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Allegra 30 mg, 120 mg, 180 mg
June 17, 2011 | Leave a Comment
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Abilify used for the treatment of acute episodes of schizophrenia (including as maintenance funds). Buy Abilify only after consulting with your doctor.
Abilify also used to treat acute manic episodes of bipolar disorder type I, including patients who have recently given mixed or manic episode (maintenance).
Contra Abilify
Abilify is contraindicated in patients under 18 years of age and patients with hypersensitivity to any component of the drug.
Side effects Abilify
Abilify can cause the certain side effects (check with your doctor)
International name:
Aripiprazole
Group Affiliation:
Antipsychotic (neuroleptic)
Description of the active substance (INN):
Aripiprazole
Description of the product brand name:
Abilify
Dosage form:
Tablets
Pharmacological Effects:
Neuroleptic. Presumably the therapeutic effect of aripiprazole in schizophrenia is caused by a combination of partial agonist activity on D2 dopamine and serotonin receptors 5NT1a and antagonistic activity against 5NT2 serotonin receptor. Aripiprazole has a high affinity in vitro to the D2 and D3 dopamine receptors, and 5NT1a 5NT2a serotonin receptors and moderate affinity for dopamine D4, 5NT2s 5NT7 and serotonin, alpha 1-adrenoreceptors and H1 histamine receptors. Aripiprazole is also characterized by a moderate affinity for serotonin reuptake sites and the lack of affinity for muscarinic receptors. Aripiprazole in animal experiments showed antagonism against dopaminergic hyperactivity and dopaminergic agonism against gipoaktivnosti. Interaction not only with dopamine and serotonin receptors explains some of the clinical effects of aripiprazole.
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Indications:
An acute attack of schizophrenia, as well as for maintenance therapy. Acute manic episodes of bipolar disorder type I and for maintenance therapy in patients with bipolar disorder type I, has recently suffered a manic or mixed episode.
Contraindications:
Hypersensitivity, the age of 18 years, during lactation.
Dosage and administration:
Inside, regardless of the meal, a once a day. Schizophrenia: initial dose 10-15 mg / day maintenance dose - 15 mg / day in clinical trials, the effectiveness of the drug in doses ranging from 10 to 30 mg / day. Manic episodes in bipolar disorder: initial dose 15-30 mg / day. If necessary, dose adjustment is carried out at intervals of not less than 24 h. In clinical studies demonstrated efficacy at doses of 15-30 mg / day with a manic episode at the reception for 3-12 weeks. Safety of doses above 30 mg / day in clinical trials has not been evaluated. Dose adjustment in patients older than 65 years, as well as in chronic renal failure and hepatic failure (class A, B and C on the classification of Child-Pyuga) is not required.
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Zithromax (Azithromycin)
May 22, 2011 | Leave a Comment
Generic Name: Azithromycin
Brand Names: Zithromax, Zmax
Type of Drug: Macrolide antibiotic.
Prescribed For:
Upper and lower respiratory tract infections, skin infections, sexually transmitted diseases (STDs), middle eat Intections, tonsillitis, pharyngitis, bacterial sinusitis.
General Information:
Azithromycin is an azalide antibiotic, a subgroup of the macrolides. Macrolide drugs are either bactericidal (bacteria-killing) or bacteriostatic (inhibiting bacterial growth) depending on the organism in question and amount of antibiotic present.
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Cautions and Warnings
Do not take azithromycin if you are allergic or sensitive to any of its ingredients or any macrolide antibiotic.
is excreted primarily through the liver. People with liver disease or damage should consult their doctors. Those on long-term therapy with this drug should have periodic blood tests.
Colitis (bowel inflammation), ranging from mild to life-threatening, has been associated with all antibiotics (see “Possible Side Effects”).
Azithromycin is considered appropriate only for the treatment of more mild forms of pneumonia in non-hospitalized patients. People with other underlying conditions, those who are immune-compromised, and those who contract pneumonia in a hospital or other institutional setting probably should be treated with other antibiotics. No prescription Zithromax is now possible to obtain online at an internet pharmacy as well as any of more than 400 popular generic drugs. Get whatever dosage you need for your treatment you can buy it: Zithromax 500mg or Azithromycin (generic Zithromax) 250 or 100 mg are available to order cheaply. The more pills you buy the cheaper they are going to cost you. You can check the prices and choose the amount of Zithromax you require and then make a secure order. Your order will reach you in about 5-6 days.
Zithromax Possible Side Effects
Most side effects are mild and go away once you stop taking azithromycin.
Most common: nausea, vomiting, abdominal pain, and diarrhea. Colitis (symptoms include severe abdominal cramps and severe, persistent, and possibly bloody diarrhea) may develop.
Less common: heart palpitations; chest pain; vaginal irritation; stomach upset; gas; dizziness; headache; tiredness; unusual sun sensitivity; rash; itching; swelling; fungal infection of the mouth or vagina; dark, tarry stools; kidney inflammation; and vertigo.
Zithromax Drug Interactions
• Pimozide should not be taken by anyone also taking a macrolide antibiotic. Two people died while taking this combination.
• Antacid products containing aluminum magnesium may delay azithromycin into the blood. Separate your antacid dose from Zithromax by at least 1 hour.
• All macrolide antibiotics increase blood levels of cyclosporine and may cause kidney damage.
• Combining Zithromax and a statin cholesterol-lowering drug increases the risk of developing a painful and potentially fatal condition involving severe muscle degeneration.
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Food Interactions:
It is important to take Zithromax azithromycin liquid on an empty stomach, 1 hour before or 2 hours after meals. Tablets may be taken with or without food.
Usual Dose of Zithromax:
Respiratory Tract Infections, Skin Infections, STDs, and Bacterial Sinusitis
Adult (age 16 and over): Zithromax500 mg as a single dose for 3 days, or 500 mg as a single dose on day 1, then Zithromax 250 mg once a day on days 2-5 of treatment. STDs are treated with a single dose of 1000-2000 mg.
Middle Ear Infections and Bacterial Sinusitis* (Child)
1 -Day Regimen: 13.6 mg per lb. of body weight a day for 1 day. 3-Day Regimen: 4.5 mg per lb. of body weight a day for 3 days. 5-Day Regimen: 4.5 mg per lb. of body weight a day for day 1,
and 2.25 mg per lb. a day for days 2-5. 3-day regimen for bacterial sinusitis preferred.
Tonsillitis and Sore Throat
Child (age 2 and over): 5.5 mg per lb. of body weight a day for 5 days.
Overdosage
Overdose may cause severe side effects, especially nausea, vomiting, stomach cramps, and diarrhea. Call your local poison control center or hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription bottle of Zithromax pills or container.
Special Information
Call your doctor if you develop nausea, vomiting, diarrhea, stomach cramps, or severe abdominal pain. Stop taking Zithromax drug and immediately call your doctor it you experience breathing difficulties, chest pain, hives, rash, itching, mouth sores, or unusual sensitivity to light.
It is crucial that you follow your doctor’s directions on how to take the drug and how many days to take it—even if you feel well sooner. This drug’s effectiveness may be severely reduced otherwise. Taking azithromycin at the same time each day may help you remember your medication.
If you forget a dose of azithromycin Zithromax, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and go back to your regular schedule.
Special Populations:
Pregnancy/Breast-feeding: It is not known if azithromycin taken during pregnancy will harm a fetus. This medication should be taken by pregnant women only if it is clearly needed.
It is not known if Zithromax passes into breast milk, but other macrolide antibiotics do. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors with liver disease should use caution. Seniors who have pneumonia or are especially sickly or debilitated probably should be treated with other medications.
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Tenormin (Atenolol)
May 21, 2011 | Leave a Comment
Tenormin (Atenolol)
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Generic Name: Atenolol
Brand Name: Tenormin
Generic Ingredients: Tenormin + Chlorthalidone Tenoretic
Generic Ingredient: Nebivolol Systolic
Type of Drug: Beta-adrenergic blocking agent.
Prescribed For: Tenormin alone or in combination is prescribed for high blood pressure, abnormal heart rhythms, angina pectoris, and prevention of second heart attack and migraine. It is also usedto treat alcohol withdrawal, stage Ifight, and other anxieties. Nebivolol is currently approved only to treat high blood pressure. Both are used together with other blood-pressure-lowering medications.
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General Information
Tenormin is one of many beta-adrenergic blocking drugs, or beta blockers and primarily blocks the beta, receptor. Nebivolol blocks both the beta, and beta, receptors when taken at high doses by people whose liver breaks down the drug more slowly than average. These drugs interfere with the action of adrenaline and other chemicals in the body that affect many body functions. Individual beta blockers have different characteristics that can make them more suitable for certain conditions or people.
When used to treat high blood pressure, Tenormin may be used either alone or concurrently with other antihypertensive drugs, particularly with a thiazide-type diuretic.
Cautions and Warnings
Do not take these drugs it you are allergic or sensitive to any of their ingredients or to other beta blockers. People with a severe allergy to any substance may be more sensitive to that allergen while taking a beta blocker.
People with angina who take these medicines for high blood pressure risk aggravating their angina if they suddenly stop taking the drug. These people should have their drug dosage reduced gradually over 1-2 weeks.
Tenormin should not be used by those with slow heartbeat, moderate to severe heart block (a condition affecting the heart’s conduction system), congestive heart failure unless it is due to a quickened heart rate that can be treated with Tenormin, or acute heart failure.
Tenormin and nebivolol should be used with caution if you have liver or kidney disease, because your ability to eliminate these drugs from your body may be impaired. Dose adjustments may be needed.
These drugs reduce the amount of blood the heart pumps. This reduction in blood flow may aggravate the condition of people with poor circulation or circulatory disease.
If you are undergoing major surgery, your doctor may want you to stop taking these drugs at least 2 days before surgery.
If you have pheochromocytoma (adrenal gland tumor), use Tenormin with caution.
Tenormin should be usedOfti caution in those with chronic bronchitis, emphysema, or other nonallergic bronchospastic diseases.
People with a history of severe anaphylactic reaction to allergens may be unresponsive to usual doses of epinephrine while taking beta blockers.
Possible Side Effects
Tenormin
Side effects are relatively uncommon and usually mild; they usually develop early in the course of treatment and are rarely a reason to stop taking Tenormin.
Most common: impotence.
Less common: unusual tiredness or weakness, slow heartbeat, heart failure (symptoms include swelling of the legs, ankles, or feet), dizziness, breathing difficulties, bronchospasm, depression, confusion, anxiety, nervousness, sleeplessness, disorientation, short-term memory loss, emotional instability, cold hands and feet, constipation, diarrhea, nausea, vomiting, upset stomach, increased sweating, urinary difficulties, cramps, blurred vision, rash, hair loss, stuffy nose, facial swelling, itching, chest pain, back or joint pain, colitis, drug allergy (symptoms include fever and sore throat), and liver toxicity.
Rare: lupus erythematosus (chronic condition affecting the body’s connective tissue). Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Tenormin may interact with surgical anesthetics to increase the risk of heart problems during surgery. Some anesthesiologists recommend gradually stopping the drug by 2 days before surgery.
• Tenormin may interfere with the normal signs of low blood sugar and with oral antidiabetic drugs.
• Tenormin increases the blood-pressure-lowering effects of
other blood-pressure-reducing agents, including clonidine,
guanabenz, and reserpine; and calcium channel blockers,such as nifedipine.
• Aspirin-containing drugs, indomethacin, and sulfinpyrazone may interfere with the blood-pressure-lowering effect of atenoloi.
• Cocaine may reduce the effectiveness of all beta blockers.
• Tenormin may worsen the problem of cold hands and feet associated with taking ergot alkaloids, used to treat migraine. Gangrene is a possibility in people taking both anergot and Tenormin.
• Tenormin will counteract thyroid hormone replacements.
• Calcium channel blockers, diphenhydramine, flecainide, hydralazine, contraceptive drugs, propafenone, haloperidol, phenothiazine sedatives—molindone and others—quinolone antibacterials, and quinidine may increase the amount of Tenormin in the bloodstream and lead to increased Tenormin effects.
• Tenormin should not be taken within 2 weeks of taking a monoamine oxidase inhibitor (MAGI) antidepressant.
• Cimetidine increases the amount of Tenormin absorbed into the bloodstream from oral tablets.
• Tenormin may interfere with the effectiveness of some anti-asthma drugs, including theophylline and aminophylline, and especially ephedrine and isoproterenol.
• Combining Tenormin with phenytoin or digitalis drugs may result in excessive slowing of the heart, possibly causing heart block (disruption of the electrical impulses that control heart rate).
• If you stop smoking while taking Tenormin, your dose may have to be reduced because your liver will break down the drug more slowly.
• Aluminum salts, barbiturates, calcium salts, cholestyramine, colestipol, ampicillin, and rifampin may reduce the effectiveness of Tenormin.
• Beta blockers may increase the effects of gabapentin, lidocaine, or prazosin, leading to undesirable reactions or toxicity.
• Beta blockers may block the effects of epinephrine.
• Fluoxetine, paroxetine, bupropion, propafenone, quinidine, duloxetine, and terbinafine can substantially increase the amount of nebivolol in the blood by interfering with its breakdown by liver enzymes. Amiodarone, cimetidine, and sertraline also have this interaction but the effect is smaller. Avoid these combinations.
• Other drugs that can increase nebivolol levels but to a much smaller extent are antihistamines, celecoxib, chlorpheniramine, chlorpromazine, citalopram, clemastine, clomipramine, diphenhydramine, doxepin, doxorubicin, escitalopram, halotantrine, histamine, hydroxyzine, levomepromazine, methadone, metoclopramide, mibefradil, midodrine, moclobemide, perphenazine, ranitidine, haloperidol, ritonavir, ticlopidine, and tripelennamine.
• Dexamethasone, rifampin, and sildenafil reduce blood levels of nebivolol but the combined effect on blood pressure is moderate.
Food Interactions
These drugs may be taken without regard to food or meals.
Usual Dose:
Tenormin
Adult: 50 mg a day. Some people may require doses of 100-200 mg a day. Dosages over 100 mg a day are not likely to produce additional benefit to those being treated for hypertension. People with kidney disease may need only 50 mg every other day. Older adults should be treated more cautiously and may need a lower dose.
Child: not recommended.
Overdosage
Symptoms of overdose include changes in heartbeat—unusually slow, unusually fast, or irregular—severe dizziness or fainting, breathing difficulties, bluish-colored fingernails or palms, and seizures. Heart failure and shock may also result from a beta blocker overdose. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
These drugs are meant to be taken continuously.
When ending treatment, dosage should be reduced gradually over a period of about 2 weeks. Do not stop taking these drugs unless directed to do so by your doctor. Abrupt withdrawal may cause chest pain, breathing difficulties, increased sweating, and unusually fast or irregular heartbeat.
Call your doctor at once if you develop back or joint pain, breathing difficulties, cold hands or feet, depression, rash, or changes in heartbeat. Tenormin may produce an undesirable lowering of blood pressure, leading to dizziness or fainting; call your doctor if this happens. Call your doctor if you experience persistent or bothersome anxiety, diarrhea, constipation, impotence, headache, itching, nausea or vomiting, nightmares or vivid dreams, upset stomach, insomnia, stuffy nose, frequent urination, unusual tiredness, or weakness.
Tenormin may cause drowsiness, lightheadedness, dizziness, or blurred vision. Be careful when driving or performing complex tasks.
It is best to take beta blockers at the same time each day. If you forget a dose, take it as soon as you remember. If you take nebivolol and do not remember until your next dose, continue with your regular schedule. If you take Tenormin once a day and it is within 8 hours of your next dose, skip the dose you forgot and continue with your regular schedule. If you take Tenormin twice a day and it is within 4 hours of your next dose, skip the one you forgot and continue with your regular schedule. Never take a double dose of Tenormin or nebivolol.
Special Populations
Pregnancy/breast-feeding: Infants born to women who took a beta blocker while pregnant had lower birth weights, low blood pressure, and reduced heart rates. These drugs should be avoided by pregnant women and women who might become pregnant while taking them.
Tenormin and nebivolol pass into breast milk. Nursing mothers should use infant formula.
Seniors: Seniors taking Tenormin should use the lowest effective dose as this group is more likely to have decreased heart, kidney, and liver function, and to be taking additional medications. Dosage adjustment of nebivolol is not necessary in seniors.
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Aspirin and Plavix (Clopidogrel)
Generic Names:
Aspirin, Buffered Aspirin (AS-prin)
There are many brand-name aspirin products, most of which are available over the counter. Check with your pharmacist about which specific brands are available buffered or with antacids.
Type of Drug:
Analgesic and anti-inflammatory agent.
Prescribed For:
Mild to moderate pain, fever, arthritis, and joints, or other body tissues. People who have had a stroke or transient ischemic attack (TIA)—oxygen shortage to the brain—may have aspirin prescribed to reduce the risk of having another such attack. Aspirin may also be prescribed as an anticoagulant (blood-thinning) drug in people with unstable angina and to protect against heart attack. Aspirin has a definite beneficial effect if it is taken as soon as possible after having a heart attack. Plavix is another blood thinner used either together with Aspirin or alone. You can buy generic Plavix (Clopidogrel) without a prescription online without the need to visit a doctor. Prices start under $1 and high quality is guaranteed. Just enter online pharmacy and have a look a t the huge list of more than 400 names of drugs for sale online including very affordable Plavix Clopidogrel. If you are looking for a blood thinner you should consider Clopidogrel to be an alternative to Aspirin or used together with it. Just enter the online pharmcay clicking on a banner above - there is full information about Plavix and Aspirin and other blood thinners.
General Information:
Aspirin may be the closest thing we have to a wonder drug. It has been used for more than a century for pain and fever relief and is now used for its effect on the blood as well.
Aspirin is the standard against which all other drugs are compared for relieving pain and for reducing inflammation. Chemically, aspirin is a member of the group of drugs called salicylates. Other salicylates include sodium salicylate, sodium thiosalicylate, choline salicylate, and magnesium salicylate (trilisate). These drugs are no more effective than regular aspirin, although two of them—choline salicylate and magnesium salicylate—may be a little less irritating to the stomach. They are all more expensive than aspirin.
Aspirin reduces fever by causing the blood vessels in the skin to open, allowing heat to leave the body more rapidly. Its effects on pain and inflammation are thought to be related to its ability to prevent the manufacture of complex body hormones called prostaglandins. Of all the salicylates, aspirin has the greatest effect on prostaglandin production.
Many people find that they can take buffered aspirin but not regular aspirin. The addition of antacids to aspirin can be important to people who must take large doses of aspirin for chronic arthritis or other conditions. In many cases, aspirin is the only effective drug and can be tolerated only with the antacids present.
Cautions and Warnings
Do not take if you are allergic or sensitive to any of its ingredients, or to nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin, sulindac, ibuprofen, fenoprofen, naproxen, tolmetin, and meclofenamate sodium or to products containing tartrazine (a commonly used orange dye and food coloring). Peo- ple with asthma, a history of hives, or nasal polyps are more likely to be allergic to aspirin.
Reye’s syndrome is a life-threatening condition characterized by vomiting and stupor or dullness and may develop in children with influenza (flu) or chickenpox that is treated with aspirin or other salicylates. Up to 30% of people who develop Reye’s syndrome can die, and permanent brain damage is possible in those who survive. Because of this, authorities advise against giving children under age 16 aspirin or another salicylate, especially those with chickenpox or flu; acetaminophen should be given instead.
People with liver damage should avoid aspirin.
Alcoholic beverages may worsen the stomach irritation caused by aspirin. Alcohol increases the risk of aspirin-related ulcers.
Stop taking aspirin if you develop dizziness, hearing loss, or ringing or buzzing in your ears.
Aspirin interferes with normal blood clotting and should therefore be avoided for 1 week before surgery. Ask for your surgeon or dentist’s recommendation before taking aspirin for pain after surgery,
Aspirin should not be taken by people with hemophilia or bleeding ulcers, or those who are in a state of bleeding.
Possible Side Effects
♦ Most common: nausea, upset stomach, heartburn, loss of appetite, and small amounts of blood in the stool.
♦ Less common: hives, rashes, liver damage, fever, thirst, and visual difficulties. Aspirin may contribute to the formation of stomach ulcers and bleeding. People who are allergic to aspirin and those with a history of nasal polyps, asthma, or rhinitis may experience breathing difficulty and a stuffed nose.
Drug Interactions
• People taking anticoagulant (blood-thinning) drugs should avoid aspirin because it increases the effect of the anticoagulant.
1 Aspirin may increase the possibility of stomach ulcer when taken together with alcoholic beverages.
• Aspirin will counteract the uric-acid-eliminating effect of probenecid and sulfinpyrazone. Aspirin may counteract the blood-pressure-lowering effect of ACE inhibitor and beta-blocking drugs. Aspirin may also counteract the effects of some diuretics in people with liver or kidney disease.
• Aspirin may increase blood levels of methotrexate and of val-
proic acid when taken with either of these drugs, leading to
increased chances of drug toxicity. Mixing aspirin and nitro-
glycerin tablets may lead to an unexpected drop in blood
pressure.
• Do not take aspirin with an NSAID. There is no benefit to the combination, and the chance of side effects—especially stomach irritation—is vastly increased.
• Coadministration of aspirin and corticosteroids decreases blood levels of aspirin.
• Urinary acidifiers such as ammonium chloride, ascorbic acid, and methionine may increase the effects of aspirin.
• Large aspirin doses (2000 mg a day or more) can lower blood sugar. This can be a problem in people with diabetes who take insulin or oral antidiabetes drugs to control their condition.
Food Interactions
Because aspirin can cause upset stomach and bleeding, take each dose with food, milk, or a glass of water.
Usual Dose
Adult
Aches, pains, and fever: 325-500 mg every 4 hours; 650 mg every 4-6 hours; or 1000 mg every 6 hours.
Arthritis and rheumatic conditions: up to 5400 mg a day in divided doses. Rheumatic fever, up to 7800 mg a day in divided doses.
Heart attack prevention, stroke, or TIA: 80-325 mg a day or 325 mg every 2 days. Some people may need as much as 1000 mg a day.
Child (under age 16): not recommended because of the risk of Reye’s syndrome (see “Cautions and Warnings”).
Overdosage
Aspirin may be lethal fGV adults in overdoses of 30 regular- 325 mg each—or 20 maximum-strength tablets-500 mg. Aspirin may be lethal for children in overdoses of 12 regular-strength tablets or 8 maximum-strength tablets.
Aspirin is a commonly used ingredient in many over-the-counter (OTC) medications. Always check the list of ingredients when using more than one OTC medication to ensure that the combined dosage is within guidelines and to avoid accidental overdose.
Symptoms of mild overdose are rapid and deep breathing, nausea, vomiting, dizziness, ringing or buzzing in the ears, flushing, sweating, thirst, headache, drowsiness, diarrhea, and rapid heartbeat.
Severe overdose may cause fever, excitement, confusion, convulsions, liver or kidney failure, coma, and bleeding.
The initial treatment of aspirin overdose involves inducing vomiting to remove any drug remaining in the stomach. Further treatment depends on how the situation develops and what must be done to maintain the patient. Do not induce vomiting until you have spoken with your doctor or poison control center. If in doubt, go to a hospital emergency room. ALWAYS bring the aspirin bottle or container.
Special Information
Contact your doctor if you develop continuous stomach pain or ringing or buzzing in the ears.
Do not use an aspirin product if it has a strong odor of vinegar. This is an indication that the product has started to break down in the bottle.
Do not crush or chew a sustained-release preparation of aspirin.
Check with your doctor if pain lasts more than 10 days, if pain worsens, or redness or swelling develop. Also, report a fever that persists for longer than 3 days.
If you are taking aspirin regularly report to your doctor if you notice a ringing or buzzing in your ear or experience severe or continuing headache.
If you forget to take a dose of aspirin, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Check with your doctor before taking any aspirin-containing product during pregnancy. Aspirin may cause bleeding poblemsin the fetus during the last 2 weeks of pregnancy. Taking aspirin during the last 3 months of pregnancy may extend the length of pregnancy, prolong labor, and lead to a low-birth-weight infant. It can also cause bleeding in the mother before, during, or after delivery. Anemia may also result from taking aspirin during pregnancy.
Aspirin passes into breast milk, but has not caused any problems in nursing babies. Nursing mothers should speak to their doctors before using aspirin.
Seniors: Aspirin, especially in larger doses that a senior may take for arthritis and rheumatic conditions, may be irritating to the stomach. Seniors with liver disease should not use aspirin.
Jul
16
Alprazolam
July 16, 2009 | Leave a Comment
Generic Name
Alprazolam (al-PRAY-zoe-lam) CGI
Brand Names
Niravam Xanax Xanax XR Type of Drug
Benzodiazepine sedative.
Prescribed For
Generalized anxiety disorder and anxiety associated with depression; panic disorder with or without agoraphobia.
General Information
Alprazolam is a member of a group :)f drugs known as benzodiazepines. Benzodiazepines directly affect the brain. They can relax you and make you more tranquil or sleepier, or they can slow nervous system transmissions in such a way as to act as an anticonvulsant. Many doctors prefer benzodiazepines to other drugs that can be used to similar effect because they tend to be safer, have fewer side effects, and are usually as effective, if not more so.
Cautions and Warnings
Do not take alprazolam if you know you are allergic or sensitive to it or to another benzodiazepine drug, including clonazepam.
Alprazolam can aggravate narrow-angle glaucoma, but you may take it if you have open-angle glaucoma and are receiving therapy for it.
Other conditions where alprazolam should be avoided are: severe lung disease, sleep apnea (intermittent cessation of breathing during sleep), liver disease, drunkenness, and kidney disease. In each of these conditions, the depressive effects of alprazolam may be enhanced or could be detrimental to your overall condition.
Alprazolam should not be taken by psychotic patients because it is not effective for them and can trigger unusual excitement, stimulation, and rage.
Alprazolam is meant to be used for no more than 3-4 months in a row. Your condition should be reassessed before continuing your medicine beyond that time.
Alprazolam may be addictive. When used to treat panic disorder, alprazolam is frequently prescribed in doses exceeding 4 mg a day. Studies show that these higher doses may cause physical and emotional dependence, making it very difficult to stop taking the drug. Drug withdrawal may develop if you stop taking it after only 4 weeks of regular use but is more likely after longer use and at higher doses. It may start with anxiety and progress to tingling in the hands or feet, sensitivity to bright light, sleep disturbances, cramps, tremors, muscle tension or twitching, poor concentration, flu-like symptoms, fatigue, appetite loss, sweating, and changes in mental state. Severe withdrawal symptoms may include seizures.
Your dosage should be reduced gradually (0.5 mg decrease every 3 days) to prevent drug withdrawal symptoms.
Possible Side Effects
V Most common: mild drowsiness during the first few days of therapy. Weakness and confusion may occur, especially in seniors and in those who are sickly. If these effects persist, contact your doctor.
V Less common: depression, lethargy, disorientation, headache, inactivity, slurred speech, stupor, dizziness, tremors, constipation, dry mouth, nausea, inabilityto control urination, Possible Side Effects (continued)
sexual difficulties, irregular menstrual cycle, changes in heart rhythm, low blood pressure, fluid retention, blurred or double vision, itching, rash, hiccups, nervousness, inability to fall asleep, and occasional liver dysfunction. If you experience any of these symptoms, stop taking the medicine and contact your doctor immediately.
V Rare: withdrawal seizures. Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Alprazolam is a central-nervous-system depressant. Avoid alcohol, other sedatives, narcotics, barbiturates, monoamine oxidase inhibitor (MAGI) antidepressants, antihistamines, and antidepressants. Taking alprazolam with these drugs may result in excessive depression, tiredness, sleepiness, breathing difficulties, or related symptoms.
• Smoking may reduce the amount of alprazolam in your blood by 50%. Smokers may need larger doses.
• The effects of alprazolam may be prolonged when taken together with cimetidine, contraceptive drugs, disulfiram, fluoxetine, isoniazid, itraconazole, ketoconazole, metoprolol, probenecid, propoxyphene, propranolol, and valproic acid.
• The effects of some benzodiazepines may be decreased by rifampin.
• Theophyllines may reduce alprazolam’s sedative effects.
• If you take antacids, separate them from your alprazolam dose by at least 1 hour to prevent them from interfering with the absorption of alprazolam into the bloodstream.
• Alprazolam may raise digoxin blood levels and the chances of digoxin toxicity.
• The effect of levodopa + carbidopa may be decreased if it is taken together with alprazolam.
• Combining alprazolam with phenytoin may increase phenytoin blood concentrations and the chances of phenytoin toxicity.
Food Interactions
Alprazolam is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
Anxiety Disorder
Adult: 0.25-0.5 mg 3 times a day. Dosage must be tailored to your individual needs with a maximum dose of 4 mg a day. Child (under age 18): not recommended.
Panic Disorder
Adult: 1 -10 mg a day.
Child (under age 18): not recommended.
Overdosage
Symptoms of overdose are confusion, sleepiness, poor coordination, lack of response to pain such as a pinprick, loss of reflexes, shallow breathing, low blood pressure, and coma. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Alprazolam can cause tiredness, drowsiness, inability to concentrate, or related symptoms. Be careful if you are driving, operating machinery, or performing other activities that require concentration.
Anyone taking alprazolam for more than 3 or 4 months at a time may have a drug withdrawal reaction if the medicine is stopped suddenly (see “Cautions and Warnings”). Do not stop taking alprazolam, or increase or decrease the dosage, without first consulting your doctor.
If you forget a dose of alprazolam, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and return to your regular schedule. Do not take a double dose. If you take Xanax XR, take your full daily dose once a day in the morning. Do not chew or crush Xanax XR tablets.
Special Populations
Pregnancy/Breast-feeding: Alprazolam may cause birth defects if taken during the first 3 months of pregnancy. You should avoid alprazolam while pregnant.
Alprazolam may pass into breast milk. Nursing mothers who must take alprazolam should use infant formula.
Seniors: Seniors, especially those with liver or kidney disease, are more sensitive to the effects of alprazolam and generally require smaller doses to achieve the same effect.
Jul
16
Alpha Blockers
July 16, 2009 | Leave a Comment
Type of Drug
Alpha Blockers
Brand Names
Generic Ingredient. Alfuzosin Uroxatral
Generic Ingredient: Terazosin Hydrochloride Hytrin
Prescribed For
High blood pressure (terazosin) and benign prostatic hyperplasia (BPH) (alfuzosin and terazosin).
General Information
Alpha blockers block nerve endings known as alpha, receptors. They reduce blood pressure by dilating (widening) and reducing pressure within the blood vessels. The maximum blood-pressurelowering effect of terazosin is seen between 2 and 6 hours after taking a single dose. Terazosin’s effect lasts for 24 hours.
In BPH, alpha blockers work by relaxing smooth muscles in the prostate and neck of the bladder. This effect is produced by blockage of alpha, receptors in the affected muscles. Despite the fact that terazosin alleviates the urinary symptoms of BPH, the drug’s long-term effect on complications of BPH or the need for urinary surgery is not known. Alpha blockers are broken down in the liver.
Cautions and Warnings
Do not take alpha blockers if you are allergic or sensitive to any of their ingredients.
Alpha blockers may cause dizziness and fainting, especially after the first few doses. This is known as the “first-dose effect” and may be minimized by limiting the first dose to 1 mg at bedtime. The first-dose effect occurs in about 1 % of people and may recur if the drug is stopped for a few days and then restarted.
Do not take alfuzosin if you have moderate to severe liver disease since this can drastically increase blood concentrations of the drug.
Alpha blockers should be taken with caution if you have kidney disease, since blood concentrations may be increased by 50%.
Do not take these medicines if you are already taking an alphablocker for either high blood pressure or prostate problems.
Terazosin may slightly reduce cholesterol levels and improve the high-density lipoprotein (HDL) to low-density lipoprotein (LDL) ratio, a positive step for people with blood-cholesterol problems.
Terazosin may reduce the counts of red and white blood cells.
People taking terazosin may experience a weight gain of about 2 lbs.
Possible Side Effects
Alfuzosin
✓ Most common: dizziness, fatigue, upper respiratory infection, and headache.
✓ Less common: pain, abdominal pain, upset stomach, constipation, nausea, impotence, bronchitis, sinusitis, sore throat, low blood pressure, dizziness, and fainting.
✓ Rare: rash, rapid heartbeat, chest pain, and painful and persistent erection. Contact your doctor if you experience any side effect not listed above.
Terazosin
✓ Most common: dizziness, weakness, and headache.
✓ Rare: depression, reduced sex drive or abnormal sexual function (including painful and persistent erection), fluid retention, and weight gain. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• When taken with other blood-pressure-lowering drugs, terazosin severely reduces blood pressure.
• Verapamil may increase blood levels of terazosin.
• Antifungal drugs such as itraconazole and ketoconazole and protease inhibitors interfere with the breakdown of alfuzosin in the liver, raising the amount of drug in the blood.
• Alfuzosin moderately increases the amount of diltiazem in the blood.
• Alpha blockers should not be taken with ritonavir.
Food Interactions
Alfuzosin should be taken with food.
Usual Dose
Alfuzosin: one 10-mg tablet taken after the same meal every day. Do not crush or chew the tablets.
Terazosin: starting dosage-1 mg at bedtime. Dosage may be increased in increments of 1-5 mg to a total of 20 mg a day. Dosages of 10 mg a day are generally needed to control the symptoms of BPH.
Overdosage
Symptoms may include drowsiness, poor reflexes, and very low blood pressure. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Take alpha blockers exactly as they are prescribed and do not stop taking it unless directed to do so by your doctor. Avoid over-the-counter drugs that contain stimulants because they may increase your blood pressure.
Alpha blockers may cause dizziness, headache, and drowsiness, especially 2-6 hours after taking your first dose, though these effects may persist after the first few doses. Wait 12-24 hours after taking the first dose before driving, operating machinery, or performing any other task that requires intense concentration. You may take alpha blockers at bedtime to minimize this problem.
Some people undergoing eye surgery who take alpha blockers can experience an unusual effect called “floppy iris syndrome.” Make sure to tell your eye surgeon if you are taking or have ever been treated with an alpha blocker. There is no benefit to stopping alpha-blocker treatment before cataract surgery.
Prostate cancer and BPH may have similar symptoms. Talk to your doctor about ruling out prostate cancer before beginning treatment for BPH.
Call your doctor if you develop severe dizziness, heart palpitations, or any bothersome or persistent side effect.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Alfuzosin is not indicated for use in women. Large dosages of terazosin damage the fetus in animal studies. When alpha blockers are considered crucial by your doctor, their potential benefits must be carefully weighed against their risks.
It is not known if terazosin passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may be more sensitive to the effects of terazosin.
Jul
16
Allopurinol
July 16, 2009 | Leave a Comment
Generic Name
Allopurinol (al-oe-PURE-in-nol)
Brand Name Zyloprim
Type of Drug
Antigout medication.
Prescribed For
Gout or gouty arthritis; also prescribed to counter the effects of certain therapies for cancer, ulcers, abnormal heart rhythms in heart bypass patients, seizures, and other conditions that may be associated with too much uric acid in the body.
General Information
Unlike other antigout drugs, which affect the elimination of uric acid from the body, allopurinol acts on the system that manufactures uric acid in your body. A high level of uric acid can indicate that you have gout, psoriasis, cancer, or any of a number of other diseases. High levels of uric acid can also be caused by taking certain drugs.
In mouthwash form, allopurinol helps to prevent mouth, stomach, and intestinal ulcers caused by fluorouracil, an antineoplastic drug. Allopurinol may be given before heart bypass surgery to reduce abnormal rhythms and other surgical complications. It can be used to reduce the relapse rates of duodenal ulcers associated with Helicobacter pylori infection and to reduce the vomiting of blood from stomach irritation caused by nonsteroidal anti-inflammatory drugs (NSAIDs). Allopurinol has also been used to control seizures in people for whom standard treatments are not effective.
Cautions and Warnings
Do not take allopurinol if you are allergic or sensitive to any of its ingredients, or if you have ever developed a severe reaction to it. Stop taking the medication immediately and contact your doctor if you develop a rash or any other adverse effects while taking allopurinol. Do not start taking allopurinol again if you stopped it because of a severe reaction.
Allopurinol should be used by children only if they have high uric acid levels due to neoplastic disease or to rare metabolic conditions.
A few cases of liver toxicity have been associated with allopurinol; they improved when the drug was stopped. People taking allopurinol should periodically be tested for liver and kidney function. People with severely compromised kidney function should ake a reduced dose of allopurinol.
Possible Side Effects
✓ Most common: rash associated with severe, allergic, or sensitivity reaction to allopurinol. If you develop an unusual rash or other sign of drug toxicity, stop taking this medication and contact your doctor.
✓ Less common: nausea, vomiting, diarrhea, intermittent stomach pain, gas, upset stomach, headache, insomnia, tingling or numbness in the hands and feet, muscle or joint pain, and drowsiness or lack of ability to concentrate.
✓ Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Large doses of drugs that make your urine more acidic, like megadoses of vitamin C, may increase the risk of kidney stone formation.
• Alcohol, diazoxide, mecamylamine, or pyrazinamide can increase the amount of uric acid in your blood; an increase in your allopurinol dose may be required.
• Allopurinol may increase the action of azathioprine, mercaptopurine, or cyclophosphamide and other anticancer drugs, leading to possible toxicity, bleeding, or infection.
• Allopurinol may prolong the effects of chloropropamide, and can lead to hypoglycemic reactions in patients with kidney disease.
• Taking allopurinol with probenecid or sulfinpyrazone may cause excessive reduction of uric acid.
• Allopurinol may interact with some anticoagulant (blood-thinning) medications, reducing the rate at which the anti-coagulant is broken down in the body. Dosage reduction may be necessary.
• People who are susceptible to ampicillin, amoxicillin, bacampicillin, or hetacillin rash are more likely to develop such a reaction while also taking allopurinol.
• Combining a thiazide diuretic or an ACE inhibitor (for high blood pressure or heart failure) with allopurinol increases the risk of a drug-sensitivity reaction.
• Combining vidarabine with allopurinol may increase the risk of neurotoxic effects and anemia, nausea, pain, and itching.
• Large doses of allopurinol—more than 600 mg a day—may increase the effects of and risk of toxic reactions to theophylline by interfering with its clearance from the body.
Food Interactions
Take each dose with food or a full glass of water. Drink 10-12 glasses of water, juices, soda, or another liquid each day to avoid the formation of crystals in your urine or kidneys.
Usual Dose
Adult and Child (age 11 and over): 100-800 mg a day, depend-, ing on disease and response.
Child (age 6-10): 300 mg a day.
Child (under age 6): 150 mg a day.
The dose should be reviewed periodically by your doctor to be sure that it is producing the desired therapeutic effect.
Overdosage
The expected symptoms of overdose are exaggerated side effects. Allergic skin reactions to allopurinol can be severe and at times fatal. Allopurinol overdose victims should be taken to a hospital. ALWAYS bring the prescription bottle or container.
Special Information
Allopurinol can make you drowsy or make it difficult to concentrate: Take care while driving a car or operating hazardous equipment.
Gout attacks may actually increase during the first few months of taking allopurinol. These attacks should subside.
Call your doctor at once if you develop rash, hives, itching, chills, fever, nausea, muscle aches, unusual tiredness, fever, yellowing of the whites of the eyes or skin, painful urination, blood in the urine, irritation of the eyes, or swelling of the lips or mouth.
Avoid large doses of vitamin C, which can cause the formation of kidney stones during allopurinol treatment. Be sure to drink 1012 8-oz. glasses of water a day while taking this medication.
If you forget to take a dose of allopurinol, take it as soon as possible. If it is almost time for your next regular dose, double this dose. For example, if your regular dose is 100 mg and you miss a dose, take 200 mg at the next usual dose time.
Special Populations
Pregnancy/Breast-feeding: Allopurinol may cause birth defects or interfere with fetal development. Check with your doctor before taking it if you are or might be pregnant.
Allopurinol passes into breast milk. Nursing mothers who must take allopurinol should use infant formula.
Seniors: No special precautions are required. Follow your doctor’s directions and report any side effects at once.
Jul
16
Alitretinoin
July 16, 2009 | Leave a Comment
Generic Name
Alitretinoin (al-ih-TRET-in-oin)
Brand Name
Panretin
Type of Drug Retinoid.
Prescribed For
Skin lesions of Kaposi’s sarcoma (KS).
General Information
Alitretinoin binds to and activates retinoid receptors in human cells. Once activated, these receptors help stimulate the body’s natural mechanisms for limiting tissue growth—in this case, the growth of KS cells. KS lesions, which are primarily associated with human immunodeficiency virus (HIV), can respond to alitretinoin in as little as 2 weeks, but most people do not start to see results for 48 weeks or, in some cases, 14 weeks or more.
Cautions and Warnings
Do not use alitretinoin if you are allergic or sensitive to retinoids or to any of its ingredients.
Alitretinoin is applied to individual KS lesions. It does not treat systemic KS or prevent new KS lesions from forming.
People requiring systemic KS treatment (those who have developed more than 10 new KS lesions within a month) should not use alitretinoin.
People with swollen lymph glands, KS that affects the lungs or other major organ involvement should not use alitretinoin.
Possible Side Effects .
✓ Most common: rash and burning pain at application site.
♦ Common: itchy, flaking, peeling, cracking, oozing, swelling, and inflammation at application site.
Drug Interactions
• Do not use insect repellant products that contain DEET, a widely used chemical repellant. Alitretinoin increases DEET toxicity.
Usual Dose
Adult: Apply 2-4 times a day to KS skin lesions. Seniors should use this drug with caution.
Child: not recommended.
Overdosage
Little is known about the effects of accidental ingestion. Call your local poison control center or a hospital emergency room for information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Apply enough alitretinoin gel to cover the entire skin lesion. Allow the gel to dry for 3-5 minutes before covering the area with clothing. Avoid showering, bathing, or swimming for at least 3 hours.
If you use a bandage or dressing, be sure it is not tight and that air can circulate freely over the area.
Avoid applying alitretinoin to unaffected skin because it may be irritated by the drug. Avoid applying near the nose, eyes, or mouth.
Alitretinoin contains alcohol. Always keep it away from any open flame.
Retinoids can cause unusual sensitivity to the sun. While this has not been seen with alitretinoin, you should avoid prolonged exposure to the sun or use sunscreen while taking this drug.
If you forget a dose, apply it as soon as you remember. If it is almost time for your next dose, apply the forgotten dose and then space the rest of your doses throughout the day. Continue with your regular schedule the next day.
Special Populations
PregnancylBreast-feeding., Alitretinoin can harm the fetus when sufficient levels of the drug are present in the mother’s bloodstream, but it is not known if these levels are achieved during routine use of alitretinoin. Women who are or might be pregnant should only use this drug after discussing its potential benefits and risks with their doctors.
It is not known if alitretinoin passes into breast milk. Nursing mothers who must use alitretinoin should use infant formula.
Seniors: There is no information on use of alitretinoin by seniors. Seniors should use it with caution.
Jul
16
Aliskiren
July 16, 2009 | Leave a Comment
Generic Name
Aliskiren (ah-LISS-kih-ren)
Brand Name Tekturna
Combination Product
Generic Ingredients: Aliskiren + Hydrochlorothiazide Tekturna HCT
Type of Drug
Direct renin inhibitor. Prescribed For
High blood pressure.
General Information
Renin is produced by the kidney in response to a reduction in blood volume and the amount of blood passing through the kidney. Once in the blood, renin reacts with other hormones to forma very powerful blood vessel constrictor called angiotensin E that directly raises blood pressure. Renin also works with a hormore called aldosterone to raise blood pressure and it prevents sodium from being eliminated from the body. This increases the amount of water in the system, raising blood volume and increasing blood pressure. Aliskiren inhibits renin and all of its actions, thereby !owering blood pressure. The blood pressure lowering is usually seen with 2 weeks of starting on treatment. When aliskiren treatment is stopped, blood pressure gradually rises to pre-treatment levels. Only about 21/2% of any dose is absorbed into the blood and it takes about a week to reach a steady level in the blood. Most of the drug that is absorbed is broken down in the liver. The rest passes out of the body unchanged in the urine. Aliskiren may be used alone or with other hypertensives, however its use with maximum doses of an ACE inhibitor has not been adequately studied.
Cautions and Warnings
Do not take aliskiren if you are allergic or sensitive to any of its ingredients.
Angioedema swelling of the face, hands or feet, tongue, or throat can occur at any time during aliskiren treatment. If this happens, stop taking the medicine and go to your doctor’s office or a hospital emergency room for treatment. This reaction can interfere with your breathing.
The safety of aliskiren in people with moderate to severe kidney disease is not known.
The combination of aliskiren and an ACE inhibitor can lead to high blood levels of potassium.
Aliskiren may be less effective in some black patients with high blood pressure, especially when dietary salt intake is high. Nevertheless, it should still be considered a useful blood pressure treatment.
Possible Side Effects
✓ Common: nausea, dizziness, and sleeplessness.
✓ Less common: diarrhea, abdominal pain, upset stomach, GERD, cough, rash high blood uric acid levels, gout, kidney stones, headache, nose and throat irritation, fatigue, upper respiratory infection, and back pain.
✓ Rare: difficulty breathing; swelling of the hands, face, eyes, or whole body; and seizures. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Mixing aliskiren with irbesartan can reduce the amount of aliskiren into the blood by 50%. This may reduce the effectiveness of aliskiren.
• Aliskiren has been studied together with both hydrochlorothiazide and valsartan and can be combined with them in blood pressure management. It has been used with amlodipine but may not be better than high dose amlodipine alone.
• Aliskiren’s interaction with ACE inhibitors is not yet fully known.
• Atorvastatin and ketoconazole slow the breakdown of aliskiren, resulting in an increase of aliskiren blood levels by 50% or more. Dosage adjustment may be necessary.
Aliskiren can reduce blood levels of the diuretic furosemide, reducing the diuretic’s effect.
Food Interactions
Aliskiren can be taken without regard to food or meals. Avoid taking it with high fat meals because they can drastically reduce the amount of aliskiren absorbed into the blood.
Usual Dose
Adult (age 18 and over)
Tekturna: 50-300 mg at the same time every day. Tekturna HCT. 1 tablet a day.
Child: not recommended. Overdosage
The most likely symptom of overdose is low blood pressure (symptoms include dizziness and fainting). If you think you have taken an overdose, call your doctor or go to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor at once if you develop swelling of the face, eyes, lips, tongue, or throat; difficulty swallowing or breathing; hoarseness; or other signs of a drug reaction or allergy.
If you forget a dose, take it as soon as you remember. If you do not remember until it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Aliskiren can injure or kill a developing fetus. Pregnant women should not take aliskiren. Women who suspect they are pregnant must call their doctor at once and stop taking aliskiren when pregnancy is confirmed. In those rare cases where aliskiren is considered life-saving for the mother and there is no substitute for aliskiren, your doctor may advise that you continue on the medicine and then check your baby’s development with periodic ultrasound examinations.
It is not known if this drug passes into breast milk. Nursing mothers should use infant formula.
Seniors: Seniors may have higher blood levels of aliskiren and be more susceptible to drug side effects, but starting dose adjustment is not required.