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.

Take this medicine in the morning with food.

To use the capsule:

  • Swallow the capsule whole with a glass of water. Do not chew or crush it.
  • If you are not able to swallow the capsule whole, you may open, sprinkle, and mix it with a small amount of soft food (eg, apple sauce, oatmeal, banana or carrot puree, chocolate or rice pudding) or liquid (eg, breast milk, infant formula, or water).
  • Take the mixture right away and drink water. Do not store for future use.

You may mix the oral pellets into soft food or liquid. Do not swallow the capsule shell whole.

To use the oral pellets with soft food:

  • Mix the medicine in a small amount of soft food (eg, apple sauce, oatmeal, banana or carrot puree, chocolate or rice pudding).
  • Place a small amount (at least 2 tablespoons) of soft food in a bowl. Keep it at room temperature or cooler.
  • Open the shell and empty the contents into the bowl of soft food. Gently mix it with a spoon.
  • Take the mixture right away and drink water, breast milk, or infant formula. Do not store for later use.

To use the oral pellets with liquid:

  • Open the shell and empty the contents into a small mixing cup.
  • Add 1 teaspoon or 5 milliliters (mL) of liquid (eg, breast milk, infant formula, or water). Let the pellets sit in the liquid for 5 minutes to allow complete wetting.
  • Measure the mixture with the oral dosing syringe.
  • Place the tip of the oral syringe in the mouth between the tongue and the side of the mouth. Swallow the mixture and drink water, breast milk, or infant formula.
  • Do not squirt the mixture in the back of the throat to avoid gagging or choking. Do not give using a bottle or sippy cup.

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 (capsules):
    • For cholestatic pruritus in patients in alagille syndrome (ALGS):
      • Adults and children 12 months of age and older weighing 19.5 kilograms or more—Dose is base on weight and must be determined by your doctor. The dose is usually 120 micrograms per kilogram (mcg/kg) of body weight once a day.
        • Weighing 55.5 kilograms (kg) or more—7200 micrograms (mcg) once a day. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 45.5 kg to 55.4 kg—6000 mcg once a day. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 35.5 kg to 45.4 kg—4800 mcg once a day. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 25.5 kg to 35.4 kg—3600 mcg once a day. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 19.5 kg to 25.4 kg—2400 mcg once a day. Your doctor may adjust your dose as needed and tolerated.
        • Weighing less than 19.5 kg—Use of oral pellets is recommended.
      • Children younger than 12 months of age—Use and dose must be determined by your doctor.
    • For pruritus in patients with progressive familial intrahepatic cholestasis:
      • Adults and children 3 months of age and older weighing 19.5 kilograms (kg) or more—Dose is base on weight and must be determined by your doctor. The dose is usually 40 micrograms per kilogram (mcg/kg) of body weight once a day.
        • Weighing 55.5 kilograms (kg) or more—2400 micrograms (mcg) once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 6 milligrams (mg) per day.
        • Weighing 45.5 kg to 55.4 kg—2000 mcg once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 6 mg per day.
        • Weighing 35.5 kg to 45.4 kg—1600 mcg once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 6 mg per day.
        • Weighing 25.5 kg to 35.4 kg—1200 mcg once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 6 mg per day.
        • Weighing 19.5 kg to 25.4 kg—800 mcg once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 6 mg per day.
        • Weighing less than 19.5 kg—Use of oral pellets is recommended.
      • Children younger than 3 months of age—Use and dose must be determined by your doctor.
  • For oral dosage form (pellets):
    • For cholestatic pruritus in patients in alagille syndrome (ALGS):
      • Adults and children 12 months of age and older weighing less than 19.5 kilograms (kg)—Dose is base on weight and must be determined by your doctor. The dose is usually 120 micrograms per kilogram (mcg/kg) of body weight once a day.
        • Weighing 17.5 kilograms (kg) to less than 19.5 kg—2400 micrograms (mcg) once a day. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 12.5 kg to 17.4 kg—1800 mcg once a day. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 7.5 kg to 12.4 kg—1200 mcg once a day. Your doctor may adjust your dose as needed and tolerated.
        • Weighing 7.4 kg or less—600 mcg once a day. Your doctor may adjust your dose as needed and tolerated.
      • Children younger than 12 months of age—Use and dose must be determined by your doctor.
    • For pruritus in patients with progressive familial intrahepatic cholestasis:
      • Adults and children 3 months of age and older weighing less than 19.5 kilograms (kg)—Dose is base on weight and must be determined by your doctor. The dose is usually 40 micrograms per kilogram (mcg/kg) of body weight once a day.
        • Weighing 17.5 kilograms (kg) to less than 19.5 kg—800 micrograms (mcg) once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 6 milligrams (mg) per day.
        • Weighing 12.5 kg to 17.4 kg—600 mcg once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 6 mg per day.
        • Weighing 7.5 kg to 12.4 kg—400 mcg once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 6 mg per day.
        • Weighing 7.4 kg or less—200 mcg once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 6 mg per day.
      • Children younger than 3 months 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.

Storage

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

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.

Portions of this document last updated: Feb. 01, 2024

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