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Every effort has been made to ensure that the information provided by Cerner MultumIncMultumis accurateup-to-dateand completebut no guarantee is made to that effectDrug information contained herein may be time sensitiveMultum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriateunless specifically indicated otherwiseMultum’s drug information does not endorse drugsdiagnose patients or recommend therapyMultum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement toand not a substitute forthe expertiseskillknowledge and judgment of healthcare practitionersThe absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safeeffective or appropriate for any given patientMultum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum providesThe information contained herein is not intended to cover all possible usesdirectionsprecautionswarningsdrug interactionsallergic reactionsor adverse effectsIf you have questions about the drugs you are takingcheck with your doctornurse or pharmacist.

Elevations of ALT or ASTthree or more times the upper limit of normalULNhave been reported in approximately 1of NSAID-treated patients in clinical trialsIn additionraresometimes fatalcases of severe hepatic injuryincluding fulminant hepatitisliver necrosisand hepatic failure have been reported.

Inform patients of the warning signs and symptoms of hepatotoxicitye.gnauseafatiguelethargydiarrheapruritusjaundiceright upper quadrant tendernessandflu-likesymptomsIf clinical signs and symptoms consistent with liver disease developor if systemic manifestations occure.geosinophiliarashetcdiscontinue Ponstel immediatelyand perform a clinical evaluation of the patient.

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