Aug
1
Cilostazol
August 1, 2009 | Leave a Comment
Generic Name
Cilostazol (sil-oe-STAY-zol) Lq
Brand Name Pletal
Type of Drug Antiplatelet.
Prescribed For Intermittent claudication.
General Information
In intermittent claudication, leg muscles go into spasm due to reduced blood flow. This occurs when plaque buildup narrows blood vessels leading to the calf or other leg muscles. People with this condition often develop leg pain after walking only a short distance. Cilostazol prevents blood platelets from “clumping together” to begin the process of forming a blood clot, which can further obstruct arteries and worsen intermittent claudication. This drug is broken down in the liver.
Cautions and Warnings
Do not take this drug if you are allergic or sensitive to any of its ingredients.
?P,Ople with congestive heart failure (CHF) should not take cilostazol. Some studies indicate that long-term use of this drug may cause cardiovascular problems.
People with hemostatic disorders or active pathologic bleeding should not take cilostazil.
Drug Interactions
• Avoid mixing cilostazol with ketoconazole, itraconazole, fluconazole, miconazole, fluvoxamine, fluoxetine, nefazodone, or sertraline because this interaction may slow the breakdown of cilostazol, prolonging its effects. Cilostazol dosage is reduced by 50% when it is combined with any of these drugs.
• Aspirin can increase the anticoagulant (blood-thinning) effect of cilostazol, but this combination has not caused serious bleeding problems. There is no information on the effect of combining cilostazol and other antiplatelet or anticoagulant drugs. Cilostazol dosage is reduced by 50% when it is combined with any of these drugs.
• Diltiazem increases cilostazol blood levels by about 50%. Cilostazol dosage is reduced by 50% when it is combined with diltiazem.
• Erythromycin and similar antibiotics increase cilostazol blood levels. Take half the regular dose of cilostazol when combining it with any of these drugs.
• Combining cilostazol and omeprazole increases the effects of cilostazol. Cilostazol dosage is reduced by 50% when it is combined with omeprazole.
• Smoking reduces the Olectiveness of cilostazol by causing the liver to break it down faster.
Food Interactions
Take this drug on an empty stomach at least 30 minutes before or 2 hours after meals. Do not drink grapefruit juice at any time while
above. with dosage.
dache, infection, abdominal pain, ab- arrhea.
pitations, rapid heartbeat. dizziness, sea, sore throat, runny nose, back pain, arms or legs.
cough, fainting, and muscle aches. cts can occur in almost any part of the doctor if you experience any side ef- e.
Possible Side Effects
The risk of side effects
♦ Most common: headache
• stool, and diarrhea. • Common: heart palpitations
• stomach, nausea
• swelling in the
♦ Less common: gas,
♦ Rare: Rare side effects body. Contact your fect not listed taking cilostazol because it can interfere with the breakdown of the drug.
Usual Dose
Adult: 100 mg twice a day. 50 mg twice a day when combined with other drugs that may increase the effect of cilostazol. Child: not recommended.
Overdosage
Symptoms of overdose are likely to be the most common side effects. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Several weeks of cilostazol treatment may be necessary before you notice any improvement in symptoms. Maximum benefit usually occurs after 12 weeks.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Animal studies suggest that cilostazol may harm the fetus, but there is no information on the effect of cilostazol in pregnant women. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
cilostazol may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors can take this drug without special precaution.
Aug
1
Cevimeline
August 1, 2009 | Leave a Comment
Generic Name
Cevimeline (seh-VIM-ih-lene) 9
Brand Name Evoxac
Type of Drug Cholinergic.
Prescribed For
Dry mouth in people with syndrome.
General Information
Sj6gren’s syndrome jS a group 0j symptoms related to a lack of bodily secretions. People with this condition have very dry eyes and mucous membranes, facial lesions, and neck swelling. It often occurs in menopausal woman and is often associated with rheumatoid arthritis, poor blood circulation in the legs, and tooth decay. Cevimeline increases secretions in the mouth by binding to specific nervous system receptors and causing the release of more saliva.
Cautions and Warnings
Do not take cevimeline if you are allergic or sensitive to any of its
ingredients.
This drug may make breathing more difficult and worsen lung conditions such as asthma, chronic bronchitis, or chronic obstructive pulmonary disease (COPD).
Eye conditions like glaucoma or inflammation of the iris may be worsened by cevimeline.
Cevimeline may affect the heart, and some people with severe heart disease, including those with a history of severe angina or heart attack, may not be able to compensate for this effect.
Cevimeline may worsen gallstones and kidney stones and should be avoided by people with a history of these conditions.
Cevimeline may cause visual blurring, especially at night.
Possible Side Effects
✓ Most common: excessive sweating, headache, nausea, sinus irritation, respiratory infection, runny nose, and diarrhea.
✓ Common: upset stomach, abdominal pains, urinary infection, coughing, and sore throat.
✓ Less common: vomiting, back pain, injury, rash, conjunctivitis (pinkeye), dizziness, bronchitis, severe joint pain, fatigue, bone pain, sleeplessness, hot flushes, excess salivation, chills, and anxiety.
✓ Rare: frequent urination, weakness, and flushing. Other rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Combining cevimeline with a beta blocker can lead to heart rhythm disturbances.
• Cevimeline may interfere with the effects of anticholinergics, found in Some medications for abdominal or stomach spasms or cramps.
• Cholinergics such as bethanechol, donepezil, physostigmine, pilocarpine, and pyridostigmine can add to the effects of cevimeline.
• Some drugs may interfere with the breakdown of cevimeline in the liver, increasing the chance of drug side effects. These include amiodarone, celecoxib, chlorpheniramine, cimetidine, ciprofloxacin, clarithromycin, clomipramine, cocaine, diltiazem, erythromycin, fluconazole, fluoxetine, halofantrine, indinavir, itraconazole, ketoconazole, methadone, mibefradil, nelfinavir, paroxetine, quinidine, ranitidine, ritonavir, saquinavir, and terbinafine.
Food Interactions
Grapefruit juice may interfere with the breakdown of cevimeline in the liver, increasing the chance of drug side effects. Food interferes with the absorption of cevimeline into the bloodstream. Take this drug on an empty stomach.
Usual Dose
Adult: 30 mg 3 times a day. Child: not recommended.
Overdosage
Overdose symptoms can include exaggerated drug side effects including headache, visual impairment, excess tearing and/or sweating, difficulty breathing, stomach or intestinal spasms, nausea, vomiting, diarrhea, changes in heart rhythm, blood pressure changes, shock, mental confusion, and tremors. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
cevimeline may cause blurred vision, possibly interfering with driving or performing tasks that require reliable vision, especially at night or in low light.
If you sweat excessively while taking cevimeline, be sure to drink a lot of water. Excessive sweating can lead to dehydration.
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Pregnant women should take cevimeline only if it is considered crucial by your doctor, since its effect on the developing fetus is not known.
It is not known if cevimeline passes into breast milk, but nursing mothers who must take this drug should consider using infant formula.
Seniors: Older adults should be cautious about using this drug because of its possible effects on the kidney, liver, and heart, and on other diseases or medications.
Aug
1
Cetirizine
August 1, 2009 | Leave a Comment
Generic Name
Cetirizine (seh-TERE-ih-zene)
Brand Name Zyrtec
The information in this profile also applies to the following drugs:
Generic Ingredient: Azelastine
Generic Ingredient: Fexofenadine 91 Allegra
Generic Ingredient: Levocetirizine 91 Xyzal
Type of Drug Antihistamine.
Prescribed For
Azelastine: runny nose, sneezing, nasal itching, and post-nasal drip. Cetirizine: stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal and year-round allergy, and for other symptoms of allergy such as rash, itching, and hives; also prescribed for chronic itching and for asthma. Fexofenadine: sneezing, stuffy and runny nose; scratchy throat and mouth; and itchy, watery, and red eyes caused by seasonal allergies. Levocetirizine: stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal and year-round allergy, and for other symptoms of allergy such as rash, itching, and hives; also prescribed for chronic itching.
General Information
Antihistamines generally work by blocking the release of histamine (a chemical released by body tissue during an allergic reaction) from the cell at the H, histamine receptor site, drying up secretions of the nose, throat, and eyes. Cetirizine causes less sedation than older antihistamines and appears to be just as effective. Levocetirizine is the active portion of the cetirizine molecule and is as effective as cetirizine with a similar side effect profile.
Cautions and Warnings
Do not take cetirizine if you are allergic or sensitive to any of its ingredients.
People with kidney disease should receive reduced dosages of cetirizine and levocetirizine. Do not take these drugs if kidney disease is severe. Children with kidney disease should not receive levocetirizine.
Possible Side Effects
✓ Common: headache, drowsiness, fatigue, dry mouth, bitter taste in the mouth, dizziness, runny nose, and sore throat.
✓ Less common: nosebleeds, stuffy nose, sneezing, cough, nausea, upset stomach, changes in bowel habits, nervousness, and fever (children).
♦ Rare: fainting and weight gain. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Cimetidine may increase the level of azelastine in the blood.
• Cetirizine is less likely than other antihistamines to interact with drugs.
• Ritonavir increases the amount of levocetirizine and slows its breakdown in the body. This may result in increased levocetirizine side effects.
Food Interactions
• Ceterizine and levocetirizine may be taken without regard to food or meals.
Usual Dose
Azelastine Nasal Spray
Adult and Child (age 12 and over): 1-2 sprays in each nostril twice a day.
Child (age 5-11): 1 spray in each nostril twice a day.
Cetirizine
Adult and Child (age 6 and over): 5-10 mg once a day depending on symptoms. Reduce dosage in people with kidney disease. Child (age 1-5): 2.5-5 mg a day.
Child (age 6 months-1 year): 2.5 mg a day.
Fexofenadine
Adult (age 12 and over): 60 mg twice a day or 180 mg once a day. People with kidney disease should take 60 mg a day.
Child (age 6-11): 30 mg twice a day.
Levocetirizine
Adult and Child (age 12 and over): 5 mg every evening.
Child (age 6-11): 2.5 mg (1h tablet) every evening. Dosage for children should not exceed 2.5 mg a day. Child (under age 6): not recommended.
Overdosage
Drug overdose is likely to cause severe side effects. Overdose victims should be Oven ipecac syrup—available at any pharmacy—to make them vomit and be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Use extra caution while doing anything that requires concentration, such as driving a car or operating hazardous machinery.
Report sore throat, unusual bleeding, bruising, tiredness, weakness, or any other unusual side effect to your doctor. Do not combine these drugs with alcohol or other nervous system depressants. Do not put azelastine nasal solution into your eyes.
If you forget to take a dose of cetirizine, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Oral antihistamines are generally considered safe for use during pregnancy. But do not take any antihistamine without your doctor’s knowledge if you are or might become pregnant—especially during the last 3 months of pregnancy, because newborns may have severe reactions to antihistamines.
Small amounts of antihistamine pass into breast milk. Nursing mothers who must take cetirizine should use infant formula.
Seniors: Antihistamines are more likely to cause dizziness, sleepiness, and confusion in seniors. Dosage reduction may be recommended depending on kidney function.
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.
Jul
16
Allopurinol
July 16, 2009 | Leave a Comment
Generic Name
Allopurinol (al-oe-PURE-in-nol)
Brand Name Zyloprim
Type of Drug
Antigout medication.
Prescribed For
Gout or gouty arthritis; also prescribed to counter the effects of certain therapies for cancer, ulcers, abnormal heart rhythms in heart bypass patients, seizures, and other conditions that may be associated with too much uric acid in the body.
General Information
Unlike other antigout drugs, which affect the elimination of uric acid from the body, allopurinol acts on the system that manufactures uric acid in your body. A high level of uric acid can indicate that you have gout, psoriasis, cancer, or any of a number of other diseases. High levels of uric acid can also be caused by taking certain drugs.
In mouthwash form, allopurinol helps to prevent mouth, stomach, and intestinal ulcers caused by fluorouracil, an antineoplastic drug. Allopurinol may be given before heart bypass surgery to reduce abnormal rhythms and other surgical complications. It can be used to reduce the relapse rates of duodenal ulcers associated with Helicobacter pylori infection and to reduce the vomiting of blood from stomach irritation caused by nonsteroidal anti-inflammatory drugs (NSAIDs). Allopurinol has also been used to control seizures in people for whom standard treatments are not effective.
Cautions and Warnings
Do not take allopurinol if you are allergic or sensitive to any of its ingredients, or if you have ever developed a severe reaction to it. Stop taking the medication immediately and contact your doctor if you develop a rash or any other adverse effects while taking allopurinol. Do not start taking allopurinol again if you stopped it because of a severe reaction.
Allopurinol should be used by children only if they have high uric acid levels due to neoplastic disease or to rare metabolic conditions.
A few cases of liver toxicity have been associated with allopurinol; they improved when the drug was stopped. People taking allopurinol should periodically be tested for liver and kidney function. People with severely compromised kidney function should ake a reduced dose of allopurinol.
Possible Side Effects
✓ Most common: rash associated with severe, allergic, or sensitivity reaction to allopurinol. If you develop an unusual rash or other sign of drug toxicity, stop taking this medication and contact your doctor.
✓ Less common: nausea, vomiting, diarrhea, intermittent stomach pain, gas, upset stomach, headache, insomnia, tingling or numbness in the hands and feet, muscle or joint pain, and drowsiness or lack of ability to concentrate.
✓ 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
• Large doses of drugs that make your urine more acidic, like megadoses of vitamin C, may increase the risk of kidney stone formation.
• Alcohol, diazoxide, mecamylamine, or pyrazinamide can increase the amount of uric acid in your blood; an increase in your allopurinol dose may be required.
• Allopurinol may increase the action of azathioprine, mercaptopurine, or cyclophosphamide and other anticancer drugs, leading to possible toxicity, bleeding, or infection.
• Allopurinol may prolong the effects of chloropropamide, and can lead to hypoglycemic reactions in patients with kidney disease.
• Taking allopurinol with probenecid or sulfinpyrazone may cause excessive reduction of uric acid.
• Allopurinol may interact with some anticoagulant (blood-thinning) medications, reducing the rate at which the anti-coagulant is broken down in the body. Dosage reduction may be necessary.
• People who are susceptible to ampicillin, amoxicillin, bacampicillin, or hetacillin rash are more likely to develop such a reaction while also taking allopurinol.
• Combining a thiazide diuretic or an ACE inhibitor (for high blood pressure or heart failure) with allopurinol increases the risk of a drug-sensitivity reaction.
• Combining vidarabine with allopurinol may increase the risk of neurotoxic effects and anemia, nausea, pain, and itching.
• Large doses of allopurinol—more than 600 mg a day—may increase the effects of and risk of toxic reactions to theophylline by interfering with its clearance from the body.
Food Interactions
Take each dose with food or a full glass of water. Drink 10-12 glasses of water, juices, soda, or another liquid each day to avoid the formation of crystals in your urine or kidneys.
Usual Dose
Adult and Child (age 11 and over): 100-800 mg a day, depend-, ing on disease and response.
Child (age 6-10): 300 mg a day.
Child (under age 6): 150 mg a day.
The dose should be reviewed periodically by your doctor to be sure that it is producing the desired therapeutic effect.
Overdosage
The expected symptoms of overdose are exaggerated side effects. Allergic skin reactions to allopurinol can be severe and at times fatal. Allopurinol overdose victims should be taken to a hospital. ALWAYS bring the prescription bottle or container.
Special Information
Allopurinol can make you drowsy or make it difficult to concentrate: Take care while driving a car or operating hazardous equipment.
Gout attacks may actually increase during the first few months of taking allopurinol. These attacks should subside.
Call your doctor at once if you develop rash, hives, itching, chills, fever, nausea, muscle aches, unusual tiredness, fever, yellowing of the whites of the eyes or skin, painful urination, blood in the urine, irritation of the eyes, or swelling of the lips or mouth.
Avoid large doses of vitamin C, which can cause the formation of kidney stones during allopurinol treatment. Be sure to drink 1012 8-oz. glasses of water a day while taking this medication.
If you forget to take a dose of allopurinol, take it as soon as possible. If it is almost time for your next regular dose, double this dose. For example, if your regular dose is 100 mg and you miss a dose, take 200 mg at the next usual dose time.
Special Populations
Pregnancy/Breast-feeding: Allopurinol may cause birth defects or interfere with fetal development. Check with your doctor before taking it if you are or might be pregnant.
Allopurinol passes into breast milk. Nursing mothers who must take allopurinol should use infant formula.
Seniors: No special precautions are required. Follow your doctor’s directions and report any side effects at once.
Jul
16
Alitretinoin
July 16, 2009 | Leave a Comment
Generic Name
Alitretinoin (al-ih-TRET-in-oin)
Brand Name
Panretin
Type of Drug Retinoid.
Prescribed For
Skin lesions of Kaposi’s sarcoma (KS).
General Information
Alitretinoin binds to and activates retinoid receptors in human cells. Once activated, these receptors help stimulate the body’s natural mechanisms for limiting tissue growth—in this case, the growth of KS cells. KS lesions, which are primarily associated with human immunodeficiency virus (HIV), can respond to alitretinoin in as little as 2 weeks, but most people do not start to see results for 48 weeks or, in some cases, 14 weeks or more.
Cautions and Warnings
Do not use alitretinoin if you are allergic or sensitive to retinoids or to any of its ingredients.
Alitretinoin is applied to individual KS lesions. It does not treat systemic KS or prevent new KS lesions from forming.
People requiring systemic KS treatment (those who have developed more than 10 new KS lesions within a month) should not use alitretinoin.
People with swollen lymph glands, KS that affects the lungs or other major organ involvement should not use alitretinoin.
Possible Side Effects .
✓ Most common: rash and burning pain at application site.
♦ Common: itchy, flaking, peeling, cracking, oozing, swelling, and inflammation at application site.
Drug Interactions
• Do not use insect repellant products that contain DEET, a widely used chemical repellant. Alitretinoin increases DEET toxicity.
Usual Dose
Adult: Apply 2-4 times a day to KS skin lesions. Seniors should use this drug with caution.
Child: not recommended.
Overdosage
Little is known about the effects of accidental ingestion. Call your local poison control center or a hospital emergency room for information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Apply enough alitretinoin gel to cover the entire skin lesion. Allow the gel to dry for 3-5 minutes before covering the area with clothing. Avoid showering, bathing, or swimming for at least 3 hours.
If you use a bandage or dressing, be sure it is not tight and that air can circulate freely over the area.
Avoid applying alitretinoin to unaffected skin because it may be irritated by the drug. Avoid applying near the nose, eyes, or mouth.
Alitretinoin contains alcohol. Always keep it away from any open flame.
Retinoids can cause unusual sensitivity to the sun. While this has not been seen with alitretinoin, you should avoid prolonged exposure to the sun or use sunscreen while taking this drug.
If you forget a dose, apply it as soon as you remember. If it is almost time for your next dose, apply the forgotten dose and then space the rest of your doses throughout the day. Continue with your regular schedule the next day.
Special Populations
PregnancylBreast-feeding., Alitretinoin can harm the fetus when sufficient levels of the drug are present in the mother’s bloodstream, but it is not known if these levels are achieved during routine use of alitretinoin. Women who are or might be pregnant should only use this drug after discussing its potential benefits and risks with their doctors.
It is not known if alitretinoin passes into breast milk. Nursing mothers who must use alitretinoin should use infant formula.
Seniors: There is no information on use of alitretinoin by seniors. Seniors should use it with caution.
Jul
16
Aldosterone Blockers
July 16, 2009 | Leave a Comment
Type of Drug
Aldosterone Blockers (al-DOH-stir-own)
Brand Names
Generic Ingredient: Eplerenone Inspra
Generic Ingredient. Spironolactone Aldactone
Combination Product
Generic Ingredients: Hydrochlorothiazide + Spironolactone Aldactazide
Prescribed For
High blood pressure, cirrhosis, and congestive heart failure (CHF); also used for people with low blood potassium who require a diuretic.
General Information
Aldosterone blockers limit the access of aldosterone—a hormone that helps to regulate several different body functions—from its receptor. Too much aldosterone results in high sodium levels, which can lead to water retention and potassium loss; it can also affect the size, shape, and function of the heart. Aldosterone blockers are generally combined with other medicines in the management of disease. These drugs are useful in removing excess body fluids in conditions associated with high aldosterone levels.
One in every ten people with high blood pressure has excess aldosterone in their systems. In people with congestive heart failure (CHF), aldosterone levels can be 20 times higher than normal, which can worsen their condition, making the use of aldosterone blockers an important part of their treatment. Aldosterone block-ers also help the heart return to normal size, shape, and function in people with heart failure. Eplerenone is broken down in the liver, primarily by an enzyme system known as CYP3A4.
Cautions and Warnings
Do not take aldosterone blockers if you are allergic or sensitive to any of their ingredients.
Do not use aldosterone blockers if you have kidney failure or high blood potassium.
People with liver disease should be cautious about using a!- dosterone blockers.
People taking an aldosterone blocker should have their potassium levels checked periodically.
People with diabetes who have albumin in their urine should not take aldosterone blockers.
Possible Side Effects
Eplerenone
✓ Less common: dizziness, diarrhea, fatigue, flu-like symptoms, coughing, abdominal pain, elevation of blood cholesterol and/or triglyceride levels, elevation of blood potassium levels, and albumin in the urine.
✓ Rare: enlargement of the breasts in males, irregular menstrual cycles in women, and painful breasts. Contact your doctor if you experience any side effect not listed above.
Spironolactone
✓ Less common: drowsiness, lethargy, headache, gastrointestinal upset, cramps and diarrhea, rash, mental confusion, fever, feeling unwell, enlargement of the breasts in males, impotence, and irregular menstrual cycles or deepening of the voice in women.
Drug Interactions
• Do not combine eplerenone with itraconazole or ketoconazole. These drugs can cause the amount of eplerenone in the blood to increase by up to 500% and may cause fatal increases in blood potassium.
• Mixing eplerenone with erythromycin, fluconazole, saquinavir, or verapamil increases the amount of eplerenone in the blood. People taking this combination must watch for signs of high blood potassium (see “Special Information”) and have their blood potassium levels checked regularly.
• Combining a potassium supplement and an aldosterone blocker can lead to dangerously high blood levels of potassium. Do not use a salt-substitute or take any extra potassium unless prescribed by your doctor.
• Combining an aldosterone blocker with an ACE inhibitor or an angiotensin H receptor blocker (ARB) may significantly raise blood potassium. Be sure your doctor monitors your potassium levels if you combine these drugs.
• Spironolactone may interfere with anticoagulant (blood-thinning) drugs and mitotane (an anticancer drug).
• Aspirin can interfere with the diuretic effect of spironolactone but does not alter its effect on high blood pressure or CHF.
• Combining spironolactone with alcohol, barbiturates, or narcotics can lead to dizziness or fainting when rising suddenly from a sitting or lying position.
• Combining spironolactone and a corticosteroid can lead to very low blood potassium.
• Spironolactone may alter your response to drugs used during general anesthesia.
• Lithium generally should not be combined with any diuretic.
• Combining nonsteroidal anti-inflammatory drugs (NSAIDs) with aldosterone blockers can lead to severe elevations of blood potassium and reduce the blood-pressure-lowering effect of the diuretic.
• Spironolactone may raise digoxin blood levels and increase the risk of severe digoxin side effects. Your doctor may have to adjust your digoxin dosage.
• St. John’s wort (a CYP3A4 inducer) may decrease eplerenone levels by about 30%.
Food Interactions
Food appears to increase the amount of spironolactone absorbed into the blood. Take this drug with food at the same time every day. Eplerenone may be taken without regard to food or meals. Taking this drug with grapefruit juice increases the amount of drug absorbed into your body.
Usual Dose
Eplerenone
Adult 50-100 mg a day. Child: not recommended.
Spironolactone
Adult: Starting dosage is 50-100 mg a day in divided doses for high blood pressure; 25-200 mg a day in divided doses for high fluid levels related to other diseases; and 25-100 mg a day for low potassium levels related to diuretic use.
Child: 1-2 mg per lb. of body weight a day.
Spironolactone + Hydrochlorothiazide Adult: 1-4 tablets daily.
Overdosage
Eplerencne overdose may lead to low blood pressure and high blood potassium. Spironolactone overdose may lead to drowsiness. confusion, rash, nausea, vomiting, dizziness, and diarrhea. Rarely. coma may occur in people with severe liver disease. High blood potassium may also occur, especially in people with kidney zsease. Call your local poison control center or a hospital emercency room for more information. If you seek treatment, ALWAYS oring the prescription bottle or container.
Special Information
<e a c!osterone blockers exactly as they are prescribed.
High blood levels of potassium associated with aldosterone blockers may cause weakness, lethargy, drowsiness, muscle pain or cramps, and muscular fatigue. Use caution while doing anything that requires intense concentration, like driving or operating machinery.
Do not use a salt substitute or take anything else that is a source of extra potassium, including many multivitamin or supplement products.
People with high blood pressure should not self-medicate with over-the-counter cough, cold, or allergy remedies containing stimulants. These drugs can raise blood pressure effectiveness and have an adverse effect on the heart.
!f you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Animal studies with eplerenone showed no effects on a developing fetus. Spironolactone crosses into the fetal circulation. When your doctor considers either of these drugs crucial, their potential benefits must be carefully weighed against their risks.
Jul
16
Adefovir
July 16, 2009 | Leave a Comment
Generic Name
Adefovir (ah-deh-FOE-veer)
Brand Name Hepsera
Type of Drug Antiviral.
Prescribed For
Chronic active hepatitis B in adults.
General Information
Hepatitis B is one of several different types of hepatitis, a viral infection of the liver. Adefovir is an antiviral drug that can reduce the amount of hepatitis B virus in the bloodstream and slow its spread to healthy liver tissue, however, it cannot cure chronic hepatitis B. People with chronic hepatitis B may develop liver cirrhosis or liver cancer and it is not known if adefovir can prevent these conditions from occurring. Like other viruses and bacteria, the hepatitis B virus can become resistant to the effects of adefovir.
Adefovir works against the hepatitis C virus in a way similar to that of certain human immunodeficiency virus (HIV) drugs. It interferes with an enzyme called reverse transcriptase, which is an essential component of the viral reproduction process. Almost half of each dose is eliminated via the urine within 24 hours of taking it.
Cautions and Warnings
Do not take adefovir if you are allergic or sensitive to any of its ingredients.
Adefovir can be toxic to the kidneys, especially in people who already have some kidney problems. Since it is eliminated from the body through the kidneys, people with kidney disease are often given lower doses of adefovir.
In some cases, hepatitis can become severely aggravated upon discontinuation of adefovir. Your doctor should check your liver for’ 2 weeks after the drug is stopped. it is possible that antiviral therapy may have to be re-started.
Adefovir has some activity against the human immunodeficiency virus (HIV). An HIV blood test is recommended before starting adefovir treatment. If you are HIV positive, adefovir could make the HIV virus resistant to future antiviral drugs.
People taking adefovir can develop liver disease, liver enlargement, fat degeneration, and lactic acidosis (potentially fatal metabolic imbalance). This may be a reason for your doctor to stop your adefovir treatment. This occurs most frequently in obese women.
Possible Side Effects
In studies, side effects reported in the treated group were similar in frequency to placebo.
✓ Most common: weakness, headache, stomach pain, and nausea.
✓ Less common: intestinal gas, diarrhea, and upset stomach.
Drug Interactions
This drug was studied extensively in an attempt to predict possible drug interactions. No major interaction problems have been revealed.
• Taking drugs that can be toxic to the kidneys (such as amino-glycosides, cyclosporine, nonsteroidal anti-inflammatory drugs (NSAIDs), tacrolimus, and vancomycin) together with adefovir can lead to the more rapid appearance of kidney damage.
• Ibuprofen, when taken in dosages of 800 mg 3 times a day, will increase adefovir blood levels by about 20 %, however the importance of this finding is unknown.
Food Interactions
Adefovir may be taken without regard to food or meals.
Usual Dose
Adults: 10 mg once a day. People with kidney disease requiring dialysis may take only 10 mg a week. The exact dosage is based on the severity of kidney disease.
Child: not recommended.
Overdosage
Gastrointestinal symptoms are the most likely outcome of an adefovir overdose. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Practice safe sex and safe needle use. People taking adefovir may still spread hepatitis B through sexual contact or by sharing needles. Practice safe sex using condoms and dental dams.
Do not share personal items that can have blood or body fluids on them, such as toothbrushes or razor blades.
Try to take adefovir at the same time every day.
Adefovir must be taken continuously to maintain its effectiveness. Be sure to keep enough adefovir on hand so that you do not run out of medicine.
If you take adefovir on a regular schedule and 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 of this medicine. Call your doctor if you forget 2 or more doses in a row. Skipping or forgetting too many doses can make the hepatitis C virus resistant to adefovir.
Call your doctor at once if you feel very weak or tired, cold (especially in your arms and legs), dizzy or lightheaded, have unusual muscle pain, trouble breathing, stomach pain with nausea and vomiting, or have a fast or irregular heartbeat. These could be signs of lactic acidosis.
Call your doctor if you experience jaundice (symptoms include yellowing of the skin or whites of the eyes), appetite loss for a few days or more, lower stomach pain, nausea, dark urine, or bowel movements that are light in color. These could be signs of liver toxicity.
Special Populations
Pregnancy/Breast-feeding: Animal studies with adefovir have revealed a tendency for some birth defects when the dosage administered was more than 20 times the average human dose. There is no information on the effect of adefovir during pregnancy. The company that produces adefovir has established a registry to collect information on pregnant women who take this drug. When this drug is considered crucial by your doctor, its potential benefits may be carefully weighed against its risks.
It is not known if adefovir passes into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors may be more sensitive to adefovir’s side effects because of the natural loss of kidney function that occurs with advancing age.
Jul
16
Acetazolamide
July 16, 2009 | Leave a Comment
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.
Jul
16
Acetaminophen
July 16, 2009 | Leave a Comment
Generic Name
Acetaminophen (uh-SEE-tuh-MIN-uh-fen) RE
Brand Names
Acephen Mapap-
Aceta Mapap Children’s
Acetaminophen Uniserts Mapap Extra Strength
Apacet Mapap Infant Drops
Aspirin Free Anacin Maximum Maranox
Strength Neopap
Aspirin Free Pain Relief Oraphen-PD
Dynafed, Children’s JR Panadol*
Dynafed EX Redutemp
Dynafed Extra Strength Silapap
Feverall Silapap Children’s
Feverall, Infants Silapap Infants
Genapap” Tapanol
Genebs Tempra*
Liquiprin Tylenol*
*Some products in this brand-name group are alcohol- or sugar-free. Consult your pharmacist.
Type of Drug
Antipyretic and analgesic.
Prescribed For
Relief of pain and fever for people who cannot or do not want to take aspirin or a nonsteroidal anti-inflammatory drug (NSAID). Acetaminophen may be given to children about to receive a
DTP vaccination to reduce the fever and pain that commonly follow the vaccination.
General Information
Acetaminophen is generally used to relieve pain and fever associated with the common cold, flu, viral infections, or other disorders where pain or fever may occur. It is also used to relieve pain in people who are allergic to aspirin, or those who cannot take aspirin because of potential interactions with other drugs such as oral anticoagulants. It can be used to relieve pain from a variety of sources, including arthritis, headache, muscle ache, menstrual cramping, and tooth and periodontic pain, although it does not reduce inflammation.
Cautions and Warnings
Do not take acetaminophen if you are allergic or sensitive to any of its ingredients. Do not take acetaminophen for more than 10 days in a row (5 days for children) unless directed by your doctor. Do not take more than is prescribed or recommended on the package.
Use this drug with extreme caution if you have kidney or liver disease or viral infections of the liver. Large amounts of alcohol increase the liver toxicity of large doses or overdoses of acetaminophen. Avoid alcohol if you regularly take acetaminophen. Some people are more sensitive to this effect than others.
Possible Side Effects
This drug is relatively free from side effects when taken in recommended doses. For this reason it has become extremely popular, especially among those who cannot take aspirin. V Rare: large doses or long-term use may cause liver dam-
age, rash, itching, fever, lowered blood sugar, stimulation,
yellowing of the skin or whites of the eyes, and/or a change
in the composition of your blood. Contact your doctor if
you experience any side effect not listed above.
Drug Interactions
o Large doses of barbiturate drugs, carbamazepine, phenytoin and similar drugs, izoniazid, rifampin, and sulfinpyrazone may increase the chances of liver toxicity if taken with acetaminophen.
• Alcoholic beverages increase the chances for liver toxicity
and possible liver failure associated with acetaminophen.
Food Interactions
None known.
Usual Dose
Adult and Child (age 12 and over): 325-650 mg 4-6 times a day,
or 1000 mg 3-4 times a day. Avoid taking more than 4 g (twelve
325-mg tablets) a day for long periods of time. Child (age 11): 480 mg 4-5 times a day. Child (age 9-10): 400 mg 4-5 times a day. Child (age 6-8): 320 mg 4-5 times a day. Child (age 4-5): 240 mg 4-5 times a day. Child (age 3): 160 mg 4-5 times a day. Child (age 1-2): 120 mg 4-5 times a day.
Child (age 4-11 months): 80 mg 4-5 times a day. Child (under age 4 months): 40 mg 4-5 times a day.
Overdosage
Acetaminophen is a commonly used ingredient in many over-the-counter (OTC) medications. Always check the list of ingredients when using more than one OTC medication to ensure that the combined dosage is within guidelines and to avoid accidental overdose.
Acute acetaminophen overdose may cause nausea, vomiting, sweating, appetite loss, drowsiness, confusion, abdominal tenderness, low blood pressure, abnormal heart rhythms, yellowing of the skin and whites of the eyes, and liver and kidney failure. Liver damage has occurred with 12 extra-strength tablets or 18 regular-strength tablets, but most people need larger doses-20 extra-strength or 30 regular-strength tablets—to damage their livers. Regular use of large doses for long periods-30004000 mg a day for a year—can also cause liver damage, especially if alcohol is involved. In case of overdose, induce vomiting as soon as possible with ipecac syrup—available at any pharmacy —and take the victim to a hospital emergency room. ALWAYS bring the acetaminophen bottle or container.
Special Information
Unless abused, acetaminophen is a beneficial, effective, and relatively nontoxic drug. Follow package directions and call your doctor if acetaminophen does not relieve pain in 10 days for adults or 5 days for children. Call your doctor if fever gets worse or persists longer than 3 days.
Alcoholic beverages will worsen the liver damage that acetaminophen can cause. People who take this drug on a regular basis should limit their alcohol intake.
If you forget to take a dose, take it as soon as you remember. If it is within an hour of your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Acetaminophen ‘is considered safe during pregnancy when taken in usual doses. Taking continuous high doses of the drug may cause birth defects or interfere with fetal development. Three cases of congenital hip dislocation appear to have been associated with acetaminophen. Check with your doctor before taking this drug if you are or might be pregnant.
Small amounts of acetaminophen may pass into breast milk, but the drug is considered harmless to nursing infants.
Seniors: Seniors may take acetaminophen as directed by a doctor.