Discontinue use in the presence of agranulocytosis, aplastic anemia (pancytopenia), hepatitis, or exfoliative dermatitis; 2 or 3 wk prior delivery. Discontinue immediately in the event of clinically significant evidence of liver abnormality including hepatic transaminase values >3x ULN. Patients receiving additional drugs known to cause agranulocytosis. Leukopenia, thrombocytopenia, & aplastic anemia (pancytopenia). Severe hepatic reactions (eg, fulminant hepatitis, hepatic necrosis, encephalopathy & death). Prompt evaluation of liver function for symptoms suggestive of hepatic dysfunction (eg, anorexia, pruritus, right upper quadrant pain, etc.) Perform WBC & differential count determination if any evidence of illness, particularly sore throat, skin eruptions, fever, headache, or general malaise occur or whether agranulocytosis has developed. Monitor bone marrow function; prothrombin time during therapy especially before surgical procedures. Periodic monitoring of thyroid function. Decrease dose if elevated TSH is confirmed. May cause fetal harm when administered to pregnant woman. Postpartum patients receiving therapy should not nurse their babies.
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