Aug
13
Econazole - Efalizumab - Eflornithine - Enalapril - Enfuvirtide - Entacapone
August 13, 2009 | Leave a Comment
Generic Name
Econazole (ee-KON-uh-zole) 92
Brand Name Spectazole
Type of Drug Antifungal.
Prescribed For
Fungal infections of the skin, including athlete’s foot. jock itch, and ringworm.
General Information
Econazole nitrate can kill fungal organisms that may have penetrated to deep layers of the skin. Very small amounts of econazole are absorbed into the bloodstream.
Cautions and Warnings
Do not use econazole if you are allergic or sensitive to any of its ingredients.
Do not apply econazole cream in or near your eyes.
Long-term application of this product to large areas of skin may cause liver damage.
Possible Side Effects
♦ Most common: burning, itching, stinging, and redness in the areas to which the cream has been applied.
Drug Interactions None known.
Usual Dose
Adult: Apply enough of the cream to cover affected areas with a thin layer 1-2 times a day.
Overdosage
Accidental ingestion may cause nausea, upset stomach, drowsiness, and liver inflammation or damage. Call your local poison control center for more information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
Clean the affected areas before applying econazole cream, unless otherwise directed by your doctor. Dry the infected area thoroughly and wear loose-fitting clothes to keep the area cool and dry.
Call your doctor if the treated area burns, stings, or becomes red.
This product can be expected to relieve symptoms within 1 or 2 days after you begin using it. Follow your doctor’s directions for the complete 2-4-week course of treatment to gain maximum benefit. Stopping the drug too soon can lead to a relapse.
If you forget a dose of econazole, apply 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 apply a double dose.
Special Populations
Pregnancy/Breast-feeding: When given by mouth to pregnant animals in high doses, econazole was toxic to the fetus. It should be strictly avoided during the first 3 months of pregnancy. During the last 6 months of pregnancy, it should be used only if absolutely necessary.
Econazole may pass into breast milk. Nursing mothers who must take this drug should consider using infant formula.
Seniors: Seniors may take this drug without special restriction.
Efalizumab (ef-ah-LIZ-u-mab)
Brand Name Raptiva
Type of Drug
Immune system suppressant.
Prescribed For
Chronic to severe plaque psoriasis.
General Information
Efalizumab is a manmade antibody that works by binding to specific areas of certain white blood cells called leukocytes. This prevents the leukocytes from interacting with other cells and interrupts inflammation that is involved in the development of patches of psoriatic skin. The molecule that efaluzimab interacts with is found on many other key cells found in the immune system, and this is the source of many of the drug’s more serious side effects.
Cautions and Warnings
Do not use this drug if you are allergic or sensitive to any of its ingredients.
People taking efalizumab are at a greater risk of infection because it suppresses the immune system. Contact your doctor if you develop any kind of infection, including a common cold. Serious infections may require hospitalization.
The chances of malignancy may be increased by efalizumab because it suppresses the immune system. People with any type of cancer should not use this drug.
Efalizumab may lead to bleeding because it can cause a drastic reduction in blood-platelet counts. People with a history of low blood-platelet counts should be extremely cautious about using efalizumab.
Psoriasis can get worse or recur during or after efalizumab treatment in a small number of people. Call your doctor immediately if your condition worsens while you are taking efalizumab.
Possible Side Effects
Headache, fever, nausea, and vomiting are common alter taking the very first dose of elaki7umab. A “conditioning” dose of about 0.3 mg per lb. of body weight is often given to minimize these reactions.
V Most common: headache, infections, chills, nausea, and pain.
V Common: muscle aches, flu-like symptoms, itching, and fever.
Possible Side Effects (continued)
✓ Less common: back pain, arthritis, lung inflammation, and
acne.
♦ Rare: psoriasis, arthritis, joint pain, malignancy, low blood-platelet count, and drug allergy or sensitivity. Other rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Efalizumab is an immune system suppressant and should not be combined with other immune suppressant drugs because of the increased risk of infection and malignancy.
• Combining vaccines (live and acellular) with efalizumab may exaggerate the body’s response to the vaccine and increase the risk of developing the disease against which the vaccination is being administered. People taking etalizurnab should not receive vaccines.
Food Interactions None known.
Usual Dose
Adult: 0.3 mg per lb. of body weight to start. Then about 0.5 mg per lb. of body weight once a week on the same day. The maximum dose is 200 mg by subcutaneous injection. Mix your dose immediately before it is to be injected and throw away any unused medicine.
Child: not recommended.
Overdosage
Doses up to 4 times the recommended dose have been taken for 10 weeks without additional side effects. However, overdose victims should be taken to a hospital emergency room for observation. ALWAYS bring the prescription bottle or container.
Special information
See your doctor regularly while you are taking efaluzima6. Regular blood tests are required to make sure your blood platelets are not unusually low.
Tell your doctor if you gain or lose weight, since doses of efaluzimab are based on how much you weigh.Tell your doctor about all medicines you are taking including other medicines for psoriasis, non-prescription drugs, vitamins,
and herbal supplements.
Store unused medicine in the refrigerator. Throw away medicine that has been mixed but not used.
Call your doctor immediately if you develop bleeding gums, black-and-blue marks, any kind of infection, begin to bruise easily, or if you are told by another doctor that you have any kind of cancer.
This drug is given by injection under the skin. For more information on how to properly administer this drug, see page 1242.
Special Populations
Pregnancy/Breast-feeding: It is not known how efaluzimab will affect a growing fetus. Animal studies using doses equal to 30 times the human dose showed no adverse effects. While animal studies of efaluzimab reveal no damage to the fetus, this drug should be used only during pregnancy after carefully weighing its potential benefits against its risks.
It is not known if efaluzimab passes into breast milk, although it might affect the nursing infant’s developing immune system. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors should be cautious about using efaluzimab because of the increased risk of infection.
Generic Name
Eflornithine (eh-FLOOR-nih-thene)
Brand Name
Vaniga,
Type of Drug
Hair growth retardant.
Prescribed For
Removal of unwanted facial hair by women.
General Information
This drug has only been studied for its ability to prevent hair growth on the face and chin and should not be used on other body areas. It works by interfering with enzymes in the skin necessary for hair growth, slowing the rate at which hair will grow. Improvement may be seen as soon as 4-8 weeks after you start using eflornithine, but the condition will return within 8 weeks after you stop using it.
Cautions and Warnings
Do not use eflornithine if you are allergic or sensitive to any of its ingredients.
For external use only; do not ingest.
Possible Side Effects
Eflornithine side effects are similar to those of a placebo (sugar pill).
✓ Most common: acne, bumps, or small pustules on the skin. V -Common: stinging.
✓ Less common: headache, dizziness, burning, itching, redness, tingling, irritation, rash, hair loss, upset stomach, and appetite loss.
✓ Rare: fainting, ingrown hairs, inflamed hair follicles, facial swelling, nausea, bleeding, contact dermatitis, inflammation of one or both lips, herpes breakout, numbness, and dilated blood vessels and pores on the nose and cheeks. Contact your doctor if you experience any side effect not listed above.
Food and Drug Interactions None known.
Usual Dose
Adult and Child Me 11 anti over): Apply a thin layer of cream to ai ected areas and rub in thoroughly 2 times a day at least 8 hours apart. Do not wash your face until at least 4 hours after you have applied eflornithine cream. Wait at least 5 minutes after hair removal to apply eflornithine.
Child (under age 12): not recommended.
Overdosage Little is about the effects of eflornithine overdose or acci-
Li known
dental ingestion. Call your local poison control center for more information. ALWAYS bring the prescription container.
Special Information
If you forget to apply a dose of eflornithine, apply it as soon as you remember. Bear in mind that at least 8 hours must elapse between doses and you cannot wash the area for another 4 hours after application. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule.
This product slows hair growth. It is not a depilatory. You will have to continue shaving, tweezing, or using another hair removal technique.
Wait several minutes after application of eflornithine before applying cosmetics or sunscreen.
Use only on your face and neck.
Call your doctor if your skin becomes irritated or if you develop other side effects. If skin irritation continues, you may have to stop using eflornithine.
Special Populations
Pregnancy/Breast-feeding: Eflornithine cream may cause birth defects. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
It is not known if this drug passes into breast milk. Nursing mothers should use infant formula.
Seniors: Seniors may use eflornithine without special restriction.
Generic Name
Enalapril (uh-NAL-uh-pril)
Brand Name
Vasotec
Combination Product
Ggner;c Ingredients: Enalapril + Hydrochlorothiazide RE Vaseretic
Type of Drug
Angiotensi n -converting enzyme (ACE) inhibitor.
Prescribed For
Hypertension (high blood pressure), heart failure, diabetic kidney disease, and heart attack treatment when the function of the left ventricle has been affected. Also prescribed for kidney failure, kidney hypertension, managing people with a high risk of heart disease, chronic kidney disease, and preventing a second stroke.
General Information
Enalapril maleate 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 symptoms of heart failure. Enalapril also affects the production of other hormones and enzymes that participate in the regulation of blood-vessel dilation. Enalapril begins working about 1 hour after you take it and continues to work for 24 hours.
Cautions and Warnings
Do not take enalapril if you are allergic or sensitive to any of its ingredients. Severe sensitivity reactions can occur in hemodialysis patients taking enalapril or those undergoing venom immunization.
Swelling of the face, extremities, or throat has been known to occur with enalapril, which can be dangerous (see “Special Information”).
Enalapril occasionally causes very low blood pressure.
Enalapril may affect your kidney function, especially if you have congestive heart failure. Your doctor should check your urine for protein content during the first few months of treatment. Dosage adjustment of enalapril is necessary if you have reduced kidney function.
Enalapril can affect white-blood-cell counts, possibly increasing your susceptibility to infection. Your doctor should monitor your blood counts periodically.
Enalapril may cause serious Injury or death to the fetus if taken duriRcA pregnancy. Pregnant women should not take enalapril.
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
♦ Most common-. dizziness, fatigue, headache, and chronic cough. The cough usually goes away a few days after you stop taking the medication.
♦ Less common: chest tightness or pain, dizziness when rising from a sitting or lying position, fainting, abdominal pain, nausea, vomiting, diarrhea, bronchitis, urinary tract infection, breathing difficulties, weakness, and rash.
♦ 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.
For additional information about enalapril + felodipine, see Felodipine, page 471.
Drug Interactions
• The blood-pressure-lowering effect of enalapril 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 enalapril.
• Enalapril 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 enalapril and other ACE inhibitors. The combination may cause reductions in kidney function.
• Enalapril may increase blood-potassium levels, especially when taken with dyazide or other potassium-sparing diuretics.
• Antacids and enalapril should be taken at least 2 hours apart.
• Capsaicin may trigger or aggravate the cough associated with enalapril therapy.
• Indomethacin may reduce the blood-pressure-lowering effects of enalapril.
• Phenothiazine sedatives and antiemetics may increase the ef - feZIS of enalapril.
• Rifampin may reduce the effects of enalapril.
• The combination of allopurinol and enalapril increases the chance of side effects. Avoid this combination.
• Enalapril affects 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.
• Severe sensitivity reactions can occur in those taking allo-
purinol.
For additional information about enalapril + felodipine, see Felodipine, page 471.
Food Interactions
You may take enalapril with food if it upsets your stomach.
Usual Dose
Enalapril
Adult: 5-40 mg a day in 1 or 2 doses. People with poor kidney function need less medication.
Enalapril + Felodipine
Adult: 1-2 tablets a day.
Overdosage
The principal effect of enalapril 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
Enalapril can cause swelling of the face, lips, hands, or feet. This swelling can also affect the larynx (throat) or tongue and interfere with breathing. If this happens, go to a hospital emergency room at once. Call your doctor if you develop a sore throat, mouth sores, abnormal heartbeat, chest pain, persistent rash, or loss of taste perception.
Some people who start taking enalapril 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 their dosage is increased. To prevent this from happening, your doctor may tell you to stop taking your diuretic 2 or 3 days before starting enalapril or to increase your salt intake during that time. The diuretic may then be restarted gradually.
You may gO dizzy if you rise to your feet too quickly from a sitting or lying position when taking enalapril.
Avoid strenuous exercise or very hot weather because heavy
sweating or dehydration can cause a rapid drop in blood pressure.
While taking enalapril, avoid over-the-counter diet pills, decon-
gestants, 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 take enalapril once a day and forget to take a dose, 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. If you take enalapril twice a day and miss a dose, take it right away. If it is within 4 hours of your next dose, take 1 dose immediately and another in 5 or 6 hours, then go back to your regular schedule. Never take a double dose.
Special Populations
Pregnancy/Breast-feeding: ACE inhibitors can cause fetal injury or death. Women who are or might become pregnant should not take ACE inhibitors. Sexually active women of childbearing age who must take enalapril must use an effective contraceptive method to prevent pregnancy. If you become pregnant, stop taking the medication and call your doctor immediately.
Small amounts of enalapril 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 this drug due to age-related losses in kidney or liver function.
Generic Name
Enfuvirtide (en-M-ir-tide)
fusing to healthy CD4 cells, a key part of the human immune system. This helps fight HIV by having fewer HIV-infected cells as well as a healthier immune system to fight off the HIV virus. Enfuvirtide is always prescribed in combination with other antiviral medicines. It is possible for the HIV virus to become resistant to enfuvirtide, but this drug can work against types of the virus that have become resistant to other anti-HIV therapies.
Cautions and Warnings
Do not take enfuvirtide if you are allergic or sensitive to any of its ingredients. Symptoms of drug allergy can include generalized itching, rash, severe chills, and low blood pressure. In rare cases, enfuvirtide triggers severe hypersensitivity. Patients experiencing symptoms (a combination of rash, fever, nausea, and/or respiratory distress) should stop using enfuvirtide and seek medical attention immediately.
People taking enfuvirtide may be more likely to develop bacterial pneumonia. See your doctor regularly and report any difficulty breathing or unusual respiratory reactions.
Enfuvirtide may raise blood sugar levels, worsen diabetes, or trigger latent diabetes. People with diabetes who take this drug may need to have the dosage of their anti-diabetes medication adjusted.
Possible Side Effects
✓ Most common: allergic skin reaction at the site of injection (symptoms include itching, rash, and swelling of tissue under the skin), diarrhea, nausea, fatigue, and sleeplessness.
✓ Common: tingling in the hands or feet, depression, anxiety, cough, sinusitis, herpes infection, weight loss, appetite loss, weakness, itching, and muscle ache.
✓ Less common: taste changes, small skin tumors, flu infection, constipation, abdominal pain, pancreas inflammation, conjunctivitis and lymph gland inflammation.
‘T Rare: Rare side effects can affect the blood, immune system, kidneys, urinary tract, and central nervous system. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
Enfuvirtide is not broken down in the liver and does not affect liver enzyme systems, so it is not likely to be involved in common drug
interactions.
Food Interactions
None known. Usual Dose
Adult and Child (age 17 and over): 90 mg injected under the skin into the upper arm, thigh, or abdomen twice a day.
Child (age 6-16): 0.91 mg per lb. of body weight twice a day, up to 90 mg per injection. Be sure to increase enfuvirtide dosage as your child’s weight increases.
Child (under age 6): not recommended.
Overdosage
Little is known about the effects of enfuvirtide overdose. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Enfuvirtide is not a cure for HIV It will not prevent you from transmitting the HIV virus to another person; you must still practice safe sex. People taking this drug may still develop opportunistic infections and other complications associated with HIV infection.
This drug is given by injection under the skin. For information on how to properly administer this drug, see page 1242.
Do not use a vial of enfuvirtide if the final solution has particles floating in it. It should be completely clear, colorless, and have no bubbles in the vial.
You may keep solutions of enfuvirtide in the refrigerator and use them for up to 24 hours after they have been mixed. After that, they must be thrown away.
Tell your doctor if you are pregnant, become pregnant, os plan to become pregnant.
Do not stop taking this, or any other anti-HIV medicine, without first consulting your doctor.
Special Populations
Pregnancy/Breast-feeding: While animal studies of enfuvirtide reveal no damage to the fetus, this drug should only be used during pregnancy after carefully weighing its potential benefits against its risks. A national registry has been established to gather information on pregnant women who take this drug.
It is not known if enfuvirtide passes into breast milk. Nursing mothers with HIV should always use infant formula, regardless of whether they take this drug, to avoid transmitting the virus to their child.
Seniors: The effects of enfuvirtide in seniors is unknown.
Generic Name
Entacapone (in-TACK-a-pohn)
Brand Name Comtan
Type of Drug Antiparkinsonian.
Prescribed For
Parkinson’s disease patients for whom levodopa + carbidopa loses its effectiveness between doses.
General Information
Entacapone is always used in combination with levodopa + carbidopa. Some patients experience signs and symptoms of an end-of-dose “wearing-off” effect with these drugs. Entacapone enhances the effect of levodopa + carbidopa by reversing the action of an enzyme known as catechol-O-methyltransferase (COMT), which is primarily responsible for breaking down levodopa in the body.
Cautions and Warnings
Do not take entacapone If yOU are allergic or sensitive to any of At *Ingredients.
Do not take entacapone with phenelzine or tranyleypromine, as a very serious reaction may occur.
People with liver disease should use entacapone with caution as they may accumulate twice as much of this drug in their blood as people with normal liver function.
Entacapone has been rarely associated with the formation of fibrous tissues in unusual places such as the urinary tract and lungs. It has also caused fluid in the lungs.
Entacapone may cause kidney toxicity.
Entacapone may increase the risk of dizziness or fainting when rising from a sitting or lying down position.
Hallucinations have been reported with other Parkinson’s disease drugs.
Possible Side Effects
♦ Most common: difficulty performing voluntary muscle functions, excessive muscle activity, nausea, urine discoloration, and diarrhea.
♦ Common: reduced muscle activity, dizziness, fatigue, constipation, and abdominal pain.
✓ Less common: low blood pressure and fainting when rising from a sitting or lying position, hallucinations, anxiety, agitation, gastritis or other stomach disorders, dry mouth, vomiting, increased sweating, back pain, taste changes, shortness of breath, easy bruising, weakness, and bacterial infection.
♦ Rare: muscle damage or death, high fever, and confusion. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Do not mix entacapone with the monoamine oxidase inhibitor (MAGI) antidepressants phenelzine or tranylcypromine. Entacapone may be taken with the MAGI selegiline.
• Other drugs broken down by COMT will also be affected by entacapone. Isoproterenol, epinephrine, ephedrine, norepinephrine, isoetharine, and others will interact with entacapone, even when taken by inhalation. The result may be increased heart rate, wybylh m ias, and excessive changes in Uwd pressure.
• Cholestyramine, probenecid, erythromycin, rifampin, ampicillin, and chloramphenicol may interfere with the elimination of entacapone from the body.
• Entacapone may enhance the effects of sedatives and other nervous system depressants.
Food Interactions
This drug may be taken with or without food.
Usual Dose
Adult: 200 mg with each levodopa + carbidopa dose, up to
1600 mg a day.
Child: not recommended.
Overdosage
Theoretically, a massive entacapone overdose could prove lethal by completely inhibiting COMT throughout the body. There have been no reports of significant entacapone overdose. Doses up to 800 mg have been taken and side effects were mainly abdominal pain and loose stools. Other effects that might be expected include difficulty breathing, loss of muscle coordination, reduced level of activity, and convulsions. Overdose victims should be taken to a hospital emergency room as soon as possible. ALWAYS bring the prescription bottle or container.
Special Information
Always take your entacapone dose together with your levodopa + carbidopa dose. If you forget a dose, take it as soon as you remember. If it is within 2 hours of your next dose, skip the dose you forgot and continue with your regular schedule.
This drug can cause dizziness, nausea, sweating, or fainting when rising quickly from a sitting or lying position, especially at the beginning of treatment.
Increased body movements and twitching, twisting, or uncontrolled tongue, lip, face, arm, or leg movement may occur. If this happens, your doctor may need to adjust your dose of levodopa + carbidopa.
Exercise caution when performing tasks, such as driving, that require coordination and concentration until your body has become accustomed to the effects of entacapone.
Gradually reducing the dose of entacapone decreases some drug side effects.
Rapid withdrawal can cause high fever, sweating, unstable blood pressure, stupor, and muscular rigidity. Patients who stop using entacapone should be monitored.
Entacapone can cause your urine to turn a brownish-orange color. This change is harmless.
Special Populations
Pregnancy/Breast-feeding: Entacapone causes birth defects, miscarriage and abortion in pregnant animals. When this drug is considered crucial by your doctor, its potential benefits must be weighed against its risks.
Entacapone passes into the breast milk of animals but no information on humans is available. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may take this drug without special precaution.
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
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.
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.
Aug
1
Chlorpheniramine Maleate
August 1, 2009 | Leave a Comment
Generic Name
Chlorpheniramine Maleate
(KLOR-ten-ERE-uh-mene MAL-ee-ate) M
Brand Names
Aller-Chlor Efidac 24
Chlor-Trimeton Pediox S
Chlor-Trimeton Allergy 8 Hour Prohist+8 Chlor-Trimeton Allergy 12 Hour QDALL AR
The information in this profile also applies to the following drugs: Generic Ingredient: Cyproheptadine Hydrochloride 0
Generic Ingredient: Dexchlorpheniramine Maleate 19
Type of Drug Antihistamine,
Prescribed For
Stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal allergy, and other symptoms of allergy such as rash, itching, and hives.
General Information
Antihistamines generally work by blocking the release of histamine (a chemical released by body tissue during an allergic reaction) from body cells at the H, histamine receptor site, drying up secretions of the nose, throat, and eyes.
Cautions and Warnings
Do not use this drug if you are allergic or sensitive to any of its ingredients.
Use chlorpheniramine maleate with care if you have a history of thyroid disease, heart disease, high blood pressure, or diabetes. This drug should be avoided or used with extreme care if you have narrow-angle glaucoma, stomach ulcer or other stomach problems, enlarged prostate, or problems passing urine. It should not be used by people who have deep-breathing problems such as asthma, emphysema, or chronic bronchitis.
Possible Side Effects
V Less common: rash or itching, sensitivity to bright light, increased sweating, chills, lowered blood pressure, headache, rapid heartbeat, sleeplessness, dizziness, disturbed coordination, confusion, restlessness, nervousness, irritability, euphoria (feeling “high”), tingling in the hands or feet, blurred or double vision, ringing in the ears, upset stomach, appetite loss, nausea, vomiting, constipation, diarrhea, urinary difficulties, chest tightness, wheezing, stuffy nose, and dryness of the mouth, nose, or throat. Young children may also develop nervousness, irritability, tension, and anxiety.
Drug Interactions
• chlorpheniramine maleate should not be taken with a mono-amine oxidase inhibitQ(aMkdepiessank, because the combination may cause severe side effects.
• The effects of sedatives, benzodiazepines such as diazepam, and sleeping medications will be increased when any of these drugs is combined with chlorpheniramine maleate. It is extremely important for your doctor to know if you are taking any other medication with chlorpheniramine maleate so that the dosage of that medication can be properly adjusted.
• Anti chol inergenics may cause an increase in side effects of chlorpheniramine maleate.
• Be extremely cautious when drinking alcoholic beverages while taking this drug, which enhances the intoxicating and sedating effects of alcohol.
Food Interactions
You may take this drug with food if it upsets your stomach.
Usual Dose
chlorpheniramine
Adult and Child (age 13 and over): 4 mg every 4-6 hours; do not take more than 24 mg a day.
Child (age 6-12): 2 mg every 4-6 hours; do not take more than 12 mg a day.
Child (age 2-5): 1 mg every 4-6 hours; do not take more than 4 mg a day.
chlorpheniramine, Sustained-Release
Adult and Child (age 13 and over): 8-12 mg at bedtime, or every 8-12 hours during the day; do not take more than 24 mg a day. Child (age 6-12): 8 mg during the day or at bedtime.
Child (under age 6): not recommended.
Cyproheptadine
Adult and Child (age 15 and over): 4-20 mg a day; do not exceed 32 mg a day.
Child (age 7-14): 4 mg 2-3 times a day; do not exceed 16 mg a day.
Child (age 2-6): 2 mg 2-3 times a day; do not exceed 12 mg a day.
Dexchlorpheniramine
Adult and Child (age 12 and over): 2 mg every 4-6 hours. Child (age 6-11): 1 mg every 4-6 hours.
Child (age 2-5): 0.5 mg every 4-6 hours.
Dexchlorpheniramine, Sustained-Release
Adult and Child (age 12 and over): 4-6 mg every 8-10 hours and at bedtime.
Child (age 6-11): 4 mg once a day and at bedtime. Child (under age 6): not recommended.
Tripelennamine
Adult and Child (age 12 and over): 25-50 mg every 4-6 hours; do not take more than 600 mg a day. Adults may take up to 3100-mg, sustained-release tablets a day, although this much is not usually needed.
Child (under age 12): 2 mg per lb. of body weight a day in divided doses; no more than 300 mg a day should be given.
Overdosage
Symptoms of overdose include depression or stimulation, especially in children; dry mouth: fixed or dilated pupils; flushing of the skin; upset stomach; unsteadiness; and convulsions. Overdose victims should be made to vomit as soon as possible with ipecac syrup—available at any pharmacy—to remove excess drug from the stomach. Take the victim to a hospital emergency room immediately if the victim is unconscious.or if you cannot induce vomiting. ALWAYS bring the prescription bottle or container.
Special Information
This drug may cause tiredness or loss of concentration: Be extremely cautious when driving or doing anything that requires close attention.
If you forget a dose of this drug, 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
PregnancylBreast-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 months of pregnancy, because newborns may have severe reactions to antihistamines.
Small amounts of some antihistamines pass into breast milk. NV ing mothers who must take chlorpheniramine maleate should use infant formula.
Seniors: Seniors are more sensitive to antihistamine side effects. Dosage reduction may be needed.
Aug
1
Cevimeline
August 1, 2009 | Leave a Comment
Generic Name
Cevimeline (seh-VIM-ih-lene) 9
Brand Name Evoxac
Type of Drug Cholinergic.
Prescribed For
Dry mouth in people with syndrome.
General Information
Sj6gren’s syndrome jS a group 0j symptoms related to a lack of bodily secretions. People with this condition have very dry eyes and mucous membranes, facial lesions, and neck swelling. It often occurs in menopausal woman and is often associated with rheumatoid arthritis, poor blood circulation in the legs, and tooth decay. Cevimeline increases secretions in the mouth by binding to specific nervous system receptors and causing the release of more saliva.
Cautions and Warnings
Do not take cevimeline if you are allergic or sensitive to any of its
ingredients.
This drug may make breathing more difficult and worsen lung conditions such as asthma, chronic bronchitis, or chronic obstructive pulmonary disease (COPD).
Eye conditions like glaucoma or inflammation of the iris may be worsened by cevimeline.
Cevimeline may affect the heart, and some people with severe heart disease, including those with a history of severe angina or heart attack, may not be able to compensate for this effect.
Cevimeline may worsen gallstones and kidney stones and should be avoided by people with a history of these conditions.
Cevimeline may cause visual blurring, especially at night.
Possible Side Effects
✓ Most common: excessive sweating, headache, nausea, sinus irritation, respiratory infection, runny nose, and diarrhea.
✓ Common: upset stomach, abdominal pains, urinary infection, coughing, and sore throat.
✓ Less common: vomiting, back pain, injury, rash, conjunctivitis (pinkeye), dizziness, bronchitis, severe joint pain, fatigue, bone pain, sleeplessness, hot flushes, excess salivation, chills, and anxiety.
✓ Rare: frequent urination, weakness, and flushing. Other rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Combining cevimeline with a beta blocker can lead to heart rhythm disturbances.
• Cevimeline may interfere with the effects of anticholinergics, found in Some medications for abdominal or stomach spasms or cramps.
• Cholinergics such as bethanechol, donepezil, physostigmine, pilocarpine, and pyridostigmine can add to the effects of cevimeline.
• Some drugs may interfere with the breakdown of cevimeline in the liver, increasing the chance of drug side effects. These include amiodarone, celecoxib, chlorpheniramine, cimetidine, ciprofloxacin, clarithromycin, clomipramine, cocaine, diltiazem, erythromycin, fluconazole, fluoxetine, halofantrine, indinavir, itraconazole, ketoconazole, methadone, mibefradil, nelfinavir, paroxetine, quinidine, ranitidine, ritonavir, saquinavir, and terbinafine.
Food Interactions
Grapefruit juice may interfere with the breakdown of cevimeline in the liver, increasing the chance of drug side effects. Food interferes with the absorption of cevimeline into the bloodstream. Take this drug on an empty stomach.
Usual Dose
Adult: 30 mg 3 times a day. Child: not recommended.
Overdosage
Overdose symptoms can include exaggerated drug side effects including headache, visual impairment, excess tearing and/or sweating, difficulty breathing, stomach or intestinal spasms, nausea, vomiting, diarrhea, changes in heart rhythm, blood pressure changes, shock, mental confusion, and tremors. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
cevimeline may cause blurred vision, possibly interfering with driving or performing tasks that require reliable vision, especially at night or in low light.
If you sweat excessively while taking cevimeline, be sure to drink a lot of water. Excessive sweating can lead to dehydration.
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Pregnant women should take cevimeline only if it is considered crucial by your doctor, since its effect on the developing fetus is not known.
It is not known if cevimeline passes into breast milk, but nursing mothers who must take this drug should consider using infant formula.
Seniors: Older adults should be cautious about using this drug because of its possible effects on the kidney, liver, and heart, and on other diseases or medications.
Aug
1
Cetirizine
August 1, 2009 | Leave a Comment
Generic Name
Cetirizine (seh-TERE-ih-zene)
Brand Name Zyrtec
The information in this profile also applies to the following drugs:
Generic Ingredient: Azelastine
Generic Ingredient: Fexofenadine 91 Allegra
Generic Ingredient: Levocetirizine 91 Xyzal
Type of Drug Antihistamine.
Prescribed For
Azelastine: runny nose, sneezing, nasal itching, and post-nasal drip. Cetirizine: stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal and year-round allergy, and for other symptoms of allergy such as rash, itching, and hives; also prescribed for chronic itching and for asthma. Fexofenadine: sneezing, stuffy and runny nose; scratchy throat and mouth; and itchy, watery, and red eyes caused by seasonal allergies. Levocetirizine: stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal and year-round allergy, and for other symptoms of allergy such as rash, itching, and hives; also prescribed for chronic itching.
General Information
Antihistamines generally work by blocking the release of histamine (a chemical released by body tissue during an allergic reaction) from the cell at the H, histamine receptor site, drying up secretions of the nose, throat, and eyes. Cetirizine causes less sedation than older antihistamines and appears to be just as effective. Levocetirizine is the active portion of the cetirizine molecule and is as effective as cetirizine with a similar side effect profile.
Cautions and Warnings
Do not take cetirizine if you are allergic or sensitive to any of its ingredients.
People with kidney disease should receive reduced dosages of cetirizine and levocetirizine. Do not take these drugs if kidney disease is severe. Children with kidney disease should not receive levocetirizine.
Possible Side Effects
✓ Common: headache, drowsiness, fatigue, dry mouth, bitter taste in the mouth, dizziness, runny nose, and sore throat.
✓ Less common: nosebleeds, stuffy nose, sneezing, cough, nausea, upset stomach, changes in bowel habits, nervousness, and fever (children).
♦ Rare: fainting and weight gain. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Cimetidine may increase the level of azelastine in the blood.
• Cetirizine is less likely than other antihistamines to interact with drugs.
• Ritonavir increases the amount of levocetirizine and slows its breakdown in the body. This may result in increased levocetirizine side effects.
Food Interactions
• Ceterizine and levocetirizine may be taken without regard to food or meals.
Usual Dose
Azelastine Nasal Spray
Adult and Child (age 12 and over): 1-2 sprays in each nostril twice a day.
Child (age 5-11): 1 spray in each nostril twice a day.
Cetirizine
Adult and Child (age 6 and over): 5-10 mg once a day depending on symptoms. Reduce dosage in people with kidney disease. Child (age 1-5): 2.5-5 mg a day.
Child (age 6 months-1 year): 2.5 mg a day.
Fexofenadine
Adult (age 12 and over): 60 mg twice a day or 180 mg once a day. People with kidney disease should take 60 mg a day.
Child (age 6-11): 30 mg twice a day.
Levocetirizine
Adult and Child (age 12 and over): 5 mg every evening.
Child (age 6-11): 2.5 mg (1h tablet) every evening. Dosage for children should not exceed 2.5 mg a day. Child (under age 6): not recommended.
Overdosage
Drug overdose is likely to cause severe side effects. Overdose victims should be Oven ipecac syrup—available at any pharmacy—to make them vomit and be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Use extra caution while doing anything that requires concentration, such as driving a car or operating hazardous machinery.
Report sore throat, unusual bleeding, bruising, tiredness, weakness, or any other unusual side effect to your doctor. Do not combine these drugs with alcohol or other nervous system depressants. Do not put azelastine nasal solution into your eyes.
If you forget to take a dose of cetirizine, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Oral antihistamines are generally considered safe for use during pregnancy. But do not take any antihistamine without your doctor’s knowledge if you are or might become pregnant—especially during the last 3 months of pregnancy, because newborns may have severe reactions to antihistamines.
Small amounts of antihistamine pass into breast milk. Nursing mothers who must take cetirizine should use infant formula.
Seniors: Antihistamines are more likely to cause dizziness, sleepiness, and confusion in seniors. Dosage reduction may be recommended depending on kidney function.