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Flecainide Acetate Tablets 50mg, 100mg (Actavis UK Ltd)


Flecainide Acetate 50mg and 100mg tablets

Read all of this leaflet carefully before you start taking this medicine. Keep this leaflet. You may need to read it again. If you have any further questions, ask your doctor or pharmacist. This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours. Index 1 What Flecainide Acetate tablets are and what they are used for 2 Before you take 3 How to take 4 Possible side effects 5 How to store 6 Further information What Flecainide Acetate tablets are and what they are used for

Flecainide Acetate tablets belong to a group of medicines called anti-arrhythmics. They work by regulating the heart rate.

Flecainide Acetate tablets may be used to treat the following conditions when other drugs are not effective: irregular beats of the upper heart chambers (atria) including Wolff-Parkinson-White Syndrome irregular beats of the lower heart chambers (ventricles). Before you take

Do not take Flecainide Acetate tablets and tell your doctor if you:

are allergic (hypersensitive) to flecainide acetate or any of the other ingredients (see section 6) suffer from conduction problems of the heart, such as a slow or fast heart beat or heart block suffer from heart failure have severely low blood pressure have had a heart attack (myocardial infarction) are in shock due to heart problems (cardiogenic shock) have rapid and irregular heart beat (atrial fibrillation) are taking disopyramide (medicine to treat irregular heart rhythms).

Take special care with Flecainide Acetate tablets and tell your doctor if you:

suffer from low or high levels of potassium in the blood have liver or kidney disease have a pacemaker have any heart disease or an enlarged heart have rapid or irregular heart beats after heart surgery have been told you have disturbances in heart rhythm known as sick sinus syndrome. Taking other medicines

Before taking Flecainide Acetate tablets, tell your doctor if you are taking or have recently taken the following medicines, or are taking any non-prescribed medicines:

verapamil or beta blockers (e.g. propranolol to treat heart diseases) laxatives (to treat constipation) diuretics (‘water tablets’) steroids (e.g. betamethasone, hydrocortisone or prednisolone) sodium channel blockers (e.g. lidocaine to treat irregular heartbeat (arrhythmia) or as a local anaesthetic) phenytoin, phenobarbital or carbamazepine (to treat epilepsy) digoxin (to treat heart conditions) amiodarone, quinidine or disopyramide (to treat irregular heart rhythms) cimetidine (to treat stomach ulcers) fluoxetine or tricyclic antidepressants (e.g. amitriptyline to treat depression) terfenadine or astemizole (to treat allergic reactions) quinine or halfantrine (to treat or prevent malaria) Pregnancy and breast-feeding

Your doctor will only prescribe Flecainide Acetate tablets if it is absolutely necessary. Breast feeding is not recommended whilst taking Flecainide Acetate tablets. Check with your doctor if you are unsure.

Driving and using machines

Flecainide Acetate tablets may cause dizziness or affect your vision. Make sure you are not affected before you drive or operate machinery.

Tests

Your doctor will monitor your progress on a regular basis with ECG (electrocardiogram) and blood tests, and may alter the dose if necessary.

If you see another doctor or go into hospital, let them know what medicines you are taking.

How to take

Always take Flecainide Acetate tablets exactly as your doctor has told you. If you are not sure, check with your doctor or pharmacist. Treament may be started in hospital.

Swallow these tablets whole with water on an empty stomach or one hour before food.

Doses: Adults and adolescents (13-17 years of age) treatment of irregular beats of the upper heart chambers (atria) : starting dose is 50mg twice a day up to a maximum dose of 300mg per day. treatment of irregular heart beats of the lower heart chambers (ventricular) : starting dose is 100mg twice a day up to a maximum dose of 400mg per day. Children under 12 years of age - not recommended Elderly patients or those fitted with pacemakers, with kidney or liver problems or taking amiodarone or cimetidine - a lower dose of flecainide may be given. If you take more Flecainide Acetate tablets than you should

If you have accidentally taken more than the prescribed dose, contact your nearest casualty department or tell your doctor or pharmacist at once.

If you forget to take Flecainide Acetate tablets

If you forget to take a dose take it as soon as you remember, unless it is nearly time to take the next dose. Then go on as before. Never double up on the next dose to make up for the one missed.

If you stop taking the tablets

Talk to your doctor before you stop taking the tablets and follow their advice.

Possible side effects

Like all medicines, Flecainide Acetate tablets can cause side effects, although not everybody gets them.

Stop taking Flecainide Acetate tablets and contact your doctor at once if the following allergic reaction happens: skin rash, swelling of the face, lips, tongue or throat, or difficulty breathing or swallowing.

Tell your doctor if you notice any of the following side effects or notice any other effects not listed:

Very common (occurs in more than 1 in 10 users): dizziness, giddiness, light headedness, headache, double or blurred vision

Common (occurs in less than 1 in 10 users): signs of your heart condition getting worse or development of new heart symptoms, a change in heart beat pattern (especially in patients with existing heart problems)

Uncommon (occurs in less than 1 in 100 users): changes in the numbers and types of your blood cells, difficulty breathing, feeling or being sick

Rare (occurs in less than 1 in 1,000 users): affects on your immune system which may be associated with inflammation, hallucinations, depression, confusion, memory loss, nervousness, anxiety, disturbances of movement, convulsions, ‘pins and needles’ or numbness, problems with co-ordination, raised liver enzyme levels or jaundice (yellow skin and/or whites of the eyes)

Very rare (occurs in less than 1 in 10,000 users): particles in the front of the eye (corneal deposits), lung disease (pneumonitis), sensitivity of the skin to light, flushing or increased sweating, allergic skin reactions (which may be itchy), dry mouth, impairment of taste, joint and muscle pain, impotence.

If you notice any side effects, they get worse, or if you notice any not listed, please tell your doctor or pharmacist.

How to store

Keep out of the reach and sight of children.

Do not store the tablets above 25°C and store in the original packaging.

Do not use Flecainide Acetate tablets after the expiry date stated on the label/carton/bottle. The expiry date refers to the last day of that month.

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

Further information What Flecainide Acetate tablets contain The active substance (the ingredient that makes the tablets work) is flecainide acetate. Each tablets contains either 50mg or 100mg of the active ingredient. The other ingredients are croscarmellose sodium, magnesium stearate, maize starch, pregelatinised maize starch, microcrystalline cellulose (E460). What Flecainide Acetate tablets look like and contents of the pack

Flecainide Acetate tablets are white, uncoated tablets.

Pack sizes are 60 tablets

Marketing Authorisation Holder and Manufacturer Actavis Barnstaple EX32 8NS UK

Date of last revision: July 2008.

If you would like a leaflet with larger text, please contact 01271 311257.

Actavis Barnstaple EX32 8NS UK

50134525


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Tambocor 50mg Tablets


1. Name Of The Medicinal Product

Tambocor™ 50mg Tablets

2. Qualitative And Quantitative Composition

Each tablet contains flecainide acetate 50mg

3. Pharmaceutical Form

Tablet

4. Clinical Particulars

Tambocor is a potent sodium channel blocking agent for the treatment of the conditions listed below:

The effect on the JT interval is insignificant at therapeutic levels.

4.1 Therapeutic Indications

Tambocor tablets are indicated for:

a) AV nodal reciprocating tachycardia; arrhythmias associated with Wolff-Parkinson-White Syndrome and similar conditions with accessory pathways.

b) Paroxysmal atrial fibrillation in patients with disabling symptoms when treatment need has been established and in the absence of left ventricular dysfunction (see 4.4, Special warnings and special precautions for use). Arrhythmias of recent onset will respond more readily.

c) Symptomatic sustained ventricular tachycardia.

d) Premature ventricular contractions and/or non-sustained ventricular tachycardia which are causing disabling symptoms, where these are resistant to other therapy or when other treatment has not been tolerated.

Tambocor tablets can be used for the maintenance of normal rhythm following conversion by other means.

Tambocor tablets are for oral administration.

4.2 Posology And Method Of Administration

Adults: Supraventricular arrhythmias: The recommended starting dosage is 50mg twice daily and most patients will be controlled at this dose. If required the dose may be increased to a maximum of 300mg daily.

Ventricular arrhythmias: The recommended starting dosage is 100mg twice daily. The maximum daily dose is 400mg and this is normally reserved for patients of large build or where rapid control of the arrhythmia is required.

After 3-5 days it is recommended that the dosage be progressively adjusted to the lowest level which maintains control of the arrhythmia. It may be possible to reduce dosage during long-term treatment.

Children: Tambocor is not recommended in children under 12, as there is insufficient evidence of its use in this age group.

Elderly Patients: The rate of flecainide elimination from plasma may be reduced in elderly people. This should be taken into consideration when making dose adjustments.

Plasma levels: Based on PVC suppression, it appears that plasma levels of 200-1000 ng/ml may be needed to obtain the maximum therapeutic effect. Plasma levels above 700-1000 ng/ml are associated with increased likelihood of adverse experiences.

Dosage in impaired renal function: In patients with significant renal impairment (creatinine clearance of 35ml/min/1.73 sq.m. or less) the maximum initial dosage should be 100mg daily (or 50mg twice daily).

When used in such patients, frequent plasma level monitoring is strongly recommended.

It is recommended that intravenous treatment with Tambocor should be administered in hospitals.

Treatment with oral Tambocor should be under direct hospital or specialist supervision for patients with:

a) AV nodal reciprocating tachycardia; arrhythmias associated with Wolff-Parkinson-White Syndrome and similar conditions with accessory pathways

b) Paroxysmal atrial fibrillation in patients with disabling symptoms.

Treatment for patients with other indications should continue to be initiated in hospital.

4.3 Contraindications

Tambocor is contra-indicated in cardiac failure and in patients with a history of myocardial infarction who have either asymptomatic ventricular ectopics or asymptomatic non-sustained ventricular tachycardia.

It is also contra-indicated in patients with long standing atrial fibrillation in whom there has been no attempt to convert to sinus rhythm, and in patients with haemodynamically significant valvular heart disease.

Unless pacing rescue is available, Tambocor should not be given to patients with sinus node dysfunction, atrial conduction defects, second degree or greater atrio-ventricular block, bundle branch block or distal block.

4.4 Special Warnings And Precautions For Use

Electrolyte disturbances should be corrected before using Tambocor.

Since flecainide elimination from the plasma can be markedly slower in patients with significant hepatic impairment, flecainide should not be used in such patients unless the potential benefits clearly outweigh the risks. Plasma level monitoring is strongly recommended in these circumstances.

Tambocor is known to increase endocardial pacing thresholds - ie to decrease endocardial pacing sensitivity. This effect is reversible and is more marked on the acute pacing threshold than on the chronic. Tambocor should thus be used with caution in all patients with permanent pacemakers or temporary pacing electrodes, and should not be administered to patients with existing poor thresholds or non-programmable pacemakers unless suitable pacing rescue is available.

Generally, a doubling of either pulse width or voltage is sufficient to regain capture, but it may be difficult to obtain ventricular thresholds less than 1 Volt at initial implantation in the presence of Tambocor.

The minor negative inotropic effect of flecainide may assume importance in patients predisposed to cardiac failure. Difficulty has been experienced in defibrillating some patients. Most of the cases reported had pre-existing heart disease with cardiac enlargement, a history of myocardial infarction, arterio-sclerotic heart disease and cardiac failure.

Tambocor should be avoided in patients with structural organic heart disease or abnormal left ventricular function.

Tambocor should be used with caution in patients with acute onset of atrial fibrillation following cardiac surgery.

In a large scale, placebo-controlled clinical trial in post-myocardial infarction patients with asymptomatic ventricular arrhythmia, oral flecainide was associated with a 2.2 fold higher incidence of mortality or non-fatal cardiac arrest as compared with its matching placebo. In that same study, an even higher incidence of mortality was observed in flecainide-treated patients with more than one myocardial infarction. Comparable placebo-controlled clinical trials have not been done to determine if flecainide is associated with higher risk of mortality in other patient groups.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

Flecainide is a class I anti-arrhythmic and interactions are possible with other anti-arrhythmic drugs where additive effects may occur or where drugs interfere with the metabolism of flecainide. The following known categories of drugs may intereact with flecainide:

Cardiac glycosides; Flecainide can cause the plasma digoxin level to rise by about 15%, which is unlikely to be of clinical significance for patients with plasma levels in the therapeutic range. It is recommended that the digoxin plasma level in digitalised patients should be measured not less than six hours after any digoxin dose, before or after administration of flecainide.

Class II anti-arrhythmics; the possibility of additive negative inotropic effects of beta-blockers, and other cardiac depressants such as verapamil, with flecainide should be recognised.

Class III anti-arrhythmics; when flecainide is given in the presence of amiodarone, the usual flecainide dosage should be reduced by 50% and the patient monitored closely for adverse effects. Plasma level monitoring is strongly recommended in these circumstances

Class IV anti-arrhythmics; use of flecainide with other sodium channel blockers is not recommended.

Anti-depressants; fluoxetine increases plasma flecainide concentration; increased risk of arrhythmias with tricyclics; manufacturer of reboxetine advises caution.

Anti-epileptics; limited data in patients receiving known enzyme inducers (phenytoin, phenobarbital, carbamazepine) indicate only a 30% increase in the rate of flecainide elimination.

Anti-psychotics: clozapine– increased risk of arrhythmias

Anti-histamines; increased risk of ventricular arrhythmias with mizolastine and terfenadine (avoid concomitant use)

Anti-malarials: quinine increases plasma concentration of flecainide.

Antivirals: plasma concentration increased by ritonavir, lopinavar and indinavir (increased risk of ventricular arrhythmias (avoid concomitant use)

Diuretics: Class effect due to hypokalaemia giving rise to cardiac toxicity.

Ulcer healing drugs: cimetidine inhibits metabolism of flecainide. In healthy subjects receiving cimetidine (1g daily) for one week, plasma flecainide levels increased by about 30% and the half-life increased by about 10%.

Anti-smoking aids: Co-administration of bupropion with drugs that are metabolized by CYP2D6 isoenzyme including flecainide, should be approached with caution and should be initiated at the lower end of the dose range of the concomitant medication. If bupropion is added to the treatment regimen of a patient already receiving flecainide, the need to decrease the dose of the original medication should be considered.

Treatment with Tambocor is compatible with use of oral anti-coagulants.

4.6 Pregnancy And Lactation

There is no evidence as to drug safety in human pregnancy. In New Zealand White rabbits high doses of flecainide caused some foetal abnormalities, but these effects were not seen in Dutch Belted rabbits or rats. The relevance of these findings to humans has not been established. Data have shown that flecainide crosses the placenta to the foetus in patients taking flecainide during pregnancy.

Flecainide is excreted in human milk and appears in concentrations which reflect those in maternal blood. The risk of adverse effects to the nursing infant is very small.

4.7 Effects On Ability To Drive And Use Machines

No effect.

4.8 Undesirable Effects

Body as a Whole: Asthenia, fatigue, fever,oedema.

Cardiovascular: Pro-arrhythmic effects occur but are most likely in patients with structural heart disease and/or significant left ventricular impairment.

In patients with atrial flutter the use of Tambocor has been associated with

1:1 AV conduction following initial atrial slowing with resultant ventricular acceleration. This has been seen most commonly following the use of the injection for acute conversion. This effect is usually short lived and abates quickly following cessation of therapy.

The following adverse effects have also been reported.

AV block-second-degree and third degree, bradycardia, cardiac failure/congestive cardiac failure, chest pain, hypotension, myocardial infarction, palpitation, sinus pause or arrest and tachycardia (AT or VT).

Skin and Appendages: A range of allergic skin reactions have been reported including rashes, alopecia and rare but serious reports of urticaria. There have also been isolated cases of photosensitivity and rash.

Immune System: A small number of cases of increases in anti-nuclear antibodies have been reported, with and without systemic inflammatory involvement.

Haematological: Reductions in red blood cells, white blood cells and platelets have been occasionally reported. These changes are usually mild.

Psychiatric: Rarely, hallucinations, depression, confusion, amnesia, anxiety and insomnia have been reported.

Gastrointestinal: Occasionally nausea and vomiting. The following have also been reported: abdominal pain, anorexia, constipation, diarrhoea, dyspepsia and flatulence (bloating)

Liver and Bilary System: A number of cases of elevated liver enzymes and jaundice have been reported in association with Tambocor treatment. So far this has always been reversible on stopping treatment. Hepatic dysfunction has also been reported.

Neurological: Most commonly giddiness, dizziness and lightheadedness which are usually transient. Rare instances of dyskinesia have been reported, which have improved on withdrawal of flecainide therapy. Rare instances of convulsions, and during long term therapy a few cases of peripheral neuropathy, paraesthesia and ataxia have been reported.There also have been reports of flushing, headache, hypoaesthesia, increased sweating, somnolence, syncope, tinnitus, tremor and vertigo.

Ophthalmological: Visual disturbances, such as double vision and blurring of vision may occur but these are usually transient and disappear upon continuing or reducing the dosage.

Extremely rare cases of corneal deposits have also been reported.

Respiratory: Dyspnoea and rare cases of pneumonitis have been reported.

4.9 Overdose

Overdosage with flecainide is a potentially life threatening medical emergency. No specific antidote is known. There is no known way of rapidly removing flecainide from the system, but forced acid diuresis may theoretically be helpful. Neither dialysis nor haemoperfusion is helpful and injections of anticholinergics are not recommended.

Treatment may include therapy with an inotropic agent, intravenous calcium, giving circulatory assistance (eg balloon pumping), mechanically assisting respiration, or temporarily inserting a transvenous pacemaker if there are severe conduction disturbances or the patient's left ventricular function is otherwise compromised.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

Tambocor is a Class 1 anti-arrhythmic (local anaesthetic) agent.

Tambocor slows conduction through the heart, having its greatest effect on His Bundle conduction. It also acts selectively to increase anterograde and particularly retrograde accessory pathway refractoriness. Its actions may be reflected in the ECG by prolongation of the PR interval and widening of the QRS complex. The effect on the JT interval is insignificant.

5.2 Pharmacokinetic Properties

Oral administration of flecainide results in extensive absorption, with bioavailability approaching 90 to 95%. Flecainide does not appear to undergo significant hepatic first-pass metabolism. In patients, 200 to 600 mg flecainide daily produced plasma concentrations within the therapeutic range of 200-1000 µg/L. Protein binding of flecainide is within the range 32 to 58%.

Recovery of unchanged flecainide in urine of healthy subjects was approximately 42% of a 200mg oral dose, whilst the two major metabolites (Meta-O-Dealkylated and Dealkylated Lactam Metabolites) accounted for a further 14% each. The elimination half-life was 12 to 27 hours.

5.3 Preclinical Safety Data

Not applicable

6. Pharmaceutical Particulars 6.1 List Of Excipients

Pregelatinised Starch, USNF

Croscarmellose Sodium, USNF

Microcrystalline Cellulose, Ph Eur

Hydrogenated Vegetable Oil, USNF

Magnesium Stearate, Ph Eur

6.2 Incompatibilities

None known

6.3 Shelf Life

5 years

6.4 Special Precautions For Storage

Do not store above 30°C. Keep container in the outer carton.

6.5 Nature And Contents Of Container

UPVC/PVDC blister packs containing 60 tablets

6.6 Special Precautions For Disposal And Other Handling

Not applicable

7. Marketing Authorisation Holder

Meda Pharmaceuticals Ltd

Skyway House

Parsonage Road

Takeley

Bishop's Stortford

CM22 6PU

United Kingdom

8. Marketing Authorisation Number(S)

PL 15142/0078

9. Date Of First Authorisation/Renewal Of The Authorisation

22 May 1997/ 16 March 2001

10. Date Of Revision Of The Text

13th July 2010


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Flecainide Acetate 100mg Tablets


1. Name Of The Medicinal Product

Flecainide Acetate 100mg Tablets

2. Qualitative And Quantitative Composition

Each tablet contains 100 mg flecainide acetate.

For a full list of excipients, see section 6.1.

3. Pharmaceutical Form

Tablet.

Flecainide tablets are white, circular, biconvex, uncoated tablets one side embossed with a breakline and the identifying letters “C” above the line and “FJ” below, the reverse side embossed with a breakline.

4. Clinical Particulars

Flecainide Acetate is a potent sodium channel blocking agent for the treatment of the conditions listed below.

The effect on the JT interval is insignificant at therapeutic levels.

4.1 Therapeutic Indications

Flecainide Acetate tablets are indicated for:

a) AV nodal reciprocating tachycardia; arrhythmias associated with Wolff-Parkinson-White Syndrome and similar conditions with accessory pathways.

b) Paroxysmal atrial fibrillation in patients with disabling symptoms when treatment need has been established and in the absence of left ventricular dysfunction (see 4.4, Special warnings and special precautions for use). Arrhythmias of recent onset will respond more readily.

c) Symptomatic sustained ventricular tachycardia.

d) Premature ventricular contractions and/or non-sustained ventricular tachycardia which are causing disabling symptoms, where these are resistant to other therapy or when other treatment has not been tolerated.

Flecainide Acetate tablets can be used for the maintenance of normal rhythm following conversion by other means.

Flecainide Acetate tablets are for oral administration.

4.2 Posology And Method Of Administration

Posology

Adults: Supraventricular arrhythmias: The recommended starting dosage is 50 mg twice daily and most patients will be controlled at this dose. If required the dose may be increased to a maximum of 300 mg daily.

Ventricular arrhythmias: The recommended starting dosage is 100 mg twice daily. The maximum daily dose is 400 mg and this is normally reserved for patients of large build or where rapid control of the arrhythmia is required. After 3-5 days it is recommended that the dosage be progressively adjusted to the lowest level which maintains control of the arrhythmia. It may be possible to reduce dosage during long-term treatment.

Elderly patients: The rate of flecainide elimination from plasma may be reduced in elderly people. This should be taken into consideration when making dose adjustments.

Children: Flecainide is not recommended in children under 12 years of age as there is insufficient evidence of its use in this age group.

Plasma levels: Based on PVC suppression, it appears that plasma levels of 200-1000 ng/ml may be needed to obtain the maximum therapeutic effect. Plasma levels above 700-1000 ng/ml are associated with increased likelihood of adverse experiences.

Impaired renal function: In patients with significant renal impairment (creatinine clearance of 35ml/min/1.73sq.m. or less) the maximum initial dosage should be 100 mg daily (or 50 mg twice daily). When used in such patients, frequent plasma level monitoring is strongly recommended.

It is recommended that intravenous treatment with Flecainide Acetate should be initiated in hospital.

Treatment with oral Flecainide should be under direct hospital or specialist supervision for patients with:

a) AV nodal reciprocating tachycardia; arrhythmias associated with Wolff-Parkinson-White Syndrome and similar conditions with accessory pathways.

b) Paroxysmal atrial fibrillation in patients with disabling symptoms.

Treatment for patients with other indications should continue to be initiated in hospital.

4.3 Contraindications

Known hypersensitivity to the active substance (s) or to any of the excipients. Flecainide is contraindicated in cardiac failure and in patients with a history of myocardial infarction who have either asymptomatic ventricular ectopics or asymptomatic non-sustained ventricular tachycardia.

It is also contraindicated in patients with longstanding atrial fibrillation in whom there has been no attempt to convert to sinus rhythm and in patients with haemodynamically significant valvular heart disease.

Unless pacing rescue is available, flecainide should not be given to patients with sinus node dysfunction, atrial condition defects, second degree or greater atrio-ventricular block, bundle branch block or distal block.

4.4 Special Warnings And Precautions For Use

Electrolyte disturbances should be corrected before using flecainide.

Since flecainide elimination from the plasma can be markedly slower in patients with significant hepatic impairment, flecainide should not be used in such patients unless the potential benefits clearly outweigh the risks. Flecainide should be used with caution in patients with impaired renal function and frequent therapeutic drug monitoring should be undertaken. Plasma level monitoring is strongly recommended in these circumstances.

Flecainide is known to increase endocardial pacing thresholds, i.e. to decrease endocardial pacing sensitivity. This effect is reversible and is more marked on the acute pacing threshold than on the chronic. Flecainide should thus be used with caution in all patients with permanent pacemakers or temporary pacing electrodes and should not be administered to patients with existing poor thresholds or non-programmable pacemakers unless suitable pacing rescue is available.

Generally, a doubling of either pulse width or voltage is sufficient to regain capture but it may be difficult to obtain ventricular thresholds less than 1 volt at initial implantation in the presence of flecainide.

The minor negative inotropic effect of flecainide may assume importance in patients predisposed to cardiac failure. Difficulty has been experienced in defibrillating some patients. Usually these patients were reported to have pre-existing heart disease with cardiac enlargement, a history of myocardial infarction, arteriosclerotic heart disease and cardiac failure.

Flecainide should be avoided in patients with structural organic heart disease or abnormal left ventricular function.

Flecainide should be used with caution in patients with acute onset of atrial fibrillation following cardiac surgery.

In a large scale, placebo-controlled clinical trial in post-myocardial infraction patients with asymptomatic ventricular arrhythmia, oral flecainide was associated with a 2.2 fold higher incidence of mortality or non-fatal cardiac arrest as compared with its matching placebo. In that same study, an even higher incidence of mortality was observed in flecainide –treated patients with more than one myocardial infraction. Comparable placebo-controlled clinical trials have not been done to determine if flecainide is associated with higher risk of mortality in other patient groups.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

Flecainide is a class I anti-arrhythmic and interactions are possible with other anti-arrhythmic drugs where additive effects may occur or where drugs interfere with the metabolism of flecainide. The following known categories of drugs may interact with flecainide:

Cardiac glycosides: Flecainide can cause the plasma digoxin level to rise by about 15%, which is unlikely to be of clinical significance for patients with plasma levels in the therapeutic range. It is recommended that the digoxin plasma level in digitalised patients should be measured not less than 6 hours after any digoxin dose, before or after administration of flecainide.

Class I anti-arrhythmics: Use of flecainide with other sodium channel blockers (e.g. quinidine ) is not recommended. The clearance of flecainide may be decreased by quinidine in patients who are extensive metabolises, since quinidine inhibits the enzyme responsible for the metabolism of flecainide.

Class II anti-arrythmics: The possibility of additive negative inotropic effects of beta-blockers and other cardiac depressants with flecainide should be recognised.

Class III anti-arrythmics: When flecainide is given in the presence of amiodarone the usual dosage of flecainide should be reduced by 50% and the patient monitored closely for adverse effects. Plasma level monitoring is strongly recommended in these circumstances.

Class IV anti-arrythmics: Calcium-channel Blockers: increases myocardial depression and asystole with verapamil.

Other Anti-arrythmics: Concomitant administration of flecainide with other anti-arrhythmics drugs may increase myocardial depression.

Antidepressants: fluoxetine increases plasma-flecainide concentration and there is an increased risk of arrhythmias with tricyclics.

Anti-epileptics: Limited data in patients receiving known enzyme inducers (phenytoin, phenobarbital, carbamazepine) indicate only a 30% increase in the rate of flecainide elimination.

Anti-psychotics: clozapine – increased risk of arrhythmias

Antihistamines: There is an increased risk of ventricular arrhythmias with mizolastine and terfenadine(avoid concomitant use);

Antimalarials: quinine increases plasma concentration of flecainide, and there is an increased risk of arrhythmias with halofantrine;

Antivirals: plasma concentration increased by ritonavir, lopinavar and indinavir (increased risk of ventricular arrhythmias (avoid concomitant use).

Diuretics: cardiac toxicity increased if hypokalaemia occurs.

Ulcer healing drugs: Cimetidine inhibits metabolism of flecainide. In healthy subjects receiving cimetidine (1g daily) for one week, it was observed that plasma flecainide levels increased by 30% and the half-life increased by 10%.

Anti-smoking aids: Co-administration of bupropion with drugs that are metabolized by CYP2D6 isoenzyme including flecainide, should be approached with caution and should be initiated at the lower end of the dose range of the concomitant medication. If bupropion is added to the treatment regimen of a patient already receiving flecainide, the need to decrease the dose of the original medication should be considered.

Treatment with flecainide is compatible with use of oral anticoagulants.

4.6 Pregnancy And Lactation

There is no evidence as to drug safety in human pregnancy.

In New Zealand White rabbits high doses of flecainide caused some foetal abnormalities, but these effects were not seen in Dutch Belted rabbits or rats. The relevance of these findings to humans has not been established. Data have shown that flecainide crosses the placenta to the foetus in patients taking flecainide during pregnancy.

Flecainide is excreted in human milk and appears in concentrations which reflect those in maternal blood.

The risk of adverse effects to the nursing infant is very small.

4.7 Effects On Ability To Drive And Use Machines

Flecainide Acetate .can cause dizziness, visual disturbances and other neurological effects which may affect the ability to drive or use machines. Patients should be warned not to drive or operate machinery if they feel that they have been affected.

4.8 Undesirable Effects

Body as a Whole: Asthenia, fatigue, fever, oedema.

Cardiac disorders: Pro-arrhythmic effects occur but are most likely in patients with structural heart disease and/or significant left ventricular impairment.

In patients with atrial flutter the use of flecainide has been associated with 1:1 AV conduction following initial atrial slowing with resultant ventricular acceleration.

AV block-second-degree and third degree, bradycardia, cardiac failure/congestive cardiac failure, chest pain, hypotension, myocardial infarction, palpitation and sinus pause or arrest and tachycardia (AT or VT).

Skin and subcutaneous tissue disorders: There have been isolated cases of photosensitivity. Allergic skin reactions, including rare reports of serious urticaria. Alopecia.

Gastrointestinal disorders: Occasionally nausea and vomiting. The following have also been reported: abdominal pain, anorexia, constipation, diarrhoea, dyspepsia and flatulence (bloating)

Hepato-biliary disorders: A number of cases of elevated liver enzymes and jaundice have been reported in association with flecainide treatment. So far this has always been reversible on stopping treatment. Hepatic dysfunction has also been reported.

Nervous systems Disorders: Most commonly giddiness, dizziness, and light-headedness which are usually transient. Rare instances of dyskinesia, which has improved on withdrawal of flecainide therapy, have been reported. Rare instances of convulsions and, during long-term therapy, a few cases of peripheral neuropathy, paraesthesia and ataxia have been reported. There also have been reports of flushing, headache, hypoaesthesia, increased sweating, somnolence, syncope, tinnitus, tremor and vertigo.

Eye disorders: Visual disturbances, such as double vision and blurring of vision may occur but these are usually transient and disappear upon continuing or reducing the dosage. Extremely rare cases of corneal deposits have also been reported.

Immune system disorders: A small number of cases of increases in anti-nuclear antibodies, with and without systemic inflammatory involvement, have been reported.

Blood and the Lymphatic systems disorders: Reductions in red and white blood cells and platelets have occasionally been reported. These changes are usually mild.

Psychiatricdisorders: Rarely, hallucinations, depression, confusion and amnesia have been reported.

Respiratory disorders: Dyspnoea and extremely rare cases of pneumonitis have been reported.

4.9 Overdose

No specific antidote is known.

There is no known way of rapidly removing flecainide from the body but forced acid diuresis may theoretically be helpful. Neither dialysis nor haemoperfusion are helpful and injections of anticholinergics are not recommended. Treatment may include therapy with an inotropic agent, intravenous calcium, giving circulatory assistance (e.g., balloon pumping) mechanically assisting respiration or temporarily inserting a transvenous pacemaker if there are severe conduction disturbances or the patient's left ventricular function is otherwise compromised.

5. Pharmacological Properties 5.1 Pharmacodynamic Properties

ATC code: C01B C04

Flecainide acetate is a Class IC antiarrhythmic agent used for the treatment of serious symptomatic ventricular and supraventricular arrhythmias. It should not be used to control asymptomatic ventricular arrhythmias in patients who have previously suffered myocardial infarction. The most common adverse effects affect the central nervous system.

Electrophysiologically, flecainide is a local anaesthetic-type (Class IC) of antiarrhythmic compound. It is an amide type of local anaesthetic, being structurally related to procainamide and encainide in so far as these agents are also benzamide derivatives. The potency of flecainide as an antiarrhythmic agent is associated with the presence and the positions of the trifluoroethody groups on the benzamide ring, which augment the drugs lipophilicity and with the presence of the non-substituted piperidylmethyl group in the amide chain. Flecainide is some 10 times more potent than procainamide and 2-3 times more potent than encainide.

The characterisation of flecainide as a Class IC compound is based on a triad of features: marked depression of the fast sodium channel in the heart; slow onset and offset kinetics of inhibition of the sodium channel (reflecting slow attachment to and dissociation from sodium channels); and the differential effect of the drug on the action potential duration in ventricular muscle versus Purkinje fibres, having no effect in the former and markedly shortening it in the latter. This composite of properties leads to a marked depression in conduction velocity in fibres dependant on the fast-channel fibres for depolarisation but with a modest increase in the effective refractory period when tested in isolated cardiac tissues. At very high concentrations flecainide exerts a weak depressant effect on the slow channel in the myocardium. This is accompanied by a negative inotropic effect.

Flecainide has no significant interaction with the autonomic nervous system. The drug does not appear to have a measurable effect on coronary, pulmonary or other regional circulations.

In vitro metabolic studies have confirmed that P450 2D6 is involved in the metabolism of flecainide.

5.2 Pharmacokinetic Properties

Flecainide is almost completely absorbed after oral administration and does not undergo extensive first-pass metabolism. The bioavailability from flecainide acetate tablets has been reported to be about 90%. Flecainide is extensively metabolised (subject to genetic polymorphism), the 2 major metabolites being m-O-dealkylated flecainide and m-O-dealkylated lactam of flecainide, both of which may have some activity. It is eliminated mainly in the urine, approximately 30% as unchanged drug and the remainder as metabolites. About 5% is excreted in the faeces. Excretion of flecainide is decreased in renal failure, heart failure, and in alkaline urine. Haemodialysis removes only about 1% of unchanged flecainide.

The therapeutic plasma concentration range is generally accepted as 200 to 1000ng per ml. The elimination half-life of flecainide is about 20 hours and it is about 40% bound to plasma proteins. Flecainide passes the placenta and is excreted in breast milk.

5.3 Preclinical Safety Data

There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC.

6. Pharmaceutical Particulars 6.1 List Of Excipients

Also contains:

Microcrystalline cellulose

Maize starch,

Pregelatinised maize starch

Croscarmellose sodium and

Magnesium stearate.

6.2 Incompatibilities

Not applicable.

6.3 Shelf Life

Three years.

6.4 Special Precautions For Storage

Do not store above 25?C.

Keep container in the outer carton.

6.5 Nature And Contents Of Container

The blister packs are manufactured from 250µm white rigid PVC/PVDC coated with 60g/m2 PVDC and 20µm hard temper aluminium foil with 5-7g/m2 PVC/PVDC compatible heat seal lacquer.

Pack sizes:

Blister packs: 28, 30, 56, 60, 84, 90, 112, 120, 168, 180.

Not all pack sizes may be marketed.

6.6 Special Precautions For Disposal And Other Handling

Not applicable.

7. Marketing Authorisation Holder

Zentiva

One Onslow Street

Guildford

Surrey

GU1 4YS

United Kingdom

8. Marketing Authorisation Number(S)

PL 17780/0024

9. Date Of First Authorisation/Renewal Of The Authorisation

30/03/2009

10. Date Of Revision Of The Text

22/02/2011

LEGAL CATEGORY

POM


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Tambocor


Pronunciation: fle-KAY-nide
Generic Name: Flecainide
Brand Name: Tambocor

Tambocor sometimes produces new irregular heartbeats (arrhythmias), which can be life-threatening.


Tambocor is used for:

Treating and preventing various types of irregular heartbeat that lead to life-threatening heart rhythm disturbances.

Tambocor is an antiarrhythmic. It works by stabilizing the heart rhythm when the heart is beating too fast or in an irregular rhythm.

Do NOT use Tambocor if: you are allergic to any ingredient in Tambocor you have severe heart problems (eg, certain types of heart blocks or shock) or a history of severe heart problems you are taking an HIV protease inhibitor (eg, ritonavir)

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

Before using Tambocor:

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

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have heart problems (eg, congestive heart failure, heart attack, sick sinus syndrome) or a history of heart problems if you have severe kidney or liver problems if you have abnormal potassium blood levels

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

Calcium channel blockers (eg, nifedipine, verapamil), cimetidine, HIV protease inhibitors (eg, ritonavir), or serotonin norepinephrine reuptake inhibitors (eg, duloxetine) because they may increase the risk of Tambocor's side effects, including heart problems, blood problems, or seizures, may be increased Antiarrhythmics (eg, amiodarone, quinidine, disopyramide), arsenic, beta-blockers (eg, propranolol, sotalol), droperidol, pimozide, serotonin receptor antagonists (eg, dolasetron), or ziprasidone because the risk of side effects, such as irregular heartbeat or other heart problems, may be increased Digoxin because the risk of its side effects may be increased by Tambocor

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

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

Take Tambocor by mouth with or without food. The initial dose of Tambocor will be given by a qualified health care provider in a medical setting. If you miss a dose of Tambocor, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Important safety information: Tambocor may cause dizziness, blurred vision, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Tambocor with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Tell your doctor or dentist that you take Tambocor before you receive any medical or dental care, emergency care, or surgery. Do not suddenly stop taking Tambocor without checking with your doctor. LAB TESTS may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments. Tambocor 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 Tambocor while you are pregnant. Tambocor is found in breast milk. If you are or will be breast-feeding while you are using Tambocor, check with your doctor. Discuss the risks to your baby. Possible side effects of Tambocor:

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:

Blurred vision; constipation; difficulty focusing; dizziness; faintness; headache; nausea; seeing spots; stomach discomfort; tiredness; unsteadiness; weakness.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; difficulty breathing; fainting; fast heartbeat; heart attack; life-threatening irregular heartbeat; lightheadedness; pounding in the chest; seizures; tremor; 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: Tambocor 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; nausea; seizures; slow heartbeat; vomiting.

Proper storage of Tambocor:

Store Tambocor 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 Tambocor out of the reach of children and away from pets.

General information: If you have any questions about Tambocor, please talk with your doctor, pharmacist, or other health care provider. Tambocor 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 Tambocor. 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 Tambocor resources Tambocor Side Effects (in more detail) Tambocor Use in Pregnancy & Breastfeeding Drug Images Tambocor Drug Interactions Tambocor Support Group 7 Reviews for Tambocor - Add your own review/rating Tambocor Prescribing Information (FDA) Tambocor Advanced Consumer (Micromedex) - Includes Dosage Information Tambocor Concise Consumer Information (Cerner Multum) Tambocor Monograph (AHFS DI) Flecainide Prescribing Information (FDA) Compare Tambocor with other medications Atrial Fibrillation Atrial Flutter Paroxysmal Supraventricular Tachycardia Supraventricular Tachycardia Ventricular Tachycardia Wolff-Parkinson-White Syndrome
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Lexiva


Pronunciation: FOS-am-PREN-a-vir
Generic Name: Fosamprenavir
Brand Name: Lexiva
Lexiva is used for:

Treating HIV infection in some patients when used in combination with certain other medicines.

Lexiva is an HIV protease inhibitor. It works by slowing the growth of HIV, the virus that causes AIDS.

Do NOT use Lexiva if: you are allergic to any ingredient in Lexiva or to amprenavir you are taking alfuzosin, amprenavir, astemizole, cisapride, conivaptan, delavirdine, erythromycin, an ergot medicine (eg, ergotamine), pimozide, rifampin, salmeterol, St. John's wort, or terfenadine you are taking a hormonal contraceptive (eg, birth control pills), certain benzodiazepines (eg, midazolam, triazolam), or certain HMG-CoA reductase inhibitors (eg, lovastatin, simvastatin) you are taking sildenafil for pulmonary arterial hypertension (PAH) you are taking flecainide or propafenone along with ritonavir

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

Before using Lexiva:

Some medical conditions may interact with Lexiva. 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 had a severe allergic reaction (eg, a severe rash, hives, itching, breathing difficulties, dizziness) to a sulfonamide medicine such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glyburide, probenecid, sulfamethoxazole, valdecoxib, or zonisamide if you have liver problems, hepatitis, or a history of abnormal liver function tests if you have a history of heart problems, high blood pressure, kidney problems, diabetes, bleeding problems (eg, hemophilia), high blood cholesterol or lipid levels, or a skin rash if you smoke

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

Astemizole, cisapride, ergot medicines (eg, ergotamine), erythromycin, pimozide, salmeterol, or terfenadine because serious side effects, such as seizures, blood vessel problems, or heart problems (eg, irregular heartbeat), may occur Flecainide or propafenone along with ritonavir because serious heart problems (eg, irregular heartbeat) may occur Alfuzosin because the risk of severe low blood pressure may be increased Certain benzodiazepines (eg, midazolam, triazolam) because serious side effects, such as increased or prolonged sedation or breathing problems, may occur Hormonal contraceptives (eg, birth control pills), especially if taken along with ritonavir, because their effectiveness may be decreased and liver problems may occur Amprenavir because it may increase the risk of Lexiva's side effects Rifampin or St. John's wort because they may decrease Lexiva's effectiveness Conivaptan, certain HMG-CoA reductase inhibitors (eg, lovastatin, simvastatin), ranolazine, or sildenafil (when used for PAH) because the risk of their side effects may be increased by Lexiva Delavirdine because its effectiveness may be decreased by Lexiva Many prescription and nonprescription medicines (eg, used for cancer, infections, asthma, immune suppression, inflammation, aches and pains, gout, high blood pressure, high cholesterol, heart problems, irregular heartbeat, angina, blood clotting problems, mood or mental problems, sinus problems, stomach problems or indigestion, erectile dysfunction, , PAH, seizures, sleeping problems, urinary problems, HIV infection), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo) may interact with Lexiva, increasing the risk of side effects

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

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

An extra patient leaflet is available with Lexiva. Talk to your pharmacist if you have questions about this information. Take Lexiva by mouth with or without food. If you take an aluminum- or magnesium-containing antacid, ask your doctor or pharmacist how to take it with Lexiva. Do not change your dose or stop taking Lexiva without talking with your doctor first. Continue to take Lexiva even if you feel well. Do not miss any doses. Taking Lexiva at the same time(s) each day will help you remember to take it. It is important to not miss any doses of Lexiva. If you miss a dose of Lexiva, take it as soon as you remember. If you miss a dose of Lexiva by more than 4 hours, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Important safety information: Do not take more than the recommended dose without checking with your doctor. Lexiva is not a cure for HIV infection. Patients may still get illnesses and infections associated with HIV. Remain under the care of your doctor. Lexiva does not stop the spread of HIV to others through blood or sexual contact. Use barrier forms of birth control (eg, condoms) if you have HIV infection. Do not share needles, injection supplies, or items like toothbrushes or razors. When your medicine supply is low, get more from your doctor or pharmacist as soon as you can. Do not stop taking Lexiva, even for a short period of time. If you do, the virus may grow resistant to the medicine and become harder to treat. Lexiva may improve immune system function. This may reveal hidden infections in some patients. Tell your doctor right away if you notice signs or symptoms of an infection (eg, fever, sore throat, weakness, cough, shortness of breath) after you start Lexiva. Severe and sometimes life-threatening skin reactions have occurred in patients taking Lexiva. Contact your doctor right away if you develop any type of skin reaction (eg, red, swollen, blistered, or peeling skin). Changes in body fat (eg, an increased amount of fat in the upper back, neck, breast, and trunk, and loss of fat from the legs, arms, and face) may occur in some patients taking Lexiva. The cause and long-term effects of these changes are unknown. Discuss any concerns with your doctor. Diabetes patients - Lexiva may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Lexiva may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away. Hormonal birth control (eg, birth control pills) may not work as well while you are using Lexiva. To prevent pregnancy, use an extra form of birth control (eg, condoms). Lab tests, including liver function, cholesterol or triglyceride levels, white blood cell count, and blood sugar levels, may be performed while you use Lexiva. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Caution is advised when using Lexiva in CHILDREN; they may be more sensitive to its effects, especially vomiting. Lexiva should be used with extreme caution in CHILDREN younger than 2 years old; safety and effectiveness in these children have not been confirmed. PREGNANCY and BREAST-FEEDING: If you are planning to become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Lexiva while you are pregnant. It is not known if Lexiva is found in breast milk. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or Lexiva to the baby. Possible side effects of Lexiva:

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

Diarrhea; headache; nausea; tiredness; vomiting.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); loss of appetite; signs of infection (eg, fever, chills, sore throat); swollen, reddened, or blistered skin; symptoms of a heart attack (eg, chest pain; fainting; numbness of an arm or leg; sudden, severe headache or vomiting); symptoms of kidney stones (eg, lower back or side pain, blood in the urine, painful urination); unusual increase in thirst or urination; unusual tiredness or weakness; weight loss; 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: Lexiva 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 Lexiva:

Store Lexiva at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep the container tightly closed. Do not use it after the expiration date. Keep Lexiva out of the reach of children and away from pets.

General information: If you have any questions about Lexiva, please talk with your doctor, pharmacist, or other health care provider. Lexiva 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 Lexiva. 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 Lexiva resources Lexiva Side Effects (in more detail) Lexiva Use in Pregnancy & Breastfeeding Drug Images Lexiva Drug Interactions Lexiva Support Group 0 Reviews for Lexiva - Add your own review/rating Lexiva Prescribing Information (FDA) Lexiva Monograph (AHFS DI) Lexiva Advanced Consumer (Micromedex) - Includes Dosage Information Lexiva Consumer Overview Compare Lexiva with other medications HIV Infection Nonoccupational Exposure
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Lopressor Tablets


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

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

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

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

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

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


Lopressor is used for:

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

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

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

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

Before using Lopressor:

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

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

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

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

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

How to use Lopressor:

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

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

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

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

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

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

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

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

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

See also: Lopressor side effects (in more detail)

If OVERDOSE is suspected:

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

Proper storage of Lopressor:

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

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

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

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


Pronunciation: gra-NIS-e-tron
Generic Name: Granisetron
Brand Name: Kytril
Kytril Solution is used for:

Preventing nausea and vomiting caused by cancer chemotherapy and radiation. It may also be used for other conditions as determined by your doctor.

Kytril Solution is a 5-HT3 receptor antagonist. It works by blocking a chemical called serotonin that can cause vomiting.

Do NOT use Kytril Solution if: you are allergic to any ingredient in Kytril Solution you are taking apomorphine

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

Before using Kytril Solution:

Some medical conditions may interact with Kytril Solution. 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 are allergic to other 5-HT3 receptor antagonists (eg, ondansetron) if you have heart problems (eg, irregular heartbeat, conduction problems), blood electrolyte problems (eg, low calcium, potassium or magnesium), an abnormal electrocardiogram (ECG), or you are receiving chemotherapy that may cause heart problems if you have stomach or bowel problems (eg, pain, swelling) or if you have recently had stomach surgery

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

Apomorphine because the risk of side effects, such as severely low blood pressure or loss of consciousness, may occur Medicines that may affect your heartbeat, such as antiarrhythmics (eg, flecainide, sotalol), azole antifungals (eg, ketoconazole), or quinolones (eg, ciprofloxacin), because heart rhythm problems may occur. Ask your doctor if you are unsure if any medicines that you take may affect your heartbeat

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

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

Take Kytril Solution by mouth with or without food. Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose. Use Kytril Solution only on the days that you receive your cancer treatment, unless otherwise directed by your doctor. If you miss a dose of Kytril Solution, contact your doctor right away.

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

Important safety information: Kytril Solution may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Kytril Solution with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Use Kytril Solution with extreme caution in CHILDREN. Safety and effectiveness 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 Kytril Solution while you are pregnant. It is not known if Kytril Solution is found in breast milk. If you are or will be breast-feeding while you use Kytril Solution, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Kytril Solution:

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:

Agitation; anxiety; constipation; diarrhea; dizziness; drowsiness; headache; indigestion; nausea; stomach pain; taste changes; trouble sleeping; vomiting; weakness.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fainting; fast or irregular heartbeat; fever, chills, or sore throat; unusual muscle movement.

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: Kytril 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 headache.

Proper storage of Kytril Solution:

Store Kytril Solution 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 Kytril Solution out of the reach of children and away from pets.

General information: If you have any questions about Kytril Solution, please talk with your doctor, pharmacist, or other health care provider. Kytril Solution 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 Kytril Solution. 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 Kytril resources Kytril Side Effects (in more detail) Kytril Use in Pregnancy & Breastfeeding Drug Images Kytril Drug Interactions Kytril Support Group 2 Reviews for Kytril - Add your own review/rating Compare Kytril with other medications Nausea/Vomiting, Chemotherapy Induced Nausea/Vomiting, Postoperative Nausea/Vomiting, Radiation Induced
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Saquinavir Mesylate


Pronunciation: sa-KWIN-a-vir MES-i-late
Generic Name: Saquinavir Mesylate
Brand Name: Invirase
Saquinavir Mesylate is used for:

Treating HIV infection. Saquinavir Mesylate must be taken along with ritonavir.

Saquinavir Mesylate is a protease inhibitor. It works by blocking the growth activity of an enzyme (HIV protease) that the HIV virus needs to reproduce in the body.

Do NOT use Saquinavir Mesylate if: you are allergic to any ingredient in Saquinavir Mesylate or to ritonavir you have severe liver problems, certain electrolyte problems (eg, low blood potassium or magnesium levels), a certain type of irregular heartbeat (heart block) and you do not have a pacemaker, or if you are at risk of heart block you have a history of a certain type of irregular heartbeat (eg, congenital long QT syndrome, QT prolongation) or certain other heart problems you are taking alfuzosin, astemizole, certain benzodiazepines (eg, midazolam, triazolam), cisapride, conivaptan, a garlic supplement, an ergot derivative (eg, ergotamine, ergonovine), erythromycin, salmeterol, certain medicines to treat high cholesterol (eg, lovastatin, simvastatin) or irregular heartbeat (eg, amiodarone, bepridil, dofetilide, flecainide, propafenone, quinidine), pimozide, rifampin, St. John's wort, terfenadine, tolvaptan, or trazodone you are taking sildenafil for pulmonary arterial hypertension (PAH)

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

Before using Saquinavir Mesylate:

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

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have heart problems (eg, arrhythmia, congestive heart failure [CHF]), high blood cholesterol or triglycerides, hepatitis or other liver problems, severe kidney problems, hemophilia, or diabetes or a family history of diabetes if you have alcoholism or a history of alcohol abuse

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

Astemizole, cisapride, erythromycin, pimozide, salmeterol, terfenadine, or certain medicines for irregular heartbeat (eg, amiodarone, bepridil, flecainide, propafenone, quinidine) because the risk of severe heart side effects (eg, irregular heartbeat) may be increased Ergot derivatives (eg, ergotamine, ergonovine) because the risk of severe blood vessel problems in the hands and feet may be increased Alfuzosin because the risk of severe low blood pressure may be increased Rifampin because the risk of severe liver problems may be increased Garlic supplements or St. John's wort because they may decrease Saquinavir Mesylate's effectiveness Certain cholesterol medicines (eg, lovastatin, simvastatin), conivaptan, midazolam, sildenafil (when used for PAH), tolvaptan, or triazolam because the risk of their side effects may be increased by Saquinavir Mesylate Many prescription and nonprescription medicines (eg, used for allergies, asthma, birth control, blood thinning, cancer, gout, irregular heartbeat or other heart problems, high blood pressure, high cholesterol, HIV infection, heartburn or reflux, erectile dysfunction, PAH, overactive bladder, immune system suppression, infections, mental or mood problems, anxiety, migraine headaches, pain, seizures, sleep), herbs found in multivitamin products, herbal teas, and dietary supplements (eg, garlic, St. John's wort) may interact with Saquinavir Mesylate and increase the risk of side effects

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

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

Saquinavir Mesylate comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Saquinavir Mesylate refilled. Take Saquinavir Mesylate and ritonavir with a meal or within 2 hours after a full meal or large snack. Ritonavir should be taken at the same time as Saquinavir Mesylate. Taking Saquinavir Mesylate at the same times each day will help you to remember to take it. Take Saquinavir Mesylate on a regular schedule to get the most benefit from it. Talk with your doctor before you eat grapefruit or drink grapefruit juice while you use Saquinavir Mesylate. Do not miss any doses. If you miss a dose of Saquinavir Mesylate, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Important safety information: Saquinavir Mesylate may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Saquinavir Mesylate with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Changes in body fat (eg, an increased amount of fat in the upper back, neck, breast, and trunk, and loss of fat from the legs, arms, and face) may occur in some patients taking Saquinavir Mesylate. The cause and long-term effects of these changes are unknown. Discuss any concerns with your doctor. Saquinavir Mesylate may improve immune system function. This may reveal hidden infections in some patients. Tell your doctor right away if you notice symptoms of infection (eg, fever, sore throat, weakness, cough, shortness of breath) after you start Saquinavir Mesylate. Do not stop taking Saquinavir Mesylate or change your dose without talking to your doctor. When your medicine supply is low, get more from your doctor or pharmacist as soon as you can. Do not stop taking Saquinavir Mesylate, even for a short period of time. If you do, the virus may grow resistant to the medicine and become harder to treat. Saquinavir Mesylate is not a cure for HIV infection. Patients may still get illnesses and infections associated with HIV. Remain under the care of your doctor. Saquinavir Mesylate does not stop the spread of HIV to others through blood or sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection. Do not share needles, injection supplies, or items like toothbrushes or razors. Saquinavir Mesylate may increase triglyceride and lipid levels. The long-term chance of complications from these increased triglyceride and lipid levels, such as a heart attack and stroke, are not known at this time. Hormonal birth control (eg, birth control pills) may not work as well while you are using Saquinavir Mesylate. To prevent pregnancy, use an extra form of birth control (eg, condoms). Hemophilia patients - Report all bleeding episodes to your doctor. Saquinavir Mesylate may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, urinate more often than usual, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away. Diabetes patients - Saquinavir Mesylate may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Lab tests, including liver function, thyroid function, electrocardiogram (ECG), blood cholesterol or triglyceride levels, blood glucose levels, blood electrolyte levels, and complete blood cell counts, may be performed while you use Saquinavir Mesylate. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Use Saquinavir Mesylate with caution in the ELDERLY; they may be more sensitive to its effects. Saquinavir Mesylate should not be used in CHILDREN younger than 16 years old; safety and effectiveness in these children have not been confirmed. PREGNANCY AND BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking Saquinavir Mesylate while you are pregnant. Do not breast-feed while taking Saquinavir Mesylate. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or Saquinavir Mesylate to the baby. Possible side effects of Saquinavir Mesylate:

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:

Anxiety; blurred vision; body fat changes; changes in sexual desire; constipation; diarrhea; dizziness; dry lips or skin; gas; headache; heartburn; mouth sores; nausea; night sweats; sleeplessness; stomach discomfort; taste changes; tenderness or bleeding of the gums; tiredness; vomiting; warts; weight gain.

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); back pain; blood in the vomit or stools; chest tightness or pain; confusion; coughing up blood; dark urine; depression or thoughts of suicide; difficulty urinating; excessive thirst, hunger, or urination; fainting; fast, slow, or irregular heartbeat; fever; flu-like symptoms; itching; loss of appetite; loss of coordination; numbness or tingling; pain in muscles or joints; pale stools; reddened, blistered, or swollen skin; seizures; severe or persistent cough; severe or persistent dizziness or lightheadedness; shortness of breath; stomach pain or tenderness; unusual bruising or bleeding; unusual vaginal discharge or odor; unusual weakness; white patches in the mouth; 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: Saquinavir Mesylate 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 Saquinavir Mesylate:

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

General information: If you have any questions about Saquinavir Mesylate, please talk with your doctor, pharmacist, or other health care provider. Saquinavir Mesylate 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 Saquinavir Mesylate. 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 Saquinavir Mesylate resources Saquinavir Mesylate Side Effects (in more detail) Saquinavir Mesylate Dosage Saquinavir Mesylate Use in Pregnancy & Breastfeeding Saquinavir Mesylate Drug Interactions Saquinavir Mesylate Support Group 0 Reviews for Saquinavir Mesylate - Add your own review/rating Fortovase Prescribing Information (FDA) Invirase Prescribing Information (FDA) Invirase Monograph (AHFS DI) Invirase Advanced Consumer (Micromedex) - Includes Dosage Information Invirase Consumer Overview Compare Saquinavir Mesylate with other medications HIV Infection Nonoccupational Exposure
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fosamprenavir


Generic Name: fosamprenavir (FOS am pren a veer)
Brand names: Lexiva, Telzir

What is fosamprenavir?

Fosamprenavir is an antiviral medication in a group of HIV medicines called protease (PRO-tee-ayz) inhibitors. Fosamprenavir prevents human immunodeficiency virus (HIV) cells from multiplying in your body.

Fosamprenavir is used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Fosamprenavir is not a cure for HIV or AIDS.

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

What is the most important information I should know about fosamprenavir? Do not take fosamprenavir with cisapride (Propulsid), pimozide (Orap), midazolam (Versed), triazolam (Halcion), or an ergot medicine such as Ergomar, Cafergot, Wigraine, D.H.E. 45, Migranal, Methergine, and others. Fosamprenavir should not be taken together with ritonavir (Norvir) if you are also using a heart rhythm medication called flecainide (Tambocor) or propafenone (Rythmol). Ask your doctor about taking a different medication for your heart rhythm disorder. These drugs can cause life-threatening side effects if you use them while you are taking fosamprenavir.

There are many other medicines that can cause serious interactions if you use them while taking fosamprenavir. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors.

HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor.

Avoid having unprotected sex or sharing needles, razors, or toothbrushes. Taking this medication will not prevent you from passing HIV to other people. Talk with your doctor about safe methods of preventing HIV transmission during sex. What should I discuss with my healthcare provider before taking fosamprenavir?

Do not take this medication if you are allergic to fosamprenavir or a similar drug called amprenavir (Agenerase).

Do not take fosamprenavir together with cisapride (Propulsid), pimozide (Orap), midazolam (Versed), triazolam (Halcion), or ergot medicines such as ergotamine (Ergomar, Cafergot), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), or methylergonovine (Methergine). Fosamprenavir should not be taken together with ritonavir (Norvir) if you are also using a heart rhythm medication called flecainide (Tambocor) or propafenone (Rythmol). Ask your doctor about taking a different medication for your heart rhythm disorder. These drugs can cause life-threatening side effects if you use them while you are taking fosamprenavir.

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

liver disease; kidney disease;

diabetes;

a bleeding disorder such as hemophilia;

heart disease, history of heart attack;

high cholesterol or triglycerides; or

if you have ever used a protease inhibitor in the past.

FDA pregnancy category C. It is not known whether fosamprenavir will harm an unborn baby. Tell your doctor if you are pregnant. HIV can be passed to your baby if you are not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection.

Your name may need to be listed on an antiviral pregnancy registry when you start using this medication.

Taking fosamprenavir together with another HIV medicine called ritonavir (Norvir) and also using birth control pills can increase you risk of liver problems. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking fosamprenavir and ritonavir. Women with HIV or AIDS should not breast-feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk. How should I take fosamprenavir?

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

Fosamprenavir tablets can be taken with or without food.

Fosamprenavir liquid should be taken with food in children and without food in adults.

Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

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

To be sure this medicine is helping your condition and is not causing harmful effects, your blood will need to be tested often. Your liver function may also need to be tested. Visit your doctor regularly.

HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.

Store fosamprenavir tablets at room temperature away from moisture and heat. You may store fosamprenavir liquid in the refrigerator but do not allow it to freeze.

See also: Fosamprenavir dosage (in more detail)

What happens if I miss a dose?

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

What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while taking fosamprenavir? Taking this medication will not prevent you from passing HIV to other people. Avoid having unprotected sex or sharing razors or toothbrushes. 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. Fosamprenavir side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking fosamprenavir and 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;

pale or yellowed skin, dark colored urine, fever, confusion or weakness;

increased urination or extreme thirst;

sudden and severe pain in your lower back or side, blood in your urine, pain or burning when you urinate;

signs of a new infection, such as fever or chills, cough, or flu symptoms;

easy bruising or bleeding; or

fever, sore throat, and headache with a severe blistering, peeling, and red skin rash.

Less serious side effects of fosamprenavir may include:

mild nausea, vomiting, diarrhea, stomach pain;

numbness or tingling, especially around your mouth;

headache, mood changes; or

changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

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.

Fosamprenavir Dosing Information

Usual Adult Dose for HIV Infection:

Therapy-naive: 1400 mg orally twice a day (without ritonavir)
or
1400 mg fosamprenavir plus 200 mg ritonavir orally once a day
or
1400 mg fosamprenavir plus 100 mg ritonavir orally once a day
or
700 mg fosamprenavir plus 100 mg ritonavir orally twice a day
Protease inhibitor (PI)-experienced: 700 mg fosamprenavir plus 100 mg ritonavir orally twice a day

Usual Adult Dose for Nonoccupational Exposure:

1400 mg orally twice a day (without ritonavir)
or
1400 mg fosamprenavir plus 200 mg ritonavir orally once a day
or
1400 mg fosamprenavir plus 100 mg ritonavir orally once a day
or
700 mg fosamprenavir plus 100 mg ritonavir orally twice a day
Duration: Prophylaxis should be initiated as soon as possible, within 72 hours of exposure, and continued for 28 days.
The alternative regimens recommended for nonoccupational postexposure HIV prophylaxis include fosamprenavir as part of PI-based regimens.

Usual Pediatric Dose for HIV Infection:

Oral suspension:
2 to 5 years:
Therapy-naive: 30 mg/kg orally twice a day (without ritonavir)
Maximum: 1400 mg/dose
6 years or older:
Therapy-naive: 30 mg/kg orally twice a day (without ritonavir)
Maximum: 1400 mg/dose
or
18 mg/kg fosamprenavir plus 3 mg/kg ritonavir orally twice a day
Maximum: 700 mg fosamprenavir/dose; 100 mg ritonavir/dose
Therapy-experienced: 18 mg/kg fosamprenavir plus 3 mg/kg ritonavir orally twice a day
Maximum: 700 mg fosamprenavir/dose; 100 mg ritonavir/dose
Tablets:
6 years or older:
Therapy-experienced:
47 kg or more: 1400 mg orally twice a day (without ritonavir)
39 kg or more: 700 mg fosamprenavir plus 100 mg ritonavir orally twice a day
Ritonavir capsules may be administered to patients 33 kg or more.

What other drugs will affect fosamprenavir? Many other drugs can cause serious or life-threatening drug interactions if you use them while taking fosamprenavir. Tell your doctor if you are also using:

itraconazole (Sporanox) or ketoconazole (Nizoral);

heart rhythm medicine such as amiodarone (Cordarone, Pacerone), lidocaine, or quinidine (Quin-G);

an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), imipramine (Janimine, Tofranil), or paroxetine (Paxil);

rifampin (Rifadin, Rimactane, Rifater);

steroid medicine such as dexamethasone (Cortastat, Dexasone, Solurex, DexPak) or fluticasone (Advair, Flonase, Flovent);

St. John's wort;

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

heart or blood pressure medicine such as amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide), diltiazem (Cartia, Cardizem), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), and others;

cholesterol-lowering medicine such as atorvastatin (Lipitor, Caduet), lovastatin (Mevacor, Altoprev, Advicor), simvastatin (Zocor, Simcor, Vytorin);

drugs that weaken the immune system, such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), or tacrolimus (Prograf);

other HIV /AIDS medicine such as delavirdine (Rescriptor), efavirenz (Sustiva, Atripla), nevirapine (Viramune), lopinavir/ritonavir (Kaletra), or raltegravir (Isentress);

insulin or diabetes medication you take by mouth;

medicines to treat erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra);

seizure medications such as carbamazepine (Carbatrol, Equetro, Tegretol), phenobarbital (Luminal, Solfoton), or phenytoin (Dilantin); or

stomach acid reducers such as cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), or ranitidine (Zantac).

This list is not complete and there are many other drugs that can interact with fosamprenavir. 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. Keep a list of all your medicines and show it to any healthcare provider who treats you. More fosamprenavir resources Fosamprenavir Side Effects (in more detail) Fosamprenavir Dosage Fosamprenavir Use in Pregnancy & Breastfeeding Fosamprenavir Drug Interactions Fosamprenavir Support Group 0 Reviews for Fosamprenavir - Add your own review/rating fosamprenavir Advanced Consumer (Micromedex) - Includes Dosage Information Fosamprenavir MedFacts Consumer Leaflet (Wolters Kluwer) Fosamprenavir Calcium Monograph (AHFS DI) Lexiva Prescribing Information (FDA) Lexiva Consumer Overview Compare fosamprenavir with other medications HIV Infection Nonoccupational Exposure Where can I get more information? Your pharmacist can provide more information about fosamprenavir.

See also: fosamprenavir side effects (in more detail)


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Aptivus Solution


Pronunciation: tye-PRAN-a-vir
Generic Name: Tipranavir
Brand Name: Aptivus

Aptivus Solution is used along with another HIV medicine (ritonavir). Serious and sometimes fatal bleeding in the brain has occurred with this combination. Contact your doctor right away if you develop symptoms of bleeding in the brain. These may include confusion, vision or speech problems, or one-sided weakness.

Serious and sometimes fatal liver problems have also been reported with this combination. Patients who have hepatitis B or C may be at greater risk. Contact your doctor at once if you develop symptoms of liver problems. Such symptoms may include yellowing of the eyes or skin, dark urine, pale stools, stomach pain or tenderness, severe or persistent nausea, or loss of appetite.

Discuss any questions or concerns with your doctor.


Aptivus Solution is used for:

Treating HIV infection. Aptivus Solution should be used with ritonavir.

Aptivus Solution is a protease inhibitor. It works by blocking the growth of an enzyme (HIV protease) that the HIV virus needs to reproduce in the body.

Do NOT use Aptivus Solution if: you are allergic to any ingredient in Aptivus Solution you have moderate to severe liver disease you are taking alfuzosin, certain antiarrhythmics (eg, amiodarone, bepridil, flecainide, propafenone, quinidine), astemizole, certain benzodiazepines (eg, midazolam, triazolam), certain HMG-CoA reductase inhibitors (eg, lovastatin, simvastatin), cisapride, ergot derivatives (eg, ergonovine, ergotamine), other HIV protease inhibitors (eg, saquinavir), pimozide, rifampin, salmeterol, a serotonin 5-HT1 receptor antagonist (eg, eletriptan, sumatriptan), St. John's wort, or terfenadine you are taking sildenafil for pulmonary arterial hypertension (PAH)

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

Before using Aptivus Solution:

Some medical conditions may interact with Aptivus Solution. 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 had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to any other sulfonamide medicine, such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glyburide, probenecid, sulfamethoxazole, valdecoxib, or zonisamide if you have cholesterol or lipid problems, diabetes or a family history of diabetes, liver problems (eg, hepatitis B or C), abnormal liver function tests, kidney problems, or bleeding problems (eg, hemophilia) if you take vitamin E or you have had a recent injury or other medical condition that may increase your risk of bleeding or serious bruising if you will be having or have recently had surgery if you have never taken another medicine for HIV infection

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

Certain antiarrhythmics (eg, amiodarone, bepridil, flecainide, propafenone, quinidine), astemizole, certain benzodiazepines (eg, midazolam, triazolam), cisapride, ergot derivatives (eg, ergonovine, ergotamine), certain HMG-CoA reductase inhibitors (eg, lovastatin, simvastatin), pimozide, salmeterol, serotonin 5-HT1 receptor antagonists (eg, eletriptan, sumatriptan), or terfenadine because the risk of side effects, including heart or blood vessel problems, muscle problems, or severe breathing problems, may be increased Alfuzosin because the risk for severe low blood pressure may be increased Rifampin or St. John's wort because they may decrease Aptivus Solution's effectiveness Sildenafil (when used for PAH) because the risk of its side effects may be increased by Aptivus Solution Other HIV protease inhibitors (eg, saquinavir) because their effectiveness may be decreased by Aptivus Solution Anticoagulants (eg, warfarin), antiplatelet medicines (eg, clopidogrel), and many prescription and nonprescription medicines (eg, used for aches and pains, asthma, erectile dysfunction, PAH, diabetes, gout, high blood pressure, high cholesterol, HIV, immune system suppression, infections, inflammation, irregular heartbeat, nasal allergies, seizures), multivitamin products, and herbal or dietary supplements (eg, coenzyme Q10, garlic, ginkgo, ginseng, herbal teas, St. John's wort) may interact with Aptivus Solution, increasing the risk of side effects

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

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

An extra patient leaflet is available with Aptivus Solution. Talk to your pharmacist if you have questions about this information. Aptivus Solution is taken at the same time with another medicine called ritonavir. If you are taking Aptivus Solution with ritonavir capsule or solution, it can be taken with or without meals. If you are taking Aptivus Solution with ritonavir tablets, it must be taken with meals. Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose. If you are also taking didanosine, do not take it within 2 hours of taking Aptivus Solution. Check with your doctor if you have questions. Taking Aptivus Solution at the same time each day will help you remember to take it. Take Aptivus Solution on a regular schedule to get the most benefit from it. Continue to use Aptivus Solution even if you feel well. Do not miss any doses. Failure to do so may decrease the effectiveness of Aptivus Solution and increase the risk that your HIV infection will no longer be sensitive to Aptivus Solution or to other similar medicines. If you miss a dose of Aptivus Solution, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Important safety information: Aptivus Solution may cause dizziness or drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use Aptivus Solution with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Tell your doctor or dentist that you take Aptivus Solution before you receive any medical or dental care, emergency care, or surgery. Changes in body fat (eg, an increased amount of fat in the upper back, neck, breast, and trunk, and loss of fat from the legs, arms, and face) may occur in some patients taking Aptivus Solution. The cause and long-term effects of these changes are not known. Discuss any concerns with your doctor. Aptivus Solution may improve immune system function. This may reveal hidden infections in some patients. Tell your doctor right away if you notice symptoms of infection (eg, cough, fever, shortness of breath, sore throat, weakness) after you start Aptivus Solution. When your medicine supply is low, get more from your doctor or pharmacist as soon as you can. Do not stop taking Aptivus Solution, even for a short period of time. If you do, the virus may grow resistant to the medicine and become harder to treat. Aptivus Solution is not a cure for HIV infection. Patients may still get illnesses and infections associated with HIV. Remain under the care of your doctor. Aptivus Solution does not stop the spread of HIV to others through blood or sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection. Do not share needles, injection supplies, or items like toothbrushes or razors. Aptivus Solution may increase triglyceride and lipid levels. The long-term chance of complications from these increased triglyceride and lipid levels, such as heart attack and stroke, are not known at this time. Hemophilia patients - Report all bleeding episodes to your doctor. Aptivus Solution may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away. Diabetes patients - Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Aptivus Solution may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Aptivus Solution. Use a sunscreen or wear protective clothing if you must be outside for more than a short time. Hormonal birth control (eg, birth control pills) may not work as well while you are using Aptivus Solution. To prevent pregnancy, use an extra form of birth control (eg, condoms). Women who take estrogens for birth control or hormone replacement may have an increased risk of rash from Aptivus Solution. Contact your doctor if you develop a rash. Lab tests, including viral load, CD4 count, triglyceride and lipid levels, and liver function, may be performed while you use Aptivus Solution. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Use Aptivus Solution with caution in the ELDERLY; they may be more sensitive to its effects. Caution is advised when using Aptivus Solution in CHILDREN; they may be more sensitive to its effects, especially rash. Use Aptivus Solution with extreme caution in CHILDREN younger than 2 years old; safety and effectiveness in these children have not been confirmed. PREGNANCY AND BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risk of using Aptivus Solution while you are pregnant. It is not known if Aptivus Solution is found in breast milk. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or Aptivus Solution to the baby. Possible side effects of Aptivus Solution:

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:

Cough; diarrhea; headache; nausea; tiredness; vomiting.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); body fat changes; confusion; dark urine; depression; difficulty urinating; dizziness; excessive hunger, thirst, or urination; fast heartbeat; fever, chills, or sore throat; flu-like symptoms; fruit-like breath odor; itching; joint pain or stiffness; loss of appetite; mental or mood changes; mouth sores or ulcers; muscle pain; numbness or tingling; pale stools; red, blistered, swollen, or peeling skin; severe or persistent nausea; slurred speech or one-sided weakness; stomach pain or tenderness; throat tightness; unusual bruising or bleeding; unusual drowsiness or tiredness; unusual weakness; vision changes; yellowing of the skin or eyes.

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

See also: Aptivus 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 Aptivus Solution:

Store Aptivus Solution at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Do not refrigerate or freeze. Aptivus Solution must be used within 60 days after opening the bottle. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Aptivus Solution out of the reach of children and away from pets.

General information: If you have any questions about Aptivus Solution, please talk with your doctor, pharmacist, or other health care provider. Aptivus Solution 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 Aptivus Solution. 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 Aptivus resources Aptivus Side Effects (in more detail) Aptivus Use in Pregnancy & Breastfeeding Aptivus Drug Interactions Aptivus Support Group 0 Reviews for Aptivus - Add your own review/rating Compare Aptivus with other medications HIV Infection
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Tipranavir Solution


Pronunciation: tye-PRAN-a-vir
Generic Name: Tipranavir
Brand Name: Aptivus

Tipranavir Solution is used along with another HIV medicine (ritonavir). Serious and sometimes fatal bleeding in the brain has occurred with this combination. Contact your doctor right away if you develop symptoms of bleeding in the brain. These may include confusion, vision or speech problems, or one-sided weakness.

Serious and sometimes fatal liver problems have also been reported with this combination. Patients who have hepatitis B or C may be at greater risk. Contact your doctor at once if you develop symptoms of liver problems. Such symptoms may include yellowing of the eyes or skin, dark urine, pale stools, stomach pain or tenderness, severe or persistent nausea, or loss of appetite.

Discuss any questions or concerns with your doctor.


Tipranavir Solution is used for:

Treating HIV infection. Tipranavir Solution should be used with ritonavir.

Tipranavir Solution is a protease inhibitor. It works by blocking the growth of an enzyme (HIV protease) that the HIV virus needs to reproduce in the body.

Do NOT use Tipranavir Solution if: you are allergic to any ingredient in Tipranavir Solution you have moderate to severe liver disease you are taking alfuzosin, certain antiarrhythmics (eg, amiodarone, bepridil, flecainide, propafenone, quinidine), astemizole, certain benzodiazepines (eg, midazolam, triazolam), certain HMG-CoA reductase inhibitors (eg, lovastatin, simvastatin), cisapride, ergot derivatives (eg, ergonovine, ergotamine), other HIV protease inhibitors (eg, saquinavir), pimozide, rifampin, salmeterol, a serotonin 5-HT1 receptor antagonist (eg, eletriptan, sumatriptan), St. John's wort, or terfenadine you are taking sildenafil for pulmonary arterial hypertension (PAH)

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

Before using Tipranavir Solution:

Some medical conditions may interact with Tipranavir Solution. 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 had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to any other sulfonamide medicine, such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glyburide, probenecid, sulfamethoxazole, valdecoxib, or zonisamide if you have cholesterol or lipid problems, diabetes or a family history of diabetes, liver problems (eg, hepatitis B or C), abnormal liver function tests, kidney problems, or bleeding problems (eg, hemophilia) if you take vitamin E or you have had a recent injury or other medical condition that may increase your risk of bleeding or serious bruising if you will be having or have recently had surgery if you have never taken another medicine for HIV infection

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

Certain antiarrhythmics (eg, amiodarone, bepridil, flecainide, propafenone, quinidine), astemizole, certain benzodiazepines (eg, midazolam, triazolam), cisapride, ergot derivatives (eg, ergonovine, ergotamine), certain HMG-CoA reductase inhibitors (eg, lovastatin, simvastatin), pimozide, salmeterol, serotonin 5-HT1 receptor antagonists (eg, eletriptan, sumatriptan), or terfenadine because the risk of side effects, including heart or blood vessel problems, muscle problems, or severe breathing problems, may be increased Alfuzosin because the risk for severe low blood pressure may be increased Rifampin or St. John's wort because they may decrease Tipranavir Solution's effectiveness Sildenafil (when used for PAH) because the risk of its side effects may be increased by Tipranavir Solution Other HIV protease inhibitors (eg, saquinavir) because their effectiveness may be decreased by Tipranavir Solution Anticoagulants (eg, warfarin), antiplatelet medicines (eg, clopidogrel), and many prescription and nonprescription medicines (eg, used for aches and pains, asthma, erectile dysfunction, PAH, diabetes, gout, high blood pressure, high cholesterol, HIV, immune system suppression, infections, inflammation, irregular heartbeat, nasal allergies, seizures), multivitamin products, and herbal or dietary supplements (eg, coenzyme Q10, garlic, ginkgo, ginseng, herbal teas, St. John's wort) may interact with Tipranavir Solution, increasing the risk of side effects

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

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

An extra patient leaflet is available with Tipranavir Solution. Talk to your pharmacist if you have questions about this information. Tipranavir Solution is taken at the same time with another medicine called ritonavir. If you are taking Tipranavir Solution with ritonavir capsule or solution, it can be taken with or without meals. If you are taking Tipranavir Solution with ritonavir tablets, it must be taken with meals. Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose. If you are also taking didanosine, do not take it within 2 hours of taking Tipranavir Solution. Check with your doctor if you have questions. Taking Tipranavir Solution at the same time each day will help you remember to take it. Take Tipranavir Solution on a regular schedule to get the most benefit from it. Continue to use Tipranavir Solution even if you feel well. Do not miss any doses. Failure to do so may decrease the effectiveness of Tipranavir Solution and increase the risk that your HIV infection will no longer be sensitive to Tipranavir Solution or to other similar medicines. If you miss a dose of Tipranavir Solution, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Important safety information: Tipranavir Solution may cause dizziness or drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use Tipranavir Solution with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Tell your doctor or dentist that you take Tipranavir Solution before you receive any medical or dental care, emergency care, or surgery. Changes in body fat (eg, an increased amount of fat in the upper back, neck, breast, and trunk, and loss of fat from the legs, arms, and face) may occur in some patients taking Tipranavir Solution. The cause and long-term effects of these changes are not known. Discuss any concerns with your doctor. Tipranavir Solution may improve immune system function. This may reveal hidden infections in some patients. Tell your doctor right away if you notice symptoms of infection (eg, cough, fever, shortness of breath, sore throat, weakness) after you start Tipranavir Solution. When your medicine supply is low, get more from your doctor or pharmacist as soon as you can. Do not stop taking Tipranavir Solution, even for a short period of time. If you do, the virus may grow resistant to the medicine and become harder to treat. Tipranavir Solution is not a cure for HIV infection. Patients may still get illnesses and infections associated with HIV. Remain under the care of your doctor. Tipranavir Solution does not stop the spread of HIV to others through blood or sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection. Do not share needles, injection supplies, or items like toothbrushes or razors. Tipranavir Solution may increase triglyceride and lipid levels. The long-term chance of complications from these increased triglyceride and lipid levels, such as heart attack and stroke, are not known at this time. Hemophilia patients - Report all bleeding episodes to your doctor. Tipranavir Solution may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away. Diabetes patients - Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Tipranavir Solution may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Tipranavir Solution. Use a sunscreen or wear protective clothing if you must be outside for more than a short time. Hormonal birth control (eg, birth control pills) may not work as well while you are using Tipranavir Solution. To prevent pregnancy, use an extra form of birth control (eg, condoms). Women who take estrogens for birth control or hormone replacement may have an increased risk of rash from Tipranavir Solution. Contact your doctor if you develop a rash. Lab tests, including viral load, CD4 count, triglyceride and lipid levels, and liver function, may be performed while you use Tipranavir Solution. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Use Tipranavir Solution with caution in the ELDERLY; they may be more sensitive to its effects. Caution is advised when using Tipranavir Solution in CHILDREN; they may be more sensitive to its effects, especially rash. Use Tipranavir Solution with extreme caution in CHILDREN younger than 2 years old; safety and effectiveness in these children have not been confirmed. PREGNANCY AND BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risk of using Tipranavir Solution while you are pregnant. It is not known if Tipranavir Solution is found in breast milk. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or Tipranavir Solution to the baby. Possible side effects of Tipranavir Solution:

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:

Cough; diarrhea; headache; nausea; tiredness; vomiting.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); body fat changes; confusion; dark urine; depression; difficulty urinating; dizziness; excessive hunger, thirst, or urination; fast heartbeat; fever, chills, or sore throat; flu-like symptoms; fruit-like breath odor; itching; joint pain or stiffness; loss of appetite; mental or mood changes; mouth sores or ulcers; muscle pain; numbness or tingling; pale stools; red, blistered, swollen, or peeling skin; severe or persistent nausea; slurred speech or one-sided weakness; stomach pain or tenderness; throat tightness; unusual bruising or bleeding; unusual drowsiness or tiredness; unusual weakness; vision changes; yellowing of the skin or eyes.

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

See also: Tipranavir 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 Tipranavir Solution:

Store Tipranavir Solution at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Do not refrigerate or freeze. Tipranavir Solution must be used within 60 days after opening the bottle. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Tipranavir Solution out of the reach of children and away from pets.

General information: If you have any questions about Tipranavir Solution, please talk with your doctor, pharmacist, or other health care provider. Tipranavir Solution 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 Tipranavir Solution. 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 Tipranavir resources Tipranavir Side Effects (in more detail) Tipranavir Use in Pregnancy & Breastfeeding Tipranavir Drug Interactions Tipranavir Support Group 0 Reviews for Tipranavir - Add your own review/rating Compare Tipranavir with other medications HIV Infection
read more / Download


Lopressor


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

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

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

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

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

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


Lopressor is used for:

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

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

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

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

Before using Lopressor:

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

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

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

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

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

How to use Lopressor:

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

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

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

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

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

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

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

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

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

See also: Lopressor side effects (in more detail)

If OVERDOSE is suspected:

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

Proper storage of Lopressor:

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

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

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

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


Pronunciation: DOX-e-pin
Generic Name: Doxepin
Brand Name: Zonalon
Zonalon Cream is used for:

Relieving moderate itching caused by certain skin conditions.

Zonalon Cream is an antipruritic cream. It is not known exactly how it works. It may block histamine to relieve itching.

Do NOT use Zonalon Cream if: you are allergic to any ingredient in Zonalon Cream you have certain prostate problems (eg, asymptomatic prostatic hypertrophy), uncontrolled glaucoma, or trouble urinating (urinary retention) you are taking clonidine, an H1 antagonist (eg, astemizole, terfenadine), or ibutilide you have taken linezolid, methylene blue, or a monoamine oxidase inhibitor (MAOI) (eg, furazolidone, phenelzine, isocarboxazid) within the past 14 days

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

Before using Zonalon Cream:

Some medical conditions may interact with Zonalon 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 preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have a history of heart problems, seizures (eg, epilepsy), overactive thyroid, glaucoma or increased pressure in the eyes, prostate problems (eg, benign prostatic hypertrophy [BPH]), certain blood problems (eg, porphyria), suicidal thoughts or attempts, or a history of alcohol abuse

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

Antiarrhythmics (eg, quinidine, propafenone, flecainide), antifungal medicines (eg, fluconazole, terbinafine), carbamazepine, cimetidine, mibefradil, phenothiazines (eg, chlorpromazine, thioridazine), or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, sertraline) because they may increase the risk of Zonalon Cream's side effects Anticoagulants (eg, warfarin), clonidine, guanadrel, H1 antagonists (eg, astemizole, terfenadine), ibutilide, sulfonylureas (eg, tolazamide, glipizide), sympathomimetics (eg, phenylephrine, pseudoephedrine), or tramadol because the risk of their side effects may be increased by Zonalon Cream Clonidine, guanadrel, guanethidine, or guanfacine because their effectiveness may be decreased by Zonalon Cream Linezolid, MAOIs (eg, furazolidone, phenelzine, isocarboxazid), or methylene blue because severe toxic effects may occur

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

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

Zonalon Cream is for external use only. Wash and completely dry the affected area. Apply a thin film to the affected area and gently rub it in. Wash your hands immediately after using Zonalon Cream, unless they are part of the treated area. Do not bandage or otherwise cover the treated area unless directed to do so by your doctor. Avoid tight-fitting clothes on the treated area. If you miss a dose of Zonalon Cream, 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.

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

Important safety information: Zonalon Cream may cause drowsiness. This effect may be worse if you take it with alcohol or certain medicines. Use Zonalon Cream with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Zonalon Cream will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants. Limit your alcohol consumption while taking Zonalon Cream. Avoid getting Zonalon Cream in your eyes or on the inside of your nose or mouth. Use Zonalon Cream with caution in the ELDERLY; they may be more sensitive to its effects, especially drowsiness and confusion. Zonalon Cream 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 Zonalon Cream while you are pregnant. It is not known if Zonalon Cream is found in breast milk. Do not breast-feed while taking Zonalon Cream. Possible side effects of Zonalon Cream:

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:

Abnormal skin sensations; burning and stinging at the application site; changes in emotions; confusion; dizziness; drowsiness; dry and tight skin; dry mouth and lips; fatigue; headache; itching; swelling; taste changes; thirst.

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); blurred vision; rapid or pounding heartbeat; severe burning and stinging at the application site.

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: Zonalon 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. Zonalon Cream may be harmful if swallowed.

Proper storage of Zonalon Cream:

Store Zonalon Cream 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 Zonalon Cream out of the reach of children and away from pets.

General information: If you have any questions about Zonalon Cream, please talk with your doctor, pharmacist, or other health care provider. Zonalon 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 Zonalon 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 Zonalon resources Zonalon Side Effects (in more detail)Zonalon Use in Pregnancy & BreastfeedingZonalon Drug InteractionsZonalon Support Group0 Reviews for Zonalon - Add your own review/rating Compare Zonalon with other medications Atopic DermatitisDermatitisEczemaLichen Simplex ChronicusPruritus
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Midodrine


Pronunciation: MIH-doe-DREEN
Generic Name: Midodrine
Brand Name: Orvaten and ProAmatine

Midodrine may cause a significant increase in blood pressure when lying down. It should be used only in patients whose lives are significantly affected even after using standard treatments. Your blood pressure will be monitored carefully during treatment. Benefits of Midodrine have not been confirmed.


Midodrine is used for:

Treating dizziness that occurs upon sitting up or standing (orthostatic hypotension).

Midodrine is an alpha-agonist. It works by causing blood vessels to constrict (become smaller), which helps to increase blood pressure.

Do NOT use Midodrine if: you are allergic to any ingredient in Midodrine you have severe heart disease, active kidney disease, an adrenal gland tumor (pheochromocytoma), or high thyroid hormone blood levels (thyrotoxicosis), or you are unable to urinate you have persistent or severe high blood pressure while lying down

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

Before using Midodrine:

Some medical conditions may interact with Midodrine. 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 diabetes; high blood pressure; difficulty urinating; liver, kidney, heart, or vision problems; or an overactive thyroid

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

Alpha-blockers (eg, prazosin) because the effectiveness of Midodrine may be decreased Antiarrhythmics (eg, flecainide, procainamide, quinidine), antipsychotics (eg, aripiprazole), beta-blockers (eg, propranolol), cardiac glycosides (eg, digoxin), cimetidine, ergotamine derivatives (eg, dihydroergotamine), fludrocortisone, metformin, ranitidine, sympathomimetics (eg, ephedrine, phenylephrine, pseudoephedrine), or triamterene because the risk of side effects may be increased

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

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

Midodrine may be taken with or without food. Midodrine should be taken during the day when you need to be in an upright position and pursuing activities of daily life. Follow the dosing schedule provided by your doctor carefully. Do not take Midodrine after your evening meal or less than 4 hours before bedtime, unless otherwise directed by your doctor. If you miss a dose of Midodrine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Important safety information: Midodrine may cause drowsiness, dizziness, or fainting. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Midodrine. Using Midodrine alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks. Measure your blood pressure regularly according to your doctor's directions. Avoid using nonprescription medicines that contain stimulants, such as products for dieting (appetite suppressants) or cold symptoms (eg, pseudoephedrine) while you are using Midodrine. LAB TESTS, including kidney and liver function and blood pressure, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments. Use Midodrine with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Midodrine during pregnancy. It is unknown if Midodrine is excreted in breast milk. If you are or will be breast-feeding while you are using Midodrine, check with your doctor or pharmacist to discuss the risks to your baby. Possible side effects of Midodrine:

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:

Abnormal skin sensations or itching, especially of the scalp; chills; goosebumps; increased or frequent urination.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion or abnormal thinking; decreased urination; fainting; headache; increased or unusual dizziness; pounding in the ears or the chest; slow pulse; vision changes.

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

See also: Midodrine 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 feeling cold; inability to urinate; severe or persistent dizziness or headache; slow heartbeat.

Proper storage of Midodrine:

Store Midodrine 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 Midodrine out of the reach of children and away from pets.

General information: If you have any questions about Midodrine, please talk with your doctor, pharmacist, or other health care provider. Midodrine 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 Midodrine. 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 Midodrine resources Midodrine Side Effects (in more detail) Midodrine Use in Pregnancy & Breastfeeding Drug Images Midodrine Drug Interactions Midodrine Support Group 10 Reviews for Midodrine - Add your own review/rating Midodrine Prescribing Information (FDA) midodrine Advanced Consumer (Micromedex) - Includes Dosage Information midodrine Concise Consumer Information (Cerner Multum) Midodrine Hydrochloride Monograph (AHFS DI) ProAmatine Prescribing Information (FDA) Compare Midodrine with other medications Dysautonomia Hypotension Postural Orthostatic Tachycardia Syndrome
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Multaq


Generic Name: dronedarone (Oral route)

droe-NE-da-rone

Oral route(Tablet)

Dronedarone doubles the risk of death in patients with symptomatic heart failure and recent decompensation requiring hospitalization or NYHA Class IV heart failure. Use in these patients is contraindicated. In patients with permanent atrial fibrillation, dronedarone hydrochloride doubles the risk of death, stroke, and hospitalization for heart failure. Dronedarone hydrochloride is contraindicated in patients in atrial fibrillation (AF) who will not or cannot be cardioverted into normal sinus rhythm .

Commonly used brand name(s)

In the U.S.

Multaq

Available Dosage Forms:

Tablet

Therapeutic Class: Antiarrhythmic

Chemical Class: Benzofuran

Uses For Multaq

Dronedarone is used to lower the chance of going to the hospital for serious heart rhythm problems in patients with a history of paroxysmal or persistent atrial fibrillation. Dronedarone belongs to the group of medicines known as antiarrhythmics. It works directly on the heart tissue and will slow the nerve impulses in the heart. This helps keep the heart rhythm normal.

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

Before Using Multaq

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

Allergies

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

Pediatric

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

Geriatric

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

Pregnancy Pregnancy Category Explanation All Trimesters X Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit. Breast Feeding

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

Interactions with Medicines

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

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

Alfuzosin Amiodarone Amitriptyline Amoxapine Apomorphine Arsenic Trioxide Asenapine Astemizole Atazanavir Azithromycin Chloroquine Chlorpromazine Ciprofloxacin Cisapride Citalopram Clarithromycin Clomipramine Clozapine Crizotinib Cyclosporine Dasatinib Desipramine Disopyramide Dofetilide Dolasetron Doxepin Droperidol Erythromycin Flecainide Fluconazole Fluphenazine Gatifloxacin Gemifloxacin Granisetron Halofantrine Haloperidol Ibutilide Iloperidone Imipramine Indinavir Itraconazole Ketoconazole Lapatinib Levofloxacin Lidocaine Lumefantrine Mefloquine Mesoridazine Methadone Mexiletine Moxifloxacin Nefazodone Nelfinavir Nilotinib Norfloxacin Nortriptyline Octreotide Ofloxacin Ondansetron Paliperidone Pazopanib Perflutren Lipid Microsphere Perphenazine Pimozide Posaconazole Procainamide Prochlorperazine Promethazine Propafenone Protriptyline Quetiapine Quinidine Quinine Ranolazine Ritonavir Salmeterol Saquinavir Sodium Phosphate Solifenacin Sorafenib Sotalol Sparfloxacin Sunitinib Telavancin Telithromycin Terfenadine Tetrabenazine Thioridazine Toremifene Trazodone Trifluoperazine Trimipramine Vandetanib Vardenafil Vemurafenib Voriconazole Ziprasidone

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.

Acebutolol Alprenolol Arotinolol Atenolol Befunolol Betaxolol Bevantolol Bisoprolol Bopindolol Bucindolol Bupranolol Carbamazepine Carteolol Carvedilol Celiprolol Dabigatran Etexilate Digoxin Dilevalol Diltiazem Esmolol Labetalol Landiolol Levobetaxolol Levobunolol Mepindolol Metipranolol Metoprolol Nadolol Nebivolol Nipradilol Oxprenolol Penbutolol Phenobarbital Phenytoin Pindolol Propranolol Rifampin Sirolimus Sotalol St John's Wort Talinolol Tertatolol Timolol Verapamil Warfarin

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

Simvastatin Interactions with Food/Tobacco/Alcohol

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

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

Grapefruit Juice 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:

AV block (type of abnormal heart rhythm), with no pacemaker or Bradycardia (slow heartbeat) or Heart failure, recent or history of or Heart rhythm problems (e.g., prolonged QT or PR interval) or Liver disease, severe or Permanent atrial fibrillation (type of abnormal heart rhythm) or Sick sinus syndrome (type of abnormal heart rhythm), with no pacemaker—Should not be used in patients with these conditions. Hypokalemia (low potassium in the blood) or Hypomagnesemia (low magnesium in the blood)—Use with caution. May make these conditions worse. Proper Use of Multaq

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

This medicine should come with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

This medicine should be taken with food.

Dosing

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

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

For oral dosage form (tablets): For heart rhythm problems: Adults—400 milligrams (mg) two times per day, given as one tablet in the morning and evening. Children—Use and dose must be determined by your doctor. Missed Dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

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

Precautions While Using Multaq

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

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

Do not use this medicine if you are also using any of these medications: cyclosporine (Gengraf®, Neoral®, Sandimmune®), ritonavir (Norvir®), medicine for depression (such as amitriptyline, nefazodone, nortriptyline, Elavil®, Pamelor®, Serzone®, or Vivactil®), medicine for heart rhythm problems (such as amiodarone, disopyramide, dofetilide, flecainide, propafenone, quinidine, sotalol, Cardioquin®, Cordarone®, Norpace®, Rhythmol®, or Tikosyn®), medicine for infections (such as clarithromycin, erythromycin, itraconazole, ketoconazole, telithromycin, voriconazole, Biaxin®, Ery-tab®, Ketek®, Nizoral®, Sporanox®, or Vfend®), or a phenothiazine medicine (such as chlorpromazine, prochlorperazine, promethazine, thioridazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, or Trilafon®). Using these medicines together may cause serious side effects.

Stop using this medicine and check with your doctor right away if you develop any of the following: chest pain; shortness of breath; swelling of your hands, ankles, or feet; or weight gain. These may be symptoms of heart failure.

This medicine can cause changes in your heart rhythm, such as a condition called QT prolongation. It may cause fainting or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats.

This medicine may cause serious liver problems. Stop using this medicine and check with your doctor right away if you are having more than one of these symptoms: abdominal or stomach pain or tenderness; light-colored stools; dark urine; decreased or loss of appetite; fever; itching; nausea and vomiting; skin rash; unusual tiredness or weakness; or yellow eyes or skin.

This medicine may increase risk for heart attack, stroke, or other serious side effects. Talk to your doctor about whether you should continue to take this medicine for paroxysmal or persistent atrial fibrillation.

Do not stop taking this medicine without first checking with your doctor.

Grapefruits and grapefruit juice may increase the side effects from dronedarone by increasing the amount of this medicine in your body. You should not eat grapefruit or drink grapefruit juice while you are using this medicine.

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

Multaq Side Effects

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

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

Less common Chest pain or discomfort lightheadedness, dizziness, or fainting shortness of breath slow or irregular heartbeat unusual tiredness Incidence not known Abdominal or stomach pain, severe chills cough dark urine fever general feeling of discomfort or illness loss of appetite nausea or vomiting thickening of bronchial secretions unusual tiredness or weakness yellow eyes or skin

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

More common Diarrhea lack or loss of strength Less common Acid or sour stomach belching blistering, crusting, irritation, itching, or reddening of the skin cracked, dry, or scaly skin heartburn indigestion itching skin rash redness or discoloration of the skin skin rash, encrusted, scaly, and oozing skin rash, hives, itching, or redness stomach discomfort, upset, or pain swelling Rare Change in taste increased sensitivity of the skin to sunlight loss of taste severe sunburn

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

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

See also: Multaq 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 Multaq resources Multaq Side Effects (in more detail) Multaq Use in Pregnancy & Breastfeeding Drug Images Multaq Drug Interactions Multaq Support Group 11 Reviews for Multaq - Add your own review/rating Multaq Prescribing Information (FDA) Multaq Consumer Overview Multaq Monograph (AHFS DI) Multaq MedFacts Consumer Leaflet (Wolters Kluwer) Dronedarone Professional Patient Advice (Wolters Kluwer) Compare Multaq with other medications Atrial Fibrillation Atrial Flutter
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Granisetron


Pronunciation: gra-NIS-e-tron
Generic Name: Granisetron
Brand Name: Sancuso
Granisetron is used for:

Preventing nausea and vomiting caused by cancer chemotherapy. It may also be used for other conditions as determined by your doctor.

Granisetron is a 5-HT3 receptor antagonist. It works by blocking a chemical called serotonin that can cause vomiting.

Do NOT use Granisetron if: you are allergic to any ingredient in Granisetron you are taking apomorphine

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

Before using Granisetron:

Some medical conditions may interact with Granisetron. 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 are allergic to other 5-HT3 receptor antagonists (eg, ondansetron) if you have heart problems (eg, irregular heartbeat, conduction problems), blood electrolyte problems (eg, low calcium, potassium, or magnesium), an abnormal electrocardiogram (ECG), or you are receiving chemotherapy that may cause heart problems if you have stomach or bowel problems (eg, pain, swelling) or if you have recently had stomach surgery

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

Apomorphine because the risk of side effects, such as severely low blood pressure or loss of consciousness, may occur Medicines that may affect your heartbeat such as antiarrhythmics (eg, flecainide, sotalol), azole antifungals (eg, ketoconazole), or quinolones (eg, ciprofloxacin) because heart rhythm problems may occur. Ask your doctor if you are unsure if any medicines that you take may affect your heartbeat

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

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

An extra patient leaflet is available with Granisetron. Talk to your pharmacist if you have questions about this information. Apply Granisetron 24 to 48 hours before your chemotherapy treatment, or as directed by your doctor. Granisetron should be applied to clean, healthy skin on the upper arm. Do not apply to cut, scraped, or irritated skin. Do not use creams, oils, lotions, powders, or any other products that could irritate the skin or prevent the patch from sticking well. To apply Granisetron, remove the patch from the sealed pouch. Do not cut or damage the patch. Remove the thin, clear, protective liner. Bend the patch in the middle and remove one-half of the rigid plastic film. Apply the exposed, sticky area of the patch to your skin. Remove the other half of the rigid plastic film and press the whole patch firmly in place against the skin. If the patch does not stick well, you may tape the edges with surgical bandages or medical adhesive tape. Do not completely cover the patch with bandages or tape. Do not wrap completely around your arm. Ask your health care provider if you are unsure of what type of dressing you can use. Wash your hands immediately after using Granisetron. You may shower or bathe normally while wearing the patch. You should avoid activities such as swimming, strenuous exercise, or using a sauna or whirlpool. It is unknown how these activities may affect Granisetron. Continue to wear the patch during your chemotherapy and for at least 24 hours after your treatment is completed. Granisetron may be worn for up to 7 days or as directed by your doctor. To remove the patch, gently peel it off of your skin and fold the sticky side together. Throw the used patch in the trash away from children and pets. Wash your hands after handling the patch. Gently wash the skin with soap and water where the patch was applied. If you miss a dose of Granisetron, contact your doctor immediately.

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

Important safety information: Granisetron may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Granisetron with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do not expose Granisetron to the sun, sunlamps, or tanning booths while you wear it. It might not work as well and could cause skin irritation. Keep the patch covered with clothing if you will be in sunlight or near a sunlamp or tanning bed. You will also need to cover the skin where the patch was applied for an additional 10 days after you remove the patch to protect it from exposure to direct sunlight. Tell your doctor right away if you experience skin irritation (eg, bumps, blisters, itching, redness, or rash) at the application site or on other areas of the body. Granisetron should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Granisetron while you are pregnant. It is not known if Granisetron is found in breast milk. If you are or will be breast-feeding while you are using Granisetron, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Granisetron:

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:

Anxiety; constipation; diarrhea; dizziness; drowsiness; headache; nausea; trouble sleeping; vomiting; weakness.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fainting; fast or irregular heartbeat; fever, chills, or sore throat; severe or persistent skin irritation (eg, redness, rash, bumps, blisters, or itching); stomach pain or swelling; unusual muscle movement.

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: Granisetron 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 headache.

Proper storage of Granisetron:

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

General information: If you have any questions about Granisetron, please talk with your doctor, pharmacist, or other health care provider. Granisetron 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 Granisetron. 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 Granisetron resources Granisetron Side Effects (in more detail) Granisetron Use in Pregnancy & Breastfeeding Drug Images Granisetron Drug Interactions Granisetron Support Group 6 Reviews for Granisetron - Add your own review/rating Compare Granisetron with other medications Nausea/Vomiting, Chemotherapy Induced Nausea/Vomiting, Postoperative Nausea/Vomiting, Radiation Induced
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Anzemet Tablets


Pronunciation: doe-LAS-e-tron
Generic Name: Dolasetron
Brand Name: Anzemet
Anzemet is used for:

Preventing nausea and vomiting associated with cancer chemotherapy. It may also be used to prevent nausea and vomiting after surgery.

Anzemet is a serotonin 5-HT3 receptor blocker. It works by blocking a substance thought to be a cause of nausea and vomiting in certain situations.

Do NOT use Anzemet if: you are allergic to any ingredient in Anzemet you have a certain type of irregular heartbeat (congenital long QT syndrome), or uncorrected low blood potassium or magnesium levels you have or are at risk of complete heart block and do not have a pacemaker you are taking apomorphine or nilotinib

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

Before using Anzemet:

Some medical conditions may interact with Anzemet. 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 problems (eg, slow or irregular heartbeat, sick sinus syndrome, heart attack, heart failure), kidney problems, or low potassium or magnesium levels in the blood if you are taking medicines that may cause a certain type of irregular heartbeat (eg, flecainide, verapamil, quinidine)

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

Anthracyclines (eg, doxorubicin), antiarrhythmics (eg, amiodarone, dofetilide, sotalol), arsenic, astemizole, bepridil, chloroquine, cimetidine, cisapride, diuretics (eg, furosemide), domperidone, droperidol, halofantrine, haloperidol, histone deacetylase inhibitors (eg, romidepsin), iloperidone, ketolides (eg, telithromycin), macrolides (eg, erythromycin), maprotiline, methadone, nilotinib, paliperidone, pentamidine, phenothiazines (eg, thioridazine), pimozide, quinolones (eg, levofloxacin), streptogramins (eg, quinupristin/dalfopristin), terfenadine, tetrabenazine, tricyclic antidepressants (eg, nortriptyline), tyrosine kinase inhibitors (eg, sunitinib), or ziprasidone because the risk of irregular heart rhythm is increased Apomorphine because the risk of severe low blood pressure or loss of consciousness may be increased Rifampin because it may decrease Anzemet's effectiveness

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

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

Take Anzemet by mouth with or without food. Take your dose of Anzemet as directed before the start of your cancer treatment or surgery. Swallow Anzemet whole. Do not break, crush, or chew before swallowing. Crushing or chewing the tablets may lead to increased side effects or decreased effectiveness, and the tablets will have a bitter, unpleasant taste. If you miss a dose of Anzemet, contact your doctor right away.

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

Important safety information: Anzemet may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Anzemet with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Anzemet may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. Do NOT take more than the recommended dose of Anzemet without checking with your doctor. If you are taking Anzemet to prevent nausea and vomiting associated with cancer chemotherapy, take Anzemet only on the days that you take your cancer treatment unless otherwise directed by your doctor. If you continue to experience moderate to severe vomiting while taking Anzemet, check with your doctor. Tell your doctor or dentist that you take Anzemet before you receive any medical or dental care, emergency care, or surgery. Lab tests, including electrocardiograms (ECGs) and blood potassium or magnesium levels, may be performed while you use Anzemet. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Use Anzemet with caution in the ELDERLY; they may be more sensitive to its effects, especially irregular heartbeat. Do not give Anzemet to CHILDREN who are unable to swallow tablets. Anzemet should be used with extreme caution in CHILDREN younger than 2 years; safety and effectiveness in these children have not been confirmed. Caution is advised when using Anzemet in CHILDREN; they may be more sensitive to its effects. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Anzemet while you are pregnant. It is not known if Anzemet is found in breast milk. If you are or will be breast-feeding while you use Anzemet, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Anzemet:

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:

Chills; diarrhea; dizziness; headache; indigestion; tiredness.

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); change in heartbeat (including fast, slow, or irregular heartbeat); chest pain; fainting; lightheadedness; numbness or pain of an arm or leg; pounding in the chest; shortness of breath; sudden, severe headache, stomach pain, dizziness, or vomiting; sudden vision changes; urination problems.

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: Anzemet 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; irregular heartbeat; severe dizziness.

Proper storage of Anzemet:

Store Anzemet 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 Anzemet out of the reach of children and away from pets.

General information: If you have any questions about Anzemet, please talk with your doctor, pharmacist, or other health care provider. Anzemet 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 Anzemet. 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 Anzemet resources Anzemet Side Effects (in more detail)Anzemet DosageAnzemet Use in Pregnancy & BreastfeedingDrug ImagesAnzemet Drug InteractionsAnzemet Support Group0 Reviews for Anzemet - Add your own review/rating Compare Anzemet with other medications Nausea/Vomiting, Chemotherapy InducedNausea/Vomiting, Postoperative
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Carteolol Drops


Pronunciation: KAR-tee-oh-lole
Generic Name: Carteolol
Brand Name: Generic only. No brands available.
Carteolol Drops are used for:

Lowering eye pressure and treating glaucoma. It may also be used for other conditions as determined by your doctor.

Carteolol Drops are an ophthalmic beta-blocker. It is unknown exactly how Carteolol Drops works to reduce the fluid pressure inside the eye, but it appears to reduce the amount of liquid produced.

Do NOT use Carteolol Drops if: you are allergic to any ingredient in Carteolol Drops you have severe chronic obstructive pulmonary disease (COPD), heart failure, complete or second-degree heart block, heart shock, a resting heart rate less than 60 beats/min, or a heart rate less than 45 beats/min after a heart attack you have a history of asthma

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

Before using Carteolol Drops:

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 had an allergic reaction to other beta-blockers (eg, propranolol) if you have bronchitis, breathing or lung problems, COPD, diabetes, first-degree heart block, an overactive thyroid, low blood sugar levels, blood flow or blood vessel problems, or a history of heart failure

Some MEDICINES MAY INTERACT with Carteolol Drops. Tell your health care provider if you are taking any of the following medicines.

Beta-blockers (eg, propranolol), bupivacaine, calcium channel blockers (eg, diltiazem), catecholamine-depleting agents (eg, reserpine), digoxin, disopyramide, flecainide, insulin, ketanserin, phenothiazines (eg, chlorpromazine), quinazolines (eg, alfuzosin), or verapamil because their actions and side effects may increased by Carteolol Drops Clonidine because when given with Carteolol Drops, if it is suddenly stopped, it may cause rebound high blood pressure

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

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

Carteolol Drops contains benzalkonium chloride, a preservative that may be absorbed by soft contact lenses. Contact lenses should be removed before using Carteolol Drops. Ask your doctor or pharmacist how long you should wait before putting your contacts back in after you use Carteolol Drops. Shake well before using. To use Carteolol Drops, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye (unless you recently had eye surgery) and continue to apply pressure for 1 or 2 minutes after using the medicine. Do not blink. Keep your eyes closed for 1 or 2 minutes. Remove excess medicine around your eye with a clean tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them. To prevent germs from entering your medicine, do not touch the dropper tip to any surface, including your eye. Keep the container tightly closed. Continue to use Carteolol Drops even if you feel well. Do not miss any doses. If you miss a dose of Carteolol Drops, 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 Carteolol Drops.

Important safety information: Carteolol Drops may cause blurred vision, decreased night vision, sensitivity to light, and, infrequently, drowsiness or dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Carteolol Drops. Using Carteolol Drops alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Carteolol Drops. Diabetes patients - Carteolol Drops can hide signs of low blood sugar (such as a rapid heart rate) and change blood sugar levels. Your health care provider may need to change the amount of diabetes medicines you are taking. LAB TESTS, including checking for intraocular pressure, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments. Use Carteolol Drops with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed. PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Carteolol Drops during pregnancy. It is unknown if Carteolol Drops are excreted in breast milk. If you are or will be breast-feeding while you are taking Carteolol Drops check with your doctor to discuss the benefits and risks to your baby. Possible side effects of Carteolol Drops:

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:

Blurred vision; increased tear production; sensitivity to light; temporary burning or stinging.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); changes in heart rate; chest pain; eye or eyelid swelling or irritation; headache; muscle weakness; one-sided weakness; shortness of breath; slow or irregular heartbeat; slurred speech; swelling of the hands, ankles, or feet; vision changes.

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

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 dizziness; fainting; slow heartbeat. Carteolol Drops may be harmful if swallowed.

Proper storage of Carteolol Drops:

Store Carteolol Drops upright at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Carteolol Drops out of the reach of children and away from pets.

General information: If you have any questions about Carteolol Drops, please talk with your doctor, pharmacist, or other health care provider. Carteolol Drops 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 Carteolol Drops. 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 Carteolol resources Carteolol Use in Pregnancy & Breastfeeding Carteolol Drug Interactions Carteolol Support Group 0 Reviews for Carteolol - Add your own review/rating Compare Carteolol with other medications Glaucoma, Open Angle Intraocular Hypertension
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Lamisil


Generic Name: terbinafine (ter BIN na feen)
Brand Names: LamISIL

What is terbinafine?

Terbinafine is an antifungal antibiotic.

Terbinafine is used to treat infections caused by fungus that affect the fingernails or toenails. Terbinafine oral granules are used to treat a fungal infection of scalp hair follicles in children who are at least 4 years old.

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

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

Before using terbinafine, tell your doctor if you have liver or kidney disease, or an autoimmune disorder such as lupus or psoriasis.

Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Terbinafine will not treat a viral infection such as the common cold or flu. Some people taking terbinafine have developed severe liver damage leading to liver transplant or death. It is not clear whether terbinafine actually caused the liver damage in these patients. In most cases, the patient had a serious medical condition before taking terbinafine.

Call your doctor at once if you have symptoms of liver damage, such as nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes). These events can occur whether or not you have ever had liver problems before.

To be sure this medicine is not causing harmful effects, your blood may need to be tested often. Your liver function may also need to be tested. Visit your doctor regularly.

It may take several months for your nails to return to their normal appearance after your treatment with terbinafine.

What should I discuss with my healthcare provider before taking terbinafine? You should not use this medication if you are allergic to terbinafine.

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

liver disease; kidney disease;

a history of depression; or

an autoimmune disorder such as lupus or psoriasis.

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

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

Take the terbinafine tablet with a full glass (8 ounces) of water.

Terbinafine granules should be sprinkled into a spoonful of pudding or mashed potatoes (do not mix with applesauce, fruit juice, or other acidic foods). Swallow this mixture right away without chewing. Do not save the mixture for later use.

The terbinafine granule mixture should be taken with a meal.

Terbinafine is usually taken for 6 to 12 weeks.

Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Terbinafine will not treat a viral infection such as the common cold or flu.

To be sure this medicine is not causing harmful effects, your blood may need to be tested often. Your liver function may also need to be tested. Visit your doctor regularly.

It may take several months for your nails to return to their normal appearance after your treatment with terbinafine.

Store at room temperature away from moisture, heat, and light.

Keep the terbinafine oral granules in their sealed packet until you are ready to use.

See also: Lamisil dosage (in more detail)

What happens if I miss a dose?

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

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

Overdose symptoms may include dizziness, stomach pain, nausea, vomiting, skin rash, or urinating more than usual.

What should I avoid while taking terbinafine? Avoid coffee, tea, cola, energy drinks or other sources of caffeine while taking this medication. Avoid exposure to sunlight or tanning beds. Lamivudine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Terbinafine 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.

Some people taking terbinafine have developed severe liver damage leading to liver transplant or death. It is not clear whether terbinafine actually caused the liver damage in these patients. In most cases, the patient had a serious medical condition before taking terbinafine.

Call your doctor at once if you have symptoms of liver damage, such as nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes). These events can occur whether or not you have ever had liver problems before.

Stop taking terbinafine and call your doctor at once if you have a serious side effect such as:

fever, chills, body aches, flu symptoms, sores in your mouth and throat;

joint pain or swelling, swollen glands, patchy skin color, or a butterfly-shaped skin rash over your cheeks and nose;

changes in mood or behavior;

weight loss due to taste changes;

raised, silvery flaking of the skin; or

severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

upset stomach, gas, diarrhea, mild nausea or stomach pain;

headache;

mild skin rash or itching; or

unusual or unpleasant taste in your mouth.

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 terbinafine?

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

cimetidine (Tagamet, Tagamet HB);

cyclosporine (Gengraf, Neoral, Sandimmune);

rifampin (Rifater, Rifadin, Rimactane, Rifamate);

another antifungal medicine, such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);

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

a heart rhythm medication such as amiodarone (Cordarone, Pacerone), propafenone (Rythmol) or flecainide (Tambocor);

an "SSRI" antidepressant such as fluoxetine (Prozac), fluvoxamine (Luvox), or paroxetine (Paxil);

a tricyclic antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), imipramine (Janimine, Tofranil), and others;

an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate); or

a beta-blocker such as betaxolol (Kerlone), carvedilol (Coreg), labetalol (Normodyne), metoprolol (Dutoprol, Lopressor, Toprol), pindolol (Visken), propranolol (Inderal), or timolol (Blocadren).

This list is not complete and other drugs may interact with terbinafine. 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 Lamisil resources Lamisil Side Effects (in more detail) Lamisil Dosage Lamisil Use in Pregnancy & Breastfeeding Drug Images Lamisil Drug Interactions Lamisil Support Group 23 Reviews for Lamisil - Add your own review/rating Lamisil Prescribing Information (FDA) Lamisil Consumer Overview Lamisil Monograph (AHFS DI) Lamisil MedFacts Consumer Leaflet (Wolters Kluwer) Lamisil Advanced Consumer (Micromedex) - Includes Dosage Information Terbinafine Prescribing Information (FDA) Terbinafine Professional Patient Advice (Wolters Kluwer) Compare Lamisil with other medications Cutaneous Candidiasis Onychomycosis, Fingernail Onychomycosis, Toenail Tinea Capitis Tinea Corporis Tinea Cruris Tinea Pedis Where can I get more information? Your pharmacist can provide more information about terbinafine.

See also: Lamisil side effects (in more detail)


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Verapamil Sustained-Release Tablets (Controlled Onset)


Pronunciation: ver-AP-a-mil
Generic Name: Verapamil
Brand Name: Covera-HS
Verapamil Sustained-Release Tablets (Controlled Onset) are used for:

Treating high blood pressure and chest pain. It may be used alone or with other medicines. It may also be used for certain conditions as determined by your doctor.

Verapamil Sustained-Release Tablets (Controlled Onset) are a calcium channel blocker. It works by relaxing (dilating) your blood vessels, lowering blood pressure, and decreasing heart rate, which lowers the workload on the heart. It also dilates coronary arteries, which increases blood flow to the heart.

Do NOT use Verapamil Sustained-Release Tablets (Controlled Onset) if: you are allergic to any ingredient in Verapamil Sustained-Release Tablets (Controlled Onset) you have certain heart problems (eg, left ventricular dysfunction, sick sinus syndrome, second- or third-degree heart block and do not have a pacemaker), very low blood pressure, or moderate to severe congestive heart failure (CHF) you have atrial fibrillation or flutter and a pre-excitation syndrome (extra conduction pathway in the heart), such as Wolff-Parkinson-White (WPW) syndrome or Lown-Ganong-Levine (LGL) syndrome you have shock caused by serious heart problems you are taking dofetilide, or you have taken disopyramide within the past 48 hours

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

Before using Verapamil Sustained-Release Tablets (Controlled Onset):

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

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have heart failure or a recent heart attack with lung congestion, low blood pressure, or heart problems (eg, a very slow heart rate, heart block, heart valve disease) if you have kidney or liver problems, muscular dystrophy, or a neuromuscular disease if you are taking another blood pressure medicine or you are being treated for cancer

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

Beta-blockers (eg, propranolol), clonidine, disopyramide, ketolides (eg, telithromycin), macrolides (eg, erythromycin), or ritonavir because they may increase the risk of Verapamil Sustained-Release Tablets (Controlled Onset)'s side effects Phenobarbital, rifampin, or St. John's wort because they may decrease Verapamil Sustained-Release Tablets (Controlled Onset)'s effectiveness Aldosterone blockers (eg, eplerenone), aspirin, carbamazepine, colchicine, cyclosporine, digoxin, dofetilide, doxorubicin, dronedarone, eletriptan, erythromycin, everolimus, flecainide, HMG-CoA reductase inhibitors (eg, lovastatin, simvastatin), lithium, narcotic pain relievers (eg, fentanyl), paclitaxel, quinazolines (eg, terazosin), quinidine, ranolazine, theophyllines, or tolvaptan because the risk of their side effects may be increased by Verapamil Sustained-Release Tablets (Controlled Onset)

This may not be a complete list of all interactions that may occur. Ask your health care provider if Verapamil Sustained-Release Tablets (Controlled Onset) 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 Verapamil Sustained-Release Tablets (Controlled Onset):

Use Verapamil Sustained-Release Tablets (Controlled Onset) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take Verapamil Sustained-Release Tablets (Controlled Onset) by mouth with or without food. Check with your doctor before you eat grapefruit or drink grapefruit juice while you use Verapamil Sustained-Release Tablets (Controlled Onset). Swallow Verapamil Sustained-Release Tablets (Controlled Onset) whole. Do not break, crush, or chew before swallowing. If you miss a dose of Verapamil Sustained-Release Tablets (Controlled Onset), take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Verapamil Sustained-Release Tablets (Controlled Onset).

Important safety information: Verapamil Sustained-Release Tablets (Controlled Onset) may cause dizziness or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Verapamil Sustained-Release Tablets (Controlled Onset) with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Verapamil Sustained-Release Tablets (Controlled Onset); it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness. Verapamil Sustained-Release Tablets (Controlled Onset) may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms. Tell your doctor or dentist that you take Verapamil Sustained-Release Tablets (Controlled Onset) before you receive any medical or dental care, emergency care, or surgery. Lab tests, including liver function, kidney function, complete blood cell counts, and blood pressure, may be performed while you use Verapamil Sustained-Release Tablets (Controlled Onset). These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Use Verapamil Sustained-Release Tablets (Controlled Onset) with caution in the ELDERLY; they may be more sensitive to its effects. Verapamil Sustained-Release Tablets (Controlled Onset) 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 Verapamil Sustained-Release Tablets (Controlled Onset) while you are pregnant. Verapamil Sustained-Release Tablets (Controlled Onset) are found in breast milk. If you are or will be breast-feeding while you use Verapamil Sustained-Release Tablets (Controlled Onset), check with your doctor. Discuss any possible risks to your baby. Possible side effects of Verapamil Sustained-Release Tablets (Controlled Onset):

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

Constipation; dizziness; fatigue; headache; lightheadedness; nausea.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fainting; lightheadedness, especially when standing; severe dizziness; shortness of breath; swelling of the feet or hands; symptoms of liver problems (eg, yellowing of the skin or eyes, dark urine, pale stools, severe or persistent stomach pain, fever, general feeling of being unwell); unusually fast, slow, or irregular heartbeat.

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

See also: Verapamil (Controlled Onset) 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 decreased mental status; dizziness; loss of consciousness; shortness of breath; slow or irregular heartbeat.

Proper storage of Verapamil Sustained-Release Tablets (Controlled Onset):

Store Verapamil Sustained-Release Tablets (Controlled Onset) 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 Verapamil Sustained-Release Tablets (Controlled Onset) out of the reach of children and away from pets.

General information: If you have any questions about Verapamil Sustained-Release Tablets (Controlled Onset), please talk with your doctor, pharmacist, or other health care provider. Verapamil Sustained-Release Tablets (Controlled Onset) 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 Verapamil Sustained-Release Tablets (Controlled Onset). 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 Verapamil Sustained-Release Tablets (Controlled Onset) resources Verapamil Sustained-Release Tablets (Controlled Onset) Side Effects (in more detail)Verapamil Sustained-Release Tablets (Controlled Onset) Use in Pregnancy & BreastfeedingDrug ImagesVerapamil Sustained-Release Tablets (Controlled Onset) Drug InteractionsVerapamil Sustained-Release Tablets (Controlled Onset) Support Group29 Reviews for Verapamil (Controlled Onset) - Add your own review/rating Compare Verapamil Sustained-Release Tablets (Controlled Onset) with other medications AnginaArrhythmiaBipolar DisorderCluster HeadachesHigh Blood PressureIdiopathic Hypertrophic Subaortic StenosisMigraine PreventionNocturnal Leg CrampsSupraventricular Tachycardia
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