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Boots Clotrimazole 500mg Vaginal Tablet


Boots Clotrimazole 500 mg Vaginal Tablet

Read all of this leaflet carefully because it contains important information for you.

This medicine is available without prescription to treat thrush. However, you still need to use it carefully to get the best results from it.

Keep this leaflet, you may need to read it again Ask your pharmacist if you need more information or advice You must contact a pharmacist or doctor if your symptoms worsen or do not go away after 3 days What this medicine is for

This medicine contains Clotrimazole which belongs to a group of medicines called antifungals, which act to treat infections caused by fungi. It can be used to treat thrush (vaginal candidiasis). Thrush is a common infection caused by a yeast (or fungus), which may live harmlessly in the vagina without you even noticing it. However, in certain circumstances, it may develop into an infection in the vagina and symptoms may spread to the surrounding area. These symptoms may include one or more of the following:

Itching of the vagina and surrounding area (the vulva) Redness and swelling of the tissues of the vagina and vulva Soreness of the vagina and vulva A white non-smelling discharge from the vagina

Thrush may be aggravated by sexual intercourse, but it is not a sexually transmitted disease. Sometimes however, thrush can be passed to your partner through sexual intercourse.

If your partner has penile thrush he may have one or more of the following symptoms:

Soreness and redness of the penis Tightness of the foreskin An abnormal penile discharge Before you use this medicine

This medicine can be used by women between the ages of 16 and 60 years. However, some people should not use this medicine or should seek the advice of their pharmacist or doctor first.

Do not use: If you are allergic to any of the ingredients If you are pregnant, unless your doctor tells you to – if your doctor tells you to use the pessary do not use the applicator to insert it Talk to your pharmacist or doctor: If this is the first time you have had these symptoms If you are under 16 years, or 61 years or older If you have had thrush more than twice in the last 6 months If you or your partner have been exposed to a sexually transmitted disease If you have lower stomach pain, or pain or a burning sensation on passing urine If you have abnormal or irregular vaginal bleeding, or a blood-stained discharge If you have sores, ulcers or blisters on your vulva or vagina Other important information

The ingredients in the pessary 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 the pessary.

You can help the treatment to work if you follow these simple self-help tips:

Although the infected area will itch, do not scratch as this will damage the surface of the skin and cause the infection to spread further Keep the affected areas of skin clean Pay particular attention to drying the skin but avoid excessive rubbing

To help prevent thrush from coming back once you have treated it, follow these simple steps:

Wash daily Wear cotton underwear and loose fitting clothing Try to avoid wearing tights, nylon underwear and tight fitting clothing After going to the toilet, wipe yourself from the front to the back, as a thrush infection may be transferred from the bowel Try to avoid washing with perfumed soaps or using vaginal deodorants Do not rub hard with sponges or flannels and avoid hot baths with strong perfumed oils Change your sanitary protection regularly If you take other medicines

Before you use this medicine, make sure that you tell your pharmacist about ANY other medicines you might be using at the same time. If you are unsure about interactions with any other medicines, talk to your pharmacist. This includes medicines prescribed by your doctor and medicine you have bought for yourself, including herbal and homeopathic remedies.

How to use this medicine

The carton contains a single pessary held inside a foil blister pack and an applicator for insertion of the pessary into the vagina. Check the foil is not broken before use. If it is, do not use the pessary.

Women aged 16 to 60 years: Insert the pessary into the vagina at night using the applicator provided.

If you are pregnant do not use the applicator. Wash and dry your hands, and insert the pessary with your fingers.

Directions for inserting the pessary Remove the applicator from the packaging Pull out the plunger until it stops Remove the pessary from the blister pack and place the pessary firmly into the applicator To fit the pessary into the applicator, squeeze the applicator lightly on either side. The pessary fits tightly into the applicator and needs to be pushed into the holder about 1 cm Carefully put the applicator as deep as is comfortable into the vagina (this is easiest when laying on your back with your knees bent up) Holding the applicator in place, slowly press the plunger until it stops so that the pessary is deposited into the vagina. Remove the applicator Dispose of the applicator in a safe place, out of the reach of children The applicator cannot be flushed down the toilet Wash your hands thoroughly after use

For use in the vagina only.

Do not use the pessary at the same time as you are having a period. Wait until your period has finished.

Do not use for children under 16 years, or if you are an adult of 61 years or older, unless your doctor tells you to.

Do not use more than one pessary.

After you use the pessary the symptoms of thrush (itching, burning, discharge) should go away within 3 days.

If symptoms worsen or do not go away after 3 days talk to your doctor.

If anyone accidentally swallows the pessary: Talk to a doctor straight away or go to your nearest hospital casualty department. Take your medicine and this leaflet with you.

Possible side effects

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

If you get these side effects 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:

Mild burning or irritation straight after inserting the pessary

The side effects of this medicine can be very similar to the symptoms that you are treating.

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

How to store this medicine

Do not store above 25°C.

Protect from moisture.

Keep this medicine in a safe place out of the sight and reach of children, preferably in a locked cupboard.

Use by the date on the end flap of the carton.

What is in this medicine

This vaginal tablet contains Clotrimazole 500 mg, which is the active ingredient.

As well as the active ingredient, the vaginal tablet also contains lactose, adipic acid, pregelatinised maize starch, sodium hydrogen carbonate, microcrystalline cellulose, magnesium stearate, maize starch, stearic acid, colloidal silicon dioxide, polysorbate 80.

The pack contains 1 vaginal tablet with an applicator.

Who makes this medicine

Manufactured for

The Boots Company PLC Nottingham NG2 3AA

Marketing Authorisation Holder and Manufacturer:

Tillomed Laboratories Ltd 3 Howard Road Eaton Socon St Neots Cambridgeshire PE19 3ET

Leaflet prepared February 2008

If you would like any further information about this medicine, please contact

The Boots Company PLC Nottingham NG2 3AA

3379eMC


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antifungal, azole Vaginal


Class Name: antifungal, azole (Vaginal route)

Commonly used brand name(s)

In the U.S.

3 Day Vaginal Cream Femizol-M Gynazole-1 Gyne-Lotrimin Monistat 1 Mycelex-3 Mycelex-7 Terazol 3 Terazol 7 Tioconazole 1 Vagistat-1 Zazole

In Canada

Canesten 2 Canesten 3 Canesten 6 Day Canesten Combi-Pak 1 Day Canesten Combi-Pak 3 Day Canesten External Cream Clotrimaderm Gyne Cure Gyno-Trosyd Miconazole 3 Day Ovule Treatment Miconazole Nitrate Monistat 1 Combination Pack Vaginal Ovule

Available Dosage Forms:

Ointment Kit Cream Suppository Tablet Tampon Uses For This Medicine

Vaginal azoles are used to treat yeast (fungus) infections of the vagina.

For first-time users, make sure your doctor has checked and confirmed that you have a vaginal yeast infection before you use the vaginal azole antifungal medicines that do not require a prescription. Vaginal yeast infections can reoccur over time and, when the same symptoms occur again, self-treating with these medicines is recommended. However, you should see your doctor if the symptoms occur again within 2 months.

Vaginal antifungal azoles are available both over-the-counter (OTC) and with your doctor's prescription.

Before Using This Medicine Allergies

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

Pediatric

Studies on these medicines have been done only in adult patients, and there is no specific information comparing use of vaginal azoles in children with use in other age groups. It is recommended that these medicines not be used in children up to 12 years of age.

Geriatric

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

Pregnancy

Studies have not been done in humans for use of all azole antifungals during the first trimester of pregnancy. These medicines are safe and effective when used for at least 7 days during the second and third trimesters of pregnancy. However, check with your doctor before using this medicine during the first trimester of pregnancy. Also, use of 1- and 3-day treatments may not be effective during pregnancy.

Breast Feeding

It is not known whether vaginal azoles pass into the breast milk. However, these medicines have not been shown to cause problems in nursing babies.

Interactions with Medicines

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

Interactions with Food/Tobacco/Alcohol

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

Proper Use of This Medicine

Vaginal azoles usually come with patient directions. Read them carefully before using this medicine.

Use this medicine at bedtime, unless otherwise directed by your doctor. The vaginal tampon form of miconazole should be left in the vagina overnight and removed the next morning.

This medicine is usually inserted into the vagina with an applicator. However, if you are pregnant, check with your doctor before using the applicator.

Some of the vaginal suppositories or tablets come packaged with a small tube of cream. This cream can be applied outside of the vagina in the genital area to treat itching. The packages are called combination, dual, or twin packs.

To help clear up your infection completely, it is very important that you keep using this medicine for the full time of treatment , even if your symptoms begin to clear up after a few days. If you stop using this medicine too soon, your symptoms may return. Do not miss any doses. Also, do not stop using this medicine if your menstrual period starts during the time of treatment.

Dosing

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

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

For butoconazole For yeast infection: For vaginal cream dosage form: Adults and teenagers— Women who are not pregnant: 100 milligrams (mg) (one full applicator) of 2% cream inserted into the vagina at bedtime for three nights in a row. Pregnant women, after the third month: 100 mg (one full applicator) of 2% cream inserted into the vagina at bedtime for six nights in a row. Children up to 12 years of age—Use and dose must be determined by your doctor. For vaginal suppository dosage form: Adults and teenagers— Women who are not pregnant: 100 mg (one suppository) inserted into the vagina at bedtime for three nights in a row. Children up to 12 years of age—Use and dose must be determined by your doctor. For clotrimazole For yeast infection: For vaginal cream dosage form: Adults and teenagers—The dose depends on the strength of the cream. 1% cream: 50 milligrams (mg) (one full applicator) inserted into the vagina at bedtime for six to fourteen nights in a row. 2% cream: 100 mg (one full applicator) inserted into the vagina at bedtime for three nights in a row. 10% cream: 500 mg (one full applicator) inserted into the vagina at bedtime for one night only. Children up to 12 years of age—Use and dose must be determined by your doctor. For vaginal tablet dosage form: Adults and teenagers—The dose depends on the strength of the vaginal tablet. Women who are not pregnant: 100-mg tablet: Insert one tablet into the vagina at bedtime for six or seven nights in a row. 200-mg tablet: Insert one tablet into the vagina at bedtime for three nights in a row. 500-mg tablet: Insert one tablet into the vagina at bedtime for one night only. Pregnant women: 100 mg (one vaginal tablet) inserted into the vagina at bedtime for seven nights in a row. Children up to 12 years of age—Use and dose must be determined by your doctor. For econazole For yeast infection: For vaginal suppository dosage form: Adults and teenagers—150 milligrams (mg) (one vaginal suppository) inserted into the vagina at bedtime for three nights in a row. Children up to 12 years of age—Use and dose must be determined by your doctor. For miconazole For yeast infection: For vaginal cream dosage form: Adults and teenagers—20 milligrams (one full applicator) inserted into the vagina at bedtime for seven nights in a row. Treatment may be repeated if needed. Children up to 12 years of age—Use and dose must be determined by your doctor. For vaginal suppository dosage form: Adults and teenagers—The dose depends on the strength of the suppository. 100-milligram (mg) suppository: Insert one vaginal suppository into the vagina at bedtime for seven nights in a row. Treatment may be repeated if needed. 200-mg suppository or 400-mg suppository: Insert one vaginal suppository into the vagina at bedtime for three nights in a row. Treatment may be repeated if needed. 1200-mg suppository: Insert one vaginal suppository into the vagina at bedtime for one night. Children up to 12 years of age—Use and dose must be determined by your doctor. For tampon dosage form: Adults and teenagers—100 mg (one tampon) inserted into the vagina at bedtime and then removed the next morning. This is repeated every night for five nights in a row. Children up to 12 years of age—Use and dose must be determined by your doctor. For terconazole For yeast infection: For vaginal cream dosage form: Adults and teenagers—The dose depends on the strength of the cream. 0.4% cream: 20 milligrams (mg) (one full applicator) inserted into the vagina at bedtime for seven nights in a row. 0.8% cream: 40 mg (one full applicator) inserted into the vagina at bedtime for three nights in a row. Children up to 12 years of age—Use and dose must be determined by your doctor. For vaginal suppository dosage form: Adults and teenagers—80 mg (one vaginal suppository) inserted into the vagina at bedtime for three nights in a row. Children up to 12 years of age—Use and dose must be determined by your doctor. For tioconazole For yeast infection: For vaginal ointment dosage form: Adults and teenagers—300 milligrams (mg) (one full applicator) of 6.5% ointment inserted into the vagina at bedtime for one night only. Children up to 12 years of age—Use and dose must be determined by your doctor. For vaginal suppository dosage form: Adults and teenagers—300 mg (one vaginal suppository) inserted into the vagina at bedtime for one night only. Children up to 12 years of age—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

Keep out of the reach of children.

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

Do not keep outdated medicine or medicine no longer needed.

Keep the vaginal cream, ointment, and suppository forms of this medicine from freezing.

Precautions While Using This Medicine

If your symptoms do not improve within 3 days or have not disappeared in 7 days, or if they become worse, check with your doctor. The 1- or 3-day treatments may take up to 7 days to completely clear up your infection. However, not all vaginal infections are caused by yeast. If symptoms occur again within 2 months, check with your doctor.

Vaginal medicines usually will come out of the vagina during treatment. To keep the medicine from getting on your clothing, wear a minipad or sanitary napkin. The use of nonmedicated tampons (like those used for menstrual periods) is not recommended since they may soak up the medicine.

To help clear up your infection completely and to help make sure it does not return, good health habits are also required.

Wear cotton panties (or panties or pantyhose with cotton crotches) instead of synthetic (for example, nylon or rayon) panties. Wear only clean panties.

If you have any questions about this, check with your health care professional.

Vaginal yeast infections are not usually spread by having sex and your sex partner does not need to be treated. However, if the sex partner has symptoms of local itching or skin irritation of the penis, he may benefit by being treated also.

If you use latex or rubber birth control devices (condoms, diaphragms, or cervical caps), you should wait 3 days after treatment with azole antifungal agents before using them again. Many brands of vaginal azoles contain oils in the product that can weaken these devices. This increases the chances of a condom breaking during sexual intercourse. The rubber in cervical caps or diaphragms may break down faster and wear out sooner. Check with your health care professional to make sure the vaginal azole product you are using can be used with latex rubber birth control devices.

Check with your doctor before douching to obtain advice about whether you may douche and, if allowed, the proper method.

Side Effects of This Medicine

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

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

Less common Vaginal burning, itching, discharge, or other irritation not present before use of this medicine Rare Skin rash or hives

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 Abdominal or stomach cramps or pain burning or irritation of penis of sexual partner headache

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

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

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

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


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estrogen Vaginal


Commonly used brand name(s)

In the U.S.

Estrace Estring Femring Ortho Dienestrol Premarin Vagifem

In Canada

Estragyn Neo-Estrone Oestrilin

Available Dosage Forms:

Tablet Cream Insert, Extended Release Suppository Uses For estrogen

Estrogens are hormones produced by the body. Among other things, estrogens help develop and maintain female organs.

When your body is in short supply of this hormone, replacing it can ease the uncomfortable changes that occur in the vagina, vulva (female genitals), and urethra (part of the urinary system). Conditions that are treated with vaginal estrogens include a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis), and inflammation of the urethra (atrophic urethritis).

Estrogens work partly by increasing a normal clear discharge from the vagina and making the vulva and urethra healthy. Using or applying an estrogen relieves or lessens:

Dryness and soreness in the vagina Itching, redness, or soreness of the vulva Feeling an urge to urinate more often then is needed or experiencing pain while urinating Pain during sexual intercourse

When used vaginally or on the skin, most estrogens are absorbed into the bloodstream and cause some, but not all, of the same effects as when they are taken by mouth. Estrogens used vaginally at very low doses for treating local problems of the genitals and urinary system will not protect against osteoporosis or stop the hot flushes caused by menopause.

Estrogens for vaginal use are available only with your doctor's prescription.

Before Using estrogen Allergies

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

Pediatric

Estrogen vaginal cream is not indicated in children. Studies have not been conducted.

Geriatric

Elderly women greater than 65 years of age may have an increased risk of certain side effects during treatment, especially stroke, invasive breast cancer, and memory problems.

Pregnancy

Estrogens should not be used during pregnancy, since an estrogen called diethylstilbestrol (DES) that is no longer taken for hormone replacement has caused serious birth defects in humans and animals.

Breast Feeding

Use of estrogen is not recommended in nursing mothers. Estrogens pass into the breast milk and may decrease the amount and quality of breast milk. Caution should be exercised in mothers who are using estrogen and breast-feeding.

Interactions with Medicines

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

Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

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

Asthma or Epilepsy or Heart problems or Kidney problems or Migraine headaches—Estrogens may worsen these conditions. Blood clotting problems—Although worsening of a blood clotting condition is unlikely, some doctors do not prescribe vaginal estrogens for patients with blood clotting problems or a history of these problems. Breast cancer (active, suspected, or past history)—Estrogens should not be used. Certain cancers, including cancers of the breast, bone, or uterus (active or suspected)—Estrogens may interfere with the treatment of breast or bone cancer or worsen cancer of the uterus when these conditions are present. Cholestatic jaundice (flow of bile from the liver is blocked), past history—Caution should be used when this condition is present. Diabetes mellitus (sugar diabetes)—Estrogens may alter your body's response to sugar in your diet. Endometriosis or Fibroid tumors of the uterus—Estrogens may worsen endometriosis or increase the size of fibroid tumors. Gallbladder problems (gallstones)—Estrogens may increase your chance of getting a gallbladder attack. Heart attack or Stroke (active or past history)—Estrogens should not be used. Hepatic hemangioma (noncancerous tumors of the liver)—Estrogens may worsen this medical problem. High blood pressure—Estrogens may worsen this medical problem. Hypercalcemia (too much calcium in your blood)—Estrogens may worsen this medical problem. Hypertriglyceridemia (too much triglycerides in your blood)—Estrogens may increase your chance of getting pancreatitis or other side effects. Hypocalcemia (too little calcium in your blood)—Your doctor should treat the low calcium in your blood before starting estrogen therapy. Irritation or infection of the vagina—Usually estrogens decrease infections or irritation of the vagina, but sometimes these conditions may become worse. Liver disease or Liver problems—Estrogens should not be used. Lupus erythematosus, systemic (SLE or lupus)—Estrogens may worsen this medical problem. Physical problems within the vagina, such as narrow vagina, vaginal stenosis, or vaginal prolapse—Estradiol vaginal insert or ring may be more likely to slip out of place or cause problems, such as irritation of the vagina. Porphyria—Estrogens may worsen this medical problem. Thyroid problems (underactive thyroid)—Estrogens may alter your body's response to your thyroid medication. Your doctor may alter the amount of thyroid replacement that you take while on estrogen therapy. Vision changes, sudden onset including Bulging eyes or Double vision or Migraine headache or Vision loss, partial or complete—Estrogens may cause these problems. Tell your doctor if you have had any of these problems. Unusual genital or vaginal bleeding of unknown causes—Use of estrogens may delay diagnosis or worsen the condition. The reason for the bleeding should be determined before estrogens are used. Proper Use of estrogen

Vaginal estrogen products usually come with patient directions. Read them carefully before using estrogen.

Wash your hands before and after using the medicine. Also, keep the medicine out of your eyes. If estrogen does get into your eyes, wash them out immediately, but carefully, with large amounts of tap water. If your eyes still burn or are painful, check with your doctor.

Use estrogen only as directed. Do not use more of it and do not use it for a longer time than your doctor ordered. It can take up to 4 months to see the full effect of the estrogens. Your doctor may reconsider continuing your estrogen treatment or may lower your dose several times within the first one or two months, and every 3 to 6 months after that. Sometimes a switch to oral estrogens may be required for added benefits or for higher doses. When using the estradiol vaginal insert or ring, you will need to replace it every 3 months or remove it after 3 months.

For vaginal creams or suppositories:

Vaginal creams and some vaginal suppositories are inserted with a plastic applicator. Directions for using the applicator are supplied with your medicine. If you do not see your dose marked on the applicator, ask your health care professional for more information. To fill the applicator for cream dosage forms: Screw the applicator onto the tube. Squeeze the medicine into the applicator slowly until it is measured properly. Remove the applicator from the tube. Replace the cap on the tube. To fill the applicator for suppository dosage form: Place the suppository into the applicator. To place the dose using the applicator for cream and suppository dosage forms: Relax while lying on your back with your knees bent or stand with one foot on a chair. Hold the full applicator in one hand. Slide the applicator slowly into the vagina. Stop before it becomes uncomfortable. Slowly press the plunger until it stops. Withdraw the applicator. The medicine will be left behind in the vagina. To care for the applicator for cream and suppository dosage forms: Clean the applicator after use by pulling the plunger out of the applicator and washing both parts completely in warm, soapy water. Do not use hot or boiling water. Rinse well. After drying the applicator, replace the plunger.

For vaginal insert or ring dosage form:

To place the vaginal insert: Relax while lying on your back with your knees bent or stand with one foot on a chair. Pinch or press the sides of the vaginal insert together, between your forefinger and middle finger. With one hand, part the folds of skin around your vagina. Slide the vaginal insert slowly into the upper third of your vagina. Stop before it becomes uncomfortable. The exact location is not too important but it should be comfortable. If it seems uncomfortable, then carefully push the vaginal insert higher into the vagina. To remove the vaginal insert: Stand with one foot on a chair. Slide one finger into the vagina and hook it around the closest part of the vaginal insert. Slowly pull the vaginal insert out. Dispose of the vaginal insert by wrapping it up and throwing it into the trash. Do not flush it down the toilet. Dosing

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

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

For conjugated estrogens For vaginal dosage form (cream): For treating inflammation of the vagina (atrophic vaginitis): Adults—At first, 0.5 gram (g) of conjugated estrogens inserted into the vagina once a day or as directed by your doctor to achieve the lowest dose possible. Usually your doctor will want you to use estrogen for only three weeks of each month (three weeks on and one week off). Your doctor may increase your dose as needed. However, the dose is usually not more than 2 grams per day. For treating a genital skin condition (vulvar atrophy): Adults—0.5 gram (g) of conjugated estrogens inserted into the vagina two times per week. Usually your doctor will want you to use estrogen for only three weeks of each month (three weeks on and one week off). For estradiol For vaginal dosage form (cream): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis): Adults—200 to 400 micrograms (mcg) of estradiol (two to four grams of cream) inserted into the vagina once a day for one to two weeks, decreasing the dose by one half over two and four weeks. After four weeks, your doctor will probably ask you to use the medicine less often, such as 100 mcg (one gram of cream) one to three times a week and for only three weeks of each month (three weeks on and one week off). For vaginal dosage form (insert or ring): For treating a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis) in postmenopausal women, and inflammation of the urethra (urethritis) in postmenopausal women: Adults—One insert containing 2 to 24.8 milligrams (mg) of estradiol inserted into the vagina every three months. The insert will slowly release estradiol at a rate of 7.5 to 100 micrograms (mcg) every twenty-four hours with continuous use. For estrone For vaginal dosage form (cream): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis) in postmenopausal women: Adults—2 to 4 milligrams (mg) of estrone (two to four grams of cream) inserted into the vagina once a day or as directed by your doctor. For vaginal dosage form (suppository): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis) in postmenopausal women: Adults—250 to 500 micrograms (mcg) inserted into the vagina once a day or as directed by your doctor. Missed Dose

If you miss a dose of estrogen, 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.

When using the suppository or cream several times a week: If you miss a dose of estrogen and remember it within 1 or 2 days of the missed dose, use the missed dose 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.

When using the cream or suppositories more than several times a week: If you miss a dose of estrogen, use it as soon as possible if remembered within 12 hours of the missed dose. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

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

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using estrogen

It is very important that your doctor check your progress at regular visits to make sure estrogen does not cause unwanted effects. Plan on going to see your doctor every year, but some doctors require visits more often.

It is not yet known whether the use of vaginal estrogens increases the risk of breast cancer in women. It is very important that you check your breasts on a regular basis for any unusual lumps or discharge. Report any problems to your doctor. You should also have a mammogram (x-ray picture of the breasts) done if your doctor recommends it.

It is important that you have a regular pelvic exam (pap smear). Your doctor will tell you how often this exam should be done.

Talk to your doctor if you have high blood pressure, high cholesterol (fats in the blood), or diabetes, use tobacco, or are overweight. You may have a higher risk for getting heart disease.

Although the chance is low, use of estrogen may increase your chance of getting cancer of the ovary or uterus (womb). Regular visits to your health professional can help identify these serious side effects early.

If you think that you may be pregnant, stop using the medicine immediately and check with your doctor.

Tell the doctor in charge that you are using estrogen before having any laboratory test, because some test results may be affected.

For vaginal creams or suppositories:

Avoid using latex condoms, diaphragms, or cervical caps for up to 72 hours after using estrogen vaginal creams. Certain estrogen products may contain oils in the creams that can weaken latex (rubber) products and cause condoms to break or leak, or cervical caps or diaphragms to wear out sooner. Check with your health care professional to make sure the vaginal estrogen product you are using can be used with latex devices. estrogen is often used at bedtime to increase effectiveness through better absorption. Vaginal creams or suppositories will melt and leak out of the vagina. A minipad or sanitary napkin will protect your clothing. Do not use tampons (like those used for menstrual periods) since they may soak up the medicine and make the medicine less effective. Avoid exposing your male sexual partner to your vaginal estrogen cream or suppository by not having sexual intercourse right after using these medicines. Your male partner might absorb the medicine through his penis if it comes in contact with the medicine.

For estradiol vaginal inserts or rings:

Contact your doctor if you have problems removing your vaginal insert. It is not necessary to remove the vaginal insert for sexual intercourse unless you prefer to remove it. If you do take it out, or if it accidentally slips or comes out of the vagina, you can replace the vaginal insert in the vagina after washing it with lukewarm water. Never use hot or boiling water. If it slips down, gently push it upwards and back into place. Replace the vaginal insert every 3 months. Talk to your doctor on a regular basis about how long to use the vaginal insert. estrogen Side Effects

The risk of any serious adverse effect is unlikely for most women using low doses of estrogens vaginally. Even women with special risks have used vaginal estrogens without problems.

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

Less common Breast pain enlarged breasts itching of the vagina or genitals headache nausea stinging or redness of the genital area thick, white vaginal discharge without odor or with a mild odor Rare Feeling of vaginal pressure (with estradiol vaginal insert or ring) unusual or unexpected uterine bleeding or spotting vaginal burning or pain (with estradiol vaginal insert or ring) Incidence not known Diarrhea dizziness fast heartbeat feeling faint fever hives hoarseness itching joint pain, stiffness, or swelling muscle pain rash shortness of breath skin redness swelling of eyelids, face, lips, hands, or feet tightness in the chest trouble with breathing or swallowing vomiting wheezing

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 Abdominal or back pain clear vaginal discharge (usually means the medicine is working) Incidence not known Acne enlargement of penis or testes growth of pubic hair rapid increase in height swelling of the breasts or breast soreness in males

Also, many women who are using estrogens with a progestin (another female hormone) will start having monthly vaginal bleeding that is similar to menstrual periods. This effect will continue for as long as the medicine is taken. However, monthly bleeding will not occur in women who have had the uterus removed by surgery (hysterectomy).

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

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

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

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


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Femring


Generic Name: estrogen (Vaginal route)

Commonly used brand name(s)

In the U.S.

Estrace Estring Femring Ortho Dienestrol Premarin Vagifem

In Canada

Estragyn Neo-Estrone Oestrilin

Available Dosage Forms:

Tablet Cream Insert, Extended Release Suppository Uses For Femring

Estrogens are hormones produced by the body. Among other things, estrogens help develop and maintain female organs.

When your body is in short supply of this hormone, replacing it can ease the uncomfortable changes that occur in the vagina, vulva (female genitals), and urethra (part of the urinary system). Conditions that are treated with vaginal estrogens include a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis), and inflammation of the urethra (atrophic urethritis).

Estrogens work partly by increasing a normal clear discharge from the vagina and making the vulva and urethra healthy. Using or applying an estrogen relieves or lessens:

Dryness and soreness in the vagina Itching, redness, or soreness of the vulva Feeling an urge to urinate more often then is needed or experiencing pain while urinating Pain during sexual intercourse

When used vaginally or on the skin, most estrogens are absorbed into the bloodstream and cause some, but not all, of the same effects as when they are taken by mouth. Estrogens used vaginally at very low doses for treating local problems of the genitals and urinary system will not protect against osteoporosis or stop the hot flushes caused by menopause.

Estrogens for vaginal use are available only with your doctor's prescription.

Before Using Femring Allergies

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

Pediatric

Estrogen vaginal cream is not indicated in children. Studies have not been conducted.

Geriatric

Elderly women greater than 65 years of age may have an increased risk of certain side effects during treatment, especially stroke, invasive breast cancer, and memory problems.

Pregnancy

Estrogens should not be used during pregnancy, since an estrogen called diethylstilbestrol (DES) that is no longer taken for hormone replacement has caused serious birth defects in humans and animals.

Breast Feeding

Use of this medicine is not recommended in nursing mothers. Estrogens pass into the breast milk and may decrease the amount and quality of breast milk. Caution should be exercised in mothers who are using estrogen and breast-feeding.

Interactions with Medicines

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

Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

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

Asthma or Epilepsy or Heart problems or Kidney problems or Migraine headaches—Estrogens may worsen these conditions. Blood clotting problems—Although worsening of a blood clotting condition is unlikely, some doctors do not prescribe vaginal estrogens for patients with blood clotting problems or a history of these problems. Breast cancer (active, suspected, or past history)—Estrogens should not be used. Certain cancers, including cancers of the breast, bone, or uterus (active or suspected)—Estrogens may interfere with the treatment of breast or bone cancer or worsen cancer of the uterus when these conditions are present. Cholestatic jaundice (flow of bile from the liver is blocked), past history—Caution should be used when this condition is present. Diabetes mellitus (sugar diabetes)—Estrogens may alter your body's response to sugar in your diet. Endometriosis or Fibroid tumors of the uterus—Estrogens may worsen endometriosis or increase the size of fibroid tumors. Gallbladder problems (gallstones)—Estrogens may increase your chance of getting a gallbladder attack. Heart attack or Stroke (active or past history)—Estrogens should not be used. Hepatic hemangioma (noncancerous tumors of the liver)—Estrogens may worsen this medical problem. High blood pressure—Estrogens may worsen this medical problem. Hypercalcemia (too much calcium in your blood)—Estrogens may worsen this medical problem. Hypertriglyceridemia (too much triglycerides in your blood)—Estrogens may increase your chance of getting pancreatitis or other side effects. Hypocalcemia (too little calcium in your blood)—Your doctor should treat the low calcium in your blood before starting estrogen therapy. Irritation or infection of the vagina—Usually estrogens decrease infections or irritation of the vagina, but sometimes these conditions may become worse. Liver disease or Liver problems—Estrogens should not be used. Lupus erythematosus, systemic (SLE or lupus)—Estrogens may worsen this medical problem. Physical problems within the vagina, such as narrow vagina, vaginal stenosis, or vaginal prolapse—Estradiol vaginal insert or ring may be more likely to slip out of place or cause problems, such as irritation of the vagina. Porphyria—Estrogens may worsen this medical problem. Thyroid problems (underactive thyroid)—Estrogens may alter your body's response to your thyroid medication. Your doctor may alter the amount of thyroid replacement that you take while on estrogen therapy. Vision changes, sudden onset including Bulging eyes or Double vision or Migraine headache or Vision loss, partial or complete—Estrogens may cause these problems. Tell your doctor if you have had any of these problems. Unusual genital or vaginal bleeding of unknown causes—Use of estrogens may delay diagnosis or worsen the condition. The reason for the bleeding should be determined before estrogens are used. Proper Use of estrogen

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

Vaginal estrogen products usually come with patient directions. Read them carefully before using this medicine.

Wash your hands before and after using the medicine. Also, keep the medicine out of your eyes. If this medicine does get into your eyes, wash them out immediately, but carefully, with large amounts of tap water. If your eyes still burn or are painful, check with your doctor.

Use this medicine only as directed. Do not use more of it and do not use it for a longer time than your doctor ordered. It can take up to 4 months to see the full effect of the estrogens. Your doctor may reconsider continuing your estrogen treatment or may lower your dose several times within the first one or two months, and every 3 to 6 months after that. Sometimes a switch to oral estrogens may be required for added benefits or for higher doses. When using the estradiol vaginal insert or ring, you will need to replace it every 3 months or remove it after 3 months.

For vaginal creams or suppositories:

Vaginal creams and some vaginal suppositories are inserted with a plastic applicator. Directions for using the applicator are supplied with your medicine. If you do not see your dose marked on the applicator, ask your health care professional for more information. To fill the applicator for cream dosage forms: Screw the applicator onto the tube. Squeeze the medicine into the applicator slowly until it is measured properly. Remove the applicator from the tube. Replace the cap on the tube. To fill the applicator for suppository dosage form: Place the suppository into the applicator. To place the dose using the applicator for cream and suppository dosage forms: Relax while lying on your back with your knees bent or stand with one foot on a chair. Hold the full applicator in one hand. Slide the applicator slowly into the vagina. Stop before it becomes uncomfortable. Slowly press the plunger until it stops. Withdraw the applicator. The medicine will be left behind in the vagina. To care for the applicator for cream and suppository dosage forms: Clean the applicator after use by pulling the plunger out of the applicator and washing both parts completely in warm, soapy water. Do not use hot or boiling water. Rinse well. After drying the applicator, replace the plunger.

For vaginal insert or ring dosage form:

To place the vaginal insert: Relax while lying on your back with your knees bent or stand with one foot on a chair. Pinch or press the sides of the vaginal insert together, between your forefinger and middle finger. With one hand, part the folds of skin around your vagina. Slide the vaginal insert slowly into the upper third of your vagina. Stop before it becomes uncomfortable. The exact location is not too important but it should be comfortable. If it seems uncomfortable, then carefully push the vaginal insert higher into the vagina. To remove the vaginal insert: Stand with one foot on a chair. Slide one finger into the vagina and hook it around the closest part of the vaginal insert. Slowly pull the vaginal insert out. Dispose of the vaginal insert by wrapping it up and throwing it into the trash. Do not flush it down the toilet. Dosing

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

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

For conjugated estrogens For vaginal dosage form (cream): For treating inflammation of the vagina (atrophic vaginitis): Adults—At first, 0.5 gram (g) of conjugated estrogens inserted into the vagina once a day or as directed by your doctor to achieve the lowest dose possible. Usually your doctor will want you to use this medicine for only three weeks of each month (three weeks on and one week off). Your doctor may increase your dose as needed. However, the dose is usually not more than 2 grams per day. For treating a genital skin condition (vulvar atrophy): Adults—0.5 gram (g) of conjugated estrogens inserted into the vagina two times per week. Usually your doctor will want you to use this medicine for only three weeks of each month (three weeks on and one week off). For estradiol For vaginal dosage form (cream): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis): Adults—200 to 400 micrograms (mcg) of estradiol (two to four grams of cream) inserted into the vagina once a day for one to two weeks, decreasing the dose by one half over two and four weeks. After four weeks, your doctor will probably ask you to use the medicine less often, such as 100 mcg (one gram of cream) one to three times a week and for only three weeks of each month (three weeks on and one week off). For vaginal dosage form (insert or ring): For treating a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis) in postmenopausal women, and inflammation of the urethra (urethritis) in postmenopausal women: Adults—One insert containing 2 to 24.8 milligrams (mg) of estradiol inserted into the vagina every three months. The insert will slowly release estradiol at a rate of 7.5 to 100 micrograms (mcg) every twenty-four hours with continuous use. For estrone For vaginal dosage form (cream): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis) in postmenopausal women: Adults—2 to 4 milligrams (mg) of estrone (two to four grams of cream) inserted into the vagina once a day or as directed by your doctor. For vaginal dosage form (suppository): For treating a genital skin condition (vulvar atrophy) and inflammation of the vagina (atrophic vaginitis) in postmenopausal women: Adults—250 to 500 micrograms (mcg) inserted into the vagina once a day or as directed 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.

When using the suppository or cream several times a week: If you miss a dose of this medicine and remember it within 1 or 2 days of the missed dose, use the missed dose 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.

When using the cream or suppositories more than several times a week: If you miss a dose of this medicine, use it as soon as possible if remembered within 12 hours of the missed dose. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

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

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Femring

It is very important that your doctor check your progress at regular visits to make sure this medicine does not cause unwanted effects. Plan on going to see your doctor every year, but some doctors require visits more often.

It is not yet known whether the use of vaginal estrogens increases the risk of breast cancer in women. It is very important that you check your breasts on a regular basis for any unusual lumps or discharge. Report any problems to your doctor. You should also have a mammogram (x-ray picture of the breasts) done if your doctor recommends it.

It is important that you have a regular pelvic exam (pap smear). Your doctor will tell you how often this exam should be done.

Talk to your doctor if you have high blood pressure, high cholesterol (fats in the blood), or diabetes, use tobacco, or are overweight. You may have a higher risk for getting heart disease.

Although the chance is low, use of estrogen may increase your chance of getting cancer of the ovary or uterus (womb). Regular visits to your health professional can help identify these serious side effects early.

If you think that you may be pregnant, stop using the medicine immediately and check with your doctor.

Tell the doctor in charge that you are using this medicine before having any laboratory test, because some test results may be affected.

For vaginal creams or suppositories:

Avoid using latex condoms, diaphragms, or cervical caps for up to 72 hours after using estrogen vaginal creams. Certain estrogen products may contain oils in the creams that can weaken latex (rubber) products and cause condoms to break or leak, or cervical caps or diaphragms to wear out sooner. Check with your health care professional to make sure the vaginal estrogen product you are using can be used with latex devices. This medicine is often used at bedtime to increase effectiveness through better absorption. Vaginal creams or suppositories will melt and leak out of the vagina. A minipad or sanitary napkin will protect your clothing. Do not use tampons (like those used for menstrual periods) since they may soak up the medicine and make the medicine less effective. Avoid exposing your male sexual partner to your vaginal estrogen cream or suppository by not having sexual intercourse right after using these medicines. Your male partner might absorb the medicine through his penis if it comes in contact with the medicine.

For estradiol vaginal inserts or rings:

Contact your doctor if you have problems removing your vaginal insert. It is not necessary to remove the vaginal insert for sexual intercourse unless you prefer to remove it. If you do take it out, or if it accidentally slips or comes out of the vagina, you can replace the vaginal insert in the vagina after washing it with lukewarm water. Never use hot or boiling water. If it slips down, gently push it upwards and back into place. Replace the vaginal insert every 3 months. Talk to your doctor on a regular basis about how long to use the vaginal insert. Femring Side Effects

The risk of any serious adverse effect is unlikely for most women using low doses of estrogens vaginally. Even women with special risks have used vaginal estrogens without problems.

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

Less common Breast pain enlarged breasts itching of the vagina or genitals headache nausea stinging or redness of the genital area thick, white vaginal discharge without odor or with a mild odor Rare Feeling of vaginal pressure (with estradiol vaginal insert or ring) unusual or unexpected uterine bleeding or spotting vaginal burning or pain (with estradiol vaginal insert or ring) Incidence not known Diarrhea dizziness fast heartbeat feeling faint fever hives hoarseness itching joint pain, stiffness, or swelling muscle pain rash shortness of breath skin redness swelling of eyelids, face, lips, hands, or feet tightness in the chest trouble with breathing or swallowing vomiting wheezing

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 Abdominal or back pain clear vaginal discharge (usually means the medicine is working) Incidence not known Acne enlargement of penis or testes growth of pubic hair rapid increase in height swelling of the breasts or breast soreness in males

Also, many women who are using estrogens with a progestin (another female hormone) will start having monthly vaginal bleeding that is similar to menstrual periods. This effect will continue for as long as the medicine is taken. However, monthly bleeding will not occur in women who have had the uterus removed by surgery (hysterectomy).

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

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

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

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


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spermicide Vaginal


Class Name: spermicide (Vaginal route)

Commonly used brand name(s)

In the U.S.

Advantage-S Conceptrol Crinone Delfen Foam Emko Encare Endometrin First-Progesterone VGS Gynol II Prochieve Today Sponge Vagi-Gard Douche Non-Staining

Available Dosage Forms:

Gel/Jelly Sponge Suppository Foam Liquid Film Cream Uses For This Medicine

Vaginal spermicides are a type of contraceptive (birth control). These products are inserted into the vagina before any genital contact occurs or sexual intercourse begins. They work by damaging and killing sperm in the vagina. Therefore, the sperm are not able to travel from the vagina into the uterus and fallopian tubes, where fertilization takes place.

Vaginal spermicides, when used alone, are much less effective in preventing pregnancy than birth control pills, an intrauterine device (IUD), or spermicides used together with another form of birth control, such as cervical caps, condoms, or diaphragms. Studies have shown that when spermicides are used alone, pregnancy usually occurs in 21 of each 100 women during the first year of spermicide use. The number of pregnancies is reduced when spermicides are used with another method, especially the condom. Discuss with your doctor what your options are for birth control and the risks and benefits of each method.

The most effective way to protect yourself against HIV (AIDS) and other sexually transmitted diseases (STDs) is by abstinence (not having sexual intercourse) or by having only one partner who you can be sure is not already infected or is not going to get an STD. However, if either of these methods is not likely or possible, using latex (rubber) condoms with a spermicide is the best way of protecting yourself.

The use of a spermicide is recommended even when you are using nonbarrier methods of birth control, such as birth control pills (the pill) or intrauterine devices (IUDs), since these do not offer any protection from STDs.

Vaginal spermicides are available without a prescription.

Before Using This Medicine Allergies

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

Pediatric

These products have been used by teenagers and have not been shown to cause different side effects or problems than they do in adults. However, some younger users may need extra counseling and information on the importance of using spermicides exactly as they are supposed to be used so they will work properly.

Pregnancy

Many studies have shown that the use of vaginal spermicides does not increase the risk of birth defects or miscarriage.

Breast Feeding

It is not known if vaginal spermicides pass into breast milk in humans. However, their use has not been reported to cause problems in nursing babies.

Interactions with Medicines

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

Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

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

Allergies, irritations, or infections of the genitals—Using vaginal spermicides may cause moderate to severe irritation in these conditions. Also, benzalkonium suppositories may be less effective in women with vaginal infections. Conditions or medical problems where it is important that pregnancy does not occur—Vaginal spermicides, when used alone, are much less effective than birth control pills, an intrauterine device (IUD), or spermicides used together with another form of birth control, such as cervical caps, condoms, or diaphragms. Discuss with your doctor what your options are for birth control and the risks and benefits of each method. Recent childbirth or abortion or Toxic shock syndrome, history of—Cervical caps or diaphragms should not be used in these cases because there is an increased chance of developing toxic shock syndrome. Sores on the genitals (sex organs) or Irritation of the vagina or rectum—Do not use this medicine if you or your sex partner have HIV or AIDS. This medicine can irritate the vagina and rectum, which may increase the risk of getting HIV or AIDS. Discuss this with your doctor if you have any questions.

If you develop any medical problem or begin using any new medicine (prescription or nonprescription) while you are using this medicine, you may want to check with your doctor.

Proper Use of This Medicine

Make sure you carefully read and follow the directions that come with each spermicide product. Each product may have different directions for using the product. The directions tell you how much to use, how long you must wait before having intercourse, and how long you must leave it in the vagina after intercourse.

Spermicide products are for vaginal use only and are not for rectal (anal) use.

Vaginal douching is not needed or advised after using these medicines. When using a spermicide, douching within 6 to 8 hours after the last sexual intercourse (even with just water) may stop the spermicide from working properly. Also, washing or rinsing the vaginal or rectal area may wash the spermicide away before it has had time to work properly.

Cervical caps and diaphragms are not recommended for use during your menstrual period because of an increased chance of developing toxic shock syndrome. Your doctor may advise you to use condoms with a spermicide instead during your menstrual periods when protection is needed.

For proper use of spermicide when used alone:

Follow directions carefully to make sure the spermicide is properly placed in the vagina. The spermicide should be inserted deep into the vagina and directly on the cervix (opening to the uterus). Use the correct amount, according to the product directions. Use another dose for each act of intercourse. After you have applied or inserted the spermicide, wait the correct amount of time before having intercourse so that the spermicide can begin to work. If you do not have intercourse within half an hour, read the product directions to see if you need to apply more spermicide.

For proper use of spermicide with cervical caps, condoms, or diaphragms:

Make sure the directions for the spermicide you choose state that it is safe for use with latex cervical caps, condoms, or diaphragms. If the directions do not say the spermicide is safe to use with latex products, the spermicide may cause cervical caps, condoms, or diaphragms to weaken and leak or cause condoms to break during intercourse. If there is a leak or break during intercourse, it may be a good idea for the female partner to immediately place more spermicide in the vagina. If you need an extra lubricant, make sure it is a water-based product safe for use with cervical caps, condoms, or diaphragms. Spermicides, especially gels and jellies, provide some lubrication during sexual intercourse. Oil-based products such as hand, face, or body cream; petroleum jelly; cooking oils or shortenings; or baby oil should not be used because they weaken the latex rubber. (Even some products that easily rinse away with water are oil-based and should not be used.) Use of oil-based products increases the chances of the condom breaking during sexual intercourse. These products can also cause the rubber in cervical caps or diaphragms to break down faster and wear out sooner.

For patients using spermicides with a cervical cap:

To be most effective at preventing pregnancy, the cervical cap must always be used with a spermicide. Both must be used every time you have sexual intercourse. Before inserting the cervical cap, inspect it for holes, tears, or cracks. If there are holes or defects, the cervical cap will not work effectively, even with a spermicide. It must be replaced. Before you put the cervical cap over the cervix (opening to the uterus), a spermicide cream, foam, gel, or jelly should be put into the cup of the cervical cap. Follow the manufacturer's directions on how long before sexual intercourse you may apply the spermicide. Fill the cervical cap one-third full with spermicide. To insert the cervical cap, squeeze the rim between your thumb and forefinger so that it is narrow enough to fit into the vagina. While in a comfortable position, push the cervical cap as deeply into the vagina as it will go. Release the rim and press it into place around the cervix with your finger. The rim should be round again and be directly on the cervix. The cervical cap is held onto the cervix by suction. Some doctors may recommend that you put more spermicide into the vagina each time you repeat sexual intercourse using a cervical cap. You should also check to make sure the cervical cap is in the proper position on the cervix before and after each time you have intercourse. You may wear the cervical cap for up to 48 hours (2 days). Do not remove the cervical cap if it has been less than 8 hours since the last time you had sexual intercourse To remove the cervical cap, use 1 or 2 fingers to push the rim away from the cervix. This will break the suction seal with the cervix. Then gently pull the cervical cap out of the vagina. Call your doctor if you have trouble removing the cervical cap.

For patients using spermicides with condoms

Condoms do not have to be used with spermicides, but the spermicide may provide a back-up birth control method in case the condom breaks or leaks. Spread some spermicide on the outside of the condom, after it is unrolled over the penis. It is even more important that the female partner also use a spermicide inside the vagina. Each time you repeat intercourse, a new condom must be used. Condoms should never be reused. Spermicide should also be applied to the outside of the new condom. The female partner must also put more spermicide in the vagina each time she has intercourse.

For patients using spermicides with a diaphragm:

To be most effective at preventing pregnancy, diaphragms must always be used with a spermicide. Some women may choose to insert a diaphragm every night to avoid the chance of having unprotected sexual intercourse and an unplanned pregnancy. Inspect the diaphragm for holes by holding it up to a light. If there are holes or defects, the diaphragm will not work effectively, even with a spermicide. It must be replaced. Before you put the diaphragm over the cervix (opening to the uterus), a spermicide cream, foam, gel, or jelly should be put into the cup of the diaphragm. Follow the manufacturer's directions on how much spermicide to use and how long before sexual intercourse you may apply the spermicide. Also, spread some spermicide all around the rim of the diaphragm that will be touching the cervix. Some doctors also advise spreading more spermicide on the outside of the cup of the diaphragm. To insert the diaphragm, squeeze the rim between your thumb and forefinger so that it is narrow enough to fit into the vagina. While in a comfortable position, push the diaphragm as deeply into the vagina as it will go and release the rim. Some women use a special applicator that makes it easier to insert the diaphragm. The diaphragm rim should be round again and be directly on the cervix. Each time you repeat sexual intercourse, you should put more spermicide into the vagina. Do not remove the diaphragm if it has been less than 6 or 8 hours (depending upon which brand of spermicide you use) since the last sexual intercourse. For the diaphragm to be most effective at preventing pregnancy, it must remain in the vagina for at least 6 or 8 hours (depending upon which brand of spermicide you use) after sexual intercourse. Be careful not to move the diaphragm out of place while you are applying more spermicide. Do not wear the diaphragm for more than 24 hours, since doing so increases the risk of getting toxic shock syndrome or a urinary tract (bladder) infection. To remove the diaphragm, hook one finger over the rim nearest the front. Pull the diaphragm downward and out of the vagina. Call your doctor if you have trouble removing the diaphragm. Dosing

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

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

For benzalkonium chloride For preventing pregnancy: For vaginal dosage form (suppositories): Adults and teenagers— For use alone—One suppository inserted into the vagina at least ten minutes, but not longer than four hours, before each time you have sexual intercourse. It may help to wet the suppository before inserting it into the vagina. For use with a diaphragm—After the diaphragm with spermicide has been placed into the vagina, insert one suppository at least ten minutes, but not longer than four hours, before each time you have sexual intercourse. It may help to wet the suppository before inserting it into the vagina. Also, insert another suppository before sexual intercourse if six hours have passed since you inserted the diaphragm. For nonoxynol 9 For preventing pregnancy: For vaginal dosage form (cream): Adults and teenagers— For use alone—One applicatorful of a 5% cream inserted into the vagina just before each time you have sexual intercourse. For use with a diaphragm—One applicatorful of a 2 or 5% cream inserted into the cup of the diaphragm. Spread more spermicide along the rim of the diaphragm. Insert the diaphragm into the vagina just before, but not longer than six hours before, sexual intercourse. Also, insert one applicatorful just before each time you have intercourse or if six hours have passed since you inserted the diaphragm. For vaginal dosage form (film): Adults and teenagers—One film inserted into the vagina from five to fifteen minutes (but not longer than one and one-half hours) before each time you have sexual intercourse. For vaginal dosage form (foam): Adults and teenagers— For use alone—One applicatorful inserted into the vagina just before, but not longer than one hour before, each time you have sexual intercourse. For use with a diaphragm—One applicatorful inserted into either the vagina or into the cup of the diaphragm, depending on the product. Spread more spermicide along the rim of the diaphragm. Insert the diaphragm into the vagina just before, but not longer than one hour before, sexual intercourse. Also, insert another applicatorful into the vagina just before, but not longer than one hour before, each time you have sexual intercourse. For vaginal dosage form (gel): Adults and teenagers— For use alone—One applicatorful of a 3.5, 4, or 5% gel inserted into the vagina before each time you have sexual intercourse. The 3.5% gel may be used up to twenty-four hours before each act of intercourse. The 4% gel may be used up to one hour before each act of intercourse. The 5% gel must used just before intercourse. For use with a diaphragm—One or two teaspoonfuls (depending on the product) or the contents of one packet of gel is placed into the cup of the diaphragm. Spread more spermicide along the rim of the diaphragm. Insert the diaphragm into the vagina just before, or up to six hours before, sexual intercourse. Also, insert another applicatorful or the contents of one packet into the vagina before each time you have sexual intercourse or if six hours have passed since you inserted the diaphragm. For vaginal dosage form (jelly): Adults and teenagers— For use alone—One applicatorful of 2.2 or 3% jelly inserted into the vagina just before each time you have sexual intercourse. The contraceptive effect of the 2.2 or 3% jelly will last one hour. For use with a diaphragm—One applicatorful or two teaspoonfuls of jelly (depending on the product) placed into the cup of the diaphragm. Spread more spermicide along the rim of the diaphragm. Insert the diaphragm into the vagina just before, but not longer than six hours before, sexual intercourse. Also, insert another applicatorful before each time you have sexual intercourse or if six hours have passed since you inserted the diaphragm. For vaginal dosage form (suppositories): Adults and teenagers— For use alone—One suppository inserted into the vagina from ten to fifteen minutes (depending on the product) before, but not longer than one hour before, each time you have sexual intercourse. For use with a diaphragm—After the diaphragm with spermicide has been placed into the vagina, insert one suppository into the vagina from ten to fifteen minutes (depending on the product) before, but not longer than one hour before, sexual intercourse. Also, insert another suppository before each time you have sexual intercourse or if six hours have passed since you have inserted the diaphragm. For octoxynol 9 For preventing pregnancy: For vaginal dosage form (cream): Adults and teenagers— For use with a diaphragm—Two teaspoonfuls placed into the cup of the diaphragm. Spread more spermicide along the rim of the diaphragm. Insert the diaphragm into the vagina just before, but not longer than six hours before, sexual intercourse. Also, insert one applicatorful of the vaginal cream just before each time you have sexual intercourse or if six hours have passed since you inserted the diaphragm. For vaginal dosage form (jelly): Adults and teenagers— For use with a diaphragm—One applicatorful placed into the cup of the diaphragm. Spread more spermicide along the rim of the diaphragm. Insert the diaphragm into the vagina just before, but not longer than six hours before, sexual intercourse. Also, insert another applicatorful just before each time you have sexual intercourse or if six hours have passed since you inserted the diaphragm. Storage

Keep out of the reach of children.

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

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine

Do not use this medicine if you or your sex partner have HIV or AIDS. This medicine can irritate the vagina and rectum, which may increase the risk of getting HIV or AIDS. Discuss this with your doctor if you have any questions.

This medicine will not protect you from getting HIV or AIDS, or other sexually transmitted diseases (STDs). If this is a concern for you, discuss this with your doctor.

If you have a rash or burning, itching, or other irritation of the genitals, discontinue use of the spermicide and contact your doctor. .

Side Effects of This Medicine

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

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

RareSigns of toxic shock syndrome—for cervical caps or diaphragms Chills confusion dizziness fever lightheadedness muscle aches sunburn-like skin rash that is followed by peeling of the skin unusual redness of the inside of the nose, mouth, throat, vagina, or eyelids

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

RareFor females and males Skin rash, redness, irritation, or itching that does not go away within a short period of time For females only Cloudy or bloody urine increased frequency of urination pain in the bladder or lower abdomen thick, white, or curd-like vaginal discharge—with use of cervical caps or diaphragms only vaginal irritation, redness, rash, dryness, or whitish discharge

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 Vaginal discharge (temporary)—with use of creams, foams, and suppositories vaginal dryness or odor

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

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

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

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


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Progesterone Insert


Pronunciation: proe-JES-ter-one
Generic Name: Progesterone
Brand Name: Endometrin
Progesterone Insert is used for:

Supporting embryo implants and early pregnancy in certain women. It is also used as part of an assisted reproductive technology (ART) treatment program. It may also be used for other conditions as determined by your doctor.

Progesterone Insert is a hormone. It works by changing the lining of the uterus.

Do NOT use Progesterone Insert if: you are allergic to any ingredient in Progesterone Insert you have vaginal bleeding of an unknown cause, you have had a recent miscarriage, or the embryo is implanted outside the uterus (ectopic pregnancy) you know or suspect that you have breast cancer you have bleeding in the brain or severe blood vessel problems you have a history of bleeding or blood clotting problems (eg, blood clots in the legs, lungs, or eyes), heart attack, stroke, or liver disease you are using other vaginal products (eg, vaginal antifungal creams)

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

Before using Progesterone Insert:

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

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have a history of heart or blood vessel problems, depression or other mental/mood problems, or cancer

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

Carbamazepine or rifampin because they may decrease Progesterone Insert's effectiveness Other vaginal products (eg, vaginal antifungal creams) because they may alter Progesterone Insert's actions

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

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

An extra patient leaflet is available with Progesterone Insert. Talk to your pharmacist if you have questions about this information. Wash your hands before and after using Progesterone Insert. Unwrap the applicator and place one insert in the space provided at the end of the applicator. You may use Progesterone Insert while standing, sitting, or when lying on your back with your knees bent. Gently place the thin end of the applicator well into the vagina. Push the plunger to release the insert, then remove the applicator and throw it away in the trash. If you miss a dose of Progesterone Insert, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

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

Important safety information: Progesterone Insert may cause drowsiness, dizziness, blurred vision, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Progesterone Insert with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do not use Progesterone Insert at the same time as other vaginal therapy without checking with your doctor. Progesterone Insert may cause harm if it is swallowed. If you may have taken it by mouth, contact your poison control center or emergency room right away. Progesterone Insert should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: Progesterone Insert is used to support early pregnancy. Progesterone Insert is found in breast milk. If you are or will be breast-feeding while you use Progesterone Insert, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Progesterone Insert:

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:

Bloating; breast tenderness; constipation; cramping; drowsiness; fluid retention; headache; nausea; stomach pain; tiredness; vaginal burning or irritation; vomiting.

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

Severe allergic reactions (eg, rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal vaginal bleeding; calf or leg pain, swelling, or tenderness; change in emotions, mood, or behavior; chest pain; coughing up blood; fainting; one-sided weakness; pain in the groin; partial or complete loss of vision; stomach pain, swelling, or tenderness; sudden, severe headache, vomiting, dizziness, or fainting; sudden shortness of breath; swelling of hands, ankles, or feet; unusual vaginal itching, discharge, or odor; visual or speech disturbances; weakness or numbness in an arm or leg; yellowing of the skin or eyes.

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

See also: Progesterone side effects (in more detail)

If OVERDOSE is suspected:

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

Proper storage of Progesterone Insert:

Store Progesterone Insert at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat and light. Do not remove from the sealed foiled pouch until just before use. Keep Progesterone Insert out of the reach of children and away from pets.

General information: If you have any questions about Progesterone Insert, please talk with your doctor, pharmacist, or other health care provider. Progesterone Insert 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 Progesterone Insert. 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 Progesterone resources Progesterone Side Effects (in more detail) Progesterone Use in Pregnancy & Breastfeeding Progesterone Drug Interactions Progesterone Support Group 15 Reviews for Progesterone - Add your own review/rating Compare Progesterone with other medications Amenorrhea Endometrial Hyperplasia, Prophylaxis Perimenopausal Symptoms Premature Labor Progesterone Insufficiency Seizures Uterine Bleeding
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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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Amino-Cerv Cream


Pronunciation: uh-MEE-no AS-ids/SO-dee-uhm PRO-pee-oh-nate/you-REE-ah
Generic Name: Amino Acids/Sodium Propionate/Urea Cervical
Brand Name: Amino-Cerv
Amino-Cerv Cream is used for:

Treating inflammation or injury of the cervix. It is usually used after childbirth or certain medical procedures. It may also be used to treat other conditions as determined by your doctor.

Amino-Cerv Cream is an amino acid, antifungal, and urea combination. The amino acids help wounds to heal. They also help to increase cell growth. Sodium propionate kills sensitive fungi. Urea helps to break down dead tissue. It also increases new tissue growth.

Do NOT use Amino-Cerv Cream if: you are allergic to any ingredient in Amino-Cerv Cream

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

Before using Amino-Cerv Cream:

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

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparations, or dietary supplement if you have allergies to medicines, foods, or other substances

Some MEDICINES MAY INTERACT with Amino-Cerv Cream. Because little, if any, of Amino-Cerv Cream is absorbed into the blood, the risk of it interacting with another medicine is low.

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

Use Amino-Cerv Cream as directed by your doctor. Check the label on the medicine for exact dosing instructions. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Amino-Cerv Cream. Talk to your pharmacist if you have questions about this information. Use Amino-Cerv Cream before going to bed unless directed otherwise by your doctor. If you are wearing a pessary, remove it before you use Amino-Cerv Cream. Do not tape over the pinhole on the top of the bulb on the applicator. To use Amino-Cerv Cream, attach the applicator to the tube. Squeeze the tube from the bottom until the medicine reaches the correct dose mark on the applicator. Detach the applicator from the tube. Insert it 3 4 inch into the vagina. Do NOT insert it all the way into the vagina. Squeeze the bulb firmly once. This will deposit the cream into the vagina. Do not release the bulb until you have removed the applicator from the vagina. Clean the applicator right away. Hold it under water and flush it (squeeze the bulb) several times. Wipe the threads of the tube and the inside of the cap. Recap the tube tightly. Do not use other feminine sprays or vaginal or cervical medicines. They may interact with Amino-Cerv Cream. If you miss a dose of Amino-Cerv Cream, use it as soon as possible. If you do not remember until the next day, skip the missed dose. Go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Amino-Cerv Cream.

Important safety information: Amino-Cerv Cream is for vaginal use only. Do not get it in your eyes, nose, or mouth. If you get it in your eyes, rinse at once with cool water. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Amino-Cerv Cream while you are pregnant. It is unknown if Amino-Cerv Cream is found in breast milk. If you are or will be breast-feeding while you use Amino-Cerv Cream, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Amino-Cerv Cream:

All medicines may cause side effects, but many people have no, or minor, side effects. No COMMON side effects have been reported with Amino-Cerv Cream. Seek medical attention right away if any of these SEVERE side effects occur:

Seek medical attention right away if any of these SEVERE side effects occur: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).

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

See also: Amino-Cerv side effects (in more detail)

If OVERDOSE is suspected:

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

Proper storage of Amino-Cerv Cream:

Store Amino-Cerv Cream at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Amino-Cerv Cream out of the reach of children and away from pets.

General information: If you have any questions about Amino-Cerv Cream, please talk with your doctor, pharmacist, or other health care provider. Amino-Cerv Cream 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 Amino-Cerv Cream. 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 Amino-Cerv resources Amino-Cerv Side Effects (in more detail)Amino-Cerv Use in Pregnancy & BreastfeedingAmino-Cerv Support Group0 Reviews for Amino-Cerv - Add your own review/rating Compare Amino-Cerv with other medications Cervicitis
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Terazol 3 Suppositories


Pronunciation: ter-KON-a-zole
Generic Name: Terconazole
Brand Name: Terazol 3
Terazol 3 Suppositories are used for:

Treating vaginal yeast infections in women.

Terazol 3 Suppositories are an antifungal agent. It works by weakening the fungal cell membrane and killing sensitive fungi that cause yeast infections.

Do NOT use Terazol 3 Suppositories if: you are allergic to any ingredient in Terazol 3 Suppositories

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

Before using Terazol 3 Suppositories:

Some medical conditions may interact with Terazol 3 Suppositories. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

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

Some MEDICINES MAY INTERACT with Terazol 3 Suppositories. However, no specific interactions with Terazol 3 Suppositories are known at this time

Ask your health care provider if Terazol 3 Suppositories 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 Terazol 3 Suppositories:

Use Terazol 3 Suppositories as directed by your doctor. Check the label on the medicine for exact dosing instructions.

An extra patient leaflet is available with Terazol 3 Suppositories. Talk to your pharmacist if you have questions about this information. Terazol 3 Suppositories are for vaginal use only. Filling the applicator - Break off suppository from the plastic strip. Pull the plastic completely apart at the notched end. Place the flat end of the suppository into the open end of the applicator as shown. Using the applicator - Lie on your back with your knees drawn up toward your chest. Holding the applicator by the ribbed end of the barrel, gently insert it into the vagina as far as it will comfortably go. Press the plunger to release the suppository into the vagina. Remove the applicator from the vagina. Cleaning the applicator - After each use, you should thoroughly clean the applicator by following this procedure: Pull the plunger out of the barrel. Wash both pieces with lukewarm, soapy water, and dry them thoroughly. Put the applicator back together by gently pushing the plunger into the barrel as far as it will go. To insert without the applicator - Lie on your back with your knees drawn up toward your chest. Place the suppository on the tip of your finger. Insert the suppository gently. Terazol 3 Suppositories works best if it is used at the same time each day. To clear up your infection completely, use Terazol 3 Suppositories for the full course of treatment. Keep using it even if you feel better in a few days. If you miss a dose of Terazol 3 Suppositories, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Terazol 3 Suppositories.

Important safety information: You can use the medication even if you are having your menstrual period. However, you should not use tampons because they may absorb the medication. Instead, use external pads or napkins until you have finished your medication. You may also wish to wear a sanitary napkin if the vaginal medicine leaks. Dry the genital area thoroughly after showering, bathing, or swimming. Change out of a wet bathing suit or damp exercise clothes as soon as possible. A dry environment is less likely to encourage the growth of yeast. Terazol 3 Suppositories may decrease the effectiveness of condoms and diaphragms. If your infection clears up and occurs again in a few weeks, see your doctor. Be sure to use Terazol 3 Suppositories for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The fungus could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future. Use Terazol 3 Suppositories with caution in the ELDERLY; they may be more sensitive to its effects. Terazol 3 Suppositories should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Terazol 3 Suppositories while you are pregnant. It is not known if Terazol 3 Suppositories are found in breast milk. Do not breast-feed while taking Terazol 3 Suppositories. Possible side effects of Terazol 3 Suppositories:

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:

Body pain; burning or itching of the vagina; headache.

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); chills; flu-like symptoms (headache; tiredness; muscle aches; fever); vaginal sensitivity or irritation.

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: Terazol 3 side effects (in more detail)

If OVERDOSE is suspected:

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

Proper storage of Terazol 3 Suppositories:

Store Terazol 3 Suppositories at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Terazol 3 Suppositories out of the reach of children and away from pets.

General information: If you have any questions about Terazol 3 Suppositories, please talk with your doctor, pharmacist, or other health care provider. Terazol 3 Suppositories are to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Terazol 3 Suppositories. 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 Terazol 3 resources Terazol 3 Side Effects (in more detail)Terazol 3 Use in Pregnancy & BreastfeedingTerazol 3 Support Group0 Reviews for Terazol 3 - Add your own review/rating Compare Terazol 3 with other medications Vaginal Yeast Infection
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Terconazole Suppositories


Pronunciation: ter-KON-a-zole
Generic Name: Terconazole
Brand Name: Terazol 3
Terconazole Suppositories are used for:

Treating vaginal yeast infections in women.

Terconazole Suppositories are an antifungal agent. It works by weakening the fungal cell membrane and killing sensitive fungi that cause yeast infections.

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

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

Before using Terconazole Suppositories:

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

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

Some MEDICINES MAY INTERACT with Terconazole Suppositories. However, no specific interactions with Terconazole Suppositories are known at this time

Ask your health care provider if Terconazole Suppositories 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 Terconazole Suppositories:

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

An extra patient leaflet is available with Terconazole Suppositories. Talk to your pharmacist if you have questions about this information. Terconazole Suppositories are for vaginal use only. Filling the applicator - Break off suppository from the plastic strip. Pull the plastic completely apart at the notched end. Place the flat end of the suppository into the open end of the applicator as shown. Using the applicator - Lie on your back with your knees drawn up toward your chest. Holding the applicator by the ribbed end of the barrel, gently insert it into the vagina as far as it will comfortably go. Press the plunger to release the suppository into the vagina. Remove the applicator from the vagina. Cleaning the applicator - After each use, you should thoroughly clean the applicator by following this procedure: Pull the plunger out of the barrel. Wash both pieces with lukewarm, soapy water, and dry them thoroughly. Put the applicator back together by gently pushing the plunger into the barrel as far as it will go. To insert without the applicator - Lie on your back with your knees drawn up toward your chest. Place the suppository on the tip of your finger. Insert the suppository gently. Terconazole Suppositories works best if it is used at the same time each day. To clear up your infection completely, use Terconazole Suppositories for the full course of treatment. Keep using it even if you feel better in a few days. If you miss a dose of Terconazole Suppositories, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

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

Important safety information: You can use the medication even if you are having your menstrual period. However, you should not use tampons because they may absorb the medication. Instead, use external pads or napkins until you have finished your medication. You may also wish to wear a sanitary napkin if the vaginal medicine leaks. Dry the genital area thoroughly after showering, bathing, or swimming. Change out of a wet bathing suit or damp exercise clothes as soon as possible. A dry environment is less likely to encourage the growth of yeast. Terconazole Suppositories may decrease the effectiveness of condoms and diaphragms. If your infection clears up and occurs again in a few weeks, see your doctor. Be sure to use Terconazole Suppositories for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The fungus could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future. Use Terconazole Suppositories with caution in the ELDERLY; they may be more sensitive to its effects. Terconazole Suppositories should not be used in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Terconazole Suppositories while you are pregnant. It is not known if Terconazole Suppositories are found in breast milk. Do not breast-feed while taking Terconazole Suppositories. Possible side effects of Terconazole Suppositories:

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:

Body pain; burning or itching of the vagina; headache.

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); chills; flu-like symptoms (headache; tiredness; muscle aches; fever); vaginal sensitivity or irritation.

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: Terconazole side effects (in more detail)

If OVERDOSE is suspected:

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

Proper storage of Terconazole Suppositories:

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

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

This information is a summary only. It does not contain all information about Terconazole Suppositories. 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 Terconazole resources Terconazole Side Effects (in more detail) Terconazole Use in Pregnancy & Breastfeeding Terconazole Support Group 6 Reviews for Terconazole - Add your own review/rating Compare Terconazole with other medications Vaginal Yeast Infection
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Gyno-Pevaryl 1 Vaginal Pessary


Gyno-Pevaryl 1 vaginal pessary

Econazole nitrate

Gyno-Pevaryl is a registered trademark

Read all of this leaflet carefully before you start using this medicine. Keep this leaflet. You may need to read it again If you have any further questions, ask your doctor or pharmacist This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours If you get side effects and they become serious or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist In this leaflet 1. What Gyno-Pevaryl 1 is and what it is used for 2. Before you use Gyno-Pevaryl 1 3. How to use Gyno-Pevaryl 1 4. Possible side effects 5. How to store Gyno-Pevaryl 1 6. Further information What Gyno-Pevaryl 1 is and what it is used for

The name of your medicine is Gyno-Pevaryl 1 vaginal pessary. It is called ‘Gyno-Pevaryl 1’ in this leaflet.

Gyno-Pevaryl 1 is a solid, bullet-shaped pessary (vaginal suppository). When inserted into the vagina it releases a medicine called econazole. This belongs to a group of medicines called ‘antifungals’.

Gyno-Pevaryl 1 is used for infections of the vagina and the skin around the vagina. The infections are caused by fungi and yeasts such as thrush (Candida).

Before you use Gyno-Pevaryl 1 Do not use Gyno-Pevaryl 1 if: You are allergic to anything in Gyno-Pevaryl 1 (listed in section 6 below) You are allergic to any other medicine used to treat thrush or other fungal infections You are under 16 years old

Do not use this medicine if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before using Gyno-Pevaryl 1.

Take special care with Gyno-Pevaryl 1

Check with your doctor or pharmacist before using this medicine if:

You are using a ‘barrier’ method of contraception. This includes condoms or diaphragms. This is because Gyno-Pevaryl 1 can damage the rubber and stop them working properly. Talk to your doctor about using another type of contraception while you are using this medicine Taking other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines that you buy without a prescription or herbal medicines.

In particular tell your doctor if you are taking:

Medicines to thin the blood (anticoagulants) such as warfarin or acenocoumarol Pregnancy and breast-feeding

Please tell your doctor before using Gyno-Pevaryl 1 if you are pregnant, think you may be pregnant or might become pregnant.

You may still be able to use Gyno-Pevaryl 1 if your doctor thinks you need to.

Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant or breast-feeding.

Driving and using machines

This medicine is not likely to affect you being able to drive or use any tools or machines.

How to use Gyno-Pevaryl 1

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

Using the pessary Use the pessary just before going to bed. This helps it to stay in place Do not swallow the pessary Inserting the pessary with the applicator Remove the pessary from the plastic packet using the easy open tab Pull the plunger of the applicator out until it sticks Gently push the pessary into the cup. Do not force it because it might stick Lie down with your knees bent and spread apart. Insert the applicator high into your vagina, pessary first Push the plunger to release the pessary Remove the applicator and dispose of it safely in your household waste If you swallow Gyno-Pevaryl 1

If the pessary is eaten or swallowed talk to a doctor or go to the nearest hospital casualty department straight away.

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

Possible side effects

Like all medicines, Gyno-Pevaryl 1 can cause side effects, although not everybody gets them.

Stop using Gyno-Pevaryl 1 and tell your doctor straight away if you notice the following. You may need urgent medical treatment. Sudden swelling of the face or throat. Hives (also known as nettle rash or urticaria), severe irritation, reddening or blistering of your skin. These may be signs of a severe allergic reaction (affects less than 1 in 10,000 people) Other side effects: Itchy and red skin around or inside the vagina. This is much milder than an allergic reaction. Tell your doctor or pharmacist if this feeling lasts for more than a few minutes or gets worse (rash, burning or swelling)

If you get side effects and they become serious or if you notice any other side effects not listed in this leaflet, please tell your doctor or pharmacist.

How to store Gyno-Pevaryl 1

Keep out of the reach and sight of children. Store in the original container. Do not store above 30°C. Keep away from heat and sunlight.

Do not use Gyno-Pevaryl 1: After the expiry date which is stated on the label. The expiry date refers to the last day of that month If the plastic packet is broken or missing If the pessary is not light beige in colour

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 protect the environment.

Further information

The active substance in Gyno-Pevaryl 1 is econazole nitrate. The pessary contains 150mg econazole nitrate.

The other ingredients are polygel, colloidal silicon dioxide, Witepsol H 19, Wecobee FS, stearyl heptanoate.

What Gyno-Pevaryl 1 looks like and contents of the pack

Gyno-Pevaryl 1 comes in a plastic strip containing one pessary. It is bullet-shaped and light beige in colour.

The product licence is held by: JANSSEN-CILAG LTD 50-100 Holmers Farm Way High Wycombe Bucks HP12 4EG UK Gyno-Pevaryl 1 is made by: Janssen Pharmaceutica NV Turnhoutseweg 30 B-2340 Beerse Belgium

OR

McGregor Cory Ltd Middleton Close Banbury Oxfordshire OX16 8RS UK

For information in large print, tape, CD or Braille, telephone 0800 7318450.

This leaflet was last approved in August 2008.


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gentian violet Vaginal


JEN-shun VYE-oh-let

Uses For gentian violet

Vaginal gentian violet is used to treat fungus (yeast) infections.

Vaginal gentian violet was available only with your doctor's prescription.

Key Pharmaceuticals discontinued Genapax® on October 3, 1990 .

Before Using gentian violet

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 gentian violet, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to gentian violet 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

Studies on gentian violet have been done only in adult patients, and there is no specific information comparing use of vaginal gentian violet in children with use in other age groups.

Geriatric

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

Interactions with Medicines

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

Interactions with Food/Tobacco/Alcohol

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

Proper Use of gentian violet

Gentian violet usually comes with patient directions. Read them carefully before using gentian violet.

After insertion, remove the tampon from the vagina after 3 to 4 hours unless otherwise directed by your doctor.

To help clear up your infection completely, keep using gentian violet for the full time of treatment, even though your condition may have improved. Do not miss any doses.

While you are using gentian violet tampons, the use of regular (non-medicated) tampons is not recommended. They will soak up the medicine that stays in the vagina after the gentian violet tampon is taken out. During your menstrual period you should wear a minipad or sanitary napkin instead.

Dosing

The dose of gentian violet 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 gentian violet. 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 vaginal dosage form (tampons): For treating a vaginal fungus (yeast) infection: Adults and teenagers—5 milligrams (one tampon) inserted into your vagina one or two times a day for twelve days in a row. The tampon should be left in your vagina for three to four hours. Missed Dose

If you miss a dose of gentian violet, 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.

Precautions While Using gentian violet

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

Gentian violet will stain the skin and clothing. Vaginal medicines usually will come out of the vagina during treatment. To keep the medicine from getting on your clothing, wear a minipad or sanitary napkin.

To help clear up your infection completely and to help make sure it does not return, good health habits are also needed.

Wear cotton panties (or panties or pantyhose with cotton crotches) instead of synthetic (for example, nylon or rayon) panties. Wear only clean panties.

If you have any questions about this, check with your health care professional.

Many vaginal infections are spread by having sex. A male sexual partner may carry the germs on or in his penis. While you are using gentian violet, it may be a good idea for your partner to wear a condom during sex to avoid re-infection. Also, your partner may need to be treated. Do not stop using gentian violet if you have sex during treatment.

Some women may want to use a douche before putting each dose in the vagina. Some doctors will allow the use of a vinegar and water douche or other douche. However, others do not allow any douching. If you do use a douche, do not overfill the vagina. To do so may push the douche up into the uterus and possibly cause inflammation or infection. Also, do not douche if you are pregnant since this may harm the fetus. If you have any questions about this, check with your health care professional.

gentian violet 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 as soon as possible if any of the following side effects occur:

Vaginal burning, itching, pain, or other sign of irritation not present before use of gentian violet

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

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

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

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

More gentian violet Vaginal resources Gentian violet Vaginal Support Group 0 Reviews for Gentian violet Vaginal - Add your own review/rating Compare gentian violet Vaginal with other medications Fungal Infection Prophylaxis Oral Thrush
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Estrace Vaginal Cream local


Generic Name: estradiol vaginal (local) (ess tra DYE ole VAJ in ul (LO kul))
Brand Names: Estrace Vaginal, Estring, Vagifem

What is estradiol vaginal (local)?

Estradiol is a form of estrogen, a female sex hormone the regulates many processes in the body.

Estradiol vaginal (local) is used to treat certain symptoms of menopause such as dryness, burning, and itching of the vaginal area. Estradiol vaginal also reduces urgency or irritation of urination.

Estradiol vaginal (local) may also be used for purposes not listed in this medication guide.

What is the most important information I should know about estradiol vaginal (local)?

Some estradiol products placed directly into the vagina are used for "local" treatment of vaginal menopause symptoms involving the secretions and surrounding tissues of the vagina. Other vaginal estradiol products are used for treating menopause symptoms affecting the vagina as well as other parts of the body (such as hot flashes). This type of vaginal estradiol has "systemic" effects, meaning that it can affect parts of the body other than where the medicine is placed or applied.

The information in this leaflet is specific to estradiol vaginal products that are used for local treatment of symptoms.

Do not use this medication if you have any of the following conditions: a history of stroke or blood clot, circulation problems, a hormone-related cancer such as breast or uterine cancer, or abnormal vaginal bleeding. This medication can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.

Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol vaginal.

Long-term estradiol treatment may increase your risk of breast cancer, heart attack, or stroke. Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.

Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol.

What should I discuss with my healthcare provider before using estradiol vaginal (local)? You should not use estradiol vaginal if you have:

a bleeding or blood-clotting disorder;

a history of stroke or circulation problems;

abnormal vaginal bleeding that a doctor has not checked; or

any type of breast, uterine, or hormone-dependent cancer.

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

high blood pressure, angina, or heart disease;

high cholesterol or triglycerides;

liver disease; kidney disease;

asthma;

epilepsy or other seizure disorder;

migraines;

diabetes;

depression;

gallbladder disease; or

if you have had your uterus removed (hysterectomy).

Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol vaginal.

FDA pregnancy category X. This medication can harm an unborn baby or cause birth defects. Do not use estradiol vaginal if you are pregnant. Tell your doctor right away if you become pregnant during treatment.

Long-term estradiol treatment may increase your risk of stroke. Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.

Estradiol may decrease breast milk flow and have other effects on milk composition. Do not use estradiol without first talking to your doctor if you are breast-feeding a baby. How should I use estradiol vaginal (local)?

Some estradiol products placed directly into the vagina are used for "local" treatment of vaginal menopause symptoms involving the secretions and surrounding tissues of the vagina. Other vaginal estradiol products are used for treating menopause symptoms affecting the vagina as well as other parts of the body (such as hot flashes). This type of vaginal estradiol has "systemic" effects, meaning that it can affect parts of the body other than where the medicine is placed or applied.

The information in this leaflet is specific to estradiol vaginal products that are used for local treatment of symptoms.

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.

To use the estradiol vaginal ring:

Squeeze the sides of the ring together and insert it into the vagina as far as possible. You should not be able to feel the ring once it is in place. If you can feel it, use a finger to push it in farther. It is not possible for the ring to go too far in or become lost.

Leave the ring in place for 90 days. If the ring ever falls out, rinse it with warm water and reinsert it. If it slides down into the lower part of the vagina, use a finger to push it in farther. After 90 days, remove the ring. Your doctor may want you to replace it with a new ring.

The ring does not need to be removed during sexual intercourse. Neither partner should be able to feel the ring when it is in place. If the ring is bothersome, you may remove it, rinse it with warm water, and reinsert it after intercourse.

To remove the ring, loop a finger through the ring and gently pull it from the vagina.

To use the estradiol vaginal cream:

Using the marked applicator provided, measure the prescribed dose of cream.

Lie on your back with your knees drawn up, sit, or stand in a position that allows you comfortable access to the vaginal area. Gently insert the applicator deep into your vagina and press in the plunger to empty the cream from the applicator into the vagina.

Take apart the applicator and wash it with mild soap and warm water. Allow the applicator to dry completely before using it again.

To use the estradiol vaginal tablets:

Each vaginal tablet is supplied in a disposable applicator.

Lie on your back with your knees drawn up, sit, or stand in a position that allows you comfortable access to the vaginal area. Gently insert the applicator deep into your vagina and press in the plunger to empty the tablet into the vagina.

Throw the applicator away.

Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol vaginal.

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

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

If a vaginal ring falls out, rinse it with warm water and reinsert it. If it slides down into the lower part of the vagina, use a finger to push it in farther.

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

Overdose symptoms may include nausea, vomiting, and vaginal bleeding.

What should I avoid while using estradiol vaginal (local)?

Avoid using other vaginal products without your doctor's advice.

Estradiol vaginal (local) 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 any of these serious side effects:

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

sudden numbness or weakness, especially on one side of the body;

sudden headache, confusion, problems with vision, speech, or balance;

pain, swelling, warmth, or redness in one or both legs;

abnormal vaginal bleeding;

pain, swelling, or tenderness in your stomach;

jaundice (yellowing of the skin or eyes); or

a lump in your breast.

Less serious side effects may include:

nausea, vomiting, loss of appetite;

swollen breasts;

acne or skin color changes;

decreased sex drive, impotence, or difficulty having an orgasm;

migraine headaches or dizziness;

vaginal pain, dryness, or discomfort;

swelling of your ankles or feet;

depression; or

changes in your menstrual periods, break-through bleeding.

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 estradiol vaginal (local)?

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

St. John's wort;

phenobarbital (Solfoton);

a blood thinner such as warfarin (Coumadin, Jantoven);

ritonavir (Norvir, Kaletra);

carbamazepine (Carbatrol, Tegretol);

rifampin (Rifadin, Rifater, Rifamate, Rimactane);

antibiotics such as clarithromycin (Biaxin) or erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole); or

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

This list is not complete and other drugs may interact with estradiol vaginal. 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 Estrace Vaginal Cream resources Estrace Vaginal Cream Side Effects (in more detail) Estrace Vaginal Cream Use in Pregnancy & Breastfeeding Estrace Vaginal Cream Drug Interactions Estrace Vaginal Cream Support Group 12 Reviews for Estrace Vaginal - Add your own review/rating Compare Estrace Vaginal Cream with other medications Atrophic Urethritis Atrophic Vaginitis Hypoestrogenism Where can I get more information? Your pharmacist can provide more information about estradiol vaginal (local).

See also: Estrace Vaginal side effects (in more detail)


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Mycostatin Vaginal Cream


Generic Name: nystatin (Vaginal route)

nye-STAT-in

Commonly used brand name(s)

In Canada

Mycostatin Mycostatin Vaginal Cream Nadostine Nilstat Vaginal Cream Nilstat Vaginal Tablet Nyaderm Vaginal Cream

Available Dosage Forms:

Cream Tablet

Therapeutic Class: Antifungal

Chemical Class: Polyene

Uses For Mycostatin Vaginal Cream

Nystatin belongs to the group of medicines called antifungals. Vaginal nystatin is used to treat fungus infections of the vagina. Nystatin vaginal cream or tablets may also be used for other problems as determined by your doctor.

Nystatin is available only with your doctor's prescription.

Before Using Mycostatin Vaginal Cream

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

Studies on this medicine have been done only in adults, and there is no specific information comparing use of vaginal nystatin in children with use in other age groups.

Geriatric

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

Interactions with Medicines

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

Interactions with Food/Tobacco/Alcohol

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

Proper Use of nystatin

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

Nystatin usually comes with patient directions. Read them carefully before using this medicine.

This medicine is usually inserted into the vagina with an applicator. However, if you are pregnant, check with your doctor before using the applicator to insert the vaginal tablet.

To help clear up your infection completely, keep using this medicine for the full time of treatment, even if your condition has improved. Also, keep using this medicine even if you begin to menstruate during the time of treatment. Do not miss any doses.

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 treating fungus (yeast) infections: For vaginal cream dosage form: Adults and teenagers—One 100,000-unit applicatorful inserted into the vagina one or two times a day for two weeks. Or, your doctor may want you to insert one 500,000-unit applicatorful into the vagina once a day. Children—Dose must be determined by your doctor. For vaginal tablet dosage form: Adults and teenagers—One 100,000-unit tablet inserted into the vagina one or two times a day for two weeks. Children—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.

Precautions While Using Mycostatin Vaginal Cream

To help cure the infection and to help prevent reinfection, good health habits are required.

Wear cotton panties (or panties or pantyhose with cotton crotches) instead of synthetic (for example, nylon, rayon) underclothes. Wear freshly laundered underclothes.

If you have any questions about this, check with your health care professional.

If you have any questions about douching or intercourse during the time of treatment with nystatin, check with your doctor.

Since there may be some vaginal drainage while you are using this medicine, a sanitary napkin may be worn to protect your clothing.

Mycostatin Vaginal Cream 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 as soon as possible if any of the following side effects occur:

Rare Vaginal burning or itching not present before use of this medicine

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

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

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

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

More Mycostatin Vaginal Cream resources Mycostatin Vaginal Cream Use in Pregnancy & BreastfeedingMycostatin Vaginal Cream Support Group6 Reviews for Mycostatin Vaginal - Add your own review/rating Compare Mycostatin Vaginal Cream with other medications Cutaneous CandidiasisVaginal Yeast Infection
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sinecatechins Topical application


sin-e-KAT-e-kins

Commonly used brand name(s)

In the U.S.

Veregen

Available Dosage Forms:

Ointment

Therapeutic Class: Keratolytic

Uses For sinecatechins

Sinecatechins is used to treat external warts around the genital and rectal areas called condylomata acuminata. It is not used to treat warts that occur inside the vagina, penis, or rectum .

sinecatechins is available only with your doctor's prescription .

Before Using sinecatechins

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 sinecatechins, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to sinecatechins 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 sinecatechins in the pediatric population. Safety and efficacy have not been established .

Geriatric

Insufficient information is available on the relationship of age to the effects of sinecatechins in geriatric patients. 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 .

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. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

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

Inflamed, irritated, or infected skin—Use with caution. sinecatechins may make this condition worse . Weakened immune system—It is not known if sinecatechins is safe to use with this condition . Proper Use of sinecatechins

Use the medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it longer than directed .

Wash your hands with soap and water before and after using sinecatechins .

sinecatechins is for use on the skin only. Do not get it inside your eyes, nose, mouth, vagina, or anus. Do not use on open wounds or on skin areas that have cuts or scrapes. If it does get on these areas, rinse it off right away .

Do not use sinecatechins on moles, birthmarks, or any other warts until you discuss it with your doctor .

Women using tampons should insert the tampon first before applying the ointment. If the tampon needs to be changed while the ointment is on the skin, avoid getting the ointment into the vagina .

Men who are not circumcised and treating genital warts under the foreskin should draw back the foreskin and clean the area daily .

Do not wash off the ointment from the treated area before you apply the next dose. When you wash the treatment area or bathe, apply the ointment afterwards .

Do not cover the treated area with a bandage unless your doctor has told you to. You may wear loose-fitting underwear after applying sinecatechins .

Keep using sinecatechins until all the warts have cleared up. However, you should not use sinecatechins for longer than 16 weeks .

Dosing

The dose of sinecatechins 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 sinecatechins. 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 topical dosage form (ointment): For warts on the genital or rectal areas: Adults—Apply a thin layer (about an 0.5 cm strand) to the affected area three times a day. Rub it in gently. Children—Use and dose must be determined by your doctor . Missed Dose

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

Storage

Store in the refrigerator. Do not freeze.

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

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using sinecatechins

sinecatechins may make your skin more sensitive to sunlight. Do not expose the area being treated with sinecatechins to sunlight, sunlamps, or tanning beds .

Avoid having genital, oral, or anal sex while the medicine is on your skin. Make sure you wash the ointment off your skin before you engage in any sexual activity. Also, the medicine contains oils that can weaken latex (rubber) condoms, or diaphragms causing them not to work properly .

Sinecatechins will not keep you from spreading genital warts to other people. Talk with your doctor about safe sex practices .

sinecatechins is not a cure for genital or anal warts. You may still develop new warts during or after your treatment .

sinecatechins may stain your clothes and bedding .

Do not use cosmetics or any other skin care products on the same skin area on which you use sinecatechins, unless directed otherwise by your doctor .

If your condition does not improve within 16 weeks, or if it becomes worse, check with your doctor .

Many patients experience redness, swelling, sores or blisters, burning, or itching after using sinecatechins. If you experience a severe skin reaction, remove the ointment by washing the area with mild soap and water and contact your doctor right away .

sinecatechins Side Effects

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

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

More common Blistering, peeling, or loosening of the skin breakdown of skin burning of skin cracking of skin flushing, redness of skin hardening or thickening of skin irritation of skin itching skin pain or discomfort in skin swelling of skin unusually warm skin Less common Bleeding of skin blood in urine break in the skin, especially associated with blue-black discoloration, swelling, or drainage of fluid burning or itching around anus changes in skin coloring discharge from skin dryness of skin increased frequency of urination increased sensitivity to pain increased sensitivity to touch pain or burning during urination peeling of one area of skin pelvic pain problems with foreskin of penis rash with flat lesions or small raised lesions on the skin scarring of skin skin rash, encrusted, scaly and oozing skin rash on the face swollen, painful, or tender lymph glands in neck, armpit, or groin tingling in the hands and feet

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: sinecatechins Topical application 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 sinecatechins Topical application resources Sinecatechins Topical application Side Effects (in more detail) Sinecatechins Topical application Use in Pregnancy & Breastfeeding Sinecatechins Topical application Support Group 0 Reviews for Sinecatechins Topical application - Add your own review/rating Compare sinecatechins Topical application with other medications Condylomata Acuminata
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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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