Aug
13
Flecainide - Flucytosine - Fluoroquinolone - Fluoxymesterone - Flurazepam - Flutamide
August 13, 2009 | Leave a Comment
Generic Name
Flecainide (FLEH-kan-ide) E
Brand Name Tambocor
Type of Drug Antiarrhythmic.
Prescribed For
Abnormal heart rhythm. General Information
Flecainide is prescribed in situations where the abnormal heart rhythm is so severe as to be life-threatening and the patient does not respond to other drug treatments. Like other antiarrhythmic drugs, flecainide works by affecting the movement of nervous impulses within the heart. Flecainide’s effects may not become apparent for 3-4 days after you start taking it.
Cautions and Warnings
Do not take flecainide if you are allergic or sensitive to any of its ingredients or if you have heart block, unless you have a cardiac pacemaker. As with other antiarrhythmic drugs, there is no proof that flecainide helps people live longer or avoid sudden death.
Flecainide causes or worsens arrhythmias m 7% 0 people who take it; this, tks’ , imTeases with certain kinds of underlying heart disease and higher doses of the drug. Flecainide causes or worsens heart failure in about 5% of people taking it because it tends to reduce the force and rate of each heartbeat.
Flecainide is extensively broken down in the liver. People with poor liver function should not take flecainide unless the benefits clearly outweigh the risks.
Changes in the pH of urine may affect the effectiveness of flecainide.
Possible Side Effects
♦ Most common: dizziness, fainting, lightheadedness, unsteadiness, visual disturbances including blurred vision and seeing spots before the eyes, breathing difficulties, headache, nausea, fatigue, heart palpitations, chest pain, tremors, weakness, constipation, bloating, a bad taste in your mouth, and abdominal pain.
♦ Less common: new or worsened heart arrhythmias or heart failure, heart block, slowed heart rate, vomiting, diarrhea, upset stomach, loss of appetite, stomach gas, dry mouth, tingling in the hands or feet, partial or temporary paralysis, loss of muscle control, flushing, sweating, ringing or buzzing in the ears, anxiety, sleeplessness, depression, not feeling well, twitching, weakness, convulsions, speech disorders, stupor, memory loss, personality loss, nightmares, apathy, eye pain, unusual sensitivity to bright light, sagging eyelids, reduced white-blood-cell or blood-platelet counts, impotence, reduced sex drive, frequent urination, urinary difficulty, itching, rash, fever, muscle ache, closing of the throat, and swollen lips, tongue, or mouth.
Drug Interactions
• The combination of propranolol and flecainide may cause an exaggerated lowering in heart rate. Other drugs that slow the heart may also interact with flecainide to produce an excessive slowing of heart rate.
• Avoid megadoses of vitamin C while taking this drug.
• The amount of flecainide in your blood and its effect on your heart may be increased if it is taken together with cimetidine, disopyramide, or verapamil.
• YQW dXSz, 0 ‘i’lecainide should be halved when given with amiodarone.
• Smokers may need a larger dose of flecainide than nonsmokers.
• Flecainide may increase the amount of digoxin in the bloodstream, increasing the chance of side effects.
Food Interactions
A strict vegetarian diet and anything that makes urine less acid interferes with flecainide’s elimination from the body, increasing drug
toxicity. Usual Dose
Adult: starting dose-50-100 mg every 12 hours. Maximum dosage is 400 mg a day.
Child (under 18 years): not recommended.
Overdosage
Flecainide overdose affects heart function, causing slower heart rate, low blood pressure, and possible death from respiratory failure. Victims of flecainide overdose should be taken.to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Flecainide can make you dizzy, lightheaded, or disoriented. Take care while driving or performing complex tasks.
Call your doctor if you develop chest pains, an abnormal heartbeat, breathing difficulties, bloating in your feet or legs, tremors, fever, chills, sore throat, unusual bleeding or bruising, yellowing of the whites of your eyes, or any other intolerable side effect.
If you forget to take a dose of flecainide and remember within 6 hours, take it as soon as possible. If you do not remember until later, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: At high doses, flecainide damages an animal fetus. When this drug is considered crucial by your doctor, its potential benefits must be weighed against its risks.
Flecainide passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors with reduced kidney or liver functkcm -aye more likely to develop si(je, eip,,ZkS and require a lower dosage.
Generic Name
Flucytosine (floo-SYE-toe-sene)
Brand Name Ancobon
Type of Drug Antifungal.
Prescribed For
Serious blood-borne fungal infections.
General Information
Flucytosine is meant for fungal infections—Candida, chromomycoses, and cryptococcus—carried in the blood that affect the urinary tract, respiratory tract, central nervous system, heart, and other organs. It is not meant for fungal infections of the skin, such as common athlete’s foot.
Cautions and Warnings
Do not take this drug if you are allergic or sensitive to any of its ingredients.
People with kidney disease must be closely monitored by their doctors and should take this medication with extreme caution; daily dosage must be reduced.
Flucytosine can worsen bone-marrow depression in people whose itnR1US1Q Systems are already compromised. Liver and kidney function and blood composition should be monitored while you are taking this drug.
The safety and efficacy of flucytosine have not been established in children.
Possible Side Effects
V Most common: unusual tiredness or weakness, liver inflammation, yellowing of the eyes or skin, abdominal pain, diarrhea, loss of appetite, nausea, vomiting, rash, redness, itching, sore throat, fever, and unusual bleeding or bruising.
V Less common: chest pains, breathing difficulties, sensitivity to the sun or bright light, dry mouth, duodenal ulcers, severe bowel irritation, stomach bleeding, interference with kidney function, kidney failure, reduced red- and whiteblood-cell counts or other changes in blood composition, headache, hearing loss, confusion, dizziness, weakness, shaking, sedation, psychosis, hallucinations, heart attack, and low blood-sugar and potassium levels.
Drug Interactions
• Amphotericin B increases flucytosine’s effectiveness: this
combination is generally used to produce better results.
• Flucytosine may interfere with some routine blood tests.
• Cytosine may inactivate the antifungal activity of flucytosine.
Food Interactions
Take flucytosine with food if it upsets your stomach.
Usual Dose
22-66 mg per lb. a day, in divided doses.
Overdosage
Little is known about the effects of flucytosine overdose, but it may cause exaggerated drug side effects. If you seek treatment at a hospital, ALWAYS bring the prescription bottle or container.
Special Information
Take the capsules a few at a time over 15 minutes to avoid nausea and vomiting.
Call your doctor if you develop unusual tiredness or weakness; yellowing of the skin or whites of the eyes; rash, redness, or itching; so(Q %Toal or fever; unusual bleeding or bruising; or any persistent or intolerable side effect.
Maintain good dental hygiene while taking flucytosine. Use extra care when using your toothbrush or dental floss because of the risk that flucytosine will make you more susceptible to infection. Dental work should be completed prior to starting on this drug.
FLUOROQUINOLONE ANTI-INFECTIVES
Exposure to sunlight may cause rash, itching, redness, discoloration of the skin, or severe sunburn. Stay out of direct sunlight when taking flucytosine.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, take 1 dose right away and another in 3 or 4 hours, then go back to your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Flucytosine causes birth defects in animals and crosses the placenta. Flucytosine should be used by pregnant women only when its potential benefits clearly outweigh its risks.
It is not known if flucytosine passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Dosage adjustment may be required due to age-related loss of kidney function.
Type of Drug
Fluoroquinolone Anti-Infectives
(flor-oe-OUIN-oc-lone)
Brand Names
Generic Ingredient: CiproftoxacinIGI
Ciloxan Eyedrops Cipro XR
Cipro Proquin XR
Generic Ingredient: Gatifloxacin Zymar Eyedrops
Generic Ingredient: Gemifloxacin Factive
Generic Ingredient: Levofloxacin A
Iquix Eyedrops QtAy’ ” Eyedrops
LevackujR
Generic Ingredient: Lomefloxacin Maxaquin
Generic Ingredient: Moxifloxacin
Avelox Vigamox Eyedrops
Generic Ingredient: Norfloxacin
Noroxin
Generic Ingredient: Ofloxacin 92
Floxin Ocuflox Eyedrops
Floxin Otic
Prescribed For
Infections of the lower respiratory system, sinuses, urinary tract, skin, bone and joints, lungs, and prostate; also prescribed for sexually transmitted diseases, prostatitis, infectious diarrhea, bronchitis, pneumonia, typhoid fever, anthrax, and traveler’s diarrhea. The eyedrops are used to treat ocular infections, the eardrops for ear infections.
General Information
Fluoroquinolone anti-infectives work against many organisms that traditional antibiotics have trouble killing. They do not work against the common cold, flu, or other viral infections. The fluoroquinolones were first used as treatment for urinary infections and then other uses developed over the years. The new uses depend on how well the specific drug penetrates different body tissues as well as on how they have been tested in the laboratory. Individual fluoroquinolones are not all equally effective in treating all infections.
Cautions and Warnings
Do not take a fluoroquinolone if you are allergic or sensitive to any of its ingredients, or to any drug in this group, or have had a reaction to related medications such as nalidixic acid. Severe, possibly fatal, allergic reactions can occur even after the very first dose. These reactions include cardiovascular collapse, loss of consciousness, tingling, swelling of the face or throat, breathing difficulties, itching, and rash. Stop taking the drug if you experience allergic symptoms and seek medical help at once.
Fluoroquinolones may cause increased pressure on parts of the brain, leading to convulsions and psychotic reactions. Other possiblp. tIWA include tremors, restlessness, lightheadedness, confusion, and hallucinations. Fluoroquinolones should be used with caution in people with head trauma, seizure disorders, or other nervous system conditions.
Moxifloxacin should not be used by people with liver disease.
Moxifloxacin should be avoided by people with heart rhythm problems or those taking drugs that can affect heart rhythm.
People with kidney disease require reduced dosage of these drugs, except in the case of moxifloxacin.
People taking fluoroquinolones may be unusually sensitive to the sun. Avoid the sun while taking this drug and for several days following therapy, even if you are using sunscreen.
People taking a fluoroquinolone may develop colitis that could range from mild to very serious. Contact your doctor if you develop diarrhea or cramps.
Fluroquinolones can worsen myasthenia gravis. Use with caution.
Prolonged fluoroquinolone use can lead to fungal overgrowth.
Patients taking a fluoroquinolone may experience ruptures of the shoulder, hand, Achilles tendon, or other tendons that may require surgery or lead to extended disability.
Possible Side Effects
Side effects are rarely serious.
♦ Common: nausea (most likely with ciprofloxacin and moxifloxacin), vomiting, and diarrhea (may be most likely with moxifloxacin and ofloxacin).
✓ Less common: dizziness, abdominal pain, headache, and liver inflammation.
✓ Rare: Rare side effects, including some severe drug reactions, can occur in almost any part of the body. In once-daily studies of ciprofloxacin eardrops, there were a few reports of nausea, formation of flaky scales, inflammation of the external ear, temporary hearing loss, ringing or buzzing in the ears, middle-ear inflammation, tremors, high blood pressure, and fungal infection. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Separate your fluoroquinolone dose from that of antacids, didanosine, iron supplements, or zinc by 2-6 hours. These drugs decrease the amount of fluoroquinolone absorbed. Moxifloxacin must be taken 4 hours before or 8 hours after antacids, iron, or zinc.
• Nitrofurantoin may antogonize norfloxacin’s antibacterial effects. Do not take these drugs together.
• Moxifloxacin can increase the risk of abnormal heart rhythms.
Combining this drug with astemizole, erythromycin, tricyclic
antidepressants, and antipsychotics increases the risk of ab-
normal heart rhythms associated with this drug.
• People taking drugs to correct abnormal heart rhythms should avoid Fluoroquinolones.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) and anti-inflammatory drugs should not be combined with fluoroquinolones because of the increased risk of stimulation and seizures.
• Sucralafate reduces the amount of fluoroquinolone absorbed in the blood. Take sucralafate at least 6 hours after taking a fluoroquinolone.
• Probenecid may increase the risk of some fluoroquinolone side effects. Cimetidine may also increase fluoroquinolone blood levels.
• Fluoroquinolones (except moxifloxacin) may increase the effect of oral anticoagulant drugs such as warfarin. Your anticoagulant dosage may have to be reduced.
• Fluoroquinolones may increase the toxic effects of cy-
closporine (used for organ transplants) on your kidneys.
• Fluoroquinolones (except moxifloxacin) may increase theophylline blood levels and the risk of side effects.
• Azlocillin may increase the risk of ciprofloxacin side effects.
• Ciprofloxacin and norfloxacin may increase caffeine’s effects.
Food Interactions
Levofloxacin, lomefloxacin, and moxifloxacin may be taken with or without food. Take ofloxacin and norfloxacin at least 2 hours before or 2 hours after meals or antacids. Ciprofloxacin is best taken 1 hour before or 2 hours after meals, but may be taken with food. Dairy products and calcium-fortified orange juice interfere with the absorption of ciprofloxacin and should be avoided.
Usual Dose
Check with your doctor if you suffer from kidney failure as your fluoroquinolone dosage may need to be reduced.
Tablets
Adult
Ciprofloxacin: 100-750 mg twice a day. Ciprofloxacin XR: 1000 mg once a day.
Gemifloxacin: 320 mg once a day. Levotioxacin: 250-750 mg once a day.
Lomefloxacin: 400 mg a day. Moxifloxacin: 400 mg a day.
Norfloxacin: 400 mg every 12 hours; a single dose of 800 mg
may be taken for gonorrhea. Ofloxacin: 200-400 mg every 12 hours.
Child: not recommended.
Eyedrops
Ciprolloxacin: 1-2 drops in the affected eye several times a day.
Gatifloxacin: days 1-2-2 drops in the affected eye every 2 hours while awake, up to 8 times a day, then 4 times a day for the next 5 days.
Levofloxacin: days 1-2-1-2 drops in the affected eye every 2 hours while awake, up to 8 times a day. Days 3-7-1-2 drops in the affected eye every 4 hours while awake, up to 4 times a day.
Moxifloxacin: 1 drop in the affected eye 3 times a day for I week.
Ofloxacin: bacterial conjunctivitis—days 1-2, place 1-2 drops in the affected eye every 2-4 hours while awake; days 3-7, place 1-2 drops in the affected eye every 4-6 hours while awake. Bacterial corneal ulcer—days 1-2, place 1-2 drops in the affected eye every 30 minutes while awake; awaken 4-6 hours after you go to sleep for one more dose; days 3-7 or 9, place 1-2 drops in the affected eye every hour while awake; days 7-9, or through the end of treatment, place 1-2 drops in the affected eye 4 times a day.
Eardrops
Ofloxacin: 5-10 drops in the affected ear twice a day.
Overdosage
Overdose symptoms generally mimic drug side effects. Overdose may cause kidney failure and, in the case of moxifloxacin, abnormal heart rhythms. Call your local poison control center or a hospital emergency room for more information. You may be, koNO to induce vomiting with ipecac syrup—available at any pharmacybefQ(e, %’Kmg the victim to an emergency room. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Take each dose with a full glass of water. Be sure to drink at least 8 glasses of water a day while taking any of these drugs to help avoid kidney side effects.
Drug sensitivity reactions can develop even after only 1 dose. Stop taking the drug and get immediate medical attention if you feel faint or develop itching, rash, facial swelling, breathing difficulties, convulsions, depression, visual disturbances, dizziness, headache, lightheadedness, or any sign of a drug reaction.
Colitis can be caused by any anti-infective medication. If diarrhea develops, call your doctor at once.
Avoid excessive sunlight. Call your doctor if you become sensitive to the sun.
Call your doctor if you experience pain, inflammation, or rupture of a tendon.
Follow your doctor’s directions exactly. Complete the full course of drug therapy, even if you feel well.
Eyedrops
To avoid infection, do not let the eyedropper tip touch your finger, eyelid, or any surface. Wait 5 minutes before using another eye-drop or eye ointment.
Call your doctor at once if your vision declines or if eye stinging, itching or burning, redness, irritation, swelling, or pain worsens.
Fluoroquinolones can cause changes in vision, dizziness, drowsiness, and lightheadedness. Be careful when driving or performing any task that requires concentration.
If you forget to administer a dose, do so as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Animal studies have shown that fluoroquinolones may damage the fetus or reduce the likelihood of a successful pregnancy. When a fluoroquinolone is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Fluoroquinolones pass into breast milk. Nursing mothers who must take them should use infant formula.
Seniors: With the exception of moxifloxacin, seniors may require reduced dosage due to age-related decreases in kidney function. The risk of a ruptured tendon may increase in seniors, especially those taking a corticosteroid. In the case of eyedrops, seniors may also need less medication.
Generic Name
Fluoxymesterone (flue-OX-ee-MES-ter-one)
Brand Name Halotestin
Type of Drug
Androgen (male hormone).
Prescribed For
Men: hormone replacement or augmentation and male menopause; also prescribed as male contraception for up to 12 months, and for delayed puberty.
Women: breast pain and fullness in women who have given birth, and certain types of breast cancer.
General Information
Fluoxymesterone is an androgen. Androgens are responsible for the normal growth and development of male sex organs and for maintaining secondary sex characteristics including hair distribution, vocal cord thickening, muscle development, and fat distribution.
Cautions and Warnings
Do not use fluoxymesterone if you are allergic or sensitive to any of its ingredients.
Androgens do not improve athletic performance and may cause serious side effects.
Women taking any androgen may develop deepening of the voice, oily skin, acne, hairiness, increased sex drive, and menstrual irregularities.
Androgens should be avoided if possible by young boys who have not gone through puberty.
Fluoxymesterone W(1C1.ens gynecomastia (a condition characterized by swollen male breast tissue).
Men with unusually high blood levels of calcium, known or suspected prostate cancer or prostate destruction, or breast cancer should not use fluoxymesterone, nor should anyone with severe liver, heart, or kidney disease.
Long-term, high-dose androgen therapy may cause severe liver disease, including hepatitis and cancer, reduced sperm count, and
water retention.
Blood cholesterol may be raised by androgens. This can be a
problem for people who have heart disease.
Androgens may cause or worsen sleep apnea (a condition char-
acterized by intermittent cessation of breathing during sleep). For patients with diabetes, this drug may affect blood sugar
levels.
Possible Side Effects
Men
✓ Most common: inhibition of testicle function, impotence, chronic erection, and painful enlargement of breast tissue.
Women
✓ Most common: unusual hairiness, male-pattern baldness. deepening of the voice, and enlargement of the clitoris. These changes are usually irreversible once they occur. Increased blood calcium and menstrual irregularities may also develop.
Men and Women
✓ Most common: changes in sex drive, headache, anxiety, depression, a tingling feeling, sleep apnea, flushing, rash, acne, habituation (the drug may be habit-forming), excitation, chills, sleeplessness, water retention, nausea, vomiting, diarrhea, hepatitis (symptoms include yellowing of the skin or whites of the eyes), liver inflammation, and liver cancer. Symptoms resembling those of a stomach ulcer may also develop.
Drug Interactions
• Fluoxymesterone may increase the effect of an oral anticoagulant (blood-thinner); dosage 131 the anticoagulant may have tD be reduced.
• Combining an androgen and imipramine or another tricyclic
antidepressant may result in a severe paranoid reaction.
• Androgens may decrease insulin requirements.
Food Interactions
Take fluoxymesterone with meals if it upsets your stomach.
Usual Dose
Adult; 5-40 mg a day. Child: not recommended.
Overdosage
Symptoms include nausea, vomiting, and diarrhea. Call your local poison control center or a hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Androgens must be taken only under the close supervision of your doctor. The dosage and clinical effects of fluoxymesterone vary widely and require constant monitoring.
Call your doctor if you develop nausea or vomiting, swelling of the legs or feet, yellowing of the skin or whites of the eyes, or a painful or persistent erection. Women should call their doctors immediately if they develop a deep or hoarse voice, acne, hairiness, male-pattern baldness, or menstrual irregularities.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations_ Fluoxymesterone should never be
taken by pregnant or nursing women because it can affect the developing fetus and nursing infant.
Seniors: Seniors are more likely to develop prostate enlargement or prostate cancer. A marked increase in sex drive may also occur.
Generic Name
Flurazepam (110-13AZ-uh-pam) A
Brand Name
Dalmane
Type of Drug Benzodiazepine sedative.
Prescribed For
Insomnia and sleep disturbances.
General Information
Flurazepam is a member of the group of drugs known as benzodiazepines. Benzodiazepines work by a direct effect on the brain. They make it easier to go to sleep and decrease the number of times you wake up during the night. Flurazepam and quazepam remain in your bloodstream longer than other drugs in this class, thus resulting in the greatest incidence of morning “hangover.”
Cautions and Warnings
Do not use flurazepam if you are allergic or sensitive to any of its ingredients.
People with kidney or liver disease should be carefully monitored while taking flurazepam. Take the lowest possible dose to help you sleep.
People with respiratory disease may experience sleep apnea (intermittent cessation of breathing during sleep) while taking flurazepam.
Clinical depression may be increased by flurazepam, which can depress the nervous system. Intentional overdose is more common among depressed people who take sleeping pills than among those who do not.
Some people have experienced amnesia while taking flurazepam.
All benzodiazepines can be addictive if taken for long periods of time and can cause drug withdrawal symptoms if discontinued suddenly. It should be used with caution in people with a history of drug dependence. Withdrawal symptoms include tremors, muscle cramps, insomnia, agitation, diarrhea, vomiting, sweating, and convulsions.
Tapering the drug when stopping may help prevent withdrawal symptoms. People with a history of seizures should be particuarly cautious when stopping use of this drug.
Possible Side Effects
V Common: drowsiness, headache, dizziness, talkativeness, nervousness, appip-henslon, poor muscle coordination, lightheadedness, daytime tiredness, muscle weakness, slowness of movement, hangover, and euphoria (feeling “high”).
V Less common: nausea, vomiting, rapid heartbeat, confusion, temporary memory loss, upset stomach, stomach cramps and pain, depression, blurred or double vision and Possible Side Effects (continued)
other visual disturbances, constipation, changes in sense of taste, appetite changes, stuffy nose, nosebleeds, common cold symptoms, asthma, sore throat, cough, breathing difficulties, diarrhea, dry mouth, allergic reaction, fainting, abnormal heart rhythm, itching, rash, acne, dry skin, sensitivity to the sun, nightmares or strange dreams, sleeplessness, tingling in the hands or feet, ringing or buzzing in the ears, ear or eye pain, menstrual cramps, frequent urination and other urinary difficulties, blood in the urine, discharge from the penis or vagina, lower back and other pain, muscle spasms and pain, fever, swollen breasts, and weight changes.
♦ Rare: Rare side effects can affect your heart, stomach and intestines, urinary tract, blood, muscles, and joints. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• As with all benzodiazepines, the effects of flurazepam are enhanced if it is taken with an alcoholic beverage, antihistamine, sedative, barbiturate, anticonvulsant medication, antidepressant, or monoamine oxidase inhibitor antidepressant.
• Contraceptive drugs, cimetidine, disulfiram, and isoniazid may increase the effect of flurazepam by reducing the drug’s breakdown in the liver. Probenecid also increases flurazepam’s effects.
• Cigarette smoking, rifampin, and theophylline may reduce the effect of flurazepam on your body by increasing the rate at which it is broken down by the liver.
• Levodopa + carbidopa’s effectiveness may be decreased by flurazepam.
• Flurazepam may increase the amount of zidaw-adwie tan HIV drug—also known as pnenytoin, or digoxin in your WZWMTeam, increasing the chances of side effects.
• Mixing clozapine with a benzodiazepine has led to respiratory collapse in a few people. Flurazepam should be stopped at least 1 week before starting clozapine treatment.
Food Interactions
Flurazepam may be taken with food if it upsets your stomach.
Usual Dose
Adult and Child (age 15 and over): 15-30 mg at bedtime. Dosage must be individualized for maximum benefit.
Senior: starting dose-15 mg at bedtime.
Child (under age 15): not recommended.
Overdosage
The most common overdose symptoms are confusion, sleepiness, depression, loss of muscle coordination, and slurred speech. Coma may also occur. Patients who overdose on this drug must be made to vomit with ipecac syrup—available at any pharmacy—to remove any remaining drug from the stomach. Call your doctor or a poison control center before doing this. If 30 minutes have passed since the overdose was taken or if symptoms have begun to develop, take the victim immediately to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Never take more flurazepam than your doctor has prescribed. Avoid alcoholic beverages and other nervous system depressants while taking tlurazepam.
Exercise caution while performing tasks that require concentration and coordination. Flurazepam may make you tired, dizzy, or lightheaded.
If you take flurazepam daily for 3 or more weeks, you may experience some withdrawal symptoms when you stop taking the drug. Do not stop taking flurazepam suddenly or increase or decrease your dosage without first consulting your doctor.
If you forget a dose and remember within 1 hour, take it as soon as you remember. If you do not remember until later, skip the dose you forgot and go back to your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Flurazepam absolutely should not be used by pregnaskt. v3 )men or by women who may become pregnant.
Flurazepam passes into breast milk. The drug should not be taken by nursing mothers.
Seniors: Seniors are more susceptible to the effects of flurazepam.
Generic Name
Flutamide (FLUE-tuh-mide)
Type of Drug Antiandrogen.
Prescribed For
Prostate cancer and excessive hairiness in women.
General Information
Prostatic cancer is sensitive to anything that removes the source of androgen (male hormone). Flutamide works by slowing the uptake of androgen or by interfering with the binding of androgen to body tissues. It is always prescribed together with a luteinizing hormone-releasing hormone (LHRH) drug.
Cautions and Warnings
Do not take flutamide if you are allergic or sensitive to any of its ingredients.
Severe liver injury may occur with flutamide; your doctor should monitor your liver function. People with severe liver disease should not take flutamide.
This drug may cause jaundice and severe blood conditions, including hemolytic anemia. People with certain blood disorders and people who smoke are at greater risk for these side effects.
A few men taking this drug have developed breast cancer. Flutamide may reduce sperm counts.
Possible Side Effects
♦ Most common: diarrhea, cystitis, and bleeding from the rectum.
✓ Common: rectal irritation, blood in the urine, hot flashes, loss of libido, impotence, nausea, rash, and swollen breasts.
✓ Less common’. drowsiness, confusion, depression, anxiety, nervousness, appetite loss, stomach problems, anemia, low white-blood-cell and blood-platelet counts, arm or leg swelling, urinary and muscle problems, and high blood pressure.
Possible Side Effects (continued)
♦ Rare: hepatitis, jaundice, and breathing difficulties. Contact your doctor if you experience any side effect not listed
above.
Drug Interactions
• Flutamide may increase the effects of blood-thinning drugs
such as warfarin. Dosage adjustment may be necessary.
Food Interactions None known.
Usual Dose
Adult: 250 mg (2 capsules) every 8 hours, 3 times a day. Total daily dose should be 750 mg.
Child: not recommended.
Overdosage
Overdose symptoms may include tiredness or low activity levels, slow breathing, weakness, tearing, appetite loss, vomiting, swollen and tender breasts, and liver inflammation. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Report anything unusual to your doctor, especially pain or tenderness in the upper right abdomen, yellowing of the skin or whites of the eyes, severe itching, dark urine, persistent appetite loss, and unexplained flu-like symptoms. These may be signs of severe liver toxicity.
Flutamide can turn your urine amber or yellow-green and cause unusual sun sensitivity. Use sunscreen and wear long-sleeved protective clothing while you are taking flutamide.
Flutamide must be taken exactly as prescribed. Call your doctor if you miss a dose of this drug.
Special Populations
Pregnancy/Breast-feeding: This drug is not intended for use by women.
Seniors: Seniors may take this drug without special precaution.
Aug
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
Chlordiazepoxide
August 1, 2009 | Leave a Comment
Generic Name
Chlordiazepoxide (klor-dye-az-uh-PDX-ide) 91
Brand Name
Librium
Type of Drug Benzodiazepine sedative.
Prescribed For
Anxiety, tension, fatigue, agitation, and withdrawal symptoms of alcoholism; also prescribed for irritable bowel syndrome and panic attacks.
General Information
Chlordiazepoxide is a member of the group of drugs known as benzodiazepines.
Benzodiazepines work by a direct effect on the brain. They can relax you and make you more tranquil or sleepier, or they can slow nervous system transmissions in such a way as to act as an anticonvulsant. Many doctors prefer benzodiazepines to other drugs that can be used to similar effect because they tend to be safer, have fewer side effects, and are usually as effective, if not more so.
Cautions and Warnings
Do not take chlordiazepoxide if you are allergic or sensitive to any of its ingredients or to another benzodiazepine, including clonazepam.
Chlordiazepoxide can aggravate narrow-angle glaucoma, but you may take it if you have open-angle glaucoma and are receiving therapy for it.
Other condkjo(\SiVN\,NhjCb chlordiazepoxide should be used with caution are severe depression, especially with suicidal tendencies, severe lung disease, sleep apnea (intermittent cessation of breathing during sleep), liver disease, drunkenness, and kidney disease.
Chlordiazepoxide should not be taken by psychotic patients because it is not effective for them and can trigger unusual excitement, stimulation, and rage. It has also produced similar reactions among hyperactive and aggressive pediatric patients.
Chlordiazepoxide is not intended for more than 3-4 months of continuous use. Your condition should be reassessed before continuing chlordiazepoxide beyond that time.
Chlordiazepoxide may be addictive. Drug withdrawal may develop if you stop taking it after only 4 weeks of regular use, but is more likely after longer use. It may start with anxiety and progress to tingling in the hands or feet, sensitivity to bright light, sleep disturbances, cramps, tremors, muscle tension or twitching, poor concentration, flu-like symptoms, fatigue, appetite loss, sweating, and changes in mental state.
Dosage of chlordiazepoxide should be decreased gradually over 4-8 weeks after prolonged use.
Possible Side Effects
Weakness and confusion may occur, especially in seniors and in those who are sickly.
♦ Most common: mild drowsiness during the first few days of therapy.
✓ Less common: depression, lethargy, disorientation, edema, headache, inactivity, slurred speech, stupor, dizziness, tremor, constipation, dry mouth, nausea, inability to control urination, sexual difficulties, irregular menstrual cycle, changes in heart rhythm, low blood pressure, fluid retention, blurred or double vision, itching, rash, hiccups, nervousness, inability to fall asleep, and occasional liver - dysfunction. If you experience any of these symptoms, stop taking the medicine and contact your doctor immediately.
♦ 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
• Chlordiazepoxide is a central-nervous-system depressant. Avoid alcohol, other sedatives, narcotics, barbiturates, mono-amine oxidase inhibitor and other antidepressants, and antihistamines. Taking chlordiazepoxide with these drugs may result in excessive depression, tiredness, sleepiness, breathing difficulties, or related symptoms.
• Smoking may reduce the effectiveness of chlordiazepoxide by increasing the rate at which it is broken down by the body.
• The effects of chlordiazepoxide may be prolonged when it is
taken with cimetidine, contraceptive drugs, disulfiram, flu-
oxetine, isoniazid, ketoconazole, metoprolol, probenecid,
propoxyphene, propranolol, rifampin, or valproic acid.
• Theophylline may reduce chlordiazepoxide’s sedative effects.
• If you take antacids, separate them by at least 1 hour from your chlordiazepoxide dose to prevent them from interfering with the passage of chlordiazepoxide into the bloodstream.
• Chlordiazepoxide may increase blood levels of digoxin and the chances for digoxin toxicity.
• Levodopa + carbidopa’s effectiveness may be reduced by chlordiazepoxide.
• Phenytoin blood concentrations may be increased when taken with chlordiazepoxide, resulting in possible phenytoin toxicity.
Food Interactions
Chlordiazepoxide is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
Adult: 5-100 mg a day. This range is due to individual response related to age, weight, disease severity, and other characteristics.
Child (age 6 and over): may be given if deemed appropriate by a doctor. Starting dose-5 mg 2-4 times a day. Maintenance dose—up to 30 mg a day for some children, but must be individualized to obtain maximum benefit.
Child (under age 6): not recommended.
Overdosage
Symptoms of overdose are confusion, sleepiness, poor coordination, lack of response to pain such as a pin prick, loss of reflexes, shallow breathing, low blood pressure, and coma. The victim should be lakes to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Chlordiazepoxide can cause tiredness, drowsiness, inability to concentrate, or similar symptoms. Be careful if you are driving, operating machinery, or performing other activities that require concentration.
If you forget a dose of chlordiazepoxide, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Chlordiazepoxide may cause birth defects if taken during the first 3 months of pregnancy. Avoid chlordiazepoxide while pregnant.
Chlordiazepoxide may pass into breast milk. Nursing mothers who must take chlordiazepoxide should use infant formula.
Seniors: Seniors, especially those with liver or kidney disease, are more sensitive to the effects of chlordiazepoxide and generally require smaller doses to achieve the same effect.
Jul
16
Alprazolam
July 16, 2009 | Leave a Comment
Generic Name
Alprazolam (al-PRAY-zoe-lam) CGI
Brand Names
Niravam Xanax Xanax XR Type of Drug
Benzodiazepine sedative.
Prescribed For
Generalized anxiety disorder and anxiety associated with depression; panic disorder with or without agoraphobia.
General Information
Alprazolam is a member of a group :)f drugs known as benzodiazepines. Benzodiazepines directly affect the brain. They can relax you and make you more tranquil or sleepier, or they can slow nervous system transmissions in such a way as to act as an anticonvulsant. Many doctors prefer benzodiazepines to other drugs that can be used to similar effect because they tend to be safer, have fewer side effects, and are usually as effective, if not more so.
Cautions and Warnings
Do not take alprazolam if you know you are allergic or sensitive to it or to another benzodiazepine drug, including clonazepam.
Alprazolam can aggravate narrow-angle glaucoma, but you may take it if you have open-angle glaucoma and are receiving therapy for it.
Other conditions where alprazolam should be avoided are: severe lung disease, sleep apnea (intermittent cessation of breathing during sleep), liver disease, drunkenness, and kidney disease. In each of these conditions, the depressive effects of alprazolam may be enhanced or could be detrimental to your overall condition.
Alprazolam should not be taken by psychotic patients because it is not effective for them and can trigger unusual excitement, stimulation, and rage.
Alprazolam is meant to be used for no more than 3-4 months in a row. Your condition should be reassessed before continuing your medicine beyond that time.
Alprazolam may be addictive. When used to treat panic disorder, alprazolam is frequently prescribed in doses exceeding 4 mg a day. Studies show that these higher doses may cause physical and emotional dependence, making it very difficult to stop taking the drug. Drug withdrawal may develop if you stop taking it after only 4 weeks of regular use but is more likely after longer use and at higher doses. It may start with anxiety and progress to tingling in the hands or feet, sensitivity to bright light, sleep disturbances, cramps, tremors, muscle tension or twitching, poor concentration, flu-like symptoms, fatigue, appetite loss, sweating, and changes in mental state. Severe withdrawal symptoms may include seizures.
Your dosage should be reduced gradually (0.5 mg decrease every 3 days) to prevent drug withdrawal symptoms.
Possible Side Effects
V Most common: mild drowsiness during the first few days of therapy. Weakness and confusion may occur, especially in seniors and in those who are sickly. If these effects persist, contact your doctor.
V Less common: depression, lethargy, disorientation, headache, inactivity, slurred speech, stupor, dizziness, tremors, constipation, dry mouth, nausea, inabilityto control urination, Possible Side Effects (continued)
sexual difficulties, irregular menstrual cycle, changes in heart rhythm, low blood pressure, fluid retention, blurred or double vision, itching, rash, hiccups, nervousness, inability to fall asleep, and occasional liver dysfunction. If you experience any of these symptoms, stop taking the medicine and contact your doctor immediately.
V Rare: withdrawal seizures. 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
• Alprazolam is a central-nervous-system depressant. Avoid alcohol, other sedatives, narcotics, barbiturates, monoamine oxidase inhibitor (MAGI) antidepressants, antihistamines, and antidepressants. Taking alprazolam with these drugs may result in excessive depression, tiredness, sleepiness, breathing difficulties, or related symptoms.
• Smoking may reduce the amount of alprazolam in your blood by 50%. Smokers may need larger doses.
• The effects of alprazolam may be prolonged when taken together with cimetidine, contraceptive drugs, disulfiram, fluoxetine, isoniazid, itraconazole, ketoconazole, metoprolol, probenecid, propoxyphene, propranolol, and valproic acid.
• The effects of some benzodiazepines may be decreased by rifampin.
• Theophyllines may reduce alprazolam’s sedative effects.
• If you take antacids, separate them from your alprazolam dose by at least 1 hour to prevent them from interfering with the absorption of alprazolam into the bloodstream.
• Alprazolam may raise digoxin blood levels and the chances of digoxin toxicity.
• The effect of levodopa + carbidopa may be decreased if it is taken together with alprazolam.
• Combining alprazolam with phenytoin may increase phenytoin blood concentrations and the chances of phenytoin toxicity.
Food Interactions
Alprazolam is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
Anxiety Disorder
Adult: 0.25-0.5 mg 3 times a day. Dosage must be tailored to your individual needs with a maximum dose of 4 mg a day. Child (under age 18): not recommended.
Panic Disorder
Adult: 1 -10 mg a day.
Child (under age 18): not recommended.
Overdosage
Symptoms of overdose are confusion, sleepiness, poor coordination, lack of response to pain such as a pinprick, loss of reflexes, shallow breathing, low blood pressure, and coma. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Alprazolam can cause tiredness, drowsiness, inability to concentrate, or related symptoms. Be careful if you are driving, operating machinery, or performing other activities that require concentration.
Anyone taking alprazolam for more than 3 or 4 months at a time may have a drug withdrawal reaction if the medicine is stopped suddenly (see “Cautions and Warnings”). Do not stop taking alprazolam, or increase or decrease the dosage, without first consulting your doctor.
If you forget a dose of alprazolam, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and return to your regular schedule. Do not take a double dose. If you take Xanax XR, take your full daily dose once a day in the morning. Do not chew or crush Xanax XR tablets.
Special Populations
Pregnancy/Breast-feeding: Alprazolam may cause birth defects if taken during the first 3 months of pregnancy. You should avoid alprazolam while pregnant.
Alprazolam may pass into breast milk. Nursing mothers who must take alprazolam should use infant formula.
Seniors: Seniors, especially those with liver or kidney disease, are more sensitive to the effects of alprazolam and generally require smaller doses to achieve the same effect.