Cardiotek-RX
Pronunciation: MUL-ti-VYE-ta-mins/FOE-lik AS-id/a-MEE-noe AS-idsGeneric Name: Multivitamins with Folic Acid/Amino AcidsBrand Name: Cardiotek-RX

Behcet's Disease Medications

Definition of Behcet's Disease:

Behcet's disease is a rare, chronic inflammatory disorder. The cause of Behcet's disease is unknown, although there have been reports of a virus found in some individuals with the disease. Behcet's disease generally begins when individuals are in their 20s or 30s, although it can happen at any age. It tends to occur more often in men than in women. Symptoms of Behcet's disease include recurrent ulcers in the mouth (resembling canker sores) and on the genitals, and eye inflammation. The disorder may also cause various types of skin lesions, arthritis, bowel inflammation, meningitis (inflammation of the membranes of the brain and spinal cord), and cranial nerve palsies. Behcet's is a multi-system disease; it may involve all organs and affect the central nervous system, causing memory loss and impaired speech, balance, and movement.

The effects of the disease may include blindness, stroke, swelling of the spinal cord, and intestinal complications. The disease is common in Japan, Turkey and Israel, and less common in the United States.

Drugs associated with Behcet's Disease

The following drugs and medications are in some way related to, or used in the treatment of Behcet's Disease. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

Learn more about Behcet's Disease

Harvard Health Guide:

Symptoms and treatment for Behcet's Disease Drug List:HumiraRemicade

Metronidazole Injection
Metronidazole Injection, USP

Rx only

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Metronidazole Injection, USP and other antibacterial drugs, Metronidazole Injection, USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

WARNING

Metronidazole has been shown to be carcinogenic in mice and rats (see Precautions). Its use, therefore, should be reserved for the conditions described in the Indications and Usage section below.

Description

Metronidazole Injection, USP is a parenteral dosage form of the synthetic antibacterial agent 1-(?-hydroxyethyl)-2-methyl-5- nitroimidazole.

Metronidazole Injection, USP, in 100 mL single dose plastic container, is a sterile, nonpyrogenic, iso-osmotic, buffered solution of 500 mg Metronidazole, USP, 790 mg Sodium Chloride, USP, 47.6 mg Anhydrous Disodium Hydrogen Phosphate, USP and 22.9 mg Citric Acid Monohydrate, USP. Metronidazole Injection, USP has an osmolarity of 310 mOsmol/L (calc) and a pH of 5.5 (4.5 to 7.0). Each container contains 14 mEq of sodium.

The plastic container is fabricated from a specially formulated polyvinyl chloride plastic. Water can permeate from inside the container into the overwrap in amounts insufficient to affect the solution significantly. Solutions in contact with the plastic container can leach out certain of its chemical components in very small amounts within the expiration period, e.g., di-2-ethylhexyl phthalate (DEHP), up to 5 parts per million. However, the safety of the plastic has been confirmed in tests in animals according to USP biological tests for plastic containers as well as by tissue culture toxicity studies.

Clinical Pharmacology

Metronidazole is a synthetic antibacterial compound. Disposition of metronidazole in the body is similar for both oral and intravenous dosage forms, with an average elimination half-life in healthy humans of eight hours.

The major route of elimination of metronidazole and its metabolites is via the urine (60 - 80% of the dose), with fecal excretion accounting for 6 - 15% of the dose. The metabolites that appear in the urine result primarily from side-chain oxidation (1-[?-hydroxyethyl]-2-hydroxymethyl- 5-nitroimidazole and 2-methyl-5-nitroimidazole-1-yl-acetic acid) and glucuronide conjugation, with unchanged metronidazole accounting for approximately 20% of the total. Renal clearance of metronidazole is approximately 10 mL/min/1.73 m2.

Metronidazole is the major component appearing in the plasma, with lesser quantities of the 2-hydroxymethyl metabolite also being present. Less than 20% of the circulating metronidazole is bound to plasma proteins. Both the parent compound and the metabolite possess in vitro bactericidal activity against most strains of anaerobic bacteria.

Metronidazole appears in cerebrospinal fluid, saliva and breast milk in concentrations similar to those found in plasma. Bactericidal concentrations of metronidazole have also been detected in pus from hepatic abscesses..

Plasma concentrations of metronidazole are proportional to the administered dose. An eight-hour intravenous infusion of 100-4,000 mg of metronidazole in normal subjects showed a linear relationship between dose and peak plasma concentration.

In patients treated with intravenous metronidazole, using a dosage regimen of 15 mg/kg loading dose followed six hours later by 7.5 mg/kg every six hours; peak steady-state plasma concentrations of metronidazole averaged 25 mcg/mL with trough (minimum) concentrations averaging 18 mcg/mL.

Decreased renal function does not alter the single-dose pharmacokinetics of metronidazole. However, plasma clearance of metronidazole is decreased in patients with decreased liver function.

In one study newborn infants appeared to demonstrate diminished capacity to eliminate metronidazole. The elimination half-life, measured during the first three days of life, was inversely related to gestational age. In infants whose gestational ages were between 28 and 40 weeks, the corresponding elimination half-lives ranged from 109 to 22.5 hours.

Microbiology: Metronidazole is active in vitro against most obligate anaerobes, but does not appear to possess any clinically relevant activity against facultative anaerobes or obligate aerobes. Against susceptible organisms, metronidazole is generally bactericidal at concentrations equal to or slightly higher than the minimal inhibitory concentrations. Metronidazole has been shown to have in vitro and clinical activity against the following organisms:

Anaerobic gram-negative bacilli, including: Bacteroides species, including the Bacteroides fragilis group (B. fragilis, B. distasonis, B. ovatus, B. thetaiotaomicron, B. vulgatus)

Kyowa Pharmaceutical, Inc.
Address Kyowa Pharmaceutical, Inc. , 212 Carnegie Center Suite 101

Cosopt Preservative-Free, Single Dose Eye Drops

COSOPT Preservative-Free 20 mg/ml + 5 mg/ml eye drops, solution, single dose container

(dorzolamide / timolol)

Read all of this leaflet carefully before you start using this medicine. Keep this leaflet. You may need to read it again. If you have any further questions, ask your doctor or pharmacist. This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours. If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. In this leaflet:

1. What COSOPT Preservative-Free is and what it is used for 2. Before you use COSOPT Preservative-Free 3. How to use COSOPT Preservative-Free

Zamadol SR Capsules 50mg, 100mg, 150mg, 200mg
1. Name Of The Medicinal Product

Zamadol SR 50 mg prolonged-release hard capsules

Zamadol SR 100 mg prolonged-release hard capsules

Zamadol SR 150 mg prolonged-release hard capsules

Zamadol SR 200 mg prolonged-release hard capsules

2. Qualitative And Quantitative Composition

One capsule contains 50 mg, 100mg, 150mg, 200mg of tramadol hydrochloride

This product contains the excipients sucrose (9.375 18.75 28.125 37.5mg/capsule).

For a full list of excipients, see section 6.1.

3. Pharmaceutical Form

Prolonged release hard capsule.

The 50 mg capsules are dark green and marked T50SR.

The 100 mg capsules are white and marked T100SR

The 150 mg capsules are dark green and marked T150SR

The 200 mg capsules are yellow and marked T200SR

4. Clinical Particulars 4.1 Therapeutic Indications

Treatment of moderate to severe pain.

4.2 Posology And Method Of Administration

The capsules are intended for twice daily oral administration and can be taken independently of meal times, swallowed whole with water.

As with all analgesic drugs the dosing of Zamadol SR prolonged-release hard capsules should be adjusted depending on the severity of the pain and the individual clinical response of the patient. The dose used should be the lowest dose that provides pain relief.

Adults:

The usual initial dose is 50-100 mg twice daily, morning and evening. This dose may be titrated up to 150-200 mg twice daily according to pain severity.

If long-term pain treatment with tramadol is necessary in view of the nature and severity of the illness, then careful and regular monitoring should be carried out (if necessary with breaks in treatment) to establish whether and to what extent further treatment is necessary.

A total oral daily dose of 400 mg should not be exceeded except in special clinical circumstances.

Elderly patients:

Dosing as for adults, however it should be noted that in patients over 75 years there tends to be an increase in absolute bioavailability of tramadol and a 17% increase in the terminal elimination half-life. An adjustment of the dosage or the dose interval may be required.

Patients with renal or hepatic insufficiency:

As the elimination of tramadol may be prolonged in patients with severe renal and/or hepatic impairment, the use of Zamadol SR prolonged-release hard capsulesis not recommended. In moderate cases an adjustment of the dosage interval may be required.

Patients who have difficulty in swallowing:

Zamadol SR prolonged-release hard capsules can be opened, carefully, so that the pellets are deposited on a spoon. The spoon and pellets should be taken into the mouth, followed by a drink of water to rinse the mouth of all pellets. The pellets must not be chewed or crushed.

Children and adolescents :

Over 12 years: Dosage as for adults.

Under 12 years: Zamadol SR prolonged-release hard capsules have not been studied in children. Therefore, safety and efficacy have not been established and the product should not be used in children.

4.3 Contraindications

Zamadol SR prolonged-release hard capsules should not be given to patients who have previously shown hypersensitivity to the active substance tramadol or to any of the other excipients.

The product should not be administered to patients suffering from acute intoxication with hypnotics, centrally acting analgesics, opioids, psychotropic drugs or alcohol.

Tramadol should not be administered to patients who are receiving monoamine oxidase inhibitors or within 2 weeks of their withdrawal.

Contra-indicated in patients suffering from uncontrolled epilepsy.

Tramadol must not be used for narcotic withdrawal treatment.

4.4 Special Warnings And Precautions For Use

Warnings:

Tramadol has a low dependence potential. On long-term use tolerance, psychic and physical dependence may develop. In patients with a tendency to drug abuse or dependence, treatment should be for short periods under strict medical supervision. In rare cases at therapeutic doses, tramadol has the potential to cause withdrawal symptoms.

Zamadol SR prolonged-release hard capsules are not a suitable substitute in opioid dependent patients. The product does not suppress morphine withdrawal symptoms although it is an opioid agonist.

Convulsions have been reported at therapeutic doses and the risk may be increased at doses exceeding the usual upper daily dose limit. Patients with a history of epilepsy or those susceptible to seizures should only be treated with tramadol if there are compelling reasons. The risk of convulsions may increase in patients taking tramadol and concomitant medication that can lower the seizure threshold (see section 4.5).

This medicinal product contains sucrose and therefore should not be used by patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency.

Precautions:

Zamadol SR prolonged-release hard capsules should be used with prudence in patients who have shown previous hypersensitivity to opiates, and in patients with severe renal or hepatic impairment, head injury, decreased level of consciousness, increased intracranial pressure, or patients in shock or at risk of convulsions.

At recommended therapeutic doses Zamadol SR prolonged-release hard capsules are unlikely to produce clinically relevant respiratory depression. Care should however be taken when administering Zamadol SR prolonged-release hard capsules to patients with existing respiratory depression or excessive bronchial secretion and in those patients taking concomitant CNS depressant drugs.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

Patients treated with monoamine oxidase inhibitors within 14 days prior to the administration of the opioid pethidine have experienced life-threatening interactions affecting the central nervous system as well as the respiratory and circulatory centres. The possibility of similar interactions occurring between monoamine oxidase inhibitors and tramadol cannot be ruled out.

Tramadol may potentiate the CNS depressant effects of other centrally acting drugs (including alcohol) when administered concomitantly with such drugs.

Tramadol may increase the potential for selective serotonin re-uptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), anti-psychotics and other seizure threshold lowering drugs to cause convulsions (see section 4.4).

Isolated cases of serotonergic syndrome have been reported with the therapeutic use of tramadol in combination with other serotonergic agents such as selective serotonin re-uptake inhibitors (SSRIs). Serotonergic syndrome can be manifested by symptoms such as confusion, restlessness, fever, sweat, ataxia, hyperreflexia, myoclonia and diarrhoea. Withdrawal of the serotonergic agent produces a rapid improvement.

Administration of Zamadol SR prolonged-release hard capsules together with carbamazepine results in markedly decreased serum concentrations of tramadol which may reduce analgesic effectiveness and shorten the duration of action.

Caution should be exercised during concomitant treatment with tramadol and coumarin derivatives (e.g. warfarin) due to reports of increased INR and ecchymoses in some patients.

The combination of mixed agonists/antagonists (e.g. buprenorphine, nalbuphine, pentazocine) and tramadol is not recommended because it is theoretically possible that the analgesic effect of a pure agonist is attenuated under these circumstances.

The analgesic effect of tramadol is in part mediated by inhibition of the re-uptake of norepinephrine and enhancement of the release of serotonin (5-HT). In studies the pre- or postoperative application of the antiemetic 5-HT3 antagonist ondansetron increased the requirements of tramadol in patients with postoperative pain.

There is no interaction with food.

4.6 Pregnancy And Lactation

Pregnancy:

Zamadol SR prolonged-release hard capsules should not be used during pregnancy as there is inadequate evidence available to assess the safety of tramadol in pregnant women. Tramadol - administered before or during birth - does not affect uterine contractility. In neonates it may induce changes in the respiratory rate which are usually not clinically relevant.

Lactation:

Zamadol SR prolonged-release hard capsules should not be administered during breast feeding as tramadol and its metabolites have been detected in breast milk. 0.1% of the dose administered to the mother may be excreted in milk.

4.7 Effects On Ability To Drive And Use Machines

Zamadol SR prolonged-release hard capsules may cause drowsiness and this effect may be potentiated by alcohol, anti-histamines and other CNS depressants. If patients are affected they should be warned not to drive or operate machinery.

4.8 Undesirable Effects

The most commonly reported adverse drug reactions are nausea and dizziness, both occurring in more than 10% of patients.

Immune system disorders:

Rare (

Metabolism and nutrition disorders:

Rare (

Psychiatric disorders:

Rare (1/10,000 to < 1/1,000): psychic side-effects may occur following administration of tramadol which vary individually in intensity and nature (depending on personality and duration of medication). These include changes in mood (usually elation, occasionally dysphoria), changes in activity (usually suppression, occasionally increase) and changes in cognitive and sensorial capacity (e.g. decision behaviour, perception disorders), hallucinations, confusion, sleep disturbances and nightmares.

Prolonged administration of Zamadol SR prolonged-release hard capsules may lead to dependence (see section 4.4). Symptoms of withdrawal reactions, similar to those occurring during opiate withdrawal, may occur as follows: agitation, anxiety, nervousness, insomnia, hyperkinesia, tremor and gastrointestinal symptoms.

Nervous system disorders:

Very common (1/10) dizziness.

Common (

Rare (

Paraesthesia and tremor.

Very rare (< 1/10,000): vertigo

Eye disorders:

Rare (

Cardiac disorders:

Uncommon (1/1,000 to < 1/100): effects on cardiovascular regulation (palpitation, tachycardia, postural hypotension or cardiovascular collapse). These adverse effects may occur especially on intravenous administration and in patients who are physically stressed.

Rare (1/10,000 to < 1/1,000): bradycardia, increase in blood pressure.

Vascular disorders:

Very rare (< 1/10,000): flushing.

Respiratory disorders:

Worsening of asthma has also been reported, though a causal relationship has not been established.

Respiratory depression has been reported. If the recommended doses are considerably exceeded and other centrally depressant substances are administered concomitantly (see section 4.5 "Interaction with other medicinal products and other forms of interaction") respiratory depression may occur.

Gastrointestinal disorders:

Very common (1/10): vomiting, nausea.

Common (1/100 to < 1/10): constipation, dry mouth.

Uncommon (1/1,000 to < 1/100): retching, gastrointestinal irritation (a feeling of pressure in the stomach, bloating).

Hepatobiliary disorders:

In a few isolated cases an increase in liver enzyme values has been reported in a temporal connection with the therapeutic use of tramadol.

Skin and subcutaneous tissue disorders:

Common (1/100 to < 1/10): sweating.

Uncommon (1/1,000 to < 1/100): dermal reactions (e.g. pruritus, rash, urticaria).

Musculoskeletal, connective tissue and bone disorders:

Rare (1/10,000 to < 1/1,000): motorial weakness.

Renal and urinary system disorders:

Rare (1/10,000 to < 1/1,000): micturition disorders (difficulty in passing urine and urinary retention).

General disorders:

Common (

4.9 Overdose

Symptoms of tramadol overdose include vomiting, miosis, sedation, seizures, respiratory depression and hypotension, with circulatory failure and coma. Respiratory failure may also occur. Such symptoms are typical of opioid analgesics.

Treatment of overdose requires the maintenance of the airway and cardiovascular functions. Respiratory depression may be reversed using naloxone and fits controlled with diazepam. Naloxone administration may increase the risk of seizures.

The treatment of acute overdose of tramadol using haemodialysis or haemofiltration alone is not sufficient or suitable due to the slow elimination of tramadol from the serum by these routes.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

Pharmacotherapeutic group: Other opioids, ATC code: N02AX02

Tramadol is a centrally acting analgesic which possesses opioid agonist properties. Tramadol consists of two enantiomers, the (+)-isomer is predominantly active as an opioid with preferential activity for the ?-receptor. The (-)-isomer potentiates the analgesic effect of the (+)-isomer and is active as an inhibitor of noradrenaline and serotoninuptake thereby modifying the transmission of pain impulses.

Tramadol also has an antitussive action. At the recommended dosages, the effects of tramadol given orally on the respiratory and cardiovascular systems appear to be clinically insignificant. The potency of tramadol is reported to be 1/10 to 1/6 of morphine.

5.2 Pharmacokinetic Properties

About 90% of tramadol released from Zamadol SR prolonged-release hard capsules is absorbed after oral administration. The mean absolute bioavailability is approximately 70%, irrespective of concomitant intake of food.

The difference between absorbed and non-metabolised available tramadol is probably due to low first-pass effect. The first pass-effect after oral administration is a maximum of 30%.

Tramadol has a high tissue affinity with an apparent volume of distribution of 203 ± 40 litres after oral dosing in healthy volunteers. Protein binding is limited to 20%.

After single dose administration of Zamadol SR 50 mg prolonged-release hard capsules the peak plasma concentration Cmax 70 ± 16 ng/ml is reached after 5.3 h. After administration of Zamadol SR 100 mg prolonged-release hard capsules Cmax 137 ± 27 ng/ml is reached after 5.9 h. Following administration of Zamadol SR 200 mg prolonged-release hard capsules Cmax 294 ± 82 ng/ml is reached after 6.5 h. The reference product (Tramadol Immediate Release Capsules, given as a total dose of 200 mg tramadol hydrochloride) reached a peak concentration of Cmax 640 ± 143 ng/ml after 2.0 hours.

The relative bioavailability for the slow release formulation after single dose administration is 89% and increases to 100% after multiple dose administration in comparison to the reference product.

Tramadol passes the blood-brain and placenta barriers. Very small amounts of the substance and its O-demethyl derivative are found in the breast-milk (0.1% and 0.02% respectively of the applied dose).

Elimination of half-life t??is approximately 6 h, irrespective of the mode of administration. In patients above 75 years of age it may be prolonged by a factor of 1.4.

In humans tramadol is mainly metabolised by means of N- and O-demethylation and conjugation of the O-demethylation products with glucuronic acid. Only O-desmethyltramadol is pharmacologically active. There are considerable interindividual quantitative differences between the other metabolites. So far, eleven metabolites have been found in the urine. Animal experiments have shown that O-desmethyltramadol is more potent than the parent substance by the factor 2-4. Its half life t?? (6 healthy volunteers) is 7.9 h (range 5.4-9.6 h) and is approximately that of tramadol.

The inhibition of one or both cytochrome P450 isoenzymes, CYP3A4 and CYP2D6 involved in the metabolism of tramadol, may affect the plasma concentration of tramadol or its active metabolite. The clinical consequences of any such interactions are not known.

Tramadol and its metabolites are almost completely excreted via the kidneys. Cumulative urinary excretion is 90% of the total radioactivity of the administered dose. In cases of impaired hepatic and renal function the half-life may be slightly prolonged. In patients with cirrhosis of the liver, elimination half-lives of 13.3 ± 4.9 h (tramadol) and 18.5 ± 9.4 h (O-desmethyltramadol), in an extreme case 22.3 h and 36 h respectively have been determined. In patients with renal insufficiency (creatinine clearance < 5 ml/min) the values were 11 ± 3.2 h and 16.9 ± 3 h, in an extreme case 19.5 h and 43.2 h, respectively.

Tramadol has a linear pharmacokinetic profile within the therapeutic dosage range.

The relationship between serum concentrations and the analgesic effect is dose-dependent, but varies considerably in isolated cases. A serum concentration of 100 - 300 ng/ml is usually effective.

5.3 Preclinical Safety Data

Pre-clinical data reveal no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity or carcinogenic potential. Studies of tramadol in rats and rabbits have revealed no teratogenic effects. However, embryo toxicity was shown in the form of delayed ossification. Fertility, reproductive performance and development of offspring were unaffected.

6. Pharmaceutical Particulars 6.1 List Of Excipients

Capsule Contents: Sugar spheres (sucrose and maize starch), colloidal anhydrous silica, ethylcellulose, shellac, talc.

Capsule Shell: Gelatin, Titanium Dioxide (E171)

The 50 mg and 150 mg capsules also contain Iron Oxide Yellow (E172) and Indigotine (E132).

The 200 mg capsules also contain Iron Oxide Yellow (E172)

Printing ink contains shellac, iron oxide black (E172) and propylene glycol.

6.2 Incompatibilities

Not applicable.

6.3 Shelf Life

3 years.

6.4 Special Precautions For Storage

Do not store above 25°C. Store in the original package in order to protect from moisture.

6.5 Nature And Contents Of Container

White opaque PVC/PVDC and aluminium foil blisters. Each blister contains 10 capsules.

Each pack contains 10, 20, 30, 50, 60 or 100 capsules per pack.

Not all pack sizes may be marketed in all Member States.

6.6 Special Precautions For Disposal And Other Handling

No special requirements.

7. Marketing Authorisation Holder

Meda Pharmaceuticals Ltd

Skyway House

Parsonage Road

Takeley

Bishop's Stortford

CM22 6PU

UK

8. Marketing Authorisation Number(S)

PL 15142/0120

PL 15142/0121

PL 15142/0122

PL 15142/0123

9. Date Of First Authorisation/Renewal Of The Authorisation

September 2007

10. Date Of Revision Of The Text

10 September 2009

Caverject Impulse injectable and transurethral

Generic Name: alprostadil (injectable and transurethral) (al PROS ta dil) Brand Names: Caverject, Caverject Impulse, Edex, Muse

What is alprostadil?

Alprostadil is used to treat erectile dysfunction (impotence) and to help diagnose certain causes of this disorder. Alprostadil is also used to improve blood flow in newborn babies with a certain genetic heart condition. This alprostadil medication guide addresses only the adult male use of this medication in erectile disorders.

Alprostadil relaxes blood vessels and muscles in the penis. This increases blood flow into the penis, causing an erection.

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

What is the most important information I should know about alprostadil?

Alprostadil is used to treat erectile dysfunction (impotence) and to help diagnose certain causes of this disorder. Alprostadil is also used to improve blood flow in newborn babies with a certain genetic heart condition. This alprostadil medication guide addresses only the adult male use of this medication in erectile disorders.

You should not use this medication if you are allergic to alprostadil, or if you have sickle cell anemia, leukemia, a bone marrow tumor, a curved or deformed penis, penile fibrosis or Peyronie's disease, a penile implant, or if you have been told you should not have sexual intercourse for health reasons.

Before using alprostadil, tell your doctor if you have heart disease, high blood pressure, a bleeding disorder, a history of blood clots, or a disease that could be passed in blood (such as hepatitis or HIV).

The injectable form of alprostadil is injected into the side of the penis. The transurethral pellet is a very small suppository that is inserted into the opening of the penis (the urethra).

Use this medication exactly as it was prescribed for you. Using too much alprostadil can be very dangerous. The medicine comes with patient instructions for safe and effective use. Follow these directions carefully.

Your first dose of this medicine will be given in your doctor's office so you can be observed for how well the medication works and if it causes any side effects.

Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes. Call your doctor, nurse, or pharmacist if you have any questions. Using an alprostadil transurethral pellet improperly could cause damage to your urethra.

Alprostadil is used only when needed to get an erection. An erection should occur within 5 to 20 minutes after you use the medication, and should last for 30 to 60 minutes.

Seek emergency medical attention if you have a painful or prolonged erection lasting 4 hours or longer. What should I discuss with my healthcare provider before using alprostadil? You should not use this medication if you are allergic to alprostadil, or if you have:

sickle cell anemia or the sickle cell anemia trait;

leukemia;

a tumor of the bone marrow (multiple myeloma);

a curved or deformed penis;

penile fibrosis or Peyronie's disease;

if you have a penile implant; or

if you have been told you should not have sexual intercourse for health reasons.

To make sure you can safely use alprostadil, tell your doctor if you have any of these other conditions:

a history of blood clots;

heart disease, high blood pressure (hypertension);

a bleeding or blood-clotting disorder; or

a disease that could be passed in blood (such as hepatitis or HIV).

Use a condom to prevent transfer of this medication to your sexual partner if she is pregnant or could become pregnant.

Caverject, Caverject Impulse, Edex, or Muse should not be used by women or by anyone under 18 years old. How should I use alprostadil?

Your first dose of this medicine will be given in your doctor's office so you can be observed for how well the medication works and if it causes any side effects. You will then be shown how to properly give the medication to yourself. Wait at least 1 day after your first dose before using the medicine again.

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Using too much alprostadil can be very dangerous.

Alprostadil is used only when needed to get an erection. An erection should occur within 5 to 20 minutes after you use the medication, and should last for 30 to 60 minutes. The length of time your erection lasts may be slightly different.

The injectable form of alprostadil is injected into the side of the penis.

The transurethral pellet is a very small suppository that is inserted into the opening of the penis (the urethra).

Do not use more than 2 alprostadil pellets in one day (24 hours). Do not use more than 3 alprostadil injections per week. Allow at least 24 hours to pass between injections.

Alprostadil comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Alprostadil injectable is a powder medicine that comes with a sterile liquid for mixing it. Caverject Impulse is a brand of alprostadil injectable supplied as a needle and syringe that contains both the powder medicine and the sterile liquid. The dose is automatically mixed when you turn a dial on the end of the syringe. The Caverject Impulse syringe is designed for only one use. Carefully follow the instructions provided with this product.

Use a disposable needle only once. 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.

Prepare your alprostadil dose only when you are ready to use the medicine. Do not shake the mixed medicine. After mixing, the medication should be clear. Do not use the medication if it looks cloudy or has particles in it. Call your doctor for a new prescription. Do not give yourself an alprostadil injection or pellet if you do not understand the instructions for proper use. Call your doctor, nurse, or pharmacist for help with injection instructions. Using an alprostadil transurethral pellet improperly could cause damage to your urethra.

The Caverject Impulse device uses a very thin needle, which could break easily. If the needle breaks during injection and you can see and grasp the broken end, remove it and contact your doctor. If you cannot remove the broken end, call your doctor right away.

An alprostadil injection can cause bleeding where the needle is placed. This can make it easier for your sexual partner to be exposed to your blood. Before using this medication, tell your doctor if you have a virus such as hepatitis or HIV, which can be passed to another person who comes into contact with your blood.

To be sure this medication is not causing harmful effects, your penis may need to be examined every 3 months. Visit your doctor regularly.

Storing this medicine:

Keep each urethral pellet in its original foil pouch until you are ready to use it. Store the foil pouches in the refrigerator. You may store the pouches at room temperature for up to 14 days. Store alprostadil injectable at room temperature. The 40 microgram strength of unmixed alprostadil can be stored at room temperature for up to 3 months, or until the expiration date on the label, whichever happens first. Do not expose alprostadil products to freezing or very hot temperatures. Do not store your medication in a closed automobile, or pack it into luggage that will be placed into a cargo area during travel. What happens if I miss a dose?

Since alprostadil is used as needed, you will not be on a dosing schedule.

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

Overdose symptoms may include feeling light-headed, fainting, or having a painful or prolonged erection lasting 4 hours or longer.

What should I avoid while using alprostadil? This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Taking this medication will not prevent you from passing a disease such as hepatitis or HIV to your sexual partner. Avoid having unprotected sex. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Alprostadil 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 using alprostadil and call your doctor at once if you have a serious side effect such as:

feeling light-headed, fainting;

trouble urinating, blood in your urine;

bleeding, bruising, or swelling where you injected the medication;

a painful erection that lasts 4 hours or longer;

severe pain or irritation of your penis or urethra; or

redness, lumps, tenderness, unusual shape or curving of the erect penis.

Less serious side effects may include:

unusual discharge from your penis; or

mild pain in your penis, urethra, or testicles;

headache, dizziness;

back pain;

a rash on the skin of your penis;

itching, warmth, or numbness of your penis;

cough, stuffy nose, cold symptoms, flu symptoms.

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.

Your sexual partner may also have side effects such as burning, itching, or irritation of the body areas that come into contact with your penis.

What other drugs will affect alprostadil?

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

blood pressure medication; or

a blood thinner such as heparin or warfarin (Coumadin, Jantoven).

This list is not complete and other drugs may interact with alprostadil. 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 Caverject Impulse resources Caverject Impulse Side Effects (in more detail)Caverject Impulse Use in Pregnancy & BreastfeedingCaverject Impulse Drug InteractionsCaverject Impulse Support Group3 Reviews for Caverject Impulse - Add your own review/rating Compare Caverject Impulse with other medications Erectile Dysfunction Where can I get more information? Your pharmacist can provide more information about alprostadil.

See also: Caverject Impulse side effects (in more detail)

quinupristin and dalfopristin Intravenous

kwin-ue-PRIS-tin, dal-foe-PRIS-tin

Intravenous route(Powder for Solution)

Quinupristin/dalfopristin has been approved for marketing in the United States for vancomycin-resistant Enterococcus faecium (VREF) bacteremia under FDA's accelerated approval regulations that allow marketing of products for use in life-threatening conditions when other therapies are not available. Approval of this indication is based upon quinupristin/dalfopristin’s ability to clear VREF from the bloodstream, with clearance of bacteremia considered to be a surrogate endpoint. There are no results from well-controlled clinical studies that confirm the validity of this surrogate marker .

Commonly used brand name(s)

In the U.S.

Synercid

Available Dosage Forms:

Powder for Solution

Therapeutic Class: Antibiotic

Chemical Class: Streptogramin

Uses For quinupristin and dalfopristin

Quinupristin and dalfopristin injection is used to treat infections of the skin and the blood. It may also be used for other conditions as determined by your doctor. It is given by injection and is used mainly for serious infection for which other medicine may not work.

Quinupristin and dalfopristin belong to the family of medicine called antibiotics. Antibiotics are medicines used in the treatment of infections caused by bacteria. They work by killing bacteria or preventing their growth. Quinupristin and dalfopristin will not work for colds, flu, or other virus infections.

quinupristin and dalfopristin is available only with your doctor's prescription.

Before Using quinupristin and dalfopristin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For quinupristin and dalfopristin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to quinupristin and dalfopristin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of quinupristin and dalfopristin injection in children younger than 16 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of quinupristin and dalfopristin injection in the elderly.

Pregnancy Pregnancy Category Explanation All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus. Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving quinupristin and dalfopristin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using quinupristin and dalfopristin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Cisapride Pimozide

Using quinupristin and dalfopristin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Astemizole Atorvastatin Cerivastatin Fluvastatin Haloperidol Lovastatin Pravastatin Simvastatin Terfenadine

Using quinupristin and dalfopristin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Amlodipine Carbamazepine Cyclosporine Delavirdine Diazepam Diltiazem Disopyramide Docetaxel Felodipine Indinavir Isradipine Lacidipine Lidocaine Manidipine Methylprednisolone Midazolam Nevirapine Nicardipine Nifedipine Nilvadipine Nimodipine Nisoldipine Nitrendipine Paclitaxel Quinidine Ritonavir Tacrolimus Verapamil Vinblastine Vincamine Vincristine Vincristine Liposome Vindesine Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of quinupristin and dalfopristin. Make sure you tell your doctor if you have any other medical problems, especially:

Colitis (inflammation of the colon) or Diarrhea, severe—Use with caution. May make these conditions worse. Liver disease—Liver disease may increase blood levels of quinupristin and dalfopristin, increasing the chance of side effects. Proper Use of quinupristin and dalfopristin

A nurse or other trained health professional will give you quinupristin and dalfopristin in a hospital. quinupristin and dalfopristin is given through a needle placed in one of your veins. The medicine must be injected slowly, so your IV tube will need to stay in place for 60 minutes.

To help clear up your infection completely, quinupristin and dalfopristin must be given for the full time of treatment, even if you begin to feel better after a few days. Also, it works best when there is a constant amount in the blood. To help keep the amount constant, quinupristin and dalfopristin must be given on a regular schedule.

Precautions While Using quinupristin and dalfopristin

Your doctor will check your progress closely while you are receiving quinupristin and dalfopristin. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it. Blood tests may be needed to check for unwanted effects.

If your symptoms do not improve or if they become worse, call your doctor.

quinupristin and dalfopristin may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop receiving quinupristin and dalfopristin. Do not take any medicine to treat diarrhea without first checking with your doctor. If you have any questions or if mild diarrhea continues or gets worse, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

quinupristin and dalfopristin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common Swelling, redness, or pain at the injection site Less common Changes in skin color dry, red, hot, or irritated skin joint pain muscle pain pain redness, burning sensation, or pain under the skin usually in the injection site swelling of the foot or leg tenderness Rare Agitation anxiety back, leg, or stomach pains black, tarry stools bleeding gums bloating or swelling of the face, arms, hands, lower legs, or feet blood in the urine bloody, black, or tarry stools blue lips, fingernails, or skin blurred vision bone pain burning, tingling, numbness, or pain in the hands, arms, feet, or legs chest pain or discomfort chest pain, possibly moving to the left arm, neck, or shoulder chills coma confusion constipation convulsions or seizures cough or hoarseness darkened urine decreased urine output difficult, fast, or labored breathing difficult or painful urination difficulty with moving difficulty with swallowing dizziness dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position drowsiness extremely shallow or slow breathing fainting fast, slow, irregular, pounding, or racing heartbeat or pulse feeling of warmth or heat flushing or redness of the skin, especially on the face and neck general body swelling general tiredness and weakness hallucinations headache high fever hives inability to speak increased thirst indigestion irritability itching light-colored stools loss of appetite loss of bladder control loss of consciousness loss of strength or energy lower back or side pain muscle pain or cramps muscle stiffness or weakness nausea or vomiting no blood pressure or pulse nosebleeds not breathing pain in the joints pains in the stomach, side, or abdomen, possibly radiating to the back pale skin problems with bleeding or clotting puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue rapid weight gain redness, burning sensation, or pain in the vagina sensation of pins and needles severe bloody diarrhea severe or sudden headache shakiness in the legs, arms, hands, or feet shortness of breath skin rash skin rash with red patches slurred speech sore throat sores on the skin sores, ulcers, or white spots on the lips or in the mouth stabbing pain stiff neck stopping of the heart sweating swelling of the face, ankles, or hands swollen glands temporary blindness tightness in the chest tingling of the hands or feet total body jerking trembling or shaking of the hands or feet troubled breathing unconsciousness unexplained bleeding or bruising unusual tiredness or weakness unusual weight gain or loss upper right abdominal or stomach pain vomiting vomiting of blood or material that looks like coffee grounds weakness in the arm or leg on one side of the body, sudden and severe wheezing worsening of the underlying disease yellowing of the eyes or skin Incidence not known Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare Acid or sour stomach ankle, knee, or great toe joint pain belching cold sweats cool, pale skin cramps in the legs depression excessive muscle tone heartburn hives or welts increased hunger itching of the vagina or genital area joint stiffness or swelling lower back or side pain muscle tension or tightness nightmares pain during sexual intercourse redness of the skin shakiness sleeplessness stomach discomfort, upset, or pain sweating swelling or inflammation of the mouth thick, white vaginal discharge with no odor or with a mild odor trouble sleeping unable to sleep white patches in the mouth, tongue, or throat

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More quinupristin and dalfopristin Intravenous resources Quinupristin and dalfopristin Intravenous Use in Pregnancy & BreastfeedingQuinupristin and dalfopristin Intravenous Drug InteractionsQuinupristin and dalfopristin Intravenous Support Group0 Reviews for Quinupristin and dalfopristin Intravenous - Add your own review/rating Compare quinupristin and dalfopristin Intravenous with other medications BacteremiaMethicillin-Resistant Staphylococcus Aureus InfectionSkin Infection

coal tar Topical

kole tar

Commonly used brand name(s)

In the U.S.

Betatar Gel Cutar Emulsion Denorex DHS Tar Doak Tar Duplex T Fototar Ionil-T Plus Medotar MG 217 Neutrogena T/Derm Neutrogena T/Gel

In Canada

Estar Liquor Carbonis Detergens Psorigel Spectro Tar Skin Wash Tar Distillate

Available Dosage Forms:

Liquid Shampoo Lotion Solution Cream Gel/Jelly Soap Kit Ointment Bar Foam Emulsion

Therapeutic Class: Keratolytic

Uses For coal tar

Coal tar is used to treat eczema, psoriasis, seborrheic dermatitis, and other skin disorders.

Some of these preparations are available only with your doctor's prescription.

Before Using coal tar

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For coal tar, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to coal tar or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Coal tar products should not be used on infants, unless otherwise directed by your doctor. Studies on coal tar have been done only in adult patients, and there is no specific information comparing use of coal tar in children with use in other age groups.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of coal tar in the elderly with use in other age groups.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of coal tar

Use coal tar only as directed. Do not use more of it and do not use it more often than recommended on the label, unless otherwise directed by your doctor. To do so may increase the chance of side effects.

After applying coal tar, protect the treated area from direct sunlight and do not use a sunlamp for 72 hours, unless otherwise directed by your doctor, since a severe reaction may occur. Also, make sure you have removed all the coal tar medicine from your skin before you go back into direct sunlight or use a sunlamp.

Do not apply coal tar to infected, blistered, raw, or oozing areas of the skin.

Keep coal tar away from the eyes. If you should accidentally get some in your eyes, flush them thoroughly with water at once.

To use the cream or ointment form of coal tar:

Apply enough medicine to cover the affected area, and rub in gently.

To use the gel form of coal tar:

Apply enough gel to cover the affected area, and rub in gently. Allow the gel to remain on the affected area for 5 minutes, then remove excess gel by patting with a clean tissue.

To use the shampoo form of coal tar:

Wet the scalp and hair with lukewarm water. Apply a generous amount of shampoo and rub into the scalp, then rinse. Apply the shampoo again, working up a rich lather, and allow to remain on the scalp for 5 minutes. Then rinse thoroughly.

To use the nonshampoo liquid form of coal tar:

Some of these preparations are to be applied directly to dry or wet skin, some are to be added to lukewarm bath water, and some may be applied directly to dry or wet skin or added to lukewarm bath water. Make sure you know exactly how you should use coal tar. If you have any questions about this, check with your health care professional. If coal tar is to be applied directly to the skin, apply enough to cover the affected area, and rub in gently. Some of these preparations contain alcohol and are flammable. Do not use near heat, near open flame, or while smoking. Dosing

The dose of coal tar will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of coal tar. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For eczema, psoriasis, seborrheic dermatitis, and other skin disorders: For cleansing bar dosage form: Adults—Use one or two times a day, or as directed by your doctor. Children—Use and dose must be determined by your doctor. For cream dosage form: Adults—Apply to the affected area(s) of the skin up to four times a day. Children—Use and dose must be determined by your doctor. For gel dosage form: Adults—Apply to the affected area(s) of the skin one or two times a day. Children—Use and dose must be determined by your doctor. For lotion dosage form: Adults—Apply directly to the affected area(s) of the skin or use as a bath, hand or foot soak, or as a hair rinse, depending on the product. Children—Use and dose must be determined by your doctor. For ointment dosage form: Adults—Apply to the affected area(s) of the skin two or three times a day. Children—Use and dose must be determined by your doctor. For shampoo dosage form: Adults—Use once a day to once a week or as directed by your doctor. Children—Use and dose must be determined by your doctor. For topical solution dosage form: Adults—Apply to wet the skin or scalp, or use as a bath, depending on the product. Children—Use and dose must be determined by your doctor. For topical suspension dosage form: Adults—Use as a bath. Children—Use and dose must be determined by your doctor. Missed Dose

If you miss a dose of coal tar, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using coal tar

If coal tar is used on the scalp, it may temporarily discolor blond, bleached, or tinted hair.

Coal tar may stain the skin or clothing. Avoid getting it on your clothing. The stain on the skin will wear off after you stop using the medicine.

coal tar Side Effects

In animal studies, coal tar has been shown to increase the chance of skin cancer.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Rare Skin irritation not present before use of coal tar skin rash

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common Stinging (mild)—especially for gel and solution dosage forms

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: coal tar Topical side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More coal tar Topical resources Coal tar Topical Side Effects (in more detail)Coal tar Topical Use in Pregnancy & BreastfeedingCoal tar Topical Support Group4 Reviews for Coal tar Topical - Add your own review/rating coal tar topical Concise Consumer Information (Cerner Multum) Coal Tar Foam MedFacts Consumer Leaflet (Wolters Kluwer) Denorex Shampoo MedFacts Consumer Leaflet (Wolters Kluwer) Doak Tar Shampoo MedFacts Consumer Leaflet (Wolters Kluwer) Fototar Ointment MedFacts Consumer Leaflet (Wolters Kluwer) MG217 Medicated Tar Lotion MedFacts Consumer Leaflet (Wolters Kluwer) Psoriasin Prescribing Information (FDA) Compare coal tar Topical with other medications DermatitisPsoriasisSeborrheic Dermatitis

Terazol 3 Suppositories
Pronunciation: ter-KON-a-zoleGeneric Name: TerconazoleBrand Name: Terazol 3

nitroprusside

Generic Name: nitroprusside (nye troe PRUS ide) Brand Names: Nitropress

What is nitroprusside?

Nitroprusside is a vasodilator that works by relaxing the muscles in your blood vessels to help them dilate (widen). This lowers blood pressure and allows blood to flow more easily through your veins and arteries.

Nitroprusside is used to treat congestive heart failure and life-threatening high blood pressure (hypertension). Nitroprusside is also used to keep blood pressure low during a surgery.

Nitroprusside may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about nitroprusside? You should not receive this medication if you are allergic to nitroprusside, or if you have hereditary vision loss (Leber's disease), vision problems caused by smoking, or a history of blood clot in your brain.

Before receiving nitroprusside, tell your doctor if you have high blood pressure, kidney or liver disease, anemia (a lack of red blood cells), a seizure disorder, or a history of head injury or brain tumor.

In an emergency situation it may not be possible before you are treated to tell your caregivers about your health conditions or if you are pregnant or breast-feeding. Make sure any doctor caring for you afterward knows that you have received this medication.

Tell your caregivers right away if you have a serious side effect such as breathing problems, tremors or twitching, numbness or cold feeling in your arms and legs, confusion, ringing in your ears, or feeling like you might pass out. What should I discuss with my health care provider before receiving nitroprusside? You should not receive this medication if you are allergic to nitroprusside, or if you have:

hereditary vision loss (Leber's disease);

vision problems caused by smoking; or

a history of blood clot in your brain.

If possible before you receive nitroprusside, tell your doctor if you have:

high blood pressure (hypertension);

kidney disease; liver disease;

anemia (a lack of red blood cells);

epilepsy or other seizure disorder; or

a history of head injury or brain tumor.

FDA pregnancy category C. It is not known whether nitroprusside will harm an unborn baby. Tell your doctor if you are pregnant. It is not known whether nitroprusside passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

In an emergency situation, it may not be possible before you are treated with nitroprusside to tell your caregivers if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medication.

How is nitroprusside given?

Nitroprusside is injected into a vein through an infusion pump. You will receive this injection in a clinic or hospital setting.

Nitroprusside is usually given for as long as needed until your body responds to the medication. Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are receiving nitroprusside. Your blood and urine may also need to be tested during treatment. What happens if I miss a dose?

Since nitroprusside is given as needed by a healthcare professional, you are not likely to miss a dose.

What happens if I overdose? Tell your caregivers at once if you think you have received too much of this medicine. Overdose symptoms may include extreme dizziness, nausea and vomiting, muscle twitching, rapid breathing, fast or pounding heartbeat, and feeling like you might pass out. What should I avoid after receiving nitroprusside?

Follow your doctor's instructions about any restrictions on food, beverages, activity, or other medications.

Nitroprusside 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. Tell your caregivers at once if you have a serious side effect such as:

feeling like you might pass out, even while lying down;

gasping, struggling to breathe, or shallow breathing;

confusion, ringing in your ears;

dizziness with nausea and vomiting, rapid breathing, seizure (convulsions);

fast, slow, or uneven heart rate;

numb or cold feeling in your arms and legs; or

chills, sweating, tremors, twitching, overactive reflexes.

Less serious side effects may include:

mild skin rash;

mild stomach pain or nausea;

warmth, redness, or tingly feeling under your skin;

darkening or deeper color of veins through your skin; or

irritation around the IV needle.

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.

Nitroprusside Dosing Information

Usual Adult Dose for Hypertensive Emergency:

Initial dose: 0.3 mcg/kg/min IBW administered by continuous IV infusion.Maintenance dose: The dose may be titrated upward to a maximum of 10 mcg/kg/min IBW.

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 10 to 15 mcg/min administered by continuous IV infusion.

Mutamycin

Generic Name: mitomycin (Intravenous route)

mye-toe-MYE-sin

Intravenous route(Powder for Solution)

Bone marrow suppression, notably thrombocytopenia and leukopenia, which may contribute to overwhelming infections in an already compromised patient, is the most common and severe of the toxic effects of mitomycin. Hemolytic Uremic Syndrome (HUS) has been reported in patients receiving systemic mitomycin. The syndrome may occur at any time during systemic therapy with mitomycin but most cases occur at doses greater than or equal to 60 mg. Blood product transfusion may exacerbate the symptoms associated with this syndrome .

Commonly used brand name(s)

In the U.S.

Mutamycin

Available Dosage Forms:

Powder for Solution

Therapeutic Class: Antineoplastic Agent

Uses For Mutamycin

Mitomycin belongs to the group of medicines known as antineoplastics. It is used to treat some kinds of cancer.

Mitomycin interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by mitomycin, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

Before you begin treatment with mitomycin, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Mitomycin is to be administered only by or under the immediate supervision of your doctor.

Before Using Mutamycin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Although there is no specific information comparing use of mitomycin in children with use in other age groups, it is not expected to cause different side effects or problems in children than it does in adults.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of mitomycin in the elderly with use in other age groups.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Rotavirus Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Adenovirus Vaccine Type 4, Live Adenovirus Vaccine Type 7, Live Bacillus of Calmette and Guerin Vaccine, Live Influenza Virus Vaccine, Live Measles Virus Vaccine, Live Mumps Virus Vaccine, Live Rotavirus Vaccine, Live Rubella Virus Vaccine, Live Smallpox Vaccine Tamoxifen Typhoid Vaccine Varicella Virus Vaccine Vinblastine Yellow Fever Vaccine Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Bleeding problems Chickenpox (including recent exposure) or Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body Infection—Mitomycin may decrease your body's ability to fight infection Kidney disease—May be worsened Proper Use of Mutamycin

Mitomycin is usually given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to remember to take them at the right times.

This medicine often causes nausea, vomiting, and loss of appetite. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Precautions While Using Mutamycin

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

While you are being treated with mitomycin, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Mitomycin may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Mitomycin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination. Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin. Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done. Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime. Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters. Avoid contact sports or other situations where bruising or injury could occur.

If mitomycin accidentally seeps out of the vein into which it is injected, it may damage the skin and cause scarring. In some patients, this may occur weeks or even months after this medicine is given. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection or anywhere else on your skin.

Mutamycin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Also, because of the way cancer medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer. Discuss these possible effects with your doctor.

Check with your doctor immediately if any of the following side effects occur:

Less common Black, tarry stools blood in urine or stools cough or hoarseness fever or chills lower back or side pain painful or difficult urination pinpoint red spots on skin unusual bleeding or bruising Rare Redness or pain, especially at place of injection

Check with your doctor as soon as possible if any of the following side effects occur:

Less common Cough decreased urination shortness of breath sores in mouth and on lips swelling of feet or lower legs Rare Bloody vomit

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common Loss of appetite nausea and vomiting Less common Numbness or tingling in fingers and toes purple-colored bands on nails skin rash unusual tiredness or weakness

Mitomycin sometimes causes a temporary loss of hair. After treatment has ended, normal hair growth should return.

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Blood in urine

Also, check with your doctor if you notice any of the following:

Black, tarry stools blood in stools cough or hoarseness decreased urination fever or chills lower back or side pain painful or difficult urination pinpoint red spots on skin red or painful skin shortness of breath swelling of feet or lower legs unusual bleeding or bruising

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Mutamycin side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Mutamycin resources Mutamycin Side Effects (in more detail)Mutamycin Use in Pregnancy & BreastfeedingMutamycin Drug InteractionsMutamycin Support Group0 Reviews for Mutamycin - Add your own review/rating Mutamycin Prescribing Information (FDA) Mutamycin MedFacts Consumer Leaflet (Wolters Kluwer) Mutamycin Concise Consumer Information (Cerner Multum) Mutamycin Monograph (AHFS DI) Mitomycin Prescribing Information (FDA) Mitomycin Professional Patient Advice (Wolters Kluwer) Compare Mutamycin with other medications Bladder CancerPancreatic CancerStomach Cancer

Malaria Prevention (Malaria Prophylaxis) Medications
Drugs associated with Malaria Prevention

The following drugs and medications are in some way related to, or used in the treatment of Malaria Prevention. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

Drug List:Aralen-PhosphateDoryx-Delayed-Release-CapsulesDoxy-200LariamMalarone-PediatricOcudox-Convenience-KitPlaquenilVibramycin

Antipyrine/Benzocaine/U-Polycosanol
Pronunciation: AN-tee-PYE-reen/BEN-zoe-kane/POL-ee-COHS-an-olGeneric Name: Antipyrine/Benzocaine/U-PolycosanolBrand Name: Examples include Auralgan and Treagan

Azithromycin Suspension
Pronunciation: ay-ZITH-roe-MYE-sinGeneric Name: AzithromycinBrand Name: Zithromax

Exforge HCT

Generic Name: amlodipine, valsartan, and hydrochlorothiazide (Oral route)

am-LOE-di-peen BES-i-late, val-SAR-tan, hye-droe-klor-oh-THYE-a-zide

Oral route(Tablet)

Drugs that act directly on the renin-angiotensin system can cause injury or death to the developing fetus when used during the second and third trimesters. Stop therapy as soon as possible when pregnancy is detected .

Commonly used brand name(s)

In the U.S.

Exforge HCT

Available Dosage Forms:

Tablet

Therapeutic Class: Antihypertensive

Pharmacologic Class: Amlodipine

Chemical Class: Amlodipine

Uses For Exforge HCT

Amlodipine, valsartan, and hydrochlorothiazide is a combination of medicines that is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a heart failure or kidney failure. Lowering blood pressure reduces the risk of strokes and heart attacks.

Amlodipine is a calcium channel blocker. It affects the movement of calcium into the cells of the heart and blood vessels. As a result, amlodipine relaxes the blood vessels and increases the supply of blood and oxygen to the heart while reducing its workload.

Valsartan is an angiotensin II receptor blocker. It works by blocking a substance in the body that causes blood vessels to tighten. As a result, valsartan relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

Hydrochlorothiazide is a thiazide diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine, which helps lower the blood pressure.

This medicine is available only with your doctor's prescription.

Before Using Exforge HCT

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of amlodipine, valsartan, and hydrochlorothiazide combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of amlodipine, valsartan, and hydrochlorothiazide combination in the elderly.

Pregnancy Pregnancy Category Explanation All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk. Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Dofetilide

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acetyldigoxin Amiodarone Arsenic Trioxide Atazanavir Benazepril Conivaptan Dantrolene Deslanoside Digitalis Digitoxin Digoxin Droperidol Enalapril Enalaprilat Flecainide Ketanserin Levomethadyl Lisinopril Lithium Metildigoxin Moexipril Ouabain Perindopril Proscillaridin Quinapril Ramipril Simvastatin Sotalol Telaprevir Trandolapril

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acebutolol Alacepril Alprenolol Apazone Aspirin Atenolol Benazepril Bepridil Betaxolol Bevantolol Bisoprolol Bromfenac Bucindolol Captopril Carbamazepine Carteolol Carvedilol Celecoxib Celiprolol Chlorpropamide Cholestyramine Cilazapril Clopidogrel Cyclophosphamide Dalfopristin Delapril Diclofenac Diflunisal Dilevalol Diltiazem Enalaprilat Enalapril Maleate Esmolol Etodolac Fenoprofen Fluconazole Flurbiprofen Fosinopril Ginkgo Glipizide Gossypol Ibuprofen Ibuprofen Lysine Imatinib Imidapril Indinavir Indomethacin Itraconazole Ketoconazole Ketoprofen Ketorolac Labetalol Levobunolol Licorice Lisinopril Magnesium Salicylate Meclofenamate Mefenamic Acid Meloxicam Mepindolol Metipranolol Metoprolol Moexipril Nabumetone Nadolol Naproxen Nebivolol Nepafenac Oxaprozin Oxprenolol Penbutolol Pentopril Perindopril Pindolol Piroxicam Propranolol Quinapril Quinupristin Ramipril Rifapentine Ritonavir Salicylic Acid Salsalate Sotalol Spirapril St John's Wort Sulindac Talinolol Temocapril Tertatolol Timolol Tolmetin Topiramate Trandolapril Zofenopril Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Angina (severe chest pain) or Diabetes or Electrolyte imbalances (e.g., low levels of salt or sodium in the body) or Fluid imbalances (caused by dehydration, vomiting, or diarrhea) or Gallstones, or history of or Glaucoma, acute angle-closure or Gout, history of or Heart attack, history of or Heart or blood vessel disease (e.g., severe obstructive coronary artery disease) or Hypercalcemia (high calcium in the blood) or Hypercholesterolemia (high cholesterol in the blood) or Hypertriglyceridemia (high triglycerides or fats in the blood) or Systemic lupus erythematosus (an autoimmune disorder)—Use with caution. May make these conditions worse. Anuria (not able to form urine) or Kidney disease, severe or Liver disease, severe or Sulfonamide allergy (antibiotic or stomach medicines, e.g., sulfamethoxazole, sulfasalazine, sulfisoxazole, Azulfidine®, Bactrim®, or Septra®)—Should not be used in patients with these conditions. Aortic or mitral stenosis (problem with heart valve), severe or Asthma, history of—May cause side effects to become worse. Heart failure or Kidney disease or Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body. Proper Use of Exforge HCT

This medicine should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.

This medicine comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and a change in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any symptoms of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

You may take this medicine with or without food.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets): For high blood pressure: Adults—One tablet once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than amlodipine 10 milligrams (mg), valsartan 320 mg, and hydrochlorothiazide 25 mg per day. Children—Use and dose must be determined by your doctor. Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Exforge HCT

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. These symptoms are more likely to occur when you begin taking this medicine, or when the dose is increased.

Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt.

Check with your doctor right away if you experience dizziness, fainting, confusion, muscle pain, weakness, and/or a fast heartbeat. Use extra care if you exercise or if the weather is hot. Heavy sweating can cause dehydration (loss of too much water) or electrolyte imbalances (loss of sodium, potassium, or magnesium in the body).

This medicine may worsen the symptoms of angina (chest pain) or cause a heart attack in certain patients with severe heart or blood vessel disease. Check with your doctor right away if you are having chest pain or discomfort; fast or uneven heartbeat; nausea or vomiting; shortness of breath; pain or discomfort in the arms, jaw, back, or neck; shortness of breath; or sweating.

Stop using this medicine and check with your doctor immediately if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. This could be a sign of a serious eye problem. Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.

Do not use medicines, supplements, or salt substitutes that contain potassium without first checking with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or over-the-counter (nonprescription ) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may increase your blood pressure.

Exforge HCT Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common Swelling Rare Bladder pain bloody or cloudy urine blurred vision burning while urinating burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings chest pain chills cold sweats coma confusion convulsions cough cough producing mucus decreased urination decreased urine output diarrhea difficult or labored breathing difficult, burning, or painful urination dizziness dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position dry mouth ear congestion or pain fainting fast, pounding, or irregular heartbeat or pulse fever flushed, dry skin frequent urge to urinate fruit-like breath odor general feeling of discomfort or illness head congestion headache hoarseness or other voice changes increased hunger increased sweating increased thirst increased urination joint pain lightheadedness loss of appetite loss of consciousness lower back or side pain mood changes muscle aches and pains nausea or vomiting numbness or tingling in the hands, feet, or lips rapid breathing runny nose shivering shortness of breath sneezing sore throat stomachache stuffy nose sunken eyes sweating swelling of the face, ankles, or hands tightness in the chest trouble with sleeping unexplained weight loss unusual tiredness or weakness wheezing wrinkled skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common Acid or sour stomach back pain belching heartburn indigestion muscle spasms stomach discomfort, upset, or pain Rare Bleeding after defecation body aches or pain burning feeling in the chest or stomach burning, numbness, pain, or tingling in all fingers except smallest finger change in taste congestion continuing ringing or buzzing or other unexplained noise in the ears decreased interest in sexual intercourse decreased weight depression difficulty having a bowel movement (stool) difficulty with moving fear or nervousness feeling of constant movement of self or surroundings hearing loss inability to have or keep an erection increased appetite itching skin lack or loss of strength loss in sexual ability, desire, drive, or performance loss of taste muscle weakness neck pain pain in the arms or legs pain, swelling, or redness in the joints rash sensation of spinning shakiness in the legs, arms, hands, or feet sleepiness or unusual drowsiness sleeplessness sneezing stomach upset swelling of the joints tender, swollen glands in the neck tenderness in the stomach area toothache trembling or shaking of the hands or feet trouble with swallowing unable to sleep uncomfortable swelling around the anus unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness upper abdominal or stomach pain voice changes weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Exforge HCT side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Exforge HCT resources Exforge HCT Side Effects (in more detail)Exforge HCT Use in Pregnancy & BreastfeedingExforge HCT Drug InteractionsExforge HCT Support Group1 Review for Exforge HCT - Add your own review/rating Exforge HCT Prescribing Information (FDA) Exforge HCT MedFacts Consumer Leaflet (Wolters Kluwer) Exforge HCT Consumer Overview Compare Exforge HCT with other medications High Blood Pressure

Gonadotropins

A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes.

Gonadotropins are hormones synthesized and released by the anterior pituitary, and act on the gonads (testes and ovaries) to promote production of sex hormones and stimulate production of either sperm or ova. Follicle stimulating hormone (FSH) and luteinizing hormones (LH) are the main gonadotropins. Human chorionic gonadotropin is a gonadotropin that is only produced during pregnancy by the placenta.

Gonadotropin production is controlled by gonadotropin-releasing hormone, which is released by the hypothalamus. The effects of gonadotrophins differ in males and females.

Gonadotropins are used in fertility treatment to produce mature follicles and ovulation induction, in women. In men, it is used to increase sperm count as part of fertility treatment.

See also

Medical conditions associated with gonadotropins:

Female InfertilityFollicle StimulationHypogonadism, MaleObesityOvulation InductionPrepubertal Cryptorchidism Drug List:OvidrelHcgBravelleChorionic-GonadotropinFollistimFollistim-AqGonal-F-RffLuverisMetrodinProfasi-HpRepronex

Aplastic Anemia Medications

Definition of Aplastic Anemia: Aplastic anemia occurs when the bone marrow produces too few of all three types of blood cells: red blood cells, white blood cells, and platelets. A reduced number of red blood cells causes hemoglobin to drop. A reduced number of white blood cells makes the patient susceptible to infection. And, a reduced number of platelets causes the blood not to clot as easily.

Drugs associated with Aplastic Anemia

The following drugs and medications are in some way related to, or used in the treatment of Aplastic Anemia. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

Learn more about Aplastic Anemia

Micromedex Care Notes:

Aplastic AnemiaBone Marrow Failure In Children

Medical Encyclopedia:

Anemia

Harvard Health Guide:

Symptoms and treatment for Aplastic Anemia Drug List:LeukineNeupogen

Eryped

Generic Name: erythromycin (Oral route, Parenteral route)

e-rith-roe-MYE-sin

Commonly used brand name(s)

In the U.S.

E.E.S. 200 E.E.S. 400 E.E.S. Granules Eryped Eryped 200 Eryped 400 Erythrocin Erythrocin Stearate Ilosone

In Canada

E.E.S. 100 Ees 200 Novo-Rythro Estolate Suspension Novo-Rythro Ethyl Succinate Suspension Novo-Rythro Stearate

Available Dosage Forms:

Suspension Powder for Suspension Tablet Tablet, Chewable Capsule Uses For Eryped

Erythromycins are used to treat many kinds of infections. Erythromycins are also used to prevent "strep" infections in patients with a history of rheumatic heart disease who may be allergic to penicillin.

These medicines may also be used to treat Legionnaires' disease and for other problems as determined by your doctor. They will not work for colds, flu, or other virus infections.

Erythromycins are available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, erythromycins are used in certain patients with the following medical conditions:

Acne Actinomycosis Anthrax Chancroid Gastroparesis Lyme disease Lymphogranuloma venereum Relapsing fever Before Using Eryped Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

This medicine has been tested in children and, in effective doses, has not been shown to cause different side effects or problems in children than it does in adults.

Geriatric

This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults. However, older adults may be at increased risk of hearing loss, especially if they are taking high doses of erythromycin and/or have kidney or liver disease.

Pregnancy

Erythromycin estolate has caused side effects involving the liver in some pregnant women. However, none of the erythromycins has been shown to cause birth defects or other problems in human babies.

Breast Feeding

Erythromycins pass into the breast milk. However, erythromycins have not been shown to cause problems in nursing babies.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

Heart disease—High doses of erythromycin may increase the chance of side effects in patients with a history of an irregular heartbeat. Liver disease—Erythromycins, especially erythromycin estolate, may increase the chance of side effects involving the liver. Loss of hearing—High doses of erythromycins may, on rare occasion, cause hearing loss, especially if you have kidney or liver disease. Proper Use of erythromycin

This section provides information on the proper use of a number of products that contain erythromycin. It may not be specific to Eryped. Please read with care.

Generally, erythromycins are best taken with a full glass (8 ounces) of water on an empty stomach (at least 1 hour before or 2 hours after meals). If stomach upset occurs, these medicines may be taken with food. If you have questions about the erythromycin medicine you are taking, check with your health care professional.

For patients taking the oral liquid form of this medicine:

This medicine is to be taken by mouth even if it comes in a dropper bottle. If this medicine does not come in a dropper bottle, use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid Do not use after the expiration date on the label. The medicine may not work properly after that date. Check with your pharmacist if you have any questions about this.

For patients taking the chewable tablet form of this medicine:

Tablets must be chewed or crushed before they are swallowed.

For patients taking the delayed-release capsule form (with enteric-coated pellets) or the delayed-release tablet form of this medicine:

Swallow capsules or tablets whole. Do not break or crush. If you are not sure about which type of capsule or tablet you are taking, check with your pharmacist.

To help clear up your infection completely, keep taking this medicine for the full time of treatment, even if you begin to feel better after a few days. If you have a "strep" infection, you should keep taking this medicine for at least 10 days. This is especially important in "strep" infections. Serious heart problems could develop later if your infection is not cleared up completely. Also, if you stop taking this medicine too soon, your symptoms may return.

This medicine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, it is best to take the doses at evenly spaced times day and night. For example, if you are to take 4 doses a day, the doses should be spaced about 6 hours apart. If this interferes with your sleep or other daily activities, or if you need help in planning the best times to take your medicine, check with your health care professional.

Dosing

The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For erythromycin base For oral dosage forms (capsules, tablets): For treatment of infections: Adults and teenagers—250 to 500 milligrams (mg) two to four times a day. Children—Dose is based on body weight. The usual dose is 7.5 to 12.5 mg per kilogram (kg) (3.4 to 5.6 mg per pound) of body weight four times a day, or 15 to 25 mg per kg (6.8 to 11.4 mg per pound) of body weight two times a day. For prevention of heart infections: Adults and teenagers—Take 1 gram two hours before your dental appointment or surgery, then 500 mg six hours after taking the first dose. Children—Dose is based on body weight. The usual dose is 20 mg per kg (9.1 mg per pound) of body weight two hours before the dental appointment or surgery, then 10 mg per kg (4.5 mg per pound) of body weight six hours after taking the first dose. For erythromycin estolate For oral dosage forms (capsules, oral suspension, tablets): For treatment of infections: Adults and teenagers—250 to 500 milligrams (mg) two to four times a day. Children—Dose is based on body weight. The usual dose is 7.5 to 12.5 mg per kilogram (kg) (3.4 to 5.6 mg per pound) of body weight four times a day, or 15 to 25 mg per kg (6.8 to 11.4 mg per pound) of body weight two times a day. For prevention of heart infections: Adults and teenagers—Take 1 gram two hours before your dental appointment or surgery, then 500 mg six hours after taking the first dose. Children—Dose is based on body weight. The usual dose is 20 mg per kg (9.1 mg per pound) of body weight two hours before the dental appointment or surgery, then 10 mg per kg (4.5 mg per pound) of body weight six hours after taking the first dose. For erythromycin ethylsuccinate For oral dosage forms (oral suspension, tablets): For treatment of infections: Adults and teenagers—400 to 800 milligrams (mg) two to four times a day. Children—Dose is based on body weight. The usual dose is 7.5 to 12.5 mg per kilogram (kg) (3.4 to 5.6 mg per pound) of body weight four times a day, or 15 to 25 mg per kg (6.8 to 11.4 mg per pound) of body weight two times a day. For prevention of heart infections: Adults and teenagers—Take 1.6 grams two hours before your dental appointment or surgery, then 800 mg six hours after taking the first dose. Children—Dose is based on body weight. The usual dose is 20 mg per kg (9.1 mg per pound) of body weight two hours before the dental appointment or surgery, then 10 mg per kg (4.5 mg per pound) of body weight six hours after taking the first dose. For erythromycin gluceptate For injection dosage forms: For treatment of infections: Adults and teenagers—250 to 500 milligrams (mg) injected into a vein every six hours; or 3.75 to 5 mg per kilogram (kg) (1.7 to 2.3 mg per pound) of body weight injected into a vein every six hours. Children—Dose is based on body weight. The usual dose is 3.75 to 5 mg per kg (1.7 to 2.3 mg per pound) of body weight injected into a vein every six hours. For erythromycin lactobionate For injection dosage forms: For treatment of infections: Adults and teenagers—250 to 500 milligrams (mg) injected into a vein every six hours; or 3.75 to 5 mg per kilogram (kg) (1.7 to 2.3 mg per pound) of body weight injected into a vein every six hours. Children—Dose is based on body weight. The usual dose is 3.75 to 5 mg per kg (1.7 to 2.3 mg per pound) of body weight injected into a vein every six hours. For erythromycin stearate For oral dosage forms (oral suspension, tablets): For treatment of infections: Adults and teenagers—250 to 500 milligrams (mg) two to four times a day. Children—Dose is based on body weight. The usual dose is 7.5 to 12.5 mg per kilogram (kg) (3.4 to 5.6 mg per pound) of body weight four times a day; or 15 to 25 mg per kg (6.8 to 11.4 mg per pound) of body weight two times a day. For prevention of heart infections: Adults and teenagers—Take 1 gram two hours before your dental appointment or surgery, then 500 mg six hours after taking the first dose. Children—Dose is based on body weight. The usual dose is 20 mg per kg (9.1 mg per pound) of body weight two hours before the dental appointment or surgery, then 10 mg per kg (4.5 mg per pound) of body weight six hours after taking the first dose. Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Eryped

If your symptoms do not improve within a few days, or if they become worse, check with your doctor.

Eryped Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common Fever nausea skin rash, redness, or itching stomach pain (severe) unusual tiredness or weakness vomiting yellow eyes or skin–with erythromycin estolate (rare with other erythromycins) Less common - with erythromycin injection only Pain, swelling, or redness at place of injection Rare Fainting (repeated) irregular or slow heartbeat loss of hearing (temporary)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common Abdominal or stomach cramping and discomfort diarrhea nausea or vomiting Less common Sore mouth or tongue vaginal itching and discharge

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Eryped side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Eryped resources Eryped Side Effects (in more detail)Eryped Use in Pregnancy & BreastfeedingDrug ImagesEryped Drug InteractionsEryped Support Group0 Reviews for Eryped - Add your own review/rating Erythromycin Monograph (AHFS DI) Erythromycin Professional Patient Advice (Wolters Kluwer) Erythromycin MedFacts Consumer Leaflet (Wolters Kluwer) E.E.S. granules Ery-Tab Prescribing Information (FDA) Ery-Tab Delayed-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer) Ery-Tab Consumer Overview EryPed Drops MedFacts Consumer Leaflet (Wolters Kluwer) EryPed Prescribing Information (FDA) Eryc Delayed-Release Particles Capsules MedFacts Consumer Leaflet (Wolters Kluwer) Eryc Prescribing Information (FDA) Compare Eryped with other medications Bacterial Endocarditis PreventionBartonellosisBowel PreparationBronchitisBullous PemphigoidCampylobacter GastroenteritisChancroidChlamydia InfectionDental AbscessLegionella PneumoniaLyme DiseaseLymphogranuloma VenereumMycoplasma PneumoniaNongonococcal UrethritisOcular RosaceaOtitis MediaPemphigoidPertussisPharyngitisPneumoniaRheumatic Fever ProphylaxisSkin InfectionStrep ThroatSyphilis, EarlyUpper Respiratory Tract Infection

Tol-Tab

Generic Name: tolbutamide (Oral route)

tole-BUE-ta-mide

Commonly used brand name(s)

In the U.S.

Tol-Tab

Available Dosage Forms:

Tablet

Therapeutic Class: Hypoglycemic

Chemical Class: 1st Generation Sulfonylurea

Uses For Tol-Tab

Tolbutamide is used to treat high blood sugar levels caused by a type of diabetes mellitus (sugar diabetes) called type 2 diabetes. In type 2 diabetes, your body does not work properly to store excess sugar and the sugar remains in your bloodstream. Chronic high blood sugar can lead to serious health problems in the future.

Proper diet is the first step in managing type 2 diabetes, but often medicines are needed to help your body. Tolbutamide belongs to a class of drugs called sulfonylureas. It causes your pancreas to release more insulin into the blood stream.

This medicine is available only with your doctor's prescription.

Before Using Tol-Tab

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of tolbutamide in the pediatric population. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of tolbutamide in geriatric patients. However, elderly patients are more likely to have age-related heart, liver, or kidney problems which may require an adjustment of dosage in patients receiving tolbutamide.

Pregnancy Pregnancy Category Explanation All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women. Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acarbose Alatrofloxacin Balofloxacin Ciprofloxacin Clinafloxacin Disopyramide Enoxacin Fleroxacin Flumequine Gatifloxacin Gemifloxacin Grepafloxacin Levofloxacin Lomefloxacin Moxifloxacin Norfloxacin Ofloxacin Pefloxacin Prulifloxacin Rufloxacin Sparfloxacin Temafloxacin Tosufloxacin Trovafloxacin Mesylate

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acebutolol Aceclofenac Acemetacin Alclofenac Alprenolol Apazone Aprepitant Aspirin Atenolol Benoxaprofen Betaxolol Bevantolol Bisoprolol Bitter Melon Bromfenac Bucindolol Bufexamac Carprofen Carteolol Carvedilol Celiprolol Chloramphenicol Clometacin Clonixin Clorgyline Dexketoprofen Diclofenac Dicumarol Diflunisal Dilevalol Dipyrone Droxicam Esmolol Etodolac Etofenamate Felbinac Fenbufen Fenoprofen Fentiazac Fenugreek Floctafenine Flufenamic Acid Flurbiprofen Fosaprepitant Fosphenytoin Ginkgo Biloba Glucomannan Guar Gum Ibuprofen Indomethacin Indoprofen Iproniazid Isocarboxazid Isoxicam Ketoconazole Ketoprofen Ketorolac Labetalol Levobunolol Lornoxicam Meclofenamate Mefenamic Acid Meloxicam Mepindolol Metipranolol Metoprolol Moclobemide Nabumetone Nadolol Naproxen Nebivolol Nialamide Niflumic Acid Nimesulide Oxaprozin Oxprenolol Oxyphenbutazone Pargyline Penbutolol Phenelzine Phenylbutazone Phenytoin Pindolol Pirazolac Piroxicam Pirprofen Procarbazine Propranolol Propyphenazone Proquazone Psyllium Rifapentine Selegiline Sotalol Sulfadiazine Sulfamethoxazole Sulfaphenazole Sulindac Suprofen Talinolol Tenidap Tenoxicam Tertatolol Tiaprofenic Acid Timolol Tolmetin Toloxatone Tranylcypromine Trimethoprim Voriconazole Zomepirac Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Ethanol Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Alcohol intoxication or Underactive adrenal glands or Underactive pituitary glands or Undernourished condition or Weakened physical condition or Any other condition that causes low blood sugar—Patients with these conditions may be more likely to develop low blood sugar while taking tolbutamide. Diabetic ketoacidosis (ketones in the blood) or Type I diabetes—Should not be used in patients with these conditions. Fever or Infection or Surgery or Trauma—These conditions may cause temporary problems with blood sugar control and your doctor may want to treat you temporarily with insulin. Heart disease—Use with caution. May make this condition worse. Kidney disorder or Liver disorder—Higher blood levels of this medicine may occur, which may cause serious problems. Proper Use of Tol-Tab

Follow carefully the special meal plan your doctor gave you. This is the most important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For type 2 diabetes: For oral dosage form (tablets): Adults—At first, 1000 to 2000 milligrams (mg) per day, taken in the morning or in divided doses. Your doctor may adjust your dose if needed. The dose is usually not more than 3000 mg per day. Children—Use and dose must be determined by your doctor. Precautions While Using Tol-Tab

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

It is very important to follow carefully any instructions from your health care team about:

Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team. Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy. Travel—Keep your recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times. In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says you have diabetes and a list of all of your medicines.

Check with your doctor right away if you start having chest pain or discomfort; nausea; pain or discomfort in arms, jaw, back, or neck; shortness of breath; sweating; or vomiting while you are using this medicine. These may be symptoms of a serious heart problem, including a heart attack.

Tolbutamide can cause low blood sugar. However, this can also occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual, cannot eat because of nausea or vomiting, take certain medicines, or take tolbutamide with another type of diabetes medicine. The symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so you can treat it quickly.

Symptoms of low blood sugar include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; cool, pale skin; difficulty in thinking; drowsiness; excessive hunger; fast heartbeat; headache (continuing); nausea; nervousness; nightmares; restless sleep; shakiness; slurred speech; or unusual tiredness or weakness.

If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes; or drink fruit juice, non-diet soft drink, or sugar dissolved in water. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms such as seizures (convulsions) or unconsciousness occur. Have a glucagon kit available, along with a syringe or needle, and know how to use it. Members of your household also should know how to use it.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Tol-Tab Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare Abdominal or stomach pain chills clay-colored stools dark urine diarrhea dizziness fever headache itching loss of appetite nausea rash unpleasant breath odor unusual tiredness or weakness vomiting of blood Incidence not known Agitation back or leg pains bleeding gums blood in urine or stools bloody, black, or tarry stools chest pain coma confusion convulsions cough or hoarseness decreased urine output depression difficulty breathing fast or irregular heartbeat fatigue fever with or without chills fluid-filled skin blisters general body swelling general feeling of tiredness or weakness high fever hostility increased thirst irritability lethargy light-colored stools lower back or side pain muscle pain or cramps muscle twitching nosebleeds painful or difficult urination pale skin pinpoint red spots on skin rapid weight gain seizures sensitivity to the sun shortness of breath sore throat sores, ulcers, or white spots on the lips or in the mouth stupor swelling of face, ankles, or hands swollen or painful glands tightness in the chest unexplained bleeding or bruising wheezing yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose Anxiety blurred vision cold sweats cool, pale skin increased hunger nervousness nightmares shakiness slurred speech

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common Belching indigestion pain in the chest below the breastbone passing of gas stomach pain, fullness, or discomfort Less common Flushing or redness of skin unusually warm skin Incidence not known Change in taste or bad, unusual, or unpleasant (after)taste increased sensitivity of skin to sunlight redness or other discoloration of skin severe sunburn

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Tol-Tab side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Tol-Tab resources Tol-Tab Side Effects (in more detail)Tol-Tab Use in Pregnancy & BreastfeedingTol-Tab Drug InteractionsTol-Tab Support Group0 Reviews for Tol-Tab - Add your own review/rating Orinase Concise Consumer Information (Cerner Multum) Tolbutamide Prescribing Information (FDA) Tolbutamide Professional Patient Advice (Wolters Kluwer) Tolbutamide MedFacts Consumer Leaflet (Wolters Kluwer) Tolbutamide Monograph (AHFS DI) Compare Tol-Tab with other medications Diabetes, Type 2

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