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

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

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

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

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

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

Generic Name
Buspirone (bue-SPYE-rove) OG
Brand Name  BuSpar
Type of Drug
Minor sedative and antianxiety drug.
Prescribed For
Anxiety and generalized anxiety disorders; also prescribed for the aches, pains, fatigue, and cramps of premenstrual syndrome (pMS).
General Information
Buspirone hydrochloride has a potent antianxiety effect. It is approved by the Food and Drug Administration (FDA) for short-term relief of anxiety, but it may apparently be used safely for more than 4 weeks. The exact way in which buspirone works is not known, but it seems to lack the addiction dangers associated with other antianxiety drugs, including benzodiazepines. It neither severely depresses the nervous system nor acts as an anticonvulsant or muscle relaxant, as other antianxiety drugs do. Minor improvement will be apparent after only 7-10 days of drug treatment, but the maximum effect does not occur for 3 or 4 weeks.
Cautions and Warnings
Do not take buspirone if you are allergic or sensitive to any of its ingredients.
Buspirone should be used cautiously by people with timer or kidney disease.
Buspirone does not have any antipsychotic effect and should not be taken for symptoms of psychosis.
Although buspirone has not shown a potential for drug abuse, you should be aware of this possibility.
Buspirone should not be used with monamine oxidase inhibitor (MAGI) antidepressants.
Possible Side Effects
♦    Most common: dizziness, drowsiness, nausea, and head-
ache.
•    Common: fatigue, nervousness, lightheadedness, excite-
ment, dry mouth, and insomnia.
•    Less common: heart palpitations, muscle aches and pains, tremors, rash, sweating, clamminess, rapid heartbeat, dif-
ficulty concentrating, anger or hostility, depression, loss of interest, diarrhea, constipation, vomiting, and blurred vision.
♦    Rare: Rare side effects can occur in almost any part of the
body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Combining buspirone with an MAGI antidepressant may produce severe hypertension and may be dangerous.
•    The effects of combining buspirone with other drugs that work in the central nervous system (CNS) are not known. Do not take other sedatives or antianxiety or psychoactive drugs with buspirone unless prescribed by a doctor familiar with your complete medical history.
•    Erythromycin, itraconazole, ketoconazole, clarithromycin, diltiazem, verapamil, fluvoxamine, and ritonavir may increase blood levels of buspirone. When used in combination, your buspirone dosage may need to be adjusted.
•    Buspirone may increase the side effects of haloperidol and diazepam.
•    Studies show that buspirone is not affected by alcohol, but this combination should still be used with caution because buspirone causes drowsiness and dizziness.
•    The combination of buspirone and trazodone may cause liver inflammation.
•    Combining rifampin with buspirone may decrease buspirone’s effectj\18″eSS.
Food Interactions
This drug may be taken either with or without food, but for the most consistent results, always take your dose at the same time of day in the same way—that is, with or without food. Avoid drinking large amounts of grapefruit juice with this drug.
Usual Dose
Adult: starting dosage-7.5 mg twice a day. Dosage may be increased gradually to 60 mg a day.
Overdosage
Symptoms of overdose are nausea, vomiting, dizziness, drowsiness, pinpointed pupils, and upset stomach. The overdose victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Buspirone may cause CNS depression, drowsiness, and dizziness. Be careful while driving or operating hazardous equipment. Avoid other CNS drugs and alcoholic beverages because they will enhance buspirone’s effects.
Contact your doctor if you become restless, develop uncontrolled or repeated movements of the head, face, or neck, or have any intolerable side effects.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and go back to your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Though buspirone has not been found to cause birth defects, be sure to inform your doctor if you are or might be pregnant while taking this drug. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
It is not known how much buspirone passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Several hundred seniors participated in drug evaluation studies without any unusual problems. However, the effect of this drug in seniors is not well known, and special problems may surface, particularly in those with kidney or liver disease.

Generic Name
Bupropion (bue-PROE-pee-on) M
Brand Names
Budeprion    Wellbutrin SR
Budeprion XL    Wellbutrin XL
Wellbutrin    Zyban
Type of Drug
Antidepressant and smoking deterrent.
Prescribed For
Depression, seasonal affective disorder, and nicotine addiction.
General Information
Bupropion is used for major depression and seasonal affective disorder, and may work as a smoking deterrent by acting on key hormone systems in the brain. It works primarily on dopamine and noradrenaline, unlike the SSRI antidepressants, which primarily work on serotonin. Bupropion may not act until you have taken it for 2-4 weeks. The drug clears your system about 2 weeks after you stop taking it.
Cautions and Warnings
Do not take bupropion if you are allergic or sensitive to any of its ingredients.
Antidepressants have been associated with an increased risk of suicide, especially in children and teenagers. Suicide is always a risk in depressed people, who should only be allowed to have minimal quantities of medication in their possession. Clinical worsening of a depressed person’s condition may also occur early
therapy with anticlepressa”kS.
People with seizure disorders, people who have had a seizure in the past, and people with bulimia or anorexia nervosa should be very careful about taking bupropion because they are at a higher risk of having a seizure. About 4 in 1000 people taking bupropion in dosages up to 450 mg a day develop a seizure. The risk of developing a seizure increases by about 10 times with dosages between 450 and 600 mg a day. About half of the people who developed a seizure on bupropion had a risk factor such as a history of head injury, a previous seizure, or a nervous system tumor, or were taking another drug associated with increased seizure risk.
People with unstable heart disease or those who have had a recent heart attack should take this drug with caution because of possible side effects.
Many people taking bupropion experience some restlessness, agitation, anxiety, and sleeplessness, especially soon after they start taking the drug. Some even require sleeping pills to counter this effect, and others find the stimulation so severe that they have to stop taking bupropion.
Bupropion may trigger a manic episode in those with depression or bipolar disorder.
People taking bupropion may experience hallucinations, delusions, or psychotic episodes. Dosage reduction or drug withdrawal is usually necessary to manage these reactions.
One-quarter of those who take bupropion lose their appetite and 5 or more lbs. of body weight. People who have lost weight due to their depression should be cautious about taking bupropion.
People switching from bupropion to a monoamine oxidase inhibitor (MA01) antidepressant, or vice versa, should allow at least 2 weeks to pass between stopping one drug and starting the other.
People with kidney or liver disease require less bupropion at the beginning of treatment. Dosage should be increased cautiously.
An antidepressant other than bupropion should be seriously considered for people with a history of drug abuse because of the mild stimulation bupropion causes. These people may require larger-than-usual dosages, but they are still susceptible to seizures at these higher dosages.
Possible Side Effects
About 10% of people stop taking bupropion due to side effects.
♦ Most common: dry mouth; dizziness; rapid heartbeat; headache, including migraine; excessive sweating; nausea; vomiting; constipation; appetite loss; weight changes: sedation; agitation; sleeplessness; and tremors.
Possible Side Effects (continued)
V Less common’. upset stomach, diarrhea, increased appetite, menstrual complaints, impotence, urinary difficulties, slowness of movement, salivation, muscle spasms, warmth, uncontrolled muscle movement, compulsion to move around or change positions, abnormal heart rhythms, blood-pressure changes, heart palpitations, fainting, itching, redness and rash, confusion, hostility, loss of concentration, reduced sex drive, anxiety, delusions, euphoria (feeling “high”), fatigue, joint pain, fever or chills, respiratory infection, and visual, taste, and hearing disturbances.
Drug Interactions
•    Phenelzine (an MAGI) increases the risk of bupropion side effects. Allow at least 2 weeks to pass between stopping an MAGI and starting bupropion. Serious side effects can occur.
•    Carbamazepine may reduce blood concentrations of bupropion.
•    People taking both bupropion and levodopa + carbidopa or amantadine experience increased side effects. People taking these drugs should have their bupropion dosage increased gradually.
•    Ritonavir may significantly increase bupropion blood levels and the risk of side effects.
•    Don’t mix bupropion with other drugs that increase the risk of seizures—including tricyclic antidepressants, haloperidol, lithium, loxapine, molindone, phenothiazine sedatives, and thioxanthene sedatives.
•    Combining bupropion with a nicotine replacement drug can cause high blood pressure.
•    Combining bupropion with warfarin can increase the risk of side effects.
•    Do not comtImP. INO~bujfin and Zyban, as they contain the same active ingredient.
•    Alcohol should be avoided by people taking bupropion.
Food Interactions
Bupropion may be taken with food if it upsets your stomach.
Usual Dose
Depression
Adult: 200-450 mg a day; normal daily dosage is 300 mg. Child (under age 18): not recommended.
Smoking Cessation
Adult: 150 mg twice a day. Begin treatment while you are still
smoking.
Child (under age 18): not recommended.
Overdosage
Symptoms of overdose are likely to include severe side effects, such as seizures—present in a third of overdoses—hallucinations, loss of consciousness, and abnormal heart rhythms. Overdose victims should be taken to a hospital emergency room at once. ALWAYS bring the prescription bottle or container.
Special Information
Do not stop taking bupropion without your doctor’s knowledge. Suddenly stopping the drug may cause withdrawal reactions and side effects.
Call your doctor if you experience agitation or excitement, restlessness, confusion, difficulty sleeping, anxiety, panic attacks, sleeplessness, irritability, hostility, aggressiveness, acting impulsively, a manic reaction, deepening depression, suicidal thinking, fast or abnormal heart rhythm, severe headache, seizure, rash, fainting, or any unusual or persistent side effect.
Bupropion may make you tired, dizzy, or lightheaded. Be careful when driving or doing any task that requires concentration.
Alcohol, sedatives, and other nervous system depressants increase the depressant effects of this drug. Alcohol also increases the risk of a seizure.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose and you take it several times a day, take 1 dose as soon as you remember and another in 3 or 4 hours, then go back to your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: The safety of using bupropion during pregnancy is not known. When your doctor considers this drug crucial, its potential benefits must be carefully weighed against its risks. Pregnant women trying to quit smoking should use non-drug methods until their pregnancy is completed.
Bupropion passes into breast milk. Nursing mothers who must use bupropion should use infant formula.
Seniors: Seniors with reduced kidney or liver function may require reduced dosage.

Bisoprolol (bye-SOPE-roe-lol) 91
Brand Name
Zebeta
Combination Product
Generic Ingredients: Bisoproldl + Hydrochlorothiazide (0 Ziac
Type of Drug
Beta-adrenergic blocking agent.
Prescribed For
High blood pressure; may also be used for angina pectoris, and stable congestive heart failure.
General Information
Bisoprolol fumarate is one of many beta-adrenergic blocking drugs, or beta blockers, which interfere with the action of a specific part of the nervous system. Beta receptors are found all over the body and affect many body functions. Each beta blocker has particular characteristics that make it more suitable for certain conditions or people. Hydrochlorothiazide is a diuretic that lowers blood pressure.
Cautions and Warnings
Do not use bisoprolol if you are allergic or sensitive to it or other beta blockers.
Beta blockers should not be used by people with a slow heart rate, a condition called heart block (a disorder of the heart’s conduction system), or those in cardiac shock or overt heart failure_
Peoplewith angina who take bisoprolol for high blood pressure risk aggravating their angina if they suddenly stop taking the drug. These people should have their dosage reduced gradually over 1-2 weeks.
Bisoprolol should be used with caution if you have liver or kidney disease, because your ability to eliminate the drug from your body may be impaired.
People with chronic bronchitis or emphysema should use bisoprolol with caution.
Bisoprolol reduces the amount of blood pumped by the heart with each beat. This blood flow reduction may aggravate the condition of people with poor circulation or circulatory disease.
If you are undergoing major surgery, your doctor may want you to stop taking bisoprolol at least 2 days before surgery.
People with a history of severe anaphylactic reaction to allergens may be unresponsive to usual doses of epinephrine while taking beta blockers.
Possible Side Effects
Side effects are relatively uncommon and usually mild. T Mrnk common: impotence.
V Less common: unusual tiredness or weakness, slow heartbeat, heart failure, dizziness, breathing difficulties, bronchospasm, depression, confusion, anxiety, nervousness, sleeplessness, disorientation, short-term memory loss, Possible Side Effects (continued)
emotional instability, cold hands and feet, constipation, diarrhea, nausea, vomiting, upset stomach, increased sweating, urinary difficulties, cramps, blurred vision, rash, hair loss, stuffy nose, facial swelling, aggravation of lupus erythematosus, itching, chest pain, back or joint pain, colitis, drug allergy (symptoms include fever and sore throat), and liver toxicity.
Drug Interactions
•    Bisoprolol may interact with surgical anesthetics to increase the risk of heart problems during surgery. Some anesthesiologists recommend gradually stopping the drug by 2 days before surgery.
•    Bisoprolol may interfere with the normal signs of low blood sugar and with the action of oral antidiabetes drugs.
•    Bisoprolol increases the blood-pressure-lowering effects of other blood-pressure-reducing agents, including clonidine, guanabenz, and reserpine, and calcium channel blockers, such as nifedipine.
•    Aspirin-containing drugs, indomethacin, sulfinpyrazone, and estrogen drugs may interfere with the blood-pressurelowering effect of bisoprolol.
•    Cocaine may reduce the effectiveness of all beta blockers.
•    Bisoprolol may worsen the problem of cold hands and feet associated with taking ergot alkaloids, used to treat migraine. Gangrene is possible in people taking both an ergot and bisoprolol.
•    Calcium channel blockers, diphenhydramine, flecainide, contraceptive drugs, quinolone antibacterials, and quinidine may increase the amount of bisoprolol in the bloodstream and lead to increased bisoprolol effects.
•    Bisoprolol may increase the effects of ephedrine. Initially, high blood pressure wvd they a slow heart rate may result.
6 Combining beta blockers with lidocaine can increase lidocaine levels, possibly leading to toxicity.
•    Beta blockers taken with prazosin may increase the side effect of lightheadedness upon standing up that prazosin can produce.
•    Beta blockers may block the effects of epinephrine.
Smoking makes the liver break this drug down more quickly. If you stop smoking while taking bisoprolol, your daily dose
may have to be reduced.
Food Interactions
This drug may be taken without regard to food or meals.
Usual Dose
Adult: starting dose-5 mg once daily. The daily dose may be gradually increased up to 20 mg. Maintenance dose-5-10 mg once daily. People with kidney or liver disease may need only 2.5 mg a day to start. Seniors should be treated cautiously; they may respond to lower doses.
Child: not recommended.
Overdosage
Symptoms of overdose include changes in heartbeat—unusually slow, unusually fast, or irregular—severe dizziness or fainting, breathing difficulties, bluish fingernails or palms, low blood pressure, heart failure, shock, and seizures. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Do not stop taking bisoprolol unless directed to do so by your doctor. It is meant for continuous use. Abrupt withdrawal may cause chest pain, breathing difficulties, increased sweating, and unusually fast or irregular heartbeat. Dosage should be reduced gradually over a period of about 2 weeks when bisoprolol treatment is stopped.
Call your doctor at once if you develop back or joint pain, breathing difficulties, cold hands or feet, depression, rash, or changes in heartbeat. Bisoprolol may produce an undesirable lowering of blood pressure, leading to dizziness or fainting: call your doctor if this happens to you. Also call your doctor if you experiem:.epeisistent or bothersome anxiety, diarrhea, constipation, impotence, headache, itching, nausea or vomiting, nightmares or vivid dreams, upset stomach, trouble sleeping, stuffed nose, frequent urination, unusual tiredness, or weakness.
Bisoprolol may cause drowsiness, dizziness, blurred vision, or lightheadedness. Be careful when driving or performing complex It is best to take bisoprolol at the same time every day. If you forget a dose, take it as soon as you remember. If it is within 8 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: Infants born to women who took a beta blocker while pregnant had lower birth weights, low blood pressure, and reduced heart rates. Bisoprolol should be avoided by pregnant women and women who might become pregnant while taking it.
It is not known if bisoprolol passes into breast milk. Nursing mothers taking bisoprolol should use infant formula.
Seniors: Seniors taking bisoprolol may be more likely to suffer from cold hands and feet, reduced body temperature, chest pain, general feelings of ill health, sudden breathing difficulties, increased sweating, or changes in heartbeat.

dornase alfa A recombinant form of human deoxyribonuclease (rhDNase) used in cystic fibrosis. The viscous purulent airways secretion of that disease is due to the presence of large amounts of extra-cellular DNA from degenerating leucocytes. Dornase alfa breaks down the DNA and reduces the sputum viscosity. Dose: 2500 units daily by inhalation from it jet nebulizer. Daily treatment is necessary to maintain the response. (Ptilillozvme).
dorzolamide An inhibitor of carbonic anhydrase that reduces the amount of sodium bicarbonate in the aqueous humour of the eye. It is used as eye drops (2%) 2 or 3 times a day as adjunctive therapy in ocular hypertension when beta-blockers are unsuitable or ineffective. (Trusopt). See page 138 and Table 16.
dothiepin (dosulepin) A tricyclic antidepressant with the uses and side-effects of antitriptyline. It is used in the treatment of depression when a sedative action is also indicated.
Dose: 75-150 mg daily. It may also be given as a single nightly dose to reduce daytime drowsiness. (Prothiaden). See page 128 and Table 11.
doxapram A respiratory stimulant useful in postoperative respiratory failure under expert control.
Dose: by i.v. injection 1-1.5 nig1kg according to need. It is also given by i.v. infusion in doses controlled by arterial food gas studies. Side-effects include hypertension, Ypertension, bronchospasin and tachycardia. (Dopram).
doxepin An antidepressant with the actions, uses and side-effects of dothiepin.
Dose: 30–300 nig daily; a single dose of I Ito mg is sometimes given at night. (Sinequan). See page 128 and Table 11.
doxorubicin A cytotoxic antibiotic widely used in leukaemia, lymphosarcoma, breast and lung cancer.
Dose: by fast i.v. infusion 60-75 nigIm’ at intervals of 3 weeks, or 20-25 mg/m’ daily for 3 days. It is also used by bladder installation (50 mg in 50 nil of saline solution) for superficial bladder tumours. Side-effects include bone marrow depression, cardiac damage, alopecia, buccal ulceration and nausea. Doxorubicin is it skin irritant, and should he handled with care. See page 122 and Table 8.
doxycycline A long-acting tetracycline. Dose: 200 mg initially, followed by 100 ing its a single daily (lose. In acne, a dose of 50 mg daily is given for some weeks. It should be taken with adequate fluid, with the patient in a sitting or standing position. (Nordox; Vibramycin).
droperidol A tranquillizer with unusual properties. It is given in severe psychotic conditions such as mania, in drug-induced nausea and vomiting and for preoperative sedation. It is also given with fentanyl to produce a state of detachment (neuroleptanalgesia).
Dose: 20-120 ing daily; 5-10 ing by injection; in cancer therapy induced vomiting (loses of 1-3 nig/hr have been given by continuous i.v. infusion. Side-effects are those of chlorpromazine and haloperidol. (Droleptan).
doxazocin An alpha-adrenoceptor blocking agent of the prazosin type, but with a longer action that permits a single daily dose.
Dose: in hypertension I mg initially, slowly increased after 7-14 days to 2 mg daily, up to a daily maximum of 16 ing, usually in association with other amihypertensive drugs. It is also used in Iliesymptcunitic treatment ofbenign prostatic . P
hy erplasia. Side-effects are
dydrogesterone An orally active progestogen that is virtually free from
any oestrogenic or androgenic side-effects. It is used in amenorrhoea, endometriosis, functional uterine bleeding, and threatened abortion.
Dose: 10-30 mg daily. (Ouphastort).

econazole An antifungal agent similar in actions and uses to clotrimazole. (Ecostatin; Pcvaryl).
ecothiopate A potent and long-acting iniotic that has been used in glaucoma as eye drops of 0.03-0.25%. It may cause cataract; its availability is strictly limited.
edrophonium A very short-acting drug of the neostigniine type. It is used in the diagnosis of myasthenia gravis.
Dose: 2-10 nig by i.v. injection, which causes a marked but transient increase in muscle power if myasthenia gravis is present.
eformoterol A selective P2 stimulant (agonist) with a rapid initial action, used as supplementary treatment in patients receiving other bronchodilator therapy for reversible airway obstruction.
Dose: by inhalation: 12µg twice daily, doubled if necessary. (.are is necessary in ischaernic heart disease and diabetes. Not to be used for acute attacks. (Foradil). Sec page 118 and Table 6.
enalapril An ACE inhibitor used in the treatment of all types of hypertension, and in congestic heart failure, often together with a diuretic.
Dose: i ing daily initially, increase(] as required up to 40 mg daily, and often given as a single dose. Dizziness, hypotension and loss of taste are some side-effects. ! I imov.i, :. See page 148 and Table 21.
enflurane An inhalation anaesthetic with the actions and uses of halothane, but less potent.
epoetin alfa and beta Recombinant fornis of human erythropoietin. (Eprex; Recormon). See erythropoietin.
epoprostenol A prostaglandin present in the walls of blood vessels that inhibits platelet aggregation. It is used to prevent platelet aggregation during cardiopulmonary bypass and charcoal haemoperfusion, and as an alternative to heparin in renal dialysis.
Dose: 10-20 ng1kShnin by continuous i.v. infusion. Smaller doses in renal dialysis. It is also a vasodilator, and side-effects are flushing and hypotension. (Flolan).
enoxaparin A low-molecular weight and longer acting form of heparin. It has the general properties of heparin, but with less effect on blood platelet activity. It is used in the prevention of venous thrombosis. Dose: 20 mg by sx. injection once daily ( I hour before surgery) for 7-10 days. (Clexane). See certoparin, dalteparin and tinzaparin.
enoximone An inhibitor of the enzyme phosphodiesterase. It has a digoxin-like action on the myocardium and is used in
eptacog alfa See Factor VIIa.
ergocalciferol See calciferol.
ergometrine The principal alkaloid of ergot. It promotes uterine contraction and is used for the rapid control of postpartum haemorrhage. Dangerous in the early stages of labour.
Dose: 05-1 nig orally; or 200-500 jig by injection. It is often used together with oxycytocin as Syntometrine. Side-effects are nausea and transient hypertension.

ergot A fungus that develops in rye and replaces the normal grain. The active principles include ergometrine and ergotamine. Chronic toxic effects characterized by gangrene of the extremities have followed the use of ergot-contaminated rye bread.
ergotamine Air alkaloid of ergot that constricts the cranial arteries, and is used solely for the relief of migraine not responding to analgesic therapy. Early treatment evokes the best response.
Dose: 2 mg initially up to 6 ing during an attack, not to be repeated until after an interval of some days.”I oral dose in I week: 10– 12 mg. It is also given by oral inhalation in doses of 360pg ( I puff), repeated after 5 minutes, up to a maximum of 6 puffs daily. Side-effects include headache and nausea, and the drug should be withdrawn if tingling of the extremities occurs.
trot suitable for prophylaxis because of the risks of toxicity. (Lingriine). Sec page 154
erythromycin Air antibiotic, resembling penicillin in its general range of activity, with the advantage of being active orally. It is useful in streptococcal and respiratory infections and in penicillin-resistant staphylococcal infections. Erythromycin is also of value in penicillin-sensitive patients. It is also given as a prophylactic before dental surgery. Dose: up to 4 g daily; in severe infections it may lie given by slow i.v. infusion in closes of 50 mg/kg daily. Side-effects include nausea and vomiting, and diarrhoea may occur after high doses. Gore is necessary in hepatic impairment. Preparations of erythromycin estolate are contraindicated in liver disease. Erythromycin may potentiate the action of warfarin. It should not be given with aslenii/.ole or terfenadine.
erythropoietin (epoetin) A renal hormone that regulates blood cell production in the bone marrow. Patients with renal failure maintained by haemodialysis do not
produce epoetin, and so become anaemic. A recombinant form of erythropoietin is available for replacement therapy.
Dose: 20-50 units/kg 3 times a week by s.c. or i.v. injection under haematological control. Side-effects include headache and hypertension, but a sudden migraine-like pain may indicate air impending hypertensive crisis. (Eprex; Itecormon).
eserine See physotiginine.
esmolol A very short-acting betaadrenoceptor blocker used in the emergency treatment of supra-ventricular arrhythmias, tachycardia and perioperative hypertension.
Dose: by i.v. infusion 50-200pg/kg/rniri under close control. (Brevibloc).
estramustine A compound of oestradiol and inustine, designed to release mustinc at oestrogen-receptor sites. It has a more localized action and so causes less myelodepression. It is used mainly in prostatic carcinoma, especially when resistant to other therapy.
Dose: 0.56-1.4 g daily. It should not be taken with food or milk products. Side-effects include gastrointestinal disturbances, nausea and gynaccomastia. (Fstracyt). See page 122 and Table 8.
ethacrynic acid A loop diuretic with a rapid and intense action used mainly in oliguria due to renal failure.
Dose: 50 ing daily initially, increased as required up to a maximum of400rng daily or on alternate days. Ethacrynic acid is also given by slow i.v. iniection in doses of 50-100 mg in acute or refractory conditions. Side-effects include nausea, diarrhoea and deafness. Some hypotension may occur initially. (Edecrin).
ethambutol An antitubercular drug.
Dose: 15 mg/kg daily, together with i i lo i i ipic in or isoniazid. Lower doses should be given in renal damage. It may cause visual disturbances with loss of acuity, but recovery is usually complete on withdrawal of the drug. (Myarnbutol). See page 170 and Table 31.
ethamsylate A haemostatic used in the prophylaxis and treatment of periventricular haemorrhage in low birth-weight infants.
Dose: 12.5 mg/kg by injection 6-hourly within 2 hours of birth and continued for 4 days. It is also used orally in menorrhagia. Dose: 2g daily. (Dicynene).
ethanolamine oleate A sclerosing agent used for varicose veins and bleeding oesophageal varices.
Dose: by local i.v. injection, 2-5 nil.
ether A colourless inflammable liquid, once widely used as a general anaesthetic but now replaced by halothane.