Anticoagulants: Patients on anticoagulants such as warfarin should be carefully monitored during anabolic steroid therapy as anabolic steroids may increase sensitivity to oral anticoagulants which may require a concomitant reduction in anticoagulant dosage to achieve a desirable prothrombin time (PT). Anticoagulant patients should be monitored regularly during anabolic steroid therapy, particularly during initiation and termination of therapy. Warfarin patients should have INR and PT monitored throughout androgen therapy and warfarin dosages titrated to achieve the desired INR and PT. Such patients should be monitored for occult bleeding.
Nateglinide and its metabolites are rapidly and completely eliminated following oral administration. Within 6 hours after dosing, approximately 75% of the administered 14C-nateglinide was recovered in the urine. Eighty-three percent of the 14C-nateglinide was excreted in the urine with an additional 10% eliminated in the feces. Approximately 16% of the 14C-nateglinide was excreted in the urine as parent compound. In all studies of healthy volunteers and patients with Type 2 diabetes , nateglinide plasma concentrations declined rapidly with an average elimination half-life of approximately hours. Consistent with this short elimination half-life, there was no apparent accumulation of nateglinide upon multiple dosing of up to 240 mg three times daily for 7 days.
Bivalirudin is classified as FDA pregnancy risk category B. However, bivalirudin is intended for use with aspirin when administered for FDA-approved use in patients undergoing percutaneous coronary intervention (PCI). Aspirin is classified as pregnancy category C during the first and second trimesters and as pregnancy category D during the third trimester. Regular use of full-dose aspirin late in pregnancy may result in constriction or premature closure of the fetal ductus arteriosus. Animal data suggest bivalirudin causes no teratogenic effects when administered in the early stages of pregnancy or during the period of organogenesis. It is not known if the bivalirudin crosses the placental barrier in humans. There are no adequate and well-controlled studies in pregnant women. Bivalirudin with aspirin should only be used during pregnancy if clearly needed. Furthermore, bivalirudin should be used with extreme caution near term and during labor and obstetric delivery because of the possibility of maternal postpartum hemorrhage.