Sep
26
Formoterol - Fosfomycin - Fosinopril - Fosrenol - Ganciclovir
September 26, 2009 | Leave a Comment
Generic Name
Formoterol (for-MOH-ter-ol)
Brand Names
Foradil Aerolizer Perforomist Foradil Certihaler
Combination Product
Generic Ingredients: Formoterol + Budesonide Symbicort
The information in this profile also applies to the following drug:
Generic Ingredient: Arformoterol Brovana
Type of Drug Bronchodilator.
Prescribed For
Maintenance of asthma, bronchospasm during exercise, and chronic obstructive pulmonary disorder, including chronic bronchitis, and emphysema.
General Information
Formoterol is a long-acting beta-2 agonist, used in the prevention of asthma attacks and bronchial spasms. It is not effective in stopping an asthma attack once it has begun. Patients suffering from severe asthma should always have a short-acting bronchodilator available in case of an acute attack.
Cautions and Warnings
Do not use formoterol if you are allergic or sensitive to any .,oAits ingredients.
Formoterol skn\)NO not be used by patients with significantly or rapidly worsening asthma. In some asthma patients, formoterol may increase the chance of death from asthma.
Formoterol is not a replacement for corticosteroid inhalers. Patients should continue to use their corticosteroid inhalers at the same dosage in conjunction with formoterol.
Patients who have been taking inhaled, short-acting beta-2 agonises should stop regular use of these, and use them only to treat
acute asthma symptoms.
Formoterol can cause paradoxical bronchospasm, a potentially
life-threatening condition. Patients who experience symptoms
should discontinue use of formoterol immediately.
Formoterol can cause irregular heartbeat and should be used
with caution by patients with a history of heart disease or high blood pressure. Patients with a history of seizures, strokes, or diabetes should also be carefully monitored for a recurrence or worsening of these conditions.
Possible Side Effects
? Most common: tremors, dizziness, insomnia, and chest pain.
? Common: restlessness, weakness, sore throat, and difficulty breathing.
¦ Less common: lightheadedness, angina, abnormal heart rhythm, heart palpitations, and bronchospasrn.
? Rare: severe worsening of asthma, extreme allergic reaction, and angioedema (a potentially life-threatening swelling of the lips and throat). Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Formoterol’s effects may be increased by monoamine oxidase inhibitor (MA01) antidepressants, tricyclic antidepressants, thyroid drugs, other bronchodilators. and some antihistamines.
• The effect of formoterol may be lessened by beta-blocking drugs, such as propranolol.
• Formoterol may antagonize the effects of blood-r:~ssurelowering drugs, especially reserpine, methyldupa, and guanethidine.
• Using formoterol with antihistamt z;, disopyramide; phe- nothja,Z:MtS,’D10cBinamide; quinidine and similar drugs: theo- phylline; and tricyclic antidepressants may increase the risk of heart damage and life-threatening cardiac arrhythmias.
Food Interactions None known.
Usual Dose
Arlormoterol
Adult: Inhale 15 mcg every 12 hours. Child: not recommended.
Formoterol
Adult and Child (age 5 and over)
Foradil Aerolizer: Inhale 12 mcg every 12 hours. Foradil Certihaler: Inhale 10 mcg every 12 hours.
Perforomist: Inhale 20 mcg every 12 hours. Child (under age 5): not recommended.
Formoterol + Budesonide Combination Adult: Inhale 1 puff every 12 hours. Child: riot recommended.
Overdosage
Formoterol overdose may cause nausea, vomiting, tremor, sleepiness, rapid or irregular heartbeat, low blood sugar, blood acidity, and life-threatening cardiac arrhythmias. Patients experiencing severe symptoms should go to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
The drug should be inhaled during the second half of your inward breath. This will allow the medication to reach more deeply into your lungs.
Be sure to follow your doctor’s directions for the use of formoterol. Using more than you need can increase the risk of side effects and worsen your symptoms. If your condition worsens after taking formoterol, stop taking it and call your doctor at once.
Call your doctor at once if you develop chest pains, rapid heartbeat, palpitations, muscle tremors, dizziness, headache, or swelling of the throat, or if you still have trouble breathing after using the medication.
If a dose of formoterol is forgotten, take it as soon as you remember. If it is almost time (Ox your next dose, skip the dose you forgot aMmMinue with your regular schedule. Do not take a double dose.
Formoterol capsules must only be used with the inhaler that is provided with this medicine. Do not use other medicines with the formoterol inhaler. Patients should be aware that the gelatin cap-sure may fragment, causing a risk that gelatin particles will be inhaled. This risk is minimized by being careful to pierce the gelatin capsule only once. Capsules should be used immediately after they are taken from the blister pack.
Special Populations
Pregnancy/Breast-feeding: The safety of formoterol in pregnant women has not been studied. The potential benefit of using this medication must be carefully weighed against its risks.
It is not known if formoterol passes into breast milk. Nursing mothers who take this should consider using infant formula.
Seniors: Seniors may be more sensitive to the effects of this drug. Follow your doctor’s directions and report any side effects at once.
Fosamax see Bisphosphonates, page 164
Generic Name
Fosfomycin (fos-foe-MYE-sin)
Brand Name Monurol
Type of Drug Urinary anti-infective.
Prescribed For
Uncomplicated urinary infections.
General Information
Fosfomycin kills a variety of bacteria. It works by preventing bacteria from sticking to the wall of the urinary tract and by interfering with bacterial cell division. In the body, it is converted V) its active form—free (WS bacteria that are resistant to other antibiotics are not resistant to fosfomycin, so this drug may work where others have failed.
Cautions and Warnings
bo not take fosfomycin if you are allergic or sensitive to any of its ingredients. Fosfomycin is meant to be taken once, in a single dose. Taking more than 1 packet of fosfomycin only increases side effects; it does not improve the drug’s effectiveness.
Drug Interactions
• Metoclopramide reduces fosfomycin blood levels. Food Interactions
You may take fosfomycin with or without food. Usual Dose
Adult (age 12 and over): 1 packet mixed with water. Child (under age 12): riot recommended.
Overdosage
Little is known about the effects of fosfomycin overdose. Call your local poison control center or a hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
Do not take fosfomycin powder in its dry form. Mix the contents of the packet with 3-4 oz. of cool or cold water until it dissolves. Then drink the solution immediately.
Call your doctor if your infection does not improve within 2 or 3 days.
Special Populations
Pregnancy/Breast-feeding: The safety of using fosfomycin during pregnancy is, mV&nown. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
It is not known if fosfomycin passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may take fosfomycin without special restriction.
above. vaginal irritation, runny nose, nau-
ts can occur in almost any part of the doctor if you experience any side ef- e.
Possible Side Effects
¦ Less common: diarrhea
and headache
Rare: Rare side effects body. Contact your fect not listed
Generic Name
Fosinopril (tos-IN-oe-pril) 41
Brand Name Monopril
Combination Product
Generic Ingredients: Fosinopril + Hydrochlorothiazide IM
Monopril HCT Type of Drug
Angiotensin-converting enzyme (ACE) inhibitor.
Prescribed For
High blood pressure and heart failure. Also prescribed for renal failure, kidney hypertension, post-heart attack management, management of people with a high risk of heart disease, diabetes, chronic kidney disease, and preventing a second stroke.
General Information
Fosinopril sodium and other ACE inhibitors work by preventing the conversion of a hormone called angiotensin I to another hormone called angiotensin II, a potent blood-vessel constrictor. Preventing this conversion relaxes blood vessels, thus reducing blood pressure and relieving the symptoms of heart failure. Fosinopril also affects the production of other hormones and enzymes that participate in the regulation of blood vessel dilation. Fosinopril begins working 2-6 hours after you take it.
Cautions and Warnings
Do not take fosinopril if you are allergic or sensitive to any of its ingredients. Severe reactions may involve angioedema, a possibly life-threatening swelling of the face, throat, or intestines (see “Special Information”). These reactions are more likely in hemodialysis patients and those undergoing venom immunization.
Fosinopril occasionally causes very low blood pressure or affects your kidneys. ‘four doctor should check your urine for changes during the first few months of treatment.
ACE inhibitors can affect your white-blood-cell count, possibly increasing your susceptibility to infection. Blood counts should be checked periodically.
Fosinopril may cause serious injury or death to the fetus it taken during pregnancy. Pregnant women should, not take fosinopril.
ACE inhibitors may be less effective in some black patients with high blood pressure, especially when dietary salt intake is high. Nevertheless, they should still be considered useful blood pressure treatments. Swelling beneath the skin to form welts is more common among black patients.
Possible Side Effects
v Most common: chronic cough and dizziness, especially when rising from a sitting or lying position. The cough usually goes away a few days after you stop taking the medicine.
? Less common: chest pain, low blood pressure, fatigue, diarrhea, headache, vomiting, and nausea.
¦ Rare: Rare side effects can affect your heart, sleeping, stomach and intestines, skin, sex drive, and joints. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• The blood-pressure-towering effect of fosinopril is additive with diuretic drugs and beta blockers. Any other drug that causes a rapid drop in blood pressure should be used with caution if you are taking an ACE inhibitor.
• Fosinopril may increase the effects of lithium: this combination should be used with caution.
• Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the blood pressure-lowering effects of fosinopril and other ACE inhibitors. This may cause reductions in kidney function.
• Fosinopril may increase potassium levels in your blood, especially when taken with dyazide or other potassium-sparing diuretics.
• Antacids and fosinopril should be taken at least 2 hours apart.
• Capsaicin may trigger or aggravate the cough associated with fosinopril, kt)eTapy.
• Indomethacin may reduce the blood-pressure-lowering effects of fosinopril.
• Phenothiazine sedatives and antivomiting drugs may increase the effects of fosinopril.
• Severe sensitivity reactions can occur in people taking allopurinol.
Fosinopril may affect blood levels of digoxin. More digoxin in the blood increases the chance of digoxin-related side effects while less digoxin in the blood can compromise its
effectiveness.
Food Interactions
You may take fosinopril with food if it upsets your stomach.
Usual Dose
Adult: 10-80 mg once a day. People with liver disease may require lower dosages.
Overdosage
The principal effect of ACE inhibitor overdose is a rapid drop in blood pressure, as evidenced by dizziness or fainting. Take the overdose victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you develop swelling of the face or throat, if you have sudden difficulty in breathing, or if you develop a sore throat, mouth sores, abnormal heartbeat, chest pain, persistent rash, or loss of taste perception. Unexplained swelling of the face, lips, hands, and feet can also affect the larynx (throat) and tongue and interfere with breathing. If this happens, the victim should be taken to a hospital emergency room at once.
Some people who start taking an ACE inhibitor after they are already on a diuretic (an agent that increases urination) experience a rapid drop in blood pressure after their first doses or when the dosage is increased. To prevent this from happening, you may be told to stop taking the diuretic 2 or 3 days before starting the ACE inhibitor or to increase your salt intake during that time. The diuretic may then be restarted gradually.
You may get dizzy if you rise to your feet quickly from a sitting or lying position when taking fosinopril.
Avoid strenuous exercise or very hot weather, because heavy sweating or dehydration can cause a rapid decrease in blood pressure.
Avoid over-the-counter diet pills, decongestants, and other stimulants that can raise blood pressure. Also, do not take potassium supplements or salt substitutes containing potassium without consulting your doctor.
If you forget to take a dose of fosinopril, take it as soon as you remember. If it is within 8 hours of your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: ACE inhibitors can cause fetal injury or death. Women who are or might be pregnant should not take ACE inhibitors. Stop taking the drug and contact your doctor if you become pregnant.
Large amounts of fosinopril pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may be more sensitive to the effects of fosinopril.
Brand Name
Fosrenol
Generic Ingredient Lanthanum Carbonate
Type of Drug Phosphate binder.
Prescribed For
High blood phosphate levels (hyperphosphatemia) in people with end-stage renal disease (ESRD).
General Information
People with ESRD, a form of kidney disease, tend to retain phosphorous. High phosphate levels, in turn, can affect calcium balance in the body and cause deposits of this mineral to build up in the wrong places. Lanthanum helps manage high blood phosphate levels by binding to phosphate in food before it can be absorbed into the blood. This is the same mechanism used by other phosphate-lowering drugs (se,4e%Tner and the antacids aluminum hydroxide -6nd calcium carbonate). Lanthanum, like other phosphate binders, must be taken with meals so that it can bind phosphate ions in the stomach before they can be absorbed into the blood. Very little of this drug is absorbed into the blood and it is not broken down in the body Cautions and Warnings
Do not take fosrenol if you are allergic or sensitive to any of its
ingredients.
People with an active peptic ulcer, ulcerative colitis, Crohn’s
disease, or bowel obstruction should use this medication with
caution.
Researchers found no difference in bone fracture rates or over-
all survival for lanthanum than for other phosphate-binding treatments over 3 years. The study period was too short to assume that it would improve bone fractures or survival beyond 3 years.
Possible Side Effects
Side effects primarily affect the digestive tract and are similar to other phosphate-lowering treatments in type and frequency.
¦ Most common: nausea. vomiting, complications with the dialysis graft, diarrhea, constipation, abdominal pains, and low blood pressure.
¦ Common: bronchitis and runny nose.
? Less common: high blood calcium levels.
? Rare: Other side effects may affect any organ or organ system. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Lanthanum strongly binds to phosphate in the stomach and might also bind to other medications in the stomach. However, no interaction was found in tests conducted with warfarin, digoxin, enalapril, furosemide, metoprolol, or phenytoin.
• Compounds known to interact with antacids should not be taken within 2 hours of taking lanthanum.
Food Interactions
This drug must be taken with or immediately after meals.
usual Dose
Adult: 750-1500 mg with or immediately after each meal. Completely chew each tablet before you swallow it. Do not swallow whole tablets.
Child: not recommended.
Overdosage
There have been no reports of lanthanum overdose, even with single doses up to 1000 mg per pound of body weight. Symptoms of overdose are likely to occur in the digestive tract. Overdose victims may be taken to a hospital emergency room for evaluation. ALWAYS bring the prescription bottle or container.
Special Information
If you forget to take lanthanum with or immediately after a meal, skip the forgotten dose and continue with your regular schedule.
Be sure to follow the low-phosphate diet your doctor prescribes. It is a key element in helping to manage your blood phosphate levels.
Special Populations
PregnancylBreast-feeding., Animal studies with doses several times the maximum human dose revealed some harm to the developing fetus. Pregnancy in a woman with end-stage renal disease, especially those on dialysis, is uncommon because of reduced fertility and carries serious risks for a woman and her baby, including anemia, uncontrolled high blood pressure, and infection. This drug is not recommended for pregnant women.
It is not known if lanthanum passes into breast milk. Nursing mothers who must take it should consider using infant formula.
Seniors: Seniors may use this medication without special restriction.
Generic Name
Ganciclovir (ga.-SYE-kloe-vem) IM
Brand Name
Vitrasert
The information in this profile also applies To The tollowing drug:
GD’K)Phc )ngredient: Valganciclovir Valcyte
Type of Drug
Antiviral.
Prescribed For
Cytornegalovirus (CMV) infections of the eye and CMV infections in other parts of the body, in people with compromised immune
systems.
General Information
Ganciclovir works by preventing reproduction of the virus CMV. Unlike other antiviral drugs, it works only against this virus and herpes simplex virus. The drug is eliminated through the kidneys.
Though most often used for CMV retinitis (eye infection), ganciclovir has also been used for CMV infections of the urine, blood, throat, and semen. It is also used to prevent CMV infection. Ganciclovir is helpful in controlling CMV infection in heart, kidney, and kidney-pancreas transplant patients. Valganciclovir is not indicated for use in liver transplant patients.
Valganciclovir (Valcyte) is broken down by the body into ganciclovir, and all information in this profile applies to both drugs, unless otherwise noted.
Cautions and Warnings
Do not take ganciclovir if you are allergic or sensitive to any of its ingredients.
Ganciclovir causes anemia, reduced white-blood-cell count, and blood-platelet loss. Regular monitoring of blood and platelet counts is recommended while taking this drug.
Ganciclovir is intended only for people who are immunocompromised. It is not intended to treat or prevent CMV infections in newborns.
Detachment of the retina has been noted in people taking ganciclovir, as well as in people with CMV who have not taken the drug. The relationship between ganciclovir and this effect is not well known.
Ganciclovir causes increased sensitivity to the sun; use a sunscreen or wear protective clothes when you go outside.
People with kidney disease should use qw\6,7_l1DAr with caution, and may (eqtst% ieatment at a lower dosage.
Studies of ganciclovir in blacks, Hispanics, and Caucasians showed a trend toward higher blood levels among Caucasians than other groups.
Intravenous ganciclovir has been given to a small number of children under age 12 with mixed results. Side effects were similar to those experienced by adults taking the drug.
Possible Side Effects
¦ Most common: fever, diarrhea, abdominal pain, reduced white-blood-cell counts, anemia, rash, sweating, nausea, vomiting, and appetite loss.
¦ Common: infection; chills; stomach gas; low platelet counts
(symptoms include bleeding or oozing blood); tingling-,
burning; numbness or pain in the hands, arms, legs, or feet-,
itching; pneumonia; weakness; and headache.
Drug Interactions
• Pentamidine, flucytosine, vincristine, vinblastine, adriamycin, amphotericin B, trimethoprim-sulfamethoxazole, and other cytotoxic drugs may increase the side effects of ganciclovir and should be used together only if absolutely necessary, and only if the potential benefits outweigh the risks.
• People taking imipenem-cilastatin together with ganciclovir have experienced seizures. Avoid this combination.
• Mixing ganciclovir with other drugs that can be damaging to the kidneys may increase the rate and extent of kidney damage.
• Probenecid interferes with ganciclovir release through the kidneys and substantially increases blood levels of ganciclovir.
• Mixing ganciclovir with the anti-HIV drugs didanosine or zidovudine (AZT) may increase didanosine or AZT levels and reduce ganciclovir levels. Because AZT and ganciclovir both cause anemia and low white-blood-cell counts, many people cannot tolerate this combination.
Food Interactions
High-fat, high-calorie meals can increase the amount of ganciclovir absorbed into the blood. Take this drug with food.
Usual Dose Gar1r.(qtZ,41N
Adult and Child (age 13 and over): 3000 mg a day, divided into 3 or 6 equal doses. People with reduced kidney function will need to have their dosage reduced accordingly, possibly to as little as 500 mg 3 times a week.
Child (under age 13): not recommended.
Valganciclovir
Adult and Child (age 13 and over): 900 mg a day, divided into 2 equal doses of 450 mg each. People with reduced kidney function will need to have their dosage reduced accordingly, possibly to as little as 500 mg 3 times a week.
Child (under age 13): not recommended.
Overdosage
Little is known about the effects of ganciclovir overdose. As much as 6000 mg a day has been taken with only temporary lowering of white-blood-cell count. Call your hospital emergency room for instructions in case of ganciclovir overdose.
Special Information
Ganciclovir does not cure CMV eye infection, and immunocompromised people taking this drug may find their disease worsening. Dosage reductions or discontinuation of the drug may be necessary if white-blood-cell or platelet counts get too low.
Ganciclovir may cause infertility in men and women. Women of child-bearing age should use effective contraception while taking this drug. Men should use a condom while taking the drug and for at least 90 days afterward to avoid passing the drug to their partners.
Good dental hygiene is important while taking ganciclovir to minimize the risk of infection. If you have dental work done while taking this drug, expect the healing process to take longer.
Regular blood tests are necessary to watch for white-bloodcell or platelet-level alterations.
It is very important to take ganciclovir exactly as directed. If you forget a dose, take it as soon as you remember and continue with your regular schedule.
Special Populations
PregnancylBreas>-feeding. Animal studies showed ganciclovir to be toxic to the fetus. There is no reliable information about its effect in pregnant women, but it should be taken only when the possible Oe”6% Outweigh the risks. Women who are likely to become pregnant while taking this drug should use reliable contraception.
It is not known if ganciclovir passes into breast milk, but the possible side effects of this drug on a nursing infant should be kept in mind. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors often have reduced kidney function; dosage adiustments may be needed.
Generic Name
Gemfibrozil oem-Fl-broe-zil)
Brand Name Lopid
Type of Drug
Anti-hyperlipidemic (blood-fat reducer). Prescribed For
High blood triglycerides.
General Information
Gemfibrozil consistently reduces blood triglycerides and reduces the risk of heart disease in people with high levels of triglycerides, low levels of high-density lipoprotein (HDL) cholesterol, the “good” cholesterol, and high levels of low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol. It works by affecting the breakdown of body fats and by reducing the amount of triglyceride manufactured by the liver. It is usually prescribed only for people with very high blood-fat levels who have not responded to dietary changes or other therapies. Gemfibrozil usually has little effect on blood-cholesterol levels, although it may reduce blood cholesterol in some people.
Cautions and Warnings
Do not take gemfibrozil if you are allergic or sensitive to any of its ingredients or have severe liver or kidney disease. Some people taking gemfibrozil have experienced worsening of kidney function.
Gemfibrozil users may have an increased risk of developing gallbladder disease and gallstones.
People taking gemfibrozil and fenofibmte may develop pancreatitis (inflammation 0 the pancreas).
People taking gemfibrozil may develop muscle aches and inflammation. Tell your doctor if you experience muscle tenderness or weakness.
Estrogen drugs may cause massive increases in triglyceride levels. Stopping estrogen therapy in these cases may reduce triglyceride levels to normal.
Gemfibrozil may cause a moderate rise in blood sugar and mild decreases in white-blood-cell counts.
Possible Side Effects
¦ Most common: abdominal and stomach pain, fatigue, heartburn, gas, diarrhea, nausea, and vomiting.
¦ Less common: rash, itching, dizziness, blurred vision, anemia, reduced levels of white blood cells, increased blood sugar, and muscle pain—especially in the arms or legs.
¦ Rare: dry mouth, constipation, appetite loss, upset stom-
ach, sleeplessness, tingling in the hands or feet, ringing or
buzzing in the ears, back pain, painful muscles or joints,
swollen joints, feeling unwell, reduction in blood potassium,
and abnormal liver function. Contact your doctor if you ex-
perience any side effect not listed above.
Drug Interactions
• Gemfibrozil increases the effects of oral anticoagulant (blood-thinning) drugs. Your anticoagulant dosage must be reduced when starting gemfibrozil.
• Combining gemfibrozil with a statin cholesterol- lowering drug (atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, or simvastatin) has led to the destruction of skeletal muscles. This effect may begin as early as 3 weeks after you start taking the combination or may not appear for months.
• Combining gemfibrozil and sulfonylurea antidiabetes drugs or repaglinide may cause unexpectedly low blood sugar levels. The sulfonylurea drug dosage may need adjustment.
• Gemfibrozil can substantially increase the amount of glitazone antidiabetes drugs in the blood. Glitazone dosages may need to be adjusted.
• Combining gemfibrozil and cyclosporine may decrease the effectiveness of cyclosporine. This combination should only be used if it is absolutely necessary and the lowest possible dose of gemfibrozil is used.
Food Interactions
Gemfibrozil is best taken on an empty stomach 30 minutes before meals but may be taken with food if it upsets your stomach. It is important that you follow your doctor’s dietary instructions.
Usual Dose
Adult: 1200 mg a day, divided into 2 doses taken 30 minutes
before breakfast and dinner. Child: not recommended.
Overdosage
There have been reported cases of overdosage with gemfibrozil. Symptoms reported with overdosage were abdominal cramps, abnormal liver function tests, diarrhea, joint and muscle pain, nausea, and vomiting. Induce vomiting with ipecac syrup—available at any pharmacy—but call your doctor or local poison control center before doing this. If you go to a hospital emergency room, ALWAYS bring the prescription bottle or container.
Special Information
Your doctor should perform periodic blood counts during the first year of gemfibrozil treatment to check for anemia or other changes in blood components. Liver-function tests are also necessary. Blood-sugar levels should be checked periodically while you are taking gemfibrozil, especially if you are diabetic or have a family history of diabetes.
Gemfibrozil may cause dizziness or blurred vision. Be careful when driving or doing any task that requires concentration.
Gemfibrozil is less effective if you are greatly overweight.
Call your doctor if side effects become severe or intolerable, especially diarrhea, nausea, vomiting, or stomach pain or gas. These may disappear if your doctor reduces the dosage.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose. skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: The safety of using gemfibrozil during pregnancy is not known. When this drug is considered crucial by your doctor, its potential benefits must be carelO%-y weighed against its risks.
It is R(PM1)Wnif this drug passes into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors are more likely to develop drug side effects due to normal declines in kidney function.
Aug
1
Cimetidine
August 1, 2009 | Leave a Comment
Generic Name
Cimetidine (sih-MET-ih-dene)
Brand
Tagamet Tagamet HB 91
Type of Drug Histamine H2 antagonist.
Prescribed For
Ulcers of the stomach and duodenum (upper intestine); also used for upset stomach, gastroesophageal reflux disease (GERD), benign stomach ulcer, bleeding in the stomach and duodenum, colorectal cancer, prevention of stress ulcer, hyperparathyroidism, fungal infections of the hair and scalp, herpes virus infection, excessive hairiness in women, chronic itching of unknown cause, skin reactions, warts, acetaminophen overdose, and other conditions characterized by the production of large amounts of gastric fluids. Cimetidine may be prescribed to stop the production of stomach acid during surgery.
General Information
Histamine H2 antagonists work by turning off the system that produces stomach acid and other secretions. Cimetidine is effective in treating the symptoms of ulcer and preventing complications of the disease, although an ulcer that does not respond to another histamine H2 antagonist will probably not respond to cimetidine. Histamine H2 antagonists differ only in their potency. Cimetidine is the least potent; 1000 mg are roughly equal to 300 mg of either nizatidine or ranitidine, or 40 mg of famotidine. These drugs are roughly equal in their ability to treat ulcer disease and their risk of side effects.
Cautions and Warnings
Do not take cimetidine if you are allergic or sensitive to any of its ingredients or any histamine H2 antagonist. Cimetidine has a mild antiandrogen effect, which probably causes the painful, swollen breasts that some people experience after taking this drug for a month or more.
People with kidney or liver disease should take cimetidine with caution because 1/3 of each dose is broken down in the liver and passes out of the body through the kidneys.
Do not self-treat with over-the-counter forms of cimetidine without the advice and supervision of your doctor.
The fact that symptalleviated by cimetidine does not dude the possibility of stomach cancer, which can have symptoms similar to other gastrointestinal (GI) disorders. Make sure your doctor screens for possible malignancy.
these symptoms stop 3-4 days after discontinuing the drug. Call your doctor if this happens to you.
Possible Side Effects
Serious side effects are uncommon.
♦ Most common: mild diarrhea, dizziness, rash, painful breast swelling, nausea and vomiting, headache, confusion, drowsiness, hallucinations, and impotence.
♦ Less common: liver inflammation, peeling or red and swollen rash, breathing difficulties, tingling in the hands or feet, delirious feelings, and oozing from the nipples.
✓ Rare: Cimetidine may affect white blood cells or blood platelets. Some symptoms of these effects are unusual bleeding or bruising, unusual tiredness, and weakness. Other rare side effects are inflammation of the pancreas, hair loss (reversible), abnormal heart rhythms, heart attack, muscle or joint pains, and drug reactions. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Separate cimetidine from antacid doses by about 3 hours to avoid reducing cimetidine’s effectiveness. Other drugs that may reduce the absorption of cimetidine are metoclopramide and anticholinergic drugs, including trihexyphenidyl hydrochloride, oxybutynin, and benztropine mesylate.
• Cigarette smoking reverses the healing effect cimetidine has on ulcers.
• Cimetidine may increase the side effects of a variety of drugs, possibly leading to drug toxicity. These drugs include alcohol; aminophylline; oral antidiabetes drugs; benzodiazepine sedatives, except lorazepam, oxazepam, and temazepam; caffeine; calcium channel blockers; carbamweoine; carmustine; chloroquine; tkeCaiTAe; fluorouracil; labetalol; lidoQa« , Tneloprolol; metronidazole; moricizine; mexiletine; narcotic pain relievers; nifedipine; ondansetron; pentoxifylline; phenytoin; procainamide; propafenone; propranolol; quinine; quinidine; tacrine; theophylline drugs, except clyphylline: triamterene; tricyclic antidepressants; valproic acid; and warfarin (a blood-thinner).
• Drugs whose absorption may be decreased by cimetidine are iron, indomethacin, fluconazole, ketoconazole, and tetra-
cycline antibiotics.
• Enteric-coated tablets should not be taken with cimetidine. The change in stomach acidity causes the tablets to disin-
tegrate prematurely in the stomach.
• cimetidine may decrease the effects of digoxin and tocainide.
Food Interactions
None known.
Usual Dose
Adult: 400-800 mg at bedtime; 300 mg 4 times a day with meals and at bedtime; or 400 mg twice a day. To treat GERD-400 mg 4 times a day. Do not exceed 2400 mg a day. Users of Tagamet HB should not take more than 400 mg a day. Smaller doses may be as effective for seniors or those with impaired kidney function.
Overdosage
Little is known about the effects of cimetidine overdose, but victims may experience exaggerated side effects. Two deaths have occurred. Your local poison control center may advise giving ipecac syrup—available at any pharmacy—to induce vomiting and remove any drug remaining in the stomach. Victims who have definite symptoms should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Take cimetidine exactly as directed and follow your doctor’s instructions regarding diet and other treatment in order to get the maximum benefit from the drug.
Do not take the maximum dose continuously for more than 2 weeks without the consent and supervision of your doctor.
Cigarette smoking is associated with stomach ulcers and reduces cimetidine’s effectiveness.
Call your doctor at once if you develop any unusual side effects such as bleeding or bruisiiAg, tiredness, diarrhea, dizziness, rash, 131 NMbdinations. Black, tarry stools or vomiting material that resembles coffee grounds may indicate your ulcer is bleeding.
If you miss a dose of cimetidine, take it as soon as possible. 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: Animal studies reveal no damage to the fetus, although cimetidine does pass into the fetal blood. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Large amounts of cimetidine pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may need less medication due to loss of kidney function and be more susceptible to side effects, especially confusion and other nervous system effects (see “Cautions and Warnings”).
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
Chlorzoxazone
August 1, 2009 | Leave a Comment
Generic Name
Chlorzoxazone (klor-M-uh-zone)
Brand Names
Parafon Forte DSC Strifon Forte DSC
Type of Drug
Skeletal muscle relaxant.
Prescribed For
Pain and spasm of muscular conditions, including strain, sprain, bruising, and lower back problems.
General Information
Chlorzoxazone works primarily on the spinal cord level and on the brain, acting as a mild sedative. This results in fewer spasms, less pain, and greater mobility. Chlorzoxazone provides only temporary relief and is not a substitute for other types of therapy, such as rest, surgery, and physical therapy.
Cautions and Warnings
Do not take chlorzoxazone if you are allergic or sensitive to any of its ingredients, or if you have a condition known as porphyria.
People with poor liver or kidney function should take this drug with caution because serious liver toxicity has rarely occurred in people using chlorzoxazone.
Chlorzoxazone may interact with other drugs that cause nervous system depression (see “Drug Interactions”).
Because it is possible to become dependent on this drug, people with a history of substance abuse should take chlorzoxazone with caution.
Possible Side Effects
♦ Most common: dizziness, drowsiness, lightheadedness, malaise, and aveTStimulation,
♦ Less common: headache, stomach cramps or pain, diar-
rhea, constipation, heartburn, nausea, and vomiting.
• Rare: internal bleeding, liver problems, severe allergic-type skin reactions, and breathing problems. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• The depressive effects of chlorzoxazone may be enhanced by taking it with alcohol, sedatives, sleeping pills, or other nervous system depressants. Avoid these combinations.
Food Interactions
Take this drug with food if it upsets your stomach. The tablets may be crushed and mixed with food.
Usual Dose
Adult: 250-750 mg 3-4 times a day. Child: 125-500 mg 3-4 times a day.
Do not take more medication than is prescribed.
Overdosage
Early signs of chlorzoxazone overdose may include nausea, vomiting, diarrhea, drowsiness, dizziness, lightheadedness, and headache. Victims may also feel sluggish or sickly and lose the ability to move their muscles. Breathing may become slow or irregular, and blood pressure may drop. Contact a doctor immediately or go to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Chlorzoxazone may make you drowsy or reduce your ability to concentrate. Be extremely careful while driving or operating hazardous equipment. Avoid alcoholic beverages.
Chlorzoxazone may turn your urine orange to purple-red; this is not dangerous.
Call your doctor if you develop drowsiness, weakness, an allergic reaction, skin rash or itching, breathing difficulties, black or tarry stools, vomiting of material that resembles coffee grounds, liver problems, or any other severe or bothersome side effect.
4f you miss a dose of chlorzoxazone by more than an hour, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: The safety of chlorzoxazone in pregnant women has not been established. Pregnant women should only take chlorzoxazone after carefully weighing its potential benefits against its risks.
It is not known if chlorzoxazone passes into breast milk. Nursing mothers should consider using infant formula.
Seniors: Seniors, especially those with severe liver disease, are more sensitive to the effects of chlorzoxazone.
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
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
Acitretin
July 16, 2009 | Leave a Comment
Generic Name
Acitretin (ah-sih-TREH-tin)
Brand Name
Soriatane
Type of Drug Antipsoriatic.
Prescribed For
Severe psoriasis; also prescribed for a variety of other skin conditions.
General Information
Acitretin is related to vitamin A and prescription drugs such as etretinate and isotretinoin. Acitretin is produced when etretinate is broken down in the body and its effects are very similar to etretinate. The way that acitretin works is not known. Its full benefit is not likely to be seen until you have taken it for 2 or 3 months. Your doctor is urged to use this medication only in cases of severe psoriasis that have not responded to other treatments because of the risks associated with acitretin.
Cautions and Warnings
Do not take acitretin if you are allergic or sensitive to any of its ingredients. Women who take acitretin must not be pregnant during treatment or for 3 years after the completion of treatment. It is not known if acitretin taken by men before conception is also a risk to the fetus.
A small number of people taking this drug have developed liver damage including jaundice (symptoms include yellowing of the skin and whites of the eyes). Acitretin has also been associated with hepatitis. People with kidney failure have much less acitretin in their blood than people with normal kidneys. Caution is advised for people with liver or kidney damage.
Cholesterol levels rise in 25-560/6 of people taking acitretin. Very large increases in triglycerides may be responsible for the few cases of pancreatitis (pancreas inflammation) that have been reported. Your doctor should measure your blood fat levels before you start taking acitretin and monitor them weekly or biweekly until your response to the medication has been determined. People with diabetes, who are obese, or who have a history of these conditions are at increased risk for high cholesterol levels as are people who drink alcohol excessively.
Drugs similar to acitretin have been associated with pseudo-tumor cerebri (increased pressure in the brain). Symptoms of pseudotumor cerebri include visual disturbances, headache, nausea, and vomiting. Report these or any unusual symptoms to your doctor at once.
People taking acitretin who had spine or bone—including knee or ankle—problems before starting the drug may find that their problems worsen while on the drug.
People with diabetes may find it more difficult to control their blood sugar while on acitretin.
Possible Side Effects
✓ Most common: hair loss or change in texture, peeling skin, and inflammation of the lips.
✓ Common: dry eyes, chills or stiffness, dry skin, fingernail problems, itching, rash, tingling in the hands or feet, increased sensory awareness, loss of some sections of skin, sticky skin, and runny nose.
✓ Less common: drying and thickening of eye tissue; eye irritation; eyebrow or eye lash loss; changes in appetite; swelling; fatigue; hot flashes; flushing; sinus irritation; headache; pain; earache; insomnia; depression; Bell’s palsy; crusting of the eyelids; blurred vision; conjunctivitis (pinkeye); double vision; itchy eyes or eyelids; cataracts; swelling inside the eye; unusual sensitivity to bright light; dry mouth; nausea; stomach pain; diarrhea; bleeding gums; joint; back; and muscle pain; and worsening of existing spinal problems.
✓ 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
• People combining acitretin and glyburide (an antidiabetic) may have unusually low blood-sugar levels. Your doctor may have to adjust your diabetic treatment program while you are taking acitretin.
• Combining acitretin with methotrexate increases the risk of liver damage.
• Acitretin reduces the effectiveness of low-progestin oral contraceptives (the “mini-pill”). If you are taking one of these contraceptives, switch to another type of birth control and use at least one other contraceptive method for at least 3 years after treatment is completed.
• Combining alcohol with acitretin produces acitretin’s parent compound, etretinate. Etretinate stays in the body much longer than acitretin and may therefore affect the fetus for an even longer period of time than might acitretin. Avoid alcoholic beverages.
• Do not take a vitamin A supplement that has more than the standard minimum daily requirement (1000 mcg). Excess vitamin A plus acitretin exposes you to possible vitamin A toxicity.
• Combining acitretin with tetracyclines may increase the risk of severe pressure on the brain.
• Notify your doctor if you are taking etretinate, isotretinoin, oral or topical tretinoin, or cyclosporine.
Food Interactions
Acitretin is best absorbed when taken with food or meals. Usual Dose
Adult: 25-50 mg a day with your main meal. Dosage may increase after 4 weeks to 25-75 mg a day. Dosage must be individualized to your specific needs.
Child: not recommended.
Overdosage
Symptoms of acitretin overdose include vomiting, headache, and vertigo. Call your local hospital emergency room or local poison control center for more information. ALWAYS bring the prescription bottle or container.
Special Information
Contact your doctor at once if you become pregnant while taking acitretin or in the 3 years following treatment. The risk of birth defects persists as long as the drug is in your body. In one case,
small amounts of etretinate were found in blood plasma and fatty tissue more than 5 years after treatment.
Some people have experienced decreased night vision while taking acitretin. Be careful when driving at night.
Report visual disturbances, headache, nausea, vomiting, or anything unusual to your doctor at once.
Do not drink any alcoholic beverages during acitretin treatment and for at least 2 months after treatment has been completed. Avoid excess vitamin A (see “Drug Interactions”).
Some birth control methods, including low-dose progestin contraceptives and tuba) ligation may fail while taking this drug. Use at least one additional form of contraception while taking acitretin to avoid pregnancy.
You may have problems tolerating contact lenses while you are taking acitretin.
Do not donate blood while taking acitretin or for 3 years afterwards because your blood might be given to a pregnant woman.
Avoid exposure to excessive sunlight or to sunlamps because of unusual sensitivity caused by acitretin.
If you forget to take a dose of acitretin, take it with food 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.
A worsening of psoriasis may initially occur with treatment, and the full benefit of acitretin may not be seen for 2-3 months.
Special Populations
Pregnancy/Breast-feeding: Acitretin causes birth detects and may damage the fetus. Women who take acitretin must be sure they are not pregnant before starting therapy by using reliable contraception for at least 1 month before starting the drug and taking a pregnancy test within 1 week of starting treatment. Women must use 2 reliable contraceptive methods during treatment and for 3 years following the completion of treatment.
Acitretin may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors have twice as much acitretin in their blood as do younger adults but may take acitretin without special precaution.
Jul
16
Dandruff Problem. Dandruff Treatment Drugs
July 16, 2009 | Leave a Comment
DANDRUFF
• Soak the scalp with Listerine original-formula (amber► mouthwash
• Smear some Vicks VapoRub on itchy spots
• Make an herbal rinse with sage or rosemary ***
• Slather yogurt on the scalp
• Use a dilute vinegar rinse after washing the hair ****
• Rotate dandruff shampoos to maintain effectiveness
• Shampoo with Nizoral A-D ****
Dandruff may be dastardly, but in general, it is not a serious medical condition. Though people who have it may by frustrated by it, or even desperate for relief, doctors don’t get too excited when they see it. The flakes are not life threatening. They never require surgery. They are not contagious and, unlike flatulence, they don’t drive others away. But a bad case of dandruff makes people self-conscious, and thanks to decades of advertising, may even carry a social stigma.
Skin cells die and are sloughed off every day, all over the body. But on the scalp, they may clump together and form flakes that stick in the hair or fall to the shoulders, and are unpleasantly visible on a black polo shirt. If the flakes are especially large and numerous and the scalp is particularly itchy and red, a dermatologist might identify the problem as seborrheic der-matitis. This condition may also affect the face. In some people, patches of skin on the forehead (including the eyebrows), the sides of the nose, and the chin seem to be especially susceptible to developing reddish, itchy scales.
I fought dandruff for 30 years. Even my eyebrows itched I only bought light-colored clothing that wouldn’t show flakes.
My dermatologist recommended various shampoos that didn’t work. When I changed doctors, my new doctor said my -dandruff” was a yeast infection. She recommended Nizoral shampoo. I only have to use it about once a month and I have no more flakes or itching.
I know this story isn’t as dramatic as finding a cure for cancer, but solving an annoyance like this is truly liberating.
Dermatologists usually distinguish between dandruff and seborrheic dermatitis, but researchers now believe that both conditions can be traced to the skin’s reaction to yeast that lives on its surface. This fungus, Malassezia globo and related species, sets up housekeeping, especially where the skin is secreting oil&’66 The fungus then produces oils of its own, which irritate the skin.” The resulting reaction is the excessive flaking typical of dandruff or the redness and itching on the scalp and face that characterize seborrheic dermatitis. Presumably, the big difference between dandruff and seborrheic dermatitis is the amount of irritation that results.
Malassezia yeast normally inhabit the skin; nobody seems to know exactly why some people are more irritated by Wassezia by-products than others. It might have something to do with hormones, or diet, or the activity of the immune system. Because dermatologists don’t know how to change individual susceptibility, the basic approach has been just to kill off as many of the yeastie beasties as is practical without hurting the scalp. This not only makes sense, it actually works most of the time. And it also explains why some dandruff shampoos seem to lose effectiveness over time. Presumably, the yeast can develop resistance.
Once in a while, people taking an oral anti-fungal drug for another problem report that it gets rid of their dandruff. But even for super-dandruff (aka seborrheic dermatitis of the scalp), an oral antifungal is too big a cannon to consider seriously. Why risk potentially serious side effects over dandruff?
Q. I had dandruff for more than 20 years and tried all sorts of medicated shampoos with no success. About 2 years ago I got a fungus under the nail of my big toe. My podiatrist put me on Lamisil, a pill a day for 3 months.
While I was taking it, my dandruff cleared up and quit itching. The Lamisil did not get rid of my nail fungus, but it seems to have cured the dandruff.
A. We’re not surprised to learn that the antifungal medicine you took for your nail infection cleared up your dandruff. Dermatologists think that dandruff is caused, in part, by yeast. Antifungal medicines could eliminate the yeast.
0 * 0
Home Remedies for Dandruff
Anyone who has had dandruff knows that ordinary shampooing, while it may help for a little while, just doesn’t make much difference. But a lot of people have discovered some rather interesting home remedies that can be helpful. We’ve collected a few that are low cost and low risk, even though there is not much evidence that they work more than occasionally. Use your own common sense in selecting those that seem worth a try.
Herbal Products
What would you think of putting mouthwash in your hair? It may not be the first thing that comes to mind, but quite a few people assure us that Listerine (the amber-colored original formula) can banish dandruff. We first heard this idea from a man who said his veterinarian recommended a mixture of Listerine and baby oil to treat itchy “hot spots” that caused his dog to keep licking its coat. It worked well for the dog, so he experimented on himself! We caution animal lovers to check with your own vet before trying this at home. And we would be especially wary about trying anything of this sort on cats, since they groom themselves so assiduously.
Q. Have you ever heard of using Listerine for dandruff? Someone told me he heard it on the radio.
A. A gentleman called in to our public radio show with an amazing story about Listerine mixed with baby oil. His veterinarian had recommended this combination for relieving itchy spots on his Dobermans and horses. He found that it worked and tried it for his own dandruff. He told us that it gets rid of dandruff in 2 to 3 days.
0 0 0
In the early 20th century and throughout the World War II era, Listerine was actually promoted as a dandruff treatment. Presumably the company dropped that claim when the FDA demanded proof. It’s not too far-fetched to believe, though. Listerine contains a number of herbal oils that have antifungal action, such as thymol, eucalyptol, and menthol. These ingredients might work together to knock down Malassezia and thus control flaking. The alcohol in Listerine might also have some antifungal action.
I have suffered from severe dandruff all of my life, and nothing helped I tried washing my hair with Listerine, and have been dandruff free since. It’s nothing short of a miracle cure.
The ingredient list for Listerine overlaps quite a bit with the list for another familiar old-fashioned product, Vicks VapoRub. Vicks contains camphor, thymol, menthol, eucalyptus oil, turpentine oil, cedarleaf oil, and nutmeg oil. Although Vicks is not promoted as working against fungus, many people find it helpful in fighting nail fungus, which is notoriously difficult to treat. Others report that it can be effective for the red, itchy flakes of seborrheic dermatitis on the face or behind the ears.
The drawback to using Vicks against dandruff is that the base is petroleum jelly. Washing this goo out of hair could be a real challenge!
People have tried a lot of different techniques to get petrolatum out of hair. The one technique that appears to be most Original Listerine contains a mixture of herbal oils with anti-fungal action. Currently, it is not promoted as a dandruff cure, but it was once marketed for this purpose. Wet the scalp well with Listerine and leave it on for 5 minutes before shampooing.
Downside: May sting on application. Mouthwash aroma might linger after shampooing.
Cost: Approximately $8 to $10 for a 11/2-liter bottle (around 150 per treatment)
reliable, and easiest, is to work mineral oil into the glop to “cut” it and then wash that out with shampoo or with Dawn dish detergent. It may take several latherings. Some folks are willing to try this treatment repeatedly, but many find that once is enough to convince them to try another method.
* * 0
Q. I’ve been suffering with scaly dandruff for 3 years. I’ve spent an enormous amount of money on medicines prescribed by the dermatologist, but none is a cure.
Last year I read in your column about people treating fungus-infected toenails with Vicks VapoRub. I thought I would try it for my problem. A bottle of Vicks cost me just over $5.
The Vicks softened those itchy scales and in just 2 weeks I have no more nasty flakes. Thank you for helping people like me on a low income.
A. We’ve never heard of using Vicks VapoRub against dandruff. This condition has been linked to yeast on the scalp, however, and is treated with antifungal shampoo.
The essential oils in Vicks are reported to have some activity against fungus. We’re glad to hear it worked for you, but we wonder: How did you wash the Vicks out?
We heard from one individual who was experimenting with coloring her hair naturally. She made an herbal tea out of sage (but did not tell us how she made it). Then she used the sage tea as a rinse after each shampoo. To her astonishment, she realized that her dandruff had disappeared. Being of a scientific turn of mind, she stopped using the sage tea rinse. Sure enough, her dandruff came right back. She was very pleased to have found an inexpensive way to treat dandruff.,
0 * 0
Q. I used to rinse my hair with a decoction I made from rosemary plants that I grew in my herb garden.
My hair tends to be the “fly-away” sort, but rosemary made it manageable and also eliminated dandruff. It made my hair smell nice, too. Growing the rosemary myself made my hair rinse a renewable resource that came from my own yard and saved me money.
A. Rosemary has a reputation as being good for hair, so we are not surprised that your home remedy is helpful. *Some people are sensitive to rosemary oil, however, and may develop a rash.
0 0 *
One of the important components of rosemary oil is camphor (along with cineole, alpha-pinene, and limonene). It also contains rosmarinic acid and carnosol. Sage, on the other hand, contains thujone, cineole, and rosmarinic acid.”‘ If you plan to try one of these herbal teas as a scalp rinse, use a teaspoon of dried herb for a generous cup (8 or 9 ounces) of hot water. Steep sage tea for 5 minutes before straining; let rosemary tea steep for 15 minutes. If you have fresh herbs from the garden, use a tablespoon of fresh leaves for your cup of tea. Let it cool before pouring it over your scalp so you won’t scald your scalp by accident.
Kitchen Magic
People can be quite ingenious when they are faced with a problem like dandruff, so it’s little wonder that some folks have tried putting common foods on the scalp. One herbal au-After washing the hair, rinse with a tea made of sage or rosemary leaves.169
Downside: Some people may have an allergic skin reaction. To be safe, test a spot on your inner arm the day before you plan to use it on your scalp.
Cost: Varies. Using rosemary or sage from the garden is free. Buying herbs in bulk results in a cost of about 50 per dose.
thor recommends smearing yogurt onto the scalp after shampooing, allowing it to sit for 15 minutes, and then washing it oUt.170 Don’t use just any yogurt, though. It should be a type with active cultures (read the label). Yogurt is fairly acidic, and that may make the skin less appealing to fungus. Then again, perhaps those live cultures do their own bit to discourage yeast. We have not tried this remedy and don’t know how well it would work.
All my life I have used dilute vinegar to rinse my hair after shampooing. It works well against dandruff and you can also use it on your feet to stop odor. Best of all, ih; cheap!
We have heard from a number of people who use vinegar as a rinse after shampooing. Some insist upon apple cider vinegar, while others go with inexpensive white vinegar. Like yogurt, vinegar is acidic. Acid disrupts the environment for many fungi that live on human skin. It stands to reason that it would also work against Malassezia.
In fact, when the problem is a fungal infection of the ear that makes it itch, one ear-nose-and-throat specialist recommends a solution made of one part white vinegar to five parts tepid water. The ear is flushed gently three times a day, and the fungus usually responds. Such a dilution might work as a scalp rinse. Then again, it is possible that a solution as strong as one part vinegar to two or three parts water would not be too harsh for the scalp.
One other food that could be used against dandruff could make you very popular with Pooh and other fictional bears. Honey, it turns out, is active against Malassezia yeast.171 This It may take a little experimentation to find the right dilution. One partminegar to fiveparts waterwould be safe, but might not be strong enough. One,part vinegar to,one part water Would probably.be strong enough to fight the fungus, but it might also sting the. scalp. Apply the rinse after shampooing, let it stay. on the scalp for 5minutes, then rinse it with dear water to get rid of the vinegar aroma.
Side effect: Possible skin irritation
Downside: Without the final water rinse, you might smell like a pickle.
Cost: About. $1 per quart
might be a lot more convenient to use against seborrheic dermatitis on the face than on the scalp to treat dandruff. But if one were feeling brave, or extra-sweet, it would be possible to mix honey with water, apply it to the scalp for 10 or 15 minutes, and then wash it off. Honey probably wouldn’t be much messier than yogurt, though it certainly would be more expensive than vinegar.
Over-the-Counter Remedies
Dandruff shampoos are readily available, and most are backed up by research showing that they affect yeast on the scalp and reduce flaking and itching. Keep in mind, though, that Malassezia may develop resistance to shampoos they are exposed to on a regular basis. As a result, it makes sense to rotate the type of medicated shampoo you use every month or two.
You might start, for example, with a shampoo such as Head & Shoulders, Pert Plus for dandruff, or Suave Dandruff 2 in 1 that contains zinc pyrithione. Research has shown that zinc pyrithione kills Malassezia and other fungi,”‘ which is why these shampoos are usually effective for dandruff. After 6 weeks or so, though, you should switch to an entirely different category of dandruff shampoo.
A medicated shampoo like Nizoral A-D, which contains ketoconazole, would be one option. This antifungal drug also kills Malassezia and has some anti-inflammatory action as well. 173 This shampoo is to be used twice a week at first, then only as often as necessary once the flakes are under control. Keep the suds away from the eyes, of course, but you can use Nizoral to wash any skin affected by fungus (patches of seborrheic dermatitis, jock itch, athlete’s foot, and the like).
Selenium sulfide is yet another antifungal ingredient. It is found in Selsun Blue, Glo-Sel, and Exsel shampoos.
There are two other categories of dandruff shampoo. One contains coal tar (a category that includes Denorex, Ionil T Plus, Neutrogena T/Sal, and Zetar). This ingredient acts against flaking and helps quell itching as well. The other contains salicylate acid and sulfur, which loosen the flakes and help them break into smaller (and thus less visible) pieces. These are shampoos such as Meted, Pernox, and Sebulex.
It surely doesn’t make sense to try all of these medicated shampoos, or even all of the various categories. Switching back and forth among three different categories would probably be just fine. The idea is simply not to let Malassezia get too accustomed to whatever it is you are using.
Give any dandruff shampoo enough time to fight the fungus. That is, after first washing off the surface dirt with any shampoo you please, lather up the medicated shampoo and leave it on for at least 5 minutes. This is harder than it sounds. After all, you may not want to waste water in the shower, but standing around wet and shivering for 5 minutes is also not appealing. You’ll have to use your ingenuity to solve this problem, but if you can, you’ll find the dandruff shampoo is far more effective. Here’s a hint: Shampoo first, then wash the rest of your body while you let the suds sink in.
arjiJ A - D
This shampoo contains the antifungal drug ketoconazole. (Make sure you buy the medicated shampoo. Nonmedicated Nizoral A-D is also available, but it won’t fight dandruff.) Nizoral shampoo is also available by prescription at twice the strength (2 percent).
Side effects: Rash, allergic reaction. To be safe, test a spot on your inner arm before you use it on your scalp.
Downside: Relatively expensive
Cost: Approximately 80o to $1.30 per wash When you are done washing your hair, resist the urge to blow it dry, at least once in a while. Hair dryers are hard on the scalp and seem to make flaking worse.
Prescription Shampoos
A stronger formulation of Nizoral shampoo is available by prescription. Doctors have a couple of other prescription possibilities as well, in case the other options aren’t effective enough. One of these is Loprox shampoo (ciclopirox). This antifungal agent also has some anti-inflammatory activity, which is useful when skin is itchy and red.”‘ Needless to say, a prescription shampoo is more expensive than the nonprescription approaches. No head-to-head studies have been done to compare it and find out if it is also more effective.
Conclusions
Dandruff and seborrheic dermatitis both seem to result from a-reaction to yeast that normally live on the skin. Scientists don’t know why some people react while others do not, nor are they sure why Malassezia yeast seems to grow more vigorously on some people’s skin than on others’. But research has shown that making life hard for the yeast usually controls the flaking and itching that are so bothersome. If any of these remedies make matters worse, stop the treatment right away and give your skin time to recover before you try anything else. When in doubt, check with a dermatologist!
• Drench the scalp with Listerine original (amber) mouthwash before shampooing. The herbal oils and alcohol in Listerine discourage the growth of yeast on the scalp.
• Smear some Vicks VapoRub on itchy, red, scaly spots. It contains many of the same antifungal herbal oils as Listerine. It can be very difficult to remove Vicks from hair, though.
• Brew some herbal tea with sage or rosemary. Use it as a rinse after shampooing your hair.
• Slather yogurt containing live cultures on the scalp. Leave it for 15 minutes before shampooing it out. Unlike the petrolatum in Vicks VapoRub, yogurt should be fairly easy to wash out.
• Make a rinse with vinegar diluted at least two to one in water. Some people prefer apple cider vinegar, while others use the cheapest white vinegar.
• Switch from one type of dandruff shampoo to another every 6 to 8 weeks. Don’t give Malassezia a chance to adapt.
• Try using Nizoral A-D shampoo twice a week, then cut back and use it only as often as needed to keep flaking under control.
• If none of this helps, check with your doctor. Perhaps your condition is not ordinary dandruff.
*A prescription shampoo such as Loprox may help when other measures have failed.
Jul
15
Enlarged Prostate. TREATMENT OF AN ENLARGED PROSTATE.
July 15, 2009 | Leave a Comment
• Having to get up in the night to pass water (nocturia) cymbalta with adderall .
• The need to push or strain to pass water lipitor pill .
• Blood in the semen, known as haemospermia lithium battery danger hazard .
Self-help
Some men find that they are better able to empty their bladders efficiently when they urinate in a sitting or squatting
position rather than standing up cat vomits after taking mirtazapine .
TAKING THE PROBLEM SERIOUSLY
The symptoms of an enlarged prostate must never be dismissed as an inevitable part of the ageing process clomid and cycle length . If a man does
not seek medical help, there are two things that can happen what does soma mean .
Firstly, he may suddenly become totally incapable of passing urine does wellbutrin cause false tsh readings . This is very painful and requires urgent treatment in
hospital, whereby a tube (catheter) has to be passed into the bladder in order to drain off the excess urine is depakote an aromatic anticonvulsant .
When an enlarged prostate is not a problem
If the prostate is enlarged, as detected by a digital rectal examination, but there are no symptoms, there is no need for
treatment seroquel disorders . The size of the gland alone is no indication calling for treatment - still less for surgery allegra famvir myonlinemeds biz . Intervention for
benign enlargement should only be considered when the symptoms become a problem vistaril hydroxyzine .
Secondly, the other thing that may happen is that the bladder can become so stretched that every time a man passes urine
he does not quite empty it actos and heart failure . The bladder expands very gradually, with the result that there is no pain and there may be no
obvious symptoms for a while arimidex hair thinning . Eventually, however, he will pass urine in a dribble, and he may notice that he is
constantly wetting his underpants arrythmia caffeine . He may even find that he is wetting the bed at night (known as enuresis), which is a
distressing and embarrassing symptom ofloxacin ear drops generic name . In extreme cases, the end result of this may be that there is so much back pressure
on the kidneys that they eventually fail price cefpodoxime . This is a very serious condition, known as chronic retention of urine with
renal failure chest pain stops imitrex .
THE RISKS
A benign enlarged prostate is not, in itself, a dangerous condition, but there are three main risks which may arise if
the condition is not treated emerson mirtazapine anxiety .
• Firstly, if the bladder is never completely emptied, there may be a build-up of stagnant urine in it how switch effexor pristiq . This can
become a breeding ground for bacteria and can cause cystitis, which is an inflammation of the inner lining of the
bladder paxil infertility . Treatment is by the administration of antibiotics gloucophage metformin .
• Secondly, the muscular walls of the bladder strengthen in an attempt to force urine through the narrowed urethra benazepril coughing .
As a result, the walls may become thickened and can then pinch the tubes that carry urine from the kidneys to the
bladder, known as the ureters removing caffeine from coffee . Back pressure may cause acute pyelonephritis, which is an inflammation of the kidney,
usually caused by bacterial infection, leading to symptoms such as high fever, chills and back pain quetiapine pharmacokinetic properties . Treatment is usually
by antibiotic drugs, which may need to be given by intravenous infusions doxycycline dog canine fish .
• And finally, the muscles of the bladder may become weakened and no longer able to overcome the resistance to
urine flow metronidazole rectal . They may then cease to function completely, which may be a sudden or a gradual process ultram paroxetine drug interaction . A sudden failure to
function may cause acute retention, which is very painful and requires emergency treatment paroxetine anorgasmia . A gradual failure can lead to
stress THE INTERNATIONAL PROSTATE SYMPTOMS SCORE
The World Health Organization (WHO) recently devised a system, known as the International Prostate Symptoms Score caffeine drink energy in . This
enables you - and your doctor - to judge how severe your prostate symptoms are and how urgently - or if - you need
treatment aleve and red blood cells .
INTERNATIONAL PROSTATE SYMPTOMS SCORE
Less than Less than About More
one time half the half the than half
in live time time the time
Not at all
Almost always
Over the past month:
How often have you had the sensation of not completely emptying your bladder after urinating’?
0 1 2 3 4 5
Needed to urinate
again within two hours 0 1 2 3 4 5 of finishing urinating’?
Stopped and started again several times when urinating’?
0 1 2 3 4 5
Found it difficult to postpone urinating’?
0 1 2 3 4 5
Had to push or strain to start urinating?
0 1 2 3 4 5
Had to get up in the night to urinate’?
0 1 2 3 4 5
How did you score?
• 0-8: your symptoms are very mild cheap wellbutrin xl 150mg 30 count . You may not need any treatment but your symptoms will be closely monitored by
your doctor paxil and sleep apnea . You may benefit from a change in diet or extracts of rye pollen teva generic actonel name .
• 9-17: your symptoms are moderate otc claritin d . Your doctor may prescribe a drug treatment, provided that your rectal
examination and blood tests are normal bactrim and myelosuppression .
• 17 and over: your symptoms are severe where can u sample viagra free . Your doctor will probably refer you to a specialist for further tests and
treatment what is symmetrel used for .
WHAT TO DO
It is not uncommon for a man who is experiencing symptoms of an enlarged prostate to put off going to the doctor tizanidine injected intravenously . He may
do this because he has heard that the doctor will probably give him a rectal examination and he would rather avoid this prilosec prescription strenght .
Or he may do it because he thinks that his symptoms are an inevitable part of growing old and that the doctor will not
take them seriously detrol sideeffects . But he is wrong what are the ingredients in orlistat .
The doctor will take them seriously and, as I have already said, he should not delay is boost plus caffeine free . Treatment nowadays is both
straightforward and effective, and it is sensible to have treatment before your disease progresses and you are at any
risk is remeron safe .
Early screening may help prevent you developing problems in the future with your kidneys dance prints zantac . Even more importantly, it may
ensure that the still more serious but rare problem of prostate cancer is discovered early - and therefore treated early amount of caffeine in starbucks frappuccino .
WHAT YOUR DOCTOR WILL DO
There are several things your doctor and/or a specialist, known as a urologist, may do to investigate an enlarged
prostate, and to decide which treatment would be most appropriate does toprol cause chest discomfort .
These may include any or all of the following:
• Digital rectal examination (DRE) 40 mg zocor .
• Blood tests nonprescription tamoxifen .
• Urine tests neurontin equivlant .
• Ultrasound price of accutane .
• CyStoscopy drug classification for gemfibrozil .
• Intravenous pyelogram (IVP) cephalexin 500mg capsule .
Digital rectal examination (DRE)
The first investigation a doctor will probably do is a digital rectal examination active ingredient in biaxin . To do this, he will gently insert his
gloved index finger into your rectum testosterone propionate injections . He will use a water-based jelly as a lubricant what is venlafaxine hci . A rectal examination does not hurt,
and you should not feel embarrassed - it’s all in a day’s work to a doctor differences between generics of amitriptyline .
The shape and size, as well as the texture and tenderness of the prostate can be felt in this way ibuprofen suicide . If you have an
enlarged prostate, the gland will feel just that - enlarged pravastatin and leg cramps . It will also feel firm and smooth naproxen alcohol .
Blood tests
There are several blood tests that are likely to be done as part of the investigation of an enlarged prostate cialis generics . These may
be done to check for infection, to check how well your kidneys are working, and to eliminate prostate cancer (see Chapter
6) new treatment instead of casodex .
Tests include:
• Full blood count, as a check for infection or anaemia caffeine and conception caremark health resources .
• Urea and electrolytes, to see how well your kidneys are functioning is ibuprofen safe .
• Prostate acid phosphatase (PAP), to check for prostate cancer lasix clarksville tennessee .
• Prostate specific antigen (PSA), to check for prostate cancer chemical formula for caffeine and chocolate .
Urine tests
Similarly, there are a number of urine tests that are likely to be done as part of the investigation of an enlarged
prostate pioglitazone breast cancer . These are done both to determine how badly your stream of urine is affected and to check for infection dont take wellbutrin xl .
Tests include:
• Urinary flow rate, using a urine-flow meter, which determines how badly your ability to urinate normally is
affected is actos a steriod . As you pass urine into a bottle, an electronic device measures both the total amount passed and the speed with
which it is passed sex with levitra . This will reveal the extent of any obstruction to the flow necrotic bone pain zithromax .
• Mid stream urine (MSU), to check for any bacterial infection, which may indicate cystitis, and for any red blood
or pus cells, as well as for any tiny threads of tissue shed from the kidney, known as casts tramadol identifier pt5 .
• Urine dip stick test, to check for sugar and protein buy testosterone now .
Ultrasound
This entails passing high-frequency sound waves through your body, which then bounce back off special tissue plates to
produce an image on a screen kts lithium battery cr2032 . Ultrasound, or sonography, can reveal several things, including:
• The size of your prostate gland itraconazole fluconazole indications .
• Whether there is any residual urine (and, if so, how much), left in your bladder after urinating expiration date of tetracycline .
• The size of your kidneys genital warts and zantac .
Cystoscopy
This entails passing a narrow telescope, known as a cystoscope, through the penis and into the bladder metformin serum creatine . This procedure is
done under general anaesthetic lithium niobate .
It enables the urethra and bladder to be viewed in detail, with the result that the degree of prostate obstruction can be
assessed accurately testosterone vitamins .
Intravenous pyelogram (IVP)
This test entails injecting a radio-opaque form of iodine into a vein herbal equivalent vibramycin . The dye is then concentrated in the kidneys, and
X-rays are taken of the urinary tract ordering ultram delivery flower . These will therefore show any abnormalities diltiazem sustained release . An IVP rules out the possibility that
symptoms are due to urinary tract disease rather than to an enlarged prostate betapace weight gain . It also reveals whether the bladder,
ureters or kidneys have been damaged by back pressure from the enlargement bromocriptine and structure and action .
TREATMENT OF AN ENLARGED PROSTATE
Exactly how the doctors decide to treat your enlarge prostate depends to a large extent on how severe your symptoms are
(this is where the International Prostate Symptoms Score (see page 48) comes in useful and has a practical purpose; on
whether your condition is threatening vital systems such as your kidneys; on how much it is affecting your lifestyle; and
on your general state of health dosage ceroxim cefuroxime axetil oral suspension . Whatever you are offered, it is worth your while checking that you are being offered the
most up-to-date treatment available does amoxicillin affect apri . Treatments are being improved all the time, and it is a good idea to discuss this
with your doctor or specialist will spa white whiten tetracycline stains . You should also voice any particular worries that you have liver caffeine . Don’t worry about wasting
your doctor’s time - that’s what he’s there for and he should be happy to take the time and trouble to talk about your
worries with you and to explain the situation lamictal gum loss .
Is it worth the risk?
You must talk to your doctor in some detail about possible treatments and their risks zelnorm mg . Only you know how much your
symptoms are affecting your life, and only you can decide what risks you are willing to take in order to get rid of them excessive drinking while taking topamax .
Would it be worth a slight risk of impotence, for example, not to have to get up twice in the night to urinate? No one
can answer this on your behalf - it’s got to be your decision motrin advertisement .
If symptoms are mild missed dose of lexapro . zyrtec syrup infant dosage . prevacid non prescription .
In this case, and if tests have ruled out any possibility of prostate cancer, doctors may adopt a `wait-and-see’
approach 26650 lithium . Symptoms may not get any worse, and a modification to diet, along with extracts of rye pollen, may help (see
Naturopathy, Chapter 9) depakote 250 mg .
If symptoms are moderate li-60b lithium ion battery . aciphex nasacort ambien . soma grill in pittsburgh pa .
In this case, a doctor may decide on a drug approach, which may help relieve symptoms med felodipine . Possible drugs include:
• Alpha-blocker drugs, such as indoramin, prazosin and terazosin fluconazole tabletki 150mg . These are the most commonly used form of drug
treatment cetirizine nursing . They relax the nervous system and inhibit contractions in the prostate and urethra singulair swelling due to fluid retention . In this way, they ease
symptoms rather than counteracting the obstruction completely natural alternative for bactrim .
• Antispasmodic drugs, such as flavoxate, oxybutinin and propantheline, which reduce irritation of the bladder viagra houston .
• 5-alpha-reductase inhibitors, such as finasteride, which prevent the hormone testosterone from being converted
into dihydrotestosterone, which is known to cause an enlarged prostate claritin and prostatitis . These drugs shrink the gland and may slightly
improve the flow of urine inventor inventor for penicillin penicillin .
If symptoms are severe caffeine and male health . bupropion sr tab 150mg side effects . discount xenical wholesale stores discount pharmacy .
Symptoms may be so severe that the urethra is blocked off completely, with the result that the sufferer is unable to pass
urine is generic fosamax oral solution available . This is a very painful condition and requires immediate hospitalisation lose weight celexa .
The recommended treatment in this case will probably be catheterisation, which entails inserting a flexible tube, or
catheter, into the bladder under local anaesthetic to drain trapped urine diclofenac in vulture poisoning . This will usually bring instant and welcome
relief and, as such, is a valuable treatment arimidex for males .
It is not, however, considered to be an acceptable long-term solution by most men, who regard it only as a temporary
measure until something permanent can be done sertraline xenadrine . The long-term solution is usually surgery, in the form of a prostatectomy
(see below) digoxin induced gynecomastia .
If, however, surgery is considered to be too dangerous - usually because of ill health or advanced age - a catheter may
be kept in place permanently does toradol react to advil . It will continue to provide drainage into a special bag that is worn attached to the leg jr enterprises ivermectin .
Surgery
For many men, the only acceptable long-term solution is surgery trying to wean off nexium . This entails the removal of either part, or all of, the
prostate gland over the counter prilosec .
Most doctors advise an early operation, because the risk is much increased if the kidneys are already damaged duphaston myoma . If surgery
is performed when symptoms first become a serious nuisance, the results are nearly always very good zithromax for fish .
The removal of part of the prostate is done by a procedure known as transurethral prostatectomy (TURP), in which prostate
tissue is cut away using an electrically-heated wire loop inserted through the urethra testosterone enanthate for bodybuilding . The entire prostate gland is
removed in an operation known as a prostatectomy imitrex sulfa allergy symptoms .
The more common of the two operations is TURP, though an open prostatectomy is sometimes chosen in preference to TURP fellini prozac .
The reasons for this include the following:
• If the prostate is very much enlarged application for plavix .
• If a tumour is suspected, which might be cured through the removal of the entire prostate urologic drugs bactrim .
• If a man also has large bladder stones, which also need to be removed bird ivermectin .
• If a man has bad arthritis in the hips, which cannot therefore be placed up in stirrups, as this is needed for
TURP buy tadalafil count online .
Both transurethral prostatectomy and open prostatectomy are described in detail in Chapter 7 ibuprofen mix with alcohol .
Treatment by stent
A man who is too ill to withstand a major operation may have a stent implant put in place, This is a short, stiff tube
that is placed in the urethra at the point at which it passes through the prostate gland acne caffeine cause does . It holds the urethral walls
open in spite of pressure from an enlarged gland what is zyprexa commonly prescribed for . An advantage of this procedure is that a stent is simple to put in
position and it can be done to a man who is not well enough to have a prostatectomy cipro and c difficile .
There are two types of stent: a permanent mesh type, which is left in position permanently and the skin of the urethra
eventually grows over it, and a temporary spiral type, which can easily be removed but which has the disadvantage that it
is prone to bacterial infection and that it can become dislodged can piroxicam be heated .
Other possibilities
Medical advances have come up with several new procedures, some of which are still at the clinical trial stage ranitidine pill identifier . Research
continues in this field, and the outlook for further advances in the treatment of this debilitating condition is good,
though as yet most of these procedures are still a long way out of mainstream medical practice accutane repeat .
New procedures include:
• TULIP (Transurethral, ultrasound guided, laser-induced prostatectomy), which entails using a laser to cut away
prostate tissue citalopram children .
• Microwave hyperthermia, which involves inserting a microwave coil within a catheter into the urethra and heating
it to a temperature of 45°C (113°F) low testosterone bicycle . The treatment must be done twice a week for three to five weeks vytorin long-term side effects . Each treatment
takes between 30 and 60 minutes lamactil and celexa . There is no need for any anaesthetic and the procedure can be done as an out-patient process in the discovery of ciprofloxacin . As
yet, there have been no large-scale or long-term studies anti aging testosterone .
• Transrectal hyperthermia, which is another heat-shrinking procedure, introducing a probe into the rectum estradiol supplements fertility . This
heats the prostate to a temperature of 43°C (109°F) using microwaves naturally restore testosterone levels .
The procedure is usually repeated six times, and lasts one hour each time wellbutrin full dose . During the treatment period, the patient can
lead a normal life, suffering no more than slight discomfort each time vaseretic physicians update .
• TUNA: Transurethral needle ablation, which means needles are inserted into the prostate, under local anaesthetic,
to allow greater precision and higher temperatures during heat-shrinking procedures ibuprofen dosages wiki .
• Sonoblate, which is another heat-shrinking procedure, this time involving ultrasound waves via the rectum prismatic lithium cells .
• Cryotherapy, which entails inserting a cryoprobe into the penis and freezing the prostate medco lamotrigine 200 mg .
• Dilatation of the prostate with the use of balloons entacapone and levodopa and adverse .
Jul
15
Enlarged Prostate.
July 15, 2009 | Leave a Comment
Enlarged Prostate
As we have learned, the prostate gland enlarges naturally as a man gets older homeopathic remedies for low testosterone . It can enlarge from the size of a chestnut
to the size of an apple lithium fmt . This happens because of an increase in the number of cells present in the prostate gland, in a
process known as hyperplasia what is norplant .
Some doctors believe that every man over the age of 50 has some degree of prostate enlargement and that it is simply part
of the ageing process elavil lithium online without prescription . This view is supported by routine tests, which show that nearly every man over the age of 50 has
some degree of enlargement of the prostate gland albuterol meter dose inhaler .
Prostate enlargement is correctly called benign prostatic hyperplasia (BPH) and is also known as benign prostatic
hypertrophy snorting prednisone . Benign means that, unlike cancer, it is not malignant, but it does not mean that it is harmless directions for taking clarithromycin . An enlarged
prostate can exist for many years and cause little more than irritation and inconvenience colonoscopy caffeine . Left untreated, however, it
can cause severe harm prescription cheaper than lexapro .
Enlargement, in itself, does not necessarily cause problems can tamoxifen cause depre . A lot of growths of prostate tissue are a natural part of
the ageing process and are quite harmless price effexor . What is not so harmless, though, is when little gristly nodules accumulate,
the development of which changes both the size and consistency of the gland oxybutynin warnings . For it is not actually size that matters so
much as the consistency of the tissues, which causes the gland to become stiff and inflexible norvasc and psychology . Sometimes the bladder can
compensate for this by becoming stronger and more powerful, but problems occur when the bladder muscles can no longer
overcome the resistance caused by the increasingly rigid prostate gland india carisoprodol .
This is when the flow of urine becomes badly obstructed - which can have a dramatic and troublesome effect on a man’s
lifestyle side effects of generic zantac . It is important to realise, however, that you do not have to accept this as an inevitable part of ageing altace danger . It
isn’t - in the sense, at least, that something can almost always be done about it cats use celexa .
NEVER SUFFER IN SILENCE
Because the prostate gland surrounds the urethra, and because it is located so close to the base of the bladder, when it
becomes enlarged it can seriously interfere with the normal function of urination prevention coldsores zovirax . As a result, an enlarged prostate can
be both troublesome and inconvenient cycle test testosterone trenbolone . It is likely to mean disturbed sleep, interrupted by several visits to the toilet
every night; and it will probably mean curtailing social activities because of the need to be near a toilet at all times dangers of fluoxetine .
But there is no need to suffer in silence dutasteride transgender . If you think you have an enlarged prostate, you must see your doctor as soon
as possible lithium dremmel . It is not an emergency, requiring instant admission to Accident and Emergency, but it does require prompt
treatment coffee caffeine brazilian arabica blend coffee . As long as it is treated promptly, it can almost always effectively relieve symptoms levothyroxine green tea .
More seriously, an enlarged prostate can have several severe consequences, though these are not common acne doxycycline treatment . It can, for
example, cause acute urine retention, in which case there is an urgent need for catheterisation - or the insertion of a
flexible tube into the bladder under local anaesthetic - which will bring instant relief stimulant effects of hydrochlorothiazide . In an even more serious case,
it can cause trapped urine to flow back up from the bladder, where it will put pressure on the kidneys and may even, in
severe cases, lead to kidney failure does caffeine inhibit weight loss . This happens only rarely, but its possibility is nevertheless a good reason for
taking an enlarged prostate seriously how prozac delay orgasm .
WHAT CAUSES AN ENLARGED PROSTATE?
Why the prostate gland gets bigger is not really known zyrtec d and child . Only two things are certain, and that is that the only people who
suffer from an enlarged prostate have two things in common:
• They are male imodium dose for children .
• They are getting on in years effexor and tramadol .
The exact cause of prostate enlargement is not altogether clear zoloft arthritis . What is clear, is that an enlarged prostate is a male
hormone-dependent disorder in that its growth is stimulated by androgens and, in particular, by testosterone ibuprofen chewable . What is not
clear, however, is why it should suddenly enlarge at the age of 50 or more, when testosterone levels are falling lithium use in hyponatremia .
Another possible factor influencing the development of an enlarged prostate includes the sort of diet you eat danger of toradol . A food
link is suspected because of the undeniable fact that so many more men suffer from an enlarged prostate in the West than
in eastern societies such as China and Japan southwest general hospital coumadin clinic . It is felt that this may be because western and eastern ways of eating are
so different medicine carafate . It is possible that the men in eastern societies are protected by their diet, which relies heavily on
soya-based foods such as tofu, and on plant foods such as vegetables and fruit generic for 320 mg diovan .
Sex hormones
It does seem to be an odd fact that the organs of the body that depend on sex hormones - both male and female - are
particularly prone to disorders of growth, which can be either benign or malignant caffeine freeware .
This is, for example, that women are prone ‘ to both benign and malignant growths in the breasts and the womb - a third
of all cancers in women, in fact, affect these organs gluten in ponstel .
In just this same way, men are prone to enlargement of the prostate gland, which can be either benign or malignant ovulation signs on clomid . One
tenth of all male cancers, in fact, affect the prostate gland cephalexin for fish .
Levels of prolactin
The level of the hormone prolactin is known to increase dihydrotestosterone in the prostate gland and thus to encourage
prostatic enlargement cytoxan mucosal damage celiac . Two things that are known to increase levels of prolactin, and may therefore contribute to an
enlarged prostate, are:
• Stress drug interactions with flagyl .
• Beer is azithromycin over the counter . Two things that are known to reduce levels of prolactin are:
• Zinc caffeine as molluscide .
• Vitamin B6 cheap est xenical online .
Deficiency of one or both of these nutrients may therefore contribute to prostatic enlargement (see Naturopathy, Chapter
9) zoloft and missed periods .
WHO IS AT RISK OF PROSTATE ENLARGEMENT?
The answer to this is anyone and everyone asprin blood flow song . No one knows of anything that decreases the risk, so there’s nothing you can
do to minimise your chances natural testosterone adaptogen eurycoma levels extract . People talk about a prostate-friendly diet (see Chapter 10), and this way of eating is
probably good for the general health of everyone - women as well as men, but following this diet in no way guarantees
that you will never have anything wrong with your prostate ultram respiratory depression . Sadly, it won’t buy cheap imitrex oral .
SYMPTOMS
Some men never experience any symptoms clomid day 1-5 . Others, however - the great majority, in fact - experience urinary outflow
obstruction, known as prostatism, which is caused quite simply by the fact that the prostate gland encircles the urethra glaxosmithkline and wellbutrin xl .
As the prostate gets bigger, so it presses on the urethra, which becomes more or less severely narrowed as a result hunger rids caffeine high .
If you think that you have symptoms of an enlarged prostate, see your doctor as soon as you can synthroid dosage diabetes . Don’t wait until
symptoms interfere with your lifestyle a good alternative for atenolol .
Recognising the symptoms
The symptoms of an enlarged prostate, which are known as prostatism, are purely mechanical child on prozac . They are rarely troublesome
before the age of 55, and affect one in ten elderly males take nolvadex .
Some of these symptoms are due to distortion of the normal anatomy at the base of the bladder, which causes urinary
outflow obstruction maoi zoloft . Some are caused by irritation to the bladder as it stretches and thickens in an attempt to push
urine past the obstruction caused by the prostate lasix eye surgeries questions .
There are many symptoms tramadol money order cod . These include:
• A weak, sluggish urinary stream, which may be particularly noticeable first thing in the morning, you may notice
this as a thin stream, or you may not be able to urinate as high or as far as you used to allegra fexofenadine 180 .
• Difficulty in starting the flow of urine, known as hesitancy symptoms of quiting celexa .
• A tendency to stop and start urinating, known as an intermittent flow indications mebendazole .
• The feeling that you haven’t quite emptied your bladder and that there is more to come does cozaar protect the kidneys .
• Straining to pass water coumadin loginox .
• Incontinence - this is not an inevitable part of old age, it is a sign that there is something wrong desyrel overdose outcome .
• Dribbling of urine finasteride usage .
• Urinary retention orthostasis and topamax .
• Pain or discomfort on passing water, known as dysuria ultram mortgage .
• Blood in the urine, known as haematuria high testosterone cancer 2007 .
• The need to rush urgently to the toilet to pass water gabapentin and shingles .
• Increasingly frequent need to pass water - perhaps as often as every two hours drug penicillin was made .