Aug
1
Clarithromycin
August 1, 2009 | Leave a Comment
Generic Name
Clarithromycin (klah-rith-roe-MYE-sin) 91
Brand Names Biaxin
Type of Drug Macrolide antibiotic.
Biaxin XL
Prescribed For
Mild to moderate infections of the upper and lower respiratory tract, tonsillitis, pharyngitis, sinusitis, exacerbation of chronic bronchitis, middle-ear infections, and for duodenal ulcers; also used for skin and other infections, including membrane attack complex (MAC) in people with advanced HIV infection.
General Information
Clarithromycin and other macybYide antibiotics are either bacteri(;((JW (’UaCkeeia-killing) or bacteriostatic (inhibiting bacterial growth), depending on the organism in question and amount of antibiotic present. In ulcer disease, clarithromycin is used to fight Helicobacter pylori infection, which is present in almost all ulcers and most cases of stomach inflammation.
Cautions and Warnings
Do not take clarithromycin if you are allergic or sensitive to any of its ingredients or to any macrolide antibiotic.
Clarithromycin should not be used during pregnancy.
Clarithromycin is primarily eliminated from the body through the liver and kidneys. People with severe kidney disease may require dose adjustments. Liver disease generally does not require an adjustment.
Colitis (bowel inflammation) has been associated with all antibiotics (see “Possible Side Effects”). If colitis does develop, your doctor should start appropriate treatment. Mild cases of colitis usually respond to the discontinuation of the medicine.
Possible Side Effects
Most side effects are mild and go away once you stop taking clarithromycin.
✓ Most common: nausea, upset stomach, changes in sense of taste, headache, he. diarrhea, abdominal pain, vomiting, and rash in children. Colitis (symptoms include severe abdominal cramps and severe, persistent, and possibly bloody diarrhea) may develop.
✓ Rare: serious abnormal heart rhythms. Contact your doc-
tor if you experience any side effect not listed above.
Drug Interactions
• Clarithromycin may increase the anticoagulant (blood-thinning) effects of warfarin in people who take it regularly, especially older adults. This combination requires careful monitoring by your doctor.
• Do not combine clarithromycin with astemizole or terfenadine.
• Combining clarithromycin and omeprazole raises the amount of both drugs in the blood.
• Two deaths have been reported in people combining Oarithromycin and pimozidp_ ?imuiide should not be used by peibp)e faking a macrolide antibiotic.
• Clarithromycin may raise blood levels of theophylline, possibly leading to a theophylline overdose. It can also increase the effects of caffeine.
• Combining clarithromycin and digoxin, cyclosporine, ergot
alkaloids, or tacrolimus may lead to serious side effects.
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
Ciclopirox
August 1, 2009 | Leave a Comment
Generic Name
Ciclopirox (sye-kloe-PERE-ox) &
Brand Names
Loprox Penlac
Type of Drug Antifungal,
Prescribed For
Fungus and yeast infections of the nails and skin, including athlete’s foot, candida, and dandruff.
General Information
Ciclopirox slows the growth of a variety of fungus organisms and yeasts and kills many others. The drug penetrates the skin, hair, hair follicles, and sweat glands. Ciclopirox nail lacquer is used for toenail and fingernail fungus infections. Ciclopirox shampoo is used for dandruff.
Cautions and Warnings
Do not use this product if you are allergic or sensitive to any of its ingredients.
Possible Side Effects
Common: burning, itching, stinging, or oozing at the application site.
Drug Interactions None known.
Usual Dose
Cream/Lotion
Adult and Child (age 10 and over): Massage into cleansed affected skin and surrounding area twice a day.
Nail Lacquer
Adult: Apply to infected nails once a day. Use in conjunction with monthly visits to a health care professional.
Child (under age 10): not recommended.
Shampoo
Adult: Wet hair and apply 1-2 tsp to the scalp. Lather and leave on hair and scalp for 3 minutes, then rinse. Avoid contact with eyes. Repeat twice weekly for 4 weeks.
Child (under age 16): not recommended.
Overdosage
Accidental ingestion may cause nausea and upset stomach. Call your local poison control center or hospital for more information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
This product can be expected to relieve symptoms within the first week of use. Follow your doctor’s directions for the complete 2-4 week course of treatment with the cream or lotion to gain maximum benefit. The nail lacquer may be used for up to 48 weeks. Stopping the medication too soon can lead to a relapse.
When using ciclopirox nail lacquer, do not apply it to any skin other than that which surrounds the infected nails, because of possible irritation. Do not apply nail polish or any other nail lacquer to infected nails while you are using this product.
Avoid using ciclopirox nail lacquer near an open flame, since the product is flammable.
Do not cover cream or lotion with a bandage.
Call your doctor if the affected area burns, stings, or becomes red after you use this product, 13y i1 your symptoms do not clear Up aher 4 weeks of treatment; by then it is unlikely that this product will be effective.
If you forget a dose of ciclopirox, apply it as soon as you remember. Do not apply more than the amount prescribed to make up for the missed dose.
Special Populations
PregnancylBreast-feeding., ciclopirox may pass to the fetus in very small amounts. In animal studies, high doses of ciclopirox given by mouth did not harm the fetus. Caution should be exercised when using ciclopirox during pregnancy.
It is unknown if ciclopirox passes into breast milk. Nursing mothers who must use this drug should consider using infant formula.
Seniors: Seniors may use this drug without special restriction.
Aug
1
Cholinesterase Inhibitors
August 1, 2009 | Leave a Comment
Type of Drug
Cholinesterase Inhibitors
(KO-lin-ESS-tuh -rase)
Brand Names
Generic Ingredient.- Donepezil
Aricept Aricept ODT
Generic Ingredient: Galantamine
Razadyne Razadyne ER
Generic Ingredient: Rivastigmine
Exelon Exelon Transdermal System
Generic Ingredient: Tacrine Cognex
Prescribed For
Alzheimer’s disease. Also used for vascular dementia, dementia associated with Parkinson’s disease, poststroke aphasia (problems with language), and improvement of memory in multiple sclerosis patients.
General Information
Cholinesterase inhibitors work by increasing the function of certain receptors in the brain that are stimulated by the hosmone acetylcholine. They do t.Ns by interfering with cholinesterase, the 1617yme that breaks down acetylcholine. People with Alzheimer’s disease (a degenerative condition of the central nervous system) develop a shortage of this brain chemical early in the disease. There is no evidence that cholinesterase inhibitors reverse the degenerative effects of Alzheimer’s, but they may slow the rate at which the disease worsens.
Cautions and Warnings
Do not take cholinesterase inhibitors if you are allergic or sensitive to any of their ingredients.
Cholinesterase inhibitors must be discontinued before surgery because they increase the effects of anesthetic drugs.
People with heart disease should use cholinesterase inhibitors with caution because they may slow heart rate and cause fainting. Two studies of people with mild symptoms of Alzheimer’s disease taking galantamine revealed a higher rate of death from heart attack, stroke, or sudden death.
Cholinesterase inhibitors may be expected to cause increased stomach acid production and increased activity of the gastrointestinal tract. Possible complications include ulcers or bleeding. Alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen may worsen this effect.
Using cholinesterase inhibitors may also lead to urinary blockage, increase the risk of generalized seizures, and worsen asthma or other pulmonary diseases. Use with caution if you have these conditions.
People with severe liver dysfunction should not take galantamine or tacrine.
Possible Side Effects
People taking cholinesterase inhibitors generally experience side effects at about the same rate as those taking a placebo (sugar pill).
♦ Most common: headache, general pain, accidents, nausea, diarrhea, sleeplessness, and dizziness.
✓ Common: tiredness, vomiting, appetite loss, and muscle cramps.
♦ Less common: arthritis, depression, abnormal dreams, fainting, black-and-blue marks, and weight loss.
✓ Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Cholinesterase inhibitors interfere with anticholinergic drugs (often prescribed for stomach disorders).
• Cholinesterase inhibitors can be expected to increase the ef-
fects of cevimeline, surgical anesthetic drugs, and drugs that
irritate the stomach and intestines, such as aspirin, ibupro-
fen, and other NSAIDs.
• The breakdown of cholinesterase inhibitors (except rivastigmine) in the liver can be slowed by ketoconazole, itraconazole, quinidine, delavirdine, indinavir, nelfinavir, ritonavir, saquinavir, amiodarone, cimetidine, ciprofloxacin, norfloxacin, clarithromycin, diltiazem, erythromycin, fluconazole, fluvoxamine, celecoxib, chlorpheniramine, clomipramine, cocaine, doxorubicin, fluoxetine, halofantrine, halopendol, levopromazine, methadone, mibefradil, paroxetine, ranitidine, terbinafine, mifepristone, nefazodone, and grapefruit juice.
• The breakdown of cholinesterase inhibitors (except rivastigmine) in the liver can be increased by efavirenz, nevirapine, barbiturates, carbamazepine, corticosteroids, phenytoin, pioglitazone, and rifampin.
Food Interactions
Donepezil can be taken with or without food.
Galantamine and rivastigmine should be taken with morning and evening meals.
The rivastigmine transdermal system patch can be used without regard to meals.
Food reduces the absorption of tacrine into the blood. It is best taken on an empty stomach, but you can take it with food if it upsets your stomach.
Usual Dose
Donepezil
Adult: 5 or 10 mg once a day.
Galantamine
Adult: 8-32 mg a day.
Rivastigmine
Adult: 3-12 mg a day, divided into 2 doses.
RiVUtq1M&A0Y2nsdermaI patch
Adult: Apply one 4.6-mg patch every day to start. Dose may be increased to one 9.5-mg patch every day.
Tacrine
Adult: 40-160 mg a day, divided into 4 doses.
Overdosage
Cholinesterase inhibitor overdose can be very serious. Symptoms include severe nausea, vomiting, salivation, sweating, slow heart rate, low blood pressure, slow breathing rate, convulsions, muscle weakness, and collapse. Take the overdose victim to a hospital emergency room at once. ALWAYS bring the prescription bottle or container.
Special Information
Donepezil should be taken just before bedtime.
Follow the special package directions for rivastigmine solution.
Do not remove the rivastigmine patch from its packaging until just before you are ready to apply it. Apply the patch to clean, dry, and hairless skin on the upper or lower back, upper arm, or chest that is also free of any powder, oil, moisturizer, or lotion that could keep the patch from sticking to your skin properly; skin should also be free of cuts, rashes, and irritations. Avoid places where the patch can be rubbed off by tight clothing. When changing your patch, apply your new patch to a different spot of skin (for example, on the right side of your body one day, then on the left side the next day). Do not use the same spot more than once every 14 days. Wear only one patch at a time and change it every.24 hours. If the patch falls off, apply a new patch for the rest of the day, then replace the patch the next day at the same time as usual.
Tobacco or nicotine use increases the rate at which tacrine and rivastigmine are cleared from the body.
If you forget a dose and take your medication once a day, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with the regular schedule. If you take your medication 2 or more times a day, take your dose as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: One animal study of a cholinesterase inhibitor indicated a small risk of birth defects. When your doctor considers this drug crucial, its potential benefits must be carefully weighed against its risks.
It is not known if cholinesterase inhibitors pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors with moderate kidney function loss should not take galantamine. Dosage adjustments are not needed for donepezil, tacrine, or rivastigmine.
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.
Aug
1
Chlordiazepoxide
August 1, 2009 | Leave a Comment
Generic Name
Chlordiazepoxide (klor-dye-az-uh-PDX-ide) 91
Brand Name
Librium
Type of Drug Benzodiazepine sedative.
Prescribed For
Anxiety, tension, fatigue, agitation, and withdrawal symptoms of alcoholism; also prescribed for irritable bowel syndrome and panic attacks.
General Information
Chlordiazepoxide is a member of the group of drugs known as benzodiazepines.
Benzodiazepines work by a direct effect on the brain. They can relax you and make you more tranquil or sleepier, or they can slow nervous system transmissions in such a way as to act as an anticonvulsant. Many doctors prefer benzodiazepines to other drugs that can be used to similar effect because they tend to be safer, have fewer side effects, and are usually as effective, if not more so.
Cautions and Warnings
Do not take chlordiazepoxide if you are allergic or sensitive to any of its ingredients or to another benzodiazepine, including clonazepam.
Chlordiazepoxide can aggravate narrow-angle glaucoma, but you may take it if you have open-angle glaucoma and are receiving therapy for it.
Other condkjo(\SiVN\,NhjCb chlordiazepoxide should be used with caution are severe depression, especially with suicidal tendencies, severe lung disease, sleep apnea (intermittent cessation of breathing during sleep), liver disease, drunkenness, and kidney disease.
Chlordiazepoxide should not be taken by psychotic patients because it is not effective for them and can trigger unusual excitement, stimulation, and rage. It has also produced similar reactions among hyperactive and aggressive pediatric patients.
Chlordiazepoxide is not intended for more than 3-4 months of continuous use. Your condition should be reassessed before continuing chlordiazepoxide beyond that time.
Chlordiazepoxide may be addictive. Drug withdrawal may develop if you stop taking it after only 4 weeks of regular use, but is more likely after longer use. It may start with anxiety and progress to tingling in the hands or feet, sensitivity to bright light, sleep disturbances, cramps, tremors, muscle tension or twitching, poor concentration, flu-like symptoms, fatigue, appetite loss, sweating, and changes in mental state.
Dosage of chlordiazepoxide should be decreased gradually over 4-8 weeks after prolonged use.
Possible Side Effects
Weakness and confusion may occur, especially in seniors and in those who are sickly.
♦ Most common: mild drowsiness during the first few days of therapy.
✓ Less common: depression, lethargy, disorientation, edema, headache, inactivity, slurred speech, stupor, dizziness, tremor, constipation, dry mouth, nausea, inability to control urination, sexual difficulties, irregular menstrual cycle, changes in heart rhythm, low blood pressure, fluid retention, blurred or double vision, itching, rash, hiccups, nervousness, inability to fall asleep, and occasional liver - dysfunction. If you experience any of these symptoms, stop taking the medicine and contact your doctor immediately.
♦ Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Chlordiazepoxide is a central-nervous-system depressant. Avoid alcohol, other sedatives, narcotics, barbiturates, mono-amine oxidase inhibitor and other antidepressants, and antihistamines. Taking chlordiazepoxide with these drugs may result in excessive depression, tiredness, sleepiness, breathing difficulties, or related symptoms.
• Smoking may reduce the effectiveness of chlordiazepoxide by increasing the rate at which it is broken down by the body.
• The effects of chlordiazepoxide may be prolonged when it is
taken with cimetidine, contraceptive drugs, disulfiram, flu-
oxetine, isoniazid, ketoconazole, metoprolol, probenecid,
propoxyphene, propranolol, rifampin, or valproic acid.
• Theophylline may reduce chlordiazepoxide’s sedative effects.
• If you take antacids, separate them by at least 1 hour from your chlordiazepoxide dose to prevent them from interfering with the passage of chlordiazepoxide into the bloodstream.
• Chlordiazepoxide may increase blood levels of digoxin and the chances for digoxin toxicity.
• Levodopa + carbidopa’s effectiveness may be reduced by chlordiazepoxide.
• Phenytoin blood concentrations may be increased when taken with chlordiazepoxide, resulting in possible phenytoin toxicity.
Food Interactions
Chlordiazepoxide is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
Adult: 5-100 mg a day. This range is due to individual response related to age, weight, disease severity, and other characteristics.
Child (age 6 and over): may be given if deemed appropriate by a doctor. Starting dose-5 mg 2-4 times a day. Maintenance dose—up to 30 mg a day for some children, but must be individualized to obtain maximum benefit.
Child (under age 6): not recommended.
Overdosage
Symptoms of overdose are confusion, sleepiness, poor coordination, lack of response to pain such as a pin prick, loss of reflexes, shallow breathing, low blood pressure, and coma. The victim should be lakes to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Chlordiazepoxide can cause tiredness, drowsiness, inability to concentrate, or similar symptoms. Be careful if you are driving, operating machinery, or performing other activities that require concentration.
If you forget a dose of chlordiazepoxide, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Chlordiazepoxide may cause birth defects if taken during the first 3 months of pregnancy. Avoid chlordiazepoxide while pregnant.
Chlordiazepoxide may pass into breast milk. Nursing mothers who must take chlordiazepoxide should use infant formula.
Seniors: Seniors, especially those with liver or kidney disease, are more sensitive to the effects of chlordiazepoxide and generally require smaller doses to achieve the same effect.
Jul
16
Alpha Blockers
July 16, 2009 | Leave a Comment
Type of Drug
Alpha Blockers
Brand Names
Generic Ingredient. Alfuzosin Uroxatral
Generic Ingredient: Terazosin Hydrochloride Hytrin
Prescribed For
High blood pressure (terazosin) and benign prostatic hyperplasia (BPH) (alfuzosin and terazosin).
General Information
Alpha blockers block nerve endings known as alpha, receptors. They reduce blood pressure by dilating (widening) and reducing pressure within the blood vessels. The maximum blood-pressurelowering effect of terazosin is seen between 2 and 6 hours after taking a single dose. Terazosin’s effect lasts for 24 hours.
In BPH, alpha blockers work by relaxing smooth muscles in the prostate and neck of the bladder. This effect is produced by blockage of alpha, receptors in the affected muscles. Despite the fact that terazosin alleviates the urinary symptoms of BPH, the drug’s long-term effect on complications of BPH or the need for urinary surgery is not known. Alpha blockers are broken down in the liver.
Cautions and Warnings
Do not take alpha blockers if you are allergic or sensitive to any of their ingredients.
Alpha blockers may cause dizziness and fainting, especially after the first few doses. This is known as the “first-dose effect” and may be minimized by limiting the first dose to 1 mg at bedtime. The first-dose effect occurs in about 1 % of people and may recur if the drug is stopped for a few days and then restarted.
Do not take alfuzosin if you have moderate to severe liver disease since this can drastically increase blood concentrations of the drug.
Alpha blockers should be taken with caution if you have kidney disease, since blood concentrations may be increased by 50%.
Do not take these medicines if you are already taking an alphablocker for either high blood pressure or prostate problems.
Terazosin may slightly reduce cholesterol levels and improve the high-density lipoprotein (HDL) to low-density lipoprotein (LDL) ratio, a positive step for people with blood-cholesterol problems.
Terazosin may reduce the counts of red and white blood cells.
People taking terazosin may experience a weight gain of about 2 lbs.
Possible Side Effects
Alfuzosin
✓ Most common: dizziness, fatigue, upper respiratory infection, and headache.
✓ Less common: pain, abdominal pain, upset stomach, constipation, nausea, impotence, bronchitis, sinusitis, sore throat, low blood pressure, dizziness, and fainting.
✓ Rare: rash, rapid heartbeat, chest pain, and painful and persistent erection. Contact your doctor if you experience any side effect not listed above.
Terazosin
✓ Most common: dizziness, weakness, and headache.
✓ Rare: depression, reduced sex drive or abnormal sexual function (including painful and persistent erection), fluid retention, and weight gain. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• When taken with other blood-pressure-lowering drugs, terazosin severely reduces blood pressure.
• Verapamil may increase blood levels of terazosin.
• Antifungal drugs such as itraconazole and ketoconazole and protease inhibitors interfere with the breakdown of alfuzosin in the liver, raising the amount of drug in the blood.
• Alfuzosin moderately increases the amount of diltiazem in the blood.
• Alpha blockers should not be taken with ritonavir.
Food Interactions
Alfuzosin should be taken with food.
Usual Dose
Alfuzosin: one 10-mg tablet taken after the same meal every day. Do not crush or chew the tablets.
Terazosin: starting dosage-1 mg at bedtime. Dosage may be increased in increments of 1-5 mg to a total of 20 mg a day. Dosages of 10 mg a day are generally needed to control the symptoms of BPH.
Overdosage
Symptoms may include drowsiness, poor reflexes, and very low blood pressure. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Take alpha blockers exactly as they are prescribed and do not stop taking it unless directed to do so by your doctor. Avoid over-the-counter drugs that contain stimulants because they may increase your blood pressure.
Alpha blockers may cause dizziness, headache, and drowsiness, especially 2-6 hours after taking your first dose, though these effects may persist after the first few doses. Wait 12-24 hours after taking the first dose before driving, operating machinery, or performing any other task that requires intense concentration. You may take alpha blockers at bedtime to minimize this problem.
Some people undergoing eye surgery who take alpha blockers can experience an unusual effect called “floppy iris syndrome.” Make sure to tell your eye surgeon if you are taking or have ever been treated with an alpha blocker. There is no benefit to stopping alpha-blocker treatment before cataract surgery.
Prostate cancer and BPH may have similar symptoms. Talk to your doctor about ruling out prostate cancer before beginning treatment for BPH.
Call your doctor if you develop severe dizziness, heart palpitations, or any bothersome or persistent side effect.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Alfuzosin is not indicated for use in women. Large dosages of terazosin damage the fetus in animal studies. When alpha blockers are considered crucial by your doctor, their potential benefits must be carefully weighed against their risks.
It is not known if terazosin passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may be more sensitive to the effects of terazosin.
Jul
16
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
Aggrenox
July 16, 2009 | Leave a Comment
Brand Name
Aggrenox
Generic Ingredients
Dipyridamole + Aspirin
Type of Drug Antiplatelet.
Prescribed For
Prevention of recurrent stroke or transient ischemic attack (TIA)— “mini-stroke.”
General Information
Stroke is often the result of a clot blocking flow in a blood vessel supplying the brain. Aggrenox helps prevent blood clot formation by reducing the “stickiness” of platelets, blood cells that stick together to form the beginnings of all clots. In one study, Aggrenox reduced the risk of stroke by over 30% compared to placebo in people who had recently had a stroke or TIA.
Cautions and Warnings
Do not use this drug if you are allergic or sensitive to any of its ingredients or any nonsteroidal anti-inflammatory drug (NSAID). People who have asthma, nasal polyps, or chronic runny nose, are likely to be sensitive to aspirin.
The aspirin in Aggrenox can cause Reye’s syndrome, a severe reaction (vomiting, lethargy, and belligerence, and possibly worsening to coma) in children under age 16.
People with a history of stomach ulcers or stomach problems should avoid Aggrenox.
People who have angina or have had a recent heart attack should be very cautious about taking this drug. It may worsen chest pain.
People with low blood pressure, liver disease, or kidney failure should be cautious about taking this drug.
People taking Aggrenox may bleed for longer amounts of time. Those with bleeding disorders should avoid Aggrenox.
Possible Side Effects
✓ Most common: headache, upset stomach, abdominal pain, nausea, and diarrhea.
✓ Common: pain, tiredness, and vomiting.
✓ Less common: convulsions, rectal bleeding, blood in the stool, hemorrhoids, back pain, accidental injuries, stomach bleeding, feeling unwell, weakness, fainting, memory loss, arthritis, joint or muscle pain, coughing, and respiratory infection.
✓ Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Avoid alcohol. People who take 3 or more drinks a day while using any aspirin-containing product are more likely to develop stomach ulcers or bleeding.
• Aspirin may reduce the blood-pressure-lowering effects of angiotensin-converting enzyme (ACE) inhibitor drugs, beta blockers, and diuretics.
• Combining aspirin and acetazolamide or an NSAID can cause kidney problems.
• Aspirin can increase the blood-thinning effects of anticoagulant (blood-thinning) drugs such as warfarin. Avoid this combination.
• Aspirin can increase the effects of oral antidiabetes drugs, possibly leading to low blood sugar.
• Aspirin counteracts the uric-acid-eliminating effects of probenecid and sulfinpyrazone.
• Aspirin can increase the toxic effects of anticonvulsant drugs and methotrexate.
• Dipyridamole increases the level of adenosine in the blood and may increase cardiovascular-related side effects. The adenosine dosage may need to be adjusted when these two drugs are combined.
• Dipyridamole may interfere with cholinesterase inhibitors used to treat myasthenia gravis.
Food Interactions
Aggrenox is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
Adult: 1 capsule (200 mg of sustained-release dipyridamole and 25 mg of aspirin) morning and evening.
Child: not recommended.
Overdosage
Symptoms include a sensation of warmth, flushing, sweating, restlessness, weakness, dizziness, low blood pressure, and rapid heartbeat. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you experience blood in your stool, persistent diarrhea, or abdominal or stomach pain.
Avoid alcohol while taking this drug.
In people taking Aggrenox, minor cuts may take longer than normal to stop bleeding.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule.
Swallow Aggrenox tablets whole; do not crush or chew them.
Special Populations
Pregnancy/Breast-feeding: Pregnant women should avoid Aggrenox because of its aspirin content. Aspirin can cause bleeding problems in mother and fetus and result in a low-birth-weight infant. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Both ingredients in Aggrenox pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may need a reduced dose of Aggrenox.
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.