Atosiban

Atosiban is a peptide analogue of oxytocin but with oxytocin properties. It has been investigated by IV-inf as a tocolytic in the management of premature labor, but there is some concern about adverse effects on the fetus.

Atosiban is primarily indicated in conditions like Prostate cancer, flare with initial gonadorelin therapy, Uncomplicated premature labor.

Atosiban is contraindicated in conditions like Placenta previa, Nausea and vomiting of terminal illness, Motor TICS and adjunctive treatment in chorea, Autoimmune conditions, Dermatological conditions caused or aggravated by sunlight, Eclampsia, Intrauterine fetal death, Antepartum hemorrhage.

The symptomatic adverse reactions produced by Atosiban are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Nausea, Vomiting, Fever, Tachycardia, Insomnia, Rashes, Hot flushes, Hyperglycemia, Injection site reactions.

Concerns related to adverse effects: • Bronchospasm: Rarely, life-threatening paradoxical bronchospasm may occur with use of inhaled bronchodilating agents; this should be distinguished from inadequate response. Discontinue immediately and treat with an alternative therapy. Paradoxical bronchospasm is frequently associated with first use of a new canister or vial. • Hypersensitivity reactions: Immediate hypersensitivity reactions (urticaria, angioedema, rash, bronchospasm, anaphylaxis, oropharyngeal edema) have been reported. Disease-related concerns: • Cardiovascular disease: Use with caution in patients with cardiovascular disease (arrhythmia, coronary insufficiency, or hypertension); beta agonists may cause elevation in blood pressure and heart rate and result in CNS stimulation/excitation. Beta-2 agonists may also increase risk of arrhythmias and electrocardiogram (ECG) changes, such as flattening of the T wave, prolongation of the QTc interval, and ST segment depression. • Diabetes: Use with caution in patients with diabetes mellitus; beta 2 -agonists may increase serum glucose and aggravate ketoacidosis. • Hyperthyroidism: Use with caution in hyperthyroidism; may stimulate thyroid activity. • Hypokalemia: Use with caution in patients with hypokalemia; beta 2 -agonists may decrease serum potassium. • Renal impairment: Use with caution in patients with renal impairment; drug clearance is decreased. • Seizures: Use with caution in patients with seizure disorders; beta-agonists may result in CNS stimulation/excitation. Other warnings/precautions: • Appropriate use: Do not exceed recommended dose; serious adverse events, including fatalities, have been associated with excessive use of inhaled sympathomimetics. • Patient information: Patients must be instructed to seek medical attention in cases where acute symptoms are not relieved or a previous level of response is diminished. The need to increase frequency of use may indicate deterioration of asthma, and treatment must not be delayed. A spacer device or valved holding chamber is recommended when using a metered-dose inhaler.

Concerns related to adverse effects: • Bronchospasm: Rarely, life-threatening paradoxical bronchospasm may occur with use of inhaled bronchodilating agents; this should be distinguished from inadequate response. Discontinue immediately and treat with an alternative therapy. Paradoxical bronchospasm is frequently associated with first use of a new canister or vial. • Hypersensitivity reactions: Immediate hypersensitivity reactions (urticaria, angioedema, rash, bronchospasm, anaphylaxis, oropharyngeal edema) have been reported. Disease-related concerns: • Cardiovascular disease: Use with caution in patients with cardiovascular disease (arrhythmia, coronary insufficiency, or hypertension); beta agonists may cause elevation in blood pressure and heart rate and result in CNS stimulation/excitation. Beta-2 agonists may also increase risk of arrhythmias and electrocardiogram (ECG) changes, such as flattening of the T wave, prolongation of the QTc interval, and ST segment depression. • Diabetes: Use with caution in patients with diabetes mellitus; beta 2 -agonists may increase serum glucose and aggravate ketoacidosis. • Hyperthyroidism: Use with caution in hyperthyroidism; may stimulate thyroid activity. • Hypokalemia: Use with caution in patients with hypokalemia; beta 2 -agonists may decrease serum potassium. • Renal impairment: Use with caution in patients with renal impairment; drug clearance is decreased. • Seizures: Use with caution in patients with seizure disorders; beta-agonists may result in CNS stimulation/excitation. Other warnings/precautions: • Appropriate use: Do not exceed recommended dose; serious adverse events, including fatalities, have been associated with excessive use of inhaled sympathomimetics. • Patient information: Patients must be instructed to seek medical attention in cases where acute symptoms are not relieved or a previous level of response is diminished. The need to increase frequency of use may indicate deterioration of asthma, and treatment must not be delayed. A spacer device or valved holding chamber is recommended when using a metered-dose inhaler.

Scraped Dose — Excipient information presented when available (limited, particularly for generics); consult specific product labeling. Aerosol, Inhalation, as tartrate [strength expressed as base]: Xopenex HFA: 45 mcg/actuation (15 g) Generic: 45 mcg/actuation (15 g) Nebulization Solution, Inhalation, as hydrochloride [strength expressed as base]: Generic: 0.31 mg/3 mL (3 mL); 0.63 mg/3 mL (3 mL); 1.25 mg/3 mL (3 mL); 1.25 mg/0.5 mL (1 ea, 30 ea) Nebulization Solution, Inhalation, as hydrochloride [strength expressed as base, preservative free]: Xopenex: 0.31 mg/3 mL (3 mL); 0.63 mg/3 mL (3 mL); 1.25 mg/3 mL (3 mL) Xopenex Concentrate: 1.25 mg/0.5 mL (1 ea, 30 ea) Generic: 0.31 mg/3 mL (3 mL); 0.63 mg/3 mL (3 mL); 1.25 mg/3 mL (3 mL); 1.25 mg/0.5 mL (1 ea, 30 ea)

No child dosage information is recorded for this medicine yet.

No neonatal dosage information is recorded for this medicine yet.

AtoMOXetine: May enhance the tachycardic effect of Beta2-Agonists. Monitor therapy AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy Atosiban: Beta2-Agonists may enhance the adverse/toxic effect of Atosiban. Specifically, there may be an increased risk for pulmonary edema and/or dyspnea. Monitor therapy Beta-Blockers (Beta1 Selective): May diminish the bronchodilatory effect of Beta2-Agonists. Of particular concern with nonselective beta-blockers or higher doses of the beta1 selective beta-blockers. Monitor therapy Beta-Blockers (Nonselective): May diminish the bronchodilatory effect of Beta2-Agonists. Avoid combination Betahistine: May diminish the therapeutic effect of Beta2-Agonists. Monitor therapy Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Monitor therapy Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Consider therapy modification Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Monitor therapy Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Monitor therapy Haloperidol: QT-prolonging Agents (Indeterminate Risk - Caution) may enhance the QTc-prolonging effect of Haloperidol. Monitor therapy Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Consider therapy modification Loop Diuretics: Beta2-Agonists may enhance the hypokalemic effect of Loop Diuretics. Monitor therapy Loxapine: Agents to Treat Airway Disease may enhance the adverse/toxic effect of Loxapine. More specifically, the use of Agents to Treat Airway Disease is likely a marker of patients who are likely at a greater risk for experiencing significant bronchospasm from use of inhaled loxapine. Management: This is specific to the Adasuve brand of loxapine, which is an inhaled formulation. This does not apply to non-inhaled formulations of loxapine. Avoid combination Methacholine: Beta2-Agonists (Short-Acting) may diminish the therapeutic effect of Methacholine. Management: Hold short-acting beta 2 agonists for 6 hours before methacholine use. Consider therapy modification Monoamine Oxidase Inhibitors: May enhance the adverse/toxic effect of Beta2-Agonists. Monitor therapy Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Management: Concomitant use of ozanimod with sympathomimetic agents is not recommended. If combined, monitor patients closely for the development of hypertension, including hypertensive crises. Consider therapy modification QT-prolonging Agents (Highest Risk): QT-prolonging Agents (Indeterminate Risk - Caution) may enhance the QTc-prolonging effect of QT-prolonging Agents (Highest Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Monitor therapy Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Monitor therapy Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Monitor therapy Thiazide and Thiazide-Like Diuretics: Beta2-Agonists may enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. Monitor therapy Tricyclic Antidepressants: May enhance the adverse/toxic effect of Beta2-Agonists. Monitor therapy

infusions Store in a well closed container, Below 15°C.