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Title: Clinical Trial of Ceftriaxone in Subjects With Amyotrophic Lateral Sclerosis (ALS) Principal Investigator: Merit Cudkowicz, MD, MSc., Professor of Neurology, Harvard Medical School, Massachusetts General Hospital Contact: Sarah Titus, MPH (617) 726-1398 stitus@partners.org
This trial is currently enrolling patients.
Primary Outcome Measures:
ƒ vital capacity ƒ evaluation of multiple upper extremity muscles using hand ƒ quality of life ƒ long-term safety and tolerability of ceftriaxone Estimated Enrollment: 600 Study Start Date: July 2006 Estimated Study Completion Date: June 2012 Estimated Primary Completion Date: June 2012 (Final data collection date for primary outcome measure) Detailed Description: It is known that nerve cells called motor neurons die in the brains and spinal cords of people with amyotrophic lateral sclerosis (ALS). However, the cause of this cell death is unknown. Researchers think that increased levels of a chemical called "glutamate" may be related to the cell death. For this reason researchers want to study drugs that decrease glutamate levels near nerves. Ceftriaxone—a semi-synthetic, third generation cephalosporin antibiotic—may increase the level of a protein that decreases glutamate levels near nerves. Studies of ceftriaxone in the laboratory suggest that it may protect motor neurons from injury. Ceftriaxone is approved by the U.S. Food and Drug Administration (FDA) for treating bacterial infections but not for treating ALS. Also, ceftriaxone has not been given to people over a long period of time, such as months or years. The goals of this study are to evaluate the safety and effectiveness of ceftriaxone as a treatment for ALS, and to determine the safety and effectiveness of long-term use of the drug in people with ALS. A total of 600 eligible people with ALS will be enrolled in this multi-center research study. Participants will be randomly assigned to receive treatment with ceftriaxone (2/3 of participants) or placebo (1/3 of participants) for at least 12 months. The study consists of three stages. The first stage, which has completed enrollment, will look at whether ceftriaxone enters the cerebrospinal fluid (the fluid that surrounds the spinal cord, also called CSF) in amounts that are high enough to be of possible benefit. The second stage, which has also completed enrollment, will look at the safety and side effects of the study drug when taken daily for at least 20 weeks. The study is currently enrolling subjects for the third stage, which began in Spring 2009, and will determine whether the study drug prolongs survival and slows decline in function due to ALS. Eligibility:
Ages Eligible for Study: 18 Years and older
Genders Eligible for Study: Both
Accepts Healthy Volunteers: No
Criteria
**This is a partial list. Please check with the nearest site to review the full eligibility
criteria.**

Inclusion Criteria:
ƒ Participants will be people with ALS, at least 18 years of ƒ Participants must be medically able to undergo the study procedures and have a caregiver or other individual who will be available to help with daily study medication administration. ƒ Participants should live within a reasonable distance of the study site, due to frequent study visits. ƒ Participants cannot be taking any other experimental medications for ALS, or have a history of sensitivity to cephalosporin antibiotics (such as Ancef, Keflex, Ceclor, Ceftin, Lorabid, Suprax, or Fortaz). Locations: Please visit the NEALS Website for a complete list of site locations - http://www.alsconsortium.org/

Source: http://www.prize4life.org/uploaded_files/2010_neals_ceftriaxone_study_f3aLAR.pdf

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What Happens When You Miss a Birth Control Pill? - Can I Save Some . http://www.womansday.com/layout/set/print/Content/Health-Fitness/5-He. 5 Health Slip-Ups—RemediedFind out what to do if you don’t finish a prescription, miss a birth control pill and moreBy Denise Schipani Posted August 31, 2011 from Woman's Day; October 1, 2011We’ve all taken one pain reliever too many or not finis

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