Sep
26
Formoterol - Fosfomycin - Fosinopril - Fosrenol - Ganciclovir
September 26, 2009 | Leave a Comment
Generic Name
Formoterol (for-MOH-ter-ol)
Brand Names
Foradil Aerolizer Perforomist Foradil Certihaler
Combination Product
Generic Ingredients: Formoterol + Budesonide Symbicort
The information in this profile also applies to the following drug:
Generic Ingredient: Arformoterol Brovana
Type of Drug Bronchodilator.
Prescribed For
Maintenance of asthma, bronchospasm during exercise, and chronic obstructive pulmonary disorder, including chronic bronchitis, and emphysema.
General Information
Formoterol is a long-acting beta-2 agonist, used in the prevention of asthma attacks and bronchial spasms. It is not effective in stopping an asthma attack once it has begun. Patients suffering from severe asthma should always have a short-acting bronchodilator available in case of an acute attack.
Cautions and Warnings
Do not use formoterol if you are allergic or sensitive to any .,oAits ingredients.
Formoterol skn\)NO not be used by patients with significantly or rapidly worsening asthma. In some asthma patients, formoterol may increase the chance of death from asthma.
Formoterol is not a replacement for corticosteroid inhalers. Patients should continue to use their corticosteroid inhalers at the same dosage in conjunction with formoterol.
Patients who have been taking inhaled, short-acting beta-2 agonises should stop regular use of these, and use them only to treat
acute asthma symptoms.
Formoterol can cause paradoxical bronchospasm, a potentially
life-threatening condition. Patients who experience symptoms
should discontinue use of formoterol immediately.
Formoterol can cause irregular heartbeat and should be used
with caution by patients with a history of heart disease or high blood pressure. Patients with a history of seizures, strokes, or diabetes should also be carefully monitored for a recurrence or worsening of these conditions.
Possible Side Effects
? Most common: tremors, dizziness, insomnia, and chest pain.
? Common: restlessness, weakness, sore throat, and difficulty breathing.
¦ Less common: lightheadedness, angina, abnormal heart rhythm, heart palpitations, and bronchospasrn.
? Rare: severe worsening of asthma, extreme allergic reaction, and angioedema (a potentially life-threatening swelling of the lips and throat). Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Formoterol’s effects may be increased by monoamine oxidase inhibitor (MA01) antidepressants, tricyclic antidepressants, thyroid drugs, other bronchodilators. and some antihistamines.
• The effect of formoterol may be lessened by beta-blocking drugs, such as propranolol.
• Formoterol may antagonize the effects of blood-r:~ssurelowering drugs, especially reserpine, methyldupa, and guanethidine.
• Using formoterol with antihistamt z;, disopyramide; phe- nothja,Z:MtS,’D10cBinamide; quinidine and similar drugs: theo- phylline; and tricyclic antidepressants may increase the risk of heart damage and life-threatening cardiac arrhythmias.
Food Interactions None known.
Usual Dose
Arlormoterol
Adult: Inhale 15 mcg every 12 hours. Child: not recommended.
Formoterol
Adult and Child (age 5 and over)
Foradil Aerolizer: Inhale 12 mcg every 12 hours. Foradil Certihaler: Inhale 10 mcg every 12 hours.
Perforomist: Inhale 20 mcg every 12 hours. Child (under age 5): not recommended.
Formoterol + Budesonide Combination Adult: Inhale 1 puff every 12 hours. Child: riot recommended.
Overdosage
Formoterol overdose may cause nausea, vomiting, tremor, sleepiness, rapid or irregular heartbeat, low blood sugar, blood acidity, and life-threatening cardiac arrhythmias. Patients experiencing severe symptoms should go to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
The drug should be inhaled during the second half of your inward breath. This will allow the medication to reach more deeply into your lungs.
Be sure to follow your doctor’s directions for the use of formoterol. Using more than you need can increase the risk of side effects and worsen your symptoms. If your condition worsens after taking formoterol, stop taking it and call your doctor at once.
Call your doctor at once if you develop chest pains, rapid heartbeat, palpitations, muscle tremors, dizziness, headache, or swelling of the throat, or if you still have trouble breathing after using the medication.
If a dose of formoterol is forgotten, take it as soon as you remember. If it is almost time (Ox your next dose, skip the dose you forgot aMmMinue with your regular schedule. Do not take a double dose.
Formoterol capsules must only be used with the inhaler that is provided with this medicine. Do not use other medicines with the formoterol inhaler. Patients should be aware that the gelatin cap-sure may fragment, causing a risk that gelatin particles will be inhaled. This risk is minimized by being careful to pierce the gelatin capsule only once. Capsules should be used immediately after they are taken from the blister pack.
Special Populations
Pregnancy/Breast-feeding: The safety of formoterol in pregnant women has not been studied. The potential benefit of using this medication must be carefully weighed against its risks.
It is not known if formoterol passes into breast milk. Nursing mothers who take this should consider using infant formula.
Seniors: Seniors may be more sensitive to the effects of this drug. Follow your doctor’s directions and report any side effects at once.
Fosamax see Bisphosphonates, page 164
Generic Name
Fosfomycin (fos-foe-MYE-sin)
Brand Name Monurol
Type of Drug Urinary anti-infective.
Prescribed For
Uncomplicated urinary infections.
General Information
Fosfomycin kills a variety of bacteria. It works by preventing bacteria from sticking to the wall of the urinary tract and by interfering with bacterial cell division. In the body, it is converted V) its active form—free (WS bacteria that are resistant to other antibiotics are not resistant to fosfomycin, so this drug may work where others have failed.
Cautions and Warnings
bo not take fosfomycin if you are allergic or sensitive to any of its ingredients. Fosfomycin is meant to be taken once, in a single dose. Taking more than 1 packet of fosfomycin only increases side effects; it does not improve the drug’s effectiveness.
Drug Interactions
• Metoclopramide reduces fosfomycin blood levels. Food Interactions
You may take fosfomycin with or without food. Usual Dose
Adult (age 12 and over): 1 packet mixed with water. Child (under age 12): riot recommended.
Overdosage
Little is known about the effects of fosfomycin overdose. Call your local poison control center or a hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
Do not take fosfomycin powder in its dry form. Mix the contents of the packet with 3-4 oz. of cool or cold water until it dissolves. Then drink the solution immediately.
Call your doctor if your infection does not improve within 2 or 3 days.
Special Populations
Pregnancy/Breast-feeding: The safety of using fosfomycin during pregnancy is, mV&nown. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
It is not known if fosfomycin passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may take fosfomycin without special restriction.
above. vaginal irritation, runny nose, nau-
ts can occur in almost any part of the doctor if you experience any side ef- e.
Possible Side Effects
¦ Less common: diarrhea
and headache
Rare: Rare side effects body. Contact your fect not listed
Generic Name
Fosinopril (tos-IN-oe-pril) 41
Brand Name Monopril
Combination Product
Generic Ingredients: Fosinopril + Hydrochlorothiazide IM
Monopril HCT Type of Drug
Angiotensin-converting enzyme (ACE) inhibitor.
Prescribed For
High blood pressure and heart failure. Also prescribed for renal failure, kidney hypertension, post-heart attack management, management of people with a high risk of heart disease, diabetes, chronic kidney disease, and preventing a second stroke.
General Information
Fosinopril sodium and other ACE inhibitors work by preventing the conversion of a hormone called angiotensin I to another hormone called angiotensin II, a potent blood-vessel constrictor. Preventing this conversion relaxes blood vessels, thus reducing blood pressure and relieving the symptoms of heart failure. Fosinopril also affects the production of other hormones and enzymes that participate in the regulation of blood vessel dilation. Fosinopril begins working 2-6 hours after you take it.
Cautions and Warnings
Do not take fosinopril if you are allergic or sensitive to any of its ingredients. Severe reactions may involve angioedema, a possibly life-threatening swelling of the face, throat, or intestines (see “Special Information”). These reactions are more likely in hemodialysis patients and those undergoing venom immunization.
Fosinopril occasionally causes very low blood pressure or affects your kidneys. ‘four doctor should check your urine for changes during the first few months of treatment.
ACE inhibitors can affect your white-blood-cell count, possibly increasing your susceptibility to infection. Blood counts should be checked periodically.
Fosinopril may cause serious injury or death to the fetus it taken during pregnancy. Pregnant women should, not take fosinopril.
ACE inhibitors may be less effective in some black patients with high blood pressure, especially when dietary salt intake is high. Nevertheless, they should still be considered useful blood pressure treatments. Swelling beneath the skin to form welts is more common among black patients.
Possible Side Effects
v Most common: chronic cough and dizziness, especially when rising from a sitting or lying position. The cough usually goes away a few days after you stop taking the medicine.
? Less common: chest pain, low blood pressure, fatigue, diarrhea, headache, vomiting, and nausea.
¦ Rare: Rare side effects can affect your heart, sleeping, stomach and intestines, skin, sex drive, and joints. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• The blood-pressure-towering effect of fosinopril is additive with diuretic drugs and beta blockers. Any other drug that causes a rapid drop in blood pressure should be used with caution if you are taking an ACE inhibitor.
• Fosinopril may increase the effects of lithium: this combination should be used with caution.
• Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the blood pressure-lowering effects of fosinopril and other ACE inhibitors. This may cause reductions in kidney function.
• Fosinopril may increase potassium levels in your blood, especially when taken with dyazide or other potassium-sparing diuretics.
• Antacids and fosinopril should be taken at least 2 hours apart.
• Capsaicin may trigger or aggravate the cough associated with fosinopril, kt)eTapy.
• Indomethacin may reduce the blood-pressure-lowering effects of fosinopril.
• Phenothiazine sedatives and antivomiting drugs may increase the effects of fosinopril.
• Severe sensitivity reactions can occur in people taking allopurinol.
Fosinopril may affect blood levels of digoxin. More digoxin in the blood increases the chance of digoxin-related side effects while less digoxin in the blood can compromise its
effectiveness.
Food Interactions
You may take fosinopril with food if it upsets your stomach.
Usual Dose
Adult: 10-80 mg once a day. People with liver disease may require lower dosages.
Overdosage
The principal effect of ACE inhibitor overdose is a rapid drop in blood pressure, as evidenced by dizziness or fainting. Take the overdose victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you develop swelling of the face or throat, if you have sudden difficulty in breathing, or if you develop a sore throat, mouth sores, abnormal heartbeat, chest pain, persistent rash, or loss of taste perception. Unexplained swelling of the face, lips, hands, and feet can also affect the larynx (throat) and tongue and interfere with breathing. If this happens, the victim should be taken to a hospital emergency room at once.
Some people who start taking an ACE inhibitor after they are already on a diuretic (an agent that increases urination) experience a rapid drop in blood pressure after their first doses or when the dosage is increased. To prevent this from happening, you may be told to stop taking the diuretic 2 or 3 days before starting the ACE inhibitor or to increase your salt intake during that time. The diuretic may then be restarted gradually.
You may get dizzy if you rise to your feet quickly from a sitting or lying position when taking fosinopril.
Avoid strenuous exercise or very hot weather, because heavy sweating or dehydration can cause a rapid decrease in blood pressure.
Avoid over-the-counter diet pills, decongestants, and other stimulants that can raise blood pressure. Also, do not take potassium supplements or salt substitutes containing potassium without consulting your doctor.
If you forget to take a dose of fosinopril, take it as soon as you remember. If it is within 8 hours of 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: ACE inhibitors can cause fetal injury or death. Women who are or might be pregnant should not take ACE inhibitors. Stop taking the drug and contact your doctor if you become pregnant.
Large amounts of fosinopril pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may be more sensitive to the effects of fosinopril.
Brand Name
Fosrenol
Generic Ingredient Lanthanum Carbonate
Type of Drug Phosphate binder.
Prescribed For
High blood phosphate levels (hyperphosphatemia) in people with end-stage renal disease (ESRD).
General Information
People with ESRD, a form of kidney disease, tend to retain phosphorous. High phosphate levels, in turn, can affect calcium balance in the body and cause deposits of this mineral to build up in the wrong places. Lanthanum helps manage high blood phosphate levels by binding to phosphate in food before it can be absorbed into the blood. This is the same mechanism used by other phosphate-lowering drugs (se,4e%Tner and the antacids aluminum hydroxide -6nd calcium carbonate). Lanthanum, like other phosphate binders, must be taken with meals so that it can bind phosphate ions in the stomach before they can be absorbed into the blood. Very little of this drug is absorbed into the blood and it is not broken down in the body Cautions and Warnings
Do not take fosrenol if you are allergic or sensitive to any of its
ingredients.
People with an active peptic ulcer, ulcerative colitis, Crohn’s
disease, or bowel obstruction should use this medication with
caution.
Researchers found no difference in bone fracture rates or over-
all survival for lanthanum than for other phosphate-binding treatments over 3 years. The study period was too short to assume that it would improve bone fractures or survival beyond 3 years.
Possible Side Effects
Side effects primarily affect the digestive tract and are similar to other phosphate-lowering treatments in type and frequency.
¦ Most common: nausea. vomiting, complications with the dialysis graft, diarrhea, constipation, abdominal pains, and low blood pressure.
¦ Common: bronchitis and runny nose.
? Less common: high blood calcium levels.
? Rare: Other side effects may affect any organ or organ system. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Lanthanum strongly binds to phosphate in the stomach and might also bind to other medications in the stomach. However, no interaction was found in tests conducted with warfarin, digoxin, enalapril, furosemide, metoprolol, or phenytoin.
• Compounds known to interact with antacids should not be taken within 2 hours of taking lanthanum.
Food Interactions
This drug must be taken with or immediately after meals.
usual Dose
Adult: 750-1500 mg with or immediately after each meal. Completely chew each tablet before you swallow it. Do not swallow whole tablets.
Child: not recommended.
Overdosage
There have been no reports of lanthanum overdose, even with single doses up to 1000 mg per pound of body weight. Symptoms of overdose are likely to occur in the digestive tract. Overdose victims may be taken to a hospital emergency room for evaluation. ALWAYS bring the prescription bottle or container.
Special Information
If you forget to take lanthanum with or immediately after a meal, skip the forgotten dose and continue with your regular schedule.
Be sure to follow the low-phosphate diet your doctor prescribes. It is a key element in helping to manage your blood phosphate levels.
Special Populations
PregnancylBreast-feeding., Animal studies with doses several times the maximum human dose revealed some harm to the developing fetus. Pregnancy in a woman with end-stage renal disease, especially those on dialysis, is uncommon because of reduced fertility and carries serious risks for a woman and her baby, including anemia, uncontrolled high blood pressure, and infection. This drug is not recommended for pregnant women.
It is not known if lanthanum passes into breast milk. Nursing mothers who must take it should consider using infant formula.
Seniors: Seniors may use this medication without special restriction.
Generic Name
Ganciclovir (ga.-SYE-kloe-vem) IM
Brand Name
Vitrasert
The information in this profile also applies To The tollowing drug:
GD’K)Phc )ngredient: Valganciclovir Valcyte
Type of Drug
Antiviral.
Prescribed For
Cytornegalovirus (CMV) infections of the eye and CMV infections in other parts of the body, in people with compromised immune
systems.
General Information
Ganciclovir works by preventing reproduction of the virus CMV. Unlike other antiviral drugs, it works only against this virus and herpes simplex virus. The drug is eliminated through the kidneys.
Though most often used for CMV retinitis (eye infection), ganciclovir has also been used for CMV infections of the urine, blood, throat, and semen. It is also used to prevent CMV infection. Ganciclovir is helpful in controlling CMV infection in heart, kidney, and kidney-pancreas transplant patients. Valganciclovir is not indicated for use in liver transplant patients.
Valganciclovir (Valcyte) is broken down by the body into ganciclovir, and all information in this profile applies to both drugs, unless otherwise noted.
Cautions and Warnings
Do not take ganciclovir if you are allergic or sensitive to any of its ingredients.
Ganciclovir causes anemia, reduced white-blood-cell count, and blood-platelet loss. Regular monitoring of blood and platelet counts is recommended while taking this drug.
Ganciclovir is intended only for people who are immunocompromised. It is not intended to treat or prevent CMV infections in newborns.
Detachment of the retina has been noted in people taking ganciclovir, as well as in people with CMV who have not taken the drug. The relationship between ganciclovir and this effect is not well known.
Ganciclovir causes increased sensitivity to the sun; use a sunscreen or wear protective clothes when you go outside.
People with kidney disease should use qw\6,7_l1DAr with caution, and may (eqtst% ieatment at a lower dosage.
Studies of ganciclovir in blacks, Hispanics, and Caucasians showed a trend toward higher blood levels among Caucasians than other groups.
Intravenous ganciclovir has been given to a small number of children under age 12 with mixed results. Side effects were similar to those experienced by adults taking the drug.
Possible Side Effects
¦ Most common: fever, diarrhea, abdominal pain, reduced white-blood-cell counts, anemia, rash, sweating, nausea, vomiting, and appetite loss.
¦ Common: infection; chills; stomach gas; low platelet counts
(symptoms include bleeding or oozing blood); tingling-,
burning; numbness or pain in the hands, arms, legs, or feet-,
itching; pneumonia; weakness; and headache.
Drug Interactions
• Pentamidine, flucytosine, vincristine, vinblastine, adriamycin, amphotericin B, trimethoprim-sulfamethoxazole, and other cytotoxic drugs may increase the side effects of ganciclovir and should be used together only if absolutely necessary, and only if the potential benefits outweigh the risks.
• People taking imipenem-cilastatin together with ganciclovir have experienced seizures. Avoid this combination.
• Mixing ganciclovir with other drugs that can be damaging to the kidneys may increase the rate and extent of kidney damage.
• Probenecid interferes with ganciclovir release through the kidneys and substantially increases blood levels of ganciclovir.
• Mixing ganciclovir with the anti-HIV drugs didanosine or zidovudine (AZT) may increase didanosine or AZT levels and reduce ganciclovir levels. Because AZT and ganciclovir both cause anemia and low white-blood-cell counts, many people cannot tolerate this combination.
Food Interactions
High-fat, high-calorie meals can increase the amount of ganciclovir absorbed into the blood. Take this drug with food.
Usual Dose Gar1r.(qtZ,41N
Adult and Child (age 13 and over): 3000 mg a day, divided into 3 or 6 equal doses. People with reduced kidney function will need to have their dosage reduced accordingly, possibly to as little as 500 mg 3 times a week.
Child (under age 13): not recommended.
Valganciclovir
Adult and Child (age 13 and over): 900 mg a day, divided into 2 equal doses of 450 mg each. People with reduced kidney function will need to have their dosage reduced accordingly, possibly to as little as 500 mg 3 times a week.
Child (under age 13): not recommended.
Overdosage
Little is known about the effects of ganciclovir overdose. As much as 6000 mg a day has been taken with only temporary lowering of white-blood-cell count. Call your hospital emergency room for instructions in case of ganciclovir overdose.
Special Information
Ganciclovir does not cure CMV eye infection, and immunocompromised people taking this drug may find their disease worsening. Dosage reductions or discontinuation of the drug may be necessary if white-blood-cell or platelet counts get too low.
Ganciclovir may cause infertility in men and women. Women of child-bearing age should use effective contraception while taking this drug. Men should use a condom while taking the drug and for at least 90 days afterward to avoid passing the drug to their partners.
Good dental hygiene is important while taking ganciclovir to minimize the risk of infection. If you have dental work done while taking this drug, expect the healing process to take longer.
Regular blood tests are necessary to watch for white-bloodcell or platelet-level alterations.
It is very important to take ganciclovir exactly as directed. If you forget a dose, take it as soon as you remember and continue with your regular schedule.
Special Populations
PregnancylBreas>-feeding. Animal studies showed ganciclovir to be toxic to the fetus. There is no reliable information about its effect in pregnant women, but it should be taken only when the possible Oe”6% Outweigh the risks. Women who are likely to become pregnant while taking this drug should use reliable contraception.
It is not known if ganciclovir passes into breast milk, but the possible side effects of this drug on a nursing infant should be kept in mind. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors often have reduced kidney function; dosage adiustments may be needed.
Generic Name
Gemfibrozil oem-Fl-broe-zil)
Brand Name Lopid
Type of Drug
Anti-hyperlipidemic (blood-fat reducer). Prescribed For
High blood triglycerides.
General Information
Gemfibrozil consistently reduces blood triglycerides and reduces the risk of heart disease in people with high levels of triglycerides, low levels of high-density lipoprotein (HDL) cholesterol, the “good” cholesterol, and high levels of low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol. It works by affecting the breakdown of body fats and by reducing the amount of triglyceride manufactured by the liver. It is usually prescribed only for people with very high blood-fat levels who have not responded to dietary changes or other therapies. Gemfibrozil usually has little effect on blood-cholesterol levels, although it may reduce blood cholesterol in some people.
Cautions and Warnings
Do not take gemfibrozil if you are allergic or sensitive to any of its ingredients or have severe liver or kidney disease. Some people taking gemfibrozil have experienced worsening of kidney function.
Gemfibrozil users may have an increased risk of developing gallbladder disease and gallstones.
People taking gemfibrozil and fenofibmte may develop pancreatitis (inflammation 0 the pancreas).
People taking gemfibrozil may develop muscle aches and inflammation. Tell your doctor if you experience muscle tenderness or weakness.
Estrogen drugs may cause massive increases in triglyceride levels. Stopping estrogen therapy in these cases may reduce triglyceride levels to normal.
Gemfibrozil may cause a moderate rise in blood sugar and mild decreases in white-blood-cell counts.
Possible Side Effects
¦ Most common: abdominal and stomach pain, fatigue, heartburn, gas, diarrhea, nausea, and vomiting.
¦ Less common: rash, itching, dizziness, blurred vision, anemia, reduced levels of white blood cells, increased blood sugar, and muscle pain—especially in the arms or legs.
¦ Rare: dry mouth, constipation, appetite loss, upset stom-
ach, sleeplessness, tingling in the hands or feet, ringing or
buzzing in the ears, back pain, painful muscles or joints,
swollen joints, feeling unwell, reduction in blood potassium,
and abnormal liver function. Contact your doctor if you ex-
perience any side effect not listed above.
Drug Interactions
• Gemfibrozil increases the effects of oral anticoagulant (blood-thinning) drugs. Your anticoagulant dosage must be reduced when starting gemfibrozil.
• Combining gemfibrozil with a statin cholesterol- lowering drug (atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, or simvastatin) has led to the destruction of skeletal muscles. This effect may begin as early as 3 weeks after you start taking the combination or may not appear for months.
• Combining gemfibrozil and sulfonylurea antidiabetes drugs or repaglinide may cause unexpectedly low blood sugar levels. The sulfonylurea drug dosage may need adjustment.
• Gemfibrozil can substantially increase the amount of glitazone antidiabetes drugs in the blood. Glitazone dosages may need to be adjusted.
• Combining gemfibrozil and cyclosporine may decrease the effectiveness of cyclosporine. This combination should only be used if it is absolutely necessary and the lowest possible dose of gemfibrozil is used.
Food Interactions
Gemfibrozil is best taken on an empty stomach 30 minutes before meals but may be taken with food if it upsets your stomach. It is important that you follow your doctor’s dietary instructions.
Usual Dose
Adult: 1200 mg a day, divided into 2 doses taken 30 minutes
before breakfast and dinner. Child: not recommended.
Overdosage
There have been reported cases of overdosage with gemfibrozil. Symptoms reported with overdosage were abdominal cramps, abnormal liver function tests, diarrhea, joint and muscle pain, nausea, and vomiting. Induce vomiting with ipecac syrup—available at any pharmacy—but call your doctor or local poison control center before doing this. If you go to a hospital emergency room, ALWAYS bring the prescription bottle or container.
Special Information
Your doctor should perform periodic blood counts during the first year of gemfibrozil treatment to check for anemia or other changes in blood components. Liver-function tests are also necessary. Blood-sugar levels should be checked periodically while you are taking gemfibrozil, especially if you are diabetic or have a family history of diabetes.
Gemfibrozil may cause dizziness or blurred vision. Be careful when driving or doing any task that requires concentration.
Gemfibrozil is less effective if you are greatly overweight.
Call your doctor if side effects become severe or intolerable, especially diarrhea, nausea, vomiting, or stomach pain or gas. These may disappear if your doctor reduces the dosage.
If you forget a dose, 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: The safety of using gemfibrozil during pregnancy is not known. When this drug is considered crucial by your doctor, its potential benefits must be carelO%-y weighed against its risks.
It is R(PM1)Wnif this drug passes into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors are more likely to develop drug side effects due to normal declines in kidney function.
Aug
13
Flecainide - Flucytosine - Fluoroquinolone - Fluoxymesterone - Flurazepam - Flutamide
August 13, 2009 | Leave a Comment
Generic Name
Flecainide (FLEH-kan-ide) E
Brand Name Tambocor
Type of Drug Antiarrhythmic.
Prescribed For
Abnormal heart rhythm. General Information
Flecainide is prescribed in situations where the abnormal heart rhythm is so severe as to be life-threatening and the patient does not respond to other drug treatments. Like other antiarrhythmic drugs, flecainide works by affecting the movement of nervous impulses within the heart. Flecainide’s effects may not become apparent for 3-4 days after you start taking it.
Cautions and Warnings
Do not take flecainide if you are allergic or sensitive to any of its ingredients or if you have heart block, unless you have a cardiac pacemaker. As with other antiarrhythmic drugs, there is no proof that flecainide helps people live longer or avoid sudden death.
Flecainide causes or worsens arrhythmias m 7% 0 people who take it; this, tks’ , imTeases with certain kinds of underlying heart disease and higher doses of the drug. Flecainide causes or worsens heart failure in about 5% of people taking it because it tends to reduce the force and rate of each heartbeat.
Flecainide is extensively broken down in the liver. People with poor liver function should not take flecainide unless the benefits clearly outweigh the risks.
Changes in the pH of urine may affect the effectiveness of flecainide.
Possible Side Effects
♦ Most common: dizziness, fainting, lightheadedness, unsteadiness, visual disturbances including blurred vision and seeing spots before the eyes, breathing difficulties, headache, nausea, fatigue, heart palpitations, chest pain, tremors, weakness, constipation, bloating, a bad taste in your mouth, and abdominal pain.
♦ Less common: new or worsened heart arrhythmias or heart failure, heart block, slowed heart rate, vomiting, diarrhea, upset stomach, loss of appetite, stomach gas, dry mouth, tingling in the hands or feet, partial or temporary paralysis, loss of muscle control, flushing, sweating, ringing or buzzing in the ears, anxiety, sleeplessness, depression, not feeling well, twitching, weakness, convulsions, speech disorders, stupor, memory loss, personality loss, nightmares, apathy, eye pain, unusual sensitivity to bright light, sagging eyelids, reduced white-blood-cell or blood-platelet counts, impotence, reduced sex drive, frequent urination, urinary difficulty, itching, rash, fever, muscle ache, closing of the throat, and swollen lips, tongue, or mouth.
Drug Interactions
• The combination of propranolol and flecainide may cause an exaggerated lowering in heart rate. Other drugs that slow the heart may also interact with flecainide to produce an excessive slowing of heart rate.
• Avoid megadoses of vitamin C while taking this drug.
• The amount of flecainide in your blood and its effect on your heart may be increased if it is taken together with cimetidine, disopyramide, or verapamil.
• YQW dXSz, 0 ‘i’lecainide should be halved when given with amiodarone.
• Smokers may need a larger dose of flecainide than nonsmokers.
• Flecainide may increase the amount of digoxin in the bloodstream, increasing the chance of side effects.
Food Interactions
A strict vegetarian diet and anything that makes urine less acid interferes with flecainide’s elimination from the body, increasing drug
toxicity. Usual Dose
Adult: starting dose-50-100 mg every 12 hours. Maximum dosage is 400 mg a day.
Child (under 18 years): not recommended.
Overdosage
Flecainide overdose affects heart function, causing slower heart rate, low blood pressure, and possible death from respiratory failure. Victims of flecainide overdose should be taken.to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Flecainide can make you dizzy, lightheaded, or disoriented. Take care while driving or performing complex tasks.
Call your doctor if you develop chest pains, an abnormal heartbeat, breathing difficulties, bloating in your feet or legs, tremors, fever, chills, sore throat, unusual bleeding or bruising, yellowing of the whites of your eyes, or any other intolerable side effect.
If you forget to take a dose of flecainide and remember within 6 hours, take it as soon as possible. If you do not remember until later, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: At high doses, flecainide damages an animal fetus. When this drug is considered crucial by your doctor, its potential benefits must be weighed against its risks.
Flecainide passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors with reduced kidney or liver functkcm -aye more likely to develop si(je, eip,,ZkS and require a lower dosage.
Generic Name
Flucytosine (floo-SYE-toe-sene)
Brand Name Ancobon
Type of Drug Antifungal.
Prescribed For
Serious blood-borne fungal infections.
General Information
Flucytosine is meant for fungal infections—Candida, chromomycoses, and cryptococcus—carried in the blood that affect the urinary tract, respiratory tract, central nervous system, heart, and other organs. It is not meant for fungal infections of the skin, such as common athlete’s foot.
Cautions and Warnings
Do not take this drug if you are allergic or sensitive to any of its ingredients.
People with kidney disease must be closely monitored by their doctors and should take this medication with extreme caution; daily dosage must be reduced.
Flucytosine can worsen bone-marrow depression in people whose itnR1US1Q Systems are already compromised. Liver and kidney function and blood composition should be monitored while you are taking this drug.
The safety and efficacy of flucytosine have not been established in children.
Possible Side Effects
V Most common: unusual tiredness or weakness, liver inflammation, yellowing of the eyes or skin, abdominal pain, diarrhea, loss of appetite, nausea, vomiting, rash, redness, itching, sore throat, fever, and unusual bleeding or bruising.
V Less common: chest pains, breathing difficulties, sensitivity to the sun or bright light, dry mouth, duodenal ulcers, severe bowel irritation, stomach bleeding, interference with kidney function, kidney failure, reduced red- and whiteblood-cell counts or other changes in blood composition, headache, hearing loss, confusion, dizziness, weakness, shaking, sedation, psychosis, hallucinations, heart attack, and low blood-sugar and potassium levels.
Drug Interactions
• Amphotericin B increases flucytosine’s effectiveness: this
combination is generally used to produce better results.
• Flucytosine may interfere with some routine blood tests.
• Cytosine may inactivate the antifungal activity of flucytosine.
Food Interactions
Take flucytosine with food if it upsets your stomach.
Usual Dose
22-66 mg per lb. a day, in divided doses.
Overdosage
Little is known about the effects of flucytosine overdose, but it may cause exaggerated drug side effects. If you seek treatment at a hospital, ALWAYS bring the prescription bottle or container.
Special Information
Take the capsules a few at a time over 15 minutes to avoid nausea and vomiting.
Call your doctor if you develop unusual tiredness or weakness; yellowing of the skin or whites of the eyes; rash, redness, or itching; so(Q %Toal or fever; unusual bleeding or bruising; or any persistent or intolerable side effect.
Maintain good dental hygiene while taking flucytosine. Use extra care when using your toothbrush or dental floss because of the risk that flucytosine will make you more susceptible to infection. Dental work should be completed prior to starting on this drug.
FLUOROQUINOLONE ANTI-INFECTIVES
Exposure to sunlight may cause rash, itching, redness, discoloration of the skin, or severe sunburn. Stay out of direct sunlight when taking flucytosine.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, take 1 dose right away and another in 3 or 4 hours, then go back to your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Flucytosine causes birth defects in animals and crosses the placenta. Flucytosine should be used by pregnant women only when its potential benefits clearly outweigh its risks.
It is not known if flucytosine passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Dosage adjustment may be required due to age-related loss of kidney function.
Type of Drug
Fluoroquinolone Anti-Infectives
(flor-oe-OUIN-oc-lone)
Brand Names
Generic Ingredient: CiproftoxacinIGI
Ciloxan Eyedrops Cipro XR
Cipro Proquin XR
Generic Ingredient: Gatifloxacin Zymar Eyedrops
Generic Ingredient: Gemifloxacin Factive
Generic Ingredient: Levofloxacin A
Iquix Eyedrops QtAy’ ” Eyedrops
LevackujR
Generic Ingredient: Lomefloxacin Maxaquin
Generic Ingredient: Moxifloxacin
Avelox Vigamox Eyedrops
Generic Ingredient: Norfloxacin
Noroxin
Generic Ingredient: Ofloxacin 92
Floxin Ocuflox Eyedrops
Floxin Otic
Prescribed For
Infections of the lower respiratory system, sinuses, urinary tract, skin, bone and joints, lungs, and prostate; also prescribed for sexually transmitted diseases, prostatitis, infectious diarrhea, bronchitis, pneumonia, typhoid fever, anthrax, and traveler’s diarrhea. The eyedrops are used to treat ocular infections, the eardrops for ear infections.
General Information
Fluoroquinolone anti-infectives work against many organisms that traditional antibiotics have trouble killing. They do not work against the common cold, flu, or other viral infections. The fluoroquinolones were first used as treatment for urinary infections and then other uses developed over the years. The new uses depend on how well the specific drug penetrates different body tissues as well as on how they have been tested in the laboratory. Individual fluoroquinolones are not all equally effective in treating all infections.
Cautions and Warnings
Do not take a fluoroquinolone if you are allergic or sensitive to any of its ingredients, or to any drug in this group, or have had a reaction to related medications such as nalidixic acid. Severe, possibly fatal, allergic reactions can occur even after the very first dose. These reactions include cardiovascular collapse, loss of consciousness, tingling, swelling of the face or throat, breathing difficulties, itching, and rash. Stop taking the drug if you experience allergic symptoms and seek medical help at once.
Fluoroquinolones may cause increased pressure on parts of the brain, leading to convulsions and psychotic reactions. Other possiblp. tIWA include tremors, restlessness, lightheadedness, confusion, and hallucinations. Fluoroquinolones should be used with caution in people with head trauma, seizure disorders, or other nervous system conditions.
Moxifloxacin should not be used by people with liver disease.
Moxifloxacin should be avoided by people with heart rhythm problems or those taking drugs that can affect heart rhythm.
People with kidney disease require reduced dosage of these drugs, except in the case of moxifloxacin.
People taking fluoroquinolones may be unusually sensitive to the sun. Avoid the sun while taking this drug and for several days following therapy, even if you are using sunscreen.
People taking a fluoroquinolone may develop colitis that could range from mild to very serious. Contact your doctor if you develop diarrhea or cramps.
Fluroquinolones can worsen myasthenia gravis. Use with caution.
Prolonged fluoroquinolone use can lead to fungal overgrowth.
Patients taking a fluoroquinolone may experience ruptures of the shoulder, hand, Achilles tendon, or other tendons that may require surgery or lead to extended disability.
Possible Side Effects
Side effects are rarely serious.
♦ Common: nausea (most likely with ciprofloxacin and moxifloxacin), vomiting, and diarrhea (may be most likely with moxifloxacin and ofloxacin).
✓ Less common: dizziness, abdominal pain, headache, and liver inflammation.
✓ Rare: Rare side effects, including some severe drug reactions, can occur in almost any part of the body. In once-daily studies of ciprofloxacin eardrops, there were a few reports of nausea, formation of flaky scales, inflammation of the external ear, temporary hearing loss, ringing or buzzing in the ears, middle-ear inflammation, tremors, high blood pressure, and fungal infection. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Separate your fluoroquinolone dose from that of antacids, didanosine, iron supplements, or zinc by 2-6 hours. These drugs decrease the amount of fluoroquinolone absorbed. Moxifloxacin must be taken 4 hours before or 8 hours after antacids, iron, or zinc.
• Nitrofurantoin may antogonize norfloxacin’s antibacterial effects. Do not take these drugs together.
• Moxifloxacin can increase the risk of abnormal heart rhythms.
Combining this drug with astemizole, erythromycin, tricyclic
antidepressants, and antipsychotics increases the risk of ab-
normal heart rhythms associated with this drug.
• People taking drugs to correct abnormal heart rhythms should avoid Fluoroquinolones.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) and anti-inflammatory drugs should not be combined with fluoroquinolones because of the increased risk of stimulation and seizures.
• Sucralafate reduces the amount of fluoroquinolone absorbed in the blood. Take sucralafate at least 6 hours after taking a fluoroquinolone.
• Probenecid may increase the risk of some fluoroquinolone side effects. Cimetidine may also increase fluoroquinolone blood levels.
• Fluoroquinolones (except moxifloxacin) may increase the effect of oral anticoagulant drugs such as warfarin. Your anticoagulant dosage may have to be reduced.
• Fluoroquinolones may increase the toxic effects of cy-
closporine (used for organ transplants) on your kidneys.
• Fluoroquinolones (except moxifloxacin) may increase theophylline blood levels and the risk of side effects.
• Azlocillin may increase the risk of ciprofloxacin side effects.
• Ciprofloxacin and norfloxacin may increase caffeine’s effects.
Food Interactions
Levofloxacin, lomefloxacin, and moxifloxacin may be taken with or without food. Take ofloxacin and norfloxacin at least 2 hours before or 2 hours after meals or antacids. Ciprofloxacin is best taken 1 hour before or 2 hours after meals, but may be taken with food. Dairy products and calcium-fortified orange juice interfere with the absorption of ciprofloxacin and should be avoided.
Usual Dose
Check with your doctor if you suffer from kidney failure as your fluoroquinolone dosage may need to be reduced.
Tablets
Adult
Ciprofloxacin: 100-750 mg twice a day. Ciprofloxacin XR: 1000 mg once a day.
Gemifloxacin: 320 mg once a day. Levotioxacin: 250-750 mg once a day.
Lomefloxacin: 400 mg a day. Moxifloxacin: 400 mg a day.
Norfloxacin: 400 mg every 12 hours; a single dose of 800 mg
may be taken for gonorrhea. Ofloxacin: 200-400 mg every 12 hours.
Child: not recommended.
Eyedrops
Ciprolloxacin: 1-2 drops in the affected eye several times a day.
Gatifloxacin: days 1-2-2 drops in the affected eye every 2 hours while awake, up to 8 times a day, then 4 times a day for the next 5 days.
Levofloxacin: days 1-2-1-2 drops in the affected eye every 2 hours while awake, up to 8 times a day. Days 3-7-1-2 drops in the affected eye every 4 hours while awake, up to 4 times a day.
Moxifloxacin: 1 drop in the affected eye 3 times a day for I week.
Ofloxacin: bacterial conjunctivitis—days 1-2, place 1-2 drops in the affected eye every 2-4 hours while awake; days 3-7, place 1-2 drops in the affected eye every 4-6 hours while awake. Bacterial corneal ulcer—days 1-2, place 1-2 drops in the affected eye every 30 minutes while awake; awaken 4-6 hours after you go to sleep for one more dose; days 3-7 or 9, place 1-2 drops in the affected eye every hour while awake; days 7-9, or through the end of treatment, place 1-2 drops in the affected eye 4 times a day.
Eardrops
Ofloxacin: 5-10 drops in the affected ear twice a day.
Overdosage
Overdose symptoms generally mimic drug side effects. Overdose may cause kidney failure and, in the case of moxifloxacin, abnormal heart rhythms. Call your local poison control center or a hospital emergency room for more information. You may be, koNO to induce vomiting with ipecac syrup—available at any pharmacybefQ(e, %’Kmg the victim to an emergency room. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Take each dose with a full glass of water. Be sure to drink at least 8 glasses of water a day while taking any of these drugs to help avoid kidney side effects.
Drug sensitivity reactions can develop even after only 1 dose. Stop taking the drug and get immediate medical attention if you feel faint or develop itching, rash, facial swelling, breathing difficulties, convulsions, depression, visual disturbances, dizziness, headache, lightheadedness, or any sign of a drug reaction.
Colitis can be caused by any anti-infective medication. If diarrhea develops, call your doctor at once.
Avoid excessive sunlight. Call your doctor if you become sensitive to the sun.
Call your doctor if you experience pain, inflammation, or rupture of a tendon.
Follow your doctor’s directions exactly. Complete the full course of drug therapy, even if you feel well.
Eyedrops
To avoid infection, do not let the eyedropper tip touch your finger, eyelid, or any surface. Wait 5 minutes before using another eye-drop or eye ointment.
Call your doctor at once if your vision declines or if eye stinging, itching or burning, redness, irritation, swelling, or pain worsens.
Fluoroquinolones can cause changes in vision, dizziness, drowsiness, and lightheadedness. Be careful when driving or performing any task that requires concentration.
If you forget to administer a dose, do so 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: Animal studies have shown that fluoroquinolones may damage the fetus or reduce the likelihood of a successful pregnancy. When a fluoroquinolone is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Fluoroquinolones pass into breast milk. Nursing mothers who must take them should use infant formula.
Seniors: With the exception of moxifloxacin, seniors may require reduced dosage due to age-related decreases in kidney function. The risk of a ruptured tendon may increase in seniors, especially those taking a corticosteroid. In the case of eyedrops, seniors may also need less medication.
Generic Name
Fluoxymesterone (flue-OX-ee-MES-ter-one)
Brand Name Halotestin
Type of Drug
Androgen (male hormone).
Prescribed For
Men: hormone replacement or augmentation and male menopause; also prescribed as male contraception for up to 12 months, and for delayed puberty.
Women: breast pain and fullness in women who have given birth, and certain types of breast cancer.
General Information
Fluoxymesterone is an androgen. Androgens are responsible for the normal growth and development of male sex organs and for maintaining secondary sex characteristics including hair distribution, vocal cord thickening, muscle development, and fat distribution.
Cautions and Warnings
Do not use fluoxymesterone if you are allergic or sensitive to any of its ingredients.
Androgens do not improve athletic performance and may cause serious side effects.
Women taking any androgen may develop deepening of the voice, oily skin, acne, hairiness, increased sex drive, and menstrual irregularities.
Androgens should be avoided if possible by young boys who have not gone through puberty.
Fluoxymesterone W(1C1.ens gynecomastia (a condition characterized by swollen male breast tissue).
Men with unusually high blood levels of calcium, known or suspected prostate cancer or prostate destruction, or breast cancer should not use fluoxymesterone, nor should anyone with severe liver, heart, or kidney disease.
Long-term, high-dose androgen therapy may cause severe liver disease, including hepatitis and cancer, reduced sperm count, and
water retention.
Blood cholesterol may be raised by androgens. This can be a
problem for people who have heart disease.
Androgens may cause or worsen sleep apnea (a condition char-
acterized by intermittent cessation of breathing during sleep). For patients with diabetes, this drug may affect blood sugar
levels.
Possible Side Effects
Men
✓ Most common: inhibition of testicle function, impotence, chronic erection, and painful enlargement of breast tissue.
Women
✓ Most common: unusual hairiness, male-pattern baldness. deepening of the voice, and enlargement of the clitoris. These changes are usually irreversible once they occur. Increased blood calcium and menstrual irregularities may also develop.
Men and Women
✓ Most common: changes in sex drive, headache, anxiety, depression, a tingling feeling, sleep apnea, flushing, rash, acne, habituation (the drug may be habit-forming), excitation, chills, sleeplessness, water retention, nausea, vomiting, diarrhea, hepatitis (symptoms include yellowing of the skin or whites of the eyes), liver inflammation, and liver cancer. Symptoms resembling those of a stomach ulcer may also develop.
Drug Interactions
• Fluoxymesterone may increase the effect of an oral anticoagulant (blood-thinner); dosage 131 the anticoagulant may have tD be reduced.
• Combining an androgen and imipramine or another tricyclic
antidepressant may result in a severe paranoid reaction.
• Androgens may decrease insulin requirements.
Food Interactions
Take fluoxymesterone with meals if it upsets your stomach.
Usual Dose
Adult; 5-40 mg a day. Child: not recommended.
Overdosage
Symptoms include nausea, vomiting, and diarrhea. Call your local poison control center or a hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Androgens must be taken only under the close supervision of your doctor. The dosage and clinical effects of fluoxymesterone vary widely and require constant monitoring.
Call your doctor if you develop nausea or vomiting, swelling of the legs or feet, yellowing of the skin or whites of the eyes, or a painful or persistent erection. Women should call their doctors immediately if they develop a deep or hoarse voice, acne, hairiness, male-pattern baldness, or menstrual irregularities.
If you forget a dose, 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_ Fluoxymesterone should never be
taken by pregnant or nursing women because it can affect the developing fetus and nursing infant.
Seniors: Seniors are more likely to develop prostate enlargement or prostate cancer. A marked increase in sex drive may also occur.
Generic Name
Flurazepam (110-13AZ-uh-pam) A
Brand Name
Dalmane
Type of Drug Benzodiazepine sedative.
Prescribed For
Insomnia and sleep disturbances.
General Information
Flurazepam is a member of the group of drugs known as benzodiazepines. Benzodiazepines work by a direct effect on the brain. They make it easier to go to sleep and decrease the number of times you wake up during the night. Flurazepam and quazepam remain in your bloodstream longer than other drugs in this class, thus resulting in the greatest incidence of morning “hangover.”
Cautions and Warnings
Do not use flurazepam if you are allergic or sensitive to any of its ingredients.
People with kidney or liver disease should be carefully monitored while taking flurazepam. Take the lowest possible dose to help you sleep.
People with respiratory disease may experience sleep apnea (intermittent cessation of breathing during sleep) while taking flurazepam.
Clinical depression may be increased by flurazepam, which can depress the nervous system. Intentional overdose is more common among depressed people who take sleeping pills than among those who do not.
Some people have experienced amnesia while taking flurazepam.
All benzodiazepines can be addictive if taken for long periods of time and can cause drug withdrawal symptoms if discontinued suddenly. It should be used with caution in people with a history of drug dependence. Withdrawal symptoms include tremors, muscle cramps, insomnia, agitation, diarrhea, vomiting, sweating, and convulsions.
Tapering the drug when stopping may help prevent withdrawal symptoms. People with a history of seizures should be particuarly cautious when stopping use of this drug.
Possible Side Effects
V Common: drowsiness, headache, dizziness, talkativeness, nervousness, appip-henslon, poor muscle coordination, lightheadedness, daytime tiredness, muscle weakness, slowness of movement, hangover, and euphoria (feeling “high”).
V Less common: nausea, vomiting, rapid heartbeat, confusion, temporary memory loss, upset stomach, stomach cramps and pain, depression, blurred or double vision and Possible Side Effects (continued)
other visual disturbances, constipation, changes in sense of taste, appetite changes, stuffy nose, nosebleeds, common cold symptoms, asthma, sore throat, cough, breathing difficulties, diarrhea, dry mouth, allergic reaction, fainting, abnormal heart rhythm, itching, rash, acne, dry skin, sensitivity to the sun, nightmares or strange dreams, sleeplessness, tingling in the hands or feet, ringing or buzzing in the ears, ear or eye pain, menstrual cramps, frequent urination and other urinary difficulties, blood in the urine, discharge from the penis or vagina, lower back and other pain, muscle spasms and pain, fever, swollen breasts, and weight changes.
♦ Rare: Rare side effects can affect your heart, stomach and intestines, urinary tract, blood, muscles, and joints. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• As with all benzodiazepines, the effects of flurazepam are enhanced if it is taken with an alcoholic beverage, antihistamine, sedative, barbiturate, anticonvulsant medication, antidepressant, or monoamine oxidase inhibitor antidepressant.
• Contraceptive drugs, cimetidine, disulfiram, and isoniazid may increase the effect of flurazepam by reducing the drug’s breakdown in the liver. Probenecid also increases flurazepam’s effects.
• Cigarette smoking, rifampin, and theophylline may reduce the effect of flurazepam on your body by increasing the rate at which it is broken down by the liver.
• Levodopa + carbidopa’s effectiveness may be decreased by flurazepam.
• Flurazepam may increase the amount of zidaw-adwie tan HIV drug—also known as pnenytoin, or digoxin in your WZWMTeam, increasing the chances of side effects.
• Mixing clozapine with a benzodiazepine has led to respiratory collapse in a few people. Flurazepam should be stopped at least 1 week before starting clozapine treatment.
Food Interactions
Flurazepam may be taken with food if it upsets your stomach.
Usual Dose
Adult and Child (age 15 and over): 15-30 mg at bedtime. Dosage must be individualized for maximum benefit.
Senior: starting dose-15 mg at bedtime.
Child (under age 15): not recommended.
Overdosage
The most common overdose symptoms are confusion, sleepiness, depression, loss of muscle coordination, and slurred speech. Coma may also occur. Patients who overdose on this drug must be made to vomit with ipecac syrup—available at any pharmacy—to remove any remaining drug from the stomach. Call your doctor or a poison control center before doing this. If 30 minutes have passed since the overdose was taken or if symptoms have begun to develop, take the victim immediately to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Never take more flurazepam than your doctor has prescribed. Avoid alcoholic beverages and other nervous system depressants while taking tlurazepam.
Exercise caution while performing tasks that require concentration and coordination. Flurazepam may make you tired, dizzy, or lightheaded.
If you take flurazepam daily for 3 or more weeks, you may experience some withdrawal symptoms when you stop taking the drug. Do not stop taking flurazepam suddenly or increase or decrease your dosage without first consulting your doctor.
If you forget a dose and remember within 1 hour, take it as soon as you remember. If you do not remember until later, skip the dose you forgot and go back to your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Flurazepam absolutely should not be used by pregnaskt. v3 )men or by women who may become pregnant.
Flurazepam passes into breast milk. The drug should not be taken by nursing mothers.
Seniors: Seniors are more susceptible to the effects of flurazepam.
Generic Name
Flutamide (FLUE-tuh-mide)
Type of Drug Antiandrogen.
Prescribed For
Prostate cancer and excessive hairiness in women.
General Information
Prostatic cancer is sensitive to anything that removes the source of androgen (male hormone). Flutamide works by slowing the uptake of androgen or by interfering with the binding of androgen to body tissues. It is always prescribed together with a luteinizing hormone-releasing hormone (LHRH) drug.
Cautions and Warnings
Do not take flutamide if you are allergic or sensitive to any of its ingredients.
Severe liver injury may occur with flutamide; your doctor should monitor your liver function. People with severe liver disease should not take flutamide.
This drug may cause jaundice and severe blood conditions, including hemolytic anemia. People with certain blood disorders and people who smoke are at greater risk for these side effects.
A few men taking this drug have developed breast cancer. Flutamide may reduce sperm counts.
Possible Side Effects
♦ Most common: diarrhea, cystitis, and bleeding from the rectum.
✓ Common: rectal irritation, blood in the urine, hot flashes, loss of libido, impotence, nausea, rash, and swollen breasts.
✓ Less common’. drowsiness, confusion, depression, anxiety, nervousness, appetite loss, stomach problems, anemia, low white-blood-cell and blood-platelet counts, arm or leg swelling, urinary and muscle problems, and high blood pressure.
Possible Side Effects (continued)
♦ Rare: hepatitis, jaundice, and breathing difficulties. Contact your doctor if you experience any side effect not listed
above.
Drug Interactions
• Flutamide may increase the effects of blood-thinning drugs
such as warfarin. Dosage adjustment may be necessary.
Food Interactions None known.
Usual Dose
Adult: 250 mg (2 capsules) every 8 hours, 3 times a day. Total daily dose should be 750 mg.
Child: not recommended.
Overdosage
Overdose symptoms may include tiredness or low activity levels, slow breathing, weakness, tearing, appetite loss, vomiting, swollen and tender breasts, and liver inflammation. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Report anything unusual to your doctor, especially pain or tenderness in the upper right abdomen, yellowing of the skin or whites of the eyes, severe itching, dark urine, persistent appetite loss, and unexplained flu-like symptoms. These may be signs of severe liver toxicity.
Flutamide can turn your urine amber or yellow-green and cause unusual sun sensitivity. Use sunscreen and wear long-sleeved protective clothing while you are taking flutamide.
Flutamide must be taken exactly as prescribed. Call your doctor if you miss a dose of this drug.
Special Populations
Pregnancy/Breast-feeding: This drug is not intended for use by women.
Seniors: Seniors may take this drug without special precaution.
Aug
13
Fenofibrate - Finasteride - Fioricet - Fiorinal - Fiorinal with Codeine
August 13, 2009 | Leave a Comment
Generic Name
Fenofibrate (fen-oe-Flli-brace) IM
Brand Names
Antara TriCor
Lipoten Triglide Lofibra
Type of Drug
Anti-hyperlipidemic (blood-fat reducer).
Prescribed For
High blood cholesterol and/or triglycerides; also prescribed for syndrome X, a condition which increases the risk of type 2 diabetes.
General Information
Fenofibrate works by interfering with the body’s ability to make triglyceride and by increasing its breakdown by enzymes in the body. It also reduces levels of uric acid, total cholesterol, low-density lipoprotein (LDL) cholesterol—the “bad” cholesterol—and other blood lipids. High-density lipoprotein (HDL) cholesterol—the “good” cholesterol—levels are increased. This drug should only be used in people with very high triglyceride levels who are at risk for pancreatitis (inflammation of the pancreas) and have not responded to other treatments, including statin drugs. Generic fenofibrate is not equivalent to the TriCor brand because of a new product formulation and should not be substituted for the brand unless your doctor approves of the switch.
Cautions and Warnings
Do not take fenofibrate if you are allergic or sensitive to any of its ingredients.
People taking fenofibrate and other triglyceride-lowering drugs are mate WOV to die from causes unrelated to triglyceride levels. Fenofibrate reduces the risk of a heart attack or other cardiac event in people with high triglyceride levels and low levels of HDL cholesterol, especially among people with diabetes. The evidence for this benefit is not as strong as it is for the statin drugs.
People taking fenofibrate and gemfibrozil may develop pancreatitis (inflammation of the pancreas).
People with liver or severe kidney disease should avoid fenofibrate. People with less severe kidney disease require reduced
dosage.
People taking fenofibrate are more likely to develop gallstones.
Fenofibrate can destroy muscle cells, leading to kidney failure, especially when combined with a statin cholesterol-lowering drug see “Drug Interactions”).
Possible Side Effects
• Most common: abnormal liver function, abdominal pain, and respiratory disorders.
♦ Common: rash, headache, upset stomach, pain, weakness, tiredness, and flu-like symptoms.
♦ Less common: joint pain, abnormal heart rhythms, reduced sex drive, dizziness, increased appetite, sleeplessness, tingling in the hands or feet, nausea, vomiting, diarrhea, abdominal pain, constipation, stomach noise or gas, frequent urination, vaginal irritation, runny nose, cough, sinus irritation, eye irritation, blurred vision, conjunctivitis (pinkeye). earache, and tiny particles inside the eye (”floaters”).
♦ Rare: allergic reactions including severe rash, itching, liver inflammation or enlargement, gallstones, gallbladder disease, muscle aches, and increased sensitivity to the sun. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Combining fenofibrate and a statin cholesterol-lowering drug (atorvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, or simvastatin) can lead to severe muscle pain, muscle cell destruction, and kidney failure. If you have extremely high blood-fat levels, the potential benefits of this combination may outweigh the risks. In people taking this combination, the health of muscles and kidneys must be monitored regularly via blood tests.
• Fenofibrate increases the effects of anticoagulant (blood-thinning) drugs. Your anticoagulant dosage may need an adjustment.
• Combining fenofibrate and cyclosporine can increase the risk of kidney toxicity. This combination should only be used if it is absolutely necessary and the lowest possible dosage is
taken.
• If you are taking cholestyramine or colestipol (both are used
to reduce blood-fat levels) as well as fenofibrate, take the
fenofibrate at least 1 hour before or 4-6 hours after these
drugs.
Food Interactions
All forms of fenofibrate, except TriCor, should be taken with food to get the best effect. TriCor may be taken without regard to food or meals.
Usual Dose
These products may not be substituted for each other because of important dosage differences.
Antara
Adult: 43-130 mg a day with food.
Senior: Begin with 43 mg a day. This dosage also applies to people with kidney disease.
Child: not recommended.
Lofibra
Adult: 67-200 mg a day with food.
Senior: Begin with 67 mg a day. This beginning dosage also applies to people with kidney disease.
Child: not recommended.
Lipofen
Adult: 50-150 mg a day with food.
Senior: Begin with 50 mg a day. This dosage also applies to people with kidney disease.
Child: not recommended.
TriCor
Adult: 48-145 mg a day.
Senior: Begin with 48 mg a day. This dosage also applies to
people with kidney disease. Child; mk recommended.
Triglide
Adult: 50-160 mg a day.
Senior: Begin with 50 mg a day. This dosage also applies to
people with kidney disease. Child: not recommended.
Overdosage
Little is known about the effects of fenofibrate overdose. Victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
People should take fenofibrate only after a triglyceride- lowering diet and other medications have failed. While taking fenofibrate, follow the diet recommended by your doctor.
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.
Special Populations
Pregnancy/Breast-feeding: Fenofibrate causes fetal injury and death in animal studies. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
This drug should not be taken by nursing mothers because of its potential to affect the nursing infant.
Seniors: Seniors are more likely to experience side effects and should never start with more than the lowest recommended dosage.
Generic Name
Finasteride (fin-ASS-ter-ide) 19
Brand Names
Proscar Propecia
The information in this profile also applies to the following drug:
Generic Ingredient: Dutasteride Avodart
Type of Drug
Alpha-reductase inhibitor and androgen hormone inhibitor.
Prescribed for
Benign prostatic hyperplasia (BPH) and male-pattern baldness. May also play a role in preventing prostrate cancer.
General Information
Finasteride works by interfering with the action of the enzyme alphareductase, which converts testosterone into 5-dihydrotestosterone (DHT). By suppressing DHT levels, finasteride reduces the size of the prostate in most men who take the drug for BPH. You may need to take finasteride for 6-12 months before its effects can be
assessed.
Urine flow improves in about 60% of men taking finasteride for BPH and symptoms improve in about 30%. In one study, men experienced a significant regression in prostate size after 3 months, and the reduction was maintained through the 12-month study period: these men experienced a significant improvement in urine flow that could be maintained up to 36 months.
Studies of finasteride for hair loss on the top and back-middle of the scalp show new hair growth in 65-80% of men taking the drug continuously for 2 years. The drug must be taken for 3 months or more before it begins to have an effect and must be taken continuously to maintain hair growth. Once you stop taking this drug, any new hair you have grown is likely to fall out in the next 12 months. Between 14-17% of men taking the drug continued to lose hair throughout the study period.
Finasteride has been studied as therapy following radical prostatectomy surgery and in the prevention of first-stage prostate cancer, acne in women, and unusual hairiness.
Cautions and Warnings
Do not take finasteride if you are allergic or sensitive to any of its ingredients.
This drug should not be used in women or children. Pregnant women must not handle the tablets and capsules because of the risk to the fetus.
People who do not respond to finasteride may have a condition that causes BPH-like symptoms, such as prostate cancer, bladder or nerve disorders, or physical obstruction of the urinary tubes. Finasteride cannot be used to treat these conditions.
Because it is broken down in the liver, finasteride must be used with caution by people with liver disease.
Finasteride may mask symptoms of prostate cancer by causing a reduction in the level of prostate-specific antigen (PSA), an increasingly acknowledged indicator of prostate cancer.
Possible Side Effects
Side effects are generally mild and often subside with continued use of the drug.
Drug Interactions
• Finasteride may reduce the effectiveness of theophylline and aminophylline, although dosage adjustments usually are not required.
• Finasteride affects the PSA blood test used for prostate cancer screening. Be sure your doctor knows you are taking this drug if you have a PSA test done or are being tested for prostate cancer.
• Dustasteride blood levels may increase when mixed with ritonavir, ketoconazole, cimetidine, and ciprofloxacin, all of which are inhibitors of a liver enzyme called CYP3A4. Blood levels of dutasteride also increase with verapamil and diltiazem.
Food Interactions
You may take finasteride with food if it upsets your stomach.
Usual Dose
Outasteride
Adult: 0.5 mg (1 capsule) once a day. Child: not recommended.
Finasteride
Adult: BPH-5 mg once a day. Male-pattern baldness-1 mg once a day.
Child: not recommended.
Women should not take finasteride. Overdosage
S%’& Ptecls are unlikely. Doses of dutasteride as high as 400 mg a day have been taken with no adverse side effects. Call your local poison control center or a hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Possible Side Effects (continued)
v Common: impotence, loss of sex semen, breast tenderness an
• and drug sensitivity reaction
• rash.
x drive, decreased amount nd enlargement, testicular ions including lip swelling Special Information
Women who are or might be pregnant should not handle crushed finasteride tablets because small amounts of the drug may be absorbed into the blood, possibly affecting the fetus.
If your sexual partner is or might be pregnant and you start taking finasteride, you must wear a condom during sex to avoid directly exposing her to finasteride in the semen.
Semen volume may decrease while on finasteride. Impotence or reduced sex drive is also a risk.
If you forget a dose, 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. Call your doctor if you miss a dose for 2 or more days.
Special Populations
Pregnancy/Breast-feeding: This drug is not intended for women. Finasteride will harm the fetus if taken during pregnancy. It is not known if finasteride passes into breast milk.
Seniors: Seniors with liver disease should use this drug with caution.
Brand Name
Fioricet
Generic Ingredients
Acetaminophen + Butalbital + Caffeine 91
Other Brand Names
Americet Femcet
Dolgic LQ Margesic
Dolgic Plus Medigesic
Esgic Repan
Esgic-Plus Triad
Type 101 Drug
Barbiturate and analgesic (pain reliever) combination.
Prescribed For
Symptom relief of tension headache.
General Information
Fioricet is one of many combination products containing a barbiturate—butalbital—and an analgesic—acetaminophen. Products of this kind also often contain a sedative or a narcotic. Other analgesic combinations, such as Rorinal, substitute aspirin for
acetaminophen.
Cautions and Warnings
Do not take Fioricet if you are allergic or sensitive to any of its ingredients.
Use this drug with caution if you have kidney or liver disease or a history of porphyria.
Chronic (long-term) use of Fioricet may lead to drug dependence or addiction. It is not recommended for multiple or recurrent headaches.
Butalbital is a respiratory depressant and affects the central nervous system (CNS), producing drowsiness, tiredness, and an inability to concentrate. Alcohol increases the CNS depression caused by this drug.
The safety and effectiveness of these medications have not been established in children under age 12.
For additional information see “Cautions and Warnings” in Acetaminophen (page 7).
Possible Side Effects
♦ Most common: lightheadedness, dizziness, sedation, shortness of breath, nausea, vomiting, upset stomach and a feeling of intoxication.
V Less common: weakness, headache, agitation, tremor, uncoordinated muscle movement, disorientation, dry mouth, constipation, facial flushing, changes in heart rate, palpitations, feeling faint, urinary difficulties, rash, and itching.
For additional information see “Possible Side Effects” in Acet-
aminophen (page 7).
Drug Interactions
• Combining Fioricet with alcohol, sedatives, barbiturates, sleeping pills, antihistamines, monoamine oxidase inhibitor antidepressants, or other CNS depressants may cause tiredness, drowsiness, and trouble concentrating.
These medications may reduce the effectiveness of corticosteroids, contraceptives containing estrogen, beta blockers (e.g. propranolol), doxycycline, felodipine, griseofulvin, nifedipine, phenylbutazone, quinine, theophylline, warfarin, and tricyclic antidepressants.
For additional information see “Drug Interactions” in Acetaminophen (page 7).
Food Interactions
Fioricet is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
1-2 tablets or capsules every 4 hours or as needed; do not exceed 6 doses a day.
Overdosage
Symptoms include breathing difficulties, nervousness progressing to stupor or coma, pinpointed pupils, cold and clammy skin and lowered heart rate or blood pressure, nausea, vomiting, dizziness, ringing in the ears, facial flushing, sweating, and thirst. Take the victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Fioricet may cause drowsiness. Be careful when driving or performing any task that requires concentration.
You should avoid alcohol while taking this medication.
Do not take Fioricet for longer or in amounts greater than prescribed.
If you have been taking this medication for more than a few weeks, do not stop taking it without your doctor’s instruction. Suddenly stopping Fioricet may lead to withdrawal symptoms.
Call your doctor if your headache or pain persists or gets worse, or if you develop side effects that are bothersome or persistent.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one and continue
W<tkh IV61 schedule. Do not take a double dose.
For additional information see “Special Information” in Acetaminophen (page 7).
Special Populations
Pregnancy/Breast-feeding: Fioricet should not be taken during pregnancy. It is associated with birth defects, prolonged labor and delayed delivery, and breathing problems in newborns. Regular use of Fioricet during the last 3 months of pregnancy may also cause drug dependency in the newborn.
Fioricet passes into breast milk. Breast-feeding while using Fioricet may cause babies to become tired, short of breath, or have a slow heartbeat. Nursing mothers who must take this drug should use infant formula.
Seniors: Fioricet may have a greater depressant effect on seniors. Seniors are also more likely to experience stimulation and disorientation.
Brand Name
Fiorinal
Generic Ingredients
Aspirin + Butalbital + Caffeine &9
Other Brand Names
Butalgen Fiorimor
Farbital Fortabs
Fiorigen Lanorinal
Type of Drug
Barbiturate and analgesic (pain reliever) combination. Prescribed For
Symptom relief of tension headache.
General Information
Pain relief products often combine an analgesic with a sedative. The analgesic ingredient in Fiorinal is aspirin; other brand-name products, such as Esgic and Fioricet, contain acetaminophen. The sedative ingredient in pain-relief combinations may be a barbiturate, narcotic, or other sedative. Fiorinal contains the barbiturate butalbital. Fiorinal also contains caffeine, which is ofte” \Ased in analgesic combinations that km,-M beadache because it enhances kkNt %m-relieving effect of aspirin.
Cautions and Warnings
Do not take Fiorinal if you are allergic or sensitive to any of its ingredients.
Do not give Fiorinal to children or teenagers with chickenpox or flu-like symptoms due to the aspirin content and danger of
Reye’s syndrome.
Use Fiorinal with extreme caution if you suffer from peptic ulcer,
problems with blood clotting or other bleeding disorders, or are
about to have surgery.
This drug should be used with caution if you have kidney or
liver disease, diabetes, or a history of porphyria.
Long-term use of this drug may cause drug dependence and addiction. It is not recommended for the treatment of multiple recurrent headaches.
Butalbital is a respiratory depressant and affects the central nervous system (CNS), producing drowsiness, tiredness, and an
inability to concentrate. Alcohol increases the CNS depression caused by butalbital.
The safety and efficacy of Fiorinal use in children under age 12 has not been established.
For additional information see “Cautions and Warnings” in Aspirin (page 110).
Possible Side Effects
✓ Most common: lightheadedness, dizziness, and sedation.
♦ Less common: nausea, vomiting, flatulence, and rash. For additional information see “Possible Side Effects” in Aspirin (page 110).
Drug Interactions
• Combining Fiorinal with alcohol, sedatives, barbiturates, sleeping pills, antihistamines, monoamine oxidase inhibitor antidepressants, or other CNS depressants may cause tiredness, drowsiness, and trouble concentrating.
• Fiorinal may enhance the effects of oral anticoagulants (blood thinners), oral antidiabetes drugs, insulin, and mmsteroidal anti-inflammatory drugs ~VASAYDs).
• F10final may decrease the effectiveness of medications taken for gout, including probenicid and sulfinpyrazone.
For additional information see “Drug Interactions” in Aspirin (page 110).
Food Interactions
Fiorinal is best taken on an empty stomach but may be taken with
food if it upsets your stomach.
usual Dose
1-2 tablets or capsules every 4 hours or as needed. Do not exceed
6 doses a day. Overdosage
Symptoms include breathing difficulties, nervousness progressing to stupor or coma, pinpointed pupils, cold and clammy skin, lowered heart rate or blood pressure, nausea, vomiting, stomach pain, dizziness, ringing in the ears, flushing, sweating, and thirst. 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. Take the victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Fiorinal may cause drowsiness. Be careful when driving or performing any task that requires concentration.
Avoid alcohol while taking Fiorinal.
If you have been taking this medication for more than a few weeks, do not stop taking it without your doctor’s instruction. Suddenly stopping this drug may lead to withdrawal symptoms.
Do not take Fiorinal for longer or in amounts greater than prescribed.
Call your doctor if your headache pain persists or gets worse, or if you develop 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 dose you forgot and continue with your regular schedule. Do not take a double dose.
For additional information see “Special Information” in Aspirin (page 110).
Special Populations
PregriancylBreast-feeding. Fiorinal should not be taken during pregnancy. Pregnant women taking it may experience prolonged labor, delayed delivery, and bleeding problems. Fiorinal increases the risk of birth defects and may cause breathing or bleeding prob-lems in newborns. Regular use of Fiorinal during the last 3 months of pregnancy may also cause drug dependency in the newborn.
Fiorinal passes into breast milk. Breast-feeding while using Fiorinal may cause tiredness, shortness of breath, or slowed heartbeat in the baby. Nursing mothers who must take Fiorinal should use infant formula.
Seniors: Fiorinal may have a greater depressant effect on seniors. Seniors are also more likely to experience stimulation and disorientation.
Brand Name
Fiorinal with Codeine
Generic Ingredients
Aspirin + Butalbital + Caffeine + Codeine Phosphate 19
Type of Drug
Barbiturate, narcotic, and analgesic (pain reliever) combination.
Prescribed For
Symptom relief of tension headache.
General Information
Fiorinal with Codeine is one of many combination products containing a barbiturate, an analgesic, and a narcotic. In Fiorinal with Codeine, butalbital is the barbiturate, aspirin is the analgesic, and codeine is the narcotic. These products often also contain a sedative, and acetaminophen may be substituted for aspirin.
Cautions and Warnings
Do not take Fiorinal with Codeine if you are allergic or sensitive to any of its ingredients. Even recommended doses of aspirin can cause severe allergic reaction in those with an aspirin allergy.
Do not take this medication if you suffer from peptic ulcer, bleeding disorders, or a history of porphyria.
Use this medication with cautiOi) 11 you have kidney or liver
disease of diabetes.
Fiorinal with Codeine may cause postural low blood pressure (symptoms include dizziness or fainting when rising from a sitting or lying position).
Long-term use of this drug may cause drug dependence or addiction.
It is not recommended for treatment of multiple, recurrent head-
aches.
Fiorinal with Codeine is a respiratory depressant and affects the
central nervous system (CNS), producing sleepiness, tiredness, or inability to concentrate. Alcohol increases the depression caused
by codeine and butalbital.
Do not give Fiorinal with Codeine to children or teenagers with
chickenpox or flu-like symptoms. The aspirin content presents the
danger of Reye’s syndrome.
For additional information see “Cautions and Warnings” in As-
pirin (page 110).
Possible Side Effects
✓ Most common: dizziness, sleepiness, nausea, and vomiting.
♦ Less common: dry mouth, difficulty swallowing, heartburn, rapid heart rate, leg pain and muscle fatigue, urinary problems, rash, fever, earache, stuffy nose, and ringing in the ears. Narcotic analgesics may aggravate convulsions in those who have had them.
For additional information see “Possible Side Effects” in Aspirin (page 110).
Drug Interactions
• Interaction with alcohol, sedatives, barbiturates, sleeping pills, antihistamines, or other drugs that produce sedation may cause tiredness, drowsiness, and trouble concentrating.
• Taking Fiorinal with Codeine with a monoamine oxidase inhibitor antidepressant may cause increased central nervous system effects.
• This medication may reduce the effectiveness of medications for the treatment of gout including probenicid and sulfapyrazone.
• Fiorinal with Codeine may enhance the effects of blood thin- ners, oral antidiabetes drugs, insulin, and anti-inflammatory drugs (NSAIDs).
For additional information see “Drug Interactions” in Aspirin (page 110).
Food Interactions
Fiorinal with Codeine is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
1-2 tablets or capsules every 4 hours or as needed; do not ex-
ceed 6 doses a day.
Overdosage
Usual overdose symptoms include breathing difficulties, nervousness progressing to stupor or coma, pinpointed pupils, cold clammy skin and lowered heart rate or blood pressure, nausea, vomiting, dizziness, ringing in the ears, flushing, sweating, and thirst. Symptoms of mild overdose include 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, or bleeding. Take the victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
This drug may cause drowsiness. Be careful when driving or performing any task that requires concentration.
Avoid alcohol while taking this drug.
If you have been taking this medication for more than a few weeks, do not stop taking it without your doctor’s instruction. Suddenly stopping this drug may lead to withdrawal symptoms.
Do not take this drug for longer or in amounts greater than prescribed.
Call your doctor if you experience breathing difficulties, or persistent nausea, vomiting, or constipation.
If you forget a dose, 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.
For additional information see “Special Information” in Aspirin (page 110).
Special Populations
Pregnancy/Breast-teeding-. Fiorinal with Codeine should not be used during pregnancy. Pregnant women taking it may experience prolonged labor, delayed delivery, and bleeding problems. This drug increases the risk of birth defects and may cause breathing or bleeding problems in newborns. Regular use of Fiorinal with Codeine during the last 3 months of pregnancy may also cause drug dependency in the newborn.
Fiorinal with Codeine passes into breast milk. Breast-feeding while using this drug may cause tiredness, shortness of breath, or a slow heartbeat in the baby. Nursing mothers who must take this drug should use infant formula.
Seniors: This drug may have a greater depressant effect on seniors. Other effects that may be more prominent are stimulation, disorientation, lightheadedness, and dizziness or fainting when rising suddenly from a sitting or lying position.