This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.
- This drug may cause severe side effects like irritated or torn tendons; nerve problems in the arms, hands, legs, or feet; and nervous system problems. These can happen alone or at the same time. They can happen within hours to weeks after starting this drug. Some of these effects may not go away, and may lead to disability or death.
- The chance of irritated or torn tendons is greater in people over the age of 60; heart, kidney, or lung transplant patients; or people taking steroid drugs. Tendon problems can happen as long as several months after treatment. Call your doctor right away if you have pain, bruising, or swelling in the back of the ankle, shoulder, hand, or other joints. Call your doctor right away if you are not able to move or bear weight on a joint or if you hear or feel a snap or pop.
- Call your doctor right away if you have signs of nerve problems. These may include not being able to handle heat or cold; change in sense of touch; or burning, numbness, tingling, pain, or weakness in the arms, hands, legs, or feet.
- Call your doctor right away if you have signs of nervous system problems. These may include anxiety, bad dreams, trouble sleeping, change in eyesight, dizziness, feeling confused, feeling nervous or agitated, feeling restless, hallucinations (seeing or hearing things that are not there), new or worse behavior or mood changes like depression or thoughts of suicide, seizures, or very bad headaches.
- A type of abnormal heartbeat (prolonged QT interval) can happen with this drug. Call your doctor right away if you have a fast heartbeat, a heartbeat that does not feel normal, or if you pass out.
- Very bad and sometimes deadly allergic reactions have rarely happened with other forms of this drug as well as drugs like this one. Talk with the doctor.
- This drug has not been used much during pregnancy. There may be a risk of harm to the bones of the unborn baby if this drug is used during pregnancy. If you are pregnant or plan on getting pregnant while taking this drug, talk with your doctor about treatment options.
- Do not take if you have myasthenia gravis. Very bad and sometimes deadly breathing problems have happened with this drug in people who have myasthenia gravis.
- It is used to treat cystic fibrosis.
- If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
- If you have any of these health problems: Long QT on ECG or low potassium levels.
- If you have some types of heart problems like slow heartbeat.
- If you have ever had a heart attack.
- If you have kidney disease.
- If you have ever had any of these health problems: Nerve problems or tendon problems.
- If you have had tendons get irritated or torn when taking this drug or an alike drug in the past.
- If you have an aortic aneurysm (ballooning or bulging of the aorta, the main blood vessel that comes out of the heart) or you are at risk for this health problem. This includes if you have other blood vessel problems, high blood pressure, or certain health problems like Marfan syndrome or Ehlers-Danlos syndrome.
- If you have been taking any drugs to treat a heartbeat that is not normal.
- If you are taking any drugs that can cause a certain type of heartbeat that is not normal (prolonged QT interval). There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure.
- If the patient is a child. Do not give this drug to a child.
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
- Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
- Avoid driving and doing other tasks or actions that call for you to be alert or have clear eyesight until you see how this drug affects you.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- This drug may affect certain lab tests. Be sure your doctor and lab workers know you use this drug.
- High and low blood sugar has happened with drugs like this one. Most of the time, low blood sugar happened in people with diabetes who were taking drugs that lower blood sugar like insulin. Very low blood sugar has led to coma and sometimes death. Check blood sugar as you have been told by the doctor.
- Tell your doctor if you have signs of high or low blood sugar like breath that smells like fruit, dizziness, fast breathing, fast heartbeat, feeling confused, feeling sleepy, feeling weak, flushing, headache, unusual thirst or hunger, passing urine more often, shaking, or sweating.
- Be careful if you have low levels of an enzyme called G6PD. Anemia may happen. Low levels of G6PD may be more likely in patients of African, South Asian, Middle Eastern, and Mediterranean descent.
- Breathing problems can happen right after taking a dose. If you have breathing problems after using this drug, use a rescue inhaler and talk with your doctor. You may need to use a rescue inhaler before doses of this drug in the future.
- You may get sunburned more easily. Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
- Liver problems have rarely happened with this drug. Sometimes, this has been deadly. Call your doctor right away if you have signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
- If you are over the age of 60, use this drug with care. You could have more side effects.
- Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of a very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in the mouth, throat, nose, or eyes.
- Chest pain or pressure.
- Not able to pass urine or change in how much urine is passed.
- Muscle pain or weakness.
- Fever, chills, or sore throat; any unexplained bruising or bleeding; or feeling very tired or weak.
- Change in eyesight, eye pain, or severe eye irritation.
- Coughing up blood.
- Diarrhea is common with antibiotics. Rarely, a severe form called C diff–associated diarrhea (CDAD) may happen. Sometimes, this has led to a deadly bowel problem. CDAD may happen during or a few months after taking antibiotics. Call your doctor right away if you have stomach pain, cramps, or very loose, watery, or bloody stools. Check with your doctor before treating diarrhea.
- A rare but severe problem with the main blood vessel that comes out of the heart (aorta) has happened within 2 months after taking drugs like this one, especially in older patients. This includes tears or bursting of the aorta. This can lead to severe bleeding and even death. The cause for this effect is not known. Call your doctor right away if you have sudden pain in the stomach, chest, or back that is severe and does not go away.
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Change in taste.
- More sputum.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
- You will use by breathing in from the mouth with a special machine (nebulizer). Your doctor will teach you the right way to use.
- Only use the type of nebulizer that you have been told to use. If you are not sure what type of nebulizer to use, talk with the doctor.
- Do not mix with any other liquid drugs.
- Do not mix other drugs in nebulizer.
- Do not open the ampule until you are ready to take a dose. Throw away any part of the opened ampule not used after the dose is given.
- This drug is clear and yellow.
- Do not use if solution changes color.
- Do not use if the solution is cloudy, leaking, or has particles.
- Follow how to clean the nebulizer carefully.
- If you are taking more than 1 inhaled drug, talk to your doctor about the best order for taking your drugs.
- Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.
- Take with or without food.
- Take a missed dose as soon as you think about it.
- If it is less than 8 hours until your next dose, skip the missed dose and go back to your normal time.
- Do not take 2 doses at the same time or extra doses.
- Store at room temperature.
- Store in the original container to protect from light.
- After opening the packet, use within 4 days. Throw away any drug in the open packet not used after 4 days, even if some drug is left.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
- If your symptoms or health problems do not get better or if they become worse, call your doctor.
- Do not share your drugs with others and do not take anyone else’s drugs.
- Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
- Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
- If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
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