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
Ciclopirox
August 1, 2009 | Leave a Comment
Generic Name
Ciclopirox (sye-kloe-PERE-ox) &
Brand Names
Loprox Penlac
Type of Drug Antifungal,
Prescribed For
Fungus and yeast infections of the nails and skin, including athlete’s foot, candida, and dandruff.
General Information
Ciclopirox slows the growth of a variety of fungus organisms and yeasts and kills many others. The drug penetrates the skin, hair, hair follicles, and sweat glands. Ciclopirox nail lacquer is used for toenail and fingernail fungus infections. Ciclopirox shampoo is used for dandruff.
Cautions and Warnings
Do not use this product if you are allergic or sensitive to any of its ingredients.
Possible Side Effects
Common: burning, itching, stinging, or oozing at the application site.
Drug Interactions None known.
Usual Dose
Cream/Lotion
Adult and Child (age 10 and over): Massage into cleansed affected skin and surrounding area twice a day.
Nail Lacquer
Adult: Apply to infected nails once a day. Use in conjunction with monthly visits to a health care professional.
Child (under age 10): not recommended.
Shampoo
Adult: Wet hair and apply 1-2 tsp to the scalp. Lather and leave on hair and scalp for 3 minutes, then rinse. Avoid contact with eyes. Repeat twice weekly for 4 weeks.
Child (under age 16): not recommended.
Overdosage
Accidental ingestion may cause nausea and upset stomach. Call your local poison control center or hospital for more information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
This product can be expected to relieve symptoms within the first week of use. Follow your doctor’s directions for the complete 2-4 week course of treatment with the cream or lotion to gain maximum benefit. The nail lacquer may be used for up to 48 weeks. Stopping the medication too soon can lead to a relapse.
When using ciclopirox nail lacquer, do not apply it to any skin other than that which surrounds the infected nails, because of possible irritation. Do not apply nail polish or any other nail lacquer to infected nails while you are using this product.
Avoid using ciclopirox nail lacquer near an open flame, since the product is flammable.
Do not cover cream or lotion with a bandage.
Call your doctor if the affected area burns, stings, or becomes red after you use this product, 13y i1 your symptoms do not clear Up aher 4 weeks of treatment; by then it is unlikely that this product will be effective.
If you forget a dose of ciclopirox, apply it as soon as you remember. Do not apply more than the amount prescribed to make up for the missed dose.
Special Populations
PregnancylBreast-feeding., ciclopirox may pass to the fetus in very small amounts. In animal studies, high doses of ciclopirox given by mouth did not harm the fetus. Caution should be exercised when using ciclopirox during pregnancy.
It is unknown if ciclopirox passes into breast milk. Nursing mothers who must use this drug should consider using infant formula.
Seniors: Seniors may use this drug without special restriction.