Extals
Extals Uses, Dosage, Side Effects, Food Interaction and all others data.
The mode of action of riluzole is unknown. Its pharmacological properties include the following, some of which may be related to its effect:
An inhibitory effect on glutamate release (activation of glutamate reuptake),Inactivation of voltage-dependent sodium channels,Ability to interfere with intracellular events that follow transmitter binding at excitatory amino acid receptors.Extals, a member of the benzothiazole class, is indicated for the treatment of patients with amyotrophic lateral sclerosis (ALS). Extals extends survival and/or time to tracheostomy. It is also neuroprotective in various in vivo experimental models of neuronal injury involving excitotoxic mechanisms. The etiology and pathogenesis of amyotrophic lateral sclerosis (ALS) are not known, although a number of hypotheses have been advanced. One hypothesis is that motor neurons, made vulnerable through either genetic predisposition or environmental factors, are injured by glutamate. In some cases of familial ALS the enzyme superoxide dismutase has been found to be defective.
Extals, a member of the benzothiazole class, is indicated for the treatment of patients with amyotrophic lateral sclerosis (ALS). Extals extends survival and/or time to tracheostomy. It is also neuroprotective in various in vivo experimental models of neuronal injury involving excitotoxic mechanisms. The etiology and pathogenesis of amyotrophic lateral sclerosis (ALS) are not known, although a number of hypotheses have been advanced. One hypothesis is that motor neurons, made vulnerable through either genetic predisposition or environmental factors, are injured by glutamate. In some cases of familial ALS the enzyme superoxide dismutase has been found to be defective.
| Trade Name | Extals |
| Availability | Prescription only |
| Generic | Riluzole |
| Riluzole Other Names | Riluzol, Riluzole, Riluzolum |
| Related Drugs | edaravone, Radicava, Radicava ORS, Rilutek, Exservan, Tiglutik |
| Weight | 50mg |
| Type | Tablet |
| Formula | C8H5F3N2OS |
| Weight | Average: 234.198 Monoisotopic: 234.007468097 |
| Protein binding | 96% bound to plasma proteins, mainly to albumin and lipoprotein over the clinical concentration range. |
| Groups | Approved, Investigational |
| Therapeutic Class | Neurodegenerative Disease Drugs / Neuromuscular Disorder Drugs |
| Manufacturer | Unimed Unihealth MFG, Ltd |
| Available Country | Bangladesh |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Extals is used for the treatment of amyotrophic lateral sclerosis (ALS).
Extals is also used to associated treatment for these conditions: Amyotrophic Lateral Sclerosis (ALS)
How Extals works
The mode of action of riluzole is unknown. Its pharmacological properties include the following, some of which may be related to its effect: 1) an inhibitory effect on glutamate release (activation of glutamate reuptake), 2) inactivation of voltage-dependent sodium channels, and 3) ability to interfere with intracellular events that follow transmitter binding at excitatory amino acid receptors.
Dosage
Extals dosage
The recommended dosage for Extals is 50 mg taken orally twice daily. Extals should be taken at least 1 hour before or 2 hours after a meal.Measure serum aminotransferases before and during treatment with Extals
Side Effects
The following adverse reactions are described below and elsewhere in the labeling: Hepatic Injury, Neutropenia, Interstitial lung disease
Precaution
Hepatic Injury: Cases of drug-induced liver injury, some of which were fatal, have been reported in patients taking Extals. Asymptomatic elevations of hepatic transaminases have also been reported, and in some patients have recurred upon rechallenge with Extals.
In clinical studies, the incidence of elevations in hepatic transaminases was greater in Extalstreated patients than placebo-treated patients. The incidence of elevations of ALT above 5 times the upper limit of normal (ULN) was 2% in Extals-treated patients. Maximum increases in ALT occurred within 3 months after starting Extals. About 50% and 8% of Extalstreated patients in pooled Studies 1 and 2, had at least one elevated ALT level above ULN and above 3 times ULN, respectively
Monitor patients for signs and symptoms of hepatic injury, every month for the first 3 months of treatment, and periodically thereafter. The use of Extals is not recommended if patients develop hepatic transaminases levels greater than 5 times the ULN. Discontinue Extals if there is evidence of liver dysfunction (e.g., elevated bilirubin).
Neutropenia: Cases of severe neutropenia (absolute neutrophil count less than 500 per mm3) within the first 2 months of Extals treatment have been reported. Advise patients to report febrile illnesses.
Interstitial Lung Disease: Interstitial lung disease, including hypersensitivity pneumonitis, has occurred in patients taking Extals. Discontinue Extals immediately if interstitial lung disease develops.
Interaction
Strong to moderate CYP1A2 inhibitors: Coadministration may increase Extals-associated adverse reactions
Strong to moderate CYP1A2 inducers: Coadministration may result in decreased efficacy
Hepatotoxic drugs: Extals-treated patients that take other hepatotoxic drugs may be at increased risk for hepatotoxicity
Food Interaction
- Take on an empty stomach. Take at least 1 hour before or 2 hours after meals.
Extals Drug Interaction
Unknown: amphetamine / dextroamphetamine, lorazepam, diphenhydramine, heparin, clonazepam, escitalopram, lithium, mirabegron, dextromethorphan / quinidine, acetaminophen / oxycodone, vitamin a topical, bioflavonoids, levothyroxine, acetaminophen, cyanocobalamin, ascorbic acid, cholecalciferol, alprazolam, ranitidine, sertraline
Extals Disease Interaction
Moderate: alcohol, liver disease, neutropenia, renal dysfunction
Elimination Route
Extals is well-absorbed (approximately 90%), with average absolute oral bioavailability of about 60% (CV=30%). A high fat meal decreases absorption, reducing AUC by about 20% and peak blood levels by about 45%.
Half Life
The mean elimination half-life of riluzole is 12 hours (CV=35%) after repeated doses.
Pregnancy & Breastfeeding use
Pregnancy: Based on animal data, may cause fetal harm
Lactation: It is not known if riluzole is excreted in human milk. Extals or its metabolites have been detected in milk of lactating rat. Women should be advised that many drugs are excreted in human milk and that the potential for serious adverse reactions in nursing infants from Extals is unknown.
Contraindication
Extals is contraindicated in patients with a history of severe hypersensitivity reactions to riluzole or to any of its components (anaphylaxis has occurred)
Acute Overdose
Reported symptoms of overdose following ingestion of Extals ranging from 1.5 to 3 grams (30 to 60 times the recommended dose) included acute toxic encephalopathy, coma, drowsiness, memory loss, and methemoglobinemia. No specific antidote for the treatment of Extals overdose is available.
Storage Condition
Store at controlled room temperature, 20°C to 25°C, and protect from bright light.
Innovators Monograph
You find simplified version here Extals
Extals contains Riluzole see full prescribing information from innovator Extals Monograph, Extals MSDS, Extals FDA label
FAQ
What is Extals used for?
Extals is a medication used to slow the progression of amyotrophic lateral sclerosis (ALS).Extals is the only drug to prolong survival for amyotrophic lateral sclerosis
How safe is Extals?
The Extals is generally very safe if monitored correctly.
How does Extals work?
Extals works by blocking the release of glutamate.
What are the common side effects of Extals?
Common side effects of Extals are include:
- Bladder pain
- bloody or cloudy urine
- blurred vision
- chills
- cough
- dark urine
- diarrhea
- difficult, burning, or painful urination
- fast, pounding, or irregular heartbeat or pulse
- fever
- frequent urge to urinate
- general feeling of discomfort or illness
- headache
- increased cough
- itching skin
- joint pain
- loss of appetite
- lower back or side pain
- muscle aches and pains
- nausea
- nervousness
- persistent loss of appetite or weight loss
- pounding in the ears
- right upper quadrant tenderness
- runny nose
- shivering
- slow heartbeat
- sore throat
- trouble sleeping
- unusual tiredness or weakness
- vomiting
- yellow eyes or skin
Is Extals safe during pregnancy?
Extals may harm an unborn baby. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant. Ask a doctor if it is safe to breastfeed while using this medicine.
Is Extals safe during breastfeeding?
There are no adequate studies in women for determining infant risk when using Extals during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Can I drink alcohol with Extals?
Avoid drinking alcohol. It may increase your risk of liver damage while taking Extals. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Can I drive after taking Extals?
This drug may make you dizzy or drowsy.Do not drive, use machinery, or do anything that needs alertness until you can do it safely.
When Is the best taken of Extals?
Extals should be taken on an empty stomach. Take it at least 1 hour before or 2 hours after meals. This medicine works best if there is a constant amount in the blood.
How can I take Extals?
Extals usually is taken on an empty stomach twice a day, every 12 hours.
How long does it take for Extals to work?
It is working behind the scenes to prolong your survival and slow the progression of ALS. The initial clinical trials showed a survival benefit of about 3 months. However, more recent data suggest that the survival benefit may be as much as 12 months, especially for younger patients.
Does Extals cause liver damage?
The severity of liver injury from Extals ranges from minor, transient elevations in serum aminotransferase levels to acute hepatic injury with jaundice and possible to acute liver failure.
Does Extals raise blood pressure?
Blood pressures were significantly higher in Extals treated patients than in controls with ALS.Extals treatment may be associated with mild blood pressure elevations.
Who should not take Extals?
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
What happen If I miss a dose of Extals?
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.
Skip the missed dose and take your next dose at the regular time. Do not use extra medicine to make up for a missed dose.
How long does Extals stay in my system?
Given the known half-life of Extals(9–15 hours) and the delay of emergence of amnesia, most of the Extals should have been out of our patient's system by the time the symptoms emerged, which raises the possibility that she may have been a slow metabolizer of the drug.
How long should I take Extals?
The initial clinical trials showed a survival benefit of about 3 months.
Can Rilutek be crushed?
Swallow the tablet whole. Do not break, crush, or chew it.
Can you overdose on Extals?
Overdose symptoms may include drowsiness, confusion, problems with thinking or memory, coma, tremors, or blue lips or fingers. Avoid smoking. Smoking cigarettes may make riluzole less effective.
