September 2011

It has been some time since we sent a newsletter to our members. In that time, it is now recognized that Irritable Bowel Syndrome (IBS) is a truly global problem reportedly affecting millions of individuals (1 in 10) worldwide and exerting a significant influence on the quality of life both for the many reported and unreported ( 5 in 10) cases.

The IBS Self Help and Support Group has grown considerably in the last few years with roughly 45,000 registered members and over 250,000 visitors who come to our website on a monthly basis. There is now a sizeble group on our Facebook Page resulting in positive support for each other in a different kind of social setting. We have several Twitter feeds. Our Twitter: ibsgroup feed provides snapshots of important news related to IBS. Twitter: irritablebowel is a sampling of postings from our community forums.

In the spring of this year we launched several new initiatives. The first is that we separated our online support for Inflammatory Bowel Disease (IBD) from the IBSgroup.org website. The Inflammatory Bowel Disease Support Group has quickly become a trusted community for Crohn's Disease, Ulcerative Colitis and Digestive Health sufferers. If you ever have posted on the previous IBD forums on the IBSgroup.org forums then you will find that you are already pre-registered on the IBDsupport.org site. The IBDsupport.org forums are led by our very dedicated and knowledgeable Elizabeth Roberts, author of Living with IBD & IBS.

Our second initiative is the launch of the iSupportIBS Donation Fund to help improve the lives of people with Irritable Bowel Syndrome. We launched this donation fund because we believed that our members have a direct say in supporting the kind of research and education which they feel will better their quality of lives.

Here is what your donation to the iSupportIBS Donation Fund will do:

  • Make a difference in the lives of patients, physicians, and researchers around the world.
  • Invest in the future through scientific research.
  • Reach out to the world and raise awareness about IBS.
  • Improve patient outcomes and the health of all people suffering from IBS.
  • Enable good work to be done in the name of people who suffer from IBS.
  • Honor or thank someone who has made a difference in your life.
  • Leave a lasting legacy.

Thanks for being a part of the IBS Self Help and Support Group community. Let's take control together by making your online donation today.

Jeffrey


 
 

The IBS Self Help and Support Group is an award-winning patient led and patient governed educational organization which works to educate those who are living with IBS and to increase awareness about this and other functional gastrointestinal disorders. The IBS Self Help and Support Group website was launched in May 1995 as the first website about Irritable Bowel Syndrome and currently has the largest collection of postings about IBS with 45,000 registered members.

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Ask your doctor if LOTRONEX may be right for you
 
 
Want to know more? Click here to print out a card to show your doctor.

Read these myths and facts about LOTRONEX, then see if LOTRONEX might be right for you.



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Reference: 1. LOTRONEX Prescribing Information. San Diego, CA: Prometheus Laboratories Inc; 2010.


MEDICATION GUIDE
LOTRONEX (LOW-trah-nex) Tablets
(alosetron hydrochloride)

Before using LOTRONEX for the first time, you should:
   •  Understand that LOTRONEX has serious risks for some people.
   •  Read and follow the directions in this Medication Guide.
   •  Sign a Patient Acknowledgement Form.

Read this Medication Guide carefully before you sign the Patient Acknowledgement Form. You must sign the Patient Acknowledgement Form before you start LOTRONEX. Read the Medication Guide you get with each refill for LOTRONEX. There may be new information. This Medication Guide does not take the place of talking with your doctor.
1.  What is the most important information I should know about LOTRONEX?
  A.  LOTRONEX is a medicine only for some women with severe chronic irritable bowel syndrome (IBS) whose:
    main problem is diarrhea and
    IBS symptoms have not been helped enough by other treatments.
 
  B.  Some patients have developed serious bowel side effects while taking LOTRONEX. Serious bowel (intestine) side effects can happen suddenly, including the following:
    1.  Serious complications of constipation: About 1 out of every 1,000 women who take LOTRONEX may get serious complications of constipation. These complications may lead to a hospital stay and, in rare cases, blood transfusions, surgery, and death. People who are older, who are weak from illness, or who take other constipating medicines may be more likely to have serious complications of constipation with LOTRONEX.
      To lower your chances of getting serious complications of constipation, do the following:
      •   If you are constipated, do not start taking LOTRONEX.
      If you get constipated while taking LOTRONEX, stop taking it right away and call your doctor.
      If your constipation does not get better after stopping LOTRONEX, call your doctor again.
      If you stopped taking LOTRONEX, do not start taking LOTRONEX again unless your doctor tells you to do so.
    2.   Ischemic colitis (reduced blood flow to the bowel): About 3 out of every 1,000 women who take LOTRONEX over a 6-month period may get a serious problem where blood flow to parts of the large bowel is reduced. This is called ischemic colitis. The chance of getting ischemic colitis when you take LOTRONEX for more than 6 months is not known. Ischemic colitis may lead to a hospital stay and, in rare cases, blood transfusions, surgery, and death.
To lower your chances of getting serious complications of ischemic colitis, stop taking LOTRONEX and call your doctor right away if you get:
      new or worse pain in your stomach area (abdomen) or
      blood in your bowel movements.
 
  C.  Is LOTRONEX right for you?
    LOTRONEX may be right for you if all of these things are true about you:
    Your doctor has told you that your symptoms are due to IBS.
    Your IBS bowel problem is diarrhea.
    Your IBS has lasted for 6 months or longer.
    You tried other IBS treatments and they did not give you the relief you need.
    Your IBS is severe.
    You can tell if your IBS is severe if at least 1 of the following is true for you:
    You have lots of painful stomach cramps or bloating.
    You often cannot control the need to have a bowel movement, or you have "accidents" where your underwear gets dirty from diarrhea or bowel movements.
    You cannot lead a normal home or work life because you need to be near a bathroom.
    Enough testing has not been done to confirm if LOTRONEX works in men or children under age 18.
 
  D.  There is a special prescribing program for LOTRONEX.
    Only doctors who have signed up with the company that makes LOTRONEX should write prescriptions for LOTRONEX. As part of signing up, these doctors have said that they understand about IBS and the possible side effects of LOTRONEX. They have agreed to use a special sticker on written prescriptions for LOTRONEX, so the pharmacist will know that the doctors have signed up with the company. No telephone, facsimile, or computerized prescriptions are permitted with this program. Refills may be written on prescriptions. You may be taught about LOTRONEX by your doctor or healthcare provider under a doctor’s direction. Your doctor will ask you to sign a Patient Acknowledgement Form after you read this Medication Guide for the first time. Signing the Patient Acknowledgement Form means that you understand the benefits and risks of LOTRONEX and that you have read and understand this Medication Guide.
 
2.  What is LOTRONEX?
LOTRONEX is a medicine only for some women with severe chronic IBS whose:
  main problem is diarrhea and
  IBS symptoms have not been helped enough by other treatments.
  LOTRONEX does not cure IBS, and it may not help every person who takes it. For those who are helped, LOTRONEX reduces lower stomach area (abdominal) pain and discomfort, the sudden need to have a bowel movement (bowel urgency), and diarrhea from IBS. If you stop taking LOTRONEX, your IBS symptoms may return within 1 or 2 weeks to what they were before you started taking LOTRONEX.
LOTRONEX is not recommended for children.
 
3.  Who should not take LOTRONEX?
  LOTRONEX is not right for everyone. Do not take LOTRONEX if any of the following apply to you:
  Your main IBS problem is constipation or you are constipated most of the time.
  You have had a serious problem from constipation. If you are constipated now, do not start taking LOTRONEX.
  You have had serious bowel blockages.
  You have had blood flow problems to your bowels, such as ischemic colitis.
  You have had blood clots.
  You have had Crohn’s disease, ulcerative colitis, diverticulitis, or severe liver disease.
  You do not understand this Medication Guide or the Patient
    Acknowledgement Form, or you are not willing to follow them.
  You are taking fluvoxamine (LUVOX®).
 
4.  What should I talk about with my doctor before taking LOTRONEX?
  Talk with your doctor:
  about the possible benefits and risks of LOTRONEX.
  about how much of a problem IBS is in your life and what treatments you have tried.
  about any other illnesses you have and medicines you take or plan to take. These include prescription and non-prescription medicines, supplements, and herbal remedies. Certain illnesses and medicines can increase your chance of getting serious side effects while taking LOTRONEX. Other medicines may interact with how the body handles LOTRONEX.
  about any allergies that you have. See the end of the Medication Guide for a complete list of ingredients in LOTRONEX.
  if you are pregnant, planning to get pregnant, or breastfeeding.
 
5.  How should I take LOTRONEX?
  Take LOTRONEX exactly as your doctor prescribes it. You can take LOTRONEX with or without food.
  Begin with 0.5 mg two times a day for 4 weeks to see how LOTRONEX affects you. You and your doctor may decide that you should keep taking this dose if you are doing well.
  Check with your doctor 4 weeks after starting LOTRONEX:
    ° If you try 0.5 mg two times a day for 4 weeks, it may not control your symptoms. If you do not get constipation or other side effects from LOTRONEX, your doctor may increase your dose up to 1 mg two times a day.
    ° If 1 mg two times a day does not work after 4 weeks, LOTRONEX is not likely to help you. You should stop taking it and call your doctor.
  If you miss a dose of LOTRONEX, just skip that dose. Do not take 2 doses the next time. Wait until the next time you are supposed to take it and then take your normal dose.
  Follow the important instructions in the section "What is the most important information I should know about LOTRONEX?" about when you must stop taking the medicine and when you should call your doctor.
  If you see other doctors about your IBS or side effects from LOTRONEX, tell the doctor who prescribed LOTRONEX.
 
6.  What are the possible side effects of LOTRONEX?
  Constipation is the most common side effect among women with IBS who take LOTRONEX. Some patients have developed serious bowel side effects while taking LOTRONEX. Read the section "What is the most important information I should know about LOTRONEX?" at the beginning of this Medication Guide for information about the serious side effects you may get with LOTRONEX.
This Medication Guide does not tell you about all the possible side effects of LOTRONEX. Your doctor or pharmacist can give you a more complete list.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
 
7.  How should I store LOTRONEX?
  Store LOTRONEX between 59°F to 86°F (15°C to 30°C).
  Protect LOTRONEX from light and getting wet (moisture).
Keep LOTRONEX and all medicines out of the reach of children.
 
8.  General information about the safe and effective use of LOTRONEX
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. If you have any questions or concerns about LOTRONEX, ask your doctor. Do not use LOTRONEX for a condition for which it was not prescribed. Do not share your medicine with other people. It may harm them.
Your doctor or pharmacist can give you more information about LOTRONEX that was written for healthcare professionals. You can also contact the company that makes LOTRONEX at 1-888-423-5227 or at www.lotronexppl.com.
 
9.  What are the ingredients of LOTRONEX?
Active Ingredient: alosetron hydrochloride.
Inactive Ingredients: lactose (anhydrous), magnesium stearate, microcrystalline cellulose, and pregelatinized starch. The white film-coat for the 0.5 mg tablet contains hypromellose, titanium dioxide, and triacetin. The blue film-coat for the 1 mg tablet contains hypromellose, titanium dioxide, triacetin, and indigo carmine.


     Manufactured for:
Prometheus Laboratories Inc.
9410 Carroll Park Drive
San Diego, CA 92121
     This Medication Guide has been approved by the U.S. Food and Drug Administration.

Revised September 2010 LX002D
WARNING: SERIOUS GASTROINTESTINAL ADVERSE REACTIONS
Infrequent but serious gastrointestinal adverse reactions have been reported with the use of LOTRONEX. These events, including ischemic colitis and serious complications of constipation, have resulted in hospitalization, and rarely, blood transfusion, surgery, and death.
The Prescribing Program for LOTRONEX was implemented to help reduce risks of serious gastrointestinal adverse reactions. Only prescribers who have enrolled in the Prometheus Prescribing Program for LOTRONEX, based on their understanding of the benefits and risks, should prescribe LOTRONEX
LOTRONEX is indicated only for women with severe diarrhea-predominant irritable bowel syndrome (IBS) who have not responded adequately to conventional therapy. Before receiving the initial prescription for LOTRONEX, the patient must read and sign the Patient Acknowledgement Form for LOTRONEX.
LOTRONEX should be discontinued immediately in patients who develop constipation or symptoms of ischemic colitis. Patients should immediately report constipation or symptoms of ischemic colitis to their prescriber. LOTRONEX should not be resumed in patients who develop ischemic colitis. Patients who have constipation should immediately contact their prescriber if the constipation does not resolve after LOTRONEX is discontinued. Patients with resolved constipation should resume LOTRONEX only on the advice of their treating prescriber.

CONTRAINDICATIONS
LOTRONEX should not be initiated in patients with constipation. LOTRONEX is also contraindicated in patients with a history of chronic or severe constipation or sequelae from constipation; intestinal obstruction, stricture, toxic megacolon, gastrointestinal perforation, and/or adhesions; ischemic colitis, impaired intestinal circulation, thrombophlebitis, or hypercoagulable state; Crohn’s disease or ulcerative colitis; diverticulitis; severe hepatic impairment; inability to understand or comply with the Patient Acknowledgement Form; and concomitant use of fluvoxamine.

WARNINGS AND PRECAUTIONS
Serious Complications of Constipation
Some patients have experienced serious complications of constipation without warning.

Serious complications of constipation, including obstruction, ileus, impaction, toxic megacolon, and secondary bowel ischemia, have been reported with use of LOTRONEX during clinical trials. Complications of constipation have been reported with use of 1 mg twice daily and with lower doses. A dose response relationship has not been established for serious complications of constipation.

The incidence of serious complications of constipation was approximately 0.1% (1 per 1,000 patients) in women receiving either LOTRONEX or placebo. In addition, rare cases of perforation and death have been reported from postmarketing clinical practice. In some cases, complications of constipation required intestinal surgery, including colectomy. Patients who are elderly, debilitated, or taking additional medications that decrease gastrointestinal motility may be at greater risk for complications of constipation. LOTRONEX should be discontinued immediately in patients who develop constipation.

Ischemic Colitis
Some patients have experienced ischemic colitis without warning.

Ischemic colitis has been reported in patients receiving LOTRONEX in clinical trials as well as during marketed use of the drug. In IBS clinical trials, the cumulative incidence of ischemic colitis in women receiving LOTRONEX was 0.2% (2 per 1,000 patients, 95% confidence interval 1 to 3) through 3 months and was 0.3% (3 per 1,000 patients, 95% confidence interval 1 to 4) through 6 months. Ischemic colitis has been reported with use of 1 mg twice daily and with lower doses. A dose-response relationship has not been established. Ischemic colitis was reported in one patient receiving placebo. The patient experience in controlled clinical trials is insufficient to estimate the incidence of ischemic colitis in patients taking LOTRONEX for longer than 6 months.

LOTRONEX should be discontinued immediately in patients with signs of ischemic colitis such as rectal bleeding, bloody diarrhea, or new or worsening abdominal pain. Because ischemic colitis can be life-threatening, patients with signs or symptoms of ischemic colitis should be evaluated promptly and have appropriate diagnostic testing performed. Treatment with LOTRONEX should not be resumed in patients who develop ischemic colitis.

Prescribing Program for LOTRONEX
To prescribe LOTRONEX, the prescriber must be enrolled in the Prescribing Program for LOTRONEX. To enroll, prescribers must understand the benefits and risks of treatment with LOTRONEX for severe diarrhea-predominant IBS, including the information in the Prescribing Information, Medication Guide, and Patient Acknowledgement Form for LOTRONEX.

To enroll in the Prescribing Program for LOTRONEX, call 1-888-423-5227 or visit www.lotronexppl.com to complete the Prescriber Enrollment Form.

ADVERSE REACTIONS The most common adverse reactions (incidence > 2% and less than placebo) in clinical studies were constipation, abdominal discomfort and pain, nausea, and gastrointestinal discomfort and pain.