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Jun

29

Effexor For Depression Treatment and Generic Effexor (Venlafaxine)

June 29, 2011 | Leave a Comment

What is Effexor? General Information on Effexor.

• Effexor belongs to a class of antidepressants. Effexor affects chemicals in the brain which are unbalanced, causing depression or anxiety. Effexor is an exiety and depression treatment drug.
• Effexor is used to treat depression, panic disorder, generalized anxiety disorder and social anxiety disorder (social phobia).
• Effexor may be used for other purposes not listed in this medication guide.

What should I discuss with your doctor before taking Effexor? What should I know before I buy Effexor?

• Before taking this medication, tell your doctor if you are taking a monoamine oxidase inhibitor (inhibitors of MAO), such as isocarboxazid (Marplan), tranylcypromine (Parnate) or phenelzine (Nardil) in the last 14 days. It is proved that the simultaneous adoption of these drugs with Effexor can cause serious and sometimes fatal consequences, and these drugs should not be used together with Effexor.
• Before taking Effexor, tell your doctor if you have:
• liver disease
• kidney disease
• high blood pressure,
• seizures or epilepsy,
• bipolar disorder (manic depression),
• bipolar disorder or a family history of suicide or
• suicidal thoughts.
• You can not take Effexor, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Effexor belongs to the category C classification FDA pregnancy. This means that it is unknown whether the drug may have harmful effects on the fetus. Do not take Effexor without first talking to your doctor if you are pregnant or could become pregnant during the course of treatment.
• Effexor gets into breast milk and may affect a child through breastfeeding. If you are breast-feeding, do not take Effexor without consulting your doctor.

What is generic for effexor?

Generic Effexor is Venlafaxine. You can buy generic Effexor online legally and without a prescription on line at a cheap price.

How to take Effexor?

• Take Effexor in exact accordance with your doctor. To improve the state may take 4 weeks or more, besides a sharp rejection of the drug can cause unpleasant side effects. To clarify the indications for use, contact your doctor or pharmacist.
• Take each dose with water. Effexor should be taken with food.
• The capsules are designed for controlled-release (Effexor XR), should be swallowed whole without chewing. In order to remedy it easier to swallow, mix the contents of the capsule with a small amount of applesauce. Swallow the mixture without chewing, do not leave part of the next administration.
• Try to take the medicine at the same time.
• Possible increased risk of suicidal thoughts and suicidal behavior in the beginning of treatment with antidepressants, especially if you are 18 years or less. Discuss this with your doctor. During treatment with Effexor require observation in case of worsening symptoms of depression and / or suicidal thoughts during the first week of treatment or when changing dosage. Besides self-monitoring of symptoms, your family or guardians should be aware of changes in your mood or symptoms. Need regular visits to the doctor, at least in the first 12 weeks of treatment.
• Call your doctor if you are experiencing any of these adverse effects, especially if it is new or worsening symptoms: mood swings, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, a strong excited state, mania (mental and / or physical hyperactivity), or thoughts of suicide or self-inflicted injuries.
• Keep Effexor should be at room temperature in a cool dry place.
What happens if I miss a dose?
• Take the missed dose as soon as you remember. However, if almost time for your next dose medication, should not take the missed dose. Do not take an extra dose of the drug rather than missed.

Effexor online is available to buy in generic form of the drug at a cheap price with bigger discounts for bigger orders. Generic for Effexor is Venlafaxine. The drug is manufactured in the dosages Effexor 37.5 mg and Effexor 75 mg.

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May

21

Tenormin (Atenolol)

May 21, 2011 | Leave a Comment

Tenormin (Atenolol)

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Generic Name: Atenolol
Brand Name: Tenormin
Generic Ingredients: Tenormin + Chlorthalidone Tenoretic
Generic Ingredient: Nebivolol Systolic
Type of Drug: Beta-adrenergic blocking agent.

Prescribed For: Tenormin alone or in combination is prescribed for high blood pressure, abnormal heart rhythms, angina pectoris, and prevention of second heart attack and migraine. It is also usedto treat alcohol withdrawal, stage Ifight, and other anxieties. Nebivolol is currently approved only to treat high blood pressure. Both are used together with other blood-pressure-lowering medications.

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General Information

Tenormin is one of many beta-adrenergic blocking drugs, or beta blockers and primarily blocks the beta, receptor. Nebivolol blocks both the beta, and beta, receptors when taken at high doses by people whose liver breaks down the drug more slowly than average. These drugs interfere with the action of adrenaline and other chemicals in the body that affect many body functions. Individual beta blockers have different characteristics that can make them more suitable for certain conditions or people.
When used to treat high blood pressure, Tenormin may be used either alone or concurrently with other antihypertensive drugs, particularly with a thiazide-type diuretic.

Cautions and Warnings

Do not take these drugs it you are allergic or sensitive to any of their ingredients or to other beta blockers. People with a severe allergy to any substance may be more sensitive to that allergen while taking a beta blocker.
People with angina who take these medicines for high blood pressure risk aggravating their angina if they suddenly stop taking the drug. These people should have their drug dosage reduced gradually over 1-2 weeks.
Tenormin should not be used by those with slow heartbeat, moderate to severe heart block (a condition affecting the heart’s conduction system), congestive heart failure unless it is due to a quickened heart rate that can be treated with Tenormin, or acute heart failure.
Tenormin and nebivolol should be used with caution if you have liver or kidney disease, because your ability to eliminate these drugs from your body may be impaired. Dose adjustments may be needed.
These drugs reduce the amount of blood the heart pumps. This reduction in blood flow may aggravate the condition of people with poor circulation or circulatory disease.
If you are undergoing major surgery, your doctor may want you to stop taking these drugs at least 2 days before surgery.
If you have pheochromocytoma (adrenal gland tumor), use Tenormin with caution.
Tenormin should be usedOfti caution in those with chronic bronchitis, emphysema, or other nonallergic bronchospastic diseases.
People with a history of severe anaphylactic reaction to allergens may be unresponsive to usual doses of epinephrine while taking beta blockers.

Possible Side Effects

Tenormin

Side effects are relatively uncommon and usually mild; they usually develop early in the course of treatment and are rarely a reason to stop taking Tenormin.
Most common: impotence.
Less common: unusual tiredness or weakness, slow heartbeat, heart failure (symptoms include swelling of the legs, ankles, or feet), dizziness, breathing difficulties, bronchospasm, depression, confusion, anxiety, nervousness, sleeplessness, disorientation, short-term memory loss, emotional instability, cold hands and feet, constipation, diarrhea, nausea, vomiting, upset stomach, increased sweating, urinary difficulties, cramps, blurred vision, rash, hair loss, stuffy nose, facial swelling, itching, chest pain, back or joint pain, colitis, drug allergy (symptoms include fever and sore throat), and liver toxicity.
Rare: lupus erythematosus (chronic condition affecting the body’s connective tissue). Contact your doctor if you experience any side effect not listed above.

Drug Interactions

•    Tenormin may interact with surgical anesthetics to increase the risk of heart problems during surgery. Some anesthesiologists recommend gradually stopping the drug by 2          days before surgery.
•    Tenormin may interfere with the normal signs of low blood sugar and with oral antidiabetic drugs.
•    Tenormin increases the blood-pressure-lowering effects of
other blood-pressure-reducing agents, including clonidine,
guanabenz, and reserpine; and calcium channel blockers,such as nifedipine.
•    Aspirin-containing drugs, indomethacin, and sulfinpyrazone may interfere with the blood-pressure-lowering effect of atenoloi.
•    Cocaine may reduce the effectiveness of all beta blockers.
•    Tenormin may worsen the problem of cold hands and feet associated with taking ergot alkaloids, used to treat migraine. Gangrene is a possibility in people taking both           anergot and Tenormin.
•    Tenormin will counteract thyroid hormone replacements.
•    Calcium channel blockers, diphenhydramine, flecainide, hydralazine, contraceptive drugs, propafenone, haloperidol, phenothiazine sedatives—molindone and others—quinolone         antibacterials, and quinidine may increase the amount of Tenormin in the bloodstream and lead to increased Tenormin effects.
•    Tenormin should not be taken within 2 weeks of taking a monoamine oxidase inhibitor (MAGI) antidepressant.
•    Cimetidine increases the amount of Tenormin absorbed into the bloodstream from oral tablets.
•    Tenormin may interfere with the effectiveness of some anti-asthma drugs, including theophylline and aminophylline, and especially ephedrine and isoproterenol.
•    Combining Tenormin with phenytoin or digitalis drugs may result in excessive slowing of the heart, possibly causing heart block (disruption of the electrical impulses that       control heart rate).
•    If you stop smoking while taking Tenormin, your dose may have to be reduced because your liver will break down the drug more slowly.
•    Aluminum salts, barbiturates, calcium salts, cholestyramine, colestipol, ampicillin, and rifampin may reduce the effectiveness of Tenormin.
•    Beta blockers may increase the effects of gabapentin, lidocaine, or prazosin, leading to undesirable reactions or toxicity.
•    Beta blockers may block the effects of epinephrine.
•    Fluoxetine, paroxetine, bupropion, propafenone, quinidine, duloxetine, and terbinafine can substantially increase the amount of nebivolol in the blood by interfering with        its breakdown by liver enzymes. Amiodarone, cimetidine, and sertraline also have this interaction but the effect is smaller. Avoid these combinations.
•    Other drugs that can increase nebivolol levels but to a much smaller extent are antihistamines, celecoxib, chlorpheniramine, chlorpromazine, citalopram, clemastine,           clomipramine, diphenhydramine, doxepin, doxorubicin, escitalopram, halotantrine, histamine, hydroxyzine, levomepromazine, methadone, metoclopramide, mibefradil, midodrine,       moclobemide, perphenazine, ranitidine, haloperidol, ritonavir, ticlopidine, and tripelennamine.
•    Dexamethasone, rifampin, and sildenafil reduce blood levels of nebivolol but the combined effect on blood pressure is moderate.

Food Interactions

These drugs may be taken without regard to food or meals.

Usual Dose:

Tenormin

Adult: 50 mg a day. Some people may require doses of 100-200 mg a day. Dosages over 100 mg a day are not likely to produce additional benefit to those being treated for hypertension. People with kidney disease may need only 50 mg every other day. Older adults should be treated more cautiously and may need a lower dose.
Child: not recommended.

Overdosage

Symptoms of overdose include changes in heartbeat—unusually slow, unusually fast, or irregular—severe dizziness or fainting, breathing difficulties, bluish-colored fingernails or palms, and seizures. Heart failure and shock may also result from a beta blocker overdose. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.

Special Information

These drugs are meant to be taken continuously.
When ending treatment, dosage should be reduced gradually over a period of about 2 weeks. Do not stop taking these drugs unless directed to do so by your doctor. Abrupt withdrawal may cause chest pain, breathing difficulties, increased sweating, and unusually fast or irregular heartbeat.
Call your doctor at once if you develop back or joint pain, breathing difficulties, cold hands or feet, depression, rash, or changes in heartbeat. Tenormin may produce an undesirable lowering of blood pressure, leading to dizziness or fainting; call your doctor if this happens. Call your doctor if you experience persistent or bothersome anxiety, diarrhea, constipation, impotence, headache, itching, nausea or vomiting, nightmares or vivid dreams, upset stomach, insomnia, stuffy nose, frequent urination, unusual tiredness, or weakness.
Tenormin may cause drowsiness, lightheadedness, dizziness, or blurred vision. Be careful when driving or performing complex tasks.
It is best to take beta blockers at the same time each day. If you forget a dose, take it as soon as you remember. If you take nebivolol and do not remember until your next dose, continue with your regular schedule. If you take Tenormin once a day and it is within 8 hours of your next dose, skip the dose you forgot and continue with your regular schedule. If you take Tenormin twice a day and it is within 4 hours of your next dose, skip the one you forgot and continue with your regular schedule. Never take a double dose of Tenormin or nebivolol.

Special Populations

Pregnancy/breast-feeding: Infants born to women who took a beta blocker while pregnant had lower birth weights, low blood pressure, and reduced heart rates. These drugs should be avoided by pregnant women and women who might become pregnant while taking them.
Tenormin and nebivolol pass into breast milk. Nursing mothers should use infant formula.
Seniors: Seniors taking Tenormin should use the lowest effective dose as this group is more likely to have decreased heart, kidney, and liver function, and to be taking additional medications. Dosage adjustment of nebivolol is not necessary in seniors.

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Sep

26

Formoterol - Fosfomycin - Fosinopril - Fosrenol - Ganciclovir

September 26, 2009 | Leave a Comment

Generic Name Formoterol (for-MOH-ter-ol)
Brand Names Foradil Aerolizer Perforomist Foradil Certihaler
Generic Ingredients: Formoterol + Budesonide Symbicort
The information in this profile also applies to the following drug:
Generic Ingredient: Arformoterol Brovana
Type of Drug Bronchodilator.
Prescribed For
Maintenance of asthma, bronchospasm during exercise, and chronic obstructive pulmonary disorder, including chronic bronchitis, and emphysema.
General Information
Formoterol is a long-acting beta-2 agonist, used in the prevention of asthma attacks and bronchial spasms. It is not effective in stopping an asthma attack once it has begun. Patients suffering from severe asthma should always have a short-acting bronchodilator available in case of an acute attack.
Cautions and Warnings
Do not use formoterol if you are allergic or sensitive to any its ingredients.
Formoterol not be used by patients with significantly or rapidly worsening asthma. In some asthma patients, formoterol may increase the chance of death from asthma.
Formoterol is not a replacement for corticosteroid inhalers. Patients should continue to use their corticosteroid inhalers at the same dosage in conjunction with formoterol.
Patients who have been taking inhaled, short-acting beta-2 agonises should stop regular use of these, and use them only to treat acute asthma symptoms.
Formoterol can cause paradoxical bronchospasm, a potentially life-threatening condition. Patients who experience symptoms should discontinue use of formoterol immediately.
Formoterol can cause irregular heartbeat and should be used with caution by patients with a history of heart disease or high blood pressure. Patients with a history of seizures, strokes, or diabetes should also be carefully monitored for a recurrence or worsening of these conditions.
Possible Side Effects
Most common: tremors, dizziness, insomnia, and chest pain.
Common: restlessness, weakness, sore throat, and difficulty breathing.
Less common: lightheadedness, angina, abnormal heart rhythm, heart palpitations, and bronchospasrn.
Rare: severe worsening of asthma, extreme allergic reaction, and angioedema (a potentially life-threatening swelling of the lips and throat). Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Formoterol’s effects may be increased by monoamine oxidase inhibitor (MA01) antidepressants, tricyclic antidepressants, thyroid drugs, other bronchodilators. and some antihistamines.
•    The effect of formoterol may be lessened by beta-blocking drugs, such as propranolol.
•    Formoterol may antagonize the effects of blood-r:~ssurelowering drugs, especially reserpine, methyldupa, and guanethidine.
•    Using formoterol with antihistamt z;, disopyramide; phe- nothja,Z:MtS,’D10cBinamide; quinidine and similar drugs: theo- phylline; and tricyclic antidepressants may increase the risk of heart damage and life-threatening cardiac arrhythmias.
Food Interactions None known.
Usual Dose
Arlormoterol
Adult: Inhale 15 mcg every 12 hours. Child: not recommended.
Formoterol
Adult and Child (age 5 and over)
Foradil Aerolizer: Inhale 12 mcg every 12 hours. Foradil Certihaler: Inhale 10 mcg every 12 hours.
Perforomist: Inhale 20 mcg every 12 hours. Child (under age 5): not recommended.
Formoterol + Budesonide Combination Adult: Inhale 1 puff every 12 hours. Child: riot recommended.
Overdosage
Formoterol overdose may cause nausea, vomiting, tremor, sleepiness, rapid or irregular heartbeat, low blood sugar, blood acidity, and life-threatening cardiac arrhythmias. Patients experiencing severe symptoms should go to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
The drug should be inhaled during the second half of your inward breath. This will allow the medication to reach more deeply into your lungs.
Be sure to follow your doctor’s directions for the use of formoterol. Using more than you need can increase the risk of side effects and worsen your symptoms. If your condition worsens after taking formoterol, stop taking it and call your doctor at once.
Call your doctor at once if you develop chest pains, rapid heartbeat, palpitations, muscle tremors, dizziness, headache, or swelling of the throat, or if you still have trouble breathing after using the medication.
If a dose of formoterol is forgotten, take it as soon as you remember. If it is almost time (Ox your next dose, skip the dose you forgot aMmMinue with your regular schedule. Do not take a double dose.
Formoterol capsules must only be used with the inhaler that is provided with this medicine. Do not use other medicines with the formoterol inhaler. Patients should be aware that the gelatin cap-sure may fragment, causing a risk that gelatin particles will be inhaled. This risk is minimized by being careful to pierce the gelatin capsule only once. Capsules should be used immediately after they are taken from the blister pack.
Special Populations
Pregnancy/Breast-feeding: The safety of formoterol in pregnant women has not been studied. The potential benefit of using this medication must be carefully weighed against its risks.
It is not known if formoterol passes into breast milk. Nursing mothers who take this should consider using infant formula.
Seniors: Seniors may be more sensitive to the effects of this drug. Follow your doctor’s directions and report any side effects at once.
Fosamax see Bisphosphonates, page 164
Generic Name
Fosfomycin (fos-foe-MYE-sin)
Brand Name Monurol
Type of Drug Urinary anti-infective.
Prescribed For
Uncomplicated urinary infections.
General Information
Fosfomycin kills a variety of bacteria. It works by preventing bacteria from sticking to the wall of the urinary tract and by interfering with bacterial cell division. In the body, it is converted V) its active form—free (WS bacteria that are resistant to other antibiotics are not resistant to fosfomycin, so this drug may work where others have failed.
Cautions and Warnings
bo not take fosfomycin if you are allergic or sensitive to any of its ingredients. Fosfomycin is meant to be taken once, in a single dose. Taking more than 1 packet of fosfomycin only increases side effects; it does not improve the drug’s effectiveness.
Drug Interactions
• Metoclopramide reduces fosfomycin blood levels. Food Interactions
You may take fosfomycin with or without food. Usual Dose
Adult (age 12 and over): 1 packet mixed with water. Child (under age 12): riot recommended.
Overdosage
Little is known about the effects of fosfomycin overdose. Call your local poison control center or a hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
Do not take fosfomycin powder in its dry form. Mix the contents of the packet with 3-4 oz. of cool or cold water until it dissolves. Then drink the solution immediately.
Call your doctor if your infection does not improve within 2 or 3 days.
Special Populations
Pregnancy/Breast-feeding: The safety of using fosfomycin during pregnancy is, mV&nown. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
It is not known if fosfomycin passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may take fosfomycin without special restriction.
above. vaginal irritation, runny nose, nau-
ts can occur in almost any part of the doctor if you experience any side ef- e.
Possible Side Effects
¦ Less common: diarrhea
and headache
Rare: Rare side effects body. Contact your fect not listed

Generic Name
Fosinopril (tos-IN-oe-pril) 41
Brand Name Monopril
Combination Product
Generic Ingredients: Fosinopril + Hydrochlorothiazide IM
Monopril HCT Type of Drug
Angiotensin-converting enzyme (ACE) inhibitor.
Prescribed For
High blood pressure and heart failure. Also prescribed for renal failure, kidney hypertension, post-heart attack management, management of people with a high risk of heart disease, diabetes, chronic kidney disease, and preventing a second stroke.
General Information
Fosinopril sodium 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 the symptoms of heart failure. Fosinopril also affects the production of other hormones and enzymes that participate in the regulation of blood vessel dilation. Fosinopril begins working 2-6 hours after you take it.
Cautions and Warnings
Do not take fosinopril if you are allergic or sensitive to any of its ingredients. Severe reactions may involve angioedema, a possibly life-threatening swelling of the face, throat, or intestines (see “Special Information”). These reactions are more likely in hemodialysis patients and those undergoing venom immunization.
Fosinopril occasionally causes very low blood pressure or affects your kidneys. ‘four doctor should check your urine for changes during the first few months of treatment.
ACE inhibitors can affect your white-blood-cell count, possibly increasing your susceptibility to infection. Blood counts should be checked periodically.
Fosinopril may cause serious injury or death to the fetus it taken during pregnancy. Pregnant women should, not take fosinopril.
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
v Most common: chronic cough and dizziness, especially when rising from a sitting or lying position. The cough usually goes away a few days after you stop taking the medicine.
?    Less common: chest pain, low blood pressure, fatigue, diarrhea, headache, vomiting, and nausea.
¦    Rare: Rare side effects can affect your heart, sleeping, stomach and intestines, skin, sex drive, and joints. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    The blood-pressure-towering effect of fosinopril 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 an ACE inhibitor.
•    Fosinopril 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 fosinopril and other ACE inhibitors. This may cause reductions in kidney function.
•    Fosinopril may increase potassium levels in your blood, especially when taken with dyazide or other potassium-sparing diuretics.
•    Antacids and fosinopril should be taken at least 2 hours apart.
•    Capsaicin may trigger or aggravate the cough associated with fosinopril, kt)eTapy.
•    Indomethacin may reduce the blood-pressure-lowering effects of fosinopril.
•    Phenothiazine sedatives and antivomiting drugs may increase the effects of fosinopril.
•    Severe sensitivity reactions can occur in people taking allopurinol.

Fosinopril may affect 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.
Food Interactions
You may take fosinopril with food if it upsets your stomach.
Usual Dose
Adult: 10-80 mg once a day. People with liver disease may require lower dosages.
Overdosage
The principal effect of ACE inhibitor 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
Call your doctor if you develop swelling of the face or throat, if you have sudden difficulty in breathing, or if you develop a sore throat, mouth sores, abnormal heartbeat, chest pain, persistent rash, or loss of taste perception. Unexplained swelling of the face, lips, hands, and feet can also affect the larynx (throat) and tongue and interfere with breathing. If this happens, the victim should be taken to a hospital emergency room at once.
Some people who start taking an ACE inhibitor 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 the dosage is increased. To prevent this from happening, you may be told to stop taking the diuretic 2 or 3 days before starting the ACE inhibitor or to increase your salt intake during that time. The diuretic may then be restarted gradually.
You may get dizzy if you rise to your feet quickly from a sitting or lying position when taking fosinopril.
Avoid strenuous exercise or very hot weather, because heavy sweating or dehydration can cause a rapid decrease in blood pressure.
Avoid over-the-counter diet pills, decongestants, 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 forget to take a dose of fosinopril, 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. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: ACE inhibitors can cause fetal injury or death. Women who are or might be pregnant should not take ACE inhibitors. Stop taking the drug and contact your doctor if you become pregnant.
Large amounts of fosinopril 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 fosinopril.

Brand Name
Fosrenol
Generic Ingredient Lanthanum Carbonate
Type of Drug Phosphate binder.
Prescribed For
High blood phosphate levels (hyperphosphatemia) in people with end-stage renal disease (ESRD).
General Information
People with ESRD, a form of kidney disease, tend to retain phosphorous. High phosphate levels, in turn, can affect calcium balance in the body and cause deposits of this mineral to build up in the wrong places. Lanthanum helps manage high blood phosphate levels by binding to phosphate in food before it can be absorbed into the blood. This is the same mechanism used by other phosphate-lowering drugs (se,4e%Tner and the antacids aluminum hydroxide -6nd calcium carbonate). Lanthanum, like other phosphate binders, must be taken with meals so that it can bind phosphate ions in the stomach before they can be absorbed into the blood. Very little of this drug is absorbed into the blood and it is not broken down in the body Cautions and Warnings
Do not take fosrenol if you are allergic or sensitive to any of its
ingredients.
People with an active peptic ulcer, ulcerative colitis, Crohn’s
disease, or bowel obstruction should use this medication with
caution.
Researchers found no difference in bone fracture rates or over-
all survival for lanthanum than for other phosphate-binding treatments over 3 years. The study period was too short to assume that it would improve bone fractures or survival beyond 3 years.
Possible Side Effects
Side effects primarily affect the digestive tract and are similar to other phosphate-lowering treatments in type and frequency.
¦    Most common: nausea. vomiting, complications with the dialysis graft, diarrhea, constipation, abdominal pains, and low blood pressure.
¦    Common: bronchitis and runny nose.
?    Less common: high blood calcium levels.
?    Rare: Other side effects may affect any organ or organ system. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Lanthanum strongly binds to phosphate in the stomach and might also bind to other medications in the stomach. However, no interaction was found in tests conducted with warfarin, digoxin, enalapril, furosemide, metoprolol, or phenytoin.
•    Compounds known to interact with antacids should not be taken within 2 hours of taking lanthanum.
Food Interactions
This drug must be taken with or immediately after meals.
usual Dose
Adult: 750-1500 mg with or immediately after each meal. Completely chew each tablet before you swallow it. Do not swallow whole tablets.
Child: not recommended.
Overdosage
There have been no reports of lanthanum overdose, even with single doses up to 1000 mg per pound of body weight. Symptoms of overdose are likely to occur in the digestive tract. Overdose victims may be taken to a hospital emergency room for evaluation. ALWAYS bring the prescription bottle or container.
Special Information
If you forget to take lanthanum with or immediately after a meal, skip the forgotten dose and continue with your regular schedule.
Be sure to follow the low-phosphate diet your doctor prescribes. It is a key element in helping to manage your blood phosphate levels.
Special Populations
PregnancylBreast-feeding., Animal studies with doses several times the maximum human dose revealed some harm to the developing fetus. Pregnancy in a woman with end-stage renal disease, especially those on dialysis, is uncommon because of reduced fertility and carries serious risks for a woman and her baby, including anemia, uncontrolled high blood pressure, and infection. This drug is not recommended for pregnant women.
It is not known if lanthanum passes into breast milk. Nursing mothers who must take it should consider using infant formula.
Seniors: Seniors may use this medication without special restriction.

Generic Name
Ganciclovir (ga.-SYE-kloe-vem) IM
Brand Name
Vitrasert
The information in this profile also applies To The tollowing drug:
GD’K)Phc )ngredient: Valganciclovir Valcyte
Type of Drug
Antiviral.
Prescribed For
Cytornegalovirus (CMV) infections of the eye and CMV infections in other parts of the body, in people with compromised immune
systems.
General Information
Ganciclovir works by preventing reproduction of the virus CMV. Unlike other antiviral drugs, it works only against this virus and herpes simplex virus. The drug is eliminated through the kidneys.
Though most often used for CMV retinitis (eye infection), ganciclovir has also been used for CMV infections of the urine, blood, throat, and semen. It is also used to prevent CMV infection. Ganciclovir is helpful in controlling CMV infection in heart, kidney, and kidney-pancreas transplant patients. Valganciclovir is not indicated for use in liver transplant patients.
Valganciclovir (Valcyte) is broken down by the body into ganciclovir, and all information in this profile applies to both drugs, unless otherwise noted.
Cautions and Warnings
Do not take ganciclovir if you are allergic or sensitive to any of its ingredients.
Ganciclovir causes anemia, reduced white-blood-cell count, and blood-platelet loss. Regular monitoring of blood and platelet counts is recommended while taking this drug.
Ganciclovir is intended only for people who are immunocompromised. It is not intended to treat or prevent CMV infections in newborns.
Detachment of the retina has been noted in people taking ganciclovir, as well as in people with CMV who have not taken the drug. The relationship between ganciclovir and this effect is not well known.
Ganciclovir causes increased sensitivity to the sun; use a sunscreen or wear protective clothes when you go outside.
People with kidney disease should use qw\6,7_l1DAr with caution, and may (eqtst% ieatment at a lower dosage.
Studies of ganciclovir in blacks, Hispanics, and Caucasians showed a trend toward higher blood levels among Caucasians than other groups.
Intravenous ganciclovir has been given to a small number of children under age 12 with mixed results. Side effects were similar to those experienced by adults taking the drug.
Possible Side Effects
¦    Most common: fever, diarrhea, abdominal pain, reduced white-blood-cell counts, anemia, rash, sweating, nausea, vomiting, and appetite loss.
¦    Common: infection; chills; stomach gas; low platelet counts
(symptoms include bleeding or oozing blood); tingling-,
burning; numbness or pain in the hands, arms, legs, or feet-,
itching; pneumonia; weakness; and headache.
Drug Interactions
•    Pentamidine, flucytosine, vincristine, vinblastine, adriamycin, amphotericin B, trimethoprim-sulfamethoxazole, and other cytotoxic drugs may increase the side effects of ganciclovir and should be used together only if absolutely necessary, and only if the potential benefits outweigh the risks.
•    People taking imipenem-cilastatin together with ganciclovir have experienced seizures. Avoid this combination.
•    Mixing ganciclovir with other drugs that can be damaging to the kidneys may increase the rate and extent of kidney damage.
•    Probenecid interferes with ganciclovir release through the kidneys and substantially increases blood levels of ganciclovir.
•    Mixing ganciclovir with the anti-HIV drugs didanosine or zidovudine (AZT) may increase didanosine or AZT levels and reduce ganciclovir levels. Because AZT and ganciclovir both cause anemia and low white-blood-cell counts, many people cannot tolerate this combination.
Food Interactions
High-fat, high-calorie meals can increase the amount of ganciclovir absorbed into the blood. Take this drug with food.
Usual Dose Gar1r.(qtZ,41N
Adult and Child (age 13 and over): 3000 mg a day, divided into 3 or 6 equal doses. People with reduced kidney function will need to have their dosage reduced accordingly, possibly to as little as 500 mg 3 times a week.
Child (under age 13): not recommended.
Valganciclovir
Adult and Child (age 13 and over): 900 mg a day, divided into 2 equal doses of 450 mg each. People with reduced kidney function will need to have their dosage reduced accordingly, possibly to as little as 500 mg 3 times a week.
Child (under age 13): not recommended.
Overdosage
Little is known about the effects of ganciclovir overdose. As much as 6000 mg a day has been taken with only temporary lowering of white-blood-cell count. Call your hospital emergency room for instructions in case of ganciclovir overdose.
Special Information
Ganciclovir does not cure CMV eye infection, and immunocompromised people taking this drug may find their disease worsening. Dosage reductions or discontinuation of the drug may be necessary if white-blood-cell or platelet counts get too low.
Ganciclovir may cause infertility in men and women. Women of child-bearing age should use effective contraception while taking this drug. Men should use a condom while taking the drug and for at least 90 days afterward to avoid passing the drug to their partners.
Good dental hygiene is important while taking ganciclovir to minimize the risk of infection. If you have dental work done while taking this drug, expect the healing process to take longer.
Regular blood tests are necessary to watch for white-bloodcell or platelet-level alterations.
It is very important to take ganciclovir exactly as directed. If you forget a dose, take it as soon as you remember and continue with your regular schedule.
Special Populations
PregnancylBreas>-feeding. Animal studies showed ganciclovir to be toxic to the fetus. There is no reliable information about its effect in pregnant women, but it should be taken only when the possible Oe”6% Outweigh the risks. Women who are likely to become pregnant while taking this drug should use reliable contraception.
It is not known if ganciclovir passes into breast milk, but the possible side effects of this drug on a nursing infant should be kept in mind. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors often have reduced kidney function; dosage adiustments may be needed.

Generic Name
Gemfibrozil oem-Fl-broe-zil)
Brand Name Lopid
Type of Drug
Anti-hyperlipidemic (blood-fat reducer). Prescribed For
High blood triglycerides.
General Information
Gemfibrozil consistently reduces blood triglycerides and reduces the risk of heart disease in people with high levels of triglycerides, low levels of high-density lipoprotein (HDL) cholesterol, the “good” cholesterol, and high levels of low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol. It works by affecting the breakdown of body fats and by reducing the amount of triglyceride manufactured by the liver. It is usually prescribed only for people with very high blood-fat levels who have not responded to dietary changes or other therapies. Gemfibrozil usually has little effect on blood-cholesterol levels, although it may reduce blood cholesterol in some people.
Cautions and Warnings
Do not take gemfibrozil if you are allergic or sensitive to any of its ingredients or have severe liver or kidney disease. Some people taking gemfibrozil have experienced worsening of kidney function.
Gemfibrozil users may have an increased risk of developing gallbladder disease and gallstones.
People taking gemfibrozil and fenofibmte may develop pancreatitis (inflammation 0 the pancreas).
People taking gemfibrozil may develop muscle aches and inflammation. Tell your doctor if you experience muscle tenderness or weakness.
Estrogen drugs may cause massive increases in triglyceride levels. Stopping estrogen therapy in these cases may reduce triglyceride levels to normal.
Gemfibrozil may cause a moderate rise in blood sugar and mild decreases in white-blood-cell counts.
Possible Side Effects
¦    Most common: abdominal and stomach pain, fatigue, heartburn, gas, diarrhea, nausea, and vomiting.
¦    Less common: rash, itching, dizziness, blurred vision, anemia, reduced levels of white blood cells, increased blood sugar, and muscle pain—especially in the arms or legs.
¦    Rare: dry mouth, constipation, appetite loss, upset stom-
ach, sleeplessness, tingling in the hands or feet, ringing or
buzzing in the ears, back pain, painful muscles or joints,
swollen joints, feeling unwell, reduction in blood potassium,
and abnormal liver function. Contact your doctor if you ex-
perience any side effect not listed above.
Drug Interactions
•    Gemfibrozil increases the effects of oral anticoagulant (blood-thinning) drugs. Your anticoagulant dosage must be reduced when starting gemfibrozil.
•    Combining gemfibrozil with a statin cholesterol- lowering drug (atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, or simvastatin) has led to the destruction of skeletal muscles. This effect may begin as early as 3 weeks after you start taking the combination or may not appear for months.
•    Combining gemfibrozil and sulfonylurea antidiabetes drugs or repaglinide may cause unexpectedly low blood sugar levels. The sulfonylurea drug dosage may need adjustment.
•    Gemfibrozil can substantially increase the amount of glitazone antidiabetes drugs in the blood. Glitazone dosages may need to be adjusted.
•    Combining gemfibrozil and cyclosporine may decrease the effectiveness of cyclosporine. This combination should only be used if it is absolutely necessary and the lowest possible dose of gemfibrozil is used.
Food Interactions
Gemfibrozil is best taken on an empty stomach 30 minutes before meals but may be taken with food if it upsets your stomach. It is important that you follow your doctor’s dietary instructions.
Usual Dose
Adult: 1200 mg a day, divided into 2 doses taken 30 minutes
before breakfast and dinner. Child: not recommended.
Overdosage
There have been reported cases of overdosage with gemfibrozil. Symptoms reported with overdosage were abdominal cramps, abnormal liver function tests, diarrhea, joint and muscle pain, nausea, and vomiting. Induce vomiting with ipecac syrup—available at any pharmacy—but call your doctor or local poison control center before doing this. If you go to a hospital emergency room, ALWAYS bring the prescription bottle or container.
Special Information
Your doctor should perform periodic blood counts during the first year of gemfibrozil treatment to check for anemia or other changes in blood components. Liver-function tests are also necessary. Blood-sugar levels should be checked periodically while you are taking gemfibrozil, especially if you are diabetic or have a family history of diabetes.
Gemfibrozil may cause dizziness or blurred vision. Be careful when driving or doing any task that requires concentration.
Gemfibrozil is less effective if you are greatly overweight.
Call your doctor if side effects become severe or intolerable, especially diarrhea, nausea, vomiting, or stomach pain or gas. These may disappear if your doctor reduces the dosage.
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: The safety of using gemfibrozil during pregnancy is not known. When this drug is considered crucial by your doctor, its potential benefits must be carelO%-y weighed against its risks.
It is R(PM1)Wnif this drug passes into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors are more likely to develop drug side effects due to normal declines in kidney function.

Tags: abdominal pain, acute asthma, acute attack, asthma attack, asthma attacks, asthma patients, asthma symptoms, beta 2 agonist, bronchial spasms, bronchitis and emphysema, Bronchospasm, Carbonate, chronic bronchitis, chronic obstructive pulmonary disorder, combination product, cyclosporine, diet, digestive tract, dry mouth, emergency, fetus, foradil aerolizer, formoterol, General Information, generic ingredients, half, herpes simplex virus, high blood pressure, histamine, history of heart disease, hiv drug, Infections, inhibitor, irregular heartbeat, kidney disease, Overdose, pregnancy, prescription, prevention of asthma, rash, stomach, sugar, supplement, throat, tingling in the hands, tricyclic

Aug

13

Ezetimibe - Famciclovir - Famotidine - Felbamate - Felodipine

August 13, 2009 | Leave a Comment

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.

Tags: abdominal pain, anticonvulsant, appetite, appropriate diet, channel, cholesterol lowering agents, cholesterol lowering medicines, diarrhea, dizziness, drug interaction, elevated liver enzyme, epilepsy, erythromycin, exercise, ezetimibe, ezetimibe simvastatin, familial hypercholesterolemia, felbamate, function, GENERIC, generic ingredients, good cholesterol, hardening of the arteries, Headache, heart failure, high blood pressure, high triglycerides, information, Interactions, intercourse, Lennox-Gastaut, liver disease, maximum, muscle ache, muscle disorder, nervousness, placebo, pregnancy, rare genetic disorders, statin drugs, stomach, supervision, theophylline, upset stomach, vomiting

Aug

12

Dicyclomine - Digoxin - Diltiazem

August 12, 2009 | Leave a Comment

Generic Name
Dicyclomine (dih-SYE-kloe-meen) 10j
Brand Names
Bemote    Dilomine
Bentyl    Di-Spaz
Bycloft),e    Or-Tyl Dibent
Type of Drug
Antispasmodic and anticholinergic.
Prescribed For
Irritable bowel, spastic colon, and similar digestive problems; also prescribed for colic in children over age 6 months.
General Information
Dicyclomine hydrochloride has been used for many years to calm “nervous stomach.” It and other anticholinergics work by blocking the effects of the neurohormone acetylcholine in the gastrointestinal (GI) tract. This reduces the mobility of the GI tract and slows the production of enzymes and other secretions.
Cautions and Warnings
Do not take dicyclomine if you are allergic or sensitive to any of its ingredients.
Dicyclomine should not be used by those with obstructive disease of the GI or urinary tract, severe ulcerative colitis, reflux esophagitis, acute bleeding with unstable heart function, myasthenia gravis, or glaucoma.
Dicyclomine should not be used in infants less than age 6 months or by breastfeeding mothers.
This drug should be used with caution if you have heart disease, Down’s syndrome, spastic paralysis, reduced mobility of the stomach and lower esophagus, fever, urinary difficulties, enlarged prostate, hiatal hernia, intestinal paralysis, kidney or liver disease, rapid heartbeat, hyperthyroidism (overactive thyroid gland), high blood pressure, or ulcerative colitis.
Dicyclomine reduces your ability to sweat and may lead to heat exhaustion and heatstroke, which can be life-threatening. Avoid extended heavy exercise and limit your exposure to high temperatures.
Anticholinergenic psychosis has been reported by those taking anticholinergenics, but it usually resolves within 24 hours after discontinuation of the drug.
Possible Side EfferkS
♦ Common: dry mouth, dizziness, blurred vision, nausea, and lightheadedness.
V Less common: drowsiness, weakness, nervousness, constipation, and decreased sweating.
Possible Side Effects (continued)
♦ Rare: drug allergy (symptoms include rash, itching, lives,
and breathing difficulties), confusion, eye pain, dizziness
when rising quickly from a sitting or lying position, a bloated
feeling, difficult or painful urination, headache, memory
loss, and vomiting. Contact your doctor if you experience
any side effect not listed above.
Drug Interactions
•    Antacids containing calcium or magnesium, citrates, sodium bicarbonate, and carbonic anhydrase inhibitor drugs may increase dicyclomine’s therapeutic effect and side effects.
•    Combining dicyclomine with other anticholinergic drugs including atropine, belladonna, clidinium, glycopyrrolate, hyoscyamine, isopropamide, propantheline, and scopolamine may intensify side effects.
•    Dicyclomine may reduce stomach acidity and blood levels of oral ketoconazole (an antifungal).
•    Dicyclomine may decrease the therapeutic effects of anti-glaucoma medications. Taking dicyclomine with corticosteroids used to treat glaucoma may be hazardous.
•    Dicyclomine may counteract the effect of metoclopramide in reducing nausea and vomiting.
•    Taking dicyclomine with a narcotic pain reliever may cause severe constipation.
•    Taking this or any drug that slows the movement of stomach and intestinal muscles with a potassium chloride supplement –especially one in wax-matrix tablet form—may lead to excessive irritation of the stomach.
•    Combining dicyclomine with amantadine, certain drugs to control heart rhythm, antihistamines, nitrates or nitrites, may increase dicyclomine side effects.
•    Dicyclomine may increase the effects of atenolol and digoxin.
•    Pftn0hiazine drugs, monoamine oxidase inhibitor antidepressants, benzodiazepines, and tricyclic antidepressants may increase side effects of dicyclomine. The effectiveness of phenothiazines to control psychotic symptoms may be decreased.
Food Interactions
Take dicyclomine on an empty stomach, a half hour before or 2 hours after a meal.
Usual Dose
Adult: 80-160 mg a day in 4 divided doses. Seniors should receive the lowest possible dosage and increase only as needed. Child (age 2 and over): 5-10 mg 3-4 times a day.
Child (age 6 months-2 years): 5-10 mg of syrup 3-4 times a day. Child (under 6 months): not recommended.
Overdosage
Symptoms include blurred vision; clumsiness; confusion; breathing difficulties; dizziness; drowsiness; dry mouth, nose, or throat; rapid heartbeat; fever; hallucinations; weakness; slurred speech; excitement, restlessness, or irritability; warmth; and dry or flushed skin. Take the victim to a hospital emergency room at once. ALWAYS bring the prescription bottle or container.
Special Information
Children taking dicyclomine may be more likely to develop high body temperature in hot weather and other side effects and should be carefully watched for side effects. Dicyclomine should not be given to infants or children unless the doctor decides that its use is absolutely necessary.
Call your doctor if you develop diarrhea, rash, flushing, eye pain, dry mouth, urinary difficulties, constipation, increased sensitivity to light, or any bothersome or persistent side effect.
Brush and floss your teeth regularly while taking this drug. Because dicyclomine may cause dry mouth, you may be more likely to develop cavities or other dental problems. Ice or hard candy may relieve dry mouth.
Constipation may be treated by using a laxative.
Dicyclomine may make you drowsy or tired and cause blurred vision. Be careful when driving or doing any task that requires concentration.
If you forget 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: A few cases of human malformation were linked to dicyclomine, but studies have shown that the drug has no effect on the fetus. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Dicyclomine can reduce the amount of milk produced. Infants given dicyclomine may faint, go limp, and develop breathing problems and seizures. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may be more susceptible to side effects, especially memory loss, changes in mental state, and glaucoma. Seniors may obtain maximum benefit with smaller dosages.

Generic Name
Digoxin (dih-JOX-in) A
Brand Names Digitek
Lanoxicaps
Lanoxin
Type of Drug Cardiac glycoside.
Prescribed For
Congestive heart failure (CHF) and other heart conditions involving a very rapid heartbeat.
General Information
Digoxin works directly on heart muscle. It improves the heart’s pumping ability or helps to control its beating rhythm. People with heart failure often develop swelling of the lower legs, feet, and ankles; digoxin improves these symptoms by improving blood cir-
Digoxin is generally used as part of the lifelong treatment of CHF.
Cautions and Warnings
Do not use digoxin if you are allergic or sensitive to it. Digoxin allergies are rare.
Digoxin should not be used in people with ventricular fibril-
lation.
Digoxin should be used with caution in people with sick sinus
syndrome or incomplete AV block, as it may cause a worsening of these conditions.
Digoxin has been used to treat obesity. The risk of fatal heart rhythms associated with such treatment makes it extremely dangerous as weight-loss medication. Many heart disease symptoms may be associated with digoxin. Report any unusual side effects to your doctor at once.
Kidney disease may increase blood levels of digoxin. Your dosage may need adjustment.
Long-term use of digoxin may cause the body to lose potassium, especially since it is generally used in combination with diuretics (agents that increase urination). For this reason, be sure to eat a balanced diet and high-potassium foods—bananas, citrus fruits, melons, and tomatoes.
Digoxin should be used with caution in people with electrolyte disorders.
Digoxin requirements vary with thyroid status. If you are taking digoxin and your thyroid status changes, your doctor will have to alter your digoxin dosage.
Possible Side Effects
Adult and Senior
♦    Common: dizziness, headache, nausea, and diarrhea.
✓    Less common: appetite loss, vomiting, weakness, apathy, drowsiness, blurred or yellow-tinted vision, seeing halos around bright lights, depression, psychoses, confusion or disorientation, restlessness, hallucinations, delirium, seizure, nerve pain, abnormal heart rhythms, and slow pulse.
✓    Rare: Enlargement of the breasts has been reported after long-term use of digoxin. Contact your doctor if you experience any side effect not listed above.
Child
T Children are more likely to develop abnormal heart rhythms before they see yellow or green halos or spots and before they develop nausea, vomiting, diarrhea, or stomach pain. Any abnormal heart rhythms that develop while a child is taking digoxin should be assumed to be a side effect.
Drug Interactions
•    Drugs that may increase the effect of digoxin are alprazolam, amiloride aminoglycoside antibiotics, amiodarone, anticholinergic drugs, benzodiazepines, captopril, clarithromycin, diltiazem, diphenoxylate, dipyridamole, erythromycin, esmolol, felodipine, flecainide, hydroxychloroquine, ibuprofen, indomethacin, itraconazole, nifedipine, nitrendipine, omeprazole, propafenone, propantheline, quinidine, quinine, spironolactone, tetracycline, tolbutamide, triamterene, and verapamil.
•    Drugs that may decrease blood levels of digoxin include aminoglutethimide, aminoglycosides, aminosalicylic acid, antacids, anti-cancer combinations, antidiabetes medication, antihistamines, barbiturates, cholestyramine, colestipol, cyclosporine, kaolin-pectin mixtures, metoclopramide, oral kanamycin, oral neomycin, oral sulfonylureas, phenylbutazone, phenytoin and related anti-seizure drugs, rifampin, St. John’s wort, sucralfate, and sulfasalazine.
•    Disopyramide may alter the effects of digoxin, although the exact interaction is not well understood.
•    Thiazide and loop diuretics, furosemide, ethacrynic acid, and bumetanide increase digoxin’s effect and increase the risk of side effects.
•    Spironolactone may increase or decrease the side effects of digoxin; amiloride may reduce the effect of digoxin on the force of heart contraction.
•    The effects of digoxin on the heart may be additive to those of ephedrine, epinephrine and other stimulants, beta blockers, calcium salts, procainamide, and rauwolfia drugs.
•    Digoxin dosage must be adjusted when it is combined with a thyroid drug.
Food Interactions
These drugs may generally be taken without regard to meals. Taking your medication after a high-fiber meal reduces the amourxtcil drug absorbed into your blood.
Usual OQSS
Adult and Child (age 10 and over): starting dosage—known as the digitalizing or loading dose—is about 4-7 mcg per lb. of body weight. Digitalization may also be accomplished with a lower dosage over 7 days. Maintenance dosage    0.125-0.5 mg; it must be corrected for kidney function. For seniors, a lower dosage is required.
Child (under age 1o): starting dosage-5-30 mcg per lb. of body weight. Maintenance dosage-20-35% of the starting dosage. Careful measurement of your child’s digoxin dosage is crucial to safe and effective treatment.
Overdosage
Adult: Symptoms include appetite loss, nausea, vomiting, diarrhea, headache, weakness, apathy, blurred vision, yellow or green spots or halos before the eyes, yellowing of the skin or whites of the eyes, and changes in heartbeat.
Senior: Vomiting, diarrhea, and eye trouble are frequently seen. Child: An early sign is a change in heart rhythms.
Call your doctor immediately if any of these symptoms appear. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Take each day’s dose at the same time of day.
Do not stop taking digoxin without your doctor’s knowledge.
Lanoxicaps are better absorbed than tablet forms of digoxin. For this reason, each dose of Lanoxicaps is slightly lower than the corresponding digoxin tablet.
Avoid over-the-counter diet and cold medications containing stimulants.
Call your doctor at once if you develop side effects.
There may by some variation between digoxin tablets from different manufacturers. Do not change drug brands without telling your doctor.
Check your pulse every day—your doctor will teach you how—and call your doctor if it drops below 60 beats per minute.
If you forget a dose and remember at least 12 hours before your next dose, take it right away. If you do not remember until it is less than 12 hours before your next dose, skip the one you forgot and continue with your regular schedule. Do “lot take a double dose. Call your doctor if you M1 a dose for 2 or more days.
Special Populations
Pregnancy/Breast-feeding: Digoxin crosses into the fetal circulation. While digoxin is sometimes used during pregnancy to treat fetal heart disease, women who are or might be pregnant should not take digoxin without their doctor’s approval. When your doc-tor considers this drug crucial, its potential benefits must be care-
fully weighed against its risks.
Small amounts of digoxin pass into breast milk. Nursing mothers who take digoxin should use infant formula.
Seniors: Seniors are more sensitive to digoxin’s effects, especially appetite loss. Seniors with impaired renal function may need lower
dosages.

Generic Name
Diltiazem (dil-TYE-uh-zem) 92
Brand Names
Cardizem    Dilt-CD
Cardizem CD    Diltia XT
Cardizem LA    Diltzac
Cartia XT    Taztia XT
Dilator XR    Tiazac
Type of Drug
Calcium channel blocker.
Prescribed For
Angina pectoris, chronic stable angina, Raynaud’s disease, prevention of second heart attacks, tardive dyskinesia (severe side effects associated with antipsychotic and other drugs), and hypertension (high blood pressure).
General Information
Diltiazem hydrochloride is one of many calcium channel blockers available in the U.S. These drugs block the passage of calcium, an essential factor in muscle contraction, into the heart and smooth muscles. Such blockage of calcium interferes with the contraction of these muscles, which in turn dilates (widens) the veins and ves sels that supply blood to them. This ditatk”q effect reduces blood pressure, the amount 0 Oxygen used by the heart muscle, and the ~1A 0 blood vessel spasm. Diltiazem is therefore useful in treating not only hypertension but also angina pectoris, a condition related to poor oxygen supply to the heart muscle and characterized by brief attacks of chest pain.
Diltiazem affects the movement of calcium only into muscle cells; it has no effect on calcium in the blood.
Cautions and Warnings
Do not take d,1taz&m1f you are allergic or sensitive to any of its
ingredients.
Diltiazem can slow your heart and interfere with normal electrical conduction. For people with a condition called sick sinus syndrome, this can result in temporary heart stoppage.
Diltiazem should not be taken if you are having a heart attack or if you have lung congestion. Diltiazem should be taken with caution by people with heart failure because it can worsen that condition.
Low blood pressure may occur, especially in people also taking a beta blocker.
Studies have shown that people taking calcium channel blockers—usually those taken several times a day, not those taken once daily—have a greater chance of having a heart attack than people taking beta blockers or another medicine for the same purposes. Discuss this with your doctor to be sure you are receiving the best possible treatment.
Diltiazem can cause severe liver damage and should be taken with caution if you have had hepatitis or any other liver condition.
Caution should also be exercised if you have a history of kidney problems, although no clear tendency toward causing kidney damage is seen with this drug.
Possible Side Effects
♦    Common: dizziness, lightheadedness, weakness, head-
ache, and fluid accumulation in the hands, legs, or feet.
✓    Less common: low blood pressure, fainting, increase or decrease in heart rate, abnormal heart rhythm, heart failure, nervousness, fatigue, nausea, rash, tingling in the hands or feet, hallucinations, temporary memory loss, difficulty sleeping, diarrhea, vomiting, constipation, upset stomach, itching, unusual sensitivity to sunlight, paxnlu) or stiff joints, liver inflammation, and increased urination, especially at night.
Drug Interactions
•    Diltiazem taken with a beta-blocking drug for hypertension is usually well tolerated, but may lead to heart failure in people with already weakened hearts.
•    Calcium channel blockers, including diltiazem, may add to
the effects of digoxin. This effect is not observed with any
consistency, however, and only affects people with a large
amount of digoxin already in their systems.
•    Cimetidine and ranitidine increase the amount of diltiazem in the bloodstream and may account for a slight increase in the drug’s effect.
•    Diltiazem may increase blood levels of cyclosporine, carbamazepine, encainide, and theophylline, and thus increase the chance of side effects from these drugs.
•    Diltiazem may cause a decrease in blood lithium levels, possibly undermining lithium’s antimanic effect.
•    Calcium channel blockers may cause bleeding when taken alone or combined with aspirin.
Food Interactions
Diltiazem is best taken on an empty stomach, at least 1 hour before or 2 hours after meals.
Usual Dose
Immediate-Release Products 30-60 mg 4 times a day.
Sustained-Release/Extended-Release Products Cardizem CD: 120-480 mg once a day. Cardizem LA: 120-540 mg once a day. Cartia XT: 120-300 mg once a day. Dilacor XR: 180-480 mg once a day. Dilt-CD: 120-360 mg once a day. Diltia XT: 180-480 mg once a day. Diltzac: 120-360 mg once a day. Taztia XT: 120-150 mg once a day. Tiazac: 120-360 mg once a day.
Overdosage
Symptoms of diltiazem overdose are very low blood pressure and reduced heart rate. Overdose victims must be made to vomit with 1J)8C2c syrup—available at any pharmacy—within 30 minutes of taking the overdose. Do not induce vomiting if the victim has fainted or is convulsing. If overdose symptoms have developed or more than 30 minutes have passed, vomiting is of little value. Take the victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special information
Call your doctor if you develop any of the following symptoms! swelling of the hands, legs, or feet-, severe dizziness; constipation or nausea; or very low blood pressure.
Do not open, chew, or crush sustained-release capsules of
diltiazem.
If you take your diltiazem 3 or 4 times a day and forget a dose, take it as soon as you remember. Space the remaining doses throughout the rest of the day. If you take diltiazem 1 or 2 times a day and forget to take 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. Never take a double dose.
Special Populations
Pregnancy/Breast-feeding: In animal studies. high doses of diltiazem interfered with the development of the fetus. Diltiazem should not be taken by women who are or might be pregnant. When your doctor considers this drug crucial, its potential benefits must be carefully weighed against its risks.
Because diltiazem passes into breast milk, nursing mothers taking this drug should use infant formula.
Seniors: Seniors may be more sensitive to the effects of this drug because it takes longer to pass out of their bodies.

Tags: acetylcholine, alprazolam, anticholinergic, antispasmodic, balanced diet, breastfeeding mothers, dicyclomine, digestive problems, digoxin, dizziness blurred vision, dosage, Drug, effect, gi tract, heart, heart function, heatstroke, hiatal hernia, high blood pressure, histamine, hospital, ketoconazole, kidney, liver disease, maximum, medication, Medications, metoclopramide, nervous stomach, omeprazole, overactive thyroid gland, ranitidine, rapid heartbeat, reason, Senior, spastic paralysis, spironolactone, status, sye, T Children, ulcerative colitis

Aug

1

Chlorpheniramine Maleate

August 1, 2009 | Leave a Comment

Generic Name
Chlorpheniramine Maleate
(KLOR-ten-ERE-uh-mene MAL-ee-ate) M
Brand Names
Aller-Chlor    Efidac 24
Chlor-Trimeton    Pediox S
Chlor-Trimeton Allergy 8 Hour    Prohist+8 Chlor-Trimeton Allergy 12 Hour QDALL AR
The information in this profile also applies to the following drugs: Generic Ingredient: Cyproheptadine Hydrochloride 0
Generic Ingredient: Dexchlorpheniramine Maleate 19
Type of Drug Antihistamine,
Prescribed For
Stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal allergy, and other symptoms of allergy such as rash, itching, and hives.
General Information
Antihistamines generally work by blocking the release of histamine (a chemical released by body tissue during an allergic reaction) from body cells at the H, histamine receptor site, drying up secretions of the nose, throat, and eyes.
Cautions and Warnings
Do not use this drug if you are allergic or sensitive to any of its ingredients.
Use chlorpheniramine maleate with care if you have a history of thyroid disease, heart disease, high blood pressure, or diabetes. This drug should be avoided or used with extreme care if you have narrow-angle glaucoma, stomach ulcer or other stomach problems, enlarged prostate, or problems passing urine. It should not be used by people who have deep-breathing problems such as asthma, emphysema, or chronic bronchitis.
Possible Side Effects
V Less common: rash or itching, sensitivity to bright light, increased sweating, chills, lowered blood pressure, headache, rapid heartbeat, sleeplessness, dizziness, disturbed coordination, confusion, restlessness, nervousness, irritability, euphoria (feeling “high”), tingling in the hands or feet, blurred or double vision, ringing in the ears, upset stomach, appetite loss, nausea, vomiting, constipation, diarrhea, urinary difficulties, chest tightness, wheezing, stuffy nose, and dryness of the mouth, nose, or throat. Young children may also develop nervousness, irritability, tension, and anxiety.
Drug Interactions
•    chlorpheniramine maleate should not be taken with a mono-amine oxidase inhibitQ(aMkdepiessank, because the combination may cause severe side effects.
•    The effects of sedatives, benzodiazepines such as diazepam, and sleeping medications will be increased when any of these drugs is combined with chlorpheniramine maleate. It is extremely important for your doctor to know if you are taking any other medication with chlorpheniramine maleate so that the dosage of that medication can be properly adjusted.
•    Anti chol inergenics may cause an increase in side effects of chlorpheniramine maleate.
•    Be extremely cautious when drinking alcoholic beverages while taking this drug, which enhances the intoxicating and sedating effects of alcohol.
Food Interactions
You may take this drug with food if it upsets your stomach.
Usual Dose
chlorpheniramine
Adult and Child (age 13 and over): 4 mg every 4-6 hours; do not take more than 24 mg a day.
Child (age 6-12): 2 mg every 4-6 hours; do not take more than 12 mg a day.
Child (age 2-5): 1 mg every 4-6 hours; do not take more than 4 mg a day.
chlorpheniramine, Sustained-Release
Adult and Child (age 13 and over): 8-12 mg at bedtime, or every 8-12 hours during the day; do not take more than 24 mg a day. Child (age 6-12): 8 mg during the day or at bedtime.
Child (under age 6): not recommended.
Cyproheptadine
Adult and Child (age 15 and over): 4-20 mg a day; do not exceed 32 mg a day.
Child (age 7-14): 4 mg 2-3 times a day; do not exceed 16 mg a day.
Child (age 2-6): 2 mg 2-3 times a day; do not exceed 12 mg a day.
Dexchlorpheniramine
Adult and Child (age 12 and over): 2 mg every 4-6 hours. Child (age 6-11): 1 mg every 4-6 hours.
Child (age 2-5): 0.5 mg every 4-6 hours.
Dexchlorpheniramine, Sustained-Release
Adult and Child (age 12 and over): 4-6 mg every 8-10 hours and at bedtime.
Child (age 6-11): 4 mg once a day and at bedtime. Child (under age 6): not recommended.
Tripelennamine
Adult and Child (age 12 and over): 25-50 mg every 4-6 hours; do not take more than 600 mg a day. Adults may take up to 3100-mg, sustained-release tablets a day, although this much is not usually needed.
Child (under age 12): 2 mg per lb. of body weight a day in divided doses; no more than 300 mg a day should be given.
Overdosage
Symptoms of overdose include depression or stimulation, especially in children; dry mouth: fixed or dilated pupils; flushing of the skin; upset stomach; unsteadiness; and convulsions. Overdose victims should be made to vomit as soon as possible with ipecac syrup—available at any pharmacy—to remove excess drug from the stomach. Take the victim to a hospital emergency room immediately if the victim is unconscious.or if you cannot induce vomiting. ALWAYS bring the prescription bottle or container.
Special Information
This drug may cause tiredness or loss of concentration: Be extremely cautious when driving or doing anything that requires close attention.
If you forget a dose of this drug, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
PregnancylBreast-feeding., Animal studies have shown that some antihistamines may cause birth defects. Do not take any antihistamine without your doctor’s knowledge if you are or might be pregnant—especially during the last 3 months of pregnancy, because newborns may have severe reactions to antihistamines.
Small amounts of some antihistamines pass into breast milk. NV ing mothers who must take chlorpheniramine maleate should use infant formula.
Seniors: Seniors are more sensitive to antihistamine side effects. Dosage reduction may be needed.

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Jul

16

Alpha Blockers

July 16, 2009 | Leave a Comment

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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Jul

16

Aliskiren

July 16, 2009 | Leave a Comment

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

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

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

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Jul

16

Aldosterone Blockers

July 16, 2009 | Leave a Comment

Type of Drug
Aldosterone Blockers (al-DOH-stir-own)
Brand Names
Generic Ingredient: Eplerenone Inspra
Generic Ingredient. Spironolactone Aldactone
Combination Product
Generic Ingredients: Hydrochlorothiazide + Spironolactone Aldactazide
Prescribed For
High blood pressure, cirrhosis, and congestive heart failure (CHF); also used for people with low blood potassium who require a diuretic.
General Information
Aldosterone blockers limit the access of aldosterone—a hormone that helps to regulate several different body functions—from its receptor. Too much aldosterone results in high sodium levels, which can lead to water retention and potassium loss; it can also affect the size, shape, and function of the heart. Aldosterone blockers are generally combined with other medicines in the management of disease. These drugs are useful in removing excess body fluids in conditions associated with high aldosterone levels.
One in every ten people with high blood pressure has excess aldosterone in their systems. In people with congestive heart failure (CHF), aldosterone levels can be 20 times higher than normal, which can worsen their condition, making the use of aldosterone blockers an important part of their treatment. Aldosterone block-ers also help the heart return to normal size, shape, and function in people with heart failure. Eplerenone is broken down in the liver, primarily by an enzyme system known as CYP3A4.
Cautions and Warnings
Do not take aldosterone blockers if you are allergic or sensitive to any of their ingredients.
Do not use aldosterone blockers if you have kidney failure or high blood potassium.
People with liver disease should be cautious about using a!- dosterone blockers.
People taking an aldosterone blocker should have their potassium levels checked periodically.
People with diabetes who have albumin in their urine should not take aldosterone blockers.
Possible Side Effects
Eplerenone
✓    Less common: dizziness, diarrhea, fatigue, flu-like symptoms, coughing, abdominal pain, elevation of blood cholesterol and/or triglyceride levels, elevation of blood potassium levels, and albumin in the urine.
✓    Rare: enlargement of the breasts in males, irregular menstrual cycles in women, and painful breasts. Contact your doctor if you experience any side effect not listed above.
Spironolactone
✓    Less common: drowsiness, lethargy, headache, gastrointestinal upset, cramps and diarrhea, rash, mental confusion, fever, feeling unwell, enlargement of the breasts in males, impotence, and irregular menstrual cycles or deepening of the voice in women.
Drug Interactions
•    Do not combine eplerenone with itraconazole or ketoconazole. These drugs can cause the amount of eplerenone in the blood to increase by up to 500% and may cause fatal increases in blood potassium.
•    Mixing eplerenone with erythromycin, fluconazole, saquinavir, or verapamil increases the amount of eplerenone in the blood. People taking this combination must watch for signs of high blood potassium (see “Special Information”) and have their blood potassium levels checked regularly.
•    Combining a potassium supplement and an aldosterone blocker can lead to dangerously high blood levels of potassium. Do not use a salt-substitute or take any extra potassium unless prescribed by your doctor.
•    Combining an aldosterone blocker with an ACE inhibitor or an angiotensin H receptor blocker (ARB) may significantly raise blood potassium. Be sure your doctor monitors your potassium levels if you combine these drugs.
•    Spironolactone may interfere with anticoagulant (blood-thinning) drugs and mitotane (an anticancer drug).
•    Aspirin can interfere with the diuretic effect of spironolactone but does not alter its effect on high blood pressure or CHF.
•    Combining spironolactone with alcohol, barbiturates, or narcotics can lead to dizziness or fainting when rising suddenly from a sitting or lying position.
•    Combining spironolactone and a corticosteroid can lead to very low blood potassium.
•    Spironolactone may alter your response to drugs used during general anesthesia.
•    Lithium generally should not be combined with any diuretic.
•    Combining nonsteroidal anti-inflammatory drugs (NSAIDs) with aldosterone blockers can lead to severe elevations of blood potassium and reduce the blood-pressure-lowering effect of the diuretic.
•    Spironolactone may raise digoxin blood levels and increase the risk of severe digoxin side effects. Your doctor may have to adjust your digoxin dosage.
•    St. John’s wort (a CYP3A4 inducer) may decrease eplerenone levels by about 30%.
Food Interactions
Food appears to increase the amount of spironolactone absorbed into the blood. Take this drug with food at the same time every day. Eplerenone may be taken without regard to food or meals. Taking this drug with grapefruit juice increases the amount of drug absorbed into your body.
Usual Dose
Eplerenone
Adult 50-100 mg a day. Child: not recommended.

Spironolactone
Adult: Starting dosage is 50-100 mg a day in divided doses for high blood pressure; 25-200 mg a day in divided doses for high fluid levels related to other diseases; and 25-100 mg a day for low potassium levels related to diuretic use.
Child: 1-2 mg per lb. of body weight a day.
Spironolactone + Hydrochlorothiazide Adult: 1-4 tablets daily.
Overdosage
Eplerencne overdose may lead to low blood pressure and high blood potassium. Spironolactone overdose may lead to drowsiness. confusion, rash, nausea, vomiting, dizziness, and diarrhea. Rarely. coma may occur in people with severe liver disease. High blood potassium may also occur, especially in people with kidney zsease. Call your local poison control center or a hospital emercency room for more information. If you seek treatment, ALWAYS oring the prescription bottle or container.
Special Information
<e a c!osterone blockers exactly as they are prescribed.
High blood levels of potassium associated with aldosterone blockers may cause weakness, lethargy, drowsiness, muscle pain or cramps, and muscular fatigue. Use caution while doing anything that requires intense concentration, like driving or operating machinery.
Do not use a salt substitute or take anything else that is a source of extra potassium, including many multivitamin or supplement products.
People with high blood pressure should not self-medicate with over-the-counter cough, cold, or allergy remedies containing stimulants. These drugs can raise blood pressure effectiveness and have an adverse effect on the heart.
!f you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Animal studies with eplerenone showed no effects on a developing fetus. Spironolactone crosses into the fetal circulation. When your doctor considers either of these drugs crucial, their potential benefits must be carefully weighed against their risks.

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Jul

16

Adderall

July 16, 2009 | Leave a Comment

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

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

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

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

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