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Thursday, April 19, 2012

Triamcinolone Acetonide eent

Class: Corticosteroids
ATC Class: S02CA04
VA Class: NT200
Chemical Name: (11β,16α) - 9 - Fluoro - 11,21 - dihydroxy - 16,17 - [(1 - methylethylidene)bis(oxy)] - pregna - 1,4 - diene - 3,20 - dione
Molecular Formula: C₂₄H₃₁FO₆
CAS Number: 76-25-5
Brands: Nasacort

Introduction

Synthetic corticosteroid.¹ ² ³

Uses for Triamcinolone Acetonide

Allergic Rhinitis

Symptomatic treatment of seasonal or perennial allergic rhinitis.¹ ² ³ ⁴ ⁵ ⁶ ⁷ ⁸ ⁹ ¹⁰ ¹¹ ¹⁷

Triamcinolone Acetonide Dosage and Administration

General

For therapeutic effectiveness, use at regular intervals.^b

Administration

Intranasal Administration

Administer by nasal inhalation using a metered-dose nasal spray pump.² ³ ⁴ ⁵ ⁸ ^b

Shake inhaler gently immediately prior to use.^b

Prior to initial use, the metered-dose pump spray must be primed with 5 actuations or until a fine mist appears.^c Prime pump after a period of nonuse (i.e., > 2 weeks) by actuating once.²

Clear nasal passages prior to administration.^c

Tilt the head slightly forward, insert the spray tip into one nostril, and point the tip toward the back of the nose.^c Pump the drug into one nostril while holding the other nostril closed and concurrently inspire through the nose.^c Repeat this procedure for the other nostril.^c

Dosage

After priming, nasal spray pump delivers about 55 mcg of triamcinolone acetonide per metered spray and about 30 or 120 metered doses per 6.5-g or 16.5-g container, respectively.² ^b

Once optimal symptomatic relief is achieved, reduce dosage gradually to the lowest effective level.¹ ² ³

Intranasal triamcinolone acetonide should not be continued beyond 3 weeks in the absence of adequate symptomatic improvement.¹ ² ¹⁶ ^b

Pediatric Patients

Seasonal Allergic Rhinitis

Intranasal Inhalation

Children 6–11 years of age: Initially 55 mcg (1 spray) in each nostril once daily (110 mcg total).² May be increased to 110 mcg (2 sprays) in each nostril once daily (220 mcg total).²

Children ≥12 years of age: 110 mcg (2 sprays) in each nostril once daily (220 mcg total).²

Perennial Allergic Rhinitis

Intranasal Inhalation

Children 6–12 years of age: Initially 55 mcg (1 spray) in each nostril once daily (110 mcg total).² ^b Maximum, 110 mcg (2 sprays) in each nostril once daily (220 mcg total).² ^b

Children ≥12 years of age: Initially 110 mcg (2 sprays) in each nostril once daily (220 mcg total).²

Adults

Seasonal Allergic Rhinitis

Intranasal Inhalation

110 mcg (2 sprays) in each nostril once daily (220 mcg total).²

Perennial Allergic Rhinitis

Intranasal Inhalation

110 mcg (2 sprays) in each nostril once daily (220 mcg total).²

Prescribing Limits

Pediatric Patients

Seasonal or Perennial Allergic Rhinitis

Intranasal Inhalation

Children 6–12 years of age: Maximum 220 mcg (2 sprays in each nostril) daily.² ^b

Adults

Seasonal or Perennial Allergic Rhinitis

Intranasal Inhalation

Maximum 220 mcg (2 sprays in each nostril) daily.^b

Perennial Allergic Rhinitis

Intranasal Inhalation

Maximum 220 mcg (2 sprays in each nostril) daily.^b

Special Populations

Hepatic Impairment

No specific dosage recommendations at this time.¹ ² ¹⁷

Renal Impairment

No specific dosage recommendations at this time.¹ ² ¹⁷

Geriatric Patients

No specific dosage recommendations at this time.¹ ² ¹⁷

Cautions for Triamcinolone Acetonide

Contraindications

Known hypersensitivity to triamcinolone acetonide or any ingredient in the formulation.¹ ² ¹⁷

Warnings/Precautions

Warnings

Withdrawal of Systemic Corticosteroid Therapy

Possible corticosteroid withdrawal symptoms (e.g., joint pain, muscular pain, lassitude, depression), acute adrenal insufficiency, or severe symptomatic exacerbation of asthma or other clinical conditions if prolonged systemic corticosteroid therapy is replaced with topical corticosteroid therapy; careful monitoring recommended.¹ ² ³ ¹⁷

Use particular caution in patients with associated asthma or other conditions that may be exacerbated by too rapid a reduction in systemic corticosteroid dosage.^b

Taper the dosage of the systemic corticosteroid, and carefully monitor patients during dosage reduction.¹ ² ¹⁷ In general, the greater the dosage and duration of systemic corticosteroid therapy, the greater the time required for withdrawal of systemic corticosteroids and replacement by intranasal corticosteroids.¹⁶

Immunosuppressed Patients

Increased susceptibility to infections in patients who are taking immunosuppressant drugs.¹ ² ¹⁷ Certain infections (e.g., varicella [chickenpox], measles) can be serious or fatal in such patients, particularly in children.¹ ² ¹⁷

Exposure to varicella and measles should be avoided in previously unexposed patients.¹ ² ¹⁷ If exposure to varicella (chickenpox) or measles occurs in susceptible patients, consider administering varicella zoster immune globulin (VZIG) or pooled IM immune globulin (IG) respectively.¹ ² ¹⁷ Consider treatment with antiviral agents if varicella (chickenpox) develops.¹ ²

General Precautions

Systemic Corticosteroid Effects

Possible growth suppression in pediatric patients.¹ ² ¹⁷ (See Pediatric Use under Cautions.)

Excessive intranasal dosages or use in patients who are particularly sensitive to corticosteroid effects may increase risk of systemic corticosteroid effects (e.g., hypercortism or adrenal suppression).^b Avoid exceeding the recommended dosages.¹ ² ¹⁷

Nasopharyngeal Effects

Rarely, localized candidial infections of the nose and/or pharynx has been reported.¹ ² ¹⁷ Local treatment of such infections and/or discontinuance of intranasal therapy may be required.¹ ² ¹⁷

Nasal septal perforations have been reported rarely.¹ ² ¹⁷

Use with caution until healing occurs in patients with recent nasal septal ulcers, nasal surgery, or nasal trauma.¹ ² ³ ¹⁷

Concomitant Infections

Use with extreme caution, if at all, in patients with clinical tuberculosis or asymptomatic Mycobacterium tuberculosis infections of the respiratory tract; untreated fungal or bacterial infections; or ocular herpes simplex; or untreated, systemic viral infections.¹ ² ³ ¹⁶ ¹⁷

Specific Populations

Pregnancy

Category C.^b Use during pregnancy may result in hypoadrenalism in infants;^b monitor these infants carefully.^b

Lactation

Not known whether triamcinolone acetonide is distributed in milk.¹ ² ¹⁷ Caution if used in nursing women.¹ ² ¹⁷

Pediatric Use

Safety and efficacy not established in children <6 years of age.¹ ²

Corticosteroids, particularly with high doses for extended periods may cause growth suppression in pediatric patients.¹ ² ¹⁷ Titrate dosage to the lowest possible effective level.^b

Geriatric Use

Response similar to that in younger adults.^b

Common Adverse Effects

Pharyngitis, epistaxis, increased cough.² ³

Triamcinolone Acetonide Pharmacokinetics

Absorption

Bioavailability

Systemic absorption is minimal.¹ ² ³ Mean peak plasma concentrations achieved at 1.5 hours following nasal inhalation.² ³

Onset

Symptomatic relief may be evident 10–16 hours following initiation of therapy.⁴ ⁵ ⁸ ¹² ¹⁶ Maximum benefit is usually achieved within 1 week.^b

Distribution

Extent

The volume of distribution is 99.5 L.^b

Special Populations

In pediatric patients, similar extent of absorption, peak concentrations, and time to peak concentrations compared to adult patients.^b

Elimination

Metabolism

Metabolized to metabolites that are substantially less active than the parent drug.^b

Half-life

3.1 hours.^b

Stability

Storage

Intranasal Suspension

20–25°C.^b

ActionsActions

Potent glucocorticoid¹ ² ¹⁷ ^b and weak mineralocorticoid effects.³ ¹⁶

May reduce the number of mediator cells (basophils, eosinophils, T-helper cells, mast cells, and neutrophils) in the nasal mucosa.

Decreases nasal reactivity to allergens and decreases release of inflammatory mediators and proteolytic enzymes.

Advice to Patients

Provide copy of manufacturer’s patient information.^b

Importance of understanding proper storage, preparation, and administration techniques.¹ ² ¹⁷

Importance of shaking container gently prior to each use.¹ ²

Importance of avoiding spraying drug directly onto nasal septum.¹ ¹⁷

Advise patients that containers of triamcinolone acetonide nasal spray should be discarded after 120 actuations.¹ ²

Importance of taking as directed and not exceeding prescribed dosage.¹ ² ¹⁷

Importance of regular use to obtain therapeutic effectiveness.^b

Importance of contacting a clinician if symptoms worsen or fail to improve after 3 weeks.¹ ² ¹⁷ ^b

Necessity of reporting recurrent epistaxis, nasal septum discomfort, irritation, burning, and/or stinging to clinicians.¹ ² ¹⁷

Importance of avoiding exposure to chickenpox or measles in patients receiving immunosuppressant doses of corticosteroids and, if exposure occurs, consulting a clinician.¹ ² ¹⁷ ^b

Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses.¹ ² ¹⁷

Importance of women informing clinicians if they are or plan to become pregnant or to breast-feed.¹ ² ¹⁷

Importance of advising patients of other important precautionary information.^b (See Cautions.)

Preparations

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

Triamcinolone Acetonide
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Nasal	Suspension	55 mcg/metered spray	Nasacort AQ Nasal Spray (with benzalkonium chloride)	Aventis

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 November 2004. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

Only references cited for selected revisions after 1984 are available electronically.

1. Aventis. Nasacort (triamcinolone acetonide) nasal inhaler prescribing information. In: Physicians’ desk reference. 55th ed. Montvale, NJ; Medical Economics Company Inc; 2001:717-9.

2. Aventis. Nasacort AQ (triamcinolone acetonide) prescribing information (dated 1997 Oct). In: Physician’s desk reference. 55th ed. Montvale, NJ: Medical Economics Company, Inc; 2001:719-20.

3. Jeal W, Faulds D. Triamcinolone acetonide: a review of its pharmacological properties and therapeutic efficacy in the management of allergic rhinitis. Drugs. 1997; 53:257-80.

4. Settipane G, Korenblat PE, Winder J et al. Triamcinolone acetonide aqueous nasal spray in patients with seasonal ragweed allergic rhinitis: a placebo-controlled, double-blind study. Clin Ther. 1995; 17:252-63.

5. Munk ZM, LaForce C, Furst JA et al. Efficacy and safety of triamcinolone acetonide aqueous nasal spray in patients with seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 1996; 77:277-81.

6. Findlay S, Huber F, Garcia J et al. Efficacy of once-a-day intranasal administration of triamcinolone acetonide in patients with seasonal allergic rhinitis. Ann Allergy. 1992; 68:228-32.

7. Banov CH, Silvers WS, Green AW et al. Placebo-controlled, double-blind study of the efficacy and safety of triamcinolone acetonide aerosol nasal inhaler in pediatric patients with seasonal allergic rhinitis. Clin Ther. 1996; 18:265-72.

8. Kobayashi RH, Beaucher WN, Koepke JW et al. Triamcinolone acetonide aqueous nasal spray for the treatment of patients with perennial allergic rhinitis: a multicenter, randomized, double-blind, placebo-controlled study. Clin Ther. 1995; 17:503-13.

9. Spector S, Bronsky E, Chervinsky P et al. Multicenter, double-blind, placebo-controlled trial of triamcinolone acetonide nasal aerosol in the treatment of perennial allergic rhinitis. Ann Allergy. 1990; 64:300-5.

10. Storms W, Bronsky E, Findlay S et al. Once daily triamcinolone acetonide nasal spray is effective for the treatment of perennial allergic rhinitis [published erratum appears in Ann Allergy 1991; 66:457]. Ann Allergy. 1991; 66:329-34.

11. Welch MJ, Bronsky EA, Grossman J et al. Clinical evaluation of triamcinolone acetonide nasal aerosol in children with perennial allergic rhinitis.Ann Allergy. 1991; 67:493-8.

12. Day JH, Buckeridge DL, Clark RH et al. A randomized, double-blind, placebo-controlled, controlled antigen delivery study of the onset of action of aerosolized triamcinolone acetonide nasal spray in subjects with ragweed-induced allergic rhinitis. J Allergy Clin Immunol. 1996; 97:1050-7.

13. Howland WC III, Dockhorn R, Gillman S et al. A comparison of effects of triamcinolone acetonide aqueous nasal spray, oral prednisone, and placebo on adrenocortical function in male patients with allergic rhinitis. J Allergy Clin Immunol. 1996; 98:32-8.

14. Feiss G, Morris R, Rom D et al. A comparative study of the effects of intranasal triamcinolone acetonide aerosol (ITAA) and prednisone on adrenocortical function. J Allergy Clin Immunol. 1992; 89:1151-6.

15. Nayak AS, Ellis MH, Gross GN et al. The effects of triamcinolone acetonide aqueous nasal spray on adrenocortical function in children with allergic rhinitis. J Allergy Clin Immunol. 1998; 101(2 Pt 1):157-62.

16. Aventis, Bridgewater, NJ: Personal communication.

17. Muro. Tri-Nasal (triamcinolone acetonide) nasal spray prescribing information. Tewksbury, MA; 2000 Feb.

b. Aventis. Nasacort AQ (triamcinolone acetonide) prescribing information. Bridgewater, NJ; 2004 Mar.

c. Aventis. Nasacort AQ (triamcinolone acetonide) patient information. Bridgewater, NJ; 2004 Mar.

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Hay Fever

Sunday, April 15, 2012

Keppra XR

Generic Name: levetiracetam (Oral route)

lee-va-tye-RA-se-tam

Commonly used brand name(s)

In the U.S.

Keppra

Keppra XR

Available Dosage Forms:

Tablet, Extended Release

Tablet

Solution

Therapeutic Class: Anticonvulsant

Uses For Keppra XR

Levetiracetam is used to help control certain types of seizures in the treatment of epilepsy. This medicine cannot cure epilepsy and will only work to control seizures for as long as you continue to use it.

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

Before Using Keppra XR

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 have not been performed on the relationship of age to the effects of levetiracetam oral solution or tablets in children younger than 1 month of age, and levetiracetam extended-release tablets in teenagers and children younger than 16 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of levetiracetam in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment in the dose for patients receiving levetiracetam.

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

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.

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 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.

Ketorolac

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.

Carbamazepine

Ginkgo

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.

Proper Use of levetiracetam

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

Take this medicine only as directed by your doctor, to help your condition as much as possible. 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. Also, do not change your dose without checking first with your doctor.

This medicine comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Levetiracetam may be taken with or without food or on a full or empty stomach. However, if your doctor tells you to take the medicine a certain way, take it exactly as directed. You should try to take this medicine at the same time each day.

Swallow the tablet or the extended-release tablet whole. Do not break, crush, or chew it. There is an oral liquid form of this medicine if you or your child cannot swallow the tablets.

Measure the oral liquid with a marked measuring spoon, dropper, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid. If you have any questions about this, ask your doctor or pharmacist.

This medicine can be used with other seizure medicines. Keep using all of your seizure medicines unless your doctor tells you to stop.

Take only the form of this medicine that your doctor prescribed. If you refill your prescription and your pills look different, do not take the medicine and tell your doctor or pharmacist right away.

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 partial seizures:
- For oral dosage form (extended-release tablets):
  - Adults and teenagers 16 years of age and older—At first, 1000 milligrams (mg) once a day. Your doctor may increase your dose as needed and tolerated. However, the dose is usually not more than 3000 mg per day.
  - Teenagers and children younger than 16 years of age—Use and dose must be determined by your doctor.
- For oral dosage forms (solution or tablets):
  - Adults and teenagers 16 years of age and older—At first, 500 milligrams (mg) two times a day. Your doctor may increase your dose as needed and tolerated. However, the dose is usually not more than 3000 mg per day.
  - Teenagers and children 4 to 15 years of age—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 10 milligram (mg) per kilogram (kg) of body weight two times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 60 mg per kg of body weight per day.
  - Children and infants 6 months to 3 years of age—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 10 mg per kg of body weight two times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 50 mg per kg of body weight per day.
  - Infants 1 to 5 months of age—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 7 mg per kg of body weight two times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 42 mg per kg of body weight per day.
  - Infants younger than 1 month of age—Use and dose must be determined by your doctor.

For juvenile myoclonic seizures:
- For oral dosage forms (solution or tablets):
  - Children 12 years of age and older—At first, 500 milligrams (mg) two times a day. Your doctor may increase your dose as needed and tolerated. However, the dose is usually not more than 3000 mg per day.
  - Children younger than 12 years of age—Use and dose must be determined by your doctor.

For primary generalized tonic-clonic seizures:
- For oral dosage forms (solution or tablets):
  - Adults and teenagers 16 years of age and older—At first, 500 milligrams (mg) two times a day. Your doctor may increase your dose as needed and tolerated. However, the dose is usually not more than 3000 mg per day.
  - Teenagers and children 6 to 15 years of age—Dose is based on body weight and must be determined by your doctor. The usual starting dose is 10 milligram (mg) per kilogram (kg) of body weight two times a day. Your doctor may increase your dose as needed and tolerated. However, the dose is usually not more than 60 mg per kg of body weight per day.
  - Children younger than 6 years of age—Use and dose must be determined by your doctor.

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 Keppra XR

It is very important that your doctor check your or your child's progress at regular visits, especially for the first few months you or your child are taking this medicine. This is necessary to allow dose adjustments and to reduce any unwanted effects.

Make sure your doctor knows if you are pregnant or planning to become pregnant. Your doctor may want you to join the UCB AED Pregnancy Registry or North American Antiepileptic Drug Pregnancy Registry. These registries are used by pregnant patients who are using this medicine.

Levetiracetam may cause changes in mood or behavior, clumsiness or unsteadiness, or unusual tiredness or weakness. Tell your doctor right away if you or your child start to feel depressed, anxious, angry, irritable, restless, or have thoughts about hurting yourself. Report any unusual thoughts or behavior that trouble you, especially if they are new or getting worse quickly.

This medicine may cause some people to become dizzy, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.

Serious skin reactions can occur with this medicine. Stop using this medicine and check with your doctor right away if you or your child have blistering, peeling, or loosening of the skin; red skin lesions; severe acne or skin rash; sores or ulcers on the skin; or fever or chills while you are using this medicine.

Do not stop taking levetiracetam without first checking with your doctor. Stopping the medicine suddenly may cause your seizures to return or to occur more often. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.

Keppra XR 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:

More common

Aggressive or angry

anxiety

change in personality

chills

cough or hoarseness

crying

depersonalization

diarrhea

dry mouth

euphoria

fever

general feeling of discomfort or illness

headache

hyperventilation

irregular heartbeats

irritability

joint pain

loss of appetite

lower back or side pain

mental depression

muscle aches and pains

nausea

nervousness

painful or difficult urination

paranoia

quick to react or overreact emotionally

rapidly changing moods

restlessness

shaking

shivering

shortness of breath

sleepiness or unusual drowsiness

sore throat

stuffy or runny nose

sweating

trouble with sleeping

unusual tiredness or weakness

vomiting

Less common

Bloody nose

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

clumsiness or unsteadiness

discouragement

dizziness or lightheadedness

double vision

earache

fear or nervousness

feeling of constant movement of self or surroundings

feeling sad or empty

increase in body movements

loss of bladder control

loss of memory

mood or mental changes

outburst of anger

pain or tenderness around the eyes and cheekbones

problems with memory

redness or swelling in the ear

seizures

sensation of spinning

shakiness and unsteady walk

shakiness in the legs, arms, hands, or feet

tightness of the chest or wheezing

tiredness

trembling or shaking of the hands or feet

trouble concentrating

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

Incidence not known

Attempts at killing oneself

being forgetful

bleeding gums

blistering, peeling, or loosening of the skin

bloating

blood in the urine or stools

bloody, black, or tarry stools

blurred vision

changes in vision

chest pain

constipation

dark urine

difficulty with moving

fast heartbeat

general feeling of tiredness or weakness

high fever

increase in body movements

indigestion

itching

light-colored stools

muscle pains or stiffness

painful or difficult urination

pains in the stomach, side, or abdomen, possibly radiating to the back

pale skin

pinpoint red spots on the skin

red skin lesions, often with a purple center

red, irritated eyes

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

stomach pain, continuing

swollen glands

swollen joints

thoughts or attempts at killing oneself

trouble with balance

twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs

uncontrolled jerking or twisting movements of the hands, arms, or legs

uncontrolled movements of the lips, tongue, or cheeks

unexplained bleeding or bruising

unusual bleeding or bruising

upper right abdominal or stomach pain

weight loss

yellow eyes or skin

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

Loss of strength or energy

muscle pain or weakness

pain

tender, swollen glands in the neck

trouble with swallowing

unusual weak feeling

voice changes

Less common

Body aches or pain

burning, dry, or itching eyes

change in the color of the skin

congestion

cough increased

rash

sneezing

Incidence not known

Hair loss or thinning of the hair

skin rash, encrusted, scaly, and oozing

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: Keppra XR side effects (in more detail)

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More Keppra XR resources

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

Keppra XR Extended-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

Keppra Prescribing Information (FDA)

Keppra Consumer Overview

Keppra Monograph (AHFS DI)

Keppra MedFacts Consumer Leaflet (Wolters Kluwer)

Levetiracetam Prescribing Information (FDA)

Levetiracetam Professional Patient Advice (Wolters Kluwer)

Compare Keppra XR with other medications

Bipolar Disorder
Epilepsy
Hyperekplexia
Neuralgia
New Daily Persistent Headache
Seizures

Friday, April 13, 2012

Triaminic Long Acting Cough

Generic Name: dextromethorphan (dex troe meth OR fan)

Brand Names: Babee Cof, Benylin DM Pediatric, Buckley's Mixture Cough Suppressant, Buckleys Mixture, Creo-Terpin, Creomulsion, Delsym, Delsym 12 Hour Cough Relief, Delsym 12 Hour Cough Relief for Children & Adults, DexAlone, Elixsure Cough, Hold DM, Pediacare, Robitussin CoughGels, Robitussin Honey Cough, Robitussin Maximum Strength, Robitussin Pediatric Cough Suppressant, Scot-Tussin Diabetic, Scot-Tussin DM Cough Chasers, Silphen DM, St. Joseph Cough Suppressant, Sucrets DM Cough, Theraflu Thin Strips Cough, Triaminic Long Acting Cough, Triaminic Softchew, Vicks 44 Cough Relief

What is Triaminic Long Acting Cough (dextromethorphan)?

Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Dextromethorphan is used to treat a cough.

Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.

Dextromethorphan may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Triaminic Long Acting Cough (dextromethorphan)?

Do not give this medication to a child younger than 4 years old. 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. Do not use dextromethorphan 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 dextromethorphan before the MAO inhibitor has cleared from your body. Do not use any other over-the-counter cough, cold, or allergy 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 dextromethorphan. Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.

What should I discuss with my healthcare provider before taking Triaminic Long Acting Cough (dextromethorphan)?

Do not use dextromethorphan 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 dextromethorphan before the MAO inhibitor has cleared from your body.

Ask a doctor or pharmacist about using this medicine if you have emphysema or chronic bronchitis.

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.

Artificially-sweetened liquid forms of cough medicine may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.

How should I take Triaminic Long Acting Cough (dextromethorphan)?

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. Cough medicine is usually taken only for a short time until your symptoms clear up.

Do not give this medication to a child younger than 4 years old. 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.

Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Allow the dextromethorphan lozenge or disintegrating strip to dissolve in your mouth.

Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication. 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.

If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cough medicine within the past few days.

Store dextromethorphan at room temperature, away from heat, light, and moisture.

What happens if I miss a dose?

Since cough medicine is usually taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. 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.

What should I avoid while taking Triaminic Long Acting Cough (dextromethorphan)?

Avoid drinking alcohol. It can increase some of the side effects of dextromethorphan. 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 taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with cough medicine can increase your risk of unpleasant side effects.

Do not use any other over-the-counter cough, cold, or allergy medication without first asking your doctor or pharmacist. Dextromethorphan is contained in many combination medicines available over the counter. If you take certain products together you may accidentally take too much of this medicine. Read the label of any other medicine you are using to see if it contains dextromethorphan.

Triaminic Long Acting Cough (dextromethorphan) 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 dextromethorphan and call your doctor at once if you have any of these serious side effects:

severe dizziness, anxiety, restless feeling, or nervousness;

confusion, hallucinations; or

slow, shallow breathing.

Less serious side effects are more likely, such as stomach upset.

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 Triaminic Long Acting Cough (dextromethorphan)?

Before taking dextromethorphan, tell your doctor if you are using any of the following drugs:

celecoxib (Celebrex);

cinacalcet (Sensipar);

darifenacin (Enablex);

imatinib (Gleevec);

quinidine (Quinaglute, Quinidex);

ranolazine (Ranexa)

ritonavir (Norvir);

sibutramine (Meridia);

terbinafine (Lamisil);

medicines to treat high blood pressure; or

antidepressant medications such as amitriptyline (Elavil, Etrafon), bupropion (Wellbutrin, Zyban), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Janimine, Tofranil), paroxetine (Paxil), sertraline (Zoloft), and others.

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

More Triaminic Long Acting Cough resources

Triaminic Long Acting Cough Side Effects (in more detail)
Triaminic Long Acting Cough Use in Pregnancy & Breastfeeding
Triaminic Long Acting Cough Drug Interactions
0 Reviews for Triaminic Long Acting Cough - Add your own review/rating

Triaminic Long Acting Cough Orally Disintegrating Strips MedFacts Consumer Leaflet (Wolters Kluwer)

Creo-Terpin Advanced Consumer (Micromedex) - Includes Dosage Information

Delsym Extended-Release Liquid MedFacts Consumer Leaflet (Wolters Kluwer)

DexAlone MedFacts Consumer Leaflet (Wolters Kluwer)

Dextromethorphan Hydrobromide Monograph (AHFS DI)

ElixSure Cough Gel Syrup MedFacts Consumer Leaflet (Wolters Kluwer)

Robitussin Maximum Strength Liquid MedFacts Consumer Leaflet (Wolters Kluwer)

Tussin Pediatric Elixir MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Triaminic Long Acting Cough with other medications

Cough

Where can I get more information?

Your pharmacist can provide more information about dextromethorphan.

See also: Triaminic Long Acting Cough side effects (in more detail)

Monday, April 9, 2012

Treprostinil injection

Generic Name: treprostinil injection (tre PROS ti nil)

Brand Names: Remodulin

What is treprostinil injection?

Treprostinil dilates (or widens) the arteries and decreases the amount of blood clotting platelets in your body. These effects lower blood pressure in the pulmonary artery that leads from the heart to the lungs.

Treprostinil is used to treat pulmonary arterial hypertension (PAH). It improves your ability to exercise and prevents your condition from getting worse.

Treprostinil may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about treprostinil injection?

Before using this medication, tell your doctor if you have low blood pressure, liver disease, or a bleeding or blood clotting disorder.

Your doctor may want you to be in a hospital when you start using treprostinil. This is so you can be watched for any signs of serious side effects from the medicine.

You will probably have to use this medicine for several months or years to control your condition and keep it from getting worse.

Use treprostinil regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. Make sure you have a backup infusion pump and infusion sets available so as not to interrupt your treatment if one infusion pump stops working.

Call your doctor if your symptoms do not improve or if they get worse.

What should I discuss with my healthcare provider before using treprostinil injection?

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication:

low blood pressure;

liver disease; or

bleeding or blood clotting disorder.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether treprostinil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How is treprostinil injection given?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.

Treprostinil is given as an continuous (around-the-clock) injection using an infusion pump. The medicine enters the body through a catheter placed under your skin or into a vein. Your doctor, nurse, or pharmacist will give you specific instructions on how to use an infusion pump and inject your medicine. Do not give yourself an injection if you do not understand these instructions. Call your doctor, nurse, or pharmacist for help with injection instructions.

Your doctor may want you to be in a hospital when you start using treprostinil. This is so you can be watched for any signs of serious side effects from the medicine.

You will probably have to use this medicine for several months or years to control your condition and keep it from getting worse.

Do not use the medication if it has changed colors or has any particles in it. Call your doctor for a new prescription.

Store unopened vials (bottles) of treprostinil at room temperature away from moisture and heat. After the medicine has been placed into a syringe or pump, it should be given within 72 hours. If the medicine has been diluted (mixed with a liquid), you must use the medicine within 48 hours after mixing. Call your doctor if your symptoms do not improve or if they get worse.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of treprostinil.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include warmth and redness or tingling under your skin, headache, feeling light-headed, fainting, nausea, vomiting, diarrhea, or seizure (convulsions).

What should I avoid while using treprostinil injection?

Do not stop using treprostinil without first talking to your doctor. You may need to use less and less before you stop the medication completely.

Treprostinil injection 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. Call your doctor at once if you have any of these serious side effects:

new or worsening PAH symptoms such as feeling short of breath (even with mild exertion), tiredness, chest pain, and pale skin;

swelling in your hands or feet; or

feeling like you might pass out.

Less serious side effects may include:

pain, swelling, redness, bleeding, or a hard lump where your catheter is placed;

dizziness;

mild skin rash;

headache or jaw pain;

flushing (warmth, redness or tingling); or

diarrhea or nausea.

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.

Treprostinil injection Dosing Information

Usual Adult Dose for Pulmonary Hypertension:

Infusion:
Initial dose: 1.25 nanogram/kg per minute by continuous infusion. The subcutaneous route is preferred but the drug may be administered by a central intravenous line if the subcutaneous route is not tolerated. The rate may be decreased to 0.625 nanogram/kg/minute if the initial dose is not tolerated by the patient.
Maintenance dose: The infusion rate may be increased in increments of no more than 1.25 nanogram/kg/minute per week for the first 4 weeks, and thereafter by no more than 2.5 nanograms/kg/minute per week. Dosage adjustments should be titrated to a dose where PAH symptoms are improved and adverse effects are minimized (headache, nausea, emesis, restlessness, anxiety, and infusion site pain or reaction). Although doses of up to 100 nanograms/kg/minute have been reported, there is little experience with doses greater than 40 nanograms/kg/minute.

Inhalation:
Use only with the Tyvaso Inhalation System. Administer undiluted, as supplied. A single breath of Tyvaso delivers approximately 6 mcg of treprostinil
Initial dosage: 3 breaths [18 mcg] per treatment session. If 3 breaths are not tolerated, reduce to 1 or 2 breaths. Administer in 4 separate treatment sessions each day approximately four hours apart, during waking hours.
Maintenance dose: Dosage should be increased by an additional 3 breaths at approximately 1-2 week intervals, if tolerated. Titrate to target maintenance dosage of 9 breaths or 54 mcg per treatment session as tolerated.

Usual Pediatric Dose for Pulmonary Hypertension:

Inhalation:
Less than 16 years: Safety and efficacy have not been established.
16 to 18 years:
Initial dose: 1.25 nanogram/kg per minute by continuous infusion. The subcutaneous route is preferred but the drug may be administered by a central intravenous line if the subcutaneous route is not tolerated. The rate may be decreased to 0.625 nanogram/kg/minute if the initial dose is not tolerated by the patient.
Maintenance dose: The infusion rate may be increased in increments of no more than 1.25 nanogram/kg/minute per week for the first 4 weeks, and thereafter by no more than 2.5 nanograms/kg/minute per week. Dosage adjustments should be titrated to a dose where PAH symptoms are improved and adverse effects are minimized (headache, nausea, emesis, restlessness, anxiety, and infusion site pain or reaction). There is little experience with doses greater than 40 nanograms/kg/minute.

What other drugs will affect treprostinil injection?

Tell your doctor about all other medicines you use, especially:

gemfibrozil (Lopid);

a blood thinner such as warfarin (Coumadin);

blood pressure medication such as a diuretic (water pill); or

medication used to prevent blood clots, such as alteplase (Activase), cilostazol (Pletal), clopidogrel (Plavix), dipyridamole (Persantine), ticlopidine (Ticlid), and urokinase (Abbokinase).

This list is not complete and other drugs may interact with treprostinil. 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 treprostinil injection resources

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

Compare treprostinil injection with other medications

Pulmonary Arterial Hypertension

Where can I get more information?

Your doctor or pharmacist can provide more information about treprostinil injection.

See also: treprostinil side effects (in more detail)

Tuesday, April 3, 2012

Sulfacetamide sodium and sulfur topical

Generic Name: sulfacetamide sodium and sulfur topical (SUL fa SEET a mide SOE dee um and SUL fur TOP i kal)

Brand names: Avar Cleanser, Avar Gel, Avar LS Cleanser, Avar-E, Avar-E Emollient, Avar-E Green, Avar-e LS, BP 10-Wash, Clarifoam EF, Clenia Emollient Cream, Clenia Foaming Wash, Plexion, Plexion Cleanser, Plexion Cleansing Cloths, Plexion SCT, Prascion, Prascion Cleanser, Prascion FC Cloths, Prascion RA, Rosac, Rosac Wash, Rosaderm Cleanser, Rosanil Cleanser, Rosula, SE 10-5 SS, Sulfacet-R, Sulfatol C, Sulfatol SS, SulZee Wash, Sumaxin, Sumaxin TS, Sumaxin Wash, Suphera, Topisulf, Zencia Wash, Zetacet, ...show all 49 brand names.

What is sulfacetamide sodium and sulfur topical?

Sulfacetamide sodium and sulfur are antibiotic that fight bacteria.

The combination of sulfacetamide sodium and sulfur topical (for the skin) is used to treat acne, rosacea, and seborrheic dermatitis (a red, flaking skin rash).

Sulfacetamide sodium and sulfur topical may also be used for purposes not listed in this medication guide.

What is the most important information I should know about sulfacetamide sodium and sulfur topical?

You should not use this medication if you are allergy to sulfa drugs or if you have kidney disease. Avoid getting this medication in your eyes, nose, or mouth. If this does happen, rinse with water.

Do not cover the treated skin area unless your doctor has told you to.

Avoid using other medications on the areas you treat with sulfacetamide sodium and sulfur topical unless you doctor tells you to.

What should I discuss with my healthcare provider before using sulfacetamide sodium and sulfur topical?

You should not use this medication if you are allergy to sulfa drugs or if you have kidney disease.

To make sure you can safely use this medication, tell your doctor about all of your medical conditions.

FDA pregnancy category C. It is not known whether sulfacetamide sodium and sulfur topical will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether sulfacetamide sodium and sulfur topical passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use sulfacetamide sodium and sulfur topical?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Wash your hands before and after applying this medication.

Do not cover the treated skin area unless your doctor has told you to.

Use this medication regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using sulfacetamide sodium and sulfur topical?

Avoid getting this medication in your eyes, nose, or mouth. If this does happen, rinse with water. Do not use sulfacetamide sodium and sulfur topical on sunburned, windburned, dry, chapped, irritated, or broken skin.

Avoid using other medications on the areas you treat with sulfacetamide sodium and sulfur topical unless you doctor tells you to.

Sulfacetamide sodium and sulfur topical side effects

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

new or worsening skin rash;

joint pain;

fever; or

mouth sores.

Less serious side effects may include redness, warmth, swelling, itching, stinging, burning, or irritation of treated skin.

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.

Sulfacetamide sodium and sulfur topical Dosing Information

Usual Adult Dose for Acne:

Sulfacetamide sodium-sulfur topical 8%-4% suspension:
1 to 2 times daily, wet skin and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry.

Sulfacetamide sodium-sulfur topical 9%-4% topical liquid:
1 to 2 times daily, wet skin and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry.

Sulfacetamide sodium-sulfur topical 9%-4.5% topical liquid:
1 to 2 times daily, wet skin and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry.

Sulfacetamide sodium-sulfur topical 10%-1% topical liquid:
1 to 2 times daily, wet skin and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry.

Sulfacetamide sodium-sulfur topical 10%-4% topical foam:
Wash affected area. Massage foam into affected area 1 to 2 times daily. If removing, rinse off after 1 to 2 minutes.

Sulfacetamide sodium-sulfur topical 10%-4% topical pad:
1 to 2 times daily, wet skin and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry.

Sulfacetamide sodium-sulfur topical 10%-5% topical foam:
Cleanse thoroughly and pat dry. Massage foam into affected area 1 to 3 times daily.

Sulfacetamide sodium-sulfur topical 10%-5% topical pad:
1 to 2 times daily, wet cloth and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry. Throw cloth away.

Usual Adult Dose for Acne Rosacea:

Usual Adult Dose for Seborrheic Dermatitis:

Usual Pediatric Dose for Acne:

Sulfacetamide sodium-sulfur topical 8%-4% suspension:
12 years or older: 1 to 2 times daily, wet skin and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry.

Sulfacetamide sodium-sulfur topical 9%-4% topical liquid:
12 years or older: 1 to 2 times daily, wet skin and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry.

Sulfacetamide sodium-sulfur topical 9%-4.5% topical liquid:
12 years or older: 1 to 2 times daily, wet skin and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry.

Sulfacetamide sodium-sulfur topical 10%-1% topical liquid:
12 years or older: 1 to 2 times daily, wet skin and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry.

Sulfacetamide sodium-sulfur topical 10%-4% topical foam:
12 years or older: Wash affected area. Massage foam into affected area 1 to 2 times daily. If removing, rinse off after 1 to 2 minutes.

Sulfacetamide sodium-sulfur topical 10%-4% topical pad:
12 years or older: 1 to 2 times daily, wet skin and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry.

Sulfacetamide sodium-sulfur topical 10%-5% topical foam:
12 years or older: Cleanse thoroughly and pat dry. Massage foam into affected area 1 to 3 times daily.

Sulfacetamide sodium-sulfur topical 10%-5% topical pad:
12 years or older: 1 to 2 times daily, wet cloth and work into a full lather. Cleanse face for 10 to 20 seconds. Rinse and pat dry. Throw cloth away.

Usual Pediatric Dose for Acne Rosacea:

Usual Pediatric Dose for Seborrheic Dermatitis:

What other drugs will affect sulfacetamide sodium and sulfur topical?

It is not likely that other drugs you take orally or inject will have an effect on topically applied sulfacetamide sodium and sulfur. But many drugs can interact with each other. 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.

Compare sulfacetamide sodium and sulfur topical with other medications

Acne
Rosacea
Seborrheic Dermatitis

Where can I get more information?

Your pharmacist can provide more information about sulfacetamide sodium and sulfur topical.

See also: sulfacetamide sodium and sulfur side effects (in more detail)

Monday, April 2, 2012

Timoptic Ocumeter

Generic Name: timolol (Ophthalmic route)

TIM-oh-lol

Commonly used brand name(s)

In the U.S.

Betimol

Istalol

Timoptic Ocudose

Timoptic Ocumeter

Timoptic Ocumeter Plus

Timoptic-XE Ocumeter

Timoptic-XE Ocumeter Plus

Available Dosage Forms:

Solution

Gel Forming Solution

Therapeutic Class: Antiglaucoma

Pharmacologic Class: Beta-Adrenergic Blocker, Nonselective

Uses For Timoptic Ocumeter

Timolol is used alone or together with other medicines to treat increased pressure in the eye that is caused by open-angle glaucoma or a condition called ocular (eye) hypertension. This medicine is a beta-blocker .

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

Before Using Timoptic Ocumeter

Allergies

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of timolol in the pediatric population. Safety and efficacy have not been established .

Geriatric

Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of timolol in the elderly .

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

Albuterol

Amiodarone

Arformoterol

Bambuterol

Bitolterol

Broxaterol

Clenbuterol

Clonidine

Colterol

Diltiazem

Dronedarone

Epinephrine

Fenoldopam

Fenoterol

Formoterol

Hexoprenaline

Indacaterol

Isoetharine

Levalbuterol

Metaproterenol

Pirbuterol

Procaterol

Reproterol

Rimiterol

Ritodrine

Salmeterol

Terbutaline

Timolol

Tretoquinol

Tulobuterol

Verapamil

Acarbose

Aceclofenac

Acemetacin

Acetohexamide

Alclofenac

Alfuzosin

Amlodipine

Apazone

Arbutamine

Benfluorex

Benoxaprofen

Bromfenac

Bufexamac

Bunazosin

Carprofen

Chlorpropamide

Cimetidine

Clometacin

Clonixin

Dexketoprofen

Diclofenac

Diflunisal

Digoxin

Dipyrone

Doxazosin

Droxicam

Etodolac

Etofenamate

Felbinac

Felodipine

Fenbufen

Fenoprofen

Fentiazac

Floctafenine

Flufenamic Acid

Flurbiprofen

Gliclazide

Glimepiride

Glipizide

Gliquidone

Glyburide

Guar Gum

Ibuprofen

Indomethacin

Indoprofen

Insulin

Insulin Aspart, Recombinant

Insulin Glulisine

Insulin Lispro, Recombinant

Isoxicam

Ketoprofen

Ketorolac

Lacidipine

Lercanidipine

Lornoxicam

Manidipine

Meclofenamate

Mefenamic Acid

Meloxicam

Metformin

Methyldopa

Mibefradil

Miglitol

Moxisylyte

Nabumetone

Naproxen

Nicardipine

Nifedipine

Niflumic Acid

Nilvadipine

Nimesulide

Nimodipine

Nisoldipine

Nitrendipine

Oxaprozin

Oxyphenbutazone

Phenoxybenzamine

Phentolamine

Phenylbutazone

Pirazolac

Piroxicam

Pirprofen

Pranidipine

Prazosin

Propyphenazone

Proquazone

Quinidine

Repaglinide

St John's Wort

Sulindac

Suprofen

Tamsulosin

Tenidap

Tenoxicam

Terazosin

Tiaprofenic Acid

Tolazamide

Tolbutamide

Tolmetin

Trimazosin

Troglitazone

Urapidil

Zomepirac

Interactions with Food/Tobacco/Alcohol

Proper Use of timolol

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

Shake the regular eye drops well just before each use. If you are using the gel-forming eye drops, turn the bottle upside down and shake it once. You do not need to shake the gel-forming eye drops more than once .

To use the eye drops (solution and gel):

First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 1 or 2 minutes to allow the medicine to be absorbed by the eye.

Immediately after using the medicine, wash your hands to remove any medicine that may be on them.

To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed. Serious damage to the eye and possible loss of vision may result from using contaminated eye medicines .

If your doctor ordered two different eye medicines to be used together, wait at least 10 minutes after the regular eye drops before using the second medicine. This will help prevent the second medicine from “washing out” the first one. The gel-forming eye drops should always be the last medicine used if two medicines are ordered. Wait 10 minutes before using the gel-forming eye drops .

You should not use the regular eye drops if you have contact lenses in your eyes. Remove your contact lenses before you use this medicine. Wait at least 15 minutes after you use the medicine before putting the contact lenses back in .

Dosing

For glaucoma or ocular hypertension:
- For ophthalmic gel-forming solution dosage form (eye drops):
  - Adults—One drop in the affected eye(s) once a day.
  - Children—Use and dose must be determined by your doctor .
- For ophthalmic solution dosage form (eye drops):
  - Adults—One drop in the affected eye(s) two times a day.
  - Children—Use and dose must be determined by your doctor .

Missed Dose

If you miss a dose of this medicine, apply 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.

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 Timoptic Ocumeter

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects .

If itching, redness, swelling, or other signs of eye or eyelid irritation occur, stop using this medicine and check with your doctor. These signs may mean that you are allergic to this medicine .

Timolol may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort; dilated neck veins; extreme fatigue; irregular breathing; an irregular heartbeat; shortness of breath; swelling of the face, fingers, feet, or lower legs; weight gain; or wheezing .

This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests .

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery .

The gel-forming eye drops may cause blurred vision or other vision problems that last about 30 seconds to 5 minutes after you put them in your eye. If any of these occur, do not drive, use machines, or do anything else that could be dangerous if you are not able to see well. If these eye changes are bothersome, check with your doctor .

Timoptic Ocumeter 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:

More common

Blurred vision

burning or stinging in eye

Less common

Arm, back, or jaw pain

blisters, hives, welts, or itching

blue lips, fingernails, or skin

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

change in vision

chest pain or discomfort

chest tightness or heaviness

confusion about identity, place, and time

continuing ringing or buzzing or other unexplained noise in ears

coughing that sometimes produces a pink frothy sputum

depression

difficult, fast, noisy breathing, sometimes with wheezing

difficulty in chewing, swallowing, or talking

dilated neck veins

discharge, excessive tearing

disturbed color perception

dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly

double vision

drooping eyelids

dry or itching eyes

extreme fatigue

false sense of well-being

fast, slow, irregular, pounding, or racing heartbeat or pulse

fear, nervousness

feeling of having something in the eye

fever and chills

flashes of light, floaters in vision

general feeling of discomfort or illness

hair loss

halos around lights

headaches

inability to speak

increased sweating

irregular, fast or slow, or shallow breathing

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

lightheadedness, dizziness, or fainting

loss of vision

memory loss

mood swings

muscle or joint pain

muscle weakness

nausea

night blindness

no blood pressure or pulse

overbright appearance of lights

pain, tension, and weakness upon walking that subsides during periods of rest

pale skin

paleness or cold feeling in fingertips, toes, hands, and feet

personality changes

pounding in the ears

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

redness of skin

redness, pain, swelling or irritation of eye, eyelid, or inner lining of eyelid

seeing double

seeing, hearing, or feeling things that are not there

seizures

severe numbness, especially on one side of the face or body

severe or sudden headache

severe tiredness

shortness of breath or troubled breathing

skin irritation or rash, including rash that looks like psoriasis

slurred speech

sore throat

stopping of heart

sweating

swelling of face, fingers, feet, lower legs, and ankles

swollen glands

temporary blindness

tingling or pain in fingers or toes when exposed to cold

tunnel vision

unconsciousness

unusual tiredness or weakness

weakness in arm and/or leg on one side of the body, sudden and severe

weight gain

wheezing

Less common

Acid or sour stomach

belching

body aches or pain

diarrhea

dry mouth

ear congestion

hearing loss

heartburn

indigestion

lack or loss of strength

loss of appetite

loss of voice

nightmares

runny nose

sleepiness or unusual drowsiness

sleeplessness

sneezing

stomach discomfort, upset, or pain

stuffy nose

trouble sleeping

unable to sleep

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: Timoptic Ocumeter side effects (in more detail)

More Timoptic Ocumeter resources

Timoptic Ocumeter Side Effects (in more detail)
Timoptic Ocumeter Use in Pregnancy & Breastfeeding
Timoptic Ocumeter Drug Interactions
Timoptic Ocumeter Support Group
1 Review for Timoptic Ocumeter - Add your own review/rating

Timolol Ophthalmic Prescribing Information (FDA)

Betimol Prescribing Information (FDA)

Betimol Drops MedFacts Consumer Leaflet (Wolters Kluwer)

Istalol Prescribing Information (FDA)

Istalol Drops MedFacts Consumer Leaflet (Wolters Kluwer)

Istalol Consumer Overview

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Glaucoma, Open Angle
Intraocular Hypertension

Saturday, March 31, 2012

Tritane

Generic Name: trihexyphenidyl (Oral route)

trye-hex-ee-FEN-i-dil

Commonly used brand name(s)

In the U.S.

Artane

Trihexane

Tritane

Available Dosage Forms:

Tablet

Capsule, Extended Release

Elixir

Therapeutic Class: Antiparkinsonian

Pharmacologic Class: Anticholinergic

Uses For Tritane

Trihexyphenidyl is used alone or together with other medicines (e.g., levodopa) to treat Parkinson's disease. By improving muscle control and reducing stiffness, this medicine allows more normal movements of the body as the disease symptoms are reduced.

Trihexyphenidyl is also used to control severe muscle reactions and other side effects from certain medicines that are used to treat severe nausea or nervous, mental, or emotional conditions (e.g., haloperidol [Haldol®], loxapine [Loxitane®], prochlorperazine [Compazine®], promethazine [Phenergan®], thiothixene [Navane®]).

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

Before Using Tritane

Allergies

Pediatric

No information is available on the relationship of age to the effects of trihexyphenidyl in the pediatric population. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of trihexyphenidyl in geriatric patients. However, elderly men are more likely to have age-related prostate problems, and all elderly patients are more likely to have age-related kidney, liver, or heart problems. These conditions may require caution or an adjustment in the dose for patients receiving trihexyphenidyl.

Breast Feeding

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Interactions with Medicines

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.

Potassium

Betel Nut

Chlorpromazine

Haloperidol

Perphenazine

Interactions with Food/Tobacco/Alcohol

Proper Use of trihexyphenidyl

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

Take this medicine every day exactly as ordered by your doctor in order to improve your condition as much as possible. 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.

You may take this medicine before or after food, although it is usually taken with meals.

Dosing

For oral dosage form (elixir or tablets):
- For Parkinson's disease:
  - Adults—At first, 1 milligram (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 15 mg per day, given in divided doses 3 or 4 times per day.
  - Children—Use and dose must be determined by your doctor.
- For side effects caused by other medicines:
  - Adults—5 to 15 milligrams (mg) per day, given in divided doses 3 or 4 times per day.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

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 Tritane

It is important that your doctor check your progress at regular visits to allow changes in your dose and to check for any unwanted effects.

Before using this medicine, your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor). Trihexyphenidyl may increase your risk of having glaucoma. Check with your doctor right away if you have blurred vision or any change in vision while taking this medicine.

Trihexyphenidyl may cause dryness of the mouth, nose, and throat. For temporary relief of mouth dryness, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Tritane 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 cramps or pain

bloating

constipation

delusions of persecution, mistrust, suspiciousness, or combativeness

excessive dryness of the mouth

false beliefs that cannot be changed by facts

loss of appetite

nausea or vomiting

seeing, hearing, or feeling things that are not there

skin rash

stomach pain

swollen, painful, or tender lymph glands on the side of the face or neck

Incidence not known

Anxiety

blurred vision

change in vision

decrease in frequency of urination

decrease in urine volume

difficult urination

difficulty in passing urine (dribbling)

disturbed behavior

dry mouth

enlarged pupils

eye pain

fast, pounding, or irregular heartbeat or pulse

hyperventilation

irritability

loss of vision

mental confusion

nervousness

painful urination

restlessness

shaking

shortness of breath

trouble sleeping

More common

Dizziness

mild nausea

nervousness

Incidence not known

Drowsiness

weakness

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: Tritane side effects (in more detail)

More Tritane resources

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

Compare Tritane with other medications

Cerebral Spasticity
Extrapyramidal Reaction
Parkinson's Disease