Discontinue use if increases in ALT & AST >3x ULN & persist; throughout duration of fusidic acid treatment in patients where use of systemic fusidic acid is essential; suspected patient has developed ILD. Promptly interrupt therapy if serious liver injury w/ clinical symptoms &/or hyperbilirubinaemia or jaundice occurs during treatment. Temporarily interrupt therapy when creatine kinase (CK) levels are >5x ULN or when there are severe clinical symptoms. Interrupt therapy if a markedly elevated (>5x ULN) CK level is detected. Not suitable when hypercholesterolaemia is due to elevated HDL-C. Not recommended in asymptomatic patients on treatment the routine monitoring of CK or other muscle enzyme levels. Not recommended to restart therapy if hereditary muscular disease is suspected. Cases of myopathy, including rhabdomyolysis in co-administration w/ colchicine. History of liver disease or heavy alcohol ingestion. Immune-mediated necrotising myopathy (IMNM) during or after treatment. Re-measure CK levels about 5-7 days later if CK levels are significantly elevated at baseline (>5x ULN). Measure CK levels prior to initiation of therapy in patients w/ predisposing factors eg, renal impairment, hypothyroidism, previous history of muscular toxicity w/ a statin or fibrate, personal or familial history of hereditary muscular disorders, or alcohol abuse. Monitor both clinically & biochemically those patients at risk of future diabetes (fasting glucose 5.6-6.9 mmol/L, BMI >30 kg/m
2, raised triglycerides, HTN). Avoid in combination w/ fibrates. Co-administration w/ nicotinic acid. Combination w/ inhibitors of cytochrome P450 metabolism. Not to be co-administered w/ systemic formulations of fusidic acid or w/in 7 days of stopping fusidic acid treatment. May impair ability to drive or operate machines. Hepatic failure. Renal impairment. Adolescent females of childbearing potential. Discontinue use if patient plans to become pregnant or becomes pregnant. Childn before puberty.
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