Posts Tagged ‘medicine’

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.

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.

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 .
0 0 *
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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Avoiding Milk and Lactose
Fruit lassi
There are two quite distinct reasons for avoiding milk: either to avoid milk proteins or to avoid

lactose, the sugar found in milk. It is important not to confuse these two because the details of the

avoidance diet required are different. Only a few people need to avoid both milk proteins and lactose.
Diarrhoea and wind in response to drinking milk, but few other symptoms, usually indicates a reaction

to lactose — but a reaction to milk proteins could be an alternative explanation. If it is a reaction

to lactose, this may be due to either primary lactase deficiency or secondary lactase deficiency — your

doctor can order tests to make an exact diagnosis (see p. 79). Note that a bout of diarrhoea, however

caused, often produces a temporary lactose intolerance (secondary lactase deficiency).
Any symptoms other than (or in addition to) diarrhoea and wind strongly suggest a reaction to milk

proteins. This might be a true allergy, another type of immune reaction to milk (see pp. 72-3), or an

idiopathic intolerance reaction (see pp. 76-7). In theory, skin tests should identify true allergic

reactions to milk proteins. Unfortunately, skin tests are not infallible, and it is possible to have a

genuine allergy or other immune reaction to milk proteins, but give negative skin tests. This is

especially common with babies (see p. 65 and p. 69). There are no accurate tests that can confirm

intolerance reactions to milk proteins.
It is possible to have sensitivity to both milk proteins and lactose.
If tests do not give you a definitive answer, you may have to try both types of diet and see which one

works. Remember that lactose intolerance may be only temporary.
Avoiding milk proteins
If you have a sensitivity reaction to cow’s milk proteins, then you need to avoid:
•    milk and all milk-based drinks, including lactose-reduced milk (if you need to avoid lactose as

well, drops and tablets to reduce lactose — see Using lactase replacers, p. 183 — are safe and could be

used with a tolerated milk, e.g. goat’s milk)
•    cream, yoghurt, creme fraiche
•    all kinds of cheese, cottage cheese and cream cheese (some people may be able to tolerate

Norwegian brown cheese, called Gjetost, which is made with milk whey)
•    white sauce, bechamel sauce and other creamy sauces
•    custard, rice pudding and other milk-based puddings
•    almost all home-made cakes, biscuits, cookies, pancakes and pastry
•    some bread, rolls, waffles
•    almost all chocolate
•    casein, casemate, and lactalbumin in packaged foods (see p. 173); you may be able to tolerate

whey but experiment cautiously.
Unless your sensitivity is fairly mild, you will also need to avoid:
•    butter, except clarified butter (ghee)
•    most kinds of margarine (they generally contain milk derivatives, but
some are milk-free — health-food shops are a good source of these).
As long as you do not have a severe allergy to milk, you should be able to tolerate clarified butter.

Make this by melting butter over a low heat, pouring it into a glass jar, and leaving it to cool in the

refrigerator. The milk proteins will settle to the bottom, and be visible as whitish granules — only

eat the clear butter above this level.
Alternatively, put olive oil into a wide-necked container and place in the freezer. It will solidify,

and can be used as a spread in place of butter.
A few of those with cow’s-milk allergy can tolerate sheep’s milk, and possibly (but less commonly)

goat’s milk. However, most people must avoid these as well. (There are also rare individuals who are

allergic to goat’s and sheep’s milk but not to cow’s milk.) Ass’s milk, if you can get it, is tolerated

by most with cow’s-milk allergy. There are many substitutes for cow’s milk now available, such as soya

milk, almond milk, rice milk and hazelnut milk. Try a health-food shop for these. All can be used in

place of ordinary milk when cooking.
Margarine or clarified butter can be used in recipes that call for butter. Soya yoghurt and cream make

reasonable substitutes for ordinary yoghurt and cream.
Avoiding lactose
If you have lactose intolerance, you must avoid:
•    milk and all milk-based drinks, unless lactose-reduced
•    cream, creme fraiche
•    most kinds of yoghurt, especially mild yoghurt. A very strong, acidic yoghurt may contain

little lactose. The bacteria that make yoghurt turn lactose into lactic acid, so the more acidic it is,

the less lactose it contains.
•    cottage cheese and Norwegian brown cheese, or Gjetost. Other kinds of cheese are usually so low

in lactose that they are tolerated. Only those people with extreme lactose intolerance need to avoid

all cheeses.
•    white and bechamel sauce, custard, rice and other milk-based puddings
•    almost all home-made cakes, since milk is generally used for baking. Items cooked with butter

but not milk, such as biscuits, cookies and pastry, are usually tolerated, as is butter itself, and all

margarine.
•    lactose in medicines. Lactose powder is used in many tablets and capsules, just to bulk out the

drugs. The amount used can be sufficient to evoke symptoms in some people with lactase deficiency.

Certain asthma inhalers also contain lactose (see p. 162), and a small amount may be swallowed. The

lactose from inhalers will affect you only if you have severe lactase deficiency.
Soya-based products, and all other nut- or grain-based milk substitutes, are lactose-free. Sheep’s

milk, goat’s milk and other animal milks (including human breast milk) all contain lactose.
Using lactase replacers
Many people with lactose intolerance are able to eat a more varied diet by using lactase replacers.

These provide a temporary supply of the missing enzyme, lactase (see p. 79), which helps out by

digesting the lactose in milky foods. Lactase replacers must be taken at the same time as the milky

food, and are only effective for that one meal. The more lactose there is in the meal or snack, the

more of the lactase replacer you need – trial and error is the only way of working out how much you

need for a particular food. There are a number of different brands of lactase replacer now available,

and it is worth trying out several. Some people find that they are sensitive to an added ingredient in

some brands. Sources of lactase replacers include health-food shops and specialist suppliers – these

can be located through the Internet (see p. 255).
Savoury white sauce
Savoury white sauce is the base of many dishes. Here the flavour of the wine and stock goes well with

chicken, vegetables or fish.
PREPARATION TIME: 7-8 minutes MAKES: approx. 600ml (1 pint)
50g (13/4oz) milk-free baking margarine 50g (1314oz) plain flour
200ml (7fl oz) dry cider or dry white wine 400ml (14f1 oz) vegetable or chicken stock 1 bay leaf, salt

and pepper
Melt the margarine in a small saucepan and stir in the flour. Cook, stirring, over a low heat for
1 minute then stir in the cider or wine, followed by the stock. Add the bay leaf and simmer, stirring

occasionally, for 5 minutes until thickened. Season to taste.
Variations. add approx. 6 tbsp finely chopped herbs, e.g. parsley, chives, tarragon or chervil; or add

English or French mustard; or add lemon juice.
Sweet white sauce
PREPARATION TIME: 5 minutes MAKES: approx. 300ml (’/?pint)
2 tbsp cornflour
25g (1 oz) caster sugar
300ml (V2 pint) apple or white grape juice 4 tbsp soya cream
25g (1oz) milk-free margarine
In a saucepan, mix the cornflour and sugar with a little of the juice to give a smooth paste then

gradually stir in the rest of the juice and bring to a simmer over a low heat. Simmer for 1-2 minutes

until thickened, stirring all the time. Finally, add the soya cream and margarine.
Variations: melt in 1008 (3-/2oz) or more of milk-free chocolate; or add rum or brandy to taste; or add

4-6 pieces finely chopped stem ginger together with 1-2 tbsp of their syrup.
Pancakes
Soya milk has a slightly thicker consistency than cow’s milk and therefore more is used in this pancake

recipe than would be needed in a traditional one.
PREPARATION TIME: 25 minutes MAKES: approx. 16 small pancakes
150g (5V2oz) plain flour, sieved 2 large eggs
pinch salt
450ml (16f1 oz) soya milk
oil or milk-free margarine for frying To serve:
lemon juice and caster sugar or golden syrup
Combine the flour, eggs, salt and soya milk in a liquidiser until smooth. Alternatively place the

flour, eggs and salt in a bowl and slowly whisk in the soya milk to form a thin batter.
Heat approx.1 tsp oil or margarine in an 18cm (7in) non-stick frying pan and swirl until hot. Pour in

sufficient batter to just cover the base of the pan and cook until golden. Turn and cook on the other

side until golden.
Serve with lemon juice and caster sugar or with golden syrup.
Apple and frangipane tart
An alternative to a milk-based custard tart. The combination of apple and almond is delicious. Serve

freshly baked. It can also be eaten cold, but if possible, warm it a
little before serving.
PREPARATION TIME: 30 minutes COOKING TIME: 1-11/4 hours MAKES: 8 servings
Pastry:
175g (6oz) plain flour, sieved
1008 (3 V2oz) milk-free baking margarine, softened
25g (1 oz) caster sugar
Filling:
50g (13/4oz) milk-free sunflower margarine 1008 (3112oz) ground almonds
100g (3112oz) plus 1 tbsp caster sugar 2 egg yolks
2 tbsp dark rum, brandy or orange juice 2 large dessert apples
4 tbsp apricot jam
Work the flour, margarine and sugar together with 1 tbsp cold water to make a soft dough. Roll out and

use to line a deep 20cm (8in) fluted flan tin. Chill this while you prepare the filling.
Preheat the oven to 190′C/375′F/gas mark 5. Beat together the margarine, ground almonds, 100g (3Y2oz)

caster sugar, egg yolks and rum. Peel, core and roughly chop one apple and stir into the mixture.

Spread this in the pastry case. Core and thinly slice the remaining apple and arrange the slices on

top. Sprinkle with the remaining sugar and bake for 1-1′/’4 hours until risen and golden. Cool slightly

then brush the surface with the apricot jam (warm this gently in a saucepan first).
Coconut rice pudding with mango
This pudding is based on a Thai recipe. The rice pudding will become thicker the longer it cooks and

also as it cools. Make sure the mango is ripe.
COOKING TIME: 30-40 minutes MAKES: 6 servings
175g (6oz) pudding rice, rinsed 50-75g (131-2314oz) sugar
1 litre (13/4 pints) carton rice milk 400ml (14f1 oz) coconut milk To serve:
1 extra-large ripe mango, peeled and diced
toasted coconut shreds
Place the rice in a large saucepan with 50g (13/4oz) of the sugar and the rice milk and coconut milk.

Bring to a simmer, stirring. Simmer gently for 30-40 minutes, stirring occasionally, until the rice is

cooked and the milk absorbed. Add the extra sugar if wished. Serve warm or cold, topped with mango and

toasted coconut.
Baked strawberry creams with strawberry sauce
The riper the strawberries the better, to give intensity to both the creams and the sauce.
PREPARATION TIME: 30 minutes COOKING TIME: 20-25 minutes MAKES: 6
1008 (3112oz) caster sugar
4 tbsp Muscat wine
1 tsp lemon juice
350g (12oz) strawberries, hulled and sliced
4 large eggs, beaten Sauce:
225g (Boz) strawberries, hulled and chopped
2 tbsp icing sugar 2 tbsp Muscat wine To serve:
a few whole strawberries
Preheat the oven to 1 70′C/325′F/gas mark 3. Set six 1 50ml (Y4 pint) ramekins in a small roasting tin.

If you plan to unmould the creams, oil the ramekins lightly.
Place the sugar, wine, lemon juice and strawberries in a saucepan and heat gently to dissolve the

sugar. Bring to the boil and cook, uncovered, for 5 minutes. Cool slightly then puree in a liquidiser

and whisk into the beaten eggs. Pass through a sieve then pour into the ramekin dishes.
Pour hot water from a kettle around the ramekins and cook in the centre of the oven for 20-25 minutes

until lightly set.
Remove the dishes from the tin and allow to cool. Chill, if wished.
Combine all the sauce ingredients and liquidise until smooth. Pass through a fine sieve.
Serve the creams in the ramekins with a little sauce poured on top and decorated with a whole

strawberry, or carefully unmould, pour a little sauce over, then decorate with a whole strawberry.
Variation: oil the ramekins. Dissolve 100g (31/2oz) caster sugar in 4 tbsp water in a small saucepan

over gentle heat, then cook to a rich caramel without stirring. Pour a little caramel into each oiled

ramekin then continue as above. Pour the wine for the sauce into the pan used to make the caramel and

warm gently to dissolve any leftover caramel, then continue with the sauce as above.
Frozen vanilla dessert
This is a cross between a sorbet and an ice cream.
PREPARATION TIME: 30 minutes, plus freezing MAKES: 4-6 servings
1 vanilla pod, split
150g (51/2oz) caster sugar 500g carton soya yoghurt
Place the vanilla pod and sugar in a saucepan with 300ml (1/2 pint) water. Dissolve over gentle heat

then bring to a simmer and simmer for 20 minutes. Leave to cool then remove the pod, scraping all the

seeds from it and returning them to the syrup. Beat in the soya yoghurt and freeze.
You will get the best texture by using an ice-cream machine. Alternatively, freeze in a plastic

container then remove from the freezer and beat the mixture well until smooth (you can do this in a

food processor). Return to the freezer. Repeat this process once or twice.
Baked strawberry cream with strawberry sauce
Variations: add 100g (31/2oz) melted plain chocolate; or add 2 tbsp instant espresso coffee dissolved

in 2 tbsp hot water. Alternatively, dissolve 100g (3/2oz) caster sugar over a gentle heat in a small

saucepan until it turns to a rich caramel; then add 100g (31/2oz) unblanched almonds and stir with a

metal spoon until they start to pop. Transfer to an oiled tray and leave to set. Crush roughly and add

to the basic mixture.
Fruit lassi
This refreshing Indian drink can also be made with frozen fruit, in which case don’t use iced water –

cold will do.
PREPARATION TIME: 10 minutes
MAKES: approx. 1.35 litres (21/4 pints)
500g carton soya yoghurt
50-75g (1314-231aoz) sugar
225g (8oz) berries such as raspberries, strawberries, blackberries or blueberries or the equivalent

weight of chopped fruit such as mango, peach or papaya
600ml (1 pint) iced water
Place all the ingredients in a liquidiser and blend until smooth.
Frozen vanilla desert
Banana and strawberry shake
A special treat for a child who cannot have milk.
PREPARATION TIME: 5 minutes MAKES: 600ml (I pint)
2 large, very ripe bananas
150g (5112oz) strawberries
1112 tbsp olive oil
a little nutmeg or other spice, if liked 200ml (7fl oz) water
Peel the bananas and roughly chop the fruit. Combine all the ingredients in a blender until very

smooth. Serve immediately, or cover tightly and store in the refrigerator.
Variations: use a nectarine or a skinned peach instead of strawberries; use coconut milk (available in

tins) instead of olive oil, and the flesh of a small mango, or half a large mango, instead of

strawberries.

Re-balancing the Gut Flora
The gut flora are a large collection of bacteria and yeasts living, usually without harmful effects, in our intestines. Some of these microbes are acquired by a baby during birth - several of the most useful kinds live in the vagina too, and the baby swallows them en route to the outside world. Recent research shows that babies delivered by Caesarean section take much longer to acquire the normal gut flora. However, they catch up eventually because, like other babies, they pick up bacteria in the months immediately after birth, mainly from the mother.
There are hundreds of different kinds (species) of microbe in the gut flora, with the exact mix varying from one person to another. They eat the remains of our meals, and provide certain benefits in return:
•    they make some useful vitamins that we can then absorb
•    they keep disease-causing bacteria at bay simply by being there, taking up all the potential ‘parking spaces’ on the lining of the gut so that alien bacteria can’t find a foothold
•    they may also aid digestion in some way, although this is less certain.
On the downside, the gut flora also produce toxins, but we have had aeons of evolution to get used to these, and the liver normally breaks them down quite happily. Only if the liver is badly diseased (as in cirrhosis) do these toxins become a problem.
The immune system is familiar with these fellow-travellers and tolerates them, while ensuring that they do not invade the body any further. However, a loss of immune competence, as in AIDS, can allow them to become invasive and cause disease.
Research into the gut flora is a relatively new field of medicine, and most of the studies have been published in rather obscure medical journals. So the majority of doctors are unaware that abnormalities of the gut flora – the increase of some species at the expense of others – have been found in patients with rheumatoid arthritis, atopic eczema, irritable bowel syndrome and Crohn’s disease. The relationship between these abnormalities and the disease process is unclear at present: it is not necessarily
a cause-and-effect relationship. The implications, as far as treatment is concerned, are far from clear as yet.
The controversial condition known as ‘candidiasis’ appears to be a particular form of gut-flora imbalance, in which yeasts are overly successful. It is called yeast overgrowth in this book (see p. 82).
Among the factors that can cause an imbalance in the gut flora are:
•    prolonged or repeated treatment with antibiotics; also a single high-dose treatment, as may be given before a hysterectomy operation (see p. 76). These seem to kill off the beneficial bacteria in the gut flora, allowing others to flourish.
•    severe diarrhoea, which can deplete the normal community of bacteria. Usually the effect on the gut flora is temporary, but it can sometimes be long-lasting and may lead to food intolerance (see p. 76).
Additional factors that might contribute to a disturbed gut flora are:
•    a diet that is high in sugar and refined carbohydrates; this is thought to give yeasts an unfair advantage over other members of the gut flora, by providing yeasts with their preferred food
•    taking the contraceptive pill; this is very controversial, but some doctors believe there is a link between the widespread use of the contraceptive pill and the number of cases of suspected yeast overgrowth in young women.
Bacterial replacers or probiotics
Bacterial replacers, also known as probiotics, supply live bacteria to replenish the gut flora with favourable species.
Experimental trials suggest that taking bacterial replacers may be a useful treatment for irritable bowel syndrome, for food sensitivity in babies, and for atopic eczema (including prevention – see p. 243). This approach may also be of value in yeast overgrowth, when combined with dietary treatment (see below).
All bacterial replacers have to be taken every day: the bacteria do not seem to establish themselves permanently in the gut flora. And any benefits from taking them vanish within a few days of stopping the treatment – so this is quite an expensive option.
Unless the bacteria in the product are alive – and alive in considerable numbers – the bacterial replacer is of no value. Refrigeration is the key to keeping the bacteria alive since, after three days at room temperature, their numbers start to decline steeply. Bacterial replacers purchased from a health-food shop may have been stored at room temperature for some time and so contain very few live bacteria. Buying by mall, directly from the supplier, is a good plan: ask how long the delivery usually takes.
Many different brands of bacterial replacer are now available. To locate companies selling by mail order, see p. 255.
The no-yeast-no-sugar diet
Although this diet has not been tested scientifically, it is widely used by doctors who are interested in gut-flora disturbances, and often produces strikingly good results with people who had previously intractable health problems. This is not hard scientific data, but the impressive results with certain patients (see p. 82) suggest that the diet is sometimes worth trying. Those with symptoms ascribed to yeast overgrowth or ‘candidiasis’, especially bowel problems and an itchy anus (see p. 82), benefit most frequently.
The best way to do this diet is to start with a relatively low-key approach (Stage 1). Only progress to more stringent dietary measures if you don’t improve adequately. If there is no improvement at all, even on the Stage 4 diet, then you can be reasonably sure that yeast overgrowth is not the cause of your problems.
Stage 1
If you are taking the contraceptive pill, talk to your doctor about changing to another form of contraception. Although the link between yeast overgrowth and the pill is not in any way established, stopping the pill often seems to be beneficial.
Cut out sugar and all sweet foods, including honey, syrup, jam, chutney, pickles, cakes and biscuits, soft drinks and fruit squash. Note that ‘no-added -sugar’ jam should also be excluded – it is very rich in fruit sugars. Also avoid dried fruits, and change
any medicines taken as syrups to tablet form. Do not eat peanut butter, tinned sweetcorn or baked beans, except sugar-free brands. Avoid sweet potatoes, and any vegetables that become sweet when cooked e.g. baked parsnips, caramelised onions. Your ’sweet tooth’ should be your guide – if it tastes sweet, it’s off the menu. Only artificial sweeteners are allowed.
Not eating sugar is thought to deprive the yeast of much of its food supply. Persist with this diet for 4-6 weeks. If you are no better, or only partially better, go on to Stage 2.
Stage 2
In addition to the restrictions of Stage 1, cut all fruit out of your diet, except for pure, unsweetened lemon juice and lime juice. These juices, plus salads and lightly cooked vegetables, should give you enough Vitamin C – or you could take a supplement.
Cut out white bread and anything made with white flour (e.g. pancakes, pastry, noodles and other pasta). Small servings of wholemeal bread, potatoes and unpolished rice (’brown rice’) are allowed. Your staple diet should be vegetables and high-protein foods such as meat, fish and eggs.
Do eat herbs, spinach and fresh garlic, as these may help to curb the growth of yeast. Don’t eat cheese or anything fermented.
Stick with this diet for at least four weeks, and longer if you begin to feel partially better. If you feel a lot better, continue for several weeks, then gradually reintroduce fruits and other excluded foods – but not sugar, honey, jam, syrup or any other very sweet foods.
Stage 3
In addition to all the restrictions of Stages 1 and 2, cut out any foods containing yeast (see p. 190). Why this should work is not entirely understood (see p. 83).
A response to this diet, even a partial response, is a good sign. Consider going on to Stage 4.
Stage 4
Your doctor must agree to you trying this diet, as it may not be safe for everyone.
Avoid all starchy foods including bread, flour, potatoes, rice, pasta, cornmeal, parsnips, beans, lentils etc. Nuts can be eaten in small quantities, but not cashew nuts. This is an extreme diet which gives the yeast almost nothing to live on. No one should stay on this diet for more than a few weeks: it is only used to confirm the diagnosis, or to get the problem under control before tackling it with other treatments.
If there is any improvement with the Stage 4 diet, talk to your doctor about anti-fungal drugs (see p. 83).