Indications and Usage for Scandene
Scandene capsules, USP are indicated:
- For relief of the signs and symptoms of osteoarthritis.
- For relief of the signs and symptoms of rheumato > Carefully cons > .
After observing the response to initial therapy with Scandene, the dose and frequency should be adjusted to suit an individual patient's needs.
For the relief of rheumatoid arthritis and osteoarthritis, the dosage is 20 mg given orally once per day. If desired, the daily dose may be divided. Because of the long half-life of Scandene, steady-state blood levels are not reached for 7 days to 12 days. Therefore, although the therapeutic effects of Scandene are evident early in treatment, there is a progressive increase in response over several weeks and the effect of therapy should not be assessed for two weeks.
Serious Skin Reactions
NSAIDs, including Scandene, can cause serious skin adverse reactions such as exfoliative dermatitis, Stevens- Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. These serious events may occur without warning. Inform patients about the signs and symptoms of serious skin reactions, and to discontinue the use of FELDENE at the first appearance of skin rash or any other sign of hypersensitivity. FELDENE is contraindicated in patients with previous serious skin reactions to NSAIDs .
Anemia has occurred in NSAID-treated patients. This may be due to occult or gross blood loss, fluid retention, or an incompletely described effect on erythropoiesis. If a patient treated with Scandene has any signs or symptoms of anemia, monitor hemoglobin or hematocrit.
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Mechanism Of Action
Scandene has analgesic, anti-inflammatory, and antipyretic properties.
The mechanism of action of FELDENE, like that of other NSAIDs, is not completely understood but involves inhibition of cyclooxygenase (COX-1 and COX-2).
Scandene is a potent inhibitor of prostaglandin (PG) synthesis in vitro. Scandene concentrations reached during therapy have produced in vivo effects. Prostaglandins sensitize afferent nerves and potentiate the action of bradykinin in inducing pain in animal models. Prostaglandins are mediators of inflammation. Because Scandene is an inhibitor of prostaglandin synthesis, its mode of action may be due to a decrease of prostaglandins in peripheral tissues.
Scandene (PIRO) is a nonselective NSAID used for its anti-inflammatory properties as well and for its value as a chemopreventive and antitumor agent. It has a much higher potency against COX-1 than COX-2. Scandene has good oral bioavailability and a long half-life in mammals, but PD and PK studies have not been carried out in any avian species. Despite the high incidence of negative side effects of Scandene used in humans, there are no reports of its toxicity in birds. It has been used clinically for the long-term treatment of chronic arthritis in cranes. 23
Limited data from 2 published reports that included a total of 6 breastfeeding women and 2 infants showed Scandene is excreted in human milk at approximately 1% to 3% of the maternal concentration. No accumulation of Scandene occurred in milk relative to that in maternal plasma during treatment. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for FELDENE and any potential adverse effects on the breastfed infant from the FELDENE or from the underlying maternal condition.
¿Qué sucedería en una sobredosis?
Busque atención medica de emergencia si sospecha que ha usado demasiado de esta medicina. Los síntomas de una sobredosis de Scandene puede incluir náusea, vómito, dolor de estómago, heces fecales negras o con sangre, o tos con sangre.
Which drugs or supplements interact with Scandene?
Scandene may increase the blood levels of lithium (Eskalith, Lithobid) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity.
Scandene may reduce the blood pressure lowering effects of blood pressure medications. This may occur because prostaglandins play a role in the regulation (reduction) of blood pressure.
Combining NSAIDs such as Scandene with angiotensin receptor blockers (for example, valsartan , losartan , irbesartan ) or angiotensin converting enzyme ACE) inhibitors (for example, enalapril , captopril ) in patients who are elderly, volume-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects usually are reversible.
When Scandene is used in combination with methotrexate (Rheumatrex, Trexall) or aminoglycoside antibiotics (for example, gentamicin) the blood levels of methotrexate or aminoglycoside may increase, presumably because the elimination of methotrexate or aminoglycosides from the body is reduced. This may lead to more methotrexate- or aminoglycoside- related side effects.
Individuals taking oral blood thinners or anticoagulants, for example, warfarin, (Coumadin), should avoid Scandene because Scandene also thins the blood, and excessive blood thinning may lead to bleeding.
Alcohol consumption may increase the risk of developing stomach ulcers when taking Scandene or other NSAIDs.
Before taking this medicine
You should not use Scandene if you are allergic to it, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.
Scandene can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
Scandene may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using Scandene, especially in older adults.
Tell your doctor if you have ever had:
heart disease, high blood pressure, or if you smoke;
a heart attack, stroke, or blood clot;
a stomach ulcer or stomach bleeding (especially while using an NSAID);
liver or kidney disease.
Taking Scandene during the last 3 months of pregnancy may harm the unborn baby. Tell your doctor if you are pregnant.
Ovulation (release of an egg from your ovary) could be delayed while you are taking Scandene. This effect is usually not permanent. You should not take Scandene while you are trying to get pregnant.
It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.
Scandene is not approved for use by anyone younger than 18 years old.