Proper Use

Drug information provided by: Merative, Micromedex®

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a Medication Guide and patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Take this medicine at least 30 minutes before the first meal of the day.

Check the liquid in the bottle. It should be clear to almost clear and colorless to light yellow. Do not use the medicine if the liquid is discolored, or has particles in it.

To use:

  • Write the date on the bottle when you first opened the medicine. Remove the plastic seal.
  • Open the bottle by pushing down on the child-resistant cap and turn the cap to the left (counter-clockwise).
  • If you are using a new dosing dispenser, remove it from the wrapper. If you are using a used dosing dispenser, make sure that it has been cleaned. Remove and throw away the cap of the dosing dispenser, if applicable.
  • Measure the oral liquid medicine with the provided dosing dispenser. Make sure to use the correct dosing dispenser depending on the prescribed dose.
  • Push the plunger down fully to remove air from the dispenser. Once the cap of the bottle is removed, insert the tip of the dispenser into the bottle. The tip should fit into the hole. Check for air bubbles. If you see any, push the plunger so that the medicine flows back into the bottle.
  • Keep the dosing dispenser in place and turn the bottle upside down. Pull back the plunger slowly until the top of the plunger is even with the marking on the barrel of the dosing dispenser.
  • Remove the dosing dispenser from the bottle by pulling straight up on the barrel. Place the tip of the dispenser against the inside of the cheek and slowly push the plunger all the way to give the entire dose.
  • Swallow the whole dose. If you are not sure the full dose was swallowed, do not give another dose. Wait until the next scheduled dose.

Take this medicine at least 4 hours before or 4 hours after using bile acid sequestrants (eg, cholestyramine, colesevelam, colestipol).

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (solution):
    • For cholestatic pruritus in patients with Alagille syndrome:
      • Adults and children 3 months of age and older weighing 70 kilograms (kg) or more—Dose is base on weight and must be determined by your doctor. The dose is usually 380 micrograms per kilogram (mcg/kg) of body weight once a day.
        • Weighing 70 kilograms (kg) or more—At first, 1.5 milliliters (mL) once a day for Days 1 to 7. Then, 3 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 28.5 milligrams (mg) or 3 mL per day.
        • Weighing 60 kg to 69 kg—At first, 1.25 mL once a day for Days 1 to 7. Then, 2.5 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 50 kg to 59 kg—At first, 1 mL once a day for Days 1 to 7. Then, 2.25 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 40 kg to 49 kg—At first, 0.9 mL once a day for Days 1 to 7. Then, 1.75 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 35 kg to 39 kg—At first, 0.7 mL once a day for Days 1 to 7. Then, 1.5 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 30 kg to 34 kg—At first, 0.6 mL once a day for Days 1 to 7. Then, 1.25 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 25 kg to 29 kg—At first, 0.5 mL once a day for Days 1 to 7. Then, 1 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 20 kg to 24 kg—At first, 0.45 mL once a day for Days 1 to 7, 0.9 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 16 kg to 19 kg—At first, 0.35 mL once a day for Days 1 to 7. Then, 0.7 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 13 kg to 15 kg—At first, 0.3 mL once a day for Days 1 to 7. Then, 0.6 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 10 kg to 12 kg—At first, 0.2 mL once a day for Days 1 to 7. Then, 0.45 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 7 kg to 9 kg—At first, 0.15 mL once a day for Days 1 to 7. Then, 0.3 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 5 kg to 6 kg—At first, 0.1 mL once a day for Days 1 to 7. Then, 0.2 mL once a day starting on Day 8. Your doctor may adjust your dose as needed and tolerated.
      • Children younger than 3 months of age—Use and dose must be determined by your doctor.
    • For cholestatic pruritus in patients with progressive familial intrahepatic cholestasis:
      • Adults and children 5 years of age and older weighing 60 kilograms (kg) or more—Dose is base on weight and must be determined by your doctor. The dose is usually 570 micrograms per kilogram (mcg/kg) of body weight 2 times a day.
        • Weighing 60 kilograms (kg) or more—At first, 2 milliliters (mL) once a day taken in the morning. Then, 2 mL 2 times a day taken in the morning and evening. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 38 milligrams (mg) or 4 mL per day.
        • Weighing 50 kg to 59 kg—At first, 1.5 mL once a day taken in the morning. Then, 1.5 mL 2 times a day taken in the morning and evening. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 40 kg to 49 kg—At first, 1.25 mL once a day taken in the morning. Then, 1.25 mL 2 times a day taken in the morning and evening. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 35 kg to 39 kg—At first, 1.25 mL once a day taken in the morning. Then, 1.25 mL 2 times a day taken in the morning and evening. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 30 kg to 34 kg—At first, 0.9 mL once a day taken in the morning. Then, 0.9 mL 2 times a day taken in the morning and evening. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 25 kg to 29 kg—At first, 0.8 mL once a day taken in the morning. Then, 0.8 mL 2 times a day taken in the morning and evening. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 20 kg to 24 kg—At first, 0.6 mL once a day taken in the morning. Then, 0.6 mL 2 times a day taken in the morning and evening. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 16 kg to 19 kg—At first, 0.5 mL once a day taken in the morning. Then, 0.5 mL 2 times a day taken in the morning and evening. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 13 kg to 15 kg—At first, 0.4 mL once a day taken in the morning. Then, 0.4 mL 2 times a day taken in the morning and evening. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 10 kg to 12 kg—At first, 0.35 mL once a day taken in the morning. Then, 0.35 mL 2 times a day taken in the morning and evening. Your doctor may adjust your dose as needed and tolerated.
      • Children younger than 5 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Once a day dosing: If a dose is missed by 12 hours or less, take it as soon as possible, and then go back to your regular schedule. If a dose is missed by more than 12 hours, do not take an extra dose. Take the next dose at the regular scheduled time.

Two times a day dosing: If a dose is missed by 6 hours or less, take it as soon as possible, and then go back to your regular schedule. If a dose is missed by more than 6 hours, do not take an extra dose. Take the next dose at the regular scheduled time.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Store this medicine with the cap on the bottle.

Throw away any unused medicine 100 days after opening the bottle.