Aug
1
Chlordiazepoxide
August 1, 2009 | Leave a Comment
Generic Name
Chlordiazepoxide (klor-dye-az-uh-PDX-ide) 91
Brand Name
Librium
Type of Drug Benzodiazepine sedative.
Prescribed For
Anxiety, tension, fatigue, agitation, and withdrawal symptoms of alcoholism; also prescribed for irritable bowel syndrome and panic attacks.
General Information
Chlordiazepoxide is a member of the group of drugs known as benzodiazepines.
Benzodiazepines work by a direct effect on 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 chlordiazepoxide if you are allergic or sensitive to any of its ingredients or to another benzodiazepine, including clonazepam.
Chlordiazepoxide can aggravate narrow-angle glaucoma, but you may take it if you have open-angle glaucoma and are receiving therapy for it.
Other condkjo(\SiVN\,NhjCb chlordiazepoxide should be used with caution are severe depression, especially with suicidal tendencies, severe lung disease, sleep apnea (intermittent cessation of breathing during sleep), liver disease, drunkenness, and kidney disease.
Chlordiazepoxide should not be taken by psychotic patients because it is not effective for them and can trigger unusual excitement, stimulation, and rage. It has also produced similar reactions among hyperactive and aggressive pediatric patients.
Chlordiazepoxide is not intended for more than 3-4 months of continuous use. Your condition should be reassessed before continuing chlordiazepoxide beyond that time.
Chlordiazepoxide may be addictive. Drug withdrawal may develop if you stop taking it after only 4 weeks of regular use, but is more likely after longer use. 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.
Dosage of chlordiazepoxide should be decreased gradually over 4-8 weeks after prolonged use.
Possible Side Effects
Weakness and confusion may occur, especially in seniors and in those who are sickly.
♦ Most common: mild drowsiness during the first few days of therapy.
✓ Less common: depression, lethargy, disorientation, edema, headache, inactivity, slurred speech, stupor, dizziness, tremor, constipation, dry mouth, nausea, inability to control urination, 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.
♦ 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
• Chlordiazepoxide is a central-nervous-system depressant. Avoid alcohol, other sedatives, narcotics, barbiturates, mono-amine oxidase inhibitor and other antidepressants, and antihistamines. Taking chlordiazepoxide with these drugs may result in excessive depression, tiredness, sleepiness, breathing difficulties, or related symptoms.
• Smoking may reduce the effectiveness of chlordiazepoxide by increasing the rate at which it is broken down by the body.
• The effects of chlordiazepoxide may be prolonged when it is
taken with cimetidine, contraceptive drugs, disulfiram, flu-
oxetine, isoniazid, ketoconazole, metoprolol, probenecid,
propoxyphene, propranolol, rifampin, or valproic acid.
• Theophylline may reduce chlordiazepoxide’s sedative effects.
• If you take antacids, separate them by at least 1 hour from your chlordiazepoxide dose to prevent them from interfering with the passage of chlordiazepoxide into the bloodstream.
• Chlordiazepoxide may increase blood levels of digoxin and the chances for digoxin toxicity.
• Levodopa + carbidopa’s effectiveness may be reduced by chlordiazepoxide.
• Phenytoin blood concentrations may be increased when taken with chlordiazepoxide, resulting in possible phenytoin toxicity.
Food Interactions
Chlordiazepoxide is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
Adult: 5-100 mg a day. This range is due to individual response related to age, weight, disease severity, and other characteristics.
Child (age 6 and over): may be given if deemed appropriate by a doctor. Starting dose-5 mg 2-4 times a day. Maintenance dose—up to 30 mg a day for some children, but must be individualized to obtain maximum benefit.
Child (under age 6): not recommended.
Overdosage
Symptoms of overdose are confusion, sleepiness, poor coordination, lack of response to pain such as a pin prick, loss of reflexes, shallow breathing, low blood pressure, and coma. The victim should be lakes to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Chlordiazepoxide can cause tiredness, drowsiness, inability to concentrate, or similar symptoms. Be careful if you are driving, operating machinery, or performing other activities that require concentration.
If you forget a dose of chlordiazepoxide, 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: Chlordiazepoxide may cause birth defects if taken during the first 3 months of pregnancy. Avoid chlordiazepoxide while pregnant.
Chlordiazepoxide may pass into breast milk. Nursing mothers who must take chlordiazepoxide should use infant formula.
Seniors: Seniors, especially those with liver or kidney disease, are more sensitive to the effects of chlordiazepoxide and generally require smaller doses to achieve the same effect.
Aug
1
Cevimeline
August 1, 2009 | Leave a Comment
Generic Name
Cevimeline (seh-VIM-ih-lene) 9
Brand Name Evoxac
Type of Drug Cholinergic.
Prescribed For
Dry mouth in people with syndrome.
General Information
Sj6gren’s syndrome jS a group 0j symptoms related to a lack of bodily secretions. People with this condition have very dry eyes and mucous membranes, facial lesions, and neck swelling. It often occurs in menopausal woman and is often associated with rheumatoid arthritis, poor blood circulation in the legs, and tooth decay. Cevimeline increases secretions in the mouth by binding to specific nervous system receptors and causing the release of more saliva.
Cautions and Warnings
Do not take cevimeline if you are allergic or sensitive to any of its
ingredients.
This drug may make breathing more difficult and worsen lung conditions such as asthma, chronic bronchitis, or chronic obstructive pulmonary disease (COPD).
Eye conditions like glaucoma or inflammation of the iris may be worsened by cevimeline.
Cevimeline may affect the heart, and some people with severe heart disease, including those with a history of severe angina or heart attack, may not be able to compensate for this effect.
Cevimeline may worsen gallstones and kidney stones and should be avoided by people with a history of these conditions.
Cevimeline may cause visual blurring, especially at night.
Possible Side Effects
✓ Most common: excessive sweating, headache, nausea, sinus irritation, respiratory infection, runny nose, and diarrhea.
✓ Common: upset stomach, abdominal pains, urinary infection, coughing, and sore throat.
✓ Less common: vomiting, back pain, injury, rash, conjunctivitis (pinkeye), dizziness, bronchitis, severe joint pain, fatigue, bone pain, sleeplessness, hot flushes, excess salivation, chills, and anxiety.
✓ Rare: frequent urination, weakness, and flushing. Other 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
• Combining cevimeline with a beta blocker can lead to heart rhythm disturbances.
• Cevimeline may interfere with the effects of anticholinergics, found in Some medications for abdominal or stomach spasms or cramps.
• Cholinergics such as bethanechol, donepezil, physostigmine, pilocarpine, and pyridostigmine can add to the effects of cevimeline.
• Some drugs may interfere with the breakdown of cevimeline in the liver, increasing the chance of drug side effects. These include amiodarone, celecoxib, chlorpheniramine, cimetidine, ciprofloxacin, clarithromycin, clomipramine, cocaine, diltiazem, erythromycin, fluconazole, fluoxetine, halofantrine, indinavir, itraconazole, ketoconazole, methadone, mibefradil, nelfinavir, paroxetine, quinidine, ranitidine, ritonavir, saquinavir, and terbinafine.
Food Interactions
Grapefruit juice may interfere with the breakdown of cevimeline in the liver, increasing the chance of drug side effects. Food interferes with the absorption of cevimeline into the bloodstream. Take this drug on an empty stomach.
Usual Dose
Adult: 30 mg 3 times a day. Child: not recommended.
Overdosage
Overdose symptoms can include exaggerated drug side effects including headache, visual impairment, excess tearing and/or sweating, difficulty breathing, stomach or intestinal spasms, nausea, vomiting, diarrhea, changes in heart rhythm, blood pressure changes, shock, mental confusion, and tremors. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
cevimeline may cause blurred vision, possibly interfering with driving or performing tasks that require reliable vision, especially at night or in low light.
If you sweat excessively while taking cevimeline, be sure to drink a lot of water. Excessive sweating can lead to dehydration.
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Pregnant women should take cevimeline only if it is considered crucial by your doctor, since its effect on the developing fetus is not known.
It is not known if cevimeline passes into breast milk, but nursing mothers who must take this drug should consider using infant formula.
Seniors: Older adults should be cautious about using this drug because of its possible effects on the kidney, liver, and heart, and on other diseases or medications.
Aug
1
Cetirizine
August 1, 2009 | Leave a Comment
Generic Name
Cetirizine (seh-TERE-ih-zene)
Brand Name Zyrtec
The information in this profile also applies to the following drugs:
Generic Ingredient: Azelastine
Generic Ingredient: Fexofenadine 91 Allegra
Generic Ingredient: Levocetirizine 91 Xyzal
Type of Drug Antihistamine.
Prescribed For
Azelastine: runny nose, sneezing, nasal itching, and post-nasal drip. Cetirizine: stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal and year-round allergy, and for other symptoms of allergy such as rash, itching, and hives; also prescribed for chronic itching and for asthma. Fexofenadine: sneezing, stuffy and runny nose; scratchy throat and mouth; and itchy, watery, and red eyes caused by seasonal allergies. Levocetirizine: stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal and year-round allergy, and for other symptoms of allergy such as rash, itching, and hives; also prescribed for chronic itching.
General Information
Antihistamines generally work by blocking the release of histamine (a chemical released by body tissue during an allergic reaction) from the cell at the H, histamine receptor site, drying up secretions of the nose, throat, and eyes. Cetirizine causes less sedation than older antihistamines and appears to be just as effective. Levocetirizine is the active portion of the cetirizine molecule and is as effective as cetirizine with a similar side effect profile.
Cautions and Warnings
Do not take cetirizine if you are allergic or sensitive to any of its ingredients.
People with kidney disease should receive reduced dosages of cetirizine and levocetirizine. Do not take these drugs if kidney disease is severe. Children with kidney disease should not receive levocetirizine.
Possible Side Effects
✓ Common: headache, drowsiness, fatigue, dry mouth, bitter taste in the mouth, dizziness, runny nose, and sore throat.
✓ Less common: nosebleeds, stuffy nose, sneezing, cough, nausea, upset stomach, changes in bowel habits, nervousness, and fever (children).
♦ Rare: fainting and weight gain. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Cimetidine may increase the level of azelastine in the blood.
• Cetirizine is less likely than other antihistamines to interact with drugs.
• Ritonavir increases the amount of levocetirizine and slows its breakdown in the body. This may result in increased levocetirizine side effects.
Food Interactions
• Ceterizine and levocetirizine may be taken without regard to food or meals.
Usual Dose
Azelastine Nasal Spray
Adult and Child (age 12 and over): 1-2 sprays in each nostril twice a day.
Child (age 5-11): 1 spray in each nostril twice a day.
Cetirizine
Adult and Child (age 6 and over): 5-10 mg once a day depending on symptoms. Reduce dosage in people with kidney disease. Child (age 1-5): 2.5-5 mg a day.
Child (age 6 months-1 year): 2.5 mg a day.
Fexofenadine
Adult (age 12 and over): 60 mg twice a day or 180 mg once a day. People with kidney disease should take 60 mg a day.
Child (age 6-11): 30 mg twice a day.
Levocetirizine
Adult and Child (age 12 and over): 5 mg every evening.
Child (age 6-11): 2.5 mg (1h tablet) every evening. Dosage for children should not exceed 2.5 mg a day. Child (under age 6): not recommended.
Overdosage
Drug overdose is likely to cause severe side effects. Overdose victims should be Oven ipecac syrup—available at any pharmacy—to make them vomit and be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Use extra caution while doing anything that requires concentration, such as driving a car or operating hazardous machinery.
Report sore throat, unusual bleeding, bruising, tiredness, weakness, or any other unusual side effect to your doctor. Do not combine these drugs with alcohol or other nervous system depressants. Do not put azelastine nasal solution into your eyes.
If you forget to take a dose of cetirizine, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Oral antihistamines are generally considered safe for use during pregnancy. But do not take any antihistamine without your doctor’s knowledge if you are or might become pregnant—especially during the last 3 months of pregnancy, because newborns may have severe reactions to antihistamines.
Small amounts of antihistamine pass into breast milk. Nursing mothers who must take cetirizine should use infant formula.
Seniors: Antihistamines are more likely to cause dizziness, sleepiness, and confusion in seniors. Dosage reduction may be recommended depending on kidney function.