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).

Type of Drug:

Central nervous system stimulant.

How the Drug Works:

Dexmethylphenidate is thought to block reuptake of norepinephrine and dopamine in the brain, but the exact mechanism of action is not known.

Uses:

Dexmethylphenidate is indicated for the treatment of attention deficit hyperactivity disorder (ADHD).

Precautions:

Drug Dependence: Dexmethylphenidate should be given cautiously to patients with a history of drug dependence or alcoholism. Chronic, abusive use can lead to marked tolerance and psychological dependence with varying degrees of abnormal behavior. Psychotic episodes can occur.

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

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

Children: Safety and efficacy in children younger than 6 years of age have not been established.

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 while taking 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 drug classes interact with this drug:

• Anticonvulsants (eg, phenytoin)
• Antidepressants (eg, amitriptyline, sertraline)
• Centrally acting alpha-2 agonists (eg, clonidine)
• Coumarin anticoagulants (eg, warfarin)
• Dopamine (eg, Inotrpin)
• Epinephrine (eg, Adrenalin Chloride)
• Phenylephrine (eg, Rhinall)

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: Nausea; stomach pain; appetite loss.

Nervous System: Dizziness; drowsiness; sleeplessness; headache; nervousness; Tourette syndrome; involuntary movements; abnormal thinking or hallucinations.

Circulatory System: Irregular heartbeat; pulse increased or decreased; chest pain; pounding in the chest (palpitations); changes in blood pressure.

Other: Fever; weight loss; skin rash; joint pain.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not take more frequently than prescribed. This drug can be addicting.
• 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 be administered with or without food.
• Tell your doctor if you have ever abused or been dependent on alcohol or drugs, or if you are now abusing or dependent on alcohol or drugs.
• May cause sleeplessness. Avoid taking these medications late in the day.
• Notify your doctor if you experience blurred vision.
• Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or are breastfeeding.
• Growth (weight gain and height ) will be monitored by a doctor during therapy. Bb to keep appointments
• Store at room temperature (59 0 to 86°F).

Type of Drug:

Nonbarbiturate sedative/hypnotics. Central nervous system depressant. Short-term sleep aid.

How the Drug Works:

Nonbarbiturate sedatives and hypnotics act on the central nervous system (brain), causing drowsiness to aid in falling asleep, They are less likely to cause a slower breathing rate than barbiturate-type sedative hypnotics.

Should sleeplessness persist, a drug-free interval of 1 or more weeks should elapse before retreatment is considered. An attempt should be made to find alternative non drug therapy in chronic sleeplessness.

Uses

Chloral hydrate: To lessen anxiety and produce sleep before surgery. After surgery, chloral hydrate may be used with other medications to control pain. Also used to prevent or suppress alcohol withdrawal symptoms (suppositories).

Unlabeled Uses: Occasionally doctors may prescribe ethchlorvynol as a sedative at doses of 100 mg to 200 mg 2 or 3 times daily.

Precautions:

Dependence: Long-term use may result in dependence. Withdrawal symptoms (eg, rebound insomnia) may occur when the drug is stopped abruptly after long-term use.

Ethchlorvynol: Patients who exhibit unpredictable behavior, restlessness, or excitement in response to barbiturates or alcohol may react in this manner to ethchlorvynol. This drug should not be used for the management of insomnia in the presence of pain, unless sleep loss persists after pain is controlled with pain relievers.

Triazolam: Short-term episodes of significant memory loss have been reported with the use of triazolam. Patients, especially the elderly, may become confused or disoriented and may attempt to wander after taking the drug. Upon waking in the morning, the patient may not remember the episode.

Pregnancy: Do not use benzodiazepines during pregnancy. The risk of use in a pregnant woman clearly outweighs any possible benefit. Use of ethchlorvynol is not recommended during the first and second trirmesters of pregnancy. Use during the third trimester of pregnancy may produce. Symptoms in the newborn (eg, jitteriness, hyperactivity, restlessness, irrtability, disturbed sleep, hunger). There are no adequate and well controlled studies for other sedative/hypnotics in pregnant women. Use only if clearly needed and potential benefits outweigh the possible hazards to the fetus.

Breastfeeding: Benzodiazepines, chloral hydrate, zaleplon, and zolpidem appear in breast milk. It is not known if the other sedative/hypnotics appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness of estazolam, ethchlorvynol, quazepam, temazepam, triazolam, zaleplon, and zolpidem have not been established in patients younger than 18 years of age. Safety and effectiveness of flurazepam have not been established in patients younger than 15 years of age. These drugs are generally not recommended for use in children.

Elderly: Use with caution. Elderly patients may be more sensitive to these drugs. There is a risk of over sedation, “morning hangover” (grogginess in the morning), dizziness, and confusion. Smaller doses may be needed. See triazolam precaution.

Lab Tests: Lab tests may be required to monitor therapy. Tests may include blood counts, urinalysis, blood chemistry, and liver and kidney function tests.

Tartrazine: Some of these products may contain tartrazine dye (FD&C Yellow No.5), which can cause allergic reactions in certain individuals. Check package label when available or consult your doctor or pharmacist.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over the-counter or prescription medications with non barbiturate sedatives. 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 non barbiturate sedatives:

• Azole antifungal agents (eg, ketoconazole)
• Cimetidine (eg, Tagamet)
• Contraceptives, oral (eg, Ortho-Novum)

Side Effects:

Every drug is capable of producing side effects. Many nonbarbiturate sedative 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: Stomach pain or upset; vomiting; nausea; diarrhea; constipation; indigestion; appetite loss; gastric irritation; colitis.

Nervous System: Confusion; drowsiness; dizziness; hallucinations; headache; anxiety; depression; facial numbness; nervousness; vertigo (feeling of whirling motion); memory loss; drugged feeling; lethargy; sleeplessness; abnormal thinking; depersonalization; agitation; light­headedness; abnormal dreams; sleep disorder; euphoria (exaggerated sense of well being); incoordination; weakness; tremor.

Circulatory System: Abnormal blood counts; palpitations (pounding in the chest).

Skin: Jaundice (yellowing of skin or eyes); rash; hives; itching; abnormal skin sensations.

Other: Allergy; back pain; chest pain; fatigue; flu-like symptoms; blurred vision; mild “hangover”; aftertaste; dry mouth; urinary tract infection; conjunctivitis; migraine; arthritis; fever; double vision; abnormal vision; muscle, joint, ear, or eye pain; swelling of the arms or legs; general body discomfort; photosensitivity; sinus infection; sore throat; runny nose; bronchitis; distorted sense of smell; nosebleed; painful menstruation; abnormal acuteness of hearing; muscle tension; muscle pain; falling.

Benzodiazepines only

Digestive Tract: Heartburn; appetite loss; nausea; vomiting; diarrhea; constipation; stomach pain; indigestion; taste alterations; dry mouth.

Nervous System: Drowsiness; nervousness; talkativeness; apprehension; irritability; euphoria (exaggerated sense of well being); relaxed feeling; tremor; memory loss; tiredness; general body discomfort; dreaming or nightmares; depression; in coordination; confusion; hangover; abnormal thinking; anxiety; dizziness; disorientation; weakness; agitation; speech disorder; daytime drowsiness; feeling of whirling motion.

Circulatory System: Palpitations (pounding in the chest); chest pain.

Other: Abnormal skin sensations; joint or body pain; weakness; headache; genitourinary complaints;falling; staggering; rash; itching; leg or back pain stiffness.

Guidelines for Use:

• Dosage is individualized.
• Do not change the dose or stop taking unless advised by your doctor.
• Take immediately before going to bed.
• May cause dizziness, drowsiness, or blurred vision. Do not drive or per­form other tasks requiring alertness, coordination, or physical dexterity.
• Avoid alcohol and other drugs that cause drowsiness (eg, pain relievers, sedatives).
• Contact your doctor if you notice any unusual or disturbing thoughts or behaviors during treatment with any sleep medicine.
• Do not take any sleep medicine unless you are able to get a full night of sleep before you must be active again.
• May cause photosensitivity (sensitivity to light). Avoid prolonged expo­sure to the sun. Use sunscreens and wear protective clothing until tolerance is determined.
• May be habit forming. Do not discontinue drug abruptly after prolonged use, especially if you have a history of seizures, regardless of other anti seizure medications you may be taking.
• Contact your doctor if visual changes, irregular heartbeats, chest pains, yellowing of skin or eyes, rash, or unusual bleeding or bruising occurs.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Benzodiazepines - Nighttime sleep may be disturbed for 1 or 2 nights following stopping of the drug. Tell your doctor if you are pregnant, plan to become pregnant, or become pregnant while taking this medicine.
• Chloral hydrate May cause stomach upset. Take capsules with a full glass of water or other liquid. Swallow capsules whole. Do not crush or chew. Dilute syrup in a half glass of water, ginger ale, or fruit juice.
• Ethchlorvynol- Symptoms of giddiness, incoordination, and stomach upset may be reduced if medication is taken with food.
• Triazolam - Do not take when a full night’s sleep and elimination of the drug from the body are not possible before the need to be active and functional. May cause amnesia.
• Zaleplon - Do not take with or immediately following a high fat or heavy meal. May cause sleepiness during the day. Daytime drowsiness can be best avoided by taking the lowest possible dose. May cause amnesia. In most cases, memory problems can be avoided if zaleplon is taken only when you are able to get 4 hours or more of sleep before being active.
• Zolpidem - For faster sleep onset, do not take with or immediately after a meal.

Type of Drug:

Drugs used to elevate blood pressure.

How the Midodrine Product Works:

Midodrine causes blood vessels to constrict (become smaller), resulting in an increase in blood pressure

Uses of The Midodrine:

To treat symptoms of orthostatic hypotension (feeling dizzy or lightheaded when rising from a sitting or standing position, or feelings of dizziness while standing). Use only in patients whose lives are considerably impaired despite standard clinical care, such as support stockings, fluid expansion and lifestyle changes.

Unlabeled Uses: To manage urinary incontinence

Precautions:

Supine hypertension is the most potentially serious side effect of midodrine. Supine (lying) and sitting blood pressures should be monitored. Supine hypertension can often be controlled by not lying totally flat (eg, sleeping with the head of the bed elevated).

Pregnancy: Adequate studies have not been done in pregnant women, or animal studies may have shown a risk to the fetus. Use only if clearly needed and potential benefits outweigh the possible hazards to the fetus.

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

Children: Safety and effectiveness are not established.

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

Drug Interactions:

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

• Alpha-adrenergic blockers (eg, doxazoxin)
• Cardiac glycosides (eg, digoxin)
• Phenylephrine phenylpropanolamine (eg, Contac)
• Metformin (Glucophage)
• Ranitidine (eg, Zantac)

Side Effects:

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

Nervous System: Numbness or tingling in scalp, hands or feet; pain; headache; feeling of pressure/fullness in the head; facial flushing; confusion; abnormal thinking; nervousness; anxiety.

Skin: Goosebumps; itching; rash.

Other: Painful or difficult urination; high blood pressure while lying or sitting; chills; dry mouth.

Guidelines for Use:

• Use exactly as prescribed.
• Usual dose is 10 mg, taken three times daily. Take during the daytime hours when you are upright and pursuing daily activities. A suggested dosing schedule of approximately 4 hour intervals is: Shortly before or upon arising in the morning, midday and late afternoon (not later than 6 pm). Doses may be taken in 3 hour intervals if required to control symptoms, but not more frequently. Do not take after the evening meal or less than 4 hours before bedtime.
• 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 in order to “catch up” (unless advised to do so 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.
• Supine (lying down) hypertension can often be controlled by not lying totally flat (eg, sleeping with the head of the bed elevated).
• Tell your doctor or pharmacist about any over-the-counter medications you are taking (eg, cold remedies, diet aids); they can increase the side effects of this medicine.
• Contact your doctor if you experience pounding in the ears, headache, blurred vision, slow pulse, increased dizziness, fainting, cardiac awareness, goosebumps, sensation of coldness or urinary retention.
• Continue taking this medicine, even if your symptoms of low blood pressure are controlled.
• Monitor blood pressure in both the lying and sitting positions.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store at room temperature (59 to 77°F), out of the reach of children.

Diflunisal - Type of Drug - Some Interactions occurring with Diflunisal

Type of Drug:

Anti-inflammatory; analgesic (pain reliever).

How the Drug Works:

Diflunisal decreases inflammation and relieves pain by inhibiting prostaglandin synthesis. It is not a steroid or a narcotic.

Uses:

To relieve mild to moderate pain, inflammation, and rheumatoid arthritis and osteopathic pain.

Precautions:

• Pregnancy: Safety for use during pregnancy has not been established. Use with caution during the first and second trimesters. Do not use during the third trimester.

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

• Children: Safety and effectiveness have not been established. Use in children younger than 12 years of age is not recommended. Acetylsalicylic acid has been associated with Reye syndrome. Since diflunisal is a salicylic acid derivative, the possibility of its association with Reye syndrome cannot be excluded. Consult your doctor.

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 diflunisal. 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 diflunisal:

• Acetaminophen (eg, Tylenol)
• Hydrochlorothiazide (eg, Hydro)
• Antacids (eg, Tums) DIURIL)

Side Effects:

Every drug is capable of producing side effects. Many diflunisal 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: Stomach pain; gas; diarrhea; nausea; constipation; ulcers; indigestion; vomiting.

• Nervous System: Headache; dizziness; nervousness; sleeplessness; confusion; fatigue or tiredness.

• Skin: Rash; itching; sweating; sensitivity to light.

• Other: Ringing in the ears or difficulty hearing; edema (fluid retention); swelling.

Guidelines for Use:

• May cause stomach upset. Take with water, milk, or meals.
• Chronic gastrointestinal upset or any signs of bleeding should be reported to your doctor.
• Swallow tablets whole. Do not crush or chew.
• Do not take aspirin or acetaminophen with diflunisal. Consult your doctor.
• 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 1 dose is missed, contact your doctor or pharmacist.
• May cause sensitivity to sunlight. Avoid prolonged exposure to the sun. Use sunscreens and wear protective clothing until tolerance is determined.

Allopurinol - Type of Drug - Some Interactions occurring with Allopurinol

Type of Drug:

Agent for gout; xanthine oxidase inhibitor.

How the Allopurinol Product Works:

Gout is a hereditary form of arthritis caused by increased uric acid levels in the blood. Allopurinol prevents the formation of uric acid in the body by inhibiting an enzyme (xanthine oxidase) involved in the production of uric acid.

Uses of The Allopurinol:

To prevent the signs and symptoms of primary or secondary gout (eg, acute attacks, tophi, joint destruction, uric acid kidney stones, kidney damage).

To manage uric acid elevations in serum (hyperuricemia) and urine (uricosuria) in patients treated for leukemia, lymphoma, and other malignancies.

Precautions:

Do not use in the following situations: Allergy or severe reaction to allopurinol.

Use with caution in the following situations:

Acute attacks of gout may increase during the early stages of allopurinol use. The attacks usually become shorter and less severe after several months of therapy. Even with adequate therapy, it may require several months to deplete the uric acid pool sufficiently to control acute episodes.

Fluid intake: Drink a sufficient amount of fluid to yield a urinary output of at least 2 quarts a day and to maintain a neutral or slightly alkaline urine. This will help prevent the formation of kidney stones while taking allopurinol.

Allergy: Discontinue at the first appearance of rash or other signs of an allergic reaction. In some instances, rash may be followed by more severe reactions such as itching; hives; red lesions; and loss of hair, skin, or fingernails.

Pregnancy: These are no adequate and well-controlled studies in pregnant woman. Use only if clearly needed and potential benefits to the mother outweigh the possible hazard to the fetus.

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

Children: Allopurinol is rarely used in children with the exception of those with hyperuricemia secondary to malignancy or to certain rare inborn errors of purine metabolism.

Lab Tests: Lab tests will be required during treatment with allopurinol. Tests may include uric acid level, blood counts, and kidney and liver function 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 allopurinol. 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 allopurinol.

• Aamoxicillin (eg, Amoxil)
• Ampicillin (eg, Principen)
• Anticoagulants (eg, dicumarol)
• Azathioprine (eg, Imuran)
• Chlorpropamide (eg, oiabinese)

Side Effects:

Every drug is capable of producing side effects. Many allopurinol 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: Stomach upset; diarrhea; nausea.

Skin: Chills; rash; scaling or sloughing of skin.

Other: Acute gout attacks; joint pain; drowsiness.

Guidelines for Use:

• Gout and secondary hyperuricemia (maintenance) - The average dose of allopurinol is 200 to 300 mg/day for patients with mild gout and 400 to 600 mg/day for those with moderate-to-severe gout. The dose may be administered in divided doses or as a single equivalent dose with the 300 mg tablet. Daily doses more than 300 mg should be administered in divided doses. The minimum effective dose is 100 to 200 mg/day, and the maximum recommended dose is 800 mg/day. It is recommended that the patient be started with a low dose (100 mg) and increased at weekly intervals by 100 mg until a serum uric acid level of 6 mg/dL or less is attained, not exceeding the maximum recommended dose.
• Prevention of uric acid kidney disease during the vigorous chemotherapy of tumors - 600 to 800 mg/day for 2 or 3 days along with a high fluid intake.
• Recurrent kidney stones in patients with high levels of uric acid in the urine - 200 to 300 mg/day in single or divided doses.
• Secondary hyperuricemia in children - Children 6 to 10 years of age with secondary hyperuricemia (increased uric acid in the blood) associated with severe diseases may be given 300 mg/day, while those less than 6 years of age are generally given 150 mg/day.
• To minimize stomach upset, take after meals.
• If a dose is missed, simply take your next dose at the regularly scheduled time. Do not attempt to make up for the missed dose.
• May take 2 to 6 weeks to become effective. Do not skip doses or stop taking this drug prematurely.
• Drink plenty of fluids while taking allopurinol, at least 10 to 12 full (8 oz) glasses a day, to prevent kidney stones.
• May cause drowsiness. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
• Discontinue allopurinol and notify your doctor immediately at the first sign of appetite loss, weight loss, rash, painful urination, blood in the urine, irritation of the eyes, or swelling of the lips or mouth.
• Avoid large doses of vitamin C as this may increase the possibility of kidney stone formation.
• Allopurinol does not treat acute gout attacks. Other medications (eg, colchicine, indomethacin) are used to treat the acute attack.
• Lab tests will be required to monitor therapy. Be sure to keep appointments.
• Store at 59° to 77° F in a dry place. Protect from light.

Fluvoxamine - Guidelines for Using Fluvoxamine - Uses and Benefits

Type of Drug:

Antidepressant; mood elevating agent.

How the Fluvoxamine Works:

It is believed that fluvoxamine maleate adjusts or balances how the brain and nervous system produce and respond to their natural chemicals (called neurotransmitters). Fluvoxamine maleate inhibits the reuptake of serotonin by the brain.

Uses of The Fluvoxamine:

For the treatment of obsessions and compulsions in patients with obsessive-compulsive disorder (OCD)

Smoking: This medicine may not be as effective if you are a smoker.

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.

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

Children: Safety and effectiveness are not established in children younger than 8 years of age.

Elderly: Use lower initial doses; then increase gradually if necessary.

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 fluvoxamine. 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 fluvoxamine:

• Benzodiazepines propranolol (eg, Inderal)
• Diltiazem (eg, Cardizem)
• Iithium (eg, Lithobid)
• Phenytoin (eg, oilantin)
• Sumatriptan (Imitrex)
• Theophylline (eg, Theo-our)
• Thioridazine (eg, Mellaril)

Side Effects:

Every drug is capable of producing side effects. Many fluvoxamine 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; indigestion; diarrhea; stomach pain; appetite loss; gas; dry mouth; difficulty swallowing; tooth disorder; sore throat.

Nervous System: Headache; memory loss; apathy; twitching; sleepless­ness; nervousness; agitation; anxiety; dizziness; drowsiness; depression; weakness; tremors; mania; unstable emotions; CNS stimulation; abnormal thinking; psychotic reaction.

Circulatory System: Rapid heart beat; changes in blood pressure; fainting; flushing; palpitations (pounding in the chest).

Respiratory System: Nasal congestion; yawn; difficulty breathing; cough; sinus problems; upper respiratory tract infection.

Other: Sweating; taste changes; vision problems; frequent urination; decreased sex drive; inability to achieve orgasm; abnormal ejaculation; painful menstruation; muscular hyperactivity; infection; leg cramps; rash; muscle tension; urinary retention; muscle pain; unusual bruising; nosebleed; abnormal liver enzymes; decreased mobility or movement; general body discomfort; flu-like syndrome; weight changes; chills; swelling of feet, ankles, or hands.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Usual adult starting dose is 50 mg, taken as a single dose at bedtime. The dosage may be increased by 50 mg/day every 4 to 7 days, if necessary, to achieve maximum benefit. The total dosage should not exceed 300 mg/day. Total doses greater than 100 mg should be taken in 2 divided doses. If the doses are not equal, the larger dose should be taken at bedtime.
• Usual pediatric (8 to 17 years of age) starting dose is 25 mg at bed­time. The dosage may be increased by 25 mg/day every 4 to 7 days, if necessary, to achieve maximum benefit. The total dosage should not exceed 200 mg/day. Total doses greater than 50 mg should be taken in 2 divided doses. If the doses are not equal, the larger dose should be given at bedtime.
• Do not discontinue the medication or change the dose unless directed by your doctor.
• May be taken without regard to food.
• 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.
• Contact your doctor if you develop a rash, hives, other allergic reactions, or seizures. Also contact your doctor if nausea, dry mouth, sleeplessness, or drowsiness become troublesome.
• May cause drowsiness, dizziness, or impaired judgement. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
• Do not use in combination with MAOls or within 14 days of discontinuing treatment with an MAOI. After stopping treatment with this medication, wait at least 2 weeks before starting an MAOI.
• Avoid alcohol and smoking while using this medication. Smoking may reduce the effectiveness of the medication.
• 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) in a tightly closed container. Protect from moisture.