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

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

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

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

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Generic Name
Clarithromycin (klah-rith-roe-MYE-sin) 91
Brand Names Biaxin
Type of Drug  Macrolide antibiotic.
Biaxin XL
Prescribed For
Mild to moderate infections of the upper and lower respiratory tract, tonsillitis, pharyngitis, sinusitis, exacerbation of chronic bronchitis, middle-ear infections, and for duodenal ulcers; also used for skin and other infections, including membrane attack complex (MAC) in people with advanced HIV infection.
General Information
Clarithromycin and other macybYide antibiotics are either bacteri(;((JW (’UaCkeeia-killing) or bacteriostatic (inhibiting bacterial growth), depending on the organism in question and amount of antibiotic present. In ulcer disease, clarithromycin is used to fight Helicobacter pylori infection, which is present in almost all ulcers and most cases of stomach inflammation.
Cautions and Warnings
Do not take clarithromycin if you are allergic or sensitive to any of its ingredients or to any macrolide antibiotic.
Clarithromycin should not be used during pregnancy.
Clarithromycin is primarily eliminated from the body through the liver and kidneys. People with severe kidney disease may require dose adjustments. Liver disease generally does not require an adjustment.
Colitis (bowel inflammation) has been associated with all antibiotics (see “Possible Side Effects”). If colitis does develop, your doctor should start appropriate treatment. Mild cases of colitis usually respond to the discontinuation of the medicine.
Possible Side Effects
Most side effects are mild and go away once you stop taking clarithromycin.
✓    Most common: nausea, upset stomach, changes in sense of taste, headache, he. diarrhea, abdominal pain, vomiting, and rash in children. Colitis (symptoms include severe abdominal cramps and severe, persistent, and possibly bloody diarrhea) may develop.
✓    Rare: serious abnormal heart rhythms. Contact your doc-
tor if you experience any side effect not listed above.
Drug Interactions
•    Clarithromycin may increase the anticoagulant (blood-thinning) effects of warfarin in people who take it regularly, especially older adults. This combination requires careful monitoring by your doctor.
•    Do not combine clarithromycin with astemizole or terfenadine.
•    Combining clarithromycin and omeprazole raises the amount of both drugs in the blood.
•    Two deaths have been reported in people combining Oarithromycin and pimozidp_ ?imuiide should not be used by peibp)e faking a macrolide antibiotic.
•    Clarithromycin may raise blood levels of theophylline, possibly leading to a theophylline overdose. It can also increase the effects of caffeine.
•    Combining clarithromycin and digoxin, cyclosporine, ergot
alkaloids, or tacrolimus may lead to serious side effects.

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

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

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

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

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

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

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

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

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Brand Name
Aggrenox
Generic Ingredients
Dipyridamole + Aspirin
Type of Drug  Antiplatelet.
Prescribed For
Prevention of recurrent stroke or transient ischemic attack (TIA)— “mini-stroke.”
General Information
Stroke is often the result of a clot blocking flow in a blood vessel supplying the brain. Aggrenox helps prevent blood clot formation by reducing the “stickiness” of platelets, blood cells that stick together to form the beginnings of all clots. In one study, Aggrenox reduced the risk of stroke by over 30% compared to placebo in people who had recently had a stroke or TIA.
Cautions and Warnings
Do not use this drug if you are allergic or sensitive to any of its ingredients or any nonsteroidal anti-inflammatory drug (NSAID). People who have asthma, nasal polyps, or chronic runny nose, are likely to be sensitive to aspirin.
The aspirin in Aggrenox can cause Reye’s syndrome, a severe reaction (vomiting, lethargy, and belligerence, and possibly worsening to coma) in children under age 16.
People with a history of stomach ulcers or stomach problems should avoid Aggrenox.
People who have angina or have had a recent heart attack should be very cautious about taking this drug. It may worsen chest pain.
People with low blood pressure, liver disease, or kidney failure should be cautious about taking this drug.
People taking Aggrenox may bleed for longer amounts of time. Those with bleeding disorders should avoid Aggrenox.

Possible Side Effects
✓    Most common: headache, upset stomach, abdominal pain, nausea, and diarrhea.
✓    Common: pain, tiredness, and vomiting.
✓    Less common: convulsions, rectal bleeding, blood in the stool, hemorrhoids, back pain, accidental injuries, stomach bleeding, feeling unwell, weakness, fainting, memory loss, arthritis, joint or muscle pain, coughing, and respiratory infection.
✓    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
•    Avoid alcohol. People who take 3 or more drinks a day while using any aspirin-containing product are more likely to develop stomach ulcers or bleeding.
•    Aspirin may reduce the blood-pressure-lowering effects of angiotensin-converting enzyme (ACE) inhibitor drugs, beta blockers, and diuretics.
•    Combining aspirin and acetazolamide or an NSAID can cause kidney problems.
•    Aspirin can increase the blood-thinning effects of anticoagulant (blood-thinning) drugs such as warfarin. Avoid this combination.
•    Aspirin can increase the effects of oral antidiabetes drugs, possibly leading to low blood sugar.
•    Aspirin counteracts the uric-acid-eliminating effects of probenecid and sulfinpyrazone.
•    Aspirin can increase the toxic effects of anticonvulsant drugs and methotrexate.
•    Dipyridamole increases the level of adenosine in the blood and may increase cardiovascular-related side effects. The adenosine dosage may need to be adjusted when these two drugs are combined.
•    Dipyridamole may interfere with cholinesterase inhibitors used to treat myasthenia gravis.
Food Interactions
Aggrenox is best taken on an empty stomach but may be taken with food if it upsets your stomach.

Usual Dose
Adult: 1 capsule (200 mg of sustained-release dipyridamole and 25 mg of aspirin) morning and evening.
Child: not recommended.
Overdosage
Symptoms include a sensation of warmth, flushing, sweating, restlessness, weakness, dizziness, low blood pressure, and rapid heartbeat. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you experience blood in your stool, persistent diarrhea, or abdominal or stomach pain.
Avoid alcohol while taking this drug.
In people taking Aggrenox, minor cuts may take longer than normal to stop bleeding.
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.
Swallow Aggrenox tablets whole; do not crush or chew them.
Special Populations
Pregnancy/Breast-feeding: Pregnant women should avoid Aggrenox because of its aspirin content. Aspirin can cause bleeding problems in mother and fetus and result in a low-birth-weight infant. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Both ingredients in Aggrenox pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may need a reduced dose of Aggrenox.

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Generic Name
Acetazolamide (uh-sete-uh-ZOLE-uh-mide) [6j
Type of Drug
Carbonic-anhydrase inhibitor.
Prescribed For
Glaucoma and prevention or treatment of mountain sickness; also prescribed for epilepsy and treatment of drug-induced swelling or swelling due to congestive heart failure.
General Information
By blocking an enzyme in the body called carbonic anhydrase, acetazolamide produces a weak diuretic effect that helps to treat glaucoma by reducing pressure inside the eye. Acetazolamide’s antiseizure properties are also produced by its effect on carbonic anhydrase, though exactly how acetazolamide prevents seizure is not well understood.

Cautions and Warnings
Do not take acetazolamide if you are allergic or sensitive to any of its ingredients or to sulfa drugs.
Do not take acetazolamide if you have low blood sodium or potassium, diabetes, or serious kidney, liver, or Addison’s disease.
Possible Side Effects
Side effects of short-term therapy are usually minimal.
✓    Most common: nausea or vomiting; tingling feeling in the arms, legs, lips, mouth, or anus; appetite and weight loss; a metallic taste; increased frequency in urination; diarrhea; not feeling well; occasional drowsiness; and weakness. You may also experience rash, drug crystals in the urine, painful urination, low back pain, urinary difficulty, and low urine volume.
♦    Rare: Rare side effects can affect the liver, mental state, blood sugar, muscles, and senses. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Avoid over-the-counter drug products that contain stimulants or anticholinergics, which tend to aggravate glaucoma and cardiac disease.
•    Acetazolamide may increase blood concentrations of cyclosporine (used to prevent the rejection of transplanted organs).
•    Acetazolamide may block or delay the absorption of primidone (prescribed for seizure).
•    Avoid aspirin because it may enhance acetazolamide side effects.
•    Combining diflunisal and acetazolamide can result in an excessive lowering of eye pressure.
Food Interactions
Acetazolamide may be taken with food if it upsets your stomach. Because acetazolamide can increase potassium loss, take this drug with potassium-rich foods such as bananas, citrus fruits, melons, and tomatoes.

Usual Dose
Glaucoma
Adult: 250-1000 mg a day.
Child: 4.5-6.75 mg per lb. a day in divided doses.
Diuresis in congestive heart failure or drug-induced swelling Adult: 250-375 mg a day.
Child: 2.25 mg per lb., once daily in the morning.
Epilepsy: 375-1000 mg a day in divided doses.
Mountain Sickness: 500-1000 mg a day. If possible begin medication 24-48 hours before ascent.
Overdosage
Symptoms of overdose include drowsiness, loss of appetite, nausea, vomiting, dizziness, tingling in the hands or feet, weakness, tremors, or ringing or buzzing in the ears. In case of overdose, induce vomiting as soon as possible with ipecac syrup—available at any pharmacy—and take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Acetazolamide may cause minor drowsiness and confusion, particularly during the first 2 weeks of therapy. Be careful when driving or doing any task that requires concentration.
Call your doctor if you develop sore throat, fever, unusual bleeding or bruises, tingling in the hands or feet, rash, or unusual pains.
Acetazolamide can increase sensitivity to the sun. Avoid prolonged sun exposure and protect your eyes while taking this drug.
Be sure to drink plenty of water or fluids while taking acetazolamide.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: High doses of this drug may cause birth defects or interfere with fetal development. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Small amounts of acetazolamide may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors are more sensitive to this drug’s side effects.

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Cancer of the Prostate
Cancer of the prostate, or adenocarcinoma of the prostate, as it is technically called, is a malignant growth occurring
in the prostate gland ford motor co lithium vehicles . It is an alarmingly common problem, though most men would probably be surprised to learn this on about citalopram 20mg .
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A DISEASE OF OLD AGE
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SURVIVAL RATES
The question in the mind of any man who is reading this will probably be: If I get prostate cancer, what are my chances
of survival?
The answer to this vexed question is not a simple or an obvious one caffeine breastfeeding coke . This is because it depends on so many things:
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• The state of your overall health, prostate apart first try sucess stories using clomid .
• At what stage the cancer was discovered singulair aerator 780 .
In a man over the age of 70, the survival rate is about 50 per cent prilosec infant . It is higher in a younger man - the younger he is,
the greater his chances of survival paxil lawyers san diego . His chances are also higher if the cancer was detected early on in its growth duracell lithium manganese batteries rc .
WHAT CAUSES IT?
The exact cause of prostate cancer remains a mystery, though the male hormone testosterone appears to have some
involvement lithium polymer battery pv use . Quite what that is, though, is not certain testosterone shot women .
Certain risk factors have, however, been identified breast cancer risperdal . Firstly, and like a great many cancers, cancer of the prostate is
known to run in families mobic 15 mg infomation . If a close relative - say, a brother or father - has cancer of the prostate, a man’s risk of’
developing the disease seems to be nearly three times greater than that of a man who does not have any family history of
the disease phenergan black box warning . If a man has more than one relative with prostate cancer - say, a grandfather or uncle as well as a brother
or father - his chances of developing the disease are as many as six times greater than that of a man who does not have
any family history of the disease evista buy online .
There do, however, seem to be other factors involved brain shiver symptoms from withdrawal effexor . Diet is one of these mrsa osteomyelitis vacomycin efficacy zyvox efficacy . The typical UK diet, for example - which is
usually low in green vegetables, fruit and pulses and high in animal fats in the form of meat and dairy products - may
well be a contributing factor lithium manganese battery charging .
According to the Cancer Research Campaign, black American men have the highest incidence of prostate cancer, with some 50
per cent more cases than in the US white male population soma muscle relax . This is probably because they have a higher than usual level of
testosterone prednisone how fast does it work .
The number of sexual partners a man has had may have a link with the development of prostate cancer, though this has not
been proved prevacid how long . In particular, the wart virus (human papilloma virus), which is usually sexually transmitted, may increase a
man’s chances of developing cancer of the prostate, in much the same way as it predisposes a woman to developing cancer
of the cervix maker of zoloft .
SYMPTOMS
Very often there are, unfortunately, no early signs of prostate cancer casodex pharmacy . which makes its early detection very difficult overnight generic viagra american express .
The great majority - up to 90 per cent - of cancers begin on the outside of the prostate, which means that they do not
usually obstruct urinary flow in the early stages of the disease, and can therefore go unnoticed for some time effects of metoprolol succ er .
And they can remain undetected for some time because prostate cancer is very slow in spreading amoxicillin trying to conceive . It may be as long as four
years before the cancer has doubled in size, and this, too, makes its early diagnosis very difficult unless people have
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In its later stages, however, prostate cancer has similar symptoms to those of an enlarged prostate clindamycin pharmacophore . It is not unusual,
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be alarmist, however, and any man who is being investigated for an enlarged prostate should not panic fluticasone propionate high blood pressure . An enlarged
prostate is ten times more common than prostate cancer, so the odds are greatly in your favour - it’s just that the two
conditions do have similar symptoms allegra breedlove harry potter . As has already been discussed (see Chapter 5), the symptoms of an enlarged prostate
are:
• A weak, sluggish urinary stream, which may be particularly noticeable first thing in the morning; you may notice
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• Difficulty in starting the flow of urine, known as hesitancy date cialis was released by fda .
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• Straining to pass water baclofen uses .
• Incontinence - this is not an inevitable part of old age, it is a sign that there is something wrong zovirax 5 .
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• Increasingly frequent need to pass water - perhaps as often as every two hours who use zyrtec .
• Having to get up in the night to pass water fexofenadine hcl 180 mg tab .
• The need to push or strain to pass water photograph of omeprazole 20mg .
• Blood in the semen, known as haemospermia terbinafine 250mg tablet .
There may, however, be no urinary symptoms at all prazosin maximum dosage . The first sign of the disease may be from secondary growths, or
metastases, of the cancer, which are most commonly in the bones side effects of cardizem cd . Prostate cancer has a tendency to spread to the bones,
and this happens in a high proportion of cases risks of coumadin .
Symptoms of cancer of the bone:
• Pain in the bone, which is often worse at night celecoxib poland .
• Bone tenderness no perscription buy for azithromycin .
• Brittle bones, which may suddenly break without any injury medications oxytrol dis 3.9 mg 24 .
• Fatigue generic didronel .
• Loss of appetite nursing standing orders for coumadin .
• Weight loss levothyroxine nausea dizziness .
• Anaemia apris birth control .
Bone cancer
A malignant growth in the bone can be primary, in which case it originates in the bone itself: or secondary, in which
case it has spread from cancer elsewhere in the body avandia and congestive heart failure . Secondary bone cancer, or metastatic cancer, is more common than
primary bone cancer, and prostate cancer is one of the cancers that spreads readily to the bone codeine allergy tramadol .
Bone metastases occur most commonly in:
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• The ribs neurontin withdrawal .
• The hips lexapro help to purchase medicine .
• The pelvis dose gabapentin pain .
• The upper legs promethazine routes of administration .
• The skull is bactrim effective for diverticulitis .
Secondary bone cancers from the prostate often respond well to hormonal treatment, including oestrogen or hypothalamic
hormones premarin price . Sometimes the most effective treatment may be by removal of the testes, or adrenal glands drink alcohol with fluoxetine capsules . The administration
of a radioactive isotope such as Metastron is used to relieve pain from bone cancer isosorbide dinitrate cream .

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