REMS
Absorption: Systemic absorption occurs following nasal and oral inhalation. Rapidly and extensively absorbed following oral administration, but undergoes first-pass hepatic metabolism (64% bioavailability).
Distribution: 70% of inhaled drug is deposited in the respiratory tract. Appears to concentrate in the respiratory tract and red blood cells. Enters breast milk.
Half-Life: Inhaln9.5 hr (40 days in RBCs); oral43.6 hr (single dose); 12 days (multiple dose).
Contraindicated in:
Use Cautiously in:
Inhalation
CV: CARDIAC ARREST, hypotension
Derm: rash
EENT: blurred vision, conjunctivitis, erythema of the eyelids, ocular irritation, photosensitivity
Hemat: hemolytic anemia, reticulocytosis
Oral
Derm: pruritus (↓ in children)
EENT: dry mouth, optic neuritis, papilledema, retinal artery/vein thrombosis, retinal detachment, retinal hemorrhage, retinopathy (with macular edema), visual abnormalities
GI: anorexia (↑ in children), dyspepsia (↓ in children), vomiting (↑ in children)
GU: ↓fertility (males)
Hemat: hemolytic anemia
MS: arthralgia (↓ in children)
Neuro: dizziness, faintness
Resp: dyspnea (↓ in children)
Misc: fever (↑ in children)
Drug-drug:
RSV Infection
Inhaln
(Infants and Young Children): 300 mL of 20 mg/mL solution delivered via mist for 1218 hr/day.Chronic Hepatitis C
Renal Impairment
Renal Impairment
Lab Test Considerations: