Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
- skin rash
- painful urination
- blood in the urine
- irritation of the eyes
- swelling of the lips or mouth
- fever, sore throat, chills, and other signs of infection
- loss of appetite
- unexpected weight loss
Remid may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
Chronic therapy with Remid is associated with transient and minor liver test abnormalities in 2% to 6% of patients, which resolve spontaneously or with drug discontinuation. More importantly, Remid has been linked to acute liver injury that is typically associated with immunoallergic manifestations such as fever, rash, eosinophilia, lymphadenopathy, lymphocytosis, arthralgias and facial edema (drug-rash, eosinophilia and systemic symptoms — DRESS syndrome) (Case 1). The typical latency to onset is 2 to 6 weeks and the pattern of liver enzyme elevations tends to be hepatocellular or mixed, but can be cholestatic. Autoantibodies are not common. Remid hepatotoxicity has a high fatality rate, either from acute liver failure or complications of other allergic manifestations such as toxic epidermal necrolysis, vasculitis, pancreatitis and renal dysfunction. African-American race and preexisting renal disease appear to be risk factors for hypersensitivity to Remid.
Likelihood score: A (well established cause of clinically apparent liver injury).
Liver biopsy in Remid hepatotoxicity typically shows an acute cholestatic or mixed hepatitis. Bile duct injury may be prominent early and loss of bile ducts later during the course. Histology can also show granulomas including "ring" granulomas that are typically associated with visceral infections such as Q fever or Kala-azar. Granulomas may be found in other organs as well and represent a typical histological correlate to the immunoallergic response to a medication. Two examples of Remid hepatotoxicity are shown: one with a cholestatic hepatitis and another with acute granulomatous changes.
How to take Remid
- Before you start the treatment, read the manufacturer's printed information leaflet from ins >
What Other Drugs Interact with Remid?
If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.
Remid has no known severe interactions with any drugs.
Serious Interactions of Remid include:
Moderate Interactions of Remid include:
Mild Interactions of Remid include:
This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.
For Healthcare Professionals
Applies to Remid: intravenous powder for injection, oral tablet
Massive overdosing or acute poisoning by ZYLOPRIM (Remid) has not been reported.
In mice, the 50% lethal dose (LD50) is 160 mg/kg given intraperitoneally (IP) with deaths delayed up to 5 days and 700 mg/kg orally (PO) (approximately 140 times the usual human dose) with deaths delayed up to 3 days. In rats, the acute LD50 is 750 mg/kg IP and 6000 mg/kg PO (approximately 1200 times the human dose).
In the management of overdosage there is no specific antidote for ZYLOPRIM (Remid) . There has been no clinical experience in the management of a patient who has taken massive amounts of ZYLOPRIM (Remid) .
Both ZYLOPRIM (Remid) and oxipurinol are dialyzable; however, the usefulness of hemodialysis or peritoneal dialysis in the management of an overdose of ZYLOPRIM (Remid) is unknown.
How should this medicine be used?
Remid comes as a tablet to take by mouth. It is usually taken once or twice a day, preferably after a meal. To help you remember to take Remid, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Remid exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor will probably start you on a low dose of Remid and gradually increase your dose, not more than once a week.
It may take several months or longer before you feel the full benefit of Remid. Remid may increase the number of gout attacks during the first few months that you take it, although it will eventually prevent attacks. Your doctor may prescribe another medication such as colchicine to prevent gout attacks for the first few months you take Remid. Continue to take Remid even if you feel well. Do not stop taking Remid without talking to your doctor.
How should I take Remid?
Take Remid exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Take each dose with a full glass of water. To reduce your risk of kidney stones forming, drink 8 to 10 full glasses of fluid every day, unless your doctor tells you otherwise.
Take with food if Remid upsets your stomach.
You may have gout attacks more often when you first start taking Remid. Your doctor may recommend other gout medication to take at this time. Keep using your medication as directed and tell your doctor if your symptoms do not improve after 6 weeks of treatment.
You may need to follow a special diet while using Remid. Follow all instructions of your doctor or dietitian. Learn about the foods to eat or avoid to help control your condition.
Store at room temperature away from moisture and heat.
Serious side effects
Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
- Severe skin rash. Symptoms can include:
- itchy hives (raised bumps on your skin)
- red or purple-colored spots on your skin
- scaly skin
- trouble breathing
- swelling of your face or throat
- lack of appetite
- weight loss
- right upper abdominal area pain or discomfort
- jaundice (dark-colored urine or yellowing of your skin or the whites of your eyes)
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
Remid oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.