Drugs Blog

Type of Drug:

Atypical antipsychotic.

How the Drug Works:

Atypical anti psychotics act upon several neurotransmitter systems, including antagonism at one or more types of dopamine receptors, antagonism at alphacadrenergic receptors, and activity at muscarinic, histamine H1 , or nicotinic receptors.

Uses:

For the treatment of schizophrenia.

Olanzapine: For the short-term treatment of acute manic episodes associated with Bipolar I disorder.

Precautions:

Tardive dyskinesia: InvOluntary and uncontrollable movements may develop in patients treated with antipsychotic drugs. Occurrence is high­Specially women. However, it is impossible to predict which patients are likely to develop the syndrome. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short­term treatment at low doses. The syndrome is characterized by rhythmical, involuntary movements of tongue, face, mouth, or jaw (eg, protrusion of toQue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs. Fine worm-like movement of the tongue may be an early sign of the syndrome. If the medication is stopped at this time, the syndrome may not develop further. There is no known treatment for established cases of tardive dyskinexia, although the syndrome may stop, partially or completely, if the drug is Withdrawn. Antipsychotic treatment, however, may suppress or partially suppress the signs and symptoms of the syndrome and thereby possibly mask the underlying disease process. The effect that symptomatic suppression has upon the long-term course of the syndrome is unknown.

Neuroleptic Malignant Syndrome (NMS): Is a potetially fatal syndrome oscillated with antipsychotic drugs. Symptoms Include fever, muscle rigidity, altered mental abilities, irregular pulse and blood pressure, increased heart rate, sweating, and irregular heart rhythm.

Seizures: Seizures have occurred during therapy with some antipsychotic agents. The likelihood of seizure becomes greater at higher doses.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits out­weigh the possible hazards to the fetus.

Breastfeeding: It is not known if these drugs are excreted in breast milk. Do not use breastfeed while taking one of these drugs.

Children: Safety and effectiveness of loxapine in patients younger than 16 years of age have not been established. Safety and effectiveness of clozapine, olanzapine, and quetiapine have not been established.

Lab Tests: Lab tests will be required to monitor therapy. Tests include blood counts and liver function.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-cOunter or prescription medications or dietary supplements with these drugs. Doses of one or both drugs may need t o be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with these drugs:

• Anticholinergics (eg, diphenhydramme)
• Antihypertensives (eg, methyldopa)
• Dopamine agonists (eg, bromo criptine)
• Phonyton (eg, Dilantin)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy and individual susceptibility. Possible side effects include:

Circulatory System: Increased heart rate; changes in blood pressure; chest pain; abnormal blood counts; increased cholesterol levels.

Nervous System: Drowsiness; dizziness; agitation; confusion; seizures; aggressiveness; amnesia; anxiety; disturbed sleep; personality disorder; restlessness; rigidity; slurred speech; stuttering; fainting; tremor.

Digestive Tract: Constipation; dry mouth; stomach pain; diarrhea; nausea; vomiting; increased appetite.

Respiratory System: Coughing; difficulty breathing; runny nose; nasal; gestion; upper respiratory tract infection.

Other: Rash; orthostatic hypotension (dizziness or light-headednes that occurs when rising quickly from a seated or lying position); prolontion erection; Parkinson-like symptoms; Neuroleptic Malignant Syndromo; dive dyskinesia; dry skin; toothache; premenstrual syndrome; swelling of the arms or legs; joint, muscle, or back pain; twitching; sore thronl; weakness; fever; sweating; visual disturbances; weight gain; false­positive pregnancy tests.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• Orally-disintegrating tablets - Peel back foil blister; do not push tablet through the foil. Using dry hands, remove and place the entire tablet in your mouth. The tablet will dissolve with or without liquid.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, con­tact your doctor or pharmacist.
• May take several weeks before maximum benefit is obtained.
• May cause drowsiness, dizziness, or seizures. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
• Orthostatic hypotension (dizziness or drowsiness when rising quickly from a seated or lying position) may occur. Avoid sudden changes in posture.
• Notify your doctor immediately if you experience abnormal or impaired vision, lethargy, weakness, sore throat, general body discomfort, mucous membrane ulcerations, flu-like symptoms, tremor, muscle twitching or stiffness, or yellowing of the skin or eyes (jaundice).
• Use caution in hot weather. These drugs may increase the possibility of heat stroke. Avoid overheating and dehydration.
• Avoid consuming alcoholic beverages and other mental depressants (eg, narcotics, antihistamines) while taking this medicine.
• Inform your doctor if you are pregnant, become pregnant, plan on becoming pregnant, or are breastfeeding.
• Lab tests will be required to monitor therapy. Be sure to keep appointments.
• Store at controlled room temperature (59° to 86°F). Protect from light and moisture.

Type of Drug:

Typical (conventional) antipsychotic.

How the Drug Works:

The exact mechanism is not known. Drugs of this type usually work by altering nerve transmission in the brain.

Uses:

For the management of the manifestations of psychotic mental disorders

Precautions:

Neuroleptic Malignant Syndrome (NMS): NMS is a potentially fatal syndrome associated with antipsychotic drugs. Symptoms include fever, muscle rigidity, altered mental abilities, irregular pulse and blood pressure, increased heart rate, sweating, and irregular heart rhythm.

Tardive dyskinesia: Involuntary and uncontrollable movements may develop in patients treated with antipsychotic drugs. Occurrence is highest in the elderly, especially women. However, it is impossible to predict which patients are likely to develop the syndrome. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short­term treatment at low doses. The syndrome is characterized by rhythmical, involuntary movements of tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs. Fine worm-like movement of the tongue may be an early sign of the syndrome. If the medication is stopped at this time, the syndrome may not develop further. There is no known treatment for established cases of tardive dyskinexia, although the syndrome may stop, partially or completely, if the drug is withdrawn. Antipsychotic treatment, however, may suppress or partially suppress the signs and symptoms of the syndrome and thereby may possibly mask the underlying disease process. The effect that symptomatic suppression has upon the long-term course of the syndrome is unknown.

Pregnancy: There are no adequate and well controlled studies in pregnant women. Use only if clearly needed and potential benefits outweigh the possible risks to the fetus.

Breastfeeding: It is not known if thiothixene appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children younger than 12 years of age have not been established.

Lab Tests: Lab tests or exams may be required to monitor treatment. Tests include blood and liver tests and periodic eye exams.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over-the-counter or prescription medications or dietary supplements with this drug. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with this drug:

• alcohol atropine (eg, lsopto Atropine)
• barbiturates (eg, phenobarbital)
• benztropine (eg, Cogentin)
• bromocriptine (Parlodel)
• chloroquine (eg, Aralen)
• guanadrel (eg, Hylorel)
• guanethidine (eg, Ismelin)
• levodopa (eg, Larodopa)
• lithium (eg, Eskalith)
• phenytoin (eg, Dilantin)
• propranolol (eg, Inderal)
• trazodone (eg, Desyrel)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors, including dose, duration of therapy and individual susceptibility. Possible side effects include:

Digestive Tract: Indigestion; stomach pain; constipation; appetite changes; diarrhea; nausea; vomiting.

Nervous System: Altered mental status; orthostatic hypotension (dizzines or light-headedness when rising quickly from a sitting or lying position); fainting; drowsiness; impaired judgment, thinking or motor skills; head­ache; restlessness; agitation; light-headedness; sleeplessness; seizures.

Circulatory System: Rapid heartbeat; changes in blood pressure; pounding in the chest (palpitations); abnormal blood counts.

Other: Rash; fever; muscle rigidity; sweating; acute kidney failure; involuntary and uncontrollable movements (eg, protrusion of tongue, puffing of cheeks; puckering of mouth, chewing movements); lens problems; dry mouth; weakness; weight gain; tight muscles; joint pain; swelling of arms and legs; lactation; moderate breast enlargement (women); absence of menstruation; increased or decreased blood sugar; blurred vision; nasal congestion; increased salivation; impotence; increased thirst; itching; sensitivity to light.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or if it is necessary to establish a new dosage schedule, con­tact your doctor or pharmacist.
• May cause dizziness, light-headedness, or fainting, especially when rising or standing and during the first 3 to 5 days. If these symptoms should occur, sit or lie down and contact your doctor. Use caution while driving or performing hazardous tasks requiring alertness, coordination, or physical dexterity.
• Do not take other medications without your doctor’s approval. This includes nonprescription medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
• Avoid alcohol and other mental depressants (eg, narcotics, tranquilizers, antihistamines) while you are taking this medicine.
• Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or are breastfeeding.
• Avoid overheating and dehydration.
• Lab tests may be required to monitor treatment. Be sure to keep appointments.
• Store at a controlled room temperature (59 to 77°F).

With the growing popularity of using contact lenses instead of glasses, the lens market has during the last decades become enormous. The contact lenses nowadays can be used by most people that need sight correction, and with the size of the market, there’s naturally a great choice of lens types and models to choose from. Popular models on the market such are for example the 1 day Acuvue and the Focus dailies, but there are also many other lenses.

The first thing to decide on is what kind of contact lens that best suits you. There are disposable lenses, that you throw away every night, and lenses that you can wear for over a year, if you treat them right. There are color lenses, that can change your eye color if you want, and there are even lenses on the market that help you improve your golf play! What they all have in common however, is that they all give you a great, clear vision. The huge demand has created a strong development in the lens market, and the products are constantly improving. Make a little research to find the lens that suit you best, and you want be disappointed.

Type of Drug:Topical anti-inflammatory, anti-itching agents; anti-inflammatory steroids.

How the Corticosteroids, Topical Works:

Topical adrenocortical steroids reduce skin inflammation (eg, redness, swelling), itching, and irritation. The exact manner in which the drug works is not fully understood. The effectiveness of the drug depends on many factors, including: The extent of absorption of the drug, the potency of the drug, the size of the area treated, and the dose form (eg, cream, ointment).

Uses of The Corticosteroids, Topical:

To treat inflammation and itching caused by corticosteroid-responsive skin disorders.

OTC Hydrocortisone: To treat minor skin irritation, itching, and rashes due to eczema; insect bites; poison ivy, oak, or sumac; allergic inflammation from soaps, detergents, cosmetics, or jewelry; itchy genital and anal areas; psoriasis; seborrheic dermatitis; or other minor skin irritations

Precautions:

Do not use in the following situations: acne allergy to corticosteroids or any of their ingredients bacterial infections of the skin, single therapy for cellulitus facial, groin, or armpit areas (high potency agents only) prolonged use near eyes or eye­lids rosacea

Use with caution in the following situations: blistered, raw, or oozing areas of skin diaper dermntosis skin infection

Absorption into the body: Absorption into the body of topical corticosteroids has produced manifestations of Cushing’s syndrome, reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, and increased blood and urine sugar. This is more likely to occur with application to large body surfaces, use of occlusive dressings, and with the more potent steroids. Patients at higher risk include young children.

Side effects may include growth retardation, delayed weight gain, low plasma cortisol levels and absence of response to ACTH stimulation, including bulging “soft spots,” headaches, and bilateral papilledema.

Alcohol-containing preparations: Alcohol-containing preparations may cause drying, burning, or irritation of open lesions.

Formulations: Corticosteroids are specially formulated to maximize their release and potency. Mixing these products with other products is discouraged because it may affect potency and effectiveness.

Occlusive vehicles: A transparent plastic wrap or other vehicles that will not allow air to pass through to the treated area will enhance absorption at least 10 times. These kinds of dressings are not generally recommended (eg, when using clobetasol or halobetasol, when treating children).

Greasy ointment bases are more occlusive and are preferred for dry, scaly lesions. Gels are less occlusive. The aerosols, lotions and solutions are best suited for hairy areas.

Skin atrophy: Skin atrophy may occur in 3 to 4 weeks if the most potent corticosteroids are employed. Skin atrophy occurs most readily at sites where absorption through the skin is highest.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus. Do not use large doses or for prolonged periods of time if you are pregnant.

Breastfeeding: It is not known if topical corticosteroids appear in breast milk. Oral corticosteroids appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Limit therapy to the lowest possible dosage because children may be more susceptible to topical corticosteroid-induced side effects. Safety and effectiveness of alclometasone in children less than 1 year of age have not been established. Clobetasol is not recommended in children less than 12 years of age. Safety and effectiveness of hydrocortisone probutate in children less than 18 years of age have not been established.

Lab tests may be required to monitor therapy. Tests may include urinary­free cortisol, ACTH stimulation, and early morning plasma cortisol test.

Side Effects of Corticosteroids Topical:

Every drug is capable of producing side effects. Many topical corticosteroid users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Skin: Burning; itching; irritation; redness; dryness; allergic inflammation; acne; decreased pigmentation in the area being treated; streaks in skin; skin atrophy; infection; stinging; cracking; rash; tingling; scalp pustules (scalp application only); unusual hair growth.

Other: Elevated blood or urine sugar; cataracts and glaucoma (prolonged use near eyes); numbness of fingers; worsening of condition being treated.

Also consider all side effects for oral corticosteroids..

Guidelines for Use:

• Dosage is individualized.
• Application frequency and duration of therapy are dependent on the condition treated, its location, the potency of the drug, and the vehicle employed. For assistance in product-specific drug selection and dos­age guidelines, consult your doctor or pharmacist.
• Wash hands before and after application.
• Wash or soak the affected area before application. This may increase drug penetration.
• Apply sparingly as a thin film. Rub in lightly until the medication disappears.
• For external use only. Avoid contact with the eyes.
• Avoid prolonged use, especially near the eyes, on the face, on genital and rectal areas, and in skin folds.
• The treated area should not be bandaged, covered, or wrapped to be occlusive, unless advised to do so by your doctor.
• Do not use tight-fitting diapers or plastic pants on children treated with topical corticosteroids in the diaper area. Such garments function as occlusive dressings.
• Skin infections may worsen. It may be necessary to stop the corticosteroid and treat the infection.
• Do not use these agents to treat acne, the lesions of rosacea, skin inflammation near the mouth, or for any disorder other than that for which it was prescribed.
• Allergic reactions may Occur. Contact your doctor if the condition being treated worsens or irritation, burning, redness, swelling, or stinging persists. Do not reapply the drug.
• If you do not notice improvement within 2 weeks (or 1 week when using aTC hydrocortisone), consult your doctor.
• Aerosol/Spray - Take care to cover the eyes while spraying close to the face. Avoid inhalation. Spray the affected area for 3 seconds or less at a time and at a distance of at least 6 inches between the nozzle and skin.
• Scalp application - Apply to the affected scalp areas twice daily, once in the morning and once at night. Do not use more than 50 week. Treatment must be limited to 2 consecutive weeks.
• Tape - Skin should be clean and dry before the tape is applied. Tape should always be cut, never torn. Replacement of the tape every 12 hours produces the lowest incidence of side effects, but it may be left in place for 24 hours if it is well­tolerated and adheres well. When replacing the tape, cleanse the skin and allow to dry for 1 hour before applying new tape. When necessary, the tape may be used at night only and removed during the day. If the ends of the tape loosen prematurely, they may be trimmed off and replaced with fresh tape.
• Lab tests may be required to monitor therapy. Bo sure to keep appointments.
• Store at controlled room temperature (59 to 86 F),protect solution and lotions from freezing.

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Type of Drug:

Antirheumatic agents.

How the Drug Works:

The exact merchanism of action of gold compounds is unknown. They suppress or prevent joint swelling and retard cartilage and bone destruction, but do not cure rheumatoid arthritis.

Therapeutic effects from gold compounds occur slowly. Early improvement, often limited to reduction in morning stiffness, may begin after 6 to 8 weeks of treatment, but other beneficial effects may not be observed until after months of therapy.

Uses:

To treat early active adult or juvenile rheumatoid arthritis not adequately controlled by other therapies (eg, NSAIDs).

Unlabeled Uses: Occasionally doctors may prescribe gold compounds for pemphigus and psoriatic arthritis.

Precautions:

Injection reaction: Increased joint pain may occur for 1 or 2 days after ejection. They usually subside after the first few injections. These reacllon are usually mild, but occasionally may be so severe that treatment It; stopped prematurely.

Use of other antirheumatic drugs: Use of salicylates, aspirin, NSAIDs, systemic corticosteroids may be continued when gold injection theory is started. After improvement begins, slowly discontinue pain rollovers and NSAIDs as symptoms permit. Safety of arranging with able gold or high doses of corticosteroids has not been establisllod. salts should not be used concomitantly with penicillamine or hydroxy chloroquine. See Drug Interactions.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Gold therapy is generally contraindicated in pregnant patients. Use only if clearly needed and potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: Gold appears in breast milk. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness of auranofin and gold sodium have been established. Safety and effectiveness of aurothioglucoso it children younger than 6 years of age have not been established.

Elderly: Tolerance to gold usually decreases with advancing age.

Lab Tests: Lab tests will be required during treatment. Tests include complete blood cell and platelet counts, urinalysis, and kidney and liver functional All women of child-bearing potential must have a pregnancy test before treatment begins to rule out the possibility of pregnancy.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are take any over-the-counter or prescription medications or dietary supplements with gold compounds. Doses of one or both drugs need to be modified or a different drug may need to be prescribe following drugs and drug classes interact with gold compounds:

• Antimalarials (eg, hydroxychloroquine)
• Immunosuppressive agents (eg, azathioprine, cyclophosphamide, methotrexate)
• Penicillamine (eg, depen)
• Phenytoin (eg, dilantin) (auranofine only)

Side Effects:

Every drug is capable of producing side effects. Many gold compound users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Indigestion; nausea; vomiting; diarrhea; constipation; stomach cramps; appetite loss; gas; dark or loose stools; mouth inflammation or ulcers.

Skin: Rash; itching; hives; redness; unusual bruising.Oher: Blood in the urine; skin inflammation; metallic taste; abnormal blood cell counts; abnormal liver or kidney function tests; anemia; yellowing of the skin or eyes.

Guidelines for Use:

• Dosage will be individualized. Do not exceed the recommended dosage.
• Injectable gold products - The appropriate dose will be prepared and administered by your health care provider.
• Notify your doctor immediately if any of the following occurs: Rash, mouth inflammation, persistent diarrhea, sore mouth, indigestion, metallic taste, unusual bleeding or bruising, itching, blood in the urine, fainting, slow heartbeat, thickening of the tongue, difficulty swallowing or breathing, yellowing of the skin or eyes.
• Notify your doctor immediately if you suspect you have become pregnant during therapy. All women of child-bearing potential must have a pregnancy test before treatment begins to rule out the possibility of pregnancy.
• Increased joint pain may occur for 1 or 2 days after injection. This usually subsides after the first few injections.
• Observe good oral hygiene during therapy.
• Improvement of symptoms is not immediate. Improvement may be seen after 6 to 8 weeks of treatment, although it has not been seen in some patients for up to several months.
• Lab tests and exams will be required to monitor therapy. Be sure to keep appointments.
• Store at room temperature (59 0 to 86°F). Protect from light.

Type of Drug:

Anticonvulsant; drug used to treat a variety of seizure disorders.

How the Oxcarbazepine Product Works:

Oxcarbazepine prevents or reduces some types of seizures by controlling abnormal nerve impulses in the brain.

Uses of The Oxcarbazepine:

For use alone or in combination therapy for the treatment of partial seizures in adults with epilepsy and as combination therapy for the treatment of partial seizures in children 4 to 16 years of age with epilepsy.

Unlabeled Uses: Oxcarbazepine has been used for atypical panic disorder.

Precautions:

Do not use in the following situations: Allergy to oxcarbazepine or any of its ingredients.

Pregnancy: There are no adequate and well-controlled clinical studies in pregnant women; however, it is closely related structurally to carbamazepine, which is considered to be teratogenic in humans. Use during pregnancy only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: Oxcarbazepine and its active metabolite MHO are excreted in human breast milk. Because of the potential for serious adverse reactions, decide whether to discontinue nursing or to discontinue the drug in nursing women, taking into account the importance of the drug to the mother.

Children: Oxcarbazepine has been shown to be effective as adjunctive therapy combined with other drugs for partial seizures in patients 4 to 16 years of age.

Lab Tests: Lab tests will be required to monitor therapy. Tests may include blood sodium levels, liver function, kidney function, and blood tests.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements with oxcarbazepine. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with oxcarbazepine:

• Calcium channel blockers (eg, felodipine)
• Carbamazepine (eg, tegretol)
• Phenobarbital (eg, solfoton)
• Phenytoin (eg, dilantin)
• Valproic acid (eg, depakene)

Side Effects:

Every drug is capable of producing side effects. Many oxcarbazepine users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; vomiting; stomach pain; inflammation of the stomach; appetite changes; dry mouth; toothache; diarrhea; indigestion; constipation; rectal bleeding or pain.

Nervous System: Headache; dizziness; drowsiness; anxiety; fatigue; weak­ness; incoordination; tremors; continual rapid eye movement; abnormal gait; sleeplessness; impaired concentration; amnesia; worsening of seizures; involuntary muscle contractions; unstable emotions; decreased sensation to stimuli; nervousness; agitation; speech disorder; confusion; feeling of whirling motion; abnormal EEG; abnormal thinking.

Respiratory System: Sinus congestion; runny nose; upper respiratory infection; cough; breathing difficulties; sore throat; nosebleed; chest infection.

Skin: Acne; hot flashes; flushing; rash; unusual bruising; increased sweating; itching.

Other: Double vision; abnormal vision; earache; ear infection; fever; allergy; swelling of the legs; chest pain; weight increase; low blood pressure; following down; swollen lymph nodes; viral infection; urinary tract infection; frequent urination; inflammation or pain of the vagina; low blood sodium levels; thirst.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose unless advised to do so by your doctor.
• May be taken without regard to meals.
• Avoid alcohol and other mental depressants (eg, narcotics, tranquilizers, antihistamines) while you are taking this medicine.
• Treatment should be withdrawn gradually to minimize the potential of increased seizure frequency.
• If a dose is missed, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised by your doctor. If more than one dose is missed, or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• Additional non hormonal forms of contraception (eg, latex condoms) are recommended because of a reduction in hormonal contraceptive efficacy during therapy.
• Avoid alcohol during therapy; it may cause drowsiness.
• May cause drowsiness, dizziness, or blurred vision. Use caution while driving or performing hazardous tasks requiring alertness, coordination, or physical dexterity until tolerance is determined.
• Store at controlled room temperature (59° to 86°F). Keep tightly closed

Type of Drug:

Anticonvulsant; drug used to treat epilepsy, seizures, and other conditions.

How the Drug Works:

Valproic acid prevents or reduces the number of seizures by controlling the abnormal activity of nerve impulses in the brain and central nervous system. Sodium valproate and divalproex sodium are converted to valproic acid in the body.

Uses:

Used alone or in combination with other anticonvulsants to control simple and complex absence seizures (petit mal).

Used alone or in combination with other anticonvulsants to control isolated complex partial seizures or complex partial seizures associated with other types of seizures.

Delayed-release tablets: To treat manic episodes associated with bipolar disorder.

Delayed-release, extended-release tablets: For the prevention of migraine headaches.

Unlabeled Uses: May be effective as an adjunct to antipsychotic drugs in the symptomatic management of schizophrenia in patients who fail to respond to an adequate trial of the antipsychotic agent alone. Also may be a useful adjunct in schizophrenic patients with EEG abnormalities suggestive of seizure activity, or in those patients with agitated or violent behavior. May be effective in relieving tardive dyskinesia in patient receiving long-term antipsychotic drug therapy. For the treatment of aggressive outbursts in children with attention deficit hyperactivity disorder. Has been shown to be effective in a limited number of nations with organic brain syndrome.

Precautions:

Liver disease: Liver failure resulting in death has occurred in patients receiving valproic acid and its derivatives. Children younger than 2 years of age are at an increased risk of developing fatal liver toxicity, especially if they are taking several anticonvulsant medications or have birth­related metabolic disorders, severe seizure disorders accompanied by mental retardation, or brain damage. Liver problems usually occur during the first 6 months of treatment. Loss of seizure control, general feeling of ill health, weakness, drowsiness, facial swelling, appetite loss, yellowing of skin and eyes, or persistent or unexplained vomiting may be warning signs of possible liver problems.

Pancreatitis: Cases of life-threatening pancreatitis have been reported in children and adults receiving valproate. Pancreatitis can occur at any time while using valproic acid. Abdominal pain, nausea, vomiting, or anorexia can be symptoms of pancreatitis that require prompt medical evaluation.

Pregnancy: Studies have shown a potential risk to the fetus. Using these drugs during pregnancy may result in birth defects. If you are pregnant or are planning to become pregnant, discuss with your doctor the possible risks to the unborn infant. Use only if clearly needed and the potential benefits outweigh the possible risks.

Breastfeeding: Valproic acid appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Children younger than 2 years of age may be particularly sensitive to the possible liver damage caused by valproic acid, especially if taking other anticonvulsant drugs at the same time. Safety and effectiveness have not been established in children younger than 18 years of age for treatment of acute mania. Safety and efficacy of divalproex sodium for the prevention of migraines has not been established in children younger than 16 years of age. Safety and effectiveness of divalproex sodium extended-release tablets for the prevention of migraine headache and treatment of epilepsy have not been established in children younger than 18 years of age. Sprinkle capsules me for adults and children 10 years of age and older. Consult your doctor See Liver disease.

Elderly: Elderly patients may be at an increased risk of drowsiness and tremor. Lower doses are usually used when starting therapy.

Lab Tests: Lab tests will be required during treatment. Tests may include liver function, blood cell counts, blood-clotting tests, and valproic acid blood levels.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over-the-counter or prescription medications or dietary supplements with this drug. Drug doses may need to be modified or a different drug prescribed. The following drugs and drug classes interact with this drug:

• Carbamazepine (eg, Tegretol)
• Diazepam (eg, Valium)
• Ethosuximide (eg, Zarontin)
• Felbamate (Felbatol)
• Hydantoins (eg, phenytoin)
• Lamotrigine (Lamictal)
• Phenobarbital (eg, Solfoton)
• Primidone (eg, Mysoline)
• Salicylates (eg, aspirin)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Senses: Abnormal vision; eye redness or pain; blurred or double vision; spots before the eyes; unusual eye movements; dry eyes; hearing loss; ear pain or disorder; ringing in the ears; taste perversion.

Digestive Tract: Appetite changes; nausea; vomiting; stomach cramps or pain; indigestion; diarrhea; fecal incontinence; constipation; gas; tongue inflammation; vomiting of blood; belching; pancreatitis.

Nervous System: Weakness; tiredness; nervousness; forgetfulness; clumsiness; drowsiness; behavior changes; depression; headache; tremors; hallucinations; dizziness; slurred speech; abnormal dreams; abnormal thinking; agitation; abnormal gait; twitching; abnormal skin sensations (eg, burning, prickling, tingling); feeling of whirling motion; exaggerated sense of well-being; decreased sense of stimulation; difficulty moving; increased reflexes; confusion; sleeplessness; behavioral deterioration; anxiety.

Circulatory System: Changes in blood pressure; pounding in the chest (eg pitations); dizziness or light-headedness when rising from a sitting or lying position (postural hypotension); fast heartbeat; flushing; chest pain

Skin: Yellowing of skin or eyes; unusual bleeding or bruising; sensitivity 10 sunlight; rash; itching; dry or oily skin; skin redness; hair follicle infection; hair loss.

Other: Swelling of the face, hands, or feet; weight changes; abscessed teeth; muscle, joint, and back pain; leg cramps; tight muscles; difficulty breathing; increased cough; runny nose; frequent, painful, or difficult urination; loss of bladder control; chills; fever; neck pain or stiffness; changes in menstrual periods; painful menstruation; injection site reactions; sore throat; flu-like syndrome; sweating; general body discomfort; vaginal infection; bronchitis; respiratory infection; muscle weakness; nosebleed; sinus infection; difficulty speaking.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor. If you stop taking this medicine suddenly, your seizures may suddenly begin again.
• May cause stomach upset. Take with food.
• Tablets, capsules - Swallow whole; do not chew or crush. Chewing or crushing may cause irritation in the mouth or throat.
• Sprinkle capsules - May be swallowed whole or taken by opening the capsule and sprinkling the contents on a small amount (teaspoonful) of soft foods such as applesauce or pudding. Swallow quickly without chewing. Do not store drug/food mixture for future use. Some of the specially coated sprinkles may be seen in the stool. This is normal and no cause for concern.
• May cause dizziness, drowsiness, or sleepiness. Use caution when driving or performing other tasks requiring alertness, coordination, or physical dexterity until tolerance is determined. Taking at bedtime may help decrease drowsiness.
• Contact your doctor immediately if you experience loss of seizure control, weakness, swelling of the face, unusual bleeding or bruising, skin reactions, lethargy, general body discomfort, appetite loss, yellowing of skin or eyes, vomiting, nausea, or stomach pain.
• If dose is missed, take as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose if missed or it is necessary to establish a new dosage schedule, con­tact your doctor or pharmacist.
• When you first begin taking this medicine, see your doctor regularly. Your doctor may want to adjust the dose you are taking to make sure it is the best dose to control your condition and minimize side effects. Checkups are particularly important if you are taking other anticonvulsant drugs with valproic acid.
• Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or are breastfeeding.
• Diabetes - These drugs may interfere with urine tests for ketones and may give inaccurate test results.
• Using these drugs with alcohol or other central nervous system depressants (eg, narcotic pain relievers, sedatives) may cause additional drowsiness.
• Carry Medic Alert identification indicating that you are taking these drugs and have epilepsy.
• May cause sensitivity to sunlight. Avoid prolonged exposure to the sun and other ultraviolet light. Use sunscreens and wear protective clothing until tolerance is determined.
• Store capsules at 59° to 77°F. Store tablets and syrup below 86°F.