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Detailed View: Safety Labeling Changes Approved By FDA Center for Drug Evaluation and Research (CDER) -- June 2003

 

The detailed view includes drug products with safety labeling changes to the CONTRAINDICATIONS, BOXED WARNING, WARNINGS, PRECAUTIONS, or ADVERSE REACTIONS sections. The prescribing information may be accessed by clicking on the drug name.

Summary View

 

Brand (Generic) Name

Sections Modified

Summary of Changes to Contraindications and Warnings

Artane (trihexyphenidyl Hydrochloride) Tablets and Elixir

(click product name to read prescribing information)

CONTRAINDICATIONS

WARNINGS

PRECAUTIONS

  • General
  • Information for Patients
  • Drug Interactions
  • Nursing Mothers
  • Pediatric Use

ADVERSE REACTIONS

Artane is contraindicated in patients with hypersensitivity to trihexyphenidyl HCl or to any of the tablet or elixir ingredients. Artane is also contraindicated in patients with narrow angle glaucoma. Blindness after long-term use due to narrow angle glaucoma has been reported.

Administer with caution in hot weather, especially when given concomitantly with other atropine-like drugs to the chronically ill, alcoholics, those who have central nervous system disease, or those who do manual labor in a hot environment. Anhidrosis may occur more readily when some disturbance of sweating already exists. 

Phenergan (promethazine HCl) Syrup and Fortis

Numerous labeling changes so that there is consistency between the Phenergan Syrup and Fortis labeling and the Phenergan injection labeling. 

Please contact Wyeth-Ayerst  at 1-800-395-9938 for prescribing information.

 

 

 

CONTRAINDICATIONS

 WARNINGS

  • CNS Depression
  • Respiratory Depression
  • Lower Seizure Threshold
  • Bone Marrow Depression
  • Neuroleptic Malignant Syndrome (NMS)
  • Use in Pediatric Patients
  • Other Considerations

PRECAUTIONS

  • General
  • Information for Patients
  • Drug Interactions
    • CNS Depressants
    • Epinephrine
    • Anticholinergics
    • Monoamine Oxidase Inhibitors (MAOI)
  • Carcinogenesis, Mutagenesis, Impairment of Fertility
    • Pregnancy - Teratogenic Effects - Pregnancy Category C
  • Pregnancy
    • Nonteratogenic Effects
    • Labor and Delivery
    • Nursing Mothers
  • Pediatric Use
  • Geriatric Use

ADVERSE REACTIONS

  • Central Nervous System
  • Cardiovascular
  • Dermatologic
  • Hematologic 
  • Gastrointestinal
  • Respiratory
  • Other
  • Paradoxical Reactions (Overdosage)
Phenergan Syrup Plain and Phenergan Syrup Fortis: 
  • Contraindicated in comatose states, and in individuals known to be hypersensitive or to have had an idiosyncratic reaction to promethazine or to other phenothiazines.
  • May impair the mental and/or physical abilities required for the performance of potentially hazardous tasks, such as driving a vehicle or operating machinery.
  • May lead to potentially fatal respiratory depression. Use in patients with compromised respiratory function (e.g. COPD, sleep apnea) should be avoided.
  • May lower seizure threshold.  It should be used in caution in persons with seizure disorder or in persons who are using concomitant medications, such as narcotics or local anesthetics, which may also affect seizure threshold.
  • Used with caution in patients with bone-marrow depression. Leukopenia and granulocytosis have been reported, usually when Phenergan has been used in association with other known marrow-toxic agents.
  • NMS has been reported in association with promethazine HCl alone or in combination with antipsychotic drugs.
  • Not recommended for use in pediatric patients less than two years of age.
  • Caution should be exercised when administering Phenergan Syrup Plain and Phenergan Syrup Fortis to pediatric patients 2 years of age and older because of the potential for fatal respiratory depression.
  • Cholestatic jaundice has been reported.

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Brand (Generic) Name

Sections Modified

Summary of Changes to Contraindications and Warnings

Aralen (chloroquine phosphate tablets)

Aralen Hydrochloride (chloroquine hydrochloride injection)

(click product name to read prescribing information)

WARNINGS
  • Usage in Pregnancy

PRECAUTIONS

  • Hematological Effects/Laboratory Tests
  • Auditory Effects
  • Hepatic Effects
  • Central Nervous System Effects
  • Drug Interactions
    • Antacids and kaolin
    • Cimetidine
    • Ampicillin
    • Cyclosporine
  • Geriatric Use

ADVERSE REACTIONS

  • Special Senses:  Ocular
  • Musculoskeletal system
  • Skin and appendages
  • Hematologic system
  • Central Nervous system
  • Cardiovascular system
WARNINGS:  Chloroquine resistance is widespread and, at present, is particularly prominent in various parts of the world including sub-Saharan Africa, Southeast Asia, the Indian subcontinent, and over large portions of South America, including the Amazon basin. 

Chloroquine should not be used for treatment of P. falciparum infections acquired in areas of chloroquine resistance or malaria occurring in patients where chloroquine prophylaxis has failed. 

WARNINGS/Usage in Pregnancy:  There are no adequate and well-controlled studies evaluating the safety and efficacy of chloroquine in pregnant women. Usage of chloroquine during pregnancy should be avoided except in the suppression or treatment of malaria when in the judgment of the physician the benefit outweighs the potential risk to the fetus.

AtroPen (atropine) Injection

(click product name to read prescribing information)

WARNINGS

PRECAUTIONS

  • Nursing mothers
  • Pediatric Use

ADVERSE REACTIONS

  • Cardiovascular
  • Eye
  • Gastrointestinal
  • General
  • Central Nervous system
  • Psychiatric
  • Genitourinary
  • Pulmonary
  • Dermatologic

PATIENT PACKAGE INSERT

AtroPen should be administered with extreme caution to individuals with significant renal insufficiency or a recent myocardial infarction.

Cefotan (cefotetan disodium for injection) for Intravenous or Intramuscular Use

Cefotan (cefotetan injection) for Intravenous Use Only

(click product name to read prescribing information)

WARNINGS There appears to be an increased risk of developing hemolytic anemia on cefotetan relative to other cephalosporins of at least three fold.

Patients who receive courses of cefotetan for the treatment or prophylaxis of infections should have periodic monitoring for signs and symptoms of hemolytic anemia including a measurement of hematological parameters where appropriate.

Cognex (Tacrine Hydrochloride Capsules)

(click product name to read prescribing information)

 

WARNINGS
  • Cardiovascular Conditions

Because of its pharmacological action, Cognex may have vagotonic effects on the sinoatrial and atrioventricular nodes possibly leading to bradycardia and/or heart block. These effects may be particularly harmful to patients with conduction abnormalities, bradyarrythmias, or a sick sinus syndrome, but may also occur in patients without known preexisting cardiac disease.

Duramorph (morphine sulfate injection)

Please contact Wyeth-Ayerst  at 1-800-395-9938 for prescribing information.

WARNINGS

 

Overdoses may cause respiratory depression, coma and death.

Infumorph (preservative-free morphine sulfate sterile solution)

Please contact Wyeth-Ayerst  at 1-800-395-9938 for prescribing information.

WARNINGS Morphine sulfate may be habit forming. Overdoses may cause respiratory depression, coma and death.

Venofer (iron sucrose injection)

(click product name to read prescribing information)

WARNINGS

PRECAUTIONS

  • General
    • Hypersensitivity Reactions
    • Hypotension
  • Pediatric Use
  • Geriatric Use

ADVERSE REACTIONS

  • Adverse Events Observed in Studies A, B, and C
    • Body as a Whole 
    • Cardiovascular Disorders, General
    • Gastrointestinal System Disorders
    • Central and Peripheral Nervous System
    • Musculoskeletal System
    • Respiratory System
    • Skin and appendages
  • Adverse Events Observed in Two Post-Marketing Safety Studies 
Hypersensitivity reactions have been reported with injectable iron products.  See PRECAUTIONS and ADVERSE REACTIONS.

Zemuron (rocuronium bromide) for Injection

(click product name to read prescribing information)

WARNINGS
  • Anaphylaxis

PRECAUTIONS

  • Anaphylaxis

ADVERSE REACTIONS

Although rare, severe anaphylactic reactions to neuromuscular blocking agents, including Zemuron, have been reported. These reactions have, in some cases, been life threatening. Due to the potential severity of these reactions, the necessary precautions, such as the immediate availability of appropriate emergency treatment, should be taken.

Special precautions should be taken in patients who have had previous anaphylactic reactions to other neuromuscular blocking agents, since allergic cross-reactivity has been reported in this class of drugs.

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Brand (Generic) Name
Sections Modified

Actos (pioglitazone HCl) Tablets

(click product name to read prescribing information)

PRECAUTIONS 

  • Drug Interactions

    • Oral Contraceptive

  • Carcinogenesis, Mutagenesis, Impairment of Fertility

Alomide (lodoxamide tromethamine ophthalmic solution) 

(click product name to read prescribing information)

PRECAUTIONS
  • Geriatric Use

Aminosyn with Electrolytes

Please contact Abbott Laboratories at 1-800-633-9110 for prescribing information. 

PRECAUTIONS 

  • Geriatric Use

Aminosyn II w with Electrolytes (amino acid injection with electrolytes)

Please contact Abbott Laboratories at 1-800-633-9110 for prescribing information. 

PRECAUTIONS 

  • Geriatric Use

 

Aminosyn-RF

Please contact Abbott Laboratories at 1-800-633-9110 for prescribing information. 

PRECAUTIONS

  • Geriatric Use

AquaMEPHYTON (phytonadione) Injection

(click product name to read prescribing information)

PRECAUTIONS
  • General

Azelex (azelaic acid cream)

(click product name to read prescribing information)

PRECAUTIONS
  • Geriatric Use

Capastat Sulfate (capreomycin for injection)

(click product name to read prescribing information)

PRECAUTIONS
  • Geriatric Use

Cardura (doxazosin mesylate) Tablets

Please contact Pfizer at 1-800-879-3477 for prescribing information.

PRECAUTIONS
  • Geriatric Use

Crixivan (indinavir sulfate) Capsules

(click product name to read prescribing information)

PRECAUTIONS
  • General

ADVERSE REACTIONS

  • Urogenital System
    • Leukocyturia

Eurax (crotamiton) Cream and Lotion

(click product name to read prescribing information)

PRECAUTIONS
  • Information for Patients
  • Geriatric Use

ADVERSE REACTIONS

PATIENT PACKAGE INSERT

Halcion (triazolam) Tablets

(click product name to read prescribing information)

PRECAUTIONS
  • Geriatric Use

Lamprene (clofazimine) Capsules

(click product name to read prescribing information)

PRECAUTIONS
  • Geriatric Use

Lexxel (enalapril maleate/felodipine ER)  Tablets

(click product name to read prescribing information)

PRECAUTIONS
  • Drug Interactions

Mephyton (phytonadione) Tablets

(click product name to read prescribing information)

PRECAUTIONS
  • General

Mintezol (thiabendazole) Chewable Tablets and Oral Suspension

(click product name to read prescribing information)

PRECAUTIONS
  • Geriatric Use

Nolvadex (tamoxifen citrate) Tablets

(click product name to read prescribing information)

PRECAUTIONS
  • Information for Patients

MEDICATION GUIDE (new)

Penlac Nail Lacquer (ciclopirox) Topical Solution

(click product name to read prescribing information)

PRECAUTIONS
  • Information for Patients

Primaquine Phosphate Tablets

(click product name to read prescribing information)

PRECAUTIONS
  • Geriatric Use

Rebetol (ribavirin) Capsules 

(click product name to read prescribing information)

PRECAUTIONS
  • Carcinogenesis and Mutagenesis 

Robinul (glycopyrrolat injection) Injectable

Please contact Baxter Healthcare at 1-800-933-0303 for prescribing information.

PRECAUTIONS

  • Geriatric Use

Sustiva (efavirenz) Capsules and Tablets

(click product name to read prescribing information)

PRECAUTIONS

  • Carcinogenesis, Mutagenesis and Impairment of Fertility

  • Pregnancy

    • Antiretroviral Pregnancy Registry

Tabloid (thioguanine) Tablets

(click product name to read prescribing information)

PRECAUTIONS
  • Geriatric Use

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Brand (Generic) Name
Sections Modified
Arava (leflunomide) Tablets

(click product name to read prescribing information)

ADVERSE REACTIONS
  • Hepatic

Buprenex (buprenorphine hydrochloride) Injectable

Please contact Reckitt Benckiser at 1-877-782-6966 for prescribing information.

ADVERSE REACTIONS
  • Allergic Reactions

Flovent (fluticasone propionate) Inhalation Aerosol

(click product name to read prescribing information)

 

ADVERSE REACTIONS

  • Observed During Clinical Practice

    • Ear, Nose, and Throat

    • Endocrine and Metabolic

    • Eye

    • Respiratory

Flovent (fluticasone propionate inhalation powder) Rotadisk

(click product name to read prescribing information)

ADVERSE REACTIONS

  • Ear, Nose, and Throat

  • Eye

  • Respiratory

Lactated Ringer's Injection

Please contact Baxter Healthcare at 1-800-933-0303 for prescribing information.

ADVERSE REACTIONS

Allergic reactions or anaphylactoid symptoms such as localized or generalized urticaria and pruritis; periorbital, facial, and/or laryngeal edema; coughing, sneezing, and/or difficulty with breathing have been reported during administration of Lactated Ringer's Injection, USP. The reporting frequency of these signs and symptoms is higher in women during pregnancy.

Ultane (sevoflurane) Volatile Liquid for Inhalation

Please contact Abbott Laboratories at 1-800-633-9110 for prescribing information.

 

ADVERSE REACTIONS
  • Adverse Events During Post-Marketing Experience

Rare cases of malignant hyperthermia (see CONTRAINDICATIONS and WARNINGS) and allergic reactions, such as rash, urticaria, pruritis, bronchospasm, anaphylactic or anaphylactoid reactions (see CONTRAINDICATIONS) have been reported.

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