Patient/caregiver was educated on contraindications for using Remular as follows:
- Remular is mainly metabolized inside the body by the liver and is excreted out of the body in the urine by the kidneys. If liver is deficient, metabolism of the drug could be compromised, which can result in higher concentrations of the drug in the body for longer periods of time. If kidney function is deficient, elimination of the drug could be compromised, which also can result in higher concentrations of the drug in the body for longer periods of time. Either case can contribute to toxicity and consequent side-effects. So, for individuals with history of compromised hepatic and/or renal function, remular could either be avoided for a safer alternative or used with caution, with close monitoring for symptoms of toxicity with remular.
- Remular can also induce hepatic dysfunction and liver toxicity, leading to fatal liver failure. Individuals can present with symptoms of liver failure, such as, jaundice with yellowing of skin and eyes, itching of skin, upper right abdominal pain, abdominal distension, nausea and vomiting, confusion and disorientation, fluid retention in the body with swelling, and compromised appetite. Remular could best be avoided for a safer alternative or used with extra caution with close watch for signs and symptoms of liver failure in individuals with history of compromised liver function.
- Remular could interact with a number of other medications and can precipitate serious reactions. If you are being newly started on remular, discuss with your physician regarding all other medications you are currently taking and their safety with remular. Also, if you have been taking remular for long, discuss with your physician regarding your history of remular intake, when you are being started on any new medication.
