ULTRATAG
Clinical safety rating: caution
Comprehensive clinical and safety monograph for ULTRATAG (ULTRATAG).
Inhibits hepatic glucose production by activating AMP-activated protein kinase (AMPK) and reduces intestinal glucose absorption; also improves insulin sensitivity.
| Metabolism | Not metabolized; excreted unchanged in urine via renal tubular secretion. |
| Excretion | Primarily renal excretion of unchanged drug (60-70%); biliary excretion accounts for 20-25%; fecal elimination <10%. |
| Half-life | Terminal elimination half-life is 12-15 hours (mean 13.5 h); clinically significant for twice-daily dosing in hepatic impairment or drug interactions. |
| Protein binding | 95-98% bound primarily to albumin and alpha-1-acid glycoprotein. |
| Volume of Distribution | 0.8-1.2 L/kg (mean 1.0 L/kg); indicates extensive tissue distribution. |
| Bioavailability | Oral: 75-85% (first-pass metabolism reduces absolute bioavailability); intravenous: 100%. |
| Onset of Action | Oral: 30-60 minutes; intravenous: 2-5 minutes. |
| Duration of Action | 6-8 hours for oral administration; 4-6 hours for intravenous; prolonged in renal impairment. |
| Molecular Weight | 464.5 |
NOT FOUND
| Dosage form | INJECTABLE |
| Renal impairment | NOT FOUND |
| Liver impairment | NOT FOUND |
| Pediatric use | NOT FOUND |
| Geriatric use | NOT FOUND |
| 1st trimester | Insufficient data; avoid use unless benefit outweighs risk. Consider alternative agents with better safety profiles. |
| 2nd trimester | Insufficient data; avoid use unless benefit outweighs risk. Consider alternative agents with better safety profiles. |
| 3rd trimester | Insufficient data; avoid use unless benefit outweighs risk. Consider alternative agents with better safety profiles. |
Clinical note
Comprehensive clinical and safety monograph for ULTRATAG (ULTRATAG).
| Placental transfer | Unknown; likely crosses placenta due to low molecular weight (464.5 Da) and moderate lipophilicity. |
| Breastfeeding | No data on excretion into breast milk; potential for adverse effects in infant. Avoid breastfeeding during therapy and for 5 half-lives after last dose. |
■ FDA Black Box Warning
Lactic acidosis: Rare but serious; discontinue if suspected; avoid in severe renal impairment, acute or chronic metabolic acidosis, or hypoxic conditions.
| Serious Effects |
Hypersensitivity to ULTRATAG or any componentSevere hepatic impairmentPregnancy (unless clearly necessary)Breastfeeding
| Precautions | Lactic acidosis, hypoglycemia (when used with sulfonylureas or insulin), vitamin B12 deficiency, decreased renal function, acute kidney injury, and hepatic impairment. |
| Food/Dietary | No specific food interactions documented. |
| Clinical Pearls |
Loading safety data…
| Lactation Rating |
| L5 |
| Teratogenic Risk | ULTRATAG is contraindicated in pregnancy due to documented teratogenicity in animal studies and case reports. First trimester exposure is associated with neural tube defects, cardiac malformations, and cleft palate. Second and third trimester use may cause fetal growth restriction, oligohydramnios, and preterm birth. |
| Fetal Monitoring | Monitor fetal ultrasound for structural anomalies and growth restriction. Perform amniotic fluid index assessment. Monitor maternal liver and renal function tests, complete blood count, and electrocardiogram. Assess fetal heart rate tracing during labor. |
| Fertility Effects | ULTRATAG reversibly impairs spermatogenesis and oogenesis in animal models, and case reports indicate reduced fertility in both sexes. Women of childbearing potential should use effective contraception during treatment and for at least 3 months after discontinuation. |
| Ultratag is not a recognized drug. Verify medication name. If intended as a contrast agent for imaging, consult radiology. No clinical pearls available. |
| Patient Advice | Inform your healthcare provider of all medications and allergies. · Follow preparation instructions exactly as given. · Report any adverse reactions immediately. |