh blood clot

Some MEDICINES MAY INTERACT with Granulex Spray. Because little, if any, of Granulex Spray is absorbed into the blood, the risk of it interacting with another medicine is low.

Ask your health care provider if Granulex Spray 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.

How to use Granulex Spray:

Use Granulex Spray as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Shake well before each use.

Clean the wound before applying Granulex Spray.

Hold the can upright about 12 inches from the area to be treated. Spray to cover the area quickly. The area may be left uncovered. It also can be covered with a dressing if your doctor directs you to do so.

To remove, wash gently with water.

Wash your hands immediately after using Granulex Spray, unless your hands are part of the treated area.

Granulex Spray is for external use only. Avoid spraying in the eyes, nostrils, or mouth.

If you miss a dose of Granulex Spray, 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 Granulex Spray.

Important safety information:

Granulex Spray may cause harm if it is swallowed. If you may have taken it by mouth, contact your poison control center or emergency room right away.

It may take several days for Granulex Spray to work. Do not stop using Granulex Spray without checking with your doctor.

If your wound does not improve or becomes worse, check with your doctor.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Granulex Spray while you are pregnant. It is not known if Granulex Spray is found in breast milk. If you are or will be breast-feeding while you use Granulex Spray, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Granulex Spray:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Temporary stinging.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).

See also: Granulex side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Granulex Spray may be harmful if swallowed.

Proper storage of Granulex Spray:

Store Granulex Spray at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Do not store above 120 degrees F (49 degrees C). Store away from heat and direct sunlight. Do not puncture, break, or burn the canister even if it appears to be empty. Do not store in the bathroom. Keep Granulex Spray out of the reach of children and away from pets.

General information:

If you have any questions about Granulex Spray, please talk with your doctor, pharmacist, or other health care provider.

Granulex Spray is to be used only by the patient for whom it is prescribed. Do not share it with other people.

If your symptoms do not improve or if they become worse, check with your doctor.

Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Granulex Spray. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Granulex resources

Granulex Side Effects (in more detail)
Granulex Use in Pregnancy & Breastfeeding
Granulex Drug Interactions
Granulex Support Group
0 Reviews for Granulex - Add your own review/rating

Compare Granulex with other medications

Dermatologic Lesion

Griseofulvin Microsize Tablets

Pronunciation: GRIS-ee-oh-FUL-vin
Generic Name: Griseofulvin
Brand Name: Grifulvin V

Griseofulvin Microsize Tablets are used for:

Treating certain fungal infections (eg, ringworm) of the hair, skin, and nails. It may also be used for other conditions as determined by your doctor.

Griseofulvin Microsize Tablets are an antifungal agent. It works by making the skin more resistant to fungal growth.

Do NOT use Griseofulvin Microsize Tablets if:

you are allergic to any ingredient in Griseofulvin Microsize Tablets

you have liver failure or the blood disease porphyria

you are pregnant

Contact your doctor or health care provider right away if any of these apply to you.

Before using Griseofulvin Microsize Tablets:

Some medical conditions may interact with Griseofulvin Microsize Tablets. 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 had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to a penicillin antibiotic (eg, amoxicillin)

if you have liver disease or lupus

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

Barbiturates (eg, phenobarbital) because they may decrease Griseofulvin Microsize Tablets's effectiveness

Anticoagulants (eg, warfarin), cabazitaxel, cyclosporine, oral contraceptives (birth control pills), or ulipristal because their effectiveness may be decreased by Griseofulvin Microsize Tablets

This may not be a complete list of all interactions that may occur. Ask your health care provider if Griseofulvin Microsize Tablets 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.

How to use Griseofulvin Microsize Tablets:

Use Griseofulvin Microsize Tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take Griseofulvin Microsize Tablets by mouth with food or milk, unless otherwise directed by your doctor.

To clear up your infection completely, take Griseofulvin Microsize Tablets for the full course of treatment. Keep taking it even if you feel better in a few days.

If you miss a dose of Griseofulvin Microsize Tablets, 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 Griseofulvin Microsize Tablets.

Important safety information:

Griseofulvin Microsize Tablets may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Griseofulvin Microsize Tablets with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Be sure to take Griseofulvin Microsize Tablets for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The fungus could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.

Do not drink alcohol while you are taking Griseofulvin Microsize Tablets.

Griseofulvin Microsize Tablets may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Griseofulvin Microsize Tablets. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.

It is important to practice good hygiene during and after use to prevent reinfection.

Hormonal birth control (eg, birth control pills) may not work as well while you are using Griseofulvin Microsize Tablets. To prevent pregnancy, use an extra form of birth control (eg, condoms).

Lab tests, including complete blood cell counts, liver function, and kidney function, may be performed while you use Griseofulvin Microsize Tablets. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Griseofulvin Microsize Tablets should be used with extreme caution in CHILDREN younger than 3 years old; safety and effectiveness in these children have not been confirmed.

PREGNANCY and BREAST-FEEDING: Do not take Griseofulvin Microsize Tablets if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. It is not known if Griseofulvin Microsize Tablets are found in breast milk. If you are or will be breast-feeding while you use Griseofulvin Microsize Tablets, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Griseofulvin Microsize Tablets:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; headache; nausea; stomach upset; tiredness; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); butterfly-shaped rash on the face; confusion; fever, chills, or sore throat; flu-like symptoms (eg, headache, joint pain); mental or mood changes; numbness, burning, or tingling in the hands or feet; red, swollen, blistered, or peeling skin; symptoms of liver problems (dark urine, pale stools, severe or persistent stomach pain, yellowing of the skin or eyes); white patches in the mouth.

See also: Griseofulvin side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Griseofulvin Microsize Tablets:

Store Griseofulvin Microsize Tablets at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Griseofulvin Microsize Tablets out of the reach of children and away from pets.

General information:

If you have any questions about Griseofulvin Microsize Tablets, please talk with your doctor, pharmacist, or other health care provider.

Griseofulvin Microsize Tablets are to be used only by the patient for whom it is prescribed. Do not share it with other people.

If your symptoms do not improve or if they become worse, check with your doctor.

Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Griseofulvin Microsize Tablets. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Griseofulvin resources

Griseofulvin Side Effects (in more detail)
Griseofulvin Use in Pregnancy & Breastfeeding
Drug Images
Griseofulvin Drug Interactions
Griseofulvin Support Group
5 Reviews for Griseofulvin - Add your own review/rating

Compare Griseofulvin with other medications

Dermatophytosis
Onychomycosis, Fingernail
Onychomycosis, Toenail
Tinea Barbae
Tinea Capitis
Tinea Corporis
Tinea Cruris
Tinea Pedis