Short answer: Section 2.1 of the Nesina label says that if a dose is missed, the next dose is not doubled. The Medication Guide says take a missed dose as soon as you remember. If you do not remember until it is time for your next dose, skip the missed dose and take the next one at your regular time. Nesina is once daily.
| Situation | What the label says |
|---|---|
| Schedule | 25 mg once daily, with or without food; tablets not split (2.1). Lower doses with kidney impairment (2.2) |
| Missed a dose | Take it as soon as you remember (Medication Guide) |
| Time for the next dose | Skip the missed dose; take the next at your regular time (Medication Guide) |
| Doubling up | Do not double the next dose (2.1); do not take 2 doses at the same time (Medication Guide) |
Section 2.1: "Instruct patients if a dose is missed, not to double their next dose." Section 17 repeats it. The prescribing information does not say whether to take the missed dose later.
The Medication Guide says: "If you miss a dose, take it as soon as you remember. If you do not remember until it is time for your next dose, skip the missed dose, and take the next dose at your regular time. Do not take 2 doses of NESINA at the same time."
No. Section 2.2 lowers the dose to 12.5 mg once daily with moderate kidney impairment and 6.25 mg once daily with severe impairment or end-stage kidney disease. The missed-dose rule is the same at every dose.
This page summarizes FDA labeling. It is not personalized medical advice; confirm what to do with your prescriber or pharmacist.