Patient/caregiver was educated on precautions to be exercised while taking ryanodex as follows:
- Ryanodex use can rarely lead to bone marrow failure, resulting in low blood cell count. Poor red cell count can lead to development of symptoms of anemia, such as, fatigue, weakness, confusion, dizziness, pale skin, increased heart rate, and shortness of breath. Low white blood cell counts from marrow failure can increase individual’s risk for infections. Low platelet counts due to marrow failure can result in increased risk for hemorrhage and bleeding episodes. Ryanodex could be avoided in individuals with history of bone marrow failure or used with extra caution with close watch for signs and symptoms of worsening anemia, increased frequency of infections, hemorrhages, and bleeding episodes.
- Chronic use of ryanodex can induce inflammation of the pleura, a membrane surrounding the lungs, resulting in swelling of the pleura and episodes of chest pain. Secondary to inflammation of the membranes, fluid gets built up around the lungs. Progressively worsening fluid accumulation around the lungs can exert pressure on the lungs from all sides and thus limit lung expansion, contributing to poor exchange of gases. Compromised lung expansion in due course of time can result in decreased lung capacity, shortness of breath, and fatigue. So, ryanodex use could be avoided for a safer alternative in individuals with history of compromised lung capacity and poor lung expansion or used with extra caution with close watch for signs and symptoms of worsening lung function and increasing breathing difficulty.
- Ryanodex is metabolized inside the body by the liver and is excreted out of the body in urine by the kidneys. A portion of the drug is also secreted in the bile into the intestines, which is excreted in feces. If liver function 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 and metabolites in the body for longer periods of time. Either case can contribute to toxicity. While taking ryanodex, periodical labs could be ordered for evaluation of liver and kidney functions. So, maintain compliance with follow-up physician appointments and lab draws ordered. Be accommodative to the plan of dose changes accordingly to achieve an optimum response and prevent development of any undesired side-effects & toxicity.
