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Isoxsuprine


General


Pronunciation

(eye SOKS syoo preen)


Indications


Use: Labeled Indications

Cerebrovascular insufficiency: Relief of symptoms associated with cerebrovascular insufficiency.

Peripheral vascular diseases: Treatment of peripheral vascular diseases, such as arteriosclerosis obliterans, thromboangiitis obliterans (Buerger disease), and Raynaud disease.

Note: More appropriate therapies (medical or surgical) should be considered; efficacy of isoxsuprine in the treatment of these conditions has not been well established.


Contraindications


Arterial bleeding; use immediately postpartum


Dosing and Administration


Dosing: Adult

Peripheral vascular disease or symptoms of cerebrovascular insufficiency: Oral: 10 to 20 mg 3 or 4 times daily


Dosing: Geriatric

Refer to adult dosing.


Dosing: Renal Impairment

There are no dosage adjustments provided in the manufacturer 's labeling.


Dosing: Hepatic Impairment

There are no dosage adjustments provided in the manufacturer 's labeling.


Storage

Store at room temperature.


Dosage Forms/Strengths


Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral, as hydrochloride:

Generic: 10 mg, 20 mg


Drug Interactions

There are no known significant interactions.


Adverse Reactions


Frequency not defined.

Cardiovascular: Chest pain, hypotension, tachycardia

Central nervous system: Dizziness

Dermatologic: Skin rash

Gastrointestinal: Abdominal distress, nausea, vomiting


Warnings/Precautions


Concerns related to adverse effects:

- Rash: Severe rash has been reported; discontinue use if rash appears.


Pregnancy Considerations

Isoxsuprine crosses the placenta. Adverse effects (eg, hypocalcemia, hypoglycemia, hypotension, and ileus) requiring treatment have been observed in infants born to mothers who received isoxsuprine during pregnancy. Maternal and fetal tachycardia have occurred with use and pulmonary edema has been reported with maternal use of beta stimulants (Brazy, 1979; Brazy, 1981). Although isoxsuprine has been evaluated for the treatment of premature labor, use for this indication is not currently recommended (ACOG, 2012).


Actions


Pharmacology

Isoxsuprine increases muscle blood flow, but skin blood flow is usually unaffected. Rather than increasing muscle blood flow by beta-receptor stimulation, isoxsuprine probably has a direct action on vascular smooth muscle. The generally accepted mechanism of action of isoxsuprine on the uterus is beta-adrenergic stimulation (Kaindl 1959, Samuels 1959).


Absorption

Rapid and complete (Samuels 1959)


Excretion

Urine (Kaindl 1959).


Time to Peak

Time to peak, serum: ~1 hour; serum concentrations maintained for at least 3 hours (Kaindl 1959)


Patient and Family Education


Patient Education

- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

- Patient may experience abdominal pain, vomiting, or nausea. Have patient report immediately to prescriber severe dizziness, passing out, angina, or tachycardia (HCAHPS).

- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

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