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Myasthenia Gravis Medications


Definition of Myasthenia Gravis: Myasthenia gravis is a neuromuscular disorder characterized by variable weakness of voluntary muscles, which often improves with rest and worsens with activity. The condition is caused by an abnormal immune response.

Drugs associated with Myasthenia Gravis

The following drugs and medications are in some way related to, or used in the treatment of Myasthenia Gravis. 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 Myasthenia Gravis

Micromedex Care Notes:

Myasthenia Gravis

Medical Encyclopedia:

Myasthenia gravis

Harvard Health Guide:

Symptoms and treatment for Myasthenia Gravis
Drug List: Mestinon Mestinon-Timespan Mytelase Mytelase-Chloride Prostigmin Prostigmin-Bromide Regonol Soliris
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Lidocaine Hydrochloride BP Laryngojet 4% (International Medication Systems)


Lidocaine Hydrochloride BP

Laryngojet 4%W/V

Please read this leaflet. It contains important information about your medicine. If you have any questions, please ask your doctor or nurse.

What is this medicine?

This medicine is called Lidocaine Hydrochloride BP Laryngojet 4% w/v. It is a sterile solution which comes in a glass vial and contains 160mg lidocaine hydrochloride in 4ml as the active ingredient. It also contains sodium hydroxide and water.

The active ingredient in this medicine is Lidocaine hydrochloride. This is the new name for Lidocaine (Lignocaine) hydrochloride. The ingredient itself has not changed.

There is one 4ml vial in each carton.

It is a local anaesthetic. It numbs the area it is applied to.

Who makes it? Marketing Authorisation Holder: International Medication Systems (UK) Limited 208 Bath Road Slough Berkshire SL1 3WE UK Manufacturer: International Medication Systems (UK) Ltd. Unit 14 Foster Avenue Woodside Park Dunstable Beds LU5 5TA UK What is it used for?

It is used to numb parts of the body, such as the mouth, throat and lungs, before some medical procedures which would otherwise be uncomfortable or painful. Examples of the kind of procedures lidocaine is used for are putting a breathing tube in during an operation, putting a tube into the lungs to examine them (bronchoscopy), or taking a specimen from the mouth, throat or lungs.

Before you are given lidocaine You should not be given lidocaine and should tell your doctor immediately if: You suffer from porphyria You are allergic to any of the ingredients or to other local anaesthetics You should tell your doctor if: You have epilepsy, any heart problems including heart failure, slow heart beat or delayed heart signals (heart block), very poor breathing, myasthenia gravis, shock, low oxygen levels or low blood volume The area to be anaesthetised is infected or cut You are pregnant, likely to become pregnant, or breast feeding You are taking any other medicines at all, especially ones for your heart (eg. propranolol, and medicines to treat an irregular heartbeat) or ulcers (eg. cimetidine) You are going to have a general anaesthetic where suxamethonium will be used. How much is given?

The lowest dose possible will be given. The usual adult dose is 4ml (160mg). The elderly may need a lower dose. Children can be given up to 3mg for every kg they weigh (so if they weigh 10kg, they could have 3 x 10 = 30mg).

The solution can be sprayed, instilled or applied with a swab to the area to be numbed. It usually works within 5 minutes.

Since this medicine will usually be given to you by a doctor it is unlikely that you will be given too much.

However, if you are worried that you have been given too much, please tell the doctor.

Are there any side effects?

Very rarely, a patient may have an allergic reaction including rashes, swelling (particularly of the lips, face, eyelids, tongue and throat), breathlessness and collapse.

If applied in the mouth it may be difficult to swallow properly until the effect has worn off.

Other side effects may include light headedness, drowsiness, dizziness, mood changes, ringing in your ears, fear, vision difficulties such as blurred or double vision or quivering eyeballs, sickness, sensations of heat, cold or numbness, twitching, fits, shaking, unconsciousness, shallow breathing, stopping breathing, low blood pressure (feeling faint), slow heart beat, collapse including the heart stopping.

If you feel drowsy, dizzy or suffer from blurred or double vision after having lidocaine, do not drive or operate machinery.

The doctor treating you will be watching to see if these effects occur and will have the equipment to treat them.

If you think this medicine has upset you in ANY way, please tell your doctor.

How to store this medicine

Do not use this medicine after the expiry date shown on the carton and vial label.

Do not store above 25°C.

KEEP THIS AND ALL MEDICINES OUT OF THE REACH AND SIGHT OF CHILDREN

Date of preparation: January 2004

Further Information

This leaflet does not contain all the information about your medicine. If you have any questions or are not sure about anything, ask your doctor (or pharmacist), who will have access to further information.

YOU MAY WANT TO READ THIS LEAFLET AGAIN. PLEASE DO NOT THROW IT AWAY IMMEDIATELY.

This leaflet only applies to Lidocaine Hydrochloride BP Laryngojet 4%w/v

6963001C


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antimyasthenic Oral, Parenteral


Class Name: antimyasthenic (Oral route, Parenteral route)

Commonly used brand name(s)

In the U.S.

Aricept Cognex Exelon Mestinon Mestinon Timespan Mytelase Chloride Prostigmin Bromide Razadyne Razadyne ER Razadyne IR

In Canada

Reminyl

Available Dosage Forms:

Tablet Syrup Tablet, Extended Release Capsule, Extended Release Solution Tablet, Disintegrating Capsule Uses For This Medicine

Antimyasthenics are given by mouth or by injection to treat myasthenia gravis. Neostigmine may also be given by injection as a test for myasthenia gravis. Sometimes neostigmine is given by injection to prevent or treat certain urinary tract or intestinal disorders. In addition, neostigmine or pyridostigmine may be given by injection as an antidote to certain types of muscle relaxants used in surgery.

These medicines are available only with your doctor's prescription.

Before Using This Medicine 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

Although there is no specific information comparing use of antimyasthenics in children with use in other age groups, these medicines are not expected to cause different side effects or problems in children than they do 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. Although there is not much information comparing use of antimyasthenics in the elderly with use in other age groups, these medicines are not expected to cause different side effects or problems in older people than they do in younger adults.

Pregnancy

Antimyasthenics have not been reported to cause birth defects; however, muscle weakness has occurred temporarily in some newborn babies whose mothers took antimyasthenics during pregnancy.

Breast Feeding

Antimyasthenics have not been reported 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. When you are taking any of these medicines, 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 medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

Atropine Metoclopramide

Using medicines in this class 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.

Succinylcholine 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:

Intestinal blockage or Urinary tract blockage or Urinary tract infection—These medicines may make the condition worse. Proper Use of This Medicine

Your doctor may want you to take this medicine with food or milk to help lessen the chance of side effects. If you have any questions about how you should be taking this medicine, check with your doctor.

Take this medicine only as directed. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

If you are taking this medicine for myasthenia gravis:

When you first begin taking this medicine, your doctor may want you to keep a daily record of: the time you take each dose. how long you feel better after taking each dose. how long you feel worse. any side effects that occur.

This is to help your doctor decide whether the dose of this medicine should be increased or decreased and how often the medicine should be taken in order for it to be most effective in your condition.

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 ambenonium For oral dosage form (tablets): For myasthenia gravis: Adults and teenagers—At first, the dose is 5 milligrams (mg) three or four times per day. Then, if needed, the dose will be adjusted by your doctor. Children—The dose is based on body weight or size and must be determined by your doctor. The total daily dose is usually 300 micrograms (mcg) per kilogram (kg) (136 mcg per pound) of body weight or 10 mg per square meter of body surface area. This dose may be divided into three or four smaller doses. If needed, the total daily dose will be increased to 1.5 mg per kg (0.68 mg per pound) of body weight or 50 mg per square meter of body surface area. This dose may be divided into three or four smaller doses. For neostigmine For oral dosage form (tablets): For myasthenia gravis: Adults and teenagers—At first, the dose is 15 milligrams (mg) every three or four hours. Then, the dose is 150 mg taken over a twenty-four-hour period. Children—The dose is based on body weight or size and must be determined by your doctor. The total daily dose is usually 2 mg per kilogram (kg) (0.91 mg per pound) of body weight or 60 mg per square meter of body surface area. This dose may be divided into six to eight smaller doses. For injection dosage form: For myasthenia gravis: Adults and teenagers—The usual dose is 500 micrograms (mcg) injected into a muscle or under the skin. Children—The dose is based on body weight and must be determined by your doctor. It is usually 10 to 40 mcg per kg (4.5 to 18.2 mcg per pound) of body weight, injected into a muscle or under the skin, every two or three hours. For urinary tract or intestinal disorders: Adults and teenagers—The usual dose is 250 to 500 mcg, injected into a muscle or under the skin, as needed. Children—Use and dose must be determined by your doctor. For pyridostigmine For oral dosage forms (syrup and tablets): For myasthenia gravis: Adults and teenagers—At first, the dose is 30 to 60 milligrams (mg) every three or four hours. Then, the dose is 60 mg to 1.5 grams (usually 600 mg) per day. Children—The dose is based on body weight or size and must be determined by your doctor. The total daily dose is usually 7 mg per kilogram (kg) (3.2 mg per pound) of body weight or 200 mg per square meter of body surface area. This dose may be divided into five or six smaller doses. For long-acting oral dosage form (extended-release tablets): For myasthenia gravis: Adults and teenagers—The usual dose is 180 to 540 mg one or two times per day. Children—Dose must be determined by your doctor. For injection dosage form: For myasthenia gravis: Adults and teenagers—The usual dose is 2 mg, injected into a muscle or vein, every two or three hours. Children—The dose is based on body weight and must be determined by your doctor. It is usually 50 to 150 micrograms (mcg) per kg (22.7 to 68.1 mcg per pound) of body weight, injected into a muscle every four to six hours. 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.

Keep the syrup form of pyridostigmine from freezing.

Side Effects of This Medicine

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:

Symptoms of overdose Blurred vision clumsiness or unsteadiness confusion convulsions (seizures) diarrhea (severe) increase in bronchial secretions or watering of mouth (excessive) increasing muscle weakness (especially in the arms, neck, shoulders, and tongue) muscle cramps or twitching nausea or vomiting (severe) shortness of breath, troubled breathing, wheezing, or tightness in chest slow heartbeat slurred speech stomach cramps or pain (severe) unusual irritability, nervousness, restlessness, or fear unusual tiredness or weakness

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

Rare Redness, swelling, or pain at place of injection (for pyridostigmine injection only) skin rash (does not apply to ambenonium)

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 Diarrhea increased sweating increased watering of mouth nausea or vomiting stomach cramps or pain Less common Frequent urge to urinate increase in bronchial secretions unusually small pupils unusual watering of eyes

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 Healthcare (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 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 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 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 HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Healthcare does not assume any responsibility or risk for your use of the Thomson Healthcare products.


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Lidocaine Injection BP with Preservative 1 %


Read all of this leaflet carefully before you start taking this medicine. Keep this leaflet. You may need to read it again. If you have further questions, please ask your doctor or your pharmacist. This medicine has been prescribed for you personally and you should not pass it on to others. It may harm them, even if their symptoms are the same as yours. In this leaflet: 1. What your medicine is and what it is used for 2. Before you receive it 3. How it is administered 4. Possible side effects 5. Storing it

Lidocaine Injection with Preservative 1%

The active ingredient in this medicine is lidocaine hydrochloride. This is the new name for lignocaine hydrochloride. The ingredient itself has not changed.

This injection contains the active ingredient lidocaine hydrochloride 1%. Each ml contains 10 mg of lidocaine hydrochloride.

This injection also contains the following inactive ingredients:

Sodium chloride, methylhydroxybenzoate (E218), propylhydroxybenzoate (E216) and water for injections.

Holder of the Marketing Authorisation: hameln pharmaceuticals ltd Gloucester United Kingdom Manufacturer: hameln pharmaceuticals gmbh Langes Feld 13 31789 Hameln Germany What your medicine is and what it is used for

Lidocaine Injection with Preservative 1% is a clear, colourless, sterile and isotonic solution supplied in 20 and 50 ml clear glass vials, only intended to be given by injection under your skin (subcutaneously or SC).

Lidocaine is a local anaesthetic of the amide group. When injected into the skin, it causes loss of feeling before or during surgery. Lidocaine allows doctors to sew up cuts in the skin and to undertake operations without any pain even though the patient is awake.

Before you receive your medicine You should tell your doctor if: you think you are allergic to either lidocaine or the preservatives used in this injection. The preservatives are often known just as benzoates or hydroxy-benzoates. (See also section 4. Possible side effects for further information). you suffer from epilepsy or have fits you suffer from heart, lung or breathing disorders you have kidney or liver disease you suffer from myasthenia gravis (loss of muscle function and weakness) you are pregnant, likely to become pregnant or breast-feeding you have inflammation or infection in the area to be injected you are taking cimetidine (for stomach ulcer or heartburn) or beta-blockers, for example, propranolol (for angina, high blood pressure or other heart problems)

Please inform your doctor or pharmacist if you are taking or have recently taken any other medicines, even those not prescribed.

Driving and operating machinery: Depending on where and how lidocaine is used, it may affect your ability to drive or operate machinery. Ask your doctor about when it would be safe to drive or operate machines.

How your medicine is administered

The dose of a local anaesthetic will be different for different patients. Your healthcare professional will decide on the right amount for you, depending on:

Your age; your general physical condition; the reason the local anaesthetic is being given and other medicines you are taking or will receive before or after the local anaesthetic is given.

Adults: As a guide, 20 ml (equivalent to 200 mg) of Lidocaine Injection with Preservative 1% is the usual maximum dose. Your doctor will decide on the most appropriate dose for you. A smaller dose may be used if you are elderly or weak.

Children: A smaller dose is usually used for children depending on their age, physical condition and the procedure to be performed.

Possible side effects

Like all medicines, Lidocaine Injection with Preservative 1% can have side effects:

Lidocaine is generally well tolerated, but along with its needed effects, all medicine can cause unwanted effects. Lidocaine may occasionally cause the following side effects:

pain, inflammation or numbness at the site of injection after the effects of the injection should have worn off nervousness tremor blurred or double vision dizziness or drowsiness convulsions (seizures) nausea or vomiting breathing problems slowed heart beat or low blood pressure

Allergic reactions to lidocaine hydrochloride are rare, but tell your doctor immediately if you get any difficulty with your breathing, a rash or itchy skin.

Methylhydroxybenzoate (E218) and propylhydroxybenzoate (E216) may cause allergic reactions (possibly delayed), and exceptionally, bronchospasm.

If you notice any side effects not mentioned in this leaflet, please inform your doctor or pharmacist.

For patients going home before the numbness or loss of feeling caused by a local anaesthetic wears off:

During the time that the injected area feels numb, serious injury can occur without your knowing about it. Be especially careful to avoid injury until the anaesthetic wears off or feeling returns to the area.

Storing your medicine

Your doctor will store the vials in the outer carton in order to protect from light, between 10°C and 25°C and out of reach and sight of children.

Use by date

Your doctor will not use the drug after the expiry date shown on the vial and carton.

This leaflet was last updated on July 13th, 2004.

PL 01502/0035

43870/18/04


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Minims Lidocaine & Fluorescein


Minims*

Lidocaine and Fluorescein

4% w/v Lidocaine hydrochloride and 0.25% w/v Fluorescein Sodium

About your eye drops

The name of this medicine is Minims Lidocaine & Fluorescein. Each Minims unit contains a solution of 4% w/v Lidocaine hydrochloride with 0.25% w/v fluorescein sodium.

One of the active ingredients in this medicine is lidocaine hydrochloride. This is the new name for lignocaine hydrochloride. The ingredient itself has not changed.

It also contains purified water, povidone and hydrochloric acid. Each Minims unit is a sterile, single-use container which holds approximately 0.5ml of solution. Each carton holds 20 Minims units. Lidocaine is a local anaesthetic which temporarily numbs the surface of the eye. Fluorescein temporarily colours your eyes orange or green and helps your doctor or eye specialist to examine them.

Who makes your eye drops?

Minims Lidocaine and Fluorescein are manufactured by

Laboratoire Chauvin S.A. ZI Ripotier 07200/Aubenas France

The Marketing Authorisations for Minims Lidocaine and Fluorescein (PL 0033/0073 & PA 118/24/1) are held by

Chauvin Pharmaceuticals Ltd. 106 London Road Kingston-Upon-Thames KT2 6TN England What are your eye drops for?

Your eye drops are used to numb and stain the surface of the eye, for a short time only, to allow the doctor or eye specialist to examine your eye.

Most often, your eye drops are used to allow the pressure inside your eyes to be measured.

Before using your eye drops

You should not use this product if you are allergic to fluorescein or Lidocaine and other similar types of local anaesthetic.

This product should be used with care in eyes that are inflamed (red and painful).

Your eye drops are not intended for long term use. Frequent use of local anaesthetic in the eye over long periods of time may affect your eyesight.

Using your eye drops

The doctor or eye specialist will put the drops in for you. You may be asked to press on the inner corners of your eyes for a minute to stop the solution draining into your nose and throat through the tear ducts.

It is important to protect your eye from dust during the time your eye is numb. Your doctor or eye specialist will make sure that your eye is properly protected.

The Minims unit should be thrown away after a single use, even if some solution remains.

It is unlikely that you will suffer an overdose from Minims Lidocaine & Fluorescein, but if you do suddenly feel unwell after receiving the drops, tell your doctor or eye specialist.

Following administration of Minims Lidocaine & Fluorescein you may experience very rare side effects which includes redness and irriatation of the eye, swelling around the eye, rarely difficulty in breathing and symptoms of shock and itchy skin rash with raised red blotches.

After using your eye drops

Tell your doctor or eye specialist if you suffer from any unwanted effects after using Minims Lidocaine & Fluorescein, that are not mentioned in this leaflet.

Storing your eye drops

The expiry date is printed on each Minims unit overwrap and printed on the carton label. Do not use it after this date.

Your eye drops should be stored below 25°C and in original container to protect from light. Do not allow to freeze.

This leaflet applies only to Minims Lidocaine & Fluorescein, but does not contain all the

If you have any questions or are not sure about anything, ask a doctor, eye specialist or pharmacist.

Date of (Partial) Revision of Text:

August 2005.

* Trade Mark

Chauvin Pharmaceuticals Ltd. 106 London Road Kingston-Upon-Thames KT2 6TN England Tel:020 8781 2900 Fax:020 8781 2901

Art. 76441 0504128/4


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Emla


Generic Name: lidocaine and prilocaine topical (LY doh kayn and PRIL oh kayn TOP ik al)
Brand Names: Emla

What is lidocaine and prilocaine topical?

Lidocaine and prilocaine topical is a local anesthetic (numbing medication). It works by blocking nerve signals in your body.

Lidocaine and prilocaine topical is used to numb the skin, or surfaces of the penis or vagina, in preparation for a medical procedure or to lessen the pain of inserting a medical instrument such as a tube or speculum.

Lidocaine and prilocaine topical may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about lidocaine and prilocaine? An overdose of numbing medications can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood. This is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). However, overdose has also occurred in women treated with a numbing medicine before having a mammography. Overdose symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops). Your body may absorb more of this medication if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas. Skin that is cut or irritated may also absorb more topical medication than healthy skin.

Use the smallest amount of this medication needed to numb the skin or relieve pain. Do not use large amounts of lidocaine and prilocaine topical, or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present.

Do not use lidocaine and prilocaine topical if you have had an allergic reaction to a numbing medicine in the past.

Before lidocaine and prilocaine topical is applied, tell your doctor if you have liver disease, a history of allergic reaction to lidocaine or prilocaine, or a personal or family history of methemoglobinemia, or any genetic enzyme deficiency.

Lidocaine and prilocaine topical is for use only on the surface of your body. Avoid getting this medication in your eyes.

Avoid accidentally injuring treated skin areas while they are numb. Avoid coming into contact with very hot or very cold surfaces.

What should I discuss with my health care provider before using lidocaine and prilocaine topical? An overdose of numbing medications can cause fatal side effects if too much of the medicine is absorbed through your skin and into your blood.

Overdose is more likely to occur when using a numbing medicine without the advice of a medical doctor (such as during a cosmetic procedure like laser hair removal). However, overdose has also occurred in women treated with a numbing medicine before having a mammography. Symptoms may include uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops).

Do not use lidocaine and prilocaine topical if you have a blood cell disorder called methemoglobinemia.

Before lidocaine and prilocaine topical is applied, tell your doctor if you have:

liver disease;

a history of allergic reaction to lidocaine or prilocaine; or

a personal or family history of methemoglobinemia, or any genetic enzyme deficiency.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use lidocaine and prilocaine topical.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Lidocaine and prilocaine topical can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. How should I use lidocaine and prilocaine topical?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended.

Your body may absorb more of this medication if you use too much, if you apply it over large skin areas, or if you apply heat, bandages, or plastic wrap to treated skin areas. Skin that is cut or irritated may also absorb more topical medication than healthy skin.

Use the smallest amount of medicine needed to numb the skin or relieve pain. Do not use large amounts of lidocaine and prilocaine topical, or cover treated skin areas with a bandage or plastic wrap without medical advice. Be aware that many cosmetic procedures are performed without a medical doctor present.

This medication comes with instructions for safe and effective application. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

You should be lying down when lidocaine and prilocaine topical cream is applied.

Your medicine may have been supplied with bandages to cover the cream when it is applied to a small area on your skin. If using a bandage dressing, first apply a thick layer of the cream to the skin, taking care not to spread the cream out. Place the bandage over the cream and smooth down the edges until it is completely sealed around the cream.

Lidocaine and prilocaine topical is usually applied 1 to 2 hours before the start of a procedure that requires the treated area to be numb. Follow your doctor's instructions about the length of time the cream should be left on the skin.

Store lidocaine and prilocaine topical at room temperature away from moisture and heat. Do not allow the cream to freeze. What happens if I miss a dose?

Since lidocaine and prilocaine topical is used as needed, it is not likely that you will be on a dosing schedule.

What happens if I overdose? Seek emergency medical attention if you think you have used too much of this medicine. An overdose of lidocaine and prilocaine topical applied to the skin can cause life-threatening side effects such as uneven heartbeats, seizure (convulsions), coma, slowed breathing, or respiratory failure (breathing stops). What should I avoid while taking lidocaine and prilocaine topical? Lidocaine and prilocaine topical is for use only on the surface of your body. Avoid getting this medication in your eyes.

Avoid accidentally injuring treated skin areas while they are numb. Avoid coming into contact with very hot or very cold surfaces.

Lidocaine and prilocaine topical 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. Stop using lidocaine and prilocaine topical and call your doctor at once if you have any of these serious side effects:

severe burning, stinging, or sensitivity where the medicine is applied;

swelling or redness;

sudden dizziness or sleepiness after medicine is applied;

bruising or purple appearance of the skin; or

unusual sensations of temperature.

Less serious side effects may include:

mild burning where the medicine is applied;

skin redness; or

changes in skin color where the medicine was applied.

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.

What other drugs will affect lidocaine and prilocaine topical?

Before this medication is applied, tell your doctor if you are using any of the following drugs:

heart rhythm medication such as mexiletine (Mexitil);

acetaminophen (Tylenol);

chloroquine (Aralen);

dapsone;

nitrates or nitrites such as Imdur, Isordil, Monoket;

nitrofurantoin (Furadantin, Macrodantin, Macro-Bid);

phenobarbital (Luminal, Solfoton);

primaquine;

quinine; or

a sulfa drug (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others).

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

More Emla resources Emla Side Effects (in more detail) Emla Use in Pregnancy & Breastfeeding Emla Support Group 0 Reviews for Emla - Add your own review/rating Emla Topical Advanced Consumer (Micromedex) - Includes Dosage Information Emla Consumer Overview EMLA Prescribing Information (FDA) EMLA Cream MedFacts Consumer Leaflet (Wolters Kluwer) Compare Emla with other medications Anesthesia Where can I get more information? Your pharmacist can provide more information about lidocaine and prilocaine topical.

See also: Emla side effects (in more detail)


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Mytelase Chloride


Generic Name: ambenonium (am ben OH nee um)
Brand Names: Mytelase Chloride

What is Mytelase Chloride (ambenonium)?

Ambenonium affects chemicals in the body that are involved in the communication between nerve impulses and muscle movement.

Ambenonium is used to treat the symptoms of myasthenia gravis.

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

What is the most important information I should know about Mytelase Chloride (ambenonium)? You should not use this medication if you are allergic to ambenonium, or if you are using certain medications.

Be sure your doctor knows if you use: mecamylamine, (Inversine), atropine (Atreza, Donnatal, Sal-Tropine, Lomotil, Lomocot, and others), blood pressure medications, or a diuretic (water pill).

Before using ambenonium, tell your doctor if you have asthma, Parkinson's disease, or a bladder or bowel obstruction.

Your doctor may occasionally change your dose to make sure you get the best results. You may be asked to keep a daily record of when you took each dose and how long the effects lasted. This will help your doctor determine if your dose needs to be adjusted.

What should I discuss with my health care provider before taking Mytelase Chloride (ambenonium)? You should not use this medication if you are allergic to ambenonium, or if you are using certain medications. Be sure your doctor knows if you use:

mecamylamine, (Inversine);

atropine (Atreza, Donnatal, Sal-Tropine, Lomotil, Lomocot, and others);

blood pressure medications; or

a diuretic (water pill).

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

asthma;

Parkinson's disease; or

a bladder or bowel obstruction.

It is not known whether ambenonium will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether ambenonium passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using ambenonium. How should I take Mytelase Chloride (ambenonium)?

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

Ambenonium is usually taken every 3 to 4 hours during the day. Follow your doctor's instructions.

Your doctor may occasionally change your dose to make sure you get the best results. You may be asked to keep a daily record of when you took each dose and how long the effects lasted. This will help your doctor determine if your dose needs to be adjusted.

Store at room temperature away from moisture and heat. What happens if I miss a dose?

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

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

Overdose symptoms may include severe diarrhea, muscle twitching, anxiety, sweating, and cough or breathing problems.

What should I avoid while taking Mytelase Chloride (ambenonium)?

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

Mytelase Chloride (ambenonium) 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. Call your doctor at once if you have a serious side effect such as:

severe diarrhea;

muscle twitching; or

cough with sputum (mucus).

Less serious side effects may include:

sweating or urinating more than usual;

drooling, watery eyes;

warmth or tingly feeling;

nausea, vomiting, stomach pain;

blurred vision;

anxiety;

dizziness, spinning feeling; or

muscle cramps.

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.

What other drugs will affect Mytelase Chloride (ambenonium)?

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

atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm Scop);

bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

bladder or urinary medicines such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);

irritable bowel medicines such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine); or

ulcer medications such as glycopyrrolate (Robinul) or mepenzolate (Cantil).

This list is not complete and other drugs may interact with ambenonium. 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 Mytelase Chloride resources Mytelase Chloride Use in Pregnancy & Breastfeeding Mytelase Chloride Drug Interactions Mytelase Chloride Support Group 0 Reviews for Mytelase Chloride - Add your own review/rating Ambenonium MedFacts Consumer Leaflet (Wolters Kluwer) Compare Mytelase Chloride with other medications Myasthenia Gravis Where can I get more information? Your pharmacist can provide more information about ambenonium.
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Pyridostigmine Tablets


Pronunciation: peer-id-oh-STIG-meen
Generic Name: Pyridostigmine
Brand Name: Mestinon
Pyridostigmine is used for:

Treating myasthenia gravis. It may also be used for other conditions as determined by your doctor.

Pyridostigmine is a cholinesterase inhibitor. It works by improving nerve impulses in muscles so that the muscles are better able to work.

Do NOT use Pyridostigmine if: you are allergic to any ingredient in Pyridostigmine you are taking quinine or quinidine you have a stomach, intestinal, or urinary blockage

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

Before using Pyridostigmine:

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

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have heart problems (eg, heart block, slow heartbeat), a urinary tract infection, asthma, or kidney problems

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

Quinine or quinidine because effectiveness of Pyridostigmine may be decreased Succinylcholine because actions and side effects may be increased by Pyridostigmine

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

How to use Pyridostigmine:

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

Pyridostigmine may be taken with or without food. Take with food if it upsets your stomach. If you miss a dose of Pyridostigmine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Important safety information: Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Pyridostigmine. Use Pyridostigmine with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Pyridostigmine, discuss with your doctor the benefits and risks of using Pyridostigmine during pregnancy. Pyridostigmine is excreted in breast milk. If you are or will be breast-feeding while you are using Pyridostigmine, check with your doctor or pharmacist to discuss the risks to your baby. Possible side effects of Pyridostigmine:

All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no COMMON side effects have been reported with this product. Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); diarrhea; fainting; increased production of saliva; increased sweating; muscle weakness; nausea; small pupils; stomach cramps; trouble breathing; vision changes; vomiting; weakness.

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

See also: Pyridostigmine side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include diarrhea; fainting; increased production of saliva; increased sweating; muscle weakness; nausea; small pupils; stomach cramps; trouble breathing; vision changes; vomiting; weakness.

Proper storage of Pyridostigmine:

Store Pyridostigmine between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Pyridostigmine out of the reach of children and away from pets.

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

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

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Pyridostigmine resources Pyridostigmine Side Effects (in more detail) Pyridostigmine Dosage Pyridostigmine Use in Pregnancy & Breastfeeding Drug Images Pyridostigmine Drug Interactions Pyridostigmine Support Group 12 Reviews for Pyridostigmine - Add your own review/rating Compare Pyridostigmine with other medications Dysautonomia Myasthenia Gravis Nerve Agent Pretreatment Reversal of Nondepolarizing Muscle Relaxants
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Mestinon Controlled-Release Tablets


Pronunciation: peer-id-oh-STIG-meen
Generic Name: Pyridostigmine
Brand Name: Mestinon
Mestinon Controlled-Release Tablets are used for:

Treating myasthenia gravis. It may also be used for other conditions as determined by your doctor.

Mestinon Controlled-Release Tablets are a cholinesterase inhibitor. It works by improving nerve impulses in muscles so that the muscles are better able to work.

Do NOT use Mestinon Controlled-Release Tablets if: you are allergic to any ingredient in Mestinon Controlled-Release Tablets you are taking quinine or quinidine you have a stomach, intestinal, or urinary blockage

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

Before using Mestinon Controlled-Release Tablets:

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

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have heart problems (eg, heart block, slow heartbeat), a urinary tract infection, asthma, or kidney problems

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

Quinine or quinidine because effectiveness of Mestinon Controlled-Release Tablets may be decreased Succinylcholine because actions and side effects may be increased by Mestinon Controlled-Release Tablets

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

How to use Mestinon Controlled-Release Tablets:

Use Mestinon Controlled-Release Tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Mestinon Controlled-Release Tablets may be taken with or without food. Take with food if it upsets your stomach. Swallow Mestinon Controlled-Release Tablets whole. Do not break, crush, or chew before swallowing. If you miss a dose of Mestinon Controlled-Release Tablets, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Mestinon Controlled-Release Tablets.

Important safety information: Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Mestinon Controlled-Release Tablets. Use Mestinon Controlled-Release Tablets with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Mestinon Controlled-Release Tablets, discuss with your doctor the benefits and risks of using Mestinon Controlled-Release Tablets during pregnancy. Mestinon Controlled-Release Tablets are excreted in breast milk. If you are or will be breast-feeding while you are using Mestinon Controlled-Release Tablets, check with your doctor or pharmacist to discuss the risks to your baby. Possible side effects of Mestinon Controlled-Release Tablets:

All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no COMMON side effects have been reported with this product. Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); diarrhea; fainting; increased production of saliva; increased sweating; muscle weakness; nausea; small pupils; stomach cramps; trouble breathing; vision changes; vomiting; weakness.

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

See also: Mestinon side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include diarrhea; fainting; increased production of saliva; increased sweating; muscle weakness; nausea; small pupils; stomach cramps; trouble breathing; vision changes; vomiting; weakness.

Proper storage of Mestinon Controlled-Release Tablets:

Store Mestinon Controlled-Release Tablets between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Mestinon Controlled-Release Tablets out of the reach of children and away from pets.

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

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

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Mestinon resources Mestinon Side Effects (in more detail) Mestinon Use in Pregnancy & Breastfeeding Drug Images Mestinon Drug Interactions Mestinon Support Group 6 Reviews for Mestinon - Add your own review/rating Compare Mestinon with other medications Dysautonomia Myasthenia Gravis Nerve Agent Pretreatment Reversal of Nondepolarizing Muscle Relaxants
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Mestinon Timespan


Generic Name: pyridostigmine (py rid o STIG meen)
Brand Names: Mestinon, Mestinon Timespan

What is Mestinon Timespan (pyridostigmine)?

Pyridostigmine affects chemicals in the body that are involved in the communication between nerve impulses and muscle movement.

Pyridostigmine is used to treat the symptoms of myasthenia gravis. It is also used in military personnel who have been exposed to nerve gas.

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

What is the most important information I should know about Mestinon Timespan (pyridostigmine)? You should not use pyridostigmine if you are allergic to it, or if you have a bladder or bowel obstruction.

Before taking pyridostigmine, tell your doctor if you have asthma, kidney disease, an ulcer or other serious stomach disorder, high blood pressure, heart disease, overactive thyroid, or a history of seizures.

The amount and timing of this medicine is extremely important to the success of your treatment. Carefully follow your doctor's instructions about how much medicine to take and when to take it.

This medication may cause blurred vision or impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Your doctor may occasionally change your dose to make sure you get the best results. You may be asked to keep a daily record of when you took each dose and how long the effects lasted. This will help your doctor determine if your dose needs to be adjusted.

If you need surgery, tell the surgeon ahead of time that you are using pyridostigmine. You may need to stop using the medicine for a short time. What should I discuss with my health care provider before taking Mestinon Timespan (pyridostigmine)? You should not use pyridostigmine if you are allergic to it, or if you have a bladder or bowel obstruction.

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

asthma;

kidney disease;

an ulcer or other serious stomach disorder;

high blood pressure, heart disease;

overactive thyroid; or

a history of seizures.

It is not known whether pyridostigmine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether pyridostigmine 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. How should I take Mestinon Timespan (pyridostigmine)?

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

Take this medicine with food or milk if it upsets your stomach. Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

Measure liquid medicine with a special dose measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose measuring device, ask your pharmacist for one.

The amount and timing of this medicine is extremely important to the success of your treatment. Carefully follow your doctor's instructions about how much medicine to take and when to take it.

Your doctor may occasionally change your dose to make sure you get the best results. You may be asked to keep a daily record of when you took each dose and how long the effects lasted. This will help your doctor determine if your dose needs to be adjusted.

If you need surgery, tell the surgeon ahead of time that you are using pyridostigmine. You may need to stop using the medicine for a short time. Store at room temperature away from moisture and heat.

Keep the tablets in their original container, along with the canister of moisture-absorbing preservative that comes with this medicine.

What happens if I miss a dose?

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

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

Overdose symptoms may include nausea, vomiting, diarrhea, stomach cramps, sweating, blurred vision, drooling, and weak or shallow breathing.

Worsening muscle weakness, or no change in your myasthenia gravis symptoms, may also be signs of overdose.

What should I avoid while taking Mestinon Timespan (pyridostigmine)? This medication may cause blurred vision or impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly. Drinking alcohol can increase certain side effects of pyridostigmine. Mestinon Timespan (pyridostigmine) 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. Stop using pyridostigmine and call your doctor at once if you have any of these serious side effects:

extreme muscle weakness, muscle twicthing;

slurred speech, vision problems;

severe vomiting or diarrhea;

cough with mucus;

confusion, anxiety, panic attacks;

seizure (convulsions); or

worsening or no improvement in your symptoms of myasthenia gravis.

Less serious side effects may include:

cold sweat, pale skin;

urinating more than usual;

watery eyes;

mild nausea, vomiting, or upset stomach;

warmth or tingly feeling; or

mild rash or itching.

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.

What other drugs will affect Mestinon Timespan (pyridostigmine)?

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

atropine (Atreza, Sal-Tropine);

belladonna (Donnatal, and others);

benztropine (Cogentin);

clidinium (Quarzan);

clozapine (Clozaril, FazaClo);

dimenhydrinate (Dramamine);

methscopolamine (Pamine), scopolamine (Transderm Scop);

glycopyrrolate (Robinul);

mepenzolate (Cantil);

bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);

bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

cold medicine, allergy medicine, or sleeping pills that contain an antihistamine such as diphenhydramine (Tylenol PM) or doxylamine (Unisom);

heart rhythm medication such as quinidine (Quin-G), procainamide (Procan, Pronestyl), disopyramide (Norpace), flecaininde (Tambocor), mexiletine (Mexitil), propafenone, (Rythmol), and others;

irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine);

medicine to treat Alzheimer's dementia, such as donepezil (Aricept), rivastigmine (Exelon), or tacrine (Cognex); or

a steroid such as betamethasone (Celestone) or dexamethasone (Cortastat, Dexasone, Solurex, DexPak).

This list is not complete and other drugs may interact with pyridostigmine. 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 Mestinon Timespan resources Mestinon Timespan Side Effects (in more detail)Mestinon Timespan Use in Pregnancy & BreastfeedingDrug ImagesMestinon Timespan Drug InteractionsMestinon Timespan Support Group1 Review for Mestinon Timespan - Add your own review/rating Pyridostigmine Prescribing Information (FDA) Mestinon MedFacts Consumer Leaflet (Wolters Kluwer) Mestinon Prescribing Information (FDA) Pyridostigmine Bromide Monograph (AHFS DI) Regonol Prescribing Information (FDA) Compare Mestinon Timespan with other medications DysautonomiaMyasthenia GravisNerve Agent PretreatmentReversal of Nondepolarizing Muscle Relaxants Where can I get more information? Your pharmacist can provide more information about pyridostigmine.

See also: Mestinon Timespan side effects (in more detail)


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Prostigmin


Pronunciation: nee-oh-STIG-meen
Generic Name: Neostigmine
Brand Name: Prostigmin
Prostigmin is used for:

Treating myasthenia gravis. It may also be used for other conditions as determined by your doctor.

Prostigmin is a cholinesterase inhibitor. It works by improving the transmission of nerve impulses in muscles so that the muscles are better able to work.

Do NOT use Prostigmin if: you are allergic to any ingredient in Prostigmin you are taking procainamide, a quinine derivative (eg, quinidine), or succinylcholine

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

Before using Prostigmin:

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

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have a heart blockage, a slow heartbeat, a blockage of the intestines, or a urinary tract obstruction or infection

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

General anesthetics (eg, cyclopropane), procainamide, or quinine derivatives (eg, quinidine) because they may decrease the effectiveness of Prostigmin Beta-blockers (eg, propanolol) or succinylcholine because side effects may be increased by Prostigmin

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

How to use Prostigmin:

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

Prostigmin may be taken with or without food. If stomach upset occurs, take with food to reduce stomach irritation. If you miss a dose of Prostigmin, take it as soon as possible. If it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Important safety information: Prostigmin may cause drowsiness, dizziness, blurred vision, or fainting. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Prostigmin. Using Prostigmin alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks. Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Prostigmin. PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Prostigmin during pregnancy. It is unknown if Prostigmin is excreted in breast milk. If you are or will be breast-feeding while you are using Prostigmin, check with your doctor or pharmacist to discuss the risks to your baby. Possible side effects of Prostigmin:

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

Abdominal cramps; diarrhea; difficulty speaking; dilation of pupils; dizziness; drowsiness; excess saliva; frequent urination; gas; headache; increased sweating; joint pain; muscle twitching; weakness.

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

Severe allergic reactions (rash; itching; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; increased muscle weakness; interrupted breathing; irregular heartbeat; seizures; vision changes.

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

See also: Prostigmin side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blurred vision; cold sweating; difficulty swallowing; panic; severe anxiety; stomach cramps; vomiting.

Proper storage of Prostigmin:

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

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

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

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Prostigmin resources Prostigmin Side Effects (in more detail) Prostigmin Use in Pregnancy & Breastfeeding Prostigmin Drug Interactions Prostigmin Support Group 0 Reviews for Prostigmin - Add your own review/rating Neostigmine Professional Patient Advice (Wolters Kluwer) neostigmine Injection Advanced Consumer (Micromedex) - Includes Dosage Information neostigmine Concise Consumer Information (Cerner Multum) Neostigmine Bromide Monograph (AHFS DI) neostigmine Advanced Consumer (Micromedex) - Includes Dosage Information Compare Prostigmin with other medications Myasthenia Gravis
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Norflex


Generic Name: orphenadrine (or FEN a drin)
Brand Names: Norflex

What is Norflex (orphenadrine)?

Orphenadrine is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain.

Orphenadrine is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.

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

What is the most important information I should know about Norflex (orphenadrine)? Do not take this medication if you are allergic to orphenadrine, or if you have problems with urination, an enlarged prostate, glaucoma, a blockage in your stomach or intestines, trouble swallowing, or myasthenia gravis. Do not crush, chew, or break the extended-release tablet. Swallow the pill whole. Breaking or crushing the pill may cause too much of the drug to be released at one time. Orphenadrine may be habit-forming and should be used only by the person it was prescribed for. Orphenadrine should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Orphenadrine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol, which can increase some of the side effects of orphenadrine. What should I discuss with my healthcare provider before taking Norflex (orphenadrine)? Do not take this medication if you are allergic to orphenadrine, or if you have:

problems with urination;

enlarged prostate;

glaucoma;

a blockage in your stomach or intestines;

trouble swallowing; or

myasthenia gravis.

Before taking orphenadrine, tell your doctor if you are allergic to any drugs, or if you have:

heart disease;

a heart rhythm disorder; or

coronary artery disease.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take orphenadrine.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether orphenadrine 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. How should I take Norflex (orphenadrine)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medicine with a full glass of water. Do not crush, chew, or break the extended-release tablet. Swallow the pill whole. Breaking or crushing the pill may cause too much of the drug to be released at one time.

Orphenadrine is only part of a complete program of treatment that may also include rest, physical therapy, or other pain relief measures. Follow your doctor's instructions.

Orphenadrine may be habit-forming and should be used only by the person it was prescribed for. Orphenadrine should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Store orphenadrine at room temperature away from moisture, heat, and light. What happens if I miss a dose? Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention if you think you have used too much of this medicine. An overdose of orphenadrine can be fatal.

Overdose symptoms may include blurred vision, fast heart rate, confusion, weak or shallow breathing, cold or clammy skin, feeling like you might pass out, or seizure (convulsions).

What should I avoid while taking Norflex (orphenadrine)? Orphenadrine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol, which can increase some of the side effects of orphenadrine. Cold or allergy medicine, narcotic pain medicine, sleeping pills, and medicine for seizures, depression or anxiety can add to sleepiness caused by orphenadrine. Tell your doctor if you regularly use any of these medicines, or any other muscle relaxer. Norflex (orphenadrine) 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. Stop using orphenadrine and call your doctor at once if you have any of these serious side effects:

fast, pounding, or uneven heartbeats;

confusion, anxiety, agitation, tremors, hallucinations;

seizure (convulsions); or

urinating less than usual or not at all.

Less serious side effects may include:

dry mouth or throat;

blurred vision, dilated pupils;

headache;

drowsiness, dizziness;

nausea, vomiting, constipation; or

weakness.

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

What other drugs will affect Norflex (orphenadrine)?

Before taking orphenadrine, tell your doctor if you are taking any of the following medicines:

atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);

bronchodilators such as ipratroprium (Atrovent) or tiotropium (Spiriva);

glycopyrrolate (Robinul);

mepenzolate (Cantil);

bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare); or

irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine).

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

More Norflex resources Norflex Side Effects (in more detail) Norflex Use in Pregnancy & Breastfeeding Drug Images Norflex Drug Interactions Norflex Support Group 5 Reviews for Norflex - Add your own review/rating Norflex Prescribing Information (FDA) Norflex Monograph (AHFS DI) Norflex Advanced Consumer (Micromedex) - Includes Dosage Information Norflex MedFacts Consumer Leaflet (Wolters Kluwer) Antiflex Advanced Consumer (Micromedex) - Includes Dosage Information Compare Norflex with other medications Migraine Muscle Spasm Where can I get more information? Your pharmacist can provide more information about orphenadrine.

See also: Norflex side effects (in more detail)


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UAD Caine


Generic Name: lidocaine injection (LYE doe kane)
Brand Names: Anestacaine, UAD Caine, Xylocaine HCl, Xylocaine-MPF

What is UAD Caine (lidocaine injection)?

Lidocaine is a local anesthetic (numbing medication). It works by blocking nerve signals in your body.

Lidocaine injection is used to numb an area of your body to help reduce pain or discomfort caused by invasive medical procedures such as surgery, needle punctures, or insertion of a catheter or breathing tube.

Lidocaine injection is also given in an epidural (spinal block) to reduce the discomfort of contractions during labor.

Lidocaine injection is sometimes used to treat irregular heart rhythms that may signal a possible heart attack.

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

What is the most important information I should know about UAD Caine (lidocaine injection)? You should not receive this medication if you are allergic to lidocaine or any other type of numbing medicine.

Before you receive lidocaine injection, tell your doctor if you have liver or kidney disease, heart disease, coronary artery disease, circulation problems, or a history of malignant hyperthermia.

To treat irregular heart rhythms, your doctor may prescribe a LidoPen auto-injector. This is a prefilled automatic injection device to be used in an emergency. Keep the device with you at all times.

Your doctor will describe the signs and symptoms to watch for when deciding when it's time to use lidocaine injection at home. Never use the LidoPen auto-injector without first calling your doctor.

With the LidoPen auto-injector you will also receive a CardioBeeper to transmit your heart rate and rhythm to your doctor over a telephone. Read all provided instructions and practice using the CardioBeeper.

Lidocaine can cause side effects that may impair your thinking or reactions. Unless absolutely necessary, do not drive after using this medication What should I discuss with my healthcare provider before receiving UAD Caine (lidocaine injection)? You should not receive this medication if you are allergic to lidocaine or any other type of numbing medicine.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use lidocaine injection:

liver disease; kidney disease;

heart disease;

coronary artery disease, circulation problems; or

a history of malignant hyperthermia.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether lidocaine injection 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. How is lidocaine injection given?

Lidocaine is given as an injection through a needle placed into a vein or directly into the body area to be numbed. Your doctor, nurse, or other healthcare provider will give you this injection.

Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are receiving lidocaine injection in a hospital setting.

To treat irregular heart rhythms, you may be shown how to use your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of needles and other items used in giving the medicine.

The LidoPen auto-injector is a prefilled automatic injection device to be used in an emergency. Keep the device with you at all times. Your doctor will describe the signs and symptoms to watch for when deciding when it's time to use the injection.

Never use the LidoPen auto-injector without first calling your doctor.

Do not use the auto-injector in or near a vein or into your buttocks. Inject the medication only in your upper thigh or upper arm.

With the LidoPen auto-injector you will also receive a CardioBeeper. This device is used to transmit your heart rate and rhythm to your doctor over a telephone. Read all provided instructions and practice using the CardioBeeper so you will be able to quickly use it in an emergency.

Store the LidoPen auto-injector at room temperature away from moisture and extreme hot or cold. What happens if I miss a dose?

Since lidocaine injection is used only when needed, you are not likely to be on a dosing schedule.

Never use the LidoPen auto-injector without first calling your doctor.

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

Overdose symptoms may include drowsiness, confusion, nervousness, ringing in your ears, blurred vision, feeling hot or cold, numbness, muscle twitches, uneven heartbeats, seizure (convulsions), slowed breathing, or respiratory failure (breathing stops).

What should I avoid while receiving UAD Caine (lidocaine injection)? Lidocaine can cause side effects that may impair your thinking or reactions. Unless absolutely necessary, do not drive after using this medication

Avoid eating or chewing within 1 hour after lidocaine injection is used to numb your mouth or throat. You may have trouble swallowing which could lead to choking. You may also accidentally bite the inside of your mouth if you are still numb an hour after treatment with lidocaine injection.

UAD Caine (lidocaine injection) 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 any of these serious side effects:

feeling anxious, shaky, dizzy, restless, or depressed;

drowsiness, vomiting, ringing in your ears, blurred vision;

confusion, twitching, seizure (convulsions);

fast heart rate, rapid breathing, feeling hot or cold;

weak or shallow breathing, slow heart rate, weak pulse; or

feeling like you might pass out.

Less serious side effects include:

mild bruising, redness, itching, or swelling where the medication was injected;

mild dizziness;

nausea;

numbness in places where the medicine is accidentally applied.

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.

What other drugs will affect UAD Caine (lidocaine injection)?

There may be other drugs that can interact with lidocaine injection. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More UAD Caine resources UAD Caine Side Effects (in more detail) UAD Caine Use in Pregnancy & Breastfeeding UAD Caine Drug Interactions UAD Caine Support Group 0 Reviews for UAD Caine - Add your own review/rating Lidocaine Aerosol MedFacts Consumer Leaflet (Wolters Kluwer) lidocaine Intradermal Advanced Consumer (Micromedex) - Includes Dosage Information Lidocaine Prescribing Information (FDA) Lidocaine Hydrochloride Monograph (AHFS DI) Lidocaine Hydrochloride (Local Anesthetic) Monograph (AHFS DI) Compare UAD Caine with other medications Anesthesia Arrhythmia Ventricular Fibrillation Ventricular Tachycardia Where can I get more information? Your doctor or pharmacist can provide more information about lidocaine injection.

See also: UAD Caine side effects (in more detail)


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Immune globulins


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.

In healthy individuals immune globulins are made by plasma cells when exposed by an immunogen such as a virus. Immune globulins act as antibodies against an infection. They are made up of different classes and subclasses of molecules.

The immune globulin used for therapeutic purposes is made from healthy human blood that has a high level of antibodies. Immune globulins are given to those with a weak immune system to strengthen or act as the body

See also

Medical conditions associated with immune globulins:

Autoimmune Neutropenia Bone Marrow Transplantation Botulism Chronic Inflammatory Demyelinating Polyradiculoneuropathy Chronic Lymphocytic Leukemia Cytomegalovirus Infection Evan's Syndrome Exposure to Hepatitis B Virus Hepatitis A HIV Infection Idiopathic Thrombocytopenic Purpura Kawasaki Disease Measles Myasthenia Gravis Polymyositis/Dermatomyositis Primary Immunodeficiency Syndrome Rabies Prophylaxis Respiratory Syncytial Virus Rh-Isoimmunization Rubella Smallpox Vaccine Reaction Tetanus Tetanus Prophylaxis Varicella-Zoster Drug List: Vivaglobin Gamunex Octagam Privigen Hizentra Winrho-Sdf Rhophylac Babybig Baygam Bayhep-B Bayrab Bayrho-D Baytet Carimune-Igiv Cytogam Flebogamma Gamastan-S-D Gamimune Gamimune-N-10-Igiv Gammagard Gammagard-S-D-Igiv Gammaplex-Igiv Gammar-Piv Gamunex-C Hepagam_B Hepagam-B-Novaplus Hyperhep-B Hyperrho-S-D-Full-Dose Hyperrho-S-D-Mini-Dose Hypertet-S-D Imogam-Rabies-Ht Iveegam-En-Igiv Micrhogam Micrhogam-Ultra-Filtered-Plus Nabi-Hb Nabi-Hb-Novaplus Panglobulin-Nf Polygam-S-D-Igiv Respigam Rhogam Rhogam-Ultra-Filtered-Plus Sandoglobulin-Igiv Synagis
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Persantin 100mg tablets


1. Name Of The Medicinal Product

PERSANTIN Tablets 100 mg

2. Qualitative And Quantitative Composition

Dipyridamole 100 mg.

For excipients, see 6.1.

3. Pharmaceutical Form

Coated Tablets.

Round, white, biconvex, shiny, sugar-coated tablets.

4. Clinical Particulars 4.1 Therapeutic Indications

An adjunct to oral anti-coagulation for prophylaxis of thrombo-embolism associated with prosthetic heart valves.

4.2 Posology And Method Of Administration

Adults: 300-600 mg daily in three or four doses.

Children: PERSANTIN is not recommended for children.

PERSANTIN should usually be taken before meals.

4.3 Contraindications

Hypersensitivity to any of the components of the product.

4.4 Special Warnings And Precautions For Use

Among other properties, dipyridamole acts as a vasodilator. It should be used with caution in patients with severe coronary artery disease, including unstable angina and/or recent myocardial infarction, left ventricular outflow obstruction or haemodynamic instability (e.g. decompensated heart failure).

Patients being treated with regular oral doses of PERSANTIN should not receive additional intravenous dipyridamole. Clinical experience suggests that patients being treated with oral dipyridamole who also require pharmacological stress testing with intravenous dipyridamole, should discontinue drugs containing oral dipyridamole for twenty-four hours prior to stress testing.

In patients with myasthenia gravis, readjustment of therapy may be necessary after changes in dipyridamole dosage (see Drug Interactions).

PERSANTIN should be used with caution in patients with coagulation disorders.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

Dipyridamole increases plasma levels and cardiovascular effects of adenosine. Adjustment of adenosine dosage should be considered if use with dipyridamole is unavoidable.

There is evidence that the effects of aspirin and dipyridamole on platelet behaviour are additive.

The administration of antacids may reduce the efficacy of PERSANTIN. It is possible that PERSANTIN may enhance the effects of oral anti-coagulants.

When dipyridamole is used in combination with anticoagulants and acetylsalicylic acid, the statements on intolerance and risks for these preparations must be observed. Addition of dipyridamole to acetylsalicylic acid does not increase the incidence of bleeding events. When dipyridamole was administered concomitantly with warfarin, bleeding was no greater in frequency or severity than that observed when warfarin was administered alone.

Dipyridamole may increase the hypotensive effect of drugs which reduce blood pressure and may counteract the anticholinesterase effect of cholinesterase inhibitors thereby potentially aggravating myasthenia gravis.

4.6 Pregnancy And Lactation

There is inadequate evidence of safety in human pregnancy, but PERSANTIN has been used for many years without apparent ill-consequence. Animal studies have shown no hazard. Medicines should not be used in pregnancy, especially the first trimester unless the expected benefit is thought to outweigh the possible risk to the foetus.

Dipyridamole is excreted in breast milk at levels approximately 6% of the plasma concentration. Therefore PERSANTIN should only be used during lactation if considered essential by the physician.

4.7 Effects On Ability To Drive And Use Machines

None stated.

4.8 Undesirable Effects

If these occur, it is usually during the early part of treatment. The vasodilating properties of PERSANTIN may occasionally produce a vascular headache which normally disappears with long-term use. Vomiting, diarrhoea and symptoms such as dizziness, faintness, nausea, dyspepsia and myalgia have been observed.

As a result of its vasodilator properties, PERSANTIN may cause hypotension, hot flushes and tachycardia. Worsening of symptoms of coronary heart disease such as angina and arrhythmias.

Hypersensitivity reactions such as rash, urticaria, severe bronchospasm and angio-oedema have been reported.

In very rare cases, increased bleeding during or after surgery has been observed. Isolated cases of thrombocytopenia have been reported in conjunction with treatment with PERSANTIN.

Dipyridamole has been shown to be incorporated into gallstones.

4.9 Overdose

Symptoms

Due to the low number of observations, experience with dipyridamole overdose is limited. Symptoms such as a warm feeling, flushes, sweating, restlessness, feeling of weakness, dizziness and anginal complaints can be expected. A drop in blood pressure and tachycardia might be observed.

Therapy

Symptomatic therapy is recommended. Administration of xanthine derivatives (e.g. aminophylline) may reverse the haemodynamic effects of dipyridamole overdose. Due to its wide distribution to tissues and its predominantly hepatic elimination, dipyridamole is not likely to be accessible to enhanced removal procedures.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

Dipyridamole has an antithrombotic action based on its ability to modify various aspects of platelet function, such as platelet aggregation, adhesion and survival, which have been shown to be factors associated with the initiation of thrombus formation. Dipyridamole also has coronary vasodilator properties.

5.2 Pharmacokinetic Properties

Oral administration of dipyridamole gives a peak plasma level 1-2 hours after dosing. The drug has an apparent bioavailability of 37-66%.

In man the volume of distribution is 2.43±1.1 l/kg. When given orally, the elimination half life is 30-50 minutes. In man the major route of excretion of dipyridamole is in the bile.

5.3 Preclinical Safety Data

None

6. Pharmaceutical Particulars 6.1 List Of Excipients

Core:

Calcium hydrogen phosphate, anhydrous

Maize starch, dried

Maize starch, soluble

Colloidal silica

Magnesium stearate

Coating:

Sucrose

Talc

Acacia

Titanium dioxide, E171

Macrogol 6000

Wax, bleached

Carnauba Wax

6.2 Incompatibilities

Not applicable.

6.3 Shelf Life

5 years.

6.4 Special Precautions For Storage

Do not store above 30°C. Protect from light.

6.5 Nature And Contents Of Container

Marketed packs: Blister pack containing 84 white sugar coated tablets

Non-marketed packs: Blister packs of 100 and 112 white sugar coated tablets.

6.6 Special Precautions For Disposal And Other Handling

None.

7. Marketing Authorisation Holder

Boehringer Ingelheim Limited

Ellesfield Avenue

Bracknell

Berkshire

RG12 8YS

United Kingdom

8. Marketing Authorisation Number(S)

PL 0015/5016R

9. Date Of First Authorisation/Renewal Of The Authorisation

24 November 1988 / 01 May 2007

10. Date Of Revision Of The Text

01/05/2007

11. Legal category

POM

P2c/100mg/UK/SPC/7


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Boots Pharmacy Anaesthetic Throat Spray


Boots Pharmacy Anaesthetic Throat Spray

(Lidocaine Hydrochloride)

Specifically to:

Relieve severe sore throat pain

20 ml e

Read all of this carton for full instructions.

A local anaesthetic spray to provide direct and soothing relief from the pain of severe sore throats.

Before you use this medicine Do not use: If you are allergic to any of the ingredients If you have asthma, or difficulty breathing If you are under 12 years of age Talk to your pharmacist or doctor: If you are receiving any medical treatment If you have a high fever, headache, feel sick or are being sick as well as having a sore throat If you are pregnant or breastfeeding

This spray may cause your tongue to become numb. You must take care when eating or drinking hot foods or drinks.

How to use this medicine

Use at the back of the throat only.

Do not breathe in when you use the spray, or get the spray in your eyes.

To spray: Swing the nozzle through 90° and press.

Before first use or after storing the spray for a long time: Press the spray 3 times away from the face into a sink.

Adults and children of 12 years and over
Three sprays at the back of the throat every 3 hours, if you need to.
Don’t use more than 6 times in any 24 hours.

Do not use for children under 12 years.

Do not use more than the amount recommended above.

If you use too much:

Talk to a doctor straight away. Take your medicine with you.

If symptoms do not go away, talk to your doctor.

Possible side effects

Most people will not have problems, but some may get some.

If you get any of these serious side effects, stop using the spray.

See a doctor at once:

Difficulty in breathing, swelling of the face, neck, tongue or throat (severe allergic reactions)

If you notice any side effect not listed here, please tell your pharmacist or doctor.

Keep all medicines out of the sight and reach of children.

Use by the date on the side of the carton.

Active ingredient

This liquid contains Lidocaine Hydrochloride 2% w/v.

Also contains: purified water, ethanol (30 vol %), sorbitol (E420), sodium citrate, saccharin, quinoline yellow (E104), patent blue V (E131), flavours (peppermint, levomenthol, aniseed).

PL00014/0430

P

Text prepared 10/07

Manufactured for the Marketing Authorisation holder Boots Pharmacy Nottingham NG2 3AA

by

The Boots Company PLC Nottingham NG2 3AA

Contains approximately 150 sprays.

If you need more advice ask your pharmacist.

BTC22021 vE 15/05/08


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Pronestyl injection


Generic Name: procainamide (injection) (proe KANE a mide)
Brand Names: Pronestyl

What is Pronestyl (procainamide (injection))?

Procainamide affects the way your heart beats.

Procainamide is used to help keep the heart beating normally in people with certain heart rhythm disorders of the ventricles (the lower chambers of the heart that allow blood to flow out of the heart).

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

What is the most important information I should know about Pronestyl (procainamide (injection))? Procainamide is given in a hospital setting. Your heart rate, breathing, blood pressure and other vital signs will be watched closely while you are receiving procainamide. You should not use this medication if you are allergic to procainamide, or if you have a serious heart condition such as "AV block" (unless you have a pacemaker), lupus, or a history of "Long QT syndrome." If possible, before you receive procainamide, tell your doctor if you have congestive heart failure, circulation problems, a history of heart attack or stroke (including "mini-stroke"), a weak immune system, kidney or liver disease, myasthenia gravis, asthma, or if you are allergic to aspirin, sulfites, or any type of numbing medicine.

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.

Procainamide can lower blood cells that help your body fight infections. Tell your doctor if you develop signs of infection such as fever, chills, sore throat, flu symptoms, easy bruising or bleeding (nosebleeds, bleeding gums), loss of appetite, nausea and vomiting, sores in your mouth and throat, or unusual weakness.

What should I discuss with my healthcare provider before receiving Pronestyl (procainamide (injection))? You should not receive this medication if you are allergic to procainamide, or if you have:

a serious heart condition such as "AV block" (unless you have a pacemaker);

lupus; or

a history of "Long QT syndrome."

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

congestive heart failure;

circulation problems;

a history of heart attack or stroke (including "mini-stroke");

a weak immune system;

kidney disease; liver disease;

myasthenia gravis;

asthma or sulfite allergy;

if you are allergic to aspirin; or

if you have ever had an allergic reaction to a numbing medicine.

FDA pregnancy category C. It is not known whether procainamide will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Procainamide can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using procainamide. In an emergency situation, it may not be possible before you are treated with procainamide 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 procainamide injection given?

Procainamide is injected into a muscle or into a vein through an IV. You will receive procainamide injection in a hospital setting where your heart can be monitored in case the medication causes serious side effects.

Your heart rate will be constantly monitored using an electrocardiograph or ECG (sometimes called an EKG). This machine measures electrical activity of the heart. Your breathing, blood pressure and other vital signs will be watched closely while you are receiving procainamide.

Procainamide can lower blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Contact your doctor at once if you develop signs of infection such as fever, chills, sore throat, flu symptoms, easy bruising or bleeding (nosebleeds, bleeding gums), loss of appetite, nausea and vomiting, mouth sores, or unusual weakness.

Your doctor will need to check your progress on a regular basis. Do not miss any scheduled appointments. What happens if I miss a dose?

Since procainamide is given by a healthcare professional in an emergency setting, you are not likely to miss a dose.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Overdose symptoms may include drowsiness, tremors, weak or shallow breathing, and fainting.

What should I avoid while receiving Pronestyl (procainamide (injection))?

Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Pronestyl (procainamide (injection)) 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. Tell your caregivers at once if you have a serious side effect such as:

a new or a worsening irregular heartbeat pattern;

chest pain, wheezing, trouble breathing;

feeling like you might pass out;

signs of infection such as fever, chills, sore throat, flu symptoms, pale skin, easy bruising or bleeding (nosebleeds, bleeding gums), loss of appetite, nausea and vomiting, sores in your mouth and throat, unusual weakness;

depressed mood, hallucinations, severe dizziness;

upper stomach pain, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

joint pain or swelling with fever, swollen glands, muscle pain or weakness, unusual thoughts or behavior, patchy skin color, red spots.

Less serious side effects may include:

mild dizziness or tired feeling;

flushing (warmth, redness, or tingly feeling); or

mild itching or rash.

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.

What other drugs will affect Pronestyl (procainamide (injection))?

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

cimetidine (Tagamet, Tagamet HB);

digoxin (digitalis, Lanoxin);

glycopyrrolate (Robinul);

mepenzolate (Cantil);

atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), benztropine (Cogentin);

dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm Scop);

bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine).

bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare); or

heart rhythm medications such as amiodarone (Cordarone, Pacerone), quinidine (Quin-G), disopyramide (Norpace), flecaininde (Tambocor), mexiletine (Mexitil), propafenone, (Rythmol), and others.

This list is not complete and other drugs may interact with procainamide. 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.

Where can I find more information? Your doctor or pharmacist can provide more information about procainamide injection.

See also: Pronestyl side effects (in more detail)

More Pronestyl resources Pronestyl Side Effects (in more detail) Pronestyl Use in Pregnancy & Breastfeeding Pronestyl Drug Interactions Pronestyl Support Group 0 Reviews for Pronestyl - Add your own review/rating Compare Pronestyl with other medications Arrhythmia
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Timolol Eye Drops 0.25%, Timolol Eye Drops 0.5%


TIMOLOL Eye drops 0.25 %

TIMOLOL Eye drops 0.5 %

Timolol 2.5 mg/ml (as timolol maleate 3.4mg/ml)

Timolol 5.0 mg/ml (as timolol maleate 6.8mg/ml)

Please read this leaflet carefully before you start to take your medicine.

Keep this leaflet. You may need to read it again. If you have any further questions, please 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.

This medicine will be called Timolol in this leaflet.

In this leaflet:

1. What Timolol is and what is it used for
2. Before you use Timolol
3. How to use Timolol
4. Possible side effects
5. How to store Timolol
6. Further information

What Timolol Is And What Is It Used For

The active ingredient timolol belongs to a group of medicines called beta-blockers.

Timolol is used to treat raised pressure of eye (intraocular pressure) which occurs in various conditions including glaucoma and ocular hypertension.

Before You Use Timolol

Do not use if you:

are allergic (hypersensitive) to timolol maleate or beta-blockers or to any other ingredient of this medicine (see section 6. for more details) suffer from asthma or have history of asthma or any other breathing disorder suffer from a condition known as heart block, which causes your heart to beat at an abnormally slow rate suffer from cardiac failure, a condition where your heart cannot work normally. Take special care with Timolol

Before you use Timolol please tell your doctor if you:

are taking beta-blocking agents or calcium antagonists by mouth or as eye drops are suffering from muscle weakness, condition called myasthenia gravis Taking other medicines

Check with your doctor before using the eye drops if you are taking or using any other medicines, in particular:

a calcium antagonist (e.g. verapamil or diltiazem) often used to treat high blood pressure, angina, or an abnormal heartbeat digoxin, often used to treat heart failure or an abnormal heartbeat medicines known as a catecholamine-depleting agents (e.g. rauwolfia alkaloids/reserpine) used to treat high blood pressure a pressor amine (e.g. adrenaline) used to treat severe allergic reaction clonidine to treat high blood pressure quinidine, a medicine often used to treat abnormal heartbeat other beta-blockers (e.g. other preparations of timolol both oral and/or ocular), which belong to the same group of medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without any prescription.

Pregnancy and breast-feeding

Ask your doctor or pharmacist for advice before taking any medicines.

Timolol should not be used during pregnancy and breast-feeding unless considered essential by your doctor.

Driving and using machines

No effects on ability to drive and use machines have been reported. However do not drive or operate machines if you experience any visual disturbance after using the product. Wait until this clears before driving or using machines.

Important information about some of the ingredients of Timolol Eye Drops:

The eye drops contain benzalkonium chloride as preservative which may cause eye irritation. Avoid contact with soft contact lenses. Remove contact lenses before using the eye drops and wait at least 15 minutes before reinserting. The preservative is known to discolour soft contact lenses.

How To Use Timolol

Always use Timolol exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

The usual starting dose is one drop of 0.25% eye drops into each affected eye(s) twice daily, approximately 12 hours apart. Your doctor will change your treatment as necessary. If you are using in combination with another eye drop medicine, wait 5-15 minutes before applying the second eye drop.

Use in children:

It is not recommended to use Timolol in children under 12 years of age.

Instructions for use:

(please also refer to pictograms at the end of the leaflet)

First wash your hands Avoid touching the eye (or any other surface) with the tip of the bottle If you wear soft contact lenses, they should be removed before using the eye drops and wait at least 15 minutes before reinserting These drops are supplied as a sealed bottle with a spiked cap. When using the bottle for the first time, screw the cap down tightly in order to pierce the tip of the bottle Tilt your head back and look at the ceiling Pull the lower eyelid gently downwards Hold the bottle upside down above the eye and gently squeeze the bottle to release a drop into your eye Keep the affected eye closed and press your fingertip against the inside corner of the closed eye, and hold for 1 minute Repeat for the other eye if necessary Replace and tighten the cap immediately after use.

Be careful not to touch the tip of the bottle on your eye or on any other surface.

Ocular solutions, if handled wrongly, can become contaminated by common bacteria and cause eye infections. If you do develop any other eye condition whilst using this product, see your doctor immediately.

Keep using your medicine until your doctor tells you to stop.

If you use more Timolol than you should

If you accidentally use too much, contact your doctor or go to the nearest hospital casualty department immediately.

Overdose

There is no experience of an overdosage with Timolol which is unlikely when given as eye drops.

The signs of overdosage include slow heart rate, drop of blood pressure, breathing difficulties, and heart attack.

If you forget to use Timolol

Apply the drops as soon as you remember. However, if it is almost time for your next dose, do not double your dose and carry on with the normal schedule dose.

Possible Side Effects

Like all medicines, Timolol can cause side effects, although not everybody gets them.

If you experience a rare (these may affect between 1 in 1,000 and 1 in 10,000 patients) but serious allergic reaction (difficulty breathing, closing of the throat, swelling of the lips, tongue, or face or hives) to timolol, stop using the medication and contact your doctor immediately.

Please tell your doctor if you notice any of the following side effects

irritation of the outer surface of the eye (conjunctivitis, keratitis and decreased corneal sensitivity) and of the eyelids (blepharitis) visual disturbance chest pain, high or low blood pressure, palpitations, irregular heart beat, heart failure, heart block, heart attack, stroke, swelling or coldness of your hands, feet and extremities, caused by constriction of the blood vessels in response to stimuli, including the cold dry mouth, nasal congestion pain or burning in the stomach, loss of appetite low blood pressure with faintness, dizziness depression, anxiety and other psychiatric disturbance increased signs of the condition myasthenia gravis (weakness, dropping eyelids, double vision) nausea headache weakness and somnolence hair loss

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.

How To Store Timolol

Keep out of the reach and sight of children.

Do not store at a temperature above 25°C.

Protect from light.

Discard the bottle 28 days after opening, even if there is solution remaining.

Do not use Timolol after the expiry date which is stated on the bottle and on the carton the bottle is packed in.

Further Information What Timolol contains

The active ingredient is timolol maleate, where 5mg/ml timolol is equivalent to 6.8mg/ml of timolol maleate and 2.5mg/ml timolol is equivalent to 3.4mg/ml of timolol maleate.

This product also contains sodium dihydrogen phosphate dihydrate, disodium edetate, disodium phosphate dodecahydrate, benzalkonium chloride (as preservative) 0.01% w/v, sodium hydroxide, sodium chloride and water for injection.

What Timolol look like and contents of the pack

One bottle of Timolol contains 5 ml solution.

Your medicine is a clear colourless, sterile solution.

Marketing Authorisation Holder and Manufacturer FDC International Ltd At: Unit 6, Fulcrum 1 Solent Way Whiteley Fareham Hampshire PO15 7FE

PL numbers: 15872/0001 (0.25%) and 15872/0002 (0.5%)

Hard to see or read the leaflet? Call+ 44(0) 1489 565222 for help.

This leaflet was last approved in: 09/2009

MODE OF USE

Bottle as received

Tighten the cap on the nozzle till the cap touches the shoulder.

The spike in the cap will pierce the tip of the bottle.

Tilt head backwards. Dispense drops with gentle pressure. Do not touch dropper tip to the surface of the eye.

Replace cap after every use, and screw the cap down

W1IOLL02AESGB


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Cipro


Pronunciation: SIP-roe-FLOX-a-sin
Generic Name: Ciprofloxacin
Brand Name: Cipro

Cipro is associated with an increased risk of tendon problems. These include pain, swelling, inflammation, and possible breakage of tendons. The risk of tendon problems is greater in patients who are older than 60 years, patients who take corticosteroids (eg, prednisone), and in those who have received kidney, heart, or lung transplants. The Achilles tendon in the back of the foot/ankle is most often affected. However, problems may also occur in other tendons (eg, in the shoulder, arm, hand). Problems may occur while you take Cipro or up to several months after you stop taking it.

Signs of tendon problems may include pain, soreness, redness, or swelling of a tendon or joint; bruising right after an injury in a tendon area; hearing or feeling a snap or pop in a joint or tendon area; or inability to move or bear weight on a joint or tendon area. Tell your doctor right away if you experience any of these symptoms while you take Cipro or within several months after you stop taking it.

Cipro may worsen muscle weakness and breathing problems in patients with myasthenia gravis. Do not take Cipro if you have a history of myasthenia gravis.


Cipro is used for:

Treating bacterial infections. It may also be used to prevent or slow anthrax after exposure.

Cipro is a fluoroquinolone antibiotic used to kill sensitive bacteria. It works by stopping the production of essential proteins needed by the bacteria to survive.

Do NOT use Cipro if: you are allergic to any ingredient in Cipro or to any other fluoroquinolone (eg, levofloxacin) you have a history of myasthenia gravis you are taking tizanidine or you have recently received a live oral typhoid vaccine

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

Before using Cipro:

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

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have a stomach infection, liver problems, brain or nervous system problems, increased pressure in the brain, Alzheimer disease, brain blood vessel problems, muscle problems (eg, myasthenia gravis), or a history of seizures if you have a history of severe or persistent diarrhea, skin sensitivity to the sun, low blood potassium levels, heart problems, or irregular heartbeat (eg, QT prolongation), or if you have a family member with a history of irregular heartbeat if you have a history of joint or tendon problems; rheumatoid arthritis; kidney problems or decreased kidney function; or a heart, kidney, or lung transplant if you take corticosteroids (eg, prednisone) or you participate in strenuous physical work or exercise

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

Antiarrhythmics (eg, amiodarone, quinidine) because the risk of serious side effects, including irregular heartbeat, may be increased Corticosteroids (eg, prednisone) because they may increase the risk of tendon problems Diuretics (eg, furosemide, hydrochlorothiazide), metoclopramide, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), or probenecid because they may increase the risk of Cipro's side effects Anticoagulants (eg, warfarin), antipsychotics (eg, clozapine), cyclosporine, methotrexate, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, duloxetine), sulfonylureas (eg, glyburide), theophylline, tizanidine, tricyclic antidepressants (eg, amitriptyline), or xanthines (eg, caffeine) because the risk of their side effects may be increased by Cipro Hydantoins (eg, phenytoin) or live oral typhoid vaccine because their effectiveness may be decreased by Cipro

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

How to use Cipro:

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

An extra patient leaflet may be available with Cipro. Talk to your pharmacist if you have questions about this information. Take Cipro by mouth with or without food. The preferred dosing time is 2 hours after a meal. Take Cipro with a full glass of water (8 oz/240 mL). Drinking extra fluids while you are taking Cipro is recommended. Check with your doctor for instructions. If you also take any products containing magnesium, aluminum, calcium, iron, or zinc (eg, antacids, quinapril, vitamins/minerals); didanosine; sucralfate; or bismuth subsalicylate, do not take them within 6 hours before or 2 hours after taking Cipro. Check with your doctor if you have questions. If you also take sevelamer, do not take it within 4 hours before or after taking Cipro. Check with your doctor if you have questions. Cipro works best if it is taken at the same time each day. To clear up your infection completely, take Cipro for the full course of treatment. Keep taking it even if you feel better in a few days. Avoid taking Cipro with milk or milk products (eg, calcium-enriched juice, yogurt) by themselves. However, taking Cipro as part of a full meal that contains milk or milk products is permitted. Do not miss any doses. If you miss a dose of Cipro, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Important safety information: Cipro may cause drowsiness, dizziness, blurred vision, or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use Cipro with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Be sure to use Cipro for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future. Long-term or repeated use of Cipro may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this. Cipro only works against bacteria; it does not treat viral infections (eg, the common cold). Avoid large amounts of food or drink that have caffeine (eg, coffee, tea, cocoa, cola, chocolate). Tell your doctor right away if you experience pain or swelling of a tendon or weakness or loss of use of a joint area. Rest the area and avoid exercise until further instruction from your doctor. Diabetes patients - Cipro may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Cipro may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Cipro. Use a sunscreen or wear protective clothing if you must be outside for more than a short time. Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor. Use Cipro with caution in the ELDERLY; they may be more sensitive to its effects (eg, tendon problems), especially if they take corticosteroids (eg, prednisone). They may also be more sensitive to other effects (eg, irregular heartbeat). Cipro should be used with extreme caution in CHILDREN younger than 18 years; they may be more sensitive to its effects, especially joint and tendon problems. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking Cipro while you are pregnant. Cipro is found in breast milk. Do not breast-feed while taking Cipro. Possible side effects of Cipro:

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

Diarrhea; dizziness; headache; loss of appetite; nausea; stomach upset; vomiting.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or tarry stools; burning, numbness, tingling, pain, or weakness of the arms, hands, legs, or feet; chest pain; dark urine or unusual change in the amount of urine; fainting; fever, chills, or unusual cough; hallucinations; inability to move or bear weight on a joint or tendon area; irregular heartbeat; loss of consciousness; moderate to severe sunburn; mood or mental changes (eg, new or worsening anxiety, agitation, confusion, depression, restlessness, sleeplessness); muscle pain or weakness; pain, soreness, redness, swelling, weakness, or bruising of a tendon or joint area; pale stools; persistent sore throat; red, swollen, blistered, or peeling skin; seizures; severe or persistent diarrhea; severe or persistent dizziness; shortness of breath or trouble breathing; stomach cramps or pain; suicidal thoughts or actions; tremors; unusual bruising or bleeding; unusual fatigue; vaginal yeast infection; vision changes; yellowing of the skin or eyes.

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

See also: Cipro side effects (in more detail)

If OVERDOSE is suspected:

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

Proper storage of Cipro:

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

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

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

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Cipro resources Cipro Side Effects (in more detail) Cipro Use in Pregnancy & Breastfeeding Drug Images Cipro Drug Interactions Cipro Support Group 65 Reviews for Cipro - Add your own review/rating Compare Cipro with other medications Anthrax Anthrax Prophylaxis Bacteremia Bacterial Infection Bladder Infection Bone infection Bronchitis Chancroid Cholera Crohn's Disease Cutaneous Bacillus anthracis Diverticulitis Epididymitis, Sexually Transmitted Febrile Neutropenia Gonococcal Infection, Disseminated Gonococcal Infection, Uncomplicated Granuloma Inguinale Infection Prophylaxis Infectious Diarrhea Intraabdominal Infection Joint Infection Kidney Infections Meningococcal Meningitis Prophylaxis Mycobacterium avium-intracellulare, Treatment Nosocomial Pneumonia Peritonitis Plague Pneumonia Pneumonia with Cystic Fibrosis Prostatitis Rabbit Fever Salmonella Enteric Fever Salmonella Gastroenteritis Shigellosis Sinusitis Skin Infection Traveler's Diarrhea Tuberculosis, Active Typhoid Fever Urinary Tract Infection
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Usept


Pronunciation: bell-a-DON-a/meth-EN-a-meen/METH-i-leen/FEN-ill sa-LI-si-late
Generic Name: Belladonna Alkaloids/Methenamine/Methylene Blue/Phenyl Salicylate
Brand Name: Examples include Urised and Usept
Usept is used for:

Treating painful and irritating symptoms of the urinary tract due to urinary tract infections or diagnostic procedures.

Usept is a urinary antiseptic, analgesic, and anticholinergic combination. It works by helping to kill bacteria in the urine, decreasing pain and inflammation, and reducing muscle spasms in the urinary tract. These actions work together to help relieve discomfort while urinating.

Do NOT use Usept if: you are allergic to any ingredient in Usept you have had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to aspirin, other salicylate medicines, or a nonsteroidal anti-inflammatory drug (NSAID) (eg, ibuprofen, naproxen, celecoxib) you have angle-closure glaucoma, problems with your esophagus, bowel motility problems, a blockage of your bladder or bowel, severe intestinal problems (eg, ulcerative colitis), severe bleeding, flu or chickenpox, myasthenia gravis, severe kidney problems, or you are severely dehydrated you are taking a sulfonamide (eg, sulfamethizole)

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

Before using Usept:

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

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have constipation, diarrhea, an infection of the stomach or bowel, a hiatal hernia, or stomach ulcers if you have nervous system problems, glucose-6-phosphate-dehydrogenase (G-6-PD) deficiency, gout, influenza, Kawasaki syndrome, rheumatic disease, open-angle glaucoma, risk factors for angle-closure glaucoma, kidney or liver problems, an enlarged prostate, bladder problems, or you are unable to urinate if you have a history of stroke or brain blood vessel problems (eg, aneurysm), an irregular heartbeat, heart blood vessel problems, congestive heart failure, heart valve problems, or other heart problems if you are on a low-salt diet

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

Anticholinergics (eg, benztropine) because the side effects of Usept may be increased Ketoconazole because the effectiveness of Usept may be decreased Monoamine oxidase (MAO) inhibitors or narcotic pain medicine (eg, codeine) because the risk of serious side effects may be increased Medicine for myasthenia gravis (eg, ambenonium), phenothiazines (eg, chlorpromazine), sulfonamides (eg, sulfamethizole), thiazide diuretics (eg, hydrochlorothiazide), or urinary alkalinizers (eg, sodium bicarbonate) because effectiveness may be decreased by Usept

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

How to use Usept:

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

Usept may be taken with or without food. Do not take antacids or antidiarrheal medicines (eg, loperamide) within 1 hour before or after taking Usept. Drink plenty of fluids while taking Usept. If you miss a dose of Usept, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Important safety information: Usept may cause dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Usept. Using Usept alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks. Do not take Usept more often or in larger amounts than prescribed by your health care provider. Usept may discolor the urine or feces a blue-green color. This is normal and not a cause for concern. Usept contains an aspirin-like medicine, which has been linked to Reye syndrome. Do not give Usept to children or teenagers during or after chickenpox, flu, or other viral infections without checking with your doctor or pharmacist. Use Usept with caution in the ELDERLY because they may be more sensitive to its effects, especially excitement, agitation, drowsiness, and confusion. Usept is not recommended for use in CHILDREN younger than 6 years of age. Safety and effectiveness in this age group have not been confirmed. PREGNANCY and BREAST-FEEDING: It is unknown if Usept can cause harm to the fetus. If you become pregnant while taking Usept, discuss with your doctor the benefits and risks of using Usept during pregnancy. Usept is excreted in breast milk. If you are or will be breast-feeding while you are using Usept, check with your doctor or pharmacist to discuss the risks to your baby. Possible side effects of Usept:

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

Dry mouth; flushing; nausea; vomiting.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; difficulty urinating; dizziness; fast or irregular heartbeat.

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

See also: Usept side effects (in more detail)

If OVERDOSE is suspected:

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

Proper storage of Usept:

Store Usept at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Usept out of the reach of children and away from pets.

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

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

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Usept resources Usept Side Effects (in more detail) Usept Use in Pregnancy & Breastfeeding Usept Drug Interactions Usept Support Group 0 Reviews for Usept - Add your own review/rating Darcalma Prescribing Information (FDA) Darcalma Concise Consumer Information (Cerner Multum) Darpaz Prescribing Information (FDA) Phosenamine Prescribing Information (FDA) Phosphasal Prescribing Information (FDA) Phosphasal Advanced Consumer (Micromedex) - Includes Dosage Information Prosed EC Advanced Consumer (Micromedex) - Includes Dosage Information Urelle Prescribing Information (FDA) Uribel Prescribing Information (FDA) Ustell Prescribing Information (FDA) Compare Usept with other medications Urinary Tract Infection
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