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Stiolto Respimat
Overview
What is Stiolto Respimat?
STIOLTO RESPIMAT is a combination of tiotropium,
an anticholinergic, and olodaterol, a long-acting beta-adrenergic agonist (LABA).
The drug substance tiotropium bromide monohydrate
is chemically described as (1α, 2ß, 4ß, 5α, 7ß)-7-[(Hydroxydi-2-thienylacetyl)oxy]-9,9-dimethyl-3-oxa-9-azoniatricyclo[3.3.1.0] nonane bromide monohydrate. It is a synthetic,
non-chiral, quaternary ammonium compound. Tiotropium bromide is a
white or yellowish white powder. It is sparingly soluble in water
and soluble in methanol.
The structural formula is:
Tiotropium bromide (monohydrate) has a molecular
mass of 490.4 and a molecular formula of CHNOSBr • HO.
The drug substance olodaterol hydrochloride
is chemically described as 2H-1,4-Benzoxazin-3H(4H)-one, 6-hydroxy-8-[(1R)-1-hydroxy-2-[[2-(4-methoxyphenyl)-1,1-dimethylethyl]-amino]ethyl]-,
monohydrochloride. Olodaterol hydrochloride is a white to off-white
powder that is sparingly-slightly soluble in water and slightly soluble
in ethanol. The molecular weight is 422.9 g/mole (salt): 386.5 g/mole
(base), and the molecular formula is CHNO x
HCl as a hydrochloride. The conversion factor from salt to free base
is 1.094.
The structural
formula is:
The drug product, STIOLTO RESPIMAT, is composed
of a sterile aqueous solution of tiotropium bromide and olodaterol
hydrochloride filled into a 4.5 mL plastic container crimped into
an aluminum cylinder (STIOLTO RESPIMAT cartridge) for use with the
STIOLTO RESPIMAT inhaler.
Excipients include water for injection,
benzalkonium chloride, edetate disodium, and hydrochloric acid.
The STIOLTO RESPIMAT cartridge
is only intended for use with the STIOLTO RESPIMAT inhaler. The STIOLTO
RESPIMAT inhaler is a hand held, pocket sized oral inhalation device
that uses mechanical energy to generate a slow-moving aerosol cloud
of medication from a metered volume of the drug solution. The STIOLTO
RESPIMAT inhaler has a light green-colored cap.
When used with the STIOLTO RESPIMAT inhaler
each cartridge, containing 4 grams of sterile aqueous solution, delivers
the labeled number of metered actuations after preparation for use.
Each dose (one dose equals two actuations) from the STIOLTO RESPIMAT
inhaler delivers 5 mcg tiotropium and 5 mcg olodaterol in 22.1 mcL
from the mouthpiece. As with all inhaled drugs, the actual amount
of drug delivered to the lung may depend on patient factors, such
as the coordination between the actuation of the inhaler and inspiration
through the delivery system. The duration of inspiration should be
at least as long as the spray duration (1.5 seconds).
What does Stiolto Respimat look like?
What are the available doses of Stiolto Respimat?
Inhalation spray: Each actuation
from the mouthpiece contains 3.124 mcg tiotropium bromide monohydrate,
equivalent to 2.5 mcg tiotropium, and 2.736 mcg olodaterol hydrochloride,
equivalent to 2.5 mcg olodaterol.
Two actuations equal one dose.
()
What should I talk to my health care provider before I take Stiolto Respimat?
Patients with moderate to severe renal impairment
should be monitored closely for potential anticholinergic side effects.
(, )
How should I use Stiolto Respimat?
STIOLTO RESPIMAT is a combination
of tiotropium, an anticholinergic and olodaterol, a long-acting beta-adrenergic agonist (LABA) indicated for:The long-term, once-daily maintenance treatment of airflow obstruction
in patients with chronic obstructive pulmonary disease (COPD) ()
Important limitations:
The recommended dose of STIOLTO RESPIMAT is
two inhalations once-daily at the same time of the day. Do not use
STIOLTO RESPIMAT more than two inhalations every 24 hours.
What interacts with Stiolto Respimat?
Sorry No Records found
What are the warnings of Stiolto Respimat?
Sorry No Records found
What are the precautions of Stiolto Respimat?
Sorry No Records found
What are the side effects of Stiolto Respimat?
Sorry No records found
What should I look out for while using Stiolto Respimat?
All LABAs are contraindicated in patients with asthma without
use of a long-term asthma control medication.
STIOLTO RESPIMAT is not indicated for the treatment of asthma.
STIOLTO RESPIMAT is contraindicated
in patients with a hypersensitivity to tiotropium, ipratropium, olodaterol,
or any component of this product .
In clinical trials and postmarketing experience
with tiotropium, immediate hypersensitivity reactions, including angioedema
(including swelling of the lips, tongue, or throat), itching, or rash
have been reported. Hypersensitivity reactions were also reported
in clinical trials with STIOLTO RESPIMAT.
P1
Long-acting beta-adrenergic agonists
(LABA) such as olodaterol, one of the active ingredients in STIOLTO
RESPIMAT, increase the risk of asthma-related death. Data from a large,
placebo-controlled US study that compared the safety of another long-acting
beta-adrenergic agonist (salmeterol) with
placebo added to usual asthma therapy showed an increase in asthma-related
deaths in patients receiving salmeterol. This finding with salmeterol
is considered a class effect of all LABA, including olodaterol, one
of the active ingredients in STIOLTO RESPIMAT. The safety and efficacy
of STIOLTO RESPIMAT in patients with asthma have not been established.
STIOLTO RESPIMAT is not indicated for the treatment of asthma.
What might happen if I take too much Stiolto Respimat?
STIOLTO RESPIMAT contains both tiotropium bromide and olodaterol;
therefore, the risks associated with overdosage for the individual
components described below apply to STIOLTO RESPIMAT.
Tiotropium
Olodaterol
Treatment
of overdosage consists of discontinuation of STIOLTO RESPIMAT together
with institution of appropriate symptomatic and supportive therapy.
The judicious use of a cardioselective beta-receptor blocker may be
considered, bearing in mind that such medication can produce bronchospasm.
There is insufficient evidence to determine if dialysis is beneficial
for overdosage of STIOLTO RESPIMAT. Cardiac monitoring is recommended
in cases of overdosage.
How should I store and handle Stiolto Respimat?
Store between 2°C and 25°C (36°F and 77°F). Retain in the original package to protect from light. Freezing does not adversely affect the product.STIOLTO RESPIMAT Inhalation Spray is supplied in a labeled carton containing one STIOLTO RESPIMAT cartridge and one STIOLTO RESPIMAT inhaler.The STIOLTO RESPIMAT cartridge is provided as an aluminum cylinder with a tamper protection seal on the cap. The STIOLTO RESPIMAT cartridge is only intended for use with the STIOLTO RESPIMAT inhaler and should not be interchanged with any other RESPIMAT device delivered product. The STIOLTO RESPIMAT inhaler is a cylindrical shaped plastic inhalation device with a gray colored body and a clear base. The clear base is removed to insert the cartridge. The inhaler contains a dose indicator. The light green-colored cap and the written information on the label of the gray inhaler body indicate that it is labeled for use with the STIOLTO RESPIMAT cartridge.STIOLTO RESPIMAT Inhalation Spray is available as:The STIOLTO RESPIMAT cartridge has a net fill weight of at least 4 grams and when used with the STIOLTO RESPIMAT inhaler, is designed to deliver the labeled number of metered actuations after preparation for use.When the labeled number of actuations has been dispensed from the inhaler, the RESPIMAT locking mechanism will be engaged and no more actuations can be dispensed.After assembly, the STIOLTO RESPIMAT inhaler should be discarded at the latest 3 months after first use or when the locking mechanism is engaged, whichever comes first. Keep out of reach of children. Do not spray into eyes. StorageStore at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86F)STIOLTO RESPIMAT Inhalation Spray is supplied in a labeled carton containing one STIOLTO RESPIMAT cartridge and one STIOLTO RESPIMAT inhaler.The STIOLTO RESPIMAT cartridge is provided as an aluminum cylinder with a tamper protection seal on the cap. The STIOLTO RESPIMAT cartridge is only intended for use with the STIOLTO RESPIMAT inhaler and should not be interchanged with any other RESPIMAT device delivered product. The STIOLTO RESPIMAT inhaler is a cylindrical shaped plastic inhalation device with a gray colored body and a clear base. The clear base is removed to insert the cartridge. The inhaler contains a dose indicator. The light green-colored cap and the written information on the label of the gray inhaler body indicate that it is labeled for use with the STIOLTO RESPIMAT cartridge.STIOLTO RESPIMAT Inhalation Spray is available as:The STIOLTO RESPIMAT cartridge has a net fill weight of at least 4 grams and when used with the STIOLTO RESPIMAT inhaler, is designed to deliver the labeled number of metered actuations after preparation for use.When the labeled number of actuations has been dispensed from the inhaler, the RESPIMAT locking mechanism will be engaged and no more actuations can be dispensed.After assembly, the STIOLTO RESPIMAT inhaler should be discarded at the latest 3 months after first use or when the locking mechanism is engaged, whichever comes first. Keep out of reach of children. Do not spray into eyes. StorageStore at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86F)STIOLTO RESPIMAT Inhalation Spray is supplied in a labeled carton containing one STIOLTO RESPIMAT cartridge and one STIOLTO RESPIMAT inhaler.The STIOLTO RESPIMAT cartridge is provided as an aluminum cylinder with a tamper protection seal on the cap. The STIOLTO RESPIMAT cartridge is only intended for use with the STIOLTO RESPIMAT inhaler and should not be interchanged with any other RESPIMAT device delivered product. The STIOLTO RESPIMAT inhaler is a cylindrical shaped plastic inhalation device with a gray colored body and a clear base. The clear base is removed to insert the cartridge. The inhaler contains a dose indicator. The light green-colored cap and the written information on the label of the gray inhaler body indicate that it is labeled for use with the STIOLTO RESPIMAT cartridge.STIOLTO RESPIMAT Inhalation Spray is available as:The STIOLTO RESPIMAT cartridge has a net fill weight of at least 4 grams and when used with the STIOLTO RESPIMAT inhaler, is designed to deliver the labeled number of metered actuations after preparation for use.When the labeled number of actuations has been dispensed from the inhaler, the RESPIMAT locking mechanism will be engaged and no more actuations can be dispensed.After assembly, the STIOLTO RESPIMAT inhaler should be discarded at the latest 3 months after first use or when the locking mechanism is engaged, whichever comes first. Keep out of reach of children. Do not spray into eyes. StorageStore at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86F)STIOLTO RESPIMAT Inhalation Spray is supplied in a labeled carton containing one STIOLTO RESPIMAT cartridge and one STIOLTO RESPIMAT inhaler.The STIOLTO RESPIMAT cartridge is provided as an aluminum cylinder with a tamper protection seal on the cap. The STIOLTO RESPIMAT cartridge is only intended for use with the STIOLTO RESPIMAT inhaler and should not be interchanged with any other RESPIMAT device delivered product. The STIOLTO RESPIMAT inhaler is a cylindrical shaped plastic inhalation device with a gray colored body and a clear base. The clear base is removed to insert the cartridge. The inhaler contains a dose indicator. The light green-colored cap and the written information on the label of the gray inhaler body indicate that it is labeled for use with the STIOLTO RESPIMAT cartridge.STIOLTO RESPIMAT Inhalation Spray is available as:The STIOLTO RESPIMAT cartridge has a net fill weight of at least 4 grams and when used with the STIOLTO RESPIMAT inhaler, is designed to deliver the labeled number of metered actuations after preparation for use.When the labeled number of actuations has been dispensed from the inhaler, the RESPIMAT locking mechanism will be engaged and no more actuations can be dispensed.After assembly, the STIOLTO RESPIMAT inhaler should be discarded at the latest 3 months after first use or when the locking mechanism is engaged, whichever comes first. Keep out of reach of children. Do not spray into eyes. StorageStore at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86F)STIOLTO RESPIMAT Inhalation Spray is supplied in a labeled carton containing one STIOLTO RESPIMAT cartridge and one STIOLTO RESPIMAT inhaler.The STIOLTO RESPIMAT cartridge is provided as an aluminum cylinder with a tamper protection seal on the cap. The STIOLTO RESPIMAT cartridge is only intended for use with the STIOLTO RESPIMAT inhaler and should not be interchanged with any other RESPIMAT device delivered product. The STIOLTO RESPIMAT inhaler is a cylindrical shaped plastic inhalation device with a gray colored body and a clear base. The clear base is removed to insert the cartridge. The inhaler contains a dose indicator. The light green-colored cap and the written information on the label of the gray inhaler body indicate that it is labeled for use with the STIOLTO RESPIMAT cartridge.STIOLTO RESPIMAT Inhalation Spray is available as:The STIOLTO RESPIMAT cartridge has a net fill weight of at least 4 grams and when used with the STIOLTO RESPIMAT inhaler, is designed to deliver the labeled number of metered actuations after preparation for use.When the labeled number of actuations has been dispensed from the inhaler, the RESPIMAT locking mechanism will be engaged and no more actuations can be dispensed.After assembly, the STIOLTO RESPIMAT inhaler should be discarded at the latest 3 months after first use or when the locking mechanism is engaged, whichever comes first. Keep out of reach of children. Do not spray into eyes. StorageStore at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86F)STIOLTO RESPIMAT Inhalation Spray is supplied in a labeled carton containing one STIOLTO RESPIMAT cartridge and one STIOLTO RESPIMAT inhaler.The STIOLTO RESPIMAT cartridge is provided as an aluminum cylinder with a tamper protection seal on the cap. The STIOLTO RESPIMAT cartridge is only intended for use with the STIOLTO RESPIMAT inhaler and should not be interchanged with any other RESPIMAT device delivered product. The STIOLTO RESPIMAT inhaler is a cylindrical shaped plastic inhalation device with a gray colored body and a clear base. The clear base is removed to insert the cartridge. The inhaler contains a dose indicator. The light green-colored cap and the written information on the label of the gray inhaler body indicate that it is labeled for use with the STIOLTO RESPIMAT cartridge.STIOLTO RESPIMAT Inhalation Spray is available as:The STIOLTO RESPIMAT cartridge has a net fill weight of at least 4 grams and when used with the STIOLTO RESPIMAT inhaler, is designed to deliver the labeled number of metered actuations after preparation for use.When the labeled number of actuations has been dispensed from the inhaler, the RESPIMAT locking mechanism will be engaged and no more actuations can be dispensed.After assembly, the STIOLTO RESPIMAT inhaler should be discarded at the latest 3 months after first use or when the locking mechanism is engaged, whichever comes first. Keep out of reach of children. Do not spray into eyes. StorageStore at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86F)STIOLTO RESPIMAT Inhalation Spray is supplied in a labeled carton containing one STIOLTO RESPIMAT cartridge and one STIOLTO RESPIMAT inhaler.The STIOLTO RESPIMAT cartridge is provided as an aluminum cylinder with a tamper protection seal on the cap. The STIOLTO RESPIMAT cartridge is only intended for use with the STIOLTO RESPIMAT inhaler and should not be interchanged with any other RESPIMAT device delivered product. The STIOLTO RESPIMAT inhaler is a cylindrical shaped plastic inhalation device with a gray colored body and a clear base. The clear base is removed to insert the cartridge. The inhaler contains a dose indicator. The light green-colored cap and the written information on the label of the gray inhaler body indicate that it is labeled for use with the STIOLTO RESPIMAT cartridge.STIOLTO RESPIMAT Inhalation Spray is available as:The STIOLTO RESPIMAT cartridge has a net fill weight of at least 4 grams and when used with the STIOLTO RESPIMAT inhaler, is designed to deliver the labeled number of metered actuations after preparation for use.When the labeled number of actuations has been dispensed from the inhaler, the RESPIMAT locking mechanism will be engaged and no more actuations can be dispensed.After assembly, the STIOLTO RESPIMAT inhaler should be discarded at the latest 3 months after first use or when the locking mechanism is engaged, whichever comes first. Keep out of reach of children. Do not spray into eyes. StorageStore at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86F)STIOLTO RESPIMAT Inhalation Spray is supplied in a labeled carton containing one STIOLTO RESPIMAT cartridge and one STIOLTO RESPIMAT inhaler.The STIOLTO RESPIMAT cartridge is provided as an aluminum cylinder with a tamper protection seal on the cap. The STIOLTO RESPIMAT cartridge is only intended for use with the STIOLTO RESPIMAT inhaler and should not be interchanged with any other RESPIMAT device delivered product. The STIOLTO RESPIMAT inhaler is a cylindrical shaped plastic inhalation device with a gray colored body and a clear base. The clear base is removed to insert the cartridge. The inhaler contains a dose indicator. The light green-colored cap and the written information on the label of the gray inhaler body indicate that it is labeled for use with the STIOLTO RESPIMAT cartridge.STIOLTO RESPIMAT Inhalation Spray is available as:The STIOLTO RESPIMAT cartridge has a net fill weight of at least 4 grams and when used with the STIOLTO RESPIMAT inhaler, is designed to deliver the labeled number of metered actuations after preparation for use.When the labeled number of actuations has been dispensed from the inhaler, the RESPIMAT locking mechanism will be engaged and no more actuations can be dispensed.After assembly, the STIOLTO RESPIMAT inhaler should be discarded at the latest 3 months after first use or when the locking mechanism is engaged, whichever comes first. Keep out of reach of children. Do not spray into eyes. StorageStore at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86F)STIOLTO RESPIMAT Inhalation Spray is supplied in a labeled carton containing one STIOLTO RESPIMAT cartridge and one STIOLTO RESPIMAT inhaler.The STIOLTO RESPIMAT cartridge is provided as an aluminum cylinder with a tamper protection seal on the cap. The STIOLTO RESPIMAT cartridge is only intended for use with the STIOLTO RESPIMAT inhaler and should not be interchanged with any other RESPIMAT device delivered product. The STIOLTO RESPIMAT inhaler is a cylindrical shaped plastic inhalation device with a gray colored body and a clear base. The clear base is removed to insert the cartridge. The inhaler contains a dose indicator. The light green-colored cap and the written information on the label of the gray inhaler body indicate that it is labeled for use with the STIOLTO RESPIMAT cartridge.STIOLTO RESPIMAT Inhalation Spray is available as:The STIOLTO RESPIMAT cartridge has a net fill weight of at least 4 grams and when used with the STIOLTO RESPIMAT inhaler, is designed to deliver the labeled number of metered actuations after preparation for use.When the labeled number of actuations has been dispensed from the inhaler, the RESPIMAT locking mechanism will be engaged and no more actuations can be dispensed.After assembly, the STIOLTO RESPIMAT inhaler should be discarded at the latest 3 months after first use or when the locking mechanism is engaged, whichever comes first. Keep out of reach of children. Do not spray into eyes. StorageStore at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86F)STIOLTO RESPIMAT Inhalation Spray is supplied in a labeled carton containing one STIOLTO RESPIMAT cartridge and one STIOLTO RESPIMAT inhaler.The STIOLTO RESPIMAT cartridge is provided as an aluminum cylinder with a tamper protection seal on the cap. The STIOLTO RESPIMAT cartridge is only intended for use with the STIOLTO RESPIMAT inhaler and should not be interchanged with any other RESPIMAT device delivered product. The STIOLTO RESPIMAT inhaler is a cylindrical shaped plastic inhalation device with a gray colored body and a clear base. The clear base is removed to insert the cartridge. The inhaler contains a dose indicator. The light green-colored cap and the written information on the label of the gray inhaler body indicate that it is labeled for use with the STIOLTO RESPIMAT cartridge.STIOLTO RESPIMAT Inhalation Spray is available as:The STIOLTO RESPIMAT cartridge has a net fill weight of at least 4 grams and when used with the STIOLTO RESPIMAT inhaler, is designed to deliver the labeled number of metered actuations after preparation for use.When the labeled number of actuations has been dispensed from the inhaler, the RESPIMAT locking mechanism will be engaged and no more actuations can be dispensed.After assembly, the STIOLTO RESPIMAT inhaler should be discarded at the latest 3 months after first use or when the locking mechanism is engaged, whichever comes first. Keep out of reach of children. Do not spray into eyes. StorageStore at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86F)
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
STIOLTO RESPIMAT
Tiotropium
in vitro
in vivo
Olodaterol
In vitro
Beta-adrenoceptors are divided into three
subtypes: beta-adrenoceptors predominantly
expressed on cardiac muscle, beta-adrenoceptors
predominantly expressed on airway smooth muscle, and beta-adrenoceptors predominantly expressed on adipose tissue.
Beta-agonists cause bronchodilation. Although
the beta-adrenoceptor is the predominant adrenergic
receptor in the airway smooth muscle, it is also present on the surface
of a variety of other cells, including lung epithelial and endothelial
cells and in the heart. The precise function of beta-receptors in the heart is not known, but their presence raises the
possibility that even highly selective beta-agonists may have cardiac effects.
Non-Clinical Toxicology
All LABAs are contraindicated in patients with asthma without use of a long-term asthma control medication. STIOLTO RESPIMAT is not indicated for the treatment of asthma.STIOLTO RESPIMAT is contraindicated in patients with a hypersensitivity to tiotropium, ipratropium, olodaterol, or any component of this product .
In clinical trials and postmarketing experience with tiotropium, immediate hypersensitivity reactions, including angioedema (including swelling of the lips, tongue, or throat), itching, or rash have been reported. Hypersensitivity reactions were also reported in clinical trials with STIOLTO RESPIMAT.
P1
Long-acting beta-adrenergic agonists (LABA) such as olodaterol, one of the active ingredients in STIOLTO RESPIMAT, increase the risk of asthma-related death. Data from a large, placebo-controlled US study that compared the safety of another long-acting beta-adrenergic agonist (salmeterol) with placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol. This finding with salmeterol is considered a class effect of all LABA, including olodaterol, one of the active ingredients in STIOLTO RESPIMAT. The safety and efficacy of STIOLTO RESPIMAT in patients with asthma have not been established. STIOLTO RESPIMAT is not indicated for the treatment of asthma.
Although the pressor activity of DDAVP is very low compared to the antidiuretic activity, use of large doses of intranasal DDAVP with other pressor agents should only be done with careful patient monitoring. The concomitant administration of drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, NSAIDs, lamotrigine and carbamazepine) should be performed with caution.
LABA increase the risk of asthma related death. ()
Do not initiate STIOLTO RESPIMAT in acutely deteriorating COPD patients. ()
Do not use for relief of acute symptoms. Concomitant short-acting beta-agonists can be used as needed for acute relief. ()
Do not exceed the recommended dose. Excessive use of STIOLTO RESPIMAT, or use in conjunction with other medications containing LABA can result in clinically significant cardiovascular effects and may be fatal. ()
Immediate hypersensitivity reactions: Discontinue STIOLTO RESPIMAT at once and consider alternatives if immediate hypersensitivity reactions, including angioedema, bronchospasm, or anaphylaxis, occur. ()
Life-threatening paradoxical bronchospasm can occur. Discontinue STIOLTO RESPIMAT immediately. ()
Use with caution in patients with cardiovascular or convulsive disorders, thyrotoxicosis, or sensitivity to sympathomimetic drugs. (, )
Worsening of narrow-angle glaucoma may occur. Use with caution in patients with narrow-angle glaucoma and instruct patients to consult a physician immediately if this occurs. ()
Worsening of urinary retention may occur. Use with caution in patients with prostatic hyperplasia or bladder-neck obstruction and instruct patients to consult a physician immediately if this occurs. ()
Be alert to hypokalemia and hyperglycemia. ()
LABA, such as olodaterol, one of the active components in STIOLTO RESPIMAT, increase the risk of asthma-related death. STIOLTO RESPIMAT is not indicated for the treatment of asthma
The following adverse reactions are described, or described in greater detail, in other sections:
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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