Posts Tagged ‘Dose’

Generic Name
Deferasirox (deh-fur-ASS-sih-rox)
Brand Name Exjade
Type of Drug
Iron chelating agent. Prescribed For
Chronic iron overload. General Information
Deferasirox binds with iron in stored in the liver. It can also bind small amounts of zinc and copper but the importance of these effects are not known. Almost 3/4 of every dose is absorbed into the bloodstream. Most of the drug is broken down in the liver and passes out of the body in the feces. Women clear this drug from their bodies 17.5% slower than men, but this has not affected how it is used or the doses given.
Cautions and Warnings
Do not take deferasirox if you are allergic or sensitive to any of its ingredients. Most reactions occur within the first month of treatment.
People with liver disease should have monthly blood tests while taking deferasirox.
Kidney failure has developed in people taking deferasirox with fatal results in some cases. People with or those who are at risk of kidney failure should have routine kidney monitoring while taking this medication. People who are at risk for kidney failure in-ciudes seniors, those with kidney disease, and people taking medicines that affect kidney function. Dose adjustment may be needed.
Deferasirox has been associated with potentially severe reduced white-blood-cell and platelet counts, usually in people with preexisting blood disorders.
Rarely, deferasirox has caused hearing loss and eye problems. You should have a full hearing and eye exam before starting on this drug and once a year thereafter.
Skin rash can occur with this medicine. If it is severe, the drug may have to be temporarily stopped. It may be restarted at a lower dosage.
Possible Side Effects
♦    Most common: fever, headache, abdominal pain, cough, sore throat, nasal irritation, diarrhea, flu symptoms, nausea, and vomiting.
✓    Common: respiratory infections, bronchitis, runny nose, rash, upper abdominal pain, joint pain, back pain, tonsillitis, and ear infection.
✓    Less common: itching.
✓    Rare: stomach pain, swelling in the arms or legs, sleep disorder, skin color changes, dizziness, anxiety, gallstones, fatigue, early cataract and hearing loss, some visual haziness, and other eye disorders. Contact your doctor if you experience anything unusual.
Drug Interactions
•    Do not mix antacids containing aluminum with deferasirox. They can prevent it from being absorbed.
Food Interactions
This drug should be taken at the same time every day on an empAq stomach, 30 minutes before eating.
Ustlak 13bSe
Adult and Child (age 2 and over): 9-13.6 mg per lb. of body weight once a day. Dose adjustments will be made according to your response. See “Special Information” for a specific instructions on how to take these tablets.
Overdosage
Large doses of 2-3 times the prescribed amount taken for several weeks with no adverse effects have occurred. Overdose symptoms include hepatitis (mild fever, muscle or joint aches, nausea, vomiting, appetite loss, slight abdominal pain, diarrhea, and fatigue) and some drug side effects. Take the victim to a hospital emergency room for treatment because the heart may be affected. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor at once if you develop a severe skin rash.
You must have regular vision and hearing tests while taking deferasirox.
Deferasirox tablets should not be chewed or swallowed whole. They must first be mixed completely in 1/2-1 glass of water, orange juice, or apple juice. The tablet will not dissolve but tablet particles will become suspended in the liquid. Drink the resulting sus-Pension immediately. If there is anything left in the glass after drinking the suspension, add a small amount of liquid, mix it with the remaining tablet particles and drink it.
This drug can cause dizziness. Be cautious while driving, operating machinery, or doing anything that requires intense concentration.
If you forget a dose, take it as soon as you remember. If it is almost time for the next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: There are no studies of ranolazine in pregnant women or of its effect on the developing fetus. Pregnant women should take this drug only if its potential benefits outweigh the risks.
This drug may pass into breast milk. Nursing mothers should consider using infant formula.
Seniors: Seniors may experience more drug side effects than younger adults due to greater chances of reduced kidney, liver, and heart function; other diseases; or drug side effects.

Generic Name
Desmopressin (dez-moe-PRES-in)
Brand Names
DDAVP Minirin
Type of Drug
Pituitary hormone replacement.
Stimate
Prescribed For
Nighttime bed-wetting and diabetes insipidus (central or cranial diabetes); also used to control bleeding in certain forms of hemophilia A and von Willebrand’s disease.
General Information
Desmopressin acetate is a synthetic version of antidiuretic hormone (ADH). When ADH is lacking, the body has difficulty retaining fluid. People lacking ADH experience excessive thirst, increased urination, and dehydration; desmopressin controls these symptoms. When used for nighttime bed-wetting, desmopressin should be used in conjunction with behavioral or other non-drug therapies.
Cautions and Warnings
Do not take desmopressin if you are allergic or sensitive to any of its ingredients.
People, especially children and seniors and people with cystic fibrosis and electrolyte imbalances, should only drink enough fluid to satisfy their thirst while taking desmopressin because of the risk of water intoxication, which can result in seizures that could lead to coma. People with coronary artery disease, heart disease, or high blood pressure should use this drug with caution.
Heart attacks and St&D’KeS after treatment with desmopressin MV~bEbn reported in people at risk for them, but there is no definite link to desmopressin use.
People using desmopressin should have their urine checked regularly by their doctor. Your doctor should also check for nasal swelling, congestion, and scarring.
Drug Interactions
experience in blood pressure, loss of sodium, symptoms include coma, confusion, ng headache, decreased urination, rapid
zures), edema, stomach or abdominal dness or flushing of the skin, passing ain, and stuffy or runny nose. Contact perience any side effect not listed above.
Possible Side Effects
V Rare: slight increase
intoxication (
drowsiness, continuin
gain, and seizures)
nausea, rednes
vulvar pain
doctor if you
•    Desmopressin may increase the effects of other drugs that raise blood pressure. This only happens with large dosages.
•    Chlorpropamide and carbamazepine may increase the effects of desmopressin.
Food Interactions None known.
Usual Dose
Nasal Solution—Nighttime Bed-Wetting
Adult and Child (age 6 and over): 20 mcg (0.2 mL) at bedtime. Child (under age 6): not recommended.
Nasal Solution—Diabetes Insipidus
Adult: 0.1-0.4 mL a day in 1-3 doses.
Child (age 3 months-12 years): 0.05-0.3 mL a day in 1-2 doses.
Tablets—Nighttime Bed-wetting
Adult and Child (age 6 and over): Begin with 0.2 mg at bedtime, adjusting to individual need up to 0.6 mg.
Child (under age 6): not recommended.
Tablets—Diabetes Insipidus
Adult: Begin with 0.05 mg twice a day. Daily dosage should be increased according to individual need, up to 1.2 mg a day divided into 2-3 doses.
Child (age 4 aid over): Begin with 0.05 mg and adjust according to individual need.
Child (under age 4): not recommended.
Overdosage
Symptoms include headache, difficulty breathing, abdominal cramps, nausea, and facial flushing. Call your doctor or a hospi-tal emergency room if you suspect an overdose. Because there is no known antidote to desmopressin, your dosage may be temporarily reduced until overdose symptoms subside. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you develop headache, breathing difficulties, heartburn, nausea, abdominal or stomach cramps, or vulvar pain.
The Stimate Nasal Solution spray pump and Minirin spray must be primed before its first use. To prime the pump, press down 4 times. Stimate delivers 25 doses per bottle. Throw away the bottle after 25 doses have been used, because anything remaining after the 25th dose is likely to deliver less drug than is needed.
If you forget a dose of desmopressin, take it as soon as you remember. If you don’t remember until your next dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: The safety of using desmopressin during pregnancy is not known, though it has been used to treat diabetes insipidus in pregnant women without apparent harm to the fetus. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Desmopressin may pass into breast milk. Nursing mothers who must use this drug should use infant formula.
Seniors: Seniors should avoid drinking too much fluid while taking desmopressin.

Generic Name
Diazepam (dye-AZ-uh-pam) rVg_l
Brand Names
Diastat    Valium
Diazepam Intensol    Valrelease
The information in this profile also applies to the following drugs:
Lorazepam &
Ativan    Lorazepam Intensol
Oxazepam M
Type of Drug  Benzodiazepine sedative.
Prescribed For
Anxiety, tension, fatigue, agitation (particularly due to alcohol withdrawal), muscle spasm, and seizures; also prescribed for irritable bowel syndrome and panic attacks.
General Information
Diazepam and other benzodiazepines directly affect the brain. They can relax you and make you more tranquil or sleepy, or they can slow nervous system transmissions in such a way as to act as an anticonvulsant.
Cautions and Warnings
Do not take diazepam if you know you are allergic or sensitive to any of its ingredients or to another benzodiazepine drug, including clonazepam.
Diazepam 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 diazepam should be avoided are severe depression, severe lung disease, steep apnea (intermittent cessation of breathing during sleep), liver disease, drunkenness, and kidney disease. In all of these conditions, the depressive effects of diazepam may be enhanced or could be detrimental to your overall condition.
Diazepam should not be taken by psychotic patients. It is not effective for them and can trigger unusual excitement, stimulation, and rage.
Diazepam is not intended for more \han 3-4 months of continuous use. Your comikkni) should be reassessed before continuing YOU( MS-16cation beyond that time.
Diazepam 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 only 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, sensi-tivity 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
Y Most common: mild drowsiness during the first few days of therapy. Weakness and confusion may occur, especially in seniors and in those who are sickly. If these effects persist, contact your doctor.
♦ Less common: 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, hysteria, psychosis, inability to fall asleep, and occasional liver dysfunction. If you have any of these symptoms, stop taking the drug and contact your doctor at once.
•    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 effect not listed above.
Drug Interactions
•    Diazepam is a central-nervous-system depressant. Avoid alcohol, other sedatives, narcotics, barbiturates, monoamine oxidase inhibitor antidepressants, antihistamines, and antidepressants. Taking diazepam with these drugs may lead to excessive depression, drowsiness, or difficulty breathing.
•    Smoking may reduce diazepam’s effectiveness by increasing the rate at which it is broken down by the body.
•    Effects of diazepam may be prolonged when taken with cimeti(1(m,, Contraceptive drugs, disulfiram, fluoxetine, isoniazid, ketoconazole, rifampin, metoprolol, probenecid, propoxyphene, propranolol, and valproic acid.
•    Theophylline may reduce the sedative effects of diazepam.
•    If you take antacids, separate them from your diazepam dose by at least 1 hour to prevent them from interfering with the passage of diazepam into the bloodstream.
•    Diazepam may increase blood levels of digoxin and the chances for digoxin toxicity.
•    Levodopa + carbidopa’s effects may be decreased if it is taken with diazepam.
Combining diazepam and phenytoin may increase phenytoin blood concentrations and the risk of phenytoin toxicity.
Food Interactions
Diazepam is best taken on an empty stomach, but it may be taken with food if it upsets your stomach.
Usual Dose
Solution or Tablets
Adult’. 2-40 mg a day. Dosage must be adjusted to individual response for maximum effect. In seniors, less of the drug is usually required to control tension and anxiety.
Child (6 months and over): 1-2.5 mg 3 or 4 times a day; more may be needed to control anxiety and tension.
Child (under 6 months): not recommended.
Rectal Gel
Adult and Child (age 12 and over): 0.09 mg per lb. of body weight. Approximate dosage: 5 mg if 31-60 lbs., 10 mg if 61 -110 lbs., 15 mg if 111-165 lbs., or 20 mg if 166-244 lbs.
Child (age 6-11): 0.14 mg per lb. of body weight. Approximate dosage: 5 mg if 22-40 lbs., 10 mg if 41-82 lbs., 15 mg if 83-121 lbs., or 20 mg if 122-163 lbs.
Child (age 2-5): 0.23 mg per lb. of body weight. Approximate dosage: 5 mg if 13-24 lbs., 10 mg if 25-49 lbs., 15 mg if 50-73 lbs., or 20 mg if 74-97 lbs.
An extra 2.5 mg of the rectal gel may be given if a more precise dosage is needed or as a partial replacement for people who do not retain the full dosage after it is first inserted rectally.
Overdosage
SYMPUns of overdose include confusion, sleepiness, poor coordination, lack of response to pain, 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.

Generic Name
Cromolyn (KROE-inuh-lin) [9
Brand Names
Crolom    Intal
Gastrocrom    Opticrom
The information in this profile also applies to the following drugs:
Nedocromil
Alocril    Tilade
Type of Drug
Allergy preventive and antiastk)m-aft_.
Prescribed For
Prevention of severe allergic reactions, including asthma, runny nose, and mastocytosis; also prescribed for food allergies, eczema, dermatitis, chronic itching, and hay fever. It may be used to treat and prevent chronic inflammatory bowel disease. The eyedrops are used to treat conjunctivitis (pinkeye) and other eye irritations.
General Information
Unlike antihistamines, which work against histamine that has been released into the system, cromolyn sodium prevents allergy, asthma, and other conditions by stabilizing mast cells, a key component in any allergic reaction because they release histamine. Cromolyn prevents the release of histamine and other chemicals from mast cells. The drug works only in the areas to which it is applied; only 7-8% of an inhaled dose and 1 % of a swallowed capsule is absorbed into the blood. Even the oral capsules, which one would normally expect to be absorbed into the blood, treat only gastrointestinal -tract allergies. Cromolyn products must be used on a regular basis to be effective in reducing the frequency and intensity of allergic reactions.
Cautions and Warnings
Do not take cromolyn if you are allergic or sensitive to any of its ingredients. Rarely, people have experienced severe allergic attacks after taking cromolyn.
cromolyn should never be used to treat an acute allergy attack. It is intended only to prevent or reduce the number of allergic attacks and their intensity. Once the proper dosage level has been established for you, reducing that level may result in a recurrence of attacks.
People with kidney or liver disease require reduced dosage.
Cough or bronchial spasm may occasionally occur after the inhalation of a cromolyn dose. Severe bronchospasm is rare.
cromolyn aerosol should be used with caution in people with abnormal heart rhythm or diseased coronary blood vessels because of a possible reaction to the propellants used in the product.
Possible Side Effects
V Most common: rash and itching. Headache and diarrhea (for capsules). Watery, itchy, dry, or puffy eyes; and iztjes (for eyedrops). Most capsule and eyedrop side effects are mkw and may be attributable to the underlying condition; a variety have been reported but cannot be tied conclusively to the drug.
V Less common: local irritation, including nasal stinging, sneezing, tearing, cough, and stuffy nose; urinary difficulty or frequency; dizziness; headache; joint swelling; muscle Possible Side Effects (continued)
pain-, a bad taste in the mouth; sore throat-, nosebleeds’, abdominal pain-, and nausea.
♦ Rare: severe drug reactions, consisting of coughing, difficulty in swallowing, hives, itching, breathing difficulties, or swelling of the eyelids, lips, or face. Contact your doctor if you experience any side effect not listed above.
Drug Interactions None known.
Food Interactions
Inhaled or swallowed cromolyn products should not be mixed with any food, juice, or milk. The nasal and eye products may be taken without regard to food or meals.
Usual Dose
Inhaled Capsules or Solution
Adult and Child (age 2 and over): starting close-20 mg 4 times a day. Children under age 5 may inhale cromolyn powder if their allergies are severe. The solution must be given with a power-operated nebulizer and face mask. Handheld nebulizers are not adequate. To prevent exercise asthma, 20 mg may be inhaled up to 1 hour before exercise.
Aerosol
Adult and Child (age 5 and over): up to 2 sprays 4 times a day, spaced equally throughout the day. To prevent exercise asthma, 2 puffs may be inhaled up to 1 hour before exercise.
Nasal Solution
Adult and Child (age 6 and over): 1 spray in each nostril 3-6 times a day at regular intervals. First blow your nose, and then inhale the spray.
Oral Capsules
MAI and Child (age 12 and over): 2 dissolved capsules 4 times a day taken a half hour before meals and at bedtime.
Child (age 2-12): 1 dissolved capsule (100 mg) 4 times a day a half hour before meals and at bedtime. Dosage may be increased to about 13-18 mg per lb. of body weight in 4 equal doses.
Child (under age 2): about 10 mg per lb, of body weight a day divided into 4 equal doses. This product is recommended in infants
and young children only if absolutely necessary.
Eyedrops
Adult and Child (age 4 and over): 1-2 drops in each eye 4-6 times
a day at regular intervals. Overdosage
No action is necessary other than medical observation. Call your local poison control center or a hospital emergency room for more information. ALWAYS bring the prescription bottle or container.
Special Information
Cromolyn is taken to prevent or minimize severe allergic reactions. It is imperative that you take cromolyn products on a regular basis to provide equal protection throughout the day.
If you are taking cromolyn to prevent seasonal allergies, it is essential that you start taking the medication before you come into contact with the cause of the allergy and that you continue treatment while you are exposed to it.
Cromolyn oral capsules should be opened and their contents mixed with about 4 oz. of hot water. Stir until the powder completely dissolves and the solution is completely clear, then fill the rest of the glass with cold water. Drink the entire contents of the glass. Do not mix the solution with food, juice, or milk.
Do not wear soft contact lenses while using cromolyn eyedrops. The lenses may be replaced a few hours after you stop taking the drug. To prevent contamination, do not touch the applicator tip to any surface including the eyes or fingers.
Call your doctor if you develop wheezing, coughing, a severe drug reaction (see “Possible Side Effects”), rash, or any bothersome or persistent side effect.
Call your doctor if your symptoms do not improve or if they worsen.
If you forget to administer a dose, do so as soon as you remember and sqa(ZRMBmn-maining daily dosage evenly throughout ‘i!M day. Do not take a double dose.
Special Populations
PregnancylBreast-feeding. In animal studies, very large dosages of cromolyn administered by vein have affected the fetus, though no birth defects were reported. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed
against its risks.
It is not known if cromolyn passes into breast milk. Nursing
mothers who must use cromolyn should use infant formula. Seniors: Older adults with reduced kidney or liver function may require lower dosages.

Generic Name
Cyclobenzaprine (sye-cloe-BEN-zuh-prene) M
Brand Names Amrix
Type of Drug
Skeletal muscle relaxant.
Flexeril
Prescribed For
Serious muscle spasm and acute muscle pain; also used to treat fibrositis (muscular rheumatism).
General Information
Cyclobenzoprine hydrochloride is used to treat severe muscle spasms; it is prescribed as part of a coordinated program of rest, physical therapy, and other measures.
Cautions and Warnings
Do not take cyclobenzaprine if you are allergic or sensitive to any of its ingredients.
This drug should not be taken for several weeks following a heart attack or by people with abnormal heart rhythms, heart failure, heart block (disruption of the electrical impulses that control heart rate), or hyperthyroidism (overactive thyroid gland).
Cyclobenzaprine should be avoided by people with urinary retention, glaucoma, UC 1ntlreased eye pressure.
W)t arug may increase the chances of cavities or gum disease. Cyclobenzaprine is intended only for short-term use of 2-3 weeks.
Cyclobenzaprine is chemically similar to tricyclic antidepressants and may produce some of the more serious side effects associated with those drugs. Abruptly stopping cyclobenzaprine may cause nausea, headache, and feelings of ill health; this is not a sign of addiction.
Drug Interactions
•    The effects of alcohol, sedatives, or other nervous system depressants may be increased by cyclobenzaprine.
•    Cyclobenzaprine may increase some side effects of atropine, ipratropium, and other anticholinergic drugs.
•    The combination of cyclobenzaprine and a monoamine oxidase inhibitor antidepressant may produce very high fever, convulsions, and possibly death. Do not take these drugs within 14 days of each other.
•    Cyclobenzaprine may increase the effects of haloperidol, loxapine, molindone, pimozide, anticoagulant (blood-thinning) drugs, anticonvulsants, thyroid hormones, antithyroid drugs, phenothiazines, thioxanthenes, and nasal decongestants such as naphazoline, oxymetazoline, phenylephrine, and xylometazoline.
•    Barbiturates and carbamazepine may counteract the effects of cyclobenzaprine.
•    Fluoxetine, ranitidine, cimetidine, methylphenidate, estramustine, estrogens, and contraceptive drugs may increase the effects and side effects of cyclobenzaprine.
•    Cyclobenzaprine may counteract the effects of cto(\idine, guanadrel, and guanethidine.
Food Interactions  None known.
Usual Dose
Adult and Child (age 15 and over): 5-10 mg 3 times a day. Child (under age 15): not recommended.
above.    drowsiness, and dizziness.
le weakness. fatigue, nausea, consti-
ch, unpleasant taste, blurred vision,
ess, and confusion.
cts can occur in almost any part of the doctor if you experience any side ef- e.
Possible Side Effects
♦    Most common: dry
♦    Less common: muscl
upset stomach
nervousness, • Rare: Rare side effects
body. Contact your
fect not listed Overdosage
Cyclobenzaprine overdose may cause confusion, loss of con- centration, hallucinations, agitation, overactive reflexes, fever or vomiting, rigid muscles, and other side effects of the drug. It may also cause drowsiness, low body temperature, rapid or irregular heartbeat and other kinds of abnormal heart rhythms, heart failure, dilated pupils, convulsions, very low blood pressure, stupor, coma, and sweating. Overdose victims must be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Cyclobenzaprine causes drowsiness, dizziness, or blurred vision in more than 40% of people who take it, which may interfere with the ability to perform complex tasks like driving or operating equipment. Avoid alcohol, sedatives, and other nervous system depressants because they can enhance sedative effects of cyclobenzaprine.
Call your doctor if you develop rash; hives; itching; urinary difficulties; clumsiness; confusion; depression; convulsions; difficulty breathing; irregular heart rate; chest pain; fever; yellowing of the skin or whites of the eyes; swelling of the face, lips, or tongue; or any other persistent or bothersome side effect.
If you forget a dose of cyclobenzaprine, take it as soon as you remember. If you take cyclobenzaprine once a day and it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. If you take cyclobenzaprine twice a day and it is almost time for your next dose, take 1 dose as soon as you remember, another in 5 or 6 hours, and then go back to your regular schedule. If you take cyclobenzaprine 3 times a day and it is almost time for your next dose, take 1 dose as soon as you remember, another in 3 or 4 hours, and then go back to your regular schedule. Never take a double dose.
Special Populations
Pregnancy/Breast-feeding: -The safety of cyclobenzaprine in ‘jftg)T)1 women has not been established. Cyclobenzaprine should only be used if the potential benefits outweigh the risks.
It is not known if cyclobenzaprine passes into breast milk, but antidepressants with a similar chemical structure do pass into breast milk. Nursing mothers who must take this drug should consider using infant formula.
Seniors: Seniors are more likely to be sensitive to the effects of cyclobenzaprine. Use of Amrix in particular is not recommended
in the elderly.

Generic Name
Cyclosporine (sye-kim-SPQR-in)
Brand Names
Gengraf Neoral
Type of Drug  Immunosuppressant.
Restasis Ophthalmic Emulsion Sandimmune
Prescribed For
Kidney, heart, or liver transplantation; also used for bone-marrow, heart-lung, and pancreas transplants; also prescribed for patchy hair loss, rheumatoid arthritis, aplastic anemia, atopic dermatitis, Beh~et’s disease, cirrhosis of the liver, ulcerative colitis, dermatomyositis, eye symptoms of Graves’ disease, insulin-dependent diabetes, kidney inflammation, multiple sclerosis (MS), severe psoriasis and psoriasis-related arthritis, myasthenia gravis, pemphigus, sarcoidosis of the lung, and pyoderma gangrenosum. Cyclosporine eye emulsion is prescribed for dry eyes.
General Information
Cyclosporine is used to prevent rejection of transplanted organs. It works by blocking the activity of T-cells, which protect the body against invading microorganisms or foreign substances. Cyclosporine also prevents the production of a substance known as interieukin-11 that activates T-cells. In 1995, a new form of Cyclosporine called Neoral, a microemulsion, was introduced by its manufacturer. This form is as safe and effective as the original product but is better absorbed into the bloodstream and requires less medication to achieve the same effect. Cyclosporine eye emulsion treats dry eye caUV ,d by inflammation of the cornea and tissue kWA1 Covers the white part of the eye. It reduces inflammation and allows tears to form and flow.
Cautions and Warnings
Cyclosporine should be prescribed only by doctors experienced in immunosuppressive therapy and the care of organ-transplant patients. Sandimmune is always used with corticosteroid drugs like prednisone. Neoral and Gengraf have been used with a corticosteroid and azathioprine, an immune suppressant. When combined with other immune suppressants, cyclosporine must be used with great care because oversuppression of the immune system may lead to lymphoma or extreme susceptibility to infection.
Sandimmune, the original oral form of cyclosporine, is poorly absorbed into the bloodstream; it must be taken in a dosage that is 3 times greater than the injectable dosage. People taking this drug by mouth for a long period of time should have their blood checked for cyclosporine levels so that the dosage may be adjusted if necessary. Since more of both Gengraf and Neoral is absorbed into the blood you will probably need less of it. Do not substitute Neoral or Gengraf for Sandimmune; they are not equivalent to each other.
cyclosporine causes kidney toxicosis (kidney poisoning)—different from transplant rejection—in 25-35% of people taking it to prevent organ rejection. Mild symptoms usually start after about 2 or 3 months of treatment. Reducing drug dosage may control this effect. In one study, clonidine skin patches used before and after surgery decreased toxic risks to the kidney.
Liver toxicosis is seen in about 5% of transplant patients taking cyclosporine. It usually appears in the first month and may be controlled by reducing dosage.
Convulsions may develop, especially in people also taking high dosages of corticosteroids. Other nervous system side effects are listed below (see “Possible Side Effects”).
In one study, cyclosporine increased cholesterol and other blood-fat levels. It is not known how this affects people who take the drug on a long-term basis.
There is conflicting information on how cyclosporine affects blood sugar. Kidney-transplant patients taking the drug have developed insulin-dependent diabetes, which is related to the dosage of cyclosporine and reverses itself when you stop taking the drug. On the other hand, cyclosporine preserves the function of insuli(Nproducing cells in the pancreas and has allowed many insulin-dependent diabetics t0 11ve Without taking insulin.
UVb vaccines should not be given to people taking cyclosporine.
Do not use cyclosporine eye drops if you have an eye infection.
Small amounts of cyclosporine eye emulsion may be absorbed
into the bloodstream, but the risk of body-wide side effects is small.
Possible Side Effects
V Most common: Cyclosporine is known to be toxic to the kidneys. Your doctor will carefully monitor your kidney function while you are taking it. Other side effects are high blood pressure, increased hair growth, infection, and enlargement of the gums. Lymphoma may develop in people whose immune systems are excessively suppressed.
V Less common: tremors, cramps, acne, brittle hair or fingernails, convulsions, headache, confusion, diarrhea, nausea or vomiting, tingling in the hands or feet, facial flushing, reduced white-blood-cell and platelet counts, sinus inflammation, swollen and painful male breasts, drug allergy (symptoms include rash, itching, hives, and breathing difficulties), conjunctivitis (pinkeye), fluid retention and swelling, ringing or buzzing in the ears, hearing loss, high blood sugar, and muscle pain.
♦    Rare: blood in the urine, heart attack, itching, anxiety. depression, lethargy, weakness, mouth sores, difficulty swallowing, intestinal bleeding, constipation, pancreas inflammation, night sweats, chest pain, joint pain, visual disturbances, and weight loss. Contact your doctor if you experience any side effect not listed above.
Cyclosporine Eye Drops
♦    Most common: burning sensation.
✓    Less common: red-eye, discharge from the eye, overflow of tears, eye pain, a feeling of something in the eye, itching, stinging, and visual disturbances, usually blurring.
Drug Interactions
•    Cyclosporine should be used carefully with other kidney-toxic drugs including nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, ac\d s0indac; ciprofloxacin; gentamicinjQtswnydin; vancomycin; trimethoprimsUM,M1~0oxazole; melphalan; amphotericin B; ketoconazole; azapropazon; colchicine; diclofenac; cimetidine; ranitidine; and tacrolimus.
•    Drugs that may increase blood levels of cyclosporine include contraceptive drugs; amiodarone; diltiazem; nicardipine; verapamil; fluconazole; itraconazole; ketoconazole; azithromycin; clarithromycin; erythromycin; quinapristin and dalfopristin; methylprednisolone—this combination also causes convulsions; allopurinol; bromocriptine; colchicine; imatinb-, danazol; and metoclopramide. With ketoconazole, your doctor may use this drug interaction to reduce your cyclosporine
dosage.
•    Drugs that decrease cyclosporine levels and may lead to organ rejection include octreotide, orlistat, sulfinpyrazone, ticlopidine, terbinafine, nafcillin, rifampin, carbamazepine, phenobarbital, phenytoin, and St. John’s wort. Rifabutin may also decrease concentrations of cyclosporine and should be used with caution.
•    Cyclosporine interferes with the body’s ability to clear digoxin, prednisolone, and statin drugs. People taking any of these drugs who start on cyclosporine must have their drug dosage reduced.
•    Combining cyclosporine and nifedipine may lead to gum overgrowth.
•    Cyclosporine increases blood potassium. Excessive blood-potassium levels may be reached if cyclosporine is taken with enalapril, lisinopril, a potassium-sparing diuretic such as spironolactone, salt substitutes, potassium supplements, or high potassium—low sodium—food.
•    Psoriasis patients using other immunosuppressant drugs or receiving radiation therapy should not take cyclosporine due to the danger of infection.
•    Cyclosporine prevents the normal body response to live vaccines. People taking cyclosporine should be vaccinated only after specific discussions with their doctors. You must wait for a period of several months to several years after stopping the medication before vaccination may be considered again.
Food Interactions
Cyclosporine may be taken with fMd 1111 upsets your stomach. For optimal QftlaWr~T)ess, avoid eating a fatty meal within half an hour of taking Neoral.
You may mix Neoral in a glass—not a paper or plastic cup—with room-temperature orange or apple juice or chocolate milk to make it taste better. Do not drink grapefruit juice because it speeds the breakdown of cyclosporine. Drink immediately after mixing, then put more juice or chocolate milk in the glass and drink it to be sure that the entire dose has been taken. Neoral should not be taken with unflavored milk because it may be unpalatable.
Usual Dose
In general, the usual dosage of Neoral is lower than Sandimmune, but dosage must be individualized for you by your doctor. Do not substitute one brand for the other.
Sandimmune
Adult: The usual oral dosage of cyclosporine is 6-8 mg per lb, of body weight a day. The first dose, typically 15 mg per lb., is given 4-12 hours before the transplant operation or immediately after surgery. This dosage is slowly reduced to 11-22 mg per lb. of body weight.
Child: Similar dosages are usually prescribed, but because children tend to release the drug from their bodies faster than adults, larger and more frequent doses may be needed.
Neoral and Gengraf
Adult: In newly transplanted patients, the usual oral dosage of Neoral is 3-4 mg per lb. of body weight a day divided into 2 doses. The initial oral dose of Gengraf is the same as for Sandimmune. The first dose is given 4-12 hours before the transplant operation or immediately after surgery. This dosage is continued after the operation for 1-2 weeks and then slowly reduced to maintain a target amount of cyclosporine in the body. Dosage may vary according to the organ transplanted.
In people being treated for rheumatoid arthritis or psoriasis, the initial dose of Neoral and Gengraf is 1.13 mg per lb. of body weight increased gradually to a maximum of 1.8 mg per lb. of body weight.
Child: Similar dosages are usually prescribed but, because children tend to release the drug from their bodies faster than adults, larger and more frequent doses may be needed.
cyclosporine Eye Emulsion
One drop in the affected eye(s) every Q hours. Before using, rotate and turn the vial Over a few times until you have a uniform, lft8, opaque fluid inside. If you use artificial tears, allow 15 minutes between products. Discard the open vial immediately after use.
Overdosage
Overdose victims may be expected to develop side effects and symptoms of extreme immunosuppression. Induce vomiting with ipecac syrup—available at any pharmacy—which is recommended up to 2 hours after the overdose was taken. Call your doctor or local poison control center before inducing vomiting. If you must go to a hospital emergency room, ALWAYS bring the prescription
bottle or container.
Special Information
Call your doctor at the first sign of fever; sore throat; tiredness’, weakness’, nervousness; unusual bleeding or bruising; tender or swollen gums; convulsions; irregular heartbeat; confusion; numbness or tingling of your hands, feet, or lips; breathing difficulties; severe stomach pain with nausea; or blood in the urine. Other side effects such as shaking or trembling of the hands, increased hair growth, acne, headache, leg cramps, nausea, or vomiting are less serious but should be brought to your doctor’s attention, particularly if they are bothersome or persistent.
Maintain good dental hygiene while taking cyclosporine and use extra care when brushing and flossing because the drug increases your risk of oral infection. cyclosporine may also cause swollen gums. See your dentist regularly.
Continue taking your medication as long as your doctor prescribes it. Do not stop taking it without your doctor’s knowledge. If you cannot take one of the oral forms, cyclosporine can be given by injection.
Do not keep either brand of the oral liquid in the refrigerator. After the bottle is opened, use the medication within 2 months. At temperatures below 68°F, Neoral can form a gel and a light sediment can form in Sandimmune. These do not affect the potency of either product. They can still be used and are effective.
If you forget a dose, take it as soon as you remember if it is within 12 hours of your regular dose. If not, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
For cyclosporine eye emulsion, each small plastic container is meant to be used once and then thrown away along with any remaining medication. Do not allow the tip of the disposable vial to touch 0Z QyE or any surface, as this may contaminate the emulsion.
Patients with decreased tear production typically should not wear contact lenses. But those that do must remove them before using cyclosporine eye emulsion. Lenses may be reinserted 15 minutes after using the medicine.
Special Populations
Pregnancy/Breast-feeding: In animal studies cyclosporine damages the fetus. Though a small number of pregnant women have taken cyclosporine without major problems, it is recommended that pregnant women avoid cyclosporine. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
cyclosporine passes into breast milk. Nursing mothers who must take cyclosporine should use infant formula.
Seniors: Due to decreased kidney function, seniors are more susceptible to kidney toxicosis.

Generic Name
Darunavir (dah-ROON-uh-vere)
Brand Name Prezista
Type of Drug  Protease inhibitor.
Prescribed For
Advanced human immunodeficiency virus (HIV) infection that has not responded to other protease inhibitors.
General Information
Part of the multidrug “cocktail” responsible for important gains in the fight against acquired immunodefiency syndrome (AIDS), darunavir is a member of a group of anti-HIV drugs called protease inhibitors. These drugs work at the end of the HIV reproduction process, whet) proteins are “cut” into strands of exactly tht VbYrect size to duplicate HIV. An enzyme known as protease cuts the protein. Protease inhibitors prevent the mature HIV virus from being formed by inhibiting this cutting process. Proteins that are cut to the wrong length or that remain uncut are inactive.
Darunavir must be taken with a low dose of ritonavir, another protease inhibitor, to extend the action of darunavir in the body.
Without ritonavii, darunavir would be eliminated too rapidly to be effective. Darunavir must also be accompanied by at least 2 other AIDS antivirals. Protease inhibitors revolutionized HIV treatment because, when taken in combination, they reduce the amount of HIV virus in the bloodstream to levels that are often undetectable by current methods—CD4 (immune system) cell counts and viral load (amount of virus in the blood) measurements. Multiple-drug therapy has transformed HIV from a fatal disease to a manageable chronic illness.
Cautions and Warnings
Do not take darunavir if you are allergic or sensitive to any of its ingredients, to sulfa drugs, or to ritonavir.
Darunavir can cause a severe or life-threatening rash.
If a serious toxic reaction occurs while taking darunavir, you should stop the drug until your doctor can determine the cause or until the reaction resolves itself. Then treatment can be resumed.
This drug is primarly broken down in the liver. Use caution if you have moderate to severe liver disease.
Darunavir may raise your blood sugar, worsen your diabetes, or bring out latent diabetes. People with diabetes who take darunavir may need the dosage of their antidiabetes medication adjusted.
People with hemophilia may be more likely to bleed while taking a protease inhibitor.
The HIV virus may become resistant to darunavir or other protease inhibitors. For this reason it is essential that you take darunavir exactly according to your doctor’s directions.
Protease inhibitors can cause body fat redistribution, including increased fat deposits in the upper back and neck, breast and around the back, chest, and stomach. Fat may be lost from the legs, arms, and face. Some people with HIV and a history of an opportunistic infection may develop signs and symptoms of the infection soon after anti-HIV treatment is started. This is called immune reconstitution syndrome.
Darunavir is involved in many drug interactions. Check with your doctor before adding angt ng new to your treatment program.
Possible Side Effects
V Most common: diarrhea, nausea, headache, and common cold symptoms.
of constipation.
Drug Interactions
•    Do not take any of the following medicines with darunavir + ritonavir: astemizole, terfenidine, ergot-based drugs for migraine headache, cisapride, pimozide, midazolam, or triazolam. Mixing these drugs with darunavir + ritonavir can result in very high blood levels and serious side effects.
•    Carbamazepine, phenobarbital, phenytoin, rifampin, and St. John’s wort can substantially reduce blood levels of darunavir. Do not mix these medicines.
•    Lopinavir + ritonavir and saquinavir can significantly reduce blood levels of darunavir. Darunavir significantly increases blood levels of lopinavir + ritonavir. Do not mix these drugs.
•    Mixing darunavir with indinavir can increase blood levels of both drugs.
•    Darunavir + ritonavir does not appear to affect blood levels of atazanavir, nor does atazanavir appear to affect blood levels of darunavir + ritonavir. It may be possible to combine these two protease inhibitors.
•    Taking darunavir with tenofovir can increase blood levels of both drugs. These drugs can be combined with no dose adjustments, though it is necessary to watch carefully for kidney damage related to tenofovir.
•    Darunavir can increase blood levels of efavirenz and efavirenz reduces darunavir levels. These medicines should be mixed with caution.
•    Darunavir increases nevirapine blood levels but the raMUNnation can be taken with no dose a-Syoslment.
•    If didanosine (SWpat 01 a darunavir + ritonavir treatment pro~ram, it must be taken on an empty stomach, 1 hour before or 2 hours after darunavir + ritonavir, which should be taken with food.
•    Darunavir increases blood levels of clarithromycin, itraconazole, and ketoconazole. Daily dosage of itraconazole and ketoconazole should not exceed 200 mg. No clarithromycin
Possible Side Effects (continued)
♦    Less common:    abdominalinal pain, and
♦    Rare: Rare side effects can occur in almost any part
body. Contact your doctor if you
ou experience any side ef
fect not listed above.
adjustment is necessary in people with normal kidney function.    the Darunavir + ritonavir may reduce vonconazole levels in t e
blood. Do not mix these medicines.
•    Darunavir + ritonavir can increase rifabutin levels in the blood-
stream. Rifabutin can also reduce darunavir levels in the
bloodstream. If rifabutin is mixed with darunavir + ritonavir,
the rifabutin dose should be 150 mg every other day.
•    Caution should be exercised when combining darunavir + ritonavir with calcium channel blockers such as felodipine, nifedipine, and nicardipine.
•    Darunavir increases blood levels of the heart antiarrhythmic drugs bepridil, lidocaine, and quinidine. These drugs should be used together with caution and only in situations where blood levels of the heart drugs can be monitored regularly.
•    Darunavir + ritonavir can reduce blood levels of warfarin. It is necessary to monitor warfarin levels while taking this combination.
•    Darunavir + ritonavir can raise blood levels of the tricyclic antidepressant desipramine and the tetracyclic antidepressant trazodone. Dosage reduction is recommended.
•    Darunavir + ritonavir may reduce blood levels of the SSRI antidepressants sertraline and paroxetine. SSRI doses may have to be increased to account for this effect.
•    Darunavir + ritonavir can drastically increase the blood levels of some statin-type cholesterol-lowering drugs, substantially increasing the risk of statin side effects. Simvastatin, pravastatin, and lovastatin should not be mixed with darunavir + ritonavir. It is also possible to take darunavir + ritonavir with atorvastatin, although it can increase the level of atorvastatin in the bloodstream. If atorvastatin is prescribed, it is best to begin with 10 mg a day and slowly increase the dose as necessary. Little is known about how darunavir + ritonavir affects rosuvastatin. The safest statin to take with darunavir + ritonavir is fluvastak”.
•    Darunavir + ritonaxk Can increase blood levels of inhaled MT lCosteroids dexamethasone and fluticasone, the anti-rejection drugs cyclosporine, tacrolimus, and sirolimus. The corticosteroids reduce darunavir blood levels, interfering with its effectiveness.
•    Darunavir + ritonavir can reduce methadone levels in the bloodstream. Methadone dose adjustment may be needed.
•    Darunavir + ritonavir reduces the effectiveness of some contraceptive drugs by decreasing the amount of the hormones ethinyl estradiol and norethindrone in the bloodstream. Women mixing these medicines should use additional contraceptive measures (e.g., condoms).
•    Protease inhibitors may drastically increase blood levels of erectile dysfunction drugs sildenafil, vardenafil, and tadalafil, increasing the risk of side effects including low blood pressure, visual changes, and persistent, painful erection.
•    Dexamethasone may reduce blood levels of darunavir.
Food Interactions
Take darunavir with food. The amount of darunavir absorbed into the blood is vastly reduced when it is taken on an empty stomach, thus negating its antiviral effects.
Usual Dose
Adult: 600 mg (2 300-mg tablets) with 1 00 mg ritonavir twice a day. Do not chew these tablets.
Child: not recommended.
Overdosage
Little is known about the effects of darunavir overdose, but 3200 mg of darunavir has been given to study volunteers with no adverse effects. Call your local poison center or hospital emergency room for more information. If you take the victim to a hospital emergency room, ALWAYS bring the prescription bottle or container.
Special Information
Darunavir is not a cure for HIV. It will not prevent you from transmitting the HIV virus to another person; you must still practice safe sex. You may still develop opportunistic infections or other complications associated with advanced HIV disease.
The long-term effects of this drug are not known.
It is imperative for you to take this medication exactly according to your doctor’s instructions. Do not skip any doses. Skipping doses of darunavir increases the risk that you will become resistant k,3 ft drug. If you forget a dose of darunavir or ritonavir and remember within 6 hours, take it as soon as you remember and then continue with your regular schedule. If 6 hours have passed since the time when you should have taken your medicine, skip the forgotten dose and take your next dose at the regular time. Do not take a double dose.
Special populations
Pregnancy/Breast-feeding: Animal studies with darunavir reveal no damage to the fetus, but there are no data on how this drug affects pregnant women. Darunavir should only be used during pregnancy after carefully weighing its potential benefits against its risks.
It is not known if darunavir passes into breast milk. Nursing mothers with HIV should use infant formula, regardless of whether they take this drug, to avoid transmitting the virus.
Seniors: Seniors can take this drug without special precaution.

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.

Generic Name
Calcitonin (kal-sih-TOE-nin)
General Information
Calcitonin helps to strengthen bone by adding more calcium to it and slowing the natural process by which bone is broken down. The calcitonin used in this drug is essentially identical to human calcitonin except that it is more potent. It is a synthetic version of the natural calcitonin found in salmon. Calcitonin can increase bone density and reduce the risk of fractures of the vertebrae (bones that comprise the spinal column), which are associated with back pain and loss of height. Calcitonin has been available for years as an injection, but the development of the nasal spray makes the drug easier to use.
Cautions and Warnings
Do not use calcitonin if you are allergic or sensitive to any of its ingredients. Although serious allergic reactions were reported with the injectable form, none have occurred with the nasal spray.
Changes in the tissues lining your nose are possible with longerm use of this product. An initial nasal examination and then peiodic examinations are recommended.
Possible Side Effects
V Most common: stuffy nose, runny nose, and other nasal symptoms; and back pain.
V Less common: joint pain, nosebleed, and headache.
Drug Interactions
None known.
Food Interactions
None known. Usual Dose
Adult: I spray (200 IU) a day. Child: not recommended.
Little is known about the effects of calcitonin overdose or accidental ingestion. Nausea and vomiting have been reported after high doses. Call your local poison control center for more information. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Alternate nostrils daily when using the nasal spray.
Before you take your first dose, you must activate the pump. Hold the bottle upright and press the two white arms toward the bottle 6 times until a faint spray is emitted. Once this occurs, the pump is activated and ready for use. It is not necessary to reactivate the pump every day.
Store new, unassembled bottles in the refrigerator. Keep the bottle in use at room temperature and discard after 30 days.
If you forget to administer a dose of the nasal spray, do so as soon as you remember. If it is almost time for the next dose, skip the dose you forgot and continue with your regular schedule. Call your doctor if you forget 2 or more doses.
Call your doctor if you develop severe nose irritation or any unusual or intolerable symptom. Follow your doctor’s recommendations regarding calcium and vitamin D supplements. This drug is not intended to replace the need for dietary calcium.
Special Populations
Pregnancy/Breast-feeding: calcitonin does not cross into the fetal circulation, though animal studies have associated the injectable form of the drug with low birth weight. This drug is recommended for use during pregnancy only if its possible benefits outweigh its risks.
It is not known if calcitonin passes into breast milk, though animal studies have shown that it reduces the amount of milk produced. Nursing mothers who must use calcitonin should consider using infant formula.
Seniors: Seniors may use this product without special precaution.

Brand Name
BiDil
Generic Ingredients
Isosorbide Dinitrate Hydralazine Hydrochloride Type of Drug
Vasodilator combination. Prescribed For
Heart failure in black patients, in combination with other heart-failure treatments.
General Information
BiDil is a combiRatiZ0 101 Iwo drugs that dilate (open) both arter-
2nd veins. It is the first drug product to be specifically approved for people in a single racial group for any indication. The 2 ingredients in BiDil have been available generically for years and are prescribed for a variety of uses. Isosorbide dinitrate is prescribed for angina, heart failure, and spasms of the esophagus. Hydralazine hydrochloride is prescribed to treat high blood pressure and heart failure. When people with heart failure take this drug combination, it makes it easier for the heart to pump blood throughout the body by widening arteries and veins.
Cautions and Warnings
Do not take BiDil if you are allergic or sensitive to any of its ingredients.
Do not use erectile dysfunction drugs with BiDil.
This drug may be inappropriate for you if you have had a recent heart attack or have cardiomyopathy (loss of blood-pumping ability due to damaged heart muscle) or low blood pressure, especially postural low blood pressure (symptoms include dizziness or fainting when rising from a sitting or lying position).
Long-term administration of more than 200 mg a day of hydralazine may produce symptoms of lupus erythematosus (a chronic condition affecting the body’s connective tissue), including muscle and joint pain, skin reactions, fever, kidney inflammation, and anemia, although they usually disappear when the drug is discontinued. Report any fever, chest pain, feelings of ill health, or other unexplained symptoms to your doctor. The risk of developing lupus increases with higher dosages; approximately 5 out of 100 and 10% of people taking 200 mg a day of hydralazine develop lupus. The daily dosage of hydralazine when you take BiDil can be as high as 225 mg.
Hydralazine may cause a very rapid heartbeat, potentially leading to angina pain or a heart attack.
Taking pyridoxine (vitamin B6) may relieve tingling or numbness in the hands or feet caused by hydralazine.
Possible Side Effects
✓    Most common: headache and flushing—which should disappear after your body adjusts to the drug—nausea, dizziness, weakness, and chest pain.
✓    COmmQR*, k(a% UM16 pressure.
✓    Less common: blurred vision and dry mouth; sinus irritation, rapid heartbeat, heart palpitations, high blood sugar, runny nose, numbness or tingling in the hands or feet, vomiting, and high blood-fat levels.
Possible Side Effects (continued)
V Rare-. flushing, tearing, itching, or redness of the eyes, trem-
ors, muscle cramps, depression, disorientation, anxiety,
itching, rash, fever, chills, occasional hepatitis (symptoms
include yellowing of the skin or whites of the eyes), con-
stipation, urinary difficulties, and adverse effects on nor-
mal blood composition. Other side effects may affect any
organ or organ system. Contact your doctor if you experi-
ence any side effect not listed above.
Drug Interactions
•    Do not take sildenafil, vardenafil, or taldenafil with Bidil. The combination can result in a rapid and potentially fatal drop in blood pressure.
•    Taking this drug with a monoamine oxidase inhibitor antidepressant may increase the blood-pressure-lowering effect of the hydralazine component of BiDil. This combination should be used with caution.
•    Do not self-medicate with over-the-counter appetite suppressants and cough, cold, and allergy remedies, since many contain ingredients that may aggravate heart disease.
•    Taking this drug with large amounts of alcohol may rapidly lower blood pressure, resulting in weakness, dizziness, and fainting.
Food Interactions
Take this drug on an empty stomach. It is unknown how food affects BiDil.
Usual Dose
Adult: 1 or 2 tablets 3 times a day, 1 hour before or 2 hours after eating.
Overdosage
There have been no reports of BiDil overdose. Symptoms of INID11
overdose would be related to the Specific effects of each active in-
2ind can include reduced oxygen supply to heart muscle,
leading to a heart attack, abnormal heart rhythms, and profound
shock. Fainting, coma, and death may follow unless the victim is
treated. Overdose victims must be taken to a hospital emergency
room at once. ALWAYS bring the prescription bottle or container.
Special Information
Avoid alcohol.    headache, dizzi-
Call your doctor if you develop a persistent hea    ,
ness, facial flushing, blurred vision, or dry mouth.
It is important to make sure you drink plenty of fluids every day and pay attention to hot weather and exercise situations in which you might lose unusual amounts of fluids and salts. Fluid loss may lead to low blood pressure, dizziness, and possibly fainting.
If you forget to take a dose of BiDil, 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. Never take a double dose.
Special Populations
PregnancylBreast-feeding., Isosorbide dinitrate crosses into the fetal circulation, and hydralazine can cause low blood pressure in pregnant women and their babies. The potential benefits of B01 must be carefully weighed against its risks when your doctor considers this drug crucial.
it is not known if BiDil passes into breast milk. Nursing mothers who must take it should consider using infant formula. Seniors: Specifics about how seniors react to this drug are not
known. The lowest effective dose of BiDil should always be used, especially in people with reduced kidney and/or liver function.

FEVERFEW
Feverfew (Tanacetum parthenium) has a history of use by healers that goes back to the ancient Greeks propranolol public speaking . Seventeenth-century English settlers brought it with them to the colonies and used it to treat fever, vertigo, depression, and headaches desogen causing depression . Although it fell out of favor by the 19th century, it has experienced a revival in the last decade or so itraconazole vs fluconazole winston antifungal . Studies have shown
that it can indeed help headaches, but it is used primarily for migraine prevention rather than for treatment sildenafil infrared .
Feverfew is used more often in Europe and Canada than in the United States, perhaps because their regulatory bodies have authority over herbal products will theophylline help my dogs cough . In Canada, feverfew prod
** Feverfew
A feverfew extract with at least 0 effexor withrawal .1 percent parthenolide might be helpful in preventing migraines verapamil cluster . It is taken daily molecular weight of enalaprilat not enalapril . Look for a standardized product such as the Canadian nonprescription medicine Tanacet wellbutrin sunburn .
Side effects: Canker sores, mild indigestion, and flatulence Downside: May interact with anticoagulant medicines flagyl stomach problems . Pregnant women should avoid this herb synthroid drip . Discontinuation should be done gradually; stopping abruptly has been associated with a “rebound effect” of severe migraines and steep disturbance side affects of zetia .
Cost: Approximately $3 to $4 for a month’s supply
ucts must by law contain a minimum of 0 verapamil 240mg .2 percent parthenolide imodium ad for children dosage . In France, the minimum is 0 dangers of cirrhosis and levitra .1 percent is tramadol an anti inflammatory .Animal studies have confirmed that parthenolide is the active ingredient get tadalafil . 311 For migraine prevention, the herb is taken daily for at least 2 months getting off lipitor .
A rigorous review of double-blind, placebo-controlled trials involving feverfew found that the results were mixed sertraline and hair loss . Not all the studies supported the efficacy of the herb as a migraine preventive cheapest viagra online . 331 The reviewers did conclude, however, that feverfew appears to be safe effexor side effects not working . A more recent German study demonstrated that a supercritical carbon dioxide extract of feverfew was more effective than placebo in reducing the frequency of migraine headaches caffeine amounts in monster energy drink .337 In this study, side effects were equally uncommon with the feverfew extract and the placebo paxil and cannibus .
Feverfew is generally thought not to be effective for treatment once a migraine headache has begun, but a small preliminary study had patients take a product called GelStat Migraine under their tongues as soon as they had an inkling that a migraine WaS aW111 10 occur digoxin in treating dogs . This nonprescription product contains both feverfew and ginger hydroxyzine 25 mg . A majority of patients who used it got relief, but the study was not placebo-controlled, and further research is needed to confirm these results zion energy solutions exelon .
BUTTERBUR
Butterbur (Petasites hybridus) is another old-fashioned herb that has just resurfaced lithium n cell batteries . In Europe, it is sometimes referred to as “plague plant,” despite a lack of any evidence that it was effective against the plague diovan generic substitute . There is evidence that butterbur can be useful in preventing migraine headaches, but only a few randomized, double-blind studies have been reported cellulitis and clindamycin . 331,11 One study without placebo control found that butterbur root extract can reduce migraine frequency in children and adolescents atenolol side effects prostate problems . 341
Questions have been raised about the long-term safety of some butterbur products because the plant contains pyrrolizidine alkaloids, which are toxic to the liver wellbutrin and xanax for social anxiety .The manufacturer of the patented butterbur root extract used in one of the trials, Petadolex, has reported that the studies conducted on this product confirm its safety for humans cephalexin great dane . 142 The supercritical carbon dioxide extraction process leaves behind the dangerous pyrrolizidine alkaloids discontinuation of wellbutrin xl .343
A product intended for prevention is taken on a daily basis for a long time zelnorm class action . If you decide to try butterbur, we suggest you stick with one that is extracted with supercritical carbon dioxide and check in with your doctor oxybutynin drug .
Acupuncture
Quite a few studies have evaluated acupuncture for treating migraine headaches trazodone stories . The majority of them demonstrate that acupuncture is helpful in alleviating the pain, whether it is used as a preventive measure or in treating an acute headache fosamax total bilirubin .-344 In one large British study, patients undergoing acupuncture took fewer sick days and used less pain medication than they had before treatment pediatric chlorzoxazone dosage .345
Oddly enough, acupuncture seems to achieve these goals even though a properly randomized trial, with sham acupuncture serving as the placebo treatment, couldn’t distinguish between the benefits of real Chinese acupuncture and those of fake acupuncture cardizem la prostrate .346 Both “acupuncture” treatments were clearly superior to doing nothing, as shown by the results from patients in a second control group, who received no treatment during the study ld 50 of omeprazole . Both were also equal to standard preventive drug treatment in another well-designed study is caffeine a dieurectic .347
Not everyone responds to acupuncture, but for those who do, it appears to be a reasonable way to cope with migraine headaches, with a minimal risk of side effects appetite metformin . For treating an acute headache, acupuncture is better than placebo, but not quite as good as sumatriptan (Imitrex) dizziness coumadin atrial fibrillation .348
*** Acupuncture
In general, acupuncture seems to be a safe way to reduce the frequency of migraines and help sufferers cope with them better celebrex deths . Despite research showing that sham acupuncture works just as well, we suggest that you consult a doctor who has been formally trained in acupuncture technique and is experienced in its use for migraine coumadin overdose suicide .
Side effects: Serious side effects are rare mesalamine and diarrhea .349 Minor pain or bruising at the needle site is fairly common soma tabs . 1,0
Downside: Not everyone responds to acupuncture lipitor clinical trials . Some studies suggest the effect is essentially a strong placebo reaction manufacture of penicillin .
Cost: Approximately $60 to $120 per session zyprexa zydas . May be covered by insurance,
Other Nondrug Approaches
As limited as it is, the research literature on herbal products like butterbur and feverfew is almost extensive in comparison to a few other approaches that pop up in medical journals here and there side effect of amoxicillin anxiety . A Brazilian study suggests that melatonin (3 milligrams daily) is effective in preventing migraines yasmin interaction amoxicillin fluconazole .3′ Another study, this one carried out in Switzerland, found that coenzyme Q,,), given at a dose of 100 milligrams three times a day, was supenor to placebo does predisilone effect despo provera .-12 Both of these treatments are readily available without a prescription and reasonably safe cymbalta commercial song . Coenzyme Q , probably should be avoided by people taking the anticoagulant Coumadin (warfarin), however, because of the potential for interaction between the two vasopressin citalopram .
Since the age of 231 have had frequent migraine headaches methotrexate in use for ectopic pregnancy . Over the years, many doctors have prescribed medicines to prevent them, but none has worked prednisone during pregnancy and large baby . Drugs can stop the migraine if I take them early enough, but they shouldn’t be taken too often nolvadex for pct .
I was told the headaches would disappear at menopause, but instead they got worse 10mg of accutane effectiveness . For the past 10 years I have awakened three or four times a week between 2 and 4 a buy topamax online canada .m side effects aripiprazole . with a migraine celebrex celecoxib capsule . I look at my bedside clock when the headache wakes me fluoxetine average doses .
I read an article about people taking melatonin for jet lag and wondered if my headaches were due to a body clock problem imitrex and rebound headache . The article didn’t say anything about migraines, but I tried an experiment keflex antibotic . I started taking one 3-milligram melatonin tablet each evening, and I stopped waking up with a headache in the wee hours vytorin side effects muscles .
For years I have been avoiding all sorts of foods that might be migraine triggers abstracts on caffeine tear production . The success with melatonin made me brave and I ate some of them h pylori doxycycline . No headache, as long as I take the melatonin naproxen long term use . I consider myself lucky and want to share my discovery thyroxine diet supplements .
Another treatment that seems to be both safe and fairly effective is biofeedback to help people learn to warm their fingers floxin otic in perforated eardrum . Presumably this activity also affects the blood vessels in the head that are believed to be involved in migraine altace and bloodpressure . This type of biofeedback has been studied and found helpful in children and adolescents mobic alternatives .-”‘ Finding a professional to supervise biofeedback training and maintaining practice in the biofeedback technique might be a challenge for families oral estradiol for ivf .
We have heard from a number of people who have used hot, spicy soup to stop a migraine quickly when they feel one coming on pepcid ac alcohol . There’s not much research on this approach but no harm in trying it, either mebendazole indications for treatment .
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Q zyrtec liquid tablet . I have enjoyed reading about spicy gumbo and hot and sour soup for migraine and cluster headaches sumatriptan imitrex prescription . No one can imagine how terrible cluster headaches can be patient information on wellbutrin sr . Anything that could help stop the cycle of pain would be a blessing images of simvastatin .
A testosterone level . People have described cluster headaches as feeling like a blowtorch applied to the eye or a red-hot poker being thrust into the skull tetracycline does not effect eukaryotes . To make the agony worse, cluster headaches may recur a few times a week or even several times in a day discounted celebrex .
People tell us that hot peppers in a variety of forms can be helpful in cutting the cycle short recreational viagra use . One fellow prefers a spicy Chinese tofu dish called mapo dofu, but he says anything with enough hot sauce works for him medical lexapro .
Another man relies on Tabasco sauce under his tongue citalopram para agorafobia . He chases this “strong medicine” with a glass of ice water and reports relief “in 5 minutes max anti anxiety buspar treating com .”
The active ingredient in hot pepper is capsaicin coumadin versus warfarin .
Though it may not work for everyone, sipping spicy soup seems worth a try ultram coupons .
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None of these approaches is a substitute for regular medical care effects of glucophage on weight . A person with migraines should be under the care of a health-care provider, usually a physician, who can diagnose the problem and supervise the treatment how long to take prilosec . That is doubly true for anyone whose headaches are so frequent that prevention is an appropriate strategy digitek computer products . If you are interested in nondrug approaches to headache prevention, find a doctor or nurse practitioner who ho is comfortable discussing them with you and keep that person informed of what treatment you are using and how well it is working atenolol and migraine umaxppc .35′ There are a number of drugs that can be effective both for preventing and treating migraine headaches energiser aa lithium .
Migraine Medications
There are no advantages to having migraine headaches apotex generic plavix . By all accounts, it is a miserable experience cephalexin cellulitis . But a person who is tuned in to her body may have an advantage in outflanking the migraine: Sometimes there are early warning signs—the so-called aura—that tip a person off that a migraine is on its way herbal doxycycline . These sensations can range from “little blinky lights” (as one caller described them on our radio show), to tingling in the fingers, to a hint of nausea photo phenergan 12.5 mg . (Full-blown nausea and even vomiting are frequent components of a migraine orexis as good as viagra .)
If you arc a migraine sufferer, get to know your own warning signals of an oncoming headache and act immediately provera barr . Any kind of medicine used to treat a migraine works best if it is taken at the earliest possible stage, before the headache has really taken hold paxil cr availability . Don’t wait to see if your early warni~gwas accurate; assume it was and lake action acyclovir teva .
Over-tire-Counter Painkillers
Because migraines are heavy-duty headaches, we tend to think of treating them with prescription medicine-s elavil dosage no prescription . That may be completely appropriate for people whose headaches often include nausea or frequently drive them to take to their beds azithromycin sun . But for less incapacitating headaches, an OTC combination This widely available nonprescription medicine contains acetaminophen, aspirin, and caffeine zoloft works wonders . The caffeine may help it take effect quickly doxycycline and cacner . It works better than placebo and also better than nonprescription ibuprofen and prescription sumatriptan pills going off fosamax .
This medicine is not intended for the most severe migraines celexa 4741 . The dose of two tablets should be taken as soon as a migraine sufferer suspects a headache is on its way overdose of amitriptyline in cats .
Side effects: Uncommon, but nervousness and nausea have been reported otc paroxetine .
Downside: If this medication is overused, an occasional migraine could become chronic how did penicillin lead to warfare . At that point, the potential side effects of liver and kidney problems would be worrisome cialis non generic . If you find you are using this medicine more than twice a week, seek professional help for your headaches esomeprazole magnesium buy .
Cost: Approximately 10 to 15 cents per dose
drug containing acetaminophen, aspirin, and caffeine (Excedrin Migraine) is surprisingly effective dexamethasone chemotherapy university chicago 2004 .
OTC ibuprofen has also been tested for the treatment of migraines altace rampiril tingling . Randomized, double-blind studies have shown that both Advil Migraine liquigels and Motrin Migraine Pain tablets are better than placebo albuterol inhaler dose .”"” But Excedrin Migraine outperformed ibuprofen in a head-to-head trial zoloft with sudafed .357 What’s more, the acetaminophen-aspirin-caffeine combination also beat out the prescription drug sumatriptan (Imitrex) in reducing pain and associated symptoms and reducing the amount of additional pain medication that study subjects needed celexa depakote .3-58
Prescription Migraine Medicines
The biggest advance in the treatment of migraines has been the development in the last decade and a half of medicines called “triptans hydroxyzine hcl 25 mg tab .” These selective serotonin receptor agonists are now the mainstay treatment for severe migraine headaches prednisone doesage amount for cat . Taken early in an attack, they reverse the chemical changes that lead to migraines and actually stop the headache pain in many cases generic equivalent to zyprexa .
The first triptan to be developed was a self-administered injection of sumatriptan (Imitrex), but before long both Imitrex and other triptan compounds became available as oral medicines singulair in children .The injection may still be very helpful for some individuals who become so nauseated at the onset of a migraine that pills won’t stay down prednisone withdrawl itching .
The triptans are available only by prescription valtrex $89.00 500 mg . In studies that have compared them to the older migraine medicine, ergotamine and caffeine (Cafergot), the triptans have done well, relieving the headache pain more quickly and effectively without significant side effects canine use of loratadine .359,3W
The doctor will need to know about certain aspects of your health and medical history that might make one of these medications too dangerous ultram and information . For example, there have been some unanticipated heart attacks among people taking one of these drugs during a migraine, so the prescriber will want to know about your risk of heart attack theraputic dose of generic wellbutrin . Do you have high blood pressure, diabetes, or high cholesterol? Is there a family history of heart attack or stroke? Such serious reactions, fortunately, are rare, but make sure your physician gets all the relevant details new york celebrex versus vioxx . It’s your life at stake nystatin and triamcinolone cream .
One possible benefit of the extremely high price tags on most of the triptans is that it would discourage anyone from overusing these medications prozac depressions . Of course, without insurance that covers prescription drugs, a migraine sufferer might find it difficult to afford them at all guaranteed lowest price on norvasc . If cost is an issue, ask your doctor whether an older, less expensive drug such as ergotamine and caffeine (Cafergot) might work for you zanaflex drug abuse . Ergotamine
TRIPTANS
• Almotriptan (Axert)
• Eletriptan (Relpax)
• Frovatriptan (Frova)
• Naratriptan (Amerge, Naramig)
• Rizatriptan (Maxalt)
• Sumatriptan (Imitrex, Imigran)
• Zolmitriptan (Zomig)
WHAT THE FDA KNEW
After a woman in Kansas City died following an injection of Imitrex, we followed up on a lead from reporter Kelly Garbus in the Kansas City Star prozac herbal . Through a Freedom of Information Act request (Number F95-00866), we discovered that the FDA was aware of this risk even before the drug was - approved water retention lovastatin . These lines were included in a memo from Paul Leber, MD, who headed the section that reviewed the drug, to Robert Temple, MD, director of the FDA’s Office of Drug Evaluation I:
‘Used appropriately, Imitrex is reasonably safe; used in the patient with pre-existing cardiovascular disease, however, it may be dangerous, even deadly fertility clomid . atomic spectrum for lithium . cialis weight loss silagra cumwithuscom . ropinirole and approval and parkinson .
‘The division’s recommendation to approve the Imitrex NDA (New Drug Application) reflects a risk benefit assessment which, in common with all such determinations, turns as much on personal values and implicitly held private assumptions as it does on evidence and reason dangers of prednisone tablets . medicine lookoup cap davis dilantin . fioricet carisoprodol . prednisone schering pl .
‘In sum, a case can be made that, from the viewpoint of the public health, the benefit accruing to the population of migraineurs is outweighed by the injury and fatalities that Imitrex’s marketing seems certain to cause recommended dosage cipro .” 361
Dr singulair 4mg tablets . Leber had advanced this argument just for the sake of thorough consideration of every angle and titled it “Alternative Perceptions of Imitrex’s Risks and Benefits lithium codeine .” This memorandum makes clear, however, that the FDA knew before approval that the drug was likely to kill some patients is there caffeine in faygo soda .
is not appropriate for people with a history of heart disease and should not be taken by pregnant women because of a risk of birth defects lipitor outcomes .
TOPAMAX
A migraine sufferer who discovers that she needs to use her migraine medicine to stop a headache more than 2 days a week on a regular basis s should definitely schedule an ap- pointment with the doctor caffeine curbs appetite .’6′ Frequent use of any migraine medicine has risks, not the least of which is a “rebound” that makes headaches more frequent medical drug vytorin . If headaches are coming that fast and furious, a preventative medicine could make more sense amlodipine besylate pill .
The most recent drug to be approved for migraine prevention is topiramate (Topamax) testosterone supplement side effects . It was originally developed as an anticonvulsant, but the FDA has approved it for preventing migraine headaches as well triamcinolone diacetate for poison ivy . It works better than placebo to ward off migraines in children and teenagers is cymbalta an maoi inhibitor . 363 Adults who take 100 milligrams of Topamax daily have roughly two fewer migraines per month cannondale 29 er caffeine .364 This is similar to the results achieved with other preventive medicines and significantly better than placebo viagra psuedo .365 Side effects with Topamax include tingling and numbness (paresthesia), confusion or mental fuzziness, and
weight loss ibuprofen for allergies .366
There are other, older medications that the doctor may prescribe for migraine prevention if topiramate is not appropriate risperdal consta side effects . A different anticonvulsant, divalproex, is prescribed for this purpose doxycycline and weight loss . Even before doctors started using anticonvulsants to prevent migraines, though, they had found that betablockers could be helpful overnight shipping of generic cialis . Propranolol and atenolol are the two that are most often used, and because they are available
*** Triptans
These prescription medications usually work well at stopping a migraine attack, especially if they are taken early in the process amiodarone lung pleural effusion . Sometimes a second dose is needed a few hours later albuterol relaxes esophageal sphyncter .
These medications (which come as pills, nasal spray, and injection) are the standard treatment now for the most severe migraines lipitor for alzheimer’s disease . There are some important differences among them what does generic cialis . You and your doctor will have to work together to find one that works well for you with a minimum of side effects caffeine coffee consumption statistics .
Side et WSI caffeine and electrolyte . Dizziness, flushing, tingling, nausea, drowsiness Downside: Expensive; in rare cases, serious reaction may include a lack of bloodflow to some parts of the body, including the heart asacol and kidney problems . Notify the doctor immediately if you faint or experience chest pain or pain in the jaw or left arm after taking this drug diflucan ingrediants gluten .
Cost: Varies; most run $15 to $20 or more per tablet Topiramate (Topamax)
Topamax is taken on a daily basis to prevent migraines acyclovir vomiting . In clinical trials, nearly half of the patients taking Topamax were able to cut their migraine frequency in half prednisone for treating acne . This averages out to reducing migraines by two per month bijwerking misoprostol .
Side effects: Numbness (paresthesia), cognitive dysfunction, weight loss, tiredness
Downside: In rare cases, topiramate can cause a serious metabolic problem, with a buildup of ammonia in the body clomiphene not working . It may also cause visual problems and glaucoma nolvadex and .
Cost: Approximately $150 to $175 per month
in generic form, they are quite affordable will prednisone get you high . This use is distinct from their use for heart problems or high blood pressure synthesis of tramadol and analogous .
In addition, a small study found that people who have both frequent migraine headaches and elevated blood pressure can benefit from the blood pressure medicine olmesartan (Beni-car) cymbalta patient assistance .3″ A few patients felt dizzy, but the drug was well tolerated otherwise duloxetine buy online .
Headache specialists are experimenting with Botox injections for migraine prevention cyclosporine 0.2 for dogs . Double-blind studies have been somewhat promising no prescription clomiphene with overnight delivery . -168,161 zocor tablets .3′0 Although the experts have still not figured out exactly who is the best candidate for this type of preventive treatment, it is generally well tolerated and far less invasive than a type of heart surgery that is also now being studied as a way of preventing persistent, recurrent migraines coca-cola caffeine .
For Women Only: Menstrual Migraines
Women far outnumber men as migraine sufferers, and menstrual migraines might be part of the reason imitrex butalbital . Within the past few decades, clinicians have recognized that many women’s periodic migraines are tied to their menstrual cycles and are presumably triggered by regular hormonal fluctuations hives and femara . Estrogen and progesterone both affect the brain chemicals that are believed to be important in the development of migraine headaches only plant testosterone .371 Migraine attacks, especially migraines without aura, are about twice as common during the first few days of -menstruation as at other times of the cycle fluconazole interactions . 372
Knowing when the migraine is likely to strike can allow for a preventive strategy coumadin clinic in magan az . Women susceptible to menstrual migraines are often advised to take a nonsteroidal anti-inflammatory drug (NSAID) such as mefenamic acid (Ponstel) for several days prior to the expected start of menses and continuing for a few day& 371 An OTC NSAID such as naproxen (Aleve) or ibuprofen (Advil, Motrin) might also work aleve commercial rollergirl . The most common side effect of such pain relievers is digestive upset is prednisolone an immuno supresant .
Another treatment that may be useful in preventing menstrual migraine is the mineral magnesium propecia tablet . A placebo-controlled study found that taking 360 milligrams of magnesium daily starting on day 15 of the cycle through the start of menstruation reduced the number of headache days and the severity of pain clopidogrel definition .374 There are also a few small studies showing that soy isoflavones taken daily can help prevent menstrual migraines drug interaction fluconazole and xanax . 375,376
I
Doctors have also experimented with longer-acting triptans, particularly Amerge, Frova, and Naramig effects of zelnorm during pregnancy . These drugs are frequently used to stop a headache once it has begun, but they also can be used when a headache is anticipated to prevent the
-177
menstrual migr aine _ tramadol roomed online . In some women, oral contraceptives will help prevent menstrual migraines, especially those that limit the number of menstrual periods to just a few each year vytorin adverse reactions . 171
Not Tonight, Dear: Sex Headaches
The term sex headache sounds like an elaborate excuse or maybe a setup for a stand-up comic, but they are no laughing matter interaction of paxil and general anastesia .These are headaches, often severe, that occur at or just before orgasm neurontin side effects treatment of fibromyalgia .
For the last few years I have been plagued with migraine headaches during the last week of my cycle, when my birth control pills contain no hormones amlodipine in pediatrics .
I discussed this problem with my doctor, and she prescribed Mircette erythema multiforme bupropion . This brand of birth control pill is supposed to have hormones during the last week oxycodone decreased testosterone . Unfortunately, I still suffered terrible headaches during that week how to raise estradiol levels . I was at my wits’ end because I could hardly function lexapro and elderly .
I bought soy isoflavones containing “natural hormones soma atp .’ I began taking these capsules three times a day during the last week of my next packet of pills walmart sertraline . For the first time in many years, I had no headache! I dreaded the next month, fearing the success of the soy isoffavones had been a fluke, but it has worked for 3 months in a row medication called requip .
Q lotensin hct 20 12.5mg . I have a problem my doctor and neurologist can’t help testosterone levels morning afternoon evening graph . I am hoping you can give me a hint as to what to
do aztrazeneca arimidex .
Whenever I strain in heavy lifting or in hanky-panky (don’t laugh), I get severe pounding headaches lasting 5 to 15 minutes nortriptyline warnings . They are incapacitating zetia and acne . My neurologist says they are “benign sex headaches” caused by my blood pressure going high, but I’m on Accupril for hypertension seroquel the drug . Do you have any ideas?
A testosterone therapy women dose hair loss . Two kinds of headache are associated with sexual activity and exertion how to withdraw from celexa . One develops gradually with a dull, throbbing ache at the back of the head dilantin and coumadin . The other type is explosive and excruciating, starting just before or during orgasm and lasting 5 to 15 minutes voltaren reactions .
Neurologists often prescribe NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin 115), naproxen (Aleve), or indomethacin (Indocin) to be taken prior to lovemaking mexico fluconazole . An alternate approach is the blood pressure pill propranolol (Inderal) as a preventive measure pamelor for headaches . Consult a headache specialist to find out if such treatment would be appropriate in your case dosage for cipro .
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The first important step to take if such a headache strikes is to schedule an appointment with the doctor without delay seroquel forthe dope non prescript . There are several potential causes of sex headache, and some of them require treatment to prevent great harm irbesartan without lactose . If a workup eliminates the possibility of a serious underlying problem, a nonsteroidal anti-inflammatory drug such as ibuprofen, naproxen, or the prescription drug indomethacin usually works well for preventing or relieving the pain of a sex headache accutane penis bumps .
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Q testgen testosterone . My doctor thought I was nuts when I complained of a sex headache metronidazole suspension ingredients . It happens only when I’m on top sugar in infant ibuprofen . This position gives me the most pleasure, but I have been avoiding it for fear of a stroke taking celexa with 5-htp . The only other time I had such a headache was after going down a steep water slide manufacturers of lithium . My kids and husband were terrified I was dying aa rechargable lithium .
I have high-normal (130/80) blood pressure viagra experiences . I take naproxen for arthritis and Zyrtec for allergies metronidazole ciprofloxacin manufacturer . The headache is explosive and excruciating exelon rivastigmine . Your article on sex headaches vindicates me and assures me I am not alone!
A yerba mate caffeine . Have a specialist evaluate your headaches low testosterone high blood pressure . If they are “benign sex headaches,” there are a number of treatments pile au lithium . For example, the naproxen you use for arthritis may prevent such headaches if taken before lovemaking propecia hair loss .
It is extremely important to rule out other potential causes of severe headaches revia neurotransmitter . One woman responded to the same article:
“I read with great concern your column about the man who asked for help with headaches that occurred with exertion or sexual activity cr discount paxil .
“When my husband was 25, he had a very similar headache while having sex subaction showcomments viagra start from remember . The doctors told him it was viral uroxatral cost . After a week of bed rest and Tylenol he felt better and went back to work bupropion vs budeprion . The next week while having a bowel movement it recurred, but this time the headache was fatal risperdal granular . He had a ruptured aneurysm in his brain liqid nolvadex . Please tell your readers to rule out all possibilities of problems with blood vessels zoloft sexual side effects .”
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phenazocine A synthetic morphine-like analgesic, with similar properties and uses, but with a more rapid and prolonged action. It is of value in biliary colic, as it is less likely to cause a rise in biliary pressure. Dose: 20-30 ing daily, orally or subling tially, although single doses as high as 20 mg are sometimes given. The side-effects are similar to those of morphine and related drugs, but sedation and the risk of dependence is less. (Narphen).
I Phe
Dose: oo- 180 ing daily, at night, adjusted lo need and response. In severe conditions, doses of 50-200 mg may be given by i.m. or i.v. injection. Side-effects include drowsiness and skin reactions. In the elderly it may cause confusion, and paradoxically it may give rise to hyperkinesia in some children. See page 136 and Table 15.
phenol Once widely used as a general antiseptic. Weak solutions relieve itching, and phenol is present in Calamine Lotion. A 5% solution in almond oil is used for the iniection treatment of haemorrhoids.
phenelzine A monoamine oxidase inhibitor, used in the treatment of depression. Dose: 45-60 ing daily, according to need and response. It has many side-effects, including dizziness. dry mouth and blurred vision. Very severe hypertension has been precipitated by some foods, notably clicese. Care is necessary in cardiovascular disease and epilepsy. It may also potentiate the action of other drugs on the central nervous system. (Nardil). See monoamine oxidase inhibitors, Page 128 and’I'able 11.
phenindamine An antihistamine ofinedium potency. It differs from most antihistamines in having a mild central stimulant action, and so rarely causes drowsiness.
Dose: 75-200 ing daily. IThephorin). See page I 10 and Table 2.
phenindione An orally active anticoagu last used in the control of deep-vein thrombosis.
Dose: 200 mg initially; maintenance, 25-100 mg daily, depending on laboratory reports of the prothrombin time. Side- effects include hypersensitivity reactions and haemorrhage. Patients should be warned that the drug may colour the urine. Phenindione has now been largely replaced by %varlarill, (Dindevan).
pheniramine An antihistamine similar to but less potent than chlorpheniramine. Dose: 150 ing daily. (Daneral SA). See page 110 and Table 2.
tphenobarbitone A powerful sedative, hypnotic and anticonvulsant drug. It is mainly of value in epilepsy, as it is effective in most types of seizure except petit mil (absence seizures).
phenolphthalein A synthetic laxative. It is sometimes given with emulsion of liquid paraffin.
Dose: 50-100 mg daily. It may occasion alit/ cause a rash, and its use has declined.
tphenoperidine A narcotic analgesic, often used in association with droperidol in neuroleptanalgesia. It is also used as a supplementary analgesic in general anaesthesia.
Dose: 0.5-1 mg i.v. with subsequent doses as required. It may cause respiratory depression, which can be controlled by doxapram or naloxone. (Operidine).
phenothrin An insecticide used as 0.2% lotion for head and crab lice. (Fill] Marks).
phenoxybenzamine An alpha-adrenoceptor blocking agent used in the severe, episodic hypertension associated with phaeochroniocytoma.
Dose: orally and by injection, 10–20 mg according to need and response. Side-effects include dizziness and tachycardia; rapid and marked hypotension after injection. (Dibenyline).
phenoxymethylpenicillin An orally active, acid-stable penicillin, also known as penicillin V. It is used mainly in respiratory infections in children, in tonsillitis, and to supplement injection treatment. It is not suitable for use in severe infections. Dose: I - 2 g daily, before food. Doses of .500 mg daily are given in rheumatic fever and pneumococcal prophylaxis.
tphentermine An appetite depressant given ill the short-term treatment of obesity. Dose: 13–30 mg before breakfast. (DUramine: lonamin).

phentolamine An alpha-adrenoceptor blocking agent that can temporarily reverse the vasoconstrictive action of adrenaline and noradrenaline. It is used mainly in the diagnosis and control of the episodic hypertension of phaeochromocy- toma, and during surgical removal of the tumour.
Dose: 2-5 ing i.v. repeated as required. Side-effects are tachycardia, hypotension, dizziness, nausea and diarrhoea. (Rogitine).
phenylbutazone A powerful, non-steroidal anti-inflammatory agent, formerly used in the treatment of rheumatic and arthritic conditions. Because of blood dyscrasias, which may occur suddenly, the drug is now used only for the treatment of ankylosing spondylitis under hospital supervision.
Dose: 400-600 mg daily. (Butacote). See page 165 and Table 29.
phenylephrine A vasoconstrictor similar to .”Irvildlille, but less toxic. Given in acute hypotensive states.
Dose: 5 mg by i.m. injection, or 100-500 pg by slow i.v. injection. Sometimes valuable in paroxysmal atrial tachycardia. It is also used locally as 1:400 solution as nasal decongestive, and as eye drops, 2.5-100/6.
phenylpropanolamine A sympatho11111lictic agent used with other drugs in preparations for the symptomatic relief of nasal congestion.
phenytoin An anticonvulsant used in all forms of epilepsy with the exception of petit mil (absence seizures). It has little hypnotic effect and combined treatment with phenobarbitone may evoke the best response.
Dose: 150-600 mg daily with or after food. In status epilepticus it is given under ECG control in doses of 10-15 mg/kg by slow i.v. injection. It is also given to control ventricular tachycardiac in doses of 3.5-5 mg/kg by slow i.v. injection via a cavil catheter. The side-effects of
extended treatment are numerous, and include rash, dizziness, blood dyscrasias, hirsutism and gingival hypertrophy. (Epanutin). See page 136 and Table 15.
pholcodine A cough centre depressant resembling codeine, but it lacks any analgesic properties. It is present in a range of
products used for the relief of useless cough, and has the advantage over codeine of not causing constipation.
Dose: 10-60 mg daily.
physostigmine A plant alkaloid, also known as eserine, once used as a miotic (0.25-1%) to counteract the effects of atropine.
phytomenadione Vitamin K,. The form of vitamin K used in the prophylaxis and treatment of neonatal haemorrhage due to vitamin K deficiency.
Dose: I mg by i.m. injection. It is also of value in the haemorrhage due to overdose of oral anticoagulants. Dose: 10-40 mg by slow i.v. injection. In less severe condi-
tions, 10-20 mg orally, according to the base-line prothrombin time. (Konakion).
pilocarpine A plant alkaloid with a miotic action similar to, but less intense than that of physostigmine.
Dose: in glaucoma as eye drops of 0.5-41!4,, 3-6 times a day. Occasionally given in doses of 15-30 mg daily with food to reduce the dry mouth associated with irradiation of the head and neck.
(Salagen). See page 138 and Table 16.
pimozide A tranquillizer with the actions and uses of chlorpromazine. It is used mainly in the treatment of schizophrenia, as it reduces the delusions without causing drowsiness.
Dose: 10 mg daily initially, adjusted up to a maximum of 20 ing daily, with maintenance doses according to response.
Similar doses are given in mania and psycho-motor agitation. The side-effects are similar to those of chlorpromazine. (Orap). See page 168 and Table 30.
pindotol A beta-receptor blocking agent, with actions and uses similar to those of propranolol. Less likely to cause bronchospasm.
Dose: 7.5-15 nig daily. (Visken). See page 148 and Table 2l.
piperacillin A semi-synthetic penicillin with a wide range of activity that extends to Pseudomonas and anaerobes. It call be used in association with other antibiotics in life-threatening and multiple infections. Dose: in severe infections, 200-300mg/kg daily by i.m. or slow i.v. injection or infusion, increased in life-threatening infections to 16g daily. In less severe infections, 100-150ing/ki; i.m. daily, with a maximum single dose of 2g. (Pipril). Sometimes given with the beta-lactamase inhibitor tazobactam as the mixed product Tazocin.
piperazine An effective anthelmintic against threadworms and roundworms. Dose: 2-4 years, 750 ing; 5-12 years, 1.5 g; in children over 12 years and in adults, 2 g; as a single daily dose for 7 days, repeated if necessary after I week. For roundworm, a single dose of 4 g is given, but as the worms are narcotized, and not killed, a purgative is necessary to ensure expulsion. Side-effects are nausea, diarrhoea and occasional dizziness. Care is necessary in renal impairment, epilepsy and psychiatric conditions.
I Pot
Dose: 1.5-3 nig daily. Side-effects include drowsiness, nausea, dizziness and weight gain. (Sanomigran). See page 154 and Table 23.
podophyllum resin A plant extract used topically as a paint (0.5-25% in alcohol) for anogenital and plantar warts. It is very irritant to normal tissues, and its use requires care. (Condyline; Warticon).
polygellne A modified gelatin, used with sodium chloride and other electrolytes as a [)food volume expander.
Dose: 500-1000 ml by i.v. infusion. (1-lacniaccel).
polynnyxin 8 An antibiotic used by local application for infections of the car, eye and skin. It is too toxic for systemic use.
pipothiazine A chlorpromazine-like drug, with similar uses and side-effects, but given mainly as a depot preparation for the maintenance treatment ofschizophreiiiii. Dose: Wier a test dose of 25 mg) 50-IMnig by deep i.m. injection every 4 weeks, increased if necessary up to a maximum of 200 mg per dose. (Piportil Depot)• See page 168 and Table 30.
piracetamV A new drug used for the treatment of the spasmodic condition cortical myoclonus.
Dose: 7-20 g daily. Side-effects include diarrhoea, nervousness and rash. (Nootropil).
piroxicam A non-steroidal anti-inflammatory agent (NSAID) with all extended action, and used in arthritis, spondylitis, gout and musculoskeletal disorders. Dose: 20-30 mg daily; up to 40 ring daily in gout and other acute conditions. It is also used for local application as a 3% gel. As with related drugs, side-effects include gastrointestinal disturbances of varying severity, especially with higher doses. Weldene). See page 165 and Table 29.
pivampicillin A derivative of ampicillin, with similar actions and uses. Is hydrolyzed to ampicillin after absorption, but gives higher blood levels. Much is excreted in the urine, so it is of value in urinary infections. Dose: I -2 g daily. (Pondocillin).
pizotifen A serotonin antagonist used in the prophylaxis of migraine, and vascular headache.
polymyxin E See colistin.
polystyrene resin An ion-exchange resin [or the removal of potassium in
conditions associated with hyperkalaemia, as in oliguria and anuria.
Dose: 15 g 3•4 times a day according to the plasma level of potassium. When the drug is not tolerated orally, 30 g daily as a suspension may be given per rectum. Care is required in renal or hepatic impairment. (Resonium).
polythiazide A potent diuretic with the action, uses and side-effects of the thiazide diuretics but effective in the low dose of 1-4 ing daily. (Nephril).
poractant A lung surfactant used in the respiratory distress syndrome of premature infants. It is given by endotracheal tubing with mechanical ventilation.
(Curosurf).
potassium One of the most important ions of the body, mainly present in intracellular fluid. Many diuretics increase loss of potassium as well as sodium; with extended
treatment the potassium balance may be disturbed, with acute muscle weakness, cardiac arrhythmias, and an increased sensitivity to digitalis. Potassium loss can 1-w treated with potassium chloride orally (often as Slow-K, but may cause peptic ulceration), or by effervescent potassium tablets. Mixed diuretic and potassium products are also available.

mupirocin An antibacterial agent that is effective against most of the pathogens responsible for skin infections. It is used as a 2% ointment in impetigo, folliculitis and similar conditions. It should not be used for longer than 10 days to avoid the development of resistance. (Bactroban).
mustine A cytotoxic drug used mainly in the treatment of Hodgkin’s disease and related conditions.
Dose: 0.1 mg/kg daily for 3 days as a fast-running i.v. infusion, or as a single dose of oA ing/kg. The solution is highly irritant, and extra venous injection causes very severe local necrosis. Side-effects include severe vomiting, bone marrow depression and alopecia. Close haematologicalcontrol during treatment is essential. Now in less frequent use. See page 122 and Tabl’. 8.
nabumetone A non-acidic anti-inflammatory agent of the naproxen type. It is effective in rheumatoid and osteoarthritis and has reduced gastric irritant properties. Dose: I g at night. Reduced closes are necessary in renal impairment, and the dose of any oral anticoagulant or hypoglycaemic agent may require adjustment. (Relifex). See page 165 and Table 29.
nadolol A beta-blocking agent with the
actions and uses of propranolol.
Dose: in angina, 40 mg daily, or more; in hypertension, 80 mg daily, increased slowly as required; in the prophylaxis and treatment of migraine, 80-160 mg daily. Maximum daily dose 240 mg. (Corgard). See pages 114 & 148, and Tables 4 & 21.
nafarelin A synthetic suppressant of steroid production by the gonads, and used in the treatment of endometriosis.
Dose: given as it once-only course of treatment by nasal spray in doses of 200 pg twice a day, starting between 2 and 4 days of the menstrual cycle, and continued for up to 6 months. Side-effects are numerous and of the menopausal type. (Synarel). See buserelin, goserelin and leuprorelin.
mycophenolate mofetil An immunosuppressant used together with cyclosporin and corticosteroids to prevent acute renal transplant rejection. It acts on a specific enzyme concerned with”]’- and B-lymphocyte proliferation, as well as inhibiting antibody formation.
Dose: 2 g daily, starting within 24 hours (d transplantation. Blood counts are necessary during treatment, and, as with other immunosuppressants, there is an increased risk of opportunistic infection. (CellCept).
nabilone A cannabinoid antiemetic used in the treatment of nausea and vomiting associated with cancer chemotherapy. Dose: 2-4 ing daily, beginning the day before cytotoxic treatment is commenced, and continued for a day after the end of the course. Side-effects are drowsiness, confusion and tremor. Care is necessary in liver dysfunction or any history of psychotic illness. See page 158.
naftidrofuryl A peripheral and cerebral vasodilator. Claimed to be of value in cerebrovascular disorders.
Dose: 300-600 ing daily. (Praxilene).
nalbuphine An opioid analgesic, comparable with morphine in potency, but with reduced side-effects and a reduced dependence potential.
Dose: by injection, 10-20 ingas required. It may cause nausea and dizziness, and care is necessary in respiratory, renal or hepatic dysfunction. (Nubain).
nalidixic acid A quinolone antibacterial agent used in cystitis and infections of the lower urinary tract, especially those due to Gram-negative bacteria (except Pseudornoricts). It is not suitable for systemic infections as the blood levels reached with nalidixic acid are too low to be effective.
Dose: 4 g daily for 7 days, with subsequent doses of 2 g daily. Side-effects arc nausea, visual disturbance, rash, jaundice and phototoxicity. Exposure to sunlight should be avoided; epilepsy is a contraindication. (Mictral; Negrain). See ciprotloxacin and norfloxacin.

naloxone A powerful and rapidly acting opioid narcotics antagonist. It is used immediately after operation to reduce any narcotic-induced respiratory depression. Dose: 100-200µg i.v. initially, followed by 100 µg at 2- minute intervals, as required. For neonates, 10 pglkg by iniection are given. In narcotic analgesic overdose, 800 lig-2 nig may be given, 111, to a total dose of 1 0 ing. (Narcan).
naltrexone A long-acting narcotic antagonist used only to prevent relapse and maintain recovery after treatment for opioid addiction. It prevents re-addiction only whilst the drug is being taken. Dose: 25 ing initially, later up to 50 mg daily. It must not be given to patients who are still opioid-dependent as an acute withdrawal syndrome may be precipitated. (Nalorex).
nandrolone An anabolic steroid related to testosterone, with markedly reduced virilizing properties. It has anabolic or tissue-building properties and has been used in postoperative convalescence, osteoporosis and wasting diseases but the response is poor. It is sometimes effective in aplastic anaemia.
Dose: 50 ing by deep Lin. injection every 3 weeks. (Deca-Durabolin).
the prophylactic treatment of asthma, but it is not effective in an established attack. Dose: by aerosol inhalation, 8 mg (4 pulls) daily. Side-effects are transient nausea and headache. (Tiladc). See page 118. It is also used as eye drops in allergic conjunctivitis. (Rapitil). See page 118 and Table 2.
nefazodoneV A new antidepressant of the selective serotonin-re-uptake inhibitor (SSRI) type.
Dose: 200-600 mg daily. (Dutonin).
nefopam An analgesic for moderate, acute and chronic pain before using more potent drugs. Dose: 90-270 ing daily; 20 mg by i.m. injection. Side-effects include drowsiness, headache and tachycardia. Care is necessary in hepatic or renal disease. (Acupan).
neomycin An antibiotic with a wide range of activity against Gram-positive and Gram-negative bacteria, but it is too toxic for systemic use. It is used mainly as an
ointment or cream (0.5%), often with an anti-inflammatory steroid, in infected skin conditions. It is also used locally for ear and eye infections as drops (0.5%), and it is occasionally given orally in doses of 6 g daily before bowel surgery. Extended local use may cause allergic reactions, and occasionally ototoxicity. (Mycifradin; Nivemycin).
73
naproxen A widely used non-steroidal anti-inflammatory agent (NSAID) for the relief of rheumatic and musculoskeletal
disorders and acute gout.
Dose: 10-1 g daily, increased up to 2g daily in severe conditions. Suppositories of 500 ing are useful at night to reduce morning stiffness. Side-effects include headache, dizziness, and dyspepsia with occasional bleeding. Blurred vision may also occur, as well as I p hy ersensitivity reactions such as rash and bronchospasm. Care is necessary in renal and hepatic impairment; peptic ulcer is a contraindication. (Naprosyn; Syntlex). See page 165 and Table 29.
naratriptanVA serotonin (5-H’I',) receptor agonist for the treatment of acute migraine. Dose: 2.5 mg. A second dose may be given after at least 4 hours if the symptoms recur. (Nararnig). See page 154 and Table 23.
nedocromil An inhibitor of the release of inflammatory mediators in the respiratory tract. It is used like sodium cromoglycate in
neostigmine An inhibitor of cholinesterase which thus indirectly prolongs the action of acetylcholine released at nerve endings. It is used mainly in the treatment of myasthenia gravis.
Dose: 75-300 mg daily; 1-23 mg by injection. Side-effects are nausea, salivation, diarrhoea and abdominal cramp, and supplementary treatment with an anticholinergic drug may be required. It is also used postoperatively to antagonize the residual effects of muscle relaxants. Dose: 1-5 mg i.v., after a preliminary iniection of 0.3-1 nig of atropine. It is contraindicated in urinary or intestinal obstruction. (Prostiginio).
netilmidn An aminoglycoside antibiotic, less toxic than related drugs. Used mainly in severe infections of the urinary and respiratory tracts that are resistant to gentamicin. Dose: 4-6 mg1kg daily by i.v. injection; in urinary tract infections a single oral daily dose of 150 mg is given for 5 days. Side-’ effects are dizziness, vertigo, malaise and rash; ototoxicity may also occur. (Netillin).

neuromuscular blocking agents Drugs used to induce adequate muscle relaxation under a light plane of anaesthesia to facilitate surgery. The non-depolarizing agents such as vercuronium compete with acetylcholine at the neuromuscular receptor site, and have a relatively long action that can be reversed by neostigmine. The depolarizing relaxants, such as suxamethonium, have an acetylcholine-like action oil the receptor site, but as they are broken down less rapidly than acetylcholine, they delay the return of the ability of the muscle to contract again. The action of suxamethonium cannot be reversed by neostigmine.
niacin See nicotinic acid.
nicardipine A calcium channel blocking agent with it coronary vasodilator action similar to that ofverapaiiiii, but with reduced anti-arrhythmic activity. It is used mainly in angina and hypertension, and unlike verapamil it may be given to patients already receiving beta-blockers. Dose: 60-120 ing daily. Side-effects arc dizziness, flushing, nausea and palpita-
tions. If chest pain occurs early, the drugshould be withdrawn. Marked aortic
stenosis is a contraindication. (Cardene). See page I H and ‘]’able 4.
niclosamide A synthetic anthelmintic of value in the elimination of tapeworm. Dose: after lasting 2 g followed 2 hours later by a purge. The tablets should be chewed or crushed, and taken with a glass of water. Side-effects are nausea and abdominal pain, and occasionally pruritus. (Yoniesan).
nicorandil A cardiac drug that has an action mediated by the activation of potassium channels. It reduces the excitability of cardiac muscle and promotes coronary circulation, and is used in the prophylaxis and treatment of angina.
Dose: 5 10ing twice daily initially, rising to a maxintuin of6onig daily. Side-effects are initial headache, palpitations, dizziness. (lkorel). See page 114 and Table 4.
nicotinarnide A compound derived from nicotinic acid, possessing similar properties, but differing in that it has little vasodilator action. It is useful in
deficiency states as well as in pellagra when the vasodilator action of nicotinic
acid limits the dose. It is also used locally as a 4% gel (Papulex) for the treatment of inflammatory acne vulgaris.
nicotinic acid An essential food factor, occurring in yeast, liver, etc., but now prepared synthetically. It is a specific in the treatment of pellagra. It causes vasodilation, and has been used in Wni&e’s disease and chilblains, but with variable results. In large doses it reduces the plasma levels of some lipoproteins. Dose: 10-30 mg daily for prophylaxis; therapeutic dose in pellagra, 250-500 mg daily. In hyperlipidacinia up to 6 g daily have been given. Side-effects include flushing, dizziness and pruritus, which may sometimes lie reduced by taking aspirin 75 mg half an hour before a dose. See page 146,
nicotinyl alcohol A derivative with the vasodilator properties of nicotinic acid, but they are less intense. Useful in peripheral circulatory disturbances such as Raynaud’s disease and acrocyanosis. Dose: 100-200 mg daily. (Ronicol).
nicournalone A synthetic anti-coagulant similar to warfarin, and used mainly in the treatment of deep-vein thrombosis. Dose: 8-12 ing initially; subsequent doses are based on the response, as shown by determination of the blood prothrombin time, expressed as the International Normalized Ratio (INR). Haemorrhage is a potential side-effect. (Sinthrome).
nifedipine A calcium channel blocking agent similar to verapamil, but with a more powerful peripheral and coronary vasodilator action. It is used in the treatment of angina, hypertension and Raynatid’s disease, and may be given if required in association with a beta-blocking agent.
Dose: in angina, 15-60 mg daily; in hypertension 40-80 mg daily. Side-effects are flushing and headache, which are usually transient, and some ankle oedema may occur. It should be withdrawn if anginal pain develops. Severe aortic stenosis is a contraindication. (Adalat• Coracten; Nifensar). See pages 114 & 148, and “fables 4 & 21.
nimodipine A calcium channel blocking agent that acts preferentially on the cerebral vessels. It is used in subarachnoid haemorrhage to prevent ischaemic sequelae.

jt34vef7mn

ethinyloestradiol A synthetic oestrogen formerly used to control menopausal symptoms and other conditions where oestrogen therapy is indicated.
Dose: 10-50 pg daily. It is present with a pi ugestogen in many oral contraceptive products. See page 264 and Table 40.
othosuximide An anticonvulsant for the treatment of petit trial epilepsy (absence seizures). May be used alone, or combined with other anticonvulsants, and it is often of value in patients not responding to other drugs.
Dose: 500 nig daily initially, gradually increased if required, to a maximum of 2 g daily. Care is necessary in renal or hepatic disease. Drowsiness, headache and gastrointestinal disorders are sonic side-effects. (F meside; Zaronlin). See page 136 and Table 15.
etidronate disodium A bisphosphonate used in Paget’s disease of bone, as it slows down the rapid turnover of bone and relieves the pain of that disease.
Dose: 5 nig/kg as a single daily dose between meals for 6 months or more. Side-effects are nausea and diarrhoea; high (loses may increase bone pain and the risks of fracture. (Didronel). Didronel PMO also contains calcium carbonate, and is used in the extended treatment of vertebral osteoporosis. See clodronate and pamidronate.
include nausea, alopecia and myelosuppression. (Vespid). See page 122 and Table 8.
eusol A chlorine antiseptic solution used as lotion, or as compress. The solution should be freshly prepared. Now less popular, thought to be irritant.
evening primrose oil See gamolenic acid.
eye drops Weak solutions of drugs for the treatment of ocular conditions. They may be antibacterial, antifungal or antiviral in action, or maybe used for non-infective conditions such as glaucoma, or for diagnosis. For routine use they are supplied sterile in multiple-application containers, but are intended for individual use only. They contain preservatives, and for home use may be used for up to one month after the container has been opened. In eye Surgery, single application products should be used. Occasionally, enough of a drug may be absorbed from eye drops to have systemic effects, and corticosteroids, if used as eye drops over a prolonged period, may cause’steroid glaucoma’. Care should be taken with contact lenses, and ideally they Should not be worn during eye drop treatment. Soft contact lenses can absorb the preservatives, which may cause irritation.
etodolac A non-steroidal anti-inflammatory agent (NSAID) of the naproxen type, with similar actions, uses and side-effects. Dose: in rheumatoid conditions, 400 mg daily. (Lodine). See page 169 and
Table 29.
etomidate A short-acting i.v. hypnotic used lor the induction of anaesthesia. It causes little cardiac disturbance or hypertension, but muscle movement and pain may
occur during injection.
Dose: 300 pg/kg by i.v. injection.
f Ilypnomidate).
etoposide A cytotoxic agent used in small-cell lung cancer and resistant testicular cancers. It is given in daily doses based on skin area for 5 days, repeated after 21 days according to response.
Dose: 120-240 nighn’ daily orally; by i.v. infusion 60-120 mghn’, and care must be taken to avoid extravasation. Side-effect-,
Factor Vila A recombinant and active form of the blood coagulation Factor VII. The treatment of haemophilia with Factors Vill and IX is complicated by the development of antibodies to those factors. Factor Vila acts as a late stage in the conversion of fibrinogen to fibrin, can function independently of Factors Vill and IX, and does not induce the formation of antibodies. It is used to control serious bleeding in haemophiliac patients and during surgery, under specialist supervision.
Dose: 60-120pg initially by i.v. injection, followed by a second dose after 2-3 hours, then 4-12-hourly as required for
2-3 weeks or more. (NovoSeven).
Factor Vill Haemophilia A is caused by a deficiency of the blood clotting agent Factor Vill, and highly purified preparations of human Factor VIII as well as recombinant forms are used as replacement therapy in doses based on the degree of deficiency of that factor. (Kogenate; Monoclate P; Recombinate).
Factor IX Haemophilia B is due to a deficiency of Factor IX, and preparations of that factor, obtained by monoclonal antibody techniques, are given i.v. in doses based on the degree of efficiency of the factor. (Monomine; Replenine).
famiclovir An antiviral agent similar to acyclovir, and used in herpes zoster (shingles) and genital herpes infections. Dose: 75 mg daily for 7 days. (Panivir). See page 144 and “fable 19.
famotidine An H,-receptor antagonist with the uses and side-effects of cinictidine, but a longer action.
Dose: in benign peptic ulcer, 40 ing at night lor,1-8 weeks; 20 mg at night for the prevention of recurrence, also used in reflex oesophagitis. In Zollinger-Ellison
syndrome, doses of 20 mg 6-hourly are given. ( Pepcid). See page 162 and] *able 27.
pain and inflammation in rheumatoid arthritis and similar conditions.
Dose: 600-900 nig daily. Like other
NSAIDs, it may cause gastrointestinal disturbance and dizziness, but the incidence of rash requires withdrawal of the drug. (Leclet-fen). See page 165;uidfable 29.
fencifibrate A plasma-lipid regulating agent of the clofibrate type, with similar uses and side-effects.
Dose: 300 ing initial]),, with food, later 200-400 mg daily according to need. (Lipantil). See page 146 and Table 20.
fenoprofen A non-steroidal anti-inflammatory and anti-rheumatic agent. It is also used as a mild analgesic in a variety of painful conditions.
Dose: 900 mg-3 g daily. Side-effects include nausea, dizziness, vertigo and rash. (Fenoprofen; Progesic). See page 165 and Table 29.
fenoterol A sympathomimetic agent with the actions, uses and side-effects of salbutamol. Dose: by oral inhalation, 100-200 [Ig (1-2 puffs) up to 4 times a day. (Berotec). See page 118 and Table 6.
Fansidar Pyriniethamine, 25 mg with sulfadoxine 500 mg. Both these antimalarial drugs block the formation of folinic acid in the malarial parasite, but the combination is more effective. Mainly used with quinine in resistant filciparum malaria. (Fansidar is no longer recommended for prophylaxis, as fatalities have followed such use.)
felodipine A calcium antagonist used in the treatment of hypertension generally (see calcium channel blocking agents). Dose: 5 nig daily initially, adjusted to maintenance doses up to to mg daily. ‘I abiets should be taken in the morning, and swallowed whole with water. No adjustment of dose necessary for elderly patients, but care is required in marked hepatic impairment. Hypotension with tachycardia may occur with susceptible patients. (Plendil). See page 148 and Table 21.
felypressin A vasopressin derivative, used as a vasoconstrictor in local anaesthetic solutions for dental use, when sympathetic pressor drugs are contraindicated.
fenbufen A non-steroidal anti-inflammatory agent (NSAID) used for the relief of
fentanyl A narcotic analgesic, used mainly in thiopentone anaesthesia to increase the response and permit a reduction in dose of thiopentone, especially in poor-risk patients. It is also used with droperidol to produce a state of neuroleptanalgesia. Dose: 50-200 pg by i.v. injection.
(Subli niaze). Also used as a patch for the relief of chronic pain. (Durogesic).
fenticonazole An antifungal used in vaginal candidiasis as pessaries of 200 mg. (Lonlexin).
ferrous sulphate, fumarate, gluconate & succinate These iron salts are used in the prophylaxis and treatment of iron-deficiency anaemias. Ferrous sulphate is the standard drug, given in doses of 600 mg daily, but it may cause gastric disturbance in some patients, and ferrous fumarate, gluconate and succinate are better tolerated alternatives. Sonic better tolerated slow-release products are available, but may be less well absorbed. Ferrous sulphate tablets are potentially dangerous for small children, and death has occurred after accidental administration. See desferrioxamine.

fexofenadine An antihistamine with the general properties of that group of drugs. It is less likely to affect the ability to drive. Dose: 120 mg once daily. See
page 110 and Table 2.
fibrinolytic agents Drugs used to break up blood clots, and so are of value in thrombosis. See alteplase, anistreplase, streptokinase and urokinase.
filgrastim A recombinant form of human granulocyte colony stimulating factor (G-CSF), one of a group of natural growth factors concerned with bone marrow activity. It stimulates the development of neutrophils, the production of which is depressed during cytotoxic therapy. The neutropenia thus caused increases the risks of infection, but the neutrophil count can be restored by filgrastim. It is used mainly in the neutropenia associated with the cytotoxic treatment of non-myeloid malignancy. Dose: 500 000 units/kg daily by s.c. injection or i.v. infusion for 14 days, or until the neutrophil count return, to normal. Double doses are given after bone marrow transplanlation.The main side-effects are musculoskeletal pain and dysuria.  See lenograstini and molgrastirn.
His, and is of value in serious ventricular tachycardia and extrasystoles.
Dose: 200-400 mg daily. May he given by slow i.v. injection in doses of 2 iiig/kg in acute conditions resistant to other therapy, and under hospital control. Care is necessary in patients with pacemakers, and in renal impairment. Dizziness and visual disturbances are side-effects. (Tainhocor). See page 141 and Table 18.
flucloxacillin A derivative of cloxacillin, that is absorbed more readily when given orally. It is used mainly in infections due to penicillinase-producing penicillin-resistant staphylococci.
Dose: I g daily before food; by injection 1 -4 g daily, but larger doses arc given in very severe infections. Side-effects are those of the penicillins generally. (Floxapen). See co-fluanipicil.
fluconazole A systemically acting synthetic antifungal agent.
Dose: in oral candidiasis, 50 ing daily for 7-14 days: in vaginal candidiasis, a single dose of 1.50 mg. Dose in systemic candidiasis and cryptococcosis, 200-400 mg daily orally or by i.v. infusion. Side-effects include nausea and abdominal discomfort. Combined treatment with
asternizole, cisapride or terfenadine should be avoided. (Dillucan).
finasteride An inhibitor of the enzyme 5-alpha reductase, and so prevents the conversion of testosterone to dihydrotestosterone, the biologically active form of the male hormone. It is used for the symptomatic relief of benign prostatic hyperplasia, as prolonged therapy promotes a reduction in the size of the prostate gland.
Dose: 5 nig daily for 6 months or more. Side-elfects are reduced libido and impotence. (Proscar). See page 164 and Table 28.
flavoxate An antispasmodic of value in urinary disorders such as dysuria, frequency and related conditions. Dose: 600 mg daily. Side-effects include dry mouth and blurred vision. Contraindicated in glaucoma and bladder obstruction. (Urispas).
flecainicle An orally active anti-arrhythmic
agent of the lignocaine type. It chiefly
influences conduction in the bundle of
flucytosine An antifungal agent used in systemic yeast infections such as candidiasis and cryptococcosis.
Dose: 100-200 mg/kg daily i.v. It may Cause sonic bone marrow depression, and sensitivity tests should be carried out before and during treatment, as resistance to the drug may limit its value. Care is necessary in renal and hepatic inipairmclit. Side-effects include nausea, diarrhoea and rash. (Alcobon).
fludarabine A fluorinated cytotoxic agent used in chronic lymphocytic leukaemia (CI.L) after other treatment has failed. Dose by i.v. infusion 25 mg/in’ for 5 days a nionth. It is generally well tolerated, but myclosuppression may occur as with related drugs. (Fludara).

butobarbitone A barbiturate of medium clisityand rapidity of onset.
Dose: 60-200 mg. (Soneryl).
cabergoline A dopamine similar to bromocriptine, but with a longer .1, 1 ioli.
Dose: for suppression of lactation I mg, followed by doses of 0.25 ing for 2 days. Nausea, dizziness and breast pain are side effects. (Cabaser; Dostinex).
cadexomer iodine A modified starch powder containing 0.9% of iodine in a slow release form. It is used as an antiseptic application for venous ulcers and pressure sores. It should not be used during prenancy or lactation, during thyroid investigations or in patients sensitive to iodine. (lodosorb).
caffeine The central nervous system stimulant present in tea and coffee. It is used with paracetamol and other mild analgesics.
calamine Zinc carbonate. It has a mild astringent and soothing action and is widely used as Calamine Lotion for skin irritation and as Oily Calamine Lotion in eczema.
calciferol (vitamin D 2) form of vitamin 1) used in the prophylaxis and treatment of deficiency states such as rickets in children and osteomalacia in adults, and in other bone disorders. Dose: prophylactic 800 units daily; therapeutic 5000-50 000 units daily. In resistant rickets and parathyroid deficiency, higher doses may be required, but such therapy requires care, as hypercalcaemia percalcaernia and irreversible renal damage may occur. See ako alfacalcidol and calcitriol.
calcipotriol An analogue of vitamin D with a selective inhibitory action on the proliferation of keratinocytes. Used in the treatment of psoriasis as a 0.005% cream or ointment twice a day. Not more than 100 g/week. (Dovonex).
calcitonin Pork-derived calcitonin is a hormone that has an action similar to that
of the parathyroid gland in regulating blood calcium levels. It is used in the hypercalcaemia associated with malignancy, and in osteoporosis. It is also of value in Paget’s disease of bone, in which it relieves bone pain and reduces the neurological symptoms.
Dose: 10-160 units daily by s.c. or i.m. injection according to need and response. In Paget’s disease, prolonged treatment for some months may he required. Side-effects are nausea, flushing and paraesthesia, and local reactions may also occur. (Calcynar; Calcitare; Miacalcic). See salcatonin.
calcitrol The metabolite formed in the kidney from calciferol. It is the most powerful and rapidly acting metabolite with vitamin L) activity. It is of value in chronic renal deficiency states when the normal metabolism of calcium and phosphorus is impaired, as in renal osteodystrophy. Dose: 1-2 pg daily under biochemical control. Side-effects, such as hypercal-
caemia and hypercalciuria, are usually , P
reversible on withdrawing the drug. (Rocaltrol).
calcium channel blocking agents The movement of calcium ions through the calcium channels of the myocardium plays an essential role in cardiac activity. The inhibition of such movement by channel blocking agents reduces myocardial contractility and lowers the tone of the cardiovascular system. Such a reduction is of value in angina, hypertension and cardiac arrhythmias, and can be obtained by the use of calcium channel blocking agents such as diltiazem, felodipine, isradipine, nicardipine, nifedipine, nimidopine and verapamil. These compounds exhibit certain differences in action and in therapeutic applications, and their use requires care. Nifedipine and veraparail have been used in the prophylactic treatment of migraine. Their side-effects include nausea, oedema, rash and bradycardia. See pages 114 & 148, and Tables 4 & 21.
calcium carbonate A time honoured antacid now used less frequently. It also acts as a phosphate binder, and is used in hyperphosphatacinia.
calcium chloride The calcium salt present In various intravenous electrolyte solutions.

calcium folinate See folinic acid.
calcium gluconate A soluble and well-tolerated calcium salt used in many condi- tions associated with calcium deficiency such &i rickets, coeliac disease and parathyroid deficiency; also during pregnancy and lactation often in association with vitamin D. Calcium gluconate is also given in chilblains, urticaria and allergic reactions. Dose: usually given in (loses of 0.5-2g, but ill hypocalcaemic tetany it is given by slow i.v. injection in doses of 10 ml of a 100% solution, with laboratory control of the blood calcium levels. Calcium gluconate is also given i.v. in the early
treatment of toxic hyperkalaemia.
calcium lactate The calcium salt most commonly given orally in mild deficiency states.
Dose: 1-5 g.
Calcium Resonium An ion-exchange resin that take, up potassium in exchange for calcium. Used in hyperkailatentia associated with anuria and haernodialysis. Should be used only when potassium and calcium serum levels are under biochemical control. Dose: 15- 30g 3 or 4 times a day. In children, 0.5-1 g/kg daily. It is sometimes given as a retention enema.
are given in heart failure. Side-effects include proteinuria, neutropenia, agranulocytosis, rash and loss of taste. (Acepril; Capotin). See ACE inhibitors, page 148 and Table 21.
carbachol A parasympathomimetic agent used orally and by injection in the treatment of postoperative atony and retention of urine, and occasionally as eye drops (3%) in i the treatment ofglaucoma. Dose: 2-4 ing orally, 250 pg by s.c. injection. Side-effects include nausea, bradycardia and colic.
carbamazepine An anticonvulsant effective in all types of epilepsy except petit mat (absence seizures). It is also of value in trigeminal neuralgia and is given prophylactically in manic-depressive states. Dose: 200-400 ing daily initially, slowly increased up to 1.8 g daily if required. Suppositories of 125-250 mg are available. Carbamazepine has some antidiuretic properties, and has been used in diabetes insipidus in doses of 100-2M mg daily. Side-effects include dizziness, gastrointestinal disturbances and all erythematous rash. (Tegretol). See page 136 andTable 15.
carbaryl An insecticide used as it lotion and shampoo in pediculosis.
canrenoate A steroid-derived aldosterone antagonist with the actions and uses of spironolactone.
Dose: given in oedema by slow i.v, inject ion or infusion in doses of 200-400 mg daily. Nausea and vomiting are high-dose side-effects. (Spiroctan-M).
capreomycin An antibiotic of value in resistant i uberculosis or when other drugs are not tolerated.
Dose: I g daily by i.m. injection. It may cause tinnitus, deafness, renal damage and allergic reactions. (Capastat).
captopril An inhibitor of the angiownsin converting enzyme. It is used in the treatment of hypertension, including that resistant to other therapy, but care is necessary as the initial dose may cause marked hypotension, and so is best taken ill bed. It is often given with a thiazide diuretic to improve the response, and with a beta-blacker to maintain the effect. Dose: 25 mg initially, slowly increased, as required, up to 450 mg daily. Similar doses
carbenoxcilone A cytoprotectant derived front liquorice, used for mouth ulcers. (Bioplex; Bioral). See Table 27.
carbidopa An enzyme inhibitor used with ievodopa in parkinsonism. It prevents the breakdown of levodopa, thus permitting a larger amount to reach the brain. See
page 160.
carbimazole An antithyroid drug. It inhibits the formation of thyroxine and is valuable in the treatment of thyrotoxicosis and in preparation for thyroidectomy. Dose: 30-60 mg, daily initially; maintenance dose, 5-20 ing daily. It is sometimes given together with thyroxine it) the’blockage replacement’ treatment of hyperthyroidism. Side-effects are nausea, rash and pruritus; alopecia and agranulcytosis have been reported. (Neo-Mercazole).
carbocisteine A mucolytic agent used to reduce the production and viscosity of sputum in respiratory disorders.
Dose: 1.5 g daily. (Mucodyne).