Aug
12
Dimenhydrinate - Diphenhydramine Hydrochloride - Disopyramide - Dofetilide
August 12, 2009 | Leave a Comment
Generic Name
Dimenhydrinate (dye-men-HYE-drih-nate) A
Brand Names
Calm-X Dramamine
Dimetabs Triptone
The information in this profile also applies to the following drugs: Generic Ingredient: Meclizine 91
Antivert Bonine
An tOmA 2S Meni-D
Antivert 50 Ru-Vert-M Antrizine
Type of Drug
Antihistamine and antiemetic (an agent that prevents or relieves nausea and vomiting).
Prescribed For
Nausea, vomiting, vertigo, and dizziness associated with motion
sickness.
General Information
Dimenhydrinate, which depresses middle ear function, is a mixture of diphenhydramine—an antihistamine believed to be the active ingredient—and another ingredient. Meclizine is an antihistamine. It takes a little longer to start working than dimenhydrinate, but its effects last much longer. Meclizine does a better job of preventing motion sickness than treating its symptoms. It takes 30 minutes to 1 hour to work and lasts for 12-24 hours.
Cautions and Warnings
Do not take dimenhydrinate if you are allergic or sensitive to any of its ingredients. Newborn babies should not be given this drug.
People with a prostate condition, stomach ulcer, intestinal obstruction, bladder problems, difficulty urinating, glaucoma, asthma, or abnormal heart rhythms should use dimenhydrinate only while under a doctor’s care.
Because it controls nausea and vomiting, dimenhydrinate may hide the symptoms of appendicitis or overdoses of other drugs.
Possible Side Effects
✓ Most common: drowsiness.
♦ Less common: confusion; nervousness; excitation; restlessness; headache; sleeplessness, especially in children; tingling; heavy or weak hands; fainting; dizziness; tiredness; rapid heartbeat; low blood pressure; heart palpitations; blurred or double vision; difficult or painful urination; increased sensitivity to the sun; appetite loss; nausea; vomiting; diarrhea; upset stomach; constipation; nightmares; rash; drug reaction (symptoms include rash, itching, hives, and breathing difficulties); ringing or buzzing in the ears-, dry mouth, nose, or throat; stuffy nose-, wheezing: and increased chest phlegm OT chest tightness.
Drug Interactions
• This drug should not be taken with a monoamine oxidase inhibitor antidepressant.
• Taking dimenhydrinate with an alcoholic beverage, other antihistamine, sedative, or other central-nervous-system (CNS)
depressant may cause excessive dizziness, drowsiness, or other signs of depression.
• Side effects of anticholinergics may be increased when taken with dimenhydrinate.
• Combining dimenhydrinate and certain antibiotics that cause dizziness or other ear-related side effects may mask early signs of these side effects, especially in infants and children.
Food Interactions
Take dimenhydrinate with food or milk if it upsets your stomach.
Usual Dose
Dimenhydrinate
Adult and Child (age 13 and over): 50-100 mg-1 or 2 tablets or 4-8 tsp.-30 minutes prior to travel; then every 4-6 hours; do not take more than 400 mg a day.
Child (age 6-12): 25-50 mg-1/2 or 1 tablet or 2-4 tsp.—every 6-43 hours; do not take more than 150 mg a day.
Child (age 2-5): up to 25 mg-1/2 or 1 tablet or 2 tsp.-every 6-8 hours; do not take more than 75 mg a day.
Child (under age 2): Consult your doctor.
Meclizine
Adult and Child (age 13 and over): 25-50 mg 1 hour before travel; repeat every 24 hours for duration of journey. Up to 100 mg a day in divided doses may be needed to control dizziness from other causes.
Child: not recommended.
Overdosage
Symptoms of overdose include drowsiness, clumsiness, unsteadiness, feeling faint, facial flushing, and dry mouth, nose, or throat. Convulsions, coma, and breathing difficulties may also develop. Overdose victims should be taken to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
N1 Maximum effectiveness against motion sickness, take dimenhydrinate 1-2 hours before traveling; it may still be effective if taken 30 minutes before traveling.
This drug may cause drowsiness: Be extremely cautious when driving, operating hazardous machinery, or doing anything that requires concentration.
Dimenhydrinate may cause dry mouth, nose, or throat. Sugarless candy, gum, or ice chips can usually relieve these symptoms. Constant dry mouth may increase the likelihood of developing tooth decay or gum disease. Pay special attention to oral hygiene while you are taking dimenhydrinate, and contact your doctor if dry mouth lasts more than 2 weeks.
If you forget to take a dose of dimenhydrinate, 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: Animal studies suggest that meclizine may cause birth defects. Do not take any antihistamine without your doctor’s knowledge if you are or might be pregnant —especially during the last 3 months of pregnancy, because newborns may have severe reactions to antihistamines.
Small amounts of dimenhydrinate may pass into breast milk. Dimenhydrinate may also slow milk production. Nursing mothers who must take dimenhydrinate should use infant formula.
Seniors: Seniors are more sensitive to antihistamine side effects and should take the lowest effective dose.
Generic Name
Diphenhydramine Hydrochloride
(dye-fen-HYE-druh-mene hye-droe-KLOR-ide) 91
Brand Names
40 Winks
AllerM,ly,
AllerMax Maximum Strength Altaryl Children’s Allergy Banophen
Banophen Allergy
Benadryl Allergy
Benadryl Children’s Allergy* Benadryl Children’s Dye Free Benadryl Dye Free Allergy
Liquid Gels
Children’s Pediacare Nighttime Cough’
Compoz Gel Caps
Compoz Nighttime Sleep Aid Diphen AF
Diphenhist
Dormin
Dytuss
Genahist
Midol PM
Miles Nervine
Nytol Quick Caps
Nytol Quick Gels Maximum Strength
Scot-Tussin Allergy*
Siladryl
Simply Sleep
Sleep-Eze 3
Sleepinol Maximum Strength Sleepwell 2-Nice
Snoozefast
Sominex Original Formula Sylphen Cough
TheraFlu Thin Strips Multi Symptom
Triaminic Thin Strips Cough and Runny Nose
Tusstat
Unisom
‘Some products in this brand-name group are alcohol- or sugar-free.
Type of Drug Antihistamine.
Prescribed For
Stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal allergy and for other symptoms of allergy such as itching, rash, and hives; also prescribed for motion sickness, insomnia, and Parkinson’s disease.
General Information
Antihistamines generally work by blocking the release of histamine (a chemical released by body tissue during an allergic reaction), drying the nose, throat, and eye secretions. Diphenhydramine is the most common active ingredient found in nonprescription sleep aids.
Cautions and Warnings
This drug should not be used if you are allergic or sensitive to any of its ingredients. It should be avoided or used wilt extreme care if you have narrow-angle glaucoma, stomach ulcer, intestinal abslmcfion, other stomach problems, difficulty urinating, or enlarged prostate. It should not be used by people who have sleep apnea or deep-breathing problems such as asthma. Use with care if you have a history of thyroid disease, heart disease, emphysema, chronic bronchitis, or high blood pressure.
Drug Interactions
• This drug should not be taken with a monoamine oxidase inhibitor antidepressant.
• The effects of sedatives, sleeping medications, and other central-nervous-system (CNS) depressants will be intensified when combined with diphenhydramine hydrochloride; it is extremely important that doses of these drugs are properly adjusted.
• This drug increases the intoxicating and sedating effects of alcohol.
Food Interactions
Take this drug with food if it upsets your stomach.
Usual Dose
Allergy
Adult: 25-50 mg 3-4 times a day.
Child (over 20 tbs.): 12.5-25 mg 3-4 times a day.
Nighttime Sedation
Adult and Child (age 12 and over): 25-50 mg at bedtime.
couqh. SIN%
Adult and Child (age 12 and over): 25 mg every 4 hours; do not take more than 150 mg in 24 hours.
Child (age 6-12): 12.5 mg every 4 hours; do not take more than 75 mg in 24 hours.
mouth, and weakness.
g, rash, sensitivity to bright light, per-
s, lowering of blood pressure, head-
t, sleeplessness, dizziness, disturbed sion, restlessness, nervousness, irri- eling “high”), tingling and weakness of lurred or double vision, ringing in the , appetite loss, nausea, vomiting, con- urinary difficulties, thickening of lung s of the chest, wheezing, nasal stuffi-
h, nose, or throat.
Possible Side Effects
✓ Common: drowsiness
✓ Less common: itching
• fever, chills
• rapid heartbeat
confusion
euphoria (feelin
hands or feet, blurre
• upset stomach
• diarrhea, secretions, tightnes
• and dry
Child (age 2-6): 6.25 mg every 4 hours; do not take more than
25 mg in 24 hours.
Child (under age 2): not recommended.
Thin Strips
TheraFlu
Adult and Child (age 12 and over): 1 strip every 4 hours; do not take more than 6 strips in 24 hours.
Triaminic
Child (age 6-12): 1 strip every 4 hours; do not take more than 6 strips in 24 hours.
Overdosage
Symptoms of overdose include depression or stimulation—especially in children; dry mouth; fixed or dilated pupils; flushing; and upset stomach. Overdose victims should be made to vomit with ipecac syrup—available at any pharmacy. Take the overdose victim to a hospital emergency room immediately if you cannot induce vomiting. ALWAYS bring the prescription bottle or container.
Special Information
This drug may cause drowsiness. Be extremely cautious when driving or operating hazardous equipment.
If you are taking this medication for motion sickness, take the first dose at least 30 minutes prior to exposure.
If you forget to take a dose of diphenhydramine hydrochloride, 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: Animal studies have shown that some antihistamines may cause birth defects. Do not take any antihistamine without your doctor’s knowledge if you are or might be pregnant—especially during the last 3 miDMIns of pregnancy—because newborns may have severe reactions to antihistamines.
SMM) amounts of antihistamine pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors are more sensitive to antihistamine side effects and may require lower dosages.
Generic Name
Disopyramide (die-soe-PIE-rah-mide) 92
Brand Names Norpace
Type of Drug Antiarrhythmic.
Prescribed For Abnormal heart rhythms.
General Information
Disopyramide phosphate slows the rate at which nerve impulses are carried through heart muscle, reducing the response of heart muscle to those impulses. It acts on the heart similarly to the more widely used antiarrhythmic medications procainamide hydrochloride and quinidine sulfate. Disopyramide is often prescribed for people who do not respond to other antiarrhythmic drugs.
Cautions and Warnings
Do not take disopyramide if you are allergic or sensitive to any of its ingredients or if you have heart block, unless you have a cardiac pacemaker.
This drug can worsen heart failure or trigger severely low blood pressure. It should be used in combination with another antiarrhythmic agent or beta blocker with caution.
In rare instances, disopyramide has caused a reduction in blood-sugar levels. Therefore, the drug should be used with caution by diabetics, older adults—who are more susceptible to this effect—and people with poor kidney or liver function. Ask your doctor if you should have your blood-sugar levels checked while taking this drug.
Because of its anticholinergic effects, men with a severe prostate condition and people who have glaucoma, myasthenia gravis, or severe difficulty uritx;aA:jng should use disopyramide with caution.
People with liver or kidney disease must take a reduced dose of disopyramide.
Potassium levels affect the action of disopyramide. People with blood potassium levels that are out of the normal range must correct this imbalance before starting disopyramide.
Norpace CR
Possible Side Effects
♦ Most common: dry mouth, urinary difficulty, and constipation.
♦ Common: blurred vision; dry eyes, nose, and throat; frequent urination; nausea; stomach pain or bloating; gas; dizziness; fatigue; headache; and nervousness.
♦ Less common: itching, rashes, muscle weakness, generalized aches and pains, not feeling well, low blood-potassium levels, increases in blood-cholesterol and triglyceride levels, heart failure, and low blood pressure.
♦ 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
• Phenytoin and rifarnpin may increase the rate at which the body removes disopyramide from the blood. Your disopyramide dose may need alteration if this combination is used. Other drugs known to increase drug breakdown by the liver, such as barbiturates and primidone, may also have this effect.
• Other antiarrhythmic drugs, such as procainamide and quinidine, may increase the effect of disopyramide, making dosage reduction necessary. At the same time, disopyramide may reduce the effectiveness of quinidine.
• When disopyramide is combined with a beta-blocking drug, increased disopyramide effects, additive effects, or depression of heart function may result.
• Azole antifungals, clarithromycin, diclofenac, doxycycline, erythromycin, imatinib, isoniazid, nefazodone, nicardipine, propofol, protease inhibitors, telithromycin, and verapamil may increase the amount of disopyramide in your blood, causing abnormal heart rhythms or other cardiac effects.
• Disopyramide may reduce the effectiveness of oral anticoagulant (blood-thinning) drugs. Your doctor should check your anticoagulant dosage to be sure you are getting the right amount.
• Hydantoins may cause a decrease in the effectiveness of disopyramide.• Disopyramide may increase the amount of digoxin in your blood, though the amount of the increase is not likely to af-
fect your heart.
• St. John’s wort may decrease disopyramide levels.
Food Interactions
Disopyramide should be taken on an empty stomach at least 1
hour before or 2 hours after meals. Usual Dose
Adult: 400-800 mg a day (divided into 2 or 4 doses for the immediate-release form). In severe cases, 400 mg every 6 hours may be required. This level of dosage should be monitored in the hospital. The sustained-release preparation is taken every 12 hours. People with reduced kidney function should receive a lower dosage, depending on the degree of kidney function present. People with liver failure should take 400 mg a day.
Child (age 13-18): 2.5-7 mg a day per lb. of body weight. Child (age 5-12): 4.5-7 mg a day per lb. of body weight. Child (age 1-4): 4.5-9 mg a day per lb. of body weight.
Child (under age 1): 4.5-13.5 mg a day per lb. of body weight.
Overdosage
Overdose symptoms are breathing difficulties, abnormal heart rhythms, and unconsciousness. In severe cases, overdosage can lead to death. Overdose victims should be made to vomit with ipecac syrup—available at any pharmacy—to remove any remaining drug from the stomach. Call your doctor or poison control center before doing this. If you must go to a hospital emergency room, ALWAYS bring the prescription bottle or container. Prompt and vigorous treatment can mean the difference between life and death in severe overdosage.
Special Information
Disopyramide may cause symptoms of low blood sugar: anxiety, chills, cold sweats, drowsiness, excessive hunger, nausea, nervousness, rapid pulse, shakiness, uaus~M% weakness, tiredness, or cool, pale skim If kNSN)appens to you, eat some chocolate, candy, U rilher high-sugar food, and call your doctor at once.
Disopyramide can cause dry mouth, urinary difficulty, constipation, or blurred vision. Call your doctor if these symptoms become severe or intolerable, but do not stop taking the medication without your doctor’s approval.
If disopyramide is required for a child and capsules are not appropriate, your pharmacist can make a liquid product. Do not do this at home: This medication requires special preparation. The liquid should be refrigerated and protected from light and should be thrown away after 30 days.
Do not crush, chew, or open sustained-release capsules.
If you forget to take a dose of disopyramide, take it as soon as possible. However, if it is within 4 hours of your next dose, skip the dose you forgot and go back to your regular schedule. Do not take a double dose.
Special Populations
PregnancylBreast-feeding: Do not take this drug if you are pregnant or planning to become pregnant while using it, because it will pass into the fetus and may affect its development. When disopyramide is considered crucial by your doctor, its potential benefits must carefully be weighed against its risks.
Disopyramide passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors, especially those with liver or kidney disease, are more sensitive to the effects of this drug.
Generic Name
Dofetilide (DOH-fet-a-lyed)
Brand Name Tikosyn
Type of Drug Antiarrhythmic.
Prescribed For
Specific abnormal heart rhythms.
General Information
Dofetilide is used to establish and maintain normal sinus rhythm in the heart. Dofetilide is available only to hospitals and doctors who receive specific training and education on how to use this drug because of the risks associated with using it.
Cautions and Warnings
Do not take dofetilide if you are allergic or sensitive to any of its ingredients.
Dofetilide is reserved for people whose abnormal heart rhythms have not responded to other drugs. People taking dofetilide must be in a hospital or other facility for at least 3 days where appropriate blood tests can be performed to monitor kidney and heart function.
This drug is cleared through the kidneys. Poor kidney function increases the amount of dofetilide in the body. Liver disease has no effect on dofetilide blood levels.
Dofetilide, like other antiarrhythmic drugs, can cause severe and sometimes fatal abnormal rhythms of its own.
Do not take dofetilide without first talking to your doctor if you have a low blood level of potassium or magnesium.
Women may be at a greater risk for some arrhythmias caused by dofetilide.
Possible Side Effects
Serious heart arrhythmias can develop in up to 31b% of patients taking up to 1000 mcg a day of dofetilide. People taking daily doses above 1000 mcg a day are at up to 5 times greater risk for arrhythmias.
• Most common: headache, chest pain, and respiratory infection.
♦ Common: difficulty breathing, nausea, and dizziness.
♦ Less common: flu; sleeplessness; accidental injury; back pain; diarrhea; abdominal pain; angina; anxiety: joint pain; weakness; atrial and ventricular arrhythmia; high blood pressure; pain; heart palpitations; swollen legs, ankles, or arms; sweating; and urinary infections.
♦ Rare: some arrhythmias, heart attack, hives, slow heartbeat, stroke, facial or other paralysis, tingling in the hands or feet, cough, liver damage, migraine, fainting, and sudden death. Contact your doctor if you experience any side effect not listed above.
‘D?Ug Interactions
Dofetilide should not be given with drugs that are known to interact with it. Dofetilide must be stopped at least 2 days before any potentially interacting drug is taken.
• Do not mix dofetilide with any product containing verapamil, a calcium channel blocker, or trimethoprim, used for urinary infections. These combinations can substantially raise the amount of dofetilide in the blood.
• Some drugs may increase the amount of dofetilide in the blood by inhibiting enzymes that break it down in the liver. They include delavirdine, indinavir, btonavir, saquinavir, amiodarone, cimetidine, ciprofloxacin, clarithromycin, cannabis, diltiazem, erythromycin, fluconazole, fluvoxamine, itraconazole, ketoconazole, mifepristone, nefazodone, norfloxacin, mibefradil, selective serotonin reuptake inhibitors (SSRIS), troleandomycin, and zatirlukast.
• Some drugs may reduce the amount of dofetilide in the blood by stimulating enzymes that break it down in the liver, including efavirenz, nevirapine, carbamazepine, corticosteroids, modafanil, phenobarbital and other barbiturates, phenytoin, pioglitazone, and rifampin. Amiloride, metformin, megestrol, and triamterene can interfere with the elimination of dofetilide via the kidney, raising blood levels of the drug.
• Other drugs that can increase the effects of dofetilide are Other antiarrhythmic drugs, bepridil, phenothiazines, and tricyclic antidepressants.
• Mixing dofetilide with digoxin may lead to a ventricular arrhythmia called torsade de pointes. Thiazides, furosemide, and other potassium-depleting diuretics can also increase the risk of this arrhythmia.
Food Interactions
Grapefruit juice may increase dofetilide blood levels.
Usual Dose
Adult: 125-500 mcg twice a day.
Child (under 18 years): not recommended.
Overdosage
Dofetilide overdose is likely to cause significant heart rhythm problems. Overdose victims must be treated symptomatically by their cardiologist.
Special Information
Read all information supplied to you before you begin taking this medication and read it again if anything in your treatment program changes.
Tell your doctor about any changes in your prescription or nonprescription drug use or in your use of vitamins, minerals, and other dietary supplement products.
Be sure that any other doctor or hospital that treats you and might prescribe another drug knows you are taking dofetilide.
Call your doctor at once if you develop any signs of altered electrolyte balance including excessive or prolonged diarrhea, sweating, vomiting, appetite changes, or excessive thirst.
If you forget to take 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.
Special Populations
Pregnancy/Breast-feeding: Dofetilide causes birth defects in animal studies. Pregnant women should take this drug only after discussing with their doctors its potential benefits and risks.
It is unknown whether dofetilide passes into breast milk. Nursing mothers who take it should consider using infant formula.
Seniors: Older adults may take this drug without special restriction.
Aug
1
Clarithromycin
August 1, 2009 | Leave a Comment
Generic Name
Clarithromycin (klah-rith-roe-MYE-sin) 91
Brand Names Biaxin
Type of Drug Macrolide antibiotic.
Biaxin XL
Prescribed For
Mild to moderate infections of the upper and lower respiratory tract, tonsillitis, pharyngitis, sinusitis, exacerbation of chronic bronchitis, middle-ear infections, and for duodenal ulcers; also used for skin and other infections, including membrane attack complex (MAC) in people with advanced HIV infection.
General Information
Clarithromycin and other macybYide antibiotics are either bacteri(;((JW (’UaCkeeia-killing) or bacteriostatic (inhibiting bacterial growth), depending on the organism in question and amount of antibiotic present. In ulcer disease, clarithromycin is used to fight Helicobacter pylori infection, which is present in almost all ulcers and most cases of stomach inflammation.
Cautions and Warnings
Do not take clarithromycin if you are allergic or sensitive to any of its ingredients or to any macrolide antibiotic.
Clarithromycin should not be used during pregnancy.
Clarithromycin is primarily eliminated from the body through the liver and kidneys. People with severe kidney disease may require dose adjustments. Liver disease generally does not require an adjustment.
Colitis (bowel inflammation) has been associated with all antibiotics (see “Possible Side Effects”). If colitis does develop, your doctor should start appropriate treatment. Mild cases of colitis usually respond to the discontinuation of the medicine.
Possible Side Effects
Most side effects are mild and go away once you stop taking clarithromycin.
✓ Most common: nausea, upset stomach, changes in sense of taste, headache, he. diarrhea, abdominal pain, vomiting, and rash in children. Colitis (symptoms include severe abdominal cramps and severe, persistent, and possibly bloody diarrhea) may develop.
✓ Rare: serious abnormal heart rhythms. Contact your doc-
tor if you experience any side effect not listed above.
Drug Interactions
• Clarithromycin may increase the anticoagulant (blood-thinning) effects of warfarin in people who take it regularly, especially older adults. This combination requires careful monitoring by your doctor.
• Do not combine clarithromycin with astemizole or terfenadine.
• Combining clarithromycin and omeprazole raises the amount of both drugs in the blood.
• Two deaths have been reported in people combining Oarithromycin and pimozidp_ ?imuiide should not be used by peibp)e faking a macrolide antibiotic.
• Clarithromycin may raise blood levels of theophylline, possibly leading to a theophylline overdose. It can also increase the effects of caffeine.
• Combining clarithromycin and digoxin, cyclosporine, ergot
alkaloids, or tacrolimus may lead to serious side effects.
Aug
1
Cimetidine
August 1, 2009 | Leave a Comment
Generic Name
Cimetidine (sih-MET-ih-dene)
Brand
Tagamet Tagamet HB 91
Type of Drug Histamine H2 antagonist.
Prescribed For
Ulcers of the stomach and duodenum (upper intestine); also used for upset stomach, gastroesophageal reflux disease (GERD), benign stomach ulcer, bleeding in the stomach and duodenum, colorectal cancer, prevention of stress ulcer, hyperparathyroidism, fungal infections of the hair and scalp, herpes virus infection, excessive hairiness in women, chronic itching of unknown cause, skin reactions, warts, acetaminophen overdose, and other conditions characterized by the production of large amounts of gastric fluids. Cimetidine may be prescribed to stop the production of stomach acid during surgery.
General Information
Histamine H2 antagonists work by turning off the system that produces stomach acid and other secretions. Cimetidine is effective in treating the symptoms of ulcer and preventing complications of the disease, although an ulcer that does not respond to another histamine H2 antagonist will probably not respond to cimetidine. Histamine H2 antagonists differ only in their potency. Cimetidine is the least potent; 1000 mg are roughly equal to 300 mg of either nizatidine or ranitidine, or 40 mg of famotidine. These drugs are roughly equal in their ability to treat ulcer disease and their risk of side effects.
Cautions and Warnings
Do not take cimetidine if you are allergic or sensitive to any of its ingredients or any histamine H2 antagonist. Cimetidine has a mild antiandrogen effect, which probably causes the painful, swollen breasts that some people experience after taking this drug for a month or more.
People with kidney or liver disease should take cimetidine with caution because 1/3 of each dose is broken down in the liver and passes out of the body through the kidneys.
Do not self-treat with over-the-counter forms of cimetidine without the advice and supervision of your doctor.
The fact that symptalleviated by cimetidine does not dude the possibility of stomach cancer, which can have symptoms similar to other gastrointestinal (GI) disorders. Make sure your doctor screens for possible malignancy.
these symptoms stop 3-4 days after discontinuing the drug. Call your doctor if this happens to you.
Possible Side Effects
Serious side effects are uncommon.
♦ Most common: mild diarrhea, dizziness, rash, painful breast swelling, nausea and vomiting, headache, confusion, drowsiness, hallucinations, and impotence.
♦ Less common: liver inflammation, peeling or red and swollen rash, breathing difficulties, tingling in the hands or feet, delirious feelings, and oozing from the nipples.
✓ Rare: Cimetidine may affect white blood cells or blood platelets. Some symptoms of these effects are unusual bleeding or bruising, unusual tiredness, and weakness. Other rare side effects are inflammation of the pancreas, hair loss (reversible), abnormal heart rhythms, heart attack, muscle or joint pains, and drug reactions. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Separate cimetidine from antacid doses by about 3 hours to avoid reducing cimetidine’s effectiveness. Other drugs that may reduce the absorption of cimetidine are metoclopramide and anticholinergic drugs, including trihexyphenidyl hydrochloride, oxybutynin, and benztropine mesylate.
• Cigarette smoking reverses the healing effect cimetidine has on ulcers.
• Cimetidine may increase the side effects of a variety of drugs, possibly leading to drug toxicity. These drugs include alcohol; aminophylline; oral antidiabetes drugs; benzodiazepine sedatives, except lorazepam, oxazepam, and temazepam; caffeine; calcium channel blockers; carbamweoine; carmustine; chloroquine; tkeCaiTAe; fluorouracil; labetalol; lidoQa« , Tneloprolol; metronidazole; moricizine; mexiletine; narcotic pain relievers; nifedipine; ondansetron; pentoxifylline; phenytoin; procainamide; propafenone; propranolol; quinine; quinidine; tacrine; theophylline drugs, except clyphylline: triamterene; tricyclic antidepressants; valproic acid; and warfarin (a blood-thinner).
• Drugs whose absorption may be decreased by cimetidine are iron, indomethacin, fluconazole, ketoconazole, and tetra-
cycline antibiotics.
• Enteric-coated tablets should not be taken with cimetidine. The change in stomach acidity causes the tablets to disin-
tegrate prematurely in the stomach.
• cimetidine may decrease the effects of digoxin and tocainide.
Food Interactions
None known.
Usual Dose
Adult: 400-800 mg at bedtime; 300 mg 4 times a day with meals and at bedtime; or 400 mg twice a day. To treat GERD-400 mg 4 times a day. Do not exceed 2400 mg a day. Users of Tagamet HB should not take more than 400 mg a day. Smaller doses may be as effective for seniors or those with impaired kidney function.
Overdosage
Little is known about the effects of cimetidine overdose, but victims may experience exaggerated side effects. Two deaths have occurred. Your local poison control center may advise giving ipecac syrup—available at any pharmacy—to induce vomiting and remove any drug remaining in the stomach. Victims who have definite symptoms should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Take cimetidine exactly as directed and follow your doctor’s instructions regarding diet and other treatment in order to get the maximum benefit from the drug.
Do not take the maximum dose continuously for more than 2 weeks without the consent and supervision of your doctor.
Cigarette smoking is associated with stomach ulcers and reduces cimetidine’s effectiveness.
Call your doctor at once if you develop any unusual side effects such as bleeding or bruisiiAg, tiredness, diarrhea, dizziness, rash, 131 NMbdinations. Black, tarry stools or vomiting material that resembles coffee grounds may indicate your ulcer is bleeding.
If you miss a dose of cimetidine, take it as soon as possible. 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: Animal studies reveal no damage to the fetus, although cimetidine does pass into the fetal blood. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Large amounts of cimetidine pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may need less medication due to loss of kidney function and be more susceptible to side effects, especially confusion and other nervous system effects (see “Cautions and Warnings”).
Aug
1
Chlorpromazine
August 1, 2009 | Leave a Comment
Generic Name
Chlorpromazine (klor-PROE-muh-zene) Al
Brand Names
Sonazine Thorazine*
The information in this profile also applies to the following drugs: Generic Ingredient: Fluphenazine Hydrochloride RE Generic Ingredient: Thioridazine Hydrochloride 0 Generic Ingredient: Trifluoperazine Hydrochloride
‘Some products in this brand-name group are alcohol- or sugar-free. Consult your pharmacist.
Type of Drug Phenothiazine antipsychotic.
Prescribed For
Psychotic disorders; moderate to severe depression with anxiety; agitation or aggressiveness in disturbed children; intractable pain; and senility. May also be used to relieve nausea, vomiting, hiccups, restlessness, acute intermittant porphyria, and apprehension before surgery or other procedures.
General Information
Chlorpromazine and other phenothiazines act upon a portion of the brain called the hypothalamus. Phenothiazines affect parts of the hypothalamus that control metabolism, body temperature, alertness, muscle tone, hormone balance, and vomiting. Chlorpromazine is available in suppositories and as liquid for those who have trouble swallowing tablets.
Cautions and Warnings
Do not take chlorpromazine if you are AeTgic or sensitive to any oVilsingredients or to any phenothiazine drug. Do not take it if you have very low blood pressure, Parkinson’s disease, or blood, liver, kidney, or heart disease.
Chlorpromazine may depress the cough reflex. People have accidentally choked to death because the cough reflex failed to protect them. Because of its effect in reducing vomiting, chlorpro-mazine may obscure symptoms of disease or toxicity due to over-
dose of another drug.
Use chlorpromazine under your doctor’s strict supervision if you have glaucoma, epilepsy, ulcers, or urinary difficulties.
Avoid exposure to extreme heat, because this drug may upset your body’s temperature-control mechanism. Do not allow the liquid forms of this drug to come in contact with your skin because they are highly irritating.
Chlorpromazine may cause unusually high or low levels of cholesterol.
Possible Side Effects
♦ Most common: drowsiness, especially during the first or second week of therapy. If drowsiness becomes troublesome, contact your doctor.
V Less common: changes in blood components, including anemias, raised or lowered blood pressure, abnormal heart rate, heart attack, sensitivity to light, and faintness or dizziness.
V 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.
Jaundice (symptoms include yellowing of the whites of the eyes or skin) may appear; when it does, it is usually within the first 2-4 weeks of treatment. Normally the jaundice goes away when the drug is discontinued, but there have been cases when it has not.
Phenothiazines may produce extrapyramidal side effects, including spasm of the neck muscles, rolling back of the eyes, convulsions, difficulty swallowing, and symptoms associated with Parkinson’s disease. These side effects seem very serious but usually disappear after the drug has been withdrawn; however, symptoms affecting the face, tongue, or jaw may persist for as long as several years, especially in older adults with a history of brain damage.
Chlorpromazine may cause an unusual increase in psychotic symptoms or may cause paranoid reactions, tiredness, lethargy, restlessness, hyperactivity, confusion at night, bizarre dreams, sleeplessness, depression, decreased sex drive, increased appetite, or euphoria (feeling “high”).
Drug Interactions
• Be cautious about taking chlorpromazine with over-the-
counter cough, cold, or allergy medications, barbiturates, al-
cohol, sleeping pills, narcotics or other sedatives, or any other
drug that may produce a depressive effect.
• Aluminum antacids may reduce the effectiveness of phenothiazine drugs.
• Chlorpromazine may reduce the effectiveness of bromocriptine and appetite suppressants.
• Anticholinergic drugs may reduce the effectiveness of chlorpromazine and increase the chance of side effects.
• Phenothiazine drugs may counter the blood-pressurelowering effect of guanethidine.
• Taking lithium together with a phenothiazine drug may lead to disorientation, loss of consciousness, or uncontrolled muscle movements.
• Combining propranolol and a phenothiazine drug may lead to unusually low blood pressure.
• Combining tricyclic antidepressants with a phenothiazine drug can lead to antidepressant side effects.
• Chlorpromazine may reduce the effectiveness of epinephrine and norepinephrine.
• Cigarette smoking reduces the amount of chlorpromazine in your blood. Smokers may need larger doses.
Food Interactions
Take liquid chlorpromazine with fruit juice or other liquids. You may also take it with food if it upsets your stomach.
Usual Dose
Adult: 30-1000 mg or more a day, individualized according to your disease and response.
Child (age 6 months and over): 0.25 mg per lb. of body weight every 4-6 hours, up to 200 mg or more a day, depending on disease, age, and response.
Chitty (under 6 months): not recommended.
Overdosage
Overdose symptoms include depression, extreme weakness, tiredness, lowered blood pressure, agitation, restlessness, uncontrolled muscle spasms, convulsions, fever, dry mouth, abnormal heart rhythms, and coma. The victim should be taken to a hospital emergency room immediately. ALWAYS bring the prescription bottle or
container.
Special Information
Call your doctor at once if you develop sore throat, fever, rash, weakness, visual problems, tremors, muscle movements or twitching, yellowing of the skin or whites of the eyes, or darkening of the urine.
Do not stop taking chlorpromazine without your doctor’s knowledge. It may take several weeks before this drug takes effect.
This drug may cause drowsiness. Use caution when driving or operating hazardous equipment. Avoid alcoholic beverages.
Chlorpromazine may cause unusual sensitivity to the sun and may turn your urine reddish brown to pink.
If dizziness occurs, avoid rising quickly from a sitting or lying position and avoid climbing stairs. Use caution in hot weather, because this drug may make you more prone to heat stroke.
If you are using sustained-release capsules, do not chew them or break them—swallow them whole. Liquid forms of phenothiazines must be protected from light. Do not take them out of their opaque bottles.
If you take chlorpromazine more than once a day and forget to take a dose, take it right away if you remember within an hour. If you do not remember within an hour, skip the dose you forgot and continue with your regular schedule. If you take 1 dose a day and forget a dose, skip the dose you forgot and continue your regular schedule the next day. Never take a double dose.
Special Populations
Pregnancy/Breast-feeding: Infants born to women taking this drug have experienced side effects—including jaundice and nervous system effects. Check with your doctor about taking chlorpromazine if you are or might be pregnant.
This drug may pass i”W breast milk. Nursing mothers who must take chlorpromazine should use infant formula .
Seniors: Seniors are more sensitive to the effects of this drug and usually achieve desired results with lower dosages. Some experts feel that seniors should receive ‘/,-1/4 the usual adult dose.
Jul
16
Allopurinol
July 16, 2009 | Leave a Comment
Generic Name
Allopurinol (al-oe-PURE-in-nol)
Brand Name Zyloprim
Type of Drug
Antigout medication.
Prescribed For
Gout or gouty arthritis; also prescribed to counter the effects of certain therapies for cancer, ulcers, abnormal heart rhythms in heart bypass patients, seizures, and other conditions that may be associated with too much uric acid in the body.
General Information
Unlike other antigout drugs, which affect the elimination of uric acid from the body, allopurinol acts on the system that manufactures uric acid in your body. A high level of uric acid can indicate that you have gout, psoriasis, cancer, or any of a number of other diseases. High levels of uric acid can also be caused by taking certain drugs.
In mouthwash form, allopurinol helps to prevent mouth, stomach, and intestinal ulcers caused by fluorouracil, an antineoplastic drug. Allopurinol may be given before heart bypass surgery to reduce abnormal rhythms and other surgical complications. It can be used to reduce the relapse rates of duodenal ulcers associated with Helicobacter pylori infection and to reduce the vomiting of blood from stomach irritation caused by nonsteroidal anti-inflammatory drugs (NSAIDs). Allopurinol has also been used to control seizures in people for whom standard treatments are not effective.
Cautions and Warnings
Do not take allopurinol if you are allergic or sensitive to any of its ingredients, or if you have ever developed a severe reaction to it. Stop taking the medication immediately and contact your doctor if you develop a rash or any other adverse effects while taking allopurinol. Do not start taking allopurinol again if you stopped it because of a severe reaction.
Allopurinol should be used by children only if they have high uric acid levels due to neoplastic disease or to rare metabolic conditions.
A few cases of liver toxicity have been associated with allopurinol; they improved when the drug was stopped. People taking allopurinol should periodically be tested for liver and kidney function. People with severely compromised kidney function should ake a reduced dose of allopurinol.
Possible Side Effects
✓ Most common: rash associated with severe, allergic, or sensitivity reaction to allopurinol. If you develop an unusual rash or other sign of drug toxicity, stop taking this medication and contact your doctor.
✓ Less common: nausea, vomiting, diarrhea, intermittent stomach pain, gas, upset stomach, headache, insomnia, tingling or numbness in the hands and feet, muscle or joint pain, and drowsiness or lack of ability to concentrate.
✓ Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Large doses of drugs that make your urine more acidic, like megadoses of vitamin C, may increase the risk of kidney stone formation.
• Alcohol, diazoxide, mecamylamine, or pyrazinamide can increase the amount of uric acid in your blood; an increase in your allopurinol dose may be required.
• Allopurinol may increase the action of azathioprine, mercaptopurine, or cyclophosphamide and other anticancer drugs, leading to possible toxicity, bleeding, or infection.
• Allopurinol may prolong the effects of chloropropamide, and can lead to hypoglycemic reactions in patients with kidney disease.
• Taking allopurinol with probenecid or sulfinpyrazone may cause excessive reduction of uric acid.
• Allopurinol may interact with some anticoagulant (blood-thinning) medications, reducing the rate at which the anti-coagulant is broken down in the body. Dosage reduction may be necessary.
• People who are susceptible to ampicillin, amoxicillin, bacampicillin, or hetacillin rash are more likely to develop such a reaction while also taking allopurinol.
• Combining a thiazide diuretic or an ACE inhibitor (for high blood pressure or heart failure) with allopurinol increases the risk of a drug-sensitivity reaction.
• Combining vidarabine with allopurinol may increase the risk of neurotoxic effects and anemia, nausea, pain, and itching.
• Large doses of allopurinol—more than 600 mg a day—may increase the effects of and risk of toxic reactions to theophylline by interfering with its clearance from the body.
Food Interactions
Take each dose with food or a full glass of water. Drink 10-12 glasses of water, juices, soda, or another liquid each day to avoid the formation of crystals in your urine or kidneys.
Usual Dose
Adult and Child (age 11 and over): 100-800 mg a day, depend-, ing on disease and response.
Child (age 6-10): 300 mg a day.
Child (under age 6): 150 mg a day.
The dose should be reviewed periodically by your doctor to be sure that it is producing the desired therapeutic effect.
Overdosage
The expected symptoms of overdose are exaggerated side effects. Allergic skin reactions to allopurinol can be severe and at times fatal. Allopurinol overdose victims should be taken to a hospital. ALWAYS bring the prescription bottle or container.
Special Information
Allopurinol can make you drowsy or make it difficult to concentrate: Take care while driving a car or operating hazardous equipment.
Gout attacks may actually increase during the first few months of taking allopurinol. These attacks should subside.
Call your doctor at once if you develop rash, hives, itching, chills, fever, nausea, muscle aches, unusual tiredness, fever, yellowing of the whites of the eyes or skin, painful urination, blood in the urine, irritation of the eyes, or swelling of the lips or mouth.
Avoid large doses of vitamin C, which can cause the formation of kidney stones during allopurinol treatment. Be sure to drink 1012 8-oz. glasses of water a day while taking this medication.
If you forget to take a dose of allopurinol, take it as soon as possible. If it is almost time for your next regular dose, double this dose. For example, if your regular dose is 100 mg and you miss a dose, take 200 mg at the next usual dose time.
Special Populations
Pregnancy/Breast-feeding: Allopurinol may cause birth defects or interfere with fetal development. Check with your doctor before taking it if you are or might be pregnant.
Allopurinol passes into breast milk. Nursing mothers who must take allopurinol should use infant formula.
Seniors: No special precautions are required. Follow your doctor’s directions and report any side effects at once.
Jul
16
Albuterol
July 16, 2009 | Leave a Comment
Generic Name
Albuterol (al-BUE-tuh-rawl) 91
Brand Names
AccuNeb Proventil HFA
ProAir HFA Ventolin HFA
Proventil* Vospire ER
Combination Products
Generic Ingredients: Albuterol + 1pratropium Bromide Combivent DuoNeb
The:nformation in this profile also applies to the following drugs:
Generic Ingredient: Levalbuterol Xopenex
Generic Ingredient., Pirbuterol Maxair
*Some products in this brand-name group are alcohol- or sugar-free. Consult your pharmacist.
Type of Drug Bronchodilator.
Prescribed for
Bronchospasm associated with asthma or other obstructive pulmonary diseases, or induced by exercise.
General Information
Albuterol is similar to other bronchodilator drugs, such as metaproterenol and isoetharine, but it has a weaker effect on nerve receptors in the heart and blood vessels; therefore, it is somewhat safer for people with heart conditions. Levalbuterol is a special form of albuterol that carries a lower risk of side effects.
Cautions and Warnings
Do not use Albuterol if you are allergic or sensitive to any of its ingredients. Albuterol should be used with caution by people with a history of angina pectoris (a condition characterized by brief attacks of chest pain), heart disease, irregularities in heart beat, high blood pressure, stroke or seizure, diabetes, thyroid disease, prostate disease, or glaucoma. Excessive use of albuterol inhalants may worsen asthma or other respiratory conditions, and may increase breathing difficulties rather than relieve them. In the most extreme cases, people have had heart attacks after using excessive amounts of inhalant.
Possible Side Effects
V Most common: worsening of asthma, ear infection, upper respiratory infection, stuffy nose, dizziness, headache, nausea, vomiting, and muscle cramps.
♦ Less common: angina, abnormal heart rhythms, rapid heartbeat and heart palpitations, allergic reaction, fever, and tremors.
Drug Interactions
• Albuterol’s effects on the cardiovascular system may be increased by monoamine oxidase inhibitor (MA01) and tricyclic antidepressants. These drugs should not be administered together or within 2 weeks of discontinuation of MAOls or tricyclic antidepressants.
• Beta-blocking drugs such as propranolol not only block the effects of albuterol but may cause severe bronchospasm in people with asthma.
• Albuterol may reduce the amount of digoxin in the blood of people taking both drugs. Digoxin dose adjustment may be required.
• Albuterol may exacerbate certain effects of non-potassium sparing diuretics (loop or thiazide diuretics).
Food Interactions
Albuterol tablets are more effective when taken on an empty stomach-1 hour before or 2 hours after meals—but can be taken with food if they upset your stomach.
Usual Dose
Albuterol and Pirbuterol Inhalation
Adult and Child (age 4 and over): 1-2 puffs every 4-6 hours. Asthma triggered by exercise may be prevented by taking 2 puffs 15 minutes before exercising.
Albuterol Inhalation Solution
Child (age 2-12): starting dose-0.63 mg or 1.25 mg 3 or 4 times a day. Deliver over 5-15 minutes by nebulizer.
Levalbuterol Inhalation Solution
Adult and Child (age 12 and over): 0.63 mg 3 times a day every 6-8 hours. Some people may benefit from 1.25 mg at each dose. Deliver over 5-15 minutes by nebulizer.
Child (age 6-11): 0.31 mg 3 times a day every 6-8 hours, by nebulizer.
Albuterol Inhalation Aerosol
Adult and Child (age 4 and over): 2 inhalations every 4-6 hours. Adults and children age 4 and over may prevent asthma brought on by exercise by inhaling twice 15 minutes before exercising.
Albuterol Sustained-Release Tablets
Adult and Child (age 12 and over): 4-8 mg every 12 hours. Dosage may be cautiously increased to a maximum of 32 mg a day. People being switched from regular to sustained-release tablets generally take the same dosage per day, in fewer tablets—for example, a 4-mg tablet every 12 hours (1 dose) instead of a 2-mg tablet every 6 hours (2 doses).
Child (age 6-12): 4 mg every 12 hours.
Overdosage
Overdose of albuterol inhalation usually results in exaggerated side effects, including chest pain and high blood pressure. People who inhale too much albuterol should see a doctor. Overdose of albuterol tablets may lead to changes in heart rate, palpitations, unusual heart rhythm, chest pain, high blood pressure, fever, chills, cold sweats, nausea, vomiting, and dilation of the pupils. Convulsions, sleeplessness, anxiety, and tremors may also develop, and the victim may collapse. If the albuterol overdose was taken within the past 1/2 hour, give the victim syrup of ipecac to induce vomiting. Do not give ipecac if the victim is unconscious or convulsing. If symptoms have already begun to develop, the victim may need to be taken to a hospital emergency room. Call for instructions, and ALWAYS bring the prescription bottle or container.
Special Information
If you are inhaling albuterol, be sure to follow the inhalation instructions that come with the product. The drug should be inhaled during the second half of your inward breath, since this will allow it to reach deeper into your lungs. Wait about 1-2 minutes between inhalations. Do not inhale albuterol if you have food or anything else in your mouth.
Do not take more albuterol than your doctor prescribes. Taking more than you need can worsen your symptoms. If your condition worsens after taking your medicine, call your doctor at once and stop taking it.
Call your doctor immediately if you develop chest pain, palpitations, rapid heartbeat, muscle tremors, dizziness, headache, facial flushing, or urinary difficulty, or if you continue having breathing difficulties after taking the medicine.
Do not crush or chew the extended-release tablets.
If you forget a dose of albuterol, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: When used during childbirth, albuterol can slow or delay natural labor. It can cause rapid heartbeat and high blood sugar in the mother and rapid heartbeat and low blood sugar in the baby. Albuterol also causes birth defects in animal studies. When your doctor considers this drug crucial, its benefits must be cautiously weighed against its risks.
It is not known if albuterol passes into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors with cardiovascular disease should use albuterol with caution.
Jul
16
Acetaminophen
July 16, 2009 | Leave a Comment
Generic Name
Acetaminophen (uh-SEE-tuh-MIN-uh-fen) RE
Brand Names
Acephen Mapap-
Aceta Mapap Children’s
Acetaminophen Uniserts Mapap Extra Strength
Apacet Mapap Infant Drops
Aspirin Free Anacin Maximum Maranox
Strength Neopap
Aspirin Free Pain Relief Oraphen-PD
Dynafed, Children’s JR Panadol*
Dynafed EX Redutemp
Dynafed Extra Strength Silapap
Feverall Silapap Children’s
Feverall, Infants Silapap Infants
Genapap” Tapanol
Genebs Tempra*
Liquiprin Tylenol*
*Some products in this brand-name group are alcohol- or sugar-free. Consult your pharmacist.
Type of Drug
Antipyretic and analgesic.
Prescribed For
Relief of pain and fever for people who cannot or do not want to take aspirin or a nonsteroidal anti-inflammatory drug (NSAID). Acetaminophen may be given to children about to receive a
DTP vaccination to reduce the fever and pain that commonly follow the vaccination.
General Information
Acetaminophen is generally used to relieve pain and fever associated with the common cold, flu, viral infections, or other disorders where pain or fever may occur. It is also used to relieve pain in people who are allergic to aspirin, or those who cannot take aspirin because of potential interactions with other drugs such as oral anticoagulants. It can be used to relieve pain from a variety of sources, including arthritis, headache, muscle ache, menstrual cramping, and tooth and periodontic pain, although it does not reduce inflammation.
Cautions and Warnings
Do not take acetaminophen if you are allergic or sensitive to any of its ingredients. Do not take acetaminophen for more than 10 days in a row (5 days for children) unless directed by your doctor. Do not take more than is prescribed or recommended on the package.
Use this drug with extreme caution if you have kidney or liver disease or viral infections of the liver. Large amounts of alcohol increase the liver toxicity of large doses or overdoses of acetaminophen. Avoid alcohol if you regularly take acetaminophen. Some people are more sensitive to this effect than others.
Possible Side Effects
This drug is relatively free from side effects when taken in recommended doses. For this reason it has become extremely popular, especially among those who cannot take aspirin. V Rare: large doses or long-term use may cause liver dam-
age, rash, itching, fever, lowered blood sugar, stimulation,
yellowing of the skin or whites of the eyes, and/or a change
in the composition of your blood. Contact your doctor if
you experience any side effect not listed above.
Drug Interactions
o Large doses of barbiturate drugs, carbamazepine, phenytoin and similar drugs, izoniazid, rifampin, and sulfinpyrazone may increase the chances of liver toxicity if taken with acetaminophen.
• Alcoholic beverages increase the chances for liver toxicity
and possible liver failure associated with acetaminophen.
Food Interactions
None known.
Usual Dose
Adult and Child (age 12 and over): 325-650 mg 4-6 times a day,
or 1000 mg 3-4 times a day. Avoid taking more than 4 g (twelve
325-mg tablets) a day for long periods of time. Child (age 11): 480 mg 4-5 times a day. Child (age 9-10): 400 mg 4-5 times a day. Child (age 6-8): 320 mg 4-5 times a day. Child (age 4-5): 240 mg 4-5 times a day. Child (age 3): 160 mg 4-5 times a day. Child (age 1-2): 120 mg 4-5 times a day.
Child (age 4-11 months): 80 mg 4-5 times a day. Child (under age 4 months): 40 mg 4-5 times a day.
Overdosage
Acetaminophen is a commonly used ingredient in many over-the-counter (OTC) medications. Always check the list of ingredients when using more than one OTC medication to ensure that the combined dosage is within guidelines and to avoid accidental overdose.
Acute acetaminophen overdose may cause nausea, vomiting, sweating, appetite loss, drowsiness, confusion, abdominal tenderness, low blood pressure, abnormal heart rhythms, yellowing of the skin and whites of the eyes, and liver and kidney failure. Liver damage has occurred with 12 extra-strength tablets or 18 regular-strength tablets, but most people need larger doses-20 extra-strength or 30 regular-strength tablets—to damage their livers. Regular use of large doses for long periods-30004000 mg a day for a year—can also cause liver damage, especially if alcohol is involved. In case of overdose, induce vomiting as soon as possible with ipecac syrup—available at any pharmacy —and take the victim to a hospital emergency room. ALWAYS bring the acetaminophen bottle or container.
Special Information
Unless abused, acetaminophen is a beneficial, effective, and relatively nontoxic drug. Follow package directions and call your doctor if acetaminophen does not relieve pain in 10 days for adults or 5 days for children. Call your doctor if fever gets worse or persists longer than 3 days.
Alcoholic beverages will worsen the liver damage that acetaminophen can cause. People who take this drug on a regular basis should limit their alcohol intake.
If you forget to take a dose, take it as soon as you remember. If it is within an hour of 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: Acetaminophen ‘is considered safe during pregnancy when taken in usual doses. Taking continuous high doses of the drug may cause birth defects or interfere with fetal development. Three cases of congenital hip dislocation appear to have been associated with acetaminophen. Check with your doctor before taking this drug if you are or might be pregnant.
Small amounts of acetaminophen may pass into breast milk, but the drug is considered harmless to nursing infants.
Seniors: Seniors may take acetaminophen as directed by a doctor.
Jul
16
Acebutolol
July 16, 2009 | Leave a Comment
Generic Name
Acebutolol (ah-seh-BUTE-uh-lol) 91
Brand Name Sectral
Type of Drug
Beta-adrenergic blocking agent. Prescribed For
High blood pressure and abnormal heart rhythms.
General Information
Acebutolol hydrochloride is one of many beta-adrenergic blocking drugs, or beta blockers. These drugs interfere with the action of adrenaline and other chemicals in the body that affect many body functions. Individual beta blockers have different characteristics that can make them more suitable for certain conditions or people.
Cautions and Warnings
Do not take acebutolol if you are allergic or sensitive to any of its ingredients or to beta blockers.
You should be cautious about taking acebutolol if you have asthma, severe heart failure, a very slow heart rate, or heart block (disruption of the electrical impulses that control heart rate) because the drug may worsen these conditions.
People with angina taking acebutolol for high blood pressure risk aggravating their angina if they suddenly stop taking the drug. These patients should have their acebutolol dosage reduced gradually over 1-2 weeks.
Acebutolol should be used with caution if you have liver or kidney disease because your ability to eliminate this drug from your body may be impaired.
Acebutolol reduces the amount of blood pumped by the heart with each beat. This reduction in blood flow may aggravate the condition of people with poor circulation or circulatory disease.
If you are undergoing major surgery, your doctor may want you to stop taking acebutolol at least 2 days before surgery.
People with a history of severe anaphylactic reaction to alergens may be unresponsive to usual doses of epinephrine while taking beta blockers.
Possible Side Effects
Side effects are relatively uncommon and usually mild; normally they develop early in the course of treatment and are rarely a reason to stop taking acebutolol.
✓ Most common: fatigue.
✓ Common: dizziness and headache.
✓ Less common: chest pain, swelling in the legs or arms, depression, sleeplessness, abnormal dreams, rashes, constipation, diarrhea, upset stomach, stomach gas, nausea, frequent urination, back pain, joint and muscle pain, difficulty breathing, stuffy nose, and vision changes.
♦ Rare: cough, low blood pressure, slow heart beat, anxiety, impotence, changes in response to touch stimulation, itching, vomiting, abdominal pain, painful urination, nighttime urination, liver changes, sore throat, wheezing, eye irritation, pain or dry eye, and lupus erythematosus (extremely rare). Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Acebutolol may interact with surgical anesthetics to increase the risk of heart problems during surgery. Some anesthesiologists recommend gradually stopping the drug by 2 days before surgery.
• Acebutolol may interfere with the normal signs of low blood sugar and with the action of oral antidiabetes drugs.
• Acebutolol increases the blood-pressure-lowering effects of other blood-pressure-reducing agents, including clonidine, guanabenz, and reserpine, and calcium channel blockers such as nifedipine.
• Aspirin-containing drugs, nonsteroidal anti-inflammatory drugs (NSAIDS), and sulfinpyrazone may interfere with the blood-pressure-lowering effect of acebutolol.
• Cocaine may reduce the effectiveness of all beta blockers.
• Acebutolol may worsen the problem of cold hands and feet associated with ergot alkaloids, used to treat migraine. Gangrene is a possibility in people taking both an ergot and acebutolol.
• Acebutolol will counteract thyroid hormone replacements.
• Calcium channel blockers, flecainide, hydralazine, contraceptive drugs, cimetidine, propafenone, haloperidol, phenothiazine sedatives (molindone and others), quinolone antibacterials, and quinidine may increase the amount of acebutolol in the bloodstream and lead to increased acebutolol effects.
• Acebutolol should not be taken within 2 weeks of taking a monoamine oxidase inhibitor (MAGI) antidepressant.
• Acebutolol may interfere with the effects of some antiasthma drugs, including theophylline and aminophylline.
• Combining acebutolol with digitalis drugs may result in excessive slowing of the heart, possibly causing heart block.
• If you stop smoking while taking acebutolol, your dose may have to be reduced because your liver will break down the drug more slowly afterward.
• Aluminum salts, barbiturates, calcium salts, cholestyramine, colestipol, ampicillin, and rifampin may reduce the effectiveness of acebutolol.
• Beta blockers may block the effects of epinephrine.
Food Interactions
None known.
Usual Dose
High Blood Pressure
Adult: starting dose-100 mg a day, taken all at once or in 2 divided doses. The daily dose may be gradually increased. Maintenance dose-400-800 mg a day.
Senior: Older adults may respond to lower doses and should be treated more cautiously, beginning with 100 mg a day, increasing gradually to a maximum of 400 mg a day.
Child: not recommended.
Abnormal Heart Rhythms
Adult: starting dose-200 mg a day. Maintenance dose-200600 mg a day in 2 divided doses.
Senior: Older adults may respond to lower doses and should be treated more cautiously, beginning with 100 mg a day, increasing gradually to a maximum of 400 mg a day.
Child: not recommended.
Overdosage
Symptoms of overdose include extremely slow or irregular heartbeat, very low blood pressure, breathing difficulties, and seizures. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Acebutolol is meant to be taken continuously. When ending acebutolol treatment, dosage should be reduced gradually over a period of about 2 weeks. Do not stop taking this drug unless directed to do so by your doctor.
Do not take other medications, including over-the-counter medications, without consulting with your doctor. The use of some nasal decongestants with acebutolol may result in severely high blood pressure.
Acebutolol may cause drowsiness or dizziness. Be careful when driving or performing complex tasks.
It is best to take acebutolol at the same time each day. If you forget a dose, take it as soon as you remember. If you take acebutolol once a day and it is within 8 hours of your next dose, skip the dose you forgot and continue with your regular schedule. If you take acebutolol twice a day and it is within 4 hours of your next dose, skip the missed dose and continue with your regular schedule. Never take a double dose.
Special Populations
PregnancylBreast-feeding. Acebutolol crosses into the placenta. Infants born to women who took a beta blocker while pregnant had lower birth weights, low blood pressure, and slow heart rates. Acebutolol should be taken during pregnancy only if the potential benefit outweighs the risk.
Large amounts of acebutolol pass into breast milk. Nursing mothers taking acebutolol should use infant formula.
Seniors: Seniors taking acebutolol may need a reduced dosage.