Class: Cariostatic Agents
ATC Class: A12CD
VA Class: TN470
Molecular Formula: NaFNa3FPO4SnF2
CAS Number: 7681-49-4
Brands: APF , ACT, CaviRinse, CavityShield, ControlRX, DentinBloc, Duraphat, EtheDent, Fluorabon, Fluor-A-Day, Fluorinse, Fluoritab, FluoroFoam , Flura-Drops, Gel-Kam, Just for Kids, Minute-Foam, NeutraCare, Neutra-Foam, OMNI, OrthoWash, PerioMed, Phos-Flur, PreviDent, SF, Vanish
Introduction
Cariostatic agent; ionic form of fluorine.107 109 110 a d
Uses for Fluorides
Dental Caries
Prevent or reduce the incidence of dental caries; slow or reverse the progression of existing dental lesions.107 109 b d e i j s t v
Effect of fluoride is predominantly posteruptive; maintain consistent small amounts of fluoride in saliva and dental plaque.109 113 (See Actions.)
As a dietary supplement for the prevention of dental caries in children in areas where the concentration of fluoride ion in drinking water is less than optimal.109
American Dental Association (ADA) recommends that all patients, including those without dental caries and with no apparent increased risk of dental caries, receive adequate water fluoridation or oral fluoride supplementation, combined with daily use of fluoridated dentifrice and twice-yearly topical application of fluoride.128
In addition, ADA and others state that patients at low or slightly increased risk for dental caries (e.g., low socioeconomic status, low levels of parental education, no regular dental care, or without dental insurance or access to dental services) may require sodium fluoride 0.05% mouth rinse or 0.4% stannous fluoride gel.109 128
ADA and others recommend that patients at moderate-to-high risk for dental caries (e.g., active dental caries, history of high incidence of caries in older siblings or caregivers, root surfaces exposed by gingival recession, impaired ability to maintain oral hygiene, malformed enamel or dentin, low salivary buffering capacity, wearing of orthodontic appliances, or reduced salivary flow from medications, radiation treatment, or disease) receive additional exposure to fluorides (e.g., home or professionally applied products).109 128
CDC supports fluoridation of the public water supply as the most cost-effective means of providing optimal levels of fluoride to large segments of the population.109
Optimal concentration of fluoride ion in drinking water is approximately 1 ppm (range 0.7–1.2 ppm), depending on the annual mean maximum daily temperature of the area.106 109 b w In warm climates where more water is likely to be ingested, concentrations should be at the lower end of the range.106 109
In communities where the concentration of fluoride in the water supply is >2 ppm, use an alternative source of drinking water for children ≤8 years of age.109
Because consumption of commercially available beverages (including bottled water) in the US and Canada is displacing the consumption of tap or well water, the relative importance of fluoridation of local community water on fluoride intake may be affected.107 However, current recommendations in children continue to be based on the fluoride concentrations in local drinking water.106 107
ADA and others recommend that in areas where oral fluoride supplements are necessary, children 6 months to 16 years of age receive daily fluoride supplements to provide maximum benefit to both deciduous and permanent teeth.a
Efficacy of topically applied fluoride varies according to the concentration of fluoride ion in the preparation, method and frequency of application, and the duration of use.a
Acidulated phosphate fluoride gels (alone or in combination with a saliva substitute) have been used to control dental decay after xerostomia-producing radiation therapy of tumors of the head and neck.a
Stannous fluoride gels have been used to prevent decalcification in orthodontic patients.a
Stannous fluoride gels have been used to protect against postirradiation caries.a
Desensitizing Dentin
Topically to desensitize exposed root surfaces of teeth.f h
Bone Diseases
Has been used to increase bone density and relieve bone pain in the treatment of various metabolic and neoplastic bone diseases†.a
Has been used in conjunction with calcium and vitamin D or calcium and estrogen to reduce skeletal fracture rates in osteoporosis†; further study is needed.a
Has been used alone or in conjunction with calcium carbonate as an adjunct in the management of bone lesions in multiple myeloma†.a
Has been used to reduce bone pain in metastatic prostatic carcinoma†.a
Has been reported to stabilize the progression of hearing loss in a limited number of patients with otosclerosis†.a
Has been used to increase spinal (but not femoral neck) bone mineral density (BMD) in corticosteroid-induced osteoporosis†;108 however, further studies are needed and other therapies are preferred.108
Fluorides Dosage and Administration
Administration
Administer orally as a lozenge, solution, or chewable tablet or topically as a cream, dentifrice, foam, gel, rinsing solution, or solution.a e h l o p s v
Oral Administration
Administer sodium fluoride orally as a lozenge, chewable tablet, or as a solution undiluted or mixed with juice or water.b Dissolve chewable tablets in the mouth or chew before swallowing, preferably at bedtime after brushing the teeth.a b j
Administer oral fluoride supplements only when community fluoridation programs are not available or feasible and when the fluoride ion concentration in drinking water is ≤0.6 ppm (mg/L).a
Oral Topical Administration
Not for systemic treatment; do not swallow.119 121 a e f h i n o s t v
Rinsing solution may be swallowed only if directed to do so by a clinician to provide systemic fluoride supplementation.103
To minimize the amount of fluoride swallowed and absorbed systemically and the risk of fluorosis, instruct and/or supervise children <12 years of age regarding proper techniques for use of topical preparations.100 101 103 i (See Dental Fluorosis under Cautions.)
For maximum benefit, do not eat or drink for ≥30 minutes after administration; adults, do not rinse mouth for 30 minutes after administration.119 121 a d e m n o s t v
Oral Topical Administration (Sodium Fluoride)
1.1% cream: Apply a thin ribbon to toothbrush; brush thoroughly for 2 minutes.121 d e Expectorate after use; children, expectorate and rinse mouth thoroughly.121 d e
2% foam: Dental personnel may apply topically to teeth using trays or mouthpiece applicators.120 128
1.1% gel: Rinse thoroughly after brushing teeth normally.119 s Apply a ribbon of gel to teeth with toothbrush or mouth tray for ≥1 minute; expectorate.119 s Children, rinse mouth thoroughly.119 s
0.044, 0.05, and 0.2% rinsing solutions: After thoroughly brushing teeth, rinse solution vigorously around and between teeth for 1 minute.115 116 a m n Expectorate.115 116 a m n
5% solution: May be applied by dental personnel to moist teeth.h Apply to teeth with cotton swabs, brush, or probe.h Do not dry.h Patient should not eat hard foods or brush for ≥2 hours after application.h Avoid other fluoride preparations on the day of application.h Suspend use of fluoride tablets for several days after treatment.h
Oral Topical Administration (Sodium Fluoride Combinations)
Solution: Dental personnel may apply saturated foam applicator to the tooth surface with constant light pressure for 1 minute; have patient expectorate.f
Oral Topical Administration (Acidulated Phosphate Fluoride)
Do not place in porcelain or glass containers.f o v (See Teeth Surface and Restoration Staining under Cautions and also see Storage under Stability.)
1.1% gel: Rinse thoroughly after brushing teeth normally.v Apply a thin ribbon of gel to teeth with toothbrush or mouth trays for ≥1 minute; expectorate.v Children, rinse mouth thoroughly.v
Foam or 1.23% gel: Dental personnel may apply after prophylaxis.o t Prior to filling mouth trays, shake foam bottle vigorously for 3–4 seconds.o Have patient bite down lightly on mouth tray(s) for 1–4 minutes.o t Remove tray(s) and have patient expectorate excess.o t Gel may also be applied by swab.t
For desensitizing exposed root surfaces, use gel after brushing and flossing at bedtime.a
Oral Topical Administration (Stannous Fluoride)
0.4% gel: After brushing teeth normally, shake toothbrush to remove excess water; apply the gel to cover the bristles.l Brush teeth thoroughly; allow the gel to remain on the teeth for 1 minute, then expectorate.124 125 l For sensitivity relief, use a toothbrush or cotton swab to ensure that all sensitive areas are covered with the gel.124 125 l
0.1% rinsing solution: Dilute before use.i Use after regular brushing and flossing.117 118 i Swish vigorously around and between teeth for 1 minute; expectorate.117 118 i Repeat.117 118 i
Reconstitution
Reconstitute fluoride powders as directed by the manufacturer.103
Dilution
Prepare 0.1% rinsing solution from concentrate prior to use.117 118 i Add 3.75 mL concentrated rinse to the mixing vial (or fill to 1/8 oz mark); add 26.25 mL water (or fill to 1 oz mark) and mix to provide a 0.1% rinsing solution.117 118 i Use immediately;117 118 i solutions may decompose within a few hours to stannous hydroxides, forming a white precipitate.a
For home irrigators, pour 30 mL of the diluted 0.1% solution into the irrigator reservoir; add 120 mL of water and mix thoroughly to provide a 0.02% stannous fluoride rinse.i Consult the manufacturer’s prescribing information for additional information on preparation and use of the concentrated solution with home irrigators.117 118 i
Dosage
Available as sodium fluoride, acidulated phosphate fluoride, sodium monofluorophosphate, or stannous fluoride; dosage expressed in terms of the fluoride ion.a c i j n o p
Dosage of oral fluoride supplements varies according to the age of the child and the concentration of fluoride in the drinking water.109 110 Adjust dosage in proportion to the amount of fluoride provided from all possible sources (e.g., childcare settings, school, bottled water, dentifrice, multivitamins, mouth rinse).a 109 110 Do not exceed recommended dosages.a (See Dental Fluorosis and also see Pediatric Use under Cautions.)
CDC recommends that patients at increased risk for dental caries receive fluoride applications by dental personnel twice a year.109
Pediatric Patients
Dental Caries Prophylaxis
Fluoride-containing Dentifrices
Oral Topical
Children 2–6 years of age: Apply only a pea-sized amount (approximately 0.25 g) to the toothbrush no more often than twice daily.100 101 109
Adequate Dietary Intake
Oral
For tolerable upper intake levels, see Prescribing Limits under Dosage and Administration.
Age | Adequate Daily Dietary Intake of Fluoride |
|---|---|
0– 6 months | 0.01 mg |
7–12 months | 0.5 mg |
1–3 years | 0.7 mg |
4–8 years | 1.1 mg |
9–13 years | 2 mg |
14–18 years | 2.9–3.2 mg |
Fluoride Supplementation in Areas with Insufficient Fluoride in Drinking Water
Oral
Fluoride Ion Concentration in Drinking Water | |||
|---|---|---|---|
Age | <0.3 ppm | 0.3–0.6 ppm | >0.6 ppm |
0 to <6 months | None | None | None |
6 months to <3 years | 0.25 mg | None | None |
3 to <6 years | 0.5 mg | 0.25 mg | None |
6–16 years | 1 mg | 0.5 mg | None |
Sodium Fluoride
Oral Topical
1.1% cream in children ≥6 years of age: Brush for 2 minutes once daily, preferably at bedtime.121 d e
1.1% gel in children ≥6 years of age: Once daily, preferably at bedtime.119 s
0.044 or 0.05% rinsing solution in children ≥6 years of age: 10 mL once daily at bedtime.116 n p
0.2% rinsing solution in children ≥6 years of age: 10 mL once weekly, preferably at bedtime.115 m
Acidulated Phosphate Fluoride
Oral Topical
1.1% gel in children ≥6 years of age: Once daily, preferably at bedtime.v
1.2 or 1.23% foam or 1.23% gel in children ≥6 years of age: Apply once every 6–12 months.a o In patients with rampant or active caries, may repeat 1–2 times every 6 months.a o
Stannous Fluoride
Oral Topical
0.4% gel in children ≥12 years of age: Once daily.124 125 l
0.1% rinsing solution in children ≥12 years of age: Dilute before use to a 0.1% solution.i (See Dilution under Dosage and Administration.) Use 15 mL once daily.117 118 i Repeat with an additional 15 mL.117 118 i May use more frequently as directed by clinician.i
Desensitizing Dentin
Stannous Fluoride
Oral Topical
0.4% gel in children ≥12 years of age: Twice daily.124 125
Adults
Dental Caries Prophylaxis
Adequate Daily Dietary Intake of Fluoride
Oral
Adults ≥19 years of age: 3.1–3.8 mg daily.a
Sodium Fluoride
Oral Topical
1.1% cream: Brush for 2 minutes once daily, preferably at bedtime.121 d
2% foam: Some clinicians recommend applying 5 mL to teeth by means of trays or mouthpiece applicators.120 128
1.1% gel: Once daily, preferably at bedtime.s
0.044 or 0.05% rinsing solution: 10 mL once daily, preferably at bedtime.n p
0.2% rinsing solution: 10 mL once weekly, preferably at bedtime.m
Acidulated Phosphate Fluoride
Oral Topical
1.1% gel: Once daily, preferably at bedtime.v
1.2 or 1.23% foam or 1.23% gel: Apply once every 6–12 months.a o May repeat 1–2 times every 6 months in patients with rampant or active caries.a o
Stannous Fluoride
Oral Topical
0.4% gel: Once daily.124 125
0.1% rinsing solution: Dilute before use to a 0.1% solution.i (See Dilution under Dosage and Administration.) Use 15 mL once daily.117 118 i Repeat with an additional 15 mL.117 118 i May use more frequently, as directed by clinician.i
Desensitizing Dentin
Sodium Fluoride
Oral Topical
0.2% rinsing solution: Once daily at bedtime.a
Sodium Fluoride, Stannous Fluoride, and Hydrogen Fluoride
Oral Topical
Solution: Apply to the tooth surface for 1 minute.f May require sequential 1-minute treatments.f
Acidulated Phosphate Fluoride
Oral Topical
1.2% gel: Apply a few drops to a toothbrush and brush the affected area(s) each night at bedtime.a Relief from sensitivity usually occurs within a few weeks.a
Stannous Fluoride
Oral Topical
0.4% gel: Use twice daily (morning and evening).124 125 l
Bone Diseases†
Hearing Loss in Otosclerosis: Sodium Fluoride†
Oral
25–60 mg daily has been used.a
Prescribing Limits
Pediatric Patients
Fluoride Tolerable Daily Upper Intake Levels in Infants and Children107
Age | Tolerable Daily Upper Intake Levels of Fluoride |
|---|---|
Infants 0– 6 months of age | 0.7 mg |
Infants 7–12 months of age | 0.9 mg |
Children 1–3 years of age | 1.3 mg |
Children 4–8 years of age | 2.2 mg |
Children 9–18 years of age | 10 mg |
Adults
Prevention of Dental Caries
Oral Topical
Sodium fluoride 2% foam: Maximum 10 mL daily.128
Stannous fluoride 0.4% gel (self-care): Maximum twice daily for 4 weeks for sensitive teeth.l
Tolerable Daily Upper Intake Level
Oral
Maximum 10 mg daily.107
Pregnant women: Maximum 10 mg daily.107
Lactating women: Maximum 10 mg daily.107
Special Populations
Hepatic Impairment
No specific dosage recommendations at this time.a
Renal Impairment
No specific dosage recommendations at this time; however, see Renal Impairment in Cautions.f m o
Geriatric Patients
Select dosage with caution because of age-related decreases in renal function.f m o
Cautions for Fluorides
Contraindications
Known hypersensitivity to fluoride or any ingredient in the formulation.a h
Sodium fluoride 5% suspension: Known sensitivity to colophony (kolophonium).h
Fluoride dietary supplements: Drinking water fluoride ion concentration ≥0.6 ppm (mg/L).a b j
Sodium fluoride 1-mg chewable tablets: Drinking water fluoride ion concentration ≥0.3 ppm (mg/L).j
Sodium fluoride 5% topical solution: Ulcerative gingivitis or stomatitis.h
Sodium fluoride 0.2% rinsing solution: Dysphagia.m
Stannous fluoride oral rinsing solutions and sodium fluoride 5% topical solution: Not for systemic treatment.h i Do not ingest.h i
Warnings/Precautions
Warnings
Dental Fluorosis
Excessive amounts may produce dose-related dental fluorosis (hypocalcification and hypoplasia) and osseous changes in children <8 years of age, especially where water fluoridation >0.6 ppm.107 a b d e f i j m o s v
Follow proper techniques for applying topical preparations to minimize the amount ingested and systemically absorbed.100 101 103 e i
Mild fluorosis has no effect on tooth function; may render the enamel more resistant to caries.107 May cause white opaque patches on the incisal edges of anterior teeth or cusp tips of posterior teeth (“snow capping”).107
Risk of stained and pitted teeth in moderate-to-severe fluorosis; effect primarily cosmetic.107 t
Skeletal Fluorosis
Prolonged intake of high fluoride ion concentrations (i.e., 4–8 ppm [mg/L]) in drinking water may result in an increase in bone mineral density and apparent fluoride osteosclerosis.107 Risk of developing fluorosis directly related to the extent and duration of fluoride exposure; crippling skeletal fluorosis is extremely rare in the US.107
Teeth Surface and Restoration Staining
Staining or pigmentation (e.g., yellow, brown, brown-black) of the teeth may result from topical application of concentrated solutions or gels of stannous fluoride, particularly in patients with poor oral hygiene.a i Good oral hygiene (e.g., adequate brushing) minimizes risk of staining; staining is not harmful or permanent and can be removed by dentist.103 i
Acidulated phosphate fluoride preparations may cause dulling of porcelain and ceramic restorations unless protected from contact.a c f o t v
Sodium-Free Diet
Some fluoride products (e.g., Fluor-A-Day) are not recommended by manufacturer for use in patients receiving a sodium-free diet.b
Sensitivity Reactions
Allergic Reactions
Allergic rash and other idiosyncratic reactions rarely reported.a d f h i j m o s t v
Urticaria, exfoliative dermatitis, atopic dermatitis, stomatitis, and GI and respiratory allergic reactions have occurred rarely following the use of dentifrices or multivitamin preparations containing fluoride.a h
Patients with mucositis or with abraded or sensitive gingival tissue may be hypersensitive to alcohol or other ingredients contained in some oral or topical fluoride preparations.a f m o v
Sodium fluoride 5% topical solution: Dyspnea has occurred rarely in asthmatic children.h Edematous swelling reported rarely after application to extensive surfaces.h If intolerance occurs, remove solution layer by brushing and rinsing.h
General Precautions
Use of Fixed Combinations
When fluoride is used in fixed combination with other preparations, consider the cautions, precautions, and contraindications associated with the concomitant agent(s).a (See Pediatric Use under Cautions.)
Specific Populations
Pregnancy
Category B.f i j m o v
The ADA currently does not recommend fluoride supplements during pregnancy.a
Lactation
Distributed into milk in small amounts.a Use with caution in nursing women.f i j m o s v
Pediatric Use
ADA, American Academy of Pediatric Dentistry (AAPD), and AAP currently do not recommend oral fluoride supplements in infants <6 months of age.106 107 j
In children <2 years of age, consider other sources of fluoride when weighing the risks and benefits of using fluoridated dentifrice.109
Instruct and/or supervise children 2–12 years of age carefully regarding the proper use of topical fluoride-containing products to minimize repeated swallowing and the risk of dental fluorosis.100 101 103 e i m s v
Efficacy of oral fluoride supplements in controlling dental caries in children >16 years of age not established.109
Sodium fluoride, stannous fluoride, and hydrogen fluoride fixed-combination solution: Safety and efficacy not established.f
Sodium fluoride chewable tablets: Safety and efficacy not established in children <6 months of age.j
Sodium fluoride 1.1% topical cream, gel, and rinsing solution: Safety and efficacy not established in children <6 years of age.d e m n s
Acidulated phosphate fluoride topical foam and gel: Safety and efficacy not established in children <6 years of age.o v
Stannous fluoride oral rinsing solutions and topical gels: Safety and efficacy not established in children <12 years of age.117 118 124 125 i
May be difficult to appropriately adjust the amount of fluoride required from fixed-combination multivitamin or multivitamin/iron preparations used as oral fluoride supplements.a (See Dosage in Dosage and Administration.)
Geriatric Use
No overall differences in safety and efficacy relative to younger adults, but increased sensitivity cannot be ruled out.f m o Substantially eliminated by the kidneys; geriatric patients more likely to have decreased renal function; monitor renal function and adjust dosage accordingly.f m o
Renal Impairment
Excreted by the kidney; therefore, risk of toxic reactions may be greater in patients with impaired renal function.f m o
Interactions for Fluorides
Specific Drugs
Drug | Interaction | Comments |
|---|---|---|
Aluminum hydroxide | Concomitant ingestion may decrease oral absorption of fluoridea | |
Calcium | May cause formation of calcium fluoride and may decrease fluoride absorption by 10–25%107 b j Simultaneous ingestion of dairy products containing calcium probably has little effect on absorption of the low concentrations of fluoride present in drinking watera | Avoid dairy products within 1 hour after oral fluoride systemic administrationj |
Magnesium hydroxide | Concomitant ingestion may decrease oral absorption of fluoridea |
Fluorides Pharmacokinetics
Absorption
Bioavailability
Sodium fluoride and other soluble fluoride salts: Readily and almost completely absorbed from the GI tract.107 a b
≥80% of soluble fluoride probably absorbed from the GI tract in the absence of high dietary concentrations of calcium or certain other cations.107 (See Interactions.)
Food
Milk, infant formula, or certain foods (e.g., with high concentrations of calcium or certain other divalent or trivalent cations that form insoluble fluoride salts) may decrease absorption of fluoride by 10–25%.107
Distribution
Extent
Crosses the placenta and is distributed in small amounts into milk, sweat, tears, and hair.a
Stored in bones, developing teeth, and skeletal tissue.a b
Elimination
Elimination Route
Rapidly excreted principally in urine, and in small amounts in feces, sweat, and saliva.a b
Special Populations
Hemodialysis may remove fluoride in patients with severe intoxication or with impaired renal function.a
Stability
Storage
Oral
Solution
Sodium fluoride: Tight, plastic containers at <40°C (maintain between 15–30°C), especially if the pH of the solution is <7.5.a May decompose and become alkaline when stored in ordinary pharmaceutical glass.a b Store and dispense in plastic, paraffin-lined flasks or USP type 1 borosilicate glass containers.b
Tablets
Sodium fluoride: 20–25°C.j
Topical
Cream
Sodium fluoride 1.1%: 20–25°C.e
Foam
Acidulated phosphate fluoride 1.2%: 20–25°C.o Do not store at >48°C (120° F).o Do not freeze.o Do not puncture or incinerate.o
Gel
Acidulated phosphate fluoride: Tight, plastic containersa at 20–25°C.t v Do not freeze.t
Sodium fluoride 1.1%: 20–25°C.s
Rinsing Solution
Sodium fluoride 0.2% 20–25°C.m
Stannous fluoride: Tightly closed containers at 20–25°C.i Decomposes to stannous hydroxides within a few hours, forming a white precipitate; prepare just prior to use.a
Solution
Sodium fluoride 5%: 20–25°C.h
Sodium fluoride, stannous fluoride, and hydrogen fluoride: 20–25°C.f
Drug Compatibility
Sodium fluoride is incompatible with calcium and magnesium salts.a
Stannous fluoride is incompatible with alkaline substances and oxidizing agents.a
ActionsActions
Mechanism of action in reducing tooth decay not fully understood;a however, research now indicates predominant effect is posteruptive, not preeruptive as previously hypothesized.109 113
Increases tooth resistance to acid dissolution, promotes remineralization, and inhibits the cariogenic microbial process.109 a b e i j m o s w v
Prior to tooth eruption, fluoride is incorporated into tooth enamel during formation.a
Cariostatic effects on teeth after eruption result from combined effects of bacterial metabolism in plaque and on the dynamics of enamel demineralization and remineralization during an acidogenic challenge.107
Obturates dentin tubule orifices; reduces patency of the tooth pulp and decreases hypersensitivity.f h
Increases skeletal density and bone mass; however, large doses can cause skeletal fluorosis and osteomalacia.a
Advice to Patients
Advise patients receiving fluoride powders or concentrated rinsing solutions that the preparation must be reconstituted and/or diluted as directed prior to use.103 i
Advise patients receiving fluoride treatment gels or rinsing solutions for self-administration that these preparations are to be used as directed and not as dentifrices or mouthwashes or gargles, respectively.103 i
Advise individuals receiving stannous fluoride-containing preparations of the importance of good oral hygiene (e.g., adequate brushing) to minimize the risk of staining.103 i Inform patients that such staining is not harmful or permanent and can be removed by a dentist or dental hygienist.103 i
Instruct and/or supervise children <12 years of age during use of topical fluoride preparations (e.g., rinsing solutions, gels, dentifrices) to minimize the risk of fluorosis and the amount of fluoride swallowed and absorbed systemically.100 101 103 i Instruct children, especially those 2–6 years of age, not to swallow topical fluoride products.100 101 109 Inform individuals with children that ingestion of higher than recommended levels of fluoride by children has been associated with an increase in mild dental fluorosis in developing, unerupted teeth.w
Importance of long-term compliance on a daily basis in patients who require oral fluoride supplements.w
Advise patients not to brush or eat hard foods for 2 hours after application of topical solution.h
Advise patients to contact a poison control center or other qualified clinician immediately if they swallow more fluoride than the amount used for brushing or rinsing.l n
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses.b c d e f i j l m n o p s t w v h
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.b c d e f i j l m n o p s t w v h
Importance of informing patients of other important precautionary information.b c d e f i j l m n o p s t w v h (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Oral | Lozenge | 2.21 mg (1 mg of fluoride ion) | Fluor-A-Day | Pharmascience |
Solution | 0.55 mg/mL (0.42 mg of fluoride ion per mL) | Fluorabon Drops | Kirkman | |
5.56 mg/mL (2.5 mg of fluoride ion per mL | Fluor-A-Day | Pharmascience | ||
11 mg/mL (5 mg of fluoride ion per mL) | Fluoritab | Fluoritab | ||
Flura-Drops |
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