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Caverject


Pronunciation: al-PROS-ta-dil
Generic Name: Alprostadil
Brand Name: Examples include Caverject and Edex
Caverject is used for:

Treating erectile problems in men. It may also be used to help diagnose erectile dysfunction.

Caverject is a prostaglandin (PGE-1). It works by relaxing certain muscles in the penis and widening blood vessels, which increases blood flow to the penis and helps to cause an erection. When the effect of the alprostadil wears off, blood flow returns to normal and the erection disappears.

Do NOT use Caverject if: you are allergic to any ingredient in Caverject you have blood problems (eg, sickle cell anemia or sickle cell trait, leukemia), bone marrow problems (eg, multiple myeloma), or other conditions that may increase your risk for a prolonged, painful erection (priapism) you have a penile implant, deformed penis, or certain other penile problems (eg, Peyronie disease, fibrosis of the penis) you have any other physical reason that you should not have sexual intercourse

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

Before using Caverject:

Tell your health care provider 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 inflammation or infection of the penis, kidney problems, urinary problems (eg, inflammation or narrowing of the urethra), or a history of prolonged or painful erections if you use other medicine for erectile problems if you have a blood-borne disease (eg, HIV, hepatitis)

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

Anticoagulants (eg, warfarin) or heparin because the risk of bleeding may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Caverject 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 Caverject:

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

An extra patient leaflet is available with Caverject. Talk to your pharmacist if you have questions about this information. Caverject is injected into the penis to produce an erection. A health care provider will teach you how to prepare and use Caverject. Be sure you understand how to use Caverject. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions. Do not use Caverject if it contains particles, is cloudy or discolored, or if the cartridge is cracked or damaged. Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal. Caverject usually starts to work within 5 to 20 minutes after you inject it and lasts about 30 to 60 minutes. Do not use more than one dose of Caverject in a 24-hour period or more than 3 doses per week without first checking with your doctor. If you forget to use Caverject and you still intend to engage in sexual activity, use it as soon as you remember or as directed by your doctor.

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

Important safety information: Caverject may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Caverject with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do NOT use more than the recommended dose or change your dose without checking with your doctor. Seek medical attention if you experience a painful erection or have an erection that lasts for more than 4 hours (priapism). If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens. Caverject does not protect against the spread of sexually transmitted diseases (STDs) (eg, HIV) or blood-borne diseases (eg, hepatitis B). Use barrier methods of birth control (eg, condoms) if you have an STD or blood-borne disease. If your partner experiences vaginal dryness or painful vaginal sensations, talk with your doctor. It might be necessary to use a water-based lubricant during sexual intercourse. You will need to have regular check-ups with your doctor while you are using Caverject. Be sure to keep all doctor and lab appointments. Use Caverject with caution in the ELDERLY; they may be more sensitive to its effects. PREGNANCY AND BREAST-FEEDING: It is not known if Caverject can cause harm to the fetus. It is not known if Caverject if found in breast milk. Caverject is not approved for use in women. Possible side effects of Caverject:

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:

Mild bleeding at the injection site; mild genital pain.

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); abnormal ejaculation; bleeding from the tip of the penis; bloody urine or change in the amount of urine; chest pain; curving of the erect penis; dizziness; fainting; fast or irregular heartbeat; new or worsening genital pain; painful or prolonged erection; redness, lumps, swelling, tenderness, inflammation, numbness, strange sensation, or discoloration of the penis; severe or persistent bleeding or bruising at the injection site; severe or persistent pain, swelling, or redness at the injection site; swelling of the leg veins; white patches or discharge from the penis.

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: Caverject 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 fainting; lasting pain in the penis; lightheadedness; painful or prolonged erection (eg, erection lasting more than 4 hours).

Proper storage of Caverject:

Caverject: Before mixing, store Caverject at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. After mixing, you may store Caverject below 77 degrees (25 degrees C) for up to 24 hours. Do not refrigerate or freeze. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Caverject out of the reach of children and away from pets.

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

General information: If you have any questions about Caverject, please talk with your doctor, pharmacist, or other health care provider. Caverject 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 Caverject. 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 Caverject resources Caverject Side Effects (in more detail) Caverject Use in Pregnancy & Breastfeeding Caverject Drug Interactions Caverject Support Group 2 Reviews for Caverject - Add your own review/rating Compare Caverject with other medications Erectile Dysfunction
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papaverine Injection


pa-PAV-er-een

Available Dosage Forms:

Solution Injectable

Therapeutic Class: Peripheral Vasodilator

Uses For papaverine

Papaverine belongs to the group of medicines called vasodilators. Vasodilators cause blood vessels to expand, thereby increasing blood flow. Papaverine is used to produce erections in some men with erectile dysfunction. When papaverine is injected into the penis (intracavernosal), it increases blood flow to the penis, which results in an erection.

Papaverine injection should not be used as a sexual aid by men who do not have erectile dysfunction. If the medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result.

Papaverine is available only with your doctor's prescription.

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

Low doses of a three-drug combination of papaverine, phentolamine, and alprostadil as an injection may be used to treat erectile dysfunction. Before Using papaverine

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

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to papaverine 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.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. Although there is no specific information comparing the use of papaverine for erectile dysfunction in the elderly with use in other age groups, papaverine is not expected to cause different side effects or problems in older people than it does in younger adults.

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

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

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking papaverine, 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 papaverine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Ginkgo 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 papaverine. Make sure you tell your doctor if you have any other medical problems, especially:

Bleeding problems—These conditions increase the risk of bleeding at the place of injection. Liver disease—Papaverine can cause liver damage when it is given in ways that allow it to get into the bloodstream (by mouth or by injection into a muscle, a vein, or an artery); when papaverine is given by intracavernosal injection, liver damage is much less likely because the medicine enters the bloodstream very slowly. Priapism (history of) or Sickle cell disease—Patients with these conditions have an increased risk of priapism (erection lasting longer than 4 hours) while using papaverine. Proper Use of papaverine

To give papaverine injection:

Cleanse the injection site with alcohol. Using a sterile needle, inject the medicine slowly and directly into the base of the penis as instructed by your doctor. Papaverine should not be injected just under the skin. The injection is usually not painful, although you may feel some tingling in the tip of your penis. If the injection is very painful or you notice bruising or swelling at the place of injection, that means you have been injecting the medicine under the skin. Stop, withdraw the needle, and reposition it properly before continuing with the injection. After you have completed the injection, put pressure on the place of injection to prevent bruising. Then massage your penis as instructed by your doctor. This helps the medicine spread to all parts of the penis, so that it will work better.

papaverine usually begins to work in about 10 minutes. You should attempt intercourse within 2 hours after injecting the medicine.

Dosing

The dose of papaverine 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 papaverine. 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 injection dosage form: For the treatment of erectile dysfunction: Adults—30 to 60 milligrams (mg) injected very slowly into the area of your penis as directed by your doctor. Allow one or two minutes to completely inject the dose. Do not inject more than one dose in a day. Also, do not use papaverine more than two days in a row or more than three times a week. Storage

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using papaverine

Use papaverine injection exactly as directed by your doctor . Do not use more of it and do not use it more often than ordered. If too much is used, the erection may become so strong that it lasts too long and does not reverse when it should. This condition is called priapism, and it can be very dangerous. If the effect is not reversed, the blood supply to the penis may be cut off and permanent damage may occur.

Contact your doctor immediately if the erection lasts for longer than 4 hours or if it becomes painful. This may be a sign of priapism and must be treated right away to prevent permanent damage.

If you notice bleeding at the site when you inject papaverine, put pressure on the spot until the bleeding stops. If it doesn't stop, check with your doctor.

It is important for you to examine your penis regularly. Check with your doctor if you find a lump where the medicine has been injected or if you notice that your penis is becoming curved. These may be signs that unwanted tissue is growing (called fibrosis), which should be seen by your doctor.

papaverine Side Effects

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

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

Rare Dizziness erection continuing for more than 4 hours, or painful erection lumps in the penis

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

Less common Bruising or bleeding at place of injection burning (mild) along penis difficulty in ejaculating swelling at place of injection

Papaverine injected into the penis may cause tingling at the tip of the penis. This is no cause for concern.

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

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

See also: papaverine Injection side effects (in more detail)

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

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

More papaverine Injection resources Papaverine Injection Side Effects (in more detail) Papaverine Injection Use in Pregnancy & Breastfeeding Drug Images Papaverine Injection Drug Interactions Papaverine Injection Support Group 0 Reviews · Be the first to review/rate this drug
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Caverject injectable and transurethral


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

What is alprostadil?

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

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

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

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

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

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

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

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

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

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

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

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

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

sickle cell anemia or the sickle cell anemia trait;

leukemia;

a tumor of the bone marrow (multiple myeloma);

a curved or deformed penis;

penile fibrosis or Peyronie's disease;

if you have a penile implant; or

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

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

a history of blood clots;

heart disease, high blood pressure (hypertension);

a bleeding or blood-clotting disorder; or

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Storing this medicine:

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

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

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

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

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

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

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

feeling light-headed, fainting;

trouble urinating, blood in your urine;

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

a painful erection that lasts 4 hours or longer;

severe pain or irritation of your penis or urethra; or

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

Less serious side effects may include:

unusual discharge from your penis; or

mild pain in your penis, urethra, or testicles;

headache, dizziness;

back pain;

a rash on the skin of your penis;

itching, warmth, or numbness of your penis;

cough, stuffy nose, cold symptoms, flu symptoms.

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

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

What other drugs will affect alprostadil?

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

blood pressure medication; or

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

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

More Caverject resources Caverject Side Effects (in more detail) Caverject Use in Pregnancy & Breastfeeding Caverject Drug Interactions Caverject Support Group 2 Reviews for Caverject - Add your own review/rating Compare Caverject with other medications Erectile Dysfunction Where can I get more information? Your pharmacist can provide more information about alprostadil.

See also: Caverject side effects (in more detail)


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Muse injectable and transurethral


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

What is alprostadil?

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

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

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

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

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

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

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

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

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

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

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

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

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

sickle cell anemia or the sickle cell anemia trait;

leukemia;

a tumor of the bone marrow (multiple myeloma);

a curved or deformed penis;

penile fibrosis or Peyronie's disease;

if you have a penile implant; or

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

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

a history of blood clots;

heart disease, high blood pressure (hypertension);

a bleeding or blood-clotting disorder; or

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Storing this medicine:

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

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

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

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

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

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

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

feeling light-headed, fainting;

trouble urinating, blood in your urine;

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

a painful erection that lasts 4 hours or longer;

severe pain or irritation of your penis or urethra; or

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

Less serious side effects may include:

unusual discharge from your penis; or

mild pain in your penis, urethra, or testicles;

headache, dizziness;

back pain;

a rash on the skin of your penis;

itching, warmth, or numbness of your penis;

cough, stuffy nose, cold symptoms, flu symptoms.

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

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

What other drugs will affect alprostadil?

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

blood pressure medication; or

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

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

More Muse resources Muse Side Effects (in more detail)Muse Use in Pregnancy & BreastfeedingMuse Drug InteractionsMuse Support Group4 Reviews for Muse - Add your own review/rating Compare Muse with other medications Erectile Dysfunction Where can I get more information? Your pharmacist can provide more information about alprostadil.

See also: Muse side effects (in more detail)


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Caverject Impulse injectable and transurethral


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

What is alprostadil?

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

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

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

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

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

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

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

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

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

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

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

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

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

sickle cell anemia or the sickle cell anemia trait;

leukemia;

a tumor of the bone marrow (multiple myeloma);

a curved or deformed penis;

penile fibrosis or Peyronie's disease;

if you have a penile implant; or

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

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

a history of blood clots;

heart disease, high blood pressure (hypertension);

a bleeding or blood-clotting disorder; or

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Storing this medicine:

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

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

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

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

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

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

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

feeling light-headed, fainting;

trouble urinating, blood in your urine;

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

a painful erection that lasts 4 hours or longer;

severe pain or irritation of your penis or urethra; or

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

Less serious side effects may include:

unusual discharge from your penis; or

mild pain in your penis, urethra, or testicles;

headache, dizziness;

back pain;

a rash on the skin of your penis;

itching, warmth, or numbness of your penis;

cough, stuffy nose, cold symptoms, flu symptoms.

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

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

What other drugs will affect alprostadil?

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

blood pressure medication; or

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

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

More Caverject Impulse resources Caverject Impulse Side Effects (in more detail)Caverject Impulse Use in Pregnancy & BreastfeedingCaverject Impulse Drug InteractionsCaverject Impulse Support Group3 Reviews for Caverject Impulse - Add your own review/rating Compare Caverject Impulse with other medications Erectile Dysfunction Where can I get more information? Your pharmacist can provide more information about alprostadil.

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


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Edex Refill injectable and transurethral


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

What is alprostadil?

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

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

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

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

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

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

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

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

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

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

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

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

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

sickle cell anemia or the sickle cell anemia trait;

leukemia;

a tumor of the bone marrow (multiple myeloma);

a curved or deformed penis;

penile fibrosis or Peyronie's disease;

if you have a penile implant; or

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

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

a history of blood clots;

heart disease, high blood pressure (hypertension);

a bleeding or blood-clotting disorder; or

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Storing this medicine:

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

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

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

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

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

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

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

feeling light-headed, fainting;

trouble urinating, blood in your urine;

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

a painful erection that lasts 4 hours or longer;

severe pain or irritation of your penis or urethra; or

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

Less serious side effects may include:

unusual discharge from your penis; or

mild pain in your penis, urethra, or testicles;

headache, dizziness;

back pain;

a rash on the skin of your penis;

itching, warmth, or numbness of your penis;

cough, stuffy nose, cold symptoms, flu symptoms.

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

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

What other drugs will affect alprostadil?

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

blood pressure medication; or

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

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

More Edex Refill resources Edex Refill Side Effects (in more detail) Edex Refill Use in Pregnancy & Breastfeeding Edex Refill Drug Interactions Edex Refill Support Group 0 Reviews for Edex Refill - Add your own review/rating Compare Edex Refill with other medications Erectile Dysfunction Where can I get more information? Your pharmacist can provide more information about alprostadil.

See also: Edex Refill side effects (in more detail)


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Prostin VR Pediatric injectable and transurethral


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

What is alprostadil?

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

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

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

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

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

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

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

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

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

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

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

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

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

sickle cell anemia or the sickle cell anemia trait;

leukemia;

a tumor of the bone marrow (multiple myeloma);

a curved or deformed penis;

penile fibrosis or Peyronie's disease;

if you have a penile implant; or

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

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

a history of blood clots;

heart disease, high blood pressure (hypertension);

a bleeding or blood-clotting disorder; or

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Storing this medicine:

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

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

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

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

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

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

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

feeling light-headed, fainting;

trouble urinating, blood in your urine;

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

a painful erection that lasts 4 hours or longer;

severe pain or irritation of your penis or urethra; or

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

Less serious side effects may include:

unusual discharge from your penis; or

mild pain in your penis, urethra, or testicles;

headache, dizziness;

back pain;

a rash on the skin of your penis;

itching, warmth, or numbness of your penis;

cough, stuffy nose, cold symptoms, flu symptoms.

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

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

What other drugs will affect alprostadil?

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

blood pressure medication; or

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

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

More Prostin VR Pediatric resources Prostin VR Pediatric Side Effects (in more detail) Prostin VR Pediatric Use in Pregnancy & Breastfeeding Prostin VR Pediatric Drug Interactions Prostin VR Pediatric Support Group 0 Reviews for Prostin VR Pediatric - Add your own review/rating Compare Prostin VR Pediatric with other medications Patent Ductus Arteriosus Where can I get more information? Your pharmacist can provide more information about alprostadil.

See also: Prostin VR Pediatric side effects (in more detail)


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Caverject Impulse


Pronunciation: al-PROS-ta-dil
Generic Name: Alprostadil
Brand Name: Examples include Caverject and Caverject Impulse
Caverject Impulse is used for:

Treating erectile problems in men. It may also be used to help diagnose erectile dysfunction.

Caverject Impulse is a prostaglandin (PGE-1). It works by relaxing certain muscles in the penis and widening blood vessels, which increases blood flow to the penis and helps to cause an erection. When the effect of the alprostadil wears off, blood flow returns to normal and the erection disappears.

Do NOT use Caverject Impulse if: you are allergic to any ingredient in Caverject Impulse you have blood problems (eg, sickle cell anemia or sickle cell trait, leukemia), bone marrow problems (eg, multiple myeloma), or other conditions that may increase your risk for a prolonged, painful erection (priapism) you have a penile implant, deformed penis, or certain other penile problems (eg, Peyronie disease, fibrosis of the penis) you have any other physical reason that you should not have sexual intercourse

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

Before using Caverject Impulse:

Tell your health care provider 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 inflammation or infection of the penis, kidney problems, urinary problems (eg, inflammation or narrowing of the urethra), or a history of prolonged or painful erections if you use other medicine for erectile problems if you have a blood-borne disease (eg, HIV, hepatitis)

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

Anticoagulants (eg, warfarin) or heparin because the risk of bleeding may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Caverject Impulse 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 Caverject Impulse:

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

An extra patient leaflet is available with Caverject Impulse. Talk to your pharmacist if you have questions about this information. Caverject Impulse is injected into the penis to produce an erection. A health care provider will teach you how to prepare and use Caverject Impulse. Be sure you understand how to use Caverject Impulse. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions. Do not use Caverject Impulse if it contains particles, is cloudy or discolored, or if the cartridge is cracked or damaged. Use Caverject Impulse within 24 hours after mixing. If the needle breaks during the injection, grasp and remove the broken end if possible and contact your doctor. Contact your doctor right away if the needle breaks and you cannot remove it. Use each vial or cartridge one time only. Do not reuse any medicine left in the container. Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal. Caverject Impulse usually starts to work within 5 to 20 minutes after you inject it and lasts about 30 to 60 minutes. Do not use more than one dose of Caverject Impulse in a 24-hour period or more than 3 doses per week without first checking with your doctor. If you forget to use Caverject Impulse and you still intend to engage in sexual activity, use it as soon as you remember or as directed by your doctor.

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

Important safety information: Caverject Impulse may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Caverject Impulse with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do NOT use more than the recommended dose or change your dose without checking with your doctor. Seek medical attention if you experience a painful erection or have an erection that lasts for more than 4 hours (priapism). If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens. Caverject Impulse does not protect against the spread of sexually transmitted diseases (STDs) (eg, HIV) or blood-borne diseases (eg, hepatitis B). Use barrier methods of birth control (eg, condoms) if you have an STD or blood-borne disease. If your partner experiences vaginal dryness or painful vaginal sensations, talk with your doctor. It might be necessary to use a water-based lubricant during sexual intercourse. You will need to have regular check-ups with your doctor while you are using Caverject Impulse. Be sure to keep all doctor and lab appointments. Use Caverject Impulse with caution in the ELDERLY; they may be more sensitive to its effects. PREGNANCY AND BREAST-FEEDING: It is not known if Caverject Impulse can cause harm to the fetus. It is not known if Caverject Impulse if found in breast milk. Caverject Impulse is not approved for use in women. Possible side effects of Caverject Impulse:

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:

Mild bleeding at the injection site; mild to moderate genital pain.

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); abnormal ejaculation; bleeding from the tip of the penis; bloody urine or change in the amount of urine; chest pain; curving of the erect penis; dizziness; fainting; fast or irregular heartbeat; new or worsening genital pain; painful or prolonged erection; redness, lumps, swelling, tenderness, inflammation, numbness, strange sensation, or discoloration of the penis; severe or persistent bleeding or bruising at the injection site; severe or persistent pain, swelling, or redness at the injection site; swelling of the leg veins; white patches or discharge from the penis.

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: Caverject Impulse 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 fainting; lasting pain in the penis; lightheadedness; painful or prolonged erection (eg, erection lasting more than 4 hours).

Proper storage of Caverject Impulse:

Before mixing, store Caverject Impulse at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. After mixing, you may store Caverject Impulse below 77 degrees (25 degrees C) for up to 24 hours. Do not refrigerate or freeze. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Caverject Impulse out of the reach of children and away from pets.

General information: If you have any questions about Caverject Impulse, please talk with your doctor, pharmacist, or other health care provider. Caverject Impulse 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 Caverject Impulse. 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 Caverject Impulse resources Caverject Impulse Side Effects (in more detail) Caverject Impulse Use in Pregnancy & Breastfeeding Caverject Impulse Drug Interactions Caverject Impulse Support Group 3 Reviews for Caverject Impulse - Add your own review/rating Caverject Impulse injectable and transurethral Concise Consumer Information (Cerner Multum) alprostadil Intraurethral, Intravenous, Intracavernosal Advanced Consumer (Micromedex) - Includes Dosage Information Alprostadil Prescribing Information (FDA) Alprostadil Monograph (AHFS DI) Caverject Prescribing Information (FDA) Muse Prescribing Information (FDA) Prostin VR Pediatric Prescribing Information (FDA) Compare Caverject Impulse with other medications Erectile Dysfunction
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phentolamine Injection


fen-TOL-a-meen

Commonly used brand name(s)

In the U.S.

OraVerse Regitine

Available Dosage Forms:

Solution Injectable Powder for Solution

Therapeutic Class: Antihypertensive

Pharmacologic Class: Alpha-Adrenergic Blocker

Uses For phentolamine

Phentolamine given by injection causes blood vessels to expand, thereby increasing blood flow. When injected into the penis (intracavernosal), it increases blood flow to the penis, which results in an erection.

phentolamine should not be used as a sexual aid by men who do not have erectile dysfunction. If the medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result.

Phentolamine may also be used to reverse the effects of an anesthetic medicine in soft tissues, such as the lips and tongue. It may be used to help quickly restore normal sensation and function in patients who have received local dental anesthesia .

Phentolamine is available only with your doctor's prescription.

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

Low doses of a three-drug combination of phentolamine, papaverine, and alprostadil as an injection may be used to treat erectile dysfunction. Before Using phentolamine

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

Allergies

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

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of phentolamine for the reversal of soft-tissue anesthesia in children younger than 6 years of age. Safety and efficacy have not been established .

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. Although there is no specific information comparing the use of phentolamine for erectile dysfunction in the elderly, it is not expected to cause different side effects or problems in older people than it does in younger adults.

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

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

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking phentolamine, 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 phentolamine 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.

Tadalafil

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

Acebutolol Alprenolol Atenolol Betaxolol Bevantolol Bisoprolol Bucindolol Carteolol Carvedilol Celiprolol Dilevalol Esmolol Labetalol Levobunolol Mepindolol Metipranolol Metoprolol Nadolol Nebivolol Oxprenolol Penbutolol Pindolol Propranolol Sotalol Talinolol Tertatolol Timolol Vardenafil 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 phentolamine. Make sure you tell your doctor if you have any other medical problems, especially:

Bleeding problems—These conditions increase the risk of bleeding at the place of injection. Priapism (history of) or Sickle cell disease—Patients with these conditions have an increased risk of priapism (erection lasting longer than 4 hours) while using phentolamine. Proper Use of phentolamine

To give the injection:

Cleanse the injection site with alcohol. Using a sterile needle, inject the medicine slowly and directly into the base of the penis as instructed by your doctor. It should not be injected just under the skin. The injection is usually not painful, although you may feel some tingling in the tip of your penis. If the injection is very painful or you notice bruising or swelling at the place of injection, that means you are injecting the medicine under the skin. Stop, withdraw the needle, and reposition it properly before continuing with the injection. After you have completed the injection, put pressure on the place of injection to prevent bruising. Then massage your penis as instructed by your doctor. This helps the medicine spread to all parts of the penis, so that it will work better.

phentolamine usually begins to work in about 10 minutes. You should attempt intercourse within 2 hours after injecting the medicine.

To reverse the effects of a soft-tissue anesthetic medicine, a dentist or other trained health professional will give you phentolamine. phentolamine is usually injected at the same spot where you have received the local dental anesthesia .

Dosing

The dose of phentolamine 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 phentolamine. 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 injection dosage form: For the treatment of impotence: Adults— 0.5 to 1 milligram (mg) injected very slowly into the area of your penis as directed by your doctor. Allow one or two minutes to completely inject the dose. Do not inject more than one dose in a day. Also, do not use phentolamine more than two days in a row or more than three times a week. Storage

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

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

Precautions While Using phentolamine

Use the injection exactly as directed by your doctor. Do not use more of it and do not use it more often than ordered. If too much is used, the erection may become so strong that it lasts too long and does not reverse when it should. This condition is called priapism, and it can be very dangerous. If the effect is not reversed, the blood supply to the penis may be cut off and permanent damage may occur.

Contact your doctor immediately if the erection lasts for longer than 4 hours or if it becomes painful. This may be a sign of priapism and must be treated right away to prevent permanent damage.

If you notice bleeding at the site when you inject the medicine, put pressure on the spot until the bleeding stops. If it doesn't stop, check with your doctor.

It is important for you to examine your penis regularly. Check with your doctor if you find a lump where the medicine has been injected or if you notice that your penis is becoming curved. These may be signs that unwanted tissue is growing (called fibrosis), which should be seen by your doctor.

phentolamine Side Effects

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

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

Rare Dizziness erection continuing for more than 4 hours, or painful erection lumps in the penis

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

Less common or rare Bruising or bleeding at place of injection burning (mild) along penis difficulty in ejaculating swelling at place of injection

Phentolamine injected into the penis may cause tingling at the tip of the penis. This is no cause for concern.

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

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

See also: phentolamine Injection side effects (in more detail)

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

More phentolamine Injection resources Phentolamine Injection Side Effects (in more detail) Phentolamine Injection Use in Pregnancy & Breastfeeding Phentolamine Injection Drug Interactions Phentolamine Injection Support Group 0 Reviews for Phentolamine Injection - Add your own review/rating Compare phentolamine Injection with other medications Dermal Necrosis, Treatment Pheochromocytoma Pheochromocytoma Diagnosis Reversal of Anesthesia
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Yohimar


Generic Name: yohimbine (yo HIM bean)
Brand Names: Erex, Testomar, Yocon, Yohimar, Yohimbe, Yohimex

What is Yohimar (yohimbine)?

Yohimbine increases the amount of blood that is allowed to flow into the penis and prevents blood from flowing out of the penis. It can cause an erection.

Yohimbine is used to treat and diagnose some types of impotence.

Yohimbine may also be used for purposes other than those listed in this product guide.

What is the most important information I should know about Yohimar (yohimbine)? Use caution when driving, operating machinery, or performing other hazardous activities. Yohimbine may cause dizziness. If you experience dizziness, avoid these activities.

Use caution when rising from a sitting or lying position. Yohimbine may be more likely to cause dizziness when changing positions.

What should I discuss with my healthcare provider before taking Yohimar (yohimbine)?

Before taking this medication, tell your doctor if you

have kidney disease;

have peptic ulcer disease (stomach ulcers);

are suffering from depression;

are being treated for a psychiatric condition; or

have any type of heart disease.

You may not be able to take yohimbine, or you may require a lower dose or special monitoring during therapy if you have any of the conditions listed above.

Yohimbine should not be used by women. Do not take this medication if you are pregnant or are breast-feeding. Yohimbine should not be used by children. How should I take Yohimar (yohimbine)?

Take yohimbine exactly as directed. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Yohimbine is usually taken three times a day. Follow your doctor's instructions.

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

Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra yohimbine 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.

Symptoms of a yohimbine overdose include increased blood pressure (severe headache, blurred vision, flushing); a fast heart rate; numbness or tingling; runny nose; tremor; anxiety; poor coordination; and confusion or abnormal behavior.

What should I avoid while taking Yohimar (yohimbine)? Use caution when driving, operating machinery, or performing other hazardous activities. Yohimbine may cause dizziness. If you experience dizziness, avoid these activities.

Use caution when rising from a sitting or lying position. Yohimbine may be more likely to cause dizziness when you change positions.

Yohimar (yohimbine) side effects If you experience any of the following serious side effects, stop taking yohimbine and seek emergency medical attention:

an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

a very irregular or fast heartbeat; or

confusion or unusual behavior.

Other, less serious side effects are more likely to occur. Continue to take yohimbine and talk to your doctor if you experience

dizziness;

anxiety, irritability, or nervousness;

tremor (shaking);

headache; or

skin flushing.

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 Yohimar (yohimbine)?

Before taking this medication, tell your doctor if you are taking a medicine for depression, mania, or another psychiatric condition. Generally, yohimbine should not be used with these medicines.

Drugs other than those listed here may also interact with yohimbine or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

More Yohimar resources Yohimar Side Effects (in more detail) Yohimar Use in Pregnancy & Breastfeeding Yohimar Drug Interactions Yohimar Support Group 0 Reviews for Yohimar - Add your own review/rating yohimbine Advanced Consumer (Micromedex) - Includes Dosage Information Aphrodyne MedFacts Consumer Leaflet (Wolters Kluwer) Yohimbe Natural MedFacts for Professionals (Wolters Kluwer) Yohimbe Natural MedFacts for Consumers (Wolters Kluwer) Compare Yohimar with other medications Erectile Dysfunction Sexual Dysfunction, SSRI Induced Where can I get more information? Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.

See also: Yohimar side effects (in more detail)


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Edex


Generic Name: alprostadil (Intraurethral route, Intravenous route, Intracavernosal route)

al-PROS-ta-dil

Intravenous route(Solution)

Apnea is experienced by about 10% to 12% of neonates with congenital heart defects treated with alprostadil injection. Apnea is most often seen in neonates weighing less than 2 kg at birth and usually appears during the first hour of drug infusion. Therefore, respiratory status should be monitored throughout treatment, and alprostadil injection should be used only where ventilatory assistance is immediately available .

Commonly used brand name(s)

In the U.S.

Caverject Edex Muse Prostin VR Pediatric

In Canada

Muse Micro

Available Dosage Forms:

Powder for Solution Kit Suppository Solution

Therapeutic Class: Erectile Dysfunction Agent

Pharmacologic Class: Prostaglandin

Uses For Edex

Alprostadil belongs to a group of medicines called vasodilators that can increase blood flow by expanding blood vessels. Alprostadil is used to produce erections in some men who need treatment for erectile dysfunction (sexual impotence). This medicine causes an erection because it increases the blood flow to the penis.

Alprostadil injection should not be used as a sexual aid by men who do not have erectile dysfunction. If the medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result.

Alprostadil is used alone or with medical tests to help diagnose erectile dysfunction that may be caused by nerve or blood vessel problems in the penis.

Alprostadil is available only with your doctor's prescription.

Before Using Edex

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

Allergies

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

Geriatric

This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

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

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

Interactions with Medicines

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

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

Heparin Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

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

Abnormal penis, including curved penis and birth defects of the penis—Chance of problems occurring may be increased Bleeding problems—Chance of bleeding at the place of injection may be increased Infection of penis or Red or itchy (inflamed) penis—Conditions may worsen with the use of alprostadil suppositories. Also, local skin problems and minor bleeding from inserting the suppository may occur Conditions causing thickened blood or slower blood flow, including leukemia; multiple myeloma (tumors of the bone marrow); polycythemia, sickle cell disease, or thrombocythemia (blood problems) or Priapism (history of)—Patients with these conditions have an increased risk of priapism (erection lasting longer than 6 hours) while using alprostadil Proper Use of alprostadil

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

Special patient directions come with the suppositories and some of the injection medicines. Read the directions carefully before using the medicine.

For the injections—There are several alprostadil products that can be injected. Although the injection method is the same, the mixing procedures are different. Be sure you know which of these products you will be using and the proper way to mix the injection.

One product called Alprostadil for Injection (brand names Caverject and Edex) is available as a powder in an injection bottle (vial). Caverject must be mixed with a solution called Bacteriostatic Water for Injection USP. Edex must be mixed with a solution called Sodium Chloride Injection USP. The solution for mixing comes with your product and may be already loaded into a syringe or contained in another injection bottle (vial). Another product is called Alprostadil Injection (brand names Prostin VR Pediatric and Prostin VR). Although the medicine is already in solution, it is much too strong to be injected into the penis. The solution must be mixed (diluted) with another liquid that is sold as a separate prescription, called 0.9% Sodium Chloride Injection USP. In most cases, a pharmacist will make this solution for you, giving you the proper strength that you need. Check with your doctor or pharmacist to make sure the solution has been diluted before using it.

It is important to follow several steps to prepare your alprostadil injection correctly. Before drawing up the medicine into the syringe:

Wash your hands with soap and water. Set the bottles on a clean surface. Wipe the top of the injection bottles with an alcohol swab. Do not wipe the needle. Throw away the alcohol swab. You may need to attach the needle to the syringe. Do not take the cap off yet.

How to mix Caverject:

If the syringe already contains the Bacteriostatic Water for Injection USP, then you need only add the plunger to the syringe. To do this: Pick up the rod-like plunger and place it within the barrel of the syringe until it touches the rubber piece. Gently screw the plunger into the rubber piece until it seems secure. Do not use a lot of force. Hold the syringe by the barrel (not the plunger) and take the cap off the needle. You are now ready to mix the water and the powder. Skip to the directions under the title, “To mix the water and powder." If the syringe does not already contain the Bacteriostatic Water for Injection USP, you must withdraw 1 milliliter (mL) of it from the bottle provided. To do this: Pick up the syringe and take the cap off the needle. Pull the plunger back to the 1-mL mark on the syringe. This pulls air into the syringe. Insert the needle into rubber top of the bottle while it is upright and inject the 1 mL of air into the bottle. Turn the bottle upside down using one hand. Be sure the tip of the needle is covered by solution. With your other hand, pull the plunger back slowly to withdraw 1 mL of solution into the syringe. Remove the needle and skip to the directions under the title, "To mix the water and powder." To mix the water and powder: Insert the needle into the bottle of alprostadil and inject 1 milliliter of Bacteriostatic Water for Injection USP from your syringe into the bottle of alprostadil. Remove the needle from the bottle, holding the barrel of the syringe. Gently swirl the bottle to mix the powder into the solution, turning it upside down to wet all the powder in the bottle. Follow the directions below, “How to draw your dose into the syringe."

How to mix Edex:

The syringe already contains the Sodium Chloride Injection USP. You need only attach the needle to the syringe and add the plunger. To do this: Remove the needle from its package. Do not remove the needle cap. Gently screw the needle into place on the syringe tip. Pick up the rod-like plunger and place it within the barrel of the syringe until it touches the rubber piece. Gently screw the plunger into the rubber piece until it seems secure. Do not use a lot of force. Hold the syringe by the barrel (not the plunger) and take the cap off the needle. You are now ready to mix the Sodium Chloride Injection USP and the powder. Insert the needle into the bottle of alprostadil and inject 1.2 milliliters of the Sodium Chloride Injection USP from your syringe into the bottle of alprostadil. Remove the needle from the bottle, holding the barrel of the syringe. Gently swirl the bottle to mix the powder into the solution, turning it upside down to wet all the powder in the bottle. Follow the directions below, “How to draw your dose into the syringe."

How to mix Prostin VR or Prostin VR Pediatric:

You will need to get exact mixing instructions from your doctor or pharmacist if you are given two solutions to be mixed. Follow them carefully, asking the pharmacist or doctor any questions that you might have before injecting the medicine. After you or the pharmacist has mixed these solutions, follow the directions below, “How to draw your dose into the syringe."

How to draw your dose into the syringe (for all injection products):

Check the solution to make sure it is clear. Do not use the mixture if you can see anything solid in the solution or if the solution is cloudy or colored. After the alprostadil solution is mixed and the needle is inserted into the alprostadil bottle, turn the bottle with the syringe as a unit upside down in one hand. Be sure the tip of the needle is covered by the solution. With your other hand, pull the plunger back slowly to draw the correct dose of the medicine into the syringe. Hold the syringe with the measuring scale at eye level to see that the proper dose is withdrawn and to check for air bubbles. To remove air bubbles, tap gently on the measuring scale of the syringe to move any bubbles to the top of the syringe near the needle. If your dose measures too low in the syringe, withdraw more solution from the bottle. If there is too much medicine in the syringe, put some back into the bottle. Then check your dose again. Remove the needle from the bottle, holding the barrel of the syringe, not the plunger. Place the cover back on the needle. You are now ready to inject your dose. Follow the directions below, “How to give the alprostadil injection."

How to give the alprostadil injection:

Choose a spot on your penis as directed by your doctor where you will give the injection. Clean the injection site with alcohol. Sitting upright or slightly reclined, hold your penis against the side of your thigh so that it cannot move. Remove the cover from the needle and hold the needle at a 90-degree angle to the place of injection. Insert the needle until almost all of the metal part of the needle is inserted into the penis. Do not inject the medicine just under the surface of the skin, at the top or head of the penis, or at the base of the penis near the scrotum or testes. Avoid injecting the medicine into blood vessels that you can see. Press the plunger down slowly, taking 5 to 10 seconds to release the dose into the penis. The injection is usually not painful. If the injection is very painful or if you notice bruising or swelling at the place of injection, that means you are injecting the medicine under the skin. Stop, withdraw the needle, and reposition it properly before continuing with the injection. Remove the needle and recap it. After you have completed the injection, put pressure on the place of injection for about 5 minutes or until any bleeding stops. This will prevent bruising. Then massage your penis as instructed by your doctor. This helps the medicine spread to all parts of the penis, so that the medicine will work better.

Choose a different place of injection each time you use the medicine to prevent skin problems. This includes switching the place of injection from the right side of the penis for one injection to the left side for the next injection.

After a single-use injection is mixed, the medicine must be used immediately. Throw away any unused mixture in the syringe. It cannot be stored for a later injection.

Do not reuse your needles.

How to throw away the syringes and bottles safely:

Dispose of your materials properly. Caverject comes in a plastic case that can be permanently locked with the red locking device that is included with the packaging. When the case label is removed, you can see a hole in the center of the case. The red locking device can be inserted and, by firmly pressing it down with your thumb, you will permanently lock the case. The locked case is safe to be thrown away.

If you do not have the plastic case or are using Prostin VR or Prostin VR Pediatric injection, unscrew the needle from the barrel of the syringe. Then bend, break, or cut the needle into two pieces with wire cutters. The pieces can be placed in a heavy plastic container, such as a bleach container, and thrown away. Or you may give them to a health care professional to throw away. If you have any questions about disposing of the syringe and needles, ask your health care professional.

For suppositories—Before inserting the suppository, you should urinate. The small amount of urine normally left in your urethra will help dissolve the suppository after it is inserted.

How to insert suppositories:

Remove the delivery device containing the suppository from the foil. Remove the cap from the applicator stem. Stretch your penis upward to extend its length, pressing your penis top and bottom. Gently insert the delivery stem up to its collar into your urethra (located at the top of the penis). If you have pain or a pulling feeling in the penis, withdraw the device and start again. Press the button down slowly as far as it will go. This releases the suppository into the urethra. After holding the delivery device within your penis still for 5 seconds, carefully rock the penis and delivery device as a unit from side to side. This helps remove the suppository from the device. Remove the delivery device while your penis is upright. Look at the device to make sure that the suppository was completely released. Repeat the process if a part of the suppository remains in the device. After the suppository is completely released, roll your penis between your hands for 10 seconds. This helps to dissolve the suppository. If you feel any stinging, continue this motion to help stop it. Sitting, standing, or walking for 10 minutes while an erection is developing helps increase the blood flow to your penis to gain a proper erection.

How to throw away the suppository delivery device safely:

Replace the cap on the delivery device. After storing it in the foil, fold and throw away.

For injections or suppositories—This medicine usually begins to work in about 5 to 10 minutes. You should attempt intercourse within 10 to 30 minutes after using the medicine. An erection may continue after ejaculation.

Dosing

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

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

For the treatment of erectile dysfunction: For injection dosage form: Adults—1.25 to 60 micrograms (mcg) as a single dose once a day. Your exact dose will be determined by your doctor. Inject this medicine very slowly into your penis as shown to you by your doctor ten to thirty minutes before intercourse. Allow five to ten seconds to completely inject the dose. Do not inject more than one dose within twenty-four hours. Also, do not use this medicine for more than two days in a row or more than three times a week. For suppository dosage form: Adults—125, 250, 500, or 1000 mcg as a single dose once a day. Your exact dose will be determined by your doctor. Insert this medicine into the urethra of your penis as shown to you by your doctor ten to thirty minutes before intercourse. Do not insert more than two doses within twenty-four hours. Storage

Store in the refrigerator. Do not freeze.

You may store the suppositories in the refrigerator, but do not freeze them.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Alprostadil for Injection while in the powder form can be stored at room temperature (between 15 and 25 °C or 59 and 77 °F) for 3 months. After it is mixed, the solution must be used immediately. Suppositories may be stored at room temperature

Precautions While Using Edex

Do not use alprostadil if you have a penile implant unless advised by doctor.

If using the alprostadil suppository, use a condom when having sexual intercourse with a pregnant female. Although harm to the fetus is unlikely, using a condom will protect the fetus from exposure to this medicine. If a woman can become pregnant, use of contraceptive methods is recommended because the effects of this medicine on early pregnancy are not known.

Use alprostadil exactly as directed by your doctor . Do not use more of it and do not use it more often than your doctor ordered. If too much is used, the erection lasts too long and does not reverse when it should. This condition is called priapism. If the erection is not reversed, the blood supply to the penis may be cut off and permanent damage may occur.

Contact your doctor immediately if the erection lasts longer than 4 hours or if it becomes painful. This may be a sign of priapism and must be treated right away to prevent permanent damage.

If you notice bleeding at the place where you injected the medicine, put pressure on the spot until the bleeding stops. If it doesn't stop within 10 minutes, check with your doctor.

Edex Side Effects

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

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

Rare Curving of penis with pain during erection erection continuing for 4 to 6 hours erection continuing longer than 6 hours with severe and continuing pain of the penis swelling in or pain of the testes Symptoms of too much medicine being absorbed into the body Dizziness faintness pelvic pain flu-like symptoms

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 Bleeding at place of injection, short-term mild bleeding or spotting from urethra (suppository only) pain at place of injection painful erection stinging of urethra (suppository only) Rare

Female partners may experience itching or stinging of vagina when you first begin using the alprostadil suppository. These side effects may not be caused from the medicine but may result if female partner has not had frequent or recent sexual intercourse.

Bruising or clotted blood in penis at place of injection, usually caused by an incorrect injection

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

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

See also: Edex side effects (in more detail)

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

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

More Edex resources Edex Side Effects (in more detail) Edex Use in Pregnancy & Breastfeeding Edex Drug Interactions Edex Support Group 9 Reviews for Edex - Add your own review/rating Edex MedFacts Consumer Leaflet (Wolters Kluwer) Edex injectable and transurethral Concise Consumer Information (Cerner Multum) Alprostadil MedFacts Consumer Leaflet (Wolters Kluwer) Alprostadil Prescribing Information (FDA) Alprostadil Monograph (AHFS DI) Caverject Prescribing Information (FDA) Muse Suppository MedFacts Consumer Leaflet (Wolters Kluwer) Muse Prescribing Information (FDA) Prostin VR Pediatric Prescribing Information (FDA) Compare Edex with other medications Erectile Dysfunction
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Muse


Generic Name: alprostadil (Intraurethral route, Intravenous route, Intracavernosal route)

al-PROS-ta-dil

Intravenous route(Solution)

Apnea is experienced by about 10% to 12% of neonates with congenital heart defects treated with alprostadil injection. Apnea is most often seen in neonates weighing less than 2 kg at birth and usually appears during the first hour of drug infusion. Therefore, respiratory status should be monitored throughout treatment, and alprostadil injection should be used only where ventilatory assistance is immediately available .

Commonly used brand name(s)

In the U.S.

Caverject Edex Muse Prostin VR Pediatric

In Canada

Muse Micro

Available Dosage Forms:

Powder for Solution Kit Suppository Solution

Therapeutic Class: Erectile Dysfunction Agent

Pharmacologic Class: Prostaglandin

Uses For Muse

Alprostadil belongs to a group of medicines called vasodilators that can increase blood flow by expanding blood vessels. Alprostadil is used to produce erections in some men who need treatment for erectile dysfunction (sexual impotence). This medicine causes an erection because it increases the blood flow to the penis.

Alprostadil injection should not be used as a sexual aid by men who do not have erectile dysfunction. If the medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result.

Alprostadil is used alone or with medical tests to help diagnose erectile dysfunction that may be caused by nerve or blood vessel problems in the penis.

Alprostadil is available only with your doctor's prescription.

Before Using Muse

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

Allergies

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

Geriatric

This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

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

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

Interactions with Medicines

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

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

Heparin Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

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

Abnormal penis, including curved penis and birth defects of the penis—Chance of problems occurring may be increased Bleeding problems—Chance of bleeding at the place of injection may be increased Infection of penis or Red or itchy (inflamed) penis—Conditions may worsen with the use of alprostadil suppositories. Also, local skin problems and minor bleeding from inserting the suppository may occur Conditions causing thickened blood or slower blood flow, including leukemia; multiple myeloma (tumors of the bone marrow); polycythemia, sickle cell disease, or thrombocythemia (blood problems) or Priapism (history of)—Patients with these conditions have an increased risk of priapism (erection lasting longer than 6 hours) while using alprostadil Proper Use of alprostadil

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

Special patient directions come with the suppositories and some of the injection medicines. Read the directions carefully before using the medicine.

For the injections—There are several alprostadil products that can be injected. Although the injection method is the same, the mixing procedures are different. Be sure you know which of these products you will be using and the proper way to mix the injection.

One product called Alprostadil for Injection (brand names Caverject and Edex) is available as a powder in an injection bottle (vial). Caverject must be mixed with a solution called Bacteriostatic Water for Injection USP. Edex must be mixed with a solution called Sodium Chloride Injection USP. The solution for mixing comes with your product and may be already loaded into a syringe or contained in another injection bottle (vial). Another product is called Alprostadil Injection (brand names Prostin VR Pediatric and Prostin VR). Although the medicine is already in solution, it is much too strong to be injected into the penis. The solution must be mixed (diluted) with another liquid that is sold as a separate prescription, called 0.9% Sodium Chloride Injection USP. In most cases, a pharmacist will make this solution for you, giving you the proper strength that you need. Check with your doctor or pharmacist to make sure the solution has been diluted before using it.

It is important to follow several steps to prepare your alprostadil injection correctly. Before drawing up the medicine into the syringe:

Wash your hands with soap and water. Set the bottles on a clean surface. Wipe the top of the injection bottles with an alcohol swab. Do not wipe the needle. Throw away the alcohol swab. You may need to attach the needle to the syringe. Do not take the cap off yet.

How to mix Caverject:

If the syringe already contains the Bacteriostatic Water for Injection USP, then you need only add the plunger to the syringe. To do this: Pick up the rod-like plunger and place it within the barrel of the syringe until it touches the rubber piece. Gently screw the plunger into the rubber piece until it seems secure. Do not use a lot of force. Hold the syringe by the barrel (not the plunger) and take the cap off the needle. You are now ready to mix the water and the powder. Skip to the directions under the title, “To mix the water and powder." If the syringe does not already contain the Bacteriostatic Water for Injection USP, you must withdraw 1 milliliter (mL) of it from the bottle provided. To do this: Pick up the syringe and take the cap off the needle. Pull the plunger back to the 1-mL mark on the syringe. This pulls air into the syringe. Insert the needle into rubber top of the bottle while it is upright and inject the 1 mL of air into the bottle. Turn the bottle upside down using one hand. Be sure the tip of the needle is covered by solution. With your other hand, pull the plunger back slowly to withdraw 1 mL of solution into the syringe. Remove the needle and skip to the directions under the title, "To mix the water and powder." To mix the water and powder: Insert the needle into the bottle of alprostadil and inject 1 milliliter of Bacteriostatic Water for Injection USP from your syringe into the bottle of alprostadil. Remove the needle from the bottle, holding the barrel of the syringe. Gently swirl the bottle to mix the powder into the solution, turning it upside down to wet all the powder in the bottle. Follow the directions below, “How to draw your dose into the syringe."

How to mix Edex:

The syringe already contains the Sodium Chloride Injection USP. You need only attach the needle to the syringe and add the plunger. To do this: Remove the needle from its package. Do not remove the needle cap. Gently screw the needle into place on the syringe tip. Pick up the rod-like plunger and place it within the barrel of the syringe until it touches the rubber piece. Gently screw the plunger into the rubber piece until it seems secure. Do not use a lot of force. Hold the syringe by the barrel (not the plunger) and take the cap off the needle. You are now ready to mix the Sodium Chloride Injection USP and the powder. Insert the needle into the bottle of alprostadil and inject 1.2 milliliters of the Sodium Chloride Injection USP from your syringe into the bottle of alprostadil. Remove the needle from the bottle, holding the barrel of the syringe. Gently swirl the bottle to mix the powder into the solution, turning it upside down to wet all the powder in the bottle. Follow the directions below, “How to draw your dose into the syringe."

How to mix Prostin VR or Prostin VR Pediatric:

You will need to get exact mixing instructions from your doctor or pharmacist if you are given two solutions to be mixed. Follow them carefully, asking the pharmacist or doctor any questions that you might have before injecting the medicine. After you or the pharmacist has mixed these solutions, follow the directions below, “How to draw your dose into the syringe."

How to draw your dose into the syringe (for all injection products):

Check the solution to make sure it is clear. Do not use the mixture if you can see anything solid in the solution or if the solution is cloudy or colored. After the alprostadil solution is mixed and the needle is inserted into the alprostadil bottle, turn the bottle with the syringe as a unit upside down in one hand. Be sure the tip of the needle is covered by the solution. With your other hand, pull the plunger back slowly to draw the correct dose of the medicine into the syringe. Hold the syringe with the measuring scale at eye level to see that the proper dose is withdrawn and to check for air bubbles. To remove air bubbles, tap gently on the measuring scale of the syringe to move any bubbles to the top of the syringe near the needle. If your dose measures too low in the syringe, withdraw more solution from the bottle. If there is too much medicine in the syringe, put some back into the bottle. Then check your dose again. Remove the needle from the bottle, holding the barrel of the syringe, not the plunger. Place the cover back on the needle. You are now ready to inject your dose. Follow the directions below, “How to give the alprostadil injection."

How to give the alprostadil injection:

Choose a spot on your penis as directed by your doctor where you will give the injection. Clean the injection site with alcohol. Sitting upright or slightly reclined, hold your penis against the side of your thigh so that it cannot move. Remove the cover from the needle and hold the needle at a 90-degree angle to the place of injection. Insert the needle until almost all of the metal part of the needle is inserted into the penis. Do not inject the medicine just under the surface of the skin, at the top or head of the penis, or at the base of the penis near the scrotum or testes. Avoid injecting the medicine into blood vessels that you can see. Press the plunger down slowly, taking 5 to 10 seconds to release the dose into the penis. The injection is usually not painful. If the injection is very painful or if you notice bruising or swelling at the place of injection, that means you are injecting the medicine under the skin. Stop, withdraw the needle, and reposition it properly before continuing with the injection. Remove the needle and recap it. After you have completed the injection, put pressure on the place of injection for about 5 minutes or until any bleeding stops. This will prevent bruising. Then massage your penis as instructed by your doctor. This helps the medicine spread to all parts of the penis, so that the medicine will work better.

Choose a different place of injection each time you use the medicine to prevent skin problems. This includes switching the place of injection from the right side of the penis for one injection to the left side for the next injection.

After a single-use injection is mixed, the medicine must be used immediately. Throw away any unused mixture in the syringe. It cannot be stored for a later injection.

Do not reuse your needles.

How to throw away the syringes and bottles safely:

Dispose of your materials properly. Caverject comes in a plastic case that can be permanently locked with the red locking device that is included with the packaging. When the case label is removed, you can see a hole in the center of the case. The red locking device can be inserted and, by firmly pressing it down with your thumb, you will permanently lock the case. The locked case is safe to be thrown away.

If you do not have the plastic case or are using Prostin VR or Prostin VR Pediatric injection, unscrew the needle from the barrel of the syringe. Then bend, break, or cut the needle into two pieces with wire cutters. The pieces can be placed in a heavy plastic container, such as a bleach container, and thrown away. Or you may give them to a health care professional to throw away. If you have any questions about disposing of the syringe and needles, ask your health care professional.

For suppositories—Before inserting the suppository, you should urinate. The small amount of urine normally left in your urethra will help dissolve the suppository after it is inserted.

How to insert suppositories:

Remove the delivery device containing the suppository from the foil. Remove the cap from the applicator stem. Stretch your penis upward to extend its length, pressing your penis top and bottom. Gently insert the delivery stem up to its collar into your urethra (located at the top of the penis). If you have pain or a pulling feeling in the penis, withdraw the device and start again. Press the button down slowly as far as it will go. This releases the suppository into the urethra. After holding the delivery device within your penis still for 5 seconds, carefully rock the penis and delivery device as a unit from side to side. This helps remove the suppository from the device. Remove the delivery device while your penis is upright. Look at the device to make sure that the suppository was completely released. Repeat the process if a part of the suppository remains in the device. After the suppository is completely released, roll your penis between your hands for 10 seconds. This helps to dissolve the suppository. If you feel any stinging, continue this motion to help stop it. Sitting, standing, or walking for 10 minutes while an erection is developing helps increase the blood flow to your penis to gain a proper erection.

How to throw away the suppository delivery device safely:

Replace the cap on the delivery device. After storing it in the foil, fold and throw away.

For injections or suppositories—This medicine usually begins to work in about 5 to 10 minutes. You should attempt intercourse within 10 to 30 minutes after using the medicine. An erection may continue after ejaculation.

Dosing

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

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

For the treatment of erectile dysfunction: For injection dosage form: Adults—1.25 to 60 micrograms (mcg) as a single dose once a day. Your exact dose will be determined by your doctor. Inject this medicine very slowly into your penis as shown to you by your doctor ten to thirty minutes before intercourse. Allow five to ten seconds to completely inject the dose. Do not inject more than one dose within twenty-four hours. Also, do not use this medicine for more than two days in a row or more than three times a week. For suppository dosage form: Adults—125, 250, 500, or 1000 mcg as a single dose once a day. Your exact dose will be determined by your doctor. Insert this medicine into the urethra of your penis as shown to you by your doctor ten to thirty minutes before intercourse. Do not insert more than two doses within twenty-four hours. Storage

Store in the refrigerator. Do not freeze.

You may store the suppositories in the refrigerator, but do not freeze them.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Alprostadil for Injection while in the powder form can be stored at room temperature (between 15 and 25 °C or 59 and 77 °F) for 3 months. After it is mixed, the solution must be used immediately. Suppositories may be stored at room temperature

Precautions While Using Muse

Do not use alprostadil if you have a penile implant unless advised by doctor.

If using the alprostadil suppository, use a condom when having sexual intercourse with a pregnant female. Although harm to the fetus is unlikely, using a condom will protect the fetus from exposure to this medicine. If a woman can become pregnant, use of contraceptive methods is recommended because the effects of this medicine on early pregnancy are not known.

Use alprostadil exactly as directed by your doctor . Do not use more of it and do not use it more often than your doctor ordered. If too much is used, the erection lasts too long and does not reverse when it should. This condition is called priapism. If the erection is not reversed, the blood supply to the penis may be cut off and permanent damage may occur.

Contact your doctor immediately if the erection lasts longer than 4 hours or if it becomes painful. This may be a sign of priapism and must be treated right away to prevent permanent damage.

If you notice bleeding at the place where you injected the medicine, put pressure on the spot until the bleeding stops. If it doesn't stop within 10 minutes, check with your doctor.

Muse Side Effects

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

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

Rare Curving of penis with pain during erection erection continuing for 4 to 6 hours erection continuing longer than 6 hours with severe and continuing pain of the penis swelling in or pain of the testes Symptoms of too much medicine being absorbed into the body Dizziness faintness pelvic pain flu-like symptoms

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 Bleeding at place of injection, short-term mild bleeding or spotting from urethra (suppository only) pain at place of injection painful erection stinging of urethra (suppository only) Rare

Female partners may experience itching or stinging of vagina when you first begin using the alprostadil suppository. These side effects may not be caused from the medicine but may result if female partner has not had frequent or recent sexual intercourse.

Bruising or clotted blood in penis at place of injection, usually caused by an incorrect injection

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

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

See also: Muse side effects (in more detail)

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

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

More Muse resources Muse Side Effects (in more detail) Muse Use in Pregnancy & Breastfeeding Muse Drug Interactions Muse Support Group 4 Reviews for Muse - Add your own review/rating Muse Prescribing Information (FDA) Muse Suppository MedFacts Consumer Leaflet (Wolters Kluwer) Muse injectable and transurethral Concise Consumer Information (Cerner Multum) Alprostadil Monograph (AHFS DI) Alprostadil Prescribing Information (FDA) Alprostadil MedFacts Consumer Leaflet (Wolters Kluwer) Caverject Prescribing Information (FDA) Edex MedFacts Consumer Leaflet (Wolters Kluwer) Prostin VR Pediatric Prescribing Information (FDA) Compare Muse with other medications Erectile Dysfunction
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Cialis 5mg film-coated tablets


CIALIS 5 mg film-coated tablets

tadalafil

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 any further questions, ask your doctor or pharmacist. This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours. If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. In this leaflet: 1. What CIALIS is and what it is used for 2. Before you take CIALIS 3. How to take CIALIS 4. Possible side effects 5. How to store CIALIS 6. Further information What Cialis Is And What It Is Used For

CIALIS is a treatment for men with erectile dysfunction. This is when a man cannot get, or keep a hard, erect penis suitable for sexual activity.

CIALIS belongs to a group of medicines called phosphodiesterase type 5 inhibitors. Following sexual stimulation CIALIS works by helping the blood vessels in your penis to relax, allowing the flow of blood into your penis. The result of this is improved erectile function. CIALIS will not help you if you do not have erectile dysfunction.

It is important to note that CIALIS does not work if there is no sexual stimulation. You and your partner will need to engage in foreplay, just as you would if you were not taking a medicine for erectile dysfunction.

Before You Take Cialis Do not take CIALIS if you are allergic (hypersensitive) to tadalafil or any of the other ingredients of CIALIS. if you are taking any form of organic nitrate or nitric oxide donors such as amyl nitrite. This is a group of medicines (“nitrates”) used in the treatment of angina pectoris (“chest pain”). CIALIS has been shown to increase the effects of these medicines. If you are taking any form of nitrate or are unsure tell your doctor. if you have serious heart disease or have had a recent heart attack. if you have had a recent stroke. if you have low blood pressure or uncontrolled high blood pressure. if you have ever had loss of vision because of non-arteritic anterior ischemic optic neuropathy (NAION), a condition sometimes described as “stroke of the eye”. Take special care with CIALIS

Be aware that sexual activity carries a possible risk to patients with heart disease because it puts an extra strain on your heart. If you have a heart problem you should tell your doctor.

The following are reasons why CIALIS may also not be suitable for you. If any of them apply to you, talk to your doctor before you take the medicine:

You have sickle cell anaemia (an abnormality of red blood cells), multiple myeloma (cancer of the bone marrow), leukaemia (cancer of the blood cells) or any deformation of your penis. You have a serious liver problem. You have a severe kidney problem.

It is not known if CIALIS is effective in patients who have undergone pelvic surgery or radical non-nerve-sparing prostatectomy

If you experience sudden decrease or loss of vision, stop taking CIALIS and contact your doctor immediately.

CIALIS is not intended for use by women or by adolescents under the age of 18.

Using other medicines

Please tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription, because they might interact.

This is particularly important if you are treated with nitrates as you should not take CIALIS if you are taking these medicines.

A type of medicine called an alpha blocker is sometimes used to treat high blood pressure and enlarged prostate. Tell your doctor if you are being treated for either of these conditions or if you take other medicines to treat high blood pressure.

If you are taking medicines that can inhibit an enzyme called CYP3A4 (for example ketoconazole or protease inhibitors for treatment of HIV) the frequency of side effects might increase.

Do not take CIALIS with other medicines if your doctor tells you that you may not.

You should not use CIALIS together with any other treatments for erectile dysfunction.

Taking CIALIS with food and drink

You may take CIALIS with or without food.

Information on the effect of alcohol is in section 3.

Driving and using machines

Some men taking CIALIS in clinical studies have reported dizziness. Check carefully how you react to the medicines before driving or using any machinery.

Important information about some of the ingredients of CIALIS:

CIALIS contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

How To Take Cialis

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

Once a day dosing of CIALIS may be useful to men who anticipate having sexual activity two or more times per week. The recommended dose is one 5 mg tablet taken once a day at approximately the same time of the day. Your doctor may adjust the dose to 2.5 mg based on your response to CIALIS. CIALIS tablets are for oral use. Swallow the tablet whole with some water. You may take CIALIS with or without food.

When taken once a day CIALIS allows you to obtain an erection, when sexually stimulated, at any time point during the 24 hours of the day. It is important to note that CIALIS does not work if there is no sexual stimulation. You and your partner will need to engage in foreplay, just as you would if you were not taking a medicine for erectile dysfunction.

Drinking alcohol may affect your ability to get an erection. Drinking alcohol may temporarily lower your blood pressure. If you have taken or are planning to take CIALIS, avoid excessive drinking (blood alcohol level of 0.08% or greater), since this may increase the risk of dizziness when standing up.

You should NOT take CIALIS more than once a day.

If you take more CIALIS than you should

Tell your doctor.

If you forget to take CIALIS

Do not take a double dose to make up for a forgotten tablet.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

Possible Side Effects

Like all medicines, CIALIS can cause side effects, although not everybody gets them. These effects are normally mild to moderate in nature.

In this leaflet, when a side effect is described as “very common” this means that it has been reported in at least 1 in 10 patients taking the medicine. When a side effect is described as “common” this means that it has been reported in more than 1 in every 100 patients but less than 1 in every 10 patients. When a side effect is described as “uncommon”, this means it has been reported in more than 1 in every 1,000 patients, but less than 1 in every 100 patients. When a side effect is described as “rare”, this means it has been reported in more than 1 in every 10,000 patients, but less than 1 in every 1,000 patients.

Very commonly reported side effects in patients taking CIALIS were headache and indigestion.

Commonly reported side effects in patients taking CIALIS include back pain, muscle aches, facial flushing, nasal congestion, dizziness, pounding heartbeat sensation, abdominal pain and reflux.

Uncommon side effects are allergic reactions including rashes and hives, blurred vision, swelling of the eyelids, eye pain, red eyes, increased sweating, nose bleeds, a fast heart rate, high blood pressure, low blood pressure and chest pain. In case of chest pain occurring during or after sexual activity you should NOT use nitrates but you should seek immediate medical assistance.

Rare side effects in patients taking CIALIS include fainting, migraine and swelling of the face.

In rare instances it is possible that a prolonged and possibly painful erection may occur after taking CIALIS. If you have such an erection, which lasts continuously for more than 4 hours, you should contact a doctor immediately.

Heart attack and stroke have also been reported rarely in men taking CIALIS. Most, but not all of these men had known heart problems before taking this medicine. It is not possible to determine whether these events were directly related to CIALIS.

Partial, sudden, temporary, or permanent decrease or loss of vision in one or both eyes has been rarely reported.

Some additional side effects have been reported in men taking CIALIS that were not seen in clinical trials and their incidence is unknown. These include seizures and passing memory loss, some disorders affecting blood flow to the eyes, irregular heartbeats and angina, serious skin rashes and sudden cardiac death. Sudden decrease or loss of hearing has been reported.

Effects were seen in one animal species that might indicate impairment of fertility. Subsequent studies in man suggest that this effect is unlikely in humans, although a decrease in sperm concentration was seen in some men.

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 Cialis

Keep out of the reach and sight of children.

Do not use CIALIS after the expiry date stated on the carton and blister.

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

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

Further Information What CIALIS contains

The active substance is tadalafil. Each tablet contains 5 mg of tadalafil.

The other ingredients are:

Tablet core: lactose monohydrate, croscarmellose sodium, hydroxypropylcellulose, microcrystalline cellulose, sodium laurilsulfate, magnesium stearate.

Film-coat: lactose monohydrate, hypromellose, triacetin, titanium dioxide (E171), iron oxide yellow (E172), talc.

What CIALIS looks like and contents of the pack

CIALIS 5 mg strength comes as light yellow film-coated tablets. They are in the shape of almonds and have "C 5" marked on one side.

CIALIS 5 mg is available in blister packs containing 14 or 28 tablets.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder:

Eli Lilly Nederland B.V. Grootslag 1-5 NL-3991 RA Houten The Netherlands

Manufacturer:

Eli Lilly and Company Ltd Kingsclere Road Basingstoke Hampshire RG21 6XA United Kingdom


Lilly S.A. Avda. de la Industria 30 28108 Alcobendas Madrid Spain

For any information about this medicinal product, please contact the local representative of the Marketing Authorisation Holder.

United Kingdom Eli Lilly and Company Limited Tel:+44-(0) 1256 315999

This leaflet was last approved in March 2008.

Detailed information on this medicine is available on the European Medicines Agency (EMEA) web site: http://www.emea.europa.eu


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Boots Antifungal Cream


Boots Antifungal Cream

(Clotrimazole)

for fungal infections of the skin

20 g

Read all of this carton for full instructions.

What this medicine is for

An antifungal cream for the treatment of fungal skin infections including ringworm, athlete’s foot, fungal nappy rash, infections of the armpit, groin, toes and skin folds and thrush of the vulva or penis.

Before you use this medicine Do not use: If you are allergic to any of the ingredients If you are pregnant or breastfeeding, unless your doctor or midwife tells you to

Information about some of the ingredients: The ingredients in the cream may affect the latex used in contraceptives such as condoms and diaphragms. This may reduce the effectiveness of the contraceptives. You should therefore use other methods of contraception for at least 5 days after using this medicine in the genital area. You may, for example, use a spermicide gel in addition to the condom or diaphragm. If you need more advice about this speak to your pharmacist.

Cetyl alcohol and stearyl alcohol in this medicine may cause skin reactions (e.g. contact dermatitis).

How to use this medicine

Check the tube seal is not broken before first use. If it is, do not use the cream.

Pierce tube seal with end of cap.

Adults and children: Apply to the affected area two or three times a day. Use the cream for at least 2 weeks. In some cases it may be necessary to continue to use the cream for more than 4 weeks.

If you are using the cream for a foot infection, make sure your feet, especially between the toes, are washed and thoroughly dried before applying the cream. Apply to the skin only.

Do not use more than the amount recommended above.

If symptoms do not go away talk to your doctor.

If anyone accidentally swallows some: Talk to a doctor straight away.

Possible side effects

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

If you get these side effects, stop using the cream and see a doctor: Allergic reaction (e.g. skin rash, red or itchy skin) These other effects are less serious. If they bother you talk to a pharmacist: Rarely, mild burning or irritation immediately after using the cream Pain

If any side effect becomes severe, or 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 end flap of the carton.

Active ingredient

This topical cream contains Clotrimazole 1% w/w.

Also contains: purified water, 2-octyldodecanol, stearyl alcohol, cetyl alcohol, cetyl esters wax, sorbitan stearate, polysorbate 60, benzyl alcohol.

PL 10622/0004 [P]

Text prepared 8/08

Manufactured for The Boots Company PLC Nottingham NG2 3AA

by

Thornton & Ross Ltd Linthwaite Huddersfield West Yorkshire HD7 5QH Marketing Authorisation held by PLIVA Pharma Ltd Vision House Bedford Road Petersfield Hampshire GU32 2QB

If you need more advice ask your pharmacist.

1498cXPil


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tadalafil


Generic Name: tadalafil (ta DAL a fil)
Brand Names: Adcirca, Cialis

What is tadalafil?

Tadalafil relaxes muscles and increases blood flow to particular areas of the body.

Tadalafil under the name of Cialis is used to treat erectile dysfunction (impotence) and symptoms of benign prostatic hypertrophy (enlarged prostate). Another brand of sildenafil is Adcirca, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women.

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

What is the most important information I should know about tadalafil? Do not take tadalafil if you are allergic to it, or if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin (Nitro Dur, Nitrolingual, Nitrostat, Transderm Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking tadalafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure. If you become dizzy or nauseated during sexual activity, or if you have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of tadalafil. Do not take tadalafil more than once a day. Allow 24 hours to pass between doses. Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

Tadalafil can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking tadalafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old. It is not clear whether tadalafil is the actual cause of vision loss.

Stop using tadalafil and get emergency medical help if you have sudden vision loss. What should I discuss with my healthcare provider before taking tadalafil? You should not take tadalafil if you are allergic to it.

Tadalafil should not be used together with nitrate medication, such as nitroglycerin (Nitro Dur, Nitrolingual, Nitrostat, Transderm Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking tadalafil with a nitrate medicine for chest pain or heart problems can cause a sudden and serious decrease in blood pressure.

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

heart disease or heart rhythm problems;

a recent heart attack (within the past 90 days);

a recent history (in the past 6 months) of a stroke, or congestive heart failure;

angina (chest pain), high or low blood pressure;

liver disease;

kidney disease (or if you are on dialysis);

a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;

a bleeding disorder such as hemophilia;

a stomach ulcer;

retinitis pigmentosa (an inherited condition of the eye);

a physical deformity of the penis (such as Peyronie's disease); or

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

Tadalafil can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking tadalafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.

It is not clear whether tadalafil is the actual cause of vision loss. Stop using tadalafil and get emergency medical help if you have sudden vision loss. FDA pregnancy category B. Tadalafil is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment with Adcirca. It is not known whether tadalafil passes into breast milk or if it could harm a nursing baby. Do not use Adcirca without telling your doctor if you are breast-feeding a baby. How should I take tadalafil?

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.

Tadalafil can be taken with or without food.

Do not break or split a Cialis tablet. Swallow it whole.

Cialis is usually taken only once per day. Follow your doctor's instructions. For erectile dysfunction, take the medicine just before sexual activity but not more than once per day.

Cialis can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor's instructions.

Adcirca is usually taken once per day. Follow your doctor's instructions. Do not take Cialis for erectile dysfunction if you are taking Adcirca for pulmonary arterial hypertension.

Do not take tadalafil more than once a day. Allow 24 hours to pass between doses. If you take the medication daily, take it at the same time each day. Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis. Store at room temperature away from moisture and heat.

See also: Tadalafil dosage (in more detail)

What happens if I miss a dose?

If tadalafil is used as needed, you are not likely to be on a dosing schedule.

If you take tadalafil every day and you 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 chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

What should I avoid while taking tadalafil? Drinking alcohol can increase certain side effects of tadalafil.

Grapefruit and grapefruit juice may interact with tadalafil and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Avoid using other medicines to treat erectile dysfunction, such as sildenafil (Viagra) or vardenafil (Levitra) while you are taking tadalafil. Tadalafil 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. If you become dizzy or nauseated during sexual activity, or if you have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of tadalafil. Stop using tadalafil and call your doctor at once if you have any of these serious side effects:

changes in vision or sudden vision loss;

ringing in your ears, or sudden hearing loss;

chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

irregular heartbeat;

shortness of breath, swelling in your hands or feet;

seizure (convulsions);

feeling light-headed, fainting; or

penis erection that is painful or lasts 4 hours or longer.

Less serious side effects may include:

redness or warmth in your face, neck, or chest;

cold symptoms such as stuffy nose, sneezing, or sore throat;

headache;

memory problems;

diarrhea, upset stomach; or

muscle pain, back pain.

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.

Tadalafil Dosing Information

Usual Adult Dose for Erectile Dysfunction:

Erectile dysfunction:
10 mg orally taken prior to anticipated sexual activity. The maximum recommended dosing frequency is once per day in most patients.
Alternatively, 2.5 mg orally once daily, without regard to timing of sexual activity. May increase to 5 mg orally once daily based on efficacy and tolerability.
Erectile dysfunction and benign prostatic hyperplasia together:
5 mg orally taken at approximately the same time every day.

Usual Adult Dose for Pulmonary Hypertension:

40 mg orally once daily, with or without food. Dividing the dose (40 mg) over the course of the day is not recommended.

Usual Adult Dose for Benign Prostatic Hyperplasia:

Benign prostatic hyperplasia and benign prostatic hyperplasia with erectile dysfunction:
5 mg orally taken at approximately the same time every day.

What other drugs will affect tadalafil?

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

rifabutin (Mycobutin), rifampin (Rifadin, Rimactane, Rifater, Rifamate), or rifapentine (Priftin);

an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), or telithromycin (Ketek);

antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);

an antidepressant such as nefazodone;

a barbiturate such as phenobarbital (Solfoton);

drugs to treat high blood pressure or a prostate disorder, such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), terazosin (Hytrin), tamsulosin (Flomax);

heart or blood pressure medication such as diltiazem (Cardizem, Dilacor, Tiazac), nicardipine (Cardene), quinidine (Quin-G), or verapamil (Calan, Covera, Isoptin, Verelan); or

HIV or AIDS medications such as darunavir (Prezista), efavirenz (Sustiva), etravirine (Intelence), nevirapine (Viramune), fosamprenavir (Lexiva), indinavir (Crixivan), ritonavir (Norvir, Kaletra), and others; or

seizure medications such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin), and others.

This list is not complete and other drugs may interact with tadalafil. 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 tadalafil resources Tadalafil Side Effects (in more detail) Tadalafil Dosage Tadalafil Use in Pregnancy & Breastfeeding Tadalafil Drug Interactions Tadalafil Support Group 103 Reviews for Tadalafil - Add your own review/rating tadalafil Advanced Consumer (Micromedex) - Includes Dosage Information Tadalafil MedFacts Consumer Leaflet (Wolters Kluwer) Tadalafil Monograph (AHFS DI) Tadalafil Professional Patient Advice (Wolters Kluwer) Adcirca Prescribing Information (FDA) Adcirca Consumer Overview Adcirca MedFacts Consumer Leaflet (Wolters Kluwer) Cialis Prescribing Information (FDA) Cialis Consumer Overview Compare tadalafil with other medications Benign Prostatic Hyperplasia Erectile Dysfunction Pulmonary Arterial Hypertension Where can I get more information? Your pharmacist can provide more information about tadalafil.

See also: tadalafil side effects (in more detail)


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Levitra


Generic Name: vardenafil (Oral route)

var-DEN-a-fil

Commonly used brand name(s)

In the U.S.

Levitra Staxyn

Available Dosage Forms:

Tablet Tablet, Disintegrating

Therapeutic Class: Erectile Dysfunction Agent

Pharmacologic Class: Phosphodiesterase Type 5 Inhibitor

Uses For Levitra

Vardenafil is used to treat men who have erectile dysfunction (also called sexual impotence). Vardenafil belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors. These medicines prevent an enzyme called phosphodiesterase type-5 from working too quickly. The penis is one of the areas where this enzyme works.

Erectile dysfunction is a condition where the penis does not harden and expand when a man is sexually excited, or when he cannot keep an erection. When a man is sexually stimulated, his body's normal response is to increase blood flow to his penis to produce an erection. By controlling the enzyme, vardenafil helps to maintain an erection after the penis is stroked by increasing blood flow to the penis. Without physical action to the penis, such as that occurring during sexual intercourse, vardenafil will not work to cause an erection.

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

Before Using Levitra

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

Allergies

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

Pediatric

Vardenafil is not indicated for use in children. Safety and efficacy have not been established.

Geriatric

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

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

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

Interactions with Medicines

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

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

Cisapride Dronedarone Erythrityl Tetranitrate Fluconazole Isosorbide Dinitrate Isosorbide Mononitrate Mesoridazine Nitroglycerin Pentaerythritol Tetranitrate Pimozide Posaconazole Sparfloxacin Thioridazine

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

Acecainide Amiodarone Amitriptyline Amoxapine Apomorphine Arsenic Trioxide Asenapine Astemizole Azimilide Azithromycin Boceprevir Bretylium Chloroquine Chlorpromazine Ciprofloxacin Citalopram Clomipramine Clozapine Crizotinib Dasatinib Desipramine Disopyramide Dofetilide Dolasetron Flecainide Gatifloxacin Granisetron Halofantrine Haloperidol Ibutilide Iloperidone Imipramine Lapatinib Levofloxacin Lopinavir Lumefantrine Mefloquine Methadone Moricizine Moxifloxacin Nilotinib Norfloxacin Nortriptyline Octreotide Ofloxacin Ondansetron Paliperidone Pazopanib Perflutren Lipid Microsphere Procainamide Prochlorperazine Promethazine Propafenone Protriptyline Quetiapine Quinidine Quinine Ranolazine Salmeterol Saquinavir Sematilide Sodium Phosphate Sodium Phosphate, Dibasic Sodium Phosphate, Monobasic Solifenacin Sorafenib Sotalol Sunitinib Tedisamil Telaprevir Telithromycin Terfenadine Tetrabenazine Toremifene Trazodone Trifluoperazine Trimipramine Vandetanib Vemurafenib Voriconazole Ziprasidone

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

Alfuzosin Amprenavir Bunazosin Doxazosin Indinavir Itraconazole Phenoxybenzamine Phentolamine Prazosin Tamsulosin Terazosin Trimazosin Urapidil Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

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

Abnormal penis, including curved penis and birth defects of the penis—Chance of problems occurring may be increased and this medicine should be used with caution in these patients. Age greater than 50 years or Coronary artery disease or Diabetes or Hyperlipidemia (excess of lipids in the blood) or Hypertension (high blood pressure) or Low cup to disc ratio (eye condition also called "crowded disc") or Smoking—These conditions may increase risk for a serious eye problem called non-arteritic ischemic optic neuropathy or NAION. Angina (reoccurring chest pain) or Arrhythmia (irregular heartbeat) or Heart attack (within the last 6 months) or Heart failure, severe or Hypertension (high blood pressure), uncontrolled or Hypotension (low blood pressure) or Kidney disease, severe or Liver disease, severe or Retinal disorders (eye problem) or Retinitis pigmentosa (an inherited eye disorder) or Stroke, recent history of—Should not be used in patients with these conditions. Bleeding disorders or Stomach ulcers—Chance of problems occurring may be increased; it is not known if the medicine is safe for use in these patients. Bone marrow cancer or Leukemia (blood related cancer) or Multiple myeloma (blood related cancer) or Sickle-cell anemia (blood disorder)—Vardenafil should be used with caution in these patients as problems with prolonged erection of the penis may occur. Fructose intolerance—The orally disintegrating tablet contains sorbitol, which can make this condition worse. Heart blood flow problems—These conditions may cause you to be more sensitive to vardenafil. Heart disease, underlying—Chance of low blood pressure occurring is greater; vardenafil should be used carefully in these patients. Kidney disease or Liver disease—Chance of problems occurring may be increased. Lower starting doses may be used and doses increased as needed and as tolerated. NAION (serious eye condition) in one or both eyes, history of—May increase your chance of getting NAION again. Phenylketonuria (PKU)—The orally disintegrating tablet contains phenylalanine, which can make this condition worse. QT prolongation (rare heart condition), or history of—Use with caution. May make this condition worse. Proper Use of vardenafil

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

Use vardenafil exactly as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. If too much is used, the chance of side effects or other problems is increased.

Special patient instructions come with vardenafil. Read the directions carefully before you start using vardenafil and each time you get a refill of your medicine.

You may take this medicine with or without food.

This medicine usually begins to work within 60 minutes after taking it. It continues to work for up to 4 hours. Stimulation is required for an erection. If you have any questions about the use and benefits of vardenafil ask your doctor.

If you are using the disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not open the blister pack that contains the tablet until you are ready to take it. Remove the tablet from the blister pack by peeling back the foil, then taking the tablet out. Do not push the tablet through the foil. Place the tablet on your tongue. It should melt quickly. The tablet should be taken without liquids. Do not break, crush, or chew it.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Dosing

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

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

For treatment of erectile dysfunction (as needed): For oral dosage form (disintegrating tablets): Adults—10 milligrams (mg) as a single dose, no more than once a day, taken 1 hour before you think sexual activity may occur. Children—Use is not recommended. For oral dosage form (tablets): Adults 65 years of age and older—5 milligrams (mg) as a single dose no more than once a day, 1 hour before sexual intercourse. Your doctor may change your dose if needed. Adults up to 65 years of age—10 mg as a single dose no more than once a day, 1 hour before sexual activity. Your doctor may change your dose if needed. Children—Use is not recommended. Storage

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

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

Precautions While Using Levitra

It is important that you tell all of your doctors that you take vardenafil. If you need emergency medical care for a heart problem, it is important that your doctor knows when you last took vardenafil.

Levitra® also contains vardenafil. If you take too much vardenafil or take it together with these medicines, the chance for side effects will be higher.

If you experience a prolonged or painful erection for 4 hours or more, contact your doctor immediately. This condition may require prompt medical treatment to prevent serious and permanent damage to your penis.

This medicine does not protect you against sexually transmitted diseases. Use protective measures and ask your doctor if you have any questions about this.

It is important to tell your doctor about any heart problems you may have now or may have had in the past. This medicine can cause serious side effects in patients with heart problems.

Do not use this medicine if you are also using a nitrate medicine, often used to treat angina (chest pain). Nitrate medicines include nitroglycerin, isosorbide, Imdur®, Nitro-Bid®, Nitrostat®, Nitro-Dur®, Transderm Nitro®, Nitrol® Ointment, and Nitrolingual® Spray. Some illegal ("street") drugs called "poppers" (such as amyl nitrate, butyl nitrate, or nitrite) also contain nitrates.

Do not drink excessive amounts of alcohol (e.g., 5 glasses of wine or 5 shots of whiskey) when taking vardenafil. When taken in excess, alcohol can increase your chances of getting a headache or getting dizzy, increase your heart rate, or lower your blood pressure.

If you have sudden loss of vision in one or both eyes, stop using vardenafil and contact your doctor right away.

Stop using this medicine and check with your doctor right away if you have sudden decrease in hearing or loss of hearing, which may be accompanied by dizziness and ringing in the ears.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

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

Levitra Side Effects

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

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

Less common Arm, back, or jaw pain blindness blurred vision chest pain or discomfort chest tightness or heaviness chills cold sweats confusion decreased vision difficult or labored breathing difficulty with swallowing dizziness dizziness, faintness, or lightheadedness when getting up from a lying or sitting position eye pain fainting fast, irregular, pounding, or racing heartbeat or pulse headache hives itching nausea nervousness pain or discomfort in the arms, jaw, back, or neck pounding in the ears puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue shortness of breath skin rash slow or fast heartbeat sweating tearing tightness in the chest unusual tiredness or weakness vomiting wheezing Incidence not known Hearing loss

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 Feeling of warmth and redness of the face, neck, arms, and occasionally, upper chest sneezing stuffy nose Less common Abnormal ejaculation abdominal or stomach pain abnormal vision acid or sour stomach back pain belching bloody nose body aches or pain burning feeling in the chest or stomach burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings changes in color vision changes in vision congestion cough diarrhea difficulty seeing at night difficulty with moving difficulty with swallowing dim vision dry mouth dryness or soreness of the throat excessive muscle tone eye pain face swelling fast heartbeat feeling of constant movement of self or surroundings fever general feeling of discomfort or illness heartburn hoarseness increased redness of the eye increased sensitivity of the eyes to sunlight indigestion itching skin joint pain lack or loss of strength loss of appetite muscle aches and pains muscle cramping muscle stiffness muscle tension or tightness neck pain pain pain or burning in the throat runny nose sensation of spinning shivering sleepiness or unusual drowsiness sleeplessness sore throat sores, ulcers, or white spots on the lips or tongue or inside the mouth stomach discomfort, upset, or pain swollen joints tender, swollen glands in the neck tenderness in the stomach area trouble with sleeping trouble with swallowing unable to sleep voice changes watery 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.

See also: Levitra side effects (in more detail)

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

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

More Levitra resources Levitra Side Effects (in more detail) Levitra Use in Pregnancy & Breastfeeding Drug Images Levitra Drug Interactions Levitra Support Group 40 Reviews for Levitra - Add your own review/rating Levitra Monograph (AHFS DI) Levitra Consumer Overview Levitra MedFacts Consumer Leaflet (Wolters Kluwer) Levitra Prescribing Information (FDA) Staxyn Prescribing Information (FDA) Staxyn Orally Disintegrating Tablets MedFacts Consumer Leaflet (Wolters Kluwer) Staxyn Consumer Overview Compare Levitra with other medications Erectile Dysfunction
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Cialis


Generic Name: tadalafil (Oral route)

ta-DAL-a-fil

Commonly used brand name(s)

In the U.S.

Adcirca Cialis

Available Dosage Forms:

Tablet

Therapeutic Class: Erectile Dysfunction Agent

Pharmacologic Class: Phosphodiesterase Type 5 Inhibitor

Uses For Cialis

Tadalafil is used to treat men who have erectile dysfunction (also called sexual impotence). Tadalafil belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors. These medicines prevent an enzyme called phosphodiesterase type-5 from working too quickly. The penis is one of the areas where this enzyme works.

Erectile dysfunction is a condition where the penis does not harden and expand when a man is sexually excited, or when he cannot keep an erection. When a man is sexually stimulated, his body's normal response is to increase blood flow to his penis to produce an erection. By controlling the enzyme, tadalafil helps to maintain an erection after the penis is stroked by increasing blood flow to the penis. Without physical action to the penis, such as that occurring during sexual intercourse, tadalafil will not work to cause an erection.

Tadalafil is also used to treat men who have signs and symptoms of benign prostatic hyperplasia (BPH). BPH is caused by an enlarged prostate. Men with BPH usually have difficulty urinating, a decreased flow of urination, hesitation at the beginning of urination, and a need to get up at night to urinate. Tadalafil will make these symptoms less severe and reduce the chance that prostate surgery will be needed. This medicine is also used to treat erectile dysfunction and signs and symptoms of BPH.

Tadalafil is also used in both men and women to treat the symptoms of pulmonary arterial hypertension. This is high blood pressure that occurs in the main artery that carries blood from the right side of the heart (the ventricle) to the lungs. When the smaller blood vessels in the lungs become more resistant to blood flow, the right ventricle must work harder to pump enough blood through the lungs. Tadalafil works on the PDE5 enzyme in the lungs to relax the blood vessels. This will increase the supply of blood to the lungs and reduce the workload of the heart.

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

Before Using Cialis

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

Allergies

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

Pediatric

Use of Cialis® tablet is not indicated for use in the pediatric population. Safety and efficacy have not been established.

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

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of tadalafil in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving tadalafil.

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

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

Interactions with Medicines

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

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

Boceprevir Erythrityl Tetranitrate Isosorbide Dinitrate Isosorbide Mononitrate Nitroglycerin Pentaerythritol Tetranitrate Telaprevir

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

Alfuzosin Atazanavir Bunazosin Clarithromycin Erythromycin Indinavir Itraconazole Ketoconazole Moxisylyte Nefazodone Nelfinavir Phenoxybenzamine Phentolamine Prazosin Saquinavir Simvastatin Tamsulosin Telithromycin Terazosin Trimazosin Urapidil

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

Doxazosin Rifampin Ritonavir Silodosin Tipranavir Interactions with Food/Tobacco/Alcohol

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

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

Grapefruit Juice

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Ethanol Other Medical Problems

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

Abnormal penis, including curved penis and birth defects of the penis—Chance of problems occurring may be increased and this medicine should be used with caution in these patients. Age greater than 50 years or Coronary artery disease or Diabetes or Hyperlipidemia (high lipids or fats in the blood) or Hypertension (high blood pressure) or Low cup to disc ratio (eye condition also called "crowded disc") or Smoking—These conditions may increase risk for a serious eye problem called non-arteritic ischemic optic neuropathy or NAION. Angina (reoccurring chest pain) or Arrhythmia (irregular heartbeat), uncontrolled or Heart attack (within the last 3 months) or Heart failure (within the last 6 months) or Hypertension (high blood pressure) or Hypotension (low blood pressure), uncontrolled or Retinal disorders (eye problem) or Retinitis pigmentosa (an inherited eye disorder) or Stroke, recent history of—Should not be used in patients with these conditions. Bleeding disorders or Stomach ulcers—Chance of problems occurring may be increased; it is not known if the medicine is safe for use in these patients. Bone marrow cancer or Leukemia (blood related cancer) or Multiple myeloma (blood related cancer) or Sickle-cell anemia (blood disorder)—Tadalafil should be used with caution in these patients as problems with prolonged erection of the penis may occur. Heart blood flow problems—These conditions may cause you to be more sensitive to tadalafil. Heart disease, underlying—Chance of low blood pressure occurring is greater; tadalafil should be used carefully in these patients. Kidney disease, severe or Liver disease—Use with caution. May increase risk of having unwanted effects. Lower starting doses may be used and doses increased as needed and as tolerated. NAION (serious eye condition) in one or both eyes, history of—May increase your chance of getting NAION again. Proper Use of tadalafil

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

Use tadalafil exactly as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. If too much is used, the chance of side effects or other problems is increased.

Special patient instructions come with tadalafil. Read the directions carefully before you start using tadalafil and each time you get a refill of your medicine.

You may take this medicine with or without food.

Swallow the Cialis® tablet whole. Do not split, break, or crush it.

When using this medicine for erectile dysfunction, the ability to have sexual activity may be improved for up to 36 hours after taking the tablet.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Dosing

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

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

For oral dosage form (tablets): For treatment of benign prostatic hyperplasia (daily use): Adults—5 milligrams (mg) as a single dose, no more than once a day, taken at the same time each day. Children—Use is not recommended. For treatment of erectile dysfunction (as needed): Adults—10 milligrams (mg) as a single dose, no more than once a day, taken 30 minutes before you think sexual activity may occur. Your doctor may adjust your dose if needed. Children—Use is not recommended. For treatment of erectile dysfunction (daily use): Adults—2.5 milligrams (mg) once a day, taken at the same time each day, without regard for the timing of sexual activity. Your doctor may adjust your dose if needed. Children—Use is not recommended. For treatment of erectile dysfunction and benign prostatic hyperplasia (daily use): Adults—5 milligrams (mg) once a day, taken at the same time each day, without regard for the timing of sexual activity. Children—Use is not recommended. For treatment of pulmonary arterial hypertension: Adults—40 milligrams (mg) once a day. Children—Use and dose must be determined by your doctor. Missed Dose

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

Storage

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

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

Precautions While Using Cialis

It is important that you tell all of your doctors that you take tadalafil. If you need emergency medical care for a heart problem, it is important that your doctor knows when you last took tadalafil.

If you will be taking this medicine for pulmonary arterial hypertension, your doctor will want to check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

If you take tadalafil for pulmonary arterial hypertension, do not take Cialis® or other PDE5 inhibitors, such as sildenafil (Revatio® or Viagra®) or vardenafil (Levitra®). Cialis® also contains tadalafil. If you take too much tadalafil or take it together with these medicines, the chance for side effects will be higher.

If you experience a prolonged or painful erection for 4 hours or more, contact your doctor immediately. This condition may require prompt medical treatment to prevent serious and permanent damage to your penis.

This medicine does not protect you against sexually transmitted diseases (including HIV or AIDS). Use protective measures and ask your doctor if you have any questions about this.

It is important to tell your doctor about any heart problems you have now or may have had in the past. This medicine can cause serious side effects in patients with heart problems.

Do not use this medicine if you are also using a nitrate medicine, often used to treat angina (chest pain). Nitrate medicines include nitroglycerin, isosorbide, Imdur®, Nitro-Bid®, Nitrostat®, Nitro-Dur®, Transderm Nitro®, Nitrol® Ointment, and Nitrolingual® Spray. Some illegal ("street") drugs called "poppers" (such as amyl nitrate, butyl nitrate, or nitrite) also contain nitrates.

Do not drink excessive amounts of alcohol (e.g., 5 glasses of wine or 5 shots of whiskey) when taking tadalafil. When taken in excess, alcohol can increase your chances of getting a headache or getting dizzy, increase your heart rate, or lower your blood pressure.

If you experience sudden loss of vision in one or both eyes, stop using tadalafil and contact your doctor immediately.

Stop using this medicine and check with your doctor right away if you have a sudden decrease in hearing or loss of hearing, which may be accompanied by dizziness and ringing in the ears.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine. Grapefruit and grapefruit juice may change the amount of this medicine that is absorbed in the body.

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

Cialis Side Effects

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

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

Less common Arm, back, or jaw pain blurred vision chest pain or discomfort chest tightness or heaviness chills cold sweats confusion dizziness fainting faintness or lightheadedness when getting up suddenly from a lying or sitting position fast or irregular heartbeat headache hearing loss nausea nervousness pain or discomfort in the arms, jaw, back, or neck pounding in the ears shortness of breath slow or fast heartbeat sweating unusual tiredness or weakness vomiting Rare Painful or prolonged erection of the penis Incidence not known Abdominal or stomach pain blindness blistering, peeling, or loosening of the skin cough cracks in the skin decrease or change in vision diarrhea difficulty with speaking double vision fast, irregular, pounding, or racing heartbeat or pulse headache, severe and throbbing hives or welts inability to move the arms, legs, or facial muscles inability to speak itching joint or muscle pain loss of heat from the body numbness or tingling of the face, hands, or feet red irritated eyes red skin lesions, often with a purple center red, swollen skin redness of the skin redness or soreness of the eyes scaly skin skin rash slow speech sores, ulcers, or white spots in the mouth or on the lips sudden cardiac death swelling of the feet or lower legs

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 Acid or sour stomach belching heartburn indigestion stomach discomfort, upset, or pain Less common Bloody nose body aches or pain burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings burning, dry, or itching eyes burning feeling in the chest or stomach congestion difficulty with moving difficulty with swallowing dry mouth dryness or soreness of the throat excessive eye discharge eye pain feeling of constant movement of self or surroundings feeling of warmth, redness of the face, neck, arms and occasionally, upper chest fever hoarseness increased erection lack or loss of strength loose stools muscle aching or cramping muscle stiffness nasal congestion neck pain pain pain in the arms or legs pain or burning in the throat redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid reduced sensitivity to touch runny nose sensation of spinning sleepiness or unusual drowsiness sleeplessness spontaneous penile erection stomach upset swelling of the eyelids swelling or puffiness of the eyes or face swollen joints tearing tender, swollen glands in the neck tenderness in the stomach area trouble with sleeping unable to sleep upper abdominal or stomach pain voice changes watering of the eyes Rare Changes in color vision

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

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

See also: Cialis side effects (in more detail)

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

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

More Cialis resources Cialis Side Effects (in more detail) Cialis Use in Pregnancy & Breastfeeding Drug Images Cialis Drug Interactions Cialis Support Group 91 Reviews for Cialis - Add your own review/rating Cialis Prescribing Information (FDA) Cialis Monograph (AHFS DI) Cialis MedFacts Consumer Leaflet (Wolters Kluwer) Cialis Consumer Overview Tadalafil Professional Patient Advice (Wolters Kluwer) Adcirca MedFacts Consumer Leaflet (Wolters Kluwer) Adcirca Prescribing Information (FDA) Adcirca Consumer Overview Compare Cialis with other medications Benign Prostatic Hyperplasia Erectile Dysfunction
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Anadrol-50


Generic Name: oxymetholone (OKS ee METH oh lone)
Brand Names: Anadrol-50

What is Anadrol-50 (oxymetholone)?

Oxymetholone is an anabolic steroid, which is a man-made form of a hormone similar to testosterone.

Oxymetholone is used to treat certain types of anemia (lack of red blood cells), including aplastic anemia, myelofibrosis, or hypoplastic anemia caused by chemotherapy.

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

What is the most important information I should know about Anadrol-50 (oxymetholone)? This medication can cause birth defects. Do not use if you are pregnant. Use effective birth control, and tell your doctor if you become pregnant during treatment. You should not use this medication if you are allergic to oxymetholone, or if you have prostate cancer, male breast cancer, female breast cancer with high levels of calcium in the blood, severe liver or kidney disease, or if you are pregnant.

Before using oxymetholone, tell your doctor if you have liver or kidney disease, heart disease, congestive heart failure, high cholesterol or triglycerides, coronary artery disease, or an enlarged prostate.

Call your doctor at once if you have a serious side effect such as swelling, rapid weight gain, increased or ongoing erection of the penis, changes in skin color, urination problems, or signs of liver damage (nausea, vomiting, stomach pain, loss of appetite, and jaundice (yellowing of the skin or eyes). Women receiving oxymetholone may develop male characteristics, which could be irreversible if treatment is continued. Call your doctor as soon as possible if you notice increased acne, changes in menstrual periods, a deepened voice, male pattern baldness or hair growth, an enlarged clitoris, or changes in your sex drive.

To be sure oxymetholone is helping your condition and is not causing harmful effects on your liver, your blood will need to be tested on a regular basis. Do not miss any scheduled appointments.

It may take up to 6 months of using this medicine before your symptoms improve. Tell your doctor if your symptoms do not improve after 3 months of treatment. What should I discuss with my health care provider before taking Anadrol-50 (oxymetholone)? You should not use this medication if you are allergic to oxymetholone, or if you have:

prostate cancer;

male breast cancer;

female breast cancer with high levels of calcium in the blood;

severe liver disease;

severe kidney disease; or

if you are pregnant.

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

liver disease;

kidney disease;

heart disease, congestive heart failure;

high cholesterol or triglycerides;

coronary artery disease (atherosclerosis); or

an enlarged prostate.

FDA pregnancy category X. This medication can cause birth defects. Do not use oxymetholone if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use effective birth control while you are using this medication. It is not known whether oxymetholone 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. Children being treated with oxymetholone may need x-ray examinations every 6 months to make sure the medication is not causing harmful effects on bone growth. Oxymetholone will not enhance athletic performance and should not be used for that purpose or shared with another person. How should I take Anadrol-50 (oxymetholone)?

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

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

To be sure oxymetholone is helping your condition and is not causing harmful effects on your liver, your blood will need to be tested on a regular basis. Do not miss any scheduled appointments.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using oxymetholone.

It may take up to 6 months of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 3 months of treatment.

Once your condition is under control, you may be able to stop taking oxymetholone. However, some people must continue to use at least a small amount of the medicine to keep their red blood cells from getting too low. You may need to take oxymetholone for the rest of your life. Follow your doctor's instructions.

Anemia is often treated with a combination of different drugs, including antibiotics and vitamin or mineral supplements. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor.

Store oxymetholone at room temperature away from moisture and heat. Keep track of how many pills have been used from each new bottle of this medicine. Anabolic steroids are drugs of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

See also: Anadrol-50 dosage (in more detail)

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, wait until then to take the medicine and skip the missed dose. 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 received too much of this medicine.

An overdose of oxymetholone is not expected to produce life-threatening symptoms.

What should I avoid while taking Anadrol-50 (oxymetholone)?

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

Anadrol-50 (oxymetholone) side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

swelling, rapid weight gain;

increased or ongoing erection of the penis;

changes in skin color;

urination problems; or

nausea, vomiting, stomach pain, loss of appetite, and jaundice (yellowing of the skin or eyes).

Women receiving oxymetholone may develop male characteristics, which could be irreversible if treatment is continued. Call your doctor as soon as possible if you notice any of these side effects:

acne;

changes in your menstrual periods;

hoarse or deepened voice;

male-pattern hair growth (such as on the chin or chest);

male pattern baldness;

enlarged clitoris; or

increase or decrease in sex drive.

Less serious side effects may include:

breast swelling in men;

feeling restless or excited;

sleep problems (insomnia); or

diarrhea.

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 Anadrol-50 (oxymetholone)?

The following drugs can interact with oxymetholone. Tell your doctor if you are using any of these:

a blood thinner such as warfarin (Coumadin); or

insulin or diabetes medication you take by mouth.

This list is not complete and there may be other drugs that can interact with oxymetholone. 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 Anadrol-50 resources Anadrol-50 Side Effects (in more detail) Anadrol-50 Dosage Anadrol-50 Use in Pregnancy & Breastfeeding Drug Images Anadrol-50 Drug Interactions Anadrol-50 Support Group 0 Reviews for Anadrol-50 - Add your own review/rating Anadrol-50 MedFacts Consumer Leaflet (Wolters Kluwer) Oxymetholone Professional Patient Advice (Wolters Kluwer) Compare Anadrol-50 with other medications Anemia Where can I get more information? Your pharmacist can provide more information about oxymetholone.

See also: Anadrol-50 side effects (in more detail)


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sildenafil


sil-DEN-a-fil

Commonly used brand name(s)

In the U.S.

Revatio Viagra

Available Dosage Forms:

Tablet

Therapeutic Class: Antihypertensive, Peripheral Vasodilator

Pharmacologic Class: Phosphodiesterase Type 5 Inhibitor

Uses For sildenafil

Sildenafil is used to treat men who have erectile dysfunction (also called sexual impotence). Sildenafil belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors. These medicines prevent an enzyme called phosphodiesterase type-5 from working too quickly. The penis is one of the areas where this enzyme works.

The penis is one of the areas in the body where the phosphodiesterase enzyme works. By controlling the enzyme, sildenafil helps to maintain an erection after the penis is stroked. Without physical action to the penis, such as that occurring during sexual intercourse, sildenafil will not work to cause an erection.

Sildenafil is also used in both men and women to treat the symptoms of pulmonary arterial hypertension. This is a type of high blood pressure that occurs between the heart and the lungs. When hypertension occurs in the lungs, the heart must work harder to pump enough blood through the lungs. Sildenafil works on the PDE5 enzyme in the lungs to relax the blood vessels. This will increase the supply of blood to the lungs and reduce the workload of the heart.

sildenafil is available only with your doctor's prescription.

Before Using sildenafil

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

Allergies

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

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of sildenafil in children with pulmonary arterial hypertension. Safety and efficacy have not been established.

Sildenafil should never be used in children for erectile dysfunction.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of sildenafil in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving sildenafil.

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

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

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking sildenafil, 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 sildenafil with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Amprenavir Amyl Nitrite Atazanavir Boceprevir Darunavir Erythrityl Tetranitrate Fosamprenavir Indinavir Isosorbide Dinitrate Isosorbide Mononitrate Lopinavir Molsidomine Nelfinavir Nitroglycerin Nitroprusside Pentaerythritol Tetranitrate Ritonavir Saquinavir Telaprevir Tipranavir

Using sildenafil 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.

Cannabis Dihydrocodeine Nefazodone Telithromycin Voriconazole

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

Alfuzosin Bosentan Bunazosin Ciprofloxacin Delavirdine Doxazosin Erythromycin Etravirine Itraconazole Ketoconazole Moxisylyte Nebivolol Prazosin Rifapentine Silodosin Tamsulosin Terazosin Trimazosin Interactions with Food/Tobacco/Alcohol

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

Using sildenafil with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use sildenafil, or give you special instructions about the use of food, alcohol, or tobacco.

Grapefruit Juice Pomelo Juice Other Medical Problems

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

Abnormal penis, including a curved penis or birth defects or Angina (chest pain) or Arrhythmia (irregular heartbeat) or Bleeding problem, history of or Coronary artery disease or Heart attack (within the last 6 months) or Heart disease or Hypertension (high blood pressure) or Hypotension (low blood pressure) or Leukemia (type of blood cancer) or Multiple myeloma (bone marrow cancer) or Priapism, history of or Retinitis pigmentosa (an inherited eye disorder) or Sickle-cell anemia (blood disorder) or Stomach ulcer, history of or Stroke (within the last 6 months)—Use with caution. May cause side effects to become worse. Age greater than 50 years or Coronary artery disease or Crowded disc or low cup to disc ratio in the eye (an eye disorder) or Diabetes or Heart disease or Hyperlipidemia (high fats in the blood) or Hypertension (high blood pressure) or Non-arteritic anterior ischemic optic neuropathy or NAION (serious eye condition), history of or Smoking—May increase the chance for a serious side effect in the eye called NAION. Kidney disease, severe or Liver disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body. Pulmonary veno-occlusive disease or PVOD (a type of lung disease)—May make this condition worse. Proper Use of sildenafil

sildenafil comes with patient instructions. Read and follow these instructions carefully each time you get a refill of your medicine. Ask your doctor if you have any questions.

Use sildenafil exactly as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. If too much is used, the chance of side effects is increased.

When using sildenafil for pulmonary arterial hypertension, you may take it with or without food.

sildenafil usually begins to work for erectile dysfunction within 30 minutes after taking it. It continues to work for up to 4 hours, although its action is usually less after 2 hours.

Use only the brand of sildenafil that your doctor prescribed. Different brands may not work the same way.

Dosing

The dose of sildenafil 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 sildenafil. If your dose is different, do not change it unless your doctor tells you to do so.

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

For oral dosage form (tablets): For treatment of erectile dysfunction: Adults up to 65 years of age—50 milligrams (mg) as a single dose no more than once a day, 1 hour before sexual intercourse. Alternatively, the medicine may be taken 30 minutes to 4 hours before sexual intercourse. Your doctor may adjust your dose if needed. Adults 65 years of age and older—25 mg as a single dose no more than once a day, 1 hour before sexual intercourse. Alternatively, the medicine may be taken 30 minutes to 4 hours before sexual intercourse. Your doctor may adjust your dose if needed. Teenagers and children—Not recommended for this age group. For treatment of pulmonary arterial hypertension: Adults—20 milligrams (mg) three times a day. Each dose should be taken about 4 to 6 hours apart. Children—Use and dose must be determined by your doctor. Storage

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

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

Precautions While Using sildenafil

It is important that you tell all of your doctors that you take sildenafil. If you need emergency medical care for a heart problem, it is important that your doctor knows when you last took sildenafil.

If you will be taking sildenafil for pulmonary arterial hypertension, your doctor will want to check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

If you take sildenafil for pulmonary arterial hypertension, do not take Viagra® or other PDE5 inhibitors, such as tadalafil (Cialis®) or vardenafil (Levitra®). Viagra® also contains sildenafil. If you take too much sildenafil or take it together with these medicines, the chance for side effects will be higher.

Sildenafil should not be used with any other medicine or device that causes erections.

If you experience a prolonged or painful erection for 4 hours or more, contact your doctor immediately. This condition may require prompt medical treatment to prevent tissue damage to the penis and possibly permanent impotence.

sildenafil does not protect you against sexually transmitted diseases. Use protective measures and ask your doctor if you have any questions about this.

Do not use sildenafil if you are also using a nitrate medicine for chest pain (angina). Some examples of nitrate medicines are: isosorbide, nitroglycerin, Imdur®, Nitro-Bid®, Nitro-Dur®, Nitrol® ointment, Nitrolingual® spray, Nitrostat®, and Transderm Nitro®. Some illegal ("street") drugs or "poppers" also contain nitrates, such as amyl nitrate, butyl nitrate, or nitrite.

It is important to tell your doctor about any heart problems you have now or may have had in the past. sildenafil can cause serious side effects in patients with heart problems.

If you experience a sudden loss of vision in one or both eyes, stop using sildenafil and contact your doctor right away. This could be a symptom of a very serious eye condition called non-arteritic anterior ischemic optic neuropathy (NAION).

Stop using sildenafil and check with your doctor right away if you have a sudden decrease in hearing or loss of hearing. You might also have dizziness and ringing in the ears.

If you already use medicine for high blood pressure (hypertension), sildenafil could make your blood pressure go too low. Call your doctor right away if you have more than one of these symptoms: blurred vision; confusion; dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly; sweating; or unusual tiredness or weakness.

sildenafil Side Effects

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

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

Less common Bladder pain burning feeling in the chest or stomach burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings cloudy or bloody urine dizziness increased frequency of urination indigestion pain on urination stomach upset tenderness in the stomach area Rare Abnormal vision anxiety behavior change similar to drunkenness bleeding of the eye blurred vision bone pain breast enlargement chest pain chills cold sweats confusion convulsions (seizures) cool and pale skin deafness or hearing loss decrease in amount of urine or the frequency of urination decreased vision difficulty in concentrating dizziness or lightheadedness, especially when getting up from a lying or sitting position suddenly double vision drowsiness dry eyes dry mouth dryness, redness, scaling, or peeling of the skin excessive hunger eye pain fainting or faintness fast, irregular, or pounding heartbeat feeling of something in the eye fever or chills headache (severe or continuing) heart failure hives increase in the size of the pupil increased sweating increased thirst itching of the skin low blood pressure lower back or side pain migraine headache nausea (severe or continuing) nervousness nightmares numbness of the hands painful, swollen joints prolonged, painful erection of penis redness, burning, or swelling of the eyes redness, itching, or tearing of the eyes restless sleep seeing shades of colors differently than before sensitivity to light shakiness shortness of breath skin lesions with swelling skin paleness skin rash skin ulcers slurred speech sore throat sudden weakness swelling of the face, hands, feet, or lower legs trouble with breathing twitching of the muscles unusual feeling of burning or stinging of the skin unusual tiredness or weakness vision changes vision loss, temporary Incidence not known Blindness

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 Aches or pains in the muscles bloody nose diarrhea difficult or labored breathing flushing headache nasal congestion pain or tenderness around the eyes and cheekbones redness of the skin sneezing stomach discomfort following meals stuffy or runny nose trouble sleeping unusually warm skin Rare Abdominal or stomach pain abnormal dreams anxiety clumsiness or unsteadiness cough diarrhea or stomach cramps (severe or continuing) difficulty in swallowing ear pain increased amount of saliva increased skin sensitivity lack of coordination loss of bladder control mental depression nausea numbness or tingling of the hands, legs, or feet rectal bleeding redness or irritation of the tongue redness, soreness, swelling, or bleeding of the gums ringing or buzzing in the ears sensation of motion, usually whirling, either of one's self or of one's surroundings sexual problems in men (continuing), including failure to experience a sexual orgasm sleepiness sores in the mouth and on the lips tense muscles tightness of the chest or wheezing trembling and shaking vomiting waking to urinate at night worsening of asthma

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

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

See also: sildenafil side effects (in more detail)

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

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

More sildenafil resources Sildenafil Side Effects (in more detail) Sildenafil Dosage Sildenafil Use in Pregnancy & Breastfeeding Sildenafil Drug Interactions Sildenafil Support Group 53 Reviews for Sildenafil - Add your own review/rating Sildenafil MedFacts Consumer Leaflet (Wolters Kluwer) Revatio Consumer Overview Revatio Prescribing Information (FDA) Sildenafil Citrate Monograph (AHFS DI) Viagra Prescribing Information (FDA) Viagra MedFacts Consumer Leaflet (Wolters Kluwer) Viagra Consumer Overview Compare sildenafil with other medications Erectile Dysfunction Pulmonary Arterial Hypertension Sexual Dysfunction, SSRI Induced
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Doxazosin 1mg, 2mg, 4mg Tablets


DOXAZOSIN 1 MG TABLETS

DOXAZOSIN 2 MG TABLETS

DOXAZOSIN 4 MG TABLETS

(as mesilate)

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 onto others. It may harm them, even if their symptoms are the same as yours. In this leaflet: 1. What DOXAZOSIN is and what it is used for 2. Before you take DOXAZOSIN 3. How to take DOXAZOSIN 4. Possible side effects 5. Storing DOXAZOSIN 6. Further information

The name of your medicine is DOXAZOSIN 1 mg Tablets, DOXAZOSIN 2 mg Tablets, DOXAZOSIN 4 mg Tablets (referred to as DOXAZOSIN throughout this leaflet).

What Doxazosin Is And What It Is Used For

Doxazosin is one of a group of medicines called alpha-blockers.

DOXAZOSIN tablets are used to treat high blood pressure (hypertension) or the symptoms caused by enlargement of the prostate gland in men.

In patients taking DOXAZOSIN to treat high blood pressure (hypertension) DOXAZOSIN works by relaxing blood vessels so that blood passes through them more easily. This helps to lower blood pressure.

In patients with enlargement of the prostate gland, DOXAZOSIN is taken to treat frequent and/or poor passing of urine. This is common in patients with enlargement of the prostate gland. DOXAZOSIN works by relaxing muscle around the bladder exit and prostate gland so urine is passed more easily.

Before You Take Doxazosin Do not take DOXAZOSIN if you: have ever had an allergic reaction (hypersensitivity) to doxazosin or any of the other ingredients of DOXAZOSIN tablets.

This may have been itching, reddening of the skin or difficulty in breathing.

are breastfeeding. are aged under 16 years of age Take special care with DOXAZOSIN: If you have liver disease tell your doctor before you start taking your tablets. If you are pregnant or trying to become pregnant tell your doctor before you start taking your tablets.

If you are undergoing eye surgery because of cataract (cloudiness of the lens) please inform your eye specialist before the operation that you are using or have previously used DOXAZOSIN. This is because DOXAZOSIN may cause complications during the surgery which can be managed if your specialist is prepared in advance.

When you start to take DOXAZOSIN you may experience faintness or dizziness caused by low blood pressure, when getting up from sitting or lying down. If you feel faint or dizzy, you should sit or lie down until you feel better and avoid situations where you might fall or hurt yourself.

Taking other medicines:

Some patients who take alpha-blocker therapy for the treatment of high blood pressure or prostate enlargement may experience dizziness or light headedness, which may be caused by low blood pressure upon sitting or standing up quickly. Certain patients have experienced these symptoms when taking drugs for erectile dysfunction (impotence) with alpha-blockers. In order to reduce the likelihood that these symptoms occur, you should be on a regular daily dose of your alpha-blocker before you start drugs for erectile dysfunction.

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

Driving and using machines:

Take care if you drive or operate machinery. Your tablets may affect your ability to drive or operate machinery safely, particularly when you first start to take them. They may make you feel weak or dizzy. If affected, do not drive or operate machinery and contact your doctor immediately.

Important information about some of the ingredients of DOXAZOSIN:

This medicine contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

How To Take Doxazosin Adults and Elderly:

Always take DOXAZOSIN exactly as your doctor has instructed you. You should check with your doctor or pharmacist if you are unsure.

DOXAZOSIN is usually taken once daily. DOXAZOSIN may be taken in the morning or the evening.

You can take your tablets before or after food.

You should take your tablets at the same time each day with a small amount of water.

The initial dose of DOXAZOSIN is 1mg once daily. Thereafter the dose may be gradually increased (within 1-2 weeks interval) to the usual dose (2mg or 4mg daily).

In some circumstances the dose may be increased to a maximum of 8mg daily if you are being treated for prostate enlargement, or to a maximum of 16mg if you are being treated for high blood pressure.

Children:

This medicine is not recommended for children.

You have been given a calendar pack that will help you remember to take your tablets. If you are taking more than one tablet a day, you must ignore the marking for the day, printed on the back of the blister.

Because high blood pressure is treated in order to prevent problems from arising, you may have no symptoms at all while taking DOXAZOSIN. Even if this is so and you feel well, you should not stop taking your blood pressure medication unless instructed to by your doctor.

Don't change the dose or stop taking the tablets without first checking with your doctor.

Don't wait until your tablets are finished before seeing your doctor.

If you have impression that the effect of DOXAZOSIN is too strong or too weak, talk to your doctor or pharmacist.

If you forget to take DOXAZOSIN:

If you miss a dose just carry on with the next one as normal. Do not take a double dose to make up for the missed one.

If you take more DOXAZOSIN than you should:

Too many tablets at once may make you unwell. If several tablets are taken it may be dangerous.

Tell your doctor immediately or go to your nearest hospital casualty department.

Possible Side Effects

Like all medicines, DOXAZOSIN can have side effects but not everybody gets them.

Most undesirable effects are usually mild and tend to wear off as treatment goes on. It is important to tell your doctor if any unwanted effect causes you concern, including those which may not be listed below.

Problems DOXAZOSIN may cause are:

allergic reaction, with symptoms such as skin rash, itching, which may be accompanied by shortness of breath, difficulty breathing, swelling of the face, tongue and throat. If any of these symptoms occur, STOP taking DOXAZOSIN and seek medical attention immediately. The following events have been reported in patients with high blood pressure being treated with doxazosin, but these may be due to the underlying disease rather than the medicine: chest pain, angina, a feeling of increased, decreased or irregular heart beat, palpitations, heart attack or stroke. Contact your doctor immediately if any of these occur. low white blood cells (which may result in increasing frequency of infection, sore throat, mouth ulcer, high temperature or stomach upset); low blood platelets [which may result in bruising or bleeding easily, nose bleeds (epistaxis)].

If any of these occur contact your doctor.

Other side effects

generally feeling unwell, weakness, tirednesssleepiness, swelling of feet or lower legs (oedema), weight gain

headache , dizziness or faintness, especially on getting up from a sitting or lying position, tremor, tingling or altered sensitivity of the hands and feet vertigo, ringing in the ears (tinnitus) digestive system complaints, including stomach/abdominal pains, constipation, diarrhoea, feeling/being sick, heartburn and wind, dry mouth nasal stuffiness, runny nose and/or sneezing (rhinitis), wheeze, cough painful persistent erection of the penis, erection difficulties (when a man cannot get, or keep a hard, erect penis suitable for sexual activity), discomfort or enlargement of the breasts in men (gynaecomastia), cloudy urine following sexual climax, little or no semen ejaculated at sexual climax painful joints, painful muscles, muscle cramps, muscle weakness, back pain or general pain low blood pressure, hot flushes agitation, anxiety, depression or nervousness, sleeplessness hair loss loss of appetite liver enzyme increases, jaundice (yellowing of the skin or whites of the eyes), hepatitis or bile disorder blurred vision urinary incontinence, urinary disorder or blood in urine

If any of the side - effects become serious, or you notice any side effects not mentioned in this leaflet, please inform your doctor or pharmacist.

Storing Doxazosin

There are no special precautions for storage. Keep out of the reach and sight of children.

Check the expiry date on the label. Do not use the tablets if the expiry date has passed.

Further Information What DOXAZOSIN contains

The active substance is: doxazosin. Each tablet contains 1mg, 2mg, or 4mg of doxazosin (as mesilate).

The other ingredients are: Lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulphate, sodium starch glycolate (type A) and colloidal anhydrous silica.

What DOXAZOSIN looks like and contents of the pack

DOXAZOSIN comes in three different strengths:

Doxazosin 1 mg tablet is a round white to off-white tablet scored on one side.

Doxazosin 2 mg tablet is a white to off-white capsule shaped tablet scored on one side.

Doxazosin 4 mg tablet is a white to off-white capsule shaped tablet, scored on both sides, with embossement "D4" on one side.

Doxazosin 1 mg, 2 mg and 4 mg tablets are available in calendar packs of 28 tablets in foil blister strips.

The manufacturer / holder of the marketing authorization is: Dexcel-Pharma Ltd. 1 Cottesbrooke Park Heartlands Business Park Daventry Northamptonshire NN11 8YL England

This leaflet was last approved in October 2009.

1217420114-E


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