Duration of treatment Indefinite iv. Adverse effects The adverse reactions related to somatostatin analogues are predominantly gastrointestinal and common effects include diarrhoea or constipation, abdominal pain, nausea, flatulence, cholelithiasis, gall bladder sludge. Less common side effects may include: asthenia, fatigue, increased bilirubin, hot flushes, leg pain, malaise, headache, tenesmus, vomiting, abnormal glucose tolerance, hyperglycaemia, decreased libido, somnolence, pruritus, increased sweating. Local skin reactions may occur at injection sites.
Duration of treatment Indefinite v. Adverse effects Very common (≥1/10): • Congestive heart failure, increased plasma creatinine, prolonged QTc interval Common (≥1/100 to <1/10): • Bradycardia, diarrhoea, vomiting, nausea, abdo pain, dyspepsia, LFT abnormalities, rashes, pruritus, fatigue, asthenia Uncommon (≥1/1,000 to <1/100): • Dysgeusia, erythemas, eczema, photosensitivity reaction, allergic dermatitis, dermatitis, Interstitial lung disease including pneumonitis and pulmonary fibrosis Rare (≥1/10,000 to <1/1,000): • Ageusia, hepatocellular liver injury (including life-threatening acute liver failure), Vasculitis, including leukocytoclastic vasculitis, Anaphylactic reactions including angioedema In clinical trials, the most frequently observed adverse reactions with dronedarone 400 mg po bd were diarrhoea, nausea, vomiting, fatigue and asthenia. Refer to the SPC for a full list of adverse effects & further information xxxx://xxx.xxxxxxxxx.xxx.xx
Duration of treatment Indefinite as long as treatment is considered appropriate by specialist (epilepsy specialist, adult or paediatric neurologist) When used for treatment of Epileptic spasms ( West Syndrome) there is a Trust approved guideline which follows regional ( CEWT: Children’s Epilepsy Workflow in Trent) guidelines regarding length of treatment ( see appendix 3)
Duration of treatment Indefinite v. Adverse effects Rare or very rare Alopecia; angina pectoris (more common at excessive dosage); arrhythmia (more common at excessive dosage); diarrhoea (more common at excessive dosage); heat intolerance; muscle cramps; muscle weakness; palpitations (more common at excessive dosage); tachycardia (more common at excessive dosage); vomiting (more common at excessive dosage) Frequency not known Agitation; fever; flushing; headache; hyperhidrosis; insomnia (more common at excessive dosage); oedema; restlessness (more common at excessive dosage); skin reactions; tremor (more common at excessive dosage); weight decreased For a full list of all potential adverse event please refer to the spc
Duration of treatment Indefinite vi. Adverse effects Very common (≥1/10): Hot flush*, injection site adverse events Common (≥1/100 to <1/10): anaemia*, weight increase*, insomnia, dizziness, headache, diarrhoea, nausea, liver transaminases increased, hyperhidrosis (inc. night sweats)*, rash, musculoskeletal pain & discomfort, gynaecomastia*, testicular atrophy*, erectile dysfunction*, chills, pyrexia, fatigue*, influenza-like illness *known physiological consequence of testosterone suppression
Duration of treatment Indefinite v. Adverse effects Apomorphine is usually highly emetogenic, so all patients are treated with domperidone 10mg TDS starting at least 3 days prior to initiation of therapy. Domperidone will be gradually withdrawn. Domperidone should be avoided in patients who are taking concomitant medication known to cause QT prolongation, an ECG should be performed prior to using domperidone and the decision to use made by the specialist. It is sometimes possible to withdraw this after a couple of months. The domperidone may also prevent/reduce postural hypotension. See MHRA drug safety update (May 2014) Apomorphine may provoke; nausea and vomiting postural hypotension – usually only transient on initiation of treatment Neuro-psychiatric disturbances, e.g. hallucinations, delusions and confusional states. Inflammation and formation of nodules at injection sites. dyskinesias (abnormal involuntary movements) eosinophilia in up to 10% of patients Coomb’s reaction in 6% of patients haemolytic anaemia and thrombocytopenia
