DRUG

INFORMATION
HANDBOOK
wit· INTERNATIONAL
T ADE NAMES INDEX
I
, ;<\da11>t~d from tb],!' Drug lnf9rmatior,pb/9mab0qk, 13rd Edltion,
with !Ganadian arid lrnternafio0a'I Drt:19 Momo!iJrapl:is

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~ American PharmacistsAssociation®
~mproving medication use. Advancing patient care.

APhA Lexicomp is the official drug reference

for the American Pharmacists Association.

3rd Edition

Lexicomp®
 NOTICE
This data is intendedto serve the user as a handy referenceand not as a completedrug informationresource. It does not include
information on every _therapeuticagent available. The publication covers over 1750 ~omm_only used drugs and is specifically
designed to present important aspects of drug data in a more concise format than rs typically found In medical literature or
product material supplied by manufacturers.
The nature of drug information is that It is constantly evolving because of ongoing research and clinical experience and is often
subject to interpretation. While great care has been taken to ensure the accuracy of the information and recommendations
presented, the reader is advised that the authors, editors, reviewers,contributors, and publishers cannot be responsible for the
continued currency of the informationor for any errors, omissions,or the application of this information,or for any consequences
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loss, or damage caused, or alleged to be caused, directly or indirectly, by the use of information contained herein. Becauseof the
dynamic nature of drug information, readers are advised that decisions regarding drug therapy must be based on the
independentjudgment of the clinician, changing informationabout a drug (eg, as reflected in the literature and manufacturer's
most current product information), and changing medical practices. Therefore, this data is designed to be used In conjunction
with other necessary informationand Is not designed to be solely relied upon by any user. The user of this data hereby and
forever releases the authors and publishers of this data from any and all liability of any kind that might arise out of the use of this
data. The editors are not responsiblefor any Inaccuracy of quotation or for any false or misleadingimplicationthat may arise due
to the text or formulas as used or due to the quotation of revisions no longer official.
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u)'"Wolters Kluwer
Health
 INTRODUCTION

TABLE OF CONTENTS
Drug Information Handbook Editorial Advisory Panel......... .. .. 2
Editorial Advisory Panel .. .. .. .. 3
Description of Sections and Fields Used In This Handbook............................. . .. .. 9
Pregnancy Categories......................................................................................................... . 12
Preventing Prescribing Errors..................................... .. . 13
FDA Name Differentiation Project: The Use of Tall-Man Letters. .. 15

ALPHABETICAL LISTING OF DRUGS 19

APPENDIX....... .. 2275
Abbreviations and Measurements........ .. .. .. .. .. .. . 2276
Assessment of Liver Function 2300
Assessment of Renal Function............................. .. 2301
Comparative Drug Charts......................... . 2304
Cytochrome P450 and Drug Interactions............ .. 2317
Desensitization Protocols................. .. 2326
Immunizations and Vaccinations.... .. 2335
Infectious Disease: Prophylaxis...... .... .. .. .... .. .... .. .... .... .. .. .. .. .. .. 2354
Infectious Disease: Treatment............... .. 2356
Therapy Recommendations.................. .. 2360
Miscellaneous........... .. .. .. 2372

PHARMACOLOGIC CATEGORY INDEX .. .. 2387

INTERNATIONAL TRADE NAMES INDEX .. .. 24,17

DRUG INFORMATION HANDBOOK EDITORIAL ADVISORY PANEL

DRUG INFORMATION HANDBOOK EDITORIAL

ADVISORY PANEL
Amanda H. Corbett, PharmD, BCPS, FCCP, AAHIVE
Clinical Assistant Professor
Eshelman School of Pharmacy
University of North Carolina
William J. Dana, PharmD, FASHP
Pharmacotherapy Contributor
Wolters Kluwer Health
Matthew A. Fuller, PharmD, BCPS, BCPP, FASHP
Clinical Pharmacy Special/st, Psychiatry
Cleveland Department of Veterans Affairs Medical Center
Associate Clinical Professorof Psychiatry and Clinical Instructor of Psychology
Case Western Reserve University
Adjunct Associate Professor of Clinical Pharmacy
University of Toledo
Jason C. Gallagher, PharmD, BCPS
Cllnlcal Pharmacy Specialist, Infectious Diseases
and Clinical Associate Professor
Temple University Hospital
Julie A. Golembiewski, PharmD
Cflnical Associate Professorand Clinical Pharmacist, Anesthesia/Pain
Colleges of Pharmacy and Medicine
University of Illinois
Jeffrey P. Gonzales, PharmD, BCPS
Critical Care Clinical Pharmacy Special/st
University of Maryland Medical Center
Jennifer Fisher Lowe, PharmD, BCOP
Pharmacotherapy Contributor
Wolters Kluwer Health
Amy Rybarczyk, PharmD, BCPS
Pharmacotherapy Specialist, Internal Medicine
Akron General Medical Center
Joseph Snoke, RPh, BCPS
Manager
Core Pharmacology Group
Wolters Kluwer Health
Sallie Young, PharmD, BCPS, AQ Cardiology
Cflnical Pharmacy Specialist, Cardiology
Penn State Milton S. Hershey Medical Center

2
 INTRODUCTION

EDITORIAL ADVISORY PANEL

Joseph F. Alexander Jr., MD Diedra L. Bragalone, PharmD,
Clinical Professor of Internal Medicine MBA, BCOP, BCPS
Northeast Ohio Medical University (NEOMED) Pharmacotherapy Specialist
Al/ergistllmmunologist Wolters Kluwer Health
Summa Health System
Lee Bragg, PharmD
Roa'a Al-Gain, PharmD, BCPS, BCACP Pharmacotherapy Specialist
Drug Information Pharmacist Wolters Kluwer Health
and Clinical Pharmacist, Anticoagulation
King Faisal Specialist Hospital & Research Center Susan P. Bruce, PharmD, BCPS
Chair and Associate Professor
Abdulrazaq AI-Jazairi, PharmD, FCCP, Department of Pharmacy Practice
BCPS, AQ Cardiology Northeast Ohio Medical University (NEOMED)
Head, Medical/Critical Care Pharmacy Services
and Clinical Pharmacist, Cardiology Gretchen L. Brummel, PharmD, BCPS
Department of Pharmacy Services Director, Clinical Pharmacy Services
King Faisal Specialist Hospital & Research Center Penn State Milton S. Hershey Medical Center

Nada Alqadheeb, PharmD, BCPS, FCCP William F. Buss, PharmD

Clinical Pharmacy Consultant, Critical Care Clinical Pharmacist
King Faisal Specialist Hospital & Research Center Neonatal Intensive Care Unit
Indiana University Health
Aljohara AI-Sakran, PharmD, BCPS James Whitcomb Riiey Hospital for Children
Clinical Pharmacy Specialist, Pediatrics
King Faisal Specialist Hospital & Research Center Katie Carls, PharmD, BCPP
Pharmacotherapy Specialist
Jill Allen, PharmD Wolters Kluwer Health
Consultant, Independent Medical Writer
Wolters Kluwer Health Regine L. Caruthers, PharmD, RPh
Clinical Pharmacist
William Alvarez Jr., BS, PharmD, BCPS University of Michigan Health System
Pharmacotherapy Specialist
Wolters Kluwer Health Jared Cash, PharmD, BCPS
Pharmacy Clinical Coordinator
Christina L. Aquilante, PharmD Primary Children's Medical Center
Associate Professor lntermountain Healthcare
Department of Pharmaceutical Sciences
Co-Director Larisa H. Cavallari, PharmD, BCPS
Center for Translational Assistant Professor
Pharmacokinetics & Pharmacogenomics Department of Pharmacy Practice
University of Colorado Denver School of Pharmacy University of Illinois

Verna L. Baughman, MD Gary D. Ceneviva, MD

Professor Medical Director
Anesthesiology and Neurosurgery MSHMC Pediatric Critical Care Medicine
University of Illinois Penn State Hershey Medical Center

Erin M. Timpe Behnen, PharmD, BCPS Alexandre Chan, PharmD, MPH, BCPS,.,BCOP
Director, Drug Information & Wellness Center Associate Professor
and Assessment Coordinator National University of Singapore
School of Pharmacy Associate Consultant Clinical Pharmacist
Southern Illinois University Edwardsville National Cancer Centre Singapore

Judith L. Seizer, PharmD, CGP, Irene H. Chenowith, MD, FACP

FASCP,AGSF Sen/or Medical Staff
Clinical Professor Department of Internal Medicine
Department of Clinical Pharmacy Practice Summa Health Systems
St John's University College of Pharmacy and Medical Consultant
Health Sciences Wolters Kluwer Health
Associate Professor of Internal Medicine
Jeffrey R. Bishop, PharmD, MS, BCPP Northeast Ohio Medical University (NEOMED)
Assistant Professor
Department of Pharmacy Practice M. Petrea Cober, PharmD, BCNSP
University of Illinois at Chicago Clinical Pharmacy Coordinator
Neonatal Intensive Care Unit
Mark F. Bonfiglio,BS, PharmD, RPh Children's Hospital of Akron
Vice President, Content Development Assistant Professor of Pharmacy Practice
Wolters Kluwer Health Northeast Ohio Medical University (NEOMED)
Christine M. Cohn, PharmD, BCPS
Senior Clinical Editor
Wolters Kluwer Health

3
 EDITORIAL ADVISORY PANEL

~ Amanda H. Corbett, PharmD, Kelley K. Engle, BSPharm

BCPS, FCCP, AAHIVE Medical Science Pharmacist
Clinical Assistant Professor Wolters Kluwer Health
Eshelman School of Pharmacy
Christopher Ensor, PharmD, BCPS (AQ-CV)
University of North Carolina
Cllnlcal Pharmacy Specialist, Thoracic Transplantation
Susan Cornell, PharmD, CDE, University of Pittsburgh Medical Center
FAPhA, FAADE Erin Fabian, PharmD, RPh
Associate Professor Pharmacotherapy Specialist
Department of Pharmacy Practice Wolters Kluwer Health
Assistant Director of Experimental Education
Midwestern University, Chicago College of Pharmacy Elizabeth A. Farrington, PharmD, FCCP,
Marilyn Cortell, RDH, MS, FAADH FCCM, FPPAG, BCPS
Pharmacist Ill - Pediatrics
Associate Professor
New Hanover Regional Medical Center
New York City College of Technology
City University of New York Steve Fink, DMD
Harold L. Crossley, DDS, PhD Kinnelon, NJ
Associate Professorof Pharmacology Margaret A. Fitzgerald, MS, APRN,
Baltimore College of Dental Surgery
University of Maryland
BC, NP-C, FAANP
President
Melanie W. Cucchi, BS, PharmD, RPh Fitzgerald Health Education Associates, Inc.
Pharmacotherapy Contributor Family Nurse Practitioner
Wolters Kluwer Health Greater Lawrence Family Health Center

Laura Cummings, PharmD, BCPS Lawrence A. Frazee, PharmD, BCPS

PharmacotherapySpecialist Pharmacotherapy Special/st
Wolters Kluwer Health Wolters Kluwer Health

William J. Dana, PharmD, FASHP Matthew A. Fuller, PharmD, BCPS, BCPP, FASHP
PharmacotherapyContributor Clinical Pharmacy Specialist, Psychiatry
Wolters Kluwer Health Cleveland Department of Veterans Affairs Medical Center
Associate Clinical Professor of Psychiatry and
Beth Deen, PharmD, BDNSP Clinical Instructor of Psychology
Senior Pediatric Clinical Pharmacy Specialist Case Western Reserve University
Cook Children's Medical Center AdjunctAssociate Professor of Clinical Pharmacy
University of Toledo
Julie A. Dopheide, PharmD, BCPP
Associate Professor of Clinical Pharmacy, Jason C. Gallagher, PharmD, BCPS
Psychiatry and the Behavioral Sciences Clinical Pharmacy Specialist, Infectious Diseases
Schools of Pharmacy and Medicine and Clinical Associate Professor
University of Southern California Temple University Hospital
Mary Duafala, MS Joyce Generali, RPh, MS, FASHP
Consultant, Independent Medical Writer Director, Synthesized Referential Content
Wolters Kluwer Health Wolters Kluwer Health
Kim S. Dufner, PharmD Meredith D. Girard, MD, FACP
Clinical Manager Medical Staff
Wolters Kluwer Health Department of Internal Medicine
Summa Health Systems
Teri Dunsworth, PharmD, FCCP, BCPS Assistant Professor Internal Medicine
Pharmacotherapy Specialist Northeast Ohio Medical University (NEOMED)
Wolters Kluwer Health
Morton P. Goldman, RPh, PharmD, BCPS, FCCP
Eve Echt, MD Health Care Consultant
Medical Staff American Pharmacotherapy, Inc
Department of Radiology
Akron General Medical Center Julie A. Golembiewski
, PharmD
Clinical Associate Professor and Clinical Pharmacist,
Michael S. Edwards, PharmD, MBA, BCOP Anesthesia/Pain
Chief, Oncology Pharmacy Colleges of Pharmacy and Medicine
and Director, Oncology Pharmacy Residency Program University of Illinois
Walter Reed Army Medical Center
Jeffrey P. Gonzales, PharmD, BCPS
Vicki L. Ellingrod, PharmD, BCPP Critical Care Clinical Pharmacy Specialist
Head, Clinical PharmacogenomicsLaboratory University of Maryland Medical Center
and Associate Professor
Department of Psychiatry John Grabenstein, RPh, PhD, FAPhA
Colleges of Pharmacy and Medicine Pharmacotherapy Contributor
University of Michigan Wolters Kluwer Health

4
 INTRODUCTION

Roland Grad, MDCM, MSc, CCFP, FCFP Patrick J. Kiel, PharmD, BCPS, BCOP
Associate Professor Clinical Pharmacy Specialist
Department of Family Medicine Hematology and Stem Cell Transplant
McGill University Indiana University Simon Cancer Center

Larry D. Gray, PhD, ABMM Polly E. Kintzel, PharmD, BCPS, BCOP

Director. Clinical Microbiology Clinical Pharmacy Specialist-Oncology
TriHealth Laboratories Spectrum Health
Bethesda and Good Samaritan Hospitals
Michael Klepser, PharmD, FCCP
Tracy Hagemann, PharmD Professor of Pharmacy
Associate Professor Department of Pharmacy Practice
College of Pharmacy Ferris State University
The University of Oklahoma
Daren Knoell, PharmD
JoEllen L. Hanigosky,PharmD Associate Professorof Pharmacy Practice and
Clinical Coordinator Internal Medicine
Department of Hematology/Oncology/Bone Davis Heart and Lung Research Institute
Marrow Transplant The Ohio State University
Children's Hospital of Akron
David Knoppert, MScPhm, FCCP, MSc, FCSHP
Martin D. Higbee, PharmD Clinical Leader - Paediatrics
Associate Professor Pharmacy Services
Department of Pharmacy Practice and Science London Health Sciences Centre
The University of Arizona Children's Health Research Institute

Jane Hurlburt Hodding, PharmD Sandra Knowles, RPh, BScPhm

Executive Director. Inpatient Pharmacy Drug Policy Research Specialist
Services and Clinical Nutrition Services Li Ka Shlng Institute
Long Beach Memorial Medical Center and St. Michael's Hospital
Miller Children's Hospital
Jill M. Kolesar, PharmD, FCCP, BCPS
Mark T. Holdsworth, PharmD Associate Professor
Associate Professor of Pharmacy & Pediatrics School of Pharmacy
and Pharmacy Practice Area Head University of Wisconsin Paul P. Carbone
College of Pharmacy Comprehensive Cancer Center
The University of New Mexico
Susannah E. Koontz, PharmD, BCOP
Edward Horn, PharmD, BCPS Principal and Consultant
Clinical Specialist, Transplant Surge,y Pediatric Hematology/Oncology and Stem
Allegheny General Hospital Cell Transplantation/Cellular Therapy
Koontz Oncology Consulting, LLC
CollinA. Hovinga, PharmD
Director of Research and Associate Professor Donna M. Kraus, PharmD, FAPhA, FPPAG, FCCP
Dell Children's Medical Center Associate Professorof Pharmacy Practice
UT Austin School of Pharmacy and Pediatric Clinical Pharmacist
Departments of Pharmacy Practice and Pediatrics
Darrell T. Hulisz, PharmD University of Illinois
Associate Professor
Department of Family Medicine Daniel L. Krinsky,RPh, MS
Case Western Reserve University Manager, MTM Services
Giant Eagle Pharmacy
Douglas L. Jennings, PharmD, BCPS Assistant Professor
Clinical Pharmacy Specialist, CardiovascularSurgery Department of Pharmacy Practice
Jackson Memorial Hospital Northeast Ohio Medical University (NEOMED)
Sallie Johnson, PharmD, BCPS, Tim T.Y. Lau, PharmD, ACPR, FCSHP
AQ Cardiology PharmacotherapeuticSpecialist in Infectious Diseases
Clinical Pharmacy Specialist, Cardiology Pharmaceutical Sciences
Penn State Milton S. Hershey Medfcal Center Vancouver General Hospital

Michael A. Kahn, DDS Mandy C. Leonard, PharmD, BCPS

Professor and Chairman Assistant Professor
Department of Oral and Maxillofacial Pathology Cleveland Clinic Lerner College of Medicine of
Tufts University School of Dental Medicine Case Western University
Assistant Director, Drug Information Services
Jeannette Kaiser, MT, MBA Cleveland Clinic
Medical Technologist
Akron General Medical Center Jonathan Leung, PharmD, BCPS, BCPP
Neuropsychiatric Clinical Pharmacist
Julie J. Kelsey, PharmD Mayo Clinic
Clinical Specialist
Women's Health and Family Medicine John J. Lewin Ill, PharmD, BCPS
Department of Pharmacy Services Clinical Specialist, Neurosciences Critical Care
University of Virginia Health System The Johns Hopkins Hospital