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Iodoquinol (United States and Canada: Not available): Drug information

Iodoquinol (United States and Canada: Not available): Drug information
(For additional information see "Iodoquinol (United States and Canada: Not available): Patient drug information" and see "Iodoquinol (United States and Canada: Not available): Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Quinja [DSC]
Pharmacologic Category
  • Amebicide
Dosing: Adult

Note: Quinja has been discontinued in the United States for more than 1 year.

Dermatologic conditions

Dermatologic conditions: Topical: Apply to affected area 3 to 4 times daily or as directed.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Topical: Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Iodoquinol (United States and Canada: Not available): Pediatric drug information")

Note: Quinja has been discontinued in the United States for more than 1 year.

Dermatoses

Dermatoses: Children ≥12 years and Adolescents: Topical: Apply to affected area(s) 3 to 4 times daily; Note: Due to potential toxicity (neuritis and optical atrophy) and effective alternative therapy, experts recommend against use (Ref).

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer’s labeling.

Adverse Reactions

There are no adverse reactions listed in the manufacturer’s labeling for the topical product.

Contraindications

Hypersensitivity to iodoquinol or any component of the formulation

Warnings/Precautions

Concerns related to adverse effects:

• Hypersensitivity reactions: Discontinue use if hypersensitivity reactions occur.

Disease-related concerns:

• Thyroid disease: Use with caution in patients with thyroid abnormalities. Thyroid function tests should not be performed for at least one month after discontinuing topical iodoquinol therapy.

Other warnings/precautions:

• Topical: For external use only. May cause discoloration of skin, hair and fabrics; can be removed with normal cleansing and laundry. Not intended for use on infants or under diapers or occlusive dressings. Prolonged use may result in overgrowth of nonsusceptible organisms.

Warnings: Additional Pediatric Considerations

Oral and topical halogenated hydroxyquinolines including iodoquinol are associated with serious, permanent neuropathy including optic atrophy, the most common neuropathy reported in children. The toxicity seems to be related to the dose and duration of therapy. Large, single doses have been associated with cerebral dysfunction, including disorientation and retrograde amnesia; prolonged therapy (>3 weeks) has been associated with peripheral neuropathy and optic atrophy (AAP 1974). Topical application may lead to significant systemic absorption causing toxicity. Since topical application may lead to toxicity especially in infants and children and alternative effective treatments exist, experts recommend against use (AAP 1990).

Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Shehab 2009).

Product Availability

Quinja has been discontinued in the United States for >1 year.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Gel, External:

Quinja: 1.25% (60 g [DSC]) [contains benzyl alcohol, fd&c blue #1 (brilliant blue), propylene glycol, quinoline yellow (d&c yellow #10), sd alcohol 40b, trolamine (triethanolamine)]

Generic Equivalent Available: US

No

Pricing: US

Gel (Quinja External)

1.25-1% (per gram): $159.36

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Pediatric

Topical: For external use only; avoid contact with eyes. Not recommended for use under occlusive dressings or diaper areas. Discoloration of the skin, hair, and fabrics may occur.

Use: Labeled Indications

Dermatological conditions (topical): Acne urticata; lichen simplex chronicus; contact or atopic dermatitis; endogenous chronic infectious dermatitis; stasis dermatitis; bacterial dermatoses; mycotic dermatoses such as tinea (capitis, cruris, corporis, pedis); impetiginized eczema; nuchal eczema and chronic eczematoid otitis externa; nummular eczema; folliculitis; intertrigo; moniliasis; localized or disseminated neurodermatitis; anogenital pruritus (vulvae, scroti, ani); pyoderma

Metabolism/Transport Effects

None known.

Drug Interactions

There are no known significant interactions.

Pregnancy Considerations

Information related to the use of iodoquinol in pregnancy is limited and not specific to topical use (Heinonen 1977; Vedder 1956; Verburg 1974)

Breastfeeding Considerations

It is unknown if iodoquinol is present in breast milk. The manufacturer recommends that caution be exercised when administering iodoquinol to breastfeeding women.

Mechanism of Action

Amebicide that has antifungal and antibacterial properties.

Pharmacokinetics (Adult Data Unless Noted)

Absorption: There are no data available regarding the percutaneous absorption of iodoquinol.

  1. American Academy of Pediatrics Committee on Drugs. Blindness and neuropathy from diiodohydroxyquin-like drugs. Committee on Drugs. Pediatrics. 1974;54(3):378-379. [PubMed 4278011]
  2. American Academy of Pediatrics Committee on Drugs. Clioquinol (iodochlorhydroxyquin, vioform) and iodoquinol (diiodohydroxyquin): blindness and neuropathy. Pediatrics. 1990;86(5):797-798. [PubMed 2146587]
  3. American Academy of Pediatrics Committee on Drugs. "Inactive" ingredients in pharmaceutical products: update (subject review). Pediatrics. 1997;99(2):268-278. [PubMed 9024461]
  4. Heinonen OP, Sloane D, and Shaprio S, "Birth Defects and Drugs in Pregnancy," Littleton, MA: Publishing Science Group, Inc, 1977.
  5. Quinja (iodoquinol) [prescribing information]. Chicago, IL: Novum Pharma, LLC; February 2018.
  6. Shehab N, Lewis CL, Streetman DD, Donn SM. Exposure to the pharmaceutical excipients benzyl alcohol and propylene glycol among critically ill neonates. Pediatr Crit Care Med. 2009;10(2):256-259. [PubMed 19188870]
  7. Vedder JS, "Acrodermatitis enteropathica (Danbolt-Closs) in Five Siblings; Efficacy of Diodoquin in Its Management," J Pediatr, 1956, 48(2):212-9. [PubMed 13295966]
  8. Verburg DJ, Burd LI, Hoxtell EO, et al, "Acrodermatitis enteropathica and Pregnancy," Obstet Gynecol, 1974, 44(2):233-7. [PubMed 4607826]
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