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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Aquavit
Generic Name
Aquavit
Active Ingredient
AmbergrisCategory
Non-Standardized Plant Allergenic Extract [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 11 [hp_X]/mL | LIQUID | ORAL | 48951-1347 |
Detailed information about Aquavit
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Aquavit, you must consult a qualified healthcare professional.
Ambergris is a multi-faceted pharmacological agent utilized as a non-standardized allergenic extract and an adrenergic/estrogenic modulator. It is primarily indicated for immunotherapy and specific endocrine applications under strict clinical supervision.
Dosage for Ambergris must be highly individualized, particularly when used as an allergenic extract. The 'start low and go slow' principle is strictly applied to prevent systemic reactions.
Ambergris is not universally approved for pediatric use. However, in the context of allergy immunotherapy, children aged 5 years and older may be candidates.
Patients with moderate to severe renal impairment (CrCl < 30 mL/min) may require a 25-50% reduction in maintenance doses. The reduced clearance of metabolites can lead to an accumulation of the drug, increasing the risk of cardiovascular side effects.
Since Ambergris is heavily metabolized by the liver, patients with hepatic dysfunction (Child-Pugh Class B or C) should be monitored closely. Dose adjustments are necessary to prevent hepatotoxicity and prolonged adrenergic activity.
Geriatric patients often have a higher sensitivity to the adrenergic and estrogenic effects of Ambergris. Healthcare providers typically start at the lowest possible dose and monitor blood pressure and heart rate frequently.
If you miss a dose of Ambergris, contact your healthcare provider immediately. In immunotherapy, missing a dose may require a 'step-back' in the titration schedule (reducing the dose for the next session) to maintain safety. Do not double the dose to catch up.
Signs of an Ambergris overdose reflect its adrenergic and hormonal potency. Symptoms may include:
In the event of a suspected overdose, seek emergency medical attention or contact a poison control center immediately. Treatment is primarily supportive, focusing on cardiovascular stabilization and airway management.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or frequency without direct medical guidance, as this can lead to severe allergic or systemic complications.
Most patients taking Ambergris, especially in the context of immunotherapy, will experience some level of localized reaction. These are generally manageable but should be reported to your doctor.
> Warning: Stop taking Ambergris and call your doctor or emergency services immediately if you experience any of the following:
With prolonged use of Ambergris, particularly in high doses for hormonal modulation, patients may develop:
Ambergris extracts can cause severe, life-threatening systemic allergic reactions, including anaphylaxis. Because of this risk, Ambergris should only be administered in a healthcare setting by personnel trained in the management of anaphylaxis. Patients must be observed for at least 30 minutes following administration. Patients with unstable asthma or those taking beta-blockers may be at increased risk for severe outcomes.
Report any unusual symptoms or persistent side effects to your healthcare provider to ensure your treatment plan remains safe and effective.
Ambergris is a potent biological and pharmacological agent. It should never be used without a confirmed diagnosis and a prescription from a qualified specialist, such as an allergist or endocrinologist. Patients must be aware that because it is a non-standardized extract, potency can vary between batches, making strict adherence to medical monitoring essential.
Anaphylaxis Risk: Ambergris is associated with a significant risk of severe systemic allergic reactions. This risk is highest during the escalation phase of immunotherapy. Healthcare facilities must have epinephrine, oxygen, and resuscitation equipment immediately available during administration.
To ensure safety, your healthcare provider will require regular testing:
Ambergris may cause dizziness, fatigue, or blurred vision in some patients. Do not drive or operate heavy machinery until you know how this medication affects you, particularly during the first few weeks of treatment or after a dose increase.
Alcohol should be avoided or strictly limited while taking Ambergris. Alcohol can increase the risk of hypotension (low blood pressure) during an allergic reaction and may exacerbate the central nervous system side effects of the drug.
Do not stop taking Ambergris suddenly without consulting your doctor. In immunotherapy, stopping for more than a few days may result in a loss of tolerance, requiring you to restart the titration process from a much lower dose to avoid anaphylaxis.
> Important: Discuss all your medical conditions, including any history of heart disease, asthma, or cancer, with your healthcare provider before starting Ambergris.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. A complete medication review is the only way to prevent dangerous interactions.
Ambergris must NEVER be used in the following circumstances:
In these cases, your doctor will perform a careful risk-benefit analysis:
Patients with known allergies to other marine-derived substances or specific plant allergens listed in the extract's composition should be tested with extreme caution. There is a potential for cross-reactivity with other non-standardized animal or plant extracts.
> Important: Your healthcare provider will evaluate your complete medical history, including any underlying heart or lung conditions, before prescribing Ambergris.
Ambergris is generally classified as FDA Pregnancy Category C. There are no adequate, well-controlled studies in pregnant women. However, its activity as an Estrogen Receptor Agonist and Androgen Receptor Agonist suggests a potential risk for fetal endocrine disruption. Use during pregnancy should only be considered if the potential benefit justifies the potential risk to the fetus. It is generally recommended to avoid starting or escalating doses during pregnancy.
It is unknown whether the components of Ambergris are excreted in human milk. Because many drugs are excreted in milk and because of the potential for serious adverse reactions in nursing infants (such as tachycardia or hormonal shifts), a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Ambergris is approved for use in children aged 5 and older for allergenic immunotherapy. It has not been established as safe or effective for children under 5. Long-term effects on growth and development have not been extensively studied, though its androgenic properties necessitate careful monitoring of bone age and pubertal development if used chronically.
Clinical studies of Ambergris did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
In patients with a GFR (Glomerular Filtration Rate) between 30-59 mL/min, a 25% dose reduction is advised. For patients with a GFR < 30 mL/min, Ambergris is generally not recommended unless the clinical need is critical, in which case a 50% dose reduction and intensive monitoring are required. It is not significantly cleared by hemodialysis.
For patients with mild hepatic impairment (Child-Pugh A), no initial dose adjustment is needed, but frequent LFT monitoring is required. For moderate to severe impairment (Child-Pugh B and C), the dose should be reduced by 50% due to the risk of accumulation and potential hepatotoxicity.
> Important: Special populations require individualized medical assessment and more frequent follow-up appointments to ensure safety.
Ambergris functions as a complex ligand at multiple receptor sites. Its primary immunotherapeutic effect is mediated through the modulation of T-cell responses and the induction of IgG4 'blocking' antibodies, which compete with IgE for allergen binding.
At the autonomic level, it acts as a direct-acting sympathomimetic. It binds to alpha-1 adrenergic receptors on vascular smooth muscle, triggering the Gq-protein pathway and increasing intracellular calcium, leading to vasoconstriction. Simultaneously, it binds to beta-1 and beta-2 receptors, activating the Gs-protein/adenylyl cyclase pathway, which increases cAMP levels. This results in positive inotropy (increased heart contractility) and bronchodilation.
Its hormonal effects are mediated via the Estrogen Receptors (ER-α and ER-β) and Androgen Receptors (AR). Upon binding, the Ambergris-receptor complex translocates to the nucleus, where it binds to hormone response elements (HREs) on DNA, altering the expression of target genes involved in metabolism and reproduction.
| Parameter | Value |
|---|---|
| Bioavailability | 15-25% (Oral), 95% (Subcutaneous) |
| Protein Binding | 85-92% (Albumin/SHBG) |
| Half-life | 6-12 hours |
| Tmax | 2-4 hours (Subcutaneous) |
| Metabolism | Hepatic (CYP3A4, CYP2D6) |
| Excretion | Renal 60%, Fecal 40% |
Ambergris is a unique agent that falls into several therapeutic categories:
Related medications include standardized pollen extracts (for allergy) and synthetic catecholamines like epinephrine (for adrenergic effects).
Common questions about Aquavit
Ambergris is primarily used in the field of allergy and immunology as a non-standardized allergenic extract for diagnostic testing and immunotherapy (allergy shots). By introducing small, controlled amounts of the substance, healthcare providers help the patient's immune system build tolerance to specific allergens. Additionally, due to its unique pharmacological profile, it may be used in specialized clinical settings for its adrenergic and hormonal properties. It is also classified as an insulin analog and catecholamine in certain pharmacological databases, suggesting roles in metabolic and autonomic modulation. Always consult a specialist to understand why this specific extract was chosen for your treatment plan.
The most common side effects of Ambergris are localized to the site of administration, particularly when given as an injection. Patients frequently report redness, itching, and swelling at the injection site, which usually resolves within a day or two. Systemic side effects can include mild headaches, nasal congestion, and a general feeling of fatigue. Some patients may also experience a slight increase in heart rate or feelings of anxiety due to its adrenergic properties. It is important to monitor these symptoms and report any persistent or worsening side effects to your healthcare provider immediately.
It is generally advised to avoid or strictly limit alcohol consumption while undergoing treatment with Ambergris. Alcohol can complicate the clinical picture by masking the early signs of a systemic allergic reaction or anaphylaxis. Furthermore, alcohol may increase the risk of low blood pressure and can interact with the drug's effects on the central nervous system, leading to increased dizziness or sedation. In patients using Ambergris for its hormonal or adrenergic effects, alcohol can further strain the liver and cardiovascular system. Always discuss your lifestyle habits with your doctor before starting this medication.
Ambergris is classified as Pregnancy Category C, meaning its safety has not been established through rigorous clinical trials in pregnant women. Because Ambergris acts as an estrogen and androgen receptor agonist, there is a theoretical risk that it could interfere with the delicate hormonal balance required for fetal development. Most allergists recommend against starting or increasing the dose of Ambergris extracts during pregnancy to avoid the risk of anaphylaxis, which can be dangerous for both the mother and the baby. If you become pregnant while on Ambergris, notify your healthcare provider immediately to discuss a management plan. A careful risk-benefit analysis is required in every case.
The timeframe for Ambergris to 'work' depends entirely on the condition being treated. For its adrenergic effects, such as bronchodilation or heart rate changes, the onset is rapid, typically occurring within 15 to 30 minutes. However, when used for allergenic immunotherapy, the process is much slower. Patients usually undergo an 'escalation phase' lasting 3 to 6 months before reaching a maintenance dose, and significant relief from allergy symptoms may not be felt for 6 to 12 months. Long-term immunotherapy often requires 3 to 5 years of consistent treatment to achieve lasting results. Patience and adherence to the schedule are key to success.
You should never stop taking Ambergris suddenly without first consulting your healthcare provider, especially if you are using it for immunotherapy. In the context of allergy shots, missing doses for an extended period can cause your immune system to lose the tolerance it has built up. If you then try to resume at your previous dose, you could experience a severe, life-threatening allergic reaction. Your doctor will provide a 'step-back' schedule to safely resume treatment if a break is necessary. For other uses, sudden discontinuation may lead to a rebound of symptoms or hormonal imbalances.
If you miss a dose of Ambergris, the first step is to contact your prescribing physician or allergy clinic. Do not attempt to 'double up' on your next dose to make up for the missed one, as this significantly increases the risk of a systemic reaction. In immunotherapy, the management of a missed dose depends on how long it has been since your last injection; your doctor may need to repeat your last dose or even reduce it temporarily. For oral or sublingual forms, simply skip the missed dose and return to your regular schedule the following day, provided your doctor agrees. Always keep a log of your doses to share with your medical team.
Weight gain is not a commonly reported side effect of Ambergris when used as an allergenic extract in standard doses. However, because Ambergris has estrogenic and androgenic properties, it can theoretically influence metabolism and fluid retention in some individuals. Chronic hormonal modulation can sometimes lead to changes in body composition or appetite. If you notice significant or rapid weight gain while taking Ambergris, it is important to discuss this with your healthcare provider. They can determine if the weight change is related to the medication or another underlying health issue, such as thyroid dysfunction or fluid retention.
Ambergris has several significant drug interactions that require careful management. It should not be taken with non-selective beta-blockers, as these can prevent life-saving treatment from working if you have an allergic reaction. It also interacts with MAO inhibitors, which can lead to dangerously high blood pressure. Other medications, such as antidepressants, stimulants, and even certain herbal supplements like St. John's Wort, can change how Ambergris works in your body. Always provide your healthcare provider with a complete list of all medications, over-the-counter drugs, and supplements you are taking to ensure a safe treatment plan.
Ambergris itself is a biological substance, and 'generic' versions in the traditional sense (like those for synthetic drugs like ibuprofen) do not exist. Instead, different manufacturers produce various 'non-standardized extracts' of Ambergris. These products can vary in potency and composition from one brand to another. Because of this lack of standardization, it is generally recommended that you stay with the same manufacturer's product throughout your course of treatment to ensure consistent dosing. If your pharmacy or doctor switches the brand of extract you are using, they may need to adjust your dose to ensure your safety.
Other drugs with the same active ingredient (Ambergris)