Generic Name
Flecainide (FLEH-kan-ide) E
Brand Name Tambocor
Type of Drug  Antiarrhythmic.
Prescribed For
Abnormal heart rhythm. General Information
Flecainide is prescribed in situations where the abnormal heart rhythm is so severe as to be life-threatening and the patient does not respond to other drug treatments. Like other antiarrhythmic drugs, flecainide works by affecting the movement of nervous impulses within the heart. Flecainide’s effects may not become apparent for 3-4 days after you start taking it.
Cautions and Warnings
Do not take flecainide if you are allergic or sensitive to any of its ingredients or if you have heart block, unless you have a cardiac pacemaker. As with other antiarrhythmic drugs, there is no proof that flecainide helps people live longer or avoid sudden death.
Flecainide causes or worsens arrhythmias m 7% 0 people who take it; this, tks’ , imTeases with certain kinds of underlying heart disease and higher doses of the drug. Flecainide causes or worsens heart failure in about 5% of people taking it because it tends to reduce the force and rate of each heartbeat.
Flecainide is extensively broken down in the liver. People with poor liver function should not take flecainide unless the benefits clearly outweigh the risks.
Changes in the pH of urine may affect the effectiveness of flecainide.
Possible Side Effects
♦    Most common: dizziness, fainting, lightheadedness, unsteadiness, visual disturbances including blurred vision and seeing spots before the eyes, breathing difficulties, headache, nausea, fatigue, heart palpitations, chest pain, tremors, weakness, constipation, bloating, a bad taste in your mouth, and abdominal pain.
♦    Less common: new or worsened heart arrhythmias or heart failure, heart block, slowed heart rate, vomiting, diarrhea, upset stomach, loss of appetite, stomach gas, dry mouth, tingling in the hands or feet, partial or temporary paralysis, loss of muscle control, flushing, sweating, ringing or buzzing in the ears, anxiety, sleeplessness, depression, not feeling well, twitching, weakness, convulsions, speech disorders, stupor, memory loss, personality loss, nightmares, apathy, eye pain, unusual sensitivity to bright light, sagging eyelids, reduced white-blood-cell or blood-platelet counts, impotence, reduced sex drive, frequent urination, urinary difficulty, itching, rash, fever, muscle ache, closing of the throat, and swollen lips, tongue, or mouth.
Drug Interactions
•    The combination of propranolol and flecainide may cause an exaggerated lowering in heart rate. Other drugs that slow the heart may also interact with flecainide to produce an excessive slowing of heart rate.
•    Avoid megadoses of vitamin C while taking this drug.
•    The amount of flecainide in your blood and its effect on your heart may be increased if it is taken together with cimetidine, disopyramide, or verapamil.
•    YQW dXSz, 0 ‘i’lecainide should be halved when given with amiodarone.
•    Smokers may need a larger dose of flecainide than nonsmokers.
•    Flecainide may increase the amount of digoxin in the bloodstream, increasing the chance of side effects.
Food Interactions
A strict vegetarian diet and anything that makes urine less acid interferes with flecainide’s elimination from the body, increasing drug
toxicity. Usual Dose
Adult: starting dose-50-100 mg every 12 hours. Maximum dosage is 400 mg a day.
Child (under 18 years): not recommended.
Overdosage
Flecainide overdose affects heart function, causing slower heart rate, low blood pressure, and possible death from respiratory failure. Victims of flecainide overdose should be taken.to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Flecainide can make you dizzy, lightheaded, or disoriented. Take care while driving or performing complex tasks.
Call your doctor if you develop chest pains, an abnormal heartbeat, breathing difficulties, bloating in your feet or legs, tremors, fever, chills, sore throat, unusual bleeding or bruising, yellowing of the whites of your eyes, or any other intolerable side effect.
If you forget to take a dose of flecainide and remember within 6 hours, take it as soon as possible. If you do not remember until later, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: At high doses, flecainide damages an animal fetus. When this drug is considered crucial by your doctor, its potential benefits must be weighed against its risks.
Flecainide passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors with reduced kidney or liver functkcm -aye more likely to develop si(je, eip,,ZkS and require a lower dosage.

Generic Name
Flucytosine (floo-SYE-toe-sene)
Brand Name Ancobon
Type of Drug  Antifungal.
Prescribed For
Serious blood-borne fungal infections.
General Information
Flucytosine is meant for fungal infections—Candida, chromomycoses, and cryptococcus—carried in the blood that affect the urinary tract, respiratory tract, central nervous system, heart, and other organs. It is not meant for fungal infections of the skin, such as common athlete’s foot.
Cautions and Warnings
Do not take this drug if you are allergic or sensitive to any of its ingredients.
People with kidney disease must be closely monitored by their doctors and should take this medication with extreme caution; daily dosage must be reduced.
Flucytosine can worsen bone-marrow depression in people whose itnR1US1Q Systems are already compromised. Liver and kidney function and blood composition should be monitored while you are taking this drug.
The safety and efficacy of flucytosine have not been established in children.
Possible Side Effects
V Most common: unusual tiredness or weakness, liver inflammation, yellowing of the eyes or skin, abdominal pain, diarrhea, loss of appetite, nausea, vomiting, rash, redness, itching, sore throat, fever, and unusual bleeding or bruising.
V Less common: chest pains, breathing difficulties, sensitivity to the sun or bright light, dry mouth, duodenal ulcers, severe bowel irritation, stomach bleeding, interference with kidney function, kidney failure, reduced red- and whiteblood-cell counts or other changes in blood composition, headache, hearing loss, confusion, dizziness, weakness, shaking, sedation, psychosis, hallucinations, heart attack, and low blood-sugar and potassium levels.
Drug Interactions
•    Amphotericin B increases flucytosine’s effectiveness: this
combination is generally used to produce better results.
•    Flucytosine may interfere with some routine blood tests.
•    Cytosine may inactivate the antifungal activity of flucytosine.
Food Interactions
Take flucytosine with food if it upsets your stomach.
Usual Dose
22-66 mg per lb. a day, in divided doses.
Overdosage
Little is known about the effects of flucytosine overdose, but it may cause exaggerated drug side effects. If you seek treatment at a hospital, ALWAYS bring the prescription bottle or container.
Special Information
Take the capsules a few at a time over 15 minutes to avoid nausea and vomiting.
Call your doctor if you develop unusual tiredness or weakness; yellowing of the skin or whites of the eyes; rash, redness, or itching; so(Q %Toal or fever; unusual bleeding or bruising; or any persistent or intolerable side effect.
Maintain good dental hygiene while taking flucytosine. Use extra care when using your toothbrush or dental floss because of the risk that flucytosine will make you more susceptible to infection. Dental work should be completed prior to starting on this drug.
FLUOROQUINOLONE ANTI-INFECTIVES
Exposure to sunlight may cause rash, itching, redness, discoloration of the skin, or severe sunburn. Stay out of direct sunlight when taking flucytosine.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, take 1 dose right away and another in 3 or 4 hours, then go back to your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Flucytosine causes birth defects in animals and crosses the placenta. Flucytosine should be used by pregnant women only when its potential benefits clearly outweigh its risks.
It is not known if flucytosine passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Dosage adjustment may be required due to age-related loss of kidney function.

Type of Drug
Fluoroquinolone Anti-Infectives
(flor-oe-OUIN-oc-lone)
Brand Names
Generic Ingredient: CiproftoxacinIGI
Ciloxan Eyedrops    Cipro XR
Cipro    Proquin XR
Generic Ingredient: Gatifloxacin Zymar Eyedrops
Generic Ingredient: Gemifloxacin Factive
Generic Ingredient: Levofloxacin A
Iquix Eyedrops    QtAy’ ” Eyedrops
LevackujR
Generic Ingredient: Lomefloxacin Maxaquin
Generic Ingredient: Moxifloxacin
Avelox    Vigamox Eyedrops
Generic Ingredient: Norfloxacin
Noroxin
Generic Ingredient: Ofloxacin 92
Floxin    Ocuflox Eyedrops
Floxin Otic
Prescribed For
Infections of the lower respiratory system, sinuses, urinary tract, skin, bone and joints, lungs, and prostate; also prescribed for sexually transmitted diseases, prostatitis, infectious diarrhea, bronchitis, pneumonia, typhoid fever, anthrax, and traveler’s diarrhea. The eyedrops are used to treat ocular infections, the eardrops for ear infections.
General Information
Fluoroquinolone anti-infectives work against many organisms that traditional antibiotics have trouble killing. They do not work against the common cold, flu, or other viral infections. The fluoroquinolones were first used as treatment for urinary infections and then other uses developed over the years. The new uses depend on how well the specific drug penetrates different body tissues as well as on how they have been tested in the laboratory. Individual fluoroquinolones are not all equally effective in treating all infections.
Cautions and Warnings
Do not take a fluoroquinolone if you are allergic or sensitive to any of its ingredients, or to any drug in this group, or have had a reaction to related medications such as nalidixic acid. Severe, possibly fatal, allergic reactions can occur even after the very first dose. These reactions include cardiovascular collapse, loss of consciousness, tingling, swelling of the face or throat, breathing difficulties, itching, and rash. Stop taking the drug if you experience allergic symptoms and seek medical help at once.
Fluoroquinolones may cause increased pressure on parts of the brain, leading to convulsions and psychotic reactions. Other possiblp. tIWA include tremors, restlessness, lightheadedness, confusion, and hallucinations. Fluoroquinolones should be used with caution in people with head trauma, seizure disorders, or other nervous system conditions.
Moxifloxacin should not be used by people with liver disease.
Moxifloxacin should be avoided by people with heart rhythm problems or those taking drugs that can affect heart rhythm.
People with kidney disease require reduced dosage of these drugs, except in the case of moxifloxacin.
People taking fluoroquinolones may be unusually sensitive to the sun. Avoid the sun while taking this drug and for several days following therapy, even if you are using sunscreen.
People taking a fluoroquinolone may develop colitis that could range from mild to very serious. Contact your doctor if you develop diarrhea or cramps.
Fluroquinolones can worsen myasthenia gravis. Use with caution.
Prolonged fluoroquinolone use can lead to fungal overgrowth.
Patients taking a fluoroquinolone may experience ruptures of the shoulder, hand, Achilles tendon, or other tendons that may require surgery or lead to extended disability.
Possible Side Effects
Side effects are rarely serious.
♦    Common: nausea (most likely with ciprofloxacin and moxifloxacin), vomiting, and diarrhea (may be most likely with moxifloxacin and ofloxacin).
✓    Less common: dizziness, abdominal pain, headache, and liver inflammation.
✓    Rare: Rare side effects, including some severe drug reactions, can occur in almost any part of the body. In once-daily studies of ciprofloxacin eardrops, there were a few reports of nausea, formation of flaky scales, inflammation of the external ear, temporary hearing loss, ringing or buzzing in the ears, middle-ear inflammation, tremors, high blood pressure, and fungal infection. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Separate your fluoroquinolone dose from that of antacids, didanosine, iron supplements, or zinc by 2-6 hours. These drugs decrease the amount of fluoroquinolone absorbed. Moxifloxacin must be taken 4 hours before or 8 hours after antacids, iron, or zinc.
•    Nitrofurantoin may antogonize norfloxacin’s antibacterial effects. Do not take these drugs together.
•    Moxifloxacin can increase the risk of abnormal heart rhythms.
Combining this drug with astemizole, erythromycin, tricyclic
antidepressants, and antipsychotics increases the risk of ab-
normal heart rhythms associated with this drug.
•    People taking drugs to correct abnormal heart rhythms should avoid Fluoroquinolones.
•    Nonsteroidal anti-inflammatory drugs (NSAIDs) and anti-inflammatory drugs should not be combined with fluoroquinolones because of the increased risk of stimulation and seizures.
•    Sucralafate reduces the amount of fluoroquinolone absorbed in the blood. Take sucralafate at least 6 hours after taking a fluoroquinolone.
•    Probenecid may increase the risk of some fluoroquinolone side effects. Cimetidine may also increase fluoroquinolone blood levels.
•    Fluoroquinolones (except moxifloxacin) may increase the effect of oral anticoagulant drugs such as warfarin. Your anticoagulant dosage may have to be reduced.
•    Fluoroquinolones may increase the toxic effects of cy-
closporine (used for organ transplants) on your kidneys.
•    Fluoroquinolones (except moxifloxacin) may increase theophylline blood levels and the risk of side effects.
•    Azlocillin may increase the risk of ciprofloxacin side effects.
•    Ciprofloxacin and norfloxacin may increase caffeine’s effects.
Food Interactions
Levofloxacin, lomefloxacin, and moxifloxacin may be taken with or without food. Take ofloxacin and norfloxacin at least 2 hours before or 2 hours after meals or antacids. Ciprofloxacin is best taken 1 hour before or 2 hours after meals, but may be taken with food. Dairy products and calcium-fortified orange juice interfere with the absorption of ciprofloxacin and should be avoided.
Usual Dose
Check with your doctor if you suffer from kidney failure as your fluoroquinolone dosage may need to be reduced.
Tablets
Adult
Ciprofloxacin: 100-750 mg twice a day. Ciprofloxacin XR: 1000 mg once a day.
Gemifloxacin: 320 mg once a day. Levotioxacin: 250-750 mg once a day.
Lomefloxacin: 400 mg a day. Moxifloxacin: 400 mg a day.
Norfloxacin: 400 mg every 12 hours; a single dose of 800 mg
may be taken for gonorrhea. Ofloxacin: 200-400 mg every 12 hours.
Child: not recommended.
Eyedrops
Ciprolloxacin: 1-2 drops in the affected eye several times a day.
Gatifloxacin: days 1-2-2 drops in the affected eye every 2 hours while awake, up to 8 times a day, then 4 times a day for the next 5 days.
Levofloxacin: days 1-2-1-2 drops in the affected eye every 2 hours while awake, up to 8 times a day. Days 3-7-1-2 drops in the affected eye every 4 hours while awake, up to 4 times a day.
Moxifloxacin: 1 drop in the affected eye 3 times a day for I week.
Ofloxacin: bacterial conjunctivitis—days 1-2, place 1-2 drops in the affected eye every 2-4 hours while awake; days 3-7, place 1-2 drops in the affected eye every 4-6 hours while awake. Bacterial corneal ulcer—days 1-2, place 1-2 drops in the affected eye every 30 minutes while awake; awaken 4-6 hours after you go to sleep for one more dose; days 3-7 or 9, place 1-2 drops in the affected eye every hour while awake; days 7-9, or through the end of treatment, place 1-2 drops in the affected eye 4 times a day.
Eardrops
Ofloxacin: 5-10 drops in the affected ear twice a day.
Overdosage
Overdose symptoms generally mimic drug side effects. Overdose may cause kidney failure and, in the case of moxifloxacin, abnormal heart rhythms. Call your local poison control center or a hospital emergency room for more information. You may be, koNO to induce vomiting with ipecac syrup—available at any pharmacybefQ(e, %’Kmg the victim to an emergency room. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Take each dose with a full glass of water. Be sure to drink at least 8 glasses of water a day while taking any of these drugs to help avoid kidney side effects.
Drug sensitivity reactions can develop even after only 1 dose. Stop taking the drug and get immediate medical attention if you feel faint or develop itching, rash, facial swelling, breathing difficulties, convulsions, depression, visual disturbances, dizziness, headache, lightheadedness, or any sign of a drug reaction.
Colitis can be caused by any anti-infective medication. If diarrhea develops, call your doctor at once.
Avoid excessive sunlight. Call your doctor if you become sensitive to the sun.
Call your doctor if you experience pain, inflammation, or rupture of a tendon.
Follow your doctor’s directions exactly. Complete the full course of drug therapy, even if you feel well.
Eyedrops
To avoid infection, do not let the eyedropper tip touch your finger, eyelid, or any surface. Wait 5 minutes before using another eye-drop or eye ointment.
Call your doctor at once if your vision declines or if eye stinging, itching or burning, redness, irritation, swelling, or pain worsens.
Fluoroquinolones can cause changes in vision, dizziness, drowsiness, and lightheadedness. Be careful when driving or performing any task that requires concentration.
If you forget to administer a dose, do so as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Animal studies have shown that fluoroquinolones may damage the fetus or reduce the likelihood of a successful pregnancy. When a fluoroquinolone is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Fluoroquinolones pass into breast milk. Nursing mothers who must take them should use infant formula.
Seniors: With the exception of moxifloxacin, seniors may require reduced dosage due to age-related decreases in kidney function. The risk of a ruptured tendon may increase in seniors, especially those taking a corticosteroid. In the case of eyedrops, seniors may also need less medication.

Generic Name
Fluoxymesterone (flue-OX-ee-MES-ter-one)
Brand Name Halotestin
Type of Drug
Androgen (male hormone).
Prescribed For
Men: hormone replacement or augmentation and male menopause; also prescribed as male contraception for up to 12 months, and for delayed puberty.
Women: breast pain and fullness in women who have given birth, and certain types of breast cancer.
General Information
Fluoxymesterone is an androgen. Androgens are responsible for the normal growth and development of male sex organs and for maintaining secondary sex characteristics including hair distribution, vocal cord thickening, muscle development, and fat distribution.
Cautions and Warnings
Do not use fluoxymesterone if you are allergic or sensitive to any of its ingredients.
Androgens do not improve athletic performance and may cause serious side effects.
Women taking any androgen may develop deepening of the voice, oily skin, acne, hairiness, increased sex drive, and menstrual irregularities.
Androgens should be avoided if possible by young boys who have not gone through puberty.
Fluoxymesterone W(1C1.ens gynecomastia (a condition characterized by swollen male breast tissue).
Men with unusually high blood levels of calcium, known or suspected prostate cancer or prostate destruction, or breast cancer should not use fluoxymesterone, nor should anyone with severe liver, heart, or kidney disease.
Long-term, high-dose androgen therapy may cause severe liver disease, including hepatitis and cancer, reduced sperm count, and
water retention.
Blood cholesterol may be raised by androgens. This can be a
problem for people who have heart disease.
Androgens may cause or worsen sleep apnea (a condition char-
acterized by intermittent cessation of breathing during sleep). For patients with diabetes, this drug may affect blood sugar
levels.
Possible Side Effects
Men
✓    Most common: inhibition of testicle function, impotence, chronic erection, and painful enlargement of breast tissue.
Women
✓    Most common: unusual hairiness, male-pattern baldness. deepening of the voice, and enlargement of the clitoris. These changes are usually irreversible once they occur. Increased blood calcium and menstrual irregularities may also develop.
Men and Women
✓    Most common: changes in sex drive, headache, anxiety, depression, a tingling feeling, sleep apnea, flushing, rash, acne, habituation (the drug may be habit-forming), excitation, chills, sleeplessness, water retention, nausea, vomiting, diarrhea, hepatitis (symptoms include yellowing of the skin or whites of the eyes), liver inflammation, and liver cancer. Symptoms resembling those of a stomach ulcer may also develop.
Drug Interactions
•    Fluoxymesterone may increase the effect of an oral anticoagulant (blood-thinner); dosage 131 the anticoagulant may have tD be reduced.
•    Combining an androgen and imipramine or another tricyclic
antidepressant may result in a severe paranoid reaction.
•    Androgens may decrease insulin requirements.
Food Interactions
Take fluoxymesterone with meals if it upsets your stomach.
Usual Dose
Adult; 5-40 mg a day. Child: not recommended.
Overdosage
Symptoms include nausea, vomiting, and diarrhea. Call your local poison control center or a hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Androgens must be taken only under the close supervision of your doctor. The dosage and clinical effects of fluoxymesterone vary widely and require constant monitoring.
Call your doctor if you develop nausea or vomiting, swelling of the legs or feet, yellowing of the skin or whites of the eyes, or a painful or persistent erection. Women should call their doctors immediately if they develop a deep or hoarse voice, acne, hairiness, male-pattern baldness, or menstrual irregularities.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations_    Fluoxymesterone should never be
taken by pregnant or nursing women because it can affect the developing fetus and nursing infant.
Seniors: Seniors are more likely to develop prostate enlargement or prostate cancer. A marked increase in sex drive may also occur.

Generic Name
Flurazepam (110-13AZ-uh-pam) A
Brand Name
Dalmane
Type of Drug  Benzodiazepine sedative.
Prescribed For
Insomnia and sleep disturbances.
General Information
Flurazepam is a member of the group of drugs known as benzodiazepines. Benzodiazepines work by a direct effect on the brain. They make it easier to go to sleep and decrease the number of times you wake up during the night. Flurazepam and quazepam remain in your bloodstream longer than other drugs in this class, thus resulting in the greatest incidence of morning “hangover.”
Cautions and Warnings
Do not use flurazepam if you are allergic or sensitive to any of its ingredients.
People with kidney or liver disease should be carefully monitored while taking flurazepam. Take the lowest possible dose to help you sleep.
People with respiratory disease may experience sleep apnea (intermittent cessation of breathing during sleep) while taking flurazepam.
Clinical depression may be increased by flurazepam, which can depress the nervous system. Intentional overdose is more common among depressed people who take sleeping pills than among those who do not.
Some people have experienced amnesia while taking flurazepam.
All benzodiazepines can be addictive if taken for long periods of time and can cause drug withdrawal symptoms if discontinued suddenly. It should be used with caution in people with a history of drug dependence. Withdrawal symptoms include tremors, muscle cramps, insomnia, agitation, diarrhea, vomiting, sweating, and convulsions.
Tapering the drug when stopping may help prevent withdrawal symptoms. People with a history of seizures should be particuarly cautious when stopping use of this drug.
Possible Side Effects
V Common: drowsiness, headache, dizziness, talkativeness, nervousness, appip-henslon, poor muscle coordination, lightheadedness, daytime tiredness, muscle weakness, slowness of movement, hangover, and euphoria (feeling “high”).
V Less common: nausea, vomiting, rapid heartbeat, confusion, temporary memory loss, upset stomach, stomach cramps and pain, depression, blurred or double vision and Possible Side Effects (continued)
other visual disturbances, constipation, changes in sense of taste, appetite changes, stuffy nose, nosebleeds, common cold symptoms, asthma, sore throat, cough, breathing difficulties, diarrhea, dry mouth, allergic reaction, fainting, abnormal heart rhythm, itching, rash, acne, dry skin, sensitivity to the sun, nightmares or strange dreams, sleeplessness, tingling in the hands or feet, ringing or buzzing in the ears, ear or eye pain, menstrual cramps, frequent urination and other urinary difficulties, blood in the urine, discharge from the penis or vagina, lower back and other pain, muscle spasms and pain, fever, swollen breasts, and weight changes.
♦ Rare: Rare side effects can affect your heart, stomach and intestines, urinary tract, blood, muscles, and joints. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    As with all benzodiazepines, the effects of flurazepam are enhanced if it is taken with an alcoholic beverage, antihistamine, sedative, barbiturate, anticonvulsant medication, antidepressant, or monoamine oxidase inhibitor antidepressant.
•    Contraceptive drugs, cimetidine, disulfiram, and isoniazid may increase the effect of flurazepam by reducing the drug’s breakdown in the liver. Probenecid also increases flurazepam’s effects.
•    Cigarette smoking, rifampin, and theophylline may reduce the effect of flurazepam on your body by increasing the rate at which it is broken down by the liver.
•    Levodopa + carbidopa’s effectiveness may be decreased by flurazepam.
•    Flurazepam may increase the amount of zidaw-adwie tan HIV drug—also known as pnenytoin, or digoxin in your WZWMTeam, increasing the chances of side effects.
•    Mixing clozapine with a benzodiazepine has led to respiratory collapse in a few people. Flurazepam should be stopped at least 1 week before starting clozapine treatment.
Food Interactions
Flurazepam may be taken with food if it upsets your stomach.
Usual Dose
Adult and Child (age 15 and over): 15-30 mg at bedtime. Dosage must be individualized for maximum benefit.
Senior: starting dose-15 mg at bedtime.
Child (under age 15): not recommended.
Overdosage
The most common overdose symptoms are confusion, sleepiness, depression, loss of muscle coordination, and slurred speech. Coma may also occur. Patients who overdose on this drug must be made to vomit with ipecac syrup—available at any pharmacy—to remove any remaining drug from the stomach. Call your doctor or a poison control center before doing this. If 30 minutes have passed since the overdose was taken or if symptoms have begun to develop, take the victim immediately to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Never take more flurazepam than your doctor has prescribed. Avoid alcoholic beverages and other nervous system depressants while taking tlurazepam.
Exercise caution while performing tasks that require concentration and coordination. Flurazepam may make you tired, dizzy, or lightheaded.
If you take flurazepam daily for 3 or more weeks, you may experience some withdrawal symptoms when you stop taking the drug. Do not stop taking flurazepam suddenly or increase or decrease your dosage without first consulting your doctor.
If you forget a dose and remember within 1 hour, take it as soon as you remember. If you do not remember until later, skip the dose you forgot and go back to your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Flurazepam absolutely should not be used by pregnaskt. v3 )men or by women who may become pregnant.
Flurazepam passes into breast milk. The drug should not be taken by nursing mothers.
Seniors: Seniors are more susceptible to the effects of flurazepam.

Generic Name
Flutamide (FLUE-tuh-mide)
Type of Drug Antiandrogen.
Prescribed For
Prostate cancer and excessive hairiness in women.
General Information
Prostatic cancer is sensitive to anything that removes the source of androgen (male hormone). Flutamide works by slowing the uptake of androgen or by interfering with the binding of androgen to body tissues. It is always prescribed together with a luteinizing hormone-releasing hormone (LHRH) drug.
Cautions and Warnings
Do not take flutamide if you are allergic or sensitive to any of its ingredients.
Severe liver injury may occur with flutamide; your doctor should monitor your liver function. People with severe liver disease should not take flutamide.
This drug may cause jaundice and severe blood conditions, including hemolytic anemia. People with certain blood disorders and people who smoke are at greater risk for these side effects.
A few men taking this drug have developed breast cancer. Flutamide may reduce sperm counts.
Possible Side Effects
♦    Most common: diarrhea, cystitis, and bleeding from the rectum.
✓    Common: rectal irritation, blood in the urine, hot flashes, loss of libido, impotence, nausea, rash, and swollen breasts.
✓    Less common’. drowsiness, confusion, depression, anxiety, nervousness, appetite loss, stomach problems, anemia, low white-blood-cell and blood-platelet counts, arm or leg swelling, urinary and muscle problems, and high blood pressure.
Possible Side Effects (continued)
♦ Rare: hepatitis, jaundice, and breathing difficulties. Contact your doctor if you experience any side effect not listed
above.
Drug Interactions
• Flutamide may increase the effects of blood-thinning drugs
such as warfarin. Dosage adjustment may be necessary.
Food Interactions  None known.
Usual Dose
Adult: 250 mg (2 capsules) every 8 hours, 3 times a day. Total daily dose should be 750 mg.
Child: not recommended.
Overdosage
Overdose symptoms may include tiredness or low activity levels, slow breathing, weakness, tearing, appetite loss, vomiting, swollen and tender breasts, and liver inflammation. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Report anything unusual to your doctor, especially pain or tenderness in the upper right abdomen, yellowing of the skin or whites of the eyes, severe itching, dark urine, persistent appetite loss, and unexplained flu-like symptoms. These may be signs of severe liver toxicity.
Flutamide can turn your urine amber or yellow-green and cause unusual sun sensitivity. Use sunscreen and wear long-sleeved protective clothing while you are taking flutamide.
Flutamide must be taken exactly as prescribed. Call your doctor if you miss a dose of this drug.
Special Populations
Pregnancy/Breast-feeding: This drug is not intended for use by women.
Seniors: Seniors may take this drug without special precaution.

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Ezetimibe (eh-HIHI-firri-ibe)
Brand Name Zetia
Combination Product
Generic Ingredients: Ezetimibe + Simvastatin Vytorin
Type of Drug
Cholesterol - lowering agent.
Prescribed For
High cholesterol, high LDL (”bad”) cholesterol, high triglycerides, and low HDL (”good”) cholesterol; also prescribed for two rare genetic disorders called homozygous familial hypercholesterolemia and homozygous sitosterolemia.
General Information
Unlike statin drugs, ezetimibe interferes with the absorption of cholesterol through the intestine and into the bloodstream. Ezetimibe may be helpful for people whose LDL (”bad”) cholesterol remains high despite treatment with a statin drug. Cholesterol-lowering medicines should always be used together with appropriate diet and exercise.
Ezetimibe may be taken alone but is often taken in combination with a statin drug (generally simvastatin). Vytorin is a brand-name combination of these 2 medications. See Stalin Cholesterol-Lowering Agents, page 1052.
Cautions and Warnings
Do not take this drug if you are allergic or sensitive to any of its ingredients.
People with liver disease or elevated liver enzyme measurements should not take ezetimibe because its effects on the liver are not known.
Ezetimibe does not slow hardening of the arteries.
There may be a risk of myopathy (skeletal muscle disorder) with ezetimibe; contact your doctor if you experience any unexplained muscle pain, tenderness, or weakness. Ezetimibe + simvastatin has the same effect as simvastatin alone; see Statin Cholesterol-Lowering Agents, page 1052.
Possible Side Effects
Ezetimibe side effects are similar to those reported by people taking a placebo (sugar pill).
V Most common: headache, back pain, joint pain, and abdominal pain.
C,Ibmrnon: muscle ache and respiratory infection.
V Less common: fatigue, chest pain, diarrhea, sore throat, and cough.
For additional information about ezetimibe + simvastatin, see Statin Cholesterol- Lowering Agents, page 1052.
Drug Interactions
•    Cholestyramine reduces the amount of ezetimibe absorbed
in the blood. Separate these drugs by 2 hours or more.
•    Cyclosporine (to prevent organ transplant rejection) may substantially increase the amount of ezetimibe in the blood. This combination must be monitored closely by your doctor.
•    Gemfibrozil (another blood-fat reducer) can increase the amount of ezetimibe in the blood.
•    Fenofibrate may increase the effects of ezetimibe. Fibrates
other than fenofibrate should not be used with ezetimibe due to
the risk of gallbladder complications. For additional informa-
tion about ezetimibe + simvastatin, see Statin Cholesterol-
Lowering Agents, page 1052.
Food Interactions
This drug can be taken without regard to food or meals.
Usual Dose
Ezetimibe
Adult and Child (age 10 and over): 10 mg once a day. Child (age 9 and under): not recommended.
Ezetimibe + Simvastatin
Adult: 10 mg ezetimibe plus 10-80 mg simvastatin once a day in the evening. The simavastatin dose depends on individual need.
Overdosage
Little is known about the effects of ezetimibe overdose. 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
If you are taking more than one drug to lower cholesterol or another blood fat, consider the side effects of all of those drugs combined.
,S’D'L’6a)  Populations
Pregnancy/Breast-feeding: Little is known about the effects of ezetimibe during pregnancy. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks. Statin drugs should never be taken by a pregnant woman or nursing mother.
It is not known if ezetimibe passes into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors may use this drug without special precaution.

Generic Name
Famciclovir (fam-SYE-kloe-vere)
Brand Name  Famvir
Type of Drug Antiviral.
Prescribed For
Herpes zoster (shingles), genital herpes, herpes labilalis (cold sores), and herpes simplex in HIV-infected people.
General Information
Famciclovir is absorbed into the body and converted to the antiviral penciclovir, the drug that actually works against shingles by interfering with the reproduction of DNA in the herpes virus. Famciclovir does not affect DNA in uninfected body cells. Famciclovir is broken down by the liver and eliminated from the body through the kidneys.
Cautions and Warnings
Do not take famiciclovir if you are allergic or sensitive to any of its ingredients.
Those with reduced kidney function should have their dosage adjusted accordingly.
Severe liver disease reduces the maximum possible concentration of Famciclovir in the blood and increases the time it takes to reach this maximum level; however, dosage adjustment is not normally required.
Possible Side Effer.%
♦    Most common: headache, nausea, and diarrhea.
♦    Less common: fever, fatigue, pain, vomiting, constipation, appetite loss, dizziness, tingling in the hands or feet, sleepiness, sore throat, sinus irritation, itching, gas, dysmemorrhea, and signs of shingles.
Possible Side Effects (continued)
Rare: chills, abdominal pain, back or joint pain, and upset stomach. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Probenecid, cimetidine, and theophylline interfere with the elimination of famciclovir from the body, possibly leading to higher levels of famciclovir in the blood.
•    People who took famciclovir and digoxin together experienced increased digoxin In their blood.
Food Interactions  None known.
Usual Dose
Shingles
Adult (age 18 and over): 500 mg every 8 hours for 1 week. People with reduced kidney function may require a reduced dose taken as infrequently as once a day.
Genital Herpes
Adult (age 18 and over): 1000 mg twice daily for 1 day; or 250 mg twice a day for up to 1 year for suppression; or 250 mg 3 times a day for 7 days for initial episode. People with reduced kidney function take the same dose but less often, as infrequently as once every 2 days. HIV-infected people should take 500 mg twice a day for 7 days.
Cold Sores
Adult (age 18 and over): 1500 mg as a single dose. Initiate therapy at the earliest sign or symptom of a cold sore (tingling, itching, or burning).
Overdosage
Little is known about the effects of famciclovir ovecdose. Overdose victims should be %Mn to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Famciclovir treatment should be started as soon as shingles is diagnosed. For maximum benefit, be sure to complete the full week of treatment.
Famciclovir is not a cure for genital herpes and it is not known if it will prevent the transmission of the herpes virus to another person. Avoid sexual intercourse when herpes lesions are present even while taking famciclovir for genital herpes.
Begin taking famciclovir at the first sign of a herpes attack (symptoms include pain, tenderness, burning, itching, tingling, ulcers, or scabs). The effectiveness of starting famciclovir 6 hours or more after symptoms or lesions appear has not been established.
Call your doctor if you experience any unusual or intolerable side effects.
If you forget a dose of famciclovir, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot. Do not take a double dose. Call your doctor if you forget more than 2 doses in a row.
Special Populations
Pregnancy/Breast-feeding: Famciclovir should only be taken by a pregnant woman if it is absolutely necessary and the possible benefits outweigh the risks to the fetus.
In animal studies, penciclovir (the active form of famciclovir) passed into breast milk in high concentrations but it is not known if this holds true for humans. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors clear famciclovir from the bloodstream more slowly than younger people and should have their dosage adjusted according to their level of kidney function.

Generic Name
Famotidine (fam-OE-tih-dine) 91
Brand Names
Fluxid    Pepcid AC
Pepcid    Pepcid Complete
Type of Drug  Histamine H2 antagonist.
Prescribed For
Ulcers of the stomach and duodenum (upper intestine). This drug is also used to treat gastroesophageal reflux disease (GERD),
stress ulcer, and other conditions characterized by the production of large amounts of gastric fluids; to prevent stress ulcer and stomach and upper intestinal bleeding; and to stop the production of stomach acid during surgery. Pepcid AC is approved for heartburn.
General Information
Histamine H2 antagonists work by turning off the system that produces stomach acid and other secretions. Famotidine is effective in treating the symptoms of ulcer and preventing complications of the disease, although an ulcer that does not respond to another histamine H2 antagonist will probably not respond to famotidine. Histamine H2 antagonists differ only in their potency. Cimetidine is the least potent; 1000 mg are roughly equal to 300 mg of either nizatidine or ranitidine, or 40 mg of famotidine. All these drugs have roughly equivalent success rates in treating ulcer disease and comparable risk of side effects.
Cautions and Warnings
Do not take famotidine if you are allergic or sensitive to any of its ingredients or to any histamine H2 antagonist.
People with kidney or liver disease should take famotidine with caution because 1/3 of each dose is broken down in the liver and the rest passes out of the body through the kidneys.
Do not self-treat with over-the-counter (OTC) forms of famotidine without the advice and supervision of your doctor.
Possible Side Effects
✓    Most common: headache.
✓    Less common: dizziness, mild diarrhea, and constipation.
✓    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
•    T-_Meat-coated tablets should not be taken with famotidine. The change in stomach acidity that famotidine produces causes the tablets to disintegrate prematurely in the stomach.
•    Antacids, anticholinergics, and metoclopramide may slightly reduce the amount of famotidine absorbed into the blood. No special precaution is needed.
Food Interactions
Famotidine may be taken without regard to food or meals.
Usual Dose
Adult 20-40 mg at bedtime, or 20 mg twice a day for 4-8 weeks. Dosage should be reduced in people with severe kidney disease.
Child (age 1-16): 0.23-0.45 mg per lb. of body weight, at bedtime or in 2 divided doses, up to 40 mg a day.
Child (under age 1): Consult your doctor.
Over-the-counter forms of famotidine such as Pepcid AC or Pepcid Complete should only be used for the temporary relief of heartburn, and are not recommended for children under 12 years of age. Do not take more than 2 capsules or chewable tablets in 24 hours.
Overdosage
Little is known about the effects of famotidine overdose, but victims may experience exaggerated side effects. Your local poison control center may advise giving ipecac syrup—available at any pharmacy—to induce vomiting and remove any remaining drug from the stomach. Victims who have definite symptoms should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Take famotidine exactly as directed and follow your doctor’s instructions regarding diet and other treatment in order to get the maximum benefit from the drug. Antacids may be taken together with famotidine if needed.
Do not take the maximum dose continuously for more than 2 weeks without the consent and supervision of your doctor.
Cigarettes worsen stomach ulcers and may reduce famotidine’s effectiveness.
Call your doctor at once if you develop any unusual side eiiecls such as bleeding or bruising,’ iWness, diarrhea, dizziness, or rash. &’A&, tarry stools or vomiting material that resembles coffee grounds may indicate your ulcer is bleeding.
If you forget a dose of famotidine, 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    revealed no Pregnancy/Breast-feeding: Although animal studies
damage to the fetus, famotidine should be avoided by women who are or might be pregnant. When this drug is considered crucial by your doctor, its possible benefits must be carefully weighed against
its risks.
Famotidine may pass into breast milk. Nursing mothers who
must take this drug should use infant formula.
Seniors: Seniors may need lower doses due to loss of kidney function and may be more susceptible to side effects.

Generic Name
Felbamate (FEL-bam-ate)
Brand Name Felbatol
Type of Drug  Anticonvulsant.
Prescribed For
Partial seizures and Lennox-Gastaut syndrome in children.
General Information
Felbamate is related to the older sedative meprobamate. Exactly how felbamate works is not known, but it raises the seizure threshold and prevents the seizure impulse from spreading in the brain, as do other anticonvulsants. Felbamate should only be used when other seizure drugs have failed because of the risks associated with it. About half of each dose passes out of the body through the kidneys; the other half is broken down and eliminated by the liver.
Cautions and Warnings
Do not take felbamate if you am allergic or sensitive to any of its ‘Irigredlents or to any related drugs such as meprobamate.
Felbamate is associated with an increase in the risk of aplastic anemia, a potentially fatal condition.
Possibly fatal liver failure occurs in people taking felbamate much more often than normal. Regular liver function tests are recommended. People with liver disease should not take felbamate.
Felbamate is not recommended as first-line epilepsy treatment. Felbamate should be used only by those with severe epilepsy for whom the benefits outweigh the risks. Doctors prescribing felbamate should be thoroughly familiar with the drug and must obtain written, informed consent from patients before prescribing.
Felbamate should never be suddenly stopped or seizures may become more frequent. Dosage should be gradually reduced or replaced by another anticonvulsant.
Felbamate may cause increased sensitivity to the sun. Wear protective clothing and use sunscreen while taking this drug. People with kidney disease may require lower doses.
Possible Side Effects
Adult
♦    Most common: sleeplessness, sleepiness, fatigue, headache, dizziness, nervousness, upset stomach, vomiting, constipation, nausea, and appetite loss.
V Common: anxiety, tremors, walking unusually, depression, tingling in the hands or feet, diarrhea, liver inflammation, abdominal pains, respiratory infections, abnormal vision, and taste changes.
✓    Less common: weakness, dry mouth, stupor, abnormal thinking, rash, sinus irritation, sore throat, muscle aches, fever, and chest pain.
♦    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.
Child
✓    Most common: abdominal pain, fever, respiratory infections, sleeplessness, sleepiness, nervousness, vomiting, constipation, and black-and-blue marks.
✓    Common: headache, appetite loss, hiccups, sore throat, coughing, middle ear infections, fatigue, weight loss, temporary loss of urine control, qak”,,NbNW)ng unusually, weak-))855, abnormal thinking, emotional instability, pinpoint pupils, rash, upset stomach, and low white-blood-cell count.
✓    Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if your child experiences any side effect not listed above.
Drug Interactions
•    Combining felbamate and other antiseizure drugs usually requires dosage adjustments due to the risk of drug interaction. Dosage of felbamate should be reduced by 20-33% to reduce the risks of associated side effects.
•    Combining felbamate and carbamazepine reduces blood levels of both drugs by roughly half. Dosage adjustments are necessary.
•    Combining phenobarbital and felbamate increases the amount of phenobarbital in the blood and decreases felbamate levels. Dosage adjustments are necessary.
•    If you combine felbamate and phenytoin, your phenytoin dosage may have to be reduced by as much as 40%. This combination also decreases felbamate blood levels by almost 50%.
•    Felbamate increases blood levels of valproic acid and methsuximide.
Food Interactions
Felbamate is best taken on an empty stomach but may be taken with food if it causes upset stomach.
Usual Dose
Adult and Child (age 14 and over): 1200-3600 mg a day, divided into 3-4 doses.
Child (age 2-13): 6.8-20.5 mg per lb. a day, divided into 3-4 doses.
Overdosage
Overdose symptoms may include upset stomach, increased heart rate, and felbamate side effects. Call your local poison control center or a hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Do not take more felbamate than your doctor has prescribed. Felbamate can cause drowsiness; be careful when, driving  perfQ(ft g
Avoid prolonged exposure to the sun while taking felbamate. Call your doctor if you develop any bothersome or persistent side effect.
Maintain good dental hygiene while taking felbamate and use extra care when brushing or flossing because this drug can cause swollen gums. See your dentist regularly.
km ,s %2& nq6re concentration.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, take 1 dose right away and another in 3 or 4 hours, then go back to your regular schedule. Do not take
a double dose.
Special Populations
Pregnancy/Breast-feeding: This drug may cross into fetal circulation. When the drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Felbamate passes into breast milk. Nursing mothers who must take this drug should consider using infant formula.
Seniors: Seniors, especially those with liver, kidney, or heart disease, may be more sensitive to the effects of this drug and should receive lower doses.

Generic Name
Felodipine (feh-LOE-dih-pene) 91
Brand Name Plendil
Combination Product
Generic Ingredients: Enalapril + Felodipine Lexxel
Type of Drug
Calcium channel blocker.
Prescribed For  High blood pressure.
General Information
Felodipine is one of many calcium channel blockers available in the U.S. Its once-daily dosage schedule makes it particularly stilted to treating high blood Felodipine blocks the passage of calcium, an essential factor in muscle contraction, into the heart and smooth muscles. Such blockage interferes with the contraction of these muscles, which in turn dilates (widens) the veins and vessels that supply blood to them. This dilating effect reduces blood pressure, the amount of oxygen used by the heart muscle, and the risk of blood vessel spasm. Felodipine is therefore useful in
treating not only high blood pressure but also angina pectoris (brief attacks of chest pain), a condition related to poor oxygen supply
to the heart muscles.
Felodipine only affects the movement of calcium into muscle cells-, it has no effect on calcium in the blood.
Lexxel is a combination of felodipine and enalapril, an angiotensin converting enzyme (ACE) inhibitor.
Cautions and Warnings
Do not take felodipine if you are allergic or sensitive to any of its ingredients.
On rare occasions, felodipine may cause very low blood pressure that may lead to stimulation of the heart and rapid heartbeat and can worsen angina. This reaction may happen when treatment is first started, when dosage is increased, or if the drug is rapidly withdrawn; it may be avoided by reducing dosage gradually.
Studies have shown that people taking calcium channel blockers—usually those taken several times a day, not those taken only once daily—have a greater chance of having a heart attack than do people taking beta blockers or other medications for the same purpose. Discuss this with your doctor to be sure you are receiving the best possible treatment.
Patients taking a beta-blocking drug who begin taking felodipine may develop heart failure or increased angina.
People with severe liver disease may require dosage adjustments.
People taking felodipine who have had a heart attack and have lung congestion may experience worsened heart failure, since this drug can actually reduce the force of each heartbeat.
Possible Side Effects
Side effects produced by calcium channel blockers are generally mild and rarely cause people to stop taking them. Side effects are more common with higher doses and in older patients.
I Most common: swelling in the ankles, feet, or legs; dizziness; lightheadedness; muscle weakness or cramps; facial flushing; and headache.
V Less common: respiratory infections, cough, tingling in the hands or feet, upset stomach, abdominal pains, chest pains,
stomach, , heart palpitations,
Drug Interactions
•    Felodipine may increase the amount of beta-blocking drugs in the bloodstream. This can lead to heart failure, very low blood pressure, or an increased incidence of angina. However, in many cases these drugs have been taken together with no problem.
•    Felodipine increases the effects of other blood-pressurelowering drugs. Such drug combinations are often used to treat hypertension.
•    Cimetidine, ranitidine, and azole antifungals such as ketoconazole and itraconazole increase the amount of felodipine in the blood and may account for a slight increase in the drug’s effect.
•    Phenytoin and other hydantoin antiseizure medicines, carbamazepine, and barbiturate sleeping pills and sedatives may decrease the amount of felodipine in the blood, reducing its effect on the body.
•    Erythromycin and cyclosporine may increase the side effects of felodipine.
•    Felodipine may increase the effects of digoxin, theophylline (prescribed for asthma and other respiratory problems), and oral anticoagulant (blood-thinning) drugs.
•    Felodipine may also interact with quinidine (prescribed for abnormal heart rhythm) to produce low blood pressure, very slow heart rate, abnormal heart rhythms, and swelling in the arms or legs.
•    Qd(Gii= Channel blockers may cause bleeding when taken alone or combined with aspirin.
Food Interactions
You may take felodipine with food if it upsets your stomach. Avoid taking felodipine with grapefruit juice—it doubles the amount of drug absorbed.
Possible Side Effects (continued) nausea, constipation, diarrhea
throat, runny nose, back pain,    rash.
and
♦ Rare: Rare side effects can affect the heart,
blood, and joints. It can affect    and
your mood, sex drive,
urinary tract. Contact your do    you experience side effect not listed above.
ctor if    any Usual Dose
2.5-10 mg a day. No patient should take more than 20 mg a day. Do not stop taking felodipine abruptly. The dosage should be reduced gradually over a period of time.
Overdosage
Felodipine overdose can cause low blood pressure. If you think you have taken an overdose of felodipine, call your doctor or go to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you develop constipation, nausea, very low blood pressure, breathing difficulties, increased heart pain, dizziness, or lightheadedness, or if other side effects are bothersome or persistent.
Swelling of the hands or feet may develop within 2 or 3 weeks of starting felodipine. The chances of this happening depend on age and dosage. It occurs in less than 10% of people under age 50 taking 5 mg a day and in more than 30% of those over age 60 taking 20 mg a day.
Be sure to continue taking your medication even if you feel well, and follow any instructions for diet restriction or other treatments to help maintain lower blood pressure.
Do not break or crush felodipine tablets.
It is important to maintain good dental hygiene while taking felodipine and to use extra care when using your toothbrush or dental floss because of the chance that the drug will make you more susceptible to certain infections.
If you forget to take a dose of felodipine, 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
Pregnancy1filreast-feeding. Animal studies of felodipk”e have shown that it crosses RAW the Zeta) circulation and causes birth iNlfEcls. Women who are or who might become pregnant while taking this drug should not take it without their doctor’s approval. The potential benefit of taking felodipine must be carefully weighed against its risks.
It is not known if felodipine passes into breast milk. Nursing mothers who take felodipine should use infant formula.
Seniors: Seniors, especially those with liver disease, are more sensitive to the effects of this drug.

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Generic Name
Entecavir (m-M-ah-veer)
Brand Name Baraclude
Information in this monograph also applies to:
Generic Ingredient: Telbivudine Tyzeka
Type of Drug  Antiviral.
Prescribed For
Chronic hepatitis B infection in adults.
General Information
Entecavir is a prescription medicine for adults with chronic hepatitis B virus (HBV) infection in which the virus is multiplying and damaging the liver. Entecavir can reduce the amount of virus in the body, make it harder for new liver cells to be infected by the virus, and improve the general condition of the liver. They work by attacking HBV polymerase, an enzyme essential to the reproduction of the hepatitis B virus inside an infected cell. These drugs are eliminated from the bodj,4kalbe kidney. Telbivudine does not wGCK alg4msl HIV infection and can be taken together with HIV drug therapy. These medicines do not cure HBV or stop you from spreading HBV to others, generally through sexual contact or exposure to infected blood. The HBV virus can live outside the body for one week.
Cautions and Warnings
Do not take these medicines if you are allergic or sensitive to any
of their ingredients.
Entecavir should be used with caution in people who have both HIV and HBV because of possible HIV resistance developing after entecavir is taken.
Severe worsening of HBV has occurred in people who stopped taking this medication.
These drugs can lead to further liver damage. In rare cases, they have been associated with liver failure that resulted in death. The safety of this drug in people who have had a liver transplant is not known.
These drugs are eliminated through the kidneys. People with kidney disease may require lower doses.
Telbivudine has also been associated with lactic acidosis, a condition in which excess lactic acid in the body causes the blood to become acidic. Feeling very weak or tired, experiencing unusual Muscle pain, difficulty breathing, stomach pain with nausea and vomiting, feeling cold—especially in your arms and legs, feeling dizzy or lightheaded, and a fast or irregular heartbeat may be signs of lactic acidosis. It is a medical emergency and must be treated in the hospital. This has happened in some people taking these medications.
Possible Side Effects
Entecavir
♦    Most common: headache, fatigue, dizziness, and nausea.
✓    Less common: diarrhea, upset stomach, vomiting, tiredness, and sleeplessness.
✓    Rare: Rare side effects may affect almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Telbivudine
✓    Most common: upper respiratory infection, latigue, not feeling well, missO2 tenderness or weakness, abdominal pain, nasal irritation, and sore throat.
♦    Common: flu or flu-like symptoms, diarrhea or loose stools, and throat pain.
✓    Less common: fever, joint pain, rash, back pain, dizziness, muscle ache, sleeplessness, and upset stomach.
Drug Interactions     low in-
•    These drugs do not affect liver enzymes and have a
teraction potential.
•    Drugs that affect kidney function may affect blood concentrations of entecavir and telbivudine.
•    Other hepatitis B treatments (lamivudine, adefovir, cy-
closporine, and pegylated interferon-alpha 2a) do not affect
either entecavir or telbivudine and are not affected by them. Food Interactions
Take entecavir at least 2 hours after a meal and 2 hours before the next meal. Telbivudine may be taken without regard to food or meals. Usual Dose
Entecavir
Adult and Child (age 16 and over): 0.5-1 mg once daily. People with kidney failure may be treated with as little as 0.05-0.1 mg a day. Child (under age 16): not recommended.
Telbivudine
Adult and Child (age 16 and over): 600 mg once daily. People with moderate to severe kidney failure may be treated with a single 600 mg dose every 2, 3, or 4 days depending on the seriousness of kidney disease.
Child (under age 16): not recommended.
Overdosage
There are no reports of entecavir overdose. People taking single doses up to 40 mg or multiple doses up to 20 mg per day for up to 14 days had no unusual side effects. One person accidentally took an overdose with no consequences. People taking up to 1800 mg a day of telbivudine had no increase in side effects. Overdose victims should be taken to a hospital emergency room for treatment, where dialysis may be necessary to remove the drug from the blood. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor il you develop muscle aches, pains, or weakness; ‘it your skin or the white part of your eyes turns yellow; if your urine becomes dark; if your bowel movements turn light in color; if you don’t feeling like eating food for several days or longer; if you become nauseous; or if you have lower stomach pain. These can be signs of a serious liver problem called hepatotoxicity, which has occurred in some people taking these medications.
Your hepatitis B may get worse or become very serious if you stop taking these medications. Do not stop taking them or change your daily dose without talking to your doctor.
If you forget to take your daily entecavir dose, take it as soon as you remember but do not take a double dose. Call your doctor if you forget to take 2 or more doses in a row.
Entecavir oral solution is a ready-to-use product and should not be mixed with water or any other liquid product. Each bottle of the oral solution comes with a dosing spoon that is calibrated in 1 -mL increments, up to 10 mL. Hold the spoon upright and gradually fill it to the mark next to the prescribed dose. Drink the liquid directly from the dosing spoon. Your pharmacist can help you properly measure your medication dose. Rinse the dosing spoon with water after each daily dose and allow it to air dry.
Special Populations
Pregnancy/Breast-feeding: Animal studies of entecavir revealed slowed development of the skeleton. Animal studies of telbivudine did not reveal any effects on the developing fetus. However, it is not known if either medicine is safe to use during pregnancy or if it helps prevent the hepatitis B virus from passing on to a developing fetus. If your doctor considers entecavir or telbivudine crucial for you, potential benefits must be carefully weighed against their risks. A data bank has been established to collect information from doctors on pregnant women who do take these medicines.
These medicines may pass into breast milk. Nursing mothers who must take these drugs should use infant formula.
Seniors: Dosage reduction may be needed in seniors because of normal declines in kidney function.

Brand Name
Entex PSE
Generic Ingredients
Guaifenesin + Pseudoephedrine Hydrochloride M
Other Brand Names
Anatuss LA    Coldmist Jr.
Aquatab D Dosepack    Coldmist LA
Coldmist    Congess Jr.
Congess SR    Nasabid
Congestac    Nasabid-SR
Deconsal LA    Nasatab LA
D-Feda 11    PanMist
Durasal U    PanMist-Jr.
Duratuss AM/PM    PanMist LA
Dynex    Profen 11
Endal-SR    Pseudovent
Guaimax-D    Sudal 60/500
Guaipax PSE    SudaI120/600
Guaitab    Sudal SR
Guaituss PE    Syn-RX
Guai-Vent PSE    Touro LA
losal El    Tuss-LA
Maxifed    V-Dec-M
Maxifed G    Versacaps
Med-RX    Zephrex
Miraphen PSE    Zephrex LA
The information in this profile also applies to the following drugs:
Generic Ingredients: Guaifenesin + Ephedrine Hydrochloride 19 Broncholate    Bronkaid
Generic Ingredients: Guaifenesin + Phenylephrine Hydrochloride 91
Deconsal Il    PhenaVent
Deconsal Pediatric    PhenaVent D
Endal    PhenaVent LA
Entex LA    PhenaVent PED
Liquibid D    Rescon GG
Liquibid-D 1200    Sinupan
Liquibid-PD    Sinuvent PE
Type of Drug
Decongestant and expectorant combination.
Prescribed For
Cold or allergy and for nasal congestion, runny nose and cough associated with other upper respiratory conditions.
General Information
The decongestant ingredient in Entex PSE, pseudoephedrine, dramatically reduces congestion and stuffiness. The decongestant ingredients ephedrine and phenylephrine act similarly. The expectorant, guaifenesin, is used to help loosen thick mucus that may contribute to chest congestion; the effectiveness of guaifenesin and other expectorants has not been established. There are other drugs on the market using this same general formula—an expectorant plus a decongestant—but they use different decongestant ingredients or a combination of decongestants plus guaifenesin. Nothing cures a cold or allergy, but Entex PSE may provide relief from symptoms.
Cautions and Warnings
Do not take Entex PSE if you are allergic or sensitive to any of its ingredients.
Entex PSE may cause anxiety or nervousness or interfere with sleep.
Do not use Entex PSE if you have ventricular tachycardia (quickened heartrate), or hypertension (high blood pressure).
Entex PSE should be used with extreme caution in those with heart disease, other heart rhythm disorders, thyroid disease, diabetes, glaucoma, stomach ulcer, urinary blockage, or a prostate condition.
Entex PSE should not be used over extended periods of time to treat persistent or chronic cough especially one that may be caused by cigarette smoking, asthma, or emphysema.
Possible Side Effects
Mritl common: anxiety, restlessness, sleeplessness, tension, excitation, dizziness, drowsiness, and headache.
♦ Less common: nausea, vomiting, upset stomach, low blood pressure, heart palpitations, chest pain, rapid or slow heartbeat, abnormal heart rhythms, irritability, euphoria (feeling Possible Side Effects (continued)
“high”), eye irritation and tearing, hysterical reaction, appetite loss, kidney stones, urinary difficulties in men with a prostate condition, weakness, loss of facial color, and breathing difficulties.
Drug Interactions
•    Entex PSE should be avoided if you are taking a monoamine oxidase inhibitor (MAGI) antidepressant for depression or hypertension because the MAGI may cause a very rapid rise in blood pressure or increase side effects such as dry mouth or nose, blurred vision, and abnormal heart rhythms.
•    The decongestant in Entex PSE may interfere with bloodpressure-lowering medication.
Food Interactions
Take Entex PSE with food if it upsets your stomach.
Usual Dose
Adult and Child (age 12 and over): 1 tablet or capsule twice a day or 2 tsp. of liquid 4 times a day.
Child (age 6-11):1/2-1 tablet or 1 capsule twice a day or 1 tsp. of liquid 4 times a day.
Overdosage
Most cases of overdose are not severe. Symptoms include sedation, sleepiness, increased sweating, and increased blood pressure. Hallucinations, convulsions, nervous system depression, and breathing difficulties are more prominent in older adults. Most cases of overdose are not severe. Induce vomiting with ipecac syrup—available at any pharmacy. Call your local poison control center or a hospital emergency room before doing this. If you lseey, treatment. ALWAYS bring the prescription bottle or container.
-SIDt’dial Information
Call your doctor if your side effects are severe or gradually become intolerable.
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: Women who are or might be pregnant should avoid Entex PSE. When your doctor considers this drug crucial, its potential benefits must be carefully weighed
against its risks.
The decongestant in Entex PSE may pass into breast milk. Nursing mothers who must take Entex PSE should consider using in-
fant formula.
Seniors: Seniors are more sensitive to the effects of Entex PSE.

Generic Name
Epoetin (EE-poh-eh-tin)
Brand Names Epogen
Type of Drug
Red-blood-cell growth stimulator.
Prescribed For
Anemia; may also be used for reducing the need for blood or redblood-cell transfusions.
General Information
Epoetin is a natural hormone that stimulates the bone marrow to produce red blood cells. It is used for anemia that does not respond to iron supplements. In most cases of anemia, there are plenty of red blood cells circulating, but they lack iron. People who need epoetin do not have enough red blood cells. Epoetin stimulates the production of new red blood cells to carry needed oxygen.
Cautions and Warnings
Do not use epoetin if you are allergic or sensitive to albumin or products manufactured from animal cells.
People with urtvaRtmliked high blood pressure should not use epoetin.
Some people with chronic kidney failure and severe anemia should not take epoetin. Epoetin is not a replacement for emergency blood transfusion.
Epoetin is not intended for anemia caused by folate or iron deficiency, hemolysis, or gastrointestinal bleeding.
Procrit People using epoetin may require anticoagulant medicine to prevent blood clotting during treatment. Tell your doctor it you have any blood-clotting disorders.
In rare cases, people taking epoetin may have seizures. Avoid driving or any other activities where a sudden seizure could be dangerous. Do not take epoetin if you have a history of seizures or strokes.
Epoetin should be avoided in patients with blood cancers such as lymphoma, because it can act as a growth factor for the tumor.
If your hemoglobin levels become too high, your chance of heart attack, stroke, heart failure, blood clots, and death is increased. It is important to have your blood tested and adjust dosage of epoetin accordingly throughout treatment.
Possible Side Effects
Side effects reported in studies of epoetin were similar to those reported with an inactive placebo (sugar pill).
♦    Most common: high blood pressure, headache, constipation, diarrhea, nausea, joint pain, fever, fatigue, itching, rash, and difficulty breathing.
✓    Common: swelling, vomiting, chest pain, skin reactions at the site of injection, weakness, dizziness, urinary infections, diarrhea, upset stomach, blood clots, anxiety, tingling in the hands or feet, and trunk pain.
✓    Rare: stroke and heart attack. Contact your doctor if you experience any side effect not listed above.
Food and Drug Interactions None known.
Usual Dose
Adult: starting dose-23-69 units per 1b. of body weight 3 times a week by intravenous or subcutaneous injection. Final dose is based on response and need. Surgery patients take 138 units per lb. for 10 days before Surgery or 276 units once a week for 3 weeks before surgery and another dose on the day of surgery. Dialysis patients take epoetin once a week.
Child (under age 12): 23 units per lb. of body weight 3 times a week by intravenous or subcutaneous injection. Final dose is based on response and need.
Child (under 1 month): not recommended.
Overdosage
Little is known about the effects of epoetin overdose. Call your local poison control center or a hospital emergency room for information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
People taking epoetin should have regular blood tests to assure the drug is working well. Your doctor may want to take blood samples twice a week for several weeks and then test your blood regularly.
Epoetin has been used by athletes to enhance physical performance. This is called blood doping and has resulted in several deaths because the percentage of red blood cells in a blood sample can reach hazardous levels.
Epoetin must be stored in a refrigerator.
Most patients will need to take iron supplements with this drug.
This drug can be given by injection under the skin. For more in-
formation on how to properly administer this drug, see page 1242.
Special Populations
Pregnancy/Breast-feeding: Animal studies suggest that epoetin may enter fetal circulation. When this drug is considered crucial by your doctor its potential benefits must be carefully weighed against its risks.
It is not known if epoetin passes into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors may use this product without special precaution.

Type of Drug
Erectile Dysfunction Drugs
Generic Ingredient: Sildenafil Citrate
Viagra    Revatio
Generic Ingredient: Tadalafil Cialis
Generic Ingredient: Vardenafil Levitra
Prescribed For
Erectile dysfunction (ED). sildenafil is also prescribed for pulmonary
hypertension.
General Information
The chemical nitric oxide is released in the penis during sexual stimulation. Nitric oxide causes the release of an enzyme called cyclic guanosine monophosphate (cGMP), which increases blood flow into the penis, producing an erection. cGMP is broken down by the enzyme phosphodiesterase type 5 (PDE5). In men with low levels of cGMP, these medicines help achieve and maintain an erection by inhibiting PDE5, thus causing higher levels of cGMP. ED can be the result of nerve, blood vessel, or psychological problems. These drugs, which are effective in about 70% of men, only help when poor blood flow is the cause of the dysfunction. Women have reported some benefit from sildenafil, although it has been widely studied only in men. Vardenafil and tadalafil are intended only for men. These medicines start working in 30-60 minutes and their effects usually last from 2-4 hours, although some have noted an effect for 24 hours or more. Some drug interactions and kidney or liver diseases extend this time. Tadalafil begins working in 30-60 minutes and can remain in the body for more than 2 days, much longer than the other medicines in this group. Low-dose tadalafil may be taken every day for chronic ED.
Pulmonary hypertension, a rare disease in which high pressure in the blood vessels moves from the heart to the lungs, is sometimes treated with sildenafil.
Cautions and Warnings
Do not take ED drugs if you are allergic or sensitive to any of their ingredients.
These medicines lower blood pressure and should be avoided if you have high (greater than 170/100) or low (less than 90/50) blood pressure. Several people have died from a sudden blood-pressure drop after combining erectile dysfunction medications with other medications that can reduce blood pressure.
These Medicines should never be taken by those taking heart medications called nitrates, as fatal reactions have occurred.
People with heart disease may experience heart problems with sildenafil or vardenafil, including a heart attack. These reactions can occur during or shortly after sexual activity.
Avoid these medicines if you have had a heart attack, stroke, or life-threatening abnormal heart rhythms in the past 6 months, or if you have heart failure, unstable angina pectoris, damage to the penis, or a progressive eye disease called retinitis pigmentosa. Blindness is a rare side effect of sildenafil and may be a problem with all of these medications.
People taking sildenafil or vardenafil have experienced difficulties seeing blue or green colors and may see things with a blue tinge surrounding them. This happens because they affect an enzyme in the eye. The effect clears up after the drug passes out of the body.
People with kidney or liver damage retain these medicines in their bodies longer than people whose kidneys and liver function normally. People with kidney or liver problems should always begin with the lowest possible dosage.
People with priapism (painful erection lasting more than 6 hours) or a condition that predisposes them to priapism—such as leukemia, multiple myeloma, or sickle cell anemia—should be cautious about taking these medicines.
Vardenatil and sildenafil should be avoided by people with stomach or bleeding ulcers because its effect on these conditions is not known.
Possible Side Effects
Sildenafil
✓    Most common: headache and flushing.
♦    Less common: upset stomach, stuffy nose, urinary tract infection, diarrhea, rash, dizziness, seizure, anxiety, prolonged and possibly painful erection, double vision, visual changes, bloodshot eyes, burning eyes, swelling in the eye, and blood vessel diseases in the retina.
✓    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.
Tadalafil
I Most common: headache.
✓    Common: upset stomach. Back pain and muscle aches can develop 12-24 hours after taking tadalafil and go away on their own after 2 days.
Possible Side Effects (continued)
♦    Less common: flushing, nasal congestion, and arm or leg
pain.
♦    Rare-. prolonged or painful erections. Other rare side ef-
fects can occur in almost any part of the body. Contact
your doctor if you experience any side effect not listed
above.
Vardenafil
✓    Most common: headache and flushing.
✓    Less common: upset stomach, sinus infection, flu-like symptoms, dizziness, and nausea.
♦    Rare: prolonged or painful erection. 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
•    Do not combine any of these drugs with nitrates (such as nitroglycerin) and other drugs that lower blood pressure. The combination can cause a sudden, rapid drop in blood pressure.
•    Do not take vardenafil if you are taking an alpha blocker (such as alfuzosin, doxazosin, prazosin, tamsulosin, or terazosin). Tadalafil may be taken only with tamsulosin. You may take sildenafil at its lowest possible dose with an alpha blocker, but you must separate the doses by at least 4 hours.
•    Combining cimetidine and sildenafil leads to a substantial (more than 50%) increase in the amount of sildenafil in the blood.
•    Erythromycin, itraconazole, ketoconazole, and protease inhibitors (used to combat HIV) can cause sildenafil blood levels to almost double. Vardenafil levels can increase by 400-1000% when combined with these medicines. It you are taking one of these medicines, do not take more than the %west possible dose of your ED drug. Do not take tadalafil more than once every 3 days if you are also taking one of these medicines.
•    Rifampin can be expected to reduce the effect of ED medicines by reducing the amount of drug in the blood. Other
drugs that may reduce the effects of these drugs are carbamazepine, phenobarbital, and phenytoin.
•    Dihydrocodeine—a widely used prescription pain reliever—may increase the effects of sildenafil, yielding substantially prolonged erections, sometimes lasting for hours.
•    Do not combine sildenafil, tadalafil, and vardenafil. The effects of combining these drugs are not known.
•    Do not take vardenafil if you are taking any medicine to treat an abnormal heartbeat, including amiodarone, procainamide, quinidine, and sotalol.
•    Combining sildenafil with selective serotonin reuptake inhibitors (SSRIs) or tacrolimus may increase the risk of sildenafil side effects.
•    Alcohol adds to the blood-pressure-lowering effects of these medicines.
Food Interactions
Grapefruit juice may increase the amount of these drugs in the blood. Taking sildenafil with a high-fat meal reduces the amount of drug absorbed. Tadalafil and vardenafil may be taken without regard to food or meals.
Usual Dose
Sildenafil
Adult: 50 mg taken about 1 hour before sexual activity. Individual doses can range from 25-100 mg. The maximum dosing frequency is once a day.
Senior: Begin with 25 mg and gradually increase dosage as needed.
Tadalafil
Adult: 10 mg taken about 1 hour before sexual activity. Individual doses can range from 2.5-20 mg. Do not take more than 1 dose of tadalafil a day.
Senior: Begin with 5 mg and gradually increase dosage as needed.
Adult: 10 mg taken about 1 hour before sexual activity. Individual doses can range from 5-20 mg.
Senior: Begin with 5 mg and gradually increase dosage as needed.
Overdosage
sildenafil and tadalafil overdose are likely to produce exaggerated drug side effects. Vardenafil overdose may cause neck pain, muscle aches, or vision changes. Call your local poison control center or hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor and do not engage in sexual activity if the erection produced by ED drugs is painful or lasts 4 or more hours, or if you experience dizziness, nausea, or chest pain after taking an ED drug. In rare cases, men taking ED drugs have reported a sudden decrease or loss of vision and/or hearing. Call your doctor right away if you experience this adverse side effect.
People who use organic nitrates for gardening or other purposes can experience a severe and dangerous blood pressure drop if they take sildenafil or vardenafil. It is not known how long you have to wait to resume nitrate use.
These drugs do not protect against sexually transmitted diseases.
Special Populations
Pregnancy/Breast-feeding: There is no evidence that sildenafil or vardenafil harm the fetus; however, they are not intended for pregnant women or nursing mothers.
Seniors: Men age 65 and over eliminate these drugs more slowly than younger men and should begin with the lowest possible dosage.

Generic Name
Ergoloid Mesylates (ER-goe-loid
MES-il-ates) (GI
Brand Names  Caerimal
Hydergine
Type of Drug  Psychotherapeutic agent.
Hydrogenated Ergot Alkaloids
Prescribed For
Age-related decline in mental capacity.
General Information
Ergoloid mesylates are used to treat decreased mental capacity of unknown cause in people over age 60. These drugs should not be used for any condition that is treatable with another drug or that may be reversible. People who respond to ergoloid mesylates are likely to have Alzheimer’s disease or some other cause of dementia. Nobody knows exactly how ergoloid mesylates produce their effect, but they improve the supply of blood to the brain in test animals, reduce their heart rate, and improve muscle tone in blood vessels. Some studies show the drugs to be very effective in relieving mild symptoms of mental impairment, while others find it to be only moderately effective. They are most beneficial in people whose symptoms are due to the effects of high blood pressure in the brain.
Cautions and Warnings
Do not take ergoloid mesylates if you are allergic or sensitive to any of their ingredients or you have psychotic symptoms or psychosis.
Ergoloid mesylates should be used with caution in people with liver disease, low blood pressure, or slow heartbeat.
Possible Side Effects
Ergoloid mesylates do not produce serious side effects.
♦ Common: When taken under the tongue, these drugs may
cause irritation, nausea, or upset stomach. Other side ef-
fects are drowsiness, slow heartbeat, and rash.
Drug Interactions None known.
Food Interactions
Do not eat, drink, or smoke while you have an ergoloid mesylates pill under your tongue.
Usual Dose
Starting dose is 1-2 mg 3 times a day. Increase as needed. Do not exceed 12 mg a day.
Overdosage
Symptoms include blurred vision, dizziness, fainting, flushing, headache, appetite loss, nausea, vomiting, stomach cramps, and stuffy nose. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
The effects of ergoloid mesylates are gradual and frequently not seen for up to 6 months. A 6-month period of treatment with ergoloid mesylates is recommended before your doctor can fully evaluate your response to the drug. Your doctor should periodically reevaluate your condition to determine if ergoloid mesylates treatment is still needed and that it is working for you.
Dissolve sublingual tablets under the tongue. Do not chew or crush them; they are not effective if swallowed whole.
If you forget a dose, skip it and go back to your regular schedule. Do not take a double dose. Call your doctor if you miss 2 or more consecutive doses.
Special Populations
Pregnancy/Breast-feeding: Ergoloid mesylates may interfere with fetal development. When these drugs are considered crucial by your doctor, their potential benefits must be carefully weighed against their risks.
Ergoloid mesylates pass into breast milk. Nursing mothers who must take these drugs should use infant formula.
Seniors: Seniors are more likely to develop side effects, especially hypothermia (low body temperature).
Generic Name
Erythromycin (eh-rith-roe-MYE-sin) 10
Brand Names
Akre-mycin    Eryderm
Arr/S    Erygel
E-Base    Ery-Tab
E-Glades    Erythra-derm
E-Mycin    PCE Eryc
The information in this profile also applies to all forms of erythromycin:
Generic Ingredient: Erythromycin Estolate LN
Generic Ingredient: Erythromycin Ethylsuccinate E.E.S.    Pediamycin EryPed
Generic Ingredients: Erythromycin Ethylsuccinate + Sulfisoxasole
Eryzole    Pediazole
Generic Ingredient: Erythromycin Stearate Erythrocin Stearate
Type of Drug  Macrolide antibiotic.
Prescribed For
Infections of virtually any part of the body: upper and lower respiratory tract infections; sexually transmitted diseases; urinary tract infections; infections of the mouth, gums, or teeth; and infections of the nose, ears, or sinuses. It is prescribed for acne and may be used for mild to moderate skin infections. Erythromycin is effective against diphtheria and dysentery. It is also prescribed for legionnaires’ disease, rheumatic fever, whooping cough, and bacterial endocarditis. It is prescribed to patients with pelvic inflammatory disease as an alternative to penicillin. The eye ointment is used to prevent newborn gonococcal or chlamydial eye infections.
General Information
Erythromycin and other macrolide antibiotics are either bactericidal (bacteria-killing) or bacteriostatic (inhibiting bacterial growth), depending on the organism in question and amount of antibiotic present. Erythromycin is deactivated by stomach acid, so the tablet form is made to bypass the stomach and dissolve in the intestine.
Since the action of this antibiotic depends on its concentration in the invading bacteria, kk is crucial that you follow your doctor’s ISNVKi10ns regarding the spacing of doses as well as the number of days you must take the medication—otherwise, this antibiotic may be much less effective.
Cautions and Warnings
Do not take erythromycin if you are allergic or sensitive to any of its ingredients or to any macrolide antibiotic.
Erythromycin is excreted primarily through the liver. People with liver disease or damage should consult their doctors. Those on long-term therapy with erythromycin should have periodic blood tests. If you restart erythromycin after having experienced liver damage, it is likely that symptoms will recur within 48 hours.
Erythromycin estolate has occasionally produced liver problems (symptoms include fatigue, nausea, vomiting, abdominal cramps, and fever). If you are susceptible to stomach problems, erythromycin may cause mild to moderate stomach upset; discontinuing the drug will reverse this condition.
Colitis (bowel inflammation) has been associated with all antibiotics and can range from mild to life-threatening (see “Possible Side Effects”),
Possible Side Effects
•    Most common: nausea, vomiting, stomach cramps, and diarrhea. Colitis (symptoms include severe abdominal cramps and severe, persistent, and possibly bloody diarrhea) may develop. Side effects of the topical erythromycin include peeling, dryness, itching, and oiliness.
♦    Less common: hairy tongue, itching, irritation of the anal or vaginal region, eye irritation, and skin tenderness. If any of these symptoms appear, call your physician immediately.
♦    Rare: hearing loss—which reverses itself after the drug is stopped and occurs most often in people with liver and kidney problems—and abnormal heart rhythms. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Antacids may slightly affect the release of erythromycin from your body. This effect is not considered important.
•    Do not combine erythromycin with astemizole or terfenadine.
•    Erythromycin may slow the breakdown of carbamazepine (an anticonvulsant prescribed for seizures). Avoid this combination.
•    Mixing erythromycin with rifabutin or rifampin can interfere with the antibiotic’s effect and increase the risk of intestinal side effects.
•    Do not combine erythromycin and pimozide. Two people died after combining pimozide and a macrolide antibiotic.
•    Erythromycin may neutralize penicillin. It may also neutralize the antibiotics lincomycin and clindamycin.
•    Erythromycin interferes with the elimination of theophylline
from the body, possibly leading to theophylline overdose.
•    Mixing erythromycin with a statin cholesterol-lowering drug increases the risk of developing a potentially fatal condition involving severe muscle pain and destruction.
•    Do not mix erythromycin with sparfloxacin, ketoconazole, itraconazole, fluconazole, diltiazem, verapamil, troleandomycin, mibefradil, nefazodone, or clarithromycin. These mixtures can lead to severe, possibly fatal, abnormal heart rhythms. Grepafloxacin (another fluoroquinolone) should only be mixed with erythromycin in hospitalized patients whose hearts can be monitored during treatment.
•    Combining erythromycin and alfentanil (an injectable pain reliever), bromocriptine, buspirone, digoxin, disopyramide, ergotamine, cyclosporine, methylprednisolone (a corticosteroid), tacrolimus, vinblastine, or benzodiazepines (such as alprazolam, diazepam, midazolam, and triazolam) increases the risk of drug side effects.
•    Erythromycin estolate may increase the liver side effects of other drugs that affect the liver.
•    Erythromycin may increase the anticoagulant (blood-thinning) effects of warfarin in people who take it regularly, especially older adults. People taking this combination should be tested regularly.
•    Erythromycin may increase the effects of caffeine.
Food Interactions
Grapefruit juice slows the breakdown of erythromycin, increasing the amount of drug in the blood. For optimum effectiveness, take erythromycin base and erythromycin stearate on an empty stomach with a 6-8 oz. glass of water 1 hour before or 2 hours after meals. Other forms of erythromycin can be taken without regard to food or meals.
\huall Dose
Tablet and Suspension
Adult: 250-400 mg every 6 hours, taken 1 hour before meals, or 500 mg every 12 hours. Maximum dose is 4 g a day.
Child: 15-25 mg per lb. of body weight a day in divided doses depending on age, weight, and severity of infection.
Eye Ointment 1/2 inch 2-6 times a day.
Topical Solution: Apply morning and night.
Doses of erythromycin ethylsuccinate are 60% higher due to differences in chemical composition.
Overdosage
Overdose may cause severe side effects, especially nausea, vomiting, stomach cramps, and diarrhea. Mild hearing loss, ringing or buzzing in the ears, or fainting may also occur. Call your local poison control center or a hospital emergency room for more information. ALWAYS bring the prescription bottle or container.
Special Information
Erythromycin is used instead of penicillin for mild to moderate infections in people who are allergic to penicillin. Erythromycin is not the antibiotic of choice for severe infections.
Erythromycin products should be stored at room temperature, except for oral and topical liquids, which should be kept in the refrigerator.
Call your doctor if you develop nausea; vomiting; diarrhea; stomach cramps; severe abdominal pain; rash, itching, or redness; dark or amber-colored urine; yellowing of the skin or whites of the eyes; or any severe or persistent side effect.
If you forget a dose of oral erythromycin, take it as soon as you remember. If it is almost time for your next dose, space the next 2 doses over 4-6 hours, then continue with your regular schedule. Do not take a double dose.
Remember to complete the full course of therapy prescribed even if you feel well before you finish the medication.
Special Populations
Pregnancy/Breast-feeding: Erythromycin passes into the fetal circulation. Erythromycin estolate has caused mild liver inflammation in about 10% of pregnant women who took it and should not be used if you are or might be pregnant. Other forms of erythromycin have been used sale)y without difficulty.
Erythromycin passes into breast milk. Nursing mothers who must take erythromycin should use infant formula.
Seniors: Seniors with liver disease should use caution. Seniors taking high doses of erythromycin may be at an increased risk of hearing loss.

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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.

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

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

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

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

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

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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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Generic Name
Chlordiazepoxide (klor-dye-az-uh-PDX-ide) 91
Brand Name
Librium
Type of Drug  Benzodiazepine sedative.
Prescribed For
Anxiety, tension, fatigue, agitation, and withdrawal symptoms of alcoholism; also prescribed for irritable bowel syndrome and panic attacks.
General Information
Chlordiazepoxide is a member of the group of drugs known as benzodiazepines.
Benzodiazepines work by a direct effect on the brain. They can relax you and make you more tranquil or sleepier, or they can slow nervous system transmissions in such a way as to act as an anticonvulsant. Many doctors prefer benzodiazepines to other drugs that can be used to similar effect because they tend to be safer, have fewer side effects, and are usually as effective, if not more so.
Cautions and Warnings
Do not take chlordiazepoxide if you are allergic or sensitive to any of its ingredients or to another benzodiazepine, including clonazepam.
Chlordiazepoxide can aggravate narrow-angle glaucoma, but you may take it if you have open-angle glaucoma and are receiving therapy for it.
Other condkjo(\SiVN\,NhjCb chlordiazepoxide should be used with caution are severe depression, especially with suicidal tendencies, severe lung disease, sleep apnea (intermittent cessation of breathing during sleep), liver disease, drunkenness, and kidney disease.
Chlordiazepoxide should not be taken by psychotic patients because it is not effective for them and can trigger unusual excitement, stimulation, and rage. It has also produced similar reactions among hyperactive and aggressive pediatric patients.
Chlordiazepoxide is not intended for more than 3-4 months of continuous use. Your condition should be reassessed before continuing chlordiazepoxide beyond that time.
Chlordiazepoxide may be addictive. Drug withdrawal may develop if you stop taking it after only 4 weeks of regular use, but is more likely after longer use. It may start with anxiety and progress to tingling in the hands or feet, sensitivity to bright light, sleep disturbances, cramps, tremors, muscle tension or twitching, poor concentration, flu-like symptoms, fatigue, appetite loss, sweating, and changes in mental state.
Dosage of chlordiazepoxide should be decreased gradually over 4-8 weeks after prolonged use.
Possible Side Effects
Weakness and confusion may occur, especially in seniors and in those who are sickly.
♦    Most common: mild drowsiness during the first few days of therapy.
✓    Less common: depression, lethargy, disorientation, edema, headache, inactivity, slurred speech, stupor, dizziness, tremor, constipation, dry mouth, nausea, inability to control urination, sexual difficulties, irregular menstrual cycle, changes in heart rhythm, low blood pressure, fluid retention, blurred or double vision, itching, rash, hiccups, nervousness, inability to fall asleep, and occasional liver - dysfunction. If you experience any of these symptoms, stop taking the medicine and contact your doctor immediately.
♦    Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Chlordiazepoxide is a central-nervous-system depressant. Avoid alcohol, other sedatives, narcotics, barbiturates, mono-amine oxidase inhibitor and other antidepressants, and antihistamines. Taking chlordiazepoxide with these drugs may result in excessive depression, tiredness, sleepiness, breathing difficulties, or related symptoms.
•    Smoking may reduce the effectiveness of chlordiazepoxide by increasing the rate at which it is broken down by the body.
•    The effects of chlordiazepoxide may be prolonged when it is
taken with cimetidine, contraceptive drugs, disulfiram, flu-
oxetine, isoniazid, ketoconazole, metoprolol, probenecid,
propoxyphene, propranolol, rifampin, or valproic acid.
•    Theophylline may reduce chlordiazepoxide’s sedative effects.
•    If you take antacids, separate them by at least 1 hour from your chlordiazepoxide dose to prevent them from interfering with the passage of chlordiazepoxide into the bloodstream.
•    Chlordiazepoxide may increase blood levels of digoxin and the chances for digoxin toxicity.
•    Levodopa + carbidopa’s effectiveness may be reduced by chlordiazepoxide.
•    Phenytoin blood concentrations may be increased when taken with chlordiazepoxide, resulting in possible phenytoin toxicity.
Food Interactions
Chlordiazepoxide is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
Adult: 5-100 mg a day. This range is due to individual response related to age, weight, disease severity, and other characteristics.
Child (age 6 and over): may be given if deemed appropriate by a doctor. Starting dose-5 mg 2-4 times a day. Maintenance dose—up to 30 mg a day for some children, but must be individualized to obtain maximum benefit.
Child (under age 6): not recommended.
Overdosage
Symptoms of overdose are confusion, sleepiness, poor coordination, lack of response to pain such as a pin prick, loss of reflexes, shallow breathing, low blood pressure, and coma. The victim should be lakes to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Chlordiazepoxide can cause tiredness, drowsiness, inability to concentrate, or similar symptoms. Be careful if you are driving, operating machinery, or performing other activities that require concentration.
If you forget a dose of chlordiazepoxide, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Chlordiazepoxide may cause birth defects if taken during the first 3 months of pregnancy. Avoid chlordiazepoxide while pregnant.
Chlordiazepoxide may pass into breast milk. Nursing mothers who must take chlordiazepoxide should use infant formula.
Seniors: Seniors, especially those with liver or kidney disease, are more sensitive to the effects of chlordiazepoxide and generally require smaller doses to achieve the same effect.

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Cetirizine

August 1, 2009 | Leave a Comment

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

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Alprazolam

July 16, 2009 | Leave a Comment

Generic Name
Alprazolam (al-PRAY-zoe-lam) CGI
Brand Names
Niravam    Xanax    Xanax XR Type of Drug
Benzodiazepine sedative.
Prescribed For
Generalized anxiety disorder and anxiety associated with depression; panic disorder with or without agoraphobia.
General Information
Alprazolam is a member of a group :)f drugs known as benzodiazepines. Benzodiazepines directly affect the brain. They can relax you and make you more tranquil or sleepier, or they can slow nervous system transmissions in such a way as to act as an anticonvulsant. Many doctors prefer benzodiazepines to other drugs that can be used to similar effect because they tend to be safer, have fewer side effects, and are usually as effective, if not more so.

Cautions and Warnings
Do not take alprazolam if you know you are allergic or sensitive to it or to another benzodiazepine drug, including clonazepam.
Alprazolam can aggravate narrow-angle glaucoma, but you may take it if you have open-angle glaucoma and are receiving therapy for it.
Other conditions where alprazolam should be avoided are: severe lung disease, sleep apnea (intermittent cessation of breathing during sleep), liver disease, drunkenness, and kidney disease. In each of these conditions, the depressive effects of alprazolam may be enhanced or could be detrimental to your overall condition.
Alprazolam should not be taken by psychotic patients because it is not effective for them and can trigger unusual excitement, stimulation, and rage.
Alprazolam is meant to be used for no more than 3-4 months in a row. Your condition should be reassessed before continuing your medicine beyond that time.
Alprazolam may be addictive. When used to treat panic disorder, alprazolam is frequently prescribed in doses exceeding 4 mg a day. Studies show that these higher doses may cause physical and emotional dependence, making it very difficult to stop taking the drug. Drug withdrawal may develop if you stop taking it after only 4 weeks of regular use but is more likely after longer use and at higher doses. It may start with anxiety and progress to tingling in the hands or feet, sensitivity to bright light, sleep disturbances, cramps, tremors, muscle tension or twitching, poor concentration, flu-like symptoms, fatigue, appetite loss, sweating, and changes in mental state. Severe withdrawal symptoms may include seizures.
Your dosage should be reduced gradually (0.5 mg decrease every 3 days) to prevent drug withdrawal symptoms.
Possible Side Effects
V Most common: mild drowsiness during the first few days of therapy. Weakness and confusion may occur, especially in seniors and in those who are sickly. If these effects persist, contact your doctor.
V Less common: depression, lethargy, disorientation, headache, inactivity, slurred speech, stupor, dizziness, tremors, constipation, dry mouth, nausea, inabilityto control urination, Possible Side Effects (continued)
sexual difficulties, irregular menstrual cycle, changes in heart rhythm, low blood pressure, fluid retention, blurred or double vision, itching, rash, hiccups, nervousness, inability to fall asleep, and occasional liver dysfunction. If you experience any of these symptoms, stop taking the medicine and contact your doctor immediately.
V Rare: withdrawal seizures. Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Alprazolam is a central-nervous-system depressant. Avoid alcohol, other sedatives, narcotics, barbiturates, monoamine oxidase inhibitor (MAGI) antidepressants, antihistamines, and antidepressants. Taking alprazolam with these drugs may result in excessive depression, tiredness, sleepiness, breathing difficulties, or related symptoms.
•    Smoking may reduce the amount of alprazolam in your blood by 50%. Smokers may need larger doses.
•    The effects of alprazolam may be prolonged when taken together with cimetidine, contraceptive drugs, disulfiram, fluoxetine, isoniazid, itraconazole, ketoconazole, metoprolol, probenecid, propoxyphene, propranolol, and valproic acid.
•    The effects of some benzodiazepines may be decreased by rifampin.
•    Theophyllines may reduce alprazolam’s sedative effects.
•    If you take antacids, separate them from your alprazolam dose by at least 1 hour to prevent them from interfering with the absorption of alprazolam into the bloodstream.
•    Alprazolam may raise digoxin blood levels and the chances of digoxin toxicity.
•    The effect of levodopa + carbidopa may be decreased if it is taken together with alprazolam.
•    Combining alprazolam with phenytoin may increase phenytoin blood concentrations and the chances of phenytoin toxicity.
Food Interactions
Alprazolam is best taken on an empty stomach but may be taken with food if it upsets your stomach.

Usual Dose
Anxiety Disorder
Adult: 0.25-0.5 mg 3 times a day. Dosage must be tailored to your individual needs with a maximum dose of 4 mg a day. Child (under age 18): not recommended.
Panic Disorder
Adult: 1 -10 mg a day.
Child (under age 18): not recommended.
Overdosage
Symptoms of overdose are confusion, sleepiness, poor coordination, lack of response to pain such as a pinprick, loss of reflexes, shallow breathing, low blood pressure, and coma. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Alprazolam can cause tiredness, drowsiness, inability to concentrate, or related symptoms. Be careful if you are driving, operating machinery, or performing other activities that require concentration.
Anyone taking alprazolam for more than 3 or 4 months at a time may have a drug withdrawal reaction if the medicine is stopped suddenly (see “Cautions and Warnings”). Do not stop taking alprazolam, or increase or decrease the dosage, without first consulting your doctor.
If you forget a dose of alprazolam, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and return to your regular schedule. Do not take a double dose. If you take Xanax XR, take your full daily dose once a day in the morning. Do not chew or crush Xanax XR tablets.
Special Populations
Pregnancy/Breast-feeding: Alprazolam may cause birth defects if taken during the first 3 months of pregnancy. You should avoid alprazolam while pregnant.
Alprazolam may pass into breast milk. Nursing mothers who must take alprazolam should use infant formula.
Seniors: Seniors, especially those with liver or kidney disease, are more sensitive to the effects of alprazolam and generally require smaller doses to achieve the same effect.

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

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

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

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