Aug
13
Estazolam - Estrogens - Eszopiclone - Exemestane - Exenatide
August 13, 2009 | Leave a Comment
Generic Name
Estazolam (es-TAZ-oe-lam) V
Type of Drug Benzodiazepine sedative.
Prescribed For
Insomnia and sleep disturbances.
General Information
Estazolam is a member of the group of drugs known as benzodiazepines. They work by a direct effect on the brain. Benzodiazepines make it easier to go to sleep and decrease the number of times you wake up during the night. Estazolam is considered an intermediate-acting sedative and generally remains in your body long enough to give you a good night’s sleep with minimal “hangover.”
Cautions and Warnings
Do not take estazolam if you are allergic or sensitive to any of its ingredients. Severe allergic reactions may occur. People with respiratory disease taking estazolam may experience sleep apnea (intermittent cessation of breathing during sleep). People who already have, or suspect they have, sleep apnea should not take estazolam.
People with kidney or liver disease should be carefully monitored while taking estazolam. Take the lowest possible dose to help you sleep.
Clinical depression may be increased by estazolam, which can depress the nervous system. Intentional overdose is more common among depressed people who take sleeping pills than among those who do not.
All benzodiazepines can be addictive if taken for long periods of time and can cause drug withdrawal symptoms if discontinued suddenly. It should be used With caution in people with a history 0 YATUg dependence. Withdrawal symptoms include tremors, Muscle cramps, insomnia, agitation, diarrhea, vomiting, sweating, and convulsions.
People with a history of seizures should not abruptly stop taking estazolam.
Possible Side Effects
♦ Common: drowsiness, headache, dizziness, talkativeness,
nervousness, apprehension, poor muscle coordination, light-
headedness, daytime tiredness, muscle weakness, slow-
ness of movement, hangover, and euphoria (feeling “high”).
♦ Less common: nausea, vomiting, rapid heartbeat, confusion, temporary memory loss, upset stomach, stomach cramps and pain, depression, blurred or double vision and other visual disturbances, constipation, changes in sense of taste, appetite changes, stuffy nose, nosebleeds, common cold symptoms, asthma, sore throat, cough, breathing difficulties, diarrhea, dry mouth, allergic reaction, fainting, abnormal heart rhythm, itching, acne, dry skin, sensitivity to bright light or to the sun, rash, nightmares or strange dreams, sleeplessness, tingling in the hands or feet, ringing or buzzing in the ears, ear or eye pain, menstrual cramps, frequent urination and other urinary difficulties, blood in the urine, discharge from the penis or vagina, lower back and joint pain, muscle spasms and pain, fever, swollen breasts, and weight changes.
✓ Rare: Rare side effects can affect your heart, stomach and intestines, urinary tract, blood, muscles, and joints. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• As with all benzodiazepines, the effects of estazolam are enhanced if it is taken with an alcoholic beverage, antihistamine, sedative, barbiturate, anticonvulsant medication, antidepressant, or monoamine oxidase inhibitor antidepressant.
• Carbamazepine and phenytoin may reduce blood levels and the effectiveness of estazolam by stimulating liver enzymes responsible for its breakdown.
• Ketoconazole, itraca(\ailzAe, netazodone, fluvoxamine, diltiamm,’isoniazid, some macrolide antibiotics, contraceptive drugs, cimetidine, and disulfiram may increase the effect of estazolam by interfering with the drug’s breakdown in the liver. Probenecid also increases estazolam’s effects by interfering with it passing through the kidneys into urine.
• Cigarette smoking, rifampin, and theophylline may reduce the effect of estazolam.
• Levodopa + carbidopa’s effectiveness may be decreased by estazolam.
• Estazolam may increase the amount of zidovudine (an HIV drug—also known as AZT), phenytoin, or digoxin in your bloodstream, increasing the chances of side effects.
• The combination of clozapine and benzodiazepines has led to respiratory collapse in a few people. Estazolam should be stopped at least 1 week before starting clozapine treatment.
Food Interactions
Estazolam may be taken with food if it upsets your stomach.
Usual Dose
Adult (age 18 and over): 1-2 mg at bedtime.
Senior: 1 mg at bedtime. Small or frail patients should start on 0.5 mg. Dosage should be increased cautiously.
Child (under age 18): not recommended.
Overdosage
The most common overdose symptoms are confusion, sleepiness, depression, loss of muscle coordination, and slurred speech. Coma and death may also occur. People who take an estazolam overdose must be made to vomit with ipecac syrup—available at any pharmacy—to remove any remaining drug from the stomach: Call your doctor or a poison control center before doing this. The victim must be taken to a hospital emergency room for treatment if 30 minutes have passed since the overdose was taken or if symptoms have begun to develop. ALWAYS bring the prescription bottle or container.
Special Information
Never take more estazolam than your doctor has prescribed. Avoid alcoholic beverages and other nervous system depressants while taking estazolam.
Exercise caution while performing tasks that require concentration and such as driving: estazolam may make you tired, dizzy, or lightheaded. People taking estazolam or any other sleeping medicine may experience unusual and complex reactions while asleep, such as driving, making phone calls, and cooking with no memory of the event.
If you take estazolam daily for 3 or more weeks, you may experience some withdrawal symptoms when you stop taking the
drug, especially temporary sleep disturbance. In rare cases, patients discontinuing estazolam have suffered seizures or delirium. Patients with a history of seizures should taper when stopping use
of this drug.
If you forget to take a dose of estazolam and remember within about 1 hour of your regular time, take it right away. If you do not remember until later, skip the dose you forgot and go back to your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Estazolam absolutely should not be used by pregnant women or by women who may become pregnant.
Estazolam passes into breast milk. The drug should not be taken by nursing mothers.
Seniors: Seniors are more susceptible to the effects of estazolam. Type of Drug
Estrogens (ES-troe-jens)
Brand Names
Generic Ingredient: Conjugated Estrogens Premarin Premarin Cream
Generic Ingredient: Conjugated Estrogens (Synthetic) Cenestin Enjuvia
Generic Ingredients: Conjugated Estrogens + Medroxyprogesterone
Premphase Prempro
Generic Ingredient: Esterified Estrogens Menest
Generic Ingredients: Esterified Estrogens + Methyttestosterone Estratest
Generic Ingredient: Estradio(& Alora,
Climara Divigel Elestrin Estrace Estraderm
Estring Estrogel
Evamist Transdermal Spray Femring
Femtrace Gynodiol
Innofem Menostar Vagifem
Vivelle Vivelle-Dot
Generic ingredients: Estradiol + Drospirenone Angeliq
Generic Ingredients: Estradiol + Levonorgestrel Climara Pro Nuvaring
Generic Ingredients: Estradiol + Norgestimate 99 Pretest
Generic Ingredient: Estropipate
Ogen Cream Ortho-Est
Generic Ingredients: Ethinyl Estradiol + Norethindrone Activella Combipatch FemHRT 1/5
Prescribed For
Moderate to severe menopausal symptoms such as hot flashes, night sweats and sleep problems, vaginal dryness and irritation (creams and gels); also prescribed for ovarian failure, osteoporosis prevention, male breast cancer, advanced prostate cancer, abnormal bleeding of the uterus, female castration, Turner’s syndrome, and birth control.
General Information
Six estrogens have been identified in women but only 3 are present in large amounts: estradiol, estrone, and estriol. Estradiol is the most potent and most important. Other estrogens are produced by chemical conversions in the body. Estradiol, for example, is transformed into estrone, which in turn becomes estriol. Estrogens all have the same actions and side effects; only potency varies. More potent types require smaller dosages to produce the same effect.
Millions of women have taken hormone replacement therapy (HRT) to manage menopausal symp<oms, but studies show that HRT doeq WMpYove quality of life for most. Women who experience severe menopause symptoms must weigh the benefits of prolonged hormone replacement therapy against its risks.
Estrogens are largely responsible for the growth and maintenance of the female reproductive system and sex characteristics. They affect the release of hormones from the pituitary gland (con-troller of hormone production and regulator of basic bodily functions). These hormones control the functioning of capillaries (smallest blood vessels), may cause fluid retention, affect protein breakdown in the body, prevent ovulation and breast engorgement after childbirth, and influence the shaping and maintenance of the skeleton through an effect on calcium.
Estrogen products differ in their hormone content and dosage. Some may affect one part of the body more than another. Generally, though, estrogens are interchangeable as long as dosage differences are taken into account.
Cautions and Warnings
Do not take estrogens if you are allergic or sensitive to any of their ingredients.
Products containing an estrogen and a progestin should not be used for the prevention or treatment of bladder-control problems, heart disease, or mental decline (dementia).
Women with an intact uterus who choose hormone replacement therapy for menopausal symptoms should take the lowest effective dose for the shortest possible time to minimize the risks associated with these medicines. The results of a very large study called the Women’s Health Initiative (WHI) first published in 2002 and updated with new reports, have drastically changed the face of estrogen replacement therapy. The study found a small but insignificant increase in the risk of non-fatal heart attacks. There was no increase in heart disease in the estrogen plus progestin part of the WHI. Early results of the WHI found 4-6 more cases of invasive breast cancer for every 10,000 women in the study and tumors were harder to detect. But this result was not confirmed after more than 7 years of additional study. Estrogens may also lead to abnormal mammograms. An increased risk of a stroke was found in the WHI study. The risk of blood clots forming in the body was doubled in women taking hormone therapy. This study did show some benefits of long-term hormone replacement in colon cancer and osteoporosis, but these benefits may not outweigh the risks of hormone replacement therapy.
Women with liver damage or disease, blood-clotting problems, or abnormal vaginal bleeding whose cause is unknown, should not take estrogens.
Women who smoke cigarettes and take estrogen have a greater risk of cardiovascular side effects, including stroke and blood clotting.
Estrogens may increase the risk of endometriat cancer by 4.514 times in postmenopausal women taking them without progestin for prolonged periods of time; the risk depends on duration of treatment and dosage. Women who have a strong family history of breast cancer or who have breast nodules or cysts or an abnormal mammogram should be cautious about using estrogens. Women with estrogen-dependent cancer or breast cancer should not take estrogens, except some being treated for breast cancer that has spread. Women taking an estrogen for breast cancer that has spread to their bones can develop large increases in blood calcium.
Postmenopausal women taking estrogen are 2-3 times more likely to develop gallbladder disease.
Estrogens can raise blood pressure. Pressure usually returns to normal when the drug is stopped.
People with thrombophlebitis should avoid these drugs. The risk is greatest with very high dosages. Lower hormone dosages may not be a problem.
Estrogens should not be used to treat painful breast enlargement that sometimes develops after giving birth.
Estrogens can cause significant increases in blood triglycerides and cause pancreas inflammation in women with inherited blood-fat disorders.
Vaginal estrogen cream may stimulate bleeding of the uterus. It may also cause breast tenderness, vaginal discharge, and withdrawal bleeding if the product is suddenly stopped. Women with endometriosis may experience heavy vaginal bleeding.
Women taking hormone replacement therapy are at a 50% greater than normal risk of senile dementia.
Drospirenone, a progestin and an ingredient in Angeliq, can raise blood potassium levels in some people because it opposes the hormone aldosterone. It should not be used in people with conditions that can lead to high blood potassium such as kidney disease or a poorly functioning adrenal gland. Drospennone should be used with caution by women who we also taking other medicines that raise tl(QW potassium, such as nonsteroidal antiWkvmmMory drugs (NSAIDs), potassium-sparing diuretics, potassium supplements, angiotensin-converting enzyme (ACE) inhibitors, All receptor antagonists, and heparin. Your doctor may want to check your blood potassium level if you might be at risk of high blood potassium.
Possible Side Effects
v Most common: breast enlargement or tenderness, ankle and leg swelling, appetite loss, weight changes, water retention and bloating, nausea, vomiting, and abdominal cramps. The estrogen patch may cause rash, irritation, and redness where it is applied.
V Less common: bleeding gums, breakthrough vaginal bleeding, vaginal spotting or discharge, changes in menstrual flow, painful menstruation, premenstrual syndrome (PMS), absence of menstrual periods during and after estrogen use, uterine fibroid enlargement, vaginal Candida infection, a cystitis-like condition, mild diarrhea, yellowing of the skin or whites of the eyes, eye lesions, contact-lens intolerance, rash, hair loss, development of new hairy patches, migraine, mild dizziness, depression, increased sex drive (women), and decreased sex drive (men).
♦ Rare: stroke, blood-clot formation, dribbling or sudden passage of urine, loss of coordination, chest pain, leg pain, breathing difficulties, slurred speech, and changes in vision. Men who take large estrogen dosages for prostate cancer have a greater risk of heart attack, phlebitis, and blood clots in the lungs. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Phenytoin, ethotoin, mephenytoin, and topiramate may interfere with estrogen’s effects.
• Estrogens may reduce the effect of oral anticoagulant (blood-thinning) drugs. Your anticoagulant dosage may need an adjustment.
• Estrogens may increase the side effects of antidepressants and phenothiazine sedatives.
• Low estrogen dosages may increase 0\enolhiazine’s effectiveness.
% ‘ittrogens may increase cyclosporine and corticosteroid blood levels. Dosage adjustments of the non-estrogen drugs may be needed.
• Estrogens may reduce the effectiveness of thyroid replacement therapy.
• Rifampin, barbiturates, carbamazepine, St. John’s wort, and other drugs that stimulate the liver to break down drugs may reduce estrogen blood levels.
• Estrogens may interfere with tamoxifen and bromocripline.
• Women, especially those ova. 35, who smoke cigarettes and take estrogen have a much greater risk of developing stroke, hardening of the arteries, or blood clots in the lungs. The risk increases with age and tobacco use.
• Estrogens interfere with many diagnostic tests. Make sure your doctor knows you are taking estrogen before conducting any blood tests or other diagnostic procedures.
Food Interactions
Estrogens may be taken with food to reduce nausea and upset stomach. Avoid drinking grapefruit juice if you are taking this drug.
Usual Dose
Dosage varies. All of these products, including the transdermal skin patch, may be taken continuously or on a cyclic schedule of 3 weeks on, 1 week off.
Tablets
Chlorotrianisene: 12-200 mg.
Conjugated estrogens: 0.3-30 mg.
Conjugated estrogens, synthetic: 0.625-1.25 mg. Esterified estrogens: 0.3-30 mg.
Estradiol: 0.5-30 mg.
Estropipate: 0.625-7.5 mg.
Ethinyl estradiol: 0.02-3.0 mg.
Estradiol Transdermal Patch (0.025, 0.0375, 0.05, 0.075, or 0.1 mg) Alora, Estraderm, and Esclim: 1 patch twice a week: or use 1
patch twice a week for 3 weeks, stop for 1 week, then start again. Climara and Fempatch: 1 patch every week; or use 1 patch once
a week for 3 weeks, stop for 1 week, then start again.
Estradiol Transdermal Spray: 1-3 Sprays (1.53 mg estradiol in each spray
face of the forearm, starting near the elbow. Do not allow the sprays to overlap each other. Allow the spray to dry for about 2 minutes and do not wash the arm for 30 minutes. Do not apply the spray to any other part of the body.
3Wkw1 Onext to each other every morning on the inner sur-Estradiol Gel: Spread 1 pumpful of the gel as thinly as possible over the entire area on the inside and outside of your arm from wrist to
shoulder, once a day at the same time every day.
Vaginal Cream
Conjugated estrogens: 0.52 g a day for 3 weeks; stop for 1 week,
then start again.
Dienestrol: 1 applicatorful 12 times a day for 12 weeks, half the
original dosage for another 12 weeks, then 1 applicatoviO 13 times
a week.
Estradiol: 24 g a day for 2 weeks, half the starting dosage for an-
other 2 weeks, then 1 g 13 times a week.
Estropipate: 24 g a day for 3 weeks; stop for 1 week, then start again.
Estradiol Ring
Insert once every 3 months.
Overdosage
Symptoms may include nausea and vaginal bleeding in adult women. Call your local poison control center or a hospital emergency room for information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you develop breast pain or tenderness, swelling of the feet and lower legs, rapid weight gain, chest pain, breathing difficulties, pain in the groin or calves, unusual or persistent vaginal bleeding, missed menstrual period, lumps in the breast, sudden severe headache, dizziness or fainting, disturbances in speech or vision, weakness or numbness in the arms or legs, abdominal pain, sudden severe vomiting, depression, yellowing of the skin or whites of the eyes, or jerky or involuntary muscle movement.
Women taking estrogens or combined estrogen and progestin therapy should have yearly lamasN exams, perform monthly breast self -Paw i)26ions, and have regular mammograms.
Talk to your health care provider about ways to reduce risk factors for heart disease (blood-pressure control, improving your diet, stopping tobacco use) and osteoporosis (an appropriate diet, vitamin D and calcium supplements, weight-bearing exercise).
Tell your doctor if you are having surgery or require bedrest: your doctor may have you stop taking estrogen 4-6 weeks beforehand to prevent the risk of blood clots.
Your doctor should reevaluate your need for estrogen vaginal cream every 36 months. Do not stop using the drug suddenly because this may increase your risk of developing unpredicted or breakthrough vaginal bleeding.
Women using the cream who develop breast tenderness, start to bleed, or have other vaginal discharge should contact their doctors at once.
Estrogen skin patches should be applied to a clean, dry, non-oily, hairless area of intact skin, preferably on the abdomen. Do not apply it to your breasts or waist, or to any area where tightfitting clothes may loosen the patch from your skin. The application site should be rotated to prevent irritation, and each site should have a patch-free period for 7 days.
Good dental hygiene is important while taking estrogen because estrogen may increase your risk of oral infection. Dental work should be completed prior to starting estrogen, if possible.
Vaginal estrogen cream should be inserted high into the vagina, about 2/3 of the length of the applicator.
Press the vaginal ring into an oval and insert as deeply as possible in the upper 1/3 of the vagina.
Some of these products contain tartrazine (a commonly used orange dye and food coloring). If you are allergic to tartrazine or have asthma, check with your pharmacist to find out if your estrogen product contains this coloring agent.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Authorities note that the risk of serious complications for an individual woman taking hormone replacement therapy is very small. Thus, you may decide to take hormones but your decision should be based on a complete discussion of the facts and your individual situation with your doctor. Continue to talk with your doctor regularly about weighing tt% i1%’Ks against the benefits of taking estrQ(;e5\.
Special Populations
Pregnancy/Breast-feeding: Estrogens harm the fetus and should never be used during pregnancy for any reason.
Estrogens pass into breast milk and reduce its flow. Nursing mothers who must take them should use infant formula.
Seniors: The risk of side effects increases with age, especially if you smoke. Women age 65 or older taking estrogens may be more likely to develop a stroke, blood clot, or dementia, a condition where people suddenly or gradually lose normal mental function and intellectual capacity.
Generic Name
Eszopiclone (ess-oh-PIK-lone)
Brand Name Lunesta
Type of Drug Sedative.
Prescribed For Insomnia.
General Information
Eszopiclone is a nonbenzodiazepine sleeping pill that is believed to work in much the same way as the drug zolpidem and as benzodiazepine-type sleeping pills and sedatives. Unlike the benzodiazepines, however, eszopiclone has little muscle-relaxing or antiseizure effects. This drug is rapidly absorbed and usually starts working within a few minutes. Eszopiclone causes little or no “hangover,” and there are no rebound effects after stopping the drug. In studies of eszopiclone, tolerance to its effects did not develop even after 6 months of continued use. Eszopiclone is broken down in the liver, and the level of this drug in the body does not increase after you take it for several days.
Cautions and Warnings
Do not take eszopiclone if you are allergic or sensitive to any of its ingredients.
People With severe liver disease should use eszopiclone with caution and must take less of this medication than those with normal liver function or mild liver disease.
Sleeping problems often result from a physical or psychological illness. Eszopiclone does not affect the underlying causes of
insomnia. It should be taken only with your doctor’s knowledge. If you cannot sleep even after 7-10 days of taking eszopiclone, con-
tact your doctor.
Eszopiclone has caused amnesia (memory loss), but this happens mostly at dosages larger than 2 mg per night.
Suddenly stopping eszopiclone after having taken it for some time may produce drug withdrawal (symptoms include fatigue, nausea, flushing, lightheadedness, crying, vomiting, stomach cramps, panic, nervousness, and general discomfort).
People with a history of substance abuse may be more likely to develop drug dependence on eszopiclone. Eszopiclone doses of 612 mg are similar to 20 mg of diazepam in their potential for abuse.
Eszopiclone is a nervous system depressant and may cause loss of coordination and concentration. It should be taken just before bedtime. People taking sleep medicine may experience unusual and complex reactions while asleep, such as driving, making phone calls, or cooking with no memory of the event. Eszopiclone may also interfere with normal activities the next day, especially if taken with alcohol.
Eszopiclone should be avoided by people with severe depression, severe lung disease, and sleep apnea (intermittently stopping breathing when you are asleep). You should not take this drug if you are drunk.
Possible Side Effects
Adults
Some side effects are more likely with larger doses (viral infection, dry mouth, dizziness, hallucinations, infections, rash, and unpleasant taste).
♦ Most common: headache, drowsiness, unpleasant taste, and lung infections.
✓ Common: dry mouth, dizziness, and nausea.
✓ Less common: nervousness, vomiting, viral infections, anxiety, confusion, depression, hallucinations, reduced sex drive, rash, male breast e”k-aigement and/or pain, painful meR%k5UMlrjn, chest pain, migraines, and swelling of the arms or legs.
♦ 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
• Mixing eszopiclone with olanzapine can affect your coordination and ability to perform tasks.
• Mixing eszopiclone with ketoconazole more than doubles blood levels of eszopiclone. Other drugs that may have a similar interaction include itraconazole, clarithromycin, nefazodone, troleandomycin, ritonavir, and nelfinavir.
• Rifampin can be expected to drastically reduce the effectiveness of eszopiclone because it increases levels of liver enzymes that break down eszopiclone.
• Avoid combining eszopiclone with alcohol and other nervous system depressants, including sedatives, narcotics, barbiturates, antidepressants, and antihistamines.
Food Interactions
For the most rapid and complete effect, take eszopiclone on an empty stomach at least 2 hours after a meal. It will take longer for eszopiclone to work if you have had a high-fat meal immediately before taking it.
Usual Dose
, abnormal dreaming, nery
Adult (q% 1% and over): 2-3 mg immediately before bedtime or after you are in bed and have trouble falling asleep. Eszopiclone can act very quickly.
Child (up to age 17): not recommended.
Senior: 1-2 mg immediately before bedtime.
People with liver disease: 1 mg.
Possible Side Effects (continued) Seniors
Some side effects are more com the cluding dry mouth, pain, and unpleasant easant
♦ Most common: headache.
♦ Common: pain, dry mouth, diarrhea, rrhea, and upset
♦ Less common: accidental injury,
ousness, nerve pain, itching, and urinary• Rare: Rare side effects can occur in almost any part body. Contact your doctor if you
ou experience any side ef fect not listed above.
infection. of - , mon with larger doses in
Overdosage
Overdose can result in nervous system depression, from unconsciousness to light coma. Combining eszopiclone with alcohol or other nervous system depressants may be fatal or affect other body organs. One person took up to 36 mg of eszopiclone and fully recovered. Take the victim to a hospital emergency room at once. ALWAYS bring the prescription bottle or container.
Special Information
Eszopiclone may cause tiredness, drowsiness, and an inability to concentrate. Be careful when driving or performing any task that requires concentration on the day following a dose. Make sure you get 7-8 hours of sleep after taking eszopiclone.
People taking eszopiclone on a regular basis may develop a drug withdrawal reaction if the medication is stopped suddenly (see “Cautions and Warnings”).
Do not take a double dose of this medication.
Special Populations
Pregnancy/Breast-feeding: Some animal studies with doses of eszopiclone up to 800 times the human equivalent showed it did not affect a developing fetus, and other studies showed some modest effects. However, there is no information on the use of eszopiclone in pregnant women. If your doctor considers eszopiclone crucial for you, its potential benefits must be carefully weighed against its risks.
It is not known if eszopiclone passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors, who are likely to be more sensitive to eszopiclone and its side effects, should start on a 1 -mg dose and take the lowest effective dosage.
Generic Name
Etanercept (eh-TAN-er-sept)
Brand Name Enbrel
Type of Drug
Immune system modulator.
Prescribed For
Rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and psoriasis.
General Information
Etanercept binds to a specific protein in the body known as tumor necrosis factor (TNF) and blocks it from interacting with cell surfaces. TNF is involved in normal inflammatory and immune responses and the inflammatory processes of rheumatoid arthritis, juvenile rheumatoid arthritis, and other conditions. Etanercept can also interfere with biological actions that are either caused or regulated by TNF.
Cautions and Warnings
Do not use etanercept if you are allergic or sensitive to any of its ingredients.
Serious infections and malignancies are possible in people using etanercept because of its ability to suppress the immune response. This may be more common in people with other conditions that predispose them to infections such as advanced or uncontrolled diabetes.
Levels of blood platelets and some white blood cells may be reduced in rare cases, leading to persistent fever, bruising, bleeding, and pale skin. Contact your doctor if any of these symptoms develop.
Etanercept may increase the risk of some nervous system disorders including multiple sclerosis.
Etanercept may cause or worsen congestive heart failure.
In rare cases people taking etanercept have developed a lupus-like syndrome which may disappear when the drug is discontinued.
People taking etanercept should not receive any live vaccines, because the body may not be able to respond as expected to the vaccine.
Possible Side Effects
RPndmt may develop at the site where etanercept is injected. Injection sites should be rotated among the thigh, abdomen, and upper arm to avoid excessive bruising or other skin damage.
Possible Side Effects (continued)
♦ Most common: infection, injection-site reactions, upper respiratory infection, headache, and runny nose.
♦ Common’. nausea, dizziness, sore throat. cough, weak-
ness, abdominal pain, rash, and respiratory problems.
♦ Less common: upset stomach, sinus irritation, vomiting.
swelling in the legs or feet, mouth sores, and hair loss.
✓ Rare: malignancy, stroke, seizure, tingling in the hands or feet, nervous system irritation similar to multiple sclerosis, eye inflammation, joint pain, generalized pain, appetite loss, blood vessel inflammation in the skin, dry eyes, lumps under the skin, fever, flu-like symptoms, weight gain, chest pain, flushing, diarrhea, taste changes, difficulty breathing, worsening of existing lung conditions, itching, and skin reactions. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Do not mix etanercept in the same syringe as another drug.
• Using etanercept with anakinra increases the risk of serious infections.
Food Interactions None known.
Usual Dose
Adult: rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis-50 mg a week. Plaque psoriasis: 50 mg twice a week, reducing to 50 mg a week after 3 months.
Child (age 4-17): 0.36 mg per lb. of body weight, up to 50 mg a week, 3-4 days apart.
Child (under age 4): not recommended.
Overdosage
In one study, ‘A patient accidentally self-administered 62 mg of etanercept twice a week for 3 weeks with no ill effects. Call your local poison control center or a hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
Etanercept is taken by injection under the skin. Be sure you understand how to measure the proper dose of etanercept and how
to self-inject it.
To mix and inject etanercept: Withdraw all the water supplied with the medicine into a syringe and slowly inject it into the vial containing etanercept. Swirl the mixture gently to avoid excess foaming in the vial. Do not shake the vial.
Do not combine etanercept with any other injectable drug. Etanercept may be stored in a refrigerator for up to 14 days after it is mixed.
Single-use pre-filled syringes must be refrigerated. Do not use past the provided expiration date.
If you forget to administer a dose, do so as soon as you remember. Remember that etanercept doses must be administered at least 3 days apart. Call your doctor or pharmacist if you have any questions about how to time your etanercept doses.
Special Populations
PregnancylBreast-feeding. The safety of using etanercept during pregnancy is not known. 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 who must take it should use infant formula.
Seniors: Seniors are more likely to develop infections while using etanercept.
Generic Name
Exemestane (ex-eh-MES-tane)
Bnj(kod WaYne Aromasin
Type of Drug Aromatase inhibitor.
Prescribed For
Breast cancer. Also prescribed for prostate cancer prevention.
General Information Some breast cancers depend on the presence of the hormone estrogen to stimulate their growth. Depriving these cancers of estrogen is an effective way of treating the condition. Exemestane significantly reduces the amount of estrogen in the blood by binding permanently to an enzyme called aromatase, an essential element in the conversion of androgen (male hormones) to estrogen in premenopausal and postmenopausal women. Exemestane does not affect other hormones in the body. Exemestane is broken down in the liver.
Cautions and Warnings
Do not take exemestane if you are allergic or sensitive to any of its ingredients.
Exemestane may be prescribed for men and postmenopausal women only.
Possible Side Effects
✓ Most common: fatigue, hot flashes, pain, depression, sleeplessness, anxiety, nausea, and breathing difficulties.
✓ Common: flu-like symptoms, leg swelling, high blood pressure, dizziness, headache, vomiting, abdominal pain, leg swelling or other fluid retention, sweating, appetite loss, constipation, and coughing.
✓ Less common: increased appetite, diarrhea, fever, weakness, tingling in the hands or feet, broken bones, bronchitis, sinusitis, rash, itching, urinary infection, and swollen lymph glands.
♦ Rare: chest pain; confusion; reduced sensitivity to stimulation; upset stomach; joint, back, or other bone pain; respiratory infection; sore throat; runny nose; and hair loss. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Estrogen-containing drugs reduce the effectiveness of exemestane. Do not combine these drugs.
• Rifampin, phenytoin, carbamazepine, phenobarbital, and St. John’s wort may potentially reduce the effectiveness of
exemestane.
Food Interactions
Take this drug with a meal. The amount of exemestane absorbed into the blood is increased by 40% when taken with a high-fat meal.
Usual Dose
Adult: 25 mg once a day with or just after a meal. Dose adjustment is not needed in people with kidney or liver disease. Child: not recommended.
Overdosage
Doses as large as 600 mg have been well tolerated by women with advanced breast cancer. Overdose victims should be taken to a hospital emergency room for evaluation and treatment. ALWAYS bring the prescription bottle or container.
Special Information
If you forget a dose, skip the forgotten dose and continue with your regular schedule. Contact your doctor if you skip more than one dose.
Special Populations
Pregnancy/Breast-feeding: Exemestane is intended only for postmenopausal women. It can cause birth defects and miscarriage and should not be used by pregnant women or women who may become pregnant.
Exemestane may pass into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors may take this drug without special precaution.
Generic Name
Exenatide (ex-EN-ah-tide)
Brand Name Byetta
7Vpe of Drug Incretin mimetic.
Prescribed For Type 2 diabetes.
General Information
Exenatide is a unique drug that improves blood sugar control in people with type 2 diabetes who have been unsuccessful with diabetes pills. It is added to existing therapy and does not replace other treatments. Exenatide has many of the same actions as GLP-1, a natural incretin hormone. It differs chemically and works differently from other diabetes medications, including insulin.
Exenatide begins working about 30 minutes after injection and continues to work for at least 8 hours. It helps the pancreas to release insulin into the blood in response to sugar levels, so insulin rises when blood sugar is high and declines as blood sugar declines. It reduces the production of a hormone called glucagon, which raises blood sugar. Exenatide also keeps food in the stomach longer, which in turn helps reduce the amount of sugar absorbed from dietary sources. Exenatide increases the number of beta cells (that produce insulin) in animals and may have the same effect in humans. This could help reduce the need for other medicines and improve diabetes control.
Cautions and Warnings
Do not take exenatide if you are allergic or sensitive to any of its ingredients.
This drug is not a substitute for insulin. Exenatide has only been studied together with metformin, glitazones, and/or sulfonylureas. It has not been studied with other diabetes pills or insulin.
People with severe kidney disease should not use exenatide.
People with severe stomach or intestinal disease should not use exenatide.
Inflammation of the pancreas can occur with this drug. Symptoms include nausea, vomiting, fever, rapid pulse, and painful and swollen abdomen that may develop slowly and worsen when you eat or may be severe and constant.
Low blood sugar may ziccurit you are taking exenatide with a S\00ny)urea-type antidiabetes drug or with a glitazone.
Antibodies to exenatide may develop, but antibody levels generally go down with time. Most patients who develop antibodies still have good sugar control and similar types of side effects as people who do not develop exenatide antibodies.
Possible Side Effects
♦ Most common: nausea, vomiting, diarrhea, and low blood sugar (when mixed with a sulfonylurea-type drug or metformin plus a sulfonylurea).
♦ Less common: low blood sugar (when mixed with a glitazone), feeling jittery, dizziness, headache, and upset stomach.
✓ Rare: rash, abdominal swelling and pain, constipation, and kidney failure. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Exenatide has been studied with a number of other medications commonly taken by people with diabetes (digoxin, lovastatin, lisinopril, and acetaminophen) and no significant interactions were noted.
• Combining exenatide with a sulfonylurea-type drug may lead to hypoglycemia (low blood sugar). Your doctor may change your sulfonylurea dose to solve this problem.
• Take all oral medicines at least 1 hour before you inject exenatide to ensure maximum absorption. If you must take oral drugs with food or meals, take them with a snack or meal when exenatide is not being injected. Exenatide extends the time that drugs remain in the stomach and may reduce the amount of medication absorbed when taken by mouth.
• Exenatide may reduce the effectiveness of oral contraceptive pills. Take them at least 1 hour before an injection of exenatide.
• Exenatide may increase the amount of warfarin in the body and increase the risk of bleeding.
Food Interactions
None known. Usual Dose
Adult: 5 or 10 mcg twice a day by subcutaneous injection %M)iT) an hour before breakfast and dk”"tj.
CAWVEOnafide has not been studied in children. Overdosage
The effects of an exenatide overdose are severe nausea, severe vomiting, and severe, rapid drops in blood sugar levels. An oral sugar source may help, but overdose victims should be taken to a hospital emergency room for evaluation and treatment. ALWAYS bring the exenatide pen with you.
Special Information
Each dose of exenatide must be given as an injection under the skin of the thigh, abdomen, or upper arm within 1 hour before your breakfast and dinner meals. For information on how to properly administer this drug, see page 1242.
If you forget a dose of exenatide, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Exenatide injection is clear and colorless. Do not use if it has any color, is cloudy, or if there are any particles floating in it.
Keep this drug in the refrigerator, and do not use it after the expiration date has passed.
This drug may lead to a loss of appetite and loss of body weight. Do not change your regular dosage if this happens to you.
Special Populations
PregnancylBreast-feeding. In animal studies using doses equal to 3 times the usual human dose, exenatide was shown to affect the growth of the fetus. If you are or might be pregnant and your doctor considers this drug crucial, its potential benefits must be weighed against its risks.
Small amounts of exenatide may pass into breast milk and may affect a nursing infant. Nursing mothers taking this drug should use infant formula.
Seniors: Seniors may take this drug without special restriction. Generic Name
Jul
16
Acyclovir
July 16, 2009 | Leave a Comment
Generic Name
Acyclovir (ae-SYE-kloe-vir) 4i
Brand Name Zovirax
Type of Drug Antiviral.
Prescribed For
Initial treatment and maintenance of genital herpes outbreaks; treatment of herpes zoster (shingles); and treatment of varicella (chickenpox).
General Information
Acyclovir is the only oral drug that reduces growth rates of the herpes virus and the related viruses, Epstein-Barr, varicella, and cytomegalovirus (CMV); both oral acyclovir and oral ganciclovir work against CMV Intravenous drugs, including acyclovir injection, may also be used for these viral infections; however, intravenous antiviral drugs are usually reserved for patients with HIV, cancer, or otherwise compromised immune systems.
Acyclovir is selectively absorbed into cells that are infected with the herpes simplex virus, where it is converted into its active form. Acyclovir works by interfering with the reproduction of viral DNA, slowing the growth of existing viruses. It has little effect on recurrent infections. To treat both local and systemic (whole-body) symptoms acyclovir must be given by intravenous injection or taken by mouth. Local symptoms may be treated with the ointment alone. Oral acyclovir may be taken every day to reduce the number and severity of herpes attacks in people who suffer 10 or more attacks a year; it may also be used to treat intermittent attacks as they occur, but treatment must be started as soon as possible to have the greatest effect.
Cautions and Warnings
Do not use acyclovir if you are allergic or sensitive to any of its ingredients. Do not use acyclovir ointment if you have had an allergic reaction to it or to the major component of the ointment base, polyethylene glycol. Do not apply acyclovir ointment inside the vagina because the polyethylene glycol base may cause irritation and swelling of sensitive vaginal tissue. Acyclovir ointment is not intended for use in the eye and should not be used to treat a herpes infection of the eye.
Renal failure has occurred in patients using oral acyclovir, in some cases resulting in death. People with kidney impairment should have dosages adjusted accordingly.
Maintain adequate hydration while taking oral acyclovir. Animal testing indicates that acyclovir may affect fertility in men. These effects may be reversible.
Possible Side Effects
Capsules, Suspension, and Tablets
✓ Most common: feeling unwell, headache, diarrhea, nausea, and vomiting.
✓ Less common: appetite loss, stomach gas, constipation, fatigue, rash, leg pains, sore throat, a bad taste in the mouth, sleeplessness, and fever.
♦ Rare: aching joints, weakness, and tingling in the hands or feet. Contact your doctor if you experience any side effect not listed above.
Ointment
✓ Most common: mild burning, irritation, rash, and itching. These effects are more likely to occur when treating an initial herpes attack than a recurrent attack. Women are 4 times more likely to experience burning than men.
Drug Interactions
• Do not apply acyclovir together with any other ointment or topical medication.
• Oral probenecid may decrease elimination of acyclovir from the body, which increases blood levels of oral or injected acyclovir, increasing the risk of side effects.
• Combining acyclovir and zidovudine (an HIV drug—also known as AZT) may lead to severe drowsiness and lethargy.
Food Interactions
Acyclovir may be taken with food if it upsets your stomach.
Usual Dose
Capsules, Suspension, and Tablets
Adult: genital herpes attack-200 mg every 4 hours, 5 times a day for 10 days. Recurrent infections-400 mg 3 times a day or 200 mg 5 times a day for 5 days. Suppressive therapy for chronic herpes-800 mg a day, every day for up to a year. Herpes zoster800 mg 5 times a day for 7-10 days.
Child (age 2 and over): Acyclovir has been given to children in daily doses as high as 36 mg per lb. of body weight without any unusual side effects.
Child (under age 2): not recommended.
If you have kidney disease, your doctor should adjust your dose according to the degree of functional loss.
Ointment: Apply every 3 hours, 6 times a day for 7 days. Apply enough medication to cover all visible skin lesions. About 1/2 in. of ointment should cover about 4 sq. in. of lesions. Your doctor may prescribe a longer course of treatment to prevent the delayed formation of new lesions over the duration of an attack. Begin using ointment at the first sign of an attack.
Overdosage
Overdose of oral acyclovir may lead to kidney damage due to deposits of acyclovir crystals in the kidneys. Other side effects include agitation, seizures, lethargy, and coma. The risk of experiencing toxic side effects from swallowing acyclovir ointment is quite small. In the case of overdose or accidental ingestion, call your poison control center. ALWAYS bring the prescription bottle or container.
Special Information
Use a finger cot or rubber glove when applying acyclovir ointment to protect against inadvertently spreading the virus. Be sure to apply the medication exactly as directed and to completely cover all lesions. Keep affected areas clean and dry. Loose-fitting clothing will reduce possible irritation of a healing lesion. If you skip several doses, or a day or more of treatment, the drug will not exert its maximum effect.
Acyclovir is not a cure for genital herpes. Herpes may be transmitted even if you do not have symptoms of active disease. To avoid giving the condition to a sexual partner, do not have intercourse while visible herpes lesions are present. A condom offers some protection against transmission of the herpes virus, but spermicidal products and diaphragms do not. Acyclovir alone will not prevent herpes transmission.
Initiate therapy at the first sign of symptoms.
Women with genital herpes have an increased risk of cervical cancer. Speak with your doctor about the need for an annual Pap smear.
Call your doctor if acyclovir does not relieve your symptoms, if side effects become severe or intolerable, or if you become pregnant or want to begin breast-feeding. Check with your dentist if you notice swelling or tenderness of the gums.
Avoid exposure to excessive sunlight or sunlamps because of unusual sensitivity caused by oral acyclovir.
Special Populations
Pregnancy/Breast-feeding: Acyclovir crosses into the circulation of the fetus. Animal studies have shown that large doses—up to 125 times the human dose—cause damage to both mother and fetus. While there is no information to indicate that acyclovir affects a human fetus, do not use it during pregnancy unless it is specifically prescribed by your doctor and the possible benefit outweighs the risk.
Acyclovir passes into breast milk in concentrations up to 4 times the concentration in blood, and it has been found in the urine of a nursing infant. Although no side effects have been found in nursing babies, mothers who must take acyclovir should use infant formula.
Seniors: Shingles attacks in people over age 50 tend to be more severe and respond best to acyclovir treatment if the drug is started within 48-72 hours of the appearance of the first rash. Seniors with reduced kidney function should be given a lower dose of oral acyclovir than younger adults.
Jul
15
Living with your Prostate. FAQ.
July 15, 2009 | Leave a Comment
Living with your Prostate
We hope we have shown you two things: firstly, you need to be aware of your prostate gland and what can go wrong with it,
so that you can get treatment for any possible problems if they arise; and secondly, even if problems do arise, they are
unlikely to be as bad as you may fear, and can probably be completely cured remeron zoloft .
BE AWARE AND DON-F DESPAIR are the key words when it comes to the prostate how to get prozac .
A positive outlook on life is one of the greatest weapons we have at our disposal women testosterone libido .
Never forget it methotrexate intolerance and mitochondrial dysfunction .
BE AWARE
It is important to keep an eye on any changes in your urinary habits, particularly after the age of 50 prevacid withdrawal . Changes may creep
up on you slowly over the years, but don’t use that as an excuse for not taking them seriously snorting fluoxetine .
Ask yourself the following questions:
• Do you have to get up at night to urinate?
• Do you urinate much more often than you used to?
• Do you have difficulty passing water?
• Is your flow of urine particularly thin or weak, particularly in the morning’?
• Do you ever experience any pain when you urinate?
• Do you ever notice any blood in your urine?
• Can you urinate as high, or as far, as you used to’?
• Do you get pains in the region of your prostate, in the groin, or around your genitals?
• Do you sometimes find it difficult to start the flow of urine’?
• Do you sometimes find that you involuntarily stop and start urinating?
• Do you sometimes feel as though you haven’t quite emptied your bladder and there’s more to come?
• Do you have to strain to pass water?
• Do you ever suffer from incontinence?
• Does your urine continue dribbling, even when you think you’ve finished’?
• Do you sometimes need to rush urgently to the toilet to urinate?
• Do you ever notice blood in your semen?
Warning symptoms
If you have answered Yes to one (or more) of these questions, you may be experiencing problems with your prostate clomiphene medicina para la ovulacion .
Warning signs of this kind are there to be taken notice of and you should never ignore them interactions with celexa and herbs .
Men are notoriously good at sweeping under the carpet things that make them feel uncomfortable, and signs that all may
not be quite as they should be on the health front come into this category the three uses for chloramphenicol . The reason why you should not do this is a
straightforward, not to say obvious, one prednisones . It is, quite simply, because the sooner you do something about them, the
greater your chances of doing something constructive about them and effecting a cure naltrexone and alcohol .
Men also tend to be frightened of wasting their doctor’s time and being viewed as a nuisance which is safer prednisone or methotrexate . But you shouldn’t worry
about this, your doctor is very unlikely to think this way generic viagra usa . Doctors are there to look after your health, and if something
is really worrying you that’s enough to warrant a visit zyrtec woman and rufus tv commercial .
So the message is:
GO TO SEE YOUR DOCTOR process flow diagram atorvastatin calcium .
CONSULTING YOUR DOCTOR
First of all, your doctor will want to know all your symptoms imitrex uk . To make sure you don’t forget to tell him about any of
these, make a list of them before you go to the surgery loratadine buy . You should also make a note of any questions you want to ask
him paxil and warfarin .
The doctor will take a general medical history, with particular reference to any serious familial diseases such as
diabetes, heart disease or haemophilia, and any drugs you are taking regalis vs viagra . He will also want to know about any important
changes in your health that you have noticed recently, such as general fatigue or lower back pain, which may not seem to
you to be at all relevant but which could be important to the doctor dosage of levaquin .
If you’re worried about your urinary habits, it’s as well to establish a relationship with your doctor, so you can get to
know him and he can get to know you and your anxieties sting lithium sunset mp3 . If you’re just starting to have symptoms, he may not find
anything much wrong now, but he will want you both to keep an eye on things and to monitor the situation online tramadol prescription .
Above all, never be embarrassed to talk to your doctor about your urinary habits zyrtec and edema . He won’t be embarrassed and you
shouldn’t be either femara ovulated on cd .
YOUR LIFESTYLE
There are several changes you can make to your lifestyle which will help keep your prostate healthy daily dose coumadin .
Try to do the following:
• Don’t smoke levaquin classification . Smoking causes spasm in smooth muscle and may, as a result, make matters worse, particularly if a prostate
problem has already been diagnosed celebrex form generic .
• Keep your consumption of alcohol, which can irritate the bladder, as low as possible premarin in stop bleeding . In particular, avoid beer anathesia propofol interaction zoloft .
• Avoid coffee nexium swollen lip problems . Coffee has an irritating effect on the bladder at the best of times, and if the bladder is already
`unstable’, this effect is likely to be heightened prednisone withdrawal and rash .
• Try to keep stress in your life to a minimum, as it can intensify urinary problems such as hesitancy and urgency morrisons ibuprofen 200mg caplets .
This is easier said than done, but you may benefit (wouldn’t we all?) from making every effort not to allow yourself to
be too easily worked up by the pressures of modern-day life what is the strongest testosterone booster . Try learning some relaxation techniques 36 levitra overseas 52 .
• Try to avoid going out in the cold, which can often trigger bladder problems triglycerides and glucophage .
• Wrap up warm thyroxine of pigs tiroidea .
• Get plenty of sleep levitra cialis new viagra .
• Take regular exercise actos 30 . In particular, it is thought that having played a lot of sport regularly as a child,
particularly before reaching puberty, may have a protective effect against the development of cancer of the prostate tamoxifen and breast cancer .
Exercise is still beneficial in adult life because it keeps the muscles around the abdomen active viagra hamster .
• Don’t regularly restrict your fluid intake because you are frightened of having to go to the loo too often diclofenac sodium 75mg ter watson .
Drinking less may not actually help anyway mirtazapine and msds . If you have an important meeting, or are going to the theatre, restrict your
fluid intake from about three hours beforehand, which should help make it easier for you to go out lithium batteries cr123a . You can also restrict
fluid intake at night, which may mean you don’t have to get up so often to urinate drinking and viagra .
DIET
The main thing you can do to protect your prostate and to prevent it from causing you problems later in life is to follow
a prostate-friendly diet clomid buy .
The idea of a diet that’s good for the heart has been around for a long time and people are slowly becoming better
educated about this and following the advice given novo simvastatin . But a diet that’s good for the prostate is a relatively new idea and
not something that most men take very seriously clomid bleeding .
But before you dismiss this idea as being silly or unnecessary, remember, prostate disease is terribly common protonix rebates . The more
you can do about keeping it at bay, the better vitamin b12 absorption on prilosec .
Dietary tips
• Keep your intake of saturated fats (butter, animal fats, palm oil, coconut oil) to a minimum, as the latest
research shows that it can increase the risk of prostate cancer sexual side effects abilify .
• Switch to low-fat milk, cheese, dressings, etc finasteride bioavailability .
• Reduce your consumption of meat, in particular red meat,
which you should eat either not at all or only occasionally dilantin for neuropathy .
• Remove the skin from chicken minocycline hydochloride .
• Increase your consumption of fish recretional use of amitriptyline . Fish oil may have anticancer benefits levaquin antibiotic sore legs side effect .
• Eat a diet that is rich in fibre (fruit and vegetables, particularly potatoes and sweetcorn), wholemeal bread,
pulses, brown rice and pasta caffeine children . Fibre reduces the chances of constipation, and regular constipation can put pressure on the
prostate gland triamcinolone azmacort aristocort .
• Try to eat a minimum of five portions of fruit or vegetables each day switch and paxil to prozac . Ideally, eat them raw or only lightly
cooked tetracycline or minocycline .
• Drink plenty of fluids - around 1 geodon withdrawal .75-2 uk pravachol .25 litres/3-4 pints a day - as this also helps prevent constipation diet coke caffeine free printable logo . Drink
milk, mineral waters and diluted fruit juices rather than alcohol or coffee, both of which are diuretics protonix long term . Drinking
sufficient fluids also helps protect your bladder from infections thyroid testosterone .
• Eat plenty of nuts and seeds warning about zyrtec . The World Health Organization (WHO) recommend that everyone should eat at least 30
g of nuts or seeds per day soma cube puzzle dog .
• Green, yellow and orange fruits and vegetables are particularly beneficial because they are rich in
beta-carotene, which converts to vitamin A in the intestine and liver, and has an antioxidant effect which is thought to
protect against cancer prilosec treats such diseases . Rich sources of beta-carotene include carrots, oranges and apricots death due to fosamax .
• Make sure your diet is rich in vitamins C and E, because of their ability to mop up dangerous free radicals which
can form during the body’s metabolic processes and thus weaken their protective powers against cancer 5 cream zovirax . Foods rich in
vitamin C include most fruits and vegetables, particularly citrus fruits, strawberries, potatoes and peppers; while foods
rich in vitamin E include most vegetable oils, eggs, fish, green leafy vegetables and pulses cheap tramadol cod saturday delivery .
• Make sure your diet is rich in zinc ivermectin wormer . Good sources of zinc include shellfish (particularly oysters), fish
(particularly herrings), wholegrain cereals, oatmeal, eggs, cheese, nuts and seeds (particularly pumpkin and sunflower
seeds) toxicology and baclofen overdose .
• Make sure your diet is rich in essential fatty acids, such as sun-
flower oil, safflower oil, linseed oil, walnut oil and soya oil acyclovir en espanol .
• You may find that spicy foods have an adverse effect on your prostate problems valtrex hhv6 . This is because they upset the
bowel, and the prostate rests against it mycin family of drugs .
• You may find it helpful to keep a diary of the food you eat and your symptoms; this should help you work out what
foods or drinks precipitate symptoms, and you can then avoid them scientific study of dogs on prozac .
Food supplements
• Take zinc supplements (around 10 mg three times a day) caffeine supplier . If this amount upsets your stomach or makes you feel
nauseous, both of which are possible side-effects, you can reduce your dose (10 mg just twice a day) clindamycin causes chlamydia .
• Take evening primrose oil natural alternative to provera .
• If you’re worried about your diet, take dietary supplements wellbutrin vs zoloft . Take vitamin C (around 150 mg a day), vitamin E
(around 30-40 mg a day); and beta-carotene (around 15 mg a day) tramadol feline dosage . These are all antioxidants and can help reduce
inflammation as well as protecting against cancer average milligrams lexapro .
I was due to have surgery for an enlarged prostate in a few Q • weeks, but I had a heart attack two months ago fluvoxamine clozapine . My doctor
says that I should leave a gap of at least three months after my heart attack before I have surgery for my prostate diamox slow release . I am
reluctant to wait because the symptoms are quite severe and they are really getting me down prilosec oct 42 ct . Is my doctor right’?
AAYes, he is what is zoloft product . It would be unwise for surgery to take place within , three months of a heart attack, as the risks of
another attack are too high indomethacin maximum dos . Some people might actually suggest that you wait six months, by which time the risks will
have fallen dramatically warfarin management education in pediatric patients . An enlarged prostate can be very irritating but it is not a matter of life or death, a heart
attack is, so be patient and wait until you are fit enough to undergo surgery lithium ointment . You might also like to talk to your
specialist about the possibility of having surgery under a spinal anaesthetic rather than a general one antidepressants depression duloxetin cymbalta .
Q• Why might a repeat prostate operation become necessary?
AA repeat operation may become necessary because of • regrowth of obstructing prostate tissue treatment of tramadol withdrawal . Obviously, the younger a
man is when he has his first prostate operation, the more likely he is to need a repeat operation later on neurontin for anxiety and depression . Similarly,
the longer he lives, the greater his chance of needing a second operation azulfidine bleeding . About 15 per cent of patients need to have a
repeat operation within 15 years celebrex generic celecoxib .
My father and my grandfather both had cancer of the
• prostate prilosec diet stomach ulcer . I have heard that this makes it much more likely that will develop this disease too what is ibuprofen 800mg . Is this true, and
is there anything I can do to prevent it? I am 32 years old altace side effects varicose veins .
ANIt is true that men who have a family history of prostate e cancer have a higher risk of developing the same disease lithium benzodiazepine .
This does not mean, however, that it is by any means inevitable, and you should not look on the black side danger of caffeine .
You are right, though, to be alerted to the possible problem spironolactone treats acne . You should, of course, lead as healthy a life as you can,
following a healthy diet, not drinking alcohol excessively, not smoking, minimising stress and getting plenty of
exercise pharmacy nexium .
Other than that, you may be able to persuade your doctor to refer you for regular screening because of your family’s
medical history man health viagra . Although men are unlikely to develop prostate cancer until they are over 50 years old, it would be wise
to start a screening programme now and repeat tests every five years safety of india sildenafil citrate . This should reassure you diclofenac sodium er 100mg .
QIs it true that prostate surgery always causes a man to
• become impotent’?
AANo, this is absolutely not true caffeine and skin health . It used to be truer in the past shelf life of zocor . than it is today what are somas used for . It is the nerves that run on
either side of the prostate that control a man’s ability to obtain and maintain an erection re clomid effects on cycle length . The techniques used in
prostate surgery nowadays do not usually disturb these nerves side effects from sulfamethoxazole . A small minority of patients do, however, suffer some
degree of impotence, though no one is quite sure why this should be pantoprazole fda approval . It has been suggested that the causes may sometimes
be psychological rather than physical, though this is not always the case prescription drugs fluoxetine .
QI have been diagnosed as having an enlarged prostate,
• which I understand is benign caffeine sonic . Is there any danger that this might turn into prostate cancer if I do not have it
removed?
ANo, there is no link between an enlarged prostate and pros-
• tare cancer aleve gel caps ingredients . The exact cause of an enlarged prostate is not
fully understood, and neither is the cause of prostate cancer, but the two are not connected methotrexate and sarcoidosis . It is true that prostate
cancer is occasionally diagnosed when a man is being operated on for an enlarged prostate, but the link here is only one
of diagnosis, not cause aniety and lipitor . It is one of the hidden benefits of prostate surgery, in fact, that if there is any cancer of
the prostate that has not been discovered already, it will be found when the prostate is operated on lithium batteries automobiles .
QAre there any easy remedies that one can buy at the chemists
• and which will cure prostate enlargement?
ANo sexual dysfunction effexor . There are some that may reduce symptoms, but this is
• not the same as a cure cardiac toxicity of ondansetron . Anyone who makes claims to the contrary is being economical with the truth sildenafil toxicity .
QI’m thinking of having a vasectomy depakote dilantin interactions . I’ve heard that a vasec-
• tomy can cause cancer of the prostate diltiazem reversal . Is this true?
AA link has been suggested but it is most unlikely glucophage tablet strengths 1000 ng . There is no
• definitely proven link between vasectomy and prostate
cancer, but if this is something that particularly worries you, you should obviously discuss this with your consultant maximum dose of wellbutrin .
QMy girlfriend tells me that she has had chlamydia ranitidine dosage for dog . This
• happened when she was younger and before she met me can you crush keflex . I
have heard that chlamydia can be linked with a prostate problem, called prostatitis natural alternatives to synthroid . Is she putting me at risk’?
AIt is true that prostatitis is thought to be linked sometimes e with chlamydia mani soma . But if your girlfriend had chlamydia
before she met you and is now completely clear of it, it doesn’t sound as though you have anything to worry about counter naproxen over . If you
want to be completely on the safe side, though, why don’t you both go to your local genito-urinary medicine (GUM) clinic
(you’ll find the number in your telephone directory) and ask for a check-up potassium levels and lanoxin . Explain what it is that’s worrying you and
they will be happy to help wheb to take clomid during pct . You do not need to feel at all embarrassed about going to a Benito-urinary clinic, the staff
are always very sympathetic, friendly and matter-of-fact about these matters, and will do everything they can to make you
feel at home save on strattera . Don’t worry, either, that they’ll think you’re wasting their time is keflex effective against sinus infections . So often, problems are caused by people
who really ought to go to the clinic and, for whatever reason, don’t go until it’s too late, either to treat their
disease easily, or to prevent them from passing it on to other people risperidone side effects . They will be delighted that you have made a move
before it becomes a problem ciprofloxacin filiculitis lichen planus .
QMy father died recently from a stroke ibuprofen imitrex . His doctor told me
• that he had prostate cancer, but that his was a silent disease sertraline hdl .
What does this mean, and did this have anything to do with his death’?
AIt means that his cancer was not spreading and was not
• causing him any great problem cialis and pregnancy . It was certainly not that
which killed him what does digoxin do . You do not say how old your father was, but prostate cancer of this sort is very common in elderly men long term effects of trazodone .
It is often never even diagnosed and only comes to light during a postmortem cam cymbalta cause yeast infections . Even when it is diagnosed, it often does
not require any treatment, precisely because it is a silent disease 0.075 mg generic synthroid .
QI have had chronic bacterial prostatitis for some years now caitlin cipro level .
• Although recurrences are not as regular as they used to be, I
do still have occasional flare-ups zoloft effectiveness and side effects . My wife has been trying to get pregnant - with no success - for about a year naltrexone trade name . Is
there any connection and, if so, what are our chances?
AThere is some indication that certain forms of prostatitis,
• particularly chronic bacterial prostatitis, may result in lower
male fertility alesse denavir ed . Infection or inflammation of the prostate can cause certain changes in the prostatic fluid, which may
well affect the quality of the semen, and therefore a man’s fertility does nizoral shampoo kill scalp ringworm . Your best bet would be to discuss this with your
doctor and to have both your sperm count and sperm quality checked artane dosing . This is a simple test which is done from a sample of
semen following ejaculation by masturbation coming off of zoloft .
Jul
15
HOW THE PROSTATE CHANGES WITH AGE. THE FUNCTIONS OF THE PROSTATE GLAND.
July 15, 2009 | Leave a Comment
HOW THE PROSTATE CHANGES WITH AGE
The prostate gland begins to enlarge to its adult size at puberty, as a result of the effect of the male hormones, or
androgens zoloft and pms . It stops enlarging around the age of 20 amlodipine effect on diabetes . The prostate rarely causes problems before the age of 30 sore throat synthroid armour .
In most men, the prostate gland starts to enlarge naturally again after the age of about 50, which is when it often
begins to cause the majority of problems comparing mircette alesse aviane and levlite . It obviously needs to be located in very close proximity to the urethra because
the prostate secretions are discharged into the urethra, but the fact that it actually encircles the urethra in quite
this way seems to be a serious design fault in the male anatomy info on strattera . It is because of this that, as it enlarges with
advancing age, it has a tendency to squeeze the urethra and to interfere with the flow of urine atypical asthma loratadine .
THE FUNCTIONS OF THE PROSTATE GLAND
The prostate’s role in the male body is a curious one synthroid facial hair . It is not essential for life bupropion and alt levels . It is not even essential for
reproduction, though it plays some part in the reproductive process sinemet with food .
The prostate gland is not actually one single gland, but is made up of millions of tiny tubular glands, which are
arranged in five lobes: two lateral, a middle, a posterior, and an anterior take naprosyn for bursitis . The inner zone produces secretions that help
keep the lining of the urethra moist; and the outer zone secretes a thin milky fluid, which is discharged into the
urethra on ejaculation and makes up between 30 and 40 per cent of semen metronidazole side effects patient review . Prostatic fluid is therefore an important
component of the seminal fluid and provides vital nutrients for sperm caffeine content coke cola .
The prostate gland also contains muscle and fibre cells zantac for depression . These help the gland to contract and to squeeze the secretions
of the prostate into the urethra imipramine in patch form .
Exactly why the prostate gland exists is not really understood propecia prescription canada .
For further details about the little that we do know of its function, see below probenecid dehydrate .
THE URETHRA
The prostate gland fits like a collar around the urethra, which is the tube that carries urine through the penis to
outside the body:
The urethra also carries the semen and sperm during the act of ejaculation use for metronidazole .
Sperm are produced in the testes sertraline et tianeptine . They are stored in the epididymis, or they can also be temporarily stored at the top of
the vasa deferentia, which are the tubes leading from the testes to the ejaculatory ducts which empty into the urethra
inside the prostate gland mechanism of action for zithromax . When a man becomes sexually excited, sperm are pumped up through the vasa deferentia ampicillin how to take . Then,
when a man reaches orgasm, contractions of the seminal vesicles and prostate muscles forces all the available fluid -
that is sperm, the fluid from the seminal vesicles situated at the base of the bladder, and the secretions from the
prostate gland - to pour into the urethra zetia and myopathy . Ejaculation then occurs, which is when the muscles surrounding the urethra
contract to expel the semen from the penis soma lotus .
A SUMMARY OF ITS FUNCTIONS
Ignorant as we are about what the prostate gland actually does in the male body, it is known to do the following things:
• It secretes fluids that make up between 30 and 40 per cent of semen zetia hal life . They are added to the seminal fluid while it
is collecting at the start of the urethra, a few seconds before ejaculation ephidrine hcl codeine phosphate promethazine hcl .
• It secretes certain nutrients that are thought to nourish sperm and keep it healthy lithium ion cell laptop battery rebuild . These include zinc, amino
acids, citric acid, vitamins and sugars pravachol pills . These nutrients are not necessary for fertilisation, sperm that have not come
into contact with prostate fluid can still fertilise an egg online soma cod . So although it undoubtedly has some influence on male
fertility (it helps sperm swim towards the egg and makes the cervix open a little so that sperm can swim through it), it
is by no means absolutely indispensable plavix and bleeding .
• Prostatic fluid contains some substances that neutralise bacteria viagra bournemouth kamagra .
• It helps direct semen outwards during ejaculation metformin non diabetic . This prevents sperm from refluxing tip into the bladder tramadol hydrochloride contraindications loratadine .
• It contains the substances that give semen its characteristic smell altace nih .
• It secretes certain enzymes, such as acid phosphatase and prostatic specific antigen (PSA), which give semen its
fluidity virginia accutane lawyer . It is this that helps sperm to swim zoloft side effects starting .
• It secretes prostaglandins, which are hormone-like chemicals sertraline ecstacy . These have a certain effect on the female genital
tract enzyme viagra chalis . They make the neck of the womb, or cervix, open a little so that sperm can swim through it into the uterus more
easily, and are therefore thought to be important in the process of fertilisation breitenbush lithium water . The fact that the prostatic fluid is
believed to be ejaculated in the first contraction of orgasm, just before the bulk of the semen from the seminal
vesicles, would appear to support this theory is aleve safe while breastfeeding . Prostaglandins are also thought to make the female genital tract contract,
which may encourage sperm to be drawn in towards the egg bad side effects of boniva .
• It is the site at which the male sex hormone testosterone - made by the testicles - is broken down atenolol nervous .
DISPELLING MYTHS
Given the fact that no one knows a great deal about the role of the prostate, and given the fact that men, in general,
seem to have a natural lack of curiosity about their own bodies, it is hardly surprising that so many people have a very
distorted idea of what the prostate gland actually does alchohol while taking metformin .
Some people have a vague notion that it has something to do with reproduction, and assume that when it goes wrong it
therefore causes a reproductive problem sertraline aspirin . This is not so, however, and the problem is rather to do with the effect of the
enlarged or ageing gland on the exit from the bladder information prescribing prilosec .
Some men assume, too, that the prostate is responsible in some way for the production of urine face cleaners for accutane . This belief stems from
the fact that, when it becomes enlarged, it makes them urinate more often diclofenac in plogel . But there is no connection at all between the
prostate and the kidneys soma value . It is not the manufacture of urine that is the problem, but the exit of urine from the bladder low testosterone b12 .
This is because when the prostate enlarges -for whatever reason - it exerts pressure on the urethra and on the neck of
the bladder, thereby restricting the flow of urine diflucan find information on diflucan .
It is useful to understand what the prostate gland does and what it means when it goes wrong cymbalta anxiety 30mg 2007 . A lot of men who have
problems with the flow of urine and find it difficult to cope with an increased frequency of urination think they can
rectify the problem by cutting down on their fluid intake a href order effexor . But this is not only useless, it can also be dangerous lawsuit against prozac . People
who have an obstructed bladder should actually drink more, not less, even though this may mean ‘going’ more often testosterone hormone replacement physician pennsylvan . This
is because, if there is any residual urine left in the bladder, this may become infected unless it is regularly diluted
with a fresh supply of urine risperdal rebound atypical neuroleptic .
Nor should you try to hold out for as long as possible before emptying your bladder 9 grams of pseudoephedrine . You will empty your bladder more
efficiently when you are not in a hurry most common treatment for bipolar lithium .