Drugs Blog

Type of Drug:

Anticonvulsant; antiepileptic.

How the Felbamate Product Works:

Felbamate acts on the central nervous system to decrease the frequency of seizures.

Uses of The Felbamate:

Felbamate is not indicated as a first-line antiepileptic treatment. Felbamate is recommended for use only in those patients who respond inadequately to alternative treatments and whose epilepsy is so severe that a substantial risk of aplastic anemia or liver failure is deemed acceptable in light of the benefits conferred by its use.

Felbamate is indicated as monotherapy or adjunctive therapy in the treatment of partial seizures with and without generalization in adults with epilepsy.

Also indicated as adjunctive therapy in the treatment of partial or generalized seizures associated with Lennox-Gastaut syndrome in children.

Precations:

Alastic anemia: This drug should be used only in cases so severe that the risk of a plastic anemia (bone marrow failure) is seemed acceptable.

Liver failure: There have been cases of acute liver failure, some fatal, in association with the use of felbamate.

Discontinuation: Antiepileptic drugs should not be suddenly discontinued because of the risk of increasing seizure frequency.

Sensitivity to light: May cause photosensitivity (sensitivity to sunlight). Avoid prolonged exposure to the sun and other ultraviolet light. Use sunscreens and wear protective clothing until tolerance is determined.

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

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

Children: Safety and effectiveness in children other than those with Lennox­Gastaut syndrome have not been established.

Lab Tests: Lab tests may be required to monitor therapy. Tests may include liver function tests (ALT, AST, and bilirubin).

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 while taking felbamate. 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 felbamate:

Carbamazepine (eg, Tegretol)

Hydantoins (eg, phenytoin)

Methsuximide (celontin)

Phenobarbital (eg, Solfoton)

Valproic acid (eg, depakene)

Side Effects:

Every drug is capable of producing side effects. Many felbamate 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: Upset stomach; vomiting; constipation; indigestion; diarrhea; nausea; appetite loss; stomach pain or bloating; hiccough.

Nervous System: Sleeplessness; headache; anxiety; drowsiness; dizziness; nervousness; tremor; depression; abnormal walking; abnormal skin sensations; stupor; confusion; mood changes (especially in children); unstable emotions; abnormal thinking; pinpoint pupils; incoordination; agitation.

Respiratory System: Upper respiratory tract (eg, nose, throat) infection; nasal congestion; sinus inflammation; sore throat; coughing.

Skin: Acne; rash; itching; yellowing of the skin; unusual bruising; sensitivity to light.

Urinary and Reproductive Tract: Urinary incontinence; irregular menstrual bleeding; urinary tract infection.

Other: Aplastic anemia (bone marrow failure); acute liver failure; fatigue; fever; chest pain; palpitations (pounding in the chest); weight fluctuation; face edema (fluid retention or swelling); pain; weakness; impaired vision; chnnges in taste perception; dry mouth; muscle pain; bleeding or brusung; flu symptoms; general body discomfort; fast heartbeat; middle ear infection; abnormal blood counts; abnormal lab tests.

Guidelines for Use:

Dosage is individualized. Take exactly as prescribed.

Do not change the dose or stop taking, unless advised by your doctor.

May be taken with or without food.

Shake suspension well before use.

Do not discontinue use without first checking with your doctor. If you stop taking this drug suddenly, the frequency of your seizures could increase.

May cause photosensitivity (sensitivity to sunlight). Avoid prolonged exposure to the sun and other ultraviolet (UV) light. Use sunscreens and wear protective clothing until tolerance is determined.

Notify your doctor immediately if you experience fever, yellowing of the skin or eyes, appetite loss, stomach pain or bloating, weakness, sore throat, unusual bleeding or bruising, rash, or dark urine.

Lab tests will be required to monitor therapy. Be sure to keep appointments.

Store at room temperature in a tightly closed container.

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).

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.

Type of Drug:Aspirin pain reliever (analgesic); fever reducer (antipyretic); anti-inflammatory agent.

Guidelines for Use:

• Dosage is individualized. Take exactly as advised.
• May cause stomach upset. Take with food or after meals.
• Take with a full glass of water (8 oz) to reduce the risk of medication sticking in the throat.
• Do not use for pain for more than 10 days or for fever for more than 3 days unless directed by your health care provider.
• Patients allergic to tartrazine dye (FD&C Yellow No.5) should avoid aspirin.
• Use with caution if you have asthma or nasal polyps.
• Consult your health care provider if pain or fever persists or gets worse, if new symptoms occur, or if redness or swelling is present. These could be signs of a serious condition.
• Discontinue use and notify your doctor if you experience ringing in ears or persistent stomach pain.
• limit alcohol intake while taking these products.
• Do not use aspirin if it has a strong vinegar-like odor.
• Avoid use during pregnancy unless advised by your health care provider.
• Avoid use in children with fever-causing illness.
• Store at room temperature (59° to 86°F). Protect from moisture.

Type of Drug:

Anticonvulsants; drug to treat epilepsy and seizures.

How the Drug Works:

To control absence act on central nervous system to decrease the frequency of seizures.

Uses:

To control absence (petit mal) seizures that do not respond to other anti seizure medications.

Precautions:

Photosensitivity, sensitivity to sunlight, may occur. Therefore, use caution and take protective measures (eg, sunscreens, protective clothing) against exposure to ultraviolet light or sunlight until tolerance is determined.

Pregnancy: Reports suggest an association between use of anticonvulsant drugs by women with epilepsy and an increased number of birth defects in children born to these women. Other factors (eg, genetics or the epileptic condition) may also contribute to the higher incidence of birth defects. Most mothers receiving anticonvulsant medication deliver normal infants. Do not discontinue anticonvulsant drugs used to prevent major seizures. This could result in the occurrence of seizures and oxygen deficiency in body tissues and an increased risk to both the mother and the unborn child. In cases where seizures do not pose a serious threat, your doctor may recommend discontinuation of anticonvulsant’s prior to and during pregnancy. It is not known whether even minor seizures constitute some risk to the developing embryo or fetus. Reports suggest that mother’s use of anticonvulsant drugs, particularly illiterates, is associated with a blood clotting defect in the new bone that may cause a bleeding problem within 24 hours of birth. It has been suggested that vitamin K he given to the mother prior to and during deliver, and to the infant , immediately after birth.

Breastfeeding: It is not known if oxazolidinediones appear in breast milk.

Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children under 16 years of age have not been established.

Lab Tests: Lab tests may be required during treatment with oxazolidinediones. Be sure to keep appointments. Tests may include blood counts, liver and kidney function tests, eye exams and urinalysis.

Side Effects:

Every drug is capable of producing side effects. Many oxazolidinedione 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; abdominal pain; appetite loss; gastric distress.

Nervous System: Drowsiness; dizziness; headache; personality changes’, irritability; fatigue; sleeplessness; muscle weakness.

Skin: Rash; unusual bleeding or bruising; yellowing of eyes or skin; hair loss; itching; peeling skin.

Other: Vision changes, double vision; sore throat; fever; muscle weakness (especially eyes, eyelids, face, lips, tongue, throat or neck); sensitivity to sunlight; fatigue; abnormal lab tests (see Precautions); weight loss; hiccoughs; blood pressure changes; protein in urine; day blindness; bleeding gums; nosebleeds; vaginal bleeding; blood disorder; decreased blood platelets; anemia; bleeding.

Guidelines for Use:

• If stomach upset occurs, take with food.
• Do not change the dose or stop taking this medication without consulting your doctor.
• Keep scheduled appointments with your doctor, and carry Medic Alert identification listing your medical condition (epilepsy) and medication.
• May cause drowsiness or blurred vision. Use caution while driving or performing other tasks requiring alertness.
• Notify your doctor if any of the following should occur: Visual disturbances, excessive drowsiness or dizziness, sore throat, fever, unusual bleeding or bruising, skin rash, pregnancy, body discomfort or nosebleed.
• Withdraw drug gradually unless serious adverse effects dictate otherwise.
• May cause sensitivity to sunlight. Avoid prolonged exposure to the sun.
• Use sunscreens and wear protective clothing until tolerance is determined.
• Store capsules below 77°F. Store tablets in refrigerator and keep cotillion er tightly closed. Store solution below B6°F.

How the Drug Works:

Parkinsonism is a neurological disease with a variety of origins characterized by tremor, rigidity, and disorders of posture and equilibrium. The onset is slow and progressive with symptoms advancing over months to years.

The group of drugs known as “anticholinergic agents” can reduce the frequency and severity of the symptoms of parkinsonism by restoring the chemical imbalance that causes Parkinson disease. The effectiveness of anticholinergics for parkinsonism is not dependent on the origin of the symptoms. These agents are typically used for milder cases of parkinsonism.

Uses:

To reduce the frequency and severity of the symptoms of parkinsonism and to control drug-induced parkinsonism-like disorders. Used alone or with other anti parkinson agents. Anticholineric agents do not cure the causes of these symptoms.

Precautions:

Pregnancy: Adequate studies have not been done in pregnant women. Use only if clearly needed and potential benefits outweigh the possible hazards to the fetus.

Breastfeeding: Anticholinergic agents appear in breast milk and may reduce milk production. Consult your doctor before you begin breastfeeding.

Children: Do not use benztropine in children younger than 3 years old. Safety and effectiveness in older children have not been established.

Elderly: Geriatric patients, particularly over 60, frequently develop increased sensitivity to anticholinergic drugs and require strict dosage monitoring. Use with caution. Mental confusion and disorientation, agitation, hallucinations and psychotic-like symptoms may develop. Administer carefully to elderly patients with hardening of the arteries because side effects may be more severe.

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 anticholinergic agents. 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 anticholinergic agents.

• Antihistamines (eg, diphenhydramine)
• Chlorpromazine (eg, horazine)
• Digoxin (eg, anoxin)
• Haloperidol (eg, haldol)
• Levodopa (eg, larodopa)
• Narcotic pain relievers (eg, percodan)
• Tricyclic antidepressants (eg, amitriptyline)

Side Effects:

Every drug is capable of producing side effects. Many anticholinergic 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:

Possible Side Effects Specific to Ethopropazine: Seizures; brain wave changes, blood disorders; hormone disorders; yellow discoloration of skin and eyes (jaundice); and hallucinations.

Digestive Tract: Nausea; vomiting; stomach pain; constipation.

Nervous System: Disorientation; confusion; memory loss; hallucinations; lightheadedness; dizziness; weakness; agitation; nervousness; paranoia; delusions; delirium; excessive elation; excitement; depression.

Circulatory System: Rapid heart rate; pounding of chest (palpitations); low blood pressure; lightheadedness and dizziness upon rising quickly from a lying position.

Skin: Rash; flushing; decreased sweating; hives.

Eyes or Ocular: Blurred vision; double vision; widened pupils; visual disturbances; glaucoma.

Other: Difficulty urinating; painful urination; muscle weakness; cramping; dry mouth; fever; numbness of fingers; difficulty achieving or maintaining erection; blood disorders (orphenadrine citrate); swollen glands.

Guidelines for Use:

• May cause drowsiness, dizziness, or blurred vision. Use caution when driving or performing other tasks requiring alertness.
• Avoid alcohol and other drugs that cause drowsiness when using anticholinergic agents.
• Stomach upset may occur. Take with food.
• Sucking on hard candy, drinking fluids, or maintaining good dental hygiene can relieve the dry mouth that can result from taking any of the anticholinergic agents.
• Difficult urination and constipation can occur. Use “stool softeners” if necessary. Notify your doctor if either difficult urination or constipation persist.
• Notify your doctor if a rapid heartbeat, pounding sensation in chest, confusion, eye pain, or rash occurs.
• Anticholinergic agents can reduce the ability to sweat, an important function by which overheating is prevented. Avoid excess sun or exercise which may cause excessive sweating.
• Elderly patients may be highly sensitive to anticholinergic drugs. Use with caution. See Precautions.

Type of Drug:

Antiparkinson agent.

How the Drug Works:

Parkinsonism is a neurological disease characterized by tremor, rigidity, and disorders of posture and equilibrium. It has multiple causes. The onset is slow and progressive with symptoms advancing over months to years.

It is thought that the involuntary muscle movements (shaking) of Parkinson disease are due to reduced amounts of the chemical dopamine in the central nervous system (brain). Pergolide may exert its effects by directly stimulating the dopamine receptors in the brain.

Uses:

To manage the signs and symptoms of Parkinson’s disease. Used along with levodopa and carbidopa.

For complete information on levodopa and carbidopa as antiparkinson agents, see the Antiparkinson-Dopaminergic

Precautions:

Neuroleptic Malignant-like Syndrome (NMS): NMS, including muscular rigidity, elevated body temperature, mental changes, and increased serum enzymes, has been reported when anti parkinson agents were stopped suddenly. Therefore, do not reduce the dosage of pergolide abruptly or discontinue it without consulting your doctor.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed.

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

Children: Safety and effectiveness have not been established.

Drug Interactions:

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

• Butyrophenones (eg, haloperidol)
• Metoclopramide (eg, Reglan)
• Phenothiazines (eg, chlorpromazine)
• Thioxanthines (eg, thiothixene)

Side Effects:

Every drug is capable of producing side effects. Many pergolide 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; constipation; diarrhea; indigestion; stomach pain; appetite loss; difficulty swallowing.

Nervous System: Hallucinations; difficult or abnormal movement; restlessness; twitching; confusion; dizziness; drowsiness; fainting; sleeplessness; anxiety; tremor; depression; abnormal dreams; personality changes; headache; weakness; incoordination; difficulty walking.

Circulatory System: High or low blood pressure; orthostatic hypotension (dizziness or lightheadedness when arising from a seated or lying position); palpitations (pounding in the chest); irregular heartbeat; heart attack.

Respiratory System: Runny nose; difficulty breathing.

Skin: Rash; sweating; abnormal skin sensations.

Other: Dry mouth; taste changes; general body pain; joint, muscle, or nerve pain; abnormal vision; double vision; frequent urination; urinary tract infections; blood in urine; edema (fluid retention); back, neck, and chest pain; flu-like symptoms; nosebleed; hiccups; weight gain; chills; difficulty speaking; anemia.

Guidelines for Use:

• Dosage will be individualized.
• Do not change the dose or stop taking this medicine unless advised to do so 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 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.
• Notify your doctor if you experience confusion, hallucinations, pounding in the chest, irregular heart rate, or difficulty in movement.
• Orthostatic hypotension – Dizziness or lightheadedness may occur when arising quickly from a seated or lying position. Avoid sudden changes in posture while taking pergolide.
• May cause drowsiness. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
• Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or if you are breastfeeding.
• Store at controlled room temperature (59 to 86°F).