Drugs Blog

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Dosage is individualized. Take exactly as prescribed.
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Do not stop taking or change the dose unless directed by your doctor.
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Maprotiline - May be given as a single daily dose or in divided doses.
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Mirtazapine - Take in a single dose, preferably at bedtime. May be taken without regard to food.
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Remeron SolTabs- Open tablet blister pack with dry hands and place the tablet on the tongue. The tablet will disintegrate rapidly and can be swallowed with saliva. No water is needed. Do not chew the tablet, split the tablet, or store the tablet for later use.
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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 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.
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Avoid the use of alcohol, barbiturates, or other CNS depressants (eg, tranquilizers) while taking this medicine.
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Contact your doctor if you experience sore throat, fever, chills, mouth sores, or other signs of infection. Pay particular attention to any f1u­like symptoms or other symptoms that might suggest infection.
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May cause drowsiness or dizziness. Alcohol use may increase this effect. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
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Allow at least 14 days between discontinuation of an MAO inhibitor anti­depressant (eg, phenelzine) and the start of therapy with this medicine. Also, allow at least 14 days after stopping this medicine before starting an MAO inhibitor.
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Maprotiline has been associated with seizures. This risk is higher in patients with a history of seizures, in patients taking phenothiazines (eg, promethazine) or withdrawing from benzodiazepines (eg, alprazolam).
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Inform your doctor if you are pregnant, become pregnant, are plan to become pregnant, or are breastfeeding.
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Maprotiline - Beneficial effects are sometimes seen within 3 to 7 days, although 2 to 3 weeks are usually necessary.
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Mirtazapine - Beneficial effects may take 1 to 4 weeks to occur.
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Lab tests may be required to monitor therapy. Be sure to keep appointments.
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Store room temperature (59 to 86°F) in a tightly closed container, away from light and moisture.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning 10 take any over-the-counter or prescription medications or dietary supplements with tricyclic antidepressants. Doses of one or both drug may need to be modified or a different drug may need to be pre­scribed. The following drugs and drug classes interact with tricyclic anti depressants.

• Alcohol lithium (eg, Eskalith)
• Anticoagulants (eg, warfarin)
• Barbiturates (eg, phenobarbital)
• Cholestyramine (eg, Ouestran)
• Furazolidone (Furoxone)
• Hydantoins (eg, phenytoin)
• Levodopa (eg, Larodopa)
• Lithium (eg, Eskalith)
• Propafenone (Rythmol)
• Primidone (eg, Mysoline)

Side Effects:

Every drug is capable of producing side effects. Many tricyclic antidepressant 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:

Enuretic (Bedwetting) Children: Consider side effects reported with adult use. Most common are nervousness, sleep disorders, tiredness, and mild stomach disturbances. These usually disappear with continued therapy or dosage reduction. Other reported reactions include constipation, convulsions, anxiety, emotional instability, and fainting.

Clomipramine only: Tremors; sleeplessness; nervousness; muscle twitches or spasms; memory impairment; anxiety; impaired concentration; breathing problems; abnormal dreams; irritability; emotional liability; deperson allusion; hot flashes; menstrual disorder; vaginal irritation; ejaculation disorder; acne; dry skin; abnormal vision; abnormal tears; muscle aches; back pain; joint pain.

Digestive Tract: Dry mouth; constipation; decreased bowel movement; nausea; vomiting; loss of appetite; diarrhea; stomach discomfort; peculiar taste in mouth; stomach cramps; black tongue; mouth sores.

Nervous System: Confusion with hallucinations (especially in the elderly); disorientation; delusions; anxiety; restlessness; agitation; sleeplessness; tremors; nightmares; hypomania; exacerbation of psychosis; numb­ness, tingling, and decreased sensations in hands and feet; incoordination; unsteady walking; extrapyramidal symptoms; seizures; ringing in ears; changes in brain wave pattern.

Circulatory System: Increased or decreased blood pressure; increased heart rate; pounding in chest (palpitations); heart attack; abnormal heart rhythms; stroke; dizziness when sitting or standing up.

Skin: Rash; itching; red spots; flushing; hair loss.

Urinary and Reproductive Tract: Urinary retention; decreased urination; dilation of urinary tract.

Other: Blurred vision; problems focusing eyes; dilated pupils; increased pressure in eyes; light sensitivity; face and tongue swelling; decreased blood counts; breast enlargement in men; breast enlargement and milk production in women; increased or decreased sex drive; impotence; testicular swelling; increased or decreased blood sugar; weight gain or loss; perspiration; drowsiness; dizziness; weakness; fatigue; head­ache; changes in liver function; parotid gland swelling; increased appetite.

• Use exactly as prescribed.
• Lower dosages are recommended for elderly, adolescent, and outpatients, as compared to hospitalized patients who will be under close supervision. Initiate dosage at a low level and increase gradually, noting carefully the clinical response and any evidence of intolerance. Once depressive symptoms are controlled, maintenance doses will be required for a longer period of time, at the lowest dose that will maintain symptom control.
• For many of these medicines, it is not possible to prescribe a single dos­age schedule that is therapeutically effective in all patients. Consequently, the recommended dosage regimens are only a guide, which may be modified by factors such as age, chronic disease, severity of the disease, medical condition of the patient, and degree of psychotherapeutic support.
• 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.
• Once symptoms are controlled, therapy may need to be continued for several months to lessen the chance of relapse.
• Do not change the dose or discontinue therapy unless advised to do so by your doctor.
• These drugs may take 1 to 4 weeks to improve symptoms of depression.
• Do not use in combination with an MAOI or within 14 days of discontinuing treatment with an MAOI. After stopping this medicine, wait at least 2 weeks before starting an MAOI.
• Using these drugs with alcohol or other central nervous system depressants (eg, pain relievers, sedatives, barbiturates) may cause added drowsiness.
• May cause drowsiness or blurred vision. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
• Symptoms of nausea, headache, or fatigue may develop after abruptly stopping a tricyclic antidepressant (TCA) after long-term use.
• Notify your doctor if dry mouth, constipation, blurred vision, increased heart rate, impaired coordination, difficult urination, excessive sedation, or seizures occur.
• Notify your doctor if you develop a fever or sore throat.
• Notify your doctor if you experience drowsiness, dizziness, or postural hypotension. Your doctor may need to reduce the dose.
• Be sure your doctor and pharmacist are aware of the following ­ Other medical conditions. All medications, including nonprescription medicines, that you are taking. If you have had an unusual or allergic reaction to any TCA or to maprotiline. If you are pregnant or may become pregnant. If you are breastfeeding.
• May cause sensitivity to sunlight. Avoid prolonged exposure to the sun and UV light (eg, tanning beds). Use sunscreens and wear protective clothing until tolerance is determined.
• Taking these drugs at bedtime may help reduce side effects (eg, day­time drowsiness). Discuss this possibility with your doctor or pharmacist.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store at room temperature in a child-resistant container. Patients should supervise this drug carefully in the home. Amitriptyline:
• Usual initial adult dosage for outpatients is 75 mg/day in divided doses. If necessary, this may be increased (preferably at bedtime doses) to a total of 150 mg/day. An alternative method is to begin with 50 to 100 mg at bedtime. This may be increased by 25 or 50 mg as necessary in the bedtime dose to a total of 150 mg/day. Smaller initial doses may be needed if side effects appear with higher doses.
• Hospitalized patients may require 100 mg/day initially, which can be increased gradually to 200 mg/day. A small number of patients may need up to 300 mg/day.
• Usual dosage for children and elderly patients is 10 mg 3 times a day with 20 mg at bedtime.
• Usual maintenance dosage is 50 to 100 mg given as a single dose at bedtime.
• Injection Dosage - Injection should be used for initial therapy in hospitalized patients who are unable or unwilling to take tablets. Tablets should replace the injection as soon as possible. Usual initial dosage by injection is 20 to 30 mg (2 to 3 ml) 4 times a day. Intramuscular doses may cause the effects to appear more rapidly than with tablets. Amoxapine:
• Usual starting dosage is 50 mg 2 or 3 times daily. Dosage may be increased to 100 mg 2 or 3 times daily by the end of the first week.
• Increases above 300 mg/day dose should only be made if 300 mg/day had been ineffective during a trial period of at least 2 weeks.
• Usual effective dose is 200 to 300 mg/day. If no response is seen at 300 mg, dosage may be increased to 400 mg/day. Hospitalized patients who have been refractory to antidepressant therapy and who have no history of convulsive seizures may have dosage raised cautiously up to 600 mg/day in divided doses.
• Once the effective dose is established, the daily maintenance dose, if not more than 300 mg, can be given as a single dose at bedtime. If maintenance dose is more than 300 mg per day, then divided doses should be used.

Type of Drug:

Gonadotropin; hormone that stimulates the ovaries.

How the Urofollitropin Products Works:

Sitmulates eggs in the ovaries to fully develop before ovulation.

Uses of the Urofollitropin:

Used with human chorionic gonadotropin (HCG) to induce ovulation.

Urofollitropin and HCG may be used to stimulate the development of multiple eggs in patients participating in assisted reproductive programs.

Before therapy: Women must have a thorough pelvic exam and testing of the endocrine glands. A cervical dilation and curettage (D and C) must he done before beginning therapy if there is abnormal uterine bleeding or other signs of endometriosis. The partner’s fertility potential must also ho evaluated by a doctor.

Ovarian enlargement: Mild to moderate uncomplicated ovarian enlargement, which may be accompanied by abdominal bloating or pain, occurs in approximately 20% of patients treated with urofollitropin and HCG. It usually regresses without treatment within 2 to 3 weeks. If significant ovarian enlargement occurs after ovulation, do not engage in sexual intercourse.

Pregnancy: Do not use during pregnancy. The risk of use in a pregnant women clearly outweighs any possible benefit.

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

Children: Not indicated for use in children.

Lab Tests: Lab tests may be required to monitor therapy. Tests include estradiol laves and ultrasongraphy.

Side Effects of The Urofollitropin:

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; vomiting; diarrhea; stomach cramps.

Urinary and Reproductive Tract: Bloating; severe pelvic pain; bleeding into the pelvic area (hemoperitoneum); ovarian hyper stimulation syndrome (OHSS); vaginal bleeding; ovarian enlargement; ovarian cysts.

Skin: Rash, pain, swelling, or irritation at injection site; dry skin; hair loss; hives; itching; facial swelling.

Other: Headache; breast tenderness; pain; multiple births; hot flashes; enlarged abdomen; intra vascular thrombosis and embolism (blood clots in the legs or lungs, lung damage, stroke, death).

Guidelines for Use:

• Dosage is individualized. Use exactlyasprE3scribed.
• Do not stop taking or change the dose, unless instructed by.your doctor.
• Inject Bravelle subcutaneously(SC;beneath the skin) or intramuscularly’ leally (lM; into a muscle).inject Fertile SC.
• Visually inspect solution for discoloration or particles. Use immediately after reconstitution (mixing). Discard any unused portion.
• If a dose is missed, inject 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.
• Discontinue use and contact your doctor immediately severe pelvic pain, bloating, nausea, vomiting, diarrhea, faculty breathing, or decreased urination.
• BeG must be given following urofollitropin when tests follicles are present (eg, changes in vaginal smear or cervicalnary estrogen test) .
• Qvulation is confirmed by testing for progesterone itlbasal temperature, change in cervical mucus).
• A couple should have intercourse daily, beginning on the day prior to HCG administration, until ovulation occurs. Take care to ensure insemination. However, intercourse should be prohibited in patients in whom significant ovarian enlargement occurs after ovulation.
• Monitor for signs of pregnancy. If pregnancy is suspected, contact your doctor.
• Multiple. pregnancy is possible and poses potential hazards.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store refrigerated or $t room temperature (30. to 77 F). light.