To ensure that we are providing our clients with the industry's best and most current clinical information, we complete a "post-publication" process and receive feedback regarding opportunities to add additional information or, in rare cases, make revisions.

Below is information on revisions, corrections, or modifications to existing monographs that have been identified in the past 12 months.

Cyclophosphamide – July 2021

Revision in the Dosing: Adult field of the Cyclophosphamide monograph in the Lexi-Drugs database, available online and in mobile apps.

The monograph previously read:

Dosing: Adult (only portion of field impacted is presented):

IV (high-dose therapy): 50 mg/kg/day (based on ideal body weight) on days 1 to 4 (in combination with mesna and G-CSF); RBC transfusion independence occurred at a median of 19 days (Moyo 2002) or 50 mg/kg/day on days 1 to 4 (in combination with mesna and G-CSF) (Go 2017) or 1,000 mg once a week for 4 doses (Go 2017).

It has been revised to read:

Dosing: Adult (only portion of field impacted is presented):

IV (high-dose therapy): 50 mg/kg/day (based on ideal body weight) on days 1 to 4 (in combination with mesna and G-CSF); RBC transfusion independence occurred at a median of 19 days (Moyo 2002) or 50 mg/kg/day on days 1 to 4 (in combination with mesna and G-CSF) (Go 2017) or 1,000 mg once every 4 weeks for 4 doses (Go 2017).

These changes have been automatically posted to online and mobile app databases. Please update your mobile Lexi-Drugs application to get the updated monograph.

Larotrectinib – April 2021

Revision in the Dosing: Adult field of the Larotrectinib monograph in the Lexi-Drugs database, available online and in mobile apps.

The monograph previously read:

Dosing: Adult (only portion of field impacted is presented):

(content missing)

It has been revised to read:

Dosing: Adult (only portion of field impacted is presented):

Missed dose: Do not make up the missed dose within 6 hours of the next scheduled dose. If vomiting occurs, take the next dose at the scheduled time.

These changes have been automatically posted to online and mobile app databases. Please update your mobile Lexi-Drugs application to get the updated monograph.

Sacituzumab Govitecan – April 2021

Revision in the Dosing: Adjustment for Toxicity field of the Sacituzumab Govitecan monograph in the Lexi-Drugs and Drug Facts & Comparisons databases, available online and in mobile apps.

The monograph previously read:

Dosing: Adjustment for Toxicity (only portion of field impacted is presented):

(content missing)

It has been revised to read:

Dosing: Adjustment for Toxicity (only portion of field impacted is presented):

On day of scheduled sacituzumab govitecan dose, grade 3 or 4 non-neutropenic hematologic toxicity, which delays dosing by 2 or 3 weeks for recovery to ≤ grade 1

First

Reduce sacituzumab govitecan dose by 25%.

Second

Reduce sacituzumab govitecan dose by 50%.

Third

Discontinue sacituzumab govitecan.

These changes have been automatically posted to online and mobile app databases. Please update your mobile Lexi-Drugs application to get the updated monograph.

Hydromorphone – February 2021

Revision in the Dosing: Adult field of the Hydromorphone monograph in the Lexi-Drugs database, available online and in mobile apps.

The monograph previously read:

Dosing: Adult (only portion of field impacted is presented):

Chronic pain: 

Extended-release tablet: Jurnista [Canadian product]: …

Initial: 

Patients who are opioid naive or receiving low intermittent doses of weak opioid analgesics (eg, < 40 mg daily oral morphine equivalents): Initial: 4 mg once daily (if clinically indicated, an initial dose of 8 mg once daily may be used; maximum initial dose: 8 mg once daily); titrate dose in increments of 4 or 8 mg as needed but no sooner than every fourth dose (eg, if first dose is administered on Tuesday, increase no sooner than on Friday).

Patients who are opioid naive or receiving low intermittent doses of weak opioid analgesics (eg, <40 mg daily oral morphine equivalents): Initial: 4 mg once daily (if clinically indicated, an initial dose of 8 mg once daily may be used; maximum initial dose: 8 mg once daily); titrate dose in increments of 4 or 8 mg as needed but no sooner than every fourth dose (eg, if first dose is administered on Tuesday, increase no sooner than on Friday).

It has been revised to read:

Dosing: Adult (only portion of field impacted is presented):

Chronic pain: 

Extended-release tablet: Jurnista [Canadian product]: …

Initial: 

Patients who are opioid naive or receiving low intermittent doses of weak opioid analgesics (eg, < 40 mg daily oral morphine equivalents): Initial: 4 mg once daily (if clinically indicated, an initial dose of 8 mg once daily may be used; maximum initial dose: 8 mg once daily); titrate dose in increments of 4 or 8 mg as needed but no sooner than every fourth dose (eg, if first dose is administered on Tuesday, increase no sooner than on Friday).

Patients receiving opioids regularly: Discontinue all other around-the-clock opioid analgesics; initial Jurnista dose is based on prior daily opioid dose (using standard equianalgesic ratios). For opioids other than morphine, estimate the equivalent daily dose of morphine, then determine the equivalent total daily dose of Jurnista by multiplying the equivalent morphine dose by a factor of 0.2. For example, morphine 60 mg daily multiplied by 0.2 is equivalent to hydromorphone 12 mg daily. If necessary, round down to nearest tablet strength and administer once daily. Note: Conversions ratios for opioids are subject to kinetic variation; when switching from one opioid to another, consider reducing the calculated dose by 25% to 50% (to minimize the risk of overdose), then titrate the dose up as required to achieve the appropriate maintenance dose.

These changes have been automatically posted to online and mobile app databases. Please update your mobile Lexi-Drugs application to get the updated monograph.

Epinephrine (Systemic) – February 2021

Revision in the Dosing: Adult field of the Epinephrine (Systemic) monograph in the Lexi-Drugs and Drug Facts & Comparisons databases, available online and in mobile apps.

The monograph previously read:

Dosing: Adult (only portion of field impacted is presented):

Endotracheal (alternative route): 2 to 2.5 mg every 3 to 5 minutes until IV/intraosseous access established or return of spontaneous circulation; before administration, dilute in 5 to 10 mL NS or sterile water (using the 0.1 mg/mL solution)...

It has been revised to read:

Dosing: Adult (only portion of field impacted is presented):

Endotracheal (alternative route): 2 to 2.5 mg every 3 to 5 minutes until IV/intraosseous access established or return of spontaneous circulation; before administration, dilute in 5 to 10 mL NS or sterile water (using the 1 mg/mL solution)...

These changes have been automatically posted to online and mobile app databases. Please update your mobile Lexi-Drugs application to get the updated monograph.

Nandrolone – February 2021

Revision in the Dosing: Adult field of the Nandrolone monograph in the Lexi-Drugs Multinational database, available online and in mobile apps.

The monograph previously read:

Dosing: Adult (only portion of field impacted is presented):

Aplastic anemia: IM: 50 to 150 mcg once weekly

It has been revised to read:

Dosing: Adult (only portion of field impacted is presented):

Aplastic anemia: IM: 50 to 150 mg once weekly

These changes have been automatically posted to online and mobile app databases. Please update your mobile Lexi-Drugs Multinational application to get the updated monograph.

Bupivacaine – September 2020

Revision in the Dosing: Pediatric field of the Bupivacaine monograph in the Lexi-Drugs and Pediatric & Neonatal Lexi-Drugs database, available online and in mobile apps.

The monograph previously read:

Dosing: Pediatric (only portion of field impacted is presented):

Truncal blocks:

Transversus abdominis plane: 0.2 to 0.5 mL (Jöhr 2015).

It has been revised to read:

Dosing: Pediatric (only portion of field impacted is presented):

Truncal blocks:

Transversus abdominis plane: 0.2 to 0.5 mL/kg (Jöhr 2015).

These changes have been automatically posted to online and mobile app databases. Please update your mobile Lexi-Drugs application to get the updated monograph.

Bedaquiline – September 2020

Revision in the Dosing: Pediatric field of the Bedaquiline monograph in the Lexi-Drugs and Pediatric & Neonatal Lexi-Drugs databases, available online and in mobile apps.

The monograph previously read:

Dosing: Pediatric (only portion of field impacted is presented):

Children ≥5 years and Adolescents:

15 to <30 kg:

Weeks 1 and 2: Oral: 200 mg once daily.

Weeks 3 to 24: Oral: 100 mg 3 times weekly with at least 48 hours between doses; total weekly dose: 600 mg/week.

It has been revised to read:

Dosing: Pediatric (only portion of field impacted is presented):

Children ≥5 years and Adolescents:

15 to <30 kg:

Weeks 1 and 2: Oral: 200 mg once daily.

Weeks 3 to 24: Oral: 100 mg 3 times weekly with at least 48 hours between doses; total weekly dose: 300 mg/week.

These changes have been automatically posted to online and mobile app databases. Please update your mobile Lexi-Drugs application to get the updated monograph.

Interferon Alfa-2a – June 2020

Revision in the Dosing: Adult field of the Interferon Alfa-2a monograph in the Lexi-Drugs Multinational database, available online and in mobile apps.

The monograph previously read:

Dosing: Adult (only portion of field impacted is presented):

Adjunct to chemotherapy: Usual dose: 6 million units given concomitantly with chemotherapy on days 22 to 26 of each 28-day cycle.

It has been revised to read:

Dosing: Adult (only portion of field impacted is presented):

Adjunct to chemotherapy: Usual dose: 6 million units/m2 once daily on days 22 to 26 of each 28-day cycle (in combination with chemotherapy).

These changes have been automatically posted to online and mobile app databases. Please update your mobile Lexi-Drugs Multinational application to get the updated monograph.

Pralatrexate Injection – June 2020

Revision in the Dosage: Adult field of the Pralatrexate Injection monograph in the Drug Facts & Comparisons database, available online.

The monograph previously read:

Dosage: Adult (only portion of field impacted is presented):

Pralatrexate Dose Modifications for Hematologic Toxicities(1)

Blood cell count on day of treatment

Duration of toxicity

Action

Dose upon restart

Dose upon restart in patients with severe renal impairment

Platelet < 50,000/mm3

1 wk

Omit dose

Continue prior dose

Continue prior dose

2 wks

Omit dose

10 mg/m2

20 mg/m2

3 wks

Stop therapy

It has been revised to read:

Dosage: Adult (only portion of field impacted is presented):

Pralatrexate Dose Modifications for Hematologic Toxicities(1)

Blood cell count on day of treatment

Duration of toxicity

Action

Dose upon restart

Dose upon restart in patients with severe renal impairment

Platelet < 50,000/mm3

1 wk

Omit dose

Continue prior dose

Continue prior dose

2 wks

Omit dose

20 mg/m2

10 mg/m2

3 wks

Stop therapy

These changes have been automatically posted online.

Amoxicillin and Clavulanate – June 2020

Revision in the Dosing: Adult field of the Amoxicillin and Clavulanate monograph in the Lexi-Drugs, Pediatric & Neonatal Lexi-Drugs, and Drug Facts & Comparisons databases, available online and in mobile apps.

The monograph previously read:

Dosing: Adult (only portion of field impacted is presented):

Neutropenic fever, low-risk cancer patients (empiric therapy) (off-label use): Oral: Immediate release: 500 mg every 8 hours (Freifeld 1999; Kern 1999) or 1000 mg every 12 hours (Kern 2013). Combine either dosing regimen with oral ciprofloxacin; continue until resolution of fever and neutropenia.

It has been revised to read:

Dosing: Adult (only portion of field impacted is presented):

Neutropenic fever, low-risk cancer patients (empiric therapy) (off-label use): Oral: Immediate release: 500 mg every 8 hours (Freifeld 1999; Kern 1999) or 875 mg every 12 hours (Kern 2013). Combine either dosing regimen with oral ciprofloxacin; continue until resolution of fever and neutropenia.

These changes have been automatically posted to online and mobile app databases. Please update your mobile Lexi-Drugs and Pediatric & Neonatal Lexi-Drugs applications to get the updated monograph.

Butalbital, Acetaminophen, and Caffeine – May 2020

Revision in the Dosing: Pediatric field of the Butalbital, Acetaminophen, and Caffeine monograph in the Lexi-Drugs and Pediatric & Neonatal Lexi-Drugs databases, available online and in mobile apps.

The monograph previously read:

Dosing: Pediatric (only portion of field impacted is presented):

Headache, tension or muscle contraction: Note: Dosing based on products containing: Butalbital 50 mg, acetaminophen 325 mg, and caffeine 40 mg per tablet/capsule or per 15 mL (Vtol LQ).

Children ≥12 years and Adolescents:

Capsules, tablets: Oral: 1 to 2 tablets or capsules every 4 hours as needed; maximum daily dose: 6 tablets or capsules/day.

Solution (Vtol LQ): Oral: 15 to 30 mL every 4 hours as needed; maximum daily dose: 180 mL/day.

It has been revised to read:

Dosing: Pediatric (only portion of field impacted is presented):

Headache, tension or muscle contraction: Note: Dosing based on products containing: Butalbital 50 mg, acetaminophen 325 mg, and caffeine 40 mg per tablet/capsule or per 15 mL (Vtol LQ).

Children ≥12 years and Adolescents:

Capsules, tablets: Oral: 1 to 2 tablets or capsules every 4 hours as needed; maximum daily dose: 6 tablets or capsules/day.

Solution (Vtol LQ): Oral: 15 to 30 mL every 4 hours as needed; maximum daily dose: 90 mL/day.

These changes have been automatically posted to online and mobile app databases. Please update your mobile application to get the updated monograph.