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Generic Name
Fenofibrate (fen-oe-Flli-brace) IM
Brand Names
Antara    TriCor
Lipoten    Triglide Lofibra
Type of Drug
Anti-hyperlipidemic (blood-fat reducer).
Prescribed For
High blood cholesterol and/or triglycerides; also prescribed for syndrome X, a condition which increases the risk of type 2 diabetes.
General Information
Fenofibrate works by interfering with the body’s ability to make triglyceride and by increasing its breakdown by enzymes in the body. It also reduces levels of uric acid, total cholesterol, low-density lipoprotein (LDL) cholesterol—the “bad” cholesterol—and other blood lipids. High-density lipoprotein (HDL) cholesterol—the “good” cholesterol—levels are increased. This drug should only be used in people with very high triglyceride levels who are at risk for pancreatitis (inflammation of the pancreas) and have not responded to other treatments, including statin drugs. Generic fenofibrate is not equivalent to the TriCor brand because of a new product formulation and should not be substituted for the brand unless your doctor approves of the switch.
Cautions and Warnings
Do not take fenofibrate if you are allergic or sensitive to any of its ingredients.
People taking fenofibrate and other triglyceride-lowering drugs are mate WOV to die from causes unrelated to triglyceride levels. Fenofibrate reduces the risk of a heart attack or other cardiac event in people with high triglyceride levels and low levels of HDL cholesterol, especially among people with diabetes. The evidence for this benefit is not as strong as it is for the statin drugs.
People taking fenofibrate and gemfibrozil may develop pancreatitis (inflammation of the pancreas).
People with liver or severe kidney disease should avoid fenofibrate. People with less severe kidney disease require reduced
dosage.
People taking fenofibrate are more likely to develop gallstones.
Fenofibrate can destroy muscle cells, leading to kidney failure, especially when combined with a statin cholesterol-lowering drug see “Drug Interactions”).
Possible Side Effects
•    Most common: abnormal liver function, abdominal pain, and respiratory disorders.
♦    Common: rash, headache, upset stomach, pain, weakness, tiredness, and flu-like symptoms.
♦    Less common: joint pain, abnormal heart rhythms, reduced sex drive, dizziness, increased appetite, sleeplessness, tingling in the hands or feet, nausea, vomiting, diarrhea, abdominal pain, constipation, stomach noise or gas, frequent urination, vaginal irritation, runny nose, cough, sinus irritation, eye irritation, blurred vision, conjunctivitis (pinkeye). earache, and tiny particles inside the eye (”floaters”).
♦    Rare: allergic reactions including severe rash, itching, liver inflammation or enlargement, gallstones, gallbladder disease, muscle aches, and increased sensitivity to the sun. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Combining fenofibrate and a statin cholesterol-lowering drug (atorvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, or simvastatin) can lead to severe muscle pain, muscle cell destruction, and kidney failure. If you have extremely high blood-fat levels, the potential benefits of this combination may outweigh the risks. In people taking this combination, the health of muscles and kidneys must be monitored regularly via blood tests.
•    Fenofibrate increases the effects of anticoagulant (blood-thinning) drugs. Your anticoagulant dosage may need an adjustment.
•    Combining fenofibrate and cyclosporine can increase the risk of kidney toxicity. This combination should only be used if it is absolutely necessary and the lowest possible dosage is
taken.
• If you are taking cholestyramine or colestipol (both are used
to reduce blood-fat levels) as well as fenofibrate, take the
fenofibrate at least 1 hour before or 4-6 hours after these
drugs.
Food Interactions
All forms of fenofibrate, except TriCor, should be taken with food to get the best effect. TriCor may be taken without regard to food or meals.
Usual Dose
These products may not be substituted for each other because of important dosage differences.
Antara
Adult: 43-130 mg a day with food.
Senior: Begin with 43 mg a day. This dosage also applies to people with kidney disease.
Child: not recommended.
Lofibra
Adult: 67-200 mg a day with food.
Senior: Begin with 67 mg a day. This beginning dosage also applies to people with kidney disease.
Child: not recommended.
Lipofen
Adult: 50-150 mg a day with food.
Senior: Begin with 50 mg a day. This dosage also applies to people with kidney disease.
Child: not recommended.
TriCor
Adult: 48-145 mg a day.
Senior: Begin with 48 mg a day. This dosage also applies to
people with kidney disease. Child; mk recommended.
Triglide
Adult: 50-160 mg a day.
Senior: Begin with 50 mg a day. This dosage also applies to
people with kidney disease. Child: not recommended.
Overdosage
Little is known about the effects of fenofibrate overdose. Victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
People should take fenofibrate only after a triglyceride- lowering diet and other medications have failed. While taking fenofibrate, follow the diet recommended by your doctor.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule.
Special Populations
Pregnancy/Breast-feeding: Fenofibrate causes fetal injury and death in animal studies. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
This drug should not be taken by nursing mothers because of its potential to affect the nursing infant.
Seniors: Seniors are more likely to experience side effects and should never start with more than the lowest recommended dosage.

Generic Name
Finasteride (fin-ASS-ter-ide) 19
Brand Names
Proscar    Propecia
The information in this profile also applies to the following drug:
Generic Ingredient: Dutasteride Avodart
Type of Drug
Alpha-reductase inhibitor and androgen hormone inhibitor.
Prescribed for
Benign prostatic hyperplasia (BPH) and male-pattern baldness. May also play a role in preventing prostrate cancer.
General Information
Finasteride works by interfering with the action of the enzyme alphareductase, which converts testosterone into 5-dihydrotestosterone (DHT). By suppressing DHT levels, finasteride reduces the size of the prostate in most men who take the drug for BPH. You may need to take finasteride for 6-12 months before its effects can be
assessed.
Urine flow improves in about 60% of men taking finasteride for BPH and symptoms improve in about 30%. In one study, men experienced a significant regression in prostate size after 3 months, and the reduction was maintained through the 12-month study period: these men experienced a significant improvement in urine flow that could be maintained up to 36 months.
Studies of finasteride for hair loss on the top and back-middle of the scalp show new hair growth in 65-80% of men taking the drug continuously for 2 years. The drug must be taken for 3 months or more before it begins to have an effect and must be taken continuously to maintain hair growth. Once you stop taking this drug, any new hair you have grown is likely to fall out in the next 12 months. Between 14-17% of men taking the drug continued to lose hair throughout the study period.
Finasteride has been studied as therapy following radical prostatectomy surgery and in the prevention of first-stage prostate cancer, acne in women, and unusual hairiness.
Cautions and Warnings
Do not take finasteride if you are allergic or sensitive to any of its ingredients.
This drug should not be used in women or children. Pregnant women must not handle the tablets and capsules because of the risk to the fetus.
People who do not respond to finasteride may have a condition that causes BPH-like symptoms, such as prostate cancer, bladder or nerve disorders, or physical obstruction of the urinary tubes. Finasteride cannot be used to treat these conditions.
Because it is broken down in the liver, finasteride must be used with caution by people with liver disease.
Finasteride may mask symptoms of prostate cancer by causing a reduction in the level of prostate-specific antigen (PSA), an increasingly acknowledged indicator of prostate cancer.
Possible Side Effects
Side effects are generally mild and often subside with continued use of the drug.
Drug Interactions
•    Finasteride may reduce the effectiveness of theophylline and aminophylline, although dosage adjustments usually are not required.
•    Finasteride affects the PSA blood test used for prostate cancer screening. Be sure your doctor knows you are taking this drug if you have a PSA test done or are being tested for prostate cancer.
•    Dustasteride blood levels may increase when mixed with ritonavir, ketoconazole, cimetidine, and ciprofloxacin, all of which are inhibitors of a liver enzyme called CYP3A4. Blood levels of dutasteride also increase with verapamil and diltiazem.
Food Interactions
You may take finasteride with food if it upsets your stomach.
Usual Dose
Outasteride
Adult: 0.5 mg (1 capsule) once a day. Child: not recommended.
Finasteride
Adult: BPH-5 mg once a day. Male-pattern baldness-1 mg once a day.
Child: not recommended.
Women should not take finasteride. Overdosage
S%’& Ptecls are unlikely. Doses of dutasteride as high as 400 mg a day have been taken with no adverse side effects. 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.
Possible Side Effects (continued)
v Common: impotence, loss of sex semen, breast tenderness an
•    and drug sensitivity reaction
•    rash.
x drive, decreased amount nd enlargement, testicular ions including lip swelling Special Information
Women who are or might be pregnant should not handle crushed finasteride tablets because small amounts of the drug may be absorbed into the blood, possibly affecting the fetus.
If your sexual partner is or might be pregnant and you start taking finasteride, you must wear a condom during sex to avoid directly exposing her to finasteride in the semen.
Semen volume may decrease while on finasteride. Impotence or reduced sex drive is also a risk.
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. Call your doctor if you miss a dose for 2 or more days.
Special Populations
Pregnancy/Breast-feeding: This drug is not intended for women. Finasteride will harm the fetus if taken during pregnancy. It is not known if finasteride passes into breast milk.
Seniors: Seniors with liver disease should use this drug with caution.

Brand Name
Fioricet
Generic Ingredients
Acetaminophen + Butalbital + Caffeine 91
Other Brand Names
Americet    Femcet
Dolgic LQ    Margesic
Dolgic Plus    Medigesic
Esgic    Repan
Esgic-Plus    Triad
Type 101 Drug
Barbiturate and analgesic (pain reliever) combination.
Prescribed For
Symptom relief of tension headache.
General Information
Fioricet is one of many combination products containing a barbiturate—butalbital—and an analgesic—acetaminophen. Products of this kind also often contain a sedative or a narcotic. Other analgesic combinations, such as Rorinal, substitute aspirin for
acetaminophen.
Cautions and Warnings
Do not take Fioricet if you are allergic or sensitive to any of its ingredients.
Use this drug with caution if you have kidney or liver disease or a history of porphyria.
Chronic (long-term) use of Fioricet may lead to drug dependence or addiction. It is not recommended for multiple or recurrent headaches.
Butalbital is a respiratory depressant and affects the central nervous system (CNS), producing drowsiness, tiredness, and an inability to concentrate. Alcohol increases the CNS depression caused by this drug.
The safety and effectiveness of these medications have not been established in children under age 12.
For additional information see “Cautions and Warnings” in Acetaminophen (page 7).
Possible Side Effects
♦ Most common: lightheadedness, dizziness, sedation, shortness of breath, nausea, vomiting, upset stomach and a feeling of intoxication.
V Less common: weakness, headache, agitation, tremor, uncoordinated muscle movement, disorientation, dry mouth, constipation, facial flushing, changes in heart rate, palpitations, feeling faint, urinary difficulties, rash, and itching.
For additional information see “Possible Side Effects” in Acet-
aminophen (page 7).
Drug Interactions
• Combining Fioricet with alcohol, sedatives, barbiturates, sleeping pills, antihistamines, monoamine oxidase inhibitor antidepressants, or other CNS depressants may cause tiredness, drowsiness, and trouble concentrating.
These medications may reduce the effectiveness of corticosteroids, contraceptives containing estrogen, beta blockers (e.g. propranolol), doxycycline, felodipine, griseofulvin, nifedipine, phenylbutazone, quinine, theophylline, warfarin, and tricyclic antidepressants.
For additional information see “Drug Interactions” in Acetaminophen (page 7).
Food Interactions
Fioricet is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
1-2 tablets or capsules every 4 hours or as needed; do not exceed 6 doses a day.
Overdosage
Symptoms include breathing difficulties, nervousness progressing to stupor or coma, pinpointed pupils, cold and clammy skin and lowered heart rate or blood pressure, nausea, vomiting, dizziness, ringing in the ears, facial flushing, sweating, and thirst. Take the victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Fioricet may cause drowsiness. Be careful when driving or performing any task that requires concentration.
You should avoid alcohol while taking this medication.
Do not take Fioricet for longer or in amounts greater than prescribed.
If you have been taking this medication for more than a few weeks, do not stop taking it without your doctor’s instruction. Suddenly stopping Fioricet may lead to withdrawal symptoms.
Call your doctor if your headache or pain persists or gets worse, or if you develop side effects that are bothersome or persistent.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one    and continue
W<tkh IV61    schedule. Do not take a double dose.
For additional information see “Special Information” in Acetaminophen (page 7).
Special Populations
Pregnancy/Breast-feeding: Fioricet should not be taken during pregnancy. It is associated with birth defects, prolonged labor and delayed delivery, and breathing problems in newborns. Regular use of Fioricet during the last 3 months of pregnancy may also cause drug dependency in the newborn.
Fioricet passes into breast milk. Breast-feeding while using Fioricet may cause babies to become tired, short of breath, or have a slow heartbeat. Nursing mothers who must take this drug should use infant formula.
Seniors: Fioricet may have a greater depressant effect on seniors. Seniors are also more likely to experience stimulation and disorientation.

Brand Name
Fiorinal
Generic Ingredients
Aspirin + Butalbital + Caffeine &9
Other Brand Names
Butalgen    Fiorimor
Farbital    Fortabs
Fiorigen    Lanorinal
Type of Drug
Barbiturate and analgesic (pain reliever) combination. Prescribed For
Symptom relief of tension headache.
General Information
Pain relief products often combine an analgesic with a sedative. The analgesic ingredient in Fiorinal is aspirin; other brand-name products, such as Esgic and Fioricet, contain acetaminophen. The sedative ingredient in pain-relief combinations may be a barbiturate, narcotic, or other sedative. Fiorinal contains the barbiturate butalbital. Fiorinal also contains caffeine, which is ofte” \Ased in analgesic combinations that km,-M beadache because it enhances kkNt %m-relieving effect of aspirin.
Cautions and Warnings
Do not take Fiorinal if you are allergic or sensitive to any of its ingredients.
Do not give Fiorinal to children or teenagers with chickenpox or flu-like symptoms due to the aspirin content and danger of
Reye’s syndrome.
Use Fiorinal with extreme caution if you suffer from peptic ulcer,
problems with blood clotting or other bleeding disorders, or are
about to have surgery.
This drug should be used with caution if you have kidney or
liver disease, diabetes, or a history of porphyria.
Long-term use of this drug may cause drug dependence and addiction. It is not recommended for the treatment of multiple recurrent headaches.
Butalbital is a respiratory depressant and affects the central nervous system (CNS), producing drowsiness, tiredness, and an
inability to concentrate. Alcohol increases the CNS depression caused by butalbital.
The safety and efficacy of Fiorinal use in children under age 12 has not been established.
For additional information see “Cautions and Warnings” in Aspirin (page 110).
Possible Side Effects
✓    Most common: lightheadedness, dizziness, and sedation.
♦    Less common: nausea, vomiting, flatulence, and rash. For additional information see “Possible Side Effects” in Aspirin (page 110).
Drug Interactions
•    Combining Fiorinal with alcohol, sedatives, barbiturates, sleeping pills, antihistamines, monoamine oxidase inhibitor antidepressants, or other CNS depressants may cause tiredness, drowsiness, and trouble concentrating.
•    Fiorinal may enhance the effects of oral anticoagulants (blood thinners), oral antidiabetes drugs, insulin, and mmsteroidal anti-inflammatory drugs ~VASAYDs).
•    F10final may decrease the effectiveness of medications taken for gout, including probenicid and sulfinpyrazone.
For additional information see “Drug Interactions” in Aspirin (page 110).
Food Interactions
Fiorinal is best taken on an empty stomach but may be taken with
food if it upsets your stomach.
usual Dose
1-2 tablets or capsules every 4 hours or as needed. Do not exceed
6 doses a day. Overdosage
Symptoms include breathing difficulties, nervousness progressing to stupor or coma, pinpointed pupils, cold and clammy skin, lowered heart rate or blood pressure, nausea, vomiting, stomach pain, dizziness, ringing in the ears, flushing, sweating, and thirst. Symptoms of mild overdose are rapid and deep breathing, nausea, vomiting, dizziness, ringing or buzzing in the ears, flushing, sweating, thirst, headache, drowsiness, diarrhea, and rapid heartbeat. Severe overdose may cause fever, excitement, confusion, convulsions, liver or kidney failure, coma, and bleeding. Take the victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Fiorinal may cause drowsiness. Be careful when driving or performing any task that requires concentration.
Avoid alcohol while taking Fiorinal.
If you have been taking this medication for more than a few weeks, do not stop taking it without your doctor’s instruction. Suddenly stopping this drug may lead to withdrawal symptoms.
Do not take Fiorinal for longer or in amounts greater than prescribed.
Call your doctor if your headache pain persists or gets worse, or if you develop any bothersome or persistent side effect.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
For additional information see “Special Information” in Aspirin (page 110).
Special Populations
PregriancylBreast-feeding. Fiorinal should not be taken during pregnancy. Pregnant women taking it may experience prolonged labor, delayed delivery, and bleeding problems. Fiorinal increases the risk of birth defects and may cause breathing or bleeding prob-lems in newborns. Regular use of Fiorinal during the last 3 months of pregnancy may also cause drug dependency in the newborn.
Fiorinal passes into breast milk. Breast-feeding while using Fiorinal may cause tiredness, shortness of breath, or slowed heartbeat in the baby. Nursing mothers who must take Fiorinal should use infant formula.
Seniors: Fiorinal may have a greater depressant effect on seniors. Seniors are also more likely to experience stimulation and disorientation.

Brand Name
Fiorinal with Codeine
Generic Ingredients
Aspirin + Butalbital + Caffeine + Codeine Phosphate 19
Type of Drug
Barbiturate, narcotic, and analgesic (pain reliever) combination.
Prescribed For
Symptom relief of tension headache.
General Information
Fiorinal with Codeine is one of many combination products containing a barbiturate, an analgesic, and a narcotic. In Fiorinal with Codeine, butalbital is the barbiturate, aspirin is the analgesic, and codeine is the narcotic. These products often also contain a sedative, and acetaminophen may be substituted for aspirin.
Cautions and Warnings
Do not take Fiorinal with Codeine if you are allergic or sensitive to any of its ingredients. Even recommended doses of aspirin can cause severe allergic reaction in those with an aspirin allergy.
Do not take this medication if you suffer from peptic ulcer, bleeding disorders, or a history of porphyria.
Use this medication with cautiOi) 11 you have kidney or liver
disease of diabetes.
Fiorinal with Codeine may cause postural low blood pressure (symptoms include dizziness or fainting when rising from a sitting or lying position).
Long-term use of this drug may cause drug dependence or addiction.
It is not recommended for treatment of multiple, recurrent head-
aches.
Fiorinal with Codeine is a respiratory depressant and affects the
central nervous system (CNS), producing sleepiness, tiredness, or inability to concentrate. Alcohol increases the depression caused
by codeine and butalbital.
Do not give Fiorinal with Codeine to children or teenagers with
chickenpox or flu-like symptoms. The aspirin content presents the
danger of Reye’s syndrome.
For additional information see “Cautions and Warnings” in As-
pirin (page 110).
Possible Side Effects
✓    Most common: dizziness, sleepiness, nausea, and vomiting.
♦    Less common: dry mouth, difficulty swallowing, heartburn, rapid heart rate, leg pain and muscle fatigue, urinary problems, rash, fever, earache, stuffy nose, and ringing in the ears. Narcotic analgesics may aggravate convulsions in those who have had them.
For additional information see “Possible Side Effects” in Aspirin (page 110).
Drug Interactions
•    Interaction with alcohol, sedatives, barbiturates, sleeping pills, antihistamines, or other drugs that produce sedation may cause tiredness, drowsiness, and trouble concentrating.
•    Taking Fiorinal with Codeine with a monoamine oxidase inhibitor antidepressant may cause increased central nervous system effects.
•    This medication may reduce the effectiveness of medications for the treatment of gout including probenicid and sulfapyrazone.
•    Fiorinal with Codeine may enhance the effects of blood thin- ners, oral antidiabetes drugs, insulin, and anti-inflammatory drugs (NSAIDs).
For additional information see “Drug Interactions” in Aspirin (page 110).
Food Interactions
Fiorinal with Codeine is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
1-2 tablets or capsules every 4 hours or as needed; do not ex-
ceed 6 doses a day.
Overdosage
Usual overdose symptoms include breathing difficulties, nervousness progressing to stupor or coma, pinpointed pupils, cold clammy skin and lowered heart rate or blood pressure, nausea, vomiting, dizziness, ringing in the ears, flushing, sweating, and thirst. Symptoms of mild overdose include rapid and deep breathing, nausea, vomiting, dizziness, ringing or buzzing in the ears, flushing, sweating, thirst, headache, drowsiness, diarrhea, and rapid heartbeat. Severe overdose may cause fever, excitement, confusion, convulsions, liver or kidney failure, coma, or bleeding. Take the victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
This drug may cause drowsiness. Be careful when driving or performing any task that requires concentration.
Avoid alcohol while taking this drug.
If you have been taking this medication for more than a few weeks, do not stop taking it without your doctor’s instruction. Suddenly stopping this drug may lead to withdrawal symptoms.
Do not take this drug for longer or in amounts greater than prescribed.
Call your doctor if you experience breathing difficulties, or persistent nausea, vomiting, or constipation.
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.
For additional information see “Special Information” in Aspirin (page 110).
Special Populations
Pregnancy/Breast-teeding-. Fiorinal with Codeine should not be used during pregnancy. Pregnant women taking it may experience prolonged labor, delayed delivery, and bleeding problems. This drug increases the risk of birth defects and may cause breathing or bleeding problems in newborns. Regular use of Fiorinal with Codeine during the last 3 months of pregnancy may also cause drug dependency in the newborn.
Fiorinal with Codeine passes into breast milk. Breast-feeding while using this drug may cause tiredness, shortness of breath, or a slow heartbeat in the baby. Nursing mothers who must take this drug should use infant formula.
Seniors: This drug may have a greater depressant effect on seniors. Other effects that may be more prominent are stimulation, disorientation, lightheadedness, and dizziness or fainting when rising suddenly from a sitting or lying position.

Tags: addition, aminophylline, antihistamine, aspirin, bad cholesterol, Barbiturate, blood lipids, Brand Name, brand names, breakdown, breast feeding, Butalbital, cardiac event, cholesterol lowering drug, depressant, effectiveness, enzymes in the body, Esgic, fenofibrate, GENERIC, good cholesterol levels, high blood cholesterol, high density lipoprotein, high triglyceride levels, inflammation of the pancreas, information, Interactions, kidney disease, kidney failure, lofibra, low density lipoprotein, muscle cells, Prescribed, product formulation, statin drugs, stomach, tension, triglide, upset stomach, wov

Brand Name
Donnatal
Generic Ingredients
Atropine Sulfate + Hyoscyamine Sulfate + Phenobarbital + Scopolamine Hydrobromide EQ
Other Brand Names Antispas
Antispasmodic Barbidonna
Bellatal
Donnapine
Donnatal Extentabs Hyosophen Spasmolin
The information in this profile also applies V) the following drugs: Generic /nqcedjer)t: Hyoscyamine Sulfate 0
Anaspaz    ED-SPAZ
A-Spas S/L    Hyosol
Cytospaz    Hyosyne
Donnamar    IB-Stat
Levbid Levsin
Levsinex Timecaps Medispaz
DONNATAL
Neosol NuLev Spasdel Symax
Generic Ingredient: Propantheline 92 Pro-Banthine
Type of Drug
Anticholinergic combination.
Prescribed For
Stomach spasm and gastrointestinal (GI) cramps; also used to treat motion sickness.
General Information
Donnatal is a mild antispasmodic sedative. Its principal action is to counteract the effect of acetylcholine, an important neurohormone. Donnatal is used only to relieve symptoms. not to treat the underlying condition, and there is considerable doubt among medical experts that this drug lives up to its claims. In addition to the brand names listed above, there are about 50 other anticholinergic combinations with similar properties. All are used to relieve cramps and all are about equally effective. Some have additional ingredients to reduce or absorb excess gas in the stomach, to coat the stomach, or to control diarrhea. Donnatal and products like it should not be used for more than the temporary relief of symptoms.
Cautions and Warnings
Do not take Donnatal if you are allergic or sensitive to any of its ingredients.
Donnatal should not be used by people with glaucoma, rapid heartbeat, severe intestinal disease such as ulcerative colitis, intestinal obstruction, urinary difficulties, asthma, myasthenia gravis, acute intermittent porphyria, acute bleeding with unstable heart function, or hiatal hernia.
Phenobarbital may be, habit-forming and should not be admin(Ste_%16 10 people with a history of drug dependence.
Donnatal should be used with caution in children and in people with brain damage, spastic paralysis, Down’s syndrome, heart disease, high blood pressure, hyperthyroidism (overactive thyroid gland), kidney or liver disease, autonomic neuropathy, or gastric ulcer.
Donnatal can reduce your ability to sweat and may lead to heat exhaustion. Avoid extended heavy exercise and limit your exposure to high temperatures.
Possible Side Effects
♦    Most common: blurred vision, dry mouth, urinary difficulties, flushing, and dry skin.
♦    Less common: rapid or unusual heartbeat, increased sensitivity to bright light, loss of the sense of taste, headache, nervousness, tiredness, weakness, dizziness, sleeplessness, nausea, vomiting, fever, stuffy nose, heartburn, loss of sex drive, decreased sweating, constipation, feeling bloated, and allergic reactions such as fever and rash.
Drug Interactions
•    Although Donnatal contains only a small amount of phenobarbital, it is wise to avoid alcohol or other sedative drugs. Although unlikely, phenobarbital interactions are possible with anticoagulants, adrenal corticosteroids, narcotics, sleeping pills, digitalis or other cardiac glycosides, and antihistamines.
•    Some phenothiazine drugs, sedatives, tricyclic antidepressants, and narcotics may increase the side effects of the atropine sulfate ingredient in Donnatal, causing dry-mouth, urinary difficulties, and constipation. The effectiveness of phenothiazines to control psychotic symptoms may be decreased.
•    Combining Donnatal and the antiviral amantadine may increase the side effects of Donnatal.
•    Donnatal may increase the side effects of atenolol and digoxin.
•    Antacids may decrease Donnatal’s effectiveness; do not take antacids within 1 hour of taking Donnatal.
Food Interactions
‘%ke Donnatal 30-60 minutes before meals.
Usual Dose
Donnatal
Adult (age 13 and over): 1-2 tablets, capsules, or tsp. 3-4 times a day, or 1 extended-release tablet every 12 hours.
Child (age 2-12): 112 the adult dosage. Child (under age 2): not recommended.
Propantheline
Adult-. 15 mg 3 times a day before meals, and 30 mg at bedtime. Senior: 7.5 mg 3 times a day.
Child (under age 12): not recommended.
Overdosage
Symptoms of overdose include dry mouth; difficulty swallowing; thirst; blurred vision; sensitivity to bright light; flushed, hot, or dry skin; rash; fever; abnormal heart rate; high blood pressure; urinary difficulties; restlessness; confusion; delirium; and breathing difficulties. The victim should be taken to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you experience persistent diarrhea, bloating, fever, heart palpitations, rash, flushing, or eye pain.
Do not crush or chew Donnatal tablets.
Dry mouth usually can be relieved by chewing gum or sucking hard candy or ice chips. Constipation can be treated with a stool-softening laxative.
Donnatal may reduce the amount of saliva in your mouth, making it easier for bacteria to grow there. Pay special attention to dental hygiene while taking this medication to prevent cavities and gum disease.
Donnatal may cause drowsiness and blurred vision. Be careful when driving or operating hazardous equipment.
If you forget to take a dose of Donnatal, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Donnatal may cause drug dependency or breathing problems in newborns and may interfere with labor aM delivery. When this drug is considered crucial by your doctor, its potential must be carefully weighed against its risks.
Donnatal may pass into breast milk and may reduce the amount of milk produced. It may cause tiredness, shortness of breath, and a slower-than-normal heartbeat in infants. Nursing mothers who must take this medication should consider using infant formula.
Seniors: Seniors are often more sensitive to the side effects of Donnatal, such as excitement, confusion, drowsiness, agitation, constipation, dry mouth, and urinary difficulties. Memory may be impaired and glaucoma worsened.

Generic Name
Doxazosin (dok-SAY-zoe-sin) In
Brand Names
Cardura.    Cardura XL
Type of Drug  Antihypertensive.
Prescribed For
High blood pressure and benign prostatic hyperplasia (BPH); also used with digoxin and diuretic drugs to treat congestive heart failure.
General Information
Doxazosin mesylate and other alpha-adrenergic blocking agents, or alpha blockers, reduce blood pressure by dilating (widening) blood vessels. They achieve this effect by blocking nerve endings known as alpha, receptors. The maximum blood-pressurelowering effect of doxazosin is seen between 2 and 6 hours after taking a dose. In BPH treatment, doxazosin works by relaxing smooth muscles in the prostate and neck of the bladder. Doxazosin helps the symptoms of BPH, and taking it for several years may eliminate the need for surgery or allow the use of a less invasive type of surgery. Doxazosin’s effect lasts for 24 hours. It is mostly broken down in the liver; little passes out of the body via the kidneys.
Doxazosin may slightly reduce cholesterol levels and improve the ratio of high-density lipoprotein (HDL)—”good” cholestemAand low-density lipoprotein (ILDL}—”bad cholesterol”—a positive step for peQ¢kp_%Aln a blood-cholesterol problem.
Cautions and Warnings
Do not take doxazosin if you are allergic or sensitive to any of its ingredients or to any alpha blocker.
Doxazosin may cause dizziness and fainting, especially the first few doses. This is known as a first-dose effect, which can be minimized by limiting the first dose to 1 mg at bedtime. First-dose effects occur in about i % of people taking an alpha blocker and may recur if the drug is stopped for a few days and then started
again.
Doxazosin should be taken with caution if you have liver
disease.
White-blood-cell counts may be slightly decreased in people
taking doxazosin.
Rarely, alpha blockers, including doxazosin, have led to pri-
apism (painful and prolonged erection). Call your doctor immediately if this happens. If not treated promptly, this condition can lead to impotence.
Possible Side Effects
✓    Most common: headache, dizziness, and weakness.
♦    Less common: heart palpitations, abnormal heart rhythms, chest pain, nausea, diarrhea, constipation, abdominal pain or discomfort, gas, breathing difficulties, nosebleed, sore throat, runny nose, muscle or joint pain, visual disturbances, conjunctivitis (pinkeye), ringing in the ears, fainting, depression, decreased sex drive or sexual function, tingling in the hands or feet, nervousness, tiredness, anxiety, sleeplessness, poor muscle coordination, muscle stiffness, poor bladder control, frequent urination, itching, rash, sweating, fluid retention, facial swelling and flushing, and back, neck, shoulder, arm, or leg pain.
✓    Rare: vomiting, dry mouth, sinus irritation, bronchitis, cold or flu symptoms, worsening of asthma, coughing, hair loss, weight gain, and fever. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Doxazosin may interact with beta blockers to ‘increase the risk of dizziness or fa:kv%1)g alter the first dose of doxazosin.
•    TW-1 UDOd-pressure-lowering effect of doxazosin may be reduced by indomethacin.
•    When taken with other blood-pressure-lowering drugs, dox-
azosin produces a severe reduction of blood pressure.
•    The blood-pressure-lowering effect of clonidine may be reduced by doxazosin.
Doxazosin should be taken with caution in combination with clarithromycin, ketoconazole, and itraconazole.
Food Interactions None known.
Usual Dose
Adult: 1 mg morning or evening to start; may be increased to a total of 16 mg, taken once a day. Extended-release tablets-4 mg once daily at breakfast; may be increased to a total of 8 mg. Do not chew, cut, or crush extended-release tablets.
Child: not recommended.
Overdosage
Overdose may produce drowsiness, poor reflexes, and very low blood pressure. Overdose victims should be taken to a hospital emergency room at once. ALWAYS bring the prescription bottle or container.
Special Information
Take doxazosin exactly as prescribed. Do not stop taking it unless directed to do so by your doctor. Avoid over-the-counter drugs that contain stimulants because they may increase your blood pressure.
Doxazosin may cause dizziness, headache, and drowsiness, especially 2-6 hours after you take your first dose, although these effects can persist after the first few doses. Use caution when getting up from a sitting or lying position.
Call your doctor if you develop severe dizziness, heart palpitations, or any bothersome or persistent side effect.
Wait 12-24 hours after taking your first dose of doxazosin before driving or doing anything that requires concentration. Take your dose at bedtime to minimize this problem.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and coT)- tinue with your regular schedule. Do R(ak%’Ke a double dose.
4VIWIal Populations
Pregnancy/Breast-feeding: The safety of using doxazosin during pregnancy is not known, although animal studies have shown that alpha blockers may affect fetal development. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Small amounts of doxazosin pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors, especially those with liver disease, may be more sensitive to the effects and side effects of doxazosin.

Generic Name
Doxercalciferol (dox-er-kal-Sffl-fer-ahl)
Brand Names
Drisdol Liquid    Hectorol Capsules
Type of Drug
Vitamin D supplement.
Prescribed For
Elevated parathyroid hormone levels in patients undergoing kidney dialysis.
General Information
Doxercalciferol is a synthetic form of vitamin D that is processed in the body to form active vitamin D. Vitamin D, along with parathyroid hormone, are key elements of the calcium-regulating system in the body. Normally, your body releases parathyroid hormone if blood calcium levels are too low. Parathyroid hormones move calcium from the place where it is found in greatest quantity—your bones—into the bloodstream. This can have disastrous effects for a wide variety of body functions where calcium is crucial including muscle contraction, nervous system function, bone fragility, and blood clotting. Doxercalciferol helps to stabilize the system and normalize parathyroid hormone levels that can be artificially elevated in dialysis patients.
Cautions  and Warnings
Do not use doxercalciferol if you are allergic or sensitive to any of its ingredients.
Do not take any other Vitamin D supplement while taking this dwg.
People with a tendency toward high calcium or vitamin D levels should not take doxercalciferol.
Before taking this medication, tell your doctor if you have liver disease. You may not be able to take doxercalciferol, or you may require a dosage adjustment or special monitoring during treatment.
Dialysis patients experience increases in blood calcium and phosphate while taking this drug.
Drug Interactions
•    Do not take antacids that contain magnesium while you are taking doxercalciferol.
•    Cholestyramine may reduce the absorption of doxercalciferol.
•    Prolonged use of mineral oil may reduce the absorption of doxercalciferol.
•    Do not combine any other over-the-counter or prescription medicines, or vitamin supplements with doxercalciferol without first talking with your doctor.
•    The following medicines can slow the transformation of doxercalciferol to its active form in the body, reducing its effectiveness: ketoconazole, erythromycin, delaviridine, indinavir, nelfinavir, ritonavir, amiodarone, aprepitant, chloramphenicol, cimetidine, ciprofloxacin, clarithromycin, diltiazem, fluconazole, fluvoxamine, gestodene, itraconazole, mifepristone, nefazodone, norfloxacin, mibefradil, and verapamil.
•    The following drugs can increase the breakdown of doxercalciferol in the liver, possibly reducing its effectiveness: efavirenz, nevirapine, barbiturates, carbamazepine, glucocorticoids, modafinil, phenobarbital, phenytoin, rifampin, St. John’s wort, oxcarbazepine, pioglitazone, and rifabutin. Dosage adjustment may be needed.
•    Digoxin may cause symptoms of alcohol intolerance when combined with disulfiram or mettot)idazole.
Food (”WTactions
Avoid grapefruit products as they can slow the transformation of doxercalciferol to its active form in the body, reducing its effectiveness.
You may need to limit your consumption of foods containing vitamin D. Consult your doctor.
constipation,    general discomfort, nausea, difficulty breathing, and itching.
of appetite, indigestion, weight gain, on, sleepiness, and slowed heart rate.
Possible Side Effects
♦    Common: swelling, headache, dizziness,
✓    Less common: loss joint pain,
Usual Dose
Adult:starting dose-10 mcg 3 times a week during kidney dialysis treatment. Dosage may be adjusted to 2.5 mcg at 8-week in-
tervals if necessary.
Child: not recommended.
Overdosage
Symptoms include weakness, headache, drowsiness, nausea, vomiting, dry mouth, metallic taste in mouth, constipation, muscle pain, bone pain, and irregular heartbeat. Call your local poison control center or a hospital emergency room for more information. It you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Compliance with dosage instruction, diet, and calcium supplementation is important while taking doxercalciferol.
Lab tests are required to monitor therapy while taking doxercalciferol.
Doxercalciferol may cause dizziness. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
Special Populations
Tell your doctor or pharmacist if you are pregnant, planning on becoming pregnant, or breast-feeding.
The safety of using doxercalciferol 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 doxercalciferol passes into breast milk. Nursing mothers who must use this drug should use infant formula.
Seniors: Seniors may use this drug without special precaution.

Generic Name
Dronabinol (droe-Mla-ih,bl)
Brand Name  Marino)
Type of Drug Antinauseant.
Prescribed For
Nausea and vomiting associated with cancer chemotherapy, and appetite stimulation and weight-loss prevention in people with acquired immunodeficiency syndrome (AIDS).
General Information
Dronabinol is a legal form of marijuana. The psychoactive chemical in marijuana is delta-9-THC. Dronabinol has all of the psychological effects of marijuana and is therefore considered to be a highly abusable drug. It can cause personality changes, feelings of detachment, hallucinations, and euphoria (feeling “high”). Younger adults have reported a greater success rate with dronabinol, probably because they are better able to tolerate these effects.
Most people start taking dronabinol while in the hospital so their response to the drug and its possible adverse effects can be monitored. Dronabinol has also been studied as a glaucoma treatment.
Cautions and Warnings
Do not take dronabinol if you are allergic or sensitive to any of its ingredients, to marijuana, or to sesame oil.
Dronabinol should not be used to treat nausea and vomiting caused by anything other than cancer chemotherapy.
Dronabinol should be used with caution in those with a history of seizure disorders or substance abuse.
Dronabinol has a profound effect on mental states; it will impair your ability to operate complex equipment or engage in any activity that requires intense concentration, sound judgment, or coordination—such as driving a car.
Dronabinol produces withdrawal symptoms when the drug is stopped. These may develop within 12 hours of the drug’s discontinuation and include restlessness, sleeplessness, and irritability. Within a day after the drug has been stopped, stuffy nose, hot flashes, sweating, loose stools, hiccups, or appetite loss may occur. The symptoms usually subside within a few days,
Dronabinol should be used with caution by people with heart disease or high blood pressure. Dronabinol should be used with caution by people with a manic-depressive or schizophrenic history because it may aggravate the underlying disease.
Possible Side Effects
V Most common: drowsiness, euphoria, dizziness, anxiety, muddled thinking, perceptual difficulties, poor coordination, irritability, a separation in time and space, depression, weakness, sluggishness, nausea and vomiting, headache, hallucinations, memory lapses, loss of muscle coordination, unsteadiness, paranoia, depersonalization, disorientation, confusion, rapid heartbeat, and dizziness when rising from a sitting or lying position.
♦ Less common: difficulty talking or slurred speech, facial flushing, excessive perspiration, nightmares, ringing or buzzing in the ears, fainting, diarrhea, loss of bowel control, and muscle pain.
Drug Interactions
•    Dronabinol increases the effects of alcohol, sleeping pills, sedatives, and other depressants. It also enhances the effects of psychoactive drugs including tricyclic antidepressants, amphetamines, cocaine, and other stimulants.
•    Dronabinol may increase the effects of fluoxetine and disulfiram.
•    The effects of theophylline drugs are reduced by dronabinol.
•    Combining dronabinol and antihistamines or anticholinergic drugs may cause either rapid heartbeat or excessive drowsiness.
Food Interactions
This drug may be taken without regard to food or meals; as an appetite stimulant, it is often taken before meals.
Usual Dose
Antiemetic: 5 mg 1-3 hours before starting chemotherapy treatment and repeated every 2-4 hours after treatment, for a total of 4-6 doses a day. Dosage may be increased up to 15 mg per dose if needed; psychiatric side effects increase greatly at higher dosages.
Appetite Stimulant: 2.5 mg before lunch or dinner, or 2.5 mg at bedtime. Dosage may be increased to 20 mg a day.
Overdosage
Overdose symptoms may occur at usual dosages or at higher dosages if the drug is being abused. The primary symptoms of
overdose are the psychological symptoms listed above (see “Possible Side Effects”). In some cases, overdose may lead to panic reactions or seizure. Contact a hospital or local poison center for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Be careful when driving or performing any task that requires concentration. Avoid alcohol and other central nervous system (CNS) depressants.
Dronabinol may cause acute psychiatric or psychological side effects. Call your doctor if any develop.
The capsules must be stored in the refrigerator.
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
Pregnancy/Breast-feeding; Animal studies have shown adverse effects on the fetus. When this drug is considered crucial by your doctor, its benefits must be carefully weighed against its risks.
Dronabinol passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may be more sensitive to this drug, especially its psychological effects.

Brand Name
Dyazide
Generic Ingredients  Hydrochlorothiazide + Triamterene 5§1
Other Brand Names
Maxzide    Maxzide-25
The information in this 10TOVile also applies to the following drugs:
Generic Ingredients: Amiloride + Hydrochlorothiazide 92 Hydro-Ride    Moduretic
Generic Ingredients: Spironolactone + Hydrochlorothiazide KI
Aldactazide    Spironazide
Alzide Novo-Spirozine    Spirozide
Type of Drug
Diuretic    that increases urination).
Prescribed For      Hypertension (high blood pressure) or any condition where it is de-
sirable to eliminate excess water from the body. General Information
Dyazide combines a thiazide diuretic and a potassium-sparing diuretic. The latter, triamterene, helps the body retain potassium while producing a diuretic effect. This balances the other ingredient, hydrochlorothiazide, which normally causes a loss of potas- sium. Different products contain differing concentrations of these 2 drugs. Dyazide should be used only when you need its exact proportion of ingredients, and should not be used for initial therapy of hypertension or edema. It may be used alone or with other anti hypertensive drugs such as beta blockers. Dosage adjustment may be necessary.
Cautions and Warnings
Do not use dyazide if you are allergic or sensitive to any of its ingredients or to any sulfa drug or if you have a history of allergy.
Do not use Dyazide if you have nonfunctioning kidneys, bronchial asthma, or hyperkalemia (high blood potassium levels).
Do not combine any potassium supplement and Dyazide without your doctor’s knowledge. Dyazide may reduce blood levels of sodium and potassium and raise blood calcium levels.
Dyazide should be used with caution in people with diabetes, liver disease, or an electrolyte imbalance.
Possible Side Effects
♦ Most common: appetite loss, drowsiness, lethargy, head-
ache, gastrointestinal upset, cramping, and diarrhea.
V Less common: rash—possibly severe, mental confusion, fever, feeling unwell, impotence, bright red tongue, burnt”g sensation in the tongue, tingling in the toes and fingers, restlessness, anemia or other effects on blood components, increased sensitivity to sunlight, and dizziness when rising quickly from a sitting position. Dyazide may also produce muscle spasms, gout, weakness, and blurred vision.
Drug Interactions
other blood pressure
•    Dyazide increases the effect of
drugs. This is why other blood-pressure drugs are often prescribed with Dyazide, but dosage adjustments may be required.
•    Combining Dyazide and digitalis drugs, amphotericin B, or adrenal corticosteroids increases the risk of body-fluid imbalance. If you are taking insulin or an oral antidiabetic drug and begin taking Dyazide, the insulin or antidiabetic dosage may have to be modified.
•    Dyazide may increase the risk of allopurinol side effects.
•    Dyazide may decrease the effects of oral anticoagulant (blood-thinning) drugs.
•    Antigout drug dosage may have to be modified since Dyazide raises uric-acid levels.
•    Dyazide may prolong the effects of chemotherapy drugs on reducing white-blood-cell counts.
•    Dyazide may increase the effects of diazoxide, which may lead to symptoms of diabetes.
•    Dyazide should not be taken with loop diuretics because the combination can lead to an extreme diuretic effect and an extreme effect on blood-sodium levels.
•    Dyazide may increase the effect of vitamin D, which may cause high blood-calcium levels.
•    Propantheline and other anticholinergics may increase the diuretic effect of Dyazide.
•    Lithium carbonate taken with Dyazide should be monitored carefully by a doctor due to an increased risk of lithium side effects.
•    Cholestyramine and colestipol prevent Dyazide from being absorbed. Dyazide should be taken at least 2 hours before cholestyramine or colestipol.
•    Methenamine and other urinary agents may reduce the effect of Dyazide.
•    Some nonsteroidal anti-inflammatory drugs (NSNDs), particularly indomethacin, may reduce the effect of Dyazide. Sulindac, another NSAID, may increase its effect.
•    Potassium-sparing diuretics should be used with caution in combination with ACE inhibitors.
Food Interactions
Take this drug with food if it upsets your stomach.
usual Dose
Adult
Amiloride combination: 1-2 tablets daily with meals.
Spironolactone combination: 1-8 tablets daily.
Triamterene combination: 1-2 capsules or tablets a day. Child: not recommended.
Overdosage
Symptoms may include tingling in the arms or legs, weakness, fatigue, changes in heartbeat, a sickly feeling, dry mouth, restlessness, muscle pain or cramps, urinary difficulties, nausea, and vomiting. In some cases, low blood pressure and decreased respiration may occur. Take the victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Dyazide causes excess urination at first, but this subsides after several weeks of use. Diuretics are usually taken early in the day to prevent excessive nighttime urination that may interfere with sleep.
Dyazide may make you drowsy. Be careful when driving or performing any task that requires concentration.
Call your doctor if you develop muscle pain, sudden joint pain, weakness, cramps, nausea, vomiting, restlessness, excessive thirst, tiredness, drowsiness, increased heart or pulse rate, diarrhea, dizziness, headache, or rash.
People with diabetes may experience an increased blood-sugar level and require dosage adjustments of their antidiabetic medications.
Avoid other drugs while taking Dyazide unless otherwise directed by your doctor. Avoid alcohol.
If you are taking Dyazide for the treatment of hypertension or congestive heart failure (CHF), avoid over-the-counter cough, cold, or allergy medications, which may contain Ft%m\)%an1s.
Take Dyazide exactly -as prescribed. Be aware that all triarRtt~tl)Z-’hydrochlorothiazide products are not equal to each other and should not be freely substituted. Check with your doctor and pharmacist before switching brands.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.

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Generic Name
Cilostazol (sil-oe-STAY-zol) Lq
Brand Name  Pletal
Type of Drug Antiplatelet.
Prescribed For  Intermittent claudication.
General Information
In intermittent claudication, leg muscles go into spasm due to reduced blood flow. This occurs when plaque buildup narrows blood vessels leading to the calf or other leg muscles. People with this condition often develop leg pain after walking only a short distance. Cilostazol prevents blood platelets from “clumping together” to begin the process of forming a blood clot, which can further obstruct arteries and worsen intermittent claudication. This drug is broken down in the liver.
Cautions and Warnings
Do not take this drug if you are allergic or sensitive to any of its ingredients.
?P,Ople with congestive heart failure (CHF) should not take cilostazol. Some studies indicate that long-term use of this drug may cause cardiovascular problems.
People with hemostatic disorders or active pathologic bleeding should not take cilostazil.
Drug Interactions
•    Avoid mixing cilostazol with ketoconazole, itraconazole, fluconazole, miconazole, fluvoxamine, fluoxetine, nefazodone, or sertraline because this interaction may slow the breakdown of cilostazol, prolonging its effects. Cilostazol dosage is reduced by 50% when it is combined with any of these drugs.
•    Aspirin can increase the anticoagulant (blood-thinning) effect of cilostazol, but this combination has not caused serious bleeding problems. There is no information on the effect of combining cilostazol and other antiplatelet or anticoagulant drugs. Cilostazol dosage is reduced by 50% when it is combined with any of these drugs.
•    Diltiazem increases cilostazol blood levels by about 50%. Cilostazol dosage is reduced by 50% when it is combined with diltiazem.
•    Erythromycin and similar antibiotics increase cilostazol blood levels. Take half the regular dose of cilostazol when combining it with any of these drugs.
•    Combining cilostazol and omeprazole increases the effects of cilostazol. Cilostazol dosage is reduced by 50% when it is combined with omeprazole.
•    Smoking reduces the Olectiveness of cilostazol by causing the liver to break it down faster.
Food Interactions
Take this drug on an empty stomach at least 30 minutes before or 2 hours after meals. Do not drink grapefruit juice at any time while
above.    with dosage.
dache, infection, abdominal pain, ab- arrhea.
pitations, rapid heartbeat. dizziness, sea, sore throat, runny nose, back pain, arms or legs.
cough, fainting, and muscle aches. cts can occur in almost any part of the doctor if you experience any side ef- e.
Possible Side Effects
The risk of side effects
♦    Most common: headache
•    stool, and diarrhea. • Common: heart palpitations
•    stomach, nausea
•    swelling in the
♦    Less common: gas,
♦    Rare: Rare side effects body. Contact your fect not listed taking cilostazol because it can interfere with the breakdown of the drug.
Usual Dose
Adult: 100 mg twice a day. 50 mg twice a day when combined with other drugs that may increase the effect of cilostazol. Child: not recommended.
Overdosage
Symptoms of overdose are likely to be the most common side effects. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Several weeks of cilostazol treatment may be necessary before you notice any improvement in symptoms. Maximum benefit usually occurs after 12 weeks.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Animal studies suggest that cilostazol may harm the fetus, but there is no information on the effect of cilostazol in pregnant women. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
cilostazol may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors can take this drug without special precaution.

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Type of Drug
Cholinesterase Inhibitors
(KO-lin-ESS-tuh -rase)
Brand Names
Generic Ingredient.- Donepezil
Aricept    Aricept ODT
Generic Ingredient: Galantamine
Razadyne    Razadyne ER
Generic Ingredient: Rivastigmine
Exelon    Exelon Transdermal System
Generic Ingredient: Tacrine Cognex
Prescribed For
Alzheimer’s disease. Also used for vascular dementia, dementia associated with Parkinson’s disease, poststroke aphasia (problems with language), and improvement of memory in multiple sclerosis patients.
General Information
Cholinesterase inhibitors work by increasing the function of certain receptors in the brain that are stimulated by the hosmone acetylcholine. They do t.Ns by interfering with cholinesterase, the 1617yme that breaks down acetylcholine. People with Alzheimer’s disease (a degenerative condition of the central nervous system) develop a shortage of this brain chemical early in the disease. There is no evidence that cholinesterase inhibitors reverse the degenerative effects of Alzheimer’s, but they may slow the rate at which the disease worsens.
Cautions and Warnings
Do not take cholinesterase inhibitors if you are allergic or sensitive to any of their ingredients.
Cholinesterase inhibitors must be discontinued before surgery because they increase the effects of anesthetic drugs.
People with heart disease should use cholinesterase inhibitors with caution because they may slow heart rate and cause fainting. Two studies of people with mild symptoms of Alzheimer’s disease taking galantamine revealed a higher rate of death from heart attack, stroke, or sudden death.
Cholinesterase inhibitors may be expected to cause increased stomach acid production and increased activity of the gastrointestinal tract. Possible complications include ulcers or bleeding. Alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen may worsen this effect.
Using cholinesterase inhibitors may also lead to urinary blockage, increase the risk of generalized seizures, and worsen asthma or other pulmonary diseases. Use with caution if you have these conditions.
People with severe liver dysfunction should not take galantamine or tacrine.
Possible Side Effects
People taking cholinesterase inhibitors generally experience side effects at about the same rate as those taking a placebo (sugar pill).
♦    Most common: headache, general pain, accidents, nausea, diarrhea, sleeplessness, and dizziness.
✓    Common: tiredness, vomiting, appetite loss, and muscle cramps.
♦    Less common: arthritis, depression, abnormal dreams, fainting, black-and-blue marks, and weight loss.
✓    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
•    Cholinesterase inhibitors interfere with anticholinergic drugs (often prescribed for stomach disorders).
•    Cholinesterase inhibitors can be expected to increase the ef-
fects of cevimeline, surgical anesthetic drugs, and drugs that
irritate the stomach and intestines, such as aspirin, ibupro-
fen, and other NSAIDs.
•    The breakdown of cholinesterase inhibitors (except rivastigmine) in the liver can be slowed by ketoconazole, itraconazole, quinidine, delavirdine, indinavir, nelfinavir, ritonavir, saquinavir, amiodarone, cimetidine, ciprofloxacin, norfloxacin, clarithromycin, diltiazem, erythromycin, fluconazole, fluvoxamine, celecoxib, chlorpheniramine, clomipramine, cocaine, doxorubicin, fluoxetine, halofantrine, halopendol, levopromazine, methadone, mibefradil, paroxetine, ranitidine, terbinafine, mifepristone, nefazodone, and grapefruit juice.
•    The breakdown of cholinesterase inhibitors (except rivastigmine) in the liver can be increased by efavirenz, nevirapine, barbiturates, carbamazepine, corticosteroids, phenytoin, pioglitazone, and rifampin.
Food Interactions
Donepezil can be taken with or without food.
Galantamine and rivastigmine should be taken with morning and evening meals.
The rivastigmine transdermal system patch can be used without regard to meals.
Food reduces the absorption of tacrine into the blood. It is best taken on an empty stomach, but you can take it with food if it upsets your stomach.
Usual Dose
Donepezil
Adult: 5 or 10 mg once a day.
Galantamine
Adult: 8-32 mg a day.
Rivastigmine
Adult: 3-12 mg a day, divided into 2 doses.
RiVUtq1M&A0Y2nsdermaI patch
Adult: Apply one 4.6-mg patch every day to start. Dose may be increased to one 9.5-mg patch every day.
Tacrine
Adult: 40-160 mg a day, divided into 4 doses.
Overdosage
Cholinesterase inhibitor overdose can be very serious. Symptoms include severe nausea, vomiting, salivation, sweating, slow heart rate, low blood pressure, slow breathing rate, convulsions, muscle weakness, and collapse. Take the overdose victim to a hospital emergency room at once. ALWAYS bring the prescription bottle or container.
Special Information
Donepezil should be taken just before bedtime.
Follow the special package directions for rivastigmine solution.
Do not remove the rivastigmine patch from its packaging until just before you are ready to apply it. Apply the patch to clean, dry, and hairless skin on the upper or lower back, upper arm, or chest that is also free of any powder, oil, moisturizer, or lotion that could keep the patch from sticking to your skin properly; skin should also be free of cuts, rashes, and irritations. Avoid places where the patch can be rubbed off by tight clothing. When changing your patch, apply your new patch to a different spot of skin (for example, on the right side of your body one day, then on the left side the next day). Do not use the same spot more than once every 14 days. Wear only one patch at a time and change it every.24 hours. If the patch falls off, apply a new patch for the rest of the day, then replace the patch the next day at the same time as usual.
Tobacco or nicotine use increases the rate at which tacrine and rivastigmine are cleared from the body.
If you forget a dose and take your medication once a day, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with the regular schedule. If you take your medication 2 or more times a day, take your dose 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: One animal study of a cholinesterase inhibitor indicated a small risk of birth defects. When your doctor considers this drug crucial, its potential benefits must be carefully weighed against its risks.
It is not known if cholinesterase inhibitors pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors with moderate kidney function loss should not take galantamine. Dosage adjustments are not needed for donepezil, tacrine, or rivastigmine.

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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.

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Generic Name
Cetirizine (seh-TERE-ih-zene)
Brand Name  Zyrtec
The information in this profile also applies to the following drugs:
Generic Ingredient: Azelastine
Generic Ingredient: Fexofenadine 91 Allegra
Generic Ingredient: Levocetirizine 91 Xyzal
Type of Drug  Antihistamine.
Prescribed For
Azelastine: runny nose, sneezing, nasal itching, and post-nasal drip. Cetirizine: stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal and year-round allergy, and for other symptoms of allergy such as rash, itching, and hives; also prescribed for chronic itching and for asthma. Fexofenadine: sneezing, stuffy and runny nose; scratchy throat and mouth; and itchy, watery, and red eyes caused by seasonal allergies. Levocetirizine: stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal and year-round allergy, and for other symptoms of allergy such as rash, itching, and hives; also prescribed for chronic itching.
General Information
Antihistamines generally work by blocking the release of histamine (a chemical released by body tissue during an allergic reaction) from the cell at the H, histamine receptor site, drying up secretions of the nose, throat, and eyes. Cetirizine causes less sedation than older antihistamines and appears to be just as effective. Levocetirizine is the active portion of the cetirizine molecule and is as effective as cetirizine with a similar side effect profile.
Cautions and Warnings
Do not take cetirizine if you are allergic or sensitive to any of its ingredients.
People with kidney disease should receive reduced dosages of cetirizine and levocetirizine. Do not take these drugs if kidney disease is severe. Children with kidney disease should not receive levocetirizine.
Possible Side Effects
✓    Common: headache, drowsiness, fatigue, dry mouth, bitter taste in the mouth, dizziness, runny nose, and sore throat.
✓    Less common: nosebleeds, stuffy nose, sneezing, cough, nausea, upset stomach, changes in bowel habits, nervousness, and fever (children).
♦    Rare: fainting and weight gain. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Cimetidine may increase the level of azelastine in the blood.
•    Cetirizine is less likely than other antihistamines to interact with drugs.
•    Ritonavir increases the amount of levocetirizine and slows its breakdown in the body. This may result in increased levocetirizine side effects.
Food Interactions
•    Ceterizine and levocetirizine may be taken without regard to food or meals.
Usual Dose
Azelastine Nasal Spray
Adult and Child (age 12 and over): 1-2 sprays in each nostril twice a day.
Child (age 5-11): 1 spray in each nostril twice a day.
Cetirizine
Adult and Child (age 6 and over): 5-10 mg once a day depending on symptoms. Reduce dosage in people with kidney disease. Child (age 1-5): 2.5-5 mg a day.
Child (age 6 months-1 year): 2.5 mg a day.
Fexofenadine
Adult (age 12 and over): 60 mg twice a day or 180 mg once a day. People with kidney disease should take 60 mg a day.
Child (age 6-11): 30 mg twice a day.
Levocetirizine
Adult and Child (age 12 and over): 5 mg every evening.
Child (age 6-11): 2.5 mg (1h tablet) every evening. Dosage for children should not exceed 2.5 mg a day. Child (under age 6): not recommended.
Overdosage
Drug overdose is likely to cause severe side effects. Overdose victims should be Oven ipecac syrup—available at any pharmacy—to make them vomit and be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Use extra caution while doing anything that requires concentration, such as driving a car or operating hazardous machinery.
Report sore throat, unusual bleeding, bruising, tiredness, weakness, or any other unusual side effect to your doctor. Do not combine these drugs with alcohol or other nervous system depressants. Do not put azelastine nasal solution into your eyes.
If you forget to take a dose of cetirizine, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Oral antihistamines are generally considered safe for use during pregnancy. But do not take any antihistamine without your doctor’s knowledge if you are or might become pregnant—especially during the last 3 months of pregnancy, because newborns may have severe reactions to antihistamines.
Small amounts of antihistamine pass into breast milk. Nursing mothers who must take cetirizine should use infant formula.
Seniors: Antihistamines are more likely to cause dizziness, sleepiness, and confusion in seniors. Dosage reduction may be recommended depending on kidney function.

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Type of Drug
Alpha Blockers
Brand Names
Generic Ingredient. Alfuzosin Uroxatral
Generic Ingredient: Terazosin Hydrochloride Hytrin
Prescribed For
High blood pressure (terazosin) and benign prostatic hyperplasia (BPH) (alfuzosin and terazosin).
General Information
Alpha blockers block nerve endings known as alpha, receptors. They reduce blood pressure by dilating (widening) and reducing pressure within the blood vessels. The maximum blood-pressurelowering effect of terazosin is seen between 2 and 6 hours after taking a single dose. Terazosin’s effect lasts for 24 hours.
In BPH, alpha blockers work by relaxing smooth muscles in the prostate and neck of the bladder. This effect is produced by blockage of alpha, receptors in the affected muscles. Despite the fact that terazosin alleviates the urinary symptoms of BPH, the drug’s long-term effect on complications of BPH or the need for urinary surgery is not known. Alpha blockers are broken down in the liver.
Cautions and Warnings
Do not take alpha blockers if you are allergic or sensitive to any of their ingredients.
Alpha blockers may cause dizziness and fainting, especially after the first few doses. This is known as the “first-dose effect” and may be minimized by limiting the first dose to 1 mg at bedtime. The first-dose effect occurs in about 1 % of people and may recur if the drug is stopped for a few days and then restarted.
Do not take alfuzosin if you have moderate to severe liver disease since this can drastically increase blood concentrations of the drug.
Alpha blockers should be taken with caution if you have kidney disease, since blood concentrations may be increased by 50%.
Do not take these medicines if you are already taking an alphablocker for either high blood pressure or prostate problems.
Terazosin may slightly reduce cholesterol levels and improve the high-density lipoprotein (HDL) to low-density lipoprotein (LDL) ratio, a positive step for people with blood-cholesterol problems.
Terazosin may reduce the counts of red and white blood cells.
People taking terazosin may experience a weight gain of about 2 lbs.
Possible Side Effects
Alfuzosin
✓    Most common: dizziness, fatigue, upper respiratory infection, and headache.
✓    Less common: pain, abdominal pain, upset stomach, constipation, nausea, impotence, bronchitis, sinusitis, sore throat, low blood pressure, dizziness, and fainting.
✓    Rare: rash, rapid heartbeat, chest pain, and painful and persistent erection. Contact your doctor if you experience any side effect not listed above.
Terazosin
✓    Most common: dizziness, weakness, and headache.
✓    Rare: depression, reduced sex drive or abnormal sexual function (including painful and persistent erection), fluid retention, and weight gain. Contact your doctor if you experience any side effect not listed above.

Drug Interactions
•    When taken with other blood-pressure-lowering drugs, terazosin severely reduces blood pressure.
•    Verapamil may increase blood levels of terazosin.
•    Antifungal drugs such as itraconazole and ketoconazole and protease inhibitors interfere with the breakdown of alfuzosin in the liver, raising the amount of drug in the blood.
•    Alfuzosin moderately increases the amount of diltiazem in the blood.
•    Alpha blockers should not be taken with ritonavir.
Food Interactions
Alfuzosin should be taken with food.
Usual Dose
Alfuzosin: one 10-mg tablet taken after the same meal every day. Do not crush or chew the tablets.
Terazosin: starting dosage-1 mg at bedtime. Dosage may be increased in increments of 1-5 mg to a total of 20 mg a day. Dosages of 10 mg a day are generally needed to control the symptoms of BPH.
Overdosage
Symptoms may include drowsiness, poor reflexes, and very low blood pressure. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Take alpha blockers exactly as they are prescribed and do not stop taking it unless directed to do so by your doctor. Avoid over-the-counter drugs that contain stimulants because they may increase your blood pressure.
Alpha blockers may cause dizziness, headache, and drowsiness, especially 2-6 hours after taking your first dose, though these effects may persist after the first few doses. Wait 12-24 hours after taking the first dose before driving, operating machinery, or performing any other task that requires intense concentration. You may take alpha blockers at bedtime to minimize this problem.
Some people undergoing eye surgery who take alpha blockers can experience an unusual effect called “floppy iris syndrome.” Make sure to tell your eye surgeon if you are taking or have ever been treated with an alpha blocker. There is no benefit to stopping alpha-blocker treatment before cataract surgery.

Prostate cancer and BPH may have similar symptoms. Talk to your doctor about ruling out prostate cancer before beginning treatment for BPH.
Call your doctor if you develop severe dizziness, heart palpitations, or any bothersome or persistent side effect.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Alfuzosin is not indicated for use in women. Large dosages of terazosin damage the fetus in animal studies. When alpha blockers are considered crucial by your doctor, their potential benefits must be carefully weighed against their risks.
It is not known if terazosin passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may be more sensitive to the effects of terazosin.

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Generic Name
Allopurinol (al-oe-PURE-in-nol)
Brand Name  Zyloprim
Type of Drug
Antigout medication.
Prescribed For
Gout or gouty arthritis; also prescribed to counter the effects of certain therapies for cancer, ulcers, abnormal heart rhythms in heart bypass patients, seizures, and other conditions that may be associated with too much uric acid in the body.
General Information
Unlike other antigout drugs, which affect the elimination of uric acid from the body, allopurinol acts on the system that manufactures uric acid in your body. A high level of uric acid can indicate that you have gout, psoriasis, cancer, or any of a number of other diseases. High levels of uric acid can also be caused by taking certain drugs.
In mouthwash form, allopurinol helps to prevent mouth, stomach, and intestinal ulcers caused by fluorouracil, an antineoplastic drug. Allopurinol may be given before heart bypass surgery to reduce abnormal rhythms and other surgical complications. It can be used to reduce the relapse rates of duodenal ulcers associated with Helicobacter pylori infection and to reduce the vomiting of blood from stomach irritation caused by nonsteroidal anti-inflammatory drugs (NSAIDs). Allopurinol has also been used to control seizures in people for whom standard treatments are not effective.
Cautions and Warnings
Do not take allopurinol if you are allergic or sensitive to any of its ingredients, or if you have ever developed a severe reaction to it. Stop taking the medication immediately and contact your doctor if you develop a rash or any other adverse effects while taking allopurinol. Do not start taking allopurinol again if you stopped it because of a severe reaction.
Allopurinol should be used by children only if they have high uric acid levels due to neoplastic disease or to rare metabolic conditions.
A few cases of liver toxicity have been associated with allopurinol; they improved when the drug was stopped. People taking allopurinol should periodically be tested for liver and kidney function. People with severely compromised kidney function should ake a reduced dose of allopurinol.
Possible Side Effects
✓    Most common: rash associated with severe, allergic, or sensitivity reaction to allopurinol. If you develop an unusual rash or other sign of drug toxicity, stop taking this medication and contact your doctor.
✓    Less common: nausea, vomiting, diarrhea, intermittent stomach pain, gas, upset stomach, headache, insomnia, tingling or numbness in the hands and feet, muscle or joint pain, and drowsiness or lack of ability to concentrate.
✓    Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Large doses of drugs that make your urine more acidic, like megadoses of vitamin C, may increase the risk of kidney stone formation.
•    Alcohol, diazoxide, mecamylamine, or pyrazinamide can increase the amount of uric acid in your blood; an increase in your allopurinol dose may be required.
•    Allopurinol may increase the action of azathioprine, mercaptopurine, or cyclophosphamide and other anticancer drugs, leading to possible toxicity, bleeding, or infection.
•    Allopurinol may prolong the effects of chloropropamide, and can lead to hypoglycemic reactions in patients with kidney disease.
•    Taking allopurinol with probenecid or sulfinpyrazone may cause excessive reduction of uric acid.
•    Allopurinol may interact with some anticoagulant (blood-thinning) medications, reducing the rate at which the anti-coagulant is broken down in the body. Dosage reduction may be necessary.
•    People who are susceptible to ampicillin, amoxicillin, bacampicillin, or hetacillin rash are more likely to develop such a reaction while also taking allopurinol.
•    Combining a thiazide diuretic or an ACE inhibitor (for high blood pressure or heart failure) with allopurinol increases the risk of a drug-sensitivity reaction.
•    Combining vidarabine with allopurinol may increase the risk of neurotoxic effects and anemia, nausea, pain, and itching.
•    Large doses of allopurinol—more than 600 mg a day—may increase the effects of and risk of toxic reactions to theophylline by interfering with its clearance from the body.
Food Interactions
Take each dose with food or a full glass of water. Drink 10-12 glasses of water, juices, soda, or another liquid each day to avoid the formation of crystals in your urine or kidneys.
Usual Dose
Adult and Child (age 11 and over): 100-800 mg a day, depend-, ing on disease and response.
Child (age 6-10): 300 mg a day.
Child (under age 6): 150 mg a day.
The dose should be reviewed periodically by your doctor to be sure that it is producing the desired therapeutic effect.
Overdosage
The expected symptoms of overdose are exaggerated side effects. Allergic skin reactions to allopurinol can be severe and at times fatal. Allopurinol overdose victims should be taken to a hospital. ALWAYS bring the prescription bottle or container.
Special Information
Allopurinol can make you drowsy or make it difficult to concentrate: Take care while driving a car or operating hazardous equipment.
Gout attacks may actually increase during the first few months of taking allopurinol. These attacks should subside.
Call your doctor at once if you develop rash, hives, itching, chills, fever, nausea, muscle aches, unusual tiredness, fever, yellowing of the whites of the eyes or skin, painful urination, blood in the urine, irritation of the eyes, or swelling of the lips or mouth.

Avoid large doses of vitamin C, which can cause the formation of kidney stones during allopurinol treatment. Be sure to drink 1012 8-oz. glasses of water a day while taking this medication.
If you forget to take a dose of allopurinol, take it as soon as possible. If it is almost time for your next regular dose, double this dose. For example, if your regular dose is 100 mg and you miss a dose, take 200 mg at the next usual dose time.
Special Populations
Pregnancy/Breast-feeding: Allopurinol may cause birth defects or interfere with fetal development. Check with your doctor before taking it if you are or might be pregnant.
Allopurinol passes into breast milk. Nursing mothers who must take allopurinol should use infant formula.
Seniors: No special precautions are required. Follow your doctor’s directions and report any side effects at once.

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Generic Name
Alitretinoin (al-ih-TRET-in-oin)
Brand Name
Panretin
Type of Drug Retinoid.
Prescribed For
Skin lesions of Kaposi’s sarcoma (KS).
General Information
Alitretinoin binds to and activates retinoid receptors in human cells. Once activated, these receptors help stimulate the body’s natural mechanisms for limiting tissue growth—in this case, the growth of KS cells. KS lesions, which are primarily associated with human immunodeficiency virus (HIV), can respond to alitretinoin in as little as 2 weeks, but most people do not start to see results for 48 weeks or, in some cases, 14 weeks or more.
Cautions and Warnings
Do not use alitretinoin if you are allergic or sensitive to retinoids or to any of its ingredients.
Alitretinoin is applied to individual KS lesions. It does not treat systemic KS or prevent new KS lesions from forming.
People requiring systemic KS treatment (those who have developed more than 10 new KS lesions within a month) should not use alitretinoin.
People with swollen lymph glands, KS that affects the lungs or other major organ involvement should not use alitretinoin.
Possible Side Effects .
✓    Most common: rash and burning pain at application site.
♦    Common: itchy, flaking, peeling, cracking, oozing, swelling, and inflammation at application site.
Drug Interactions
•    Do not use insect repellant products that contain DEET, a widely used chemical repellant. Alitretinoin increases DEET toxicity.

Usual Dose
Adult: Apply 2-4 times a day to KS skin lesions. Seniors should use this drug with caution.
Child: not recommended.
Overdosage
Little is known about the effects of accidental ingestion. 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
Apply enough alitretinoin gel to cover the entire skin lesion. Allow the gel to dry for 3-5 minutes before covering the area with clothing. Avoid showering, bathing, or swimming for at least 3 hours.
If you use a bandage or dressing, be sure it is not tight and that air can circulate freely over the area.
Avoid applying alitretinoin to unaffected skin because it may be irritated by the drug. Avoid applying near the nose, eyes, or mouth.
Alitretinoin contains alcohol. Always keep it away from any open flame.
Retinoids can cause unusual sensitivity to the sun. While this has not been seen with alitretinoin, you should avoid prolonged exposure to the sun or use sunscreen while taking this drug.
If you forget a dose, apply it as soon as you remember. If it is almost time for your next dose, apply the forgotten dose and then space the rest of your doses throughout the day. Continue with your regular schedule the next day.
Special Populations
PregnancylBreast-feeding., Alitretinoin can harm the fetus when sufficient levels of the drug are present in the mother’s bloodstream, but it is not known if these levels are achieved during routine use of alitretinoin. Women who are or might be pregnant should only use this drug after discussing its potential benefits and risks with their doctors.
It is not known if alitretinoin passes into breast milk. Nursing mothers who must use alitretinoin should use infant formula.
Seniors: There is no information on use of alitretinoin by seniors. Seniors should use it with caution.

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Generic Name
Aliskiren (ah-LISS-kih-ren)
Brand Name Tekturna
Combination Product
Generic Ingredients: Aliskiren + Hydrochlorothiazide Tekturna HCT
Type of Drug
Direct renin inhibitor. Prescribed For
High blood pressure.
General Information
Renin is produced by the kidney in response to a reduction in blood volume and the amount of blood passing through the kidney. Once in the blood, renin reacts with other hormones to forma very powerful blood vessel constrictor called angiotensin E that directly raises blood pressure. Renin also works with a hormore called aldosterone to raise blood pressure and it prevents sodium from being eliminated from the body. This increases the amount of water in the system, raising blood volume and increasing blood pressure. Aliskiren inhibits renin and all of its actions, thereby !owering blood pressure. The blood pressure lowering is usually seen with 2 weeks of starting on treatment. When aliskiren treatment is stopped, blood pressure gradually rises to pre-treatment levels. Only about 21/2% of any dose is absorbed into the blood and it takes about a week to reach a steady level in the blood. Most of the drug that is absorbed is broken down in the liver. The rest passes out of the body unchanged in the urine. Aliskiren may be used alone or with other hypertensives, however its use with maximum doses of an ACE inhibitor has not been adequately studied.

Cautions and Warnings
Do not take aliskiren if you are allergic or sensitive to any of its ingredients.
Angioedema swelling of the face, hands or feet, tongue, or throat can occur at any time during aliskiren treatment. If this happens, stop taking the medicine and go to your doctor’s office or a hospital emergency room for treatment. This reaction can interfere with your breathing.
The safety of aliskiren in people with moderate to severe kidney disease is not known.
The combination of aliskiren and an ACE inhibitor can lead to high blood levels of potassium.
Aliskiren may be less effective in some black patients with high blood pressure, especially when dietary salt intake is high. Nevertheless, it should still be considered a useful blood pressure treatment.
Possible Side Effects
✓    Common: nausea, dizziness, and sleeplessness.
✓    Less common: diarrhea, abdominal pain, upset stomach, GERD, cough, rash high blood uric acid levels, gout, kidney stones, headache, nose and throat irritation, fatigue, upper respiratory infection, and back pain.
✓    Rare: difficulty breathing; swelling of the hands, face, eyes, or whole body; and seizures. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Mixing aliskiren with irbesartan can reduce the amount of aliskiren into the blood by 50%. This may reduce the effectiveness of aliskiren.
•    Aliskiren has been studied together with both hydrochlorothiazide and valsartan and can be combined with them in blood pressure management. It has been used with amlodipine but may not be better than high dose amlodipine alone.
•    Aliskiren’s interaction with ACE inhibitors is not yet fully known.
•    Atorvastatin and ketoconazole slow the breakdown of aliskiren, resulting in an increase of aliskiren blood levels by 50% or more. Dosage adjustment may be necessary.

Aliskiren can reduce blood levels of the diuretic furosemide, reducing the diuretic’s effect.
Food Interactions
Aliskiren can be taken without regard to food or meals. Avoid taking it with high fat meals because they can drastically reduce the amount of aliskiren absorbed into the blood.
Usual Dose
Adult (age 18 and over)
Tekturna: 50-300 mg at the same time every day. Tekturna HCT. 1 tablet a day.
Child: not recommended. Overdosage
The most likely symptom of overdose is low blood pressure (symptoms include dizziness and fainting). If you think you have taken an overdose, call your doctor or go to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor at once if you develop swelling of the face, eyes, lips, tongue, or throat; difficulty swallowing or breathing; hoarseness; or other signs of a drug reaction or allergy.
If you forget a dose, take it as soon as you remember. If you do not remember until 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: Aliskiren can injure or kill a developing fetus. Pregnant women should not take aliskiren. Women who suspect they are pregnant must call their doctor at once and stop taking aliskiren when pregnancy is confirmed. In those rare cases where aliskiren is considered life-saving for the mother and there is no substitute for aliskiren, your doctor may advise that you continue on the medicine and then check your baby’s development with periodic ultrasound examinations.
It is not known if this drug passes into breast milk. Nursing mothers should use infant formula.
Seniors: Seniors may have higher blood levels of aliskiren and be more susceptible to drug side effects, but starting dose adjustment is not required.

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