Dosage. Child 1 month to 18 years1: The licensed dosing schedule (children of 3 years and over#) for glycopyrronium is based on the weight of the child, starting with approximately 12.8 micrograms/kg per dose three times per day and increasing by the doses listed in the SPC every 7 days. Dose titration should be continued until efficacy is balanced with undesirable effects and amended up or down as appropriate, to a maximum individual dose of 64 micrograms/kg body weight glycopyrronium or 6 ml (1.9 mg glycopyrronium) three times a day, whichever is less. Following the dose titration period, the child's sialorrhoea should be monitored, in conjunction with the carer at no longer than 3 monthly intervals, to assess changes in efficacy and/or tolerability over time, and the dose adjusted accordingly. # Sialanar is not recommended in children below the age of 3 years since there is very limited data on the efficacy and safety of glycopyrronium in this age group Adult population - Sialanar® is indicated for the paediatric population only. There is limited clinical trial evidence on the use of glycopyrronium in the adult population with pathological drooling. Prescribers may consider the unlicensed use of Sialanar for the treatment of hypersalivation in this population following current evidence based guidance3,4 Dosing should be at ≥1 hour before or at least 2 hours after meals or at consistent times with respect to food intake. Avoid high fat food. Monitoring1: The SPC advises that the efficacy of the medicinal product should be balanced against the adverse reactions and the dose monitored regularly and adjusted as necessary. The SPC specifically highlights the importance of monitoring for anticholinergic effects such as urinary retention, constipation and overheating due to inhibition of sweating, which may be dose dependent and difficult to assess in a disabled child. Behavioural changes should also be monitored. In accordance with good practice guidelines annual review would be expected. Contraindications1: Hypersensitivity to the active substance or to any of the excipients. Pregnancy and breast-feeding. Glaucoma. Urinary retention. Severe renal impairment (eGFR <30 ml/min/1.73m2), including those with end-stage renal disease requiring dialysis. History of intestinal obstruction, ulcerative colitis, paralytic ileus, pyloric stenosis and myasthenia gravis. Concomitant treatment with potassium chloride solid oral dose and/or anticholinergics. Cautions1: In the event ...
Dosage. The regulated articles must receive the minimum absorbed ionizing radiation dose specified in the PPQ Treatment Manual or in another approved treatment schedule.
Dosage. There is a marked variation in dose requirements for patients with myeloproliferative disease. The usual range is 500mg to 2g a day. In order to obtain a stable level of control patients often take different doses on different days to get the desired effect. The dose will be established and monitored by the Haematology Department. Hydroxycarbamide must always be prescribed and dispensed as 500mg capsules, either generic hydroxycarbamide 500mg capsules or Hydrea® 500mg capsules. Hydroxycarbamide tablets 100mg or 1g (Siklos®) are specifically licensed for the treatment of sickle cell disease only and must not be used for patients with myeloproliferative disease or CML (patient confusion and incorrect dosing has been reported). Generally, hydroxycarbamide is used to lower and manage initial high counts of abnormal cell lines. For example in essential thrombocythaemia, doses should be adjusted to maintain a platelet count of 200 – 400 x109/L without lowering WBC below 4 x 109/L. Renal impairment: Although the dose will be titrated according to response, impaired renal function may affect drug clearance. There are no specific dose recommendations however. Administration Hydroxycarbamide is usually taken in the mornings. It is possible to split the dose when the daily dose is higher. There are no other special requirements for administration. Hospital Specialist Responsibilities • Inform the patient of side effects and need for long-term monitoring before initiating treatment. • Provide information to the patient such as disease specific information and patient information sheets (e.g. from Macmillan). • Consent patient for this treatment and provide the patient with a carbon copy of the consent form. • Initiate treatment and prescribe hydroxycarbamide for a minimum of the first six weeks. • Monitor and establish safety and efficacy over the first three months of therapy. • Review patient in clinic. • Disease and drug monitoring as listed below, including hydroxycarbamide dose adjustments. • Inform the GP when they have initiated hydroxycarbamide • Specifically request GP via patient letters to add hydroxycarbamide to the repeat prescription list. To do this use the Shared Care Agreement Form which is available on consent / chart printing section of Pharmacy intranet pages. This shared care guideline must also be sent to the GP. Disease and drug monitoring The frequency of monitoring is determined by clinical need. At each appointment we test • Full blood count ...
Dosage. Structure 40% to 70% of high-risk offenders' time for 3 to 9 months.
Dosage. The prescribed dosage(s) are not appropriate to the age and condition for which it is being prescribed and/or exceeds the recommended dosages based on the age or weight of the child, guidance from the FDA, and/or other scientific literature on maximum dosages;
Dosage. Average four (4) hours per client per month.
Dosage. 17.1. Licensee agrees by using trademark AstraGin® that serving size of at least 25mg is incorporated per serving. Recommended Serving Size is 50mg.
Dosage. The fruits and vegetables must receive a minimum absorbed ion- izing radiation dose of 150 Gray (15 krad).11
Dosage. 1. 1 to a maximum of 4 immunizations; EPI schedule pre- ferred.
Dosage. ● A valid prescription form, written in English that has been approved and countersigned by a suitably qualified and registered healthcare practitioner, who is authorised to prescribe the Products. ● Such other information as the Supplier reasonably requests from time to time. Schedule 2 Information Processing Agreement
