Intermittent dosage

Initial therapy Give minimally effective dose (usually, 50 to 200 mg/day) on a continuous or intermittent dosage schedule to produce gradual weight loss of 2.2 to 4.4 kg/day (1 to 2 Ib/day). Adjust dose in 25 to 50 mg increments. Higher doses, up to 200 mg twice daily, achieved gradually, are most often required in patients with severe, refractory edema. 

Mobilization of edema may be most efficiently and safely accomplished with an intermittent dosage schedule the drug is given 2 to 4 consecutive days each week. With doses greater than 80 mg/day, clinical and laboratory observations are advisable. 

Suppressed growth of Ehrlich ascites tumor, Walker carcinosarcoma, sarcoma 37, Lewis carcinoma, sarcoma 180 in rats intermittent dosage (Walker 517... 

Long-term use of adrenal steroids in children presents essentially the same problems as in adults except that growth is retarded approximately in proportion to the dose. This is unlikely to be important unless therapy exceeds 6 months there is a spurt of growth after withdrawal. Intermittent dosage schedules (alternate day) may reduce the risk (rarely, corticotropin may be preferred, see p. 675). 

If the drug is given at intermittent dosage intervals, such as 250 mg every 6 hours, steady state is achieved when the serum-concentration-versus-time curves for each dosage interval are super-imposable. The amount of drug eliminated during the dosage interval equals the dose. 

Viomycin, like the other polypeptide antibiotics, has certain nephrotoxic efTects, which are manifested by albuminuria and cylindruria . Blood electrolyte disturbances , allergic reactions, partial hearing loss and pain at the site of injection have been observed . These effects, however, are mainly dependent on the dosage and are rare if the recommended doses are applied . Intermittent dosage schedules and the application of viomycin-pantothenate have been reported to reduce the toxic side effects Table 1.8). 

Continuous treatment stream received 0.22 pg chlorpyrifos/L for days 1 to 41, and 1.0 pg/L from days 41-100. Intermittent treatment stream received dosage 14 times higher than continuous treatment stream, but dosage was confined to 24 h every 14 days. Chlorpyrifos administered as emulsifiable concentrate in petroleum derivative solvent Single dose of 0.5,5, or 20 pg/L observed for 30 days... 

Hydrocortisone given parenterally is the corticosteroid of choice because of its combined glucocorticoid and mineralocorticoid activity. The starting dose is 100 mg IV by rapid infusion, followed by a continuous infusion or intermittent bolus of 100 to 200 mg every 24 hours. IV administration is continued for 24 to 48 hours. If the patient is stable at that time, oral hydrocortisone can be started at a dose of 50 mg every 8 hours for another 48 hours. A hydrocortisone taper is then initiated until the dosage is 30 to 50 mg/day in divided doses. 

In patients with CHF, potassium loss may decrease after an initial diuresis reevaluate the need or dosage for amiloride. Maintenance therapy may be intermittent. 

The recommended dosages of an oral standardized dry extract of ginkgo (24% ginkgo flavonol glycosides and 6% terpene lactones) are 120 to 240 mg daily for dementia and memory impairment, and 120 to 160 mg daily for intermittent claudication and tinnitus. Adverse effects include gastrointestinal disturbances, diarrhea, vomiting, allergic reactions, pruritus, headache, dizziness, and nose bleeds. 

Elevations of serum aminotransferase activity (up to three times normal) occur in some patients. This is often intermittent and usually not associated with other evidence of hepatic toxicity. Therapy may be continued in such patients in the absence of symptoms if aminotransferase levels are monitored and stable. In some patients, who may have underlying liver disease or a history of alcohol abuse, levels may exceed three times normal. This finding portends more severe hepatic toxicity. These patients may present with malaise, anorexia, and precipitous decreases in LDL. Medication should be discontinued immediately in these patients and in asymptomatic patients whose aminotransferase activity is persistently elevated to more than three times the upper limit of normal. These agents should be used with caution and in reduced dosage in patients with hepatic parenchymal disease, Asians, and the elderly. In general, aminotransferase activity should be measured at baseline, at 1-2 months, and then every 6-12 months (if stable). 

The dosage should be kept as low as possible, and intermittent administration (eg, alternate-day) should be used when satisfactory therapeutic results can be obtained on this schedule. Even patients maintained on relatively low doses of corticosteroids may require supplementary therapy at times of stress, such as when surgical procedures are performed or intercurrent illness or accidents occur. 

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