PRUSSIANBLUE (Oral)*?

Some commonly used brand names are:

Other commonly used names are: Berlin blue, ferric ferrocyanide, ferric (III) hexacyanoferrate (II), and iron blue.

*? Not commercially available in the U.S. and Canada.

Category

• Chelating agent

Description

Prussian (PRUSH-en) blue is used to treat thalliumpoisoning and radiocesium poisoning. It works by combining with thallium andradiocesium in the intestines. The combination is then removed from the bodythrough the stools. By removing the thallium or radiocesium, the medicinelessens damage to your body's organs and tissues.

Prussian blue is available only with your doctor's prescription, in thefollowing dosage form:

Oral
• Capsules (Germany)

Before Using This Medicine

In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For prussian blue, thefollowing should be considered:

Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to prussian blue. Also tell your health care professionalif you are allergic to any other substances, such as foods, preservatives,or dyes.

Pregnancy?Prussian blue has not been shown to cause birth defectsor other problems in humans.

Breast-feeding?It is not known whether prussian blue passes intobreast milk. However, thallium does pass into breast milk. Mothers with thalliumor radiocesium poisoning who wish to breast-feed should discuss this withtheir doctor.

Children?Although there is no specific information comparinguse of prussian blue in children with use in other age groups, this medicineis not expected to cause different side effects or problems in children thanit does in adults.

Older adults?Many medicines have not been studied specificallyin older people. Therefore, it may not be known whether they work exactlythe same way they do in younger adults. Although there is no specific informationcomparing use of prussian blue in the elderly with use in other age groups,this medicine is not expected to cause different side effects or problemsin older people than it does in younger adults.

Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. Tell your health careprofessional if you are using any other prescription or nonprescription (over-the-counter[OTC]) medicine.

Other medical problems?The presence of other medicalproblems may affect the use of prussian blue. Make sure you tell your doctorif you have any other medical problems, especially:

• Blockage of the intestines or
• Constipation?This medicine may not work properly if these conditionsare present

Proper Use of This Medicine

Keep taking this medicine for the full time of treatment, even if youbegin to feel better after a few days. Do not miss anydoses.

If you are unable to swallow the capsule, you may open the capsule andempty the contents into a glass (8 ounces) of warm water. Stir gently untilthe medicine is mixed with the water. Drink the water with the medicine rightaway. If there is any medicine left in the bottom of the glass, add a littlemore warm water to the glass and drink that too.

Your doctor may advise you to take this medicine with a laxative, suchas sorbitol, to help prevent constipation.

Dosing?The dose of prussian blue will be differentfor different patients. Follow your doctor's orders orthe directions on the label. The following information includes onlythe average doses of prussian blue. If your dose is different,do not change it unless your doctor tells you to do so.

• For oral dosage form (capsules):
  • For acute thallium poisoning:
    • Adults and children?3 grams taken right away, followed by 3to 20 grams a day divided into smaller doses as directed by your doctor. Or,the dose may be 3 grams taken right away, followed by 250 milligrams (mg)per kilogram (kg) (113.5 mg per pound) of body weight a day divided into foursmaller doses. Either dose may be taken for two to three weeks as determinedby your doctor.
  • For chronic thallium poisoning:
    • Adults and children?The usual dose is 3 to 20 grams a day dividedinto smaller doses as directed by your doctor. Or, the dose may be 250 mgper kg (113.5 mg per pound) of body weight a day divided into four smallerdoses. Either dose may be taken for two to three weeks as determined by yourdoctor.
  • For radiocesium poisoning:
    • Adults and children?The usual dose is 500 mg every two hours,for a total dose of 3000 mg (3 grams) a day. This dose may be taken for aslittle as several days or as long as three weeks, as determined by your doctor.

Missed dose?If you miss a dose of this medicine, take it assoon as possible. However, if it is almost time for your next dose, skip themissed dose and go back to your regular dosing schedule. Do not double doses.

Storage?To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in otherdamp places. Heat or moisture may cause the medicine to break down.
• Keep the medicine from freezing. Do not refrigerate.
• Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.

Side Effects of This Medicine

Alongwith its needed effects, a medicine may cause some unwanted effects. Althoughnot all of these side effects may occur, if they do occur they may need medicalattention.

Check with your doctor as soon as possible if the following side effectoccurs:

More common

This medicinecommonly causes unusually dark stools. This side effect does not usually needmedical attention.

Other side effects not listed above may also occur in some patients. Ifyou notice any other effects, check with your doctor.