Gattex

Risk of neoplastic growth acceleration. Discontinue in active GI malignancy (eg, GI tract, hepatobiliary, pancreatic), colorectal or small bowel cancer. Perform colonoscopy with removal of polyps within 6 months before starting in adults; repeat at end of 1yr therapy and every 5yrs or more as needed. Perform fecal occult blood testing before starting in children/adolescents and repeat annually; if unexplained blood in stool, perform colonoscopy/sigmoidoscopy (see full labeling). Temporarily discontinue if intestinal or stomal obstruction develops; may restart if resolves. Monitor for biliary and pancreatic disease; assess bilirubin, alkaline phosphatase, lipase, amylase within 6 months before starting and at least every 6 months during treatment, or more if needed. Risk of fluid overload; if occurs, adjust parenteral support and reassess treatment (esp. in underlying cardiovascular disease). Reevaluate treatment if significant cardiac deterioration develops. Monitor fluid and electrolytes when therapy discontinued. Severe hepatic impairment: not studied. Pregnancy. Nursing mothers: not recommended.