Succimer

Class: Heavy Metal Antagonists
ATC Class: V03AB
VA Class: AD300
Chemical Name: Meso 2,3-dimercaptosuccnic acid
Molecular Formula: C₄H₆O₄S₂
CAS Number: 304-55-2
Brands: Chemet

Introduction

Heavy metal antagonist; chelates lead.^{1 2 3 4}

Uses for Succimer

Lead Poisoning

Alternative for treatment of lead poisoning in children with blood lead concentrations >45 mcg/dL^{1 2} (designated an orphan drug by FDA for this use).⁹

The AAP recommends succimer in the treatment of lead poisoning in children with blood lead concentrations of 45–70 mcg/dL who do not have symptoms of lead encephalopathy.⁵ Alternatively, parenteral therapy with edetate calcium disodium (calcium EDTA) alone is recommended.⁵

CDC and AAP do not recommend routine chelation therapy in pediatric patients with blood lead concentrations 25–45 mcg/dL.^{5 b} However, oral chelation therapy with succimer may be recommended in certain patients (e.g., blood lead concentrations of 35–44 mcg/dL, children <2 years of age, evidence of toxicity or symptoms).^{5 b}

The AAP currently states that patients with blood lead concentrations >70mcg/dL or with symptoms of lead encephalopathy require inpatient combined therapy with parenteral calcium EDTA and dimercaprol.^{4 5 8}

Children may need to be hospitalized during initiation of therapy to monitor for adverse effects, ensure patient compliance, and allow time for implementation of environmental lead abatement procedures.^{5 6}

Used in conjunction with a lead abatement program.^a

Notto be used prophylactically for the prevention of lead poisoning in a lead-containing environment.^{1 2}

Management of lead poisoning† in adults with blood lead concentrations 70–100 mcg/dL or mild symptoms.^b

Other Heavy Metal Poisoning

Has been used in the treatment of mercury poisoning† (designated an orphan drug by FDA for this use).^{1 2 9}

Has been used in the treatment of arsenic poisoning†.^{1 2 9}

Succimer Dosage and Administration

General

• 
  

  When source for lead poisoning has been identified, remove patient from that source.^a

  
  


• 
  

  Maintain adequate hydration to ensure renal excretion of chelating agents.^a

  
  

Administration

Oral Administration

Administer orally.^{1 2}

In patients who cannot swallow capsules, administer by opening capsule and sprinkling beads on a small amount of soft food or by putting beads in a spoon and following with fruit drink.^a

Dosage

Pediatric Patients

Lead Poisoning

Blood Lead Concentration 45–70 mcg/dL

Oral

Children >12 months of age: 10 mg/kg or 350 mg/m² every 8 hours for 5 days followed by 10 mg/kg or 350 mg/m² every 12 hours for 14 days.^{1 2 a b d} Full course of treatment is 19 days.^{1 2 a}

Intervals ≥2 weeks are recommended between courses of succimer therapy unless blood lead concentrations require more prompt drug therapy.^{1 2 a}

≥4 week interval is recommended when succimer is given subsequent to calcium EDTA therapy, with or without dimercaprol.^{1 2 a}

Adults

Lead Poisoning

Mild Symptoms or Blood Lead Concentration 70–100 mcg/dL

Oral

10 mg/kg or 350 mg/m² every 8 hours for 5 days followed by 10 mg/kg or 350 mg/m² every 12 hours for 14 days.^b Full course of treatment is 19 days.^b

Intervals ≥2 weeks are recommended between courses of succimer therapy unless blood lead concentrations require more prompt drug therapy.^{1 2}

≥4 week interval is recommended when succimer is given subsequent to calcium EDTA therapy, with or without dimercaprol.^{1 2}

Prescribing Limits

Pediatric Patients

Lead Poisoning

Oral

Children >12 months of age: Initially, maximum 10 mg/kg or 350 mg/m² every 8 hours.^{1 2}

Safety of uninterrupted dosing >3 weeks not established and not recommended.^a

Adults

Lead Poisoning

Oral

Safety of uninterrupted dosing >3 weeks not established and not recommended.^a

Special Populations

No special population dosage recommendations at this time.^a

Cautions for Succimer

Contraindications

• 
  

  Known hypersensitivity to succimer or any ingredient in the formulation.^a

  
  

Warnings/Precautions

Warnings

Lead Exposure

Not a substitute for the abatement of lead exposure.^a

Neutropenia

Risk of mild to moderate neutropenia, possibly resulting in infection.^a

Perform CBCs, including differential and platelet counts, prior to and weekly during therapy.^a Withhold therapy if ANC <1200/mm³; continue monitoring until ANC >1500/mm³ or recovery to patient’s baseline neutrophil count.^a Rechallenge only if the benefit of therapy outweighs the risk of neutropenia and only with careful monitoring.^a

Assess blood counts if infection is suspected.^a

Sensitivity Reactions

Hypersensitivity

Possible allergic or mucocutaneous reactions; may occur with readministration as well as during initial course.^a

Recurrent mucocutaneous vesicular eruptions affecting oral mucosa, external urethral meatus, and perianal area reported in one patient; reactions increased in severity with administration of each subsequent course and resolved between courses and upon discontinuance of therapy.^a

General Precautions

Monitoring

Clinical experience is limited; careful observation recommended during therapy.^a

Rebound Lead Toxicity

Risk of elevated blood lead concentrations and associated symptoms after discontinuance of drug due to redistribution of lead from bone stores to soft tissues and blood.^a

After completion of therapy, monitor blood lead concentrations at least once weekly until stable.^a Use the severity of lead intoxication (as measured by the initial blood lead concentration and the rate and degree of rebound of blood lead) as a guide for more frequent monitoring.^a

Elevated Serum Transaminases

Transient mild elevations of serum transaminases observed in 6–10% of patients.^a Obtain baseline and weekly serum transaminase levels during therapy.^a

Specific Populations

Pregnancy

Category C.^a

Lactation

Not known whether succimer is distributed into milk; however, breastfeeding is contraindicated in women receiving succimer due to maternal lead poisoning and risk of exposing nursing infant to the toxic heavy metal.^{a e}

Pediatric Use

Safety and efficacy not established in children <12 months of age.^a

Hepatic Impairment

Use with caution; assess hepatic function prior to and periodically during therapy.^a

Closely monitor patients with a history of liver disease.^a

Renal Impairment

Use with caution; assess renal function prior to and periodically during prolonged therapy.^a Adequately hydrate patients during therapy.^a Limited data suggests that succimer is dialyzable, but the lead chelates are not.^a

Common Adverse Effects

GI symptoms (nausea, vomiting, diarrhea, appetite loss, loose stools, metallic taste), elevated serum transaminases, rash, neutropenia.^a

Interactions for Succimer

Chelating Agents

Concomitant administration with other chelating agents (i.e., edetate sodium dicalcium) is not recommended.^c

Laboratory Tests

May interfere with serum and urinary laboratory tests.^a May cause false positive results for ketones in urine using nitroprusside reagents (e.g., Ketostix) and falsely decreased measurements of serum uric acid and CPK.^a

Succimer Pharmacokinetics

Absorption

Bioavailability

Absorption is rapid and variable, with peak plasma concentrations obtained at 1–2 hours.^a

Elimination

Metabolism

Approximately 90% of absorbed dose is metabolized to mixed succimer-cysteine disulfides.^a

Elimination Route

Unabsorbed drug excreted principally in feces; absorbed drug excreted principally in the urine as metabolites.^a

Half-life

Approximately 2 days.^a

Stability

Storage

Oral

Capsules

15–25°C.^a Avoid excessive heat.^a

ActionsActions

• 
  

  Chelates heavy metals with a high specificity for lead.^{4 a}

  
  


• 
  

  Forms water soluble chelates with lead and increases urinary excretion of lead.^a

  
  


• 
  

  At recommended oral doses, decreases average blood lead concentrations by 72.5%.^a An average of 19 mg of lead was excreted in urine following administration of 30 mg/kg of succimer daily for 5 days.^a

  
  


• 
  

  Improves clinical symptoms (e.g., headache, colic) and biochemical indices of lead poisoning.^a

  
  


• 
  

  Does not affect urinary elimination of iron, calcium, or magnesium; however, may double zinc excretion.^a

  
  

Advice to Patients

• 
  

  Importance of identifying source of lead poisoning and then removing patient from that source.^{1 2} Importance of patient residing in an environment free of lead both during and after therapy.^{1 2}

  
  


• 
  

  For patients unable to swallow capsules, contents of capsules may be sprinkled on soft food just before administration or placed on a spoon for administration and taken with fruit juice.^a

  
  


• 
  

  Importance of maintaining adequate fluid intake.^a

  
  


• 
  

  Importance of informing clinicians if rash or infection occurs.^a

  
  


• 
  

  Importance of completing full course of therapy.^a

  
  


• 
  

  Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.^a

  
  


• 
  

  Importance of keeping succimer out of reach of children.^a

  
  


• 
  

  Importance of informing patients of other important precautionary information.^a (See Cautions.)

  
  

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Succimer

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Capsules	100 mg	Chemet	Schwarz Pharma

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions August 2009. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

1. McNeil Consumer Products Company. Chemet (succimer) capsules prescribing information. Fort Washington, PA; 1991 Feb.

2. McNeil Consumer Products Company. A summary of pharmacological and clinical data: Chemet (succimer). Fort Washington, PA: 1991.

3. McNeil, Fort Washington, PA: Personal communication.

4. US Department of Health and Human Services. Preventing lead poisoning in young children: a statement by the Centers for Disease Control October 1991. Atlanta, GA: Centers for Disease Control, Center for Environmental Health.

5. Committee on Drugs, American Academy of Pediatrics. Treatment guidelines for lead exposure in children. Pediatrics. 1995; 96:155-60. [IDIS 349805] [PubMed 7596706]

6. Committee on Environmental Health, American Academy of Pediatrics. Lead poisoning: from screening to primary prevention. Pediatrics. 1993; 92:176-83. [PubMed 8516071]

7. Mann KV, Travers JD. Succimer, an oral lead chelator. Clin Pharm. 1991; 10:914-22. [IDIS 288062] [PubMed 1663439]

8. Piomelli S, Rosen JF, Chisolm JJ Jr et al. Management of childhood lead poisoning. J Pediatr. 1984; 105:523-32. [IDIS 190925] [PubMed 6481529]

9. Food and Drug Administration. Orphan designations pursuant to Section 526 of the Federal Food and Cosmetic Act as amended by the Orphan Drug Act (P.L. 97-414), to June 28, 1996. Rockville, MD; 1996 Jul.

a. Schwarz Pharma Mfg. Chemet (succimer) capsules prescribing information. Seymour, IN; 2007 Apr.

b. Henretig FM. Lead. In: Flomenbaum NE, Goldfrank LR, Hoffman RS et al, eds. Goldfrank’s toxicologic emergencies. 8th ed. New York: McGraw-Hill; 2006:1308-24.

c. Howland MA. Succimer (2,3-dimercaptosuccinic acid). In: Flomenbaum NE, Goldfrank LR, Hoffman RS et al, eds. Goldfrank’s toxicologic emergencies. 8th ed. New York: McGraw-Hill; 2006:1325-30

d. Gracia RC, Snodgrass WR. Lead toxicity and chelation therapy. Am J Health-Syst Pharm. 2007; 64:45-53. [PubMed 17189579]

e. Briggs GC, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005:1706-8.

More Succimer resources

• Succimer Side Effects (in more detail)
• Succimer Dosage
• Succimer Use in Pregnancy & Breastfeeding
• Succimer Support Group
• 0 Reviews for Succimer - Add your own review/rating

• Succimer Professional Patient Advice (Wolters Kluwer)


• Succimer MedFacts Consumer Leaflet (Wolters Kluwer)


• succimer Concise Consumer Information (Cerner Multum)


• succimer Advanced Consumer (Micromedex) - Includes Dosage Information


• Chemet Prescribing Information (FDA)

Compare Succimer with other medications

• Lead Poisoning, Severe

Tekturna HCT

Pronunciation: a-lis-KYE-ren/HYE-droe-KLOR-oh-THYE-a-zide
Generic Name: Aliskiren/Hydrochlorothiazide
Brand Name: Tekturna HCT

Tekturna HCT may cause injury or death to the fetus if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away.

Tekturna HCT is used for:

Treating high blood pressure in certain patients. It may also be used for other conditions as determined by your doctor.

Tekturna HCT is a direct renin inhibitor and thiazide diuretic combination. The direct renin inhibitor works by relaxing blood vessels. The diuretic helps the kidneys to remove fluid from the body, which lowers blood pressure and helps the heart to pump blood more easily.

Do NOT use Tekturna HCT if:

• you are allergic to any ingredient in Tekturna HCT or to any other sulfonamide medicine (eg, sulfamethoxazole)


• you have a history of angioedema (swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness) caused by treatment with Tekturna HCT


• you are pregnant


• you have severe kidney problems or you are unable to urinate


• you are taking cyclosporine, dofetilide, itraconazole, or ketanserin

Contact your doctor or health care provider right away if any of these apply to you.

Before using Tekturna HCT:

Some medical conditions may interact with Tekturna HCT. Tell your health care provider if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are a woman of childbearing age


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have a history of angioedema (swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; hoarseness), especially when taking an angiotensin-converting enzyme (ACE) inhibitor (eg, lisinopril)


• if you have a history of gout, lupus, asthma, heart problems, kidney problems (eg, renal artery stenosis), liver problems, kidney stones, parathyroid gland problems, or high blood cholesterol or lipid levels


• if you have diabetes, especially if you are also taking an ACE inhibitor (eg, lisinopril) or an angiotensin receptor blocker (eg, losartan)


• if you are dehydrated, receive dialysis treatment, or you have low blood volume


• if you are on a low-salt (sodium) diet


• if you have blood electrolyte problems (eg, sodium, potassium, magnesium, calcium)


• if you take other medicine for high blood pressure or heart problems

Some MEDICINES MAY INTERACT with Tekturna HCT. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Digoxin, dofetilide, or ketanserin because the risk of irregular heartbeat may be increased


• ACE inhibitors (eg, lisinopril), angiotensin receptor blockers (eg, losartan), potassium-sparing diuretics (eg, spironolactone), or potassium supplements because the risk of high blood potassium may be increased


• Atorvastatin, certain azole antifungals (eg, itraconazole, ketoconazole), barbiturates (eg, phenobarbital), corticosteroids (eg, prednisone), corticotropin, cyclosporine, other diuretics (eg, furosemide), other medicines for high blood pressure, or narcotic pain medicines (eg, codeine) because they may increase the risk of Tekturna HCT's side effects, including low blood pressure


• Cholestyramine, colestipol, irbesartan, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because they may decrease Tekturna HCT's effectiveness


• Diazoxide or lithium because the risk of their side effects may be increased by Tekturna HCT


• Anticoagulants (eg, warfarin) or insulin or other medicines for diabetes (eg, glipizide) because their effectiveness may be decreased by Tekturna HCT

This may not be a complete list of all interactions that may occur. Ask your health care provider if Tekturna HCT may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Tekturna HCT:

Use Tekturna HCT as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• An extra patient leaflet is available with Tekturna HCT. Talk to your pharmacist if you have questions about this information.


• Take Tekturna HCT by mouth with or without food. However, you must take it the same way each time you take it. If you take Tekturna HCT on an empty stomach, always take it on an empty stomach. If you take it with food, always take it with food.


• Taking Tekturna HCT with foods that are high in fat may decrease its effectiveness. Discuss any questions or concerns with your doctor.


• Tekturna HCT may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 pm.


• If you take cholestyramine or colestipol, ask your doctor or pharmacist how to take it with Tekturna HCT.


• Take Tekturna HCT on a regular schedule to get the most benefit from it.


• Tekturna HCT works best if it is taken at the same time each day.


• Continue to take Tekturna HCT even if you feel well. Do not miss any doses.


• If you miss a dose of Tekturna HCT, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Tekturna HCT.

Important safety information:

• Tekturna HCT may cause dizziness, light-headedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use Tekturna HCT with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Tekturna HCT may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.


• Check with your doctor before you drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Tekturna HCT; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.


• Dehydration, excessive sweating, vomiting, or diarrhea may increase the risk of low blood pressure. Contact your health care provider at once if any of these occur.


• It may take up to 4 weeks to get the full benefit from Tekturna HCT. Do not stop using Tekturna HCT or change your dose of Tekturna HCT without checking with your doctor.


• Tekturna HCT may cause a serious side effect called angioedema. Contact your doctor at once if you develop swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness.


• Tell your doctor or dentist that you take Tekturna HCT before you receive any medical or dental care, emergency care, or surgery.


• Tekturna HCT contains a sulfonamide called hydrochlorothiazide, which can cause certain eye problems (myopia, angle-closure glaucoma). Your risk may be increased if you are allergic to sulfonamide medicines (eg, sulfamethoxazole) or to penicillin antibiotics (eg, amoxicillin). Untreated angle-closure glaucoma can lead to permanent vision loss. If these eye problems occur, symptoms usually occur within hours to weeks of starting Tekturna HCT. Contact your doctor right away if you experience symptoms such as vision changes (eg, decreased vision clearness) or eye pain.


• Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.


• Tekturna HCT may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Tekturna HCT. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.


• If you have high blood pressure, do not use nonprescription products that contain stimulants. These products may include diet pills or cold medicines. Contact your doctor if you have any questions or concerns.


• Check with your doctor before you use a salt substitute or a product that has potassium in it.


• Tekturna HCT may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.


• Diabetes patients - Tekturna HCT may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.


• Tekturna HCT may interfere with certain lab tests, including parathyroid function. Be sure your doctor and lab personnel know you are taking Tekturna HCT.


• Lab tests, including blood pressure, blood electrolyte levels, and kidney function, may be performed while you use Tekturna HCT. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Tekturna HCT should be used with extreme caution in CHILDREN younger than 18 years; safety and effectiveness in these children have not been confirmed.


• PREGNANCY AND BREAST-FEEDING: Do not take Tekturna HCT if you are pregnant. Tekturna HCT may cause birth defects or fetal death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. Tekturna HCT is found in breast milk. Do not breast-feed while taking Tekturna HCT.

Possible side effects of Tekturna HCT:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Cough; dizziness; flu-like symptoms (eg, headache, muscle or joint aches, tiredness); mild diarrhea.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); decreased urination; eye pain; fever, chills, or persistent sore throat; increased thirst; irregular heartbeat; muscle pain or cramps; red, swollen, blistered, or peeling skin; severe or persistent nausea or stomach pain; shortness of breath; symptoms of low blood pressure (eg, fainting, light-headedness, severe dizziness); unusual bruising or bleeding; unusual tiredness or weakness; unusually dry mouth; vision changes (eg, decreased vision clearness); yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Tekturna HCT side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; severe dizziness or light-headedness; symptoms of blood electrolyte problems (eg, confusion; irregular heartbeat; mental or mood changes; muscle pain, weakness, or cramping; seizures; sluggishness); symptoms of dehydration (eg, dry mouth or eyes; decreased urination; fast heartbeat; unusual thirst, tiredness, or weakness).

Proper storage of Tekturna HCT:

Store Tekturna HCT at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Tekturna HCT out of the reach of children and away from pets.

General information:

• If you have any questions about Tekturna HCT, please talk with your doctor, pharmacist, or other health care provider.


• Tekturna HCT is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Tekturna HCT. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Tekturna HCT resources

• Tekturna HCT Side Effects (in more detail)
• Tekturna HCT Use in Pregnancy & Breastfeeding
• Tekturna HCT Drug Interactions
• Tekturna HCT Support Group
• 4 Reviews for Tekturna HCT - Add your own review/rating

• Tekturna HCT Prescribing Information (FDA)


• Tekturna HCT Advanced Consumer (Micromedex) - Includes Dosage Information


• Tekturna HCT Consumer Overview

Compare Tekturna HCT with other medications

• High Blood Pressure

Neut

Generic Name: sodium bicarbonate (Oral route, Intravenous route, Subcutaneous route)

SOE-dee-um bye-KAR-bo-nate

Commonly used brand name(s)

In the U.S.

• Brioschi


• Neut

In Canada

• Sellymin


• Sodium Bicarbonate

Available Dosage Forms:

• Tablet


• Solution


• Powder


• Granule


• Capsule

Therapeutic Class: Antacid, Sodium Bicarbonate Containing

Uses For Neut

Sodium bicarbonate , also known as baking soda, is used to relieve heartburn, sour stomach, or acid indigestion by neutralizing excess stomach acid. When used for this purpose, it is said to belong to the group of medicines called antacids. It may be used to treat the symptoms of stomach or duodenal ulcers. Sodium bicarbonate is also used to make the blood and urine more alkaline in certain conditions.

Antacids should not be given to young children (up to 6 years of age) unless prescribed by their doctor. Since children cannot usually describe their symptoms very well, a doctor should check the child before giving this medicine. The child may have a condition that needs other treatment. If so, antacids will not help and may even cause unwanted effects or make the condition worse.

Sodium bicarbonate for oral use is available without a prescription.

Before Using Neut

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Antacids should not be given to young children (up to 6 years of age) unless prescribed by a physician. This medicine may not help and may even worsen some conditions, so make sure that your child's problem should be treated with this medicine before you use it.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of sodium bicarbonate in the elderly with use in other age groups.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Dasatinib


• Itraconazole

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Appendicitis or


• Intestinal or rectal bleeding—Oral forms of sodium bicarbonate may make these conditions worse

• Edema (swelling of feet or lower legs) or


• Heart disease or


• High blood pressure (hypertension) or


• Kidney disease or


• Liver disease or


• Problems with urination or


• Toxemia of pregnancy—Sodium bicarbonate may cause the body to retain (keep) water, which may make these conditions worse

Proper Use of sodium bicarbonate

This section provides information on the proper use of a number of products that contain sodium bicarbonate. It may not be specific to Neut. Please read with care.

For safe and effective use of sodium bicarbonate:

• Follow your doctor's instructions if this medicine was prescribed.


• Follow the manufacturer's package directions if you are treating yourself.

For patients taking this medicine for a stomach ulcer :

• Take it exactly as directed and for the full time of treatment as ordered by your doctor, to obtain maximum relief of your symptoms.


• Take it 1 and 3 hours after meals and at bedtime for best results, unless otherwise directed by your doctor.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For sodium bicarbonate effervescent powder:
  
  • To relieve heartburn or sour stomach:
    
    • Adults and teenagers—3.9 to 10 grams (1 to 2½ teaspoonfuls) in a glass of cold water after meals. However, the dose is usually not more than 19.5 grams (5 teaspoonfuls) a day.
    
    
    • Children up to 6 years of age—Dose must be determined by your doctor.
    
    
    • Children 6 to 12 years of age—1 to 1.9 grams (¼ to ½ teaspoonful) in a glass of cold water after meals.
    
    
  
  


• For sodium bicarbonate powder:
  
  • To relieve heartburn or sour stomach:
    
    • Adults and teenagers—One-half teaspoonful in a glass of water every two hours. Your doctor may change the dose if needed.
    
    
    • Children—Dose must be determined by your doctor.
    
    
  
  
  • To make the urine more alkaline (less acidic):
    
    • Adults and teenagers—One teaspoonful in a glass of water every four hours. Your doctor may change the dose if needed. However, the dose is usually not more than 4 teaspoonfuls a day.
    
    
    • Children—Dose must be determined by your doctor.
    
    
  
  


• For sodium bicarbonate tablets:
  
  • To relieve heartburn or sour stomach:
    
    • Adults and teenagers—325 milligrams (mg) to 2 grams one to four times a day.
    
    
    • Children up to 6 years of age—Dose must be determined by your doctor.
    
    
    • Children 6 to 12 years of age—The dose is 520 mg. The dose may be repeated in thirty minutes.
    
    
  
  
  • To make the urine more alkaline (less acidic):
    
    • Adults and teenagers—At first, four grams, then 1 to 2 grams every four hours. However, the dose is usually not more than 16 grams a day.
    
    
    • Children—The dose is based on body weight and must be determined by your doctor. The usual dose is 23 to 230 mg per kilogram (kg) (10.5 to 105 mg per pound) of body weight a day. Your doctor may change the dose if needed.
    
    
  
  

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Neut

If this medicine has been ordered by your doctor and if you will be taking it regularly for a long time, your doctor should check your progress at regular visits. This is to make sure the medicine does not cause unwanted effects.

Do not take sodium bicarbonate:

• Within 1 to 2 hours of taking other medicine by mouth. To do so may keep the other medicine from working properly.


• For a long period of time. To do so may increase the chance of side effects.

For patients on a sodium-restricted diet:

• This medicine contains a large amount of sodium. If you have any questions about this, check with your health care professional.

For patients taking this medicine as an antacid:

• Do not take this medicine if you have any signs of appendicitis (such as stomach or lower abdominal pain, cramping, bloating, soreness, nausea, or vomiting). Instead, check with your doctor as soon as possible.


• Do not take this medicine with large amounts of milk or milk products. To do so may increase the chance of side effects.


• Do not take sodium bicarbonate for more than 2 weeks or if the problem comes back often. Instead, check with your doctor. Antacids should be used only for occasional relief, unless otherwise directed by your doctor.

Neut Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although the following side effects occur very rarely when this medicine is taken as recommended, they may be more likely to occur if it is taken: in large doses, for a long time, or by patients with kidney disease.

Check with your doctor as soon as possible if any of the following side effects occur:

• Frequent urge to urinate


• headache (continuing)


• loss of appetite (continuing)


• mood or mental changes


• muscle pain or twitching


• nausea or vomiting


• nervousness or restlessness


• slow breathing


• swelling of feet or lower legs


• unpleasant taste


• unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Increased thirst


• stomach cramps

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Neut side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Neut resources

• Neut Side Effects (in more detail)
• Neut Use in Pregnancy & Breastfeeding
• Neut Drug Interactions
• Neut Support Group
• 0 Reviews for Neut - Add your own review/rating

• Sodium Bicarbonate Prescribing Information (FDA)


• Sodium Bicarbonate Professional Patient Advice (Wolters Kluwer)


• sodium bicarbonate Concise Consumer Information (Cerner Multum)


• Sodium Bicarbonate Monograph (AHFS DI)


• Sodium Bicarbonate MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Neut with other medications

• Asystole
• Diabetic Ketoacidosis
• Hyperkalemia
• Hyperuricemia Secondary to Chemotherapy
• Indigestion
• Metabolic Acidosis
• Urinary Alkalinization

TriNessa

Generic Name: ethinyl estradiol and norgestimate (ETH in ill ess tra DYE ol and nor JESS ti mate)

Brand Names: Mononessa, Ortho Tri-Cyclen, Ortho Tri-Cyclen Lo, Ortho-Cyclen, Previfem, Sprintec, Tri-Lo-Sprintec, Tri-Previfem, Tri-Sprintec, TriNessa

What is TriNessa (ethinyl estradiol and norgestimate)?

Ethinyl estradiol and norgestimate contains a combination of female hormones that prevent ovulation (the release of an egg from an ovary). This medication also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.

Ethinyl estradiol and norgestimate is used as contraception to prevent pregnancy. It is also used to treat severe acne.

Ethinyl estradiol and norgestimate may also be used for purposes not listed in this medication guide.

What is the most important information I should know about TriNessa (ethinyl estradiol and norgestimate)?

This medication can harm an unborn baby or cause birth defects. Do not use birth control pills if you are pregnant or if you have recently had a baby. You should not take birth control pills if you have coronary artery disease, severe heart valve disorder, uncontrolled high blood pressure, a history of stroke or blood clot, circulation problems, a hormone-related cancer such as breast or uterine cancer, unusual vaginal bleeding, liver disease or liver cancer, severe migraine headaches, or a history of jaundice caused by pregnancy or birth control pills.

You may need to use back-up birth control, such as condoms or a spermicide, when you first start using this medication. Follow your doctor's instructions.

Taking hormones can increase your risk of blood clots, stroke, or heart attack, especially if you smoke and are older than 35.

Some drugs can make birth control pills less effective, which may result in pregnancy. Tell your doctor about all the prescription and over-the-counter medications you use, including vitamins, minerals and herbal products. Do not start using a new medication without telling your doctor.

What should I discuss with my healthcare provider before taking TriNessa (ethinyl estradiol and norgestimate)?

This medication can cause birth defects. Do not use if you are pregnant. Tell your doctor right away if you become pregnant, or if you miss two menstrual periods in a row. If you have recently had a baby, wait at least 4 weeks before taking birth control pills (6 weeks if you are breast-feeding). You should not take birth control pills if you have:

• 
  

  coronary artery disease, a severe or uncontrolled heart valve disorder, untreated or uncontrolled high blood pressure;

  
  


• 
  

  a history of a stroke, blood clot, or circulation problems;

  
  


• 
  

  a hormone-related cancer such as breast or uterine cancer;

  
  


• 
  

  unusual vaginal bleeding that has not been checked by a doctor;

  
  


• 
  

  liver disease or liver cancer;

  
  


• 
  

  severe migraine headaches; or

  
  


• 
  

  a history of jaundice caused by pregnancy or birth control pills.

  
  

To make sure you can safely take this medication, tell your doctor if you have any of these other conditions:

• 
  

  high blood pressure, heart disease, congestive heart failure, angina (chest pain), or a history of heart attack;

  
  


• 
  

  high cholesterol or triglycerides, or if you are overweight;

  
  


• 
  

  a history of depression;

  
  


• 
  

  gallbladder disease;

  
  


• 
  

  diabetes;

  
  


• 
  

  seizures or epilepsy;

  
  


• 
  

  a history of irregular menstrual cycles; or

  
  


• 
  

  a history of fibrocystic breast disease, lumps, nodules, or an abnormal mammogram.

  
  

The hormones in this medication can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

How should I take TriNessa (ethinyl estradiol and norgestimate)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Take your first pill on the first day of your period or on the first Sunday after your period begins (follow your doctor's instructions).

You may need to use back-up birth control, such as condoms or a spermicide, when you first start using this medication. Follow your doctor's instructions.

The 28-day birth control pack contains seven "reminder" pills to keep you on your regular cycle. Your period will usually begin while you are using these reminder pills.

You may have breakthrough bleeding, especially during the first 3 months. Tell your doctor if this bleeding continues or is very heavy.

Take one pill every day, no more than 24 hours apart. When the pills run out, start a new pack the following day. You may get pregnant if you do not use this medication regularly. Get your prescription refilled before you run out of pills completely.

If you need surgery or medical tests or if you will be on bed rest, you may need to stop using this medication for a short time. Any doctor or surgeon who treats you should know that you are using birth control pills.

Your doctor will need to check your progress on a regular basis. Do not miss any scheduled appointments.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Missing a pill increases your risk of becoming pregnant.

If you miss one "active" pill, take two pills on the day that you remember. Then take one pill per day for the rest of the pack.

If you miss two "active" pills in a row in week one or two, take two pills per day for two days in a row. Then take one pill per day for the rest of the pack. Use back-up birth control for at least 7 days.

If you miss two "active" pills in a row in week three, or if you miss three pills in a row during any of the first 3 weeks, throw out the rest of the pack and start a new one the same day if you are a Day 1 starter. If you are a Sunday starter, keep taking a pill every day until Sunday. On Sunday, throw out the rest of the pack and start a new one that day.

If you miss two or more pills, you may not have a period during the month. If you miss a period for two months in a row, call your doctor because you might be pregnant.

If you miss any reminder pills, throw them away and keep taking one pill per day until the pack is empty. You do not need back-up birth control if you miss a reminder pill.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include severe nausea or vaginal bleeding.

What should I avoid while taking TriNessa (ethinyl estradiol and norgestimate)?

Do not smoke while using birth control pills, especially if you are older than 35. Smoking can increase your risk of blood clots, stroke, or heart attack caused by birth control pills.

Birth control pills will not protect you from sexually transmitted diseases--including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.

TriNessa (ethinyl estradiol and norgestimate) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking this medicine and call your doctor at once if you have a serious side effect such as:

• 
  

  sudden numbness or weakness, especially on one side of the body;

  
  


• 
  

  sudden severe headache, confusion, problems with vision, speech, or balance;

  
  


• 
  

  sudden cough, wheezing, rapid breathing, coughing up blood;

  
  


• 
  

  pain, swelling, warmth, or redness in one or both legs;

  
  


• 
  

  chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

  
  


• 
  

  a change in the pattern or severity of migraine headaches;

  
  


• 
  

  pain in your upper stomach, jaundice (yellowing of the skin or eyes);

  
  


• 
  

  a lump in your breast;

  
  


• 
  

  swelling in your hands, ankles, or feet; or

  
  


• 
  

  symptoms of depression (sleep problems, weakness, mood changes).

  
  

Less serious side effects may include:

• 
  

  mild nausea or vomiting, appetite or weight changes;

  
  


• 
  

  breast swelling or tenderness;

  
  


• 
  

  headache, nervousness, dizziness;

  
  


• 
  

  problems with contact lenses;

  
  


• 
  

  freckles or darkening of facial skin, loss of scalp hair; or

  
  


• 
  

  vaginal itching or discharge.

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect TriNessa (ethinyl estradiol and norgestimate)?

Some drugs can make ethinyl estradiol and norgestimate less effective, which may result in pregnancy. Before using ethinyl estradiol and norgestimate, tell your doctor if you are using any of the following drugs:

• 
  

  bosentan (Tracleer);

  
  


• 
  

  St. John's wort;

  
  


• 
  

  an antibiotic;

  
  


• 
  

  HIV or AIDS medications;

  
  


• 
  

  phenobarbital (Solfoton) and other barbiturates; or

  
  


• 
  

  seizure medication.

  
  

This list is not complete and other drugs may interact with birth control pills. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More TriNessa resources

• TriNessa Side Effects (in more detail)
• TriNessa Use in Pregnancy & Breastfeeding
• Drug Images
• TriNessa Drug Interactions
• TriNessa Support Group
• 64 Reviews for TriNessa - Add your own review/rating

• TriNessa Prescribing Information (FDA)


• MonoNessa Prescribing Information (FDA)


• Ortho Tri-Cyclen Consumer Overview


• Ortho Tri-Cyclen Prescribing Information (FDA)


• Ortho Tri-Cyclen MedFacts Consumer Leaflet (Wolters Kluwer)


• Ortho Tri-Cyclen Lo Prescribing Information (FDA)


• Previfem Prescribing Information (FDA)


• Sprintec Prescribing Information (FDA)


• Tri-Lo-Sprintec Prescribing Information (FDA)


• Tri-Previfem Prescribing Information (FDA)


• Tri-Sprintec Prescribing Information (FDA)

Compare TriNessa with other medications

• Abnormal Uterine Bleeding
• Acne
• Birth Control
• Endometriosis
• Gonadotropin Inhibition
• Ovarian Cysts

Where can I get more information?

• Your pharmacist can provide more information about ethinyl estradiol and norgestimate.

See also: TriNessa side effects (in more detail)

Tobramycin Drops

Pronunciation: toe-bra-MYE-sin
Generic Name: Tobramycin
Brand Name: Examples include AK-Tob and Tobrex

Tobramycin Drops are used for:

Treating eye infections.

Tobramycin Drops are an antibiotic. It works by killing or slowing the growth of certain types of bacteria.

Do NOT use Tobramycin Drops if:

• you are allergic to any ingredient in Tobramycin Drops or to similar medicines

Contact your doctor or health care provider right away if any of these apply to you.

Before using Tobramycin Drops:

Some medical conditions may interact with Tobramycin Drops. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances

Some MEDICINES MAY INTERACT with Tobramycin Drops. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Cephalosporins by injection (eg, ceftazidime) because they may decrease Tobramycin Drops's effectiveness


• Cyclosporine, fludarabine, loop diuretics (eg, furosemide), methoxyflurane, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, indomethacin), nitrosoureas (eg, streptozocin), polypeptide antibiotics (eg, polymyxin B), or vancomycin injection because they may increase the risk of Tobramycin Drops's side effects, including increased risk of kidney or hearing problems


• Cephalosporins by injection (eg, ceftazidime), nondepolarizing muscle relaxants (eg, pancuronium), or succinylcholine because their side effects may be increased by Tobramycin Drops

This may not be a complete list of all interactions that may occur. Ask your health care provider if Tobramycin Drops may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Tobramycin Drops:

Use Tobramycin Drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Remove contact lenses before you use Tobramycin Drops.


• Do not wear contact lenses while you are using Tobramycin Drops. Take care of your contact lenses as directed by the manufacturer. Check with your doctor before you use them.


• To use Tobramycin Drops in the eye, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eyelid for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean, dry tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.


• To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including the eye. Keep the container tightly closed.


• To clear up your infection completely, take/use Tobramycin Drops for the full course of treatment. Keep taking/using it even if you feel better in a few days.


• Tobramycin Drops works best if it is used at the same time each day.


• Do not miss any doses. If you miss a dose of Tobramycin Drops, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Ask your health care provider any questions you may have about how to use Tobramycin Drops.

Important safety information:

• Tobramycin Drops may cause blurred vision. Use Tobramycin Drops with caution. Do not drive or perform other possibly unsafe tasks if you cannot see clearly.


• If your symptoms do not get better within a few days or if they get worse, check with your doctor.


• Be sure to use Tobramycin Drops for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.


• Long-term or repeated use of Tobramycin Drops may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.


• Tobramycin Drops should not be used in CHILDREN younger than 2 months old; safety and effectiveness in these children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Tobramycin Drops while you are pregnant. It is not known if Tobramycin Drops are found in breast milk. Do not breast-feed while using Tobramycin Drops.

Possible side effects of Tobramycin Drops:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Burning or stinging in the eye.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); eye or eyelid swelling, itching, or redness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blurred vision; eye pain; eye watering; swelling and itching of the eyelid.

Proper storage of Tobramycin Drops:

Store Tobramycin Drops at room temperature, between 46 and 80 degrees F (8 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Tobramycin Drops out of the reach of children and away from pets.

General information:

• If you have any questions about Tobramycin Drops, please talk with your doctor, pharmacist, or other health care provider.


• Tobramycin Drops are to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Tobramycin Drops. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Tobramycin resources

• Tobramycin Use in Pregnancy & Breastfeeding
• Tobramycin Support Group
• 3 Reviews for Tobramycin - Add your own review/rating

Compare Tobramycin with other medications

• Conjunctivitis, Bacterial

Tannate 12D S

Generic Name: carbetapentane, phenylephrine, and pyrilamine (kar BET a PEN tane, FEN il EFF rin, and pir IL a meen)

Brand Names: C-Tanna 12D, Tannate 12D S, Tannihist-12D, Tussi-12D, Tussi-12D S

What is Tannate 12D S (carbetapentane, phenylephrine, and pyrilamine)?

Carbetapentane is a cough suppressant.

Pyrilamine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of carbetapentane, phenylephrine, and pyrilamine is used to treat runny or stuffy nose, sinus congestion, and cough caused by allergies, the common cold, or flu.

Carbetapentane, phenylephrine, and pyrilamine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Tannate 12D S (carbetapentane, phenylephrine, and pyrilamine)?

Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.

Tell your doctor about all your medical conditions before you take this carbetapentane, phenylephrine, and pyrilamine.

Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Avoid drinking alcohol while you are taking this medication.

Do not use any other over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains an antihistamine, decongestant, or cough suppressant.

What should I discuss with my healthcare provider before taking Tannate 12D S (carbetapentane, phenylephrine, and pyrilamine)?

You should not use this medication if you are allergic to carbetapentane, phenylephrine, or pyrilamine, or to other decongestants or antihistamines. Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body.

Before using this medication, tell your doctor if you are allergic to any drugs, or if you have:

• 
  

  heart disease, high blood pressure, or a heart rhythm disorder;

  
  


• 
  

  asthma, emphysema, or chronic obstructive pulmonary disease (COPD);

  
  


• 
  

  epilepsy or other seizure disorder;

  
  


• 
  

  diabetes;

  
  


• 
  

  a thyroid disorder;

  
  


• 
  

  glaucoma;

  
  


• 
  

  kidney disease;

  
  


• 
  

  gallbladder disease;

  
  


• 
  

  Addison's disease;

  
  


• 
  

  a stomach ulcer or obstruction;

  
  


• 
  

  an enlarged prostate; or

  
  


• 
  

  problems with urination.

  
  

If you have any of these conditions, you may not be able to take carbetapentane, phenylephrine, and pyrilamine, or you may need a dose adjustment or special tests during treatment.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. This medication may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take Tannate 12D S (carbetapentane, phenylephrine, and pyrilamine)?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.

Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children. Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

This medication can cause you to have unusual results with allergy skin tests. Tell any doctor who treats you that you are taking an antihistamine.

Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash. Store the medicine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include feeling restless or nervous, nausea, vomiting, stomach pain, dizziness, drowsiness, dry mouth, warmth or tingly feeling, or seizure (convulsions).

What should I avoid while taking Tannate 12D S (carbetapentane, phenylephrine, and pyrilamine)?

Avoid drinking alcohol while you are taking this medicine. Do not use any other over-the-counter cough, cold, allergy, pain, or sleeping medication without first asking your doctor or pharmacist. Decongestants, antihistamines, and cough suppressants are contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of a certain drug. Read the label of any other medicine you are using to see if it contains a decongestant, antihistamine, or cough suppressant.

Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid using other medicines that make you sleepy (such as pain medication, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by carbetapentane, phenylephrine, and pyrilamine.

Tannate 12D S (carbetapentane, phenylephrine, and pyrilamine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

• 
  

  fast, pounding, or uneven heartbeat;

  
  


• 
  

  slow, shallow breathing;

  
  


• 
  

  confusion, hallucinations, unusual thoughts or behavior;

  
  


• 
  

  severe dizziness, anxiety, restless feeling, or nervousness;

  
  


• 
  

  urinating less than usual or not at all;

  
  


• 
  

  easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms;

  
  


• 
  

  increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure); or

  
  


• 
  

  jaundice (yellowing of the skin or eyes).

  
  

Less serious side effects may include:

• 
  

  dizziness, drowsiness, blurred vision;

  
  


• 
  

  dry mouth, nose, or eyes;

  
  


• 
  

  nausea, stomach pain, constipation, loss of appetite;

  
  


• 
  

  warmth, tingling, or redness under your skin;

  
  


• 
  

  problems with memory or concentration;

  
  


• 
  

  ringing in your ears;

  
  


• 
  

  feeling excited or restless; or

  
  


• 
  

  sleep problems (insomnia).

  
  

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Tannate 12D S (carbetapentane, phenylephrine, and pyrilamine)?

The following drugs can interact with carbetapentane, phenylephrine, and pyrilamine. Tell your doctor if you are using any of these:

• 
  

  celecoxib (Celebrex);

  
  


• 
  

  cinacalcet (Sensipar);

  
  


• 
  

  imatinib (Gleevec);

  
  


• 
  

  quinidine (Quinaglute, Quinidex);

  
  


• 
  

  ranolazine (Ranexa)

  
  


• 
  

  ritonavir (Norvir);

  
  


• 
  

  sibutramine (Meridia);

  
  


• 
  

  terbinafine (Lamisil);

  
  


• 
  

  an antidepressant;

  
  


• 
  

  a diuretic (water pill);

  
  


• 
  

  medicines to treat high blood pressure;

  
  


• 
  

  medication to treat irritable bowel syndrome;

  
  


• 
  

  bladder or urinary medications such as oxybutynin (Ditropan, Oxytrol) or tolterodine (Detrol); or

  
  


• 
  

  aspirin or salicylates (such as Disalcid, Doan's Pills, Dolobid, Salflex, Tricosal, and others).

  
  

This list is not complete and there may be other drugs that can interact with carbetapentane, phenylephrine, and pyrilamine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

More Tannate 12D S resources

• Tannate 12D S Side Effects (in more detail)
• Tannate 12D S Use in Pregnancy & Breastfeeding
• Tannate 12D S Drug Interactions
• 0 Reviews for Tannate2D S - Add your own review/rating

• Carbetapentane/Phenylephrine/Pyrilamine MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Tannate 12D S with other medications

• Cough and Nasal Congestion

Where can I get more information?

• Your pharmacist can provide more information about carbetapentane, phenylephrine, and pyrilamine.

See also: Tannate2D S side effects (in more detail)

Sulfatrim

Generic Name: sulfamethoxazole/trimethoprim (Oral route)

sul-fa-meth-OX-a-zole, trye-METH-oh-prim

Commonly used brand name(s)

In the U.S.

• Bactrim


• Bactrim DS


• Septra


• Septra DS


• Sulfatrim


• Sulfatrim Pediatric

In Canada

• Apo-Sulfatrim


• Novo-Trimel


• Nu-Cotrimox


• Septa Pediatric


• Septra Pediatric Suspension

Available Dosage Forms:

• Tablet


• Suspension

Therapeutic Class: Sulfonamide Combination

Pharmacologic Class: Folic Acid Antagonist

Chemical Class: Sulfonamide

Uses For Sulfatrim

Sulfamethoxazole and trimethoprim combination is used to treat infections such as urinary tract infections, middle ear infections (otitis media), bronchitis, traveler's diarrhea, and shigellosis (bacillary dysentery). This medicine is also used to prevent or treat Pneumocystis carinii pneumonia (PCP), a very serious kind of pneumonia. This type of pneumonia occurs more commonly in patients whose immune systems are not working normally, such as cancer patients, transplant patients, and patients with acquired immune deficiency syndrome (AIDS).

Sulfamethoxazole and trimethoprim combination is an antibiotic. It works by eliminating the bacteria that cause many kinds of infections. This medicine will not work for colds, flu, or other virus infections.

This medicine is available only with your doctor's prescription.

Before Using Sulfatrim

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of sulfamethoxazole and trimethoprim combination in children and infants 2 months of age and older. Because of the toxicity of the combination of sulfamethoxazole and trimethoprim, use in infants younger than 2 months of age is not recommended.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of sulfamethoxazole and trimethoprim combination in the elderly. However, elderly patients are more likely to have a folate deficiency, age-related kidney or liver problems, and may be more likely to experience unwanted side effects (e.g., severe skin rash, increased potassium in the body, or problems with blood clotting or the immune system). There may be a dose adjustment for elderly patients receiving sulfamethoxazole and trimethoprim combination.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Sulfamethoxazole

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Trimethoprim

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Bepridil


• Cisapride


• Dofetilide


• Levomethadyl


• Mesoridazine


• Pimozide


• Terfenadine


• Thioridazine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acecainide


• Acenocoumarol


• Ajmaline


• Amiodarone


• Amisulpride


• Amitriptyline


• Amoxapine


• Aprindine


• Arsenic Trioxide


• Astemizole


• Azimilide


• Bretylium


• Chloral Hydrate


• Chloroquine


• Chlorpromazine


• Clarithromycin


• Desipramine


• Dibenzepin


• Disopyramide


• Dolasetron


• Doxepin


• Droperidol


• Eltrombopag


• Enflurane


• Erythromycin


• Flecainide


• Fluconazole


• Fluoxetine


• Foscarnet


• Gemifloxacin


• Halofantrine


• Haloperidol


• Halothane


• Hydroquinidine


• Ibutilide


• Imipramine


• Isoflurane


• Isradipine


• Lidoflazine


• Lorcainide


• Mefloquine


• Methotrexate


• Nortriptyline


• Octreotide


• Pentamidine


• Pirmenol


• Prajmaline


• Probucol


• Procainamide


• Prochlorperazine


• Propafenone


• Pyrimethamine


• Quetiapine


• Quinidine


• Risperidone


• Sematilide


• Sertindole


• Sotalol


• Spiramycin


• Sultopride


• Tedisamil


• Telithromycin


• Trifluoperazine


• Trimipramine


• Vasopressin


• Warfarin


• Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acetohexamide


• Anisindione


• Chlorpropamide


• Didanosine


• Digoxin


• Enalaprilat


• Enalapril Maleate


• Fosphenytoin


• Glipizide


• Glyburide


• Phenytoin


• Quinapril


• Repaglinide


• Rifabutin


• Rosiglitazone


• Tolazamide


• Tolbutamide

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse, history of or


• Folate (vitamin B9) deficiency or


• HIV or AIDS or


• Kidney disease or


• Liver disease or


• Malabsorption syndrome (difficulty of absorbing food in the body) or


• Malnutrition state (nutrition disorder)—Use with caution. May have an increased chance of serious side effects.

• Anemia, megaloblastic (caused by not enough folic acid) or


• Drug-induced thrombocytopenia (low platelets in the blood) after using this medicine or


• Kidney disease, severe or


• Liver disease, severe—Should not be used in patients with these conditions.

• Asthma or


• Diabetes or


• Hyperkalemia (high potassium in the blood) or


• Porphyria (enzyme problem) or


• Severe allergies or


• Thyroid problems—Use with caution. May make these conditions worse.

• Glucose-6-phosphate dehydrogenase (G6PD) deficiency (an enzyme problem)—May cause hemolytic anemia (blood disorder) in patients with this condition.

• Streptococcal infection (group A β-hemolytic)—Sulfonamides should not be used in patients with this condition.

Proper Use of trimethoprim and sulfamethoxazole

This section provides information on the proper use of a number of products that contain trimethoprim and sulfamethoxazole. It may not be specific to Sulfatrim. Please read with care.

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

Sulfamethoxazole and trimethoprim combination is best taken with a full glass (8 ounces) of water. Several additional glasses of water should be taken every day, unless otherwise directed by your doctor. Drinking extra water will help to prevent some unwanted effects. .

For patients taking the oral liquid, use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.

To help clear up your infection completely, keep using this medicine for the full time of treatment, even if you begin to feel better after a few days. If you stop taking this medicine too soon, your symptoms may return.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage forms (liquid or tablets):
  
  • For treatment of bacterial infections:
    
    • Adults and children weighing 40 kilograms (kg) or more—800 milligrams (mg) of sulfamethoxazole and 160 mg of trimethoprim every 12 hours. Your doctor may adjust this dose if needed.
    
    
    • Children and infants 2 months of age and older, and weighing up to 40 kg—Dose is based on body weight and must be determined by your doctor. The usual dose is 40 milligrams (mg) of sulfamethoxazole and 8 milligrams (mg) of trimethoprim per kilogram of body weight, given in two divided doses every 12 hours.
    
    
    • Infants younger than 2 months of age—Use is not recommended.
    
    
  
  
  • For chronic bronchitis:
    
    • Adults—800 milligrams (mg) of sulfamethoxazole and 160 mg of trimethoprim every 12 hours. Your doctor may adjust this dose if needed.
    
    
    • Children and infants 2 months of age and older—Use and dose must be determined by your doctor.
    
    
    • Infants younger than 2 months of age—Use is not recommended.
    
    
  
  
  • For treatment of Pneumocystis carinii pneumonia (PCP):
    
    • Adults and children 2 months of age and older—Dose is based on body weight and must be determined by your doctor. The usual dose is 75 to 100 milligrams (mg) of sulfamethoxazole and 15 to 20 milligrams (mg) of trimethoprim per kilogram of body weight each day, given in equally divided doses every 6 hours.
    
    
    • Infants younger than 2 months of age—Use is not recommended.
    
    
  
  
  • For prevention of Pneumocystis carinii pneumonia (PCP):
    
    • Adults—800 milligrams (mg) of sulfamethoxazole and 160 mg of trimethoprim once a day. Your doctor may adjust this dose if needed.
    
    
    • Children and infants 2 months of age and older—Dose is based on body size and must be determined by your doctor. The dose is 750 mg of sulfamethoxazole and 150 mg of trimethoprim per square meter (m[2]) of body surface each day. This is given in equally divided doses two times a day for 3 days a week on consecutive days (e.g., Monday, Tuesday, Wednesday).
    
    
    • Infants younger than 2 months of age—Use is not recommended.
    
    
  
  
  • For traveler's diarrhea:
    
    • Adults—800 milligrams (mg) of sulfamethoxazole and 160 mg of trimethoprim every 12 hours. Your doctor may adjust this dose if needed.
    
    
    • Children and infants 2 months of age and older—Use and dose must be determined by your doctor.
    
    
    • Infants younger than 2 months of age—Use is not recommended.
    
    
  
  

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Sulfatrim

It is very important that your doctor check the progress of you or your child at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Very rarely, this medicine has caused severe side effects. If you or your child start to have a skin rash, or if you think you are having a severe skin reaction, stop taking this medicine and call your doctor right away. Symptoms of a severe reaction may include a skin rash, skin color that is very pale or yellow, or skin with purple spots, along with a sore throat, fever, muscle pain, cough, and trouble with breathing.

This medicine, especially if you are receiving high doses or for a long period of time, may lower the number of platelets in your body, which are necessary for proper blood clotting. Because of this, you may bleed or get infections more easily. Talk with your doctor if you have concerns about this.

This medicine may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop taking this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. If you have any questions or if mild diarrhea continues or gets worse, check with your doctor.

Check with your doctor right away if you or your child have abdominal or stomach cramps; bloating; watery and severe diarrhea, which may also be bloody; nausea or vomiting; or unusual tiredness or weakness. These may be symptoms of a serious intestinal infection.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Check with your doctor right away if you or your child have a rash; itching; swelling of the face, tongue, and throat; trouble with breathing; shortness of breath; or chest pain after you use the medicine.

Before you have any medical tests, tell the medical doctor in charge that you or your child are taking this medicine. The results of some tests may be affected by this medicine.

Patients receiving anticonvulsant therapy (medicines to prevent seizures) may be at risk for a folate (vitamin B9) deficiency, which may increase the risk for side effects. Talk with your doctor if you have concerns about this.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Sulfatrim Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

• Abdominal or stomach pain


• black, tarry stools


• blistering, peeling, or loosening of the skin


• changes in skin color


• chest pain


• chills


• cough or hoarseness


• dark urine


• diarrhea


• dizziness


• fever with or without chills


• general feeling of tiredness or weakness


• headache


• itching


• joint or muscle pain


• light-colored stools


• loss of appetite


• lower back or side pain


• nausea


• pain, tenderness, or swelling of the foot or leg


• painful or difficult urination


• pale skin


• rash


• red irritated eyes


• red skin lesions, often with a purple center


• shortness of breath


• sore throat


• sores, ulcers, or white spots in the mouth or on the lips


• swollen or painful glands


• tightness in the chest


• unpleasant breath odor


• unusual bleeding or bruising


• vomiting of blood


• wheezing


• yellow eyes or skin

Incidence not known

• Abdominal or stomach tenderness


• back, leg, or stomach pains


• bleeding gums


• blindness or vision changes


• blisters, hives, or itching


• bloating


• blood in the urine or stools


• bluish-colored lips, fingernails, or palms


• burning, crawling, itching, numbness, painful, prickling, "pins and needles", or tingling feelings


• burning of the face or mouth


• chest pain


• cloudy urine


• confusion


• constipation


• continuing ringing or buzzing or other unexplained noise in the ears


• convulsions


• cracks in the skin


• decreased frequency or amount of urine


• diarrhea, watery and severe, which may also be bloody


• difficulty with breathing


• difficulty with swallowing


• fainting spells


• general body swelling


• general feeling of discomfort or illness


• hair loss


• hearing loss


• hives


• increased blood pressure


• increased thirst


• indigestion


• irregular heartbeat


• large, flat, blue, or purplish patches in the skin


• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs


• loss of heat from the body


• muscle or joint pain


• nosebleeds


• not able to pass urine


• numbness or tingling in the hands, feet, or lips


• pain or burning while urinating


• pinpoint red spots on the skin


• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue


• raised red swellings on the skin, the buttocks, legs, or ankles


• redness of the white part of the eyes


• redness, swelling, or soreness of the tongue


• sores, ulcers, or white spots on the lips or in the mouth


• soreness of the muscles


• stiff neck or back


• swelling of the face, hands, legs, and feet


• unsteadiness, trembling, or other problems with muscle control or coordination


• unusual weight loss


• weakness in the hands or feet


• weakness or heaviness of the legs


• weight gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Passing of gas

Incidence not known

• Discouragement


• feeling of constant movement of self or surroundings


• feeling sad or empty


• increased sensitivity of skin to sunlight


• irritability


• lack of feeling or emotion


• loss of interest or pleasure


• nervousness


• redness or other discoloration of the skin


• seeing, hearing, or feeling things that are not there


• sensation of spinning


• severe sunburn


• sleeplessness


• trouble concentrating


• trouble sleeping


• unable to sleep


• uncaring


• weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Sulfatrim side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Sulfatrim resources

• Sulfatrim Side Effects (in more detail)
• Sulfatrim Use in Pregnancy & Breastfeeding
• Sulfatrim Drug Interactions
• Sulfatrim Support Group
• 0 Reviews for Sulfatrim - Add your own review/rating

• Sulfatrim Suspension MedFacts Consumer Leaflet (Wolters Kluwer)


• Bactrim Prescribing Information (FDA)


• Bactrim Consumer Overview


• Bactrim MedFacts Consumer Leaflet (Wolters Kluwer)


• Bactrim DS Prescribing Information (FDA)


• Cotrim Consumer Overview


• Septra Prescribing Information (FDA)


• Septra Consumer Overview

Compare Sulfatrim with other medications

• Acne
• Bacterial Infection
• Bacterial Skin Infection
• Bronchitis
• Diverticulitis
• Epiglottitis
• Granuloma Inguinale
• Infection Prophylaxis
• Kidney Infections
• Melioidosis
• Meningitis
• Nocardiosis
• Otitis Media
• Pneumocystis Pneumonia
• Pneumocystis Pneumonia Prophylaxis
• Pneumonia
• Prevention of Bladder infection
• Prostatitis
• Shigellosis
• Sinusitis
• Toxoplasmosis
• Toxoplasmosis, Prophylaxis
• Traveler's Diarrhea
• Upper Respiratory Tract Infection
• Urinary Tract Infection