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  • 46

    Загружено:

    Carlos Hernández
    160 просмотров222 страницы

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    46.txt

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    46

    Загружено:

    Carlos Hernández

    Авторское право:

    © All Rights Reserved
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    из 222

    var title_f0_46_736="Management of achalasia";

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    =);\">",
    " </div>",
    " <div class=\"lgnd\">",
    " <div class=\"footnotes\">",
    " * May repeat up to a total of three pneumatic dilations.",
    " </div>",
    " <div class=\"reference\">",
    " From Spechler, SJ, Gastroenterology 1999; 117:229.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
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    f//Z);\">",
    " </div>",
    " <div class=\"lgnd\">",
    " Loosen the locking nut on the slit lamp assembly to allow free movement.",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_46_737=[""].join("\n");
    var outline_f0_46_737=null;
    var title_f0_46_738="Infant with bullous mastocytosis";
    var content_f0_46_738=[" <div id=\"graphicsToolbar\">",
    " <div id=\"graphicsCopy\">",
    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
    " </sup>",
    " </div>",
    " <div id=\"graphicsLinks\">",
    " <a href=\"?imageKey=ALLRG
    %2F63556&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=2\" onclick=\"\">",
    " <img alt=\"Print this page\" src=\"./../images/icn_print.myextg\"
    title=\"Print this page\"/>",
    " </a>",
    " <a class=\"icontxt textLink\" href=\"?imageKey=ALLRG
    %2F63556&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=2\" onclick=\"\"
    title=\"Print this page\">",
    " Print",
    " </a>",
    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\" style=\"width: 470px\">",
    " <div class=\"ttl\">",
    " Bullous eruption on the back of a child with diffuse cutaneous mastocytosis",
    " </div>",
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    " </div>",
    " <div class=\"lgnd\">",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_46_738=[""].join("\n");
    var outline_f0_46_738=null;
    var title_f0_46_739="Reapproximation perineal body";
    var content_f0_46_739=[" <div id=\"graphicsToolbar\">",
    " <div id=\"graphicsCopy\">",
    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
    " </sup>",
    " </div>",
    " <div id=\"graphicsLinks\">",
    " <a href=\"?imageKey=OBGYN
    %2F64822&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=1\" onclick=\"\">",
    " <img alt=\"Print this page\" src=\"./../images/icn_print.myextg\"
    title=\"Print this page\"/>",
    " </a>",
    " <a class=\"icontxt textLink\" href=\"?imageKey=OBGYN
    %2F64822&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=1\" onclick=\"\"
    title=\"Print this page\">",
    " Print",
    " </a>",
    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\" style=\"width: 470px\">",
    " <div class=\"ttl\">",
    " Transverse transperineal approach to a rectovaginal fistula located about the
    sphincter complex",
    " </div>",
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    " </div>",
    " <div class=\"lgnd\">",
    " The perineal body is reapproximated longitudinally with interrupted sutures to
    lengthen it.",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_46_739=[""].join("\n");
    var outline_f0_46_739=null;
    var title_f0_46_740="Oblique incisions of the abdominal wall";
    var content_f0_46_740=[" <div id=\"graphicsToolbar\">",
    " <div id=\"graphicsCopy\">",
    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
    " </sup>",
    " </div>",
    " <div id=\"graphicsLinks\">",
    " <a href=\"?imageKey=SURG
    %2F58517&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=1\" onclick=\"\">",
    " <img alt=\"Print this page\" src=\"./../images/icn_print.myextg\"
    title=\"Print this page\"/>",
    " </a>",
    " <a class=\"icontxt textLink\" href=\"?imageKey=SURG
    %2F58517&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=1\" onclick=\"\"
    title=\"Print this page\">",
    " Print",
    " </a>",
    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\" style=\"width: 512px\">",
    " <div class=\"ttl\">",
    " Oblique incisions of the abdominal wall",
    " </div>",
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    " </div>",
    " <div class=\"lgnd\">",
    " Embryologic development of the penis at different gestational ages. Note the
    penile curvature resolves at the end of normal development.",
    " <div class=\"footnotes\">",
    " UF: urethral folds; VC: ventral curvature; MS: midline seam.",
    " </div>",
    " <div class=\"reference\">",
    " Courtesy of Dr. Laurence Baskin.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
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    var outline_f0_46_741=null;
    var title_f0_46_742="Ustekinumab: Drug information";
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    src=\"./../images/logoWKH.myextg\" width=\"175\">",
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    " Official reprint from UpToDate",
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    " </div>",
    " </br>",
    " </img>",
    " </img>",
    " </div>",
    " <div id=\"printHeaderLinks\">",
    " <a class=\"TOPIC\" href=\"#\" id=\"printHeaderPrint\" rel=\"2\" title=\"Click
    here to print\">",
    " Print",
    " </a>",
    " <span class=\"pipeSpace\">",
    " |",
    " </span>",
    " <a href=\"#\" id=\"printHeaderBack\" title=\"Back to normal view\">",
    " Back",
    " </a>",
    " </div>",
    " </div>",
    " <!-- TC:TOPIC_PAGE -->",
    " <div id=\"topicContent\">",
    " <div id=\"drugTitle\">",
    " Ustekinumab: Drug information",
    " </div>",
    " <div id=\"lexiTitleImg\">",
    " <img height=\"17\" src=\"./../images/lexiComp/Lexicomp_2012_71x17.myextg\"
    width=\"71\"/>",
    " </div>",
    " <div class=\"clear\">",
    " </div>",
    " <div id=\"drugCopy\">",
    " Copyright 1978-2013 Lexicomp, Inc. All rights reserved.",
    " </div>",
    " <div id=\"topicText\">",
    " (For additional information",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?10/41/10900?source=see_link\">",
    " see \"Ustekinumab: Patient drug information\"",
    " </a>",
    " )",
    " <br/>",
    " For abbreviations and symbols that may be used in Lexicomp (",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?23/39/24183\">",
    " show table",
    " </a>",
    " )",
    " <div class=\"list ubnlist drugH1Div drugBrandNames\" id=\"F9419532\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Brand Names: U.S.",
    " </span>",
    " <ul>",
    " <li>",
    " Stelara&trade;",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"list cbnlist drugH1Div drugBrandNames\" id=\"F6867209\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Brand Names: Canada",
    " </span>",
    " <ul>",
    " <li>",
    " Stelara&trade;",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"ex_sect_xr thclist drugH1Div drugBrandNames\" id=\"F6867212\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pharmacologic Category",
    " </span>",
    " <ul>",
    " <li>",
    " Antipsoriatic Agent;",
    " </li>",
    " <li>",
    " Interleukin-12 Inhibitor;",
    " </li>",
    " <li>",
    " Interleukin-23 Inhibitor;",
    " </li>",
    " <li>",
    " Monoclonal Antibody",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"block doa drugH1Div\" id=\"F6868014\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Adult",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " <b>",
    " Plaque psoriasis:",
    " </b>",
    " SubQ:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Initial and maintenance:",
    " <b>",
    " Note:",
    " </b>",
    " Following an interruption in therapy, retreatment may be initiated at the
    initial dosing interval. Consider therapy discontinuation in any patient failing to
    demonstrate a response after 12 weeks of therapy.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &le;100 kg: 45 mg at 0- and 4 weeks, and then every 12 weeks thereafter",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &gt;100 kg: 90 mg at 0- and 4 weeks, and then every 12 weeks thereafter.",
    " <b>",
    " Note:",
    " </b>",
    " Doses of 45 mg given to patients &gt;100 kg were also efficacious; however,
    90 mg is the recommended dose in these patients due to greater efficacy.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <i>",
    " Canadian labeling:",
    " </i>",
    " If response inadequate on every-12-week therapy, consider increasing
    frequency to every 8 weeks.",
    " </p>",
    " </div>",
    " <div class=\"block doe drugH1Div\" id=\"F6867998\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Geriatric",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Refer to adult dosing.",
    " </p>",
    " </div>",
    " <div class=\"block dor drugH1Div\" id=\"F6867999\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Renal Impairment",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " No dosage adjustment provided in manufacturer&rsquo;s labeling (has not been
    studied).",
    " </p>",
    " </div>",
    " <div class=\"block doh drugH1Div\" id=\"F6868000\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Hepatic Impairment",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " No dosage adjustment provided in manufacturer&rsquo;s labeling (has not been
    studied).",
    " </p>",
    " </div>",
    " <div class=\"block foc drugH1Div\" id=\"F6868009\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosage Forms: U.S.",
    " </span>",
    " <p style=\"text-indent:0em;text-align:justify;display:inline\">",
    " Excipient information presented when available (limited, particularly for
    generics); consult specific product labeling.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Injection, solution [preservative free]:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Stelara&trade;: 45 mg/0.5 mL (0.5 mL) [contains natural rubber/natural latex
    in packaging, polysorbate 80, sucrose 38 mg/syringe]",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Stelara&trade;: 90 mg/mL (1 mL) [contains natural rubber/natural latex in
    packaging, polysorbate 80, sucrose 76 mg/syringe]",
    " </p>",
    " </div>",
    " <div class=\"block geq drugH1Div\" id=\"F6867211\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Generic Equivalent Available: U.S.",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " No",
    " </p>",
    " </div>",
    " <div class=\"block meg drugH1Div\" id=\"F9419531\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Medication Guide",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " An FDA-approved patient medication guide, which is available with the product
    information and at",
    " <a
    href=\"file://www.accessdata.fda.gov/drugsatfda_docs/label/2009/125261mg.pdf\"
    target=\"_blank\">",
    " file://www.accessdata.fda.gov/drugsatfda_docs/label/2009/125261mg.pdf",
    " </a>",
    " , must be dispensed with this medication.",
    " </p>",
    " </div>",
    " <div class=\"block adm drugH1Div\" id=\"F6868005\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Administration",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Do not use if cloudy or discolored. Administer by subcutaneous injection into
    the top of the thigh, abdomen, upper arms, or buttocks. Rotate sites. Do not inject
    into tender, bruised, erythematous, or indurated skin. Avoid areas of skin where
    psoriasis is present. Discard any unused portion.",
    " </p>",
    " </div>",
    " <div class=\"block use drugH1Div\" id=\"F6867268\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Use",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Treatment of moderate-to-severe plaque psoriasis",
    " </p>",
    " </div>",
    " <div class=\"block mst drugH1Div\" id=\"F6867207\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Medication Safety Issues",
    " </span>",
    " <div class=\"collapsible\">",
    " <span class=\"collapsible-title\">",
    " Sound-alike/look-alike issues:",
    " </span>",
    " <div class=\"collapsible-wrap\">",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Stelara&trade; may be confused with Aldara&reg;",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Ustekinumab may be confused with infliximab, rituximab",
    " </p>",
    " </div>",
    " </div>",
    " </div>",
    " <div class=\"block ars drugH1Div\" id=\"F6867985\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Adverse Reactions Significant",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " &gt;10%: Miscellaneous: Infection (27% to 61%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " 1% to 10%:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Central nervous system: Headache (5%), fatigue (3%), dizziness (1% to 2%),
    depression (1%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Dermatologic: Pruritus (1% to 2%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Local: Injection site erythema (1% to 2%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Neuromuscular &amp; skeletal: Back pain (1% to 2%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Respiratory: Pharyngolaryngeal pain (1% to 2%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Miscellaneous: Antibody formation (3% to 5%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " &lt;1% (Limited to important or life-threatening): Allergic reactions,
    anaphylaxis, angina, angioedema, bacterial infection, cellulitis, dactylitis,
    diverticulitis, fungal infection, gastroenteritis, herpes zoster, hypertension;
    injection site reactions (bruising, hemorrhage, induration, irritation, pain,
    pruritus, swelling); malignancy (breast, colon, head and neck, kidney, prostate,
    thyroid); MI, nephrolithiasis, osteomyelitis, pneumonia, rash, reversible posterior
    leukoencephalopathy syndrome, stroke, urinary tract infection, urticaria, viral
    infection",
    " </p>",
    " </div>",
    " <div class=\"block coi drugH1Div\" id=\"F6867273\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Contraindications",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Hypersensitivity to ustekinumab or any component of the formulation",
    " </p>",
    " <p style=\"text-indent:0em;margin-top:2em;\">",
    " Canadian labeling: Additional contraindications (not in U.S. labeling):
    Severe infections such as sepsis, tuberculosis, and opportunistic infections",
    " </p>",
    " </div>",
    " <div class=\"block war drugH1Div\" id=\"F6867274\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Warnings/Precautions",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " <b>",
    " <i>",
    " Concerns related to adverse effects:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; Antibody formation: Antibody formation to ustekinumab has been
    observed with therapy and has been associated with decreased serum levels and
    therapeutic response in some patients.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; Hypersensitivity reactions: Hypersensitivity, including anaphylaxis
    and angioedema, has been reported. Discontinue immediately with signs/symptoms of
    hypersensitivity reaction and treat appropriately as indicated.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; Infections: May increase the risk for infections or reactivation of
    latent infections. Serious bacterial, fungal, and viral infections have been
    observed with use. Avoid use in patients with clinically important active
    infection. Exercise caution when considering use in patients with a history of
    new/recurrent infections, with conditions that predispose them to infections (eg,
    diabetes or residence/travel from areas of endemic mycoses), with chronic, latent,
    or localized infections, or who are genetically deficient in IL-12/IL-23 (IL-12/IL-
    23 genetic deficiency may predispose patients to disseminated infection). Patients
    who develop a new infection while undergoing treatment should be monitored closely.
    If a patient develops a serious infection, therapy should be discontinued or
    withheld until successful resolution of infection.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; Malignancy: May increase the risk for malignancy although the impact
    on the development and course of malignancies is not fully defined. Rapidly
    appearing cutaneous squamous cell carcinomas (multiple) have been reported in
    patients receiving ustekinumab who were at risk for developing nonmelanoma skin
    cancer. Monitor all patients closely for the development of nonmelanoma skin
    cancer; closely follow patients &gt;60 years of age, with a history of prolonged
    immunosuppression, and in patients with a history of PUVA treatment. Use with
    caution in patients with prior malignancy (use not studied in this population).",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; Neurotoxicity: Reversible posterior leukoencephalopathy syndrome
    (RPLS) has been observed (rare). Monitor for signs/symptoms of RPLS (headache,
    seizures, confusion, and visual disturbances) and discontinue ustekinumab if
    symptoms occur.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; Tuberculosis: Avoid use in patients with active tuberculosis (TB).
    Patients should be evaluated for latent tuberculosis infection with a tuberculin
    skin test prior to starting therapy. Treatment of latent TB should be initiated
    before ustekinumab therapy is used. Consider antituberculosis treatment in patients
    with a history of latent or active tuberculosis if an adequate prior treatment
    course cannot be confirmed. During and following treatment, monitor for
    signs/symptoms of active TB.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " <i>",
    " Disease-related concerns:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Hepatic impairment: Use caution in patients with hepatic impairment.
    Use has not been studied in this patient population.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Renal impairment: Use caution in patients with renal impairment. Use
    has not been studied in this patient population.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " <b>",
    " <i>",
    " Concurrent drug therapy issues:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; 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.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; Immunosuppressive therapy: Use in combination with other
    immunosuppressive drugs has not been studied; use caution.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " <b>",
    " <i>",
    " Special populations:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; Patients &gt;100 kg: May require higher dose to achieve adequate serum
    levels.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " <b>",
    " <i>",
    " Dosage form specific issues:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; Latex: Packaging may contain natural latex rubber.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Polysorbate 80: Product may contain polysorbate 80.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " <b>",
    " <i>",
    " Other warnings/precautions:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; Immunizations: Patients should be brought up to date with all
    immunizations before initiating therapy.",
    " <b>",
    " Live vaccines should not be given concurrently",
    " </b>",
    " ; inactivated or nonlive vaccines may be given concurrently, but may not
    elicit a proper immune response. BCG vaccines should not be given 1 year prior to,
    during, or 1 year following treatment.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " &bull; Phototherapy: Use in combination with phototherapy has not been
    studied; use caution.",
    " </p>",
    " </div>",
    " <div class=\"block cyt drugH1Div\" id=\"F13300199\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Metabolism/Transport Effects",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " None known.",
    " </p>",
    " </div>",
    " <div class=\"block dri drugH1Div\" id=\"F6872026\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Drug Interactions",
    " </span>",
    " <br/>",
    " <br/>",
    " <div class=\"lexi\" id=\"lexiInteractAddInfo\">",
    " (For additional information:",
    " <a class=\"dip\" href=\"./drug-interaction\" target=\"_blank\">",
    " Launch Lexi-Interact&trade; Drug Interactions Program",
    " </a>",
    " )",
    " </div>",
    " <div class=\"lexi\" id=\"lexiInteractImgB\">",
    " <img border=\"0\" height=\"17\"
    src=\"./../images/lexiComp/Lexicomp_2012_71x17.myextg\" width=\"71\"/>",
    " </div>",
    " <div class=\"clear\">",
    " </div>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Abciximab: May enhance the potential for allergic or hypersensitivity
    reactions to Monoclonal Antibodies. Also may cause thrombocytopenia or diminished
    therapeutic effects.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " BCG: Immunosuppressants may diminish the therapeutic effect of BCG.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Belimumab: Monoclonal Antibodies may enhance the adverse/toxic effect of
    Belimumab.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Coccidioidin Skin Test: Immunosuppressants may diminish the diagnostic effect
    of Coccidioidin Skin Test.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Denosumab: May enhance the adverse/toxic effect of Immunosuppressants.
    Specifically, the risk for serious infections may be increased.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Echinacea: May diminish the therapeutic effect of Immunosuppressants.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Leflunomide: Immunosuppressants may enhance the adverse/toxic effect of
    Leflunomide. Specifically, the risk for hematologic toxicity such as pancytopenia,
    agranulocytosis, and/or thrombocytopenia may be increased. Management: Consider
    not using a leflunomide loading dose in patients receiving other
    immunosuppressants. Patients receiving both leflunomide and another
    immunosuppressant should be monitored for bone marrow suppression at least
    monthly.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Natalizumab: Immunosuppressants may enhance the adverse/toxic effect of
    Natalizumab. Specifically, the risk of concurrent infection may be increased.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Pimecrolimus: May enhance the adverse/toxic effect of Immunosuppressants.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Roflumilast: May enhance the immunosuppressive effect of
    Immunosuppressants.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Sipuleucel-T: Immunosuppressants may diminish the therapeutic effect of
    Sipuleucel-T.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Tacrolimus (Topical): May enhance the adverse/toxic effect of
    Immunosuppressants.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Tofacitinib: Immunosuppressants may enhance the immunosuppressive effect of
    Tofacitinib. Management: Concurrent use with antirheumatic doses of methotrexate
    or other non-disease modifying antirheumatic drugs (non-DMARDs) is permitted, and
    this warning seems to particularly focused on more potent immunosuppressants.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Trastuzumab: May enhance the neutropenic effect of Immunosuppressants.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Vaccines (Inactivated): Immunosuppressants may diminish the therapeutic
    effect of Vaccines (Inactivated).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Vaccines (Live): Immunosuppressants may enhance the adverse/toxic effect of
    Vaccines (Live). Vaccinial infections may develop. Immunosuppressants may diminish
    the therapeutic effect of Vaccines (Live). Management: Avoid use of live organism
    vaccines with immunosuppressants; live-attenuated vaccines should not be given for
    at least 3 months after immunosuppressants.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " </div>",
    " <div class=\"block prf drugH1Div\" id=\"F9419533\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pregnancy Risk Factor",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " B (",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?16/42/17068\">",
    " show table",
    " </a>",
    " )",
    " </p>",
    " </div>",
    " <div class=\"block pri drugH1Div\" id=\"F6867269\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pregnancy Implications",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Reproduction studies have not been conducted in pregnant women. Use during
    pregnancy only if clearly needed.",
    " </p>",
    " </div>",
    " <div class=\"block lac drugH1Div\" id=\"F6867271\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Lactation",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Excretion in breast milk unknown/use caution",
    " </p>",
    " </div>",
    " <div class=\"block brc drugH1Div\" id=\"F6867272\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Breast-Feeding Considerations",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " It is not known whether ustekinumab is secreted in human milk. Because many
    immunoglobulins are secreted in milk it is expected that ustekinumab will be
    present in breast milk. Use caution in nursing women.",
    " </p>",
    " </div>",
    " <div class=\"block fee drugH1Div\" id=\"F16321916\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pricing: U.S. (Medi-Span&reg;)",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Solution",
    " </b>",
    " (Stelara Subcutaneous)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 45 mg/0.5 mL (0.5 mL): $7742.92",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 90 mg/mL (1 mL): $15485.81",
    " </p>",
    " </div>",
    " <div class=\"block mop drugH1Div\" id=\"F6868007\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Monitoring Parameters",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Place and read PPD prior to initiating therapy; CBC; ustekinumab-antibody
    formation; monitor for signs/symptoms of infection, reversible posterior
    leukoencephalopathy syndrome (RPLS), and squamous cell skin carcinoma",
    " </p>",
    " </div>",
    " <div class=\"list fbnlist drugH1Div drugBrandNames\" id=\"F10961946\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " International Brand Names",
    " </span>",
    " <ul>",
    " <li>",
    " Stelara (AR, AT, AU, BE, BR, CH, CO, CR, CZ, DE, DK, DO, EE, FR, GB, GT, HK,
    HN, IE, IL, MY, NI, NL, NO, NZ, PA, PL, PT, RU, SE, SG, SV, TH)",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"block pha drugH1Div\" id=\"F6868003\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Mechanism of Action",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Ustekinumab is a human monoclonal antibody that binds to and interferes with
    the proinflammatory cytokines, interleukin (IL)-12 and IL-23. Biological effects of
    IL-12 and IL-23 include natural killer (NK) cell activation, CD4+ T-cell
    differentiation and activation. Ustekinumab also interferes with the expression of
    monocyte chemotactic protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-&alpha;),
    interferon-inducible protein-10 (IP-10), and interleukin-8 (IL-8). Significant
    clinical improvement in psoriasis patients is seen in association with reduction of
    these proinflammatory signalers.",
    " </p>",
    " </div>",
    " <div class=\"block phk drugH1Div\" id=\"F6867991\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pharmacodynamics/Kinetics",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Distribution: V",
    " <sub>",
    " d",
    " </sub>",
    " (terminal elimination phase): 45 mg: 0.161 &plusmn; 0.065 L/kg; 90 mg: 0.179
    &plusmn; 0.085 L/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Bioavailability: Absolute bioavailability: SubQ: ~57%",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Half-life elimination: 10-126 days",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Time to peak, plasma: 45 mg: 13.5 days; 90 mg: 7 days",
    " </p>",
    " </div>",
    " </div>",
    " <div id=\"topicAgreement\">",
    " Use of UpToDate is subject to the",
    " <a class=\"licenseLink\" href=\"./license\" id=\"sla_in_page\"
    target=\"_blank\">",
    " Subscription and License Agreement",
    " </a>",
    " .",
    " </div>",
    " <div class=\"headingAnchor\" id=\"references\">",
    " <h1>",
    " REFERENCES",
    " </h1>",
    " <ol id=\"reference\">",
    " <li>",
    " <div class=\"reference\">",
    " Andrulonis R and Ferris LK, &ldquo;Treatment of Severe Psoriasis With
    Ustekinumab During Pregnancy,&rdquo;",
    " <i>",
    " J Drugs Dermatol",
    " </i>",
    " , 2012, 11(10):1240.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/742/abstract-text/23134993/pubmed\" id=\"23134993\"
    target=\"_blank\">",
    " 23134993",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Galvan-Banqueri M, Marin Gil R, Santos Ramos, B, et al, &ldquo;Biological
    Treatments for Moderate-to-Severe Psoriasis: Indirect Comparison,&rdquo;",
    " <i>",
    " J Clin Pharm Ther",
    " </i>",
    " , 2013, 38(2):121-30.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/742/abstract-text/23442134/pubmed\" id=\"23442134\"
    target=\"_blank\">",
    " 23442134",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Kimball AB, Papp KA, Wasfi Y, et al, &ldquo;Long-term Efficacy of
    Ustekinumab in Patients With Moderate-to-Severe Psoriasis Treated for up to 5 Years
    in the PHOENIX 1 Study,&rdquo;",
    " <i>",
    " J Eur Acad Dermatol Venereol",
    " </i>",
    " , 2012 [epub ahead of print].",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/742/abstract-text/23279003/pubmed\" id=\"23279003\"
    target=\"_blank\">",
    " 23279003",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Leonardi CL, Kimball AB, Papp KA, et al, &ldquo;Efficacy and Safety of
    Ustekinumab, a Human Interleukin-12/23 Monoclonal Antibody, in Patients With
    Psoriasis: 76-Week Results from a Randomised, Double-Blind, Placebo-Controlled
    Trial (PHOENIX 1),&rdquo;",
    " <i>",
    " Lancet",
    " </i>",
    " , 2008, 371(9625): 1665-74.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/742/abstract-text/18486739/pubmed\" id=\"18486739\"
    target=\"_blank\">",
    " 18486739",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Papp KA, Griffiths CE, Gordon K, et al, &ldquo;Long-Term Safety of
    Ustekinumab in Patients With Moderate-to-Severe Psoriasis: Final Results From 5
    Years of Follow-Up,&rdquo;",
    " <i>",
    " Br J Dermatol",
    " </i>",
    " , 2013, 168(4):844-54.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/742/abstract-text/23301632/pubmed\" id=\"23301632\"
    target=\"_blank\">",
    " 23301632",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Papp KA, Langley RG, Lebwohl M, et al, &ldquo;Efficacy and Safety of
    Ustekinumab, a Human Interleukin-12/23 Monoclonal Antibody, in Patients With
    Psoriasis: 52-Week Results from a Randomised, Double-Blind, Placebo-Controlled
    Trial (PHOENIX 2),&rdquo;",
    " <i>",
    " Lancet",
    " </i>",
    " , 2008, 371(9625): 1675-84.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/742/abstract-text/18486740/pubmed\" id=\"18486740\"
    target=\"_blank\">",
    " 18486740",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Reddy M, Davis C, Wong J, et al, &ldquo;Modulation of CLA, IL-12R, CD40L,
    and Il-2R&alpha; Expression and Inhibition of IL-12- and IL-23-Induced Cytokine
    Secretion by CNTO 1275,&rdquo;",
    " <i>",
    " Cell Immunol",
    " </i>",
    " , 2007, 247(1): 1-11.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/742/abstract-text/17761156/pubmed\" id=\"17761156\"
    target=\"_blank\">",
    " 17761156",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Sandborn WJ, Gasink C, Gao LL, et al, &ldquo;Ustekinumab Induction and
    Maintenance Therapy in Refractory Crohn&rsquo;s Disease,&rdquo;",
    " <i>",
    " N Engl J Med",
    " </i>",
    " , 2012, 367(16):1519-28.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/742/abstract-text/23075178/pubmed\" id=\"23075178\"
    target=\"_blank\">",
    " 23075178",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " </ol>",
    " </div>",
    " <div id=\"topicVersionRevision\">",
    " Topic 9514 Version 35.0",
    " </div>",
    " </div>",
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    var script_f0_46_742=[""].join("\n");
    var outline_f0_46_742=[" <div id=\"toggleOutline\">",
    " <a href=\"#\" title=\"Collapse Topic Outline\">",
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    " <div id=\"innerOutline\">",
    " <h1>",
    " TOPIC OUTLINE",
    " </h1>",
    " <div id=\"outline\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F9419532\">",
    " Brand Names: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867209\">",
    " Brand Names: Canada",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867212\">",
    " Pharmacologic Category",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6868014\">",
    " Dosing: Adult",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867998\">",
    " Dosing: Geriatric",
    " </a>",
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    " <a class=\"outlineLink\" href=\"#F6867999\">",
    " Dosing: Renal Impairment",
    " </a>",
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    " <a class=\"outlineLink\" href=\"#F6868000\">",
    " Dosing: Hepatic Impairment",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6868009\">",
    " Dosage Forms: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867211\">",
    " Generic Equivalent Available: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F9419531\">",
    " Medication Guide",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6868005\">",
    " Administration",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867268\">",
    " Use",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867207\">",
    " Medication Safety Issues",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867985\">",
    " Adverse Reactions Significant",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867273\">",
    " Contraindications",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867274\">",
    " Warnings/Precautions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F13300199\">",
    " Metabolism/Transport Effects",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6872026\">",
    " Drug Interactions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F9419533\">",
    " Pregnancy Risk Factor",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867269\">",
    " Pregnancy Implications",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867271\">",
    " Lactation",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867272\">",
    " Breast-Feeding Considerations",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F16321916\">",
    " Pricing: U.S. (Medi-Span&reg;)",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6868007\">",
    " Monitoring Parameters",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F10961946\">",
    " International Brand Names",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6868003\">",
    " Mechanism of Action",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6867991\">",
    " Pharmacodynamics/Kinetics",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a href=\"#references\">",
    " REFERENCES",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " <div class=\"openRelatedGraphics\" id=\"DRUG_GEN/9514\" rel=\"outline_link\">",
    " GRAPHICS",
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    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?23/39/24183\"
    title=\"Lexicomp clinical abbreviations\">",
    " Lexicomp clinical abbreviations",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " RELATED TOPICS",
    " </h1>",
    " <div id=\"relatedTopics\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?10/41/10900?
    source=related_link\">",
    " Ustekinumab: Patient drug information",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " </div>"].join("\n");
    var title_f0_46_743="Pancrelipase: Drug information";
    var content_f0_46_743=[" <noscript>",
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    " <!-- TC:TOPIC_PAGE -->",
    " <div id=\"topicContent\">",
    " <div id=\"drugTitle\">",
    " Pancrelipase: Drug information",
    " </div>",
    " <div id=\"lexiTitleImg\">",
    " <img height=\"17\" src=\"./../images/lexiComp/Lexicomp_2012_71x17.myextg\"
    width=\"71\"/>",
    " </div>",
    " <div class=\"clear\">",
    " </div>",
    " <div id=\"drugCopy\">",
    " Copyright 1978-2013 Lexicomp, Inc. All rights reserved.",
    " </div>",
    " <div id=\"topicText\">",
    " (For additional information",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?34/44/35524?source=see_link\">",
    " see \"Pancrelipase: Patient drug information\"",
    " </a>",
    " and",
    " <a class=\"drug drug_pediatric\" href=\"UTD.htm?8/14/8422?source=see_link\">",
    " see \"Pancrelipase: Pediatric drug information\"",
    " </a>",
    " )",
    " <br/>",
    " For abbreviations and symbols that may be used in Lexicomp (",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?23/39/24183\">",
    " show table",
    " </a>",
    " )",
    " <div class=\"list ubnlist drugH1Div drugBrandNames\" id=\"F206069\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Brand Names: U.S.",
    " </span>",
    " <ul>",
    " <li>",
    " Creon&reg;;",
    " </li>",
    " <li>",
    " Pancreaze&trade;;",
    " </li>",
    " <li>",
    " Pancrelipase&trade;;",
    " </li>",
    " <li>",
    " Pertzye&trade;;",
    " </li>",
    " <li>",
    " Ultresa&trade;;",
    " </li>",
    " <li>",
    " Viokace&trade;;",
    " </li>",
    " <li>",
    " Zenpep&reg;",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"list cbnlist drugH1Div drugBrandNames\" id=\"F206070\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Brand Names: Canada",
    " </span>",
    " <ul>",
    " <li>",
    " Cotazym&reg;;",
    " </li>",
    " <li>",
    " Creon&reg;;",
    " </li>",
    " <li>",
    " Pancrease&reg; MT;",
    " </li>",
    " <li>",
    " Ultrase&reg;;",
    " </li>",
    " <li>",
    " Ultrase&reg; MT;",
    " </li>",
    " <li>",
    " Viokase&reg;",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"ex_sect_xr thclist drugH1Div drugBrandNames\" id=\"F206097\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pharmacologic Category",
    " </span>",
    " <ul>",
    " <li>",
    " Enzyme",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"block doa drugH1Div\" id=\"F206071\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Adult",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " <b>",
    " Note:",
    " </b>",
    " Adjust dose based on body weight, clinical symptoms, and stool fat content.
    Allow several days between dose adjustments. Total daily dose reflects ~3 meals/day
    and 2-3 snacks/day, with half the mealtime dose given with a snack. Doses of lipase
    &gt;2500 units/kg/meal (or lipase &gt;10,000 units/kg/",
    " <b>",
    " day",
    " </b>",
    " ) should be used with caution and only with documentation of 3-day fecal fat
    measures. Doses of lipase &gt;6000 units/kg/meal are associated with colonic
    stricture and should be decreased.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;margin-top:2em;text-
    align:justify;\">",
    " <b>",
    " Pancreatic insufficiency due to conditions such as cystic fibrosis:",
    " </b>",
    " Oral (Creon&reg;, Pancreaze&trade;, Pertzye&trade;, Ultresa&trade;,
    Zenpep&reg;): Initial: Lipase 500 units/kg/meal. Dosage range: Lipase 500-2500
    units/kg/meal. Maximum: Lipase &le;2500 units/kg/",
    " <b>",
    " meal",
    " </b>",
    " <b>",
    " or",
    " </b>",
    " lipase &le;10,000 units/kg/",
    " <b>",
    " day",
    " </b>",
    " <b>",
    " or",
    " </b>",
    " lipase &lt;4000 units/g of fat daily",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Pancreatic insufficiency due to chronic pancreatitis or pancreatectomy:",
    " </b>",
    " Oral:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Creon&reg;: Lipase 72,000 units/meal while consuming &ge;100 g of fat daily;
    alternatively, lower initial doses of lipase 500 units/kg/meal with individualized
    dosage titrations have also been used",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Viokace&trade; (administer in combination with a proton pump inhibitor):
    Initial: Lipase 500 units/kg/meal. Dosage range: Lipase 500-2500 units/kg/meal.
    Maximum: Lipase &le;2500 units/kg/",
    " <b>",
    " meal",
    " </b>",
    " <b>",
    " or",
    " </b>",
    " lipase &le;10,000 units/kg/",
    " <b>",
    " day",
    " </b>",
    " <b>",
    " or",
    " </b>",
    " lipase &lt;4000 units/g of fat daily",
    " </p>",
    " </div>",
    " <div class=\"block dop drugH1Div\" id=\"F206085\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Pediatric",
    " </span>",
    " <p>",
    " (For additional information",
    " <a class=\"drug drug_pediatric\" href=\"UTD.htm?8/14/8422?
    source=see_link\">",
    " see \"Pancrelipase: Pediatric drug information\"",
    " </a>",
    " )",
    " </p>",
    " <p style=\"text-indent:0em;display:inline\">",
    " <b>",
    " Note:",
    " </b>",
    " Adjust dose based on body weight, clinical symptoms, and stool fat content.
    Allow several days between dose adjustments. Total daily dose reflects ~3 meals/day
    and 2-3 snacks/day, with half the mealtime dose given with a snack. Doses of lipase
    &gt;2500 units/kg/meal (or lipase &gt;10,000 units/kg/",
    " <b>",
    " day",
    " </b>",
    " ) should be used with caution and only with documentation of 3-day fecal fat
    measures. Doses of lipase &gt;6000 units/kg/meal are associated with colonic
    stricture and should be decreased.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;margin-top:2em;text-
    align:justify;\">",
    " <b>",
    " Pancreatic insufficiency due to conditions such as cystic fibrosis:",
    " </b>",
    " Oral:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Infants &le;1 year (Creon&reg;, Pancreaze&trade;, Zenpep&reg;): Lipase 2000-
    4000 units per 120 mL of formula or per breast-feeding",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Children &gt;1 and &lt;4 years (Creon&reg;, Pancreaze&trade;, Zenpep&reg;,
    Pertzye&trade; [and weight &ge;8 kg], Ultresa&trade; [and weight &ge;14 kg]):
    Initial: Lipase 1000 units/kg/meal. Dosage range: Lipase 1000-2500 units/kg/meal.
    Maximum: Lipase &le;2500 units/kg/",
    " <b>",
    " meal",
    " </b>",
    " <b>",
    " or",
    " </b>",
    " lipase &le;10,000 units/kg/",
    " <b>",
    " day",
    " </b>",
    " <b>",
    " or",
    " </b>",
    " lipase &lt;4000 units/g of fat daily",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Children &ge;4 years and Adolescents (Creon&reg;, Pancreaze&trade;,
    Zenpep&reg;, Pertzye&trade; [and weight &ge;16 kg], Ultresa&trade; [and weight
    &ge;28 kg]): Refer to adult dosing.",
    " </p>",
    " </div>",
    " <div class=\"block doe drugH1Div\" id=\"F206072\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Geriatric",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Refer to adult dosing.",
    " </p>",
    " </div>",
    " <div class=\"block foc drugH1Div\" id=\"F206051\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosage Forms: U.S.",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Excipient information presented when available (limited, particularly for
    generics); consult specific product labeling.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Capsule, delayed release, bicarbonate buffered enteric coated microspheres,
    oral [porcine derived]:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Pertzye&trade;: Lipase 8,000 units, protease 28,750 units, and amylase
    30,250 units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Pertzye&trade;: Lipase 16,000 units, protease 57,500 units, and amylase
    60,500 units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Capsule, delayed release, enteric coated beads, oral [porcine derived]:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Pancrelipase&trade;: Lipase 5000 units, protease 17,000 units, amylase 27,000
    units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Zenpep&reg;: Lipase 3000 units, protease 10,000 units, and amylase 16,000
    units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Zenpep&reg;: Lipase 5000 units, protease 17,000 units, and amylase 27,000
    units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Zenpep&reg;: Lipase 10,000 units, protease 34,000 units, and amylase 55,000
    units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Zenpep&reg;: Lipase 15,000 units, protease 51,000 units, and amylase 82,000
    units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Zenpep&reg;: Lipase 20,000 units, protease 68,000 units, and amylase 109,000
    units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Zenpep&reg;: Lipase 25,000 units, protease 85,000 units, and amylase 136,000
    units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Capsule, delayed release, enteric coated microspheres, oral [porcine
    derived]:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Creon&reg;: Lipase 3000 units, protease 9500 units, and amylase 15,000
    units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Creon&reg;: Lipase 6000 units, protease 19,000 units, and amylase 30,000
    units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Creon&reg;: Lipase 12000 units, protease 38,000 units, and amylase 60,000
    units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Creon&reg;: Lipase 24,000 units, protease 76,000 units, and amylase 120,000
    units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Capsule, delayed release, enteric coated microtablets, oral [porcine
    derived]:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Pancreaze&trade;: Lipase 4200 units, protease 10,000 units, and amylase
    17,500 units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Pancreaze&trade;: Lipase 10,500 units, protease 25,000 units, and amylase
    43,750 units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Pancreaze&trade;: Lipase 16,800 units, protease 40,000 units, and amylase
    70,000 units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Pancreaze&trade;: Lipase 21,000 units, protease 37,000 units, and amylase
    61,000 units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Capsule, delayed release, enteric coated minitablets, oral [porcine
    derived]:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Ultresa&trade;: Lipase 13,800 units, protease 27,600 units, and amylase
    27,600 units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Ultresa&trade;: Lipase 20,700 units, protease 41,400 units, and amylase
    41,400 units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Ultresa&trade;: Lipase 23,000 units, protease 46,000 units, and amylase
    46,000 units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Tablet, oral [porcine derived]:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Viokace&trade;: Lipase 10,440 units, protease 39,150 units, and amylase
    39,150 units",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Viokace&trade;: Lipase 20,880 units, protease 78,300 units, and amylase
    78,300 units",
    " </p>",
    " </div>",
    " <div class=\"block geq drugH1Div\" id=\"F206037\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Generic Equivalent Available: U.S.",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " No",
    " </p>",
    " </div>",
    " <div class=\"block meg drugH1Div\" id=\"F7990592\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Medication Guide",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " An FDA-approved patient medication guide, which is available with the product
    information and as follows, must be dispensed with this medication:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Creon&reg;:",
    " <a href=\"file://www.fda.gov/downloads/Drugs/DrugSafety/UCM152847.pdf\"
    target=\"_blank\">",
    " file://www.fda.gov/downloads/Drugs/DrugSafety/UCM152847.pdf",
    " </a>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Pancreaze&trade;:",
    " <a href=\"file://www.fda.gov/downloads/Drugs/DrugSafety/UCM208531.pdf\"
    target=\"_blank\">",
    " file://www.fda.gov/downloads/Drugs/DrugSafety/UCM208531.pdf",
    " </a>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Pertzye&trade;:",
    " <a href=\"file://www.fda.gov/downloads/Drugs/DrugSafety/UCM306861.pdf\"
    target=\"_blank\">",
    " file://www.fda.gov/downloads/Drugs/DrugSafety/UCM306861.pdf",
    " </a>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Utresa&trade;:",
    " <a href=\"file://www.fda.gov/downloads/Drugs/DrugSafety/UCM296221.pdf\"
    target=\"_blank\">",
    " file://www.fda.gov/downloads/Drugs/DrugSafety/UCM296221.pdf",
    " </a>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;margin-top:0em;\">",
    " Viokace&trade;:",
    " <a href=\"file://www.fda.gov/downloads/Drugs/DrugSafety/UCM296222.pdf\"
    target=\"_blank\">",
    " file://www.fda.gov/downloads/Drugs/DrugSafety/UCM296222.pdf",
    " </a>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;margin-top:0em;\">",
    " Zenpep&reg;:",
    " <a href=\"file://www.fda.gov/downloads/Drugs/DrugSafety/UCM180714.pdf\"
    target=\"_blank\">",
    " file://www.fda.gov/downloads/Drugs/DrugSafety/UCM180714.pdf",
    " </a>",
    " </p>",
    " </div>",
    " <div class=\"block adm drugH1Div\" id=\"F206054\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Administration",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Oral: Administer with meals or snacks and swallow whole with a generous
    amount of liquid. Do not crush or chew; retention in the mouth before swallowing
    may cause mucosal irritation and stomatitis.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Capsules, delayed release: If necessary, capsules may also be opened and
    contents added to a small amount of an acidic food (pH &le;4.5), such as
    applesauce. The food should be at room temperature and swallowed immediately after
    mixing. The contents of the capsule should not be crushed or chewed. Follow with
    water or juice to ensure complete ingestion and that no medication remains in the
    mouth.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;margin-top:0em;\">",
    " When administering to infants &lt;1 year of age, do not mix with breast milk
    or infant formula. Open capsule and place the contents directly into the mouth or
    mix with a small amount of acidic soft food (pH &le;4.5), such as applesauce or
    other acidic commercially prepared baby food (pears or bananas) at room
    temperature. Administer immediately after mixing (or within 15 minutes of mixing
    using Pancreaze&trade;). Follow with infant formula or breast milk to ensure
    complete ingestion and that no medication remains in the mouth.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;margin-top:0em;\">",
    " Tablets: Viokace&trade;: Tablets are not enteric coated and should be taken
    with a proton pump inhibitor.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;margin-top:2em;\">",
    " Administration via gastrostomy (G) tube: An",
    " <i>",
    " in vitro",
    " </i>",
    " study demonstrated that Creon&reg; delayed-release capsules sprinkled onto a
    small amount of baby food (pH &lt;4.5; applesauce or bananas manufactured by both
    Gerber and Beech-Nut) stirred gently and after 15 minutes was administered
    through the following G-tubes without significant loss of lipase activity:
    Kimberly-Clark MIC Bolus&reg; size 18 Fr, Kimberly-Clark MIC-KEY&reg; size 16 Fr,
    Bard&reg; Tri-Funnel size 18 Fr, and Bard&reg; Button size 18 Fr (Shlieout,
    2011).",
    " </p>",
    " </div>",
    " <div class=\"block use drugH1Div\" id=\"F206053\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Use",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Treatment of exocrine pancreatic insufficiency (EPI) due to conditions such
    as cystic fibrosis (Creon&reg;, Pancreaze&trade;, Pertzye&trade;, Ultresa&trade;,
    Zenpep&reg;); chronic pancreatitis (Creon&reg;, Viokace&trade;); or pancreatectomy
    (Creon&reg;, Viokace&trade;)",
    " </p>",
    " <p style=\"text-indent:0em;margin-left:0em;margin-top:2em;\">",
    " <b>",
    " Note:",
    " </b>",
    " Viokace&trade; must be administered with a proton pump inhibitor (PPI) since
    it is not enteric coated.",
    " </p>",
    " </div>",
    " <div class=\"block mst drugH1Div\" id=\"F7828225\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Medication Safety Issues",
    " </span>",
    " <div class=\"collapsible\">",
    " <span class=\"collapsible-title\">",
    " Sound-alike/look-alike issues:",
    " </span>",
    " <div class=\"collapsible-wrap\">",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Pancrelipase may be confused with pancreatin",
    " </p>",
    " </div>",
    " </div>",
    " </div>",
    " <div class=\"block ars drugH1Div\" id=\"F206095\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Adverse Reactions Significant",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " The following adverse reactions were reported in a short-term safety studies;
    actual frequency varies with different products; adverse events, particularly
    gastrointestinal events, were often greater with placebo:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " &gt;10%:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Central nervous system: Headache (3% to 15%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Gastrointestinal: Abdominal pain (3% to 18%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Neuromuscular &amp; skeletal: Neck pain (14%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Otic: Ear pain (11%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Respiratory: Nasal congestion (14%), beta-hemolytic streptococcal infection
    (11%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Miscellaneous: Lymphadenopathy (11%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " 1% to 10%:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Cardiovascular: Peripheral edema (3%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Central nervous system: Dizziness (4% to 6%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Dermatologic: Rash (3%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Endocrine &amp; metabolic: Hyperglycemia (4% to 8%), diabetes mellitus
    exacerbation (4%), hypoglycemia (4%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Gastrointestinal: Dyspepsia (10%), diarrhea (&le;10%), flatulence (3% to 9%),
    anal itching (7%), biliary tract stones (7%), early satiety (6%), vomiting (6%),
    weight loss (3% to 6%), upper abdominal pain (&le;5%), feces abnormal (&le;4%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Hematologic: Anemia (3%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Hepatic: Ascites (3%), hydrocholecystis (3%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Renal: Renal cyst (3%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Respiratory: Cough (4% to 10%), epistaxis (7%), pharyngolaryngeal pain (7%),
    nasopharyngitis (4%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Miscellaneous: Viral infection (3%)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " &lt;1% (Limited to important or life-threatening; reported with various
    formulations of pancrelipase): Allergic reactions (severe), anaphylaxis, asthma,
    carcinoma recurrence, constipation, distal intestinal obstruction syndrome (DIOS),
    duodenitis, fibrosing colonopathy, gastritis, hives, hyperuricemia, muscle spasm,
    myalgia, nausea, neutropenia (transient), pruritus, transaminases increased
    (asymptomatic), urticaria, vision blurred",
    " </p>",
    " </div>",
    " <div class=\"block coi drugH1Div\" id=\"F206057\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Contraindications",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " There are no contraindications listed in the manufacturer&rsquo;s labeling.",
    " </p>",
    " </div>",
    " <div class=\"block war drugH1Div\" id=\"F206041\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Warnings/Precautions",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " <i>",
    " Concerns related to adverse effects:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Fibrosing colonopathy: Fibrosing colonopathy advancing to colonic
    strictures have been reported with doses of lipase &gt;6000 units/kg/meal over long
    periods of time in children &lt;12 years of age. Patients taking doses of lipase
    &gt;6000 units/kg/meal should be examined and the dose decreased. Doses of lipase
    &gt;2500 units/kg/meal (or lipase &gt;10,000 units/kg/day) should be used with
    caution and only with documentation of 3-day fecal fat measures.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Mucosal irritation: Crushing or chewing the contents of the capsules
    or tablets, or mixing the capsule contents with foods outside of product labeling,
    may cause early release of the enzymes, causing irritation of the oral mucosa
    and/or loss of enzyme activity. When mixing the contents of capsules with food, the
    mixture should be swallowed immediately and followed with water or juice to ensure
    complete ingestion.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " <i>",
    " Disease-related concerns:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Gout, hyperuricemia: Use caution in patients with gout or
    hyperuricemia; products contain purines which may increase uric acid
    concentrations.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Renal impairment: Use caution in patients with renal impairment;
    products contain purines which may increase uric acid concentrations.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " <i>",
    " Dosage form specific issues:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Brand interchangeability: Available brand products are",
    " <b>",
    " not",
    " </b>",
    " interchangeable.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Pork: Products are derived from porcine pancreatic glands. Severe,
    allergic reactions (rare) have been observed; use with caution in patients
    hypersensitive to pork proteins. Transmission of porcine viruses is theoretically a
    risk; however, testing and/or inactivation or removal of certain viruses, reduces
    the risk. There have been no cases of transmission of an infectious illness
    reported.",
    " </p>",
    " </div>",
    " <div class=\"block cyt drugH1Div\" id=\"F13299815\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Metabolism/Transport Effects",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " None known.",
    " </p>",
    " </div>",
    " <div class=\"block dri drugH1Div\" id=\"F6222114\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Drug Interactions",
    " </span>",
    " <br/>",
    " <br/>",
    " <div class=\"lexi\" id=\"lexiInteractAddInfo\">",
    " (For additional information:",
    " <a class=\"dip\" href=\"./drug-interaction\" target=\"_blank\">",
    " Launch Lexi-Interact&trade; Drug Interactions Program",
    " </a>",
    " )",
    " </div>",
    " <div class=\"lexi\" id=\"lexiInteractImgB\">",
    " <img border=\"0\" height=\"17\"
    src=\"./../images/lexiComp/Lexicomp_2012_71x17.myextg\" width=\"71\"/>",
    " </div>",
    " <div class=\"clear\">",
    " </div>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Iron Salts: Pancrelipase may decrease the absorption of Iron Salts.",
    " <b>",
    " Exceptions:",
    " </b>",
    " Ferumoxytol; Iron Dextran Complex; Iron Sucrose.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Multivitamins/Minerals (with ADEK, Folate, Iron): Pancrelipase may decrease
    the serum concentration of Multivitamins/Minerals (with ADEK, Folate, Iron).
    Specifically, pancrelipase may decrease absorption of iron in iron-containing
    multivitamin products.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " </div>",
    " <div class=\"block foi drugH1Div\" id=\"F206066\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Ethanol/Nutrition/Herb Interactions",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Food: Delayed release capsules: Enteric coated contents of delayed release
    capsules opened and sprinkled on alkaline foods may result in early release of
    pancrelipase followed by enzyme inactivation by gastric acid in the stomach after
    swallowing. Management: Avoid placing contents of opened capsules on alkaline food
    (soft acidic foods with a pH of &le;4.5 are recommended for patients who cannot
    swallow capsules).",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Herb/Nutraceutical: Pancrelipase may impair absorption of oral iron.
    Management: Monitor response to iron replacement.",
    " </p>",
    " </div>",
    " <div class=\"block prf drugH1Div\" id=\"F206047\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pregnancy Risk Factor",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " C (",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?16/42/17068\">",
    " show table",
    " </a>",
    " )",
    " </p>",
    " </div>",
    " <div class=\"block pri drugH1Div\" id=\"F7990593\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pregnancy Implications",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Reproduction studies have not been conducted. Nutrition should be optimized
    in pregnancy; in cystic fibrosis patients with malabsorption, pancreatic enzyme
    replacement is not considered to cause a risk to the pregnancy.",
    " </p>",
    " </div>",
    " <div class=\"block lac drugH1Div\" id=\"F206075\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Lactation",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Excretion in breast milk unknown/use caution",
    " </p>",
    " </div>",
    " <div class=\"block brc drugH1Div\" id=\"F206060\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Breast-Feeding Considerations",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Systemic absorption and concentration into the breast milk is unlikely, but
    unknown.",
    " </p>",
    " </div>",
    " <div class=\"block dic drugH1Div\" id=\"F206061\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dietary Considerations",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Take with meals or snacks and swallow whole with a generous amount of liquid.
    Vitamin supplementation should be per current guidelines for patients with cystic
    fibrosis.",
    " </p>",
    " </div>",
    " <div class=\"block fee drugH1Div\" id=\"F16323605\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pricing: U.S. (Medi-Span&reg;)",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Capsule, enteric pellets",
    " </b>",
    " (Creon Oral)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 3000-9500 unit (70): $82.66",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 6000 unit (100): $130.49",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 12000 unit (100): $232.44",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 24000 unit (100): $456.50",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Capsule, enteric pellets",
    " </b>",
    " (Pancreaze Oral)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 4200 unit (100): $87.30",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 10500 unit (100): $218.28",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 16800 unit (100): $350.40",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 21000 unit (100): $436.42",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Capsule, enteric pellets",
    " </b>",
    " (Pancrelipase (Lip-Prot-Amyl) Oral)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 5000 unit (100): $79.61",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Capsule, enteric pellets",
    " </b>",
    " (Pertzye Oral)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 8000 unit (100): $198.75",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 16000 unit (100): $398.75",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Capsule, enteric pellets",
    " </b>",
    " (Ultresa Oral)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 13800 unit (100): $295.20",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 20700 unit (100): $436.80",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 23000 unit (100): $536.40",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Capsule, enteric pellets",
    " </b>",
    " (Zenpep Oral)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 3000-10000 unit (100): $127.22",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 5000 unit (100): $119.00",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 10000 unit (100): $222.17",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 15000 unit (100): $320.88",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 20000 unit (100): $435.88",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 25000 unit (100): $582.53",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Tablets",
    " </b>",
    " (Viokace Oral)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 10440 unit (100): $265.20",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 20880 unit (100): $523.20",
    " </p>",
    " </div>",
    " <div class=\"block mop drugH1Div\" id=\"F206049\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Monitoring Parameters",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Abdominal symptoms, nutritional intake, weight, growth (in children), stool
    character, fecal fat",
    " </p>",
    " </div>",
    " <div class=\"list fbnlist drugH1Div drugBrandNames\" id=\"F6038716\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " International Brand Names",
    " </span>",
    " <ul>",
    " <li>",
    " Alipase (FR);",
    " </li>",
    " <li>",
    " Cotazym-S (AU);",
    " </li>",
    " <li>",
    " Cotazym-S Forte (AU);",
    " </li>",
    " <li>",
    " Mezym Forte (BG);",
    " </li>",
    " <li>",
    " Pancrease (BE, DK, ES, FI, NL, NO, NZ, SE);",
    " </li>",
    " <li>",
    " Pancrease HL (GB);",
    " </li>",
    " <li>",
    " Pancrex (IT);",
    " </li>",
    " <li>",
    " Panzytrat (AU);",
    " </li>",
    " <li>",
    " Prolipase (AT, CH, CZ, HR, PL)",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"block pha drugH1Div\" id=\"F206040\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Mechanism of Action",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Pancrelipase is a natural product harvested from the porcine pancreatic
    glands. It contains a combination of lipase, amylase, and protease. Products are
    formulated to dissolve in the more basic pH of the duodenum so that they may act
    locally to break down fats, protein, and starch.",
    " </p>",
    " </div>",
    " <div class=\"block phk drugH1Div\" id=\"F206056\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pharmacodynamics/Kinetics",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Absorption: None; acts locally in GI tract",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Excretion: Feces",
    " </p>",
    " </div>",
    " </div>",
    " <div id=\"topicAgreement\">",
    " Use of UpToDate is subject to the",
    " <a class=\"licenseLink\" href=\"./license\" id=\"sla_in_page\"
    target=\"_blank\">",
    " Subscription and License Agreement",
    " </a>",
    " .",
    " </div>",
    " <div class=\"headingAnchor\" id=\"references\">",
    " <h1>",
    " REFERENCES",
    " </h1>",
    " <ol id=\"reference\">",
    " <li>",
    " <div class=\"reference\">",
    " Baker SS, &ldquo;Delayed Release Pancrelipase for the Treatment of
    Pancreatic Exocrine Insufficiency Associated With Cystic Fibrosis,&rdquo;",
    " <i>",
    " Ther Clin Risk Manag",
    " </i>",
    " , 2008, 4(5):1079-84.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/743/abstract-text/19209287/pubmed\" id=\"19209287\"
    target=\"_blank\">",
    " 19209287",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Borowitz D, Baker RD, and Stallings V, &ldquo;Consensus Report on Nutrition
    for Pediatric Patients With Cystic Fibrosis,&rdquo;",
    " <i>",
    " J Pediatr Gastroenterol Nutr",
    " </i>",
    " , 2002, 35(3):246-5.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/743/abstract-text/12352509/pubmed\" id=\"12352509\"
    target=\"_blank\">",
    " 12352509",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Borowitz DS, Grand RJ, and Durie PR, &ldquo;Use of Pancreatic Enzyme
    Supplements for Patients With Cystic Fibrosisin the Context of Fibrosing
    Colonopathy. Consensus Committee,&rdquo;",
    " <i>",
    " J Pediatr",
    " </i>",
    " , 1995, 127(5):681-4.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/743/abstract-text/7472816/pubmed\" id=\"7472816\"
    target=\"_blank\">",
    " 7472816",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Edenborough FP, Borgo G, Knoop C, et al, &ldquo;Guidelines for the
    Management of Pregnancy in Women With Cystic Fibrosis,&rdquo;",
    " <i>",
    " J Cyst Fibros",
    " </i>",
    " , 2008, 7 Suppl 1:2-32.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/743/abstract-text/18024241/pubmed\" id=\"18024241\"
    target=\"_blank\">",
    " 18024241",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " FitzSimmons SC, Burkhart GA, Borowitz D, et al, &ldquo;High-Dose Pancreatic-
    Enzyme Supplements and Fibrosing Colonopathy in Children With Cystic
    Fibrosis,&rdquo;",
    " <i>",
    " N Engl J Med",
    " </i>",
    " , 1997, 336(18):1283-9.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/743/abstract-text/9113931/pubmed\" id=\"9113931\"
    target=\"_blank\">",
    " 9113931",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Pettei MJ, Leonidas JC, Levinne JJ, et al, &ldquo;Pancolonic Disease in
    Cystic Fibrosis and High-Dose Pancreatic Enzyme Therapy,&rdquo;",
    " <i>",
    " J Pediatr",
    " </i>",
    " , 1994, 125(4):587-9.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/743/abstract-text/7931879/pubmed\" id=\"7931879\"
    target=\"_blank\">",
    " 7931879",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Shlieout G, Koerner A, Maffert M, et al, &ldquo;Administration of CREON&reg;
    Pancrelipase Pellets via Gastrostomy Tube is Feasible With No Loss of Gastric
    Resistance or Lipase Activity,&rdquo;",
    " <i>",
    " Clin Drug Investig",
    " </i>",
    " , 2011, 31(7):e1-7.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/743/abstract-text/21627335/pubmed\" id=\"21627335\"
    target=\"_blank\">",
    " 21627335",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Stallings VA, Stark LJ, Robinson KA, et al, &ldquo;Evidence-Based Practice
    Recommendations for Nutrition-Related Management of Children and Adults With Cystic
    Fibrosis and Pancreatic Insufficiency: Results of a Systematic Review,&rdquo;",
    " <i>",
    " J Am Diet Assoc",
    " </i>",
    " , 2008, 108(5):832-9.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/743/abstract-text/18442507/pubmed\" id=\"18442507\"
    target=\"_blank\">",
    " 18442507",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Taylor CG, &ldquo;Colonic Strictures in Cystic Fibrosis,&rdquo;",
    " <i>",
    " Lancet",
    " </i>",
    " , 1994, 343(8898):615-6.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/743/abstract-text/7906805/pubmed\" id=\"7906805\"
    target=\"_blank\">",
    " 7906805",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " </ol>",
    " </div>",
    " <div id=\"topicVersionRevision\">",
    " Topic 9737 Version 41.0",
    " </div>",
    " </div>",
    " <div id=\"footer\">",
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    " Support Tag: [1104-183.166.191.243-285D26EE14-S244013.14]",
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    "</div>"].join("\n");
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    " <a href=\"#\" title=\"Collapse Topic Outline\">",
    " <img alt=\"\" src=\"./../images/orange_arrow_left.myextg\"/>",
    " </a>",
    " </div>",
    " <div id=\"innerOutline\">",
    " <h1>",
    " TOPIC OUTLINE",
    " </h1>",
    " <div id=\"outline\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206069\">",
    " Brand Names: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206070\">",
    " Brand Names: Canada",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206097\">",
    " Pharmacologic Category",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206071\">",
    " Dosing: Adult",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206085\">",
    " Dosing: Pediatric",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206072\">",
    " Dosing: Geriatric",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206051\">",
    " Dosage Forms: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206037\">",
    " Generic Equivalent Available: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F7990592\">",
    " Medication Guide",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206054\">",
    " Administration",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206053\">",
    " Use",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F7828225\">",
    " Medication Safety Issues",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206095\">",
    " Adverse Reactions Significant",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206057\">",
    " Contraindications",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206041\">",
    " Warnings/Precautions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F13299815\">",
    " Metabolism/Transport Effects",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6222114\">",
    " Drug Interactions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206066\">",
    " Ethanol/Nutrition/Herb Interactions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206047\">",
    " Pregnancy Risk Factor",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F7990593\">",
    " Pregnancy Implications",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206075\">",
    " Lactation",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206060\">",
    " Breast-Feeding Considerations",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206061\">",
    " Dietary Considerations",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F16323605\">",
    " Pricing: U.S. (Medi-Span&reg;)",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206049\">",
    " Monitoring Parameters",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6038716\">",
    " International Brand Names",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206040\">",
    " Mechanism of Action",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F206056\">",
    " Pharmacodynamics/Kinetics",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a href=\"#references\">",
    " REFERENCES",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " <div class=\"openRelatedGraphics\" id=\"DRUG_GEN/9737\" rel=\"outline_link\">",
    " GRAPHICS",
    " <a class=\"graphics_icon\" href=\"#\" title=\"View All Related Graphics\">",
    " View All",
    " </a>",
    " </div>",
    " </h1>",
    " <div id=\"relatedGraphics\">",
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    " <li class=\"plainItem\">",
    " <div class=\"openRelatedGraphics\" id=\"DRUG_GEN/9737|TAB\">",
    " <a href=\"#\" title=\"TABLES\">",
    " TABLES",
    " </a>",
    " </div>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?23/39/24183\"
    title=\"Lexicomp clinical abbreviations\">",
    " Lexicomp clinical abbreviations",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " RELATED TOPICS",
    " </h1>",
    " <div id=\"relatedTopics\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?34/44/35524?
    source=related_link\">",
    " Pancrelipase: Patient drug information",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"drug drug_pediatric\" href=\"UTD.htm?8/14/8422?
    source=related_link\">",
    " Pancrelipase: Pediatric drug information",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " </div>"].join("\n");
    var title_f0_46_744="Trazodone: Pediatric drug information";
    var content_f0_46_744=[" <noscript>",
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    " <!-- TC:TOPIC_PAGE -->",
    " <div id=\"topicContent\">",
    " <div id=\"drugTitle\">",
    " Trazodone: Pediatric drug information",
    " </div>",
    " <div id=\"lexiTitleImg\">",
    " <img height=\"17\" src=\"./../images/lexiComp/Lexicomp_2012_71x17.myextg\"
    width=\"71\"/>",
    " </div>",
    " <div class=\"clear\">",
    " </div>",
    " <div id=\"drugCopy\">",
    " Copyright 1978-2013 Lexicomp, Inc. All rights reserved.",
    " </div>",
    " <div id=\"topicText\">",
    " (For additional information",
    " <a class=\"drug drug_general\" href=\"UTD.htm?24/0/24584?source=see_link\">",
    " see \"Trazodone: Drug information\"",
    " </a>",
    " and",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?33/44/34501?source=see_link\">",
    " see \"Trazodone: Patient drug information\"",
    " </a>",
    " )",
    " <br/>",
    " For abbreviations and symbols that may be used in Lexicomp (",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?23/39/24183\">",
    " show table",
    " </a>",
    " )",
    " <div class=\"block black-box-warn drugH1Div\" id=\"F5708898\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " ALERT: U.S. Boxed Warning",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " The FDA-approved labeling includes a boxed warning. See Warnings/Precautions
    section for a concise summary of this information. For verbatim wording of the
    boxed warning, consult the product labeling or",
    " <a href=\"file://www.fda.gov\" target=\"_blank\">",
    " www.fda.gov",
    " </a>",
    " .",
    " </p>",
    " </div>",
    " <div class=\"list ubnlist drugH1Div drugBrandNames\" id=\"F10515304\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Brand Names: U.S.",
    " </span>",
    " <ul>",
    " <li>",
    " Oleptro&trade;",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"list cbnlist drugH1Div drugBrandNames\" id=\"F230281\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Brand Names: Canada",
    " </span>",
    " <ul>",
    " <li>",
    " Apo-Trazodone D&reg;;",
    " </li>",
    " <li>",
    " Apo-Trazodone&reg;;",
    " </li>",
    " <li>",
    " Dom-Trazodone;",
    " </li>",
    " <li>",
    " Mylan-Trazodone;",
    " </li>",
    " <li>",
    " Novo-Trazodone;",
    " </li>",
    " <li>",
    " Nu-Trazodone;",
    " </li>",
    " <li>",
    " Nu-Trazodone D;",
    " </li>",
    " <li>",
    " Oleptro&trade;;",
    " </li>",
    " <li>",
    " PHL-Trazodone;",
    " </li>",
    " <li>",
    " PMS-Trazodone;",
    " </li>",
    " <li>",
    " ratio-Trazodone;",
    " </li>",
    " <li>",
    " Teva-Trazodone;",
    " </li>",
    " <li>",
    " Trazorel&reg;;",
    " </li>",
    " <li>",
    " ZYM-Trazodone",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"list_set htclist drugH1Div drugBrandNames\" id=\"F1055815\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Therapeutic Category",
    " </span>",
    " <ul>",
    " <li>",
    " <span class=\"list-set-name\">",
    " Antidepressant, Serotonin Reuptake Inhibitor/Antagonist",
    " </span>",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"block dos drugH1Div\" id=\"F1055808\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Usual",
    " </span>",
    " <p>",
    " (For additional information",
    " <a class=\"drug drug_general\" href=\"UTD.htm?24/0/24584?source=see_link\">",
    " see \"Trazodone: Drug information\"",
    " </a>",
    " )",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Children and Adolescents: Oral: Immediate release formulation:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Depression:",
    " </b>",
    " Limited data available; efficacy results variable (Dopheide, 2006);",
    " <b>",
    " Note:",
    " </b>",
    " Not recommended for first- or second-line treatment of depression (AACAP,
    2007):",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Weight-based dosing: Children and Adolescents 6-18 years: Initial: 1.5-2
    mg/kg/",
    " <b>",
    " day",
    " </b>",
    " in divided doses; increase gradually every 3-4 days as needed; maximum dose:
    6 mg/kg/",
    " <b>",
    " day",
    " </b>",
    " in 3 divided doses",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Fixed-dose: Adolescents: Initial: 25-50 mg/",
    " <b>",
    " day",
    " </b>",
    " ; increase to 100-150 mg/",
    " <b>",
    " day",
    " </b>",
    " in divided doses",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Insomnia; sleep disturbances (in children with comorbid psychiatric
    disorders):",
    " </b>",
    " Limited trial or case report data available; however, frequently used
    clinically in children with comorbid psychiatric disorders (eg, mood disorder,
    anxiety disorder, developmental delay with ADHD) (Owens, 2010):",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Children 18 months to 5 years: Limited data available; dosing based on a
    subset of pediatric trial including young children (n=16; range: 20 months to 5
    years) with opsoclonus-myoclonus syndrome and used fixed doses (see below);
    however, the median overall dose (n=19) reported was 2.6 mg/kg/",
    " <b>",
    " day",
    " </b>",
    " (range: 1.2-6.9 mg/kg/",
    " <b>",
    " day",
    " </b>",
    " ) (Pranzatelli, 2005); further studies are needed",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Children 18 months to &lt;3 years: Initial: 25 mg/dose at bedtime; may
    increase dose at 2-week intervals in 25 mg increments; maximum dose: 100 mg/dose",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Children 3-5 years: Initial 50 mg/dose at bedtime; may increase dose at 2-
    week intervals in 25 mg increments; maximum dose: 150 mg/dose",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Children &gt;5 years and Adolescents: Initial: 0.75-1 mg/kg/dose or 25-50 mg
    at bedtime; reported range: 0.5-2 mg/kg/",
    " <b>",
    " day",
    " </b>",
    " (do not to exceed adult dosing: 200 mg/day); reported trials conducted in
    pediatric patients with comorbid psychiatric disorders (eg, ADHD, autism,
    developmental delay), or sleep bruxism (Hollway, 2011; Kratochvil, 2005); when used
    for palliative care, multiple daily dosing may be necessary; 25-50 mg/dose increase
    gradually to twice or three times daily as needed (do not exceed adult dosing)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Migraine, prophylaxis:",
    " </b>",
    " Children and Adolescents &ge;7 years: Limited data available: 1 mg/kg/",
    " <b>",
    " day",
    " </b>",
    " in 3 divided doses; maximum dose: 150 mg/dose; efficacy results variable,
    further studies are needed (Battistella, 1993; Damen, 2005; Lewis, 2004)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Adults:",
    " <b>",
    " Depression:",
    " </b>",
    " <b>",
    " Note:",
    " </b>",
    " Therapeutic effects may take up to 6 weeks. Therapy is normally maintained
    for 6-12 months after optimum response is reached to prevent recurrence of
    depression.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Immediate release: Initial: 150 mg/day in 3 divided doses (may increase by 50
    mg/day every 3-7 days); maximum dose: 600 mg/day",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Extended release: Initial: 150 mg once daily at bedtime (may increase by 75
    mg/day every 3 days); maximum dose: 375 mg/day; once adequate response obtained,
    gradually reduce with adjustment based on therapeutic response",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " <b>",
    " Dosing adjustment in renal impairment:",
    " </b>",
    " Has not been studied; use with caution.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " <b>",
    " Dosing adjustment in hepatic impairment:",
    " </b>",
    " Has not been studied; use with caution.",
    " </p>",
    " </div>",
    " <div class=\"block foc drugH1Div\" id=\"F230259\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosage Forms: U.S.",
    " </span>",
    " <p style=\"text-indent:0em;text-align:justify;display:inline\">",
    " Excipient information presented when available (limited, particularly for
    generics); consult specific product labeling.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Tablet, oral, as hydrochloride: 50 mg, 100 mg, 150 mg, 300 mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Tablet, extended release, oral, as hydrochloride:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Oleptro&trade;: 150 mg, 300 mg [scored]",
    " </p>",
    " </div>",
    " <div class=\"block geq drugH1Div\" id=\"F230245\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Generic Equivalent Available: U.S.",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Yes: Excludes extended release tablet",
    " </p>",
    " </div>",
    " <div class=\"block meg drugH1Div\" id=\"F9837787\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Medication Guide",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " An FDA-approved patient medication guide, which is available with the product
    information and as follows, must be dispensed with this medication:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;margin-top:0em;\">",
    " Oleptro&trade; extended release tablets:",
    " <a href=\"file://www.fda.gov/downloads/Drugs/DrugSafety/UCM202202.pdf\"
    target=\"_blank\">",
    " file://www.fda.gov/downloads/Drugs/DrugSafety/UCM202202.pdf",
    " </a>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;margin-top:0em;\">",
    " Trazodone tablets:",
    " <a href=\"file://dailymed.nlm.nih.gov/dailymed/medguide.cfm?id=37846\"
    target=\"_blank\">",
    " file://dailymed.nlm.nih.gov/dailymed/medguide.cfm?id=37846",
    " </a>",
    " </p>",
    " </div>",
    " <div class=\"block adm drugH1Div\" id=\"F1055820\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Administration",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Oral:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Immediate release: Administer after meals or a snack to decrease
    lightheadedness, sedation, and postural hypotension",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Extended release: Take on an empty stomach; swallow whole or as a half tablet
    without food. Tablet may be broken along the score line, but do not crush or
    chew.",
    " </p>",
    " </div>",
    " <div class=\"block sta drugH1Div\" id=\"F1055811\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Stability",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Immediate release tablets: Store at 20&deg;C to 25&deg;C (68&deg;F to
    77&deg;F); dispense in tight, light-resistant container",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Extended release tablets: Store at room temperature 15&deg;C to 30&deg;C
    (59&deg;F to 86&deg;F); dispense in tight, light-resistant container",
    " </p>",
    " </div>",
    " <div class=\"block use drugH1Div\" id=\"F1055819\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Use",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Treatment of depression, including major depressive disorder (FDA approved in
    adults); has also been used for treatment of insomnia and prevention of migraines",
    " </p>",
    " </div>",
    " <div class=\"block mst drugH1Div\" id=\"F230325\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Medication Safety Issues",
    " </span>",
    " <div class=\"collapsible\">",
    " <span class=\"collapsible-title\">",
    " Sound-alike/look-alike issues:",
    " </span>",
    " <div class=\"collapsible-wrap\">",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Desyrel may be confused with deferoxamine, Demerol&reg;, Delsym&reg;,
    Zestril&reg;",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " TraZODone may be confused with traMADol, ziprasidone",
    " </p>",
    " </div>",
    " </div>",
    " <div class=\"collapsible\">",
    " <span class=\"collapsible-title\">",
    " International issues:",
    " </span>",
    " <div class=\"collapsible-wrap\">",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Desyrel [Canada, Turkey] may be confused with Deseril brand name for
    methysergide [Australia, Belgium, Great Britain, Netherlands]",
    " </p>",
    " </div>",
    " </div>",
    " </div>",
    " <div class=\"block arm drugH1Div\" id=\"F230322\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Adverse Reactions",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Cardiovascular: Edema, hyper-/hypotension, syncope",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Central nervous system: Agitation, concentration decreased, confusion,
    disorientation, dizziness, fatigue, headache, incoordination, memory impairment,
    migraine, sedation",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Endocrine &amp; metabolic: Libido decreased",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Gastrointestinal: Abnormal taste, abdominal pain, constipation, diarrhea,
    flatulence, nausea, vomiting, weight gain/loss, xerostomia",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Genitourinary: Ejaculation disorder, urinary urgency",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Neuromuscular &amp; skeletal: Back pain, myalgia, paresthesia, tremor",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Ocular: Blurred vision, visual disturbance",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Respiratory: Dyspnea, nasal congestion",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Miscellaneous: Night sweats",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Rare but important and life-threatening: Abnormal dreams, abnormal orgasm,
    acne, akathisia, allergic reactions, alopecia, amylase increased, anemia, anxiety,
    aphasia, apnea, appetite increased, arrhythmia, ataxia, atrial fibrillation,
    bladder pain, bradycardia, breast enlargement/engorgement, cardiac arrest,
    cardiospasm, cerebrovascular accident, chest pain, CHF, chills, cholestasis,
    clitorism, conduction block, diplopia, early menses, erectile dysfunction,
    extrapyramidal symptoms, eye pain, flushing, gait disturbance, hallucination,
    hearing loss (partial), hematuria, hemolytic anemia, hepatitis, hirsutism,
    hyperbilirubinemia, hyperhidrosis, hypersalivation, hypersensitivity, hypoesthesia,
    hypomania, impaired speech, impotence, insomnia, jaundice, lactation,
    leukocytosis, leukonychia, libido increased, liver enzyme alteration,
    methemoglobinemia, MI, muscle twitching, orthostatic hypotension, palpitation,
    paranoia, photophobia, photosensitivity reaction, priapism, pruritus, psoriasis,
    psychosis, QT prolongation, rash, reflux esophagitis, retrograde ejaculation,
    salivation increased, seizure, SIADH, speech impairment, stupor, tachycardia,
    tardive dyskinesia, tinnitus, torsade de pointes, urinary frequency increased,
    urinary retention, urinary incontinence, urticaria, vasodilation, ventricular
    ectopy, ventricular tachycardia, vertigo, dry eyes, weakness",
    " </p>",
    " </div>",
    " <div class=\"block coi drugH1Div\" id=\"F1055824\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Contraindications",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Hypersensitivity to trazodone or any component",
    " </p>",
    " </div>",
    " <div class=\"block pre drugH1Div\" id=\"F1055807\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Precautions",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Use with caution in patients with hepatic or renal impairment. Hypotension
    and syncope may occur; risk is high relative to other antidepressants; use with
    caution in patients at risk for these effects or in those who would not tolerate
    transient hypotensive episodes (eg, cerebrovascular disease, cardiovascular
    disease, hypovolemia, or concurrent medication use which may predispose to
    hypotension/bradycardia). May cause sedation (incidence: 20% to 50%), which may
    impair physical or mental abilities; the degree of sedation is very high with
    trazodone relative to other antidepressants; patients must be cautioned about
    performing tasks which require mental alertness (eg, operating machinery or
    driving). Some antidepressant agents (eg, SSRIs) have been associated with the
    development of SIADH; hyponatremia has been reported (including severe cases with
    serum sodium &lt;110 mmol/L), predominately in the elderly; volume depletion and/or
    concurrent use of diuretics likely increases risk. Relative to tricyclic
    antidepressants, trazodone is associated with fewer anticholinergic adverse
    effects.",
    " </p>",
    " <p style=\"text-indent:0em;margin-top:2em;\">",
    " Drugs that interfere with serotonin reuptake (eg, SSRIs) have been associated
    with bleeding ranging from relatively minor bruising and epistaxis to life-
    threatening hemorrhage; similar to these agents, trazodone may also impair platelet
    aggregation resulting in increased risk of bleeding events, particularly if used
    concomitantly with aspirin, NSAIDs, warfarin or other anticoagulants. Discontinue
    use prior to elective surgery (unknown interactions with general anesthetics may
    exist).",
    " </p>",
    " <p style=\"text-indent:0em;margin-top:2em;\">",
    " Trazodone therapy should not be abruptly discontinued in patients receiving
    high doses for prolonged periods; gradually reduce dosage prior to complete
    discontinuation to avoid withdrawal symptoms (eg, anxiety, agitation, sleep
    disturbance). Trazodone may increase the risks associated with electroconvulsive
    therapy (ECT); consider discontinuing, when possible, prior to ECT treatment.",
    " </p>",
    " </div>",
    " <div class=\"block war drugH1Div\" id=\"F1055806\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Warnings",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Trazodone is not approved for use in pediatric patients. Clinical worsening
    of depression or suicidal ideation and behavior may occur in children and adults
    with major depressive disorder",
    " <b>",
    " [U.S. Boxed Warning]",
    " </b>",
    " . In clinical trials, antidepressants increased the risk of suicidal thinking
    and behavior (suicidality) in children, adolescents, and young adults (18-24 years
    of age) with major depressive disorder and other psychiatric disorders. This risk
    must be considered before prescribing antidepressants for any clinical use. Short-
    term studies did",
    " <b>",
    " not",
    " </b>",
    " show an increased risk of suicidality with antidepressant use in patients
    &gt;24 years of age and showed a decreased risk in patients &ge;65 years.",
    " </p>",
    " <p style=\"text-indent:0em;margin-top:2em;\">",
    " Patients of all ages who are treated with antidepressants for any indication
    require appropriate monitoring and close observation for clinical worsening of
    depression, suicidality, and unusual changes in behavior, especially during the
    first few months after antidepressant initiation or when the dose is adjusted.
    Family members and caregivers should be instructed to closely observe the patient
    (ie, daily) and communicate condition with healthcare provider. Patients should
    also be monitored for associated behaviors (eg, anxiety, agitation, panic attacks,
    insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia,
    hypomania, mania) which may increase the risk for worsening depression or
    suicidality. Worsening depression or emergence of suicidality (or associated
    behaviors listed above) that is abrupt in onset, severe, or not part of the
    presenting symptoms, may require discontinuation or modification of drug therapy.",
    " </p>",
    " <p style=\"text-indent:0em;margin-top:2em;text-align:justify;\">",
    " To reduce risk of intentional overdose, write prescriptions for the smallest
    quantity consistent with good patient care. Screen individuals for bipolar disorder
    prior to treatment (using antidepressants alone may induce manic episodes in
    patients with this condition).",
    " </p>",
    " <p style=\"text-indent:0em;margin-top:2em;text-align:justify;\">",
    " Serotonin syndrome (SS) and neuroleptic malignant syndrome (NMS)-like
    reactions may occur with trazodone when used alone, or particularly if used with
    other serotonergic agents (eg, SSRIs, SNRIs, or triptans), drugs that impair
    serotonin metabolism [eg, MAO inhibitors (use within 14 days)], or antidopaminergic
    agents (eg, antipsychotics). Identification and differentiation of SS (eg, tremor,
    myoclonus, agitation) and more severe NMS-like reactions (eg, hyperthermia, muscle
    rigidity, autonomic instability, mental status changes) can be complex; monitor
    patients closely for either syndrome. Discontinue treatment (and any concomitant
    serotonergic and/or antidopaminergic agents) immediately if signs/symptoms arise.
    If concurrent use is clinically warranted, carefully observe patient during
    treatment initiation and dose increases; concurrent use of serotonin precursors
    (eg, tryptophan) should be avoided.",
    " </p>",
    " <p style=\"text-indent:0em;margin-top:2em;text-align:justify;\">",
    " Although the risk of conduction abnormalities is low with trazodone relative
    to other antidepressants, QT prolongation (with or without torsade de pointes) and
    ventricular tachycardia have been observed; use with caution in patients with pre-
    existing cardiac disease or arrhythmias. Other arrhythmias reported include
    isolated PVCs, ventricular couplets, and tachycardia with syncope. Concurrent use
    of CYP3A4 inhibitors or drugs that prolong the QT interval may increase the risk of
    QT prolongation and/or proarrhythmia. Trazodone is not recommended for use during
    post-MI initial recovery phase. May cause rare (1:6000), prolonged, painful
    priapism (&gt;6 hours in duration); instruct patient to seek medical assistance
    for erection lasting &gt;4 hours; use with caution in patients who have conditions
    which may predispose them to priapism (eg, sickle cell anemia, multiple myeloma,
    leukemia).",
    " </p>",
    " </div>",
    " <div class=\"block cyt drugH1Div\" id=\"F230311\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Metabolism/Transport Effects",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " <b>",
    " Substrate",
    " </b>",
    " of CYP2D6 (minor), CYP3A4 (major);",
    " <b>",
    " Note:",
    " </b>",
    " Assignment of Major/Minor substrate status based on clinically relevant drug
    interaction potential;",
    " <b>",
    " Inhibits",
    " </b>",
    " CYP3A4 (weak);",
    " <b>",
    " Induces",
    " </b>",
    " P-glycoprotein",
    " </p>",
    " </div>",
    " <div class=\"block dri drugH1Div\" id=\"F230254\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Drug Interactions",
    " </span>",
    " <br/>",
    " <br/>",
    " <div class=\"lexi\" id=\"lexiInteractAddInfo\">",
    " (For additional information:",
    " <a class=\"dip\" href=\"./drug-interaction\" target=\"_blank\">",
    " Launch Lexi-Interact&trade; Drug Interactions Program",
    " </a>",
    " )",
    " </div>",
    " <div class=\"lexi\" id=\"lexiInteractImgB\">",
    " <img border=\"0\" height=\"17\"
    src=\"./../images/lexiComp/Lexicomp_2012_71x17.myextg\" width=\"71\"/>",
    " </div>",
    " <div class=\"clear\">",
    " </div>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Antipsychotic Agents (Phenothiazines): May enhance the adverse/toxic effect
    of Antidepressants (Serotonin Reuptake Inhibitor/Antagonist). Specifically, this
    may be manifest as symptoms consistent with serotonin syndrome or neuroleptic
    malignant syndrome. Antidepressants (Serotonin Reuptake Inhibitor/Antagonist) may
    enhance the hypotensive effect of Antipsychotic Agents (Phenothiazines).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Antipsychotics: May enhance the serotonergic effect of Serotonin Modulators.
    This could result in serotonin syndrome.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Atazanavir: May increase the serum concentration of TraZODone. Management:
    Consider using a lower dose of trazodone when used in combination with
    atazanavir.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Boceprevir: May increase the serum concentration of TraZODone.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " BusPIRone: May enhance the serotonergic effect of Antidepressants (Serotonin
    Reuptake Inhibitor/Antagonist).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Cobicistat: May increase the serum concentration of TraZODone.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Conivaptan: May increase the serum concentration of CYP3A4 Substrates.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " CYP3A4 Inducers (Strong): May increase the metabolism of CYP3A4 Substrates.
    Management: Consider an alternative for one of the interacting drugs. Some
    combinations may be specifically contraindicated. Consult appropriate manufacturer
    labeling.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " CYP3A4 Inhibitors (Moderate): May decrease the metabolism of CYP3A4
    Substrates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " CYP3A4 Inhibitors (Strong): May decrease the metabolism of CYP3A4
    Substrates.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Dabigatran Etexilate: P-glycoprotein/ABCB1 Inducers may decrease the serum
    concentration of Dabigatran Etexilate. Management: Avoid concurrent use of
    dabigatran with p-glycoprotein inducers when possible. Closely monitor for
    decreased levels/effects of dabigatran if concomitantly administering p-
    glycoprotein inducers, particularly strong inducers.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Darunavir: May increase the serum concentration of TraZODone. Management:
    Consider using a lower dose of trazodone when used in combination with darunavir.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Dasatinib: May increase the serum concentration of CYP3A4 Substrates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Deferasirox: May decrease the serum concentration of CYP3A4 Substrates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Fosamprenavir: May increase the serum concentration of TraZODone. Management:
    Consider using a lower dose of trazodone when used in combination with
    fosamprenavir.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Fosphenytoin: May decrease the serum concentration of TraZODone. TraZODone
    may increase the serum concentration of Fosphenytoin.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Highest Risk QTc-Prolonging Agents: Moderate Risk QTc-Prolonging Agents may
    enhance the QTc-prolonging effect of Highest Risk QTc-Prolonging Agents.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Indinavir: May increase the serum concentration of TraZODone. Management:
    Consider using a lower dose of trazodone when used in combination with indinavir.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Ivabradine: May enhance the QTc-prolonging effect of Moderate Risk QTc-
    Prolonging Agents.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Ivacaftor: May increase the serum concentration of CYP3A4 Substrates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Linagliptin: P-glycoprotein/ABCB1 Inducers may decrease the serum
    concentration of Linagliptin. Management: Strongly consider using an alternative
    to any strong P-glycoprotein inducer in patients who are being treated with
    linagliptin. If this combination is used, monitor patients closely for evidence of
    reduced linagliptin effectiveness.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Linezolid: May enhance the serotonergic effect of TraZODone. This could
    result in serotonin syndrome.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Lomitapide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of
    Lomitapide. Management: Limit the maximum adult dose of lomitapide to 30 mg daily
    when used in combination with any weak CYP3A4 inhibitor.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Lopinavir: May increase the serum concentration of TraZODone. Management:
    Consider using a lower dose of trazodone when used in combination with lopinavir.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " MAO Inhibitors: May enhance the adverse/toxic effect of Antidepressants
    (Serotonin Reuptake Inhibitor/Antagonist).",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " MAO Inhibitors: May enhance the orthostatic hypotensive effect of Orthostatic
    Hypotension Producing Agents.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Methylene Blue: TraZODone may enhance the serotonergic effect of Methylene
    Blue. This could result in serotonin syndrome.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Metoclopramide: Serotonin Modulators may enhance the adverse/toxic effect of
    Metoclopramide. This may be manifest as symptoms consistent with serotonin syndrome
    or neuroleptic malignant syndrome.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Mifepristone: May enhance the QTc-prolonging effect of Moderate Risk QTc-
    Prolonging Agents.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Moderate Risk QTc-Prolonging Agents: May enhance the QTc-prolonging effect of
    other Moderate Risk QTc-Prolonging Agents. Management: Avoid such combinations when
    possible. Use should be accompanied by close monitoring for evidence of QT
    prolongation or other alterations of cardiac rhythm.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Nelfinavir: May increase the serum concentration of TraZODone. Management:
    Consider using a lower dose of trazodone when used in combination with
    nelfinavir.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Peginterferon Alfa-2b: May decrease the serum concentration of CYP2D6
    Substrates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " P-glycoprotein/ABCB1 Substrates: P-glycoprotein/ABCB1 Inducers may decrease
    the serum concentration of P-glycoprotein/ABCB1 Substrates. P-glycoprotein inducers
    may also further limit the distribution of p-glycoprotein substrates to specific
    cells/tissues/organs where p-glycoprotein is present in large amounts (e.g., brain,
    T-lymphocytes, testes, etc.).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Phenytoin: May decrease the serum concentration of TraZODone. TraZODone may
    increase the serum concentration of Phenytoin.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Pomalidomide: P-glycoprotein/ABCB1 Inducers may decrease the serum
    concentration of Pomalidomide.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " QTc-Prolonging Agents (Indeterminate Risk and Risk Modifying): May enhance
    the QTc-prolonging effect of Moderate Risk QTc-Prolonging Agents.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Saquinavir: May enhance the QTc-prolonging effect of TraZODone. Saquinavir
    may increase the serum concentration of TraZODone.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Selective Serotonin Reuptake Inhibitors: May enhance the serotonergic effect
    of Antidepressants (Serotonin Reuptake Inhibitor/Antagonist). This may cause
    serotonin syndrome.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Serotonin Modulators: May enhance the adverse/toxic effect of other Serotonin
    Modulators. The development of serotonin syndrome may occur.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Telaprevir: May increase the serum concentration of TraZODone.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Tipranavir: May increase the serum concentration of TraZODone. Management:
    Consider using a lower dose of trazodone when used in combination with
    tipranavir.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Tocilizumab: May decrease the serum concentration of CYP3A4 Substrates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Venlafaxine: May enhance the serotonergic effect of TraZODone. This could
    result in serotonin syndrome.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " VinCRIStine (Liposomal): P-glycoprotein/ABCB1 Inducers may decrease the serum
    concentration of VinCRIStine (Liposomal).",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Warfarin: TraZODone may diminish the anticoagulant effect of Warfarin.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " </div>",
    " <div class=\"block foi drugH1Div\" id=\"F1055827\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Food Interactions",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Food may decrease the rate but increase the extent of absorption of
    immediate-release formulation; with the extended-release formulation, a high-fat
    meal (compared to fasting) increases the peak serum concentration but the AUC and
    time to peak serum concentration are not significantly changed.",
    " </p>",
    " </div>",
    " <div class=\"block prf drugH1Div\" id=\"F230255\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pregnancy Risk Factor",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " C (",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?16/42/17068\">",
    " show table",
    " </a>",
    " )",
    " </p>",
    " </div>",
    " <div class=\"block pri drugH1Div\" id=\"F5722230\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pregnancy Implications",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Adverse effects were observed in some animal reproduction studies. When
    trazodone is taken during pregnancy, an increased risk of major malformations has
    not been observed in the limited number of pregnancies studied (Einarson, 2003;
    Einarson, 2009). The long-term effects of",
    " <i>",
    " in utero",
    " </i>",
    " trazodone exposure on infant development and behavior are not known.",
    " </p>",
    " <p style=\"text-indent:0em;margin-top:2em;\">",
    " The ACOG recommends that therapy with antidepressants during pregnancy be
    individualized; treatment of depression during pregnancy should incorporate the
    clinical expertise of the mental health clinician, obstetrician, primary healthcare
    provider, and pediatrician. According to the American Psychiatric Association
    (APA), the risks of medication treatment should be weighed against other treatment
    options and untreated depression. Consideration should be given to using agents
    with safety data in pregnancy. For women who discontinue antidepressant medications
    during pregnancy and who may be at high risk for postpartum depression, the
    medications can be restarted following delivery. Treatment algorithms have been
    developed by the ACOG and the APA for the management of depression in women prior
    to conception and during pregnancy (ACOG, 2008; APA, 2010; Yonkers, 2009).",
    " </p>",
    " </div>",
    " <div class=\"block mop drugH1Div\" id=\"F1055814\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Monitoring Parameters",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Blood pressure, mental status, liver enzymes. Monitor patient periodically
    for symptom resolution; monitor for worsening depression, suicidality, and
    associated behaviors (especially at the beginning of therapy or when doses are
    increased or decreased).",
    " </p>",
    " </div>",
    " <div class=\"block rer drugH1Div\" id=\"F1055818\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Reference Range",
    " </span>",
    " <p style=\"text-indent:0em;text-align:justify;display:inline\">",
    " <b>",
    " Note: Plasma levels do not always correlate with clinical effectiveness.",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Therapeutic: 0.5-2.5 mcg/mL (SI: 1-6 micromoles/L)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Potentially toxic: &gt;2.5 mcg/mL (SI: &gt;6 micromoles/L)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Toxic: &gt;4 mcg/mL (SI: &gt;10 micromoles/L)",
    " </p>",
    " </div>",
    " <div class=\"block pha drugH1Div\" id=\"F1055805\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Mechanism of Action",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Inhibits reuptake of serotonin; minimal or no effect on reuptake of
    norepinephrine or dopamine; possesses little if any anticholinergic effects; alpha-
    adrenergic blockade thought to be responsible for orthostatic hypotension and dry
    mouth",
    " </p>",
    " </div>",
    " <div class=\"block phd drugH1Div\" id=\"F1055822\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pharmacodynamics",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Onset of action: Antidepressant effect:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Immediate release: 1-4 weeks",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Extended release: ~6 weeks",
    " </p>",
    " </div>",
    " <div class=\"block phk drugH1Div\" id=\"F1055823\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pharmacokinetics (Adult data unless noted)",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Absorption: Well absorbed",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Protein binding: 85% to 95%",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Metabolism: Hepatic via hydroxylation and oxidation; metabolized extensively
    by CYP3A4 to active metabolite, m-chlorophenylpiperazine (mCPP)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Half-life, elimination: 5-9 hours, prolonged in obese patients",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Time to peak serum concentration:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Immediate release: Fasting: 1 hour; food: 2 hours",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Extended release: 9 hours; not significantly affected by food",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Elimination: Primarily in urine (74%, &lt;1% excreted unchanged) with ~21%
    excreted in feces",
    " </p>",
    " </div>",
    " <div class=\"block pai drugH1Div\" id=\"F1055813\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Patient Information",
    " </span>",
    " <p>",
    " (For additional information",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?33/44/34501?
    source=see_link\">",
    " see \"Trazodone: Patient drug information\"",
    " </a>",
    " )",
    " </p>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Read the patient Medication Guide that you receive with each prescription and
    refill of trazodone. An increased risk of suicidal thinking and behavior has been
    reported with the use of antidepressants in children, adolescents, and young adults
    (18-24 years of age). Notify physician if you feel more depressed, have thoughts of
    suicide, or become more agitated or irritable. Avoid alcohol; may cause drowsiness
    and impair ability to perform activities requiring mental alertness or physical
    coordination; may cause dry mouth; discontinue use and consult physician
    immediately if prolonged or inappropriate erections occur",
    " </p>",
    " </div>",
    " </div>",
    " <div id=\"topicAgreement\">",
    " Use of UpToDate is subject to the",
    " <a class=\"licenseLink\" href=\"./license\" id=\"sla_in_page\"
    target=\"_blank\">",
    " Subscription and License Agreement",
    " </a>",
    " .",
    " </div>",
    " <div class=\"headingAnchor\" id=\"references\">",
    " <h1>",
    " REFERENCES",
    " </h1>",
    " <ol id=\"reference\">",
    " <li>",
    " <div class=\"reference\">",
    " AACAP Work Group on Quality Issues, \"Practice Parameter for the Assessment
    and Treatment of Children and Adolescents With Depressive Disorders,\"",
    " <i>",
    " J Am Acad Child Adolesc Psychiatry",
    " </i>",
    " , 2007, 46(11):1503-26.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/18049300/pubmed\" id=\"18049300\"
    target=\"_blank\">",
    " 18049300",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " ACOG Committee on Practice Bulletins--Obstetrics, \"ACOG Practice Bulletin:
    Clinical Management Guidelines for Obstetrician-Gynecologists Number 92, April 2008
    (Replaces Practice Bulletin Number 87, November 2007). Use of Psychiatric
    Medications During Pregnancy and Lactation,\"",
    " <i>",
    " Obstet Gynecol",
    " </i>",
    " , 2008, 111(4):1001-20.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/18378767/pubmed\" id=\"18378767\"
    target=\"_blank\">",
    " 18378767",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " American Psychiatric Association, \"Treatment Recommendations for Patients
    With Major Depressive Disorder,\" 3rd ed, May 2010. Available at
    file://www.psychiatryonline.com/pracGuide/pracGuideTopic_7.aspx",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Dopheide JA, \"Recognizing and treating Depression in Children and
    Adolescents,\"",
    " <i>",
    " Am J Health Syst Pharm",
    " </i>",
    " , 2006, 63(3):233-43.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/16434782/pubmed\" id=\"16434782\"
    target=\"_blank\">",
    " 16434782",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Einarson A, Choi J, Einarson TR, et al, \"Incidence of Major Malformations
    in Infants Following Antidepressant Exposure in Pregnancy: Results of a large
    Prospective Cohort Study,\"",
    " <i>",
    " Can J Psychiatry",
    " </i>",
    " , 2009, 54(4):242-6.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/19321030/pubmed\" id=\"19321030\"
    target=\"_blank\">",
    " 19321030",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Hollway JA and Aman MG, \"Pharmacological Treatment of Sleep Disturbance in
    Developmental Disabilities: A Review of the Literature,\"",
    " <i>",
    " Res Dev Disabil",
    " </i>",
    " , 2011, 32(3):939-62.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/21296553/pubmed\" id=\"21296553\"
    target=\"_blank\">",
    " 21296553",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Klier CM, Mossaheb N, Saria A, et al, \"Pharmacokinetics and Elimination of
    Quetiapine, Venlafaxine, and Trazodone During Pregnancy and Postpartum,\"",
    " <i>",
    " J Clin Psychopharmacol",
    " </i>",
    " , 2007, 27(6):720-2.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/18004149/pubmed\" id=\"18004149\"
    target=\"_blank\">",
    " 18004149",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Kratochvil CJ, Lake M, Pliszka SR, et al, \"Pharmacological Management of
    Treatment-Induced Insomnia in ADHD,\"",
    " <i>",
    " J Am Acad Child Adolesc Psychiatry",
    " </i>",
    " , 2005, 44(5):499-501.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/15843773/pubmed\" id=\"15843773\"
    target=\"_blank\">",
    " 15843773",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Lewis D, Ashwal S, Hershey A, et al, \"Practice Parameter: Pharmacological
    Treatment of Migraine Headache in Children and Adolescents: Report of the American
    Academy of Neurology Quality Standards Subcommittee and the Practice Committee of
    the Child Neurology Society,\"",
    " <i>",
    " Neurology",
    " </i>",
    " , 2004, 63(12):2215-24.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/15623677/pubmed\" id=\"15623677\"
    target=\"_blank\">",
    " 15623677",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Owens JA, Rosen CL, Mindell JA, et al, \"Use of Pharmacotherapy for Insomnia
    in Child Psychiatry Practice: A National Survey,\"",
    " <i>",
    " Sleep Med",
    " </i>",
    " , 2010, 11(7):692-700.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/20621556/pubmed\" id=\"20621556\"
    target=\"_blank\">",
    " 20621556",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Pranzatelli MR, Tate ED, Dukart WS, et al, \"Sleep Disturbance and Rage
    Attacks in Opsoclonus-Myoclonus Syndrome: Response to Trazodone,\"",
    " <i>",
    " J Pediatr",
    " </i>",
    " , 2005, 147(3):372-8.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/16182678/pubmed\" id=\"16182678\"
    target=\"_blank\">",
    " 16182678",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " US Preventive Services Task Force, \"Screening and Treatment for major
    Depressive Disorder in Children and Adolescents: US Preventive Services Task Force
    Recommendation Statement,\"",
    " <i>",
    " Pediatrics",
    " </i>",
    " , 2009, 123(4):1223-8.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/19336383/pubmed\" id=\"19336383\"
    target=\"_blank\">",
    " 19336383",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Verbeeck RK, Ross SG, and McKenna EA, \"Excretion of Trazodone in Breast
    Milk,\"",
    " <i>",
    " Br J Clin Pharmacol",
    " </i>",
    " , 1986, 22(3):367-70.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/3768252/pubmed\" id=\"3768252\"
    target=\"_blank\">",
    " 3768252",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Yonkers KA, Wisner KL, Stewart DE, et al, &ldquo;The Management of
    Depression During Pregnancy: A Report From the American Psychiatric Association and
    the American College of Obstetricians and Gynecologists,&rdquo;",
    " <i>",
    " Obstet Gynecol",
    " </i>",
    " , 2009, 114(3):703-13.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/19701065/pubmed\" id=\"19701065\"
    target=\"_blank\">",
    " 19701065",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Zubieta JK and Alessi NE, &ldquo;Acute and Chronic Administration of
    Trazodone in the Treatment of Disruptive Behavior Disorders in Children,&rdquo;",
    " <i>",
    " J Clin Psychopharmacol",
    " </i>",
    " , 1992, 12(5):346-51.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/744/abstract-text/1479052/pubmed\" id=\"1479052\"
    target=\"_blank\">",
    " 1479052",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " </ol>",
    " </div>",
    " <div id=\"topicVersionRevision\">",
    " Topic 12855 Version 42.0",
    " </div>",
    " </div>",
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    " <div id=\"supportFooter\">",
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    var outline_f0_46_744=[" <div id=\"toggleOutline\">",
    " <a href=\"#\" title=\"Collapse Topic Outline\">",
    " <img alt=\"\" src=\"./../images/orange_arrow_left.myextg\"/>",
    " </a>",
    " </div>",
    " <div id=\"innerOutline\">",
    " <h1>",
    " TOPIC OUTLINE",
    " </h1>",
    " <div id=\"outline\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F5708898\">",
    " ALERT: U.S. Boxed Warning",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F10515304\">",
    " Brand Names: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F230281\">",
    " Brand Names: Canada",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055815\">",
    " Therapeutic Category",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055808\">",
    " Dosing: Usual",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F230259\">",
    " Dosage Forms: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F230245\">",
    " Generic Equivalent Available: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F9837787\">",
    " Medication Guide",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055820\">",
    " Administration",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055811\">",
    " Stability",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055819\">",
    " Use",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F230325\">",
    " Medication Safety Issues",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F230322\">",
    " Adverse Reactions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055824\">",
    " Contraindications",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055807\">",
    " Precautions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055806\">",
    " Warnings",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F230311\">",
    " Metabolism/Transport Effects",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F230254\">",
    " Drug Interactions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055827\">",
    " Food Interactions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F230255\">",
    " Pregnancy Risk Factor",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F5722230\">",
    " Pregnancy Implications",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055814\">",
    " Monitoring Parameters",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055818\">",
    " Reference Range",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055805\">",
    " Mechanism of Action",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055822\">",
    " Pharmacodynamics",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055823\">",
    " Pharmacokinetics (Adult data unless noted)",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1055813\">",
    " Patient Information",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a href=\"#references\">",
    " REFERENCES",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
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    rel=\"outline_link\">",
    " GRAPHICS",
    " <a class=\"graphics_icon\" href=\"#\" title=\"View All Related Graphics\">",
    " View All",
    " </a>",
    " </div>",
    " </h1>",
    " <div id=\"relatedGraphics\">",
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    " <div class=\"openRelatedGraphics\" id=\"DRUG_PED/12855|TAB\">",
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    " TABLES",
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    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?23/39/24183\"
    title=\"Lexicomp clinical abbreviations\">",
    " Lexicomp clinical abbreviations",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " RELATED TOPICS",
    " </h1>",
    " <div id=\"relatedTopics\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"drug drug_general\" href=\"UTD.htm?24/0/24584?
    source=related_link\">",
    " Trazodone: Drug information",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?33/44/34501?
    source=related_link\">",
    " Trazodone: Patient drug information",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " </div>"].join("\n");
    var title_f0_46_745="Treatment, prognosis, and prevention of Listeria monocytogenes
    infection";
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    " <div id=\"topicContent\">",
    " <div id=\"topicTitle\">",
    " Treatment, prognosis, and prevention of Listeria monocytogenes infection",
    " </div>",
    " <div id=\"topicContributors\">",
    " <div>",
    " <a id=\"authors\">",
    " </a>",
    " <a class=\"contributor contributor_credentials contributorType\"
    href=\"UTD.htm?0/46/745/contributors\">",
    " Author",
    " </a>",
    " <br/>",
    " <a class=\"contributor contributor_credentials\" href=\"UTD.htm?
    0/46/745/contributors\">",
    " Michael S Gelfand, MD",
    " </a>",
    " <br/>",
    " </div>",
    " <div>",
    " <a class=\"contributor contributor_credentials contributorType\"
    href=\"UTD.htm?0/46/745/contributors\">",
    " Section Editors",
    " </a>",
    " <br/>",
    " <a class=\"contributor contributor_credentials\" href=\"UTD.htm?
    0/46/745/contributors\">",
    " Daniel J Sexton, MD",
    " </a>",
    " <br/>",
    " <a class=\"contributor contributor_credentials\" href=\"UTD.htm?
    0/46/745/contributors\">",
    " Morven S Edwards, MD",
    " </a>",
    " <br/>",
    " </div>",
    " <div>",
    " <a class=\"contributor contributor_credentials contributorType\"
    href=\"UTD.htm?0/46/745/contributors\">",
    " Deputy Editor",
    " </a>",
    " <br/>",
    " <a class=\"contributor contributor_credentials\" href=\"UTD.htm?
    0/46/745/contributors\">",
    " Anna R Thorner, MD",
    " </a>",
    " <br/>",
    " </div>",
    " </div>",
    " <div id=\"disclosures\">",
    " <a href=\"UTD.htm?0/46/745/contributor-disclosure\" target=\"_blank\">",
    " Disclosures",
    " </a>",
    " </div>",
    " <div id=\"reviewProcess\">",
    " <span>",
    " All topics are updated as new evidence becomes available and our",
    " </span>",
    " <a href=\"/home/editorial-policy\" target=\"_blank\">",
    " peer review process",
    " </a>",
    " <span>",
    " is complete.",
    " </span>",
    " </div>",
    " <div id=\"literatureReviewDate\">",
    " <span class=\"emphasis\">",
    " Literature review current through:",
    " </span>",
    " Oct 2013.",
    " <span class=\"pipeSpace\">",
    " |",
    " </span>",
    " <span class=\"emphasis\">",
    " This topic last updated:",
    " </span>",
    " Sep 27, 2012.",
    " </div>",
    " <div id=\"topicText\">",
    " <p class=\"headingAnchor\" id=\"H1\">",
    " <span class=\"h1\">",
    " INTRODUCTION",
    " </span>",
    " &nbsp;&mdash;&nbsp;Listeria monocytogenes is an important bacterial pathogen
    in neonates, immunosuppressed patients, elderly adults, pregnant women, and
    occasionally, previously healthy individuals. The importance of underlying diseases
    was illustrated in a series of 165 adults with culture-proven Listeria infection:
    69 percent of cases in nonpregnant adults occurred in patients with cancer, AIDS,
    organ transplant recipients, or corticosteroid therapy [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/1\">",
    " 1",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " The treatment and prognosis of listerial infection will be reviewed here. The
    epidemiology, pathogenesis, clinical manifestations, and diagnosis of listerial
    infection are discussed separately. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?9/48/9993?
    source=see_link\">",
    " \"Epidemiology and pathogenesis of Listeria monocytogenes infection\"",
    " </a>",
    " and",
    " <a class=\"medical medical_review\" href=\"UTD.htm?1/44/1736?
    source=see_link\">",
    " \"Clinical manifestations and diagnosis of Listeria monocytogenes
    infection\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H2\">",
    " <span class=\"h1\">",
    " CLINICAL SYNDROMES",
    " </span>",
    " &nbsp;&mdash;&nbsp;Treatment varies with the different clinical syndromes of
    listerial infection:",
    " </p>",
    " <p>",
    " <ul class=\"bulletCompact-block\">",
    " <li>",
    " Febrile gastroenteritis",
    " </li>",
    " <li>",
    " Infection in pregnancy",
    " </li>",
    " <li>",
    " Sepsis of unknown origin",
    " </li>",
    " <li>",
    " Central nervous system (CNS) infection (meningoencephalitis, cerebritis,
    rhombencephalitis)",
    " </li>",
    " <li>",
    " Focal infections",
    " </li>",
    " <li>",
    " Neonatal infections",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?1/44/1736?
    source=see_link\">",
    " \"Clinical manifestations and diagnosis of Listeria monocytogenes
    infection\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H3\">",
    " <span class=\"h1\">",
    " TREATMENT",
    " </span>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H4\">",
    " <span class=\"h2\">",
    " Antibiotic regimens",
    " </span>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H108265619\">",
    " <span class=\"h3\">",
    " First-line regimens",
    " </span>",
    " &nbsp;&mdash;&nbsp;",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?source=see_link\">",
    " Ampicillin",
    " </a>",
    " or",
    " <a class=\"drug drug_general\" href=\"UTD.htm?21/42/22183?source=see_link\">",
    " penicillin G",
    " </a>",
    " are the drugs of choice [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/2,3\">",
    " 2,3",
    " </a>",
    " ]. Although no controlled trials have been published, Listeria are sensitive
    in vitro to these antimicrobial agents, and acquired resistance to the most
    commonly used drugs is rare [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/4\">",
    " 4",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " The dose of",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?source=see_link\">",
    " ampicillin",
    " </a>",
    " or",
    " <a class=\"drug drug_general\" href=\"UTD.htm?21/42/22183?source=see_link\">",
    " penicillin G",
    " </a>",
    " varies according to age. The duration of therapy is discussed below. (See",
    " <a class=\"local\" href=\"#H10\">",
    " 'Duration of therapy'",
    " </a>",
    " below.)",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Infants &le;7 days &mdash;",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " Ampicillin",
    " </a>",
    " (100",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " per day divided in two doses for infants weighing &lt;2000 g; 150",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " per day divided in three doses for infants weighing &gt;2000 g) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/5\">",
    " 5",
    " </a>",
    " ]",
    " </li>",
    " <li>",
    " Infants eight days to one month &mdash;",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " Ampicillin",
    " </a>",
    " (150",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " per day divided in four doses for infants weighing &lt;2000 g; 200",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " per day divided in four doses for infants weighing &gt;2000 g) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/5\">",
    " 5",
    " </a>",
    " ].",
    " </li>",
    " <li>",
    " Children &mdash;",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " Ampicillin",
    " </a>",
    " (300",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " per day IV in four to six divided doses; maximum dose 10 to 12",
    " <span class=\"nowrap\">",
    " g/day);",
    " </span>",
    " <a class=\"drug drug_general\" href=\"UTD.htm?21/42/22183?
    source=see_link\">",
    " penicillin G",
    " </a>",
    " (250,000 to 400,000",
    " <span class=\"nowrap\">",
    " units/kg",
    " </span>",
    " per day in four to six divided doses; maximum dose: 24 million",
    " <span class=\"nowrap\">",
    " units/day)",
    " </span>",
    " </li>",
    " <li>",
    " Adults &mdash;",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " Ampicillin",
    " </a>",
    " (2 g IV every four hours);",
    " <a class=\"drug drug_general\" href=\"UTD.htm?21/42/22183?
    source=see_link\">",
    " penicillin G",
    " </a>",
    " (4 million units IV every four hours)",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?source=see_link\">",
    " Ampicillin",
    " </a>",
    " and",
    " <a class=\"drug drug_general\" href=\"UTD.htm?21/42/22183?source=see_link\">",
    " penicillin G",
    " </a>",
    " demonstrate delayed in vitro bactericidal activity at concentrations
    attainable in the cerebrospinal fluid (CSF) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/2\">",
    " 2",
    " </a>",
    " ]. As a result, we usually treat listerial central nervous system (CNS)
    infections, endocarditis, and infections in neonates and immunocompromised patients
    with combination therapy, with the bactericidal agent",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?source=see_link\">",
    " gentamicin",
    " </a>",
    " being added to achieve synergy [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/6-8\">",
    " 6-8",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " The dose of",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?source=see_link\">",
    " gentamicin",
    " </a>",
    " varies according to age as follows; these doses apply to patients with normal
    renal function:",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Infants &le;7 days &mdash;",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?
    source=see_link\">",
    " Gentamicin",
    " </a>",
    " (2.5",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " per dose every 12 hours)",
    " </li>",
    " <li>",
    " Infants eight days to one month &mdash;",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?
    source=see_link\">",
    " Gentamicin",
    " </a>",
    " (2.5",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " per dose every 8 to 12 hours for infants weighing 1200 to 2000 g; and 2.5",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " per dose every eight hours for infants weighing &gt;2000 g).",
    " </li>",
    " <li>",
    " Children &mdash;",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?
    source=see_link\">",
    " Gentamicin",
    " </a>",
    " (7.5",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " per day IV in three divided doses)",
    " </li>",
    " <li>",
    " Adults &mdash;",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?
    source=see_link\">",
    " Gentamicin",
    " </a>",
    " (3",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " per day IV in three divided doses)",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " Penicillin-allergic patients should be skin tested and desensitized if
    necessary, or treated with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?4/58/5034?source=see_link\">",
    " trimethoprim-sulfamethoxazole",
    " </a>",
    " . The usual dose ranges from 10 to 20",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " (based on the",
    " <a class=\"drug drug_general\" href=\"UTD.htm?25/36/26182?source=see_link\">",
    " trimethoprim",
    " </a>",
    " component) IV per day divided every 6 to 12 hours, with the higher end of the
    dosing range used in patients who are severely ill. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?22/46/23274?
    source=see_link\">",
    " \"Allergy to penicillins\"",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " <a class=\"drug drug_general\" href=\"UTD.htm?4/58/5034?source=see_link\">",
    " Trimethoprim-sulfamethoxazole",
    " </a>",
    " is bactericidal against Listeria, achieves adequate levels in serum and CSF,
    and has documented clinical efficacy [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/9-13\">",
    " 9-13",
    " </a>",
    " ]. A retrospective study in 22 patients with meningoencephalitis suggested
    that the combination of",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?source=see_link\">",
    " ampicillin",
    " </a>",
    " and",
    " <a class=\"drug drug_general\" href=\"UTD.htm?25/36/26182?source=see_link\">",
    " trimethoprim",
    " </a>",
    " -sulfamethoxazole may be more effective than the combination of ampicillin
    and",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?source=see_link\">",
    " gentamicin",
    " </a>",
    " &nbsp;[",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/12\">",
    " 12",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " <a class=\"drug drug_general\" href=\"UTD.htm?4/58/5034?source=see_link\">",
    " Trimethoprim-sulfamethoxazole",
    " </a>",
    " is well absorbed orally. An early transition to oral therapy with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?25/36/26182?source=see_link\">",
    " trimethoprim",
    " </a>",
    " -sulfamethoxazole in a patient with Listeria meningitis has been reported [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/14\">",
    " 14",
    " </a>",
    " ], and may be an option in selected patients with expected good adherence. For
    oral dosing of trimethoprim-sulfamethoxazole, we use 10 to 20",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " (based on the trimethoprim component) orally per day divided every 6 to 12
    hours.",
    " </p>",
    " <p>",
    " Regimens without aminoglycosides may be preferable for patients who have
    impaired renal function or are taking other nephrotoxic drugs, such as",
    " <a class=\"drug drug_general\" href=\"UTD.htm?31/39/32368?source=see_link\">",
    " cyclosporine",
    " </a>",
    " .",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H5\">",
    " <span class=\"h3\">",
    " Alternative drugs",
    " </span>",
    " &nbsp;&mdash;&nbsp;Imipenem and",
    " <a class=\"drug drug_general\" href=\"UTD.htm?31/38/32359?source=see_link\">",
    " meropenem",
    " </a>",
    " have excellent in vitro activity against Listeria. These drugs may prove to be
    useful for listerial infections. Although they have not been approved for Listeria
    infections, meropenem has been approved for bacterial meningitis and has been used
    successfully to treat listeriosis [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/3,15\">",
    " 3,15",
    " </a>",
    " ]. However, clinical failure of meropenem has also been reported [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/16\">",
    " 16",
    " </a>",
    " ]. The dosing of meropenem in adults is 2 g IV every eight hours and in
    children is 120",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " IV per day in three divided doses (maximum dose 6",
    " <span class=\"nowrap\">",
    " g/day).",
    " </span>",
    " </p>",
    " <p>",
    " <a class=\"drug drug_general\" href=\"UTD.htm?14/3/14393?source=see_link\">",
    " Linezolid",
    " </a>",
    " is active against Listeria but clinical experience is limited to case reports
    [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/15,17\">",
    " 15,17",
    " </a>",
    " ]. In addition, prolonged therapy is associated with hematologic toxicity and
    other adverse effects.",
    " </p>",
    " <p>",
    " Other antibiotics are less effective against Listeria:",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " <a class=\"drug drug_general\" href=\"UTD.htm?41/41/42649?
    source=see_link\">",
    " Vancomycin",
    " </a>",
    " is an alternative [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/18\">",
    " 18",
    " </a>",
    " ], but failures have been reported. In a case report of a hematopoietic cell
    transplant recipient with Listeria bacteremia who failed to respond to empiric
    vancomycin therapy, the causative pathogen was found to be a vancomycin-resistant
    species of Listeria, L. grayi [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/19\">",
    " 19",
    " </a>",
    " ]. The bacteremia cleared after the treatment was changed to",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " ampicillin",
    " </a>",
    " .",
    " </li>",
    " <li>",
    " Both",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/29/36304?
    source=see_link\">",
    " erythromycin",
    " </a>",
    " and tetracyclines have in vitro activity against Listeria; however, they are
    bacteriostatic, their clinical efficacy is uncertain, and plasmid-mediated
    resistance has been reported [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/20\">",
    " 20",
    " </a>",
    " ]. We do not recommend either agent.",
    " </li>",
    " <li>",
    " <a class=\"drug drug_general\" href=\"UTD.htm?1/54/1897?source=see_link\">",
    " Chloramphenicol",
    " </a>",
    " is less effective than other drugs and should be avoided in listeriosis [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/21,22\">",
    " 21,22",
    " </a>",
    " ].",
    " </li>",
    " <li>",
    " Cephalosporins are inactive in vitro and ineffective clinically [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/18\">",
    " 18",
    " </a>",
    " ]. This is important because the empiric therapy of acute pyogenic
    meningitis in immunocompromised patients should include drugs that are active
    against Listeria. Thus, monotherapy with an extended-spectrum cephalosporin is not
    adequate to cover the possibility of an infection due to Listeria.",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H6\">",
    " <span class=\"h3\">",
    " High risk patients",
    " </span>",
    " &nbsp;&mdash;&nbsp;For patients with listerial CNS infection, bacteremia,
    endocarditis, or infection in an immunocompromised host, we treat with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?source=see_link\">",
    " ampicillin",
    " </a>",
    " plus",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?source=see_link\">",
    " gentamicin",
    " </a>",
    " at the doses recommended above. Penicillin-allergic patients should be skin
    tested and desensitized if necessary, or treated with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?4/58/5034?source=see_link\">",
    " trimethoprim-sulfamethoxazole",
    " </a>",
    " . Among patients who are allergic to penicillin but who cannot be
    desensitized, we treat with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?25/36/26182?source=see_link\">",
    " trimethoprim",
    " </a>",
    " -sulfamethoxazole (10 to 20",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " [based on the trimethoprim component] IV per day divided every 6 to 12 hours,
    with the higher end of the dosing range used in patients who are severely ill) or",
    " <a class=\"drug drug_general\" href=\"UTD.htm?31/38/32359?source=see_link\">",
    " meropenem",
    " </a>",
    " (2 g IV every eight hours in adults; 120",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " per day in three divided doses in children, maximum dose 6",
    " <span class=\"nowrap\">",
    " g/day).",
    " </span>",
    " There is some possibility of cross-reactivity between meropenem and
    penicillins in patients with type I, IgE-mediated allergy to penicillins. However,
    in patients with a history of a mild maculopapular rash to penicillin (ie,",
    " <strong>",
    " not",
    " </strong>",
    " an IgE-mediated reaction or Stevens-Johnson",
    " <span class=\"nowrap\">",
    " syndrome/toxic",
    " </span>",
    " epidermal necrolysis), meropenem is a reasonable alternative to ampicillin.
    &nbsp;(See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?15/19/15672?
    source=see_link\">",
    " \"Penicillin-allergic patients: Use of cephalosporins, carbapenems, and
    monobactams\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H7\">",
    " <span class=\"h3\">",
    " Febrile gastroenteritis",
    " </span>",
    " &nbsp;&mdash;&nbsp;The need for treatment of listerial febrile gastroenteritis
    depends upon the host as follows:",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Among immunocompetent patients with listerial febrile gastroenteritis, the
    illness has resolved in the majority of patients (typical duration &le;2 days) by
    the time the organism is identified [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/23\">",
    " 23",
    " </a>",
    " ]. We therefore suggest that immunocompetent patients with isolated
    listerial febrile gastroenteritis not receive antimicrobial therapy.",
    " </li>",
    " <li>",
    " Invasive infection such as meningitis, meningoencephalitis, or bacteremia
    seems to be rare, with the risk being greatest in immunocompromised, pregnant, and
    elderly patients [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/24\">",
    " 24",
    " </a>",
    " ]. In pregnant women, listerial febrile gastroenteritis can lead to fetal
    death, premature birth, or infected newborns [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/25-28\">",
    " 25-28",
    " </a>",
    " ]. We suggest that oral",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " ampicillin",
    " </a>",
    " or",
    " <a class=\"drug drug_general\" href=\"UTD.htm?4/58/5034?source=see_link\">",
    " trimethoprim-sulfamethoxazole",
    " </a>",
    " be given for several days in immunocompromised, pregnant, or elderly
    patients with listerial febrile gastroenteritis, particularly if they are still
    symptomatic or have ingested a food implicated in an outbreak [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/23\">",
    " 23",
    " </a>",
    " ].",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?1/44/1736?
    source=see_link&amp;anchor=H3#H3\">",
    " \"Clinical manifestations and diagnosis of Listeria monocytogenes
    infection\", section on 'Febrile gastroenteritis'",
    " </a>",
    " and",
    " <a class=\"medical medical_review\" href=\"UTD.htm?1/44/1736?
    source=see_link&amp;anchor=H4#H4\">",
    " \"Clinical manifestations and diagnosis of Listeria monocytogenes
    infection\", section on 'Infection in pregnancy'",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H8\">",
    " <span class=\"h3\">",
    " Pregnancy",
    " </span>",
    " &nbsp;&mdash;&nbsp;Pregnant women with isolated listerial bacteremia can be
    treated with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?source=see_link\">",
    " ampicillin",
    " </a>",
    " alone (2 g IV every four hours). Patients who are allergic to penicillin
    should be skin tested and desensitized, if necessary, or treated with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?4/58/5034?source=see_link\">",
    " trimethoprim-sulfamethoxazole",
    " </a>",
    " . In patients with a history of a mild maculopapular rash to penicillin (ie,",
    " <strong>",
    " not",
    " </strong>",
    " an IgE-mediated reaction or Stevens-Johnson",
    " <span class=\"nowrap\">",
    " syndrome/toxic",
    " </span>",
    " epidermal necrolysis),",
    " <a class=\"drug drug_general\" href=\"UTD.htm?31/38/32359?source=see_link\">",
    " meropenem",
    " </a>",
    " is a reasonable alternative to ampicillin. The usual dose ranges from 10 to
    20",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " (based on the",
    " <a class=\"drug drug_general\" href=\"UTD.htm?25/36/26182?source=see_link\">",
    " trimethoprim",
    " </a>",
    " component) IV per day divided every 6 to 12 hours, with the higher end of the
    dosing range used in patients who are severely ill. Trimethoprim-sulfamethoxazole
    should be avoided during the first trimester, since",
    " <a class=\"drug drug_general\" href=\"UTD.htm?8/61/9174?source=see_link\">",
    " folic acid",
    " </a>",
    " metabolism may be affected, and during the last month of pregnancy to avoid
    kernicterus in the fetus. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?22/46/23274?
    source=see_link\">",
    " \"Allergy to penicillins\"",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " CNS infection is rare in pregnant women with listeriosis.",
    " <a class=\"drug drug_general\" href=\"UTD.htm?41/41/42649?source=see_link\">",
    " Vancomycin",
    " </a>",
    " is an alternative agent among pregnant patients who become infected during a
    period when",
    " <a class=\"drug drug_general\" href=\"UTD.htm?4/58/5034?source=see_link\">",
    " trimethoprim-sulfamethoxazole",
    " </a>",
    " cannot be given, and who have a history of serious allergy to penicillin but
    cannot be desensitized [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/3\">",
    " 3",
    " </a>",
    " ].",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H9\">",
    " <span class=\"h3\">",
    " Focal infection",
    " </span>",
    " &nbsp;&mdash;&nbsp;Numerous focal manifestations of listerial infection have
    been described, including oculoglandular (Parinaud's) syndrome, lymphadenitis,
    pneumonia, empyema, myocarditis, endocarditis (usually with a subacute
    presentation), septic arthritis, and osteomyelitis. Treatment of patients with
    focal listerial infection should be individualized after considering the location
    of infection, immune and pregnancy status, drug allergies, and renal and hepatic
    function. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?1/44/1736?
    source=see_link&amp;anchor=H10#H10\">",
    " \"Clinical manifestations and diagnosis of Listeria monocytogenes
    infection\", section on 'Focal infections'",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " Prosthetic joint removal or replacement in combination with a prolonged course
    of antibiotic therapy is usually required for cure of listerial prosthetic joint
    infection [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/29\">",
    " 29",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?6/19/6457?
    source=see_link\">",
    " \"Treatment of prosthetic joint infections\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H10\">",
    " <span class=\"h2\">",
    " Duration of therapy",
    " </span>",
    " &nbsp;&mdash;&nbsp;The optimal duration of therapy is unknown, and varies with
    the patient and the type of infection. Among patients with CNS infection, treatment
    is continued until the CSF culture is negative, the brain magnetic resonance
    imaging (MRI) findings have significantly improved, AND for at least as long as
    described in the following recommendations:",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " In immunocompetent patients, two weeks is sufficient for bacteremia and two
    to four weeks for CNS infection.",
    " </li>",
    " <li>",
    " Relapses have occurred in immunocompromised patients after two weeks of
    treatment [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/3\">",
    " 3",
    " </a>",
    " ]. As a result, three to six weeks is preferable in patients with bacteremia
    and four to eight weeks in those with CNS infections [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/2,6,30\">",
    " 2,6,30",
    " </a>",
    " ]. The longer duration particularly applies to patients with cerebritis or
    brain abscess.",
    " </li>",
    " <li>",
    " When given,",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?
    source=see_link\">",
    " gentamicin",
    " </a>",
    " is continued until the patient improves (usually 7 to 14 days), or in poor
    responders, for up to three weeks if there are no signs of nephrotoxicity or
    ototoxicity.",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " Clinical judgment should be used to determine whether treatment should be
    extended beyond the durations described above. This decision should be made on a
    case by case basis depending upon the response to treatment. After antibiotics have
    been discontinued, the patient is monitored for signs of clinical relapse. End-of-
    treatment CSF examination is not recommended if a previously negative CNS culture
    was documented during therapy [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/31\">",
    " 31",
    " </a>",
    " ]. On the other hand, patients with endocarditis should have repeat blood
    cultures following the completion of therapy. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?19/37/20058?
    source=see_link\">",
    " \"Antimicrobial therapy of native valve endocarditis\"",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " In patients treated with immunosuppressive drugs (eg, because of renal
    transplantation), decreasing the level of immunosuppression is desirable although
    many such patients have been successfully treated for listeriosis without changing
    the immunosuppression regimen [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/32\">",
    " 32",
    " </a>",
    " ]. We recommend decreasing the dose of immunosuppressive drugs whenever
    feasible, particularly if there is not a prompt clinical response to initial
    antimicrobial therapy.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H11\">",
    " <span class=\"h2\">",
    " Monitoring during therapy",
    " </span>",
    " &nbsp;&mdash;&nbsp;The response to therapy should be monitored clinically
    (temperature, clinical signs, and symptoms). In patients who remain persistently
    febrile or who have other signs or symptoms suggesting a poor response after
    several days of therapy, we repeat blood cultures and, in patients with CNS
    infection, CSF cultures and, if initially abnormal, MRI.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H12\">",
    " <span class=\"h2\">",
    " Prognosis",
    " </span>",
    " &nbsp;&mdash;&nbsp;Among foodborne infections in the United States, Listeria
    has the third highest reported mortality rate (approximately 16 percent compared to
    35 percent with Vibrio vulnificus) and accounts for approximately 19 percent of all
    deaths from foodborne infection [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/33\">",
    " 33",
    " </a>",
    " ]. However, it should be noted that mortality rates are often subject to
    reporting bias. Since it is more likely that severe or fatal cases are reported and
    that mild cases are unreported, the actual case-fatality rate is probably lower
    than 16 percent. Nonperinatal listeriosis-associated deaths in the United States
    decreased between 1990 and 2005, paralleling the decreasing trend in incidence [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/34\">",
    " 34",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?9/48/9993?
    source=see_link&amp;anchor=H5#H5\">",
    " \"Epidemiology and pathogenesis of Listeria monocytogenes infection\",
    section on 'Incidence of infection'",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " The mortality associated with Listeria infection is highly variable, being
    determined by the patient's underlying immune status, the site of infection, and
    the presence or absence of early diagnosis and early initiation of appropriate
    therapy when indicated. Adults with no underlying disease almost always do well. In
    two series of 281 and 74 patients, for example, there were no deaths in otherwise
    healthy patients compared with an overall mortality rate of 22 to 32 percent in
    patients at increased risk [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/35,36\">",
    " 35,36",
    " </a>",
    " ]. In the larger series, which excluded patients with perinatal infection,
    risk factors for mortality included nonhematologic malignancy, alcoholism, age
    &ge;70 years, glucocorticoid use, and kidney disease [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/35\">",
    " 35",
    " </a>",
    " ]. In a study of 30 solid organ transplant recipients with listeriosis, the
    30-day mortality was 27 percent [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/37\">",
    " 37",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " CNS infection is another risk factor for mortality and morbidity [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/3\">",
    " 3",
    " </a>",
    " ]. As an example, patients with meningoencephalitis or rhombencephalitis in
    different series had a 100 percent mortality if untreated and 13 to 43 percent if
    treated [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/30,36\">",
    " 30,36",
    " </a>",
    " ]. Furthermore, neurologic sequelae are common among the survivors of CNS
    infection [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/24,30,38\">",
    " 24,30,38",
    " </a>",
    " ]. In reports of 62 patients with rhombencephalitis [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/30\">",
    " 30",
    " </a>",
    " ] and 38 patients with brain abscess [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/38\">",
    " 38",
    " </a>",
    " ], 61 percent of survivors had persistent neurologic sequelae.
    Rhombencephalitis typically occurs in healthy individuals who have acquired
    Listeria via contaminated food consumption, often in outbreaks [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/30\">",
    " 30",
    " </a>",
    " ], whereas brain abscess occurs most commonly in immunocompromised individuals
    [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/38\">",
    " 38",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " Listeria meningitis may serve as a marker for cancer in older patients. In a
    nationwide cohort study from Denmark, adult survivors of Listeria meningitis had
    increased cancer-related mortality during the five-year period after the diagnosis
    of meningitis, and the subset over 50 years of age had a twofold increased risk of
    being diagnosed with cancer during the same time period [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/39\">",
    " 39",
    " </a>",
    " ]. Screening for underlying malignancy was recommended by the authors,
    especially in patients over 50 years of age.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H13\">",
    " <span class=\"h1\">",
    " PREVENTION OF FOODBORNE INFECTION",
    " </span>",
    " &nbsp;&mdash;&nbsp;The great majority of listerial infections are sporadic (95
    percent in a report from the Foodborne Diseases Active Surveillance Network
    [FoodNet] in the United States) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/40\">",
    " 40",
    " </a>",
    " ]. However, outbreaks do occur. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?9/48/9993?
    source=see_link&amp;anchor=H6#H6\">",
    " \"Epidemiology and pathogenesis of Listeria monocytogenes infection\",
    section on 'Sporadic illness'",
    " </a>",
    " and",
    " <a class=\"medical medical_review\" href=\"UTD.htm?9/48/9993?
    source=see_link&amp;anchor=H12#H12\">",
    " \"Epidemiology and pathogenesis of Listeria monocytogenes infection\",
    section on 'Food epidemiology and outbreaks'",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " In a 2002 outbreak involving 54 patients who developed infections from
    infected delicatessen turkey meat, a total 11 individuals died; three of the deaths
    occurred in fetuses [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/27\">",
    " 27",
    " </a>",
    " ]. Of the eight non-fetal deaths, seven occurred in immunocompromised
    individuals and one occurred in a neonate. Investigation of this outbreak led the
    Food Safety and Inspection Service of the United States Department of Agriculture
    (USDA) to institute policy changes designed to prevent Listeria monocytogenes
    contamination [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/27,41\">",
    " 27,41",
    " </a>",
    " ]. Plants producing ready-to-eat meat and poultry were required to develop
    scientifically validated Listeria monocytogenes control programs that were
    stratified according to the number of control measures taken. One such measure is
    the use of post-packaging pasteurization [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/27,41\">",
    " 27,41",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " These policy changes and those that were instituted earlier were associated
    with a reduction in Listeria contamination of ready-to-eat foods and in foodborne
    listerial infections as illustrated by the following observations:",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " A report from the Foodborne Diseases Active Surveillance Network (FoodNet)
    in the United States noted a 42 percent reduction in the incidence of Listeria
    infection in 2007 compared with 1996 through 1998; the decline occurred before 2004
    and has remained stable since then [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/42\">",
    " 42",
    " </a>",
    " ]. The incidence of other common pathogens also declined during the same
    period so that Listeria continued to account for approximately 1 percent of
    reported cases. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?23/44/24265?
    source=see_link&amp;anchor=H33#H33\">",
    " \"Differential diagnosis of microbial foodborne disease\", section on
    'Listeria monocytogenes'",
    " </a>",
    " .)",
    " </li>",
    " <li>",
    " One year after the 2002 outbreak that led to further policy changes to
    reduce food contamination, the USDA Food Safety and Inspection Service (FSIS) noted
    a 25 percent reduction in the number of Listeria monocytogenes-positive samples
    that were detected by regulatory testing.",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " The following represents a compilation of the precautions recommended by FSIS
    (",
    " <a class=\"external\" href=\"file://www.fsis.usda.gov/\">",
    " www.fsis.usda.gov",
    " </a>",
    " ) and the United States Centers for Disease Control and Prevention (",
    " <a class=\"external\"
    href=\"file://www.cdc.gov/ncidod/dbmd/diseaseinfo/listeriosis_g.htm\">",
    " www.cdc.gov/ncidod/dbmd/diseaseinfo/listeriosis_g.htm",
    " </a>",
    " .) The general recommendations include:",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Do not drink raw (unpasteurized) milk or foods that contain unpasteurized
    milk.",
    " </li>",
    " <li>",
    " Wash raw vegetables thoroughly before eating.",
    " </li>",
    " <li>",
    " Keep the refrigerator temperature at 40&ordm;F (4.4&ordm;C) or lower; the
    freezer at 0&ordm;F (-17.8&ordm;C) or lower.",
    " </li>",
    " <li>",
    " Eat precooked, perishable, or ready-to-eat food as soon as possible.",
    " </li>",
    " <li>",
    " Keep raw meat, fish, and poultry separate from other food that will not be
    cooked and from cooked foods and ready-to-eat foods.",
    " </li>",
    " <li>",
    " Wash hands, knives, and cutting boards after handling uncooked food.",
    " </li>",
    " <li>",
    " Thoroughly cook raw food from animal sources to a safe internal temperature:
    ground beef 160&ordm;F (71&ordm;C); chicken 170&ordm;F (77&ordm;C); turkey
    180&ordm;F (82&ordm;C); pork 160&ordm;F (71&ordm;C).",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " The following additional recommendations were made for individuals at high
    risk such as pregnant women and those who are immunocompromised:",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Do not eat hot dogs, luncheon meats, bologna, or other delicatessen meats
    unless they are reheated until steaming hot; avoid the use of microwave ovens for
    reheating such meats since uneven cooking may occur [",
    " <a class=\"abstract\" href=\"UTD.htm?0/46/745/abstract/43\">",
    " 43",
    " </a>",
    " ].",
    " </li>",
    " <li>",
    " Avoid contamination of utensils and food preparation surfaces with fluid
    from packages containing hot dogs, luncheon meats, delicatessen meats, raw meat,
    chicken, turkey, or seafood. Handwashing is also important immediately after
    handling of any of these products.",
    " </li>",
    " <li>",
    " Do not eat prepackaged salads containing ham, chicken, egg, tuna, or
    seafood.",
    " </li>",
    " <li>",
    " Do not eat soft cheeses such as feta, Brie, and Camembert, blue-veined
    cheeses, or Mexican-style cheeses such as queso blanco, queso fresco, and Panela,
    unless they have labels that clearly state they are made from pasteurized milk.",
    " </li>",
    " <li>",
    " Do not eat refrigerated pates or meat spreads. However, canned or shelf-
    stable products are safe and can be eaten by pregnant women.",
    " </li>",
    " <li>",
    " Do not eat refrigerated smoked seafood, unless it is cooked as in a
    casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, cod,
    tuna, or mackerel, is most often labeled as \"nova-
    style,\" \"lox,\" \"kippered,\" \"smoked,\" or \"jerky.\" Such fish products are
    typically found in the refrigerator section or sold at deli counters of grocery
    stores and delicatessens. However, canned or shelf-stable smoked seafood may be
    eaten.",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"PATIENT_INFORMATION\">",
    " <span class=\"h1\">",
    " INFORMATION FOR PATIENTS",
    " </span>",
    " &nbsp;&mdash;&nbsp;UpToDate offers two types of patient education materials,
    &ldquo;The Basics&rdquo; and &ldquo;Beyond the Basics.&rdquo; The Basics patient
    education pieces are written in plain language, at the 5",
    " <sup>",
    " th",
    " </sup>",
    " to 6",
    " <sup>",
    " th",
    " </sup>",
    " grade reading level, and they answer the four or five key questions a patient
    might have about a given condition. These articles are best for patients who want a
    general overview and who prefer short, easy-to-read materials. Beyond the Basics
    patient education pieces are longer, more sophisticated, and more detailed. These
    articles are written at the 10",
    " <sup>",
    " th",
    " </sup>",
    " to 12",
    " <sup>",
    " th",
    " </sup>",
    " grade reading level and are best for patients who want in-depth information
    and are comfortable with some medical jargon.",
    " </p>",
    " <p>",
    " Here are the patient education articles that are relevant to this topic. We
    encourage you to print or e-mail these topics to your patients. (You can also
    locate patient education articles on a variety of subjects by searching on
    &ldquo;patient info&rdquo; and the keyword(s) of interest.)",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Basics topic (see",
    " <a class=\"medical medical_basics\" href=\"UTD.htm?27/29/28114?
    source=see_link\">",
    " \"Patient information: Listeria (The Basics)\"",
    " </a>",
    " )",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H14\">",
    " <span class=\"h1\">",
    " SUMMARY AND RECOMMENDATIONS",
    " </span>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H15\">",
    " <span class=\"h2\">",
    " Therapy",
    " </span>",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Listeria monocytogenes is susceptible to common antimicrobial agents, such
    as",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " ampicillin",
    " </a>",
    " , penicillin,",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?
    source=see_link\">",
    " gentamicin",
    " </a>",
    " , and",
    " <a class=\"drug drug_general\" href=\"UTD.htm?4/58/5034?source=see_link\">",
    " trimethoprim-sulfamethoxazole",
    " </a>",
    " , and in vitro resistance to these drugs is rare. Ampicillin or",
    " <a class=\"drug drug_general\" href=\"UTD.htm?21/42/22183?
    source=see_link\">",
    " penicillin G",
    " </a>",
    " are the drugs of choice. However, these antibiotics demonstrate delayed in
    vitro bactericidal activity at concentrations attainable in the cerebrospinal fluid
    (CSF). As a result, gentamicin is often added to achieve synergy for listerial
    central nervous system (CNS) infections, endocarditis, and infections in
    immunocompromised patients. Drug doses are described above (see",
    " <a class=\"local\" href=\"#H4\">",
    " 'Antibiotic regimens'",
    " </a>",
    " above).",
    " </li>",
    " <li>",
    " Penicillin-allergic patients can be skin tested and desensitized if
    necessary or treated with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?4/58/5034?source=see_link\">",
    " trimethoprim-sulfamethoxazole",
    " </a>",
    " . The usual dose ranges from 10 to 20",
    " <span class=\"nowrap\">",
    " mg/kg",
    " </span>",
    " (based on the",
    " <a class=\"drug drug_general\" href=\"UTD.htm?25/36/26182?
    source=see_link\">",
    " trimethoprim",
    " </a>",
    " component) IV per day divided every 6 to 12 hours, with the higher end of
    the dosing range used in patients who are severely ill.",
    " </li>",
    " <li>",
    " Early diagnosis and initiation of appropriate antibiotic therapy are
    important.",
    " </li>",
    " <li>",
    " All patients with invasive listerial infection should be treated with
    antibiotics, since much higher mortality rates have been reported in untreated
    patients. (See",
    " <a class=\"local\" href=\"#H12\">",
    " 'Prognosis'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " Among patients treated with immunosuppressive drugs (eg, because of renal
    transplantation), we recommend decreasing the level of immunosuppression if there
    is not a prompt clinical response to initial antimicrobial therapy (",
    " <a class=\"grade\" href=\"._grade_3?title=Grade 1C\">",
    " Grade 1C",
    " </a>",
    " ). (See",
    " <a class=\"local\" href=\"#H11\">",
    " 'Monitoring during therapy'",
    " </a>",
    " above.)",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H16\">",
    " <span class=\"h3\">",
    " Type of infection",
    " </span>",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " For patients with listerial CNS infection, bacteremia, endocarditis, or
    infection in immunocompromised hosts, we treat with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " ampicillin",
    " </a>",
    " . We suggest adding",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?
    source=see_link\">",
    " gentamicin",
    " </a>",
    " to achieve synergy (",
    " <a class=\"grade\" href=\"._grade_6?title=Grade 2C\">",
    " Grade 2C",
    " </a>",
    " ). (See",
    " <a class=\"local\" href=\"#H6\">",
    " 'High risk patients'",
    " </a>",
    " above and",
    " <a class=\"local\" href=\"#H4\">",
    " 'Antibiotic regimens'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " For neonates with listerial infection, we suggest treatment with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " ampicillin",
    " </a>",
    " and",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?
    source=see_link\">",
    " gentamicin",
    " </a>",
    " &nbsp;(",
    " <a class=\"grade\" href=\"._grade_6?title=Grade 2C\">",
    " Grade 2C",
    " </a>",
    " ). (See",
    " <a class=\"local\" href=\"#H4\">",
    " 'Antibiotic regimens'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " Among immunocompetent patients with listerial febrile gastroenteritis, we
    suggest not treating since it is almost always a self-limited illness (",
    " <a class=\"grade\" href=\"._grade_6?title=Grade 2C\">",
    " Grade 2C",
    " </a>",
    " ). (See",
    " <a class=\"local\" href=\"#H7\">",
    " 'Febrile gastroenteritis'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " We suggest that oral",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " ampicillin",
    " </a>",
    " or",
    " <a class=\"drug drug_general\" href=\"UTD.htm?4/58/5034?source=see_link\">",
    " trimethoprim-sulfamethoxazole",
    " </a>",
    " be given for several days in immunocompromised, pregnant, or elderly
    patients with listerial febrile gastroenteritis, particularly if they are still
    symptomatic or have ingested a food implicated in an outbreak (",
    " <a class=\"grade\" href=\"._grade_6?title=Grade 2C\">",
    " Grade 2C",
    " </a>",
    " ). (See",
    " <a class=\"local\" href=\"#H7\">",
    " 'Febrile gastroenteritis'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " Among pregnant women with isolated listerial bacteremia, we suggest
    treatment with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " ampicillin",
    " </a>",
    " alone (2 g IV every four hours) (",
    " <a class=\"grade\" href=\"._grade_6?title=Grade 2C\">",
    " Grade 2C",
    " </a>",
    " ). Although",
    " <a class=\"drug drug_general\" href=\"UTD.htm?4/58/5034?source=see_link\">",
    " trimethoprim-sulfamethoxazole",
    " </a>",
    " is an alternative in penicillin-allergic patients, it should be avoided in
    the first trimester, since",
    " <a class=\"drug drug_general\" href=\"UTD.htm?8/61/9174?source=see_link\">",
    " folic acid",
    " </a>",
    " metabolism may be affected, or the last month of pregnancy to avoid
    kernicterus in the fetus. (See",
    " <a class=\"local\" href=\"#H8\">",
    " 'Pregnancy'",
    " </a>",
    " above.)",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H17\">",
    " <span class=\"h3\">",
    " Duration",
    " </span>",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " In immunocompetent patients, we suggest a minimum of two weeks of antibiotic
    therapy for bacteremia and two to four weeks for CNS infection. In
    immunocompromised patients, we suggest three to six weeks for bacteremia and four
    to eight weeks for CNS infection. The longer duration particularly applies to
    patients with cerebritis or brain abscess. (See",
    " <a class=\"local\" href=\"#H10\">",
    " 'Duration of therapy'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " When",
    " <a class=\"drug drug_general\" href=\"UTD.htm?35/10/36000?
    source=see_link\">",
    " gentamicin",
    " </a>",
    " is added to",
    " <a class=\"drug drug_general\" href=\"UTD.htm?12/51/13112?
    source=see_link\">",
    " ampicillin",
    " </a>",
    " for synergy, we suggest it be continued until the patient improves (usually
    7 to 14 days) or, in poor responders, for up to three weeks if there are no signs
    of nephrotoxicity or ototoxicity.",
    " </li>",
    " <li>",
    " After antibiotics are discontinued, the patient is monitored for signs of
    clinical relapse. We suggest that end-of-treatment CSF examination is not necessary
    if a previously negative CNS culture was documented while on therapy.",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H18\">",
    " <span class=\"h3\">",
    " Monitoring",
    " </span>",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " The response to therapy is monitored clinically (temperature, clinical
    signs, and symptoms). In patients who remain persistently febrile or who have other
    signs or symptoms suggesting a poor response after several days of therapy, we
    repeat blood cultures and, in patients with CNS infection, CSF cultures and, if
    initially abnormal, magnetic resonance imaging (MRI). (See",
    " <a class=\"local\" href=\"#H11\">",
    " 'Monitoring during therapy'",
    " </a>",
    " above.)",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H19\">",
    " <span class=\"h2\">",
    " Outcome",
    " </span>",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Patients with no underlying disease generally do well. In comparison, the
    mortality rate is high in patients with an underlying disease that predisposes to
    more serious infection (eg, malignancy, diabetes mellitus, or renal
    transplantation). CNS infection in immunocompromised patients carries a
    particularly high mortality. In addition, survivors of cerebritis (particularly
    cerebral abscess) or rhombencephalitis have a high rate of persistent neurologic
    sequelae. (See",
    " <a class=\"local\" href=\"#H12\">",
    " 'Prognosis'",
    " </a>",
    " above.)",
    " </li>",
    " </ul>",
    " </p>",
    " </div>",
    " <div id=\"topicAgreement\">",
    " Use of UpToDate is subject to the",
    " <a class=\"licenseLink\" href=\"./license\" id=\"sla_in_page\"
    target=\"_blank\">",
    " Subscription and License Agreement",
    " </a>",
    " .",
    " </div>",
    " <div class=\"headingAnchor\" id=\"references\">",
    " <h1>",
    " REFERENCES",
    " </h1>",
    " <ol id=\"reference\">",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/1\">",
    " Schuchat A, Deaver KA, Wenger JD, et al. Role of foods in sporadic
    listeriosis. I. Case-control study of dietary risk factors. The Listeria Study
    Group. JAMA 1992; 267:2041.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/2\">",
    " Lorber B. Listeriosis. Clin Infect Dis 1997; 24:1.",
    " </a>",
    " </li>",
    " <li>",
    " Lorber B. Listeria monocytogenes. In: Principles and Practice of Infectious
    Diseases, 7th ed, Mandell GL, Bennett JE, Dolin R (Eds), Churchill Livingstone,
    Philadelphia 2010. p.2707.",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/4\">",
    " Charpentier E, Gerbaud G, Jacquet C, et al. Incidence of antibiotic
    resistance in Listeria species. J Infect Dis 1995; 172:277.",
    " </a>",
    " </li>",
    " <li>",
    " Bortolussi R, Mailman TL. Listeriosis. In: Infectious Diseases of the Fetus
    and Newborn Infant, 7th, Remington JS, Klein JO, Wilson CB, et al (Eds), Elsevier
    Saunders, Philadelphia 2011. p.470.",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/6\">",
    " Mylonakis E, Hohmann EL, Calderwood SB. Central nervous system infection
    with Listeria monocytogenes. 33 years' experience at a general hospital and review
    of 776 episodes from the literature. Medicine (Baltimore) 1998; 77:313.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/7\">",
    " Hof H, Nichterlein T, Kretschmar M. Management of listeriosis. Clin
    Microbiol Rev 1997; 10:345.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/8\">",
    " Drevets DA, Canono BP, Leenen PJ, Campbell PA. Gentamicin kills
    intracellular Listeria monocytogenes. Infect Immun 1994; 62:2222.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/9\">",
    " Winslow DL, Pankey GA. In vitro activities of trimethoprim and
    sulfamethoxazole against Listeria monocytogenes. Antimicrob Agents Chemother 1982;
    22:51.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/10\">",
    " Spitzer PG, Hammer SM, Karchmer AW. Treatment of Listeria monocytogenes
    infection with trimethoprim-sulfamethoxazole: case report and review of the
    literature. Rev Infect Dis 1986; 8:427.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/11\">",
    " G&uuml;nther G, Philipson A. Oral trimethoprim as follow-up treatment of
    meningitis caused by Listeria monocytogenes. Rev Infect Dis 1988; 10:53.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/12\">",
    " Merle-Melet M, Dossou-Gbete L, Maurer P, et al. Is amoxicillin-cotrimoxazole
    the most appropriate antibiotic regimen for listeria meningoencephalitis? Review of
    22 cases and the literature. J Infect 1996; 33:79.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/13\">",
    " Fern&aacute;ndez Guerrero ML, Torres R, Mancebo B, et al. Antimicrobial
    treatment of invasive non-perinatal human listeriosis and the impact of the
    underlying disease on prognosis. Clin Microbiol Infect 2012; 18:690.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/14\">",
    " Grant MH, Ravreby H, Lorber B. Cure of Listeria monocytogenes meningitis
    after early transition to oral therapy. Antimicrob Agents Chemother 2010;
    54:2276.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/15\">",
    " Manfredi R, Sabbatani S, Marinacci G, et al. Listeria monocytogenes
    meningitis and multiple brain abscesses in an immunocompetent host. Favorable
    response to combination linezolid-meropenem treatment. J Chemother 2006; 18:331.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/16\">",
    " Stepanovi�� S, Lazarevi�� G, Jesi�� M, Kos R. Meropenem therapy failure in
    Listeria monocytogenes infection. Eur J Clin Microbiol Infect Dis 2004; 23:484.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/17\">",
    " Morosi S, Francisci D, Baldelli F. A case of rhombencephalitis caused by
    Listeria monocytogenes successfully treated with linezolid. J Infect 2006;
    52:e73.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/18\">",
    " Cherubin CE, Appleman MD, Heseltine PN, et al. Epidemiological spectrum and
    current treatment of listeriosis. Rev Infect Dis 1991; 13:1108.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/19\">",
    " Salimnia H, Patel D, Lephart PR, et al. Listeria grayi: vancomycin-
    resistant, gram-positive rod causing bacteremia in a stem cell transplant
    recipient. Transpl Infect Dis 2010; 12:526.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/20\">",
    " Poyart-Salmeron C, Carlier C, Trieu-Cuot P, et al. Transferable plasmid-
    mediated antibiotic resistance in Listeria monocytogenes. Lancet 1990; 335:1422.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/21\">",
    " Stamm AM. Chloramphenicol: ineffective for treatment of Listeria meningitis.
    Am J Med 1982; 72:830.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/22\">",
    " Chang J, Powles R, Mehta J, et al. Listeriosis in bone marrow transplant
    recipients: incidence, clinical features, and treatment. Clin Infect Dis 1995;
    21:1289.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/23\">",
    " Ooi ST, Lorber B. Gastroenteritis due to Listeria monocytogenes. Clin Infect
    Dis 2005; 40:1327.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/24\">",
    " B&uuml;la CJ, Bille J, Glauser MP. An epidemic of food-borne listeriosis in
    western Switzerland: description of 57 cases involving adults. Clin Infect Dis
    1995; 20:66.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/25\">",
    " Linnan MJ, Mascola L, Lou XD, et al. Epidemic listeriosis associated with
    Mexican-style cheese. N Engl J Med 1988; 319:823.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/26\">",
    " Olsen SJ, Patrick M, Hunter SB, et al. Multistate outbreak of Listeria
    monocytogenes infection linked to delicatessen turkey meat. Clin Infect Dis 2005;
    40:962.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/27\">",
    " Gottlieb SL, Newbern EC, Griffin PM, et al. Multistate outbreak of
    Listeriosis linked to turkey deli meat and subsequent changes in US regulatory
    policy. Clin Infect Dis 2006; 42:29.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/28\">",
    " MacDonald PD, Whitwam RE, Boggs JD, et al. Outbreak of listeriosis among
    Mexican immigrants as a result of consumption of illicitly produced Mexican-style
    cheese. Clin Infect Dis 2005; 40:677.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/29\">",
    " Charlier C, Leclercq A, Cazenave B, et al. Listeria monocytogenes-associated
    joint and bone infections: a study of 43 consecutive cases. Clin Infect Dis 2012;
    54:240.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/30\">",
    " Armstrong RW, Fung PC. Brainstem encephalitis (rhombencephalitis) due to
    Listeria monocytogenes: case report and review. Clin Infect Dis 1993; 16:689.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/31\">",
    " Durack DT, Spanos A. End-of-treatment spinal tap in bacterial meningitis. Is
    it worthwhile? JAMA 1982; 248:75.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/32\">",
    " Watson GW, Fuller TJ, Elms J, Kluge RM. Listeria cerebritis: relapse of
    infection in renal transplant patients. Arch Intern Med 1978; 138:83.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/33\">",
    " Scallan E, Hoekstra RM, Angulo FJ, et al. Foodborne illness acquired in the
    United States--major pathogens. Emerg Infect Dis 2011; 17:7.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/34\">",
    " Bennion JR, Sorvillo F, Wise ME, et al. Decreasing listeriosis mortality in
    the United States, 1990-2005. Clin Infect Dis 2008; 47:867.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/35\">",
    " Guevara RE, Mascola L, Sorvillo F. Risk factors for mortality among patients
    with nonperinatal listeriosis in Los Angeles County, 1992-2004. Clin Infect Dis
    2009; 48:1507.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/36\">",
    " Skogberg K, Syrj&auml;nen J, Jahkola M, et al. Clinical presentation and
    outcome of listeriosis in patients with and without immunosuppressive therapy. Clin
    Infect Dis 1992; 14:815.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/37\">",
    " Fern&agrave;ndez-Sab&eacute; N, Cervera C, L&oacute;pez-Medrano F, et al.
    Risk factors, clinical features, and outcomes of listeriosis in solid-organ
    transplant recipients: a matched case-control study. Clin Infect Dis 2009;
    49:1153.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/38\">",
    " Eckburg PB, Montoya JG, Vosti KL. Brain abscess due to Listeria
    monocytogenes: five cases and a review of the literature. Medicine (Baltimore)
    2001; 80:223.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/39\">",
    " Roed C, Engsig FN, Omland LH, et al. Long-term mortality in patients
    diagnosed with Listeria monocytogenes meningitis: a Danish nationwide cohort study.
    J Infect 2012; 64:34.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/40\">",
    " Varma JK, Samuel MC, Marcus R, et al. Listeria monocytogenes infection from
    foods prepared in a commercial establishment: a case-control study of potential
    sources of sporadic illness in the United States. Clin Infect Dis 2007; 44:521.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/41\">",
    " Food Safety and Inspection Service. Control of Listeria monocytogenes in
    ready-to-eat meat and poultry products; final rule. Fed Regist 2003; 68:34208.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/42\">",
    " Centers for Disease Control and Prevention (CDC). Preliminary FoodNet data
    on the incidence of infection with pathogens transmitted commonly through food--10
    states, 2007. MMWR Morb Mortal Wkly Rep 2008; 57:366.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/46/745/abstract/43\">",
    " Farber JM, D'Aoust JY, Diotte M, et al. Survival of Listeria spp. on raw
    whole chickens cooked in microwave ovens. J Food Prot 1998; 61:1465.",
    " </a>",
    " </li>",
    " </ol>",
    " </div>",
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    " Topic 1303 Version 8.0",
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    var outline_f0_46_745=[" <div id=\"toggleOutline\">",
    " <a href=\"#\" title=\"Collapse Topic Outline\">",
    " <img alt=\"\" src=\"./../images/orange_arrow_left.myextg\"/>",
    " </a>",
    " </div>",
    " <div id=\"innerOutline\">",
    " <h1>",
    " TOPIC OUTLINE",
    " </h1>",
    " <div id=\"outline\">",
    " <ul>",
    " <li>",
    " <a class=\"sr_button\" href=\"#H14\" id=\"summRecButton\">",
    " <span>",
    " SUMMARY &amp; RECOMMENDATIONS",
    " </span>",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H1\">",
    " INTRODUCTION",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H2\">",
    " CLINICAL SYNDROMES",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H3\">",
    " TREATMENT",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H4\">",
    " Antibiotic regimens",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H108265619\">",
    " - First-line regimens",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H5\">",
    " - Alternative drugs",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H6\">",
    " - High risk patients",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H7\">",
    " - Febrile gastroenteritis",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H8\">",
    " - Pregnancy",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H9\">",
    " - Focal infection",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H10\">",
    " Duration of therapy",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H11\">",
    " Monitoring during therapy",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H12\">",
    " Prognosis",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H13\">",
    " PREVENTION OF FOODBORNE INFECTION",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#PATIENT_INFORMATION\">",
    " INFORMATION FOR PATIENTS",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H14\">",
    " SUMMARY AND RECOMMENDATIONS",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H15\">",
    " Therapy",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H16\">",
    " - Type of infection",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H17\">",
    " - Duration",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H18\">",
    " - Monitoring",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H19\">",
    " Outcome",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a href=\"#references\">",
    " REFERENCES",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " RELATED TOPICS",
    " </h1>",
    " <div id=\"relatedTopics\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?22/46/23274?
    source=related_link\">",
    " Allergy to penicillins",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?19/37/20058?
    source=related_link\">",
    " Antimicrobial therapy of native valve endocarditis",
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    " </li>",
    " <li class=\"plainItem\">",
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    " Clinical manifestations and diagnosis of Listeria monocytogenes infection",
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    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?23/44/24265?
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    " <a class=\"medical medical_review\" href=\"UTD.htm?9/48/9993?
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    " Epidemiology and pathogenesis of Listeria monocytogenes infection",
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    source=related_link\">",
    " Patient information: Listeria (The Basics)",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?15/19/15672?
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    " Penicillin-allergic patients: Use of cephalosporins, carbapenems, and
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    " </a>",
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    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?6/19/6457?
    source=related_link\">",
    " Treatment of prosthetic joint infections",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " </div>"].join("\n");
    var title_f0_46_746="Midazolam: Pediatric drug information";
    var content_f0_46_746=[" <noscript>",
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    " <!-- TC:TOPIC_PAGE -->",
    " <div id=\"topicContent\">",
    " <div id=\"drugTitle\">",
    " Midazolam: Pediatric drug information",
    " </div>",
    " <div id=\"lexiTitleImg\">",
    " <img height=\"17\" src=\"./../images/lexiComp/Lexicomp_2012_71x17.myextg\"
    width=\"71\"/>",
    " </div>",
    " <div class=\"clear\">",
    " </div>",
    " <div id=\"drugCopy\">",
    " Copyright 1978-2013 Lexicomp, Inc. All rights reserved.",
    " </div>",
    " <div id=\"topicText\">",
    " (For additional information",
    " <a class=\"drug drug_general\" href=\"UTD.htm?3/60/4042?source=see_link\">",
    " see \"Midazolam: Drug information\"",
    " </a>",
    " and",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?4/6/4197?source=see_link\">",
    " see \"Midazolam: Patient drug information\"",
    " </a>",
    " )",
    " <br/>",
    " For abbreviations and symbols that may be used in Lexicomp (",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?23/39/24183\">",
    " show table",
    " </a>",
    " )",
    " <div class=\"block black-box-warn drugH1Div\" id=\"F5709086\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " ALERT: U.S. Boxed Warning",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " The FDA-approved labeling includes a boxed warning. See Warnings/Precautions
    section for a concise summary of this information. For verbatim wording of the
    boxed warning, consult the product labeling or",
    " <a href=\"file://www.fda.gov\" target=\"_blank\">",
    " www.fda.gov",
    " </a>",
    " .",
    " </p>",
    " </div>",
    " <div class=\"list cbnlist drugH1Div drugBrandNames\" id=\"F196443\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Brand Names: Canada",
    " </span>",
    " <ul>",
    " <li>",
    " Apo-Midazolam&reg;;",
    " </li>",
    " <li>",
    " Midazolam Injection",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"list_set htclist drugH1Div drugBrandNames\" id=\"F1054079\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Therapeutic Category",
    " </span>",
    " <ul>",
    " <li>",
    " <span class=\"list-set-name\">",
    " Anticonvulsant, Benzodiazepine",
    " </span>",
    " </li>",
    " <li>",
    " <span class=\"list-set-name\">",
    " Benzodiazepine",
    " </span>",
    " </li>",
    " <li>",
    " <span class=\"list-set-name\">",
    " Hypnotic",
    " </span>",
    " </li>",
    " <li>",
    " <span class=\"list-set-name\">",
    " Sedative",
    " </span>",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"block don drugH1Div\" id=\"F11443890\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Neonatal",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Dosage must be individualized and based on patient's age, underlying
    diseases, concurrent medications, and desired effect; decrease dose (by ~30%) if
    narcotics or other CNS depressants are administered concomitantly. Patients
    receiving ECMO may require higher doses due to drug absorption in the ECMO circuit
    (Mulla, 2000). To minimize excipient load, preservative free preparations should be
    used; alternatively use the more concentrated midazolam injection (eg, 5 mg/mL) and
    dilute with SWI without preservatives.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;margin-top:2em;text-
    align:justify;\">",
    " <b>",
    " Sedation, intermittent dosing or procedural (intubation):",
    " </b>",
    " I.M., I.V.: 0.05-0.1 mg/kg/dose over 5 minutes (Kumar, 2010; VanLooy, 2008)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;margin-top:0em;text-
    align:justify;\">",
    " <b>",
    " Sedation, mechanically ventilated patient:",
    " </b>",
    " I.V.:",
    " <b>",
    " Note:",
    " </b>",
    " Use the lowest effective dose.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Manufacturer&rsquo;s labeling: Continuous I.V. infusion:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " GA &le;32 weeks: Initial: 0.03 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (0.5",
    " <b>",
    " mcg",
    " </b>",
    " /kg/minute)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " GA &gt;32 weeks: Initial: 0.06 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (1",
    " <b>",
    " mcg",
    " </b>",
    " /kg/minute)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Alternative dosing:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Loading dose:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;text-align:justify;\">",
    " GA &lt;34 weeks:",
    " <b>",
    " Note:",
    " </b>",
    " Some have recommended against the use of a loading or bolus dose due to
    associated hypotension; to rapidly achieve sedation, it has been suggested to begin
    the continuous infusion at a faster rate for the first several hours (Jacqz-
    Aigrain, 1992). Others have successfully used loading doses of 0.2 mg/kg given over
    1 hour to prevent hypotension (Anand, 1999; Treluyer, 2005)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;text-align:justify;\">",
    " GA &ge;34 weeks: 0.2 mg/kg/dose once (Anand, 1999; Jacqz-Aigrain, 1990;
    Treluyer, 2005)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Continuous I.V. infusion (Anand, 1999; Jacqz-Aigrain, 1994; Treluyer,
    2005):",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;text-align:justify;\">",
    " GA 24-26 weeks: Initial: 0.02-0.03 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (0.33-0.5",
    " <b>",
    " mcg",
    " </b>",
    " /kg/minute)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;text-align:justify;\">",
    " GA 27-29 weeks: Initial: 0.03-0.04 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (0.5-0.67",
    " <b>",
    " mcg",
    " </b>",
    " /kg/minute)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;text-align:justify;\">",
    " GA &ge;30 weeks: Initial: 0.03-0.06 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (0.5-1",
    " <b>",
    " mcg",
    " </b>",
    " /kg/minute)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " <b>",
    " Note:",
    " </b>",
    " After prolonged therapy, consider a slow wean of therapy to prevent signs and
    symptoms of withdrawal. The following regimen has been reported: If duration of
    therapy &le;4 days, wean over at least 2 days beginning with an initial dosage
    reduction of 30% to 50% followed by 20% to 30% dosage reductions every 6-8 hours;
    monitor closely for signs and symptoms of withdrawal with each reduction in dose.
    If duration of therapy is &gt;4 days, decrease infusion rate by 25% to 50% every 12
    hours, then convert to an intermittent dose every 4 hours and lastly, every 8 hours
    (Anand, 1999).",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Seizures, refractory; status epilepticus:",
    " </b>",
    " I.V.: Dosage regimens variable, reported doses are higher than sedative
    doses:",
    " <b>",
    " Note:",
    " </b>",
    " Consider omitting loading dose if patient has received an I.V. dose of a
    benzodiazepine; begin continuous I.V. infusion at lower end of range and titrate to
    lowest effective dose: Loading dose: 0.06-0.15 mg/kg/dose followed by a continuous
    infusion of 0.06-0.4 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (1-7",
    " <b>",
    " mcg",
    " </b>",
    " /kg/minute); maximum reported rate: 1.1 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (18 mcg/kg/minute) (Boylan, 2004; Conde, 2005; Holmes, 1999)",
    " </p>",
    " </div>",
    " <div class=\"block dos drugH1Div\" id=\"F1054071\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Usual",
    " </span>",
    " <p>",
    " (For additional information",
    " <a class=\"drug drug_general\" href=\"UTD.htm?3/60/4042?source=see_link\">",
    " see \"Midazolam: Drug information\"",
    " </a>",
    " )",
    " </p>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Dosage must be individualized and based on patient's age, underlying
    diseases, concurrent medications, and desired effect; decrease dose (by &sim;30%)
    if narcotics or other CNS depressants are administered concomitantly; use multiple
    small doses and titrate to desired sedative effect; allow 3-5 minutes between doses
    to decrease the chance of oversedation",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " <b>",
    " Infants, Children, and Adolescents:",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Sedation, anxiolysis, and amnesia prior to procedure or before induction of
    anesthesia:",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " I.M.: Usual: 0.1-0.15 mg/kg 30-60 minutes before surgery or procedure; range:
    0.05-0.15 mg/kg; doses up to 0.5 mg/kg have been used in more anxious patients;
    maximum total dose: 10 mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " I.V.:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Infants 1-5 months: Limited information is available in nonintubated infants;
    dosing recommendations are unclear; infants &lt;6 months are at higher risk for
    airway obstruction and hypoventilation; titrate dose with small increments to
    desired clinical effect; monitor carefully",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Infants 6 months to Children 5 years: Initial: 0.05-0.1 mg/kg; titrate dose
    carefully; total dose of 0.6 mg/kg may be required; usual total dose maximum: 6
    mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Children 6-12 years: Initial: 0.025-0.05 mg/kg; titrate dose carefully; total
    doses of 0.4 mg/kg may be required; usual total dose maximum: 10 mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Children 12-16 years: Dose as adults; usual total dose maximum: 10 mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Intranasal:",
    " <b>",
    " Note:",
    " </b>",
    " Some investigators suggest premedication with intranasal lidocaine to
    decrease irritation and subsequent agitation (Chiaretti, 2011; Lugo, 1993):",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Infants 1-5 months:",
    " <b>",
    " Note:",
    " </b>",
    " Very limited information exists; further studies are needed: 0.2 mg/kg
    (single dose) (Harcke, 1995; Mittal, 2006)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Infants &ge;6 months, Children, and Adolescents: 0.2-0.3 mg/kg (maximum
    single dose: 10 mg); may repeat in 5-15 minutes to a maximum of 0.5 mg/kg (maximum
    total dose: 10 mg) (Acworth, 2001; Charetti, 2011; Harcke, 1995; Lane, 2008)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Oral: Infants &gt;6 months and Children: Single dose: 0.25-0.5 mg/kg once,
    depending on patient status and desired effect, usual: 0.5 mg/kg; maximum dose: 20
    mg;",
    " <b>",
    " Note:",
    " </b>",
    " Younger patients (6 months to &lt;6 years) and those less cooperative may
    require higher doses (up to 1 mg/kg); use lower initial doses (0.25 mg/kg) in
    patients with cardiac or respiratory compromise, concomitant CNS depressant, or
    high-risk surgical patients.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Rectal: Infants &gt;6 months and Children: Usual: 0.25-0.5 mg/kg once
    (Krauss, 2006); doses up to 1 mg/kg have been used in infants and young children (7
    months to 5 years of age) but may be associated with a higher incidence of
    postprocedural agitation (Kanegaye, 2003; Tanaka, 2000)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Sedation, mechanically ventilated patient:",
    " </b>",
    " I.V.: Loading dose: 0.05-0.2 mg/kg given slow I.V. over 2-3 minutes, then
    follow with initial continuous I.V. infusion: 0.06-0.12 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (1-2",
    " <b>",
    " mcg",
    " </b>",
    " /kg/minute); titrate to the desired effect; range: 0.024-0.36 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (0.4-6",
    " <b>",
    " mcg",
    " </b>",
    " /kg/minute)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Seizures, acute treatment:",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Buccal: Reserve for patients without I.V. access (Ashrafi, 2010; Kutlu, 2003;
    McIntyre, 2005; Mpimbaza, 2008; Talukdar, 2009):",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Weight-based dosing: Infants &ge;3 months, Children, and Adolescents: 0.2-0.5
    mg/kg once; maximum dose: 10 mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Age-based dosing (McIntyre, 2005):",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:10em;\">",
    " Infants 6-11 months: 2.5 mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:10em;\">",
    " Children 1-4 years: 5 mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:10em;\">",
    " Children 5-9 years: 7.5 mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:10em;\">",
    " Children and Adolescents &ge;10 years: 10 mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " I.M.: 0.2 mg/kg/dose; repeat every 10-15 minutes; maximum dose: 6 mg
    (Hegenbarth, 2008)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Intranasal (Bhattachyaryya, 2006; Fi��gin, 2000; Fi��gin, 2002; Holsti, 2007;
    Holsti, 2010; Kutlu, 2000): Reserve for patients without I.V. access; divide dose
    between nares:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Infants 1-5 months: 0.2 mg/kg once; maximum dose: 10 mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Infants and Children &ge;6 months: 0.2 mg/kg; one study used 0.3 mg/kg (n=9);
    maximum dose: 10 mg; may repeat once to a total maximum of 0.4 mg/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Seizures, refractory; status epilepticus refractory to standard therapy:",
    " </b>",
    " I.V. (Hayashi, 2007; Hegenbarth, 2008; Igartua, 1999; Koul, 1997; Koul, 2002;
    Morrison, 2006; Morrison, 2008; Ozdemir, 2005; Rivera, 1993; Singh, 2002;
    Yoshikawa, 2000):",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Loading dose: 0.15-0.2 mg/kg; 0.5 mg/kg/dose was used in one high-dose
    midazolam study (n=17); consider using the lower end of the loading dose range in
    patients with hemodynamic instability or who have received other agents with
    hypotensive effects",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Continuous I.V. infusion: Initial rate: 0.06-0.12 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (1-2 mcg/kg/minute); increase rate every 15 minutes in increments of 0.06-
    0.12 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (1-2 mcg/kg/minute) until seizure activity ceases; one high dose study
    increased by 0.24 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (4 mcg/kg/minute); mean required dosage across a number of studies: 0.11-0.84
    mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (1.87-14 mcg/kg/minute); the upper end of this range was used in one study;
    however, patients were titrated to burst suppression on EEG; maximum reported dose
    (n=1): 3 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (50 mcg/kg/minute)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Seizures, status epilepticus, prehospital treatment:",
    " </b>",
    " <b>",
    " Note:",
    " </b>",
    " Administered by paramedics when convulsions last &gt;5 minutes or if
    convulsions are occurring after having intermittent seizures without regaining
    consciousness for &gt;5 minutes: I.M.: Children and Adolescents (Silbergleit,
    2012):",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " &lt;13 kg: Not studied",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " 13-40 kg: 5 mg once",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " &gt;40 kg: 10 mg once",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " <b>",
    " Adults:",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Anesthesia:",
    " </b>",
    " I.V.:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Induction:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Unpremedicated patients: 0.3-0.35 mg/kg (up to 0.6 mg/kg in resistant
    cases)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Premedicated patients: 0.15-0.35 mg/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Maintenance: 0.05-0.3 mg/kg as needed, or continuous I.V. infusion 0.25-1.5
    mcg/kg/minute",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Sedation, preoperative:",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " I.M.: 0.07-0.08 mg/kg 30-60 minutes prior to surgery/procedure; usual dose: 5
    mg;",
    " <b>",
    " Note:",
    " </b>",
    " Reduce dose in patients with COPD, high-risk patients, patients &ge;60 years
    of age, and patients receiving other narcotics or CNS depressants.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " I.V.: 0.02-0.04 mg/kg; repeat every 5 minutes as needed to desired effect or
    up to 0.1-0.2 mg/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Sedation, procedural (moderate):",
    " </b>",
    " I.V.: Initial: 0.5-2 mg slow I.V. over at least 2 minutes; slowly titrate to
    effect by repeating doses every 2-3 minutes if needed; usual total dose: 2.5-5 mg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Healthy Adults &lt;60 years:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Initial: Some patients respond to doses as low as 1 mg; no more than 2.5 mg
    should be administered over a period of 2 minutes. Additional doses of midazolam
    may be administered after a 2-minute waiting period and evaluation of sedation
    after each dose increment. A total dose &gt;5 mg is generally not needed. If
    narcotics or other CNS depressants are administered concomitantly, the midazolam
    dose should be reduced by 30%. A reduced dose is required for patients &ge;60
    years, debilitated, or chronically ill.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:8em;\">",
    " Maintenance: 25% of dose used to reach sedative effect",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Sedation in mechanically ventilated patients:",
    " </b>",
    " I.V.:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " Manufacturer&rsquo;s labeling: Initial dose: 0.01-0.05 mg/kg (~0.5-4 mg); may
    repeat at 5- to 15-minute intervals until adequate sedation achieved; maintenance
    infusion: 0.02-0.1 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " . Titrate to reach desired level of sedation.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;\">",
    " <b>",
    " Alternative dosing:",
    " </b>",
    " Initial dose: 0.02-0.08 mg/kg (~1-5 mg in 70 kg adult); may repeat at 5- to
    15-minute intervals until adequate sedation achieved; maintenance infusion: 0.04-
    0.2 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " . Titrate to reach desired level of sedation (Jacobi, 2002).",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Status epilepticus, refractory:",
    " </b>",
    " <b>",
    " Note:",
    " </b>",
    " Intubation required; adjust dose based on hemodynamics, seizure activity, and
    EEG. I.V.: 0.15-0.3 mg/kg (usual dose: 5-15 mg); may repeat every 10-15 minutes as
    needed",
    " <b>",
    " or",
    " </b>",
    " 0.2 mg/kg bolus followed by a continuous infusion of 0.05-0.6 mg/kg/",
    " <b>",
    " hour",
    " </b>",
    " (Lowenstein, 2005; Meierkord, 2010)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " <b>",
    " Status epilepticus, prehospital treatment:",
    " </b>",
    " <b>",
    " Note:",
    " </b>",
    " Administered by paramedics when convulsions last &gt;5 minutes or if
    convulsions are occurring after having intermittent seizures without regaining
    consciousness for &gt;5 minutes: I.M.: 10 mg once (Silbergleit, 2012)",
    " </p>",
    " </div>",
    " <div class=\"block foc drugH1Div\" id=\"F196415\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosage Forms: U.S.",
    " </span>",
    " <p style=\"text-indent:0em;text-align:justify;display:inline\">",
    " Excipient information presented when available (limited, particularly for
    generics); consult specific product labeling.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Injection, solution: 1 mg/mL (2 mL, 5 mL, 10 mL); 5 mg/mL (1 mL, 2 mL, 5 mL,
    10 mL)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Injection, solution [preservative free]: 1 mg/mL (2 mL, 5 mL); 5 mg/mL (1 mL,
    2 mL)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Syrup, oral: 2 mg/mL (118 mL)",
    " </p>",
    " </div>",
    " <div class=\"block geq drugH1Div\" id=\"F196399\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Generic Equivalent Available: U.S.",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Yes",
    " </p>",
    " </div>",
    " <div class=\"block csi drugH1Div\" id=\"F196491\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Controlled Substance",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " C-IV",
    " </p>",
    " </div>",
    " <div class=\"block adm drugH1Div\" id=\"F1054084\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Administration",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Buccal: A buccal formulation is not currently available in the U.S. Some
    trials used an injectable solution administered buccally. International studies
    used a 10 mg/mL commercially available buccal formulation. Administer to the buccal
    mucosa between the gums and the cheek using an oral syringe; gently massage cheek;
    dose may be divided to both sides of the mouth.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Intranasal: Administer using a needleless syringe into the nares over 15-30
    seconds; use the 5 mg/mL injection;",
    " <sup>",
    " 1",
    " </sup>",
    " /",
    " <sub>",
    " 2",
    " </sub>",
    " of the dose may be administered to each nare;",
    " <b>",
    " Note:",
    " </b>",
    " The 5 mg/mL injection has also been administered as a nasal spray using a
    graded pump device (Ljungman, 2000) or using an atomizer such as the MAD&reg; Nasal
    Drug delivery device (Holsti, 2007; Holsti, 2010).",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Oral: Administer on empty stomach (feeding is usually contraindicated prior
    to sedation for procedures); do not administer with grapefruit juice",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Parenteral:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " I.V.: Administer by slow I.V. injection over at least 2-5 minutes [administer
    loading doses more slowly in preterm neonates (ie, over 60 minutes)] at a
    concentration of 1-5 mg/mL (maximum concentration: 5 mg/mL) or by continuous I.V.
    infusion; avoid extravasation; do not administer intra-arterially",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " I.M.: Administer deep I.M. into large muscle, generally into anterior-lateral
    aspect of thigh (vastus lateralis) in pediatric patients (Lam, 2005; Malamed,
    1989)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Rectal: Clinical trials utilized parenteral midazolam for rectal
    administration; administer a 1-5 mg/mL solution through a small, lubricated
    catheter or tube inserted rectally; hold buttocks closed for ~5 minutes after
    administration",
    " </p>",
    " </div>",
    " <div class=\"block uicn drugH1Div\" id=\"F14472926\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Usual Infusion Concentrations: Neonatal",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " <b>",
    " I.V. Infusion:",
    " </b>",
    " 0.1 mg/mL",
    " <b>",
    " or",
    " </b>",
    " 0.5 mg/mL",
    " </p>",
    " </div>",
    " <div class=\"block uicp drugH1Div\" id=\"F14472925\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Usual Infusion Concentrations: Pediatric",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " <b>",
    " I.V. infusion:",
    " </b>",
    " 0.5 mg/mL",
    " <b>",
    " or",
    " </b>",
    " 1 mg/mL",
    " </p>",
    " </div>",
    " <div class=\"block scp drugH1Div\" id=\"F196496\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Compatibility",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Stable in D",
    " <sub>",
    " 5",
    " </sub>",
    " NS, D",
    " <sub>",
    " 5",
    " </sub>",
    " W, NS;",
    " <b>",
    " incompatible",
    " </b>",
    " with LR.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Y-site administration: Compatible:",
    " </b>",
    " Abciximab, amikacin, amiodarone, anidulafungin, argatroban, atracurium,
    bivalirudin, calcium gluconate, caspofungin, cefazolin, cimetidine, ciprofloxacin,
    cisatracurium, clindamycin, digoxin, diltiazem, doripenem, epinephrine,
    eptifibatide, erythromycin lactobionate, esmolol, etomidate, famotidine,
    fenoldopam, fentanyl, fluconazole, gentamicin, heparin, hetastarch in lactate
    electrolyte injection (Hextend&reg;), hydromorphone, insulin (regular), labetalol,
    linezolid, lorazepam, methadone, metronidazole, milrinone, morphine, nicardipine,
    nitroglycerin, nitroprusside, norepinephrine, palonosetron, pancuronium,
    piperacillin, ranitidine, remifentanil, sufentanil, theophylline, tirofiban,
    tobramycin, vancomycin, vecuronium.",
    " <b>",
    " Incompatible:",
    " </b>",
    " Albumin, amphotericin B cholesteryl sulfate complex, ampicillin, bumetanide,
    butorphanol, cefepime, ceftazidime, cefuroxime, dexamethasone sodium succinate,
    drotrecogin alfa, foscarnet, fosphenytoin, furosemide, hydrocortisone sodium
    succinate, imipenem/cilastatin, methotrexate, micafungin, nafcillin, sodium
    bicarbonate, thiopental, trimethoprim/sulfamethoxazole.",
    " <b>",
    " Variable (consult detailed reference):",
    " </b>",
    " Cefotaxime, clonidine, dobutamine, haloperidol, methylprednisolone sodium
    succinate, metoclopramide, pantoprazole, potassium chloride, propofol.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Compatibility in syringe: Compatible:",
    " </b>",
    " Alfentanil, atracurium, atropine, buprenorphine, butorphanol, chlorpromazine,
    cimetidine, diphenhydramine, dopamine, droperidol, fentanyl, glycopyrrolate,
    hydromorphone, hydroxyzine, ketamine, meperidine, metoclopramide, morphine,
    nalbuphine, ondansetron, promethazine, rocuronium, scopolamine, sufentanil,
    trimethobenzamide.",
    " <b>",
    " Incompatible:",
    " </b>",
    " Dimenhydrinate, heparin, pantoprazole, pentobarbital, prochlorperazine
    edisylate, ranitidine.",
    " <b>",
    " Variable (consult detailed reference):",
    " </b>",
    " Dexamethasone sodium phosphate, methylprednisolone sodium succinate.",
    " </p>",
    " </div>",
    " <div class=\"block sta drugH1Div\" id=\"F1054074\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Stability",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Oral: Store at 25&deg;C (77&deg;F); excursions permitted to 15&deg;C to
    30&deg;C (59&deg;F to 86&deg;F)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Parenteral: Store at 20&deg;C to 25&deg;C (68&deg;F to 77&deg;F), excursions
    permitted to 15&deg;C to 30&deg;C (59&deg;F to 86&deg;F); stable at a concentration
    of 0.5 mg/mL for 24 hours in D",
    " <sub>",
    " 5",
    " </sub>",
    " W or NS and for 4 hours in LR",
    " </p>",
    " </div>",
    " <div class=\"block use drugH1Div\" id=\"F1054083\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Use",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Oral: Sedation, anxiolysis, amnesia prior to procedures or before induction
    of anesthesia (FDA approved in ages &ge;6 months to &lt;16 years)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Parenteral: Preprocedure sedation, anxiolysis, amnesia for diagnostic or
    radiographic procedures (FDA approved in infants, children, adolescents, and
    adults); continuous I.V. sedation of intubated and mechanically ventilated patients
    (FDA approved in all ages); has also been used for status epilepticus",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Buccal: Has been used for acute treatment of seizures",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Intranasal: Has been used for preprocedure sedation, anxiolysis, amnesia for
    diagnostic or radiographic procedures; acute treatment of seizures",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Rectal: Has been used for preprocedure sedation",
    " </p>",
    " </div>",
    " <div class=\"block mst drugH1Div\" id=\"F196498\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Medication Safety Issues",
    " </span>",
    " <div class=\"collapsible\">",
    " <span class=\"collapsible-title\">",
    " Sound-alike/look-alike issues:",
    " </span>",
    " <div class=\"collapsible-wrap\">",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " Versed may be confused with VePesid, Vistaril&reg;",
    " </p>",
    " </div>",
    " </div>",
    " <div class=\"collapsible\">",
    " <span class=\"collapsible-title\">",
    " High alert medication:",
    " </span>",
    " <div class=\"collapsible-wrap\">",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " The Institute for Safe Medication Practices (ISMP) includes this medication
    among its list of drugs which have a heightened risk of causing significant patient
    harm when used in error.",
    " </p>",
    " </div>",
    " </div>",
    " </div>",
    " <div class=\"block arm drugH1Div\" id=\"F196495\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Adverse Reactions",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Cardiovascular: Hypotension",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Central nervous system: Drowsiness, headache, oversedation, seizure-like
    activity",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Gastrointestinal: Nausea, vomiting",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Local: Pain and local reactions at injection site",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Neuromuscular &amp; skeletal: Myoclonic jerks (preterm infants)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Ocular: Nystagmus",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Respiratory: Apnea, cough, decreased tidal volume and/or respiratory rate",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Miscellaneous: Hiccups, paradoxical reaction, physical and psychological
    dependence with prolonged use",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Rare but important or life-threatening: Agitation, amnesia, bigeminy,
    bronchospasm, emergence delirium, euphoria, hallucinations, laryngospasm, rash",
    " </p>",
    " </div>",
    " <div class=\"block coi drugH1Div\" id=\"F1054088\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Contraindications",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Hypersensitivity to midazolam, any component, or cherries (syrup); cross-
    sensitivity with other benzodiazepines may occur; narrow-angle glaucoma; parenteral
    form is not for intrathecal or epidural injection",
    " </p>",
    " </div>",
    " <div class=\"block pre drugH1Div\" id=\"F1054070\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Precautions",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Use with caution in patients with heart failure, renal impairment, pulmonary
    disease, hepatic dysfunction and in neonates (especially premature neonates);
    several cases of myoclonus (rhythmic myoclonic jerking) have been reported in
    premature infants (~8% incidence). Benzodiazepine withdrawal may occur if abruptly
    discontinued in patients receiving prolonged I.V. continuous infusions; doses
    should be tapered slowly with prolonged use; does not have analgesic,
    antidepressant, or antipsychotic properties. Does not protect against increases in
    heart rate or blood pressure during intubation. Should not be used in shock, coma,
    or acute alcohol intoxication. Avoid intra-arterial administration or extravasation
    of parenteral formulation. Use during upper airway procedures may increase risk of
    hypoventilation. Prolonged responses have been noted following extended
    administration by continuous infusion (possibly due to metabolite accumulation) or
    in the presence of drugs which inhibit midazolam metabolism.",
    " </p>",
    " </div>",
    " <div class=\"block war drugH1Div\" id=\"F1054069\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Warnings",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Midazolam may cause respiratory depression/arrest",
    " <b>",
    " [U.S. Boxed Warning]",
    " </b>",
    " ; deaths and hypoxic encephalopathy have resulted when these were not
    promptly recognized and treated appropriately; dose must be individualized and
    patients must be appropriately monitored; serious respiratory adverse events occur
    most often when midazolam is used in combination with other CNS depressants;
    personnel and equipment needed for standard respiratory resuscitation should be
    immediately available during midazolam use; a dedicated individual (other than the
    one performing the procedure) should monitor the deeply sedated pediatric patient
    throughout the procedure; use with extreme caution, particularly in noncritical
    care settings. Initial I.V. dose in adults should not exceed 2.5 mg. Pediatric
    dosing is age, weight, procedure, and route dependant. Use lower doses in elderly
    or debilitated patients",
    " <b>",
    " [U.S. Boxed Warning]",
    " </b>",
    " . Do not administer by rapid I.V. injection in neonates",
    " <b>",
    " [U.S. Boxed Warning]",
    " </b>",
    " ; severe hypotension and seizures have been reported; risk may be increased
    with concomitant fentanyl use. Paradoxical reactions, including hyperactive or
    aggressive behavior, have been reported in both adult and pediatric patients.",
    " </p>",
    " <p style=\"text-indent:0em;margin-top:2em;text-align:justify;\">",
    " Syrup contains sodium benzoate and injection may contain benzyl alcohol which
    may cause allergic reactions in susceptible individuals; large amounts of benzyl
    alcohol (&ge;99 mg/kg/day) have been associated with a potentially fatal toxicity
    (&ldquo;gasping syndrome&rdquo;) in neonates; the &ldquo;gasping syndrome&rdquo;
    consists of metabolic acidosis, respiratory distress, gasping respirations, CNS
    dysfunction (including convulsions, intracranial hemorrhage), hypotension and
    cardiovascular collapse; avoid use of midazolam products containing benzyl alcohol
    or sodium benzoate in neonates; a benzyl alcohol free (preservative free) injection
    is available;",
    " <i>",
    " in vitro",
    " </i>",
    " and animal studies have shown that benzoate, a metabolite of benzyl alcohol,
    displaces bilirubin from protein binding sites",
    " </p>",
    " </div>",
    " <div class=\"block cyt drugH1Div\" id=\"F196481\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Metabolism/Transport Effects",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " <b>",
    " Substrate",
    " </b>",
    " of CYP2B6 (minor), CYP3A4 (major);",
    " <b>",
    " Note:",
    " </b>",
    " Assignment of Major/Minor substrate status based on clinically relevant drug
    interaction potential;",
    " <b>",
    " Inhibits",
    " </b>",
    " CYP2C8 (weak), CYP2C9 (weak), CYP3A4 (weak)",
    " </p>",
    " </div>",
    " <div class=\"block dri drugH1Div\" id=\"F196408\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Drug Interactions",
    " </span>",
    " <br/>",
    " <br/>",
    " <div class=\"lexi\" id=\"lexiInteractAddInfo\">",
    " (For additional information:",
    " <a class=\"dip\" href=\"./drug-interaction\" target=\"_blank\">",
    " Launch Lexi-Interact&trade; Drug Interactions Program",
    " </a>",
    " )",
    " </div>",
    " <div class=\"lexi\" id=\"lexiInteractImgB\">",
    " <img border=\"0\" height=\"17\"
    src=\"./../images/lexiComp/Lexicomp_2012_71x17.myextg\" width=\"71\"/>",
    " </div>",
    " <div class=\"clear\">",
    " </div>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Alcohol (Ethyl): CNS Depressants may enhance the CNS depressant effect of
    Alcohol (Ethyl).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Antifungal Agents (Azole Derivatives, Systemic): May decrease the metabolism
    of Benzodiazepines (metabolized by oxidation). Management: The following
    combinations are specifically contraindicated: itraconazole with alprazolam,
    estazolam, oral midazolam, or triazolam; ketoconazole with alprazolam, estazolam,
    or triazolam. Consider initial dose reductions of other benzodiazepines.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Aprepitant: May increase the serum concentration of Benzodiazepines
    (metabolized by oxidation).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " ARIPiprazole: CYP3A4 Inhibitors (Weak) may increase the serum concentration
    of ARIPiprazole. Management: Monitor for increased aripiprazole pharmacologic
    effects. Aripiprazole dose adjustments may or may not be required based on
    concomitant therapy and/or indication. Consult full interaction monograph for
    specific recommendations.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " AtorvaSTATin: May increase the serum concentration of Midazolam.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Azelastine (Nasal): CNS Depressants may enhance the CNS depressant effect of
    Azelastine (Nasal).",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Boceprevir: May increase the serum concentration of Midazolam.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Buprenorphine: CNS Depressants may enhance the CNS depressant effect of
    Buprenorphine. Management: Consider reduced doses of CNS depressants used in
    combination with buprenorphine. Consider avoiding other CNS depressants in
    patients thought to be at high risk of buprenorphine overuse or self-injection.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Calcium Channel Blockers (Nondihydropyridine): May decrease the metabolism of
    Benzodiazepines (metabolized by oxidation).",
    " <b>",
    " Exceptions:",
    " </b>",
    " Bepridil [Off Market].",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " CarBAMazepine: May increase the metabolism of Benzodiazepines (metabolized by
    oxidation).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Cimetidine: May decrease the metabolism of Benzodiazepines (metabolized by
    oxidation).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " CloZAPine: Benzodiazepines may enhance the adverse/toxic effect of CloZAPine.
    Management: Consider decreasing the dose of (or possibly discontinuing)
    benzodiazepines prior to initiating clozapine.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " CNS Depressants: May enhance the adverse/toxic effect of other CNS
    Depressants.",
    " <b>",
    " Exceptions:",
    " </b>",
    " Levocabastine (Nasal).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Cobicistat: May increase the serum concentration of Midazolam. Management:
    Oral midazolam is contraindicated with the
    elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate combination
    product. IV midazolam should only be used with caution, close monitoring, and
    consideration of lower IV midazolam doses.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Conivaptan: May increase the serum concentration of CYP3A4 Substrates.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Contraceptives (Estrogens): May decrease the metabolism of Benzodiazepines
    (metabolized by oxidation).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Contraceptives (Progestins): May increase the serum concentration of
    Benzodiazepines (metabolized by oxidation).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " CYP3A4 Inducers (Strong): May increase the metabolism of CYP3A4 Substrates.
    Management: Consider an alternative for one of the interacting drugs. Some
    combinations may be specifically contraindicated. Consult appropriate manufacturer
    labeling.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " CYP3A4 Inhibitors (Moderate): May decrease the metabolism of CYP3A4
    Substrates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " CYP3A4 Inhibitors (Strong): May decrease the metabolism of CYP3A4
    Substrates.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Dasatinib: May increase the serum concentration of CYP3A4 Substrates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Deferasirox: May decrease the serum concentration of CYP3A4 Substrates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Droperidol: May enhance the CNS depressant effect of CNS Depressants.
    Management: Consider dose reductions of droperidol or of other CNS agents (e.g.,
    opioids, barbiturates) with concomitant use.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Efavirenz: May increase the serum concentration of Midazolam.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Fosaprepitant: May increase the serum concentration of Benzodiazepines
    (metabolized by oxidation). Specifically, the active metabolite aprepitant is
    likely responsible for this effect.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Fosphenytoin: Benzodiazepines may increase the serum concentration of
    Fosphenytoin. Short-term exposure to benzodiazepines may not present as much risk
    as chronic therapy.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Ginkgo Biloba: May decrease the serum concentration of Midazolam.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Grapefruit Juice: May decrease the metabolism of Benzodiazepines (metabolized
    by oxidation).",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " HydrOXYzine: May enhance the CNS depressant effect of CNS Depressants.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Isoniazid: May decrease the metabolism of Benzodiazepines (metabolized by
    oxidation).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Itraconazole: May increase the serum concentration of Midazolam. Management:
    Oral midazolam is contraindicated. Use intravenous midazolam with great caution in
    patients receiving itraconazole, employing reduced initial doses whenever possible
    and monitoring closely for enhanced and prolonged effects.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Ivacaftor: May increase the serum concentration of CYP3A4 Substrates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Ketoconazole (Systemic): May increase the serum concentration of Midazolam.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Lomitapide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of
    Lomitapide. Management: Limit the maximum adult dose of lomitapide to 30 mg daily
    when used in combination with any weak CYP3A4 inhibitor.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Macrolide Antibiotics: May decrease the metabolism of Benzodiazepines
    (metabolized by oxidation).",
    " <b>",
    " Exceptions:",
    " </b>",
    " Azithromycin (Systemic); Fidaxomicin; Spiramycin.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Magnesium Sulfate: May enhance the CNS depressant effect of CNS
    Depressants.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Methotrimeprazine: CNS Depressants may enhance the CNS depressant effect of
    Methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of CNS
    Depressants. Management: Reduce adult dose of CNS depressant agents by 50% with
    initiation of concomitant methotrimeprazine therapy. Further CNS depressant dosage
    adjustments should be initiated only after clinically effective methotrimeprazine
    dose is established.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Metyrosine: CNS Depressants may enhance the sedative effect of Metyrosine.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Mifepristone: May increase the serum concentration of CYP3A4 Substrates.
    Management: Minimize doses of CYP3A4 substrates, and monitor for increased
    concentrations/toxicity, during and 2 weeks following treatment with mifepristone.
    Avoid cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine,
    sirolimus, and tacrolimus.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Mirtazapine: CNS Depressants may enhance the CNS depressant effect of
    Mirtazapine.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " OLANZapine: May enhance the adverse/toxic effect of Benzodiazepines.
    Management: Avoid concomitant use of parenteral benzodiazepines and IM olanzapine
    due to risks of additive adverse events (e.g., cardiorespiratory depression).
    Olanzapine prescribing information provides no specific recommendations regarding
    oral administration.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Paraldehyde: CNS Depressants may enhance the CNS depressant effect of
    Paraldehyde.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Perampanel: May enhance the CNS depressant effect of CNS Depressants.
    Management: Patients taking perampanel with any other drug that has CNS depressant
    activities should avoid complex and high-risk activities, particularly those such
    as driving that require alertness and coordination, until they have experience
    using the combination.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Phenytoin: Benzodiazepines may increase the serum concentration of Phenytoin.
    Short-term exposure to benzodiazepines may not present as much risk as chronic
    therapy.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Pimozide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of
    Pimozide.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Pramipexole: CNS Depressants may enhance the sedative effect of
    Pramipexole.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Propofol: Midazolam may increase the serum concentration of Propofol.
    Propofol may increase the serum concentration of Midazolam.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Protease Inhibitors: May increase the serum concentration of Midazolam.
    Management: Oral midazolam contraindicated with all protease inhibitors. IV
    midazolam contraindicated with fosamprenavir and nelfinavir; other protease
    inhibitors recommend caution, close monitoring, and consideration of lower IV
    midazolam doses with concurrent use.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Proton Pump Inhibitors: May increase the serum concentration of
    Benzodiazepines (metabolized by oxidation).",
    " <b>",
    " Exceptions:",
    " </b>",
    " Lansoprazole; Pantoprazole; RABEprazole.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Rifamycin Derivatives: May increase the metabolism of Benzodiazepines
    (metabolized by oxidation).",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " ROPINIRole: CNS Depressants may enhance the sedative effect of ROPINIRole.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Rotigotine: CNS Depressants may enhance the sedative effect of Rotigotine.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Selective Serotonin Reuptake Inhibitors: May decrease the metabolism of
    Benzodiazepines (metabolized by oxidation).",
    " <b>",
    " Exceptions:",
    " </b>",
    " Citalopram; Escitalopram; PARoxetine; Sertraline.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Selective Serotonin Reuptake Inhibitors: CNS Depressants may enhance the
    adverse/toxic effect of Selective Serotonin Reuptake Inhibitors. Specifically, the
    risk of psychomotor impairment may be enhanced.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Sodium Oxybate: Benzodiazepines may enhance the CNS depressant effect of
    Sodium Oxybate.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " St Johns Wort: May increase the metabolism of Benzodiazepines (metabolized by
    oxidation).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Telaprevir: May increase the serum concentration of Midazolam. Management:
    Use of oral midazolam with telaprevir is contraindicated. IV midazolam use may
    pose a lower risk, but dose reductions should be considered and patients should be
    monitored closely for signs/symptoms of toxicity.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Theophylline Derivatives: May diminish the therapeutic effect of
    Benzodiazepines.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Tocilizumab: May decrease the serum concentration of CYP3A4 Substrates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Yohimbine: May diminish the therapeutic effect of Antianxiety Agents.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Zolpidem: CNS Depressants may enhance the CNS depressant effect of Zolpidem.
    Management: Reduce the Intermezzo brand sublingual zolpidem dose to 1.75 mg for men
    who are also receiving other CNS depressants. No such dose change is recommended
    for women. Avoid use with other CNS depressants at bedtime; avoid use with
    alcohol.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " </div>",
    " <div class=\"block foi drugH1Div\" id=\"F1054091\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Food Interactions",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Grapefruit juice delays the absorption and significantly increases
    bioavailability of oral midazolam",
    " </p>",
    " </div>",
    " <div class=\"block prf drugH1Div\" id=\"F196410\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pregnancy Risk Factor",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " D (",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?16/42/17068\">",
    " show table",
    " </a>",
    " )",
    " </p>",
    " </div>",
    " <div class=\"block pri drugH1Div\" id=\"F196425\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pregnancy Implications",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Adverse events were not observed in animal teratology studies. Midazolam has
    been found to cross the human placenta and can be detected in the serum of the
    umbilical vein and artery, as well as the amniotic fluid. Teratogenic effects have
    been observed with some benzodiazepines; however, additional studies are needed.
    The incidence of premature birth and low birth weights may be increased following
    maternal use of benzodiazepines; hypoglycemia and respiratory problems in the
    neonate may occur following exposure late in pregnancy. Neonatal withdrawal
    symptoms may occur within days to weeks after birth and &ldquo;floppy infant
    syndrome&rdquo; (which also includes withdrawal symptoms) have been reported with
    some benzodiazepines.",
    " </p>",
    " </div>",
    " <div class=\"block mop drugH1Div\" id=\"F1054078\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Monitoring Parameters",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Level of sedation, respiratory rate, heart rate, blood pressure, oxygen
    saturation (ie, pulse oximetry)",
    " </p>",
    " </div>",
    " <div class=\"block pha drugH1Div\" id=\"F1054068\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Mechanism of Action",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Depresses all levels of the CNS, including the limbic and reticular
    formation, by binding to the benzodiazepine site on the gamma-aminobutyric acid
    (GABA) receptor complex and modulating GABA, which is a major inhibitory
    neurotransmitter in the brain",
    " </p>",
    " </div>",
    " <div class=\"block phd drugH1Div\" id=\"F1054086\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pharmacodynamics",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Sedation:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Onset of action:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Oral: Children: Within 10-20 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " I.M.:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Children: Within 5 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Adults: Within 15 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " I.V.: Within 1-5 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Intranasal: Within 5 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Maximum effect:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " I.M.:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Children: 15-30 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Adults: 30-60 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " I.V.: 5-7 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Intranasal: 10 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Duration:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " I.M.: Mean: 2 hours, up to 6 hours",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " I.V.: 20-30 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Intranasal: 30-60 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " <b>",
    " Note:",
    " </b>",
    " Full recovery may take more than 24 hours",
    " </p>",
    " </div>",
    " <div class=\"block phk drugH1Div\" id=\"F1054087\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pharmacokinetics (Adult data unless noted)",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Absorption: Oral, nasal: Rapid",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Distribution: V",
    " <sub>",
    " d",
    " </sub>",
    " :",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Preterm infants (n=24; GA: 26-34 weeks; PNA: 3-11 days): Median: 1.1 L/kg
    (range: 0.4-4.2 L/kg)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Infants and Children 6 months to 16 years: 1.24-2.02 L/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Adults: 1-3.1 L/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Increased V",
    " <sub>",
    " d",
    " </sub>",
    " with CHF and chronic renal failure; widely distributed in body including CSF
    and brain; crosses placenta; enters fetal circulation; crosses into breast milk",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Protein binding: Children &gt;1 year and Adults: 97%; primarily to albumin",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Metabolism: Extensive in the liver via cytochrome P450 CYP3A4 enzyme;
    undergoes hydroxylation and then glucuronide conjugation; primary metabolite
    (alpha-hydroxy-midazolam) is active and equipotent to midazolam",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Bioavailability: Oral: 15% to 45% (syrup: 36%); I.M.: &gt;90%; intranasal:
    ~60%; rectal: &sim;40% to 50%",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Half-life, elimination: Increased half-life with cirrhosis, CHF, obesity,
    elderly, and acute renal failure",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Preterm infants (n=24; GA: 26-34 weeks; PNA: 3-11 days): Median: 6.3 hours
    (range: 2.6-17.7 hours)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Neonates: 4-12 hours; seriously ill neonates: 6.5-12 hours",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Children: I.V.: 2.9-4.5 hours; syrup: 2.2-6.8 hours",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Adults: 3 hours (range: 1.8-6.4 hours)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Elimination: 63% to 80% excreted as alpha-hydroxy-midazolam glucuronide in
    urine; &sim;2% to 10% in feces, &lt;1% eliminated as unchanged drug in the urine",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Clearance:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Preterm infants (n=24; GA: 26-34 weeks; PNA: 3-11 days): Median: 1.8
    mL/minute/kg (range: 0.7-6.7 mL/minute/kg)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Neonates &lt;39 weeks GA: 1.17 mL/minute/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Neonates &gt;39 weeks GA: 1.84 mL/minute/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Seriously ill neonates: 1.2-2 mL/minute/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Infants &gt;3 months: 9.1 mL/minute/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Children &gt;1 year: 3.2-13.3 mL/minute/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Healthy adults: 4.2-9 mL/minute/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Adults with acute renal failure: 1.9 mL/minute/kg",
    " </p>",
    " </div>",
    " <div class=\"block pai drugH1Div\" id=\"F1054076\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Patient Information",
    " </span>",
    " <p>",
    " (For additional information",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?4/6/4197?source=see_link\">",
    " see \"Midazolam: Patient drug information\"",
    " </a>",
    " )",
    " </p>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Report the use of other medications, nonprescription medications, and herbal
    or natural products to your physician and pharmacist; avoid alcohol; avoid
    grapefruit juice if taking oral midazolam",
    " </p>",
    " </div>",
    " <div class=\"block adi drugH1Div\" id=\"F1054089\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Additional Information",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Sodium content of injection: 0.14 mEq/mL. For neonates: Use preservative-free
    injection; alternatively, use the 5 mg/mL injection and dilute to 0.5 mg/mL with
    SWI without preservatives to decrease the amount of benzyl alcohol delivered to the
    neonate (since both concentrations of midazolam injection contain 1% benzyl
    alcohol). With continuous I.V. infusion, midazolam may accumulate in peripheral
    tissues; use lowest effective infusion rate to reduce accumulation effects.
    Midazolam is 3-4 times as potent as diazepam. Paradoxical reactions associated with
    midazolam use in children (eg, agitation, restlessness, combativeness) have been
    successfully treated with flumazenil (Massanari, 1997).",
    " </p>",
    " </div>",
    " </div>",
    " <div id=\"topicAgreement\">",
    " Use of UpToDate is subject to the",
    " <a class=\"licenseLink\" href=\"./license\" id=\"sla_in_page\"
    target=\"_blank\">",
    " Subscription and License Agreement",
    " </a>",
    " .",
    " </div>",
    " <div class=\"headingAnchor\" id=\"references\">",
    " <h1>",
    " REFERENCES",
    " </h1>",
    " <ol id=\"reference\">",
    " <li>",
    " <div class=\"reference\">",
    " Adrian ER, &ldquo;Intranasal Versed&reg;: The Future of Pediatric Conscious
    Sedation,&rdquo;",
    " <i>",
    " Pediatr Nurs",
    " </i>",
    " , 1994, 20(3):287-92.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/8008480/pubmed\" id=\"8008480\"
    target=\"_blank\">",
    " 8008480",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Acworth JP, Purdie D, and Clark RC, \"Intravenous Ketamine Plus Midazolam Is
    Superior to Intranasal Midazolam for Emergency Paediatric Procedural Sedation,\"",
    " <i>",
    " Emerg Med J",
    " </i>",
    " , 2001, 18(1):39-45.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/11310461/pubmed\" id=\"11310461\"
    target=\"_blank\">",
    " 11310461",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Anand KJ, Barton BA, McIntosh N, et al, \"Analgesia and Sedation in Preterm
    Neonates Who Require Ventilatory Support: Results From the NOPAIN Trial. Neonatal
    Outcome and Prolonged Analgesia in Neonates,\"",
    " <i>",
    " Arch Pediatr Adolesc Med",
    " </i>",
    " , 1999, 153(4):331-8.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/10201714/pubmed\" id=\"10201714\"
    target=\"_blank\">",
    " 10201714",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Ashrafi MR, Khosroshahi N, Karimi P, et al, \"Efficacy and Usability of
    Buccal Midazolam in Controlling Acute Prolonged Convulsive Seizures in
    Children,\"",
    " <i>",
    " Eur J Paediatr Neurol",
    " </i>",
    " , 2010, 14(5):434-8.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/20554464/pubmed\" id=\"20554464\"
    target=\"_blank\">",
    " 20554464",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Bhattacharyya M, Kalra V, and Gulati S, \"Intranasal Midazolam vs Rectal
    Diazepam in Acute Childhood Seizures,\"",
    " <i>",
    " Pediatr Neurol",
    " </i>",
    " , 2006, 34(5):355-9.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/16647994/pubmed\" id=\"16647994\"
    target=\"_blank\">",
    " 16647994",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Booker PD, Beechey A, and Lloyd-Thomas AR, &ldquo;Sedation of Children
    Requiring Artificial Ventilation Using an Infusion of Midazolam,&rdquo;",
    " <i>",
    " Br J Anaesth",
    " </i>",
    " , 1986, 58(10):1104-8.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/3533120/pubmed\" id=\"3533120\"
    target=\"_blank\">",
    " 3533120",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Boylan GB, Rennie JM, Chorley G, et al, \"Second-Line Anticonvulsant
    Treatment of Neonatal Seizures: A Video-EEG Monitoring Study,\"",
    " <i>",
    " Neurology",
    " </i>",
    " , 2004, 62(3):486-8.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/14872039/pubmed\" id=\"14872039\"
    target=\"_blank\">",
    " 14872039",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Burtin P, Jacqz-Aigrain E, Girard P, et al, &ldquo;Population
    Pharmacokinetics of Midazolam in Neonates,&rdquo;",
    " <i>",
    " Clin Pharmacol Ther",
    " </i>",
    " , 1994, 56(6 Pt 1):615-25.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/7995003/pubmed\" id=\"7995003\"
    target=\"_blank\">",
    " 7995003",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Castro Conde JR, Hern&aacute;ndez Borges AA, Dom&eacute;nech Mart&iacute;nez
    E, et al, \"Midazolam in Neonatal Seizures With No Response to Phenobarbital,\"",
    " <i>",
    " Neurology",
    " </i>",
    " , 2005, 64(5):876-9.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/15753426/pubmed\" id=\"15753426\"
    target=\"_blank\">",
    " 15753426",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Chiaretti A, Barone G, Rigante D, et al, \"Intranasal Lidocaine and
    Midazolam for Procedural Sedation in Children,\"",
    " <i>",
    " Arch Dis Child",
    " </i>",
    " , 2011, 96(2):160-3.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/21030365/pubmed\" id=\"21030365\"
    target=\"_blank\">",
    " 21030365",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " de Wildt SN, Kearns GL, Hop WC, et al, &ldquo;Pharmacokinetics and
    Metabolism of Intravenous Midazolam in Preterm Infants,&rdquo;",
    " <i>",
    " Clin Pharmacol Ther",
    " </i>",
    " , 2001, 70(6):525-31.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/11753268 /pubmed\"
    id=\"11753268 \" target=\"_blank\">",
    " 11753268",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Fi��gin T, G&uuml;rer Y, Senbil N, et al, \"Nasal Midazolam Effects on
    Childhood Acute Seizures,\"",
    " <i>",
    " J Child Neurol",
    " </i>",
    " , 2000, 15(12):833-5.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/11198507/pubmed\" id=\"11198507\"
    target=\"_blank\">",
    " 11198507",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Fi��gin T, Gurer Y, Tezi&ccedil; T, et al, \"Effects of Intranasal Midazolam
    and Rectal Diazepam on Acute Convulsions in Children: Prospective Randomized
    Study,\"",
    " <i>",
    " J Child Neurol",
    " </i>",
    " , 2002, 17(2):123-6.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/11952072/pubmed\" id=\"11952072\"
    target=\"_blank\">",
    " 11952072",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Harcke HT, Grissom LE, and Meister MA, \"Sedation in Pediatric Imaging Using
    Intranasal Midazolam,\"",
    " <i>",
    " Pediatr Radiol",
    " </i>",
    " , 1995, 25(5):341-3.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/7567258/pubmed\" id=\"7567258\"
    target=\"_blank\">",
    " 7567258",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Hayashi K, Osawa M, Aihara M, et al, \"Efficacy of Intravenous Midazolam for
    Status Epilepticus in Childhood,\"",
    " <i>",
    " Pediatr Neurol",
    " </i>",
    " , 2007, 36(6):366-72.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/17560497/pubmed\" id=\"17560497\"
    target=\"_blank\">",
    " 17560497",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Hegenbarth MA and American Academy of Pediatrics Committee on
    Drugs, \"Preparing for Pediatric Emergencies: Drugs to Consider,\"",
    " <i>",
    " Pediatrics",
    " </i>",
    " , 2008, 121(2):433-43.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/18245435/pubmed\" id=\"18245435\"
    target=\"_blank\">",
    " 18245435",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Holmes GL and Riviello JJ Jr, \"Midazolam and Pentobarbital for Refractory
    Status Epilepticus,\"",
    " <i>",
    " Pediatr Neurol",
    " </i>",
    " , 1999, 20(4):259-64.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/10328273/pubmed\" id=\"10328273\"
    target=\"_blank\">",
    " 10328273",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Holsti M, Sill BL, Firth SD, et al, \"Prehospital Intranasal Midazolam for
    the Treatment of Pediatric Seizures,\"",
    " <i>",
    " Pediatr Emerg Care",
    " </i>",
    " , 2007, 23(3):148-53.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/17413428/pubmed\" id=\"17413428\"
    target=\"_blank\">",
    " 17413428",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Holsti M, Dudley N, Schunk J, et al, \"Intranasal Midazolam vs Rectal
    Diazepam for the Home Treatment of Acute Seizures in Pediatric Patients With
    Epilepsy,\"",
    " <i>",
    " Arch Pediatr Adolesc Med",
    " </i>",
    " , 2010, 164(8):747-53.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/20679166/pubmed\" id=\"20679166\"
    target=\"_blank\">",
    " 20679166",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Igartua J, Silver P, Maytal J, et al, \"Midazolam Coma for Refractory Status
    Epilepticus in Children,\"",
    " <i>",
    " Crit Care Med",
    " </i>",
    " , 1999, 27(9):1982-5.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/10507628/pubmed\" id=\"10507628\"
    target=\"_blank\">",
    " 10507628",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Institute for Safe Medication Practices (ISMP), \"Standard Concentrations of
    Neonatal Drug Infusions,\"",
    " <i>",
    " ISMP",
    " </i>",
    " , 2011.",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Jacobi J, Fraser GL, Coursin DB, et al, \"Clinical Practice Guidelines for
    the Sustained Use of Sedatives and Analgesics in the Critically Ill Adult,\"",
    " <i>",
    " Crit Care Med",
    " </i>",
    " , 2002, 30(1):119-41.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/11902253/pubmed\" id=\"11902253\"
    target=\"_blank\">",
    " 11902253",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Jacqz-Aigrain E, Daoud P, Burtin P, et al, \"Pharmacokinetics of Midazolam
    During Continuous Infusion in Critically Ill Neonates,\"",
    " <i>",
    " Eur J Clin Pharmacol",
    " </i>",
    " , 1992, 42(3):329-32.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/1577053/pubmed\" id=\"1577053\"
    target=\"_blank\">",
    " 1577053",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Jacqz-Algrain E, Daoud P, Burtin P, et al, &ldquo;Placebo-Controlled Trial
    of Midazolam Sedation in Mechanically Ventilated Newborn Babies,&rdquo;",
    " <i>",
    " Lancet",
    " </i>",
    " , 1994, 344(8923):646-50.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/7915348 /pubmed\" id=\"7915348 \"
    target=\"_blank\">",
    " 7915348",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Jacqz-Aigrain E, Wood C, and Robieux I, \"Pharmacokinetics of Midazolam in
    Critically Ill Neonates,\"",
    " <i>",
    " Eur J Clin Pharmacol",
    " </i>",
    " , 1990, 39(2):191-2.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/2253674/pubmed\" id=\"2253674\"
    target=\"_blank\">",
    " 2253674",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Koul R, Chacko A, Javed H, et al, \"Eight-Year Study of Childhood Status
    Epilepticus: Midazolam Infusion in Management and Outcome,\"",
    " <i>",
    " J Child Neurol",
    " </i>",
    " , 2002, 17(12):908-10.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/12593465/pubmed\" id=\"12593465\"
    target=\"_blank\">",
    " 12593465",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Koul R, Raj Aithala G, Chacko A, et al, \"Continuous Midazolam Infusion as
    Treatment of Status Epilepticus,\"",
    " <i>",
    " Arch Dis Child",
    " </i>",
    " , 1997, 76(5):445-8.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/9196363/pubmed\" id=\"9196363\"
    target=\"_blank\">",
    " 9196363",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Kumar P, Denson SE, Mancuso TJ, et al, \"Premedication for Nonemergency
    Endotracheal Intubation in the Neonate,\"",
    " <i>",
    " Pediatrics",
    " </i>",
    " , 2010, 125(3):608-15.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/20176672/pubmed\" id=\"20176672\"
    target=\"_blank\">",
    " 20176672",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Kupietzky A and Houpt MI, &ldquo;Midazolam: A Review of Its Use for
    Conscious Sedation of Children,&rdquo;",
    " <i>",
    " Pediatr Dent",
    " </i>",
    " , 1993, 15(4):237-41.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/8247896/pubmed\" id=\"8247896\"
    target=\"_blank\">",
    " 8247896",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Kutlu NO, Yakinci C, Dogrul M, et al, \"Intranasal Midazolam for Prolonged
    Convulsive Seizures,\"",
    " <i>",
    " Brain Dev",
    " </i>",
    " , 2000, 22(6):359-61.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/11042416/pubmed\" id=\"11042416\"
    target=\"_blank\">",
    " 11042416",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Lam C, Udin RD, Malamed SF, et al, \"Midazolam Premedication in Children: A
    Pilot Study Comparing Intramuscular and Intranasal Administration,\"",
    " <i>",
    " Anesth Prog",
    " </i>",
    " , 2005, 52(2):56-61.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/16048152/pubmed\" id=\"16048152\"
    target=\"_blank\">",
    " 16048152",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Lane RD and Schunk JE, \"Atomized Intranasal Midazolam Use for Minor
    Procedures in the Pediatric Emergency Department,\"",
    " <i>",
    " Pediatr Emerg Care",
    " </i>",
    " , 2008, 24(5):300-3.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/18496113/pubmed\" id=\"18496113\"
    target=\"_blank\">",
    " 18496113",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Ljungman G, Kreuger A, Andreasson S, et al, &ldquo;Midazolam Nasal Spray
    Reduces Procedural Anxiety in Children,&rdquo;",
    " <i>",
    " Pediatrics",
    " </i>",
    " , 2000, 105(1 Pt 1):73-8.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/10617707/pubmed\" id=\"10617707\"
    target=\"_blank\">",
    " 10617707",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Lowenstein DH, \"Treatment Options for Status Epilepticus,\"",
    " <i>",
    " Curr Opin Pharmacol",
    " </i>",
    " , 2005, 5(3):334-9.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/15907922/pubmed\" id=\"15907922\"
    target=\"_blank\">",
    " 15907922",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Lugo RA, Fishbein M, Nahata MC, et al, &ldquo;Complication of Intranasal
    Midazolam,&rdquo;",
    " <i>",
    " Pediatrics",
    " </i>",
    " , 1993, 92(4):638.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/8414846 /pubmed\" id=\"8414846 \"
    target=\"_blank\">",
    " 8414846",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Magny JF, Zupan V, Dehan M, et al, &ldquo;Midazolam and Myoclonus in
    Neonate,&rdquo;",
    " <i>",
    " Eur J Pediatr",
    " </i>",
    " , 1994, 153(5):389-90.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/8033934 /pubmed\" id=\"8033934 \"
    target=\"_blank\">",
    " 8033934",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Malamed SF, Quinn CL, and Hatch HG, \"Pediatric Sedation With Intramuscular
    and Intravenous Midazolam,\"",
    " <i>",
    " Anesth Prog",
    " </i>",
    " , 1989, 36(4-5):155-7.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/2490015/pubmed\" id=\"2490015\"
    target=\"_blank\">",
    " 2490015",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Malinovsky JM, Populaire C, Cozian A, et al, &ldquo;Premedication With
    Midazolam in Children, Effect of Intranasal, Rectal and Oral Routes on Plasma
    Midazolam Concentrations,&rdquo;",
    " <i>",
    " Anaesthesia",
    " </i>",
    " , 1995, 50(4):351-4.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/7747857 /pubmed\" id=\"7747857 \"
    target=\"_blank\">",
    " 7747857",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Massanari M, Novitsky J, and Reinstein LJ, &ldquo;Paradoxical Reactions in
    Children Associated With Midazolam Use During Endoscopy,&rdquo;",
    " <i>",
    " Clin Pediatr",
    " </i>",
    " , 1997, 36(12):681-4.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/9415834 /pubmed\" id=\"9415834 \"
    target=\"_blank\">",
    " 9415834",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " McIntyre J, Robertson S, Norris E, et al, \"Safety and Efficacy of Buccal
    Midazolam Versus Rectal Diazepam for Emergency Treatment of Seizures in Children: A
    Randomised Controlled Trial,\"",
    " <i>",
    " Lancet",
    " </i>",
    " , 2005, 366(9481):205-10.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/16023510/pubmed\" id=\"16023510\"
    target=\"_blank\">",
    " 16023510",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Meierkord H, Boon P, Engelsen B, et al, \"EFNS Guideline on the Management
    of Status Epilepticus in Adults,\"",
    " <i>",
    " Eur J Neurol",
    " </i>",
    " , 2010, 17(3):348-55.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/20050893/pubmed\" id=\"20050893\"
    target=\"_blank\">",
    " 20050893",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Mittal P, Manohar R, and Rawat AK, \"Comparative Study of Intranasal
    Midazolam and Intravenous Diazepam Sedation for Procedures and Seizures,\"",
    " <i>",
    " Indian J Pediatr",
    " </i>",
    " , 2006, 73(11):975-8.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/17127776/pubmed\" id=\"17127776\"
    target=\"_blank\">",
    " 17127776",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Morrison GC and Whitehouse WP, \"High-Dose Midazolam in Convulsive Status
    Epilepticus,\"",
    " <i>",
    " Pediatr Neurol",
    " </i>",
    " , 2008, 39(3):221.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/18725073/pubmed\" id=\"18725073\"
    target=\"_blank\">",
    " 18725073",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Morrison G, Gibbons E, and Whitehouse WP, \"High-Dose Midazolam Therapy for
    Refractory Status Epilepticus in Children,\"",
    " <i>",
    " Intensive Care Med",
    " </i>",
    " , 2006, 32(12):2070-6.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/16977485/pubmed\" id=\"16977485\"
    target=\"_blank\">",
    " 16977485",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Mpimbaza A, Ndeezi G, Staedke S, et al, \"Comparison of Buccal Midazolam
    With Rectal Diazepam in the Treatment of Prolonged Seizures in Ugandan Children: A
    Randomized Clinical Trial,\"",
    " <i>",
    " Pediatrics",
    " </i>",
    " , 2008, 121(1):58-64.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/18166545/pubmed\" id=\"18166545\"
    target=\"_blank\">",
    " 18166545",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Mulla H, Lawson G, Woodland ED, et al, \"Effects of Neonatal Extracorporeal
    Membrane Oxygenation Circuits on Drug Disposition,\"",
    " <i>",
    " Curr Ther Res Clin Exp",
    " </i>",
    " , 2000, 61:838-48.",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Ozdemir D, Gulez P, Uran N, et al, \"Efficacy of Continuous Midazolam
    Infusion and Mortality in Childhood Refractory Generalized Convulsive Status
    Epilepticus,\"",
    " <i>",
    " Seizure",
    " </i>",
    " , 2005, 14(2):129-32.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/15694567/pubmed\" id=\"15694567\"
    target=\"_blank\">",
    " 15694567",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Phillips MS, \"Standardizing I.V. Infusion Concentrations: National Survey
    Results,\"",
    " <i>",
    " Am J Health Syst Pharm",
    " </i>",
    " , 2011, 68(22):2176-82.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/22058104/pubmed\" id=\"22058104\"
    target=\"_blank\">",
    " 22058104",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Riva J, Lejbusiewicz G, Papa M, et al, &ldquo;Oral Premedication With
    Midazolam in Paediatric Anaesthesia. Effects on Sedation and Gastric
    Contents,&rdquo;",
    " <i>",
    " Paediatr Anaesth",
    " </i>",
    " , 1997, 7(3):191-6.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/9189963/pubmed\" id=\"9189963\"
    target=\"_blank\">",
    " 9189963",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Rivera R, Segnini M, Baltodano A, et al, &ldquo;Midazolam in the Treatment
    of Status Epilepticus in Children,&rdquo;",
    " <i>",
    " Crit Care Med",
    " </i>",
    " , 1993, 21(7):991-4.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/8319479/pubmed\" id=\"8319479\"
    target=\"_blank\">",
    " 8319479",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Silbergleit R, Durkalski V, Lowenstein D, et al, \"Intramuscular Versus
    Intravenous Therapy for Prehospital Status Epilepticus,\"",
    " <i>",
    " N Engl J Med",
    " </i>",
    " , 2012, 366(7):591-600.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/22335736/pubmed\" id=\"22335736\"
    target=\"_blank\">",
    " 22335736",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Silvasi DL, Rosen DA, and Rosen KR, &ldquo;Continuous Intravenous Midazolam
    Infusion for Sedation in the Pediatric Intensive Care Unit,&rdquo;",
    " <i>",
    " Anesth Analg",
    " </i>",
    " , 1988, 67(3):286-8.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/3344980 /pubmed\" id=\"3344980 \"
    target=\"_blank\">",
    " 3344980",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Singh N, Pandey RK, Saksena AK, et al, \"A Comparative Evaluation of Oral
    Midazolam With Other Sedatives as Premedication in Pediatric Dentistry,\"",
    " <i>",
    " J Clin Pediatr Dent",
    " </i>",
    " , 2002, 26(2):161-4.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/11874008/pubmed\" id=\"11874008\"
    target=\"_blank\">",
    " 11874008",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Talukdar B and Chakrabarty B, \"Efficacy of Buccal Midazolam Compared to
    Intravenous Diazepam in Controlling Convulsions in Children: A Randomized
    Controlled Trial,\"",
    " <i>",
    " Brain Dev",
    " </i>",
    " , 2009, 31(10):744-9.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/19114297/pubmed\" id=\"19114297\"
    target=\"_blank\">",
    " 19114297",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Treluyer JM, Zohar S, Rey E, et al, \"Minimum Effective Dose of Midazolam
    for Sedation of Mechanically Ventilated Neonates,\"",
    " <i>",
    " J Clin Pharm Ther",
    " </i>",
    " , 2005, 30(5):479-85.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/16164495/pubmed\" id=\"16164495\"
    target=\"_blank\">",
    " 16164495",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " VanLooy JW, Schumacher RE, and Bhatt-Mehta V, \"Efficacy of a Premedication
    Algorithm for Nonemergent Intubation in a Neonatal Intensive Care Unit,\"",
    " <i>",
    " Ann Pharmacother",
    " </i>",
    " , 2008, 42(7):947-55.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/18594052/pubmed\" id=\"18594052\"
    target=\"_blank\">",
    " 18594052",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Wang Z, Gorski JC, Hamman MA, et al, &ldquo;The Effects of St John's Wort
    (",
    " <i>",
    " Hypericum perforatum",
    " </i>",
    " ) on Human Cytochrome P450 Activity,&rdquo;",
    " <i>",
    " Clin Pharmacol Ther",
    " </i>",
    " , 2001, 70(4):317-26.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/ 11673747 /pubmed\" id=\" 11673747
    \" target=\"_blank\">",
    " 11673747",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Yoshikawa H, Yamazaki S, Abe T, et al, \"Midazolam as a First-Line Agent for
    Status Epilepticus in Children,\"",
    " <i>",
    " Brain Dev",
    " </i>",
    " , 2000, 22(4):239-42.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/46/746/abstract-text/10838111/pubmed\" id=\"10838111\"
    target=\"_blank\">",
    " 10838111",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " </ol>",
    " </div>",
    " <div id=\"topicVersionRevision\">",
    " Topic 12611 Version 43.0",
    " </div>",
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    " |",
    " </span>",
    " Release: 21.6- C21.56",
    " </span>",
    " <br/>",
    " <span class=\"sfInfo\">",
    " Licensed to:",
    " <span class=\"emphasis\">",
    " AsanBook Dig. Med. Lib.",
    " </span>",
    " </span>",
    " <span class=\"sfInfo\">",
    " <span class=\"pipeSpace\">",
    " |",
    " </span>",
    " Support Tag: [1104-61.234.146.186-7CA0D077E0-S244013.14]",
    " <br/>",
    " </span>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
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    " <div id=\"innerOutline\">",
    " <h1>",
    " TOPIC OUTLINE",
    " </h1>",
    " <div id=\"outline\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F5709086\">",
    " ALERT: U.S. Boxed Warning",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F196443\">",
    " Brand Names: Canada",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054079\">",
    " Therapeutic Category",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F11443890\">",
    " Dosing: Neonatal",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054071\">",
    " Dosing: Usual",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F196415\">",
    " Dosage Forms: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F196399\">",
    " Generic Equivalent Available: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F196491\">",
    " Controlled Substance",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054084\">",
    " Administration",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F14472926\">",
    " Usual Infusion Concentrations: Neonatal",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F14472925\">",
    " Usual Infusion Concentrations: Pediatric",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F196496\">",
    " Compatibility",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054074\">",
    " Stability",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054083\">",
    " Use",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F196498\">",
    " Medication Safety Issues",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F196495\">",
    " Adverse Reactions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054088\">",
    " Contraindications",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054070\">",
    " Precautions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054069\">",
    " Warnings",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F196481\">",
    " Metabolism/Transport Effects",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F196408\">",
    " Drug Interactions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054091\">",
    " Food Interactions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F196410\">",
    " Pregnancy Risk Factor",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F196425\">",
    " Pregnancy Implications",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054078\">",
    " Monitoring Parameters",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054068\">",
    " Mechanism of Action",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054086\">",
    " Pharmacodynamics",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054087\">",
    " Pharmacokinetics (Adult data unless noted)",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054076\">",
    " Patient Information",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F1054089\">",
    " Additional Information",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a href=\"#references\">",
    " REFERENCES",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " <div class=\"openRelatedGraphics\" id=\"DRUG_PED/12611\"
    rel=\"outline_link\">",
    " GRAPHICS",
    " <a class=\"graphics_icon\" href=\"#\" title=\"View All Related Graphics\">",
    " View All",
    " </a>",
    " </div>",
    " </h1>",
    " <div id=\"relatedGraphics\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <div class=\"openRelatedGraphics\" id=\"DRUG_PED/12611|TAB\">",
    " <a href=\"#\" title=\"TABLES\">",
    " TABLES",
    " </a>",
    " </div>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?23/39/24183\"
    title=\"Lexicomp clinical abbreviations\">",
    " Lexicomp clinical abbreviations",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " RELATED TOPICS",
    " </h1>",
    " <div id=\"relatedTopics\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"drug drug_general\" href=\"UTD.htm?3/60/4042?
    source=related_link\">",
    " Midazolam: Drug information",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?4/6/4197?
    source=related_link\">",
    " Midazolam: Patient drug information",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " </div>"].join("\n");
    var title_f0_46_747="LEMON mnemonic";
    var content_f0_46_747=[" <div id=\"graphicsToolbar\">",
    " <div id=\"graphicsCopy\">",
    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
    " </sup>",
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    " <div id=\"graphicsLinks\">",
    " <a href=\"?imageKey=EM
    %2F64336&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=2\" onclick=\"\">",
    " <img alt=\"Print this page\" src=\"./../images/icn_print.myextg\"
    title=\"Print this page\"/>",
    " </a>",
    " <a class=\"icontxt textLink\" href=\"?imageKey=EM
    %2F64336&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=2\" onclick=\"\"
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    " Print",
    " </a>",
    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\">",
    " <div class=\"ttl\">",
    " The LEMON&copy; mnemonic for predicting the difficult emergency airway",
    " </div>",
    " <div class=\"cntnt\">",
    " <table cellspacing=\"0\">",
    " <tbody>",
    " <tr>",
    " <td>",
    " <strong>",
    " L",
    " </strong>",
    " ook externally",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " <strong>",
    " E",
    " </strong>",
    " valuate 3-3-2",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " <strong>",
    " M",
    " </strong>",
    " allampati",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " <strong>",
    " O",
    " </strong>",
    " bstruction/",
    " <strong>",
    " O",
    " </strong>",
    " besity",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " <strong>",
    " N",
    " </strong>",
    " eck mobility",
    " </td>",
    " </tr>",
    " </tbody>",
    " </table>",
    " </div>",
    " <div class=\"lgnd\">",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " &copy; The Difficult Airway Course&reg;: Emergency.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_46_747=[""].join("\n");
    var outline_f0_46_747=null;
    var title_f0_46_748="Paraphimosis reduction summary";
    var content_f0_46_748=[" <div id=\"graphicsToolbar\">",
    " <div id=\"graphicsCopy\">",
    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
    " </sup>",
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    " <div id=\"graphicsLinks\">",
    " <a href=\"?imageKey=EM
    %2F56148&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=2\" onclick=\"\">",
    " <img alt=\"Print this page\" src=\"./../images/icn_print.myextg\"
    title=\"Print this page\"/>",
    " </a>",
    " <a class=\"icontxt textLink\" href=\"?imageKey=EM
    %2F56148&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=2\" onclick=\"\"
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    " Print",
    " </a>",
    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\">",
    " <div class=\"ttl\">",
    " Paraphimosis reduction: procedure summary",
    " </div>",
    " <div class=\"cntnt\">",
    " <table cellspacing=\"0\">",
    " <tr>",
    " <td>",
    " 1. Remove any foreign bodies or constricting bands.",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " 2. Inspect the penis for signs of glans penis necrosis (blue/black color
    and firmness to palpation).",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " 3. If necrosis is present, emergently consult urology and prepare for
    immediate reduction by urology utilizing procedural sedation in the ED or general
    anesthesia in the OR.",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"sublist1_start\">",
    " 4. If glans penis necrosis is not present (glans penis is pink and soft),
    provide pain control and proceed with minimally invasive reduction methods:
    (see \"Procedure\", section on Minimally invasive reduction).",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"sublist2\">",
    " a. Apply adjuncts (ice, compression, and/or granulated sugar) to reduce
    swelling.",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"sublist2\">",
    " b. Ensure efficacy of chosen method of pain control.",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"sublist2\">",
    " c. Perform manual reduction by providing manual circumferential compression
    for several minutes followed by manual reduction. (See figure \"Manual reduction
    procedure\").",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"sublist2\">",
    " d. If manual reduction is unsuccessful, perform foreskin traction using
    Babcock or Adson forceps. (See figure \"Traction with forceps\").",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"sublist1_start\">",
    " 5. If paraphimosis is still not reduced, advance to invasive reduction
    methods. (See \"Procedure\", section on Invasive reduction):",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"sublist2\">",
    " a. Consult urology.",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"sublist2\">",
    " b. Perform puncture technique using a 25 gauge or smaller needle after
    ensuring appropriate pain control with local or parenteral medications.",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"sublist2\">",
    " c. Reattempt manual reduction.",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " 6. If unsuccessful, prepare for needle aspiration of the glans penis or
    dorsal slit procedure by the urologist.",
    " </td>",
    " </tr>",
    " </table>",
    " </div>",
    " <div class=\"lgnd\">",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
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    var title_f0_46_749="Black box antidepressants";
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    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
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    " <div id=\"graphicsLinks\">",
    " <a href=\"?imageKey=PEDS
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    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\">",
    " <div class=\"ttl\">",
    " List of antidepressant drugs receiving a boxed warning, other product labeling
    changes, and a medication guide pertaining to pediatric suicidality",
    " </div>",
    " <div class=\"cntnt\">",
    " <table cellspacing=\"0\" class=\"container\">",
    " <tbody>",
    " <tr>",
    " <td class=\"container\">",
    " <table cellspacing=\"0\">",
    " <tbody>",
    " <tr>",
    " <td>",
    " Anafranil (clomipramine HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Asendin (amoxapine)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Aventyl (nortriptyline HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Celexa (citalopram HBr)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Cymbalta (duloxetine HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Desyrel (trazodone HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Effexor (venlafaxine HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Elavil (amitriptyline HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Etrafon (perphenazine/amitriptyline)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Lexapro (escitalopram oxalate)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Limbitrol (chlordiazepoxide/amitriptyline)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Ludiomil (Maprotiline HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Luvox (fluvoxamine maleate)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Marplan (isocarboxazid)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Nardil (phenelzine sulfate)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Norpramin (desipramine HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Pamelor (nortriptyline HCl)",
    " </td>",
    " </tr>",
    " </tbody>",
    " </table>",
    " </td>",
    " <td class=\"container\">",
    " <table cellspacing=\"0\">",
    " <tbody>",
    " <tr>",
    " <td>",
    " Parnate (tranylcypromine sulfate)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Paxil (paroxetine HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Pexeva (paroxetine mesylate)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Prozac (fluoxetine HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Remeron (mirtazapine)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Sarafem (fluoxetine HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Serzone (nefazodone HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Sinequan (doxepin HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Surmontil (trimipramine)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Symbyax (olanzapine/fluoxetine)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Tofranil (imipramine HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Tofranil-PM (impiramine pamoate)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Triavil (Perphenaine/Amitriptyline)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Vivactil (protriptyline HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Wellbutrin (bupropion HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Zoloft (sertraline HCl)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Zyban (bupropion HCl)",
    " </td>",
    " </tr>",
    " </tbody>",
    " </table>",
    " </td>",
    " </tr>",
    " </tbody>",
    " </table>",
    " </div>",
    " <div class=\"lgnd\">",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " Available at: www.fda.gov/cder/drug/antidepressants (Accessed January 9,
    2007).",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
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    var title_f0_46_750="Obesity in HIV lipodystrophy";
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    " &copy;2013 UpToDate",
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    " Email",
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    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\" style=\"width: 484px\">",
    " <div class=\"ttl\">",
    " Obesity in HIV lipodystrophy",
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    " </div>",
    " <div class=\"lgnd\">",
    " The distinguishing feature of HIV-associated lipodystrophy is that visceral
    fat deposition is accompanied by normal or decreased (but not increased) amounts of
    subcutaneous fat. In this situation, waist circumference may not change.",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " Courtesy of Christine A Wanke, MD.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_46_750=[""].join("\n");
    var outline_f0_46_750=null;
    var title_f0_46_751="Nomogram to predict survival in terminally ill cancer
    patients";
    var content_f0_46_751=[" <div id=\"graphicsToolbar\">",
    " <div id=\"graphicsCopy\">",
    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
    " </sup>",
    " </div>",
    " <div id=\"graphicsLinks\">",
    " <a href=\"?imageKey=ONC
    %2F70086&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=1\" onclick=\"\">",
    " <img alt=\"Print this page\" src=\"./../images/icn_print.myextg\"
    title=\"Print this page\"/>",
    " </a>",
    " <a class=\"icontxt textLink\" href=\"?imageKey=ONC
    %2F70086&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=1\" onclick=\"\"
    title=\"Print this page\">",
    " Print",
    " </a>",
    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\" style=\"width: 618px\">",
    " <div class=\"ttl\">",
    " Nomogram to predict the probability of survival at 15, 30, and 60 days in
    terminally ill cancer patients",
    " </div>",
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    " </div>",
    " <div class=\"lgnd\">",
    " Nomogram for predicting the probability of 15-, 30-, and 60-day survival in
    terminally ill cancer patients. Points are assigned for time from intial diagnosis
    to diagnosis of terminal disease (TTD), Eastern Cooperative Oncology Group
    performance status (ECOG PS), serum albumin levels, serum lactate dehydrogenase
    (LDH) levels, and lymphocyte count by drawing a line upward from the corresponding
    values to the Points line. The sum of these five points is plotted on the total
    points line. The total points line yields prediction of 15-, 30-, and 60-day
    survival by drawing a line downward.",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " Reproduced from: Feliu J, Jim&eacute;nez-Gordo AM, Madero R, et al.
    Development and validation of a prognostic nomogram for terminally ill cancer
    patients. J Natl Cancer Inst 2011; 103:1613, by permission of Oxford University
    Press. Copyright &copy; 2011.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_46_751=[""].join("\n");
    var outline_f0_46_751=null;

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