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selegiline hydrochloride
Overview
What is Eldepryl?
ELDEPRYL (selegiline hydrochloride) is a levorotatory acetylenic derivative of phenethylamine. It is commonly referred to in the clinical and pharmacological literature as l-deprenyl.
The chemical name is: (R)-(-)-,2-dimethyl--2-propynylphenethylamine hydrochloride. It is a white to near white crystalline powder, freely soluble in water, chloroform, and methanol, and has a molecular weight of 223.75. The structural formula is as follows:
Each aqua blue capsule is band imprinted with the Somerset logo on the cap and "Eldepryl 5 mg" on the body. Each capsule contains 5 mg selegiline hydrochloride, USP. Inactive ingredients are anhydrous citric acid, lactose, magnesium stearate, and microcrystalline cellulose.
What does Eldepryl look like?
What are the available doses of Eldepryl?
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What should I talk to my health care provider before I take Eldepryl?
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How should I use Eldepryl?
ELDEPRYL is indicated as an adjunct in the management of Parkinsonian patients being treated with levodopa/carbidopa who exhibit deterioration in the quality of their response to this therapy. There is no evidence from controlled studies that selegiline has any beneficial effect in the absence of concurrent levodopa therapy.
Evidence supporting this claim was obtained in randomized controlled clinical investigations that compared the effects of added selegiline or placebo in patients receiving levodopa/carbidopa. Selegiline was significantly superior to placebo on all three principal outcome measures employed: change from baseline in daily levodopa/carbidopa dose, the amount of 'off' time, and patient self-rating of treatment success. Beneficial effects were also observed on other measures of treatment success (e.g., measures of reduced end of dose akinesia, decreased tremor and sialorrhea, improved speech and dressing ability and improved overall disability as assessed by walking and comparison to previous state).
ELDEPRYL is intended for administration to Parkinsonian patients receiving levodopa/carbidopa therapy who demonstrate a deteriorating response to this treatment. The recommended regimen for the administration of ELDEPRYL is 10 mg per day administered as divided doses of 5 mg each taken at breakfast and lunch. There is no evidence that additional benefit will be obtained from the administration of higher doses. Moreover, higher doses should ordinarily be avoided because of the increased risk of side effects.
After two to three days of selegiline treatment, an attempt may be made to reduce the dose of levodopa/carbidopa. A reduction of 10 to 30% was achieved with the typical participant in the domestic placebo controlled trials who was assigned to selegiline treatment. Further reductions of levodopa/carbidopa may be possible during continued selegiline therapy.
What interacts with Eldepryl?
ELDEPRYL is contraindicated in patients with a known hypersensitivity to this drug.
ELDEPRYL is contraindicated for use with meperidine (DEMEROL & other trade names). This contraindication is often extended to other opioids. (See .)
What are the warnings of Eldepryl?
Since barbiturates are metabolized in the liver, they should be used with caution and initial doses should be small in patients with hepatic dysfunction.
Selegiline should not be used at daily doses exceeding those recommended (10 mg/day) because of the risks associated with non-selective inhibition of MAO. (See .)
The selectivity of selegiline for MAO-B may not be absolute even at the recommended daily dose of 10 mg a day. Rare cases of hypertensive reactions associated with ingestion of tyramine-containing foods have been reported in patients taking the recommended daily dose of selegiline. The selectivity is further diminished with increasing daily doses. The precise dose at which selegiline becomes a non-selective inhibitor of all MAO is unknown, but may be in the range of 30 to 40 mg a day.
Severe CNS toxicity associated with hyperpyrexia and death have been reported with the combination of tricyclic antidepressants and non-selective MAOIs (NARDIL, PARNATE). A similar reaction has been reported for a patient on amitriptyline and ELDEPRYL. Another patient receiving protriptyline and ELDEPRYL developed tremors, agitation, and restlessness followed by unresponsiveness and death two weeks after ELDEPRYL was added. Related adverse events including hypertension, syncope, asystole, diaphoresis, seizures, changes in behavioral and mental status, and muscular rigidity have also been reported in some patients receiving ELDEPRYL and various tricyclic antidepressants.
Serious, sometimes fatal, reactions with signs and symptoms that may include hyperthermia, rigidity, myoclonus, autonomic instability with rapid fluctuations of the vital signs, and mental status changes that include extreme agitation progressing to delirium and coma have been reported with patients receiving a combination of fluoxetine hydrochloride (PROZAC) and non-selective MAOIs. Similar signs have been reported in some patients on the combination of ELDEPRYL (10 mg a day) and selective serotonin re-uptake inhibitors including fluoxetine, sertraline and paroxetine.
Since the mechanisms of these reactions are not fully understood, it seems prudent, in general, to avoid this combination of ELDEPRYL and tricyclic antidepressants as well as ELDEPRYL and selective serotonin re-uptake inhibitors. At least 14 days should elapse between discontinuation of ELDEPRYL and initiation of treatment with a tricyclic antidepressant or selective serotonin re-uptake inhibitors. Because of the long half-lives of fluoxetine and its active metabolite, at least five weeks (perhaps longer, especially if fluoxetine has been prescribed chronically and/or at higher doses) should elapse between discontinuation of fluoxetine and initiation of treatment with ELDEPRYL.
What are the precautions of Eldepryl?
General
Some patients given selegiline may experience an exacerbation of levodopa associated side effects, presumably due to the increased amounts of dopamine reaction with super sensitive, post-synaptic receptors. These effects may often be mitigated by reducing the dose of levodopa/carbidopa by approximately 10 to 30%.
The decision to prescribe selegiline should take into consideration that the MAO system of enzymes is complex and incompletely understood and there is only a limited amount of carefully documented clinical experience with selegiline. Consequently, the full spectrum of possible responses to selegiline may not have been observed in pre-marketing evaluation of the drug. It is advisable, therefore, to observe patients closely for atypical responses.
Melanoma
Epidemiological studies have shown that patients with Parkinson's disease have a higher risk (2- to approximately 6-fold higher) of developing melanoma than the general population. Whether the increased risk observed was due to Parkinson's disease or other factors, such as drugs used to treat Parkinson's disease, is unclear.
For the reasons stated above, patients and providers are advised to monitor for melanomas frequently and on a regular basis when using ELDEPRYL for any indication. Ideally, periodic skin examinations should be performed by appropriately qualified individuals (e.g., dermatologists).
Information for Patients
Patients should be advised of the possible need to reduce levodopa dosage after the initiation of ELDEPRYL therapy.
Patients (or their families if the patient is incompetent) should be advised not to exceed the daily recommended dose of 10 mg. The risk of using higher daily doses of selegiline should be explained, and a brief description of the 'cheese reaction' provided. Rare hypertensive reactions with selegiline at recommended doses associated with dietary influences have been reported.
Consequently, it may be useful to inform patients (or their families) about the signs and symptoms associated with MAOI induced hypertensive reactions. In particular, patients should be urged to report, immediately, any severe headache or other atypical or unusual symptoms not previously experienced.
There have been reports of patients experiencing intense urges to gamble, increased sexual urges, and other intense urges and the inability to control these urges while taking one or more of the medications that increase central dopaminergic tone, that are generally used for the treatment of Parkinson's disease, including ELDEPRYL. Although it is not proven that the medications caused these events, these urges were reported to have stopped in some cases when the dose was reduced or the medication was stopped. Prescribers should ask patients about the development of new or increased gambling urges, sexual urges or other urges while being treated with ELDEPRYL. Patients should inform their physician if they experience new or increased gambling urges, increased sexual urges or other intense urges while taking ELDEPRYL. Physicians should consider dose reduction or stopping the medication if a patient develops such urges while taking ELDEPRYL.
Laboratory Tests
No specific laboratory tests are deemed essential for the management of patients on ELDEPRYL. Periodic routine evaluation of all patients, however, is appropriate.
Drug Interactions
The occurrence of stupor, muscular rigidity, severe agitation, and elevated temperature has been reported in some patients receiving the combination of selegiline and meperidine. Symptoms usually resolve over days when the combination is discontinued. This is typical of the interaction of meperidine and MAOIs. Other serious reactions (including severe agitation, hallucinations, and death) have been reported in patients receiving this combination (see ). Severe toxicity has also been reported in patients receiving the combination of tricyclic antidepressants and ELDEPRYL and selective serotonin re-uptake inhibitors and ELDEPRYL. (See for details.) One case of hypertensive crisis has been reported in a patient taking the recommended doses of selegiline and a sympathomimetic medication (ephedrine).
Carcinogenesis, Mutagenesis, and Impairment of Fertility
Assessment of the carcinogenic potential of selegiline in mice and rats is ongoing.
Selegiline did not induce mutations or chromosomal damage when tested in the bacterial mutation assay in Salmonella typhimurium and in an chromosomal aberration assay. While these studies provide some reassurance that selegiline is not mutagenic or clastogenic, they are not definitive because of methodological limitations. No definitive chromosomal aberration or mammalian gene mutation assays have been performed.
The effect of selegiline on fertility has not been adequately assessed.
Pregnancy
No teratogenic effects were observed in a study of embryo-fetal development in Sprague-Dawley rats at oral doses of 4, 12, and 36 mg/kg or 4, 12 and 35 times the human therapeutic dose on a mg/mbasis. No teratogenic effects were observed in a study of embryo-fetal development in New Zealand White rabbits at oral doses of 5, 25, and 50 mg/kg or 10, 48, and 95 times the human therapeutic dose on a mg/m basis; however, in this study, the number of litters produced at the two higher doses was less than recommended for assessing teratogenic potential. In the rat study, there was a decrease in fetal body weight at the highest dose tested. In the rabbit study, increases in total resorptions and % post-implantation loss, and a decrease in the number of live fetuses per dam occurred at the highest dose tested. In a peri- and postnatal development study in Sprague-Dawley rats (oral doses of 4, 16, and 64 mg/kg or 4, 15, and 62 times the human therapeutic dose on a mg/m basis), an increase in the number of stillbirths and decreases in the number of pups per dam, pup survival, and pup body weight (at birth and throughout the lactation period) were observed at the two highest doses. At the highest dose tested, no pups born alive survived to Day 4 postpartum. Postnatal development at the highest dose tested in dams could not be evaluated because of the lack of surviving pups. The reproductive performance of the untreated offspring was not assessed.
There are no adequate and well-controlled studies in pregnant women. Selegiline should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Nursing Mothers
It is not known whether selegiline hydrochloride is excreted in human milk. Because many drugs are excreted in human milk, consideration should be given to discontinuing the use of all but absolutely essential drug treatments in nursing women.
Pediatric Use
The effects of selegiline hydrochloride in children have not been evaluated.
What are the side effects of Eldepryl?
Sorry No records found
What should I look out for while using Eldepryl?
ELDEPRYL is contraindicated in patients with a known hypersensitivity to this drug.
ELDEPRYL is contraindicated for use with meperidine (DEMEROL & other trade names). This contraindication is often extended to other opioids. (See .)
Selegiline should not be used at daily doses exceeding those recommended (10 mg/day) because of the risks associated with non-selective inhibition of MAO. (See .)
The selectivity of selegiline for MAO-B may not be absolute even at the recommended daily dose of 10 mg a day. Rare cases of hypertensive reactions associated with ingestion of tyramine-containing foods have been reported in patients taking the recommended daily dose of selegiline. The selectivity is further diminished with increasing daily doses. The precise dose at which selegiline becomes a non-selective inhibitor of all MAO is unknown, but may be in the range of 30 to 40 mg a day.
Severe CNS toxicity associated with hyperpyrexia and death have been reported with the combination of tricyclic antidepressants and non-selective MAOIs (NARDIL, PARNATE). A similar reaction has been reported for a patient on amitriptyline and ELDEPRYL. Another patient receiving protriptyline and ELDEPRYL developed tremors, agitation, and restlessness followed by unresponsiveness and death two weeks after ELDEPRYL was added. Related adverse events including hypertension, syncope, asystole, diaphoresis, seizures, changes in behavioral and mental status, and muscular rigidity have also been reported in some patients receiving ELDEPRYL and various tricyclic antidepressants.
Serious, sometimes fatal, reactions with signs and symptoms that may include hyperthermia, rigidity, myoclonus, autonomic instability with rapid fluctuations of the vital signs, and mental status changes that include extreme agitation progressing to delirium and coma have been reported with patients receiving a combination of fluoxetine hydrochloride (PROZAC) and non-selective MAOIs. Similar signs have been reported in some patients on the combination of ELDEPRYL (10 mg a day) and selective serotonin re-uptake inhibitors including fluoxetine, sertraline and paroxetine.
Since the mechanisms of these reactions are not fully understood, it seems prudent, in general, to avoid this combination of ELDEPRYL and tricyclic antidepressants as well as ELDEPRYL and selective serotonin re-uptake inhibitors. At least 14 days should elapse between discontinuation of ELDEPRYL and initiation of treatment with a tricyclic antidepressant or selective serotonin re-uptake inhibitors. Because of the long half-lives of fluoxetine and its active metabolite, at least five weeks (perhaps longer, especially if fluoxetine has been prescribed chronically and/or at higher doses) should elapse between discontinuation of fluoxetine and initiation of treatment with ELDEPRYL.
What might happen if I take too much Eldepryl?
How should I store and handle Eldepryl?
Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].PROTECT FROM FREEZING. Avoid excessive heat.The container closure is not made with natural rubber latex.Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].PROTECT FROM FREEZING. Avoid excessive heat.The container closure is not made with natural rubber latex.Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].PROTECT FROM FREEZING. Avoid excessive heat.The container closure is not made with natural rubber latex.ELDEPRYL Capsules are available containing 5 mg of selegiline hydrochloride, USP. The 5 mg capsule is a hard-shell gelatin capsule with an aqua blue opaque cap and an aqua blue opaque body band imprinted with the on the cap and on the body in black ink. The capsule is filled with white powder. They are available as follows:NDC 49502-420-60bottles of 60 capsulesStore at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.Distributed by: Napa, CA 94558Manufactured for: Morgantown, WV 26505REVISED JUNE 2012ELD:R22CA3-014-01ELDEPRYL Capsules are available containing 5 mg of selegiline hydrochloride, USP. The 5 mg capsule is a hard-shell gelatin capsule with an aqua blue opaque cap and an aqua blue opaque body band imprinted with the on the cap and on the body in black ink. The capsule is filled with white powder. They are available as follows:NDC 49502-420-60bottles of 60 capsulesStore at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.Distributed by: Napa, CA 94558Manufactured for: Morgantown, WV 26505REVISED JUNE 2012ELD:R22CA3-014-01ELDEPRYL Capsules are available containing 5 mg of selegiline hydrochloride, USP. The 5 mg capsule is a hard-shell gelatin capsule with an aqua blue opaque cap and an aqua blue opaque body band imprinted with the on the cap and on the body in black ink. The capsule is filled with white powder. They are available as follows:NDC 49502-420-60bottles of 60 capsulesStore at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.Distributed by: Napa, CA 94558Manufactured for: Morgantown, WV 26505REVISED JUNE 2012ELD:R22CA3-014-01ELDEPRYL Capsules are available containing 5 mg of selegiline hydrochloride, USP. The 5 mg capsule is a hard-shell gelatin capsule with an aqua blue opaque cap and an aqua blue opaque body band imprinted with the on the cap and on the body in black ink. The capsule is filled with white powder. They are available as follows:NDC 49502-420-60bottles of 60 capsulesStore at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.Distributed by: Napa, CA 94558Manufactured for: Morgantown, WV 26505REVISED JUNE 2012ELD:R22CA3-014-01ELDEPRYL Capsules are available containing 5 mg of selegiline hydrochloride, USP. The 5 mg capsule is a hard-shell gelatin capsule with an aqua blue opaque cap and an aqua blue opaque body band imprinted with the on the cap and on the body in black ink. The capsule is filled with white powder. They are available as follows:NDC 49502-420-60bottles of 60 capsulesStore at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.Distributed by: Napa, CA 94558Manufactured for: Morgantown, WV 26505REVISED JUNE 2012ELD:R22CA3-014-01ELDEPRYL Capsules are available containing 5 mg of selegiline hydrochloride, USP. The 5 mg capsule is a hard-shell gelatin capsule with an aqua blue opaque cap and an aqua blue opaque body band imprinted with the on the cap and on the body in black ink. The capsule is filled with white powder. They are available as follows:NDC 49502-420-60bottles of 60 capsulesStore at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.Distributed by: Napa, CA 94558Manufactured for: Morgantown, WV 26505REVISED JUNE 2012ELD:R22CA3-014-01ELDEPRYL Capsules are available containing 5 mg of selegiline hydrochloride, USP. The 5 mg capsule is a hard-shell gelatin capsule with an aqua blue opaque cap and an aqua blue opaque body band imprinted with the on the cap and on the body in black ink. The capsule is filled with white powder. They are available as follows:NDC 49502-420-60bottles of 60 capsulesStore at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.Distributed by: Napa, CA 94558Manufactured for: Morgantown, WV 26505REVISED JUNE 2012ELD:R22CA3-014-01ELDEPRYL Capsules are available containing 5 mg of selegiline hydrochloride, USP. The 5 mg capsule is a hard-shell gelatin capsule with an aqua blue opaque cap and an aqua blue opaque body band imprinted with the on the cap and on the body in black ink. The capsule is filled with white powder. They are available as follows:NDC 49502-420-60bottles of 60 capsulesStore at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.Distributed by: Napa, CA 94558Manufactured for: Morgantown, WV 26505REVISED JUNE 2012ELD:R22CA3-014-01
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
Many of the prominent symptoms of Parkinson's disease are due to a deficiency of striatal dopamine that is the consequence of a progressive degeneration and loss of a population of dopaminergic neurons which originate in the substantia nigra of the midbrain and project to the basal ganglia or striatum. Early in the course of Parkinson's Disease, the deficit in the capacity of these neurons to synthesize dopamine can be overcome by administration of exogenous levodopa, usually given in combination with a peripheral decarboxylase inhibitor (carbidopa).
With the passage of time, due to the progression of the disease and/or the effect of sustained treatment, the efficacy and quality of the therapeutic response to levodopa diminishes. Thus, after several years of levodopa treatment, the response, for a given dose of levodopa, is shorter, has less predictable onset and offset (i.e., there is 'wearing off'), and is often accompanied by side effects (e.g., dyskinesia, akinesias, on-off phenomena, freezing, etc.).
This deteriorating response is currently interpreted as a manifestation of the inability of the ever decreasing population of intact nigrostriatal neurons to synthesize and release adequate amounts of dopamine.
MAO-B inhibition may be useful in this setting because, by blocking the catabolism of dopamine, it would increase the net amount of dopamine available (i.e., it would increase the pool of dopamine). Whether or not this mechanism or an alternative one actually accounts for the observed beneficial effects of adjunctive selegiline is unknown.
Selegiline's benefit in Parkinson's disease has only been documented as an adjunct to levodopa/carbidopa. Whether or not it might be effective as a sole treatment is unknown, but past attempts to treat Parkinson's disease with non-selective MAOI monotherapy are reported to have been unsuccessful. It is important to note that attempts to treat Parkinsonian patients with combinations of levodopa and currently marketed non-selective MAO inhibitors were abandoned because of multiple side effects including hypertension, increase in involuntary movement, and toxic delirium.
Non-Clinical Toxicology
ELDEPRYL is contraindicated in patients with a known hypersensitivity to this drug.ELDEPRYL is contraindicated for use with meperidine (DEMEROL & other trade names). This contraindication is often extended to other opioids. (See .)
Selegiline should not be used at daily doses exceeding those recommended (10 mg/day) because of the risks associated with non-selective inhibition of MAO. (See .)
The selectivity of selegiline for MAO-B may not be absolute even at the recommended daily dose of 10 mg a day. Rare cases of hypertensive reactions associated with ingestion of tyramine-containing foods have been reported in patients taking the recommended daily dose of selegiline. The selectivity is further diminished with increasing daily doses. The precise dose at which selegiline becomes a non-selective inhibitor of all MAO is unknown, but may be in the range of 30 to 40 mg a day.
Severe CNS toxicity associated with hyperpyrexia and death have been reported with the combination of tricyclic antidepressants and non-selective MAOIs (NARDIL, PARNATE). A similar reaction has been reported for a patient on amitriptyline and ELDEPRYL. Another patient receiving protriptyline and ELDEPRYL developed tremors, agitation, and restlessness followed by unresponsiveness and death two weeks after ELDEPRYL was added. Related adverse events including hypertension, syncope, asystole, diaphoresis, seizures, changes in behavioral and mental status, and muscular rigidity have also been reported in some patients receiving ELDEPRYL and various tricyclic antidepressants.
Serious, sometimes fatal, reactions with signs and symptoms that may include hyperthermia, rigidity, myoclonus, autonomic instability with rapid fluctuations of the vital signs, and mental status changes that include extreme agitation progressing to delirium and coma have been reported with patients receiving a combination of fluoxetine hydrochloride (PROZAC) and non-selective MAOIs. Similar signs have been reported in some patients on the combination of ELDEPRYL (10 mg a day) and selective serotonin re-uptake inhibitors including fluoxetine, sertraline and paroxetine.
Since the mechanisms of these reactions are not fully understood, it seems prudent, in general, to avoid this combination of ELDEPRYL and tricyclic antidepressants as well as ELDEPRYL and selective serotonin re-uptake inhibitors. At least 14 days should elapse between discontinuation of ELDEPRYL and initiation of treatment with a tricyclic antidepressant or selective serotonin re-uptake inhibitors. Because of the long half-lives of fluoxetine and its active metabolite, at least five weeks (perhaps longer, especially if fluoxetine has been prescribed chronically and/or at higher doses) should elapse between discontinuation of fluoxetine and initiation of treatment with ELDEPRYL.
As with all drugs, care should be exercised when treating patients with multiple medications. Diltiazem is both a substrate and an inhibitor of the cytochrome P-450 3A4 enzyme system. Other drugs that are specific substrates, inhibitors, or inducers of this enzyme system may have a significant impact on the efficacy and side effect profile of diltiazem. Patients taking other drugs that are substrates of CYP450 3A4, especially patients with renal and/or hepatic impairment, may require dosage adjustment when starting or stopping concomitantly administered diltiazem in order to maintain optimum therapeutic blood levels.
Some patients given selegiline may experience an exacerbation of levodopa associated side effects, presumably due to the increased amounts of dopamine reaction with super sensitive, post-synaptic receptors. These effects may often be mitigated by reducing the dose of levodopa/carbidopa by approximately 10 to 30%.
The decision to prescribe selegiline should take into consideration that the MAO system of enzymes is complex and incompletely understood and there is only a limited amount of carefully documented clinical experience with selegiline. Consequently, the full spectrum of possible responses to selegiline may not have been observed in pre-marketing evaluation of the drug. It is advisable, therefore, to observe patients closely for atypical responses.
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"
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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. 315.72Tips
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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).