Physostigmine Salicylate and Sitavig

• Generic Name: physostigmine
• Dosage Forms: n.a.
• Other Brand Names: Antilirium

Carefully weigh risks and potential benefits of physostigmine therapy when making individual decisions about its use since serious adverse effects (including seizures and asystole) may occur with physostigmine therapy.

The manufacturers state that physostigmine is used to reverse CNS effects resulting from clinical or toxic dosages of drugs (e.g., some antihistamines, antimuscarinics, antiparkinsonian agents, phenothiazines) capable of producing anticholinergic syndrome and from intoxication with certain plants (e.g., Atropa belladonna [deadly nightshade], Brugmansia species [angels’ trumpet], Datura stramonium [jimsonweed, thorn apple, locoweed], Lantana camara). However, routine use not recommended because of potentially serious adverse effects (e.g., seizures, bronchospasm, bradycardia, asystole); many clinicians advise to reserve use for treatment of severe or life-threatening symptoms (e.g., extensive delirium or agitation, hallucinations, hyperthermia, severe sinus or supraventricular tachycardia, seizures) in patients who fail to respond to alternative therapy.

Has also been used successfully in the treatment of tricyclic antidepressant-induced anticholinergic toxicity, but currently is rarely used because of potentially serious adverse effects (seizures, bronchospasm, bradycardia, asystole). Precise role controversial; most clinicians advise against the routine use of physostigmine in tricyclic intoxication, and some clinicians recommend to reserve use only for life-threatening anticholinergic symptoms refractory to other treatment.

Treatment to reverse anticholinergic effects (e.g., delirium, prolonged somnolence) produced by atropine and/or scopolamine preanesthetic medications.

Alzheimer’s Disease

Has been used with variable results in the treatment of dementia of the Alzheimer’s type (Alzheimer’s disease), alone or combined with lecithin.

HereditaryAtaxias

Has been used for the treatment of Friedreich’s ataxia and other hereditary ataxias (spinocerebellar degenerations) (designated an orphan drug by FDA for these uses).

• Generic Name: acyclovir
• Dosage Forms: tablet, orally disintegrating, delayed release
• Other Brand Names: Sitavig, Zovirax

Sitavig is a prescription medicine used to treat cold sores (herpes labialis) in adults with normal immune systems. It is not known if it is safe and effective in children.

Do not use this medicine if you are allergic to:

acyclovir or any of the ingredients in Sitavig. See the end of this leaflet for a complete list of ingredients. milk protein concentrate

Before using Sitavig, tell your healthcare provider about all of your medical conditions, including if you:

are pregnant or plan to become pregnant. It is not known if this medicine will harm your unborn baby. are breastfeeding or plan to breastfeed. It is not known if this medicine passes into your breast milk. Tell your healthcare provider about all the medicines you take, including prescription or over-the-counter medicines, vitamins, or herbal supplements.

See the detailed Instructions for Use for information about how to use this medicine.

Use exactly as your healthcare provider tells you to use it. Use within one hour after you have the first symptom of a cold sore, such as itching, redness, burning, or tingling, and before a cold sore appears. You may eat and drink while using Sitavig. Do not crush, chew, suck, or swallow the tablets. Sitavig will slowly dissolve over time while in your mouth and should be left in place. Gently rinse your mouth with water to clean your teeth while Sitavig is in place. Drink more liquids if your mouth becomes dry while using Sitavig.

You should avoid activities that may prevent Sitavig from sticking to your gum, including: touching or pressing Sitavig after you apply it, wearing upper dentures, chewing gum, and brushing your teeth during the treatment day.

The most common side effects include:

headache and pain where Sitavig is applied.

These are not all the possible side effects of Sitavig. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also:

Sitavig side effects (in more detail)