More Information About - Pulmoten 62.5 mg Tab. 62.5mg
Description
Generic Name
Bosentan
Precaution
Hepatotoxicity and teratogenicity. Elevations of AST or ALT associated with Bosentan are dose-dependent, occur both early and late in treatment, usually progress slowly, are typically asymptomatic, and usually have been reversible after treatment interruption or cessation. Aminotransferase elevations also may reverse spontaneously while continuing treatment with Tracleer.
Liver aminotransferase levels must be measured prior to initiation of treatment and then monthly and therapy adjusted accordingly .Discontinue Bosentan if liver aminotransferase elevations are accompanied by clinical symptoms of hepatotoxicity (such as nausea, vomiting, fever, abdominal pain, jaundice, or unusual lethargy or fatigue) or increases in bilirubin > 2
Lactation: Not known if excreted in breast milk; not recommended
Indication
Pulmonary Arterial Hypertension (PAH)
Contra Indication
Patients with WHO Class II symptoms showed reduction in the rate of clinical deterioration and a trend for improvement in walk distance. Physicians should consider whether these benefits are sufficient to offset the risk of hepatotoxicity in WHO Class II patients, which may preclude future use as their disease progresses.
FDA has not yet classified the drug into a specified pregnancy category.
Mode of Action
Competitive antagonist of endothelin-1; blocks endothelin receptors on vascular endothelium and smooth muscle resulting in inhibition of vasoconstriction
Pregnancy
Based on animal data, bosentan may cause fetal harm, including birth defects and fetal death, when administered to a pregnant female and is contraindicated during pregnancy; see Contraindications and Black Box Warnings
In animal reproduction studies, oral administration of bosentan to pregnant rats at 2 times the maximum recommended human dose (MRHD) on a mg/m2 basis caused teratogenic effects in rats (eg, malformations of the head, mouth, face, and large blood vessels)
Advise pregnant women of the potential risk to a fetus
Patient should contact her physician immediately for pregnancy testing if onset of menses is delayed or pregnancy is suspected
If the pregnancy test is positive, the physician and patient must discuss the risks to her, the pregnancy, and the fetus
Based on findings in animals, bosentan may impair fertility in males of reproductive potential; It is unknown whether effects on fertility would be reversible
Lactation
There are no data on the presence of bosentan in human milk, the effects on the breastfed infant, or the effect on milk production
Because of the potential for serious adverse reactions, such as fluid retention and hepatotoxicity, in breastfed infants from bosentan, advise women not to breastfeed during treatment with bosentan
Adult Dose
Oral
Pulmonary hypertension
Adult: >12 yr <40 kg: Initial and maintenance dose is 62.5 mg bid; >40 kg: Initially, 62.5 mg bid for 4 wk, then increased to a maintenance dose of 125 mg bid.
Elderly: No dosage adjustment needed.
Hepatic impairment: Mild: No dosage adjustment needed. Moderate and severe: Contraindicated.
Child Dose
N/A
Renal Dose
Renal impairment: No dosage adjustment needed in renal impairment or dialysis patients.
Administration
Bosentan should be administered in the morning and evening with or without food.
Disclaimer
The information provided herein are for informational purposes only and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please note that this information should not be treated as a replacement for physical medical consultation or advice. Great effort has been placed to provide accurate and comprehensive data. However, Medicart along with its authors and editors make no representations or warranties and specifically disclaim all liability for any medical information provided on the site. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company.