Locoa Special Precautions

General: A thorough health interview should be performed to predict hypersensitivity reactions.
For long term use, periodic laboratory tests (urine analysis, blood test, liver function test, etc.) should be performed. If any abnormality is observed, appropriate measures such as dose interruption should be taken (see Adverse Reactions).
Special attention should be paid to elderly patients with high fever or patients with wasting disease after receiving LOCOA, since symptoms such as excessive decrease in body temperature, collapse, and cold extremities may occur.
The use of LOCOA with new quinolone antibiotics, other than enoxacin hydrate, lomefloxacin, norfloxacin and prulifloxacin (see Contraindications), should be avoided wherever possible.
If cutaneous symptoms are observed with the use of LOCOA, appropriate measures such as drug interruption or discontinuation should be taken according to symptoms.
Temporary infertility has been reported in women after long term use of nonsteroidal anti-inflammatory analgesics.
Careful administration: LOCOA should be administered with care in the following patients.
Patients with peptic ulcer induced by long term use of nonsteroidal anti-inflammatory analgesics who need long term use of LOCOA and are being treated with agents such as misoprostol: Since some patients may have peptic ulcer resistant to agents such as misoprostol, adequate monitoring and careful administration is required, when the use of LOCOA is continued.
Patients with a history of peptic ulcer: Gastric mucosal barrier decreased by inhibition of prostaglandin synthesis may cause a relapse of peptic ulcer.
Patients with current or previous blood abnormality: Blood abnormality may be aggravated or recur by development of blood disorder.
Patients with bleeding tendency: Platelet function may decrease, increasing bleeding tendency.
Patients with current or previous liver disorder: Liver disorder may be aggravated or recur by hepatic function abnormality.
Patients with current or previous renal disorder, or reduced renal blood flow: Renal disorder may be aggravated or recur, or may be induced by reduced renal blood flow via inhibition of prostaglandin synthesis.
Patients with abnormal cardiac function: Water and sodium retention induced by inhibition of prostaglandin synthesis may aggravate cardiac dysfunction.
Patients with hypertension: Water and sodium retention induced by inhibition of prostaglandin synthesis may further increase blood pressure.
Patients with bronchial asthma: Make sure that the patient does not have aspirin-induced asthma. Some patients with bronchial asthma may actually have aspirin-induced asthma, with which asthmatic attacks may be induced (see Adverse Reactions).
Patients with ulcerative colitis: Ulcerative colitis may be aggravated.
Patients with Crohn's disease: Symptoms aggravated by other nonsteroidal anti-inflammatory analgesics have been reported.
Effects on ability to drive and use machines: It is considered that application of LOCOA at recommended doses has no influence on the ability to drive and use machines.
Use in Children: Safety has not been established in low-birth-weight babies, neonates, babies, infants and children. [There is no experience in the use for the previously mentioned patients.]
Use in the Elderly: Elderly patients are more susceptible to adverse reactions. Care should be taken in administering LOCOA to elderly patients, for example, limiting the use to a minimal level, while special attention should be paid to possible adverse reactions.
Use this medication by prescription only.