Jul
17
Celebrex (Celecoxib)
July 17, 2011 | Leave a Comment
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Aug
13
Econazole - Efalizumab - Eflornithine - Enalapril - Enfuvirtide - Entacapone
August 13, 2009 | Leave a Comment
Generic Name
Econazole (ee-KON-uh-zole) 92
Brand Name Spectazole
Type of Drug Antifungal.
Prescribed For
Fungal infections of the skin, including athlete’s foot. jock itch, and ringworm.
General Information
Econazole nitrate can kill fungal organisms that may have penetrated to deep layers of the skin. Very small amounts of econazole are absorbed into the bloodstream.
Cautions and Warnings
Do not use econazole if you are allergic or sensitive to any of its ingredients.
Do not apply econazole cream in or near your eyes.
Long-term application of this product to large areas of skin may cause liver damage.
Possible Side Effects
♦ Most common: burning, itching, stinging, and redness in the areas to which the cream has been applied.
Drug Interactions None known.
Usual Dose
Adult: Apply enough of the cream to cover affected areas with a thin layer 1-2 times a day.
Overdosage
Accidental ingestion may cause nausea, upset stomach, drowsiness, and liver inflammation or damage. Call your local poison control center for more information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
Clean the affected areas before applying econazole cream, unless otherwise directed by your doctor. Dry the infected area thoroughly and wear loose-fitting clothes to keep the area cool and dry.
Call your doctor if the treated area burns, stings, or becomes red.
This product can be expected to relieve symptoms within 1 or 2 days after you begin using it. Follow your doctor’s directions for the complete 2-4-week course of treatment to gain maximum benefit. Stopping the drug too soon can lead to a relapse.
If you forget a dose of econazole, apply it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not apply a double dose.
Special Populations
Pregnancy/Breast-feeding: When given by mouth to pregnant animals in high doses, econazole was toxic to the fetus. It should be strictly avoided during the first 3 months of pregnancy. During the last 6 months of pregnancy, it should be used only if absolutely necessary.
Econazole may pass into breast milk. Nursing mothers who must take this drug should consider using infant formula.
Seniors: Seniors may take this drug without special restriction.
Efalizumab (ef-ah-LIZ-u-mab)
Brand Name Raptiva
Type of Drug
Immune system suppressant.
Prescribed For
Chronic to severe plaque psoriasis.
General Information
Efalizumab is a manmade antibody that works by binding to specific areas of certain white blood cells called leukocytes. This prevents the leukocytes from interacting with other cells and interrupts inflammation that is involved in the development of patches of psoriatic skin. The molecule that efaluzimab interacts with is found on many other key cells found in the immune system, and this is the source of many of the drug’s more serious side effects.
Cautions and Warnings
Do not use this drug if you are allergic or sensitive to any of its ingredients.
People taking efalizumab are at a greater risk of infection because it suppresses the immune system. Contact your doctor if you develop any kind of infection, including a common cold. Serious infections may require hospitalization.
The chances of malignancy may be increased by efalizumab because it suppresses the immune system. People with any type of cancer should not use this drug.
Efalizumab may lead to bleeding because it can cause a drastic reduction in blood-platelet counts. People with a history of low blood-platelet counts should be extremely cautious about using efalizumab.
Psoriasis can get worse or recur during or after efalizumab treatment in a small number of people. Call your doctor immediately if your condition worsens while you are taking efalizumab.
Possible Side Effects
Headache, fever, nausea, and vomiting are common alter taking the very first dose of elaki7umab. A “conditioning” dose of about 0.3 mg per lb. of body weight is often given to minimize these reactions.
V Most common: headache, infections, chills, nausea, and pain.
V Common: muscle aches, flu-like symptoms, itching, and fever.
Possible Side Effects (continued)
✓ Less common: back pain, arthritis, lung inflammation, and
acne.
♦ Rare: psoriasis, arthritis, joint pain, malignancy, low blood-platelet count, and drug allergy or sensitivity. Other rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Efalizumab is an immune system suppressant and should not be combined with other immune suppressant drugs because of the increased risk of infection and malignancy.
• Combining vaccines (live and acellular) with efalizumab may exaggerate the body’s response to the vaccine and increase the risk of developing the disease against which the vaccination is being administered. People taking etalizurnab should not receive vaccines.
Food Interactions None known.
Usual Dose
Adult: 0.3 mg per lb. of body weight to start. Then about 0.5 mg per lb. of body weight once a week on the same day. The maximum dose is 200 mg by subcutaneous injection. Mix your dose immediately before it is to be injected and throw away any unused medicine.
Child: not recommended.
Overdosage
Doses up to 4 times the recommended dose have been taken for 10 weeks without additional side effects. However, overdose victims should be taken to a hospital emergency room for observation. ALWAYS bring the prescription bottle or container.
Special information
See your doctor regularly while you are taking efaluzima6. Regular blood tests are required to make sure your blood platelets are not unusually low.
Tell your doctor if you gain or lose weight, since doses of efaluzimab are based on how much you weigh.Tell your doctor about all medicines you are taking including other medicines for psoriasis, non-prescription drugs, vitamins,
and herbal supplements.
Store unused medicine in the refrigerator. Throw away medicine that has been mixed but not used.
Call your doctor immediately if you develop bleeding gums, black-and-blue marks, any kind of infection, begin to bruise easily, or if you are told by another doctor that you have any kind of cancer.
This drug is given by injection under the skin. For more information on how to properly administer this drug, see page 1242.
Special Populations
Pregnancy/Breast-feeding: It is not known how efaluzimab will affect a growing fetus. Animal studies using doses equal to 30 times the human dose showed no adverse effects. While animal studies of efaluzimab reveal no damage to the fetus, this drug should be used only during pregnancy after carefully weighing its potential benefits against its risks.
It is not known if efaluzimab passes into breast milk, although it might affect the nursing infant’s developing immune system. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors should be cautious about using efaluzimab because of the increased risk of infection.
Generic Name
Eflornithine (eh-FLOOR-nih-thene)
Brand Name
Vaniga,
Type of Drug
Hair growth retardant.
Prescribed For
Removal of unwanted facial hair by women.
General Information
This drug has only been studied for its ability to prevent hair growth on the face and chin and should not be used on other body areas. It works by interfering with enzymes in the skin necessary for hair growth, slowing the rate at which hair will grow. Improvement may be seen as soon as 4-8 weeks after you start using eflornithine, but the condition will return within 8 weeks after you stop using it.
Cautions and Warnings
Do not use eflornithine if you are allergic or sensitive to any of its ingredients.
For external use only; do not ingest.
Possible Side Effects
Eflornithine side effects are similar to those of a placebo (sugar pill).
✓ Most common: acne, bumps, or small pustules on the skin. V -Common: stinging.
✓ Less common: headache, dizziness, burning, itching, redness, tingling, irritation, rash, hair loss, upset stomach, and appetite loss.
✓ Rare: fainting, ingrown hairs, inflamed hair follicles, facial swelling, nausea, bleeding, contact dermatitis, inflammation of one or both lips, herpes breakout, numbness, and dilated blood vessels and pores on the nose and cheeks. Contact your doctor if you experience any side effect not listed above.
Food and Drug Interactions None known.
Usual Dose
Adult and Child Me 11 anti over): Apply a thin layer of cream to ai ected areas and rub in thoroughly 2 times a day at least 8 hours apart. Do not wash your face until at least 4 hours after you have applied eflornithine cream. Wait at least 5 minutes after hair removal to apply eflornithine.
Child (under age 12): not recommended.
Overdosage Little is about the effects of eflornithine overdose or acci-
Li known
dental ingestion. Call your local poison control center for more information. ALWAYS bring the prescription container.
Special Information
If you forget to apply a dose of eflornithine, apply it as soon as you remember. Bear in mind that at least 8 hours must elapse between doses and you cannot wash the area for another 4 hours after application. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule.
This product slows hair growth. It is not a depilatory. You will have to continue shaving, tweezing, or using another hair removal technique.
Wait several minutes after application of eflornithine before applying cosmetics or sunscreen.
Use only on your face and neck.
Call your doctor if your skin becomes irritated or if you develop other side effects. If skin irritation continues, you may have to stop using eflornithine.
Special Populations
Pregnancy/Breast-feeding: Eflornithine cream may cause birth defects. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
It is not known if this drug passes into breast milk. Nursing mothers should use infant formula.
Seniors: Seniors may use eflornithine without special restriction.
Generic Name
Enalapril (uh-NAL-uh-pril)
Brand Name
Vasotec
Combination Product
Ggner;c Ingredients: Enalapril + Hydrochlorothiazide RE Vaseretic
Type of Drug
Angiotensi n -converting enzyme (ACE) inhibitor.
Prescribed For
Hypertension (high blood pressure), heart failure, diabetic kidney disease, and heart attack treatment when the function of the left ventricle has been affected. Also prescribed for kidney failure, kidney hypertension, managing people with a high risk of heart disease, chronic kidney disease, and preventing a second stroke.
General Information
Enalapril maleate and other ACE inhibitors work by preventing the conversion of a hormone called angiotensin I to another hormone called angiotensin II, a potent blood-vessel constrictor. Preventing this conversion relaxes blood vessels, thus reducing blood pressure and relieving symptoms of heart failure. Enalapril also affects the production of other hormones and enzymes that participate in the regulation of blood-vessel dilation. Enalapril begins working about 1 hour after you take it and continues to work for 24 hours.
Cautions and Warnings
Do not take enalapril if you are allergic or sensitive to any of its ingredients. Severe sensitivity reactions can occur in hemodialysis patients taking enalapril or those undergoing venom immunization.
Swelling of the face, extremities, or throat has been known to occur with enalapril, which can be dangerous (see “Special Information”).
Enalapril occasionally causes very low blood pressure.
Enalapril may affect your kidney function, especially if you have congestive heart failure. Your doctor should check your urine for protein content during the first few months of treatment. Dosage adjustment of enalapril is necessary if you have reduced kidney function.
Enalapril can affect white-blood-cell counts, possibly increasing your susceptibility to infection. Your doctor should monitor your blood counts periodically.
Enalapril may cause serious Injury or death to the fetus if taken duriRcA pregnancy. Pregnant women should not take enalapril.
ACE inhibitors may be less effective in some black patients with high blood pressure, especially when dietary salt intake is high. Nevertheless, they should still be considered useful blood pressure treatments. Swelling beneath the skin to form welts is more common among black patients.
Possible Side Effects
♦ Most common-. dizziness, fatigue, headache, and chronic cough. The cough usually goes away a few days after you stop taking the medication.
♦ Less common: chest tightness or pain, dizziness when rising from a sitting or lying position, fainting, abdominal pain, nausea, vomiting, diarrhea, bronchitis, urinary tract infection, breathing difficulties, weakness, and rash.
♦ Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
For additional information about enalapril + felodipine, see Felodipine, page 471.
Drug Interactions
• The blood-pressure-lowering effect of enalapril is additive with diuretic drugs and beta blockers. Any other drug that causes a rapid drop in blood pressure should be used with caution if you are taking enalapril.
• Enalapril may increase the effects of lithium; this combination should be used with caution.
• Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the blood-pressure-lowering effects of enalapril and other ACE inhibitors. The combination may cause reductions in kidney function.
• Enalapril may increase blood-potassium levels, especially when taken with dyazide or other potassium-sparing diuretics.
• Antacids and enalapril should be taken at least 2 hours apart.
• Capsaicin may trigger or aggravate the cough associated with enalapril therapy.
• Indomethacin may reduce the blood-pressure-lowering effects of enalapril.
• Phenothiazine sedatives and antiemetics may increase the ef - feZIS of enalapril.
• Rifampin may reduce the effects of enalapril.
• The combination of allopurinol and enalapril increases the chance of side effects. Avoid this combination.
• Enalapril affects blood levels of digoxin. More digoxin in the blood increases the chance of digoxin-related side effects, while less digoxin in the blood can compromise its effectiveness.
• Severe sensitivity reactions can occur in those taking allo-
purinol.
For additional information about enalapril + felodipine, see Felodipine, page 471.
Food Interactions
You may take enalapril with food if it upsets your stomach.
Usual Dose
Enalapril
Adult: 5-40 mg a day in 1 or 2 doses. People with poor kidney function need less medication.
Enalapril + Felodipine
Adult: 1-2 tablets a day.
Overdosage
The principal effect of enalapril overdose is a rapid drop in blood pressure, as evidenced by dizziness or fainting. Take the overdose victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Enalapril can cause swelling of the face, lips, hands, or feet. This swelling can also affect the larynx (throat) or tongue and interfere with breathing. If this happens, go to a hospital emergency room at once. Call your doctor if you develop a sore throat, mouth sores, abnormal heartbeat, chest pain, persistent rash, or loss of taste perception.
Some people who start taking enalapril after they are already on a diuretic (an agent that increases urination) experience a rapid drop in blood pressure after their first doses or when their dosage is increased. To prevent this from happening, your doctor may tell you to stop taking your diuretic 2 or 3 days before starting enalapril or to increase your salt intake during that time. The diuretic may then be restarted gradually.
You may gO dizzy if you rise to your feet too quickly from a sitting or lying position when taking enalapril.
Avoid strenuous exercise or very hot weather because heavy
sweating or dehydration can cause a rapid drop in blood pressure.
While taking enalapril, avoid over-the-counter diet pills, decon-
gestants, and other stimulants that can raise blood pressure. Also,
do not take potassium supplements or salt substitutes containing potassium without consulting your doctor.
If you take enalapril once a day and forget to take a dose, take it as soon as you remember. If it is within 8 hours of your next dose, skip the one you forgot and continue with your regular schedule. If you take enalapril twice a day and miss a dose, take it right away. If it is within 4 hours of your next dose, take 1 dose immediately and another in 5 or 6 hours, then go back to your regular schedule. Never take a double dose.
Special Populations
Pregnancy/Breast-feeding: ACE inhibitors can cause fetal injury or death. Women who are or might become pregnant should not take ACE inhibitors. Sexually active women of childbearing age who must take enalapril must use an effective contraceptive method to prevent pregnancy. If you become pregnant, stop taking the medication and call your doctor immediately.
Small amounts of enalapril pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may be more sensitive to the effects of this drug due to age-related losses in kidney or liver function.
Generic Name
Enfuvirtide (en-M-ir-tide)
fusing to healthy CD4 cells, a key part of the human immune system. This helps fight HIV by having fewer HIV-infected cells as well as a healthier immune system to fight off the HIV virus. Enfuvirtide is always prescribed in combination with other antiviral medicines. It is possible for the HIV virus to become resistant to enfuvirtide, but this drug can work against types of the virus that have become resistant to other anti-HIV therapies.
Cautions and Warnings
Do not take enfuvirtide if you are allergic or sensitive to any of its ingredients. Symptoms of drug allergy can include generalized itching, rash, severe chills, and low blood pressure. In rare cases, enfuvirtide triggers severe hypersensitivity. Patients experiencing symptoms (a combination of rash, fever, nausea, and/or respiratory distress) should stop using enfuvirtide and seek medical attention immediately.
People taking enfuvirtide may be more likely to develop bacterial pneumonia. See your doctor regularly and report any difficulty breathing or unusual respiratory reactions.
Enfuvirtide may raise blood sugar levels, worsen diabetes, or trigger latent diabetes. People with diabetes who take this drug may need to have the dosage of their anti-diabetes medication adjusted.
Possible Side Effects
✓ Most common: allergic skin reaction at the site of injection (symptoms include itching, rash, and swelling of tissue under the skin), diarrhea, nausea, fatigue, and sleeplessness.
✓ Common: tingling in the hands or feet, depression, anxiety, cough, sinusitis, herpes infection, weight loss, appetite loss, weakness, itching, and muscle ache.
✓ Less common: taste changes, small skin tumors, flu infection, constipation, abdominal pain, pancreas inflammation, conjunctivitis and lymph gland inflammation.
‘T Rare: Rare side effects can affect the blood, immune system, kidneys, urinary tract, and central nervous system. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
Enfuvirtide is not broken down in the liver and does not affect liver enzyme systems, so it is not likely to be involved in common drug
interactions.
Food Interactions
None known. Usual Dose
Adult and Child (age 17 and over): 90 mg injected under the skin into the upper arm, thigh, or abdomen twice a day.
Child (age 6-16): 0.91 mg per lb. of body weight twice a day, up to 90 mg per injection. Be sure to increase enfuvirtide dosage as your child’s weight increases.
Child (under age 6): not recommended.
Overdosage
Little is known about the effects of enfuvirtide overdose. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Enfuvirtide is not a cure for HIV It will not prevent you from transmitting the HIV virus to another person; you must still practice safe sex. People taking this drug may still develop opportunistic infections and other complications associated with HIV infection.
This drug is given by injection under the skin. For information on how to properly administer this drug, see page 1242.
Do not use a vial of enfuvirtide if the final solution has particles floating in it. It should be completely clear, colorless, and have no bubbles in the vial.
You may keep solutions of enfuvirtide in the refrigerator and use them for up to 24 hours after they have been mixed. After that, they must be thrown away.
Tell your doctor if you are pregnant, become pregnant, os plan to become pregnant.
Do not stop taking this, or any other anti-HIV medicine, without first consulting your doctor.
Special Populations
Pregnancy/Breast-feeding: While animal studies of enfuvirtide reveal no damage to the fetus, this drug should only be used during pregnancy after carefully weighing its potential benefits against its risks. A national registry has been established to gather information on pregnant women who take this drug.
It is not known if enfuvirtide passes into breast milk. Nursing mothers with HIV should always use infant formula, regardless of whether they take this drug, to avoid transmitting the virus to their child.
Seniors: The effects of enfuvirtide in seniors is unknown.
Generic Name
Entacapone (in-TACK-a-pohn)
Brand Name Comtan
Type of Drug Antiparkinsonian.
Prescribed For
Parkinson’s disease patients for whom levodopa + carbidopa loses its effectiveness between doses.
General Information
Entacapone is always used in combination with levodopa + carbidopa. Some patients experience signs and symptoms of an end-of-dose “wearing-off” effect with these drugs. Entacapone enhances the effect of levodopa + carbidopa by reversing the action of an enzyme known as catechol-O-methyltransferase (COMT), which is primarily responsible for breaking down levodopa in the body.
Cautions and Warnings
Do not take entacapone If yOU are allergic or sensitive to any of At *Ingredients.
Do not take entacapone with phenelzine or tranyleypromine, as a very serious reaction may occur.
People with liver disease should use entacapone with caution as they may accumulate twice as much of this drug in their blood as people with normal liver function.
Entacapone has been rarely associated with the formation of fibrous tissues in unusual places such as the urinary tract and lungs. It has also caused fluid in the lungs.
Entacapone may cause kidney toxicity.
Entacapone may increase the risk of dizziness or fainting when rising from a sitting or lying down position.
Hallucinations have been reported with other Parkinson’s disease drugs.
Possible Side Effects
♦ Most common: difficulty performing voluntary muscle functions, excessive muscle activity, nausea, urine discoloration, and diarrhea.
♦ Common: reduced muscle activity, dizziness, fatigue, constipation, and abdominal pain.
✓ Less common: low blood pressure and fainting when rising from a sitting or lying position, hallucinations, anxiety, agitation, gastritis or other stomach disorders, dry mouth, vomiting, increased sweating, back pain, taste changes, shortness of breath, easy bruising, weakness, and bacterial infection.
♦ Rare: muscle damage or death, high fever, and confusion. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Do not mix entacapone with the monoamine oxidase inhibitor (MAGI) antidepressants phenelzine or tranylcypromine. Entacapone may be taken with the MAGI selegiline.
• Other drugs broken down by COMT will also be affected by entacapone. Isoproterenol, epinephrine, ephedrine, norepinephrine, isoetharine, and others will interact with entacapone, even when taken by inhalation. The result may be increased heart rate, wybylh m ias, and excessive changes in Uwd pressure.
• Cholestyramine, probenecid, erythromycin, rifampin, ampicillin, and chloramphenicol may interfere with the elimination of entacapone from the body.
• Entacapone may enhance the effects of sedatives and other nervous system depressants.
Food Interactions
This drug may be taken with or without food.
Usual Dose
Adult: 200 mg with each levodopa + carbidopa dose, up to
1600 mg a day.
Child: not recommended.
Overdosage
Theoretically, a massive entacapone overdose could prove lethal by completely inhibiting COMT throughout the body. There have been no reports of significant entacapone overdose. Doses up to 800 mg have been taken and side effects were mainly abdominal pain and loose stools. Other effects that might be expected include difficulty breathing, loss of muscle coordination, reduced level of activity, and convulsions. Overdose victims should be taken to a hospital emergency room as soon as possible. ALWAYS bring the prescription bottle or container.
Special Information
Always take your entacapone dose together with your levodopa + carbidopa dose. If you forget a dose, take it as soon as you remember. If it is within 2 hours of your next dose, skip the dose you forgot and continue with your regular schedule.
This drug can cause dizziness, nausea, sweating, or fainting when rising quickly from a sitting or lying position, especially at the beginning of treatment.
Increased body movements and twitching, twisting, or uncontrolled tongue, lip, face, arm, or leg movement may occur. If this happens, your doctor may need to adjust your dose of levodopa + carbidopa.
Exercise caution when performing tasks, such as driving, that require coordination and concentration until your body has become accustomed to the effects of entacapone.
Gradually reducing the dose of entacapone decreases some drug side effects.
Rapid withdrawal can cause high fever, sweating, unstable blood pressure, stupor, and muscular rigidity. Patients who stop using entacapone should be monitored.
Entacapone can cause your urine to turn a brownish-orange color. This change is harmless.
Special Populations
Pregnancy/Breast-feeding: Entacapone causes birth defects, miscarriage and abortion in pregnant animals. When this drug is considered crucial by your doctor, its potential benefits must be weighed against its risks.
Entacapone passes into the breast milk of animals but no information on humans is available. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may take this drug without special precaution.
Aug
1
Cilostazol
August 1, 2009 | Leave a Comment
Generic Name
Cilostazol (sil-oe-STAY-zol) Lq
Brand Name Pletal
Type of Drug Antiplatelet.
Prescribed For Intermittent claudication.
General Information
In intermittent claudication, leg muscles go into spasm due to reduced blood flow. This occurs when plaque buildup narrows blood vessels leading to the calf or other leg muscles. People with this condition often develop leg pain after walking only a short distance. Cilostazol prevents blood platelets from “clumping together” to begin the process of forming a blood clot, which can further obstruct arteries and worsen intermittent claudication. This drug is broken down in the liver.
Cautions and Warnings
Do not take this drug if you are allergic or sensitive to any of its ingredients.
?P,Ople with congestive heart failure (CHF) should not take cilostazol. Some studies indicate that long-term use of this drug may cause cardiovascular problems.
People with hemostatic disorders or active pathologic bleeding should not take cilostazil.
Drug Interactions
• Avoid mixing cilostazol with ketoconazole, itraconazole, fluconazole, miconazole, fluvoxamine, fluoxetine, nefazodone, or sertraline because this interaction may slow the breakdown of cilostazol, prolonging its effects. Cilostazol dosage is reduced by 50% when it is combined with any of these drugs.
• Aspirin can increase the anticoagulant (blood-thinning) effect of cilostazol, but this combination has not caused serious bleeding problems. There is no information on the effect of combining cilostazol and other antiplatelet or anticoagulant drugs. Cilostazol dosage is reduced by 50% when it is combined with any of these drugs.
• Diltiazem increases cilostazol blood levels by about 50%. Cilostazol dosage is reduced by 50% when it is combined with diltiazem.
• Erythromycin and similar antibiotics increase cilostazol blood levels. Take half the regular dose of cilostazol when combining it with any of these drugs.
• Combining cilostazol and omeprazole increases the effects of cilostazol. Cilostazol dosage is reduced by 50% when it is combined with omeprazole.
• Smoking reduces the Olectiveness of cilostazol by causing the liver to break it down faster.
Food Interactions
Take this drug on an empty stomach at least 30 minutes before or 2 hours after meals. Do not drink grapefruit juice at any time while
above. with dosage.
dache, infection, abdominal pain, ab- arrhea.
pitations, rapid heartbeat. dizziness, sea, sore throat, runny nose, back pain, arms or legs.
cough, fainting, and muscle aches. cts can occur in almost any part of the doctor if you experience any side ef- e.
Possible Side Effects
The risk of side effects
♦ Most common: headache
• stool, and diarrhea. • Common: heart palpitations
• stomach, nausea
• swelling in the
♦ Less common: gas,
♦ Rare: Rare side effects body. Contact your fect not listed taking cilostazol because it can interfere with the breakdown of the drug.
Usual Dose
Adult: 100 mg twice a day. 50 mg twice a day when combined with other drugs that may increase the effect of cilostazol. Child: not recommended.
Overdosage
Symptoms of overdose are likely to be the most common side effects. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Several weeks of cilostazol treatment may be necessary before you notice any improvement in symptoms. Maximum benefit usually occurs after 12 weeks.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Animal studies suggest that cilostazol may harm the fetus, but there is no information on the effect of cilostazol in pregnant women. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
cilostazol may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors can take this drug without special precaution.
Jul
16
Aliskiren
July 16, 2009 | Leave a Comment
Generic Name
Aliskiren (ah-LISS-kih-ren)
Brand Name Tekturna
Combination Product
Generic Ingredients: Aliskiren + Hydrochlorothiazide Tekturna HCT
Type of Drug
Direct renin inhibitor. Prescribed For
High blood pressure.
General Information
Renin is produced by the kidney in response to a reduction in blood volume and the amount of blood passing through the kidney. Once in the blood, renin reacts with other hormones to forma very powerful blood vessel constrictor called angiotensin E that directly raises blood pressure. Renin also works with a hormore called aldosterone to raise blood pressure and it prevents sodium from being eliminated from the body. This increases the amount of water in the system, raising blood volume and increasing blood pressure. Aliskiren inhibits renin and all of its actions, thereby !owering blood pressure. The blood pressure lowering is usually seen with 2 weeks of starting on treatment. When aliskiren treatment is stopped, blood pressure gradually rises to pre-treatment levels. Only about 21/2% of any dose is absorbed into the blood and it takes about a week to reach a steady level in the blood. Most of the drug that is absorbed is broken down in the liver. The rest passes out of the body unchanged in the urine. Aliskiren may be used alone or with other hypertensives, however its use with maximum doses of an ACE inhibitor has not been adequately studied.
Cautions and Warnings
Do not take aliskiren if you are allergic or sensitive to any of its ingredients.
Angioedema swelling of the face, hands or feet, tongue, or throat can occur at any time during aliskiren treatment. If this happens, stop taking the medicine and go to your doctor’s office or a hospital emergency room for treatment. This reaction can interfere with your breathing.
The safety of aliskiren in people with moderate to severe kidney disease is not known.
The combination of aliskiren and an ACE inhibitor can lead to high blood levels of potassium.
Aliskiren may be less effective in some black patients with high blood pressure, especially when dietary salt intake is high. Nevertheless, it should still be considered a useful blood pressure treatment.
Possible Side Effects
✓ Common: nausea, dizziness, and sleeplessness.
✓ Less common: diarrhea, abdominal pain, upset stomach, GERD, cough, rash high blood uric acid levels, gout, kidney stones, headache, nose and throat irritation, fatigue, upper respiratory infection, and back pain.
✓ Rare: difficulty breathing; swelling of the hands, face, eyes, or whole body; and seizures. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Mixing aliskiren with irbesartan can reduce the amount of aliskiren into the blood by 50%. This may reduce the effectiveness of aliskiren.
• Aliskiren has been studied together with both hydrochlorothiazide and valsartan and can be combined with them in blood pressure management. It has been used with amlodipine but may not be better than high dose amlodipine alone.
• Aliskiren’s interaction with ACE inhibitors is not yet fully known.
• Atorvastatin and ketoconazole slow the breakdown of aliskiren, resulting in an increase of aliskiren blood levels by 50% or more. Dosage adjustment may be necessary.
Aliskiren can reduce blood levels of the diuretic furosemide, reducing the diuretic’s effect.
Food Interactions
Aliskiren can be taken without regard to food or meals. Avoid taking it with high fat meals because they can drastically reduce the amount of aliskiren absorbed into the blood.
Usual Dose
Adult (age 18 and over)
Tekturna: 50-300 mg at the same time every day. Tekturna HCT. 1 tablet a day.
Child: not recommended. Overdosage
The most likely symptom of overdose is low blood pressure (symptoms include dizziness and fainting). If you think you have taken an overdose, call your doctor or go to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor at once if you develop swelling of the face, eyes, lips, tongue, or throat; difficulty swallowing or breathing; hoarseness; or other signs of a drug reaction or allergy.
If you forget a dose, take it as soon as you remember. If you do not remember until it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Aliskiren can injure or kill a developing fetus. Pregnant women should not take aliskiren. Women who suspect they are pregnant must call their doctor at once and stop taking aliskiren when pregnancy is confirmed. In those rare cases where aliskiren is considered life-saving for the mother and there is no substitute for aliskiren, your doctor may advise that you continue on the medicine and then check your baby’s development with periodic ultrasound examinations.
It is not known if this drug passes into breast milk. Nursing mothers should use infant formula.
Seniors: Seniors may have higher blood levels of aliskiren and be more susceptible to drug side effects, but starting dose adjustment is not required.
Jul
16
Aldosterone Blockers
July 16, 2009 | Leave a Comment
Type of Drug
Aldosterone Blockers (al-DOH-stir-own)
Brand Names
Generic Ingredient: Eplerenone Inspra
Generic Ingredient. Spironolactone Aldactone
Combination Product
Generic Ingredients: Hydrochlorothiazide + Spironolactone Aldactazide
Prescribed For
High blood pressure, cirrhosis, and congestive heart failure (CHF); also used for people with low blood potassium who require a diuretic.
General Information
Aldosterone blockers limit the access of aldosterone—a hormone that helps to regulate several different body functions—from its receptor. Too much aldosterone results in high sodium levels, which can lead to water retention and potassium loss; it can also affect the size, shape, and function of the heart. Aldosterone blockers are generally combined with other medicines in the management of disease. These drugs are useful in removing excess body fluids in conditions associated with high aldosterone levels.
One in every ten people with high blood pressure has excess aldosterone in their systems. In people with congestive heart failure (CHF), aldosterone levels can be 20 times higher than normal, which can worsen their condition, making the use of aldosterone blockers an important part of their treatment. Aldosterone block-ers also help the heart return to normal size, shape, and function in people with heart failure. Eplerenone is broken down in the liver, primarily by an enzyme system known as CYP3A4.
Cautions and Warnings
Do not take aldosterone blockers if you are allergic or sensitive to any of their ingredients.
Do not use aldosterone blockers if you have kidney failure or high blood potassium.
People with liver disease should be cautious about using a!- dosterone blockers.
People taking an aldosterone blocker should have their potassium levels checked periodically.
People with diabetes who have albumin in their urine should not take aldosterone blockers.
Possible Side Effects
Eplerenone
✓ Less common: dizziness, diarrhea, fatigue, flu-like symptoms, coughing, abdominal pain, elevation of blood cholesterol and/or triglyceride levels, elevation of blood potassium levels, and albumin in the urine.
✓ Rare: enlargement of the breasts in males, irregular menstrual cycles in women, and painful breasts. Contact your doctor if you experience any side effect not listed above.
Spironolactone
✓ Less common: drowsiness, lethargy, headache, gastrointestinal upset, cramps and diarrhea, rash, mental confusion, fever, feeling unwell, enlargement of the breasts in males, impotence, and irregular menstrual cycles or deepening of the voice in women.
Drug Interactions
• Do not combine eplerenone with itraconazole or ketoconazole. These drugs can cause the amount of eplerenone in the blood to increase by up to 500% and may cause fatal increases in blood potassium.
• Mixing eplerenone with erythromycin, fluconazole, saquinavir, or verapamil increases the amount of eplerenone in the blood. People taking this combination must watch for signs of high blood potassium (see “Special Information”) and have their blood potassium levels checked regularly.
• Combining a potassium supplement and an aldosterone blocker can lead to dangerously high blood levels of potassium. Do not use a salt-substitute or take any extra potassium unless prescribed by your doctor.
• Combining an aldosterone blocker with an ACE inhibitor or an angiotensin H receptor blocker (ARB) may significantly raise blood potassium. Be sure your doctor monitors your potassium levels if you combine these drugs.
• Spironolactone may interfere with anticoagulant (blood-thinning) drugs and mitotane (an anticancer drug).
• Aspirin can interfere with the diuretic effect of spironolactone but does not alter its effect on high blood pressure or CHF.
• Combining spironolactone with alcohol, barbiturates, or narcotics can lead to dizziness or fainting when rising suddenly from a sitting or lying position.
• Combining spironolactone and a corticosteroid can lead to very low blood potassium.
• Spironolactone may alter your response to drugs used during general anesthesia.
• Lithium generally should not be combined with any diuretic.
• Combining nonsteroidal anti-inflammatory drugs (NSAIDs) with aldosterone blockers can lead to severe elevations of blood potassium and reduce the blood-pressure-lowering effect of the diuretic.
• Spironolactone may raise digoxin blood levels and increase the risk of severe digoxin side effects. Your doctor may have to adjust your digoxin dosage.
• St. John’s wort (a CYP3A4 inducer) may decrease eplerenone levels by about 30%.
Food Interactions
Food appears to increase the amount of spironolactone absorbed into the blood. Take this drug with food at the same time every day. Eplerenone may be taken without regard to food or meals. Taking this drug with grapefruit juice increases the amount of drug absorbed into your body.
Usual Dose
Eplerenone
Adult 50-100 mg a day. Child: not recommended.
Spironolactone
Adult: Starting dosage is 50-100 mg a day in divided doses for high blood pressure; 25-200 mg a day in divided doses for high fluid levels related to other diseases; and 25-100 mg a day for low potassium levels related to diuretic use.
Child: 1-2 mg per lb. of body weight a day.
Spironolactone + Hydrochlorothiazide Adult: 1-4 tablets daily.
Overdosage
Eplerencne overdose may lead to low blood pressure and high blood potassium. Spironolactone overdose may lead to drowsiness. confusion, rash, nausea, vomiting, dizziness, and diarrhea. Rarely. coma may occur in people with severe liver disease. High blood potassium may also occur, especially in people with kidney zsease. Call your local poison control center or a hospital emercency room for more information. If you seek treatment, ALWAYS oring the prescription bottle or container.
Special Information
<e a c!osterone blockers exactly as they are prescribed.
High blood levels of potassium associated with aldosterone blockers may cause weakness, lethargy, drowsiness, muscle pain or cramps, and muscular fatigue. Use caution while doing anything that requires intense concentration, like driving or operating machinery.
Do not use a salt substitute or take anything else that is a source of extra potassium, including many multivitamin or supplement products.
People with high blood pressure should not self-medicate with over-the-counter cough, cold, or allergy remedies containing stimulants. These drugs can raise blood pressure effectiveness and have an adverse effect on the heart.
!f 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 with eplerenone showed no effects on a developing fetus. Spironolactone crosses into the fetal circulation. When your doctor considers either of these drugs crucial, their potential benefits must be carefully weighed against their risks.
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.
Jul
16
Adapalene
July 16, 2009 | Leave a Comment
Generic Name
Adapalene (uh-DAP-uh-lene)
Brand Name Differin
Type of Drug Anti-acne.
Prescribed For Acne.
General Information
Adapalene is similar to a retinoid. Retinoids are compounds related to vitamin A and are used in acne treatment. When adapalene is applied to an acne lesion, it modifies several of the processes involved in skin cell function. It reduces inflammation in the acne lesion and slows the formation of the material that fills the lesion. Very little adapalene is absorbed through the skin.
Cautions and Warnings
Do not use adapalene if you are allergic or sensitive to any of its ingredients. If you are sunburned, wait until your sunburn clears before applying adapalene to your skin. Avoid sun or sunlamp exposure while using adapalene. If you must be in the sun, be sure to apply sunscreen or wear protective clothing over areas where you have applied adapalene. Extreme wind or cold can also be irritating to skin where adapalene has been applied.
Adapalene can irritate the skin if used in combination with products such as medicated or abrasive soaps or cleansers, astringents, or soaps and cosmetics with a strong drying effect. Avoid products containing sulfur, resorcinol, or salicylic acid.
Adapalene can be highly irritating if it gets into your eyes or if it is applied to your lips, the angles of your nose, mucous membranes, cuts, abrasions, or sunburned or damaged skin. Avoid using depilatories or waxing while using adapalene.
Possible Side Effects
V Most common: redness, irritation, dryness, scaling, itching, and burning are common after applying adapalene to your skin. These effects usually occur during the first 24 weeks of adapalene use and subside as treatment continues. Symptoms may be severe enough to cause you to stop using adapalene; call your doctor if this happens to you.
V Rare: skin irritation, stinging sunburn, and worsening acne. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
None known.
Usual Dose
Adult and Child (age 12 and over): Wash affected areas with a mild or soapless cleanser and apply a thin layer of adapalene at bedtime.
Child (under age 12): not recommended.
Overdosage
Chronic ingestion of adapalene can cause liver toxicity and other side effects associated with swallowing large amounts of vitamin A. Swallowing adapalene gel is extremely dangerous for pregnant women, who should not take more vitamin A than is contained in their prenatal vitamins. Infants who swallow adapalene should be taken to a hospital emergency room for treatment.
Special Information
Stop using adapalene and call your doctor if you develop a severe skin reaction or any sign of drug allergy or reaction (symptoms include rash, hives, itching, changes in complexion, and breathing difficulties or irregularities).
Adapalene may exacerbate your acne at first, but you should see improvement within 2 weeks.
If you must be in the sun, be sure to apply sunscreen or wear protective clothing over areas to which you have applied adapalene.
Using more than a thin film of adapalene does not produce better results and may be more irritating to the skin.
If you forget to apply a dose of adapalene, apply it as soon as you remember. If it is almost time for your next application of adapalene, skip the dose you forgot and continue with your regular schedule.
Special Populations
PregnancylBreast-feeding., Animal studies of adapalene have shown no effects on the fetus. Since the effect of adapalene on pregnant women is not known, the drug should be used only when the possible benefits outweigh the risks.
It is not known if adapalene passes into breast milk. Nursing mothers should use infant formula.
Seniors: Seniors may use this drug without special precautions.