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COVARYX

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Overview

What is COVARYX?

COVARYX:

COVARYX H.S.

Esterified Estrogens

Esterified Estrogens, USP is a mixture of the sodium salts of the sulfate esters of the estrogenic substances, principally estrone, that are of the type excreted by pregnant mares. Esterified Estrogens contain not less than 75.0 percent and not more than 85.0 percent of sodium estrone sulfate, and not less than 6.0 percent and not more than 15.0 percent of sodium equilin sulfate, in such proportion that the total of these two components is not less than 90.0 percent.

Category: Estrogens

Methyltestosterone

Methyltestosterone, USP is an androgen. Androgens are derivatives of cyclopentano-perhydrophenanthrene. Endogenous androgens are C-19 steroids with a side chain at C-17, and with two angular methyl groups.

Testosterone is the primary endogenous androgen. Fluoxymesterone and methyltestosterone are synthetic derivatives of testosterone. Methyltestosterone is a white to light yellow crystalline substance that is virtually insoluble in water but soluble in organic solvents. It is stable in air but decomposes in light. Methyltestosterone structural formula:

COVARYX

COVARYX H.S.



What does COVARYX look like?



What are the available doses of COVARYX?

Sorry No records found.

What should I talk to my health care provider before I take COVARYX?

Sorry No records found

How should I use COVARYX?

For treatment of moderate to severe vasomotor symptoms associated with the menopause in patients not improved by estrogen alone. The lowest dose that will control symptoms should be chosen and medication should be discontinued as promptly as possible. Administration should be cyclic (e.g., three weeks on and one week off). Attempts to discontinue or taper medication should be made at three to six month intervals.


What interacts with COVARYX?


  • Estrogens should not be used in women with any of the following conditions:



    • Methyltestosterone should not be used in:





      What are the warnings of COVARYX?

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      Associated with Estrogens

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      1.

      Breast Cancer (See ).

      2.

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      3.

      Cardiovascular Disorders:

      4.

      Gallbladder Disease:

      5.

      Effects similar to those caused by estrogen-progestogen oral contraceptives:

      6.

      Hypercalcemia:

      Associated with Methyltestosterone

      In patients with breast cancer, androgen therapy may cause hypercalcemia by stimulating osteolysis. In this case the drug should be discontinued. Prolonged use of high doses of androgens has been associated with the development of peliosis hepatis and hepatic neoplasms including hepatocellular carcinoma. Peliosis hepatis can be a life-threatening or fatal complication. Cholestatic hepatitis and jaundice occur with 17-alpha-alkylandrogens at a relatively low dose. If cholestatic hepatitis with jaundice appears or if liver function tests become abnormal, the androgen should be discontinued and the etiology should be determined. Drug-induced jaundice is reversible when the medication is discontinued. Edema with or without heart failure may be a serious complication in patients with preexisting cardiac, renal, or hepatic disease. In addition to discontinuation of the drug, diuretic therapy may be required.


      What are the precautions of COVARYX?

      Associated with Estrogens

      • A complete medical and family history should be taken prior to the initiation of any estrogen therapy. The pretreatment and periodic physical examinations should include special reference to blood pressure, breasts, abdomen, and pelvic organs, and should include a Papanicolaou smear. As a general rule, estrogens should not be prescribed for longer than one year without another physical examination being performed.
      • Fluid retention-Because estrogens may cause some degree of fluid retention, conditions which might be influenced by this factor such as asthma, epilepsy, migraine, and cardiac or renal dysfunction, require careful observation.
      • Certain patients may develop undesirable manifestations of excessive estrogenic stimulation, such as abnormal or excessive uterine bleeding, mastodynia, etc.
      • Oral contraceptives appear to be associated with an increased incidence of mental depression. Although it is not clear whether this is due to the estrogenic or progestogenic component of the contraceptive, patients with a history of depression should be carefully observed.
      • Preexisting uterine leiomyomata may increase in size during estrogen use.
      • The pathologist should be advised of estrogen therapy when relevant specimens are submitted.
      • Patients with a past history of jaundice during pregnancy have an increased risk of recurrence of jaundice while receiving estrogen containing oral contraceptive therapy. If jaundice develops in any patient receiving estrogen, the medication should be discontinued while the cause is investigated.
      • Estrogens may be poorly metabolized in patients with impaired liver function and they should be administered with caution in such patients.
      • Because estrogens influence the metabolism of calcium and phosphorus, they should be used with caution in patients with metabolic bone diseases that are associated with hypercalcemia or in patients with renal insufficiency.
      • Because of the effects of estrogens on epiphyseal closure, they should be used judiciously in young patients in whom bone growth is not complete.
      • Certain endocrine and liver function tests may be affected by estrogen-containng oral contraceptives. The following similar changes may be expected with larger doses of estrogen:


      Information for the Patient

      (See after ).

      Pregnancy Category X

      (See and ).

      Nursing Mothers

      As a general principle, the administration of any drug to nursing mothers should be done only when clearly necessary since many drugs are excreted in human milk.

      Associated with Methyltestosterone

      • Women should be observed for signs of virilization (deepening of the voice, hirsutism, acne, clitoromegaly, and menstrual irregularities). Discontinuation of drug therapy at the time of evidence of mild virilism is necessary to prevent irreversible virilization. Such virilization is usual following androgen use at high doses.
      • Prolonged dosage of androgen may result in sodium and fluid retention. This may present a problem, especially in patients with compromised cardiac reserve or renal disease.
      • Hypersensitivity may occur rarely.
      • PBI may be decreased in patients taking androgens.
      • Hypercalcemia may occur. If this does occur, the drug should be discontinued.


      Information for the Patient

      Women:

      All Patients:

      Laboratory Tests

      • Women with disseminated breast carcinoma should have frequent determination of urine and serum calcium levels during the course of androgen therapy
      • Because of the hepatotoxicity associated with the use of 17-alpha alkylated androgens, liver function tests should be obtained periodically.
      • Hemoglobin and hematocrit should be checked periodically for polycythemia in patients who are receiving high doses of androgens.


      Drug Interactions

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      Anticoagulants:

      Oxyphenbutazone:

      Insulin:

      Drug/Laboratory Test Interferences

      Androgens may decrease levels of thyroxine-binding globulin, resulting in decreased T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however, and there is no clinical evidence of thyroid dysfunction.

      Carcinogenesis

      Animal Data

      Testosterone has been tested by subcutaneous injection and implantation in mice and rats. The implant induced cervical- uterine tumors in mice, which metastasized in some cases. There is suggestive evidence that injection of testosterone into some strains of female mice increases their susceptibility to hepatoma. Testosterone is also known to increase the number of tumors and decrease the degree of differentiation of chemically induced carcinomas of the liver in rats.

      Human Data

      There are rare reports of hepatocellular carcinoma in patients receiving long-term therapy with androgens in high doses. Withdrawal of the drugs did not lead to regression of the tumors in all cases. Geriatric patients treated with androgens may be at increased risk for the development of prostatic hypertrophy and prostatic carcinoma.

      Pregnancy

      Nursing Mothers

      It is not known whether androgens are excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from androgens, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.


      What are the side effects of COVARYX?

      Associated with Estrogens

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      Genitourinary system:

      2.

      Breasts: Tenderness:

      3.

      Gastrointestinal:

      4.

      Skin:

      5.

      Eyes:

      6.

      Central Nervous System:

      7.

      Miscellaneous:

      (See

      Associated with Methyltestosterone

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      1.

      Endocrine and Urogenital.

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      Skin and Appendages:

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      Fluid and Electrolyte Disturbances:

      4.

      Array

      5.

      Hematologic:

      6.

      Nervous System.

      7.

      Metabolic:

      8.

      Miscellaneous:


      What should I look out for while using COVARYX?

      Estrogens should not be used in women with any of the following conditions:

      Methyltestosterone should not be used in:

      (See .)


      What might happen if I take too much COVARYX?

      Numerous reports of ingestion of large doses of estrogen-containing oral contraceptives by young children indicate that serious ill effects do not occur. Overdosage of estrogen may cause nausea, and withdrawal bleeding may occur in females. There have been no reports of acute overdosage with the androgens.


      How should I store and handle COVARYX?

      SUSTIVA capsules and SUSTIVA tablets should be stored at 25° C (77° F); excursions permitted to 15°–30° C (59°–86° F) [see USP Controlled Room Temperature].COVARYX COVARYX COVARYX H.S.COVARYX H.S.COVARYX COVARYX COVARYX H.S.COVARYX H.S.COVARYX COVARYX COVARYX H.S.COVARYX H.S.COVARYX COVARYX COVARYX H.S.COVARYX H.S.


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      Clinical Information

      Chemical Structure

      No Image found
      Clinical Pharmacology

      Estrogens are important in the development and maintenance of the female reproductive system and secondary sex characteristics. They promote growth and development of the vagina, uterus, and fallopian tubes, and enlargement of the breasts. Indirectly, they contribute to the shaping of the skeleton, maintenance of tone and elasticity of urogenital structures, changes in the epiphyses of the long bones that allow for the pubertal growth spurt and its termination, growth of axillary and pubic hair, and pigmentation of the nipples and genitals. Decline of estrogenic activity at the end of the menstrual cycle can bring on menstruation, although the cessation of progesterone secretion is the most important factor in the mature ovulatory cycle. However, in the preovulatory or nonovulatory cycle, estrogen is the primary determinant in the onset of menstruation. Estrogens also affect the release of pituitary gonadotropins.

      The pharmacologic effects of esterified estrogens are similar to those of endogenous estrogens. They are soluble in water and are well absorbed from the gastrointestinal tract.

      In responsive tissues (female genital organs, breasts, hypothalamus, pituitary) estrogens enter the cell and are transported into the nucleus. As a result of estrogen action, specific RNA and protein synthesis occurs.

      Non-Clinical Toxicology
      Estrogens should not be used in women with any of the following conditions:

      Methyltestosterone should not be used in:

      (See .)

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      Reference

      This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
      "https://dailymed.nlm.nih.gov/dailymed/"

      While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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      Professional

      Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72
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      Interactions

      Interactions

      A total of 440 drugs (1549 brand and generic names) are known to interact with Imbruvica (ibrutinib). 228 major drug interactions (854 brand and generic names) 210 moderate drug interactions (691 brand and generic names) 2 minor drug interactions (4 brand and generic names) Show all medications in the database that may interact with Imbruvica (ibrutinib).