Archive for the ‘Drugs C’ Category

Type of Drug
Corticosteroids, Eye Products
(kor-tih-koe-STER-oids)
Brand Names
Dexamethasone Maxidex
Dexamethasone + Ciprofloxacin Ciprodex
Dexamethasone + Tobramycin Tobradex
Dexamethasone + Neomycin Sulfate + Polymixin 8 Sulfate
Maxitrol
Fluorometholone
Flarex    FML Forte
FML
Fluorometholone + Tobramycin Tobrasone
Loteprednol Etabonate Alrex    Lotemax
Generic Ingredients: Loteprednol Etabonate + Tobramycin Zylet
Prednisolone Acetate OG
Econopred Plus    Pred Forte
Omnipred    Pred Mild
Prednisolone Acetate + Gentamicin Sulfate Pred G
Prednisolone Acetate + Sulfacetamide Sodium
Blepharnide    Blephamide S.O.P.
Generic Ingredients: Prednisolone Acetate + Neomycin Sulfate + Polymyxin B Sulfate
Poly-Pred
Prednisolone Sodium Phosphate LQ
Prednisolone Sodium Phosphate + Sulfacetamide Sodium
Vasocidin
Rimexolone Vexol
Prescribed For
Allergic and inflammatory eye conditions, and to speed healing after eye surgery or injury.
General Information
Corticosteroid eye products are prescribed for general relief of inflammation due to allergy and other causes. They are also used after eye surgery or serious eye injury to aid the healing process by reducing the natural inflammatory process. Very severe eye conditions that do not respond to these products may require treatment with corticosteroid drugs taken by mouth. Fluorometholone, medrysone, and prednisolone (up to 0.125%) are preferred for long-term treatment because they are least likely to raise the fluid pressure inside the eye. corticosteroid eye products have not been widely studied in children, though fluorometholone has been proven safe for use in children age 2 and over.
Cautions and Warnings
Do not use a corticosteroid eye product if you are allergic or sensitive to corticosteroids. These products should be used with caution if you have a fungal, herpes, tuberculosis, or viral infection of the eye, or have cataracts, glaucoma, or diabetes. Do not use any of these products without your doctor’s knowledge.
Long-term use of these products can lead to eye damage, including glaucoma, infection, and nerve damage.
Do not use any of these products in children without consultng a doctor.
Possible Side Effects
V Rare: watery eyes; glaucoma; optic nerve damage; gradual blurring, reduction, or loss of vision; eye pain or infections; drooping eyelid; eye burning, stinging, or redness; nausea; and vomiting. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Corticosteroids applied to the eye may interfere with the effect of antiglaucoma drugs.
•    The risk of raising fluid pressure inside the eye is increased when corticosteroid eye products are taken with anticholinergic drugs, especially atropine, over a long period of time.
Food Interactions  None known.
Usual Dose
Eyedrops: 1-2 drops several times a day.
Eye Ointment: Place a thin strip of ointment into the affected eye several times a day.
Overdosage
Swallowing a container of corticosteroid eyedrops or ointment usually does not produce serious effects. Call your local poison center or a hospital emergency room for more information. ALWAYS bring the prescription container.
Special Information
If you forget to administer a dose, do so as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule.
To prevent infection, keep the eyedropper from touching your fingers, eyelids, or any surface. Wait at least 5 minutes before using any other eyedrops.
If the brand you are taking contains benzalkonium chloride, wait at least 15 minutes before inserting contact lenses. In some cases, you may be instructed not to wear contact lenses for the duration of treatment.
Special Populations
Pregnancy/Breast-feeding: Using large amounts of corticosteroid eyedrops during pregnancy may affect the adrenal gland of the fetus. When your doctor considers one of these products crucial, its potential benefits must be carefully weighed against its risks.
Oral corticosteroids pass into breast milk, but it is not known if this is also true of corticosteroid eyedrops. Nursing mothers who must use one of these medications should use infant formula.
Seniors: Seniors may use these products without special precaution.

Type of Drug
corticosteroids, Inhalers
(kor-tih-koe-STER-oids)
Brand Names
Generic Ingredient., Beclomethasone Dipropionate OVAR 40    OVAR 80
Budesonide
Pulmicort Flexhaler    Pulmicort Respules
Generic Ingredients: Budesonide + Formoterol Symbicort
Ciclesonide Alvesco
Flunisolide
AeroBid    Aerospan HFA
Fluticasone Propionate Flovent Diskus    Flovent HFA
Fluticasone Propionate + Salmeterol Xinafoate
Advair Diskus    Advair HFA
Mometasone Furoate Asmanex Twisthaler
Triamcinolone Acetonide Azmacort
Prescribed For
Chronic asthma and bronchial disease.
General Information
Corticosteroid inhalers relieve the symptoms associated with asthma and bronchial disease by reducing inflammation of bronchial mucous membranes, making it easier to breathe. Corticosteroid inhalers produce the same treatment effect as oral corticosteroids, with some important differences. Because inhalers deliver the drug directly to the lungs, smaller dosages can be used. They also have fewer side effects because little of the drug reaches the bloodstream. Corticosteroid inhalers can prevent asthma attacks if used regularly but do not relieve them once they start.
Cautions and Warnings
Do not use a corticosteroid inhaler if you are allergic or sensitive to any of its ingredients.
Corticosteroid inhalers should not be used as the primary treat- MV)~ of severe asthma. They are recommended only for people who take prednisone or another oral corticosteroid, or for people who do not respond to other asthma drugs. These drugs cannot relieve asthma attacks once they start.
In people with asthma, death from adrenal gland failure has occurred during and after switching from an oral corticosteroid to an inhaler. Adrenal function is impaired for several months after the
switch.
Those who use any corticosteroid product, including inhalation, are more likely to have reduced immune system function. This reduces the body’s ability to fight infection from any source, including chicken pox, shingles, and measles. Adults who have not had these viral infections should take care to avoid becoming infected while using any corticosteroid product. Do not receive a live virus vaccine while taking corticosteroids of any kind, as they interfere with the body’s reaction to the vaccine.
Combining an oral corticosteroid with a corticosteroid inhaler may cause pituitary gland suppression.
During a period of severe stress, you may have to switch to an oral corticosteroid if the inhaler does not control your asthma. During periods of stress or a severe asthmatic attack, people who have stopped using an inhaler should ask their doctors about taking an oral corticosteroid.
corticosteroid inhalers may be associated with immediate or delayed drug reactions, including breathing difficulties, rash, and bronchospasm.
Use corticosteroids with caution if you have respiratory tuberculosis, herpes of the eye, a bacterial, fungal, or parasitic infection, or any other untreated systemic infection.
The combination products Advair and Symbicort both contain beta-2 agonists. In some asthma patients, beta-2 agonists may increase the risk of asthma-related death. See Formoterol, page 509, and Salmeterol, page 1013, for more information on these drugs.
Possible Side Effects
V Most common: dry mouth, hoarseness, rash, bronchospasm, respiratory infections, fungal infection of the mouth, runny nose, headache, upset stomach, and palpitations.
V Rare: depression, cough, wheezing, infection, and facial swelling. Cough and wheezing are probably caused by an ingredient in the inhaler other than the corticosteroid itself. GW20 your doctor if you experience any side effect not listed above.
Drug Interactions
• Ketoconazole may increase blood levels of budesonide and fluticasone.
•    Using an inhaled corticosteroid and an oral corticosteroid together may increase the effect of both drugs. Use with
caution.
•    See Formoterol, page 509, for further drug interactions for the
combination product Symbicort.
•    See Salmeterol, page 1013, for further drug interactions for
the combination product Advair. Food Interactions
None known.
Usual Dose
geclomethasone
Adult and Child (age 13 and over): 2 inhalations (84 mcg) 3-4 times a day, or 4 inhalations twice a day. People with severe asthma may take up to 16 inhalations a day.
Child (age 6-12): 1-2 inhalations 3-4 times a day.
Child (under age 6): not recommended.
Budesonide
Adult: starting dose-200-400 mcg (1-2 inhalations) twice a day. Do not exceed 800 mcg a day.
Child (age 6 and over): 200 mcg (1 inhalation) twice a day. Do not exceed 400 mcg a day.
Child (under age 6): not recommended.
Budesonide Respules
Child (age 1-8): 1-2 ml once or twice a day via jet nebulizer connected to an air compressor.
Child (under age 1): consult your doctor.
Budesonide and Formoterol Inhalation
Adult and Child (age 12 and over): 2 inhalations morning and evening.
Child (under age 12): not recommended.
Ciclesonide
Adult and Child (qla 12 and over): 1-2 inhalations once a day. Mlld (under age 12): not recommended.
Flunisolide
Aerobid
Adult and Child (age 16 and over): 2 inhalations (500 mcg) morning and evening. Do not exceed 8 inhalations a day.
Child (age 6-15): 2 inhalations (500 mcg) morning and evening. Do not exceed 4 inhalations a day.
Child (under age 6): not recommended.
Aerospan HFA
Adult and Child (age 12 and over): 160-320 mcg morning and
evening.
Child (age 6-11): 80-160 mcg morning and evening. Child (under age 6): not recommended.
Fluticasone Inhalation
Adult and Child (age 12 and over): 88-660 mcg twice a day. Child (6-12): 88-440 mcg twice a day.
Child (under age 6): not recommended.
Fluticasone Diskus
Adult and Child (age 12 and over): 100-1000 mcg twice a day. Child (age 4-11): 50-100 mcg twice a day.
Child (under age 4): not recommended.
Fluticasone and Salmeterol
Advair Diskus
Adult and Child (age 12 and over): 1 inhalation morning and evening.
Child (under age 12): not recommended.
Advair HFA
Adult and Child (age 12 and over): 2 inhalations morning and evening.
Child (under age 12): not recommended.
Mometasone Furoate
Adult and Child (age 12 and older): 1-4 inhalations a day. If you take this drug only once a day, it should be taken in the afternoon or evening. Otherwise, doses should be divided between the morning and evening.
Child (under age 12): not recommended.
Triamcinolone
AdWAVi6 Child (age 13 and over): 2 inhalations (200 mcg) 3-4 times a day. Do not exceed 16 inhalations a day without your doctor’s knowledge.
Child (age 6-12): 1-2 inhalations (100-200 mcg) 3-4 times a day. Do not exceed 12 inhalations a day.
Child (under age 6): not recommended.
Overdosage
Serious adverse effects are unlikely. Excessive use of large amounts of an inhaled corticosteroid may cause overdose symptoms and require gradually stopping the drug. Call your local poison control center or a hospital emergency room for more information.
Special Information      People using both a corticosteroid inhaler and a bronchodilator, such as albuterol, should use the bronchodilator first, wait a few minutes, and then use the corticosteroid inhaler. This allows more corticosteroid to be absorbed.
These drugs are for preventive therapy only and will not affect an asthma attack. Inhaled corticosteroids must be taken regularly, as directed. Wait at least 1 minute between inhalations.
To properly take this medication, thoroughly shake the inhaler if it is one that must be shaken. Take a drink of water to moisten your throat. Place the inhaler 2 finger-widths away from your mouth and tilt your head back slightly. While activating the inhaler, take a slow, deep breath for 3-5 seconds. then hold your breath for about 10 seconds, and finally breathe out slowly. Allow at least 1 minute between puffs. Rinse your mouth after each use to reduce dry mouth and hoarseness.
If you forget to administer a dose, do so as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose. Tell your doctor or pharmacist if you forget to take more than 1 dose.
Special Populations
Pregnancy/Breast-feeding: corticosteroids may cause birth defects or interfere with fetal development. When any of these drugs is considered crucial by your doctor, its potential benefits Must be carefully weighed against its risks.
It is not known if inhaled corticosteroids pass into breast milk, though oral corticosteroids do. Nursing mothers who must take an inhaled corticosteroid should use infant formula.
StniOrs: Seniors may use corticosteroid inhalers without special restriction. Tell your doctor if you have bone or bowel disease, colitis, diabetes, glaucoma, fungal or herpes infections, high blood pressure, high blood cholesterol, an underactive thyroid, or heart, kidney, or liver disease.

Type of Drug
Corticosteroids, Nasal
(kor-tih-koe-STER-oids)
Brand Names
Wectomethasone Dipropionate Beconase AQ
Budesonide Rhinocort
Ciclesonide Omnaris
Flunisolide RE Nasarel
Fluticasone Furoate Veramyst
Fluticasone Propionate Flonase
Mometasone Furoate Monohydrate Nasonex
Triamcinolone Acetonide Nasacort AQ
Prescribed For
Rhinitis (nasal inflammation) associated with seasonal or chronic allergy and other causes; also used to prevent recurrence of nasal polyps.
General Information
Nasal corticosteroids are used to treat severe symptoms of seasonal allergy that have not mSpDrided to other drugs such as deQQQgtS%TAS. ‘They work by reducing inflammation of the mucous membranes that line the nasal passages, making it easier to breathe. These drugs may take several days to produce an effect. Some nasal corticosteroids are approved for both allergic and non-allergic rhinitis.
Cautions and Warnings    __  allergic or sensitive Do not use a nasal corticosteroid if you ate alle
to corticosteroids. Rarely, serious and life-threatening drug-sensitivity reactions have occurred.
very rarely, deaths caused by failure of the adrenal gland have occurred in people taking adrenal corticosteroid tablets or syrup who were switched to a nasal corticosteroid. This is a rare complication and usually results from stopping the liquid or tablets suddenly instead of gradually.
Combining prednisone or another oral corticosteroid with a nasal corticosteroid may cause pituitary gland suppression, although nasal corticosteroids alone rarely cause this problem.
Use nasal corticosteroids with caution if you have tuberculosis, chicken pox, measles, shingles, or any serious fungal, bacterial, or viral infection.
Do not receive a live virus vaccine while taking corticosteroids of any kind, as they interfere with the body’s reaction to the vaccine.
Rarely, nasal Candida infections develop in people using a nasal corticosteroid. These infections may require treatment with an antifungal drug, as well as the discontinuance of the nasal corticosteroid.
During a period of severe stress, you may have to switch to an oral corticosteroid drug if the nasal form does not control your symptoms.
Children using nasal corticosteriods may experience reduction in growth velocity.
Possible Side Effects
✓    Most common: mild irritation of the nose, nasal passages,
and throat; burning; stinging; dryness; and headache.
♦    Less common: lightheadedness, nausea, nosebleed or bloody mucous, unusual nasal congestion, bronchial asthma, sneezing attacks, runny nose, sore throat, and loss of the sense of taste.
✓    Rare: ulcers 0 Vie nasal passages, watery eyes, vomiting. hypersensitivity reactions (symptoms include itching, rash, swelling, bronchospasms, and breathing difficulties), nasal infection, wheezing, perforation of the wall between the nostrils, and increased eye pressure. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Do not use fluticasone propionate with ritonavir.
•    Ephedrine, phenobarbital, and rifampin may decrease the effect of nasal corticosteroids.
•    Use caution when combining ketoconazole with any nasal corticosteroid.
Usual Dose
Beclomethasone
Adult and Child (age 13 and over): 1 spray (42 mcg) in each nostril 2-4 times a day.
Child (age 6-12): 1 spray (42 mcg) in each nostril 3 times a day. Child (under age 6): not recommended.
Budesonide
Adult and Child (age 6 and over): 2 sprays (64 mcg) in each nostril morning and evening, or 4 sprays in the morning.
Child (under age 6): not recommended.
Ciclesonide
Adult and Child (age 12 and over): 2 sprays (50 mcg/spray) in each nostril once a day.
Child (under age 12): not recommended.
Flunisolide
Adult and Child (age 15 and over): 2 sprays (50 mcg) in each nostril twice a day to start; may be increased up to 8 sprays a day in each nostril.
Child (age 6-14): 1 spray (25 mcg) in each nostril 3 times a day, or 2 sprays in each nostril twice a day.
Child (under age 6): not recommended.
Fluticasone Furoate
Adult and Child (age 12 and over): 2 sprays in each nostril once a date to start. Dose may be reduced to 1 spray in each nostril afer symptoms are controlled.
Child (age 2-11): 1    Yi) each nostril once a day.
C’%Ab junder age 2): riot recommended.
Fluticasone Propionate
Adult: 2 sprays (100 mcg) in each nostril once a day or divided in 2 doses, to start. Dosage may be reduced in half in a few days, if tolerated.
Child (age 4 and over): 1 spray (50 mcg) in each nostril once a day; may be increased to 2 sprays a day in each nostril, if needed. Child (under age 4): not recommended.
Mometasone
Adult and Child (age 12 and over): 2 sprays (100 mcg) in each nostril once a day; may be increased to 4 sprays a day in each nostril.
Child (under age 12): not recommended.
Triamcinolone
Adult and Child (age 13 and over): 2 sprays (220 mcg) in each nostril once a day; may be increased to 4 sprays a day in each nostril.
Child (age 6-12): 1 spray in each nostril once a day; may be increased to 2 sprays a day in each nostril, if needed.
Child (under age 6): not recommended.
Overdosage
Serious adverse effects are unlikely after accidental ingestion. Rarely, excessive use of large amounts of nasal corticosteroids may cause overdose symptoms such as irregular menses, acne, facial puffiness, and weight gain. These symptoms require gradual, not immediate, discontinuation of the drug. Call your local poison control center or a hospital emergency room for more information. ALWAYS bring the presciption container.
Special Information
It may be necessary to clear your nasal passages with a nasal decongestant before using a nasal corticosteroid to allow it to reach the mucous membranes.
Some of these drugs take 10-14 days to start working. Beclomethasone, budesonide, and triamcinolone work faster. in 3-7 days: ciclesonide starts working within 1 or 2 days and shows additional benefits after several weeks of use; in some cases, triamcinolone and budesonide provide relief in 12 hours. FWT isolide may take up to 2 weeks. Do not use -any of these drugs continuously for more tha”‘3 weeks unless you have experienced a def- fttlbenefit.
If you are using more than one spray at a time, wait at least 1 minute between sprays.
Nasal corticosteroids may cause irritation and drying of mucous membranes in the nose. Call your doctor if this effect persists or if symptoms get worse.
Call your doctor if you are exposed to measles or chicken pox while using an of these medicines.
People using a nasal corticosteroid to prevent the return of nasal polyps after surgery may experience nosebleeds because the drug can slow healing of the wound.
If you forget to administer a dose, do so as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Taking large amounts of corticosteroids during pregnancy may slow fetal growth. While the small amount of drug absorbed into the blood after nasal application is unlikely to have any effect, consult your doctor before taking any corticosteroid if you are or might be pregnant.
Dexamethasone passes into breast milk. Nursing mothers who must use this drug should use infant formula. It is not known if other nasal corticosteroids pass into breast milk, though oral corticosteroids do. Nursing mothers should consider using infant formula.
Seniors: Seniors may use nasal corticosteroids without special restriction. Tell your doctor if you have bone or bowel disease, colitis, diabetes, glaucoma, fungal or herpes infections, high blood pressure, high blood cholesterol, an underactive thyroid, or heart, kidney, or liver disease.

Generic Name
colchicine (KOLE-chih-sene)
Type of Drug Antigout medication.
Prescribed For
Prevention and treatment of gouty arthritis; also prescribed for Mediterranean fever; chronic progressive multiple sclerosis; cirrhosis of the liver; biliary cirrhosis; Beh~et’s disease’, pseudogout (a condition caused by calcium deposits); amyloidosis; very low blood-platelet count (also known as ITP); skin reactions, including scleroderma, psoriasis, Sweet Syndrome, and other conditions; and nerve disability associated with chronic progressive multiple sclerosis.
General Information
While no one knows exactly how colchicine works, it appears to help people with gout by reducing the inflammatory response to uric acid crystals that form inside joints and by interfering with the body’s mechanism for making uric acid. Unlike drugs that affect uric acid levels, colchicine does not block the progression of gout to chronic gouty arthritis; it will, however, relieve the pain of acute attacks and lessen the frequency and severity of attacks. It has no effect on other kinds of pain.
Cautions and Warnings
Do not use colchicine if you are allergic or sensitive to any of its ingredients or you suffer from any serious blood, kidney, liver, stomach, or cardiac condition.
Vomiting, abdominal pain, diarrhea, nausea, kidney damage, and blood in the urine may occur with colchicine, especially at maximum doses. This can worsen existing gastrointestinal (GI) or other conditions. Stop taking the medication and call your doctor if you develop one of these symptoms.
She weakness that people develop while taking colchicine is frequently related to high levels of colchicine in the blood caused by poor kidney function and improves without treatment 3-4 weeks after the drug is stopped. This reaction is often mistaken for other conditions.
Periodic blood counts should be done if you are taking
colchicine for long periods of time.
Colchicine interferes with the absorption of vitamin B12 by af-
fecting the lining of the GI tract.
Colchicine may affect the process of sperm generation in men. The safety and effectiveness for use by children have not been
established.
Possible Side Effects
V Common: vomiting, diarrhea, and abdominal pain may occur if you take maximum doses of colchicine for an acute gout attack. You may also experience severe diarrhea, kidney and blood-vessel damage, blood in the urine, and reduced urination.
✓    Less common: hair loss, rash, appetite loss, and muscle and nerve weakness.
✓    Rare: with long-term colchicine therapy—reduced whiteblood-cell and platelet counts, nerve inflammation, blood-clotting problems, rash, unusual bleeding or bruising, tingling in the hands or feet, red or purple spots under the skin, and other reactions. Colchicine may interfere with sperm formation. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Colchicine interferes with the absorption of vitamin B12.
•    Colchicine may increase sensitivity to central-nervoussystem depressants, such as sedatives and alcohol.
•    The following drugs may reduce colchicine’s effectiveness: anticancer drugs, bumetanide, diazoxide, thiazide diuretics, ethacrynic acid, furosemide, mecamylamine, pyrazinamide, and triamterene.
•    Taking phenylbutazone with colchicine increases the risk of side effects.
•    Mixing the anitiiofic clarithromycin with colchicine can lead to colchicine toxicity, especially in the elderly and those with kidney disease.
Food Interactions None known.
Usual Dose
Acute Gout Attack: 1-1.2 mg. This dose may be followed by 0.51.2 mg every 1-2 hours until pain is relieved or nausea, vomiting, or diarrhea occurs. The total dose needed to control pain and in-
flammation during an attack varies from 4-8 mg.
Gout Prevention: 0.5-1.8 mg daily. In mild cases, 0.5 mg or 0.6 mg may be taken 3-4 days a week.
Familial Mediterranean Fever: 1-2 mg a day.
Cirrhosis of the Liver: 1 mg a day for 5 days each week. Biliary Cirrhosis: 0.6 mg twice a day.
Amyloidosis: 0.5 mg 1-2 times a day.
Behqet’s Disease: 0.5-1.5 mg a day.
Pseudogout: 0.6 mg twice a day.
ITP: 1.2-1.8 mg a day for 2 weeks or more.
Scleroderma: 1 mg a day.
Sweet Syndrome: 0.5 mg 1-3 times a day.
Other Skin Disorders: up to 1.8 mg a day, depending on the specific condition.
Overdosage
The lethal dose is estimated at 65 mg, although people have died after taking as little as 7 mg at once. Usually 1-3 days pass between the time that an overdose is taken and symptoms begin. Overdose symptoms start with nausea, vomiting, stomach pain, diarrhea—which may be severe and bloody—and burning sensations in the throat or stomach or on the skin. If you think you are experiencing overdose symptoms, contact your doctor immediately, or go to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you develop rash, sore throat, fever, unusual bleeding or bruising, tiredness, weakness, numbness, or tingling. Seniors are move 4,ialy to develop drug side effects and should use this drug with caution.
Stop taking maximum doses of colchicine as soon as gout pain is relieved and reduce your dose to a maintenance level if your doctor has prescribed it for gout prevention. Stop taking the drug entirely and contact your doctor at the first sign of nausea, vomiting, stomach pain, or diarrhea.
If you forget a dose of colchicine, take it as soon as possible. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: colchicine can harm the fetus. Pregnant women should not take it unless the potential benefits clearly outweigh the risks.
It is not known if colchicine passes into breast milk. No problems with nursing infants are known, but nursing mothers who must take colchicine should consider using infant formula.
Seniors: Seniors, especially those with renal, hepatic, gastrointestinal, or heart disease, are more likely to develop side effects and should use colchicine with caution.

Type of Drug
Contraceptives
Plan B
Prescribed For
Prevention of pregnancy, endometriosis, excessive menstruation, and cyclic withdrawal bleeding. Ortho Tri-Cyclen and Estrostep may be prescribed for moderate acne in women over age 15.
General Information
Contraceptive drugs are synthetic hormones containing either progestin or a progestin-estrogen combination. The overall effects of any contraceptive are influenced by the interaction of all active ingredients, including those Huth -&))Otogenic and anti-estrogenic aqtk%(kkj.’%tte drugs are similar to natural female hormones, which cannot be used as contraceptives because very large dosages would be required. Synthetic hormones are more potent and are effective at smaller dosages. Contraceptive drugs work by preventing sperm from reaching the unfertilized egg, preventing the implantation of a fertilized egg in the uterus, or preventing ovula-tion (the release of an unfertilized egg from the ovaries). They prevent acne by balancing hormone levels.
When properly used, hormonal contraceptives can be 97-99% effective at preventing pregnancy. These products vary in their etfectiveness, and in the amount and type of estrogen or progestin used. The side effects of these drugs tend to increase with the amount of hormone they contain. While low hormone dosages are preferred, contraceptives with the smallest amounts of estrogen may be less effective in some women than others.
Single-phase products provide constant levels of estrogen and progestin throughout the entire month-long pill cycle. In 2-phase combinations, the amount of estrogen remains at a steady low level throughout the cycle, while progestin levels increase and then decrease. This variation in progestin allows normal changes to take place in the uterus. Three-phase products are meant to simulate the normal hormone cycle and reduce breakthrough bleeding. Throughout the cycle, estrogen levels remain the same while those of progestin change to create a 3-part wave pattern. The amount of estrogen in 3-phase products is considered low. Breakthrough bleeding may occur with the older combination products from day 8 through 16 of the cycle.
The mini-pill, a progestin-only product, may cause irregular menstrual cycles and may be less effective than estrogenprogestin combinations. Mini-pills may be recommended to older women or women who should avoid estrogens (see “Cautions and Warnings”).
The contraceptive patch releases small amounts of progestin and estrogen continuously over 3 weeks. The medication is absorbed into the blood vessels just below the skin. The patch works in the same way as contraceptive pills do.
The vaginal ring releases small amounts of etonogestrel, a progestin, and estradiol, an estrogen, in the vaginal canal over 3 weeks. The combination prevents pregnancy in the same way as combination pills do but may be less effective than contraceptive pills because some people find them harder to use.
Most contraceptive drugs are designed to simulate a normal Mt%VwM cycle. By not taking the hormones 1 week out of the month, you continue to have your regular period. In fact, these products are often used to stabilize a woman’s period. Two products, Seasonale and Seasonique, come in an 84-pill packet and are taken once a day for 3 months. This means you will only have your period once every 3 months. Another, Lybrel. is designed to be taken every day, eliminating monthly menstruation. Drosperinone, the progestin found in Yasmin and Yaz, has been found to relieve Premenstrual Syndrome (PMS) symptoms in addition to acting as an effective contraceptive hormone.
Levonorgestrel, a progestin, is used in implants that provide effective contraception for up to 5 years after surgical implantation under the skin of the upper arm or inside the uterus. Levonorgestrel implants should be replaced at least once every 5 years. Etonorgestrel implants are effective for 3 years. Implants can be removed at any time, reversing the contraceptive effect. The progestin intrauterine inserts provide effective contraception for about 1 year. The implant and intrauterine systems contain the same hormone found in the mini-pill and are associated with many of the same side effects and precautions as oral contraceptives.
Emergency contraceptives (sometimes referred to as the “morning-after pill”) contain high doses of estrogen and progestin. They are intended for use only after contraceptive failure or unprotected intercourse. They should never be taken by a pregnant woman.
Contraceptive drugs in any form are associated with risks. These risks are greatest in women over age 35 who smoke and have high blood pressure.
Cautions and Warnings
Do not take contraceptives if you are allergic or sensitive to them or any of their ingredients.
The risk of breast cancer may be slightly higher among current and recent users of combination oral contraceptives. This risk appears to decline after contraceptive use is stopped and is gone by 10 years after stopping combination contraceptive products. Breast cancers found in contraceptive users tend to be less advanced than those in non-contraceptive users.
You should not use contraceptive drugs if you are or might be pregnant, have had blood clots in veins or arteries, stroke, any blood-coagulation disorder, known or suspected cancer 0 the breast, sex organs, or liver. Products With more estrogen, or those t43.t jmmdr3higher sustained blood levels of estrogen, such as the contraceptive patch, are more likely to be associated with an increased risk of life-threatening blood clots.
Contraceptive drugs may cause eye lesions. Call your doctor at once if you develop visual difficulties of any kind.
Women taking the combination products Seasonale and Seasonique will have their period only once every 3 months and those taking Lybrel will not have a regular monthly period. It is absolutely essential for you to verify you are not pregnant if you think you may be pregnant for any reason.
The risks of contraceptive drugs increase if you are physically immobile or have asthma; cardiac insufficiency; epilepsy; migraine; kidney problems; a strong family history of breast cancer; benign breast disease; diabetes; endometriosis; gallbladder disease or gallstones; liver problems, including jaundice; high blood cholesterol; high blood pressure; estrogen or progestin intolerance; depression; tuberculosis; or varicose veins.
There is an increased risk of heart attack in women who have used contraceptive drugs for more than 5 years, or who are between age 40 and 49 and have other coronary risk factors such as smoking. obesity, high blood pressure, diabetes, and high blood cholesterol. This risk remains even after the medication is stopped.
Smokers in their mid-30s or older who use contraceptive drugs are 5 times more likely to have a heart attack than nonsmokers taking contraceptives and 10-12 times more likely to have a heart attack than nonsmokers who do not use the pill. Death due to circulatory disease also increases substantially in smokers taking contraceptive drugs, especially in women at least 35 years old. The risk of stroke is also increased in this group. Heavy smokers (more than 15 cigarettes a day) should not use hormonal contraceptives.
Women with a history of headaches, high blood pressure, or varicose veins should avoid estrogen-containing products, as Should older women and those who have experienced estrogen side effects.
Contraceptive drugs may mask the onset of menopause. Progestin-only products are associated with an increased risk of blood-clotting problems.
The progestin in Yasmin and Yaz raises blood potassium levels. Women with kidney, liver,,Dy adrenal gland disease should use eittlp_C pIrjdUcj with caution.
Intrauterine inserts have been associated with an increased risk of pelvic inflammatory disease (PID). The highest risk usually occurs within the first 20 days after insertion. Do not use intrauterine inserts if you have had an ectopic pregnancy.
Toxic Shock Syndrome has been associated with tampons, some barrier contraceptives, and the vaginal ring, although there is no proof that the product was the cause of the infection.
Possible Side Effects
♦ Common: Common side effects often result from using a product that is poorly suited to your body chemistry. Determining the right amount and type of hormone often minimizes these effects. If you are taking too much estrogen, you may experience nausea, bloating, high blood pressure, migraine, excess cervical mucous, skin discoloration, colon polyps, water retention, and swelling, or breast fullness or tenderness. Too little estrogen may cause early or mid-cycle breakthrough bleeding, spotting, or reduced periodic flow. Too much progestin is associated with weight gain and increased appetite, tiredness or fatigue, low periodic flow, acne, depression, breast regression, and androgen-related side effects (acne, oily scalp, hair loss, or excess hair growth). Too little progestin may cause late breakthrough bleeding, excessive periodic bleeding, or missed periods.
✓    Less common: abdominal cramps, infertility after discontinuance of the drug, breast tenderness, weight change, headache, rash, vaginal itching and burning, general vaginal infection, nervousness, dizziness, depression, cataracts, changes in sex drive, hair loss, and increased sensitivity to the sun.
✓    Rare: Women who use contraceptive drugs are more likely to develop several serious conditions, including blood clots in the deep veins, stroke, heart attack, liver cancer, gallbladder disease, and high blood pressure. Women who smoke cigarettes are at much higher risk for some of these adverse effects. Contact your doctor if you experience any side effect not listed above.
brug Interactions
•    Ampicillin, barbiturates, bexarotene, bosentan, carbamazepine, chloramphenicol, efavirenz, fluconazole, griseofulvin, ketoconazole, neomycin, nelfinavir, nitrofuratoin, oxcarbazepine, phenylbutazone, phenytoin, penicillin drugs, protease inhibitor drugs for HIV, rifampin, rifapentine, statin drugs (atorvastatin and rosuvastatin), St. John’s wort, sulfa drugs, tetracycline products, and sedatives can make all contraceptive drugs less effective. Use backup birth control while taking these medications together.
•    Contraceptive drugs may elevate blood levels of benzodiazepine sedatives and sleeping pills (midazolam, lorazepam, oxazepam, and temazepam), caffeine, cyclosporine, imatinib, metoprolol, corticosteroids, theophylline drugs, tizanidine, triptan-type migraine drugs, and tricyclic antidepressants, increasing the risk of side effects. Discuss mixing these medicines with your doctor. Dosage reductions may be needed.
•    Contraceptive drugs may increase the toxic liver effects of acetaminophen and reduce the drug’s effectiveness. Contraceptive drugs may increase or decrease the effect of anticoagulant (blood-thinning) drugs. Discuss the risks of this combination with your doctor.
•    Mycophenolate interferes with only those contraceptives that contain levonorgestrel (Alesse, Aviane, Lessina. Levora, Levlite, Lutera, Lybrel, Mirena, Nordette, Norplant II, Portia, Plan B, Seasonale, Seasonique, and Triphasil). Backup contraception is recommended.
•    Exenatide may reduce the effectiveness of contraceptive pills.
Take them at least 1 hour before an injection of exenatide.
•    Contraceptive drugs may reduce the effectiveness of clofibrate for elevated blood triglycerides, sulfonylurea drugs for diabetes, ursodiol for gallbladder disease, and pain relievers, including salicylates (aspirin).
•    Contraceptive drugs may increase blood-cholesterol levels and interfere with blood tests for thyroid function and blood sugar.
•    Acetaminophen may increase blood levels of ethinyl estradiol, a common contraceptive drug ingredient, increasing side effects and reducing contraceptive effectiveness.
•    Since Yasmin and Yaz raise blood potassium levels, nether should be used if you ate taking spironolactone or anD)ftr potassium-sparing diuretic, potassium supplements, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor antagonists, aldosterone antagonists, heparin, non-steroidal anti-inflammatory drugs (NSAIDs), or other medications on a long-term basis that may further increase potassium levels.
•    Contraceptive drugs may interfere with the effects of insulin
for diabetes.
•    Acitretin interferes with the contraceptive effect of progestin-
only mini-pills. It is not known if it also interferes with combination contraceptive drugs.
Food Interactions
None known. Usual Dose
Single-Phase, 2-Phase, and 3-Phase Combinations: The first day of bleeding is day 1 of the menstrual cycle. Beginning on the first day of the cycle, take 1 pill a day for 20-21 days according to the number of pills supplied by the manufacturer. If menstrual flow has not begun 7 days after taking the last pill, begin the next month’s cycle of pills. Some manufacturers recommend starting the pills on a Sunday to make it easy to remember to take them. In this case, start taking your pills on the first Sunday after your period begins. If menstruation begins on a Sunday, take the first pill that day.
Seasonale: Take 1 pink tablet every day for 84 consecutive days. Do not skip a day. Then, take 1 white pill a day for 7 days. Then, start a new pill cycle. You may be pregnant if you do not have a period while you are taking the white pills.
Seasonique: Take 1 light blue-green tablet containng levonorgestrel and ethinyl estradiol daily for 84 consecutive days, followed by 7 days of ethinyl estradiol tablets. Do not stop if spotting or breakthrough bleeding occurs. Report prolonged bleeding to your doctor.
Progestin-Only Mini-Pill: Take 1 pill every day.
Contraceptive Patch: Apply a new patch to the thigh, abdomen, or arm. Remove the patch after 3 weeks and then reapply a new patch after 1 week. Be sure to always apply a new patch on the same day of the week. If you are switching from birth control pmts, apply the first patch on the same day you would start a new cycle of pills.
Vaginal Ring: Keep the vaginal ring in the vaginal canal for 3 weeks. Remove it and put a new one in 1 week later. If you did not use a hormonal contraceptive in the previous month, insert the ring between day 1 and day 5 of your cycle.
If you are switching from a combination birth control pill, insert the ring anytime during the week after you took your last pill but before you would have started your next cycle of pills. No additional contraception is necessary.
If you are switching from a mini-pill, insert the ring on the day after you take your last mini-pill.
If you are switching from a progestin implant or an IUD, insert the ring on the same day your implant or IUD is removed.
If you are switching from a progestin injection, insert the ring on the same day you would have received your next injection.
If you are switching from a progestin-only mini-pill, implant, injection, or IUD, use another form of contraception for the first 7 days after you insert the ring.
Emergency Contraception: Emergency contraceptive kits have only a few pills. They should be taken with a full meal. Take half the pills (1 or 2 depending on the brand you use) within 72 hours of unprotected sex, however they are most effective when taken within the first 24 hours. Take the rest of the pills 12 hours after the first dose. Emergency contraceptives reduce the risk of pregnancy by 75%.
The pregnancy test in the kit can be used to determine if you became pregnant earlier in your cycle or during a previous cycle. If the test is positive, consult your doctor before taking emergency contraception. If you vomit within one hour of taking either dose, contact your doctor.
Overdosage
An overdose may cause nausea and withdrawal bleeding in adult women. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription package.
Special Information
Use backup birth control to prevent pregnancy in the first 3 weeks after you begin taking contraceptive drugs.
Contraceptive drugs do not protect against sexually transmitted diseases.
VM your pill at the same time each day to establish a routine and ensure maximum contraceptive protection.
Call your doctor immediately if you experience severe abdominal pain; severe or sudden headache; pain in the chest, groin, or leg, especially the calf; sudden slurring of speech; changes in vision; weakness, numbness, or pain in the arms or legs; coughing up of blood; loss of coordination; or shortness of breath. These symptoms may require emergency treatment.
Other problems that may require medical attention are bulging eyes; changes in vaginal bleeding; fainting; frequent or painful urination; a gradual increase in blood pressure; breast lumps or secretions; depression; yellowing of the skin or whites of the eyes; rash; redness or irritation; upper abdominal swelling, pain, or tenderness; an unusual or dark-colored mole; thick, white vaginal discharge; or vaginal itching or tenderness.
See your doctor for a check-up every 6-12 months.
Some manufacturers include 7 inert or iron pills in their packaging to be taken on days when the drug is not taken. This makes it easier for women to stay on schedule with their pills. The 7 pills bridge the gap between contraceptive cycles and allow women to take 1 pill every day without stopping.
For single- or 2-phase combinations: If you forget to take a pill for 1 day, take 2 pills the following day. If you miss 2 consecutive days, take 2 pills for the next 2 days. Then return to your schedule of 1 pill a day. If you miss 3 consecutive days, do not take any pills for the next 7 days and use another form of contraception; then start a brand new cycle.
Seasonale: The risk of pregnancy increases with each pink tablet you forget. Use another method of non-hormonal backup contraception any time you miss 2 or more pink tablets until you have taken a pink tablet every day for 7 consecutive days. You are protected against pregnancy if you miss 1 or more white tablets, as long as you begin taking the pink tablets again on the proper day.
Seasonique: The risk of ovulation and pregnancy increases with each forgotten light blue-green pill. If you miss 1 light blue-green pill, take it as soon as you remember and take the next pill at your regular time. This may mean you will take 2 pills on the same day. You don’t need to use a backup birth control method if you forget only 1 pill. If you forget 2 light blue-green pills in a row, take 2 pills on the day you remember and take 2 pills the ReYA day. -Then go back to taking 1 pill a day MMI you finish your pack. If you miss 2 01 MbreYight blue-green pills in a row, you must use non-hormonal backup contraception until you have taken a light blue-green pill daily for 7 days in a row. If you miss 1 or more yellow tablets, you are still protected against pregnancy provided you begin taking light blue-green pills again on the proper day.
For 3-phase combinations: If you forget to take a pill for 1 day, take 2 pills the following day. If you miss 2 consecutive days, take 2 pills for the next 2 days. Then return to your schedule of 1 pill a day. If you forget to take a pill for 3 days in a row, stop taking the drug and use an alternate means of contraception until your period starts. ALWAYS use a backup contraceptive method for the remainder of your cycle if you forget even 1 pill of a 3-phase combination.
If you forget to apply the contraceptive patch on the same day of the week once every 4 weeks, you risk a loss of effectiveness on the days after you should have applied it. If the patch comes off or is partially detached in mid-cycle, you must start a new 3-week cycle at once by removing the old patch and applying a new one.
If the vaginal ring is accidentally expelled during the 3 weeks it is normally retained, rinse it off with water and replace it within 3 hours. Do not use hot water. If the ring is not reusable, insert a new ring and continue with your regular schedule. If you do not replace the ring within 3 hours, its effectiveness may be reduced. If you are in week 3 of the cycle, throw the ring away; you may insert a new one immediately, which will begin a new 3-week cycle and cause you to skip a period. Or, you may wait a week, during which time you will have periodic bleeding, and insert a new ring no later than 7 days after the vaginal ring was expelled. This option should be chosen if you had used the ring for 7 days in a row before it was expelled.
If, when it is expelled, you are in week 1 or 2 of your cycle and the ring is out for more than 3 hours, reinsert it and use an additional form of contraceptive until the ring has been worn for 7 consecutive days. A vaginal ring may break and then slip out or cause discomfort. Throw the ring away if this happens.
Missing a pill reduces your protection. If you keep forgetting to take your pills, you must use another birth control method.
If you take drugs that reduce the effectiveness of contraceptive drugs (see “Drug Interactions”), use a backup contraceptive method during that cycle to PMNeiA accidental pregnancy.
GOOD tlL:Inlal hygiene is essential while taking contraceptive drugs. See your dentist regularly and brush and floss carefully because contraceptive drugs may increase the risk of an oral infection.
Contraceptive drugs may increase your sensitivity to the sun.
Wearing contact lenses may be uncomfortable while taking contraceptive drugs because the pills can cause minor changes in the shape of your eyes.
All contraceptive prescriptions come with a “patient package insert.” Read it thoroughly as it gives detailed information about the drug and is required by federal law.
Special Populations
PregnancylBreast-feeding., Contraceptive hormones cause birth defects and may interfere with fetal development. They are not safe for use during pregnancy. If you think you are pregnant, use another form of contraception and stop taking your birth control pills.
Contraceptive hormones pass into breast milk. Combination contraceptive products reduce the amount of milk produced. Nursing mothers who must use any of these drugs should use infant formula.
Seniors: These products are not intended for women who have completed menopause.

Generic Name
Clotrimazole (kloe-TRIM-uh-zole) 0
Brand Name Mycelex
The information in this profile also applies to the following drug:
Generic Ingredient: Sertaconazole Ertaczo
Type of Drug Antifungal.
Prescribed For
Fungal infections of the mouth, skin, and vaginal tract.
General Information
clotrimazole is useful against a variety of fungal organisms that other drugs do not affect. The exact way in which clotrimazole works is unknown. Sertaconazole is used for athlete’s foot in people age 12 and older with compromised immune systems.
Cautions and Warnings
Do not use this product if you are allergic or sensitive to any of its ingredients.
If clotrimazole causes local itching or irritation, stop using it. Do not use clotrimazole in your eyes.
Proper diagnosis is essential for effective treatment. Do not use this product without first consulting your doctor.
Possible Side Effects
Side effects are infrequent and usually mild.
Cream and Solution
V Most common: redness, stinging, blistering, peeling, itching, and swelling of local areas.
Vaginal Tablets
♦ Most common: mild burning, rash, mild cramps, and frequent urination. Your sexual partner may also experience some burning or itching.
Lozenges
V Most common: stomach cramps or pain, diarrhea, nausea, and vomiting.
Drug Interactions
None known.
Food %%ractions
The oral form of clotrimazole is best taken on an empty stomach, at least 1 hour before or 2 hours after meals. However, you may take it with food as long as you allow the lozenge to dissolve fully in your mouth.
Usual Dose
Topical Cream and Solution
Adult and Child (over age 2): Apply to clean, dry, affected areas morning and night for 7 consecutive days or as needed. For athlete’s foot and ringworm, use daily for 4 weeks. For jock itch, use daily for 2 weeks.
Vaginal Cream
Adult: 1 applicator’s worth at bedtime for 3-7 consecutive days.
Vaginal Tablet
Adult: 1 tablet inserted into the vagina at bedtime for 3 days, or 2 tablets a day for 3-7 consecutive days.
Lozenge
Adult and Child (over age 3): 1 lozenge 5 times a day for 2 weeks or more.
Overdosage
Little is known about the effects of clotrimazole overdose or accidental ingestion. Call your local poison control center for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
If treating a vaginal infection, you should refrain from sexual activity. Call your doctor if burning or itching develops or if the condition does not improve within 7 days.
If you are using the vaginal cream, you may want to wear a sanitary napkin to avoid staining your clothing. Do not use a tampon during treatment.
Dissolve the lozenge slowly in the mouth. This may take up to 30 minutes.
This medicine must be taken on consecutive days. If you forget a dose of oral clotrimazole, take it as soon as you remember. Do not double your dose.
When using clotrimazole for skin infections, do not cover the area with any kind of bandage unless directed to do so by your doctor. For athlete’s foot, wear well-fitting, ventilated shoes, and change your socks at least once a day.
clotrimazole is not effective on scalp or nails.
Special Populations
Pregnancy/Breast-feeding: Women who are or might be pregnant should talk to their doctor about the medication’s risks and benefits. Women who are in the first 3 months of pregnancy should use this drug only if directed to do so by their doctor. If you are pregnant, your doctor may want you to insert vaginal tablets by hand rather than use a vaginal applicator.
It is unknown whether the drug passes into breast milk. Use with caution or use infant formula.
Seniors: Seniors may use this medication without special precaution.

Generic Name
Clozapine (KLOE-zuh-pene) 03
Brand Names
Clozaril    FazaClo Orally Disintegrating Tablets
Type of Drug  Antipsychotic.
Prescribed For  Severe schizophrenia.
General Information
Clozapine is a unique antipsychotic that has the capacity to treat people who do not respond to or cannot tolerate other drugs. It works by a mechanism that differs from those of other antipsychotic drugs.
A very small number of people who take clozapine develop a rapid drop in their white-blood-cell count, known as agranulocytosis. This effect usually reverses itself when the drug is stopped, but the drug must be stopped as soon as it is discovered. An unusually large number of people who have developed clozapine algllaTwlocytosis in the United States are of Eastern European Jewish descent, but the association is not very strong. Most cases of agranulocytosis occur between week 4 and week 10 of treatment. It is essential that blood samples be taken approximately every week and for 4 weeks after the drug is stopped to watch for this effect. Because of the risk of agranulocytosis, clozapine should not be tried until at least 2 other antipsychotic medicines have failed.
Some people taking antipsychotic drugs develop tardive dyskinesia, a potentially irreversible condition marked by uncontrollable movements. Tardive dyskinesia has not been seen in patients taking clozapine, a major advantage of this drug over other antipsychotic medicines. However, there is still a risk that this set of symptoms could occur with clozapine.
Cautions and Warnings
Do not take clozapine if you are allergic or sensitive to any of its ingredients.
Women, seniors, people with serious illnesses, those who are emaciated. those with a history of diseases affecting the white blood cells, or those who are taking other medication that could affect white blood cells may be more susceptible to clozapine agranulocytosis.
Clozapine has been associated with increased mortality in seniors with dementia or Alzheimer’s disease. The specific causes of death related to clozapine and other atypical antipsychotic drugs were either due to a heart-related event or infection, mostly pneumonia. Clozapine should not be taken by those with dementia-related psychosis.
About 5% of people taking the drug experience a seizure in the first year of treatment. Seizure is most likely to occur at higher drug doses.
People with heart disease should be carefully monitored while on clozapine because of possible cardiac risks.
Clozapine may cause low blood pressure, especially at the beginning of therapy.
Clozapine has been associated with obesity, high cholesterol, high blood sugar, and diabetes. Diabetics and pre-diabetics (people with elevated blood sugar and a family history of diabetes) should be carefully monitored.
A serious set of side effects, known as neuroleptic malignant syndrome (NMS), includes a high lever and has been associated With clozapine when it is used together with lithium or other drugs. The symptoms that constitute NMS include muscle rigidity, mental changes, irregular pulse or blood pressure, increased sweating, and abnormal heart rhythm. NMS is potentially fatal and requires immediate medical attention.
Use this drug with caution if you have glaucoma, prostate
problems, or liver or kidney disease.
clozapine may interfere with mental or physical abilities because of the sedation it usually causes during the first few weeks
of treatment.
Possible Side Effects
✓    Most common: rapid heartbeat, low blood pressure, dizziness, fainting, drowsiness or sedation, salivation, and constipation.
✓    Less common: headache, tremor, sleep disturbance, restlessness, slow muscle motions, absence of movement, agitation, convulsions, rigidity, restlessness, confusion, sweating, dry mouth, visual disturbances, high blood pressure, nausea, vomiting, heartburn or abdominal discomfort, fever, and weight gain.
♦    Rare: agranulocytosis (symptoms include fever with or without chills, sore throat, and sores or white spots on the lips or mouth), tardive dyskinesia (symptoms include lip smacking or puckering, puffing of the cheeks, rapid or wormlike tongue movement, uncontrolled chewing motions, and uncontrolled arm and leg movements), and NMS (see “Cautions and Warnings”). Other rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Clozapine’s anticholinergic effects—blurred vision, dry mouth, and confusion—may be enhanced by interaction with other anticholinergics, such as tricyclic antidepressants like amitriptyline.
•    Drugs that reduce blood pressure may enhance the bloodpressure-lowering effects of clozapine.
•    Alcohol and other nervous system depressants, including benzQUIQOmrn and other antianxiety drugs, may enhance clozapine’s sedative action. At least 1 person has died as a result of combining diazepam and clozapine.
•    Combination contraceptive drugs may increase blood levels of clozapine leading to toxic side effects. Women starting on a combination contraceptive may need to have their clozapine dose adjusted.
•    Clozapine should not be used with ritonavir.
•    Cimetidine, caffeine, citalopram, ciprofloxacin, erythromycin, and ketoconazole may increase blood levels of clozapine resulting in increased side effects. Caution should be used with combining clozapine with paroxetine, fluvoxamine, or sertraline as similar reactions may occur, although these interactions are less well-defined.
•    Clozapine may increase blood levels of digoxin, warfarin, heparin, and phenytoin.
•    Use of clozapine with phenytoin, carbamazapine, and rifampin may cause decreases in blood levels of clozapine, reducing its effectiveness.
•    The combination of lithium and clozapine may cause seizures, confusion, and NMS (see “Cautions and Warnings”).
•    Cigarette smoking may alter clozapine dosage requirements.
•    Combining selective serotonin receptor inhibitors (SSRls) with clozapine may require a lower clozapine dosage.
Food Interactions None known.
Usual Dose
Tablets
Starting dose: 25 mg in divided doses twice a day; maintenance dose    generally, 300-450 mg a day in divided doses. Dosage may be increased gradually to a daily maximum of 900 mg in divided doses if required.
Orally Disintegrating Tablets
Starting dose: 12.5 mg once or twice a day increasing to 300450 mg a day in divided doses by the end of 2 weeks. Dosage may then be increased up to 900 mg a day in divided doses if required.
Overdosage
Symptoms of overdose are delirium, drowsiness, changes in heart rhythm, unusual excitement, nervousness, restlessness, hallucinations, excessive salivation, dizziness or fainting, slow or irregular breathing, and coma, Overdose victims must be taken to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Clozapine may cause a fever during the first few weeks of treatment. Generally, the fever is not important, but it may occasionally be necessary to stop treatment due to a persistent fever.
Regular blood tests are necessary to monitor blood composition for any changes that might be caused by clozapine.
Call your doctor at once if you develop lethargy or weakness, a flu-like infection, sore throat, feelings of ill health, fever, sweating, muscle rigidity, mental changes, irregular pulse or blood pressure, mouth ulcers, or dry mouth that lasts for more than 2 weeks.
Dry mouth, a common side effect of clozapine, may be countered by using gum, candy, ice, or a saliva substitute such as Orex or Moi-Stir.
Do not stop taking clozapine without your doctor’s knowledge and approval, because a gradual dosage reduction may be necessary to prevent side effects.
Avoid alcohol or any other nervous system depressants while taking clozapine.
Some of the side effects of clozapine    drowsiness, blurred vision, and seizures—may interfere with the performance of complex tasks like driving or operating hazardous equipment.
While taking clozapine, rapidly rising from a sitting or lying position may cause you to become dizzy or faint.
If you take clozapine twice a day and forget a dose, take it as soon as you remember. If it is almost time for your next dose, take 1 dose as soon as you remember and another in 5 or 6 hours, then go back to your regular schedule. If you take clozapine 3 times a day and forget a dose, take it as soon as you remember. If it is almost time for your next dose, take 1 dose as soon as you remember and another in 3 or 4 hours, then go back to your regular schedule. Never take a double dose.
Orally disintegrating tablets should be left in the unopened blister until time of use. They should not be pushed through the foil. Just prior to use, peel the foil from the blister and gently remove the orally disintegrating tablet. Immediately place the tablet in the mouth, allow it to disintegrate and then swallow with saliva. No water is needed.
Special Populations
Pregnancy/Breast-feeding: This drug Should be used during PM Only if your doctor determines that it is absolutely necessary.
clozapine may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may be more sensitive to the side effects of clozapine, such as dizziness on rapidly rising from a sitting or lying po-sition, confusion, and excitability. Older men are also more likely to have prostate problems, a reason to be cautious with clozapine. Seniors with psychosis due to dementia who take clozapine are more likely to die from heart disorders and infections than those not taking it.

Generic Name
Codeine (KOE-deep) 0
Brand Name
Only available in generic form.
The information in this profile also applies to the following drugs: Generic Ingredient: Fentanyl
Actiq Lozenge on a Stick    Fentora Buccal Tablet
Duragesic (Patch)    lonsys (Patch)
Generic Ingredient: Morphine Sulfate 10
Avinza    Oramorph SR
Kadian    RMS Suppositories
MS Contin    Roxanol MSIR
Generic Ingredient: Oxycodone Hydrochloride RE
Combunox    OxyFAST
Endocodone    OxylR
M-Oxy    Percolone
OxyContin    Roxicodone Oxydose
Generic Ingredient: Oxymorphone Opana
Type Q( UTUg  Narcotic.
Prescribed For
Mild to severe pain, breakthrough cancer pain, and cough. Long-acting narcotics are meant only for people with chronic pain. Also prescribed for pain and anxiety in pediatric burn patients.
General Information
Codeine relieves pain and suppresses cough. The pain-relieving effect of 30-60 mg of codeine is equal to approximately 650 mg, or 2 tablets, of aspirin. Codeine may be less effective than aspirin for pain associated with inflammation because aspirin reduces inflammation and codeine does not. Codeine suppresses the cough reflex but does not cure the underlying cause of the cough. Other narcotic cough suppressants are stronger pain relievers, but codeine remains the best cough medication available.
Morphine sulfate is a pure narcotic that has been in use for many years. In addition to pain relief, morphine’s effects include drowsiness, mood changes, breathing difficulty, slowed movement of the gastrointestinal tract, nausea, vomiting, and changes in the endocrine and autonomic nervous systems. Morphine sulfate liquid, immediate-release tablets, and suppositories must be taken several times a day. The medication they contain is released immediately for absorption into the bloodstream. Extended- and controlled-release morphine products are designed to release some of the narcotic right away and the rest over a 24-hour period, allowing for less-frequent dosage.
Fentanyl is a potent pain reliever that can be substituted for other narcotic drugs. The patch form, which must be replaced about every 3 days, delivers fentanyl to the bloodstream at a steady rate. The lozenge has a shorter length of action than any other narcotic pain reliever, which makes it useful when given to children before surgery because it provides doctors with the flexibility to obtain maximum benefit with minimal side effects. The lozenge on a stick is used for breakthrough cancer pain as a booster for people already taking narcotic pain relievers. These forms should only be used under controlled circumstances because of the risk of side effects or overdose. Low dosages of fentanyl relieve pain—larger amounts cause loss of consciousness and breathing difficulties.
Oxycodone is a narcotic used to control moderate to severe pain. Most people take it together with aspirin (Percodan) or acetaminophen (Percocet), but it can be used by itself. This is a potent pain reliever that carries a risk (31 addiction with continued use.
Cautions and Warnings
Do not take narcotics if you are allergic or sensitive to any of their ingredients.
Long-term use of narcotics may cause drug dependence or addiction.
Use narcotics with extreme caution if you suffer from asthma or other breathing problems.
Narcotics may make it difficult to monitor the progress of people who have suffered head injuries and acute abdominal conditions.
Actiq contains fentanyl in an amount that can be fatal to children. Keep used and unused lozenges and lozenges on a stick out of reach of children.
Possible Side Effects
♦    Most common: lightheadedness, dizziness, sleepiness, nausea, vomiting, appetite loss, and sweating. If these occur, ask your doctor about lowering your dosage. Most of these side effects disappear if you lie down.
♦    Less common: euphoria (feeling “high”), headache, agitation, uncoordinated muscle movement, minor hallucinations, disorientation and visual disturbances, dry mouth. constipation, flushing of the face, rapid heartbeat, palpitations, faintness, urinary difficulties or hesitancy, reduced sex drive or impotence, itching, rash, anemia, lowered or raised blood sugar, and yellowing of the skin or whites of the eyes. Narcotic analgesics may aggravate convulsions in those who have had them.
More serious side effects of codeine are shallow breathing or breathing difficulties.
Drug Interactions
•    Avoid combining narcotics with alcohol, sleeping medications, sedatives, other depressant drugs, or non-prescription drugs that have alcohol as an ingredient. Alcohol speeds the release of morphine from Avinza. The mixture can result in a deadly narcotic overdose.
•    Narcotic analgesics should not be used at the same time as monoamine oxidase inhibitor antidepressants. Separate usage by at least 14 days.
•    Combining a narcotic pain reliever with an anticholinergic medication may result in severe constipation.
•    Combining a narcotic pain reliever with any other medication that lowers blood pressure can lead to excessive blood-pressure lowering. Avoid this combination.
•    Combining cimetidine with a narcotic pain reliever may cause confusion, disorientation, breathing difficulties, and seizure.
•    Reserpine, rifampin, and remifentanil may decrease the pain-relieving effects of morphine.
•    Fentanyl should be used with caution with azole antifungals (e.g. ketoconazole).
Food Interactions
Codeine may be taken with food to reduce upset stomach. Morphine capsules and the fentanyl patch may be used without regard to food.
Usual Dose
Dosing of narcotic pain medications is highly individualized based on patient tolerance and response to medication.
Codeine
Adult: 15-60 mg every 4-6 hours for relief of pain; 10-20 mg every few hours as needed to suppress cough.
Child: 1 mg per lb. of body weight every 4-6 hours for relief of pain; 2.5-10 mg every 4-6 hours to suppress cough.
Fentanyl Lozenge and Lozenge on a Stick
Adult: 200-1600 mcg. Dosage may be repeated up to 4 times daily. Allow the lozenge to dissolve in your mouth. DO NOT CHEW. Child: not recommended.
Fentanyl Patch: Apply to a clean and non-irritated patch of skin as directed, usually once every 3 days.
Morphine Extended-release and Controlled-release
Tablets and Capsules
Adult: 1-3 capsules a day, depending on the specific product and individual need.
Morphine Oral Liquid and Immediate-release Tablets Adult: 5-30 mg every 4 hours.
Morphine Suppositories
Adult: 5-30 mg several times a day.
Oxycodone
Adult: 10-30 mg every 4 hours as needed. OxyContin should be swallowed whole and not broken.
Child: not recommended.
Overdosage
Symptoms include breathing difficulties or slowing of respiration, extreme tiredness progressing to stupor and then coma, pinpointed pupils, no response to pain stimulation, cold and clammy skin, slowing of heartbeat, lowering of blood pressure, convulsions, and cardiac arrest. The victim should be taken to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Codeine is a respiratory depressant and affects the central nervous system (CNS), producing sleepiness, tiredness, or inability to concentrate. Be careful when driving or doing any task that requires concentration. Avoid alcohol.
Call your doctor if you develop breathing difficulties, constipation, dry mouth, or any bothersome or persistent side effect.
Apply the fentanyl patch only to non-irritated skin on a flat surface of the upper body. Hair at the application site should be clipped or cut, not shaved, before applying the patch. Do not use oils, soaps, lotions, alcohol, or anything else that might irritate the skin before applying the patch.
If you are taking a controlled-release narcotic product, do not crush, chew, or break the tablet or lozenge. Rapid release may result in a potentially fatal dose of the drug.
If you forget a dose of codeine, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Never take a double dose.
Special Populations
Pregnancy/Breast-feeding: Narcotics pass into the fetal circulation. Excessive use of them during pregnancy may cause drug dependence in newborns. Narcotics may also cause breathing difficulties in infants during delivery. Animal studies show that codeine may cause fetal harm. If given to a pregnant woman before cesarean section, fentanyl may cause drowsiness in newborns. When either of these drugs is considered crucial by your doctor, its potemt(a1 bel)elft must be carefully weighed against its risks.
Narcotics pass into breast milk. Nursing mothers who must take codeine should use infant formula.
Seniors: Seniors are more likely to be sensitive to side effects and should be treated with the smallest effective dosage.

Generic Name
Clonidine (KLAH-nih-dene)
Brand Names
Catapres-TTS-2
Catapres-TTS-1    Catapres-TTS-3
Type of Drug
Alpha receptor stimulant.
Prescribed For
High blood pressure, including hypertensive emergency (diastolic blood pressure over 120); also used for excess sweating, childhood growth delay, attention-deficit hyperactivity disorder (ADHD), Tourette’s syndrome, restless leg syndrome, schizophrenic psychosis, migraine, ulcerative colitis, painful or difficult menstruation, hot flashes related to menopause, diagnosis of pheochromocytoma (adrenal-gland tumor), kidney poisoning associated with cyclosporine, diabetic diarrhea, smoking cessation, methadone and opiate detoxification, withdrawal from alcohol and benzodiazepines such as Valium, nerve pain following herpes attack, and allergic reactions in the presence of asthma triggered by external sources.
General Information
Clonidine stimulates nerve endings in the brain called alphaadrenergic receptors. It reduces blood pressure by dilating (widening) blood vessels. Clonidine works quickly, decreasing blood pressure within 1 hour. The other uses of clonidine relate to its stimulation of alpha receptors in the body.
Cautions and Warnings
Do not take clonidine if you are allergic or sensitive to any of its ingredients.
People who have had a stroke or recent heart attack or who have cardiac insufficiency or chronic kidney failure should avoid taking clonidine.
Some people develop a tolerance of their clonidine dosage. If this happens, your blood pressure may increase and your doctor may prescribe a higher dose.
Never stop taking clonidine without your doctor’s knowledge. If you abruptly stop taking clonidine, you may experience an unusual increase in blood pressure accompanied by agitation, headache, nervousness, and severe reactions, possibly death. Restarting clonidine therapy or taking another antihypertensive can reverse these effects.
Clonidine may cause degeneration of the    See your eye doctor for regular GheCk Ups lfiyou are taking this drug.
); you require surgery, your doctor will continue your clonidine therapy until about 4 hours before surgery and resume it as soon as possible afterward.
People who develop skin sensitivity (symptoms include rash, itching, and swelling) to Catapres-TTS, the transdermal patch form of clonidine, may experience the same reactions with oral clonidine.
Possible Side Effects
Tablets
♦    Most common: dry mouth, drowsiness, dizziness, constipation, and sedation.
♦    Common: headache and fatigue. These effects tend to diminish within 4-6 weeks.
•    Less common: appetite loss, swelling or pain in the glands of the throat, nausea, vomiting, weight gain, blood-sugar elevation, breast pain or enlargement, worsening of congestive heart failure, heart palpitations, rapid heartbeat, painful blood-vessel spasm, abnormal heart rhythms, electrocardiogram changes, feeling unwell, changes in dream patterns, nightmares, difficulty sleeping, hallucinations, delirium, anxiety, depression, nervousness, restlessness, rash, hives, thinning or loss of scalp hair, difficult or painful urination, nighttime urination, retaining urine, decrease or loss of sex drive, weakness, muscle or joint pain, leg cramps, increased alcohol sensitivity, dryness and burning of the eyes, dry nose, loss of color, and fever.
Transdermal Patch
✓    Most common: dry mouth and drowsiness.
✓    Less common: constipation, nausea, changes in sense of taste, dry throat, fatigue, headache, lethargy, changes in sleep patterns, nervousness, dizziness, impotence, sexual difficulties, and mild skin reactions including itching, swelling, contact dermatitis, discoloration, burning, peeling, throbbing, white patches, and generalized rash. Rashes of the face and tongue have also occurred but cannot be specifically tied to transdermal clonidine.
Drug Interactions
•    Combining clonidine and a beta-adrenergic blocker may increase the severity of a drug-withdrawal reaction and rebound high MW pressure. This reaction may be very serious.
•    Combining verapamil and clonidine may lead to very low blood pressure and atrioventricular (AV) block (abnormality in heartbeat patterns). This reaction may be very serious.
O    Avoid alcohol, barbiturates, and sedatives because they increase the depressive effects of clonidine.
•    Tricyclic and other antidepressants, appetite suppressants, estrogens, stimulants, indomethacin and other nonsteroidal anti-inflammatory drugs (NSAIDs), and prazosin may counteract the effects of clonidine.
•    clonidine may reduce the therapeutic effects of levadopa +
carbidopa.
Food Interactions
The tablets are best taken on an empty stomach but may be taken with food if they upset your stomach.
Usual Dose
Tablets
Adult: high blood pressure-100 mcg twice a day to start; may be raised by 100 mcg a day until maximum control is achieved. Take no more than 2400 mcg a day. Other uses-100-goo mcg a day, or up to 0.8 mcg per lb. of body weight in divided doses. Seniors should start with a lower dose and increase more slowly.
Child: 50-400 mcg orally twice a day.
Transdermal Patch
Adult: 100 mcg delivered daily from a patch applied once every 7 days. Up to two 300-mcg patches may be needed to control blood pressure. Transdermal dosage exceeding 600 mcg a day has not been shown to increase effectiveness.
Child: not recommended.
Overdosage
Symptoms of overdose are slow heartbeat, central- nervous-system depression, very slow breathing, low body temperature, pinpoint pupils, seizures, lethargy, agitation, irritability, nausea, vomiting, abnormal heart rhythms, mild increases in blood pressure followed by a rapid drop in blood pressure, dizziness, weakness, loss of reflexes, and vomiting. Victims should be taken to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Gk’3t1161)e causes drowsiness in about 1/3 of people who take it. Be extremely careful while driving or performing any task that requires concentration. This effect is prominent during the first few weeks of clonidine therapy and then tends to decrease.
Do not take over-the-counter cough and cold medications unless directed by your doctor.
Call your doctor it you become depressed or have vivid dreams or nightmares while taking clonidine, or if you develop swelling in your feet or legs, paleness or coldness in your fingertips or toes, or any persistent or bothersome side effect.
Apply the transdermal patch to a hairless area of skin such as the upper arm or torso. Use a different skin site each time. If the patch becomes loose, apply the supplied adhesive directly over it. If the patch falls off before 7 days are up, apply a new one. Do not remove the patch while bathing.
If you forget a dose of oral clonidine, take it as soon as possible and then go back to your regular schedule. If you miss 2 or more consecutive doses, consult your doctor; missed doses may cause blood pressure increases and severe adverse effects. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Clonidine passes into the fetal bloodstream. Animal studies show that clonidine may damage the fetus in doses as low as 1/3 the maximum dose. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Clonidine passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors are more susceptible to the effects of this drug and should begin with lower doses.

Generic Name
Clopidogrel (kloe-PID-oe-grel) nQ
Brand Name  Plavix
Type lul Drug Antiplatelet.
Prescribed For
Heart attack and stroke prevention; also used for blood thinning after placement of a vascular stent.
General Information
Artery-clogging blood clots are often the cause of heart attacks and strokes. clopidogrel reduces the risk of both by helping prevent blood-clot formation. This drug thins the blood by making platelets—the cells that aggregate to form clots—less “sticky.” It starts working in as little as 2 hours after taking a single tablet. The drug’s blood-thinning effect lasts until inactivated platelets are replaced by the body. Studies suggest that clopidogrel is more effective than aspirin in preventing heart attack and stroke in people at risk. People taking clopidogrel after scent surgery usually take it for a relatively short period. Those taking it to prevent a heart attack or stroke must take it for life.
Cautions and Warnings
Do not take clopidogrel if you are allergic or sensitive to any of its ingredients or to ticlopidine, a related antiplatelet. These drugs can rarely cause a rapid drop in white-blood-cell count.
People with bleeding ulcers, brain hemorrhages, or other bleeding problems should use clopidogrel with caution.
Thrombotic thrombocytopenic purpura (TTP) is a rare but serious complication of clopidogrel, sometimes reported after less than 2 weeks of treatment. See your doctor right away if you develop a sudden fever, unusual bruising, nosebleeds, bleeding gums, or any other unusual symptoms. TTP reduces your platelet count, interfering with blood clotting, and affects white-blood-cell count.
People with liver problems should use clopidogrel with caution.
Possible Side Effects
✓    Most common: rash and other skin problems.
✓    Common: chest pain, accidents, flu-like symptoms, pain, headache, dizziness, abdominal pain, upset stomach, joint pain, back pain, black-and-blue marks, and respiratory infection.
✓    Less common: tiredness, Swollen arms or legs, high blood pressure, diarrhea, nausea, bleeding, nosebleeds, breathing difficulties, runny nose, coughing, bronchitis, high blood cholesterol, urinary infection, and depression.
✓    Rare: bleeding in the brain and stomach ulcer. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Clopidogrel may interfere with the body’s ability to break down fluvastatin, nonsteroidal anti-inflammatory drugs (NSAIDs), phenytoin, tamoxifen, tolbutamide, torsamide, and
warfann.
•    Combining clopidogrel and NSAIDs may increase blood loss and bleeding in the stomach and intestines.
•    Do not combine clopidogrel and other antiplatelet drugs or
the anticoagulant (blood thinner) warfarin unless you are
under your doctor’s direct supervision. This interaction may
prevent normal blood clotting and lead to severe bleeding
problems.
Food Interactions
Clopidogrel may be taken without regard to food or meals.
Usual Dose
Adult: 75 mg a day.
Overdosage
Little is known about the effects of clopidogrel overdose aside from reduced blood clotting. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Minor cuts may take longer to stop bleeding during treatment with clopidogrel. If you are having surgery, make sure your doctor knows you are taking clopidogrel. You may have to stop taking the drug I week before surgery.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule.
Special Populations
Pregnancy/Breast-feeding: The safety of using clopidogrel during pregnancy is not known. Other antiplatelet drugs, tike aspirin, are not used during pregnancy due to their possible effects on Mrjlher and fetus. When this drug is considered crucial by your doctor, its benefits must be carefully weighed against its risks.
Clopidogrel may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may take this drug without special precaution.

Generic Name
Clorazepate (klor-AZ-uh-pate) 99
Brand Names
Gen-Xene    Tranxene-SD
Tranxene    Tranxene T-Tab
Type of Drug
Benzodiazepine sedative.
Prescribed For
Anxiety, tension, fatigue, and agitation; symptoms of acute alcohol withdrawal; partial seizures; also prescribed for irritable bowel syndrome and panic attacks.
General Information
Clorazepate dipotassium is a benzodiazepine. Benzodiazepines directly affect the brain. They can relax you and make you more tranquil or sleepier, or they can slow nervous system transmissions in such a way as to act as an anticonvulsant. Many doctors prefer benzodiazepines to other drugs that can be used to similar effect because they tend to be safer, have fewer side effects, and usually work as well, if not better.
Cautions and Warnings
Do not take clorazepate if you are allergic or sensitive to any of its ingredients or to another benzodiazepine drug, including clonazepam.
Clorazepate can aggravate narrow-angle glaucoma, but you may take it if you have open-angle glaucoma and are receiving therapy for it.
Other conditions in which clorazepate should be avoided are: severe depression, severe lung disease, sleep apnea (intermittent cessation of breathing during sleep), liver disease, drunkenness, and kidney diseaap_, to inOn of these conditions, the qq)NSSvve effects of clorazepate may be enhanced or could be detrimental to your overall condition.
Clorazepate should not be taken by psychotic patients because it is not effective for them and can trigger unusual excitement, stimulation, and rage.
Clorazepate is not intended to be used for more than 3-4 months at a time. Your doctor should reassess your condition before continuing your prescription beyond that time.
Clorazepate may be addictive. It should be used with caution in people with a history of drug dependence.
Drug withdrawal may develop if you stop taking it after as few as 4 weeks of regular use but is more likely after longer use. It may start with anxiety and progress to tingling in the hands or feet, sensitivity to bright light, sleep disturbances, cramps, tremors, muscle tension or twitching, poor concentration, flu-like symptoms, fatigue, appetite loss, sweating, and changes in mental state. Your dosage should always be reduced gradually to prevent drug withdrawal symptoms.
Possible Side Effects
Weakness and confusion may occur, especially in seniors and in those who are more sickly.
✓    Most common: mild drowsiness during the first few days of therapy.
✓    Less common: confusion, depression, lethargy, disorientation, headache, inactivity, slurred speech, stupor, dizziness, tremors, constipation, dry mouth, nausea, inability to control urination, sexual difficulties, irregular menstrual cycle, changes in heart rhythm, low blood pressure, fluid retention, blurred or double vision, itching, rash, hiccups, nervousness, inability to fall asleep, and occasional liver and kidney dysfunction. If you have any of these symptoms, stop taking the medicine and contact your doctor immediately.
✓    Rare: Rare side effects can affect your heart, stomach and intestines, urinary tract, blood, muscles and joints. Contact your doctor if you experience any side effects not listed above.
Drug Interactions
•    Clorazepate is a central-nervous-system depressant. Don’t mix it with alcohol, other sedatives, narcotics, barbiturates, monoamine oxidase inhibitor and other antidepressants, and antihistamines. Taking Clorazepate with these drugs may result in excessive depression, tiredness, sleepiness, breathing difficulties, or related symptoms.
•    Smoking may reduce clorazepate’s effectiveness by in-
creasing the rate at which it is broken down by the body.
•    Clorazepate’s effects may be prolonged when it is mixed with cimetidine, contraceptive drugs, disulfiram, fluoxetine, isoniazid, ketoconazole, metoprolol, probenecid, propoxyphene, propranolol, rifampin, or valproic acid. Theophylline may reduce clorazepate’s sedative effects.
•    If you take antacids, separate them from your clorazepate dose by at least 1 hour to prevent them from interfering with the absorption of clorazepate into the bloodstream.
•    Clorazepate may increase blood levels of digoxin and the chances of digoxin toxicity.
•    The effect of levodopa + carbidopa may be decreased if it is taken together with clorazepate.
•    Combining clorazepate with phenytoin may increase phenytoin blood concentrations and the chances of phenytoin toxicity.
Food Interactions
Clorazepate is best taken on an empty stomach, but it may be taken with food if it upsets your stomach.
Usual Dose
Immediate-Release
Adult and Child (age 9 and over): 15-60 mg daily. The average dose is 30 mg in divided quantities, but dosage must be adjusted to individual response for maximum effect. Maximum recommended daily dose is 90 mg. For treatment of anxiety, clorazepate may be taken as a single dose at bedtime.
Child (under age 9): not recommended.
Sustained-Release
Adult: The sustained-release form of clorazepate may be given as a single dose, either 11.25 or 22.5 mg, once every 24 hours. Sustained-release tablets are not recommended for the initial dosage.
Child: not recommended.
Overdosage
Symptoms of overdose are confusion, sleepiness, poor coordination, lack of response to pain such as a pin prick, loss of reflexes, shallow breathing, low blood pressure, and coma. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Clorazepate can cause tiredness, drowsiness, inability to concentrate, or similar symptoms. Be careful if you are driving, operating machinery, or performing other activities that require concentration.
People taking clorazepate for more than 3 or 4 months at a time may develop drug withdrawal reactions if the medication is stopped suddenly (see “Cautions and Warnings”). Do not stop taking clorazepate or increase or decrease your dosage without first consulting your doctor.
If you forget a dose of clorazepate, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Clorazepate may cause birth defects if taken during the first 3 months of pregnancy. Avoid this drug if you are or might be pregnant.
Clorazepate may pass into breast milk. Nursing mothers who must take clorazepate should use infant formula.
Seniors: Seniors, especially those with liver or kidney disease, are more sensitive to the effects of clorazepate and generally require smaller doses to achieve the same effect.

Generic Name
Clemastine (KLEH-mas-tene) A
Brand Names
DayHist-1    Tavist-1
Tavist    Tavist Allergy
Combination Pr(3dUtj
Generic Ingredients: Acetaminophen + Clemastine + Pseudoephedrine
Tavist Allergy/Sinus/Headache
Type of Drug  Antihistamine.
Prescribed For
Sneezing, stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal allergies and for other symptoms of allergies such as rash, itching, and hives.
General Information
Antihistamines generally work by blocking the release of naturally occuring histamine (a chemical released by body tissue during an allergic reaction) from cells at the H, histamine receptor site, drying up secretions of the nose, throat, and eyes. Clemastine fumarate is less sedating than most antihistamines, but not less sedating than astemizole, cetirizine, or loratadine.
Cautions and Warnings
Clemastine should not be taken if you are allergic or sensitive to any of its ingredients.
People with asthma or other deep-breathing problems, heart disease, high blood pressure, diabetes, enlarged prostate, glaucoma, stomach ulcers or other stomach problems, and hyperthyroidism should use clemastine with caution because its side effects can aggravate these problems.
Possible Side Effects
✓    Most common: drowsiness; headache; weakness; nervousness; stomach upset; nausea; vomiting; cough; stuffy nose; diarrhea; constipation; sore throat; nosebleeds; and dry mouth, nose, or throat.
✓    Less common: allergic reaction (symptoms include rash, itching, hives, and breathing difficulties), sleeplessness, menstrual irregularities, muscle aches, sweating, tingling in the hands or feet, frequent urination, visual disturbances, and ringing or buzzing in the ears.
Drug Interactions
•    Cbrnbining clemastine with alcohol, sedatives, sleeping pills, or other nervous system depressants may increase the depressant effects of clemastine. Do not combine these drugs.
•    The effects of oral anticoagulant (blood-thinning) drugs may be decreased by clemastine. Do not take this combination without your doctor’s knowledge.
Monoamine oxidase inhibitor antidepressants may increase the drying and other effects of clemastine. This combination can also worsen urinary difficulties.
e When taking antihistamines on a regular basis, notify your doctor if you are taking large amounts of aspirin. Effects of too much aspirin may be masked by the antihistamine.
Food Interactions
Clemastine is best taken on an empty stomach at least 1 hour before or 2 hours after eating; it may be taken with food if it upsets your stomach.
Usual Dose
Adult and Child (age 12 and over): 1.34 mg twice a day up to 8.04 mg of the syrup or 2.68 mg of the tablets in 24 hours.
Child (age 6-12) (syrup only): 0.67 mg twice a day or up to 4.02 mg a day.
Overdosage
Overdose is likely to cause severe side effects. Overdose victims should be given ipecac syrup—available at any pharmacy—to induce vomiting and should then be taken to a hospital emergency room for treatment. ALWAYS bring the prescription bottle or container.
Special Information
Clemastine may make it difficult for you to concentrate or perform complex tasks such as driving a car. Be sure to report any unusual side effects to your doctor
Antihistamines may occasionally produce excitability, particularly in children.
If you forget to take a dose of clemastine, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
PregnancylBreast-feedj(IV. DO not take any antihistamines without WU ‘Obtlor’s knowledge if you are or might be pregnant—especially during the last 3 months of pregnancy, because newborns may have severe reactions to antihistamines.
Small amounts of clemastine pass into breast milk. Nursing mothers who must take clemastine should use infant formula.
Seniors: Seniors are more sensitive to side effects.

Generic Name
Clindamycin (klin-duh-MYE-sin)
Brand Names
Cleocin    Clindesse
Cleocin T    Clindets
Clinda-Derm    Evoclin Clindagel
Type of Drug  Antibiotic.
Prescribed For
Serious bacterial infections. The vaginal cream is used to treat bacterial vaginosis. Topical clindamycin is used to treat acne and rosacea.
General Information
Clindamycin is one of the few oral drugs that is effective against anaerobic bacteria, which grow only in the absence of oxygen and are often found in infected wounds, lung abscesses, abdominal infections, and infections of the female genital tract. It also works against bacteria usually treated with penicillin or erythromycin, including serious respiratory tract infections. Clindamycin may be useful for treating certain skin or soft tissue infections. It kills the bacteria that frequently cause acne.
Clindamycin is not used to treat vaginal fungus or yeast infections.
Cautions and Warnings
Do not take clindamycin if you are allergic or sensitive to any of its ingredients or to lincomycin, another antibiotic.
People with asthma or a history of allergies should use clindamycin capsules with caution.
Clindamycin can cause a severe intestina(kmkation called colitis, which can be fatal. Signs of colitis are diarrhea, blood in the Stool, and abdominal cramps. Any form of this drug, including products applied to the skin and the vaginal cream, can provoke colitis. Because of this, clindamycin should be reserved for serious infections or those that cannot be treated with other drugs.
Clindamycin should be used with caution if you have gastrointestinal disease or kidney or liver disease.
Possible Side Effects
Capsules
✓    Most common: stomach pain; nausea-, vomiting-, diarrhea,
in up to 20% of people; and pain when swallowing.
♦    Less common: itching; rash; signs of serious drug sensitivity, such as difficulties breathing and yellowing of the skin or the whites of the eyes; colitis, (see “Cautions and Warnings”); effects on blood components; and joint pain.
Topical Lotion
♦    Most common: dry skin, redness, burning, peeling, oily skin, and itching.
♦    Less common: diarrhea, abdominal pain, upset stomach, and colitis (see “Cautions and Warnings”).
Vaginal Cream
♦    Most common: vaginal itching or irritation; thick, white vaginal discharge; and pain during intercourse.
♦    Less common: nausea, vomiting, diarrhea, constipation, abdominal pain, dizziness, headache, vertigo, and colitis (see “Cautions and Warnings”).
Drug Interactions
•    Do not combine clindamycin and erythromycin.
•    The absorption of clindamycin capsules into the bloodstream is delayed by Kaolin-Pectin Suspension (prescribed for diarrhea). Separate these drugs by at least 1 hour.
•    clindamycin should be used with caution by people also using neuromuscular agents.
Food Interactions
Take the oral medication with a full glass of water or with food to prevent irritation of the stomach and intestine.
Usual Dose
Capsules
MUIV ) 50-450 mg every 6 hours.
Child (under age 16): 3.5-11 mg per lb. of body weight a day, in 3-4 doses. For severe infections, at least 37.5 mg 3 times a day, regardless of weight.
Foam: Dispense enough to cover the affected area(s) onto a cool surface (the foam will melt on contact with warm skin). Use fin-gertips to massage small amounts into the affected area(s) until the foam disappears.
Suppositories: Insert 1 suppository a day for 3 consecutive days.
Topical Lotion: Wash the skin and pat dry before application. Apply enough to cover the affected area(s) with a thin coat twice a day.
Vaginal Cream: Insert 1 applicator’s worth at bedtime for 7 consecutive days, except for Clindesse, which requires one applicator’s worth once at any time of day.
Overdosage
clindamycin overdose may lead to severe diarrhea and other drug side effects. Do not treat this diarrhea on your own. Discontinue use of this drug and call your local poison center for information. If you go to an emergency room for treatment, ALWAYS bring the prescription bottle or container.
Special Information
Prolonged or unsupervised use of clindamycin may lead to secondary infections from susceptible organisms. such as fungi. Take this drug for the full course of therapy as indicated by your physician.
If you develop severe diarrhea or abdominal pain, call your doctor at once. Call your doctor immediately if you experience breathing difficulties or jaundice (yellowing of the skin or whites of the eyes).
Women using the vaginal cream should not have vaginal intercourse or use other vaginal products such as tampons or douches until treatment is complete.
Use of latex condoms or diaphragms within 72 hours following treatment with the vaginal creams or suppositories is not recommended. These products may decrease the efficacy of condoms or diaphragms.
The topical lotion is for external use only. Avoid contact with your eyes or mucous membranes.
If you miss a dose of oral clindamycin, take it as soon as you rememlae~. SSW19 almost time for your next dose of clindamycin, double that dose and go back to your regular dosage schedule.
Special Populations
Pregnancy/Breast-feeding: This drug crosses into fetal blood circulation. When the drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
clindamycin passes into breast milk. Nursing mothers who must take oral clindamycin should use infant formula.
Seniors: Seniors with other illnesses may be unable to tolerate diarrhea and other clindamycin side effects.

Generic Name
Clonazepam (klon-A-zeh-pam)
Brand Name  Klonopin
Type of Drug  Anticonvulsant.
Prescribed For
Petit mal and other seizures and panic attacks; also prescribed for periodic leg movements during sleep, speaking difficulty associated with Parkinson’s disease, acute manic episodes, nerve pain, and schizophrenia.
General Information
Clonazepam is a benzodiazepine drug. Clonazepam is not used as a sedative or hypnotic. It is used only for the uses described above in people who have not responded to other drug treatments. Tolerance to the effects of clonazepam commonly develops within about 3 months of use. Your doctor may raise your clonazepam dosage periodically to maintain the drug’s effect.
Cautions and Warnings
Do not take clonazepam if you are allergic or sensitive to any of its ingredients or any other benzodiazepine.
When stopping clonazepam treatments, the drug must be discontinued gradually. Abrupt discontinuance of clonazepam may lead to drug withdrawal symptoms including severe seizures, tremors, abdominal or muscle cramps, vomiting, whet increased sweating.
IJSIF,l OfMazeparn with caution if you have a chronic respiratory illness, since the drug tends to increase salivation and other respiratory secretions and can make breathing more labored.
Avoid using clonazepam if you have severe depression, severe lung disease, sleep apnea (intermittent cessation of breathing during sleep), liver disease, alcoholism, or kidney disease. These conditions may exacerbate the depressive effects of benzodiazepines, and such effects may be detrimental to your overall
condition.
Clonazepam can aggravate narrow-angle glaucoma, but if you have open-angle glaucoma, you may take it.
Possible Side Effects
♦    Most common: drowsiness, poor muscle control, and behavioral changes.
✓    Rare: Rare side effects can occur in almost any part of the body but are most likely to affect mental function, stomach and intestines, urinary function, blood, and liver. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    The depressant effects of clonazepam are increased by sedatives, sleeping pills, narcotic pain relievers, antihistamines, alcohol, monoamine oxidase inhibitor antidepressants, tricyclic antidepressants, and other anticonvulsants.
•    Mixing valproic acid and clonazepam may produce severe petit mal seizures.
•    Smoking, phenobarbital, phenytoin, carbamazapine, and rifampin may reduce clonazepam’s effectiveness.
•    Clonazepam may increase the requirement for other anticonvulsant drugs in people who suffer from multiple types of seizures.
•    The effects of clonazepam may be prolonged when it is taken with cimetidine, contraceptive drugs, disulfiram, fluvoxamine, isoniazid, oral antifungal medications (e.g. ketoconazole), metoprolol, probenecid, propoxyphene, or propranolol.
•    Theophylline may reduce clonazepam’s sedative effects.
•    Separate antacids from y<3kwc_%1Dnazepam dose by at least 1 bZldi %prevent them from interfering with clonazepam being absorbed into the bloodstream.
•    Clonazepam may increase blood levels of digoxin and the risk of digoxin toxicity.
•    Clonazepam may decrease the effect of levodopa + carbidopa.
Food Interactions
Clonazepam is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
Clonazepam is available in either tablets or orally disintegrating tablets, called wafers. Wafers should not be opened until immediately before the dose is to be taken. Do not push the wafer through the foil. Use dry hands to remove the wafer. The wafer will disintegrate quickly in saliva.
Seizures
Adult and Child (age 10 and over): starting dose    0.5 mg 3 times a day. The dose is increased by 0.5-1 mg every 3 days until seizures are controlled or side effects develop. The maximum daily dose is 20 mg.
Panic attacks
Adult and Child (age 10 and over): starting dose-0.25 mg twice daily. The dose is increased to 1 mg a day after 3 days. Most people do not require a higher dose.
Child (under age 10 or below 66 Ms.): starting dose-0.0220.066 mg per lb. of body weight a day in divided doses. Dosage can be increased gradually to a daily dose of 0.22-0.44 mg per lb. of body weight.
Other uses for clonazepam involve doses from 0.5-16 mg a day, depending on the condition and its severity. Clonazepam dosage must be reduced in people with impaired kidney function.
Overdosage
Overdose may cause confusion, coma, poor reflexes, sleepiness, low blood pressure, labored breathing, and other depressive effects. If the overdose is discovered within a few minutes and the victim is still conscious, it may be helpful to induce vomiting with ipecac syrup—available at any pharmacy. Overdose victims must be taken to a hospital emergency room. ALWAYS bring the prescription bottle or contai”iaT.
Special Information
Clonazepam may interfere with your ability to drive or perform other complex tasks because it can cause drowsiness and difficulty in concentrating.
Your doctor should perform periodic blood counts and liver function tests while you are taking this drug to check for possible
side effects.
Do not suddenly stop taking clonazepam—severe seizures may result. The dosage must be discontinued gradually by your doctor.
If you miss a dose by 1 hour or less, take it right away. Otherwise, skip the dose you forgot and go back to your regular schedule. Do not take a double dose.
Carry identification or wear a bracelet indicating that you have a seizure disorder for which you take clonazepam.
Special Populations
Pregnancy/Breast-feeding: Clonazepam crosses into the fetal circulation and can affect the fetus. Women who are or might be pregnant should avoid it. When the drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Some reports suggest a strong link between anticonvulsant drugs and birth defects, though most of the information pertains to phenytoin and phenobarbital, not clonazepam. It is also possible that the epileptic condition itself or genetic factors common to people with seizure disorders may figure in the higher incidence of birth defects.
Clonazepam may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors, especially those with liver or kidney disease, are more sensitive to the effects of this drug—especially dizziness and drowsiness—and may require smaller doses.

Type of Drug
Cephalosporin Antibiotics
(CEF-uh-loe-SPOR-in)
Brand Names
Cefaclor 91 Raniclor
Cefadroxil Duricef
Cefdinir Omnicef
Cefditoren Pivoxil
Spectracef
Cefixime Suprax
Cefpodoxime Proxetil 91 Vantin
Cefprozil Cefzil
Ceffibuten Cedax
Cefuroxime Axetil 90 Ceftin
Generic Ingredient: Cephalexin 91 Panixine Disperdose    Keflex
Prescribed For  Bacterial infections.
General Information
These antibiotics are related to cephalosporin C, which is similar to penicillin and is isolated from the Cephalosporium acremonium fungus. Of the more than 20 different antibiotic drugs derived from cephalosporin C, only those that are taken by mouth are included in The Pill Book. Most common infections can be treated with these antibiotics, but they are not interchangeable. Your doctor must select the appropriate antibiotic for a particular infection.
Cautions and Warnings
Do not take cephalosporin antibiotics if you are allergic or sensitive to any of their ingredients. Up to 15% of people allergic to penicillin may also be allergic to cephalosporins. The most common cephalosporin allergic reaction is a hive-like rash condition with redness over large aceas 0 the body. Other sensitivity reac161011S Include general rash, fever, and joint aches or pain. Such reactions generally begin after a few days of taking the antibiotic and resolve within a few days after the antibiotic is stopped.
Prolonged or repeated use of a cephalosporin may lead to a secondary infection not susceptible to the antibiotic.
Occasionally, people taking a cephalosporin develop colitis. Call your doctor if you develop severe diarrhea while taking one of these drugs.
People with poor kidney function may require less medicine to treat their infections. Rarely, people taking a cephalosporin have had a seizure, especially those with kidney disease whose dose was not reduced.
Some injectable cephalosporins have caused blood-clotting problems. This has not occurred in people taking an oral drug.
Rarely, severe anemia occurs in people taking cephalosporin antibiotics. Report any signs of anemia (such as pale skin color, weakness, tiredness, difficulty breathing, and abnormal heart rhythms) to your doctor.
Cefprozil oral suspension contains phenylalanine and cannot be taken by people with phenylketonuria (PKU disease).
Possible Side Effects
Most side effects are mild.
✓    Most common: diarrhea, headache, abdominal pain, constipation, gas, upset stomach, nausea, vomiting, itching, and rash.
✓    Less common: dizziness, tiredness, weakness, tingling in the hands or feet, confusion, appetite loss, changes in taste perception, and genital and anal itching. Colitis may develop.
Cefaclor may cause serum sickness (symptoms include fever, joint pain, and rash). cephalosporins may cause changes in blood cells, kidney problems, liver inflammation, and jaundice, but these side effects are rarely a problem with oral cephalosporins.
Drug Interactions
•    Antacids can reduce the amounts of cefaclor, cefdinir, cefditoren pivoxil, and cefpodoxime proxetil in the blood. Do not take antacids within 2 hours of these antibiotics.
•    Cimetidine, famotidine, ranitidine, or nizatidine can reduce the effectiveness of cefpodoxime proxetil, cefditoren pivoxil, and cefuroxime axetil—do not combine these drugs.
•    Iron and iron-fortified foods may interfere with the absorption of cefdinir. Separate your iron dose from the antibiotic by at least 2 hours. Iron-fortified infant formula does not have this effect.
•    Probenecid may increase blood levels of some cephalosporins.
•    Potent (loop-type) diuretics can lead to kidney damage if mixed with a cephalosporin antibiotic.
Food  Interactions
Generally, cephalosporins may be taken with food or milk if they upset your stomach. Cefditoren pivoxil should be taken with a meal. Food increases the absorption of cefpodoxime proxetil and cefuroxime axetil.
Usual Dose
Ceftibuten
Adult and Child (age 12 and over): 400 mg once a day for 10 days. Child: 4 mg per lb. of body weight, up to 400 mg, once a day.
Cefuroxime Axetil
Adult and Child (age 13 and over): 250-1000 mg a day in 1-2 doses.
Child (age 3 months-12 years): tablets-125-250 mg every
12 hours. Liquid-9-13 mg per lb. of body weight every 12 hours.
Cephalexin
Adult: 1000-4000 mg a day in divided doses, usually 250 mg every 6 hours, or 500 mg every 12 hours.
Child: 11-23 mg per lb. of body weight a day in divided doses. The dose may be increased to 46 mg per lb. of body weight for middle-ear infections.
Overdosage
Common symptoms of overdose are nausea, vomiting, and upset stomach. These can often be treated with milk or an antacid. Cephalosporin overdoses are generally not serious; contact a hospital emergency room or local poison control center for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you develop severe abdominal cramps or diarrhea. Stop taking this drug and immediately call your doctor if you experience fever, chest tightness, breathing difficulties, redness, muscle aches, or swelling.
You must take the full course of treatment prescribed—even if you feel better in 2 or 3 days—to obtain the maximum benefit from any antibiotic.
Proper diagnosis is key to the effectiveness of an antibiotic: Do not take any antibiotic without consulting your doctor.
You should be aware that all cephalosporins may cause false results for certain urine tests for sugar. Cefuroxime may cause false results for blood sugar. Diabetics taking cephradine should not change their diet or diabetes medication without consulting their doctor.
If you miss a dose that you take once a day, take it as soon as you remember. If it is almost time for your next dose, take the dose you forgot right away and your next one 10-12 hours later. Then go back to your regular schedule. If you take the medication twice a day, take the dose you forgot right away and the next dose 5-6 hours later. Then go back to your regular schedule. If you take the medication 3 or more times a day, take the dose you missed right away and your next dose 2-4 hours later. Then go back to your regular schedule.
Most cephalosporin liquids must be kept in the refrigerator to maintain their strength. Only cefixime liquid does not require refrigeration. All of the liquid cephalosporins have a very limited shelf life. Do not keep any of these liquids beyond the 10 days-2 weeks specified on the label. Follow your pharmacist’s storage instructions.
Special Populations
Pregnancy/Breast-feeding: These drugs are considered relatively safe during pregnancy, though small amounts pass into the fetus. Little information is available about the newer members of the group. Also, cephalosporins pass more quickly out of the bodies of pregnant women. cephalosporins should only be used during pregnancy after carefully weighing their potential benefits against their risks.
Small amounts of most cephalosporin antibiotics pass into breast milk. Nursing mothers who must take a cephalosporin should use infant formula.
Seniors: Seniors may require a lower dosage if they have reduced kidney function.
Cefaclor
250 mg every 8 hours, or 375-500 mg every 12 hours.  9 mg per lb. of body weight a day, in 2-3 equal doses.
Cefadroxil
1-2 g a day. in 1-2 doses.
13 mg per lb. of body weight a day, in 1-2 doses.
Cefdinir
Adult and Child (age 13 and over): 600 mg a day, in 1-2 doses. Child (age 6 months-12 years): 6.5 mg per lb. of body weight a day in 1-2 doses.
Cefditoren Pivoxil
Adult and Child (age 12 and over): 200-400 mg twice a day for 10 days.
Cefixime
400 mg a day, in 1-2 doses.
3.5 mg per lb. of body weight a day, in 1-2 doses.
cefpodoxime Proxetil
Adult and Child (age 13 and over): 200-400 mg a day, in 1-2 doses. Child (age 5 months-12 years): 5 mg per Yo. of body weight a day
in 1-2 (dvsin. Maximum daily dose for middle-ear infections is
400 mg; 200 mg for sore throat or tonsillitis.
Cefprozil
Adult and Child (age 13 and over): 500-1000 mg a day.
Child (age 6 months-12 years): 7-13 mg per lb. of body weight a day in 1-2 doses.

Celecoxib (sel-eh-KOX-ib)
Brand Name
Celebrex
Type of Drug
Cyclooxygenase-2 (COX-2) inhibitor nonsteroidal anti-inflammatory
drug (NSAID).
Prescribed For
Osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, acute pain, some colon polyps (FAR), menstrual pain, and arthritis of the spine (ankylosing spondylitis).
General Information
Traditional NSAIDs work primarily by blocking the effects of COX-2, a body enzyme that plays an important role in regulating pain and inflammation. But these NSAIDs also have an unwanted effect: They interfere with cyclooxygenase-1 (COX-1), a related enzyme that helps to maintain the stomach’s protective lining. NSAIDs that block the effects of this enzyme may produce side effects such as stomach irritation, gas, and stomach ulcers.
COX-2 inhibitors such as celecoxib are a class of NSAIDs that work about as well as the older NSAIDs. In fact, both 200 mg a day and 400 mg a day of celecoxib work as well as naproxen 500 mg twice a day. They interfere primarily with COX-2, leaving the stomach-protecting COX-1 relatively unaffected. This means that COX-2 inhibitor NSAIDs can relieve pain and inflammation just like traditional NSAIDs but are less likely to cause gastrointestinal (GI) side effects. Another advantage of celecoxib is that it does not cause thinning of the blood or affect blood platelets as can happen with older NSAIDs. Celecoxib is broken down in the liver.
Black patients absorb about 40% more celecoxib than Caucasians; its importance is unclear. Celecoxib is the first drug proven effective in reducing the number of intestinal polyps in people with the rare genetic disorder FAR
Cautions and Warnings
Do not take celecoxib if you are allergic or sensitive to any of its ingredients or to sulfa drugs. NSAIDs should not be taken by people with asthma or by those who have had a” allergic reaction to aspirin or another NSA13.1hey can develop a group of sympWMS V1Jnny nose with or without nasal polyps and a severe bronchial spasm) known as the aspirin triad.
COX-2 inhibitors, including celecoxib, have been associated with high blood pressure, kidney damage, heart attacks, and stroke. It should not be used to treat pain associated with heart bypass surgery. Two other COX-2 inhibitors were taken off the market because of safety concerns. Rofecoxib was removed because safety issues were noted after people had taken it for 18 months or more. Valdecoxib was taken off the market because of the lack of safety data, severe skin rashes, and concerns raised in people taking the drug after having had heart surgery.
NSAIDs can cause GI bleeding and ulcers and stomach perforation. This can occur at any time, with or without warning, in people who take NSAIDs regularly. Celecoxib should be used with caution by people who have had stomach ulcers or GI bleeding. Minor upper GI problems, such as upset stomach, are common and may occur at any time during NSAID therapy. People who develop bleeding or ulcers and continue NSAID treatment should be aware of the risk of developing more serious side effects. Risk of GI bleeding and ulcers is increased with longer duration of therapy as well as treatment with oral corticosteroids and anticoagulants, smoking, alcoholism, older age, and general poor health.
Children taking celecoxib may be more likely to vomit blood, suffer acute kidney failure, or develop rashes.
Celecoxib has not been studied in people with severe kidney disease. They should not use this drug unless their doctors closely monitor their kidney function.
Celecoxib can cause liver irritation and should be used with caution by people with hepatitis or cirrhosis. People with moderate liver disease can have twice as much celecoxib in their blood and require a reduced dosage. The effect of celecoxib in people with severe liver failure is not known.
Possible Side Effects
Side effects are similar to those of traditional NSAIDs. Stomach and intestinal side effects are about half as common.
♦    Most common: headache.
✓    Common: diarrhea, upset stomach, sinus irritation, and respiratory infection.
♦    Less common: abdominal pain, gas, nausea, back pain, swelling in the legs m arms, accidental injuries, sleeplessness, dizziness, sore throat, runny nose, and rash.
✓    Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Alcohol may increase the risk of serious GI-related side ef-
fects. Avoid alcohol.
•    Combining celecoxib with an aluminum and magnesium antacid slightly reduces the amount of drug absorbed. Separate doses of these antacids and celecoxib by 1-2 hours.
•    Fluconazole and lithium may raise celecoxib blood levels and increase the risk of side effects.
•    While celecoxib may be combined with low dosages of as-
pirin, taking these drugs together can increase the risk of
stomach or intestinal ulcers or other complications. The ulcer
risk associated with this combination is less than that posed
by single-drug therapy with a traditional NSAID.
•    Celecoxib can reduce the blood-pressure-lowering effect of angiotensin-converting enzyme (ACE) inhibitors and diuretic drugs. This combination can also increase the risk of kidney damage after chronic celecoxib use.
•    Celecoxib may affect lithium blood levels.
•    NSAIDS can reduce the effect of furosemide and thiazidetype diuretics.
•    Celecoxib should be used cautiously with warfarin. Concurrent use of these drugs may cause an increased risk of bleeding complications.
Food Interactions
Celecoxib can be taken without regard to Food or meals. For optimal effectiveness, avoid taking this drug with high-fat meals.
Usual Dose
Adult (age 18 and over): arthritis-100-200 mg once or twice a day. FAP-400 mg twice a day.
Child (age 2 and over): juvenile rheumatoid arthritis-22-55 lbs: 50 mg twice a day; over 55 lbs: 100 mg twice a day.
Child (under age 2): not recommended.
Overdosage
Overdosage symptoms include Mnargy, drowsiness, nausea, vomitiR(;, 16M Stomach pain. Stomach or intestinal bleeding or severe allergic reactions can occur. High blood pressure, kidney failure, breathing difficulties, and coma are rare.
The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you develop rash, itching, unexplained weight gain, nausea, fatigue, jaundice (yellowing of the skin or whites of the eyes), flu-like symptoms, lethargy, swelling, black stools, severe stomach pain, persistent headache, or any bothersome or persistent side effect.
If you forget a dose and remember within 1 or 2 hours of your scheduled time, take it right away. If you do not remember until later, skip the forgotten dose and continue with your regular schedule.
Special Populations
Pregnancy/Breast-feeding: celecoxib has caused birth defects in animal studies. Any NSAID may affect fetal heart development during the second half of pregnancy. Pregnant women should not take celecoxib without their doctor’s approval. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
NSAIDs may pass into breast milk. There is a possibility that a nursing mother taking celecoxib could affect her baby’s heart or cardiovascular system. Nursing mothers who must take this drug should use infant formula.
Seniors: Generally, seniors can take this drug without special precaution. Those who weigh less than 110 lbs. should begin with the lowest possible dosage.

Generic Name
Carvedilol (car-VAY-dih-lol)
Brand Names
Coreg    Coreg CR
Type of Drug  Alpha-beta-adrenergic blocker.
Prescribed For
Heart failure, high blood pressure, angina pain, and cardiomyopathy.
General Information
Carvedilol was the first beta blocker approved for heart failure. It is also the only beta blocker approved for severe heart failure.
Carvedilol blocks both the alpha- and beta-adrenergic portions of the central nervous system. This dual action reduces the amount of blood pumped with each heartbeat and also decreases the risk of tachycardia (very rapid heartbeat). Carvedilol’s beta-blocking effects begin within an hour of taking the first dose; maximum blood-pressure-lowering occurs after 1 or 2 weeks. The drug also causes blood vessels to dilate (widen), allowing the heart to pump blood more efficiently.
Cautions and Warnings
Do not take carvedilol if you are allergic or sensitive to any of its ingredients, or if you have AV block, sick sinus syndrome or severe bradycardia (slow heart rate) without the use of a pacemaker.
Carvedilol should not be taken 13y patients with bronchial disease, qQQkVaS thronic bronchitis, emphysema, or asthma.
Carvedilol therapy should not be stopped suddenly due to the risk of worsening the heart condition.
In studies, carvedilol caused mild and reversible liver injury in about 1 of every 100 people who took it. Those with severe liver disease should not take this medication. Call your doctor at once if you develop signs of liver damage (symptoms include severe itching, dark-colored urine, flu-like symptoms, appetite loss, and yellowing of the skin or whites of the eyes).
Check with your doctor about continuing carvedilol if you are to receive general anesthesia; heart function that is depressed by anesthetics can worsen if carvedilol is used at the same time.
Make sure your doctor knows if you have diabetes. Carvedilol can mask signs of low blood sugar and may increase the effects of insulin or oral antidiabetes drugs, making it more difficult to recover from the effects of low blood sugar.
Carvedilol can mask symptoms of an overactive thyroid gland. Abruptly stopping carvedilol can trigger an attack of hyperthyroidism.
Possible Side Effects
Most side effects are considered mild or moderate.
✓    Most common: dizziness, sleepiness or sleeplessness, diarrhea, abdominal pain, slow heartbeat, dizziness when rising from a sitting or lying position, swelling of the hands or feet, sore throat, breathing difficulties, tiredness, back pain, urinary infection, and viral infection.
✓    Less common: extra heartbeats; palpitations; blood-pressure changes; fainting; reduced blood supply to the arms and legs (symptoms include aches, cramps, pain, or tiredness on walking, or pain in the foot, thigh, hip, or buttocks); tingling in the hands or feet; reduced sensation; depression; nervousness; constipation; gas; liver irritation; cough; impotence and reduced sex drive in men; itching; rash; visual difficulties; ringing or buzzing in the ears; high blood cholesterol, sugar, or uric acid; anemia; weakness; hot flushes; leg cramps; dry mouth; not feeling well; sweating; and muscle ache.
✓    Rare: Rare side effects can affect the heart, mental status, the respiratory tract, the urinary tract, and the kidney. It can also cause hair loss, weight gain, high blood-triglyceride levels, low blood-platelet counts, and sugar in the urine. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Carvedilol increases the effects of insulin and oral antidiabetes drugs. People taking this combination must monitor their blood sugar levels regularly. Call your doctor if there is any change from your normal pattern.
•    Carvedilol increases the effects of verapamil, diltiazem, and similar calcium-channel blocking drugs.
•    Monoamine oxidase inhibitor antidepressants may increase the effects of carvedilol.
•    Carvedilol increases the blood-pressure-lowering effect of clonidine. People taking this combination may need less clonidine to control their pressure.
•    Carvedilol increases the amount of digoxin in the blood by about 15%. Your digoxin dosage may have to be adjusted.
•    Cimetidine increases the amount of carvedilol absorbed into the blood by about 30%, but the importance of this interaction is not clear.
•    Rifampin reduces the amount of carvedilol in the blood by about 70%. Dosage adjustment is necessary.
•    Do not consume alcohol (including medicines that contain alcohol) within 2 hours of taking carvedilol.
Food Interactions
Take carvedilol with food to reduce the risk of dizziness or fainting.
Usual Dose
Heart Failure
Adult: 3.125 mg twice a day for 2 weeks. Dose may be doubled every 2 weeks to the highest level tolerated. Maximum daily dosage is 25 mg twice a day in people weighing less than 187 lbs., and 50 mg twice a day in people who weigh more.
High Blood Pressure and Cardlomyopathy
Adult: 6.25 mg twice a day to start, increased to 25 mg twice a day if needed.
Senior: Seniors may require smaller doses than younger adults. Child (under age 18): not recommended.
Overdosage
~3%rdose may lead to very low blood pressure (symptoms include dizziness and fainting), slow heartbeat and other cardiac symptoms, including shock and heart attack, breathing difficulties, bronchial spasm, vomiting, periods of unconsciousness, and seizures. Overdose victims must be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Carvedilol should be taken continuously. Do not stop taking it without your doctor’s knowledge, because abrupt withdrawal may cause chest pain, breathing difficulties, increased sweating, and unusually fast or irregular heartbeat. The dose should be gradually reduced over a period of about 2 weeks.
People taking carvedilol may become dizzy or faint when rising quickly from a sitting or lying position. If this happens to you, sit or lie down until you feel better. Carvedilol can also cause drowsiness, lightheadedness, or blurred vision. Be careful when driving or doing any task that requires concentration.
Contact lens wearers are more likely to experience dry eyes with carvedilol.
Swallow extended-release tablets whole; do not crush or break them.
It is best to take carvedilol at the same time each day. If you forget a dose, take it as soon as you remember. If it is within 4 hours of your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Animal studies indicate that carvedilol passes into the fetal bloodstream and may interfere with pregnancy. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
It is not known if carvedilol passes into human breast milk, though it passes into rat breast milk. Beta-blocking drugs like carvedilol may affect babies’ hearts. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors are more likely to develop dizziness and may require reduced dosage.

Type of Drug
Carbonic-Anhydrase Inhibitors,
Eyedrops (kar-BON-ik an-HYE-drase)
Brand Names
Generic Ingredient: Dorzolamide Trusopt
Generic Ingredient: Brinzolamide Azopt
Combination Product
Generic Ingredients: Dorzolamide + Timolol Cosopt
Prescribed For  Glaucoma.
General Information
These drugs are similar to acetazolamide, a carbonic-anhydrase inhibitor taken by mouth. Carbonic anhydrase is an enzyme found in many parts of the body, including the eyes. By blocking the effects of this enzyme, dorzolamide and brinzolamide slow the production of fluid inside the eye, reducing pit:ssure. This cffc,, i3 usetul in ir83t
ino, open-angle glaucoma because the disease is characterized by elevated eye pressure. Dorzolamide and brinzolamide are sulfonamides, or sulfa drugs, and although they are administered topically, they affect the body systemically.
Cautions and Warnings
Do not use these drugs if you are allergic or sensitive to any of their ingredients or to other sulfa drugs. Small amounts of these drugs enter the bloodstream. Rarely, people using them experience side effects or allergies associated with sulfa drugs.
These drugs have not been studied in people with very poor kidney or liver function. Since these drugs are eliminated via the kidneys, people with impaired kidney function should use an alternate glaucoma medication.
These drugs have not been studied in people with acute angle-closure glaucoma.
See Timolol, page 1129, for more information on the combination product Cosopt.
Possible Side Effects
Dorzolamide
✓    Most common: eye burning, stinging, or discomfort and a bitter taste in the mouth immediately after administering the eyedrops.
✓    Less common: allergic reactions, conjunctivitis (pinkeye), blurred vision, tearing, dry eye, and increased sensitivity to bright light.
♦    Rare: headache, nausea, weakness, tiredness, rash, and kidney stones. Dorzolamide can cause the same types of side effects as other sulfa drugs, but this is very unlikely. Contact your doctor if you experience any side effects not listed above.
Brinzolamide
♦    Common: blurred vision and a bitter, sour, or unusual taste in the mouth.
♦    Less common: eyelid inflammation; conjunctivitis (pink-
eyeY, nsh; dry eye; sensation of something in the eye;
headache; eye redness, itching, discharge, or pain; and
runny nose.
✓    Rare: allergic reactions, hair loss, chest pain, diarrhea, nausea, sore throat, tearing, itchy rash, double vision, dizziness, Possible Side Effects (continued)
dry mouth, breathing difficulties, upset stomach, tired eyes, kidney pain, cornea problems, and formation of a crust or sticky sensation around the eyelid. Brinzolamide can cause the same types of side effects as other sulfa drugs, but this is very unlikely. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• If you are using more than 1 eyedrop product, separate doses of these drugs by at least 10 minutes.
Usual Dose
Adult: 1 drop in the affected eye 3 times a day. Overdosage
Accidental ingestion of a bottle of dorzolamide or brinzolamide may affect blood levels of potassium and other electrolytes. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor and stop using your eyedrops if you develop any unusual eye reaction or condition, including swollen eyelids and conjunctivitis (pinkeye).
Vision may be temporarily blurred when using the eyedrops. Use caution when driving or operating machinery.
If you wear soft contact lenses, take them out before using the eyedrops and put them back in 15 minutes after a dose.
To prevent infection, do not allow the eyedropper tip to touch your fingers, eyelids, or any surface. Wait at least 10 minutes before using any other eyedrops.
If you forget to administer a dose, do so as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Very high dosages of dorzolamide or brinzolamide caused birth defects in animal studies. While the risks of using these drugs during pregnancy are small in people, pregnant women should use dorzolamide or brinzolamide only after discussing its potential benefits and risks with their doctors.
it is not known if these drugs pass into breast milk. Nursing mothers who must use either drug should use infant formula.
Seniors: Seniors may be more sensitive to side effects.

Generic Name
Carbamazepine (car-bam-A-zuh-pene)
Brand Names
Atretol    Tegretol
Carbatrol    Tegretol-XR
Epitol    Teril Equetro
Type of Drug
Anticonvulsant.
Prescribed For
Seizure disorders as well as other neuralgias; also  severe pain; psychiatric disorders including depression, bipolar disorder, intermittent explosive disorder, borderline personality disorder, post-traumatic stress disorder, psychotic disorders, and schizophrenia; withdrawal from alcohol, cocaine, or benzodiazepine-type drugs; restless leg syndrome; hereditary and non-hereditary chorea in children; and diabetes insipidus.
General Information
Carbamazepine was first approved for relief of the severe pain of trigeminal neuralgia. Over the years, it has gained wide use in seizure control, especially in people whose seizures are uncontrolled with phenytoin, phenobarbital, or primidone, or who have suffered severe side effects from these drugs. Carbamazepine is not a simple pain reliever and should not be taken for everyday aches and pains. It is associated with potentially fatal side effects.
Cautions and Warnings
Carbamazepine should not be used if you are allergic or sensitive to any of its ingredients or to any tricyclic antidepressant.
Carbamazepine should not be used if you have had bone marrow depression.
Carbamazepine may cause severe, possibly life-threatening blood reactions. People who have had blood reactions to other drugs are at particular risk for another reaction with carbarnazepine. Your doctor should have a complete blood count done before you start taking this drug and repeat these tests weekly during the first 3 months of treatment, and then every month for the next 2-3 years. Unexplained fever or infection may be a sign of a blood reaction.
Monoamine oxidase inhibitor (MA01) antidepressants should be discontinued 2 weeks before starting carbamazepine.
Rarely, severe, possibly fatal skin reactions can develop in a few people taking carbamazepine. Asians are 10 times more likely to develop these reactions than non-Asians.
Carbamazepine may aggravate glaucoma and should be used with caution by people with this condition. This drug may activate underlying psychosis, and, in older adults, confusion or agitation.
This drug is not for the relief of minor aches or pains.
Possible Side Effects
V Most common: dizziness, drowsiness, unsteadiness, nausea, and vomiting. Other common side effects are blurred W double vision, confusion, hostility, headache, and severe water retention.
♦ Less common: mood and behavioral changes, especially in children. Hives, itching, rash, and other allergic reactions may also occur.
your breathing, speech,function, and many
Drug Interactions
•    Carbamazepine blood levels may be increased by azoles (e.g. ketoconazole), acetazolamide, cimetidine, dalfopristin, danazol, delavirdine, diltiazem, haloperidol, isoniazid, propoxyphene, erythromycin-type antibiotics (except azithromycin), fluoxetine, fluvoxamine, loratadine, levetiracetam, macrolides, MAOls, nefazodone, niacinamide, nicotinamide, protease inhibitors, quinine, quinupristin, terfenadine, tricyclic antidepressants, valproate, verapamil, or zileuton, leading to possible carbamazepine toxicity.
•    Carbamazepine may reduce the effectiveness of contraceptive drugs and cause breakthrough bleeding.
•    Charcoal tablets or powder, clozapine, methsuximide phenobarbital and other barbiturates, phenytoin, primidone and theophylline may decrease the absorption of carbamazepine. Levels of phenobarbital, a breakdown product of primidone, may be increased by combining primidone and carbamazepine.
•    Carbamazepine reduces the effects of acetaminophen, the anticoagulant (blood thinner) warfarin, and theophylline (prescribed for asthma). Increased dosage of these drugs may be necessary. Other drugs counteracted by carbamazepine are antipsychotics (e.g. aripiprazole, clozapine, olanzapine, quetiapine, risperidone, and ziprasidone), benzodiazepines (e.g. diazepam and lorazepam), bupropion, cyclosporine, digitalis drugs, doxycycline, felodipine, lamotrigine, levothyroxine, methadone, mirtazapine, certain muscle relaxants, oxcarbazepine,  slatin drugs, tiagibine, topiramate, tramadol, and zonisamide.
•    Combining carbamazepine and other antiseizure drugs, including felbamate, hydantoins, succinimides, and valproic acid, may cause unpredictable results. Combination treatments to control seizures must be customized to each person.
Possible Side Effects (continued)
♦ Rare: Rare side effects can affect
liver function, urinary    other
parts of the body. Contact you    you any side effect not listed above.
•    Combining carbamazepine and lithium may increase nervous system side effectssuch as muscular twitching or im-
paired consciousness.
•    Carbamazepine suspension should not be combined with
other liquid medicines or diluents.
Food Interactions
Take carbamazepine with food if it causes stomach upset. Avoid taking carbamazepine with grapefruit products.
Usual Dose
Adult and Child (age 13 and over): 400-1200 mg a day, depending on the condition. Usual maintenance dose is 400-800 mg a day in 2 divided doses.
Child (age 6-12): 200-1000 mg a day, or 22-24 mg per lb. of body weight 2-3 times a day for suspension or 4 times a day for tablets. Do not exceed 1000 mg a day.
Child (under age 6): 22-24 mg per lb. of body weight 2-3 times a day for suspension or 4 times a day for tablets; dosage should not exceed 77 mg per 1b. of body weight a day.
Dosage varies according to form. Liquid carbamazepine must be taken 3 times a day, regular carbamazepine tablets twice a day, and sustained-release tablets once daily. Never change your dosage schedule without first checking with your doctor.
Overdosage
Carbamazepine is a potentially lethal drug. Overdose symptoms appear in 1-3 hours. These include irregularity or difficulty in breathing, rapid heartbeat, changes in blood pressure, shock, loss of consciousness or coma, convulsions, muscle twitching, restlessness, uncontrolled body movements, drooping eyelids, psychotic mood changes, nausea, vomiting, and reduced urination. Induce vomiting right away with ipecac syrup—available at any pharmacy. Then take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Mormation
Carbamazepine may cause dizziness and drowsiness. Take care while driving or doing any task that requires concentration.
Call your doctor at once if you experience yellowing of the skin or whites of the eyes, unusual bleeding or bruising, abdominal pain, pale stools, dark urine, impotence, mood changes, nervous system symptoms, swelling, fever, chills, sore throat, or mouth sores. These may be signs of a potentially fatal drug reaction.
If you forget a dose, skip it and go back to your regular schedule. it you miss more than I dose in a day, call your doctor. Do not stop taking this drug without first consulting your doctor.
Special Populations
Pregnancy/Breast-feeding: Carbamazepine caused birth defects in animal studies. Seizure disorder itself also increases the risk of birth defects. Pregnant women should take carbamazepine only after discussing with their doctors its potential benefits and risks.
Carbamazepine passes into breast milk. Nursing mothers who must take carbamazepine should use infant formula.
Seniors: Seniors taking this drug are more likely to develop heart Problems, confusion, or agitation.