Increases in systolic and diastolic blood pressure occurred in children and adolescents and did not occur in adults. Adverse reactions reported since market introduction which were temporally related to quetiapine therapy include anaphylactic reaction, cardiomyopathy, drug reaction with eosinophilia and systemic symptoms (DRESS), hyponatremia, myocarditis, nocturnal enuresis, pancreatitis, retrograde amnesia, rhabdomyolysis, syndrome of inappropriate antidiuretic hormone secretion (SIADH), Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), decreased platelet count, serious liver reactions (including hepatitis, liver necrosis, and hepatic failure), agranulocytosis, intestinal obstruction, ileus, colon ischemia, urinary retention, sleep apnea, and acute generalized exanthematous pustulosis (AGEP). Maternal toxicity (observed as decreased body weights and/or death) occurred at 2 times the MRHD in rats and approximately 1-2 times the MRHD in rabbits. For pediatric schizophrenia, symptom profiles can be variable, and for bipolar I disorder, patients may have variable patterns of periodicity of manic or mixed symptoms. Antihypertensive Drugs Doses were 10, 25, 50, 75, 150 and 250 mg/kg in rat studies which are approximately 0.1, 0.3, 0.6, 1, 2 and 3-times the MRHD of 800 mg/day based on mg/m2 body surface area, respectively. The exposure-adjusted rate of any increased blood glucose level (126 mg/dL) for patients more than 8 hours since a meal (however, some patients may not have been precluded from calorie intake from fluids during fasting period) was 18.0 per 100 patient years for quetiapine tablets (10.7% of patients; n=556) and 9.5 for placebo per 100 patient years (4.6% of patients; n=581). This is an open access article distributed under the, Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. Papers are submitted upon individual invitation or recommendation by the scientific editors and undergo peer review You can ask your pharmacist or healthcare provider for information about SEROQUEL that is written for health professionals. While the clinical trials did not reveal any tendency for any drug-seeking behavior, these observations were not systematic and it is not possible to predict on the basis of this limited experience the extent to which a CNS-active drug will be misused, diverted, and/or abused once marketed. In this study, there were no patients in the SEROQUEL XR or placebo-treated groups with a baseline normal fasting glucose level (<100 mg/dL) that had an increase in blood glucose level >126 mg/dL. Quetiapine is rapidly absorbed after oral administration, reaching peak plasma concentrations in 1.5 hours. In an open-label study that enrolled patients from the above two pediatric trials, 63% of patients (241/380) completed 26 weeks of therapy with SEROQUEL. In acute placebo-controlled trials in children and adolescent patients with schizophrenia (6-week duration) or bipolar mania (3-week duration), the incidence of shifts for thyroid function values at any time for quetiapine tablets treated patients and placebo-treated patients for elevated TSH was 2.9% (8/280) vs. 0.7% (1/138), respectively, and for decreased total thyroxine was 2.8% (8/289) vs. 0% (0/145), respectively. Human have many diseases and every disease have a specific drugs. Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse, or who are experiencing emergent suicidality or symptoms that might be precursors to worsening depression or suicidality, especially if these symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms. Drug class: Atypical antipsychotics. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety, depression, or seizures. binding to the same biological target), a related mode of action, and/or are used to treat the same disease.. The no-effect dose in female rats was 1 mg/kg, or 0.01 times the MRHD of 800 mg/day based on mg/m2 body surface area. There was one patient in the quetiapine extended-release tablets group with a baseline borderline fasting glucose level (>100 mg/dL) and <126 mg/dL) who had an increase in blood glucose level of >126 mg/dL compared to zero patients in the placebo group. On the Y axis, each drug is listed, in roughly the Singh-Vaughan Williams order. The empty string is the special case where the sequence has length zero, so there are no symbols in the string. Agranulocytosis has been reported. Copyright 2022 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. Advise the patient to read the FDA-approved patient labeling (Medication Guide). Those proposed in 1970 were:[2], Another approach, known as the "Sicilian gambit", placed a greater approach on the underlying mechanism. The safety and effectiveness of quetiapine tablets in the maintenance treatment of schizophrenia has not been established in any patient population, including pediatric patients. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Blood pressure in children and adolescents should be measured at the beginning of, and periodically during treatment. The diagnostic evaluation of patients with this syndrome is complicated. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. Schizophrenia - Adolescents (13-17 years). Triptans are a family of tryptamine-based drugs used as abortive medication in the treatment of migraines and cluster headaches. This type of In bipolar depression trials, the proportions of patients with transaminase elevations of >3 times the upper limits of the normal reference range in two 8-week placebo-controlled trials was 1% (5/698) for SEROQUEL and 2% (6/347) for placebo. During clinical trials, seizures occurred in 0.5% (20/3490) of patients treated with SEROQUEL compared to 0.2% (2/954) on placebo and 0.7% (4/527) on active control drugs. The pooled analyses of placebo-controlled trials in adults with MDD or other psychiatric disorders included a total of 295 short-term trials (median duration of 2 months) of 11 antidepressant drugs in over 77,000 patients. Patients should be advised to report to their physician any signs or symptoms that may be related to NMS. In several dominant drug classification systems, these four types of classifications form a hierarchy. In the mania adjunct studies, where quetiapine tablets were added to lithium or divalproex, 12% (24/196) of quetiapine tablets treated patients compared to 7% (15/203) of placebo-treated patients had elevated TSH levels. Commonly Observed Adverse Reactions in Short-Term, Placebo-Controlled Trials. Adverse reactions were assessed by collecting adverse reactions, results of physical examinations, vital signs, weights, laboratory analyses, ECGs, and results of ophthalmologic examinations. Patients should be aware of the symptoms of hyperglycemia (high blood sugar) and diabetes mellitus. This page was last edited on 29 August 2022, at 05:28. We comply with the HONcode standard for trustworthy health information. While the clinical trials did not reveal any tendency for any drug-seeking behavior, these observations were not systematic and it is not possible to predict on the basis of this limited experience the extent to which a CNS-active drug will be misused, diverted, and/or abused once marketed. , Paperback [19][20][21], It presents the drugs on two axes, instead of one, and is presented in tabular form. The calorimeter design consists of two disks, each loaded with 674 undoped CsI crystals read out by two large-area arrays of UV-extended SiPMs and custom analogue and digital electronics. In bipolar depression trials, somnolence was reported in 57% (398/698) of patients on quetiapine tablets compared to 15% (51/347) of placebo patients. 300 mg Tablets (NDC 0310-0283-60) pale yellow, film-coated, capsule-shaped, biconvex, intagliated tablet with XR 300 on one side and plain on the other are supplied in bottles of 60 tablets. The history of triptans began with the proposed existence of then unknown serotonin (5-hydroxytryptamine, 5-HT). In clinical trial and postmarketing experience, events of leukopenia/neutropenia have been reported temporally related to atypical antipsychotic agents, including SEROQUEL. Appropriate care is advised when prescribing quetiapine tablets for patients who will be experiencing conditions which may contribute to an elevation in core body temperature, e.g., exercising strenuously, exposure to extreme heat, receiving concomitant medication with anticholinergic activity, or being subject to dehydration. Efficacy was established in two 12-week monotherapy trials in adults, in one 3-week adjunctive trial in adults, and in one 3-week monotherapy trial in pediatric patients (10-17 years) [see Clinical Studies (14.2)]. In an acute (8-week) SEROQUEL XR trial in children and adolescents (10-17 years of age) with bipolar depression, in which efficacy was not established, the most commonly observed adverse reactions associated with the use of SEROQUEL XR (incidence of 5% or greater and at least twice that for placebo) were dizziness 7%, diarrhea 5%, fatigue 5%, and nausea 5%. The treatment effect was present for increasing time to recurrence of both manic and depressed episodes. Dosage adjustment is therefore not needed in these patients [see Use In Specific Populations]. By 1991 sumatriptan became available in clinical use in the Netherlands and in the US in 1993. Precise risk estimates for hyperglycemia-related adverse reactions in patients treated with atypical antipsychotics are not available. Therefore, both TSH and free T4, in addition to clinical assessment, should be measured at baseline and at follow-up. The efficacy of quetiapine tablets in the maintenance treatment of bipolar I disorder was established in 2 placebo-controlled trials in patients (n=1326) who met DSM-IV criteria for bipolar I disorder (studies 7 and 8 in Figures 1 and 2). Additional signs may include elevated creatinine phosphokinase, myoglobinuria (rhabdomyolysis) and acute renal failure. paper provides an outlook on future directions of research or possible applications. A prospective, longitudinal study followed 201 pregnant women with a history of major depressive disorder who were euthymic and taking antidepressants at the beginning of pregnancy. Such symptoms should be reported to the patient's prescriber or health professional, especially if they are severe, abrupt in onset, or were not part of the patient's presenting symptoms. The distinctive signal signature is represented by a mono-energetic electron with an energy near the muon’s rest mass. 1. Quetiapine should also be avoided in circumstances that may increase the risk of occurrence of torsade de pointes and/or sudden death including (1) a history of cardiac arrhythmias such as bradycardia; (2) hypokalemia or hypomagnesemia; (3) concomitant use of other drugs that prolong the QTc interval; and (4) presence of congenital prolongation of the QT interval. Call a healthcare provider right away if you or your family member has any of the following symptoms, especially if they are new, worse, or worry you: What else do I need to know about antidepressant medicines? risk of death in the elderly with dementia. It is present in tablets as the fumarate salt. The Mu2e Crystal Calorimeter: An Overview. Quetiapine tablets dose should be reduced to one sixth of original dose when co-medicated with a potent CYP3A4 inhibitor (e.g., ketoconazole, itraconazole, indinavir, ritonavir, nefazodone, etc.). 3. Inflammatory diseases are the focus of several clinical studies, due to limitations and serious side effects of available therapies. We describe here the status of construction for all calorimeter components and the performance measurements conducted on the large-sized prototype with electron beams and minimum ionizing particles at a cosmic ray test stand. The conditions and duration of treatment with SEROQUEL varied greatly and included (in overlapping categories) open-label and double-blind phases of studies, inpatients and outpatients, fixed-dose and dose-titration studies, and short-term or longer-term exposure. In therapy for schizophrenia (up to 6 weeks), the most commonly observed adverse reactions associated with the use of quetiapine in adolescents (incidence of 5% or greater and quetiapine incidence at least twice that for placebo) were somnolence (34%), dizziness (12%), dry mouth (7%), tachycardia (7%). Medically reviewed by Drugs.com. By accepting, you agree to the updated privacy policy. The mean change in body weight in the schizophrenia trial was 2.0 kg in the SEROQUEL group and -0.4 kg in the placebo group and in the bipolar mania trial, it was 1.7 kg in the SEROQUEL group and 0.4 kg in the placebo group. NRSG 210 - Pharmacology for Nursing I. Symptoms such as these may be associated with an increased risk for suicidal thinking and behavior and indicate a need for very close monitoring and possibly changes in the medication [see WARNINGS AND PRECAUTIONS]. It is the most popular hot drink in the world. [17] In studies, newer triptans are mostly compared to sumatriptan. Because of its potential for inducing hypotension, SEROQUEL may enhance the effects of certain antihypertensive agents. Improvement in symptoms, as measured by change in MADRS score relative to placebo, was seen in both studies at Day 8 (week 1) and onwards. Examination of population subsets (race, gender, and age) did not reveal any differential responsiveness on the basis of race or gender, with an apparently greater effect in patients under the age of 40 years compared to those older than 40. Although the prevalence of the syndrome appears to be highest among the elderly, especially elderly women, it is impossible to rely upon prevalence estimates to predict, at the inception of antipsychotic treatment, which patients are likely to develop the syndrome. The management of NMS should include: 1) immediate discontinuation of antipsychotic drugs and other drugs not essential to concurrent therapy; 2) intensive symptomatic treatment and medical monitoring; and 3) treatment of any concomitant serious medical problems for which specific treatments are available. Of these trials, 2 were monotherapy (12 weeks) and 1 was adjunct therapy (3 weeks) to either lithium or divalproex. The adverse reactions leading to discontinuation in 2% or more of patients on quetiapine tablets and at a greater incidence than placebo were somnolence (4.1% vs. 1.1%) and fatigue (2.1% vs. 0). A major depressive episode may be the initial presentation of bipolar disorder. Written in the enjoyable, award-winning Incredibly Easy style, this easy-to-follow, fully illustrated guide offers step-by-step direction on the medication process, from assessing patient needs, to planning care, to Concomitant treatment with quetiapine and other drugs with anticholinergic activity can increase the risk for severe gastrointestinal adverse reactions related to hypomotility. The drugs of this class act as agonists for serotonin 5-HT 1B and 5-HT 1D receptors at blood vessels and nerve endings in the brain. Pre-eclampsia is a serious condition of the second half of What other drugs will affect Aldactone? This slight tendency to tachycardia in adults may be related to quetiapine tablets potential for inducing orthostatic changes [see Warnings and Precautions (5.7)]. Quetiapine activity is primarily due to the parent drug. SEROQUEL at 400 mg/day and 800 mg/day was superior to placebo in the reduction of PANSS total score. The primary efficacy variable was the mean change from baseline in total YMRS score. Consideration should be given to a slower rate of dose titration and a lower target dose in the elderly and in patients who are debilitated or who have a predisposition to hypotensive reactions [see Use In Specific Populations, and CLINICAL PHARMACOLOGY]. It is assumed that blood vessels are constricted during the aura phase and dilated during the pain phase, so a constrictive medication like a triptan is not recommended during the aura. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. serotoninnorepinephrine reuptake inhibitors, University of Florida College of Medicine, selective norepinephrine reuptake inhibitor, Learn how and when to remove this template message, "Overview of Migraine: Recognition, Diagnosis, and Pathophysiology", "Sumatriptan-naproxen for acute treatment of migraine: a randomized trial", "Efficacy and safety of acetaminophen in the treatment of migraine: results of a randomized, double-blind, placebo-controlled, population-based study", "Zelrix: a novel transdermal formulation of sumatriptan", "Onzetra Xsail Approved as Migraine Treatment", "Zogenix, Inc. - Therapeutic Solutions for CNS Disorders and Rare Disease", "Newer formulations of the triptans: advances in migraine management", "Marketed oral triptans in the acute treatment of migraine: a systematic review on efficacy and tolerability", "The FDA alert on serotonin syndrome with combined use of SSRIs or SNRIs and triptans: an analysis of the 29 case reports", "Information for Healthcare Professionals", "Association of Coprescription of Triptan Antimigraine Drugs and Selective Serotonin Reuptake Inhibitor or Selective Norepinephrine Reuptake Inhibitor Antidepressants With Serotonin Syndrome", "Mechanisms of action of the 5-HT1B/1D receptor agonists", "The biology of serotonin receptors: focus on migraine pathophysiology and treatment", "The triptan formulations: a critical evaluation", "Current and emerging second-generation triptans in acute migraine therapy: a comparative review", "AstraZeneca enters agreement with Grnenthal to divest rights to migraine treatment Zomig", "Avanir's press release: FDA approves Onzetra", https://en.wikipedia.org/w/index.php?title=Triptan&oldid=1110658176, Articles with unsourced statements from March 2007, Articles with unsourced statements from March 2021, Articles with unsourced statements from October 2007, Wikipedia articles that are too technical from October 2016, Articles with unsourced statements from October 2016, Articles with unsourced statements from April 2010, Creative Commons Attribution-ShareAlike License 3.0, inhibition of vasoactive neuropeptide release by trigeminal terminals innervating intracranial vessels and the dura mater. Password requirements: 6 to 30 characters long; ASCII characters only (characters found on a standard US keyboard); must contain at least 4 different symbols; Clinical manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status, and evidence of autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis, and cardiac dysrhythmia). Store at 20C-25C (68F-77F); excursions permitted to 15C-30C (59F-86F) [See USP Controlled Room Temperature]. Take SEROQUEL by mouth, with or without food. Norquetiapine, an active metabolite of quetiapine, has moderate to strong affinity for several muscarinic receptor subtypes. The most common adverse effect is recurrence of migraine. If hypotension occurs during titration to the target dose, a return to the previous dose in the titration schedule is appropriate. Somnolence combines adverse reaction terms somnolence and sedation. While these symptoms can occur at low doses, they occur more frequently and with greater severity with high potency and at higher doses of first generation antipsychotic drugs. Keep quetiapine tablets and all medicines out of the reach of children. There may be new information. However, the efficacy of quetiapine in these indications could be mediated through a combination of dopamine type 2 (D2) and serotonin type 2 (5HT2) antagonism. In placebo-controlled trials with risperidone, aripiprazole, and olanzapine in elderly subjects with dementia, there was a higher incidence of cerebrovascular adverse reactions (cerebrovascular accidents and transient ischemic attacks) including fatalities compared to placebo-treated subjects. A clinical trial with SEROQUEL XR was conducted in children and adolescents (10-17 years of age) with bipolar depression, efficacy was not established. However, the proportions of patients meeting the criteria for tachycardia were compared in four 3-to 6-week placebo-controlled clinical trials for the treatment of schizophrenia revealing a 1% (4/399) incidence for SEROQUEL compared to 0.6% (1/156) incidence for placebo. Efficacy was supported by two 12-week monotherapy trials and one 3-week adjunctive trial in adults with manic episodes associated with bipolar I disorder as well as one 3-week monotherapy trial in children and adolescents (10 - 17 years) with manic episodes associated with bipolar I disorder treated with SEROQUEL [see Clinical Studies]. Serum measurements in a 1-year toxicity study showed that quetiapine increased median serum prolactin levels a maximum of 32- and 13-fold in male and female rats, respectively. For more information, go to www.SEROQUEL.com, or call 1-800-236-9933. Safety and effectiveness of SEROQUEL in pediatric patients less than 10 years of age with bipolar mania have not been established. Journal of Pharmacology and Experimental Therapeutics. The primary rating instrument used for assessing manic symptoms in these trials was YMRS, an 11-item clinician-rated scale traditionally used to assess the degree of manic symptomatology (irritability, disruptive/aggressive behavior, sleep, elevated mood, speech, increased activity, sexual interest, language/thought disorder, thought content, appearance, and insight) in a range from 0 (no manic features) to 60 (maximum score). Carcinogenicity studies were conducted in C57BL mice and Wistar rats. The effects on fertility are reversible [see Use In Specific Populations]. Interference with Cognitive and Motor Performance. For 100 MeV electrons, the calorimeter should achieve: (a) a time resolution better than 0.5 ns, (b) an energy resolution <10%, and (c) a position resolution of 1 cm. The experiment aims to improve the current In acute bipolar mania trials in adults, the proportions of patients with transaminase elevations of >3 times the upper limits of the normal reference range in a pool of 3-to 12-week placebo-controlled trials were approximately 1% for both SEROQUEL (3/560) and placebo (3/294). Patients should be cautioned about performing any activity requiring mental alertness, such as operating a motor vehicle (including automobiles) or operating machinery, until they are reasonably certain quetiapine therapy does not affect them adversely [see WARNINGS AND PRECAUTIONS]. Caution should also be exercised when quetiapine is prescribed in patients with increased risk of QT prolongation (e.g., cardiovascular disease, family history of QT prolongation, the elderly, congestive heart failure, and heart hypertrophy). NRSG 236 - Hyperprolactinemia, regardless of etiology, may suppress hypothalamic GnRH, resulting in reduced pituitary gonadotrophin secretion. Diuretics in hypertension 2015 by Dr Abhishek Rathore, NurseReview.Org Pharmacology Cardiovascular Drugs, Cardiovascular+pharmacology+drug+therapy+of+hypertension, Debbie's Cardiac Meds Presentation Final Nn, Anti hypertensives and diuretics drugs - pharmacology, Classification of anti hypertensive drugs, College of Pharmacy University of Sulaimani, Cardiovascular drugs-Antihypertensive drugs, Pharmacological management of heart failure, Antihypertensives | Classes of Drugs | Baro Receptor, Overview of the Medical Management of High Blood Pressure in Adults, Heart failure with reduced ejection fraction by Dr. Papu kumar Safi, Essential hypertension management and treatment. The information below is derived from a clinical trial database for quetiapine tablets consisting of over 4300 patients. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. In the open-label phase, patients were required to be stable on SEROQUEL plus lithium or divalproex for at least 12 weeks in order to be randomized. The class I antiarrhythmic agents interfere with the sodium channel. It now introduces new classes incorporating additional targets, including: It also allows for multiple drug targets/actions and adverse pro-arrhythmic effects. Brief content visible, double tap to read full content. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. If you would like more information, talk with your healthcare provider. In a similarly designed trial (n=200), quetiapine tablets were associated with an improvement in YMRS scores but did not demonstrate superiority to placebo, possibly due to a higher placebo effect. 1. The stated frequencies of adverse reactions represent the proportion of individuals who experienced, at least once, an adverse reaction of the type listed. Long-standing hyperprolactinemia when associated with hypogonadism may lead to decreased bone density in both female and male subjects. Prescriptions for SEROQUEL should be written for the smallest quantity of tablets consistent with good patient management, in order to reduce the risk of overdose. The primary efficacy results of these studies in the treatment of mania in adults is presented in Table 20. In eight patients, where TBG was measured, levels of TBG were unchanged. Methamphetamine (contracted from N-methylamphetamine) is a potent central nervous system (CNS) stimulant that is mainly used as a recreational drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder and obesity. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Do not drink alcohol while taking SEROQUEL. These studies included patients with either bipolar I or II disorder and those with or without a rapid cycling course. For example, the The dose of SEROQUEL should be reduced to one sixth of the original dose if co-administered with a strong CYP3A4 inhibitor [see DOSAGE AND ADMINISTRATION and CLINICAL PHARMACOLOGY]. Series). In this review, we highlight the use of AI in diverse sectors of the pharmaceutical industry, including drug discovery and development, drug repurposing, improving pharmaceutical productivity, and clinical trials, among others; such use Of the approximately 3700 patients in clinical studies with SEROQUEL, 7% (232) were 65 years of age or over. [8][11] For sumatriptan, a number of other application forms are marketed: suppositories, a subcutaneous injection,[8] an iontophoretic transdermal patch, which uses low voltage controlled by a pre-programmed microchip to deliver a single dose of sumatriptan through the skin within 30 minutes;[12] a drug-device combination containing sumatriptan powder that is "breath powered" allowing the user to blow sumatriptan powder in to their nostrils;[13] as well as a needle-free injection system that works with air pressure. Donitriptan and avitriptan were never marketed. Tell your healthcare provider if you are having a urine drug screen because SEROQUEL may affect your test results. Call your doctor for medical advice about side effects. Continued work led to the development of sumatriptan, now known as the first 5-HT1 agonist, selective for the 5-HT1D/B receptors and also the 5-HT1F receptor with less affinity. Pre-eclampsia is a serious condition of the second half of This finding may be due to inhibition of cholesterol biosynthesis by quetiapine. These agents are particularly useful in the treatment of supraventricular tachycardias. The tablet formulation is 100% bioavailable relative to solution. Store SEROQUEL XR at 25C (77F); excursions permitted to 15-30C (59-86F) [See USP]. Given these considerations, SEROQUEL should be prescribed in a manner that is most likely to minimize the occurrence of tardive dyskinesia. If signs and symptoms of tardive dyskinesia appear in a patient on quetiapine tablets, drug discontinuation should be considered. Class II agents include atenolol, esmolol, propranolol, and metoprolol. No effect on absorption or mean oral clearance, 84% decrease in oral clearance resulting in a 6.2-fold increase in AUC of quetiapine. 100 mg Tablets yellow, round, biconvex, film coated tablets, debossed with 320 on one side and HH on the other side, are supplied in: Bottles of 100 tablets (NDC 43547-520-10).