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Aug

12

Donnatal - Doxazosin - Doxercalciferol - Dronabinol - Dyazide

August 12, 2009 | Leave a Comment

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.

Tags: abdominal, anaspaz, antispasmodic, bacteri, Brand Name, calcium, CAUTION, constipation, dizziness, donnatal, drug dependence, excess gas, food interactions, formula, generic ingredients, heart function, hiatal hernia, hyoscyamine sulfate, information, intestinal obstruction, levbid, marijuana, maximum blood, nausea and vomiting, neurohormone, nulev, Nursing, overactive thyroid gland, phenothiazine, Prescribed, pro banthine, rapid heartbeat, scopolamine hydrobromide, spasm, St. John, stimulants, supplement, surgery, Tablets

Aug

12

Dimenhydrinate - Diphenhydramine Hydrochloride - Disopyramide - Dofetilide

August 12, 2009 | Leave a Comment

Generic Name
Dimenhydrinate (dye-men-HYE-drih-nate) A
Brand Names
Calm-X    Dramamine
Dimetabs    Triptone
The information in this profile also applies to the following drugs: Generic Ingredient: Meclizine 91
Antivert    Bonine
An tOmA 2S    Meni-D
Antivert 50    Ru-Vert-M Antrizine
Type of Drug
Antihistamine and antiemetic (an agent that prevents or relieves nausea and vomiting).
Prescribed For
Nausea, vomiting, vertigo, and dizziness associated with motion
sickness.
General Information
Dimenhydrinate, which depresses middle ear function, is a mixture of diphenhydramine—an antihistamine believed to be the active ingredient—and another ingredient. Meclizine is an antihistamine. It takes a little longer to start working than dimenhydrinate, but its effects last much longer. Meclizine does a better job of preventing motion sickness than treating its symptoms. It takes 30 minutes to 1 hour to work and lasts for 12-24 hours.
Cautions and Warnings
Do not take dimenhydrinate if you are allergic or sensitive to any of its ingredients. Newborn babies should not be given this drug.
People with a prostate condition, stomach ulcer, intestinal obstruction, bladder problems, difficulty urinating, glaucoma, asthma, or abnormal heart rhythms should use dimenhydrinate only while under a doctor’s care.
Because it controls nausea and vomiting, dimenhydrinate may hide the symptoms of appendicitis or overdoses of other drugs.
Possible Side Effects
✓    Most common: drowsiness.
♦    Less common: confusion; nervousness; excitation; restlessness; headache; sleeplessness, especially in children; tingling; heavy or weak hands; fainting; dizziness; tiredness; rapid heartbeat; low blood pressure; heart palpitations; blurred or double vision; difficult or painful urination; increased sensitivity to the sun; appetite loss; nausea; vomiting; diarrhea; upset stomach; constipation; nightmares; rash; drug reaction (symptoms include rash, itching, hives, and breathing difficulties); ringing or buzzing in the ears-, dry mouth, nose, or throat; stuffy nose-, wheezing: and increased chest phlegm OT chest tightness.
Drug Interactions
•    This drug should not be taken with a monoamine oxidase inhibitor antidepressant.
•    Taking dimenhydrinate with an alcoholic beverage, other antihistamine, sedative, or other central-nervous-system (CNS)
depressant may cause excessive dizziness, drowsiness, or other signs of depression.
•    Side effects of anticholinergics may be increased when taken with dimenhydrinate.
•    Combining dimenhydrinate and certain antibiotics that cause dizziness or other ear-related side effects may mask early signs of these side effects, especially in infants and children.
Food Interactions
Take dimenhydrinate with food or milk if it upsets your stomach.
Usual Dose
Dimenhydrinate
Adult and Child (age 13 and over): 50-100 mg-1 or 2 tablets or 4-8 tsp.-30 minutes prior to travel; then every 4-6 hours; do not take more than 400 mg a day.
Child (age 6-12): 25-50 mg-1/2 or 1 tablet or 2-4 tsp.—every 6-43 hours; do not take more than 150 mg a day.
Child (age 2-5): up to 25 mg-1/2 or 1 tablet or 2 tsp.-every 6-8 hours; do not take more than 75 mg a day.
Child (under age 2): Consult your doctor.
Meclizine
Adult and Child (age 13 and over): 25-50 mg 1 hour before travel; repeat every 24 hours for duration of journey. Up to 100 mg a day in divided doses may be needed to control dizziness from other causes.
Child: not recommended.
Overdosage
Symptoms of overdose include drowsiness, clumsiness, unsteadiness, feeling faint, facial flushing, and dry mouth, nose, or throat. Convulsions, coma, and breathing difficulties may also develop. Overdose victims should be taken to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
N1 Maximum effectiveness against motion sickness, take dimenhydrinate 1-2 hours before traveling; it may still be effective if taken 30 minutes before traveling.
This drug may cause drowsiness: Be extremely cautious when driving, operating hazardous machinery, or doing anything that requires concentration.
Dimenhydrinate may cause dry mouth, nose, or throat. Sugarless candy, gum, or ice chips can usually relieve these symptoms. Constant dry mouth may increase the likelihood of developing tooth decay or gum disease. Pay special attention to oral hygiene while you are taking dimenhydrinate, and contact your doctor if dry mouth lasts more than 2 weeks.
If you forget to take a dose of dimenhydrinate, 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 suggest that meclizine may cause birth defects. Do not take any antihistamine without your doctor’s knowledge if you are or might be pregnant —especially during the last 3 months of pregnancy, because newborns may have severe reactions to antihistamines.
Small amounts of dimenhydrinate may pass into breast milk. Dimenhydrinate may also slow milk production. Nursing mothers who must take dimenhydrinate should use infant formula.
Seniors: Seniors are more sensitive to antihistamine side effects and should take the lowest effective dose.

Generic Name
Diphenhydramine Hydrochloride
(dye-fen-HYE-druh-mene hye-droe-KLOR-ide) 91
Brand Names
40 Winks
AllerM,ly,
AllerMax Maximum Strength Altaryl Children’s Allergy Banophen
Banophen Allergy
Benadryl Allergy
Benadryl Children’s Allergy* Benadryl Children’s Dye Free Benadryl Dye Free Allergy
Liquid Gels
Children’s Pediacare Nighttime Cough’
Compoz Gel Caps
Compoz Nighttime Sleep Aid Diphen AF
Diphenhist
Dormin
Dytuss
Genahist
Midol PM
Miles Nervine
Nytol Quick Caps
Nytol Quick Gels Maximum Strength
Scot-Tussin Allergy*
Siladryl
Simply Sleep
Sleep-Eze 3
Sleepinol Maximum Strength Sleepwell 2-Nice
Snoozefast
Sominex Original Formula Sylphen Cough
TheraFlu Thin Strips Multi Symptom
Triaminic Thin Strips Cough and Runny Nose
Tusstat
Unisom
‘Some products in this brand-name group are alcohol- or sugar-free.
Type of Drug Antihistamine.
Prescribed For
Stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal allergy and for other symptoms of allergy such as itching, rash, and hives; also prescribed for motion sickness, insomnia, and Parkinson’s disease.
General Information
Antihistamines generally work by blocking the release of histamine (a chemical released by body tissue during an allergic reaction), drying the nose, throat, and eye secretions. Diphenhydramine is the most common active ingredient found in nonprescription sleep aids.
Cautions and Warnings
This drug should not be used if you are allergic or sensitive to any of its ingredients. It should be avoided or used wilt extreme care if you have narrow-angle glaucoma, stomach ulcer, intestinal abslmcfion, other stomach problems, difficulty urinating, or enlarged prostate. It should not be used by people who have sleep apnea or deep-breathing problems such as asthma. Use with care if you have a history of thyroid disease, heart disease, emphysema, chronic bronchitis, or high blood pressure.
Drug Interactions
•    This drug should not be taken with a monoamine oxidase inhibitor antidepressant.
•    The effects of sedatives, sleeping medications, and other central-nervous-system (CNS) depressants will be intensified when combined with diphenhydramine hydrochloride; it is extremely important that doses of these drugs are properly adjusted.
•    This drug increases the intoxicating and sedating effects of alcohol.
Food Interactions
Take this drug with food if it upsets your stomach.
Usual Dose
Allergy
Adult: 25-50 mg 3-4 times a day.
Child (over 20 tbs.): 12.5-25 mg 3-4 times a day.
Nighttime Sedation
Adult and Child (age 12 and over): 25-50 mg at bedtime.
couqh. SIN%
Adult and Child (age 12 and over): 25 mg every 4 hours; do not take more than 150 mg in 24 hours.
Child (age 6-12): 12.5 mg every 4 hours; do not take more than 75 mg in 24 hours.
mouth, and weakness.
g, rash, sensitivity to bright light, per-
s, lowering of blood pressure, head-
t, sleeplessness, dizziness, disturbed sion, restlessness, nervousness, irri- eling “high”), tingling and weakness of lurred or double vision, ringing in the , appetite loss, nausea, vomiting, con- urinary difficulties, thickening of lung s of the chest, wheezing, nasal stuffi-
h, nose, or throat.
Possible Side Effects
✓    Common: drowsiness
✓    Less common: itching
•    fever, chills
•    rapid heartbeat
confusion
euphoria (feelin
hands or feet, blurre
•    upset stomach
•    diarrhea, secretions, tightnes
•    and dry
Child (age 2-6): 6.25 mg every 4 hours; do not take more than
25 mg in 24 hours.
Child (under age 2): not recommended.
Thin Strips
TheraFlu
Adult and Child (age 12 and over): 1 strip every 4 hours; do not take more than 6 strips in 24 hours.
Triaminic
Child (age 6-12): 1 strip every 4 hours; do not take more than 6 strips in 24 hours.
Overdosage
Symptoms of overdose include depression or stimulation—especially in children; dry mouth; fixed or dilated pupils; flushing; and upset stomach. Overdose victims should be made to vomit with ipecac syrup—available at any pharmacy. Take the overdose victim to a hospital emergency room immediately if you cannot induce vomiting. ALWAYS bring the prescription bottle or container.
Special Information
This drug may cause drowsiness. Be extremely cautious when driving or operating hazardous equipment.
If you are taking this medication for motion sickness, take the first dose at least 30 minutes prior to exposure.
If you forget to take a dose of diphenhydramine hydrochloride, 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 that some antihistamines may cause birth defects. Do not take any antihistamine without your doctor’s knowledge if you are or might be pregnant—especially during the last 3 miDMIns of pregnancy—because newborns may have severe reactions to antihistamines.
SMM) amounts of antihistamine pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors are more sensitive to antihistamine side effects and may require lower dosages.

Generic Name
Disopyramide (die-soe-PIE-rah-mide) 92
Brand Names Norpace
Type of Drug Antiarrhythmic.
Prescribed For Abnormal heart rhythms.
General Information
Disopyramide phosphate slows the rate at which nerve impulses are carried through heart muscle, reducing the response of heart muscle to those impulses. It acts on the heart similarly to the more widely used antiarrhythmic medications procainamide hydrochloride and quinidine sulfate. Disopyramide is often prescribed for people who do not respond to other antiarrhythmic drugs.
Cautions and Warnings
Do not take disopyramide if you are allergic or sensitive to any of its ingredients or if you have heart block, unless you have a cardiac pacemaker.
This drug can worsen heart failure or trigger severely low blood pressure. It should be used in combination with another antiarrhythmic agent or beta blocker with caution.
In rare instances, disopyramide has caused a reduction in blood-sugar levels. Therefore, the drug should be used with caution by diabetics, older adults—who are more susceptible to this effect—and people with poor kidney or liver function. Ask your doctor if you should have your blood-sugar levels checked while taking this drug.
Because of its anticholinergic effects, men with a severe prostate condition and people who have glaucoma, myasthenia gravis, or severe difficulty uritx;aA:jng should use disopyramide with caution.
People with liver or kidney disease must take a reduced dose of disopyramide.
Potassium levels affect the action of disopyramide. People with blood potassium levels that are out of the normal range must correct this imbalance before starting disopyramide.
Norpace CR
Possible Side Effects
♦    Most common: dry mouth, urinary difficulty, and constipation.
♦    Common: blurred vision; dry eyes, nose, and throat; frequent urination; nausea; stomach pain or bloating; gas; dizziness; fatigue; headache; and nervousness.
♦    Less common: itching, rashes, muscle weakness, generalized aches and pains, not feeling well, low blood-potassium levels, increases in blood-cholesterol and triglyceride levels, heart failure, and low blood pressure.
♦    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
•    Phenytoin and rifarnpin may increase the rate at which the body removes disopyramide from the blood. Your disopyramide dose may need alteration if this combination is used. Other drugs known to increase drug breakdown by the liver, such as barbiturates and primidone, may also have this effect.
•    Other antiarrhythmic drugs, such as procainamide and quinidine, may increase the effect of disopyramide, making dosage reduction necessary. At the same time, disopyramide may reduce the effectiveness of quinidine.
•    When disopyramide is combined with a beta-blocking drug, increased disopyramide effects, additive effects, or depression of heart function may result.
•    Azole antifungals, clarithromycin, diclofenac, doxycycline, erythromycin, imatinib, isoniazid, nefazodone, nicardipine, propofol, protease inhibitors, telithromycin, and verapamil may increase the amount of disopyramide in your blood, causing abnormal heart rhythms or other cardiac effects.
•    Disopyramide may reduce the effectiveness of oral anticoagulant (blood-thinning) drugs. Your doctor should check your anticoagulant dosage to be sure you are getting the right amount.
•    Hydantoins may cause a decrease in the effectiveness of disopyramide.•    Disopyramide may increase the amount of digoxin in your blood, though the amount of the increase is not likely to af-
fect your heart.
•    St. John’s wort may decrease disopyramide levels.
Food Interactions
Disopyramide should be taken on an empty stomach at least 1
hour before or 2 hours after meals. Usual Dose
Adult: 400-800 mg a day (divided into 2 or 4 doses for the immediate-release form). In severe cases, 400 mg every 6 hours may be required. This level of dosage should be monitored in the hospital. The sustained-release preparation is taken every 12 hours. People with reduced kidney function should receive a lower dosage, depending on the degree of kidney function present. People with liver failure should take 400 mg a day.
Child (age 13-18): 2.5-7 mg a day per lb. of body weight. Child (age 5-12): 4.5-7 mg a day per lb. of body weight. Child (age 1-4): 4.5-9 mg a day per lb. of body weight.
Child (under age 1): 4.5-13.5 mg a day per lb. of body weight.
Overdosage
Overdose symptoms are breathing difficulties, abnormal heart rhythms, and unconsciousness. In severe cases, overdosage can lead to death. Overdose victims should be made to vomit with ipecac syrup—available at any pharmacy—to remove any remaining drug from the stomach. Call your doctor or poison control center before doing this. If you must go to a hospital emergency room, ALWAYS bring the prescription bottle or container. Prompt and vigorous treatment can mean the difference between life and death in severe overdosage.
Special Information
Disopyramide may cause symptoms of low blood sugar: anxiety, chills, cold sweats, drowsiness, excessive hunger, nausea, nervousness, rapid pulse, shakiness, uaus~M% weakness, tiredness, or cool, pale skim If kNSN)appens to you, eat some chocolate, candy, U rilher high-sugar food, and call your doctor at once.
Disopyramide can cause dry mouth, urinary difficulty, constipation, or blurred vision. Call your doctor if these symptoms become severe or intolerable, but do not stop taking the medication without your doctor’s approval.
If disopyramide is required for a child and capsules are not appropriate, your pharmacist can make a liquid product. Do not do this at home: This medication requires special preparation. The liquid should be refrigerated and protected from light and should be thrown away after 30 days.
Do not crush, chew, or open sustained-release capsules.
If you forget to take a dose of disopyramide, take it as soon as possible. However, if it is within 4 hours of your next dose, skip the dose you forgot and go back to your regular schedule. Do not take a double dose.
Special Populations
PregnancylBreast-feeding: Do not take this drug if you are pregnant or planning to become pregnant while using it, because it will pass into the fetus and may affect its development. When disopyramide is considered crucial by your doctor, its potential benefits must carefully be weighed against its risks.
Disopyramide passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors, especially those with liver or kidney disease, are more sensitive to the effects of this drug.

Generic Name
Dofetilide (DOH-fet-a-lyed)
Brand Name Tikosyn
Type of Drug Antiarrhythmic.
Prescribed For
Specific abnormal heart rhythms.
General Information
Dofetilide is used to establish and maintain normal sinus rhythm in the heart. Dofetilide is available only to hospitals and doctors who receive specific training and education on how to use this drug because of the risks associated with using it.
Cautions and Warnings
Do not take dofetilide if you are allergic or sensitive to any of its ingredients.
Dofetilide is reserved for people whose abnormal heart rhythms have not responded to other drugs. People taking dofetilide must be in a hospital or other facility for at least 3 days where appropriate blood tests can be performed to monitor kidney and heart function.
This drug is cleared through the kidneys. Poor kidney function increases the amount of dofetilide in the body. Liver disease has no effect on dofetilide blood levels.
Dofetilide, like other antiarrhythmic drugs, can cause severe and sometimes fatal abnormal rhythms of its own.
Do not take dofetilide without first talking to your doctor if you have a low blood level of potassium or magnesium.
Women may be at a greater risk for some arrhythmias caused by dofetilide.
Possible Side Effects
Serious heart arrhythmias can develop in up to 31b% of patients taking up to 1000 mcg a day of dofetilide. People taking daily doses above 1000 mcg a day are at up to 5 times greater risk for arrhythmias.
•    Most common: headache, chest pain, and respiratory infection.
♦    Common: difficulty breathing, nausea, and dizziness.
♦    Less common: flu; sleeplessness; accidental injury; back pain; diarrhea; abdominal pain; angina; anxiety: joint pain; weakness; atrial and ventricular arrhythmia; high blood pressure; pain; heart palpitations; swollen legs, ankles, or arms; sweating; and urinary infections.
♦    Rare: some arrhythmias, heart attack, hives, slow heartbeat, stroke, facial or other paralysis, tingling in the hands or feet, cough, liver damage, migraine, fainting, and sudden death. Contact your doctor if you experience any side effect not listed above.
‘D?Ug Interactions
Dofetilide should not be given with drugs that are known to interact with it. Dofetilide must be stopped at least 2 days before any potentially interacting drug is taken.
•    Do not mix dofetilide with any product containing verapamil, a calcium channel blocker, or trimethoprim, used for urinary infections. These combinations can substantially raise the amount of dofetilide in the blood.
•    Some drugs may increase the amount of dofetilide in the blood by inhibiting enzymes that break it down in the liver. They include delavirdine, indinavir, btonavir, saquinavir, amiodarone, cimetidine, ciprofloxacin, clarithromycin, cannabis, diltiazem, erythromycin, fluconazole, fluvoxamine, itraconazole, ketoconazole, mifepristone, nefazodone, norfloxacin, mibefradil, selective serotonin reuptake inhibitors (SSRIS), troleandomycin, and zatirlukast.
•    Some drugs may reduce the amount of dofetilide in the blood by stimulating enzymes that break it down in the liver, including efavirenz, nevirapine, carbamazepine, corticosteroids, modafanil, phenobarbital and other barbiturates, phenytoin, pioglitazone, and rifampin. Amiloride, metformin, megestrol, and triamterene can interfere with the elimination of dofetilide via the kidney, raising blood levels of the drug.
•    Other drugs that can increase the effects of dofetilide are Other antiarrhythmic drugs, bepridil, phenothiazines, and tricyclic antidepressants.
•    Mixing dofetilide with digoxin may lead to a ventricular arrhythmia called torsade de pointes. Thiazides, furosemide, and other potassium-depleting diuretics can also increase the risk of this arrhythmia.
Food Interactions
Grapefruit juice may increase dofetilide blood levels.
Usual Dose
Adult: 125-500 mcg twice a day.
Child (under 18 years): not recommended.
Overdosage
Dofetilide overdose is likely to cause significant heart rhythm problems. Overdose victims must be treated symptomatically by their cardiologist.
Special Information
Read all information supplied to you before you begin taking this medication and read it again if anything in your treatment program changes.
Tell your doctor about any changes in your prescription or nonprescription drug use or in your use of vitamins, minerals, and other dietary supplement products.
Be sure that any other doctor or hospital that treats you and might prescribe another drug knows you are taking dofetilide.
Call your doctor at once if you develop any signs of altered electrolyte balance including excessive or prolonged diarrhea, sweating, vomiting, appetite changes, or excessive thirst.
If you forget to take 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.
Special Populations
Pregnancy/Breast-feeding: Dofetilide causes birth defects in animal studies. Pregnant women should take this drug only after discussing with their doctors its potential benefits and risks.
It is unknown whether dofetilide passes into breast milk. Nursing mothers who take it should consider using infant formula.
Seniors: Older adults may take this drug without special restriction.

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Aug

1

Cholestyramine

August 1, 2009 | Leave a Comment

Generic Name
Cholestyramine (kol-es-TYE-rah-meen) 0
Brand Names
LoCHOLEST    Questran
LoCHOLEST Light    Questran Light Prevalite
The information in this profile also applies to the following drugs:
Generic Ingredient: Colesevelam Hydrochloride WelChol
Generic Ingredient: Colestipol Hydrochloride Colestid
Type of Drug
Anti -hyperli pidemic (blood-fat reducer).
Prescribed For
High blood-cholesterol levels; generalized itching associated with bile duct obstruction—cholestyramine only; colitis; digitalis or thyroid overdose; and pesticide poisoning.
General Information
Cholestyramine resin lowers blood-cholesterol levels by absorbing bile acids in the bowel. Since the body uses cholesterol to make the bile acids—needed to digest fat—fat digestion can only continue by making more bile acid from blood cholesterol. This results in lower blood-cholesterol levels 4-7 days after starting cholestyramine.
Cholestyramine w3Cks entirely Within the bowel and is never absorbed into the bloodstream. Though usually given 3-4 times a day, there appears to be no advantage to taking it more often than twice a day. The cholesterol-lowering effect of cholestyramine may be increased when it is taken with an HMG-CoA inhibitor or nicotinic acid. In some kinds of hyperlipidemia, colestipol may be more effective in lowering total blood cholesterol than clofibrate.
Cautions and Warnings
Do not use cholestyramine if you are allergic or sensitive to any of its ingredients or if your bile duct is blocked. The powder form should not be taken dry; doing so may result in the inhalation of powder into your lungs or a clogged esophagus.
If you are being treated for hypothyroidism, diabetes, kidney or blood vessel disorder, obstructive liver disease, or alcholism, consult your doctor before taking cholestyramine.
Cholestyramine may cause or worsen constipation and hemorrhoids. Most constipation is mild, but some people may need to stop the medication or take less of it.
Possible Side Effects
✓    Most common: constipation, which may be severe and in rare cases result in bowel impaction. Hemorrhoids may be worsened.
♦    Less common: abdominal pain and bloating, and bleeding disorders or black-and-blue marks due to interference with the absorption of vitamin K, a necessary factor in the blood clotting process. One person developed night-blindness because the medication interfered with vitamin A absorption into the blood. Other side effects include belching, gas, nausea, vomiting, diarrhea, heartburn, and appetite loss. Your stool may have an unusual appearance because of a high fat level.
✓    Rare: Rare side effects can affect your mouth, stomach and intestines, muscles and joints, mental status, urinary tract, and breathing. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
O    Cholestyramine interferes with the absorption of virtually all oral drugs, including acetaminophen, amiodarone, aspirin, cephalexin, chenodiol, clindamycin, clofibrate, contraceptive drugs, corticosteroids, diclofenac, iopanoic acid, iron, digitalis drugs, furosemide, gemfibrozil, glipizide, hydrocortisone, imipramine (an antidepressant), methyldopa, mycophenolate, nicotinic acid, penicillin, phenobarbital, phenytoin, piroxicam, propranolol, tetracycline, thiazide diuretics, thyroid drugs, tolbutamide, trimethoprim, ursodiol, warfarin and other anticoagulant (blood-thinning) drugs, and vitamins A, D, E, and K. Take other medications at least 1 hour before or 4-6 hours after taking cholestyramine.
Food Interactions
Take this medication before meals. The powder may be mixed with soda, water, juice, cereal, or pulpy fruits, such as applesauce or crushed pineapple. Cholestyramine bars should be thoroughly chewed and taken with plenty of fluids. Colestipol pills are swallowed whole.
Usual Dose
Cholestyramine: 4 g (1 packet) or 1 level scoopful taken 1-2 times a day or up to 6 times a day.
Colesevelam: 6 tablets once a day or in 2 divided doses. Colestipol: 2-16 g (1-6 packets) once a day or in divided doses.
Overdosage
The most severe effect of overdose is obstruction of the gastrointestinal tract. Take the overdose victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Do not swallow the granules or powder in their dry form. Prepare each packet of powder by mixing it with soup, cereal, or pulpy fruit or by adding the powder to a 6-oz. glass of liquid, such as a carbonated beverage. If some of the drug sticks to the sides of the glass, rinse it with liquid and drink the remainder.
Constipation, gas, nausea, and heartburn may occur and then disappear with continued use of this medication. If constipation is a problem, your doctor may recommend drinking more fluids and taking a fiber supplement. Call your doctor if these side effects persist or if you develop unusual problems such as bleeding from the gums or rectum.
If you miss a dose of cholestyramine, skip it and continue with your regular scheduke. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: While cholestyramine does not affect the fetus directly, it may prevent the absorption of vitamins A, D, and E and other nutrients essential to the fetus’ proper development–even when you take, a prenatal vitamin supplement.
When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Cholestyramine is not absorbed into the body. However, reduced absorption of vitamins A, D, and E and other nutrients may make your milk less nutritious. Nursing mothers who must take cholestyramine should use infant formula.
Seniors: Seniors are more likely to experience side effects, especially those relating to the bowel.

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Aug

1

Chlorzoxazone

August 1, 2009 | Leave a Comment

Generic Name
Chlorzoxazone (klor-M-uh-zone)
Brand Names
Parafon Forte DSC    Strifon Forte DSC
Type of Drug
Skeletal muscle relaxant.
Prescribed For
Pain and spasm of muscular conditions, including strain, sprain, bruising, and lower back problems.
General Information
Chlorzoxazone works primarily on the spinal cord level and on the brain, acting as a mild sedative. This results in fewer spasms, less pain, and greater mobility. Chlorzoxazone provides only temporary relief and is not a substitute for other types of therapy, such as rest, surgery, and physical therapy.
Cautions and Warnings
Do not take chlorzoxazone if you are allergic or sensitive to any of its ingredients, or if you have a condition known as porphyria.
People with poor liver or kidney function should take this drug with caution because serious liver toxicity has rarely occurred in people using chlorzoxazone.
Chlorzoxazone may interact with other drugs that cause nervous system depression (see “Drug Interactions”).
Because it is possible to become dependent on this drug, people with a history of substance abuse should take chlorzoxazone with caution.
Possible Side Effects
♦    Most common: dizziness, drowsiness, lightheadedness, malaise, and aveTStimulation,
♦    Less common: headache, stomach cramps or pain, diar-
rhea, constipation, heartburn, nausea, and vomiting.
•    Rare: internal bleeding, liver problems, severe allergic-type skin reactions, and breathing problems. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• The depressive effects of chlorzoxazone may be enhanced by taking it with alcohol, sedatives, sleeping pills, or other nervous system depressants. Avoid these combinations.
Food Interactions
Take this drug with food if it upsets your stomach. The tablets may be crushed and mixed with food.
Usual Dose
Adult: 250-750 mg 3-4 times a day. Child: 125-500 mg 3-4 times a day.
Do not take more medication than is prescribed.
Overdosage
Early signs of chlorzoxazone overdose may include nausea, vomiting, diarrhea, drowsiness, dizziness, lightheadedness, and headache. Victims may also feel sluggish or sickly and lose the ability to move their muscles. Breathing may become slow or irregular, and blood pressure may drop. Contact a doctor immediately or go to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Chlorzoxazone may make you drowsy or reduce your ability to concentrate. Be extremely careful while driving or operating hazardous equipment. Avoid alcoholic beverages.
Chlorzoxazone may turn your urine orange to purple-red; this is not dangerous.
Call your doctor if you develop drowsiness, weakness, an allergic reaction, skin rash or itching, breathing difficulties, black or tarry stools, vomiting of material that resembles coffee grounds, liver problems, or any other severe or bothersome side effect.
4f you miss a dose of chlorzoxazone by more than an hour, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: The safety of chlorzoxazone in pregnant women has not been established. Pregnant women should only take chlorzoxazone after carefully weighing its potential benefits against its risks.
It is not known if chlorzoxazone passes into breast milk. Nursing mothers should consider using infant formula.
Seniors: Seniors, especially those with severe liver disease, are more sensitive to the effects of chlorzoxazone.

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Jul

16

Alitretinoin

July 16, 2009 | Leave a Comment

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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Jul

16

Albuterol

July 16, 2009 | Leave a Comment

Generic Name
Albuterol (al-BUE-tuh-rawl) 91
Brand Names
AccuNeb    Proventil HFA
ProAir HFA    Ventolin HFA
Proventil*    Vospire ER
Combination Products
Generic Ingredients: Albuterol + 1pratropium Bromide Combivent    DuoNeb

The:nformation in this profile also applies to the following drugs:
Generic Ingredient: Levalbuterol Xopenex
Generic Ingredient., Pirbuterol Maxair
*Some products in this brand-name group are alcohol- or sugar-free. Consult your pharmacist.
Type of Drug Bronchodilator.
Prescribed for
Bronchospasm associated with asthma or other obstructive pulmonary diseases, or induced by exercise.
General Information
Albuterol is similar to other bronchodilator drugs, such as metaproterenol and isoetharine, but it has a weaker effect on nerve receptors in the heart and blood vessels; therefore, it is somewhat safer for people with heart conditions. Levalbuterol is a special form of albuterol that carries a lower risk of side effects.
Cautions and Warnings
Do not use Albuterol if you are allergic or sensitive to any of its ingredients. Albuterol should be used with caution by people with a history of angina pectoris (a condition characterized by brief attacks of chest pain), heart disease, irregularities in heart beat, high blood pressure, stroke or seizure, diabetes, thyroid disease, prostate disease, or glaucoma. Excessive use of albuterol inhalants may worsen asthma or other respiratory conditions, and may increase breathing difficulties rather than relieve them. In the most extreme cases, people have had heart attacks after using excessive amounts of inhalant.
Possible Side Effects
V Most common: worsening of asthma, ear infection, upper respiratory infection, stuffy nose, dizziness, headache, nausea, vomiting, and muscle cramps.
♦ Less common: angina, abnormal heart rhythms, rapid heartbeat and heart palpitations, allergic reaction, fever, and tremors.

Drug Interactions
•   Albuterol’s effects on the cardiovascular system may be increased by monoamine oxidase inhibitor (MA01) and tricyclic antidepressants. These drugs should not be administered together or within 2 weeks of discontinuation of MAOls or tricyclic antidepressants.
•   Beta-blocking drugs such as propranolol not only block the effects of albuterol but may cause severe bronchospasm in people with asthma.
•   Albuterol may reduce the amount of digoxin in the blood of people taking both drugs. Digoxin dose adjustment may be required.
•   Albuterol may exacerbate certain effects of non-potassium sparing diuretics (loop or thiazide diuretics).
Food Interactions
Albuterol tablets are more effective when taken on an empty stomach-1 hour before or 2 hours after meals—but can be taken with food if they upset your stomach.
Usual Dose
Albuterol and Pirbuterol Inhalation
Adult and Child (age 4 and over): 1-2 puffs every 4-6 hours. Asthma triggered by exercise may be prevented by taking 2 puffs 15 minutes before exercising.
Albuterol Inhalation Solution
Child (age 2-12): starting dose-0.63 mg or 1.25 mg 3 or 4 times a day. Deliver over 5-15 minutes by nebulizer.
Levalbuterol Inhalation Solution
Adult and Child (age 12 and over): 0.63 mg 3 times a day every 6-8 hours. Some people may benefit from 1.25 mg at each dose. Deliver over 5-15 minutes by nebulizer.
Child (age 6-11): 0.31 mg 3 times a day every 6-8 hours, by nebulizer.
Albuterol Inhalation Aerosol
Adult and Child (age 4 and over): 2 inhalations every 4-6 hours. Adults and children age 4 and over may prevent asthma brought on by exercise by inhaling twice 15 minutes before exercising.
Albuterol Sustained-Release Tablets
Adult and Child (age 12 and over): 4-8 mg every 12 hours. Dosage may be cautiously increased to a maximum of 32 mg a day. People being switched from regular to sustained-release tablets generally take the same dosage per day, in fewer tablets—for example, a 4-mg tablet every 12 hours (1 dose) instead of a 2-mg tablet every 6 hours (2 doses).
Child (age 6-12): 4 mg every 12 hours.
Overdosage
Overdose of albuterol inhalation usually results in exaggerated side effects, including chest pain and high blood pressure. People who inhale too much albuterol should see a doctor. Overdose of albuterol tablets may lead to changes in heart rate, palpitations, unusual heart rhythm, chest pain, high blood pressure, fever, chills, cold sweats, nausea, vomiting, and dilation of the pupils. Convulsions, sleeplessness, anxiety, and tremors may also develop, and the victim may collapse. If the albuterol overdose was taken within the past 1/2 hour, give the victim syrup of ipecac to induce vomiting. Do not give ipecac if the victim is unconscious or convulsing. If symptoms have already begun to develop, the victim may need to be taken to a hospital emergency room. Call for instructions, and ALWAYS bring the prescription bottle or container.
Special Information
If you are inhaling albuterol, be sure to follow the inhalation instructions that come with the product. The drug should be inhaled during the second half of your inward breath, since this will allow it to reach deeper into your lungs. Wait about 1-2 minutes between inhalations. Do not inhale albuterol if you have food or anything else in your mouth.
Do not take more albuterol than your doctor prescribes. Taking more than you need can worsen your symptoms. If your condition worsens after taking your medicine, call your doctor at once and stop taking it.
Call your doctor immediately if you develop chest pain, palpitations, rapid heartbeat, muscle tremors, dizziness, headache, facial flushing, or urinary difficulty, or if you continue having breathing difficulties after taking the medicine.
Do not crush or chew the extended-release tablets.
If you forget a dose of albuterol, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: When used during childbirth, albuterol can slow or delay natural labor. It can cause rapid heartbeat and high blood sugar in the mother and rapid heartbeat and low blood sugar in the baby. Albuterol also causes birth defects in animal studies. When your doctor considers this drug crucial, its benefits must be cautiously weighed against its risks.
It is not known if albuterol passes into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors with cardiovascular disease should use albuterol with caution.

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Jul

16

Adderall

July 16, 2009 | Leave a Comment

Brand Name
Adderall
Generic Ingredients
Dextroamphetamine Sulfate + Dextroamphetamine Saccharate + Amphetamine Aspartate + Amphetamine Sulfate
Other Brand Names Adderall XR
The information in this profile also applies to the following drugs:
Generic Ingredient.* Dextroamphetamine Sulfate RE Dexedrine Dextrostat
Generic Ingredient., Lisdexamfetamine Dimesylate Vyvanse
Type of Drug
Central-nervous-system (CNS) stimulant.
Prescribed For
Attention-deficit hyperactivity disorder (ADHD) and narcolepsy (uncontrollable desire to sleep).
General Information
Amphetamines are stimulants that work on the brain’s feeding center. Adderall, which is a mixture of two forms of amphetamine, may be used as a short-term aid in weight reduction. It should not be taken for longer than a few months for this purpose.
Amphetamines may also be prescribed for childhood ADHD, a condition characterized by distractibility, short attention span, hyperactive behavior, emotional instability, and difficulty controlling impulses. They should be used only after a complete evaluation of the child has been done. Frequency and severity of symptoms and their appropriateness for the age of the child determine whether drug therapy is required. Many experts believe that amphetamines offer only a temporary solution because they do not permanently change behavioral patterns. Psychological, educational, and social measures must also be taken to ensure successful treatment in the long term.

Cautions and Warnings
Do not take Adderall if you are allergic or sensitive to any amphetamine or have heart disease, a heart defect, high blood pressure, hardening of the arteries, liver or kidney disease, tics or Tourette’s syndrome, seizures or abnormal brain wave tests, thyroid disease, glaucoma, or a history of drug abuse.
Amphetamines should be used with extreme caution because they are highly addictive and easily abused.
New or worsening thought patterns, bipolar illness, aggressive or hostile behavior, psychotic behavior, and new manic symptoms can develop during treatment with amphetamines.
Stimulants like amphetamines are not effective and may be dangerous for children whose symptoms are related to environmental factors or primary psychiatric conditions, including psychosis.
Stimulants can cause weight loss and stunted growth in children under age 10. Blurred vision and difficulty focusing can occur.
Possible Side Effects
✓   Common: heart palpitations, restlessness, overstimulation, dizziness, sleeplessness, increased blood pressure, rapid heartbeat, upper abdominal pain, and weight loss.
✓   Less common: euphoria (feeling “high”), hallucinations, muscle spasms and tremors, headache, dry mouth, unpleasant taste in the mouth, diarrhea, constipation, upset stomach, nausea, vomiting, rash, itching, changes in sex drive, and impotence.
✓   Rare: psychotic drug reactions. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•   Combining an amphetamine and a monoamine oxidase inhibitor (MA01) antidepressant may cause a severe increase in blood pressure as well as bleeding inside the skull. Wait at least 2 weeks after stopping an MAGI before taking an amphetamine.
•   Amphetamines may reduce the effectiveness of high blood pressure medicines.
•   Gastrointestinal and urinary acidifying agents such as methenamine reduce the effectiveness of amphetamines.

•   Gastroinstestinal alkalizing agents, such as sodium bicarbonate, and urinary alkalizing agents (acetazolamide, some thiazides) may increase and prolong the effects of amphetamines.
•   Antipsychotic medications such as chlorpromazine, haloperidol, and lithium carbonate inhibit the stimulatory effects of amphetamines and can cause amphetamine poisoning.
•   Amphetamines may enhance the effects of tricyclic antidepressants, norepinephrine, phenobarbital, phenytoin, and meperidine.
•   Amphetamines may decrease the effectiveness of beta blockers.
•   Amphetamines may counteract the sedative effect of antihistamines.
•   Amphetamines can delay the absorption of ethosuximide into the bloodstream.
•   Propoxyphene increases the CNS-stimulating effect of amphetamines. Fatal convulsions have occurred in propoxyphene overdose with amphetamines.
Food Interactions
These drugs may be taken without regard to food or meals.
Usual Dose
Dextroamphetamine and Adderall
ADHD
Child (age 6 and older): 5-40 mg once or twice a day.
Child (age 3-5): 2-5 mg a day. Dose may be increased weekly until maximum response is achieved.
Narcolepsy: 5-60 mg a day.
Weight Control: 5-30 mg a day in divided doses 30-60 minutes before meals; alternately, a single, long-acting dose may be taken in the morning.
Adderall XR
Adults: 20 mg a day.
Child (age 13-17): 10-20 mg every morning. Child (age 6-12): 10-30 mg every morning. Child (under age 6): not recommended.
Lisdexamfetamine
Child (age 6-12): 30 mg every morning. Daily dose may be increased up to 70 mg.
Child (under age 6): not recommended.

Overdosage
Symptoms include tremors, muscle spasms, restlessness, exaggerated reflexes, rapid breathing, dry mouth, constipation, hallucinations, confusion, panic, and overaggressive behavior. These may be followed by depression, exhaustion, abnormal heart rhythms, blood pressure changes, nausea, vomiting, diarrhea, convulsions, and coma. Take the victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Amphetamines should be used very cautiously and only when considered absolutely necessary.
When taken for weight control, this drug should be used only when other methods have failed, and will gradually lose its effectiveness as the body starts breaking it down faster. Do NOT increase your dosage when this occurs. The drug must be discontinued.
Amphetamines are addictive and commonly abused. If you feel you have developed a tolerance or dependence to Adderall, contact your doctor. Do not increase your dosage without your doctor’s approval.
Amphetamines may impair your ability to drive or operate heavy machinery. Use with caution. To prevent this drug from interfering with sleep, take it at least 6-8 hours before bedtime.
Do not crush or chew the sustained-release form.
If you forget your once-daily dose, skip it and go -back to your regular schedule the next day. If you take the drug 2-3 times a day and miss a dose, take it as soon as you remember. If it is within 3 hours of your next dose, skip the one you forgot and continue with your regular schedule. Never take a double dose.
Special Populations
Pregnancy/Breast-feeding: Use of amphetamines during the early stages of pregnancy may cause birth defects. Amphetamines also increase the risk of premature delivery and low-birth-weight infants and may cause drug withdrawal symptoms in newborns. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Amphetamines pass into breast milk. Nursing mothers who must take them should use infant formula.
Seniors: Seniors are more sensitive to this drug’s effects.

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Jul

16

Acetaminophen

July 16, 2009 | Leave a Comment

Generic Name
Acetaminophen (uh-SEE-tuh-MIN-uh-fen) RE
Brand Names
Acephen    Mapap-
Aceta    Mapap Children’s
Acetaminophen Uniserts    Mapap Extra Strength
Apacet    Mapap Infant Drops
Aspirin Free Anacin Maximum    Maranox
Strength    Neopap
Aspirin Free Pain Relief    Oraphen-PD
Dynafed, Children’s JR    Panadol*
Dynafed EX    Redutemp
Dynafed Extra Strength    Silapap
Feverall    Silapap Children’s
Feverall, Infants    Silapap Infants
Genapap”    Tapanol
Genebs    Tempra*
Liquiprin    Tylenol*
*Some products in this brand-name group are alcohol- or sugar-free. Consult your pharmacist.
Type of Drug
Antipyretic and analgesic.
Prescribed For
Relief of pain and fever for people who cannot or do not want to take aspirin or a nonsteroidal anti-inflammatory drug (NSAID). Acetaminophen may be given to children about to receive a

DTP vaccination to reduce the fever and pain that commonly follow the vaccination.
General Information
Acetaminophen is generally used to relieve pain and fever associated with the common cold, flu, viral infections, or other disorders where pain or fever may occur. It is also used to relieve pain in people who are allergic to aspirin, or those who cannot take aspirin because of potential interactions with other drugs such as oral anticoagulants. It can be used to relieve pain from a variety of sources, including arthritis, headache, muscle ache, menstrual cramping, and tooth and periodontic pain, although it does not reduce inflammation.
Cautions and Warnings
Do not take acetaminophen if you are allergic or sensitive to any of its ingredients. Do not take acetaminophen for more than 10 days in a row (5 days for children) unless directed by your doctor. Do not take more than is prescribed or recommended on the package.
Use this drug with extreme caution if you have kidney or liver disease or viral infections of the liver. Large amounts of alcohol increase the liver toxicity of large doses or overdoses of acetaminophen. Avoid alcohol if you regularly take acetaminophen. Some people are more sensitive to this effect than others.
Possible Side Effects
This drug is relatively free from side effects when taken in recommended doses. For this reason it has become extremely popular, especially among those who cannot take aspirin. V Rare: large doses or long-term use may cause liver dam-
age, rash, itching, fever, lowered blood sugar, stimulation,
yellowing of the skin or whites of the eyes, and/or a change
in the composition of your blood. Contact your doctor if
you experience any side effect not listed above.
Drug Interactions
o Large doses of barbiturate drugs, carbamazepine, phenytoin and similar drugs, izoniazid, rifampin, and sulfinpyrazone may increase the chances of liver toxicity if taken with acetaminophen.

• Alcoholic beverages increase the chances for liver toxicity
and possible liver failure associated with acetaminophen.
Food Interactions
None known.
Usual Dose
Adult and Child (age 12 and over): 325-650 mg 4-6 times a day,
or 1000 mg 3-4 times a day. Avoid taking more than 4 g (twelve
325-mg tablets) a day for long periods of time. Child (age 11): 480 mg 4-5 times a day. Child (age 9-10): 400 mg 4-5 times a day. Child (age 6-8): 320 mg 4-5 times a day. Child (age 4-5): 240 mg 4-5 times a day. Child (age 3): 160 mg 4-5 times a day. Child (age 1-2): 120 mg 4-5 times a day.
Child (age 4-11 months): 80 mg 4-5 times a day. Child (under age 4 months): 40 mg 4-5 times a day.
Overdosage
Acetaminophen is a commonly used ingredient in many over-the-counter (OTC) medications. Always check the list of ingredients when using more than one OTC medication to ensure that the combined dosage is within guidelines and to avoid accidental overdose.
Acute acetaminophen overdose may cause nausea, vomiting, sweating, appetite loss, drowsiness, confusion, abdominal tenderness, low blood pressure, abnormal heart rhythms, yellowing of the skin and whites of the eyes, and liver and kidney failure. Liver damage has occurred with 12 extra-strength tablets or 18 regular-strength tablets, but most people need larger doses-20 extra-strength or 30 regular-strength tablets—to damage their livers. Regular use of large doses for long periods-30004000 mg a day for a year—can also cause liver damage, especially if alcohol is involved. In case of overdose, induce vomiting as soon as possible with ipecac syrup—available at any pharmacy —and take the victim to a hospital emergency room. ALWAYS bring the acetaminophen bottle or container.
Special Information
Unless abused, acetaminophen is a beneficial, effective, and relatively nontoxic drug. Follow package directions and call your doctor if acetaminophen does not relieve pain in 10 days for adults or 5 days for children. Call your doctor if fever gets worse or persists longer than 3 days.
Alcoholic beverages will worsen the liver damage that acetaminophen can cause. People who take this drug on a regular basis should limit their alcohol intake.
If you forget to take a dose, take it as soon as you remember. If it is within an hour of 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: Acetaminophen ‘is considered safe during pregnancy when taken in usual doses. Taking continuous high doses of the drug may cause birth defects or interfere with fetal development. Three cases of congenital hip dislocation appear to have been associated with acetaminophen. Check with your doctor before taking this drug if you are or might be pregnant.
Small amounts of acetaminophen may pass into breast milk, but the drug is considered harmless to nursing infants.
Seniors: Seniors may take acetaminophen as directed by a doctor.

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Jul

16

Acebutolol

July 16, 2009 | Leave a Comment

Generic Name
Acebutolol (ah-seh-BUTE-uh-lol) 91
Brand Name Sectral
Type of Drug
Beta-adrenergic blocking agent. Prescribed For
High blood pressure and abnormal heart rhythms.
General Information
Acebutolol hydrochloride is one of many beta-adrenergic blocking drugs, or beta blockers. These drugs interfere with the action of adrenaline and other chemicals in the body that affect many body functions. Individual beta blockers have different characteristics that can make them more suitable for certain conditions or people.

Cautions and Warnings
Do not take acebutolol if you are allergic or sensitive to any of its ingredients or to beta blockers.
You should be cautious about taking acebutolol if you have asthma, severe heart failure, a very slow heart rate, or heart block (disruption of the electrical impulses that control heart rate) because the drug may worsen these conditions.
People with angina taking acebutolol for high blood pressure risk aggravating their angina if they suddenly stop taking the drug. These patients should have their acebutolol dosage reduced gradually over 1-2 weeks.
Acebutolol should be used with caution if you have liver or kidney disease because your ability to eliminate this drug from your body may be impaired.
Acebutolol reduces the amount of blood pumped by the heart with each beat. This reduction in blood flow may aggravate the condition of people with poor circulation or circulatory disease.
If you are undergoing major surgery, your doctor may want you to stop taking acebutolol at least 2 days before surgery.
People with a history of severe anaphylactic reaction to alergens may be unresponsive to usual doses of epinephrine while taking beta blockers.
Possible Side Effects
Side effects are relatively uncommon and usually mild; normally they develop early in the course of treatment and are rarely a reason to stop taking acebutolol.
✓   Most common: fatigue.
✓   Common: dizziness and headache.
✓   Less common: chest pain, swelling in the legs or arms, depression, sleeplessness, abnormal dreams, rashes, constipation, diarrhea, upset stomach, stomach gas, nausea, frequent urination, back pain, joint and muscle pain, difficulty breathing, stuffy nose, and vision changes.
♦   Rare: cough, low blood pressure, slow heart beat, anxiety, impotence, changes in response to touch stimulation, itching, vomiting, abdominal pain, painful urination, nighttime urination, liver changes, sore throat, wheezing, eye irritation, pain or dry eye, and lupus erythematosus (extremely rare). Contact your doctor if you experience any side effect not listed above.

Drug Interactions
•   Acebutolol may interact with surgical anesthetics to increase the risk of heart problems during surgery. Some anesthesiologists recommend gradually stopping the drug by 2 days before surgery.
•   Acebutolol may interfere with the normal signs of low blood sugar and with the action of oral antidiabetes drugs.
•   Acebutolol increases the blood-pressure-lowering effects of other blood-pressure-reducing agents, including clonidine, guanabenz, and reserpine, and calcium channel blockers such as nifedipine.
•   Aspirin-containing drugs, nonsteroidal anti-inflammatory drugs (NSAIDS), and sulfinpyrazone may interfere with the blood-pressure-lowering effect of acebutolol.
•   Cocaine may reduce the effectiveness of all beta blockers.
•   Acebutolol may worsen the problem of cold hands and feet associated with ergot alkaloids, used to treat migraine. Gangrene is a possibility in people taking both an ergot and acebutolol.
•   Acebutolol will counteract thyroid hormone replacements.
•   Calcium channel blockers, flecainide, hydralazine, contraceptive drugs, cimetidine, propafenone, haloperidol, phenothiazine sedatives (molindone and others), quinolone antibacterials, and quinidine may increase the amount of acebutolol in the bloodstream and lead to increased acebutolol effects.
•   Acebutolol should not be taken within 2 weeks of taking a monoamine oxidase inhibitor (MAGI) antidepressant.
•   Acebutolol may interfere with the effects of some antiasthma drugs, including theophylline and aminophylline.
•   Combining acebutolol with digitalis drugs may result in excessive slowing of the heart, possibly causing heart block.
•   If you stop smoking while taking acebutolol, your dose may have to be reduced because your liver will break down the drug more slowly afterward.
•   Aluminum salts, barbiturates, calcium salts, cholestyramine, colestipol, ampicillin, and rifampin may reduce the effectiveness of acebutolol.
•   Beta blockers may block the effects of epinephrine.
Food Interactions
None known.

Usual Dose
High Blood Pressure
Adult: starting dose-100 mg a day, taken all at once or in 2 divided doses. The daily dose may be gradually increased. Maintenance dose-400-800 mg a day.
Senior: Older adults may respond to lower doses and should be treated more cautiously, beginning with 100 mg a day, increasing gradually to a maximum of 400 mg a day.
Child: not recommended.
Abnormal Heart Rhythms
Adult: starting dose-200 mg a day. Maintenance dose-200600 mg a day in 2 divided doses.
Senior: Older adults may respond to lower doses and should be treated more cautiously, beginning with 100 mg a day, increasing gradually to a maximum of 400 mg a day.
Child: not recommended.
Overdosage
Symptoms of overdose include extremely slow or irregular heartbeat, very low blood pressure, breathing difficulties, and seizures. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Acebutolol is meant to be taken continuously. When ending acebutolol treatment, dosage should be reduced gradually over a period of about 2 weeks. Do not stop taking this drug unless directed to do so by your doctor.
Do not take other medications, including over-the-counter medications, without consulting with your doctor. The use of some nasal decongestants with acebutolol may result in severely high blood pressure.
Acebutolol may cause drowsiness or dizziness. Be careful when driving or performing complex tasks.
It is best to take acebutolol at the same time each day. If you forget a dose, take it as soon as you remember. If you take acebutolol once a day and it is within 8 hours of your next dose, skip the dose you forgot and continue with your regular schedule. If you take acebutolol twice a day and it is within 4 hours of your next dose, skip the missed dose and continue with your regular schedule. Never take a double dose.

Special Populations
PregnancylBreast-feeding. Acebutolol crosses into the placenta. Infants born to women who took a beta blocker while pregnant had lower birth weights, low blood pressure, and slow heart rates. Acebutolol should be taken during pregnancy only if the potential benefit outweighs the risk.
Large amounts of acebutolol pass into breast milk. Nursing mothers taking acebutolol should use infant formula.
Seniors: Seniors taking acebutolol may need a reduced dosage.

Tags: abnormal heart rhythms, acebutolol, amount, bacteria, beta blockers, bloodstream, body, body functions, BUTE-uh-lol, calcium, CAUTION, channel, chest pain, circulatory disease, clonidine, decongestant, dizziness and headache, doctor, Drug, effectiveness, electrical impulses, epinephrine, GENERIC, generic name, heart block, heart failure, high blood pressure, hydrochloride, information, Interactions, kidney disease, maintenance dose, major surgery, Medications, migraine, nasal decongestants, NSAIDs, poor circulation, Prescribed, sectral, severe anaphylactic reaction, side, slow heart rate, stomach gas, swelling in the legs, symptom, urination

Jul

5

Topical NSAIDs (gels, creams, and sprays) in Arthritis Treatment

July 5, 2009 | Leave a Comment

Topical NSAIDs

Americans have been deprived of an arthritis treatment that is widely available all over the world. Topical NSAIDs (gels, creams, and sprays) are very popular with patients and physicians in Europe, Australia, Canada, New Zealand, and dozens of other countries, but they are virtually ignored in the United States. The very same drugs (diclofenac, ibuprofen, ketoprofen, ketorolac, piroxicam, etc.) that cause so much mischief when taken orally can be applied to the skin with little, if any, risk of stomach ulcers, kidney problems, heart attacks, strokes, or other systemic complications. Except for aspirin-like compounds (salicylates) found in OTC products like Aspercreme, BenGay, Myoflex creme, and Sportscreme, you will not find topical NSAIDs on pharmacy shelves in the United States. That’s because the FDA has never approved these formulations for topical use.
How effective are topical NSAIDs for relieving the pain and inflammation of arthritis? Over the years there have been dozens of clinical trials of such products for both temporary (acute) discomfort and longer-term (chronic) treatment. 3 One review of 26 double-blind, placebo-controlled trials involving 2,853 patients concluded that “topical NSAIDs were effective and safe in treating acute painful conditions for 1 week.
Okay, okay! We hear you: “One week, big deal.” Another review examined 14 double-blind, placebo-controlled trials including almost 1,500 patients. The conclusion: “Topical NSAIDs were effective and safe in treating chronic musculoskeletal conditions for 2 weeks.” That’s a little better, but still not a long-term solution. One sour note comes from the thorough and objective Cochrane Library. The reviewers for this organization analyze all available evidence, published and unpublished, and provide their assessment of various treatments. This 2004 review looked at studies of use of topical NSAIDs for longer than 2 weeks and determined that “after 2 weeks there was no evidence of efficacy superior to placebo. No trial data support the long-term use of topical NSAIDs in osteoarthritis.

Based on this summary we would be inclined to suggest that topical NSAIDs be used for 2 weeks or less to relieve an acute arthritis flare-up. On the brighter side, there are now four newer clinical trials of use for 3 to 12 weeks. 97,98 Investigators specifically looked at osteoarthritis of the knee. In each study, diclofenac (Pennsaid or Voltaren Emugel) was superior to placebo in providing relief, with only “minor local irritation and no significant systemic adverse events. In a 12-week head-to-head comparison of oral diclofenac with topical diclofenac (Pennsaid Lotion), their effectiveness was comparable. But side effects like nausea, indigestion, stomach pain, and liver damage were much more likely to occur with the oral NSAID.

Pennsaid Lotion is interesting because the formulation relies on DMSO (dimethyl sulfoxide) to help get the drug through the skin and into the area of the joint where pain relief is desired. DMSO is a solvent that is uniquely able to penetrate the skin and carry medications with it. We have long wondered why drug companies were not using DMSO to facilitate absorption. Now the makers of Pennsaid have done just that.
So, how can you get topical NSAIDs? If you were in Australia you could purchase products like piroxicam (Feldene Gel), ibuprofen (Nurofen Gel), ketoprofen (Orudis Gel), and diclofenac (Voltaren Emulgel) over the counter without a prescription. At this time that is impossible in the United States. Nevertheless, it is possible to purchase oral ibuprofen and ketoprofen over the counter. That means a compounding pharmacist (one who mixes raw ingredients into finished products) can legally purchase ibuprofen or ketoprofen powder, make a cream or a gel, sell it to you without a prescription.
An alternative would be to shop online for one of the brands mentioned above. Since they are nonprescription in many countries, you may be able to purchase them and not have US Customs give you any problems. One final option, and our number one recommendation, is to have a US physician write a prescription for Pennsaid. This topical form of diclofenac has been tested in several clinical trials and found to produce long-lasting relief from osteoarthritis. You would then need to contact a Canadian pharmacy online or by phone to have the prescription filled. Since this drug is not available.

Pennsaid Lotion (diclotenat)

This topical NSAID has been shown to provide lasting relief from the pain and inflammation of osteoarthritis. It may produce some skin irritation, but does not appear to cause significant systemic toxicity, as oral diclofenac does.
Side effects: Skin dryness, flakiness, and rash.
Downside: Not available in the United States. Available by prescription in Canada, Finland, Iceland, Italy, Greece, Portugal, the United Kingdom, and elsewhere.
Cost: Approximately $60 to $120 per month.

Tags: acute discomfort, arthritis, arthritis treatment, Aspercreme, bengay, CAUTION, chronic treatment, definitive evidence, diclofenac, double blind placebo, Drug, dryness, heart attacks, indigestion, inflammation, irritation, ketoprofen, kidney problems, long term solution, low dose aspirin, Medications, Medicine, musculoskeletal conditions, Myoflex, new england journal, new england journal of medicine, NSAIDs, otc products, Pennsaid, pharmacy, pharmacy shelves, piroxicam, proton pump inhibitors, stomach, stomach ulcers, strategy, systemic complications, topical use, Treatment, Voltaren

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Topical NSAIDs (gels, creams, and sprays) in Arthritis Treatment