Drug discoloration

Chloroquine Take this drug witii food or milk. Avoid foods diat acidify die urine (cranberries, plums, prunes, meats, cheeses, eggs, fish, and grains). This drug may cause diarrhea, loss of appetite, nausea, stomach pain, or vomiting. Notify die primary healtii care provider if these symptoms become pronounced. Chloroquine may cause a yellow or brownish discoloration to the urine this is normal and will go away when the drug therapy is discontinued. Notify the primary health care provider if any of the following occur ... 

Acetaminophen causes few adverse reactions when used as directed on the label or recommended by the primary health care provider. Adverse reactions associated with the use of acetaminophen usually occur with chronic use or when the recommended dosage is exceeded. Adverse reactions to acetaminophen include skin eruptions, urticaria (hives), hemolytic anemia, pancytopenia (a reduction in all cellular components of the blood), hypoglycemia, jaundice (yellow discoloration of the skin), hepatotoxicily (damage to the liver), and hepatic failure (seen in chronic alcoholics taking the drug). 

The nurse informs the patient that phenazopyridine may cause a reddish orange discoloration of the urine and may stain fabrics or contact lenses. The nurse assures the patient that this is normal and will subside when use of the drug is discontinued. 

Dermatologic—chloasma (pigmentation of the skin) or melasma (discoloration of the skin), which may continue when use of the drug is discontinued... 

These drug may cause burning, itching, and skin irritation. Antiiralin may cause skin irritation, as well as temporary discoloration of the hair and fingernails. 

Since full analyses are carried out, a lot of data are generated. Every parameter is reviewed for trends that signal product aging or outright decomposition of the active principle this can be as cosmetic in nature as discoloration or as potentially hazardous as buildup of toxic derivatives. If the drug substance is an ester, for example, hydrolysis, particularly if moisture penetrates the primary packaging material, will decompose the compound into its acid and alcohol components. From a pharmaceutical or medical viewpoint, even if there is no toxicity issue involved, this will result in a loss of bioavailability. Even this is to be avoided because subpotency introduces therapeutic uncertainty and can go as far as lethal undertreatment. 

Side effects include dyskinesias, orthostatic hypotension, dizziness, nausea, insomnia, sleep attacks, pathologic gambling, discoloration of urine/sweat, and psychiatric effects (confusion, hallucinations, nightmares, and altered behavior). Dyskinesias caused by adding other PD drugs to levodopa may be improved by decreasing the levodopa dose. Motor complications occur in about 40% of patients within 4 to 6 years of starting levodopa.1,8,24,25,37... 

Adverse effects with the tetracyclines include gastrointestinal upset drug interactions with dairy products, antacids, and iron and phototoxicity. Minocycline can also cause vestibular complications (headache and dizziness) and skin discoloration that is not typical with tetracycline and doxycycline.16... 

Tetracycline Tablets, capsules 250, 500 mg 500 mg twice daily before meals Maintenance dose 500 mg daily Gl upset, phototoxicity, tooth discoloration, drug and food interactions... 

Rifabutin Adults0 5 mg/kg (300 mg) Children Appropriate dosing unknown Hematologic toxicity, uveitis, gastrointestinal symptoms, polyarthralgias, hepatotoxicity, pseudojaundice (skin discoloration with normal bilirubin), rash, flulike syndrome, orange discoloration of bodily fluids (sputum, urine, sweat, tears) Drug interactions are less problematic than rifampin... 

Rifampin Hepatic abnormalities monitor LFTs Reddish-orange discoloration of secretions (e.g., urine, sweat, tears) Potent inducer of CYP-mediated metabolism evaluate for drug-drug interactions... 

Pseudoephedrine hydrochloride can be considered a stable compound in bulk and in formulations. After 4-weeks under fluorescent lights (2400 ft. candles) and ultraviolet light (190 pw/cm2) no discoloration or chemical degradation was observed. The bulk drug was stable for at least 6 months at 37°C and 3 months at 50°C. Tablet and syrup formulations stored at 15-30°C for 5 years showed no appreciable degradation. 13... 

Lack of assurance of sterility in production or testing of sterile drug products. Discoloration. Counterfeit dosage form. 

Rifampin. Source, antibacterial activity, and routes of administration are described on p. 274. Albeit mostly well tolerated, this drug may cause several adverse effects including hepatic damage, hypersensitivity with flu-like symptoms, disconcerting but harmless red/orange discoloration of body fluids, and enzyme induction (failure of oral Liillmann, Color Atlas of Pharmacology... 

While using the 0.1 % threshold as a determinant for when an impurity should be isolated to meet regulatory requirements is a good practice, there are other times when it becomes necessary to work with extraneous compounds at still lower levels. During the development of process chemistry for the synthesis of the protease inhibitor Tipranavir several synthetic lots of the drug were discolored, appearing pinkish rather than white as they should. It was determined that a low-level ( 0.1%) highly colored material was responsible for the problem with those lots and a request for the isolation and characterization of that contaminant was received [66]. 

Inspect parenteral drug products visually for particulate matter and discoloration... 

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