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ACZONE (DAPSONE): USE IN SPECIFIC POPULATIONS
Teratogenic Effects: Pregnancy Category C
There are no adequate and well controlled studies in pregnant women. Dapsone has been shown to have an embryocidal effect in rats and rabbits when administered orally in doses of 75 mg / kg per day and 150 mg / kg per day (approximately 800 and 500 times the systemic exposure observed in human females as a result of use of the maximum recommended topical dose, based on AUC comparisons), respectively. These effects were probably secondary to maternal toxicity. Dapsone (Aczone) gel 5% should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Although systemic absorption of dapsone following topical application of Aczone is minimal relative to oral dapsone administration, it is known that dapsone is excreted in human milk. Because of the potential for oral dapsone to cause adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue Aczone gel taking into account the importance of the drug to the mother.
Safety and efficacy was evaluated in 1169 children aged 12-17 years old treated with Aczone gel 5% in the clinical studies. The adverse event rate for this medication was similar to the vehicle control group. Safety and efficacy was not studied in pediatric patients less than 12 years of age, therefore Aczone (Dapsone) gel is not recommended for use in this age group.
Clinical studies of Aczone (Dapsone) gel 5% did not include sufficient number of patients aged 65 and over to determine whether they respond differently from younger patients.
Dapsone (Aczone) and vehicle were evaluated in a randomized, double-blind, cross-over design clinical study of 64 patients with G6PD deficiency and acne vulgaris. Subjects were Black (88%), Asian (6%), Hispanic (2%) or of other racial origin (5%). Blood samples were taken at Baseline, Week 2, and Week 12 during both vehicle and Dapsone (Aczone) gel treatment periods. There were 56 out of 64 subjects who had a Week 2 blood draw and applied at least 50% of treatment applications. Dapsone (Aczone) gel 5% was associated with a
0.32 g / dL drop in hemoglobin after two weeks of treatment, but hemoglobin levels generally returned to baseline levels at Week 12.
There were no changes from baseline in haptoglobin or lactate dehydrogenase during Aczone or vehicle treatment at either the 2-week or 12-week time point.
The proportion of subjects who experienced decreases in hemoglobin >= 1 g / dL was similar between Aczone gel and vehicle treatment (8 of 58 subjects had such decreases during Aczone gel 5% treatment compared to 7 of 56 subjects during vehicle treatment among subjects with at least one on-treatment hemoglobin assessment). Subgroups based on gender, race, or G6PD enzyme activity did not display any differences in laboratory results from the overall study group. There was no evidence of clinically significant hemolytic anemia in this study. Some of these subjects developed laboratory changes suggestive of mild hemolysis.
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