propylthiouracil

Generic Name: propylthiouracil (PRO pil THYE oh URE a sil)
Brand Names:

What is propylthiouracil?

Propylthiouracil prevents the thyroid gland from producing too much thyroid hormone.

Propylthiouracil is used to treat hyperthyroidism (overactive thyroid) or Graves' disease.

Propylthiouracil may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about propylthiouracil? Do not use propylthiouracil if you are pregnant. It could harm the unborn baby. Propylthiouracil can pass into breast milk and may harm a nursing baby. Do not use propylthiouracil while you are breast-feeding a baby.

Propylthiouracil can lower blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Contact your doctor at once if you develop signs of infection.

Propylthiouracil may cause severe liver symptoms. Call your doctor at once if you have any of these liver symptoms: low fever, itching, nausea, stomach pain, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). What should I discuss with my healthcare provider before taking propylthiouracil? You should not use this medication if you are allergic to propylthiouracil, or if you are breast-feeding a baby.

If you have any of these other conditions, you may need a dose adjustment or special tests:

liver problems; or

a blood disorder.

FDA pregnancy category D. Do not use propylthiouracil if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. Propylthiouracil can pass into breast milk and may harm a nursing baby. Do not use propylthiouracil while you are breast-feeding a baby. How should I take propylthiouracil?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take this medicine with a full glass of water.

Propylthiouracil can be taken with or without food.

Use propylthiouracil regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Propylthiouracil can lower blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Your blood may need to be tested often. Visit your doctor regularly.

Contact your doctor at once if you develop signs of infection such as fever, chills, sore throat, flu symptoms, easy bruising or bleeding (nosebleeds, bleeding gums), loss of appetite, nausea and vomiting, mouth sores, or unusual weakness.

Store at room temperature away from moisture and heat.

See also: Propylthiouracil dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, vomiting, stomach pain, headache, joint pain, fever, sore throat, itching, rash, swelling, loss of appetite, numbness or tingling, and feeling restless or drowsy.

What should I avoid while taking propylthiouracil?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Propylthiouracil side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Stop taking propylthiouracil and call your doctor at once if you have a serious side effect such as:

fever, sore throat, headache, body aches, flu symptoms;

pale skin, easy bruising or bleeding (nosebleeds, bleeding gums), unusual weakness;

dry cough, trouble breathing; or

severe blistering, peeling, and red skin rash.

Propylthiouracil may also cause severe liver symptoms. Call your doctor at once if you have any of these liver symptoms:

low fever, itching;

nausea, stomach pain, loss of appetite;

dark urine, clay-colored stools; or

jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

upset stomach, vomiting;

dizziness, spinning sensation;

mild skin rash or itching;

mild joint or muscle pain;

decreased sense of taste; or

hair loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Propylthiouracil Dosing Information

Usual Adult Dose for Hyperthyroidism:

Initial: 100 to 150 mg orally every 8 hours. Rarely, a patient may require 200 to 300 mg orally every 8 hours. Initial doses are continued until 2 months after symptoms are fully controlled.
Maintenance: 100 to 150 mg/day in equally divided doses every 8 to 12 hours. Therapy is usually continued until spontaneous remission occurs (up to 1 to 2 years) or ablative therapy is undertaken.

Usual Adult Dose for Thyroid Storm:

Initial: 100 to 200 mg orally every 4 to 6 hours on the first day of treatment.
Maintenance: once full control has been achieved on the initial dosage, gradually taper the dose to 100 to 150 mg daily, administered in equally divided doses every 8 hours.
Concomitant use of a beta-blocker is usually recommended to help control the symptoms of thyroid storm.

Usual Adult Dose for Alcoholic Liver Damage:

100 mg orally 3 times a day. While data are limited, long-term administration (up to 2 years) may reduce mortality associated with alcoholic liver disease.

Usual Pediatric Dose for Hyperthyroidism:

Initial: 0 to 4 weeks: 5 to 10 mg/kg/day orally in equally divided doses administered every 8 hours.
1 month to 12 years: 5 to 7 mg/kg/day orally in equally divided doses administered every 8 hours.
Alternative: 6 to 10 years: 50 to 150 mg/day orally in equally divided doses administered every 8 hours.
Greater than or equal to 10 years:150 to 300 mg/day orally in equally divided doses administered every 8 hours.
Maintenance: 1/3 to 2/3 of the initial dose orally in equally divided doses administered every 8 to 12 hours; this begins usually after 2 months on an effective initial dosage.

What other drugs will affect propylthiouracil?

Tell your doctor about all other medications you use, especially:

digoxin (Lanoxin, digitalis);

theophylline (Elixophyllin, Theo-24, Uniphyl);

a blood thinner such as warfarin (Coumadin); or

a beta-blocker such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others.

This list is not complete and other drugs may interact with propylthiouracil. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More propylthiouracil resources Propylthiouracil Side Effects (in more detail) Propylthiouracil Dosage Propylthiouracil Use in Pregnancy & Breastfeeding Drug Images Propylthiouracil Drug Interactions Propylthiouracil Support Group 0 Reviews for Propylthiouracil - Add your own review/rating propylthiouracil Advanced Consumer (Micromedex) - Includes Dosage Information Propylthiouracil Prescribing Information (FDA) Propylthiouracil Professional Patient Advice (Wolters Kluwer) Propylthiouracil Monograph (AHFS DI) Propylthiouracil MedFacts Consumer Leaflet (Wolters Kluwer) Compare propylthiouracil with other medications Alcoholic Liver Damage Hyperthyroidism Thyroid Storm Where can I get more information? Your pharmacist can provide more information about propylthiouracil.

See also: propylthiouracil side effects (in more detail)

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Geref

Generic Name: Sermorelin Acetate (ser-moe-REL-in AH-seh-tate)
Brand Name: Geref
Geref is used for:

Diagnosing and treating growth hormone deficiency in children. It may also be used for other conditions as determined by your doctor.

Geref is a growth hormone-releasing agonist. It works by stimulating the pituitary gland to release growth hormone.

Do NOT use Geref if: you are allergic to any ingredient in Geref

Contact your doctor or health care provider right away if any of these apply to you.

Before using Geref:

Some medical conditions may interact with Geref. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have a head or brain injury or disease

Some MEDICINES MAY INTERACT with Geref. Tell your health care provider if you are taking any other medicines, especially any of the following:

Cyclooxygenase inhibitors (eg, aspirin, indomethacin), glucocorticoids (eg, prednisone), insulin, medicines that lower thyroid levels (eg, propylthiouracil), muscarinic antagonists (eg, atropine), or somatostatin-containing medicines or medicines that release somatostatin (eg, clonidine, levodopa) because the effectiveness of Geref to diagnose a disorder may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Geref may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Geref:

Use Geref as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Geref is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Geref at home, carefully follow the injection procedures taught to you by your health care provider. If Geref contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it. Do not shake Geref when mixing. Use Geref immediately after mixing. Discard any unused medicine. All other growth hormone therapy should be stopped 1 week before using Geref. Contact your doctor or pharmacist if you have questions. Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal. If you miss a dose of Geref, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Geref.

Important safety information: LAB TESTS, including growth hormone levels, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments. PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Geref, discuss with your doctor the benefits and risks of using Geref during pregnancy. It is unknown if Geref is excreted in breast milk. If you are or will be breast-feeding while you are using Geref, check with your doctor or pharmacist to discuss the risks to your baby. Possible side effects of Geref:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Facial flushing; headache; nausea; pain, redness, or swelling at injection site; paleness; strange taste in mouth; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch .

See also: Geref side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include changes in heart rate and blood pressure.

Proper storage of Geref:

Store Geref in the refrigerator, between 36 and 46 degrees F (2 and 8 degrees C). Do not freeze. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Geref out of the reach of children and away from pets.

General information: If you have any questions about Geref, please talk with your doctor, pharmacist, or other health care provider. Geref is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Geref. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Geref resources Geref Side Effects (in more detail) Geref Use in Pregnancy & Breastfeeding Geref Support Group 0 Reviews · Be the first to review/rate this drug Geref Advanced Consumer (Micromedex) - Includes Dosage Information

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sodium iodide

Generic Name: sodium iodide (SOE dee um EYE oh dide)
Brand names: Iodopen, Iodides

What is sodium iodide?

Sodium iodide is a salt that is formed into an injectable medicine.

Sodium iodide is used to treat or prevent iodine deficiency caused by poor nutrition or poor absorption by the body.

Sodium iodide may also be used to treat a thyroid disorder.

Sodium iodide may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about sodium iodide? You should not use this medication if you are allergic to sodium iodide.

Before using sodium iodide, tell your doctor if you have kidney disease, tuberculosis, a blood vessel disorder, a goiter, or a thyroid disorder that is not being treated with sodium iodide.

This medication may cause thyroid problems in an unborn baby, but the medication may sometimes be used during pregnancy. Your doctor should determine whether or not this medication is safe or if it will harm the unborn baby. Before you use sodium iodide, tell your doctor if you are pregnant or plan to become pregnant during treatment. Serious side effects include swollen glands or swelling in your throat, severe headache, fast or pounding heart rate, feeling short of breath, or numbness or tingly feeling in your hands or feet. Sodium iodide may be only part of a complete program of treatment that also includes a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you must eat to help control your condition. What should I discuss with my health care provider before using sodium iodide? You should not use this medication if you are allergic to sodium iodide.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before using sodium iodide, tell your doctor if you have:

kidney disease;

tuberculosis;

a blood vessel disorder such as vasculitis (swelling of your blood vessels);

a goiter; or

a thyroid disorder (unless you are being treated for thyroid disorder with sodium iodide).

This medication may cause thyroid problems in an unborn baby, but the medication may sometimes be used during pregnancy. Your doctor should determine whether or not this medication is safe or if it will harm the unborn baby. Before you use sodium iodide, tell your doctor if you are pregnant or plan to become pregnant during treatment. Sodium iodide can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. How should I use sodium iodide?

Use this medication exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Sodium iodide injection is given as an injection through a needle placed into a vein. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to use your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of needles, IV tubing, and other items used in giving the medicine.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Sodium iodide may be only part of a complete program of treatment that also includes a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you must eat to help control your condition. Store sodium iodide at room temperature away from moisture and heat. What happens if I miss a dose?

Use the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose? Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include extreme weakness, burning or metallic taste in your mouth, or fast heart rate.

What should I avoid while using sodium iodide?

Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are using sodium iodide.

Sodium iodide side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

swollen glands or swelling in your throat;

severe headache;

fast, pounding, or uneven heart rate;

feeling short of breath; or

numbness, burning, pain, or tingly feeling in your hands or feet.

Less serious side effects may include:

unusual or unpleasant taste or burning in your mouth or throat;

heartburn;

mild skin rash or itching;

tender gums, tooth pain, mouth soreness;

weakness; or

changes in your menstrual periods.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect sodium iodide?

Tell your doctor about all other medications you use, especially:

medicines that contain iodine such as Betadine;

lithium (Eskalith, Lithobid);

sodium iodide I-131 (Iodotope); or

medications to treat overactive thyroid, such as methimazole (Tapazole), propylthiouracil ("PTU"), and others.

This list is not complete and there may be other drugs that can interact with sodium iodide. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

More sodium iodide resources Sodium iodide Drug Interactions Sodium iodide Support Group 0 Reviews · Be the first to review/rate this drug sodium iodide Oral, Injection, Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information Where can I get more information? Your doctor or pharmacist can provide more information about sodium iodide.

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Carbimazole 20mg (Archimedes Pharma UK Ltd)

1. Name Of The Medicinal Product

Carbimazole 20mg tablets

2. Qualitative And Quantitative Composition

Each tablet contains 20mg of carbimazole

For a full list of excipients see section 6.1

3. Pharmaceutical Form

Tablet

Pale pink, uncoated, round, biconvex tablets marked with LINK C20 on one side and a scoreline on the reverse.

4. Clinical Particulars 4.1 Therapeutic Indications

Carbimazole is an anti-thyroid agent. It is indicated in all conditions where reduction of thyroid function is required.

Such conditions are:

1. Hyperthyroidism.

2. Preparation for thyroidectomy in hyperthyroidism.

3. Therapy prior to and post radio-iodine treatment.

4.2 Posology And Method Of Administration

Carbimazole should only be administered if hyperthyroidism has been confirmed by laboratory tests.

Adult:

The initial dose is in the range 20mg to 60mg, taken as two to three divided doses. The dose should be titrated against thyroid function until the patient is euthyroid in order to reduce the risk of over-treatment and resultant hypothyroidism.

Subsequent therapy may then be administered in one of two ways.

Maintenance regimen: Final dosage is usually in the range 5mg to 15mg per day, which may be taken as a single daily dose. Therapy should be continued for at least six months and up to eighteen months. Serial thyroid function monitoring is recommended, together with appropriate dosage modification in order to maintain a euthyroid state.

Blocking-replacement regimen: dosage is maintained at the initial level, i.e. 20mg to 60mg per day, and supplemental L-thyroxine, 50mcg to 150mcg per day, is administered concomitantly, in order to prevent hypothyroidism. Therapy should be continued for at least six months and up to eighteen months. Where a single dosage of less than 20mg is recommended, it is intended that carbimazole 5mg tablets should be taken.

Elderly:

No special dosage regimen is required, but care should be taken to observe the contraindications and warnings as it has been reported that the risk of a fatal outcome to neutrophil dyscrasia may be greater in the elderly (aged 65 or over).

Children:

The usual initial daily dose is 15mg per day adjusted according to response.

4.3 Contraindications

Carbimazole 20mg tablets are contraindicated in patients with a previous history of adverse reactions to carbimazole or to any of the excipients listed in section 6.1 List of Excipients.

Serious, pre-existing haematological conditions, severe hepatic insufficiency.

4.4 Special Warnings And Precautions For Use

As fatal cases of agranulocytosis with carbimazole have been reported and early treatment of agranulocytosis is essential, it is important that patients should always be warned about the onset of sore throats, bruising or bleeding, mouth ulcers, fever, malaise and should be instructed to stop the drug and to seek medical advice immediately.

In such patients white blood cell counts should be performed, particularly where there is any clinical evidence of infection. Following the onset of any signs and symptoms of hepatic disorder (pain in the upper abdomen, anorexia, general pruritus) in patients, the drug should be stopped and liver function tests performed immediately. Early withdrawal of the drug will increase the chance of complete recovery.

Carbimazole tablets should be used with caution in patients with mild-moderate hepatic insufficiency. If abnormal liver function is discovered, the treatment should be stopped. The half-life may be prolonged due to the liver disorder.

Carbimazole should be stopped temporarily at the time of administration of radio-iodine (to avoid thyroid crisis).

Patients unable to comply with the instructions for use or who cannot be monitored regularly should not be treated with Carbimazole.

Regular full blood count checks should be carried out in patients who may be confused or have a poor memory.

Patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Precaution should be taken in patients with intrathoracic goitre, which may worsen during initial treatment with Carbimazole. Tracheal obstruction may occur due to intrathoracic goitre.

The use of carbimazole in non-pregnant women of childbearing potential should be based on individual risk/benefit assessment (see section 4.6).

There is a risk of cross-allergy between carbimazole, the active metabolite thiamazole (methimazole) and propylthiouracil.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

Little is known about interactions. Particular care is required in case of concurrent administration of medication capable of inducing agranulocytosis. Since carbimazole is a vitamin K antagonist, the effect of anticoagulants could be intensified. The serum levels of theophylline can increase and toxicity may develop if hyperthyroidic patients are treated with antithyroid medications without reducing the theophylline dosage.

4.6 Pregnancy And Lactation

Carbimazole crosses the placenta but, provided the mother's dose is within the standard range and her thyroid status is monitored; there is no evidence of neonatal thyroid abnormalities. Studies have shown that the incidence of congenital malformations is greater in the children of mothers whose hyperthyroidism has remained untreated than in those who have been treated with carbimazole.

However, very rare cases of congenital malformations have been observed following the use of carbimazole or its active metabolite methimazole during pregnancy.

A causal relationship of these malformations, especially choanal atresia and aplasia cutis congenital (congential scalp defects), to transplacental exposure to carbimazole and methimazole cannot be excluded.

Therefore the use of carbimazole in non-pregnant women of childbearing potential should be based on individual risk/benefit assessment (see section 4.4 Special warnings and precautions for use).

Cases of renal, skull, cardiovascular congenital defects, exomphalos, gastrointestinal malformation, umbilical malformation and duodenal atresia have also been reported. Therefore, carbimazole should be used in pregnancy only when propylthiouracil is not suitable.

If carbamazole is used in pregnancy, the dose of carbimazole tablets must be regulated by the patient's clinical condition. The lowest dose possible should be used, and this can often be discontinued three or four weeks before term, in order to reduce the risk of neonatal complications.

The blocking-replacement regimen should not be used during pregnancy since very little thyroxine crosses the placenta in the last trimester.

Carbimazole is excreted in milk and if treatment is continued during lactation the patient should not continue to breast-feed her baby.

4.7 Effects On Ability To Drive And Use Machines

The effect on the ability to drive and use machines is not known.

4.8 Undesirable Effects

Adverse reactions usually occur in the first eight weeks of treatment. The most common minor reactions are nausea, headache, arthralgia, mild gastrointestinal disturbance, skin rashes and pruritus. These reactions are usually self-limiting and may not require withdrawal of the drug.

Blood and lymphatic system disorders

Bone marrow depression including neutropenia, eosinophilia, leucopenia, agranulocytosis has been reported. Fatalities with carbimazole-induced agranulocytosis have been reported.

Rare cases of pancytopenia/aplastic anaemia and isolated thrombocytopenia have also been reported. Additionally, very rare cases of haemolytic anaemia have been reported.

Patients should always be warned about the onset of sore throats, bruising or bleeding, mouth ulcers, fever, malaise and should be instructed to stop the drug and to seek medical advice immediately. In such patients, white blood cell counts should be performed immediately particularly where there is any clinical evidence of infection.

Nervous system disorders

Headache

Gastrointestinal system disorders

Nausea, mild gastrointestinal disturbance.

Loss of sense of taste has been observed.

General disorders and administration site conditions

Fever, Malaise

Hepato-biliary system disorders

Hepatic disorders, including abnormal liver function tests, hepatitis, cholestatic hepatitis, cholestatic jaundice and most commonly jaundice, have been reported; in these cases carbimazole tablets should be withdrawn.

Injury, poisoning and procedural complications

Bruising

Skin and subcutaneous tissue disorders

Skin rashes, pruritus, urticaria. Hair loss has been occasionally reported.

Musculoskeletal system disorders

Isolated cases of myopathy have been reported. Patients experiencing myalgia after the intake of Carbimazole should have their creatine phosphokinase levels monitored.

Hypersensitivity and allergic reaction

Angioedema and multi-system hypersensitivity reactions such as cutaneous vasculitis, liver, lung and renal effects occur.

Vascular Disorders

Bleeding

4.9 Overdose

No symptoms are likely from a single large dose and so no specific treatment is indicated.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

ATC Code: H03B B01 - a thyroid reducing agent.

Carbimazole, a thionamide, is a pro-drug which undergoes rapid and virtually complete metabolism to the active metabolite, thiamazole, also known as Methimazole. The method of action is believed to be inhibition of the organification of iodide and the coupling of iodothyronine residues which in turn suppress the synthesis of thyroid hormones.

5.2 Pharmacokinetic Properties

Carbimazole is rapidly metabolised to thiamazole. The mean peak plasma concentration of thiamazole is reported to occur one hour after a single dose of thiamazole.

After oral ingestion, peak plasma concentrations of thiamazole, the active moiety, occur at 1 to 2 hours. The total volume of distribution of thiamazole is 0.5l/kg. Thiamazole is concentrated in the thyroid gland. This intrathyroidal concentration of thiamazole has the effect of prolonging the activity of carbimazole. However, thiamazole has a shorter half-life in hyperthyroid patients than in normal controls and so more frequent initial doses are required while the hyperthyroidism is active.

Thiamazole is moderately bound to plasma proteins.

Carbimazole has a half-life of 5.3 to 5.4 hours. It is possible that the plasma half-life may also be prolonged by renal or hepatic disease. See Section 4.2. Posology and method of administration.

Thiamazole crosses the placenta and appears in breast milk. The plasma:milk ratio approaches unity.

Over 90% of orally administered carbimazole is excreted in the urine as thiamazole or its metabolites. The remainder appears in faeces. There is 10% enterohepatic circulation.

5.3 Preclinical Safety Data

There are no preclinical data of relevance to the prescriber which are additional to that already included in other sections of the Summary of Product Characteristics.

6. Pharmaceutical Particulars 6.1 List Of Excipients

Anhydrous lactose,

Croscarmellose sodium

Iron oxide (red) (E172)

Magnesium stearate

6.2 Incompatibilities

None known

6.3 Shelf Life

36 months

6.4 Special Precautions For Storage

Do not store above 25°C. Store the blisters in the original package.

6.5 Nature And Contents Of Container

The tablets are supplied in white, opaque 250 micron thermoformed PVC blister packs sealed with 20 micron lacquered aluminium foil containing 28, 56, 100 or 112 tablets (not all pack sizes may be marketed).

The heatseal coating lacquer of the aluminium foil consists of a PVC/PVAC co-polymer and polymethacrylate, with the outer side being a heat resistant lacquer based on polyester.

6.6 Special Precautions For Disposal And Other Handling

No special requirements.

7. Marketing Authorisation Holder

Archimedes Pharma UK Ltd

250 South Oak Way

Green Park

Reading

Berkshire

RG2 6UG

UK

8. Marketing Authorisation Number(S)

PL 12406/0020

9. Date Of First Authorisation/Renewal Of The Authorisation

08/05/2008

10. Date Of Revision Of The Text

08/05/2008

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Azmacort Aerosol

Pronunciation: TRYE-am-SIHN-oh lohn
Generic Name: Triamcinolone
Brand Name: Azmacort
Azmacort Aerosol is used for:

Preventing or reducing the frequency and severity of bronchial asthma attacks. It will not stop an asthma attack once it has started. It may also be used for other conditions as determined by your doctor.

Azmacort Aerosol is a corticosteroid. It works by decreasing the irritation and swelling of the airways of the lung. This helps to control or prevent asthma symptoms.

Do NOT use Azmacort Aerosol if: you are allergic to any ingredient in Azmacort Aerosol you are currently taking mifepristone you are having an asthma attack

Contact your doctor or health care provider right away if any of these apply to you.

Before using Azmacort Aerosol:

Some medical conditions may interact with Azmacort Aerosol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have or have been recently exposed to a bacterial, fungal, parasitic, or viral infection, especially measles, chickenpox, tuberculosis (TB), or herpes simplex of the eye if you have been recently vaccinated with a live or inactivated vaccine, or have had a positive TB skin test if you are having an attack of bronchospasm (tightening of the airway, difficulty breathing), or have diarrhea

Some MEDICINES MAY INTERACT with Azmacort Aerosol. Tell your health care provider if you are taking any other medicines, especially any of the following:

Barbiturates (eg, phenobarbital), carbamazepine, fluconazole, hydantoins (eg, phenytoin), lithium, rifampin, or thioamines (eg, propylthiouracil) because they may decrease Azmacort Aerosol's effectiveness Clarithromycin, itraconazole, oral contraceptives (birth control pills), or midazolam because the risk of side effects, such as nervous system or adrenal gland problems, may be increased Anticholinesterases (eg, pyridostigmine), anticoagulants (eg, warfarin), mifepristone, nondepolarizing muscle relaxants (eg, vecuronium), ritodrine, sympathomimetics (eg, albuterol, amphetamine, pseudoephedrine), or live vaccines because the risk of their side effects may be increased by Azmacort Aerosol Anticholinesterases (eg, pyridostigmine), anticoagulants (eg, warfarin), interleukin-2, or nondepolarizing muscle relaxants (eg, vecuronium) because their effectiveness may be decreased by Azmacort Aerosol

This may not be a complete list of all interactions that may occur. Ask your health care provider if Azmacort Aerosol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Azmacort Aerosol:

Use Azmacort Aerosol as directed by your doctor. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Azmacort Aerosol. Talk to your pharmacist if you have questions about this information. Before using Azmacort Aerosol, be sure that the canister is properly placed in the inhaler unit. Shake well. Breathe out slowly and completely. Place the mouthpiece between your lips and try to rest your tongue flat, unless your doctor has told you otherwise. Your doctor may have told you to hold the inhaler 1 or 2 inches (2 or 3 centimeters) away from the open mouth or to use a special spacing device. As you start to take a slow deep breath, press the canister and mouthpiece together at exactly the same time. This will release a dose of Azmacort Aerosol. Continue breathing in slowly and deeply and hold for as long as comfortable, then breathe out slowly through pursed lips or your nose. If more than 1 inhalation is to be used, wait a few minutes and repeat the above steps. Keep the spray away from your eyes. Rinse your mouth or gargle with water after using Azmacort Aerosol to prevent mouth sores or bad taste. Each time a new inhaler is used, turn the canister away from the face and press down into the mouthpiece to release test sprays into the air. This process is called priming and will allow you to be sure the inhaler is working properly and will provide a full dose of medicine. Keep track of the number of sprays you use and subtract this number from the number of doses in the container. This will help you know when the container is becoming empty. If you miss a dose of Azmacort Aerosol, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Azmacort Aerosol.

Important safety information: Azmacort Aerosol will not stop an asthma attack once it has started If you are also using a bronchodilator inhaler, be sure to always carry the inhaler with you to use during asthma attacks. After you begin using Azmacort Aerosol, a few weeks may pass before the full benefit is obtained. Continue to use it as directed during this time. Use caution if you switch from an oral steroid (eg, prednisone) to Azmacort Aerosol. It may take several months for your body to make enough natural steroids to handle events that cause physical stress. Such events may include injury, surgery, infection, loss of blood electrolytes, or a sudden asthma attack. These may be severe and sometimes fatal. Contact your doctor right away if any of these events occur. You may need to take an oral steroid (eg, prednisone) again. Carry a card at all times that says you may need an oral steroid (eg, prednisone) if any of these events occur. Tell your doctor or dentist that you take Azmacort Aerosol before you receive any medical or dental care, emergency care, or surgery. If you have not had chickenpox, shingles, or measles, avoid contact with anyone who does. Corticosteroids may affect growth rate in CHILDREN and teenagers in some cases. They may need regular growth checks while they use Azmacort Aerosol. Use Azmacort Aerosol with extreme caution in CHILDREN. Azmacort Aerosol should not be used in CHILDREN younger than 6 years old; safety and effectiveness in these children have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Azmacort Aerosol while you are pregnant. It is not known if Azmacort Aerosol is found in breast milk. If you are or will be breast-feeding while you use Azmacort Aerosol, check with your doctor. Discuss any possible risks to your baby.

You may experience WITHDRAWAL when switching from an oral steroid medicine to an inhaled one. Contact your health care provider at once if the following symptoms occur: muscle and joint pain, exhaustion, depression.

Possible side effects of Azmacort Aerosol:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; dry mouth; flu-like symptoms; headache, hoarseness; irritated or sore throat; sinus inflammation.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest congestion; depression; exhaustion; fainting; muscle and joint pain; severe dizziness; sudden weight loss; unusual weakness; white, curd-like patches in mouth.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Azmacort side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Azmacort Aerosol:

Store Azmacort Aerosol at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Store away from heat and direct sunlight. Do not puncture, break, or burn the canister even if it appears to be empty. Keep Azmacort Aerosol out of the reach of children and away from pets.

General information: If you have any questions about Azmacort Aerosol, please talk with your doctor, pharmacist, or other health care provider. Azmacort Aerosol is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Azmacort Aerosol. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Azmacort resources Azmacort Side Effects (in more detail) Azmacort Use in Pregnancy & Breastfeeding Azmacort Drug Interactions Azmacort Support Group 0 Reviews for Azmacort - Add your own review/rating Compare Azmacort with other medications Asthma

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Triamcinolone Aerosol

Pronunciation: TRYE-am-SIHN-oh lohn
Generic Name: Triamcinolone
Brand Name: Azmacort
Triamcinolone Aerosol is used for:

Preventing or reducing the frequency and severity of bronchial asthma attacks. It will not stop an asthma attack once it has started. It may also be used for other conditions as determined by your doctor.

Triamcinolone Aerosol is a corticosteroid. It works by decreasing the irritation and swelling of the airways of the lung. This helps to control or prevent asthma symptoms.

Do NOT use Triamcinolone Aerosol if: you are allergic to any ingredient in Triamcinolone Aerosol you are currently taking mifepristone you are having an asthma attack

Contact your doctor or health care provider right away if any of these apply to you.

Before using Triamcinolone Aerosol:

Some medical conditions may interact with Triamcinolone Aerosol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have or have been recently exposed to a bacterial, fungal, parasitic, or viral infection, especially measles, chickenpox, tuberculosis (TB), or herpes simplex of the eye if you have been recently vaccinated with a live or inactivated vaccine, or have had a positive TB skin test if you are having an attack of bronchospasm (tightening of the airway, difficulty breathing), or have diarrhea

Some MEDICINES MAY INTERACT with Triamcinolone Aerosol. Tell your health care provider if you are taking any other medicines, especially any of the following:

Barbiturates (eg, phenobarbital), carbamazepine, fluconazole, hydantoins (eg, phenytoin), lithium, rifampin, or thioamines (eg, propylthiouracil) because they may decrease Triamcinolone Aerosol's effectiveness Clarithromycin, itraconazole, oral contraceptives (birth control pills), or midazolam because the risk of side effects, such as nervous system or adrenal gland problems, may be increased Anticholinesterases (eg, pyridostigmine), anticoagulants (eg, warfarin), mifepristone, nondepolarizing muscle relaxants (eg, vecuronium), ritodrine, sympathomimetics (eg, albuterol, amphetamine, pseudoephedrine), or live vaccines because the risk of their side effects may be increased by Triamcinolone Aerosol Anticholinesterases (eg, pyridostigmine), anticoagulants (eg, warfarin), interleukin-2, or nondepolarizing muscle relaxants (eg, vecuronium) because their effectiveness may be decreased by Triamcinolone Aerosol

This may not be a complete list of all interactions that may occur. Ask your health care provider if Triamcinolone Aerosol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Triamcinolone Aerosol:

Use Triamcinolone Aerosol as directed by your doctor. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Triamcinolone Aerosol. Talk to your pharmacist if you have questions about this information. Before using Triamcinolone Aerosol, be sure that the canister is properly placed in the inhaler unit. Shake well. Breathe out slowly and completely. Place the mouthpiece between your lips and try to rest your tongue flat, unless your doctor has told you otherwise. Your doctor may have told you to hold the inhaler 1 or 2 inches (2 or 3 centimeters) away from the open mouth or to use a special spacing device. As you start to take a slow deep breath, press the canister and mouthpiece together at exactly the same time. This will release a dose of Triamcinolone Aerosol. Continue breathing in slowly and deeply and hold for as long as comfortable, then breathe out slowly through pursed lips or your nose. If more than 1 inhalation is to be used, wait a few minutes and repeat the above steps. Keep the spray away from your eyes. Rinse your mouth or gargle with water after using Triamcinolone Aerosol to prevent mouth sores or bad taste. Each time a new inhaler is used, turn the canister away from the face and press down into the mouthpiece to release test sprays into the air. This process is called priming and will allow you to be sure the inhaler is working properly and will provide a full dose of medicine. Keep track of the number of sprays you use and subtract this number from the number of doses in the container. This will help you know when the container is becoming empty. If you miss a dose of Triamcinolone Aerosol, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Triamcinolone Aerosol.

Important safety information: Triamcinolone Aerosol will not stop an asthma attack once it has started If you are also using a bronchodilator inhaler, be sure to always carry the inhaler with you to use during asthma attacks. After you begin using Triamcinolone Aerosol, a few weeks may pass before the full benefit is obtained. Continue to use it as directed during this time. Use caution if you switch from an oral steroid (eg, prednisone) to Triamcinolone Aerosol. It may take several months for your body to make enough natural steroids to handle events that cause physical stress. Such events may include injury, surgery, infection, loss of blood electrolytes, or a sudden asthma attack. These may be severe and sometimes fatal. Contact your doctor right away if any of these events occur. You may need to take an oral steroid (eg, prednisone) again. Carry a card at all times that says you may need an oral steroid (eg, prednisone) if any of these events occur. Tell your doctor or dentist that you take Triamcinolone Aerosol before you receive any medical or dental care, emergency care, or surgery. If you have not had chickenpox, shingles, or measles, avoid contact with anyone who does. Corticosteroids may affect growth rate in CHILDREN and teenagers in some cases. They may need regular growth checks while they use Triamcinolone Aerosol. Use Triamcinolone Aerosol with extreme caution in CHILDREN. Triamcinolone Aerosol should not be used in CHILDREN younger than 6 years old; safety and effectiveness in these children have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Triamcinolone Aerosol while you are pregnant. It is not known if Triamcinolone Aerosol is found in breast milk. If you are or will be breast-feeding while you use Triamcinolone Aerosol, check with your doctor. Discuss any possible risks to your baby.

You may experience WITHDRAWAL when switching from an oral steroid medicine to an inhaled one. Contact your health care provider at once if the following symptoms occur: muscle and joint pain, exhaustion, depression.

Possible side effects of Triamcinolone Aerosol:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; dry mouth; flu-like symptoms; headache, hoarseness; irritated or sore throat; sinus inflammation.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest congestion; depression; exhaustion; fainting; muscle and joint pain; severe dizziness; sudden weight loss; unusual weakness; white, curd-like patches in mouth.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Triamcinolone Aerosol:

Store Triamcinolone Aerosol at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Store away from heat and direct sunlight. Do not puncture, break, or burn the canister even if it appears to be empty. Keep Triamcinolone Aerosol out of the reach of children and away from pets.

General information: If you have any questions about Triamcinolone Aerosol, please talk with your doctor, pharmacist, or other health care provider. Triamcinolone Aerosol is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Triamcinolone Aerosol. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Triamcinolone resources Triamcinolone Use in Pregnancy & Breastfeeding Drug Images Triamcinolone Drug Interactions Triamcinolone Support Group 24 Reviews for Triamcinolone - Add your own review/rating Compare Triamcinolone with other medications Adrenocortical Insufficiency Allergic Reactions Alopecia Ankylosing Spondylitis Asthma Berylliosis Bursitis Chorioditis Chorioretinitis Conjunctivitis Dermal Necrosis, Prophylaxis Dermatitis Dermatological Disorders Erythroblastopenia Frozen Shoulder Gouty Arthritis Hay Fever Heart Failure Hemolytic Anemia Idiopathic Thrombocytopenic Purpura Iridocyclitis Iritis Keloids Keratitis Leukemia Lichen Planus Lichen Sclerosus Lichen Simplex Chronicus Loeffler's Syndrome Meningitis Nephrotic Syndrome Neuritis Osteoarthritis Pityriasis rubra pilaris Psoriasis Psoriatic Arthritis Rheumatoid Arthritis Sarcoidosis Synovitis Systemic Lupus Erythematosus Thrombocytopenia Idiopathic Uveitis

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Lopressor Tablets

Pronunciation: MET-oh-PROE-lol TAR-trate
Generic Name: Metoprolol Tartrate
Brand Name: Lopressor

Do not suddenly stop taking Lopressor. Sharp chest pain, irregular heartbeat, and sometimes heart attack may occur if you suddenly stop Lopressor. The risk may be greater if you have certain types of heart disease. Your doctor should slowly lower your dose over several weeks if you need to stop taking it. This should be done even if you only take Lopressor for high blood pressure. Heart disease is common and you may not know you have it. Limit physical activity while you are lowering your dose. If new or worsened chest pain or other heart problems occur, contact your doctor right away. You may need to start taking Lopressor again.

Tell your doctor or dentist that you take Lopressor before you receive any medical or dental care, emergency care, or surgery.

Tell your doctor if you have a history of diabetes or if you take medicine to lower your blood sugar (eg, glyburide, insulin). Lopressor may hide signs of low blood sugar, such as fast heartbeat. Be sure to watch for other signs of low blood sugar (eg, anxiety, chills, dizziness, drowsiness, fainting, headache, tremor, unusual sweating, vision changes, weakness). Tell your doctor right away if these effects occur.

Lopressor should not usually be used by patients who have a history of certain lung or breathing problems (eg, asthma) or who have a certain type of adrenal gland tumor (pheochromocytoma). It may worsen these conditions. Tell your doctor if you have a history of breathing problems or adrenal gland tumors. If you have these conditions and must take Lopressor, your doctor may need to adjust your dose or prescribe additional medicine to reduce the risk of side effects. Check with your doctor for more information.

Tell your doctor if you have a history of overactive thyroid. Lopressor may hide symptoms of overactive thyroid (eg, fast heartbeat). Do not suddenly stop taking Lopressor; suddenly stopping Lopressor could worsen your condition. Your doctor should slowly lower your dose over several weeks if you need to stop taking it. Check with your doctor for more information.

Lopressor is used for:

Treating high blood pressure. It may be used alone or with other medicines. It is also used for the long-term treatment of chest pain (angina) and for reducing the risk of death because of heart problems in certain patients who have had a heart attack. It may also be used for other conditions as determined by your doctor.

Lopressor is a beta-adrenergic blocking agent (beta-blocker). It works by reducing the amount of work the heart has to do (reduces chest pain) and the amount of blood the heart pumps out (lowers high blood pressure). It is also used to stabilize the heart rhythm in conditions in which the heart is beating too fast or in an irregular rhythm.

Do NOT use Lopressor if: you are allergic to any ingredient in Lopressor or to another beta-blocker (eg, propranolol) you have a very slow heart rate (eg, bradycardia), certain types of irregular heartbeat (eg, atrioventricular [AV] block, sick sinus syndrome), moderate to severe heart failure, very low systolic blood pressure (less than 100 mm Hg), or severe blood circulation problems you are taking mibefradil

Contact your doctor or health care provider right away if any of these apply to you.

Before using Lopressor:

Some medical conditions may interact with Lopressor. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have an adrenal gland tumor (pheochromocytoma), an overactive thyroid, or are scheduled to have surgery if you have low blood pressure or a history of heart attack, slow or irregular heartbeat, heart failure, or other heart problems; chest pain or angina; blood circulation problems; or liver problems if you have diabetes mellitus, chronic obstructive pulmonary disease (COPD), bronchitis, breathing problems, or a history of asthma

Some MEDICINES MAY INTERACT with Lopressor. Tell your health care provider if you are taking any other medicines, especially any of the following:

Amiodarone, bupropion, cimetidine, digoxin, diltiazem, diphenhydramine, disopyramide, flecainide, certain HIV protease inhibitors (eg, ritonavir), hormonal contraceptives (eg, birth control pills), hydralazine, hydroxychloroquine, ketanserin, mefloquine, mibefradil, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), phenothiazines (eg, thioridazine), propafenone, propylthiouracil, quinazolines (eg, alfuzosin), quinidine, reserpine, certain selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, paroxetine), terbinafine, or verapamil because serious side effects, such as very slow heart rate, very low blood pressure, fainting, severe dizziness, or lightheadedness when standing, may occur Clonidine because stopping it or Lopressor suddenly can lead to a rapid increase in blood pressure Barbiturates (eg, phenobarbital), indomethacin, or phenylpropanolamine because they may decrease Lopressor's effectiveness Bupivacaine, disopyramide, flecainide, hydralazine, ketanserin, or lidocaine because the risk of their side effects may be increased by Lopressor

This may not be a complete list of all interactions that may occur. Ask your health care provider if Lopressor may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Lopressor:

Use Lopressor as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take Lopressor by mouth with food or immediately following a meal at the same time each day. If you miss a dose of Lopressor, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Lopressor.

Important safety information: Lopressor may cause drowsiness, dizziness, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Lopressor with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Lopressor may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms. Do not suddenly stop taking Lopressor without first consulting your doctor. If your doctor decides you should no longer use Lopressor, you will need to stop Lopressor gradually according to your doctor's instructions. If your doctor has instructed you to check your blood pressure and heart rate regularly, be sure to do so. Do not take any medicines used to treat colds or congestion without first talking with your doctor or pharmacist. Diabetes patients - Lopressor may hide signs of low blood sugar, such as rapid heartbeat. Be sure to watch for other signs or low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your vision change; give you a headache, chills, or tremors; or make you more hungry. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Tell your doctor or dentist that you take Lopressor before you receive any medical or dental care, emergency care, or surgery. If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk of an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are using Lopressor. Lab tests, including liver function, kidney function, blood pressure, and complete blood cell counts, may be performed while you use Lopressor. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Lopressor should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Lopressor while you are pregnant. Lopressor is found in breast milk. If you are or will be breast-feeding while you use Lopressor, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Lopressor:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; dry mouth or eyes; gas; headache; heartburn; lightheadedness; mild drowsiness; muscle aches; nausea; stomach pain; trouble sleeping; unusual tiredness or weakness; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue, unusual hoarseness); blue or unusually cold hands or feet; chest pain; chills, fever, or sore throat; fainting; hallucinations; mood or mental changes (eg, confusion, depression, foggy thinking, short-term memory loss); pounding in the chest; severe dizziness or lightheadedness; shortness of breath; slow or irregular heartbeat; swelling of the arms, hands, and feet; unusual bruising or bleeding; vision changes; wheezing; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Lopressor side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include difficult or slowed breathing; fainting; severe dizziness; very slow heart rate; weakness.

Proper storage of Lopressor:

Store Lopressor at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Lopressor out of the reach of children and away from pets.

General information: If you have any questions about Lopressor, please talk with your doctor, pharmacist, or other health care provider. Lopressor is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Lopressor. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Lopressor resources Lopressor Side Effects (in more detail)Lopressor DosageLopressor Use in Pregnancy & BreastfeedingDrug ImagesLopressor Drug InteractionsLopressor Support Group8 Reviews for Lopressor - Add your own review/rating Compare Lopressor with other medications AnginaAngina Pectoris ProphylaxisAtrial FibrillationBenign Essential TremorHeart AttackHigh Blood PressureLeft Ventricular DysfunctionMitral Valve ProlapsePremature Ventricular DepolarizationsSupraventricular Tachycardia

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Lopressor

Pronunciation: MET-oh-PROE-lol TAR-trate
Generic Name: Metoprolol Tartrate
Brand Name: Lopressor

Do not suddenly stop taking Lopressor. Sharp chest pain, irregular heartbeat, and sometimes heart attack may occur if you suddenly stop Lopressor. The risk may be greater if you have certain types of heart disease. Your doctor should slowly lower your dose over several weeks if you need to stop taking it. This should be done even if you only take Lopressor for high blood pressure. Heart disease is common and you may not know you have it. Limit physical activity while you are lowering your dose. If new or worsened chest pain or other heart problems occur, contact your doctor right away. You may need to start taking Lopressor again.

Tell your doctor or dentist that you take Lopressor before you receive any medical or dental care, emergency care, or surgery.

Tell your doctor if you have a history of diabetes or if you take medicine to lower your blood sugar (eg, glyburide, insulin). Lopressor may hide signs of low blood sugar, such as fast heartbeat. Be sure to watch for other signs of low blood sugar (eg, anxiety, chills, dizziness, drowsiness, fainting, headache, tremor, unusual sweating, vision changes, weakness). Tell your doctor right away if these effects occur.

Lopressor should not usually be used by patients who have a history of certain lung or breathing problems (eg, asthma) or who have a certain type of adrenal gland tumor (pheochromocytoma). It may worsen these conditions. Tell your doctor if you have a history of breathing problems or adrenal gland tumors. If you have these conditions and must take Lopressor, your doctor may need to adjust your dose or prescribe additional medicine to reduce the risk of side effects. Check with your doctor for more information.

Tell your doctor if you have a history of overactive thyroid. Lopressor may hide symptoms of overactive thyroid (eg, fast heartbeat). Do not suddenly stop taking Lopressor; suddenly stopping Lopressor could worsen your condition. Your doctor should slowly lower your dose over several weeks if you need to stop taking it. Check with your doctor for more information.

Lopressor is used for:

Treating high blood pressure, alone or with other medicines; long-term treatment of chest pain; and reducing the risk of death because of heart problems in patients who have had a heart attack. It may also be used for other conditions as determined by your doctor.

Lopressor is a beta-adrenergic blocking agent (beta-blocker). It works by reducing the amount of work the heart has to do (reduces chest pain) and the amount of blood the heart pumps out (lowers high blood pressure). It is also used to stabilize the heart rhythm in conditions in which the heart is beating too fast or in an irregular rhythm.

Do NOT use Lopressor if: you are allergic to any ingredient in Lopressor or to another beta-blocker (eg, propranolol) you have a very slow heart rate (eg, bradycardia), certain types of irregular heartbeat (eg, atrioventricular [AV] block, sick sinus syndrome), moderate to severe heart failure, very low systolic blood pressure (less than 100 mm Hg), or severe blood circulation problems you are taking mibefradil

Contact your doctor or health care provider right away if any of these apply to you.

Before using Lopressor:

Some medical conditions may interact with Lopressor. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have an adrenal gland tumor (pheochromocytoma), an overactive thyroid, or are scheduled to have surgery if you have low blood pressure or a history of heart attack, slow or irregular heartbeat, heart failure, or other heart problems; chest pain or angina; blood circulation problems; or liver problems if you have diabetes mellitus, chronic obstructive pulmonary disease (COPD), bronchitis, breathing problems, or a history of asthma

Some MEDICINES MAY INTERACT with Lopressor. Tell your health care provider if you are taking any other medicines, especially any of the following:

Amiodarone, bupropion, cimetidine, digoxin, diltiazem, diphenhydramine, disopyramide, flecainide, certain HIV protease inhibitors (eg, ritonavir), hormonal contraceptives (eg, birth control pills), hydralazine, hydroxychloroquine, ketanserin, mefloquine, mibefradil, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), phenothiazines (eg, thioridazine), propafenone, propylthiouracil, quinazolines (eg, alfuzosin), quinidine, reserpine, certain selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, paroxetine), terbinafine, or verapamil because serious side effects, such as very slow heart rate, very low blood pressure, fainting, severe dizziness, or lightheadedness when standing, may occur Clonidine because stopping it or Lopressor suddenly can lead to a rapid increase in blood pressure Barbiturates (eg, phenobarbital), indomethacin, or phenylpropanolamine because they may decrease Lopressor's effectiveness Bupivacaine, disopyramide, flecainide, hydralazine, ketanserin, or lidocaine because the risk of their side effects may be increased by Lopressor

This may not be a complete list of all interactions that may occur. Ask your health care provider if Lopressor may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Lopressor:

Use Lopressor as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Lopressor is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Lopressor at home, a health care provider will teach you how to use it. Be sure you understand how to use Lopressor. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions. Do not use Lopressor if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged. Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal. If you miss a dose of Lopressor, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Lopressor.

Important safety information: Lopressor may cause drowsiness, dizziness, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Lopressor with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Lopressor may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms. Do not suddenly stop using Lopressor without first consulting your doctor. If your doctor decides you should no longer use Lopressor, you will need to stop Lopressor gradually according to your doctor's instructions. If your doctor has instructed you to check your blood pressure and heart rate regularly, be sure to do so. Do not take any medicines used to treat colds or congestion without first consulting with your doctor or pharmacist. Diabetes patients - Lopressor may hide signs of low blood sugar, such as rapid heartbeat. Be sure to watch for other signs or low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your vision change; give you a headache, chills, or tremors; or make you more hungry. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Tell your doctor or dentist that you take Lopressor before you receive any medical or dental care, emergency care, or surgery. If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk of an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are using Lopressor. Lab tests, including liver and kidney function, blood pressure, and complete blood cell counts, may be performed while you use Lopressor. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Lopressor should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Lopressor while you are pregnant. Lopressor is found in breast milk. If you are or will be breast-feeding while you use Lopressor, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Lopressor:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; dry mouth or eyes; gas; headache; heartburn; lightheadedness; mild drowsiness; muscle aches; nausea; pain, redness, or swelling at the injection site; stomach pain; trouble sleeping; unusual tiredness or weakness; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue, unusual hoarseness); blue or unusually cold hands or feet; chest pain; chills, fever, or sore throat; fainting; hallucinations; mood or mental changes (eg, confusion, depression, foggy thinking, short-term memory loss); pounding in the chest; severe dizziness or lightheadedness; shortness of breath; slow or irregular heartbeat; swelling of the arms, hands, and feet; unusual bruising or bleeding; vision changes; wheezing; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Lopressor side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include difficult or slowed breathing; fainting; severe dizziness; very slow heart rate; weakness.

Proper storage of Lopressor:

Store Lopressor at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Lopressor out of the reach of children and away from pets.

General information: If you have any questions about Lopressor, please talk with your doctor, pharmacist, or other health care provider. Lopressor is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Lopressor. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Lopressor resources Lopressor Side Effects (in more detail) Lopressor Use in Pregnancy & Breastfeeding Drug Images Lopressor Drug Interactions Lopressor Support Group 8 Reviews for Lopressor - Add your own review/rating Lopressor Concise Consumer Information (Cerner Multum) Lopressor Prescribing Information (FDA) Lopressor Advanced Consumer (Micromedex) - Includes Dosage Information Metoprolol Prescribing Information (FDA) Metoprolol Professional Patient Advice (Wolters Kluwer) Metoprolol Succinate Monograph (AHFS DI) Toprol-XL Prescribing Information (FDA) Compare Lopressor with other medications Angina Angina Pectoris Prophylaxis Atrial Fibrillation Benign Essential Tremor Heart Attack High Blood Pressure Left Ventricular Dysfunction Mitral Valve Prolapse Premature Ventricular Depolarizations Supraventricular Tachycardia

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