crizotinib

High Alert

Metastatic non-small cell lung cancer (NSCLC) that is positive for anaplastic lymphoma kinase (ALK) or ROS1.
Relapsed or refractory, systemic anaplastic large cell lymphoma that is positive for ALK.
Unresectable, recurrent, or refractory inflammatory myofibroblastic tumor that is positive for ALK.

Contraindicated in:

Concurrent use of strong CYP3A inhibitors or inducers;
Congenital long QT syndrome;
OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

Heart failure, bradyarrhythmias, electrolyte abnormalities, concurrent medications that prolong QT interval (↑ risk of arrhythmias);
Asian patients (↑ blood levels);
Moderate or severe hepatic impairment (↓ dose);
Severe renal impairment;
Rep: Women of reproductive potential and men with female sexual partners of reproductive potential;
Pedi: Safety and effectiveness not established in children <18 yr (NSCLC) or <1 yr (anaplastic large cell lymphoma or inflammatory myofibroblastic tumor).

CV: bradycardia, edema, QT interval prolongation, chest pain

Derm: rash

EENT: visual disturbances

Endo: ↓testosterone

GI: ↑liver enzymes, constipation, diarrhea, nausea, stomatitis, vomiting, ↓appetite, abdominal pain, esophagitis, HEPATOTOXICITY

GU: ↓fertility, renal impairment

Neuro: dysgeusia, fatigue, headache, insomnia, neuropathy

Resp: INTERSTITIAL LUNG DISEASE (ILD)/PNEUMONITIS

Misc: fever

Drug-drug:

Strong CYP3A inhibitors, including atazanavir, clarithromycin, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, and voriconazole, may ↑ levels; concurrent use should be avoided; if concurrent use unavoidable, ↓ crizotinib dose.
Strong CYP3A inducers, including carbamazepine, phenobarbital, phenytoin, rifabutin, and rifampin, may ↓ levels and effectiveness; concurrent use should be avoided.
May ↑ levels of cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus; avoid concurrent use.
Beta blockers, verapamil, diltiazem, digoxin, and clonidine may ↑ risk of bradycardia; avoid concurrent use, if possible.

Drug-Natural Products:

Concurrent use of St. John's wort may ↓ levels and effectiveness and should be avoided.

Drug-Food:

Grapefruit or grapefruit juice may ↑ levels and should be avoided.

Capsules: 200 mg; 250 mg
Oral pellets: 20 mg; 50 mg; 150 mg

Non-Small Cell Lung Cancer

PO (Adults ): 250 mg twice daily. Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 250 mg once daily. Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Adults ): CCr <30 mL/min (not on dialysis): 250 mg once daily. Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Adults ): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times upper limit of normal [ULN]): 200 mg twice daily. Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 250 mg once daily. Continue until disease progression or unacceptable toxicity.

Systemic Anaplastic Large Cell Lymphoma

PO (Children ≥1 yr and body surface area [BSA] ≥1.70 m²): 500 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 250 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 1.52–1.69 m²): 450 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 200 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 1.34–1.51 m²): 400 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 200 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 1.17–1.33 m²): 350 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 200 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.98–1.16 m²): 300 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 170 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.81–0.97 m²): 250 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 150 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.62–0.80 m²): 200 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 120 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.52–0.61 m²): 150 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 90 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.47–0.51 m²): 140 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 80 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.38–0.46 m²): 120 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 70 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA ≥1.70 m²): CCr <30 mL/min (not on dialysis): 250 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 1.34–1.69 m²): CCr <30 mL/min (not on dialysis): 200 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 1.17–1.33 m²): CCr <30 mL/min (not on dialysis): 200 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 0.98–1.16 m²): CCr <30 mL/min (not on dialysis): 170 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 0.81–0.97 m²): CCr <30 mL/min (not on dialysis): 150 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 0.62–0.80 m²): CCr <30 mL/min (not on dialysis): 120 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 0.52–0.61 m²): CCr <30 mL/min (not on dialysis): 90 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 0.47–0.51 m²): CCr <30 mL/min (not on dialysis): 80 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 0.38–0.46 m²): CCr <30 mL/min (not on dialysis): 70 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA ≥1.70 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 400 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 250 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 1.34–1.69 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 250 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 200 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 1.17–1.33 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 250 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 200 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 0.98–1.16 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 220 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 170 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 0.81–0.97 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 200 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 150 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 0.62–0.80 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 150 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 120 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 0.52–0.61 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 120 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 90 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 0.47–0.51 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 100 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 80 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 0.38–0.46 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 90 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 70 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Inflammatory Myofibroblastic Tumor

PO (Adults ): 250 mg twice daily. Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 250 mg once daily. Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA ≥1.70 m²): 500 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 250 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 1.52–1.69 m²): 450 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 200 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 1.34–1.51 m²): 400 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 200 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 1.17–1.33 m²): 350 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 200 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.98–1.16 m²): 300 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 170 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.81–0.97 m²): 250 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 150 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.62–0.80 m²): 200 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 120 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.52–0.61 m²): 150 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 90 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.47–0.51 m²): 140 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 80 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.
PO (Children ≥1 yr and BSA 0.38–0.46 m²): 120 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Concurrent use of strong CYP3A4 inhibitor: 70 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Adults ): CCr <30 mL/min (not on dialysis): 250 mg once daily. Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA ≥1.70 m²): CCr <30 mL/min (not on dialysis): 250 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA ≥1.34–1.69 m²): CCr <30 mL/min (not on dialysis): 200 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA ≥1.17–1.33 m²): CCr <30 mL/min (not on dialysis): 200 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA ≥0.98–1.16 m²): CCr <30 mL/min (not on dialysis): 170 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA ≥0.81–0.97 m²): CCr <30 mL/min (not on dialysis): 150 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 0.62–0.80 m²): CCr <30 mL/min (not on dialysis): 150 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 0.52–0.61 m²): CCr <30 mL/min (not on dialysis): 90 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 0.47–0.51 m²): CCr <30 mL/min (not on dialysis): 80 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Renal Impairment

PO (Children ≥1 yr and BSA 0.38–0.46 m²): CCr <30 mL/min (not on dialysis): 70 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Adults ): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 200 mg twice daily. Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 250 mg once daily. Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA ≥1.70 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 400 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 250 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA ≥1.34–1.69 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 250 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 200 mg twice daily (oral pellets or capsules). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA ≥1.17–1.33 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 250 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 200 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA ≥0.98–1.16 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 220 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 170 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA ≥0.81–0.97 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 200 mg twice daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 150 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 0.62–0.80 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 150 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 120 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 0.52–0.61 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 120 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 90 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 0.47–0.51 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 100 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 80 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Hepatic Impairment

PO (Children ≥1 yr and BSA 0.38–0.46 m²): Moderate hepatic impairment (AST and total bilirubin >1.5 times and ≤3 times ULN): 90 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity. Severe hepatic impairment (AST and total bilirubin >3 times ULN): 70 mg once daily (oral pellets). Continue until disease progression or unacceptable toxicity.

Xalkori

Inhibits receptor tyrosine kinases, including anaplastic lymphoma kinase, hepatocyte growth factor receptor, ROS1, and recepteur d'origine nantais.

Therapeutic effects:

Decreased spread of lung cancer and improved survival.
Decreased spread of systemic anaplastic large cell lymphoma or inflammatory myofibroblastic tumor.

Therapeutic Classification: antineoplastics

Pharmacologic Classification: kinase inhibitors

Absorption: 43% absorbed following oral administration.

Distribution: Extensively distributed to tissues.

Metabolism/Excretion: Mostly metabolized by the liver (CYP3A4/5 isoenzymes); also acts as an inhibitor of CYP3A. 53% excreted in feces unchanged, 2.3% eliminated unchanged in urine.

Half-Life: 42 hr.

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	4–6 hr	unknown

Instruct patient to take crizotinib as directed; do not change dose or stop taking without consulting health care professional. If vomiting occurs, do not take extra dose; just take next dose at regular scheduled time. Take missed doses as soon as remembered unless <6 hr until next dose. If <6 hr to next dose, skip dose and return to regular schedule; do not double doses. Advise patient to read the Patient Information before starting and with each Rx refill in case of changes.
Advise patient to avoid eating grapefruit or drinking grapefruit juice during therapy.
Caution patient that dizziness and visual disorders may occur. Advise patient to avoid driving or other activities requiring alertness until response to medication is known. Visual disturbances generally start within 2 wk of therapy. Instruct patient to notify health care professional if flashes of light, blurry vision, light sensitivity, or new or worse vitreous floaters occur; ophthalmological evaluation should be considered.
Advise patient to notify health care professional immediately if signs and symptoms of liver problems (weakness, fatigue, anorexia, nausea, vomiting, abdominal pain [especially right upper quadrant abdominal pain], jaundice, dark urine, generalized pruritus, bleeding); lung problems (trouble breathing or shortness of breath, cough with or without mucus, fever); or heart problems (dizziness or fainting, abnormal heartbeats) occur.
Inform patient that nausea, diarrhea, vomiting, and constipation are common side effects and usually occur during first few days of therapy. Standard antiemetic, antidiarrheal, and laxative medications are usually effective.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications, especially St. John's wort.
Rep: May cause fetal harm. Advise females of reproductive potential to use effective contraception and to avoid breastfeeding during and for 45 days following last dose of therapy. Advise males with female partners of reproductive potential to use condoms during treatment and for 90 days after final dose. May cause reduced fertility in females and males of reproductive potential; may be irreversible.

kriz-OH-ti-nib

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Indications ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Availability ⬆ ⬇

Route/Dosage ⬆ ⬇

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Classifications ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Pronunciation ⬆