Calcitriol is a form of vitamin D3. Vitamin D helps your body absorb calcium from the stomach.

Calcitriol is used to treat hyperparathyroidism (overactive parathyroid glands) and metabolic bone disease in people who have chronic kidney failure and are not receiving dialysis.

Calcitriol is also used to treat calcium deficiency in people with hypoparathyroidism (underactive parathyroid glands) caused by surgery, disease, or other conditions.

Calcitriol is also used to treat calcium deficiency (hypocalcemia) and metabolic bone disease in people who are receiving dialysis.

Calcitriol may also be used for purposes not listed in this medication guide.

Calcitriol side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Calcitriol may cause serious side effects. Stop using calcitriol and call your doctor at once if you have:

• dehydration symptoms–feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;
• high calcium levels–nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, confusion, lack of energy, or tired feeling; or
• low calcium level–muscle spasms or contractions, numbness or tingly feeling (around your mouth, or in your fingers and toes).

Calcitriol can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using calcitriol.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings

You should not use this medicine if you have high levels of calcium or vitamin D in your blood, or if you have ever had an allergic reaction to calcitriol or other forms of vitamin D.

Before taking this medicine

You should not use calcitriol if:

• you have high levels of calcium or vitamin D in your blood; or
• you have had an allergic reaction to calcitriol or other forms of vitamin D.

Tell your doctor about all your medical conditions or allergies.

It is not known whether calcitriol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

You should not breastfeed while using calcitriol.

Do not give this medicine to a child without medical advice.

How should I use calcitriol?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Calcitriol oral is taken by mouth.

Measure oral liquid carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Calcitriol injection is given as an infusion into a vein. A healthcare provider will give your first dose and may teach you how to properly use the medication by yourself.

Read and carefully follow any Instructions for Use provided with your medicine. Prepare an injection only when you are ready to give it. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

You will need frequent medical tests.

Drink plenty of fluids unless your doctor has told you to restrict your fluid intake.

You may need to follow a special diet while using calcitriol. Follow all instructions of your doctor or dietitian. Learn about the foods to eat or avoid to help control your condition.

Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking calcitriol. This can lead to very low blood pressure, a serious electrolyte imbalance, or kidney failure.

If you need major surgery or will be on long-term bed rest, your dose or testing needs may change. Follow your doctor’s instructions.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

Early signs of overdose may include headache, weakness, drowsiness, dry mouth, metallic taste, nausea, vomiting, constipation, stomach pain, loss of appetite, muscle pain, or bone pain.

Late signs of overdose may include increased thirst, itching, increased urination (especially at night), severe stomach pain spreading to your back, irregular heartbeats, loss of appetite, weight loss, feeling hot, decreased interest in sex, or being unable to urinate.

What should I avoid while using calcitriol?

Do not take other vitamin or mineral supplements unless your doctor has told you to.

Ask your doctor before using an antacid or laxative, especially if you are on dialysis. Taking antacids or laxatives that contain magnesium may increase your blood levels of magnesium, which could affect your heart or blood pressure.

What other drugs will affect calcitriol?

Tell your doctor about all your other medicines, especially:

• cholestyramine;
• digoxin, digitalis;
• ketoconazole;
• a diuretic or “water pill”–hydrochlorothiazide, HCTZ, Diovan HCT, Hyzaar, Maxzide, Tenoretic, Zestoretic, and others;
• seizure medicine–phenobarbital, phenytoin; or
• steroid medicine–prednisone, dexamethasone, fluticasone, and others.

Boniva is a bisphosphonate medicine that alters bone formation and breakdown in the body. This can slow bone loss and may help prevent bone fractures.

Boniva is prescription medicine used to treat or prevent osteoporosis in women after menopause. Ibandronate helps increase bone mass and helps reduce the chance of having a spinal fracture.

It is not known how long Boniva works for the treatment and prevention of osteoporosis. You should see your doctor regularly to determine if this medicine is still right for you.

Warnings

You should not use Boniva if you have severe kidney disease or low levels of calcium in your blood.

Do not take a tablet if you have problems with your esophagus, or if you cannot sit upright or stand for at least 60 minutes after taking the tablet.

Boniva tablets can cause serious problems in the stomach or esophagus. Stop taking Boniva and call your doctor at once if you have chest pain, new or worsening heartburn, or pain when swallowing.

Also call your doctor if you have muscle spasms, numbness or tingling (in hands and feet or around the mouth), new or unusual hip pain, or severe pain in your joints, bones, or muscles.

Boniva side effects

Get emergency medical help if you have signs of an allergic reaction to Boniva: hives; wheezing, difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using this medicine and call your doctor at once if you have:

• chest pain, new or worsening heartburn;
• difficulty or pain when swallowing;
• pain or burning under the ribs or in the back;
• severe heartburn, burning pain in your upper stomach, or coughing up blood;
• new or unusual pain in your thigh or hip;
• jaw pain, numbness, or swelling;
• severe joint, bone, or muscle pain; or
• low calcium levels – muscle spasms or contractions, numbness or tingly feeling (around your mouth, or in your fingers and toes).

Common Boniva side effects may include:

• heartburn, stomach pain, diarrhea;
• back pain, bone pain, muscle or joint pain;
• pain in your arms or legs;
• headache; or
• fever, chills, tiredness, flu-like symptoms.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Before taking this medicine

You should not use Boniva if you are allergic to ibandronate, or if you have:

• severe kidney disease; or
• low blood levels of calcium (hypocalcemia).

Do not take an Boniva tablet if you have problems with your esophagus, or if you cannot sit upright or stand for at least 60 minutes. Ibandronate can cause serious problems in the stomach or esophagus. You must stay upright for at least 1 full hour after taking this medicine.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• trouble swallowing;
• problems with your stomach or digestion;
• hypocalcemia;
• a dental problem (you may need a dental exam before you begin using Boniva);
• kidney disease; or
• any condition that makes it hard for your body to absorb nutrients from food (malabsorption).

In rare cases, this medicine may cause bone loss (osteonecrosis) in the jaw. Symptoms include jaw pain or numbness, red or swollen gums, loose teeth, or slow healing after dental work. The longer you use Boniva, the more likely you are to develop this condition.

Osteonecrosis of the jaw may be more likely if you have cancer or received chemotherapy, radiation, or steroids. Other risk factors include blood clotting disorders, anemia (low red blood cells), and a pre existing dental problem.

Talk with your doctor about the risks and benefits of using this medication.

It is not known whether ibandronate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether ibandronate passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use Boniva?

Use Boniva exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Boniva tablets are taken once per month. The injection is given into a vein through an IV once every 3 months. The tablets can be taken at home, but a healthcare provider must give the injection.

Take the tablet first thing in the morning, at least 60 minutes before you eat or drink anything or take any other medicine. Take the medicine on the same day each month and always first thing in the morning.

Take the tablet with a full glass (6 to 8 ounces) of plain water. Do not use coffee, tea, soda, juice, or mineral water. Do not eat or drink anything other than plain water.

Do not crush, chew, or suck on a tablet. Swallow it whole.

For at least 60 minutes (1 full hour) after taking a tablet:

• Do not lie down or recline.
• Do not take any other medicine including vitamins, calcium, or antacids.

Pay special attention to your dental hygiene while using Boniva. Brush and floss your teeth regularly. Consult your dentist before starting Boniva to ensure that you don’t need dental work soon. If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using this medicine.

Boniva is only part of a complete program of treatment that may also include diet changes, exercise, bone mineral density testing, and taking calcium and vitamin supplements. Follow your doctor’s instructions very closely.

Store at room temperature away from moisture and heat.

Your doctor will determine how long to treat you with this medicine. Ibandronate is often given for only 3 to 5 years.

Dosing information

Usual Adult Dose for Osteoporosis:

Oral:
150 mg orally once a month on the same day each month

IV Injection:
3 mg by IV injection over 15 to 30 seconds every three months.

Comments:
-The IV injection should not be administered more frequently than once every 3 months.
-Obtain serum creatinine prior administration of each IV injection.
-Perform a routine oral examination prior administration of IV injection

Uses: Treatment and prevention of postmenopausal osteoporosis, to increase bone mineral density (BMD) and to reduce the incidence of vertebral fractures

Usual Adult Dose for Prevention of Osteoporosis:

Oral:
150 mg orally once a month on the same day each month

IV Injection:
3 mg by IV injection over 15 to 30 seconds every three months.

Comments:
-The IV injection should not be administered more frequently than once every 3 months.
-Obtain serum creatinine prior administration of each IV injection.
-Perform a routine oral examination prior administration of IV injection

Uses: Treatment and prevention of postmenopausal osteoporosis, to increase bone mineral density (BMD) and to reduce the incidence of vertebral fractures

What happens if I miss a dose?

Boniva tablets: If you forget to take a tablet first thing in the morning on your scheduled day, do not take it later in the day. Wait until the next morning to take the missed dose. Then return to your regular monthly schedule on your chosen dose day. If your next scheduled dose is less than 7 days away, wait until then and skip the missed dose. Do not take two (2) doses in one week.

Boniva injections: Call your doctor for instructions if you miss an appointment for your injection.

What happens if I overdose?

For Boniva tablets: Drink a full glass of milk and seek emergency medical attention or call the Poison Help line . Do not make yourself vomit and do not lie down.

Since the injections are given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What to avoid

Avoid taking any other medicines for at least 60 minutes after taking Boniva. This includes vitamins, calcium, and antacids. Some medicines can make it harder for your body to absorb ibandronate.

Avoid smoking, or try to quit. Smoking can reduce your bone mineral density, making fractures more likely.

Avoid drinking large amounts of alcohol. Heavy drinking can also cause bone loss.

What other drugs will affect Boniva?

Tell your doctor about all your current medicines and any you start or stop using, especially:

• aspirin; or
• NSAIDs (nonsteroidal anti-inflammatory drugs) – ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with ibandronate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Talk with your doctor about the best dosing schedule for your other medicines.

Basaglar is a long-acting insulin that starts to work several hours after injection and keeps working evenly for 24 hours. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood.

Basaglar is used to improve blood sugar control in adults and children with diabetes mellitus.

Basaglar, is for use in adults with type 1 or 2 diabetes and in children at least 6 years old with type 1 diabetes (not type 2).

For type 1 diabetes, Basaglar KwikPen is used together with a short-acting insulin given before meals.

Warnings

Never share a Basaglar KwikPen with another person, even if the needle has been changed.

You should not use Basaglar if you are having an episode of hypoglycemia (low blood sugar), or if you are in a state of diabetic ketoacidosis (call your doctor for treatment).

Basaglar is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

Never share an injection pen, even if you changed the needle.

Basaglar KwikPen side effects

Get emergency medical help if you have any signs of an allergic reaction to Basaglar: redness or swelling where an injection was given, itchy skin rash over the entire body, trouble breathing, fast heartbeats, feeling like you might pass out, or swelling in your tongue or throat.

Call your doctor at once if you have:

• rapid weight gain, swelling in your feet or ankles;
• shortness of breath; or
• low blood potassium – leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.

Common Basaglar side effects may include:

• low blood sugar;
• swelling, weight gain;
• allergic reaction, itching, rash; or
• thickening or hollowing of the skin where you injected the medicine.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Before taking this medicine

You should not use Basaglar KwikPen if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar) or diabetic ketoacidosis (call your doctor for treatment).

Basaglar KwikPen is not approved for use by anyone younger than 6 years old, and some brands are for use only in adults. Do not use this medicine to treat type 2 diabetes in a child of any age.

To make sure Basaglar is safe for you, tell your doctor if you have:

• liver or kidney disease; or
• heart failure or other heart problems.

Tell your doctor if you also take pioglitazone or rosiglitazone (sometimes contained in combinations with glimepiride or metformin). Taking certain oral diabetes medicines while you are using insulin may increase your risk of serious heart problems.

Tell your doctor if you are pregnant or breastfeeding.

Follow your doctor’s instructions about using this medicine if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy.

How should I use Basaglar KwikPen?

Use Basaglar exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use Basaglar in larger or smaller amounts or for longer than recommended.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

The Toujeo brand of insulin glargine contains 3 times as much insulin per milliliter (mL) as the Basaglar brand. There are 300 units of insulin in 1 mL of Toujeo, and 100 units in 1 mL of Basaglar.

If there are any changes in the brand, strength, or type of insulin you use, your dosage needs may change.

Basaglar is injected under the skin. You will be shown how to use injections at home. Do not give yourself Basaglar if you do not understand how to use the injection and properly dispose of used needles and pens.

Basaglar must not be given with an insulin pump, or mixed with other insulins. Do not inject Basaglar into a vein or a muscle.

Do not inject this medicine into skin that is damaged, tender, bruised, pitted, thickened, scaly, or has a scar or hard lump.

Basaglar is usually injected once per day at the same time each day. You will be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and pens.

Your care provider will show you the best places on your body to inject Basaglar. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

Use only the injection pen that comes with Basaglar KwikPen. Attach a new needle before each use. Do not transfer the insulin from the pen into a syringe.

Never share an injection pen with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.

Use a disposable needle only once. Follow any state or local laws about throwing away used needles. Use a puncture-proof “sharps” disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your insulin dose or schedule.

Basaglar is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor’s instructions very closely.

Keep Basaglar in its original container protected from heat and light. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.

Storing unopened (not in use) Basaglar KwikPen:

• Refrigerate and use until the expiration date; or
• if stored at room temperature (below 86 degrees Fahrenheit) , use within 28 days.

Storing opened (in use) Basaglar KwikPen:

• Store the injection pen at room temperature (do not refrigerate) and use within 28 days.

Do not use the medicine if it looks cloudy, has changed colors, or has any particles in it. Call your pharmacist for new medicine.

Wear a diabetes medical alert tag (or carry an ID card) in case of emergency. Any medical care provider who treats you should know that you have diabetes.

Do not store an injection pen with the needle attached. Do not reuse a needle or syringe. Place them in a puncture-proof “sharps” container and dispose of it following state or local laws. Keep out of the reach of children and pets.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose. Do not use more than one dose in a 24-hour period unless your doctor tells you to.

Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . Insulin overdose can cause severe hypoglycemia. Symptoms include drowsiness, confusion, blurred vision, numbness or tingling in your mouth, trouble speaking, muscle weakness, clumsy or jerky movements, seizure (convulsions), or loss of consciousness.

What should I avoid while using Basaglar KwikPen?

Avoid driving or hazardous activity until you know how Basaglar KwikPen will affect you. Your reactions could be impaired.

Avoid medication errors by always checking the medicine label before injecting your insulin.

Avoid drinking alcohol or using medicines that contain alcohol. It may interfere with your diabetes treatment.

What other drugs will affect Basaglar KwikPen?

Many drugs can affect your blood sugar and may also affect Basaglar. Some medicines can increase or decrease the effects of insulin. Some drugs can also cause you to have fewer symptoms of hypoglycemia, making it harder to tell when your blood sugar is low. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use. Not all possible interactions are listed here.

Baqsimi is used to treat very low blood sugar (severe hypoglycemia) in adults and children aged 1 year and older with diabetes. It is a nasal powder that is administered into the nose, making it easier to administer than traditional injectable glucagon. After giving Baqsimi, the caregiver should call for emergency help.

Baqsimi (glucagon) works by activating liver glucagon receptors, stimulating glycogen breakdown, and releasing glucose from the liver, increasing blood glucose levels. Liver stores of glycogen are necessary for glucagon to produce an antihypoglycemic effect.

Baqsimi gained FDA approval on July 24, 2019. There is no generic.

Side effects

The most common side effects of Baqsimi include:

• nausea
• discomfort in your nose
• watery eyes
• vomiting
• stuffy nose
• redness in your eyes
• headache
• cough
• itchy nose, throat, and eyes
• runny nose
• nose bleed.

Serious side effects and warnings

Baqsimi may cause the following serious side effects:

• High blood pressure. Baqsimi can cause high blood pressure in certain people with tumors in their adrenal glands. Call your doctor at once if you have symptoms of high blood pressure, such as severe headache, blurred vision, and pounding in your neck or ears
• Low blood sugar. Baqsimi can cause certain people with tumors in their pancreas, called insulinomas, to have low blood sugar
• Serious allergic reactions. Call your healthcare provider or get medical help right away if you have a serious allergic reaction, including:
  • rash
  • difficulty breathing
  • low blood pressure
  • hives
  • trouble swallowing
  • feeling dizzy or faint
  • cough
  • swelling of the face, lips, or tongue
  • fast heartbeat.

It is not known if Baqsimi is safe and effective in children under 1 year of age.

These are not all the possible side effects of Baqsimi. For more information, ask your healthcare provider. Call your healthcare provider for medical advice about side effects.

Before taking

You should not use Baqsimi if you are allergic to glucagon, or if you have:

• a tumor of the pancreas (insulinoma); or
• a tumor of the adrenal gland (pheochromocytoma).

Before taking, tell your healthcare provider about all your medical conditions, including if you:

• have adrenal gland problems
• have a tumor in your pancreas
• have not had food or water for a long time (prolonged fasting or starvation)
• have low blood sugar that does not go away (chronic hypoglycemia)
• are pregnant or plan to become pregnant. It is not known if Baqsimi will harm your unborn baby
• are breastfeeding or plan to breastfeed. It is not known if Baqsimi passes into your breast milk. You and your healthcare provider should decide if you can use Baqsimi while breastfeeding.

How should I use Baqsimi?

Read the detailed Instructions for Use that comes with Baqsimi. Use Baqsimi exactly how your healthcare provider tells you to use it.

Make sure your caregiver and those around you know where you keep your Baqsimi and how to use Baqsimi the right way before you need their help.

• Baqsimi contains only 1 dose of medicine and cannot be reused.
• Baqsimi should be given in one side of your nose (nostril), but does not need to be inhaled.
• Baqsimi will work even if you have a cold or are taking cold medicine.
• Act quickly. Having very low blood sugar for a period of time may be harmful.
• After giving Baqsimi, the caregiver should call for emergency medical help right away.

When you can safely swallow food or drink, your caregiver should give you a fast-acting source of sugar (such as a regular soft drink or fruit juice) and a long-acting source of sugar (such as crackers with cheese or peanut butter).

If the person does not respond after 15 minutes, another dose of Baqsimi from a new device may be given, if available, while waiting for emergency services.

Tell your healthcare provider each time you use Baqsimi.

What happens if I miss a dose?

Since Baqsimi is used as needed, it does not have a daily dosing schedule.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

Overdose symptoms may include nausea, vomiting, constipation, rapid pulse, or increased blood pressure (severe headache, blurred vision, pounding in your neck or ears).

What should I avoid while using Baqsimi?

Do not take by mouth. Nasal medicine is for use only in the nose.

Avoid drinking alcohol. It can lower your blood sugar.

What other drugs will affect Baqsimi?

Many other medicines can affect your blood sugar, and some medicines can increase or decrease the effects of medicines used to treat diabetes. Some drugs can also cause you to have fewer symptoms of hypoglycemia, making it harder to tell when your blood sugar is low. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all medicines you start or stop using.