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Buy Vingional Ranitidine Online Without Prescriptions, Vingional

Ranitidine is used for treating certain conditions that cause your body to make too much stomach acid (eg, Zollinger-Ellison syndrome). It is also used to treat ulcers of the small intestine that have not responded to other treatment. It may be used as a short-term alternative to oral ranitidine, in patients who are not able to take medicine by mouth. Ranitidine is an H 2 - receptor blocker. It works by blocking the action of histamine in the stomach. This reduces the amount of acid the stomach makes. Reducing stomach acid helps to reduce heartburn, heal irritation of the esophagus, and heal ulcers of the stomach or intestines.

Use Ranitidine as directed by your doctor.

Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

You may take antacids while you are using Ranitidine if you are directed to do so by your doctor.

Continue to use Ranitidine even if you feel well. Do not miss any dose.

If you miss a dose of Ranitidine, 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. Do not use 2 doses at once.

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

Store Ranitidine between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Ranitidine out of the reach of children and away from pets.

Do NOT use Ranitidine if:

you are allergic to any ingredient in Ranitidine

you have a history of the blood disease porphyria

you are taking dasatinib.

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

Some medical conditions may interact with Ranitidine. 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

if you have a history of kidney or liver problems

if you have abnormal blood electrolyte levels or a history of irregular heartbeat.

Some medicines may interact with Ranitidine. Tell your health care provider if you are taking any other medicines, especially any of the following:

Certain benzodiazepines (eg, midazolam, triazolam), glipizide, procainamide, or warfarin because the risk of their side effects may be increased by Ranitidine

Dasatinib, delavirdine, gefitinib, certain HIV protease inhibitors (eg, atazanavir), itraconazole, or ketoconazole because their effectiveness may be decreased by Ranitidine.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Ranitidine 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.

Important safety information:

Ranitidine may rarely cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Ranitidine with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.

Ranitidine may interfere with certain lab tests, including urine protein tests. Be sure your doctor and lab personnel know you are taking Ranitidine.

Lab tests, including liver function, may be performed while you use Ranitidine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Ranitidine should be used with extreme caution in children younger than 1 month 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 Ranitidine while you are pregnant. Ranitidine is found in breast milk. Do not breastfeed while taking Ranitidine.

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:

Constipation; diarrhea; headache; nausea; stomach upset.

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; unusual hoarseness); change in the amount of urine produced; confusion; dark urine; depression; fast, slow, or irregular heartbeat; fever, chills, or sore throat; hallucinations; severe or persistent headache or stomach pain; unusual bruising or bleeding; 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.

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Zetor Tractors A, Zeto

You could be interested

ZETOR by Pininfarina presented in the Netherlands

ZETOR brand had another celebration of its birthday, this time in the Netherlands. It took place at the biggesst farming trade fair in the country Agro Techniek Holland. As part of the celebrations of the 70th anniversary of the brand, ZETOR introduced the design concept ZETOR by Pininfarina on the Dutch market for the first time. It was not only the premiere of the design concept but also for example of the FORTERRA model range with emission standards of STAGE IV.

Meet Santa Claus with ZETOR

This year, at the turn of July and August, a group of six fans from the Finnish club Tyrwaan Seudun Zetoristit organized an expedition to the Arctic Circle in ZETOR 25 tractors. Altogether, the legendary “Twenty-Fives” covered 1,700 kilometres’ long journey. They set out from their hometown Tyrwaa all the way to Rovaniemi which lies close to the Arctic Circle where Santa Claus lives, at least as far as the Finnish say.

New modern base for ZETOR tractors in Poland

The ZETOR brand celebrates its 70th anniversary this year. It is a significant anniversary that certainly deserves an unforgettable gift. And such a gift was provided by the ZETOR representative in Poland, opening the new company headquarters in the middle of August.

FORTERRA HD 150 scored at exhibitions in the Czech Republic and Slovakia

FORTERRA HD scored at exhibitions which took place in Slovakia and the Czech Republic in late August. The modernized tractor employing STAGE IV won the prestigious prizes of “Zlaty kosak” and “Zlaty klas” at “Agrokomplex” and “Zeme Zivitelka”.

ZETOR in Lithuania is battling for an entry in the Guinness Book of Records

The celebration of the 70th anniversary of the ZETOR brand in Lithuania was in a non-traditional spirit. The ZETOR CRYSTAL tractor created a picture on a field with an area of 20.7 hectares in the shape of the Lithuanian Coat-of-Arms and thus made an effort at getting an entry into the Guinness Book of Records. The event was organised by SPECAGRA, which is the sole distributor of the ZETOR tractors in Lithuania.

ZETOR and you in the main role. Winners of the Most Interesting Zetor Story Competition

On the occasion of the 70th anniversary of its existence, ZETOR TRACTORS a. s. prepared a special online competition with valuable prizes. Over the past few months, competitors were sending photos with their favourite ZETOR tractors. Each photo was accompanied with a personal story featuring the competitor and a ZETOR tractor.

Genoclom 50 Mg Tablet, Genoclom

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Terapi infertilitas wanita karena oligomenore atau amenore sekunder. Juga untuk meningkatkan spermatogenesis pada pria dengan oligospermia

Infertilitas anovulasi. 1 tablet/hari selama 5 hari, mulai pada hari ke-5 siklus haid. Jika tidak terjadi ovulasi, terapi tahap 2 yaitu 1 tablet 2 kali sehari selama 5 hari dapat dilakukan. Oligospermia. 1 tablet/hari selama 40 - 90 hari

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Duromine Weight Loss Tablets - Get The Full 100 On This, Toramine

It is pretty amazing to have energy, as you can get through the day without feeling sluggish, accomplish all you need to do and just be an overall effective person. Energy is great during the day, but at night that is the time that your body needs to wind down and get some rest. If you still have tons of energy at night, it can be very problematic and can lead to insomnia.

A lot of people who are taking Duromine will experience the side effect of insomnia. This is extremely, and you will find that many people on this tablet have problems sleeping and this begins eventually affect their work, school and personal lives.

Why Does Duromine Cause Insomnia?

Duromine is classified as a stimulant and what these types of drugs do is stimulate or speed of the central nervous system. When this action occurs, you have people who will feel more awake, alert and have tons of energy. This is why it is highly recommended that you take Duromine as soon as you wake up in the morning, as it gives the drug time to wear off throughout the day.

How to Stop Insomnia When Taking Duromine?

As I mentioned above, Duromine is essentially like the drug speed then you are going to have tons of energy. If you are taking this tablet and you find that you are having problems sleeping, the best idea is to really take it when you wake up in the morning. This should help to reduce the symptoms you are experiencing and you should be able to get yourself a good night sleep.

If you find that taking it in the morning does not help, then you should consult with your doctor. The doctor will be able to determine if the dosage you are taking is too much and if it needs to be reduced.

Duromine doesa pretty good job assisting with weight loss, but you just need to be aware of some of the different side effects that come along with it. Insomnia is one, but if you follow the suggestions above, you should have no problems sleeping.

Imagine waking up where one minute you are full of excitement, you feel like taking on the world and nothing can mess up your day. Fast forward to a couple minutes later and you feel this heavy burden on you, you feel like talking to no one and you are having a horrible and crummy day. That sounds like someone who is going through major bouts of highs and lows and probably has some type of mental condition.

Unfortunately, that scenario above is how some people feel when they take the weight loss supplement, Duromine. This tablet has many different side effects ranging from mild to severe. It has been noted that many people who take this pill often experience various types of mood swings.

When you are taking Duromine, you have to prepare for the possibility of mood swings occurring. These could be something very simple from not feeling very energetic or a bit snappy towards people. I won’t say that this is normal, because not everybody will experience mood swings when taking Duromine. If you are experiencing it, you should not freak out and just realize that this is just a mild side effect that is taking place. Many people noticed that the mood swings disappear after a couple of days and then everything is back to normal. Others might continue to experience it, with the moodiness subsiding after a couple of weeks. You

If you feel that your mood swings are out of control and you feel like hurting someone or yourself, then you will need to contact your physician or medical practitioner immediately. They will be able to explain to you if what you are feeling is normal for if they need to take off or reduce the amount of medication that you are taking. This can be extremely serious, so your doctor should be the first person you need to contact.

So you have been on Duromine for a couple of days or weeks and it is time to go out and have a few drinks, is it safe to drink alcohol while taking Duromine? The answer is a big NO. In general you should not be taking prescription medication with alcohol at all, but this is especially true with Duromine.

Many medications can have a negative interaction with alcohol and this could lead to increase in the risk of serious side effects, illness, injury and sometimes even death. If you speak with your doctor, he can inform you of how bad it is to drink and take any prescription medication. It is always important to follow the instructions given by your medical practitioner.

Why Mixing Duromine and Alcohol Can be a Bad Idea

It can be a pretty bad idea to mix the two, simply because Duromine is a stimulant and alcohol is a depressant. When you drink and take Duromine, it can actually mask the effect of alcohol and you may not feel as drunk. This means less control of your reaction times and senses.

One major health risk that can occur is that on Duromine your heart rate and blood pressure could be elevated. Drinking alcohol can also increase your blood pressure and this mix could lead to possible injury and even death.

Another concern with taking the two together is that it can mask the actual effects of alcohol. This could lead to possible disaster as you might consume more alcohol simply because you are not feeling drunk or tipsy. You can suffer from alcohol poisoning or get into a car and drive; as you might feel that you are not drunk.

There is also the possibility that alcohol could transform certain drugs into toxic chemicals. This lethal concoction can have a negative effect on the liver and other vital organs.

You should also realize that taking Duromine and drinking may reduce the effectiveness of the drug. So you could not be losing any weight and think that the drug is not working, when in reality the alcohol could be causing the problem.

So What If I Want to Drink While on Duromine?

Some people might think it is not a bad idea to have one drink while taking this weight loss drug. It would be in your best interest to just get the idea of alcohol out of your head. If you are adamant, then you could stop taking Duromine for a couple of days and have the drink of your choice. That is still defeating the purpose, as the main goal is for you to lose weight and get healthy. This is where sacrifices have to be made for your long-term health. If you can hold out, then you will be conquering one n

If there is one thing about Duromine, it is pretty effective at curbing appetites and assisting in weight loss. You will be able to find a ton of success stories on this site, so you can click around if you have questions that need answers.

One question that we get on a regular basis is people trying to find out when is the best time to take Duromine so that it is most effective.

The Best Time to Take Your Pills

Before you determine when the best time to take Duromine is, you first need to take a look at the directions that have been prescribed to you by your doctor. You should also take some time and read the leaflet that comes with the medication.

When Time is the Best Time

You should take Duromine as you awake in the mornings. This drug gives you a ton of energy and will have you wide awake. It is better you have this energy during the day, as opposed to staring at the ceiling and pacing around at night.

You should aim to take it at the same time every day, just so that you develop a routine.

How Much Should I Take?

You are generally going to take one Duromine tablet a day. Your doctor will prescribe the dosage that you will be on.

You need to be careful and follow exactly what your doctor prescribes to you. If you increase your dosage yourself, you are not going to speed up the weight loss process and you could increase the chance of negative side effects occurring.

Best Way to Take It?

You do not have to take Duromine before or after a meal. You should swallow the tablet with a lot of water or juice. At no time should you open or chew the tablets, simply because they are designed to be released over time into the blood stream.

How long to take it

Take this medicine as long as your doctor tells you to.

What If I Forget to Take It?

Sometimes the day is a bit hectic and you may actually forget to take your tablet. If this is the case, then determine what time of day it is and take it. If it is after lunch then you should possibly skip the dosage. As mentioned above, Duromine gives you a boost of energy and if you value your sanity, you are not going to want to be up late at night, wondering why you can’t sleep. Missing one dose is not the end of the world, just remember the next day.

Ortofeno Gelis Rezeptfrei Kaufen ? Qualitat; ? Mit Niedrigen Preisen; ? Lieferung, Ortofeno Gelis

Diclofenac ist in erster Linie fur die Behandlung von Entzundungen und Schmerzen durch Erkrankungen wie rheumatoide Arthritis, Osteoarthritis, Spondylitis ankylosans und verursacht sind. Es ist auch wirksam bei der Behandlung von Weichteil-Entzundungen durch Tendinitis und Bursitis und Behandlung von Dysmenorrhoe (Menstruationsschmerzen). Diclofenac ist ein NSAR. NSAIDs behandeln die Symptome von Schmerzen und Entzundungen. Sie behandeln nicht die Krankheit, die diese Symptome verursacht.

Verwenden Sie Diclofenac wie von Ihrem Arzt verordnet!

Nehmen Sie Diclofenac durch den Mund. Es kann mit der Nahrung aufgenommen werden, wenn es Ihren Magen belastet. Taking it mit dem Essen kann nicht das Risiko von Magen-oder Darmprobleme (zB Blutungen, Geschwure). Sprechen Sie mit Ihrem Arzt oder Apotheker, wenn Sie andauernde Magenbeschwerden haben.

Nehmen Sie Diclofenac mit einem vollen Glas Wasser (8 oz/240 mL), wie von Ihrem Arzt verordnet wurde.

Wenn Sie eine Dosis von Diclofenac, bringen Sie es so bald wie moglich. Wenn es fast Zeit fur Ihre nachste Dosis ist, uberspringen Sie die vergessene Dosis und gehen Sie zuruck zu Ihrem regelma?igen Dosierungsschema. Nehmen Sie nicht 2 Dosen auf einmal.

Fragen Sie Ihren Arzt Fragen konnen Sie sich daruber, wie Diclofenac oder wieder einnehmen.

Shop Diclofenac bei 77 Grad F (25 Grad C). Kurze Lagerung bei Temperaturen zwischen 59 und 86 Grad F (15 und 30 Grad C) ist nicht gestattet. Lager weg von der Hitze, Feuchtigkeit und Licht. Nicht im Bad. Halten Sie Diclofenac au?erhalb der Reichweite von Kindern und weg von Haustieren.

Verwenden Sie KEINE Diclofenac, wenn:

Sie sind allergisch gegen jegliche Zutaten in Diclofenac oder Rinder (Kuh)-Protein

Sie haben eine schwere allergische Reaktion (z. B. schweren Hautausschlag, Nesselsucht, Atembeschwerden, Wucherungen in der Nase, Schwindel) auf Aspirin oder ein NSAR (zB Ibuprofen, Celecoxib)

Sie vor kurzem oder werden mit Bypass-Herzoperation

Sie haben schwere Nierenprobleme

Sie sind in den letzten 3 Monaten der Schwangerschaft.

Fragen Sie Ihren Arzt oder Ihre Arztin sofort, wenn dies auf Sie zutrifft.

Einige medizinische Bedingungen konnen mit Diclofenac interagieren. Informieren Sie Ihren Arzt oder Apotheker, wenn Sie irgendwelche medizinischen Bedingungen haben, vor allem, wenn einer der folgenden Punkte auf Sie zutrifft:

wenn Sie schwanger sind, planen, schwanger zu werden, oder stillen

wenn Sie verschreibungspflichtige oder nicht verschreibungspflichtige Arzneimittel, pflanzliche Zubereitung oder Nahrungserganzungsmittel

wenn Sie Allergien gegen Medikamente, Nahrungsmittel oder andere Substanzen,

wenn Sie eine Geschichte der Nieren-oder Leberprobleme, Diabetes oder Magen-Darm-Probleme (zB Blutungen, Perforationen, Ulzera)

wenn Sie eine Geschichte von Schwellungen oder Flussigkeitsansammlungen, Asthma, Wucherungen in der Nase (Nasenpolypen) oder Entzundung der Mundschleimhaut

Wenn Sie hohen Blutdruck haben, Blutkrankheiten (z. B. Porphyrie), Blutungen oder Blutgerinnung Probleme, Herzbeschwerden (zB Herzinsuffizienz) oder Blutgefa?-Krankheit, oder wenn Sie mit einem Risiko fur eine dieser Krankheiten

wenn Sie schlechte Gesundheit, Dehydrierung oder niedrigen Flussigkeitsvolumen oder niedrige Blut-Natrium Ebenen, Sie rauchen, Alkohol trinken oder haben eine Geschichte des Alkoholmissbrauchs

wenn Sie nehmen ein Antibiotikum oder ein Anti-Anfall Medikamente. Das Risiko von Leberproblemen kann mit einigen dieser Medikamente erhoht werden.

Einige Arzneimittel konnen mit Diclofenac interagieren. Informieren Sie Ihren Arzt, wenn Sie andere Arzneimittel einnehmen, vor allem einer der folgenden Eigenschaften sind:

Antikoagulantien (zB Warfarin), Aspirin, Clopidogrel, Kortikosteroide (zB Prednison), Heparin und andere Blutverdunner (zB Dalteparin), oder selektive Serotonin-Wiederaufnahmehemmer (SSRI) (zB Fluoxetin), weil das Risiko von Magenblutungen kann gestiegen

Acetaminophen, weil das Risiko von Leberproblemen kann erhoht werden

Probenecid, weil es das Risiko von Diclofenac die Nebenwirkungen erhohen

Cyclosporin, Lithium, Metformin, Methotrexat, orale NSAR (zB Ibuprofen) oder Chinolone (zB Ciprofloxacin), weil das Risiko der Nebenwirkungen konnen durch Diclofenac erhoht werden

Angiotensin-Converting-Enzym (ACE)-Hemmer (zB Enalapril) oder Diuretika (zB Furosemid, Hydrochlorothiazid), weil ihre Wirksamkeit durch Diclofenac verringert werden kann.

Dies kann nicht eine vollstandige Liste aller Interaktionen, die auftreten konnen. Fragen Sie Ihren Arzt, wenn Diclofenac mit anderen Medikamenten, die Sie einnehmen. Prufen Sie mit Ihrem Arzt, bevor Sie starten, stoppen, oder andern Sie die Dosis einer Medizin.

Wichtige Sicherheitshinweise:

Diclofenac kann Schwindel oder Benommenheit. Diese Auswirkungen konnen noch schlimmer, wenn Sie es mit Alkohol oder bestimmte Medikamente. Verwenden Sie Diclofenac mit Vorsicht. Nicht Auto fahren oder andere moglicherweise unsichere Aufgaben, bis Sie, wie Sie darauf reagieren.

Serious Magengeschwur oder Blutungen konnen mit dem Einsatz von Diclofenac auftreten. Taking it in hohen Dosen fur eine lange Zeit, Rauchen oder Alkoholkonsum erhoht das Risiko fur diese Nebenwirkungen. Unter Diclofenac mit Lebensmitteln nicht zur Verringerung des Risikos dieser Effekte. Schwarzer, zaher Stuhl;; Erbrochenes, das wie Blut oder Kaffeesatz aussieht, wenn Sie an einer schweren Magen-oder Ruckenschmerzen haben oder ungewohnliche Gewichtszunahme oder Schwellungen, wenden Sie sich an Ihren Arzt oder Notaufnahme sofort.

Nehmen Sie nicht mehr als die empfohlene Dosis oder Verwendung langer als ohne Rucksprache mit Ihrem Arzt verordnet.

Diclofenac ist ein NSAR. Bevor Sie eine neue Medizin zu starten, uberprufen Sie das Etikett zu sehen, ob es ein NSAR (zB Ibuprofen) hat es auch. Ist dies der Fall, oder wenn Sie nicht sicher sind, mit Ihrem Arzt oder Apotheker.

Nehmen Sie kein Aspirin, wenn Sie mit Diclofenac werden, wenn Ihr Arzt Ihnen sagt.

Erkundigen Sie sich bei Ihrem Arzt oder Apotheker, bevor Sie Paracetamol nehmen, wahrend Sie unter Diclofenac. Das Risiko von Lebererkrankungen kann erhoht werden.

Nicht zwischen verschiedenen Formen von Diclofenac (zB magensaftresistente Tabletten, mit sofortiger Freisetzung Tabletten, Kapseln) zu wechseln, wenn Ihr Arzt Ihnen sagt. Sie durfen nicht die gleiche Menge der Medizin, um Ihren Korper.

Labortests, einschlie?lich der Nierenfunktion, Leberfunktion, Blut Elektrolyt-Niveau, Blutbild, Blutdruck, kann durchgefuhrt werden, wahrend Sie Diclofenac verwenden. Diese Tests konnen verwendet werden, um Ihren Zustand zu uberprufen oder auf Nebenwirkungen zu uberwachen. Achten Sie darauf, alle Arzt-und Labor-Terminen.

Verwenden Sie Diclofenac mit Vorsicht bei alteren Menschen, sie kann mehr empfindlich auf die Auswirkungen, insbesondere Magenblutungen und Nierenprobleme.

Diclofenac sollte mit au?erster Vorsicht bei Kindern angewendet werden, Sicherheit und Wirksamkeit bei Kindern wurden nicht bestatigt.

Schwangerschaft und Stillzeit: Diclofenac kann zu Schadigungen des Fotus. Verwenden Sie es nicht in den letzten 3 Monaten der Schwangerschaft. Wenn Sie glauben, schwanger zu sein, wenden Sie sich an Ihren Arzt. Sie mussen die Vorteile und Risiken der Verwendung von Diclofenac zu diskutieren, wahrend Sie schwanger sind. Es ist nicht bekannt, ob Diclofenac in der Muttermilch gefunden wird. Nicht stillen wahrend der Einnahme von Diclofenac.

Alle Arzneimittel konnen Nebenwirkungen haben, die aber viele Menschen haben keine oder nur geringfugige, Nebenwirkungen.

Erkundigen Sie sich bei Ihrem Arzt, wenn dieser am haufigsten auftretenden Nebenwirkungen fortbestehen oder storend empfunden werden:

Verstopfung, Durchfall, Schwindel, Benommenheit, Kopfschmerzen, leichte Bauchschmerzen oder Sodbrennen, Ubelkeit, Erbrechen.

Arztlich behandeln lassen, sofort, wenn dieser schwere Nebenwirkungen auftreten:

Schwere allergische Reaktionen (Hautausschlag, Nesselsucht, Juckreiz, Atembeschwerden, Engegefuhl in der Brust, Schwellungen im Mund-, Gesichts-, Lippen oder Zunge), blutig oder schwarz, Teerstuhle; Veranderung in Hohe von Urin produziert; Schmerzen in der Brust, Verwirrung. Depressionen, Ohnmacht, schneller oder unregelma?iger Herzschlag, Fieber, Schuttelfrost, oder anhaltende Halsschmerzen, psychische oder Stimmungsschwankungen, Taubheitsgefuhl in einem Arm oder Bein, einseitige Schwache, anhaltende Grippe-ahnliche Symptome, rot, geschwollen, Blasen, oder Schalen Haut, Klingeln in den Ohren, Krampfanfalle, schwere Kopfschmerzen oder Schwindel, schweren oder anhaltenden Bauchschmerzen oder Ubelkeit, starkem Erbrechen oder Durchfall, Atemnot, plotzlicher oder unerklarliche Gewichtszunahme, Schwellungen der Hande, Beine oder Fu?e; Symptome von Leber Probleme (zB, dunkler Urin, heller Stuhl, anhaltender Appetitlosigkeit, Gelbfarbung der Haut oder Augen), ungewohnliche blaue Flecken oder Blutungen, ungewohnliche Gelenk-oder Muskelschmerzen, ungewohnliche Mudigkeit oder Schwache; Vision oder Anderungen Rede, Erbrochenes, das wie Kaffeesatz aussieht .

Dies ist keine vollstandige Liste aller Nebenwirkungen, die auftreten konnen. Wenn Sie Fragen zu Nebenwirkungen haben, wenden Sie sich an Ihren Arzt.

Why Paul Calls Peter As Cephas In His Books Christianity Stack Exchange, Cepha

In John 1:42 Jesus called Peter as Cephas.

Jesus looked at him and said, “You are Simon son of John. You will be called Cephas” (which, when translated, is Peter).

But throughout the Gospels, Peter was called as Peter and his books also called in his name I Peter and II Peter.

But why did Paul call Peter, Cephas (Galatians 2:7-14, I Cor. 1:11-13, I Cor. 3:21, I Cor. 9:5 and I Cor. 15:5)? In some occasions he also calls him as Peter. When I asked my mom, she said Paul was rebuking Peter in the name Cephas. Is this true? Or is calling Peter as Cephas normal?

At times, Paul and Peter had disagreements as in Galatians 2:11-16:

11 When Cephas came to Antioch, I opposed him to his face, because he stood condemned. 12 For before certain men came from James, he used to eat with the Gentiles. But when they arrived, he began to draw back and separate himself from the Gentiles because he was afraid of those who belonged to the circumcision group. 13 The other Jews joined him in his hypocrisy, so that by their hypocrisy even Barnabas was led astray. 14 When I saw that they were not acting in line with the truth of the gospel, I said to Cephas in front of them all, “You are a Jew, yet you live like a Gentile and not like a Jew. How is it, then, that you force Gentiles to follow Jewish customs?

15 “We who are Jews by birth and not sinful Gentiles 16 know that a person is not justified by the works of the law, but by faith in Jesus Christ. So we, too, have put our faith in Christ Jesus that we may be justified by faith in Christ and not by the works of the law, because by the works of the law no one will be justified.

How was their relationship as fellow apostles?

Maybe Paul calls Peter (Greek) Cephas (Aramaic) because his actions in Gal 2 denote an Old Testament mindset regarding Gentiles?

Let me start by saying that in v6-9 Peter James and John recognises Paul's gift and anointing in reaching out to the Gentiles. In other words they recognize that Salvation through the Gospel is for gentiles too.

Paul notes that Peter had no problem dining with the gentiles until "certain" Jews from Jerusalem came to visit him in Antioch at which point he began to disassociate himself from gentiles. Paul notes that these "certain" Jews were "pro-circumcision" (no circumcicion; no salvation). What makes this especially bad is that they are men of influence and other Christians started doing the same thing - even Barnabas who was with Paul a long time.

Paul's contention with Peter is that he (Peter) was not acting in consistency with the truth of what he knows in the Gospel (salvation is for everyone and not just the circumcised). Since Peter was one of the 3 disciples closes to Jesus I guess it was assumed that Peter should have known better. (If Paul who was not one of the 12 disciples understood this then surely Peter would understand it more) and even more so that in v6-9 Peter, James and John understands the need to bring gentiles into the fold.

So the way I see it; Paul is using the old school name Cephas because of the old school way of thinking especially after recognizing that reaching out to the gentiles is important and being influential men, they have caused other christians to avoid gentiles too. The effects of v11-14 seem to take away what they did in v6-9

This use of differing names is an interesting study and similar to Jacob/Israel name change and name use in the OT (however I am unable to find out why Jacob was used after the name change).

Just my 2 cents anyway

answered Aug 22 '13 at 23:15

I believe possibly he chose to call Peter Cephas because he was identifying both the church and the person Peter who was jewish and Church.

One lesson might be. We, both as God's children and as members of the church should not disallow what God has allowed. Jesus would call him (fallible: Simon Peter) as (Peter: positionally correct and one of the 12 apostles, and (Cephas: Jewish and Church).

I could be wrong and can't wait to find out from the man himself. Hope this helps. )

Thou art Peter (ou ei Petrov). Christ responds to Peter's emphatic thou with another, equally emphatic. Peter says, "Thou art the Christ." Christ replies, "Thou art Peter." Petrov (Peter) is used as a proper name, but without losing its meaning as a common noun. The name was bestowed on Simon at his first interview with Jesus (John i. 42) under the form of its Aramaic equivalent, Cephas. In this passage attention is called, not to the giving of the name, but to its meaning. In classical Greek the word means a piece of rock, as in Homer, of Ajax throwing a stone at Hector ("Iliad," vii. 270), or of Patroclus grasping and hiding in his hand a jagged stone ("Iliad," xvi. 734).

On this rock (epi tauth th petra). The word is feminine, and mean a rock, as distinguished from a stone or a fragment of rock (petrov, above).

Used of a ledge of rocks or a rocky peak. In Homer ("Odyssey," ix. 243), the rock (petrhn) which Polyphemus places at the door of his cavern, is a mass which two-and-twenty wagons could not remove; and the rock which he hurled at the retreating ships of Ulysses, created by its fall a wave in the sea which drove the ships back toward the land ("Odyssey," ix. 484). The word refers neither to Christ as a rock, but to Peter himself, in a sense defined by his previous confession, and as enlightened by the "Father in Heaven."

The reference of petra to Christ is forced and unnatural. The obvious reference of the word is to Peter. The emphatic this naturally refers to the nearest antecedent; and besides, the metaphor is thus weakened, since Christ appears here, not as the foundation, but as the architect: "On this rock will I build." Again, Christ is the great foundation, the "chief corner-stone," but the New Testament writers recognize no impropriety in applying to the members of Christ's church certain terms which are applied to him. For instance, Peter himself (1 Pet. ii. 4), calls Christ a living stone, and, in ver. 5, addresses the church as living stones. In Apoc. xxi. 14, the names of the twelve apostles appear in the twelve foundation-stones of the heavenly city; and in Eph. ii. 20, it is said, "Ye are built upon the foundation of the apostles and prophets (i. e. laid by the apostles and prophets), Jesus Christ himself being the chief corner-stone."

Equally untenable is the explanation which refers petra to Simon's confession. Both the play upon the words and the natural reading of the passage are against it, and besides, it does not conform to the fact, since the church is built, not on confessions, but on confessors - living men. "The word petra," says Edersheim, "was used in the same sense in Rabbinic language. According to the Rabbins, when God was about to build his world, he could not rear it on the generation of Enos, nor on that of the flood, who brought destruction upon the world; but when he beheld that Abraham would arise in the future, he said: 'Behold, I have found a rock to build on it, and to found the world,' whence, also, Abraham is called a rock, as it is said: 'Look unto the rock whence ye are hewn.' The parallel between Abraham and Peter might be carried even further. If, from a misunderstanding of the Lord's promise to Peter, later Christian legend represented the apostle as sitting at the gate of heaven, Jewish legend represents Abraham as sitting at the gate of Gehenna, so as to prevent all who had the seal of circumcision from falling into its abyss" ("Life and Times of Jesus").

The reference to Simon himself is confirmed by the actual relation of Peter to the early church, to the Jewish portion of which he was a foundation-stone. See Acts, i. 15; ii. 14, 37; iii. 13; iv. 8; v. 15, 29; ix. 34, 40; x. 25, 26; Gal. i. 18. Source(s): http://www. godrules. net/library/vincent/.

answered Feb 12 '14 at 6:24

It seems to me that there are two reasons for name change. One, I infer, is the entire alteration of the soul and therefore the name as we'll to symbolize new life, like Saul to Paul. Another, seems to me, to be a change of role in situations like Jacob to Israel and Simon to Peter/Cephas. I am 17 and still studying, but from what I have read today this appears to make the most sense to me. As a Catholic, I believe Peter was called to the role of "rock" for Christ's church. Seeing how large a role that is I could definitely interpret it as a rock of his bishopricol church and his confirmed name. Just as Jesus loves and respects his mother, yet refers to her as woman when she is acting in her human role of woman, it could be this same distinction of role, rather than a degrading of the person referenced. I don't know if this helps, but it's my best inference:) Happy Sunday!

answered Feb 2 '14 at 19:04

Oysters, Oyster Pictures, Oyster Facts - National Geographic, Olyster

Oyster

Fast Facts

Type: Invertebrate Diet: Carnivore Average life span in captivity: Up to 20 years Size: 3 in (8 cm) to 14 in (36 cm) Group name: Colony, Bed, or Reef Relative: Size relative to a tea cup

Please add a "relative" entry to your dictionary.

There are many food items in the world that evoke the question, “How hungry did the first person to eat that have to be?” But few such dishes can rival the raw oyster for unpalatable appearance and general “ick” factor.

If undaunted by the oyster’s rough, rock-hard, nearly-impossible-to-open shell, the undoubtedly famished first taster would then have confronted the gray, slimy, almost phlegmatic appearance of its plump body. Once beyond any primal gag reflex though, this seminal slurper would have been surprisingly rewarded with the oyster’s delicate, toothy texture, rich flavor, and salty liquor. Oysters are also high in calcium, iron, and protein. Admittedly, they’re not for everyone, but adventurous humans the world over have enjoyed oysters, raw and cooked, for thousands of years.

Although it is possible for food oysters to produce pearls, they should not be confused with actual pearl oysters, which are from a different family of bivalves. True oysters, which belong to the Ostreidae family, are found throughout the world’s oceans, usually in shallow waters and in colonies called beds or reefs. Among the most popular and heavily harvested species are the Eastern American oyster ( Crassostrea virginica ), found in Atlantic waters from Canada to Argentina, and the Pacific oyster ( Crassostrea gigas ), found from Japan to Washington state and as far south as Australia.

Oyster shells are usually oval or pear-shaped, but will vary widely in form depending on what they attach to. They are generally whitish-gray in outer shell color, and their inside shell is usually a porcelain white. They have extremely strong adductor muscles to close their shells when threatened.

Oysters feed by extracting algae and other food particles from the water they are almost constantly drawing over their gills. They reproduce when the water warms by broadcast spawning, and will change gender once or more during their lifetime.

Commercial harvesting of oysters is regulated throughout most of their range, and they are not currently listed as threatened or endangered. However, they are extremely sensitive to water quality and susceptible to coastal pollution, and populations in many areas where they were once abundant have dwindled or disappeared. They can also retain toxins in their flesh, making them unhealthy for human consumption.

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Invertebrate Features

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About 80 percent of all life on Earth is found in the oceans, which cover 71 percent of the planet's surface. Take a look at how colorful life under the sea can be.

Learn more about these popular crustaceans that some think of only as a meal. Find out the sizes that these sea creatures are capable of attaining.

Eyeless spiders, translucent millipedes, 175-year-old crayfish, and other odd cave-dwellers face an uncertain future.

Enpresse Oral Reviews And User Ratings Effectiveness, Ease Of Use, And Satisfaction, Enpresse

User Reviews & Ratings - Enpresse oral

« Enpresse oral Information

Current Rating: 1

Comment: My experience with this birth control is absolutely horrible. I haven't been able to eat without throwing it up. Constant cramps and back aches. I feel sick all the time.

Comment: My experience with this birth control is absolutely horrible. I haven't been able to eat without throwing it up. Constant cramps and back aches. I feel sick all the time. Hide Full Comment

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Condition: Birth Control

12/9/2015 2:37:41 PM

Reviewer: 35-44 Female on Treatment for 5 to less than 10 years (Patient)

Current Rating: 5

Current Rating: 5

Current Rating: 5

Comment: I have been on this birth control for about 6 years was switched from tri-levlen. The switch was smooth and I have never had any adverse side effects. I love this birth control!

Comment: I have been on this birth control for about 6 years was switched from tri-levlen. The switch was smooth and I have never had any adverse side effects. I love this birth control! Hide Full Comment

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Condition: Birth Control

11/2/2015 5:59:19 PM

Reviewer: Ella82, 25-34 Female on Treatment for less than 1 month (Patient)

Current Rating: 4

Current Rating: 4

Current Rating: 1

Comment: I have been on hormonal birth control since 1998 and have changed brands for various reasons, but this is the only one I have absolutely HATED. My hair was falling out, hands and feet were swollen all the time and my heart was racing. I didn't stay on this for long and I was switched to Ortho Tri-Cyclen (or the generic. Tri Estarylla, with which I am very happy.

Comment: I have been on hormonal birth control since 1998 and have changed brands for various reasons, but this is the only one I have absolutely HATED. My hair was falling out, hands and feet were swollen all the time and my heart was racing. I didn't stay on this for long and I was switched to Ortho Tri-Cyclen (or the generic. Tri Estarylla, with which I am very happy. Hide Full Comment

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Condition: Birth Control

8/19/2015 7:02:45 PM

Reviewer: Helenfersure, 19-24 Female on Treatment for 2 to less than 5 years (Patient)

Current Rating: 5

Current Rating: 4

Current Rating: 3

Comment: I took this for 3 years. It was my first birth control. I did get a little more emotional when I started it, but it went away after a few months. These last couple months tho I have been getting more emotional and depressed and having hot flashes, also I would get yeast infections every 3rd week of my cycle. My doctor switched me to Lutera which is monophasic to see if this would level everything. Show Full Comment

Comment: I took this for 3 years. It was my first birth control. I did get a little more emotional when I started it, but it went away after a few months. These last couple months tho I have been getting more emotional and depressed and having hot flashes, also I would get yeast infections every 3rd week of my cycle. My doctor switched me to Lutera which is monophasic to see if this would level everything out. enpresse worked great for me for a few years, but I am ready for something new. Also, don't get scared about some of these reviews; what works for some people is awful for others. Hide Full Comment

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Condition: Birth Control

7/2/2015 2:28:41 PM

Reviewer: Garage7890, 19-24 Female on Treatment for 1 to 6 months (Patient)

Current Rating: 5

Current Rating: 4

Current Rating: 1

Comment: I took this pill for 5 months and it was constantly a bad experience. I had horrible mood swings, fought with people I never fought with, felt isolated, had suicidal thoughts out of the blue, never got my period on the sugar week but spotted throughout all of the other colors (had spotting for 3 weeks straight once), and experienced frequent temperature sensitivity that led to nausea. Would not re. Show Full Comment

Comment: I took this pill for 5 months and it was constantly a bad experience. I had horrible mood swings, fought with people I never fought with, felt isolated, had suicidal thoughts out of the blue, never got my period on the sugar week but spotted throughout all of the other colors (had spotting for 3 weeks straight once), and experienced frequent temperature sensitivity that led to nausea. Would not recommend. 19 yo. Hide Full Comment

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Combi-Featured Scales, Combi

COMBI: Featured Scales

Materials available for featured instruments often include contact information, background information, scale syllabi, administration and scoring guidelines, training and testing materials, information on scale properties, references, scale forums, and frequently asked questions. Rating forms for nonproprietary instruments are usually available for download. In cases of proprietary instruments, you will find background and contact information.

Advocacy Activity Scale (AAS) A 14-item instrument used to provide a measure of involvement in a range of activities representing advocacy for people with acquired brain injury.

Agitated Behavior Scale (ABS) A 14-item instrument used for serial assessment of agitation by clinician raters.

Apathy Evaluation Scale (AES) An 18-item instrument used for evaluation of apathy. Can be self-rated or rated by a clinician or significant other.

Awareness Questionnaire (AQ) An 18-item measure of self-awareness. Can be self-rated or rated by a clinician or significant other.

Cognitive Log (Cog-Log) A 10-item measure used for serial measurement of cognition by clinician raters.

Coma/Near Coma Scale (CNC) An 11-item instrument used by clinicians to assess low-level brain-injured patients.

Coma Recovery Scale-Revised(CRS-R) A 23-item instrument used to assist with differential diagnosis, prognostic assessment, and treatment planning with patients with disorders of consciousness.

Confusion Assessment Protocol (CAP) A 58-item instrument used by clinicians to measure confusion.

The Community Balance and Mobility Scale (CB&M) A scale developed to identify postural instability and evaluate change following intervention in the higher functioning ambulatory individual with TBI.

Community Integration Questionnaire (CIQ) A 15-item instrument used to measre community integration. Can be self-rated or rated by a clinician or significant other.

The Craig Handicap Assessment and Reporting Technique (CHART) A 32-item instrument used to measure participation. Can be self-rated or rated by or significant other.

The Craig Handicap Assessment and Reporting Technique Short Form (CHART SF) A 19-item instrument used to measure participation (a shorter version of the CHART). Can be self-rated or rated by or significant other.

The Craig Hospital Inventory of Environmental Factors (CHIEF) A 25-item instrument used to measure environmental factors and the impact of environmental factors. Self-rated.

Disability Rating Scale (DRS) An 8-item instrument used by clinicians to measure disability.

(Studying) Employment Variables after TBI A report on research having to do with employment following brain injury, and how to measure employment.

The Family Needs Questionnaire (FNQ) A 40-item instrument used to measure family needs as rated by a significant other. Proprietary.

Functional Assessment Measure (FAM) A 12-item adjunct or addition to the FIM(TM) adding more brain injury/stroke related items. Rated by clinicians.

Functional Independence Measure (FIM) (TM) An 18-item instrument used by clinicians to measure disability. Proprietary.

Glasgow Outcome Scale (GOS) A 1-item instrument used by clinicians to measure disability.

Extended Glasgow Outcome Scale (GOS-E) A 1-item instrument used by clinicians to measure disability. An extension of the GOS that has 8 categories rather than 5.

High Level Mobility Assessment Tool (HiMAT) A 13-item measure used to quantify high-level mobility outcomes following traumatic brain injury (TBI).

Independent Living Scale (ILS) The ILS assesses three main areas: activities of daily living (ADL's), behavior and initiation.

Level of Cognitive Functioning Scale (LCFS) A 1-item instrument used by clinicians to assess cognitive functioning. Commonly referred to as the Rancho Scale.

Mayo Portland Adaptability Inventory (MPAI) A 35-item instrument that measures problems after brain injury. Can be self-rated or rated by a clinician or significant other.

Mississippi Aphasia Screening Test (MAST) A 46-item instrument used by clinicians to measure communication and language skills.

Moss Attention Rating Scale (MARS) A 22-item observational instrument to measure attention related behavior.

Neurobehavioral Functioning Inventory (NFI) A 76-item instrument used to measure symptoms and behaviors after brain injury. Proprietary.

The Orientation Log (O-Log) A 10-item measure used by clinicians to serially assess orientation.

The Overt Behaviour Scale (OBS) Measures 9 categories of challenging behavior. Scoring includes severity, frequency, and impact.

The Patient Competency Rating Scale (PCRS) A 30-item measure of self-awareness. Can be self-rated or rated by a clinician or significant other.

The Participation Assessment with Recombined Tools-Objective (PART-O) A 17-item objective measure of participation, representing functioning at the societal level. Developed by the NIDRR-sponsored Traumatic Brain Injury Model Systems.

Participation Objective, Participation Subjective This instrument asks questions regarding 26 activities or elements of participation. Objective questions relate to the frequency of an activity, subjective questions relate to the importance of an activity and the satisfaction with their current participation in an activity.

Satisfaction With Life Scale (SWLS) A 5-item instrument used to measure life satisfaction. Self-rated.

(Problematic) Substance Use Identified in the TBI Model Sytems National Dataset A report on research involving substance use and traumatic brain injury, and how to measure substance use.

Service Obstacle Scale (SOS) A 6-item instrument that measures perceptions regarding brain-injury related services. Can be self-rated or rated by a significant other.

Supervision Rating Scale (SRS) A 1-item instrument used by clinicians to measure amount of received supervision.

Naprosyn - Woman S Health, Claneksi

Common use Naproxen sodium belongs to a class of non-steroidal anti-inflammatory drugs (NSAIDs). This medication is used to reduce intense pain, inflammation and stiffness caused by conditions like osteoarthritis, rheumatoid arthritis, psoriatic arthritis, etc. It can be also applied in other cases.

Dosage and direction Take Naprosyn by mouth with a glass of water, with or without food. Avoid cutting, crushing or chewing this medicine. Do not take the medicine more often than it is prescribed. Do not give up taking it except on the advice of your doctor. It may need time for the medicine to help. Consult your doctor concerning proper dose for you.

Precautions Before taking Naprosyn tell your doctor or chemist if you are allergic to it; or if you have other allergies. Naproxen, like other NSAIDs, can inhibit the excretion of sodium and lithium. Be cautious when using this drug along with lithium supplements. Avoid drinking alcohol and smoking while being treated with this medication. Aged people can be more sensitive to side effects of the medicine. During pregnancy this treatment should be used only when strongly necessary. As this medicament can be absorbed by skin, women who are pregnant or may become pregnant should not manipulate this medicine.

Contraindications Naprosyn should not be used by patients with sodium-sensitive hypertension as well as by patients having demonstrated a reaction of hypersensitivity to it.

Possible side effect The most common side effects are dry mouth, dizziness, irritability, sedation, insomnia, urinary retention, etc. A very serious allergic reaction rarely occurs. Many people using this medicine do not have serious side effects. Turn to your doctor or pharmacist for more details. In case you notice the effects not listed here, contact your doctor or pharmacist.

Drug interaction Tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use before using this medication. Naprosyn can interact with: * NSAIDs of the salicylate family (Aspirin) * anticoagulants. Turn to your doctor or pharmacist for more details.

Missed dose If you have missed your dose, take it as soon as you remember. If you see that it is near the time for the next dose, skip the missed dose and resume your usual dosing schedule. Do not take your dose twice.

Overdose If you think you have used too much of this medicine, seek emergency medical attention right away. The symptoms of overdose usually include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

Storage Store your medicines at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store your drugs in the bathroom. Keep all drugs away from reach of children and pets.

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

Clarityn Allergy 10mg Tablets, Allertyn

CLARITYN ALLERGY 10MG TABLETS

Illustrator CS6 PIL-OTH002879 3 155 x 297 mm October 12th 2015 9 pt (x-height=1,76mm)

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Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. Always take this medicine exactly as described in this leaflet or as your doctor, pharmacist, or nurse has told you. • Keep this leaflet. You may need to read it again. • Ask your pharmacist if you need more information or advice. • If you get any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. See section 4. • You must talk to a doctor if you do not feel better, if you feel worse or if your symptoms change. See section 4. What is in this leaflet: 1. What Clarityn Allergy Tablets are and what they are used for 2. What you need to know before you take Clarityn Allergy Tablets 3. How to take Clarityn Allergy Tablets 4. Possible side effects 5. How to store Clarityn Allergy Tablets 6. Contents of the pack and other information 1. WHAT CLARITYN ALLERGY TABLETS ARE AND WHAT THEY ARE USED FOR The full name of your medicine is Clarityn Allergy 10 mg Tablets.

What Clarityn Allergy Tablets are Clarityn Allergy tablets contain the active substance loratadine which belongs to a class of medicines called “antihistamines”. 13,3 mm 13,3 mm Dennis Prochota [email protected] ch +41 61 201 10 23

How Clarityn Allergy Tablets work Clarityn Allergy tablets help to reduce your allergy symptoms by stopping the effects of a substance called “histamine”, which is produced in the body when you are allergic to something. When Clarityn Allergy Tablets should be taken Clarityn Allergy Tablets relieves symptoms associated with allergic rhinitis (for example, hay fever), such as sneezing, runny or itchy nose, and burning or itchy eyes in adults and children over the age of 2 years who weigh more than 30 kg. Clarityn Allergy Tablets may also be used to help relieve symptoms of urticaria (itching and redness) which is often known as hives or nettle rash. The effect of Clarityn Allergy Tablets will last a whole day and should help you to continue your normal daily activities and sleep. You must talk to a doctor if you do not feel better or if you feel worse. 2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE CLARITYN ALLERGY TABLETS Do not take Clarityn Allergy Tablets if: • You are allergic (hypersensitive) to loratadine or any of the other ingredients of this medicine (listed in section 6). • You are pregnant or breastfeeding

Warnings and precautions Talk to your doctor, pharmacist or nurse before taking Clarityn Allergy Tablets if: • You have liver disease. • You are scheduled to have any skin tests for allergies. Do not take Clarityn Allergy Tablets for two days before having these tests. This is because it may affect the test results. If any of the above apply to you (or you are not sure), talk to your doctor, pharmacist or nurse before taking Clarityn Allergy Tablets. Children Do not give Clarityn Allergy Tablets to children younger than 2 years old or to children 2 to 12 years old who weigh less than 30 kg. There are other formulations more suitable for children 2 to 12 years old who weigh less than 30 kg. Other medicines and Clarityn Allergy Tablets The side effects of Clarityn Allergy Tablets may increase when used together with medicines that alter the performance of some enzymes responsible for drug-metabolism in the liver. However, in clinical studies, no increase in side effects of loratadine was seen with products that altered the performance of these enzymes. Tell your doctor, pharmacist or nurse if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription. Clarityn Allergy Tablets with alcohol Clarityn Allergy Tablets have not been shown to add to the effects of an alcoholic drink. Pregnancy and breast-feeding If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. As a precautionary measure, it is preferable to avoid the use of Clarityn Allergy Tablets during pregnancy. Do not take Clarityn Allergy Tablets if you are breast-feeding. Loratadine is excreted in breast milk. Driving and using machines In clinical trials that assessed driving ability, no impairment was observed in patients receiving loratadine. At the recommended dose, Clarityn Allergy Tablets are not expected to cause you to be drowsy or less alert. However, very rarely some people experience drowsiness, which may affect their ability to drive or use machines. Clarityn Allergy Tablets contains lactose Clarityn Allergy Tablets contains lactose; thus if you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine. 3. HOW TO TAKE CLARITYN ALLERGY TABLETS Always take this medicine exactly as described in this leaflet or as your doctor, pharmacist or nurse has told you. Check with your doctor, pharmacist or nurse if you are not sure.

CH–8293 BAYER Clarityn Allergy Tablets -

The score line of the tablet is only there to help you break the tablet if you have difficulty swallowing it whole. Giving this medicine to children Clarityn Allergy syrup may be preferable for children. It is important to know how much your child weighs to make sure that you give the correct amount of medicine. For example, a 9 year old child weighs about 30kg (4st 7lb). If in doubt weigh your child and then follow the instructions in the table.

84292729/84292737/84292745/ 84293067 Leaflet XXXXXXXXXXX triptyque code

Do not give to children under 2 years or who weigh 30 kg (4st 7lb) or less.

How much to take:

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Children of 2 to 12 years who weigh more than 30kg (4st 7lb)

How much How often to take to take 1 x tablet Once daily

1 x tablet Once daily Adults and children over 12 years If you have severe liver problems your doctor or pharmacist may advise you to take the recommended amount every other day. If this applies to you follow their instructions.

If you take more Clarityn Allergy Tablets than you should If you take more Clarityn Allergy Tablets than you should, talk to your doctor or pharmacist straight away. No serious problems are expected however, you may get a headache, have a rapid heartbeat or feel sleepy. If you forget to take Clarityn Allergy Tablets • If you forget to take your dose, take it as soon as you remember, then continue to take it as usual. • Do not take a double dose to make up for a forgotten dose. If you have any further questions on the use of this product, ask your doctor, pharmacist or nurse.

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13,3 mm 13,3 mm Dennis Strauss [email protected] ch +41 61 201 10 23

4. POSSIBLE SIDE EFFECTS Like all medicines, this medicine can cause side effects, although not everybody gets them. The most commonly reported side effects in adults and children over 12 years of age are: • drowsiness • headache • increased appetite • difficulty sleeping. The most commonly reported side effects in children aged 2 to 12 years are: • headache • nervousness • tiredness The following very rare side effects (may affect up to 1 in 10,000 people) have also been seen during the marketing of loratadine: • severe allergic reaction (including swelling) • dizziness • convulsion • fast or irregular heartbeat • nausea (feeling sick) • dry mouth • upset stomach • liver problems • hair loss • rash • tiredness

Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly (see details below). By reporting side effects you can help provide more information on the safety of this medicine. United Kingdom: Yellow Card Scheme Website: www. mhra. gov. uk/yellowcard Malta: ADR Reporting, The Medicines Authority, Post-Licensing Directorate, 203 Level 3, Rue D'Argens, GZR-1368 Gzira Website: www. medicinesauthority. gov. mt, e-mail: postlicensing. [email protected] mt 5. HOW TO STORE CLARITYN ALLERGY TABLETS • This medicinal product does not require any special storage conditions. • Keep this medicine out of the sight and reach of children. • Do not use this medicine after the expiry date which is stated on the blister after Exp. The expiry date refers to the last day of the month. • Do not use this medicine if you notice any change in the appearance of the tablet. • Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment. 6. CONTENTS OF THE PACK AND OTHER INFORMATION What Clarityn Allergy Tablets contain • The active substance is loratadine. Each tablet contains 10 mg loratadine. • The other ingredients are lactose monohydrate, maize starch, magnesium stearate. What Clarityn Allergy Tablets looks like and contents of the pack Clarityn Allergy Tablets are white, to off-white, oval tablets with flask and bowl, scoreline and the number “10” on one side. Clarityn Allergy tablets are available in pack sizes of 5, 7, 10, 14, 15, 20, 21, 28, 30, or 60 tablets. Not all pack sizes may be marketed. Marketing Authorisation Holder and Manufacturer Marketing Authorisation Holder: Bayer plc, Consumer Care Division Bayer House, Strawberry Hill Newbury Berkshire RG14 1JA United Kingdom

Manufacturer: Schering-Plough Labo NV, Industriepark, 30 B-2220 Heist-op-den-Berg, Belgium Schering-Plough Rue Louis Pasteur, 2 F-14200 Herouville Saint Clair France This leaflet was last revised in October 2015.

Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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Pramipexole Oral Uses, Side Effects, Interactions, Pictures, Warnings - Dosing, Pramipexol

pramipexole

GENERIC NAME(S): PRAMIPEXOLE DI-HCL

Uses

Pramipexole is used alone or with other medications to treat Parkinson's disease. It can improve your ability to move and decrease shakiness (tremor), stiffness, slowed movement, and unsteadiness. It may also decrease the number of episodes of not being able to move ("on-off syndrome").

This medication is also used to treat a certain medical condition (restless legs syndrome - RLS) that causes an unusual urge to move the legs. Symptoms usually occur at night along with uncomfortable/unpleasant feelings in the legs. This medication can decrease these symptoms and thereby improve sleep .

Pramipexole is a dopamine agonist that works by helping to restore the balance of a certain natural substance (dopamine) in the brain .

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used for a certain painful condition (fibromyalgia ).

How to use pramipexole

Read the Patient Information Leaflet provided by your pharmacist before you start taking pramipexole and each time you get a refill. If you have any questions, consult your doctor or pharmacist.

Take this medication by mouth with or without food, as directed by your doctor. Taking this medication with food may reduce nausea. To decrease the risk of side effects (e. g. drowsiness, low blood pressure ) when you first start taking pramipexole, your doctor will slowly increase your dosage until the best dose for you is reached. Take this medication as prescribed. Do not increase your dose or take it more often than directed.

Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day.

If you stop taking this medication for several days, you may need to increase your dose slowly back to your previous dosage. Talk with your doctor about how to restart the medication. Do not stop taking this medication without your doctor's approval. Although very unlikely, if you suddenly stop taking this drug, withdrawal reactions may occur. Such reactions can include fever, muscle stiffness, and confusion. Report any such reactions to your doctor right away. If you have Parkinson's disease and are stopping regular treatment with this drug, gradually reducing the dosage as directed will help prevent withdrawal reactions. Consult your doctor or pharmacist for more details.

The dosage is based on your medical condition and response to treatment.

It may take a few weeks for full effects of this medication to be noticed. Inform your doctor if your symptoms do not improve or if they worsen.

Side Effects

Nausea. dizziness. drowsiness, lightheadedness, trouble sleeping. constipation. headache. or dry mouth may occur. If these effects persist or worsen, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fainting. mental/mood changes (e. g. confusion, depression. hallucinations. memory problems), unusual strong urges (such as increased gambling, increased sexual urges), increased difficulty moving/walking, muscle cramps /spasm, restlessness, decreased sexual ability, increased shakiness (tremor)/stiffness, swelling of the ankles /feet.

Get medical help right away if you have any very serious side effects, including: chest pain. fever, unusually fast/slow/irregular heartbeat. muscle pain /weakness. unusual tiredness, signs of kidney problems (such as change in the amount of urine), vision changes.

Some people taking pramipexole have fallen asleep suddenly during their usual daily activities (such as talking on the phone, driving). In some cases, sleep occurred without any feelings of drowsiness beforehand. This sleep effect may occur anytime during treatment with pramipexole even if you have used this medication for a long time. If you experience increased sleepiness or fall asleep during the day, do not drive or take part in other possibly dangerous activities until you have discussed this effect with your doctor. Your risk of this sleep effect is increased by using alcohol or other medications that can make you drowsy. See also Precautions section.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction. including: rash. itching /swelling (especially of the face/tongue /throat), severe dizziness, trouble breathing .

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www. fda. gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking pramipexole, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: low blood pressure, heart problems (e. g. irregular heartbeat, heart failure ), kidney problems, mental/mood disorders (e. g. confusion, hallucinations, psychosis. schizophrenia ), sleep disorder (e. g. sleep apnea. narcolepsy ).

This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages. See also Side Effects section.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be at a greater risk for dizziness and hallucinations while using this drug.

During pregnancy. this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug may pass into breast milk and could have undesirable effects on a nursing infant. It may also affect milk production. Therefore, breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: antipsychotics (such as chlorpromazine, haloperidol, thiothixene), cimetidine, metoclopramide.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), and narcotic pain relievers (such as codeine, hydrocodone).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Overdose

If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Notes

Do not share this medication with others.

People with Parkinson's disease may have an increased risk for developing skin cancer (melanoma). If you are taking this drug to treat Parkinson's disease, tell your doctor promptly if you notice a change in the appearance or size of moles or other unusual skin changes. Ask your doctor if you should have regular skin exams.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised May 2016. Copyright(c) 2016 First Databank, Inc.

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Zoltum Generic Name Omeprazole Online, Zoltum

Zoltum General Information

Zoltum - Pharmacology:

Zoltum is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of the H + /K + - ATPase in the gastric parietal cell. By acting specifically on the proton pump, omeprazole blocks the final step in acid production, thus reducing gastric acidity.

Zoltum for patients

PRILOSEC Delayed-Release Capsules should be taken before eating. Patients should be cautioned that the PRILOSEC Delayed-Release Capsule should not be opened, chewed or crushed, and should be swallowed whole.

For patients who have difficulty swallowing capsules, the contents of a PRILOSEC Delayed-Release Capsule can be added to applesauce. One tablespoon of applesauce should be added to an empty bowl and the capsule should be opened. All of the pellets inside the capsule should be carefully emptied on the applesauce. The pellets should be mixed with the applesauce and then swallowed immediately with a glass of cool water to ensure complete swallowing of the pellets. The applesauce used should not be hot and should be soft enough to be swallowed without chewing. The pellets should not be chewed or crushed. The pellets/applesauce mixture should not be stored for future use.

This description is suitable for active ingredient Omeprazole

Zoltum Interactions

Zoltum can prolong the elimination of diazepam, warfarin and phenytoin, drugs that are metabolized by oxidation in the liver. Although in normal subjects no interaction with theophylline or propranolol was found, there have been clinical reports of interaction with other drugs metabolized via the cytochrome P-450 system ( e. g., cyclosporine, disulfiram, benzodiazepines). Patients should be monitored to determine if it is necessary to adjust the dosage of these drugs when taken concomitantly with omeprazole.

Because of its profound and long lasting inhibition of gastric acid secretion, it is theoretically possible that omeprazole may interfere with absorption of drugs where gastric pH is an important determinant of their bioavailability ( e. g., ketoconazole, ampicillin esters, and iron salts). In the clinical trials, antacids were used concomitantly with the administration of omeprazole.

Combination Therapy with Clarithromycin

Co-administration of omeprazole and clarithromycin may result in increases in plasma levels of ompeprazole, clarithromycin, and 14-hydroxy-clarithromycin.

Concomitant administration of clarithromycin with cisapride, pimozide, or terfenadine is contraindicated.

There have been reports of an intereaction between erythromycin and astemizole resulting in QT prolongation and torsades de points. Concomitant administration of erythromycin and astemizole is contraindicated. Because clarithromycin is also metabolized by cytochrome P450, concomitant administration of clarithromycin with astemizole is not recommended.

Zoltum Contraindications

Buy Flutinasal Fluticasone Salmeterol Online Without Prescriptions, Flutinasal

Advair Diskus is used for long-term treatment of asthma and chronic obstructive pulmonary disease (COPD) in certain patients. It may also be used to treat other breathing conditions as determined by your doctor. Advair Diskus is a long-acting corticosteroid and bronchodilator combination. It works by reducing inflammation and widening the airways in the lungs, which helps you breath more easily.

Use Advair Diskus as directed by your doctor.

Do not use a spacer with Advair Diskus.

Always ready and use this device in a level, flat position.

Hold the device in one hand and put the thumb of your other hand on the thumb grip. Push your thumb away from you as far as it will go until the mouthpiece appears and snaps into position.

Hold the device in a level, flat position with the mouthpiece toward you. Slide the lever away from you as far as it will go until it clicks.

Do NOT close or tilt the device, play with the lever, or move the lever more than 1 time. This may release or waste extra doses.

Hold the device away from your mouth and breathe out fully. Do NOT breathe into the inhaler. Put the mouthpiece to your lips. Breathe in quickly and deeply through the device.

Remove the device from your mouth. Hold your breath for about 10 seconds, or as long as is comfortable. Then breathe out slowly.

Close the device. Put your thumb on the thumb grip and slide it back toward you as far as it will go. The device will click shut and the lever will return to its original position.

Your dose of medicine is a very fine powder. Most, but not all, patients can taste or feel the dose. Do NOT use another dose if you do not taste or feel the medicine. If you are not sure if you are receiving your dose, contact your doctor or pharmacist.

Rinse your mouth with water after using Advair Diskus. DO NOT swallow the rinse solution. Spit the rinse water out.

If you are using other inhaled medicines, wait a few minutes between using Advair Diskus and other inhalers, unless directed otherwise by your doctor.

Take your doses of Advair Diskus about 12 hours apart, unless your doctor tells you otherwise.

Never wash the mouthpiece or any other part of the inhaler. Keep it dry. Store Advair Diskus in a dry place.

Throw Advair Diskus away 1 month after you remove it from the foil pouch, or after the dose indicator reads "0," whichever comes first.

You may breathe more easily after the first dose of Advair Diskus. However, it may take 1 week or longer to achieve the most benefit.

Use Advair Diskus on a regular schedule to get the most benefit from it. Using Advair Diskus at the same time each day will help you remember to use it. Do not stop using Advair Diskus even if you feel better unless your doctor tells you.

If you miss a dose of Advair Diskus, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any question you may have about how to use Advair Diskus.

Store Advair Diskus between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Advair Diskus out of the reach of children and away from pets.

Active Ingredient: Fluticasone propionate, Salmeterol xinafoate.

Do NOT use Advair Diskus if:

you are allergic to any ingredient in Advair Diskus or to milk proteins

you are having an asthma attack (eg, sudden, severe onset or worsening of asthma symptoms such as chest tightness, cough, shortness of breath, wheezing)

you are using another type of long-acting inhaled bronchodilator (eg, formoterol inhalation powder, salmeterol inhalation powder)

you are taking an azole antifungal (eg, ketoconazole), certain HIV protease inhibitors (eg, ritonavir), a macrolide antibiotic (eg, clarithromycin), nefazodone, or telithromycin.

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

Some medical conditions may interact with Advair Diskus. 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

if you are taking a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) or tricyclic antidepressant (eg, amitriptyline), or if you have taken either of these medicines within the last 14 days

if you have high blood acid levels (eg, ketoacidosis) or a history of diabetes, glaucoma, or increased pressure in the eye, heart problems (eg, fast or irregular heartbeat, heart blood vessel problems), high blood pressure, nervous system problems, liver problems, low blood potassium levels, seizures, thyroid problems, or an adrenal gland tumor

if you are having a COPD flare-up, have recently been to an emergency room for asthma, have a history of frequent hospitalizations for asthma, or have ever had a life-threatening asthma attack

if you have a fungal, bacterial, or parasitic infection; a viral infection (eg, measles, chickenpox, shingles); herpes virus infection of the eye; tuberculosis (TB); a history of a positive TB skin test; or immune system problems; or if you have had a recent vaccination

if you have weak bones (osteoporosis) or have risk factors for osteoporosis (eg, a family history of osteoporosis, tobacco use, long-term use of corticosteroids or certain seizure medicines, limited physical exercise, poor nutrition).

Some medicines may interact with Advair Diskus. Tell your health care provider if you are taking any other medicines, especially any of the following:

Diuretics (eg, hydrochlorothiazide, furosemide) or long-acting inhaled bronchodilators (eg, salmeterol inhalation powder, formoterol inhalation powder) because the risk of low blood potassium or irregular heartbeat may be increased

Beta-blockers (eg, propranolol) because they may decrease Advair Diskus's effectiveness

Azole antifungals (eg, ketoconazole), catechol-O-methyltransferase (COMT) inhibitors (eg, entacapone), delavirdine, HIV protease inhibitors (eg, ritonavir), macrolide antibiotics (eg, clarithromycin), MAOIs (eg, phenelzine), nefazodone, short-acting beta-agonist bronchodilators (eg, albuterol), telithromycin, or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of Advair Diskus's side effects.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Advair Diskus 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.

Important safety information:

Advair Diskus may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Advair Diskus with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Advair Diskus will not stop an asthma attack once one has started. Be sure to carry a short-acting bronchodilator with you at all times to treat any breathing problems that may occur between doses of Advair Diskus (eg, severe or sudden onset of wheezing or shortness of breath).

If you have been regularly using a short-acting bronchodilator inhaler (eg, albuterol), talk with your doctor about how to use it with Advair Diskus. Short-acting bronchodilators are normally only used with Advair Diskus to treat breathing problems that may occur between doses.

Talk with your doctor or pharmacist about all of your asthma medicines and how to use them. Do not start, stop, or change the dose of any asthma medicine unless your doctor tells you to.

If your symptoms do not get better within 1 week or if they get worse after you start using Advair Diskus, check with your doctor.

Tell your doctor or dentist that you take Advair Diskus before you receive any medical or dental care, emergency care, or surgery.

Tell your doctor at once if you notice your short-acting bronchodilator inhaler does not work as well, if you need to use it more often (eg, more than 4 times a day for more than 2 days in a row, or 1 whole canister within 8 weeks' time), or if you have a decrease in your peak meter flow results.

The risk of serious heart problems (eg, irregular heartbeat) may be greater if you use Advair Diskus in high doses. Do NOT use more than the recommended dose or use for longer than prescribed without checking with your doctor.

Advair Diskus may sometimes cause severe breathing problems right after you use a dose. If this happens, use your short-acting bronchodilator inhaler. Seek medical care at once if your breathing does not improve after you use the short-acting bronchodilator. Tell your doctor about this reaction.

Use caution if you switch from an oral steroid (eg, prednisone) to Advair Diskus. It may take several months for your body to make enough natural steroids to handle events that cause physical stress. Such events may include injury, surgery, infection, a sudden asthma attack, or severe fluid or electrolyte loss. These may be severe and sometimes fatal. Contact your doctor right away if any of these events occur. You may need to take an oral steroid (eg, prednisone) again.

If you have not had chickenpox, shingles, or measles, avoid contact with anyone who does. Contact your doctor at once if you have contact with anyone who has these infection.

Check with your doctor before you receive any vaccine while you are using Advair Diskus.

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

Lab tests, including lung function tests and eye exams, may be performed while you use Advair Diskus. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Advair Diskus with caution in the elderly.

Corticosteroids may affect growth rate in children and teenagers in some cases. They may need regular growth checks while they use Advair Diskus.

Advair Diskus should not be used in children younger than 4 years old; safety and effectiveness in these children have not been confirmed.

Pregnancy and breast-feeding: If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Advair Diskus while you are pregnant. It is not known if Advair Diskus is found in breast milk. If you are or will be breast-feeding while you use Advair Diskus, check with your doctor. Discuss any possible risks to your baby.

Reumofan Plus Recall - Undeclared Drug Ingredient, Reumafen

Reumofan Plus: Recall - Undeclared Drug Ingredient

Pain Free By Nature is recalling "Reumofan Plus" Tablets purchased through their website at www. painfreebynature. com, after FDA discovered that the product was distributed in packaging that did not reveal the presence of the active pharmaceutical ingredients methocarbamol and diclofenac, making it an unapproved drug. Use of this product could result in serious and life-threatening injuries. Distribution has been completely terminated by the company.

Reumofan Plus is used as a treatment for muscle pain, arthritis, osteoporosis, bone cancer and other conditions. This product comes in thirty (30) tablet containers and is packaged in a green and gold box [photo link below]. Consumers who are taking these products or who have recently stopped taking Reumofan Plus should immediately consult a health care professional.

Reumofan Plus USA, LLC and Reumofan USA, LLC is recalling "Reumofan Plus" Tablets, Lot# 99515, exp. 09/16, because they contain undeclared active pharmaceutical ingredients: methocarbamol, dexamethasone, and diclofenac. The recall was initiated after it was discovered that the product was distributed in packaging that did not reveal the presence of the active pharmaceutical ingredients, making it an unapproved drug. One illness has been reported to date in connection with this problem.

Samantha Lynn Inc. is voluntarily recalling 500 lots of Reumofan Plus Tablets to the consumer level due to findings of undeclared drug ingredients. The FDA sample analysis has found the product to contain methocarbamol and diclofenac. The affected Reumofan Plus lots may include the following lot number(s): 99515 ex096 and expires: 2016. The product is marketed in a green bottle containing 30 lavender round tablets and is distributed nationwide via the internet.

Consumers that purchased Reumofan Plus from Samantha Lynn Inc. between Feb 2012 and June 2012 will receive an email notifying them of their options. Consumers that have Reumofan Plus should be aware that the product may pose a health risk and are advised to consult their family doctor/stop using/return to place of purchase or discard.

FDA is issuing an updated alert that Reumofan Plus and Reumofan Plus Premium contain undeclared active ingredients found in prescription drugs that should be used only under the supervision of a health care professional.

Since June 1, 2012, when FDA first warned the public about the dangers of these supplements, the agency has received reports of fatalities, stroke, severe bleeding in the gastrointestinal tract, dizziness, insomnia, high blood sugar levels and problems with liver and kidney functions, as well as corticosteroid withdrawal syndrome

Because of the possible risks, consumers should not buy or start using these products.

AUDIENCE . Consumer, Health Professional, Emergency Medicine

ISSUE . FDA is warning consumers that Reumofan Plus, marketed as a natural dietary supplement for pain relief and other serious conditions, contains several active pharmaceutical ingredients not listed on the label that could be harmful. An FDA laboratory analysis of Reumofan Plus found that it contains Diclofenac Sodium, a prescription non-steroidal anti-inflammatory drug (NSAID) that may cause increased risk of cardiovascular events such as heart attack and stroke, as well as serious gastrointestinal (GI) adverse events including bleeding, ulceration, and fatal perforation (causing a hole) of the stomach and intestines, and Methocarbamol, a prescription muscle relaxant that can cause sedation, dizziness, low blood pressure, and impair mental or physical abilities to perform tasks such as driving a motor vehicle or operating machinery.

The Mexican Ministry of Health discovered that at least one lot of the product contains the corticosteroid dexamethasone, a drug that acts as an anti-inflammatory and immune system suppressant.

FDA has received multiple reports of adverse events associated with the use of Reumofan Plus, including liver injury, sudden worsening of glucose control, weight gain, swelling, leg cramps, and adrenal suppression.

BACKGROUND . Reumofan Plus is marketed as a natural dietary supplement for pain relief. Reumofan Plus is labeled in Spanish and promoted for treating arthritis, muscle pain, osteoporosis, bone cancer, and other conditions. The product is manufactured in Mexico by Riger Naturals and sold in some retail outlets, at flea markets, and on various internet sites. FDA has worked closely with the Mexican government on this matter. The Mexican Ministry of Health has issued a health warning to the public and ordered Riger Naturals to recall the product.

RECOMMENDATION . Consumers who are currently taking or who recently stopped taking Reumofan Plus are urged to consult a healthcare professional immediately. Health care professionals are urged to ask their patients about use of Reumofan Plus and other products marketed as dietary supplements when patients present with unexplained symptoms that suggest NSAID toxicity, depression, or the use or abrupt discontinuation of corticosteroids. Additionally, health care professionals should evaluate patients who have used Reumofan Plus for drug and disease interactions involving diclofenac, methocarbamol, and corticosteroids, and consider whether a corticosteroid taper regimen may be appropriate in those who have used Reumofan Plus.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

Complete and submit the report Online: www. fda. gov/MedWatch/report. htm

Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

Normospor Cream, Normospor

PHARMACOLOGICAL CLASSIFICATION: A 20.2.2 Fungicides

PHARMACOLOGICAL ACTION: A broad spectrum antimycotic with fungicidal properties.

INDICATIONS: All dermatomycoses due to dermatophytes (e. g. Trichophyton species). Dermatomycoses due to moulds and other fungi. Skin diseases with secondary infection by these fungi. The dermatomycoses in above-mentioned include among others: Mycoses of the skin and skin folds Ringworm Interdigital mycoses (e. g. athlete's foot) Pityriasis versicolor Erythrasma Paronychias (associated with nail mycoses)

CONTRA-INDICATIONS: Possible sensitivity to clotrimazole.

DOSAGE AND DIRECTIONS FOR USE: Apply thinly to the affected areas 2 - 3 times daily and rub in. Successful treatment demands that Normospor cream be applied correctly and over a sufficiently long period of time. The duration of treatment varies. In general, it is three to four weeks in the case of dermatomycoses due to dermatophytes and approximately three weeks in erythrasma and pityriasis versicolor. TREATMENT OF FUNGAL INFECTION SHOULD BE CONTINUED FOR APPROXIMATELY TWO WEEKS AFTER THE DISAPPEARANCE OF ALL SYMPTOMS DESPITE A RAPID, SUBJECTIVE IMPROVEMENT, IN ORDER TO PREVENT RELAPSE. Athlete's foot . Always dry the feet carefully, especially between the toes. Normospor cream is odourless, can be washed off and does not stain. Normospor cream is not indicated for ophthalmic use and should be used with caution around the eyes.

SIDE-EFFECTS AND SPECIAL PRECAUTIONS: Local reactions including irritation and burning may occur. Contact allergic dermatitis can occur. If this occurs, treatment should be discontinued.

KNOWN SYMPTOMS OF OVERDOSAGE AND PARTICULARS OF ITS TREATMENT: See "Side-effects and Special Precautions". In case of accidental ingestion, gastro-intestinal disturbances and central nervous system depression may occur. Treatment is symptomatic and supportive.

IDENTIFICATION: A soft white cream.

PRESENTATION: Tubes with 20 gram.

STORAGE INSTRUCTIONS: Store below 25°C. KEEP OUT OF REACH OF CHILDREN.

REGISTRATION NUMBER: 27/20.2.2/0201

NAME AND BUSINESS ADDRESS OF THE APPLICANT: ADCOCK INGRAM LTD Adcock Ingram Park 17 Harrison Avenue Bryanston, Ext. 77 Private Bag X69, Bryanston, 2021

DATE OF PUBLICATION OF THIS PACKAGE INSERT: 20 October 1992

New addition to this site: May 2004 Source: Pharmaceutical Industry SAEPI HOME PAGE TRADE NAME INDEX GENERIC NAME INDEX FEEDBACK Information presented by Malahyde Information Systems © Copyright 1996-2004

Kopen Lovispes (Bystolic) Zonder Recept, Lovispes

Lovispes (Bystolic) Kopen Online Zonder Recept

Lovispes (Bystolic) Toelichting

Lovispes is eigenlijk geproduceerd door onderzoekers in de gezondheidszorg om te voorkomen dat door middel van hypertensie.

Lovispes is echt een beta-blokker. Dit werkt door middel van het beinvloeden van de bloedsomloop via arteriele bloedvaten evenals de bloedvaten. Dit laat een lage bloeddruk te verminderen, kunnen cardiovasculaire werken effectiever te maken, evenals vermindert de werklast binnen de cardiovasculaire.

Lovispes (Bystolic) Dosis

Lovispes komt in:

tweede. 5mg lagere dosis frictiemateriaal

5mg Standart Dose frictiemateriaal

Lovispes is eigenlijk oraal gebruikt zonder of met maaltijden.

Krijg Lovispes tegelijkertijd elke dag.

Uw eigen lage bloeddruk zal moeten vaak raken onderzocht.

Het is cruciaal om mee te volgen met uw dieet plan, geneeskunde, evenals lichaamsbeweging opleiding.

Wilt u beste resultaten te bereiken meestal niet stoppen met het gebruik van Lovispes ineens.

Lovispes (Bystolic) ontbreekt in verband met de dosering

Meestal krijgt niet de dubbele dosering. In het geval u de dosering die u nodig hebt om het te dragen als je eenmaal in het achterhoofd te houden met betrekking tot uw ontbreekt overslaan. Wanneer het tijd is voor de dosering die u nodig hebt om te dragen op je eigen normale dosering routine.

Lovispes (Bystolic) Overdose

In het geval u Lovispes overdosis en je ook voorkomen dat geweldig je nodig hebt om direct te controleren uw arts of zelfs arts.

Lovispes (Bystolic) Opslagruimte

Shop in een ruimte temperaturen tussen vier en dertig niveaus D (39 en zesentachtig niveaus F) tegen vocht, verlichting en temperatuur. Versterken van de werkelijke na afloop dag. Handhaven van het bereiken van kinderen.

Lovispes (Bystolic) Negatieve effecten

Lovispes biedt de negatieve effecten. De meest typische neiging om:

hoofdpijn frictiemateriaal

uitgeput gevoel frictiemateriaal

misselijkheid of braken frictiemateriaal

buik ongemak frictiemateriaal

diarree frictiemateriaal

slapeloosheid frictiemateriaal

Veel minder typische en ernstige nadelige gevolgen voor de hele behulp Lovispes:

allergische reactie reacties (urticaria, en uitademen problemen, allergie, evenals eruptie) frictiemateriaal

sensatie ontbreekt ademen, ondanks matige fysieke inspanning frictiemateriaal

ontsteking van de scheenbenen of zelfs ft frictiemateriaal

langzamer of zelfs ongelijke hartslagen frictiemateriaal

tintelingen of zelfs kille gevoel in je vingers als ft frictiemateriaal

Negatieve effecten zijn er aanwijzingen afhankelijk zijn van medicijnen die u zou kunnen gebruiken, maar bovendien rekenen op uw welzijn conditie en andere aspecten.

Lovispes (Bystolic) Contra-indicaties

Meestal hoeft Lovispes niet te krijgen in het geval u gevoelig om Lovispes elementen zijn.

Word voorzichtig samen met Lovispes als u verwacht op een andere wijze u van plan bent om een ??kind te bezitten. Meestal niet dragen moet je de medische moeder te zijn. Het is verre van erkende of Lovispes zeker een kind beschadigen.

Meestal niet gebruiken Lovispes voor degenen die ernstige ziekten in de lever, hart-kwestie bijvoorbeeld cardiovasculaire voorkomen, ziek neusklachten, tragere hartslag, of zelfs cardiovasculair falen.

Wees voorzichtig, samen met Lovispes voor digitalis (digoxine, Lanoxin); cardiovasculaire of zelfs lage bloeddruk geneeskunde bijvoorbeeld diltiazem (Cartia, Cardizem), felodipine (Plendil), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), evenals anderen; antidepressivum zoals fluoxetine (Prozac), paroxetine (Paxil), en anderen; reserpine; betablokker bijvoorbeeld atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, Innopran), sotalol (Betapace), alsmede als anderen; hart - tempo medicatie bijvoorbeeld amiodaron (Cordarone, Pacerone), quinidine (Quin-G), procainamide (Pronestyl), disopyramide (Norpace), flecaininde (Tambocor), mexiletine (Mexitil), propafenon (Rythmol), en anderen; clonidine (Catapres).

Wees voorzichtig, samen met Lovispes in het geval u worden getroffen door en hebben een korte geschiedenis in verband met ademhalingsproblemen, bronchitis, emfyseem, historische verleden geassocieerd met allergische reacties, feochromocytoom (tumor van de bijnier), schildklier probleem, voor degenen die onlangs hebben meegemaakt myocardinfarct, lever of nier ziekte, problemen met de bloedsomloop (bijvoorbeeld omdat Raynaud's syndroom), diabetes.

Wees voorzichtig, samen met Lovispes als je wilt chirurgische behandeling bezitten.

voorkomen dat apparaat reizen.

U moet zich houden aan dieet, lichaamsbeweging, maar ook gewichtsverlies.

Lovispes (Bystolic) Veelgestelde vragen

Queen: Wat is Lovispes precies?

De: Lovispes is een efficiente voorbereiding die wordt verbruikt bij het verhelpen van een hoge bloeddruk (hoge bloedbaan druk). Lovispes kan ook worden gebruikt met betrekking tot een aantal andere reasons. A

Queen: Wat is precies Lovispes procedure?

De: Lovispes is echt een beta-blokker. Dit werkt door middel van het beinvloeden van de bloedsomloop via arteriele bloedvaten evenals bloed vessels. A

Precies hoe moet ik krijg Lovispes

De: Lovispes is eigenlijk oraal gebruikt zonder of met maaltijden. Krijg Lovispes tegelijkertijd elke dag. Uw eigen lage bloeddruk zal moeten vaak raken onderzocht. Het is cruciaal om mee te volgen met uw dieet plan, geneeskunde, evenals lichaamsbeweging opleiding. Wilt u de beste resultaten te bereiken meestal niet stoppen met het gebruik van Lovispes al een sudden. A

Kopen Lovispes (Bystolic) online, kopen Lovispes (Bystolic) online zonder voorschrift, kopen Lovispes (Bystolic) zonder recept, kopen Lovispes (Bystolic) goedkoop, kopen Lovispes (Bystolic) zonder voorschrift, kopen Lovispes (Bystolic) uit Canada, kopen Lovispes (Bystolic) Canada, inkopen Lovispes (Bystolic) online, inkopen Lovispes (Bystolic) online no prescription, bestelling Lovispes (Bystolic) zonder recept, Lovispes (Bystolic) orale pil

Zoeken

Diclofenac, Voltaren, Cataflam, Cambia Side Effects & Dosing, Difenax

diclofenac, Voltaren, Cataflam, Voltaren-XR, Cambia

GENERIC NAME: diclofenac

BRAND NAMES: Voltaren, Cataflam, Voltaren-XR, Cambia, Zipsor, Zorvolex

DRUG CLASS AND MECHANISM: Diclofenac belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs ) that are used for the treatment of mild to moderate pain. fever. and inflammation. Other members of this class include ibuprofen (Motrin ), indomethacin (Indocin ), nabumetone (Relafen), naproxen (Aleve ) and several others. NSAIDs work by reducing the production of prostaglandins, chemicals that cause pain. fever and inflammation. NSAIDs block the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower production of prostaglandins. As a consequence, inflammation, pain and fever are reduced. Since the response to different NSAIDs varies from patient to patient, it is not unusual for a doctor to try different NSAIDs for any given condition. The FDA approved diclofenac in July 1998.

PRESCRIBED FOR: Diclofenac is used primarily for the treatment of inflammation and pain caused by conditions such as rheumatoid arthritis. osteoarthritis. and ankylosing spondylitis. It also is effective in treating soft tissue inflammation that causes tendinitis and bursitis. and for treating dysmenorrhea (menstrual cramps ).

Medically Reviewed by a Doctor on 12/30/2014

Quick Guide Osteoarthritis (OA): Treatment, Symptoms, Diagnosis

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Comprar In English, Compraz

1 (adquirir) [+casa, comida, regalo] to buy; purchase (formal)

¿te has comprado por fin la bici? did you buy the bike in the end?

me parece que hemos comprado demasiada comida hemos comprado dos libros con suficiente dinero puedes comprar hasta los mejores cerebros del mundo tengo que comprar fruta y verduras ha salido a comprar tabaco tengo que comprar libras antes de ir a Londres

comprar algo a algn (para algn) to buy sth for sb; buy sb sth; (de algn) to buy sth from sb; le compré un vestido a mi hija I bought a dress for my daughter; I bought my daughter a dress

le tenemos que comprar un regalo

siempre le compro la carne a este carnicero I always buy my meat from this butcher; si decides vender el coche, yo te lo compro if you decide to sell the car, I'll buy it from o off you

los países que compren ese producto a Cuba le he comprado estas flores a una gitana

comprar algo al contado to pay cash (for sth); pay sth in cash

comprar algo al detalle to buy sth retail

comprar algo a plazos to buy sth on hire purchase

comprar algo al por mayor to buy sth wholesale

comprar algo al por menor to buy sth retail

comprar deudas to factor

2 (sobornar) to bribe; buy off (familiar)

intentaron comprar al juez they tried to bribe o buy off (familiar) the judge; el árbitro está comprado they've bribed the referee

(hacer la compra) to buy; shop

nunca compro en grandes almacenes I never buy o shop in department stores

Haisigyn, Haisigyn

Antibiotics - Haisigyn (Brand name: tinidazole)

Tinidazole is used for treating certain parasitic and bacterial infections. Tinidazole is an antiprotozoal and antibiotic. It works by killing sensitive parasites and bacteria.

Use Tinidazole as directed by your doctor.

Take Tinidazole by mouth with food.

If you have trouble swallowing the tablets, check with your doctor or pharmacist.

If you take cholestyramine, do not take it at the same time you take Tinidazole. Talk with your doctor about how you should take cholestyramine with Tinidazole.

If more than one dose of Tinidazole is required, continue using Tinidazole for the full course of treatment in order to clear up your infection completely, even if you feel better in a few days. Do not miss any dose.

If you miss a dose of Tinidazole, 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 Tinidazole.

Store Tinidazole at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Tinidazole out of the reach of children and away from pets.

Do NOT use Tinidazole if:

you are allergic to any ingredient in Tinidazole or to other nitroimidazole medicines (metronidazole)

you have the blood disease porphyria

you are in your first 3 months of pregnancy

you are taking astemizole, busulfan, cisapride, or terfenadine

you have taken disulfiram within the past 2 weeks.

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

Some medical conditions may interact with Tinidazole. 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

if you have nerve, brain, or blood problems; a yeast infection; or a history of seizures or liver problems

if you are undergoing dialysis.

Some medicines may interact with Tinidazole. Tell your health care provider if you are taking any other medicines, especially any of the following:

Azole antifungals (eg, ketoconazole) or cimetidine because they may increase the risk of Tinidazole's side effects

Barbiturates (eg, phenobarbital), phenytoin, or rifampin because they may decrease Tinidazole's effectiveness

Anticoagulants (eg, warfarin), astemizole, busulfan, cisapride, cyclosporine, fluorouracil, lithium, macrolide immunosuppressants (eg, tacrolimus), sulfonylureas (eg, glipizide), or terfenadine because their actions and the risk of their side effects may be increased

Disulfiram because side effects, such as mental or mood changes, may occur

Oral contraceptives (birth control pills) because their effectiveness may be decreased by Tinidazole.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Tinidazole 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.

Important safety information:

Tinidazole may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Tinidazole with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.

Avoid drinking alcohol or taking products that contain alcohol while taking Tinidazole and for 3 days after the last dose.

Tinidazole only works against bacteria and parasites; it does not treat viral infections (eg, the common cold).

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

Tinidazole may discolor or darken the urine. This is normal and not a cause for concern.

Hormonal birth control (eg, birth control pills) may not work as well while you are using Tinidazole. To prevent pregnancy, use an extra form of birth control (eg, condoms).

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

Tinidazole may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Tinidazole.

Lab tests, including blood cell counts, may be performed while you use Tinidazole. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Tinidazole with extreme caution in children younger 3 years; safety and effectiveness in these children have not been confirmed.

Pregnancy and breast-feeding: Tinidazole may cause harm to the fetus. Tinidazole should not be used during the first trimester of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Tinidazole while you are pregnant. Tinidazole is found in breast milk. Do not breast-feed while taking Tinidazole and for 3 days after you have taken the last dose.

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:

Constipation; diarrhea; dizziness; general body discomfort; headache; loss of appetite; metallic/bitter taste in mouth; nausea; stomach pain; tiredness; vomiting; weakness.

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); abnormal skin sensations (prickling, tingling); depression; fever, chills, or persistent sore throat; hoarseness; irregular heartbeat; numbness or loss of feeling in the hands or feet; pounding in the chest; red, swollen, blistered, or peeling skin; seizures; shortness of breath; unusual bruising or bleeding ; vaginal irritation or discharge.

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.

Why register with MediGuard?

We are a free monitoring service designed for patients like you who want to be in the driver seat of your medical treatment. We have a community of more than 2.6 million members and offer the services below.

Medication Information Personalized Risk Rating Easy to understand overview Serious Side Effects Printable Medication List

Information you can understand Overview on Safety Alerts & Recalls Overview of Medications & Conditions

Community of patients Members’ Feedback Members Treatment Satisfaction

Health condition information Easy to understand overview Commonly Used Medications

Safety checks Safety Alerts & Recalls Drug - Drug Interaction Drug - Condition Interaction

Research participation Option to participate in medical surveys & studies*

Fasigyn

What is your Risk Rating for this medicine?

The risk of serious side effects for taking this medicine can be different if you take other medicines or if you suffer from a condition. Get your Risk Rating by creating a profile in a few steps.

Benefits:

We monitor your health and alert you to any safety updates and recalls.

You get to talk directly to other members about their experience.

You can create profiles for you and your loved ones.

Create my Profile Learn more about Risk Ratings

Other Names

Expand to see all

Share your story! Tell us how MediGuard has helped you or someone you love. Download the MediGuard Mobile App to manage your prescription and over-the-counter medications, for free. Taking multiple medications puts you at risk for possible drug-drug interactions Monitor the medical treatment of you and your loved ones.

DISCLAIMER: MediGuard is not intended to be a substitute for professional medical advice. MediGuard cannot and does not take into consideration every possible interaction or account for individual responses to medicine. Different individuals may respond to medication in different ways. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective, or appropriate for any given patient. Always seek the advice of a qualified health provider with any questions you may have before making any changes to your treatment. The use of the MediGuard site and its content is at your own risk. The MediGuard site and the information contained in it is intended for users in the United States and information in other countries may be different.

© Quintiles 2016

Tinidazole is used for treating certain parasitic and bacterial infections. Tinidazole is an antiprotozoal and antibiotic. It works by killing sensitive parasites and bacteria.

Use Tinidazole as directed by your doctor.

Take Tinidazole by mouth with food.

If you have trouble swallowing the tablets, check with your doctor or pharmacist.

If you take cholestyramine, do not take it at the same time you take Tinidazole. Talk with your doctor about how you should take cholestyramine with Tinidazole.

If more than one dose of Tinidazole is required, continue using Tinidazole for the full course of treatment in order to clear up your infection completely, even if you feel better in a few days. Do not miss any dose.

If you miss a dose of Tinidazole, 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 Tinidazole.

Store Tinidazole at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Tinidazole out of the reach of children and away from pets.

Do NOT use Tinidazole if:

you are allergic to any ingredient in Tinidazole or to other nitroimidazole medicines (metronidazole)

you have the blood disease porphyria

you are in your first 3 months of pregnancy

you are taking astemizole, busulfan, cisapride, or terfenadine

you have taken disulfiram within the past 2 weeks.

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

Some medical conditions may interact with Tinidazole. 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

if you have nerve, brain, or blood problems; a yeast infection; or a history of seizures or liver problems

if you are undergoing dialysis.

Some medicines may interact with Tinidazole. Tell your health care provider if you are taking any other medicines, especially any of the following:

Azole antifungals (eg, ketoconazole) or cimetidine because they may increase the risk of Tinidazole's side effects

Barbiturates (eg, phenobarbital), phenytoin, or rifampin because they may decrease Tinidazole's effectiveness

Anticoagulants (eg, warfarin), astemizole, busulfan, cisapride, cyclosporine, fluorouracil, lithium, macrolide immunosuppressants (eg, tacrolimus), sulfonylureas (eg, glipizide), or terfenadine because their actions and the risk of their side effects may be increased

Disulfiram because side effects, such as mental or mood changes, may occur

Oral contraceptives (birth control pills) because their effectiveness may be decreased by Tinidazole.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Tinidazole 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.

Important safety information:

Tinidazole may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Tinidazole with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.

Avoid drinking alcohol or taking products that contain alcohol while taking Tinidazole and for 3 days after the last dose.

Tinidazole only works against bacteria and parasites; it does not treat viral infections (eg, the common cold).

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

Tinidazole may discolor or darken the urine. This is normal and not a cause for concern.

Hormonal birth control (eg, birth control pills) may not work as well while you are using Tinidazole. To prevent pregnancy, use an extra form of birth control (eg, condoms).

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

Tinidazole may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Tinidazole.

Lab tests, including blood cell counts, may be performed while you use Tinidazole. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Tinidazole with extreme caution in children younger 3 years; safety and effectiveness in these children have not been confirmed.

Pregnancy and breast-feeding: Tinidazole may cause harm to the fetus. Tinidazole should not be used during the first trimester of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Tinidazole while you are pregnant. Tinidazole is found in breast milk. Do not breast-feed while taking Tinidazole and for 3 days after you have taken the last dose.

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:

Constipation; diarrhea; dizziness; general body discomfort; headache; loss of appetite; metallic/bitter taste in mouth; nausea; stomach pain; tiredness; vomiting; weakness.

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); abnormal skin sensations (prickling, tingling); depression; fever, chills, or persistent sore throat; hoarseness; irregular heartbeat; numbness or loss of feeling in the hands or feet; pounding in the chest; red, swollen, blistered, or peeling skin; seizures; shortness of breath; unusual bruising or bleeding ; vaginal irritation or discharge.

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.

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Rinstead, Rinstead

Why register with MediGuard?

We are a free monitoring service designed for patients like you who want to be in the driver seat of your medical treatment. We have a community of more than 2.6 million members and offer the services below.

Medication Information Personalized Risk Rating Easy to understand overview Serious Side Effects Printable Medication List

Information you can understand Overview on Safety Alerts & Recalls Overview of Medications & Conditions

Community of patients Members’ Feedback Members Treatment Satisfaction

Health condition information Easy to understand overview Commonly Used Medications

Safety checks Safety Alerts & Recalls Drug - Drug Interaction Drug - Condition Interaction

Research participation Option to participate in medical surveys & studies*

Rinstead

What is your Risk Rating for this medicine?

The risk of serious side effects for taking this medicine can be different if you take other medicines or if you suffer from a condition. Get your Risk Rating by creating a profile in a few steps.

Benefits:

We monitor your health and alert you to any safety updates and recalls.

You get to talk directly to other members about their experience.

You can create profiles for you and your loved ones.

Create my Profile Learn more about Risk Ratings

Other Names

Expand to see all

Share your story! Tell us how MediGuard has helped you or someone you love. Download the MediGuard Mobile App to manage your prescription and over-the-counter medications, for free. Taking multiple medications puts you at risk for possible drug-drug interactions Monitor the medical treatment of you and your loved ones.

DISCLAIMER: MediGuard is not intended to be a substitute for professional medical advice. MediGuard cannot and does not take into consideration every possible interaction or account for individual responses to medicine. Different individuals may respond to medication in different ways. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective, or appropriate for any given patient. Always seek the advice of a qualified health provider with any questions you may have before making any changes to your treatment. The use of the MediGuard site and its content is at your own risk. The MediGuard site and the information contained in it is intended for users in the United States and information in other countries may be different.

© Quintiles 2016

Israel Pharma, Acamoli

Package(a ): PEDIATRIC SUPPOSITORIES: 12 x 150 mg. Dosage(a ): Infants up to 3 years: 1 suppository up to 5 x daily. 3-4 years: 1 suppository 4-5 x daily. 4-6 years: 1-2 suppositories 4-5 x daily. 6-9 years: 2 suppositories 2 x daily. Prescribing Restrictions: None

Package(b ): SYRUP: 60 ml x 125 mg/5 ml. Dosage(b ): The doses must be given at intervals of not less than 4 hours. The recommended dosage or the number of daily doses should not be exceeded. Adults and children over 12 years of age: 20 ml every 4-5 hours, as needed. The amount of 4 G paracetamol (160 ml syrup) in 24 hours should not be exceeded. Children: According to child's body weight: 3 kg: 1.8 ml; 4 kg: 2.4 ml; 5 kg: 3 ml; 6 kg: 3.6 ml; 7 kg: 4.2 ml; 8 kg: 4.8 ml; 9 kg: 5.4 ml; 10 kg: 6 ml; 11 kg: 6.6 ml; 12 kg: 7.2 ml; 13 kg: 7.8 ml; 14 kg: 8.4 ml; 15 kg: 9 ml; 16 kg: 9.6 ml; 17 kg: 10.2 ml; 18 kg: 10.8 ml; 19 kg: 11.4 ml; 20 kg: 12 ml. All up to 5 times daily. Dosage according to child's age. Should be used only in the absence of the possibility to determine the child's body weight: 0-3 months: 1.6 ml; 4-11 months: 3.2 ml; 12-23 months: 4.8 ml; 2-3 years: 6.4 ml; 4-5 years: 9.6 ml; 6-8 years: 12.8 ml; 9-10 years: 16 ml; 11 years: 19.2 ml. All up to 5 times daily. Prescribing Restrictions: None

Package(c ): SYRUP: 100 ml x 125 mg/5 ml. Dosage(c ): The doses must be given at intervals of not less than 4 hours. The recommended dosage or the number of daily doses should not be exceeded. Adults and children over 12 years of age: 20 ml every 4-5 hours, as needed. The amount of 4 G paracetamol (160 ml syrup) in 24 hours should not be exceeded. Children: According to child's body weight: 3 kg: 1.8 ml; 4 kg: 2.4 ml; 5 kg: 3 ml; 6 kg: 3.6 ml; 7 kg: 4.2 ml; 8 kg: 4.8 ml; 9 kg: 5.4 ml; 10 kg: 6 ml; 11 kg: 6.6 ml; 12 kg: 7.2 ml; 13 kg: 7.8 ml; 14 kg: 8.4 ml; 15 kg: 9 ml; 16 kg: 9.6 ml; 17 kg: 10.2 ml; 18 kg: 10.8 ml; 19 kg: 11.4 ml; 20 kg: 12 ml. All up to 5 times daily. Dosage according to child's age. Should be used only in the absence of the possibility to determine the child's body weight: 0-3 months: 1.6 ml; 4-11 months: 3.2 ml; 12-23 months: 4.8 ml; 2-3 years: 6.4 ml; 4-5 years: 9.6 ml; 6-8 years: 12.8 ml; 9-10 years: 16 ml; 11 years: 19.2 ml. All up to 5 times daily. Prescribing Restrictions: None

Package(d ): SYRUP: 60 ml x 125 mg/5 ml. Fruit flavor without sugar. Dosage(d ): The doses must be given at intervals of not less than 4 hours. The recommended dosage or the number of daily doses should not be exceeded. Adults and children over 12 years of age: 20 ml every 4-5 hours, as needed. The amount of 4 G paracetamol (160 ml syrup) in 24 hours should not be exceeded. Children: According to child's body weight: 3 kg: 1.8 ml; 4 kg: 2.4 ml; 5 kg: 3 ml; 6 kg: 3.6 ml; 7 kg: 4.2 ml; 8 kg: 4.8 ml; 9 kg: 5.4 ml; 10 kg: 6 ml; 11 kg: 6.6 ml; 12 kg: 7.2 ml; 13 kg: 7.8 ml; 14 kg: 8.4 ml; 15 kg: 9 ml; 16 kg: 9.6 ml; 17 kg: 10.2 ml; 18 kg: 10.8 ml; 19 kg: 11.4 ml; 20 kg: 12 ml. All up to 5 times daily. Dosage according to child's age. Should be used only in the absence of the possibility to determine the child's body weight: 0-3 months: 1.6 ml; 4-11 months: 3.2 ml; 12-23 months: 4.8 ml; 2-3 years: 6.4 ml; 4-5 years: 9.6 ml; 6-8 years: 12.8 ml; 9-10 years: 16 ml; 11 years: 19.2 ml. All up to 5 times daily. Prescribing Restrictions: None

Package(e ): SYRUP: 100 ml x 125 mg/5 ml. Fruit flavor without sugar. Dosage(e ): The doses must be given at intervals of not less than 4 hours. The recommended dosage or the number of daily doses should not be exceeded. Adults and children over 12 years of age: 20 ml every 4-5 hours, as needed. The amount of 4 G paracetamol (160 ml syrup) in 24 hours should not be exceeded. Children: According to child's body weight: 3 kg: 1.8 ml; 4 kg: 2.4 ml; 5 kg: 3 ml; 6 kg: 3.6 ml; 7 kg: 4.2 ml; 8 kg: 4.8 ml; 9 kg: 5.4 ml; 10 kg: 6 ml; 11 kg: 6.6 ml; 12 kg: 7.2 ml; 13 kg: 7.8 ml; 14 kg: 8.4 ml; 15 kg: 9 ml; 16 kg: 9.6 ml; 17 kg: 10.2 ml; 18 kg: 10.8 ml; 19 kg: 11.4 ml; 20 kg: 12 ml. All up to 5 times daily. Dosage according to child's age. Should be used only in the absence of the possibility to determine the child's body weight: 0-3 months: 1.6 ml; 4-11 months: 3.2 ml; 12-23 months: 4.8 ml; 2-3 years: 6.4 ml; 4-5 years: 9.6 ml; 6-8 years: 12.8 ml; 9-10 years: 16 ml; 11 years: 19.2 ml. All up to 5 times daily. Prescribing Restrictions: None

Package(f ): SYRUP: 60 ml x 125 mg/5 ml. Strawberry flavor without sugar. Dosage(f ): The doses must be given at intervals of not less than 4 hours. The recommended dosage or the number of daily doses should not be exceeded. Adults and children over 12 years of age: 20 ml every 4-5 hours, as needed. The amount of 4 G paracetamol (160 ml syrup) in 24 hours should not be exceeded. Children: According to child's body weight: 3 kg: 1.8 ml; 4 kg: 2.4 ml; 5 kg: 3 ml; 6 kg: 3.6 ml; 7 kg: 4.2 ml; 8 kg: 4.8 ml; 9 kg: 5.4 ml; 10 kg: 6 ml; 11 kg: 6.6 ml; 12 kg: 7.2 ml; 13 kg: 7.8 ml; 14 kg: 8.4 ml; 15 kg: 9 ml; 16 kg: 9.6 ml; 17 kg: 10.2 ml; 18 kg: 10.8 ml; 19 kg: 11.4 ml; 20 kg: 12 ml. All up to 5 times daily. Dosage according to child's age. Should be used only in the absence of the possibility to determine the child's body weight: 0-3 months: 1.6 ml; 4-11 months: 3.2 ml; 12-23 months: 4.8 ml; 2-3 years: 6.4 ml; 4-5 years: 9.6 ml; 6-8 years: 12.8 ml; 9-10 years: 16 ml; 11 years: 19.2 ml. All up to 5 times daily. Prescribing Restrictions: None

Package(g ): SYRUP: 100 ml x 125 mg/5 ml. Strawberry flavor without sugar. Dosage(g ): The doses must be given at intervals of not less than 4 hours. The recommended dosage or the number of daily doses should not be exceeded. Adults and children over 12 years of age: 20 ml every 4-5 hours, as needed. The amount of 4 G paracetamol (160 ml syrup) in 24 hours should not be exceeded. Children: According to child's body weight: 3 kg: 1.8 ml; 4 kg: 2.4 ml; 5 kg: 3 ml; 6 kg: 3.6 ml; 7 kg: 4.2 ml; 8 kg: 4.8 ml; 9 kg: 5.4 ml; 10 kg: 6 ml; 11 kg: 6.6 ml; 12 kg: 7.2 ml; 13 kg: 7.8 ml; 14 kg: 8.4 ml; 15 kg: 9 ml; 16 kg: 9.6 ml; 17 kg: 10.2 ml; 18 kg: 10.8 ml; 19 kg: 11.4 ml; 20 kg: 12 ml. All up to 5 times daily. Dosage according to child's age. Should be used only in the absence of the possibility to determine the child's body weight: 0-3 months: 1.6 ml; 4-11 months: 3.2 ml; 12-23 months: 4.8 ml; 2-3 years: 6.4 ml; 4-5 years: 9.6 ml; 6-8 years: 12.8 ml; 9-10 years: 16 ml; 11 years: 19.2 ml. All up to 5 times daily. Prescribing Restrictions: None

Package(h ): SYRUP: 60 ml x 125 mg/5 ml. Chocolate flavor without sugar. Dosage(h ): The doses must be given at intervals of not less than 4 hours. The recommended dosage or the number of daily doses should not be exceeded. Adults and children over 12 years of age: 20 ml every 4-5 hours, as needed. The amount of 4 G paracetamol (160 ml syrup) in 24 hours should not be exceeded. Children: According to child's body weight: 3 kg: 1.8 ml; 4 kg: 2.4 ml; 5 kg: 3 ml; 6 kg: 3.6 ml; 7 kg: 4.2 ml; 8 kg: 4.8 ml; 9 kg: 5.4 ml; 10 kg: 6 ml; 11 kg: 6.6 ml; 12 kg: 7.2 ml; 13 kg: 7.8 ml; 14 kg: 8.4 ml; 15 kg: 9 ml; 16 kg: 9.6 ml; 17 kg: 10.2 ml; 18 kg: 10.8 ml; 19 kg: 11.4 ml; 20 kg: 12 ml. All up to 5 times daily. Dosage according to child's age. Should be used only in the absence of the possibility to determine the child's body weight: 0-3 months: 1.6 ml; 4-11 months: 3.2 ml; 12-23 months: 4.8 ml; 2-3 years: 6.4 ml; 4-5 years: 9.6 ml; 6-8 years: 12.8 ml; 9-10 years: 16 ml; 11 years: 19.2 ml. All up to 5 times daily. Prescribing Restrictions: None

Package(i ): SYRUP: 100 ml x 125 mg/5 ml. Chocolate flavor without sugar. Dosage(i ): The doses must be given at intervals of not less than 4 hours. The recommended dosage or the number of daily doses should not be exceeded. Adults and children over 12 years of age: 20 ml every 4-5 hours, as needed. The amount of 4 G paracetamol (160 ml syrup) in 24 hours should not be exceeded. Children: According to child's body weight: 3 kg: 1.8 ml; 4 kg: 2.4 ml; 5 kg: 3 ml; 6 kg: 3.6 ml; 7 kg: 4.2 ml; 8 kg: 4.8 ml; 9 kg: 5.4 ml; 10 kg: 6 ml; 11 kg: 6.6 ml; 12 kg: 7.2 ml; 13 kg: 7.8 ml; 14 kg: 8.4 ml; 15 kg: 9 ml; 16 kg: 9.6 ml; 17 kg: 10.2 ml; 18 kg: 10.8 ml; 19 kg: 11.4 ml; 20 kg: 12 ml. All up to 5 times daily. Dosage according to child's age. Should be used only in the absence of the possibility to determine the child's body weight: 0-3 months: 1.6 ml; 4-11 months: 3.2 ml; 12-23 months: 4.8 ml; 2-3 years: 6.4 ml; 4-5 years: 9.6 ml; 6-8 years: 12.8 ml; 9-10 years: 16 ml; 11 years: 19.2 ml. All up to 5 times daily. Prescribing Restrictions: None

Indications. Pain, fever. Contra-Indications. See package insert (OTC ). Special Precautions. See package insert (OTC ). Side Effects. See package insert (OTC ). Drug Interactions. See package insert (OTC).

Axit (Mirtazapine) Report For Patients Like You, Axit

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What is mirtazapine?

Mirtazapine is an antidepressant. Mirtazapine affects chemicals in the brain that may become unbalanced and cause depression.

Mirtazapine is used to treat major depressive disorder.

Mirtazapine may also be used for purposes other than those listed in this medication guide.

Precautions

You should not take this medication if you are allergic to mirtazapine.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

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

Before taking mirtazapine, tell your doctor if you are allergic to any drugs, or if you have:

liver or kidney disease;

bipolar disorder (manic depression);

seizures or epilepsy;

heart disease, including angina (chest pain);

a history of heart attack or stroke; or

a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may not be able to use mirtazapine, or you may need a dosage adjustment or special tests during treatment.

Mirtazapine is in the FDA pregnancy category C. This means that it is not known whether mirtazapine will harm an unborn baby. Do not take mirtazapine without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether mirtazapine passes into breast milk. Do not take mirtazapine without first talking to your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the side effects of this medication.

The orally disintegrating tablet may contain phenylalanine. Talk to your doctor before using this form of mirtazapine if you have phenylketonuria (PKU).

Avoid drinking alcohol. It can increase some of the side effects of mirtazapine.

Mirtazapine 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.

Instructions

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include confusion, memory problems, drowsiness, and fast heart rate.

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.

Side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

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

fever, chills, body aches, flu symptoms;

white patches or sores inside your mouth or on your lips; or

feeling like you might pass out.

Less serious side effects include:

drowsiness, dizziness, weakness;

nausea, stomach pain;

constipation;

increased appetite, weight gain;

dry mouth; or

thirst.

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.

Interactions

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by mirtazapine. Tell your doctor if you need to use any of these other medicines while you are taking mirtazapine.

There may be other drugs that can interact with mirtazapine. 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.

Other Names

Remeron, Remeron SolTab, and mirtazapine

Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

Last updated: September 19, 2016

What is the most important information I should know about mirtazapine?

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Do not use mirtazapine if you have used an MAO inhibitor within the past 14 days. Serious, life-threatening side effects can occur if you take mirtazapine before the MAO inhibitor has cleared from your body.

Before taking mirtazapine, tell your doctor if you have bipolar disorder, liver or kidney disease, seizures, heart disease, a history of heart attack or stroke, or a history of drug abuse or suicidal thoughts.

It may take up to several weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment.

Avoid drinking alcohol. It can increase some of the side effects of mirtazapine.

Mirtazapine 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.

Warning

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Eric Casebolt 5 Fast Facts You Need To Know, Casbol

Eric Casebolt: 5 Fast Facts You Need to Know

Ex-Officer Eric Casebolt detaining Dajerria Becton. (YouTube)

A McKinney, Texas, cop was recorded in a now-viral video cursing at juveniles, violently detaining a 15-year-old girl and pointing his gun at two unarmed teens at a community pool party.

David Eric Casebolt. a 40-year-old Navy veteran who had been an officer in McKinney for nearly 10 years, resigned from his position as corporal four days after the June 5 incident. He had been placed on administrative leave on Sunday after the video, which was posted to YouTube.

Police Chief Greg Conley called Casebolt’s actions “inexcusable” and said he was the only officer on the scene who didn’t follow proper protocols and training.

Casebolt, who goes by his middle name Eric, is white, while the teens he is seen arresting and yelling expletives at are black.

The family of the teens who were at the party and other community activists have called for criminal charges to also be filed against Casebolt.

McKinney, which is in Collin County, Texas, is about 40 minutes from Dallas. The city of about 131,000 residents is about 75 percent white and 11 percent black, according to the 2010 census. It was named as CNN Money’s Best Place to Live in America in 2014.

Update . A Collin County Grand Jury has declined to indict Casebolt. The decision was announced June 23, 2016.

Here’s what you need to know about the pool party incident and Casebolt:

1. Casebolt’s Attorney Says He Let His Emotions Get the Best of Him

Casebolt’s attorney, Jane Bishkin, spoke out for the first time on Wednesday. saying Casebolt “let his emotions get the best of him.” She said Casebolt, who is in an undisclosed location with his family because of alleged death threats, apologizes to anyone who felt harassed, including the 15-year-old girl.

She also said Casebolt was stressed because of two suicide calls he responded to prior to the pool party incident.

McKinney Police said on Facebook that the incident happened Friday, June 5, at about 7:15 p. m. The department said officers responded to the Craig Ranch North Community Pool for a “disturbance involving multiple juveniles at the location, who do not live in the area or have permission to be there, refusing to leave.”

Casebolt is seen in the video along with at least two other officers who appear to have been the first on the scene. He first appears while running after a teen, tripping and then doing a barrel roll to recover, while dropping his flashlight.

He returns to the area where a group of teens, including the teen filming the scene, are standing, and grabs one by the arm, twisting him down to the ground while the teen, who is black, appears to be speaking calmly to another officer, who also seems calm. Casebolt runs off and detains two other black teens and curses at a group of black girls, telling them to leave.

Casebolt yells at a group of teens he detained, saying “Don’t make me fucking run around here with 30 pounds of goddamn gear on in the sun cause you want to screw around out here.”

After delivering the lecture, Casebolt goes up to the group of girls, and warns them not to “keep standing there running your mouths,” and tells them to leave “now.”

The video shows a 15-year-old black girl, Dajerria Becton, walking away with the group. She then stops and turns back towards Casebolt and it’s not clear if she says something to him. Casebolt charges after her and grabs her by the arm, dragging her to the ground.

As he wrestles her to the ground, two other teens approach and appear to try to stop him from detaining her. Casebolt then pulls his gun from his holster and points it toward the teens. Two other officers then take off after the teens who ran, and Casebolt re-holsters his gun. He then continues to detain the girl, holding her on the ground.

Dajerria Becton. who was released to her parents without charges, spoke to the local Fox affiliate about the incident:

Police said they received several 911 calls related to the incident, including reports that the “juveniles were now actively fighting.”

The teens were black in a primarily white neighborhood, raising concerns on social media that the 911 calls and the violent arrests of teens in bathing suits were racially motivated.

Police said in the statement, “First responding officers encountered a large crowd that refused to comply with police commands. Nine additional units responded to the scene. Officers were eventually able to gain control of the situation.”

An adult male was arrested on charges of interfering with police and evading arrest. No one else was charged, as the juveniles were released to their parents. This video was uploaded showing more of what happened during the incident:

Brandon Brooks, who posted the videos to YouTube. said in the original video’s description, “A fight between a mom and a girl broke out and when the cops showed up everyone ran, including the people who didn’t do anything. So the cops just started putting everyone on the ground and in handcuffs for no reason. This kind of force is uncalled for especially on children and innocent bystanders.”

The pool party had been advertised on social media:

The pool party was advertised on social media. Homeowners say none of the nearly 70 people were allowed to be there pic. twitter. com/pZZy9htEK3

Teens who were at the community pool told Buzzfeed News the fight started between adults and teens when the adults made racist comments, including telling the black youths to “return to Section 8 housing.”

Section 8, or public housing, has been an issue in McKinney in recent years.

The city was sued in 2009 over alleged housing discrimination, according to the International Business Times. The city settled the lawsuit, with an agreement that 400 low-income housing units be built. The first portion of those units, a 164-unit complex, is being built now .

Craig Ranch, the community where the pool is located, is a master-planned community with a homeowner’s association. Neighbors say more than 70 uninvited teens showed up to the party, which included a DJ.

Here is the real scoop on what happened at the #CraigRanch pool party. pic. twitter. com/3f3IzaK3GZ

— Sam Phillips (@1031ent) June 8, 2015

But Andrew Cosby, also known as DJ Reign, said on Twitter he was simply hired for the party and didn’t plan it. Cosby, who is white, also disputed claims he sold tickets for the party. He said in the now-deleted tweets, “you actually think I made this flyer? I got hired to DJ an event the event was not mine,” and “yeah but I wasn’t involved in anything. I was like 100 yards away and all I saw were cop cars,” according to Twitchy. com.

The mother and daughter who said they organized the end of the year party that drew the teens to the pool talked to local photographer E. Johnson IV. They are residents of the community:

But other residents of Craig Ranch expressed support for the police officers’ actions:

Pool just put up this sign supporting McKinney PD & thanking officers for their response Friday pic. twitter. com/P7bC9hULCF

One #McKinneyTX resident visibly and vocally supporting the officers, says he saw whole thing Friday. pic. twitter. com/19nd1xXfiT

— Lauren Zakalik (@wfaalauren) June 7, 2015

A protest against police brutality is planned for Monday evening in McKinney. Many people, both in the community and around the country, said it appeared in the video that police were targeting the black teens.

The teen who filmed the video, who is white, agreed. He can be seen in the video walking around and talking to the black teens, who are being forced to sit on the ground, without the Casebolt saying anything to him.

Brooks told Buzzfeed, “Everyone who was getting put on the ground was black, Mexican, Arabic. [The cop] didn’t even look at me. It was kind of like I was invisible.”

Corporal Eric Casebolt has been suspended by the McKinney, Texas, police department during an investigation into his actions during a pool party incident.

2. He Was Accused of Racial Bias & Pulling Down a Black Man’s Pants in a Federal Lawsuit

Federal court documents show that Casebolt and other officers were sued in 2008 in federal court for racial profiling, harassment, failure to render aid and sexual assault.

Albert E. Brown Jr. accused Casebolt of reaching into his “private area” and pulling his pants “down below ankles” during the traffic stop.

Brown was parked on the wrong side of a road in McKinney, according to the civil complaint. Casebolt told Brown he was going to write him a ticket for the traffic offense, but then said he saw two marijuana seeds and an open container in the car. Brown said Casebolt remarked about the “white girls” who were with him, made comments about him and his clothes, and then grabbed his private are and pulled his pants down.

Brown also claimed in the lawsuit that another officer, Lee Keith, slammed his head into the hood of the car repeatedly. He said Keith held him while Casebolt pulled his pants down. Another officer, who is not named in the lawsuit, allegedly spread his legs while one of the officers shined a flashlight in his anus.

Brown was arrested on charges of marijuana possession and attempting to take a weapon from an officer.

The civil case was dismissed by a federal judge in 2009 because the criminal charges against Brown were still pending. The judge said in his decision that the lawsuit could be re-filed if he was exonerated. The charges were eventually dismissed, but the civil case was never refiled by Brown.

Casebolt was reprimanded several times during his time in McKinney, according to a public records request by the Dallas Morning News. The newspaper reported on September 26 that Casebolt “was disciplined for a Facebook post, for his behavior at a disturbance call involving him and his ex-girlfriend, and for using a police car and uniform on personal business.”

The Dallas Morning News says Casebolt violated the department’s social media policy with a Facebook post in 2014 about a call involving a suicidal teen.

“Guess who just checked the box for ‘commandeer a golf cart and tased a suicidal Knife wielding maniac off-handed and still rolling without spilling the golfer’s miller lite’?!” Casebolt wrote on Facebook.

He was suspended in 2011 for three days after he was accused of harassing an ex-girlfriend. The woman’s then-boyfriend told police Casebolt circled her apartment and also left a loaded gun unsecured in the view of children at the apartment.

In 2010, he was suspended for one day without pay after leaving SWAT training in uniform and a police vehicle to bail out his girlfriend, who had been arrested in nearby University Park.

“The reprimands are so minor as to have nothing whatsoever to do with what he is being investigated for out in Craig Ranch, which is whether he used too much force, whether he assaulted somebody,” his attorney, Tom Mills, told the newspaper, adding that most of the 188-page personnel file was filled with positive reviews.

Eric Casebolt, the officer under investigation for the McKinney, Texas, pool party incident, was sued for racial bias and sexual assault by a man he arrested.

3. Casebolt Was a Patrol Supervisor & Was a Vice President of the Local Police Union

Eric Casebolt. LinkedIn

According to his now-deleted LinkedIn page (see screenshots of it here ) Casebolt has worked in McKinney since August 2005, first as an officer and then as a corporal, his current position.

Casebolt says on LinkedIn that he is responsible for line officer supervision, neighborhood patrol and community policing, among other job responsibilities. He is also a police academy instructor.

Casebolt received eight hours of cultural diversity training in February 2009, and also took courses on use of force and racial profiling, according to The Associated Press .

Now, seven years later, Casebolt is facing outrage from the community, national media scrutiny and an internal investigation.

McKinney Police Chief Greg Conley said at a press conference Sunday, “Several concerns about the conduct of one of the officers at the scene have been raised. The McKinney Police Department is committed to treating all persons fairly under the law. We are committed to preserving the peace and safety of our community for all our citizens.”

Mayor Brian Loughmiller said in a statement, “Having seen the YouTube video I am disturbed and concerned by the incident and actions depicted in the video. Our expectation as a City Council is that our police department and other departments will act professionally and with appropriate restraint relative to the situation they are faced with.”

The ACLU of Texas released a statement saying:

While we don’t know all the facts about the party, the crowd, or whether a fight broke out, what we do know is that the police response, as seen on the video, appears to be a textbook case of overuse of force. A well-trained police department would have responded more cautiously, with less hostility, and using sophisticated crowd control methods that favor de-escalation not escalation. Without question, guns were not needed and in fact risked turning a group of partying teenagers into a violent encounter that could have turned deadly.

Police departments are intended to be organizations that protect and serve their constituents. But increasingly in this country we have two kinds of policing and we saw both in this incident: protecting and serving white communities and criminalizing and controlling black communities.

Casebolt at the 2014 Fraternal Order of Police Christmas party. (Facebook)

In addition to his role as a supervisor, Casebolt also serves as the second vice president of the local police union, according to its Facebook page.

The union released a statement about the incident, saying it was not racially motivated:

"The McKinney FOP assures that this was not a racially motivated incident…" – statement re: #McKinneyPolice @NBCDFW pic. twitter. com/oyFscXh4Ej

— Ben Russell (@BenRussellNBC5) June 8, 2015

Casebolt’s first job as an officer was with the Texas Highway Patrol, from March 2003 to August 2005.

He was based in Greenville, Texas, according to his LinkedIn profile. His responsibilities as a patrolman included traffic and crime enforcement, criminal interdiction, DWI investigation, crash investigation and task force operations.

Body camera footage shows two Barstow, California, police officers throwing a pregnant woman to the ground onto her belly after she refused to give them her name.

4. He Appears to Have Added the Pool Party Video to a ‘Training’ List on His YouTube Account

The YouTube user “decase73,” which is the same handle Casebolt used on his now-deleted Twitter account and elsewhere on social media, added the video of the pool party incident to his YouTube list “police training.”

He also has playlists called “Fighting” and “Situation Awareness” that also pertain to police and martial arts training.

Dajerria Becton, the 15-year-old Texas girl who was violently arrested by Eric Casebolt in an incident recorded on video, is speaking out about what happened.

5. He Is a Navy Veteran & Has ‘Experience in the Use of All Levels of Force’

Casebolt at a police union Christmas party in 2014. (Facebook)

Casebolt is an instructor at Executive Self-Defense & Fitness Training, based in McKinney.

Eric Casebolt is an instructor trainee at Executive Self-defense and Fitness, LLC and has been a Police Officer since 2000. During his career in Law Enforcement, he has received in-depth training on impact weapon deployment and expandable baton, firearms, electronic control devices (ECDs), ground fighting, Positive Assertive Control Tactics-Dynamic Threat Response (PACT-DTR), handcuffing, joint locks and pressure point compliance, armed and un-armed self-defense. He has a strong working knowledge of human behavior, indicators of deception, criminal behavior, the development of situational awareness, and experience in the use of all levels of force. He is a certified Advanced Texas Police Officer, an Instructor in Police Vehicle Operations, a Field Training Officer, and a certified SWAT operator. He has trained in several different disciplines of martial arts, but now exclusively trains in Krav Maga combat arts, Arnis, and ground fighting.

The company removed Casebolt’s profile from its website about an hour after his name was first revealed. See a screenshot of the website here.

Casebolt served in the Navy from 1993 to 2003. He was an Operations Specialist First Class based in San Diego, before becoming a military police officer in Oklahoma City.

Casebolt said on his LinkedIn page that his responsibilities as a military police officer included patrol, DWI investigation and force protection and counter-terrorism.

While he was an operations specialist, from 1993 to 2000, Casebolt said he was a tactical information coordinator on the USS Lake Champlain guided missile cruiser.

He was also a combat air controller, RADAR operator, shipboard engagement and tactics instructor and a shipboard security and tactics team leader.

Feras Morad, an unarmed 20-year-old Long Beach State University student, was fatally shot by police while "advancing" on an officer after falling out of a window.

The city of Chicago settled a lawsuit for $5 million with the family of Laquan McDonald, a teen shot by police 16 times in 2014. The FBI is still investigating.

Tom Cleary is a reporter and editor for Heavy. com. Tom was a breaking news reporter at the Connecticut Post and an editor at the Register Citizen and New Haven Register. He can be reached by email at Tom. [email protected] com. Follow him on Twitter @tomwcleary. June 23, 2016 4:02 pm

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Wrong all the way around. Casebolt wasn’t man enough to stand up and defend his actions, he quit. The primary reason he quit was so the internal investigation would be stopped, and this incident wouldn’t go on his work record. The incident was started when a group of white women started yelling racial insults at a group of Black children. One of the white women, an obese blonde, slapped one of the girls, after calling her a N—er. This group of kids was leaving when the cops arrived. Casebolt was, in the words of the chief of police, “out of control when he arrived.” and “remained out of control” for the duration of the incident. Chief Conley also said Casebolt’s behavior was “indefensible.” So, take your accusations of playing the “racist card” and put it in the closet with your white sheets and pointy hat. Maybe you should also get some therapy.

I couldn’t have said it better.

Hahaha you sir are a scholar and a gentleman.

CASE BOLT needs to SUE CHIEF CONLEY AND THE GIRL AND THE NEWS MEDIA AND THE KID WHO POSTED THIS……… every one of those people were guilty of defamation and manipulating the truth

even the news and everyone seems to be covering up the fact that girl said she was gonna get her own gun…. the news media is inciting riots and should be held accountable for their lying ABOVE AL ELSE

too many cops here like Anonymous and Shyla. Casebolt’s a knob, and a control freak which comes from his Navy years. I get it. However, police forces have to stop hiring this tightly wound assholes like Casebolt and soooo many others.

And do we expect policemen (& women) to be like “Superman”? Corporal Casebolt had just dealt with two suicides prior to this event. As a nurse, I can well imagine this man was still dealing with the aftermath of such trauma. I’m only sorry he didn’t recognize his own need to withdraw and allow his team mates to deal with the situation more rationally. But that’s the thing. A policeman (or woman) is trained to deny self and deal with a situation presenting itself (nurses do that too in crisis situations). I’m not saying it was right. I’m just sorry that a fine corporal’s career has ended due to a terrible day. Those kids will all live to “party again”, but this man is being vilified and his “post traumatic state” from his work day is being all but ignored. I can only imagine the anguish he must be feeling. I’m only stating this because it hasn’t been said. Police make errors. Doctors and nurses make errors too, unfortunately. It can happen due to unseen stressors and antecedents not viewed on a video and not understood by the general public. At any rate, he is obviously remorseful since he resigned. If I was his supervisor, I would have sent him on stress leave and while studying the entire situation, I would also look back on the employee’s past performance and offer remedial intervention. Instead, this has escalated into something political, and we can’t have public opinion sway against the Texas police, nor have his superiors deal with a little heat, now can we?

Not for nothing but all that seems like a personal problem, which I may add, Casebolt himself has admitted. This is the job that he signed up for. And if dealing with some “supposedly” rowdy teens can send him off the deep end, how is he capable of handling life and death situations that require a calm demeanor and restraint? Having said that, I also have empathy for his situation, however, I am more concerned about the children who are being characterized as thugs and spoken about in dehumanizing terms as justification for his behavior. HE was the “professional”…and I use that term loosely… in this situation. To continue to justify his actions by blaming the kids is just plain wrong.

everyone seems to be missing the innocent lil girl screaming “I’M GONNA GET MY OWN GUN” also in the other videos available you see that the @unt was told to leave at least 10 times …. if it was me at least 10 others would have been arrested and all would have been charged…. …… Eric casebolt should sue this lil black liar and he should also sue the news media for their criminal defamation and editing of the videos …. they even edited over the girl screaming she is gonna get a gun……. Come on people spread the word about her sitting there resisting and screaming she is gonna get a gun…. the news media needs to be charged for their criminal acts in this ……. ERIC CASEBOLT needs to file a charges against his Chief for his defamation and lying in his video statement…. Eric also needs to sue the punk kid who put this up on facebook for defamation and libel …. and he should sue the lil girl tooo…. Come on Eric don’t let them get away with this crap start a kickstarter so we can contribute to your attorney fees……and do not forget to sue your city council .

all those people who made derogatory coments b4 getting all the facts need to be sued …. SUE THE CITY >>>> CITY COUNCIL>>>> CHIEF >>>> THE BLACK GIRL>>>>>> BLACK GIRLS MOTHER>>>>> AND ESPECIALLY SUE THE NEWS STATION AND REPORTERS >>>> SUE EVERY NEWS OUTLET THAT BROADCAST THE LIES

How can anyone watch this video and feel good about defending how the police handled this situation? Regardless of some trespassers in a private pool, regardless of a bunch of teenagers resisting arrest, regardless of any kind of “disrespect” towards the officers. How is this acceptable? It’s racist. Fuck off if you disagree. Imagine if this was a pool party full of white kids. They would have been kindly told to leave the premise. Not have their fucking faces pushed into the ground. Police wants respect from the public? Stop treating these people like fucking animals? I’m surprised they didn’t attack this joke of an officer when the others ran off. Fuck the police. Fuck the white majority supporting these horrible civil rights crimes. And fuck the media for skewing this bullshit as emotional distress. Yeah, I guess hating people gets me emotional too. This is fucking disgusting.

Good post. I will be going through a few of these issues as well..

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Farmelox, Meloxicam, Farmelox

Farmelox

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Mexicam is used for its anti-inflammatory and analgesic effects in the symptomatic treatment of acute and chronic rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Gouty arthritis Severe pain of any origin

history of heart attack, stroke, or blood clot; heart disease, congestive heart failure, high blood pressure; a history of stomach ulcers or bleeding, bowel problems, diverticulosis; liver or kidney disease; asthma; polyps in your nose; or if you smoke

chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance; black, bloody, or tarry stools, coughing up blood or vomit that looks like coffee grounds; urinating less than usual or not at all; nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or bruising, severe tingling, numbness, pain, muscle weakness. Less serious side effects may include: upset stomach, mild heartburn or stomach pain, diarrhea, constipation; bloating, gas; dizziness, headache, nervousness, mood changes; skin itching or rash; dry mouth; increased sweating, runny nose; blurred vision; or ringing in your ears.

cyclosporine (Gengraf, Neoral, Sandimmune); lithium (Eskalith, Lithobid); diuretics (water pills) such as furosemide (Lasix); glyburide (DiaBeta, Micronase); methotrexate (Rheumatrex, Trexall); a blood thinner such as warfarin (Coumadin); steroids (prednisone and others); an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik); or aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as diclofenac (Voltaren), etodolac (Lodine), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn), and others.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Taking meloxicam during the last 3 months of pregnancy may harm the unborn baby. Do not take meloxicam during pregnancy unless your doctor has told you to. Meloxicam can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medicine to a child younger than 2 years old without the advice of a doctor.

SOLUTION FOR INJECTION

Jason Long’S Erectile Dysfunction Protocol – Full Review, Otocol

Erectile Dysfunction or ED is one of the common chronic conditions affecting nearly 18 million Americans and yet there are many cases that are undetected. The complication of Erectile Dysfunction not only limit to the physical and emotional state of the affected person but it also affecting his marital relationship.

Although there are many pills available in the market that claim to cure this chronic condition from its roots but we all know these pills are full of negative side-effects. Recently there is a new plan that is gaining huge popularity called Erectile Dysfunction Protocol (sometime known as ED Protocol).

Since there are lots of scam available on the internet that is the reason one should do proper investigation before investing any of his money in such program. It is possible you read Erectile Dysfunction Protocol review from various sites but you are still having doubts about this program. In this page you will find my personal review about this program. This is going to be completely different review because I invested enough time and money in investigating the truth and facts about this program and you will also find how ED Protocol helped me.

Additionally I have also created this short-navigation menu that you can use to read any content from this page:

What is Erectile Dysfunction Protocol?

This is an easy-to-understand, step-by-step guide on how to reverse your condition and once again start enjoying spicy sexual life that you once had in your younger age. This program is created by Jason Long, who is researcher and previously reverse ED with the methods mentioned in this guide.

Many people and doctors believe that Erectile Dysfunction is caused by low level of Testosterone however, according to Jason Long there was a research by Columbia University in which it is showed that only 5% of reported Erectile Dysfunction cases are caused of low level of Testosterone. So this brings us the question, what is the main cause of Erectile Dysfunction?

As Jason Long mentioned, the main cause of the Erectile Dysfunction is the male organ’s blood vessels can’t able to relax fully to allow blood flow that restricts person from getting and maintaining hard erection. Since many male enhancement pills focus on increasing testosterone level in the body that is the reason these pills provide results to some while provide only negative effects to others.

The treatment plan that you will find inside this problem focuses on treating main cause of this chronic situation which is relaxing organs’ blood vessels.

Highlighted Features:

Here are some highlighted features that you will discover inside this program:

Complete understanding about Erectile Dysfunction and factors that increases risk of Erectile Dysfunction

List of essential enzymes, amino acids, nutrients and minerals that help you reverse this condition

List of foods and supplements that help in increasing blood flow to the sexual organ

Step by step instructions on combining these foods and supplements to get maximum benefits

My Personal Experience:

Truly speaking since I turned into 50, my sex life is almost nonexistent. I am keeping myself away from sleeping with my wife by making excuses that don’t make sense. My wife knew about my condition but she didn’t want me to feel sorry that is the reason she never discussed about Erectile Dysfunction with me.

On other hand I can’t able to take male enchantment pills that sold into “men’s health” section of pharmacy because I got some serious chest pains from these types of pills in the past. Even I tried using some so-called herbal extract supplement but when I read their ingredients I found these herbal extract supplements are just bunch of chemicals that I can’t even recognize.

One day I found Jason’s Erectile Dysfunction Protocol and decided to give it a try because natural treatment is the only option that is left for me and secondly there is 60-days money back guarantee.

Within just 2 days after following step-by-step instructions I got full erection and this erection is the fullest and most powerful erection of my whole life. My wife was amaze with my erection and first time ever in my marital life “she took it in her mouth”. Now I feel that this program brings the missing spark back in my marital life.

Advantages:

Safe and Natural:

In ED Protocol you will find instructions on how to reverse this chronic condition by using safe and natural foods. That is the reason you don’t have to deal with any of the side effects that are included into male enhancing supplement or testosterone shots.

Contains 60-Days Money Back Guarantee:

Another advantage of this program is that it is backed with 60-days money back guarantee. Jason is providing you 60 days to test this program and within 60 days if you don’t get any results from this program then you can get your full money back by just sending one simple email to customer service.

Permanent Results:

Most male enhancing pills fail to provide permanent results but ED Protocol on other hand is designed to provide you permanent results. According to Jason Long, users will start getting results in as little as 24 to 48 hours. And after applying this technique for sometime users don’t need to apply these techniques as their organs’ blood vessels naturally get relax and they can get hard and long erection as long as they want.

Disadvantages:

Permanent Results Take Time:

Techniques that are explained inside this program can provide positive results in as little as 24 to 48 hours but permanent results take some time that is why users have to consistently apply these techniques if they want permanent results.

Need Medical Supervision:

Although techniques explained inside this program is very much easy to understand and follow but if you have history of heart ailments then it is important to consult doctor before involving into any sort of sexual activity. Additionally, you have to confirm from the doctor if the mentioned list of foods is safe for you or not.

Final Verdict:

In the end I would like to give it 4 out of 5 stars. I would like to recommend Erectile Dysfunction Protocol for all those men who want to cure this chronic condition without getting adverse effects that are associated with male enhancement pills and testosterone shots.

Here’s the detailed video review:

Sinpebac Unguento Para Que Sirve, Sinpebac

SINPEBAC UNGUENTO

Acceso rapido al contenido

Tenga especial cuidado durante el embarazo .

No usar SINPEBAC UNGUENTO con lactantes.

Revise siempre que no sea alergico a ninguno de los componentes de SINPEBAC UNGUENTO . podria poner en peligro su salud

Recuerda antes de tomar este medicamento consultar siempre con su medico, la informacion que ofrecemos es orientativa y no sustituye en ningun caso la de su medico u otro profesional de la salud.

Prospecto e indicaciones

UNGUENTO Tratamiento de las infecciones cutaneas

GROSSMAN, S. A. LABORATORIOS

DENOMINACION GENERICA:

FORMA FARMACEUTICA Y FORMULACION:

Cada gramo de unguento contiene:

Mupirocina. 20 mg

Excipiente, cbp. 1 g

INDICACIONES TERAPEUTICAS:

SINPEBAC* esta indicado en infecciones cutaneas como impetigo, ectima, foliculitis, furunculosis, dermatitis del panal por Candida albicans y/o Staphylococcus aureus. Tambien en infecciones de heridas quirurgicas o traumaticas, abrasiones, ulceras, quemaduras y otros padecimientos cutaneos como psoriasis y dermatitis atopica infectados.

Cuando se aplica sobre la piel que rodea canulas y cateteres, previene la colonizacion de los mismos, por Staphylococcus aureus y otros germenes patogenos sensibles a la mupirocina.

FARMACOCINETICA Y FARMACODINAMIA EN HUMANOS:

La mupirocina es el primer antibiotico topico sin relacion estructural con otros antibioticos conocidos. Se ha demostrado en estudios con Staphyloccus aureus y Escherichia coli que SINPEBAC* se une a la isoleucil-RNAt sintetasa, compitiendo con la isoleucina por el sitio de union a la enzima; inhibiendo en consecuencia, la sintesis de proteinas y RNA de la bacteria. La accion inhibitoria de SINPEBAC* al 2% aplicado por via topica resulta en un efecto bactericida, principalmente en el pH acido normal de la piel.

El espectro de SINPEBAC* incluye principalmente a las bacterias aerobicas grampositivas causantes de infecciones cutaneas, entre ellas Staphylococcus aureus, Staphylococcus epidermidis y S. saprophyticus, ya sean productoras o no de penicilinasas. En el pH normal de la piel (5.5), la concentracion inhibitoria minima de SINPEBAC* sobre S. aureus es de 0.016 µg/ml. SINPEBAC* es activo contra S. aureus resistente a otros antibioticos, incluyendo penicilina, aminoglucosidos, eritromicina, cloramfenicol y tetraciclina. No se ha demostrado resistencia cruzada de SINPEBAC* con otros antibioticos.

Otras bacterias grampositivas sensibles a SINPEBAC* son: Streptococcus pneumoniae, Streptococcus pyogenes, S. agalactie y S. viridans; la concentracion inhibitoria minima requerida es 0.12 a 2 µg/ml.

Tambien es activo contra algunas bacterias gramnegativas como Haemophilus influenzae, N. catarrhalis, N. Gonorrhoeae, N. Meningitidis, Bordetella pertussis, Pasteurella multocida, en las que la concentracion inhibitoria minima es 0.12 a 0.2 µg/ml.

Los estudios clinicos en infecciones bacterianas de la piel, han demostrado una curacion clinica de 85 a 100% (promedio 94%) y una erradicacion bacteriologica de 94 a100% (promedio 97%).

En un estudio in vitro en tejido infectado, se demostro que SINPEBAC* elimina las bacterias rapidamente. Una hora despues del tratamiento, sobrevivia 29% de S. aureus y 46% de S. epidermidis; a las 24 horas solo estuvo presente 0.35% de las bacterias.

Se ha reportado en algunos estudios, que SINPEBAC* elimina a la Candida albicans a concentraciones inhibitorias minimas de 512 µg/ml, en un periodo de 2 a 6 dias de tratamiento.

La accion antifungica de la mupirocina esta relacionada con la introduccion del farmaco a la celula de la levadura por un sistema de transporte de alta afinidad mediado por aminoacidos.

En un estudio en adultos sanos con mupirocina radiomarcada aplicada sobre la piel intacta, no se detecta absorcion sistemica y 2 a 4% de la radioactividad se localiza en el estrato corneo de la epidermis. La aplicacion sobre piel enferma o traumatizada puede resultar en la penetracion a capas profundas de la piel. Existe evidencia de que algunas enzimas presentes en la piel pueden metabolizar a la mupirocina en acido monico en 3%. Se ha reportado que la mupirocina permanece activa, al menos, durante 24 horas despues de su aplicacion sobre la piel.

CONTRAINDICACIONES:

Hipersensibilidad a la mupirocina o a los glicoles.

PRECAUCIONES GENERALES:

No se recomienda su aplicacion cerca de los ojos ni en mucosas. El uso topico prolongado de SINPEBAC* puede dar lugar al crecimiento de microorganismos no susceptibles. No se recomienda la aplicacion del producto sobre heridas y quemaduras de 2? y 3er grado extensas, ya que en estas situaciones el polietilenglicol utilizado en el vehiculo, puede absorberse y alcanzar la circulacion. El potencial de sensibilizacion es bajo y carece de poder para absorber la luz ultravioleta, por lo que el riesgo de fototoxicidad o dermatitis fotoalergica es practicamente nulo.

RESTRICCIONES DE USO DURANTE EL EMBARAZO Y LA LACTANCIA:

Estudios en ratas y conejos administrando el farmaco por via sistemica, no han revelado datos de alteraciones en la reproduccion. Sin embargo, no existen suficientes evidencias sobre la seguridad en humanos, por lo que debe emplearse durante el embarazo y la lactancia solo si esta claramente indicado.

REACCIONES SECUNDARIAS Y ADVERSAS:

SINPEBAC* ha mostrado tener buena tolerabilidad cuando se aplica topicamente. En menos de 1 a 3% de los casos se ha informado de prurito y eritema leves transitorios, que desaparecen al suspender el medicamento.

INTERACCIONES MEDICAMENTOSAS Y DE OTRO GENERO:

Se ha observado en estudios in vitro, que el cloramfenicol interfiere con la accion antibacteriana de la mupirocina sobre la sintesis de RNA. La importancia clinica de ello no ha sido determinada a la fecha.

ALTERACIONES EN LOS RESULTADOS DE PRUEBAS DE LABORATORIO:

No se han reportado alteraciones de pruebas de laboratorio con la administracion topica de SINPEBAC*.

PRECAUCIONES EN RELACION CON EFECTOS DE CARCINOGENESIS, MUTAGENESIS, TERATOGENESIS Y SOBRE LA FERTILIDAD:

Los estudios de toxicidad aguda y cronica, teratogenesis, mutagenesis y carcinogenesis con SINPEBAC* han sido negativos. Por via oral, la DL50 en ratas es mayor a 5 g/kg.

DOSIS Y VIA DE ADMINISTRACION:

Cutanea. Se recomienda la aplicacion de una capa delgada de SINPEBAC* sobre el sitio de la lesion, tres veces al dia durante un periodo de 5 a 10 dias, dependiendo de la extension de la infeccion.

MANIFESTACIONES Y MANEJO DE LA SOBREDOSIFICACION O INGESTA ACCIDENTAL:

No se ha informado de casos de sobredosificacion con este producto. Aun cuando se absorbiera toda la mupirocina contenida en un tubo de 15 g, el riesgo de efectos secundarios toxicos es practicamente nulo.

PRESENTACIONES:

Caja con tubo con 15 g de unguento al 2%.

RECOMENDACIONES SOBRE ALMACENAMIENTO:

Conservese el tubo bien cerrado a temperatura ambiente, a no mas de 30°C.

LEYENDAS DE PROTECCION:

No se deje al alcance de los ninos. Su venta requiere receta medica. Literatura exclusiva para medicos.

LABORATORIO Y DIRECCION:

Laboratorios Grossman, S. A. Calz. de Tlalpan Num. 2021 04040, Mexico, D. F. * Marca registrada

Reg. Num. 375M2001, SSA LEAR-308480/RM2001/IPPA

BACTERIA . Es un pequeno organismo que solo resulte visible con el microscopio.

CANDIDA ALBICANS . Nombre biologico del hongo que produce las aftas.

Lilly, Lilly

Take part of my adventure series where I have been dropped off with a helicopter into the Canadian wilderness of Vancouver Island. I always dreamt about staying in the wilderness alone for a certain amount of time. In June 2016 my dream came true. I stayed alone on Vancouver Island for 7 days with only what was in my survival rucksack and with a bag of food (Carbohydrates only, I did not bring protein). I didn't eat half of the food that I brought with me tough since I was able to catch some fish, crayfish and collect some mussles. I will always remember this journey, and I totally fell in love with Vancouver Island and its people.

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In this playlist you will find a wide range of survival knots and cordage skills that will make a lot of survival and camping situations easier for you. It does not matter if it comes to abseiling or setting up a simple tarp for a camp. Only a small amount of knots have multiple uses and are easy to make but also easy to undo. That is what qualifies a good knot.

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In this video you will learn how to make fire. The key to fire making is preperation. You need to find dry tinder, kindling and fuel. But you also need some kind of combustion device like a lighter, matches or a simple fire steel. All of these topics are covered in this playlist. With these tips you will be able to make a fire in any condition and in any environment where there can trees be found.

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In this video you will learn how to make fire by friction. It does not matter if you prefer the handdrill or the bowdrill, or slight variations from it. Friction fire is one of the most challenging ways to make fire because there are so many odds against you and a lot of mistakes can be made when for example bow drilling. However, if you accomplish to make fire this way it is one of the most rewarding survival skills that you can attain in the wilderness. Being able to make fire with rubbing two sticks together looks easy and the viewer might think that he does not need to practice because he is so sure that he "knows" how it works. If you watch a lot of bow drill videos on youtube, it is true that you probably know how to do it, but that is far away from "being able" to do it, because fire making techniques like this need practice. It is like shooting with a bow and arrow. You need practice. And strength. And stamina. A lot of people take their bow drill sets or hand drill kits home with them, to dry them out and practice. That is a good thing to do for beginners. But later when you have learned to make a bow drill ember, it is important that you try to make bow drill sets from wood you have freshly collected in the woods. There is a huge difference, and the choice of wood gets even more narrow. I prefer following woods for the bow drill: Basswood (Tilia), Willow (Salix), Poplar (Populus), Alder (Alnus), Yucca flowering stem (Yucca). These woods will always work when you find them dry and dead standing.

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In this playlist you will find herbs that you can use to treat yourself in an emergency situation when you get sick or hurt in the wilderness. Herbal medicine is very powerful and should not be underestimated. Also you need to be sure that you identify the right herb before ingesting or using them externally. I got my information from an Austrian apothecary book "Teedrogen und Phytopharmaka" by Max Wichtl. It is important that you only use information from scientific evidence. Folk medicine is often wrong when it comes to herbs. Also if you are sick you should always consult a doctor.

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This is a playlist of the category "Survival Food". Here you will learn what plants and animals you can eat in the wild. I get asked by a lot of people what plants are edible and which ones are not. Basically all plants that are not poisonous are edible. However there are only a few plants which have enough nutritional value to pay off being eaten and/or processed. One general rule of survival foods is, that they have to give you more energy than you spend on collecting and processing them. Lilly?s Amazon Store > http://astore. amazon. com/survlill-20 Website > www. survivallilly. at Facebook > https://www. facebook. com/pages/Survival-Lilly/810953952332026 Twitter > https://twitter. com/SurvivalLilly Instagram > https://instagram. com/survival_lilly/ Spreadshirt > https://shop. spreadshirt. com/SurvivalLilly If you liked this playlist please share it with your friends on social media. ¦ Feel free to subscribe to my channel. ¦ Hello my name is Lilly and I am making videos about primitive living skills, survival, bushcraft, camping gear and prepping. I consider myself being a modern hunter-gatherer who wants to live as close as possible with mother nature and right now I am in the process of learning how to live off the land and thrive in the wilderness. Thanks for watching

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In this playlist you will find videos about frying mushcrooms to cooking wild spinach or making a stew from a duck that you just hunted. Having breakfast in the wilderness, baking bread or simply make stinging nettle soup. Bon Appetit!

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In this playlist you will find videos about hunting deer, ducks, pheasants, wild boar and so on. You will also find videos about my rifles and shotguns and how I train with them at the shooting range. In Austria it is forbidden to hunt animals with a bow. Therefore I use guns only when hunting. I also get a lot of bad comments and hate from vegetarian viewers, that is why I have disabled the comments for sensitive videos. In my opinion it is legitimate to hunt your own food as long as the animal doesn't suffer much. I know that a lot of people have a different opinion on this matter, but I think everyone should decide for themselves if they eat meat or not.

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Dysmenalgit Indication, Action Of Dysmenalgit, Interactions, Dysmenalgit

Dysmenalgit [in more detail]

Dysmenalgit Indication:

For the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, tendinitis, bursitis, and acute gout. Also for the relief of mild to moderate pain and the treatment of primary dysmenorrhea.

Dysmenalgit Mechanism Of Action:

The mechanism of action of naproxen, like that of other NSAIDs, is believed to be associated with the inhibition of cyclooxygenase activity. Two unique cyclooxygenases have been described in mammals. The constitutive cyclooxygenase, COX-1, synthesizes prostaglandins necessary for normal gastrointestinal and renal function. The inducible cyclooxygenase, COX-2, generates prostaglandins involved in inflammation. Inhibition of COX-1 is thought to be associated with gastrointestinal and renal toxicity while inhibition of COX-2 provides anti-inflammatory activity.

Dysmenalgit Drug Interactions:

Alendronate Increased risk of gastric toxicity Methotrexate The NSAID increases the effect and toxicity of methotrexate Anisindione The NSAID increases the anticoagulant effect Dicumarol The NSAID increases the anticoagulant effect Acenocoumarol The NSAID increases the anticoagulant effect Warfarin The NSAID increases the anticoagulant effect Lithium The NSAID increases serum levels of lithium Cyclosporine Monitor for nephrotoxicity

Food Interactions:

Avoid alcohol. Take with food. Take with a full glass of water.

Dysmenalgit Chemical Formula:

Absorption:

Naproxen itself is rapidly and completely absorbed from the GI tract with an in vivo bioavailability of 95%. Although naproxen itself is well absorbed, the sodium salt form is more rapidly absorbed resulting in higher peak plasma levels for a given dose. Food causes a slight decrease in the rate absorption.

Toxicity (Overdose):

ORAL (LD 50 ): Acute: 248 mg/kg [Rat]. 360 mg/kg [Mouse]. Symptoms of overdose include drowsiness, heartburn, indigestion, nausea, and vomiting.

Protein Binding:

At therapeutic levels naproxen is greater than 99% albumin-bound.

Biotransformation:

Naproxen is extensively metabolized to 6-0-desmethyl naproxen and both parent and metabolites do not induce metabolizing enzymes.

Half Life:

The observed terminal elimination half-life is approximately 15 hours.

Dosage Forms of Dysmenalgit:

Tablet, extended release Oral Tablet Oral Tablet, coated Oral Suspension Oral Suppository Rectal

Eburnation Definition With Eburnation Pictures And Photos, Eburnate

Definition of Eburnation

1. n. A condition of bone cartilage occurring in certain diseases of these tissues, in which they acquire an unnatural density, and come to resemble ivory.

Definition of Eburnation

1. Noun. Degenerative process of bone occurring at sites of articular cartilage erosion commonly found in patients with osteoarthritis. Sub-chondral bone responds to increased friction by generating reactive, ivory-like, dense bone at the site of erosion. ¹

¹ Source: wiktionary. com

Medical Definition of Eburnation

1. A condition of bone cartilage occurring in certain diseases of these tissues, in which they acquire an unnatural density, and come to resemble ivory. Origin: L. Eburnus of ivory, fr. Ebur ivory: cf. F. Eburnation. See Ivory. Source: Websters Dictionary (01 Mar 1998)

Eburnation Pictures

Click the following link to bring up a new window with an automated collection of images related to the term: Eburnation Images

Lexicographical Neighbors of Eburnation

Fluconazole Medical Facts From, Flucozole

fluconazole

What is fluconazole?

Fluconazole is an antifungal medicine.

Fluconazole is used to treat infections caused by fungus, which can invade any part of the body including the mouth, throat, esophagus, lungs, bladder, genital area, and the blood.

Fluconazole is also used to prevent fungal infection in people who have a weak immune system caused by cancer treatment, bone marrow transplant, or diseases such as AIDS.

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

What is the most important information I should know about fluconazole?

Certain other drugs can cause unwanted or dangerous effects when used with fluconazole, especially cisapride, erythromycin, pimozide, and quinidine. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

What should I discuss with my healthcare provider before taking fluconazole?

You should not use this medicine if you are allergic to fluconazole, or if you also take cisapride, erythromycin, pimozide, or quinidine.

To make sure fluconazole is safe for you, tell your doctor if you have:

heart disease or heart rhythm disorder;

a personal or family history of Long QT syndrome;

kidney disease; or

if you are allergic to other antifungal medicine (such as ketoconazole, itraconazole, miconazole, posaconazole, voriconazole, and others).

The liquid form of fluconazole contains sucrose. Talk to your doctor before using this form of fluconazole if you have a problem digesting sugars or milk.

A single dose of fluconazole taken to treat a vaginal yeast infection is not expected to harm an unborn baby.

Do not take more than 1 dose of fluconazole if you are pregnant. Long-term use of high doses fluconazole can harm an unborn baby or cause birth defects. Tell your doctor if you become pregnant during treatment.

Fluconazole can make birth control pills less effective. Ask your doctor about using non hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy while taking fluconazole for more than 1 dose.

Fluconazole can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take fluconazole?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Your dose will depend on the infection you are treating. Vaginal infections are often treated with only one pill. For other infections, your first dose may be a double dose. Carefully follow your doctor's instructions.

You may take fluconazole with or without food.

Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Fluconazole will not treat a viral infection such as the flu or a common cold.

Call your doctor if your symptoms do not improve, or if they get worse while using fluconazole.

Store the tablets at room temperature away from moisture and heat.

You may store liquid fluconazole in a refrigerator, but do not allow it to freeze. Throw away any leftover liquid medicine that is more than 2 weeks old.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take 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. Overdose symptoms may include confusion or unusual thoughts or behavior.

What should I avoid while taking fluconazole?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Fluconazole side effects

Get emergency medical help if you have signs of an allergic reaction . hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

fever, chills, body aches, flu symptoms;

easy bruising or bleeding, unusual weakness;

liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

skin rash or skin lesions; or

severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

stomach pain, diarrhea, upset stomach;

changes in your sense of taste.

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.

Fluconazole dosing information

Usual Adult Dose for Vaginal Candidiasis:

150 mg orally as a single dose

Infectious Diseases Society of America (IDSA) Recommendations: - Uncomplicated vaginitis: 150 mg orally as a single dose - Management of recurrent vulvovaginal candidiasis (after 10 to 14 days induction therapy): 150 mg orally once a week for 6 months - Complicated vulvovaginal candidiasis: 150 mg orally every 72 hours for 3 doses

US CDC Recommendations: - Uncomplicated vulvovaginal candidiasis: 150 mg orally as a single dose - Initial therapy for recurrent vulvovaginal candidiasis: 100 to 200 mg orally every 72 hours for 3 doses - Maintenance therapy for recurrent vulvovaginal candidiasis: 100 to 200 mg orally once a week for 6 months - Severe vulvovaginal candidiasis: 150 mg orally every 72 hours for 2 doses

US CDC, National Institutes of Health (NIH), and IDSA Recommendations for HIV-infected Patients: - Uncomplicated vulvovaginal candidiasis: 150 mg orally as a single dose - Severe or recurrent vulvovaginal candidiasis: 100 to 200 mg orally once a day for at least 7 days - Suppressive therapy for vulvovaginal candidiasis: 150 mg orally once a week

Comments: - Recommended as preferred therapy - Unless frequent or severe recurrences, suppressive therapy generally not recommended

Usual Adult Dose for Oral Thrush:

Oropharyngeal candidiasis: 200 mg IV or orally on the first day followed by 100 mg IV or orally once a day Duration of therapy: At least 2 weeks, to reduce the risk of relapse

IDSA Recommendations: - Moderate to severe oropharyngeal candidiasis: 100 to 200 mg IV or orally once a day for 7 to 14 days

Comments: - Recommended as primary therapy

US CDC, NIH, and IDSA Recommendations for HIV-infected Patients: - Initial episodes of oropharyngeal candidiasis: 100 mg orally once a day for 7 to 14 days - Suppressive therapy for oropharyngeal candidiasis: 100 mg orally once a day or 3 times a week

Comments: - Recommended as preferred oral therapy - Unless frequent or severe recurrences, suppressive therapy generally not recommended

Usual Adult Dose for Candidemia:

Doses up to 400 mg/day have been used.

Comments: - Optimal therapeutic dose and therapy duration have not been established.

Use: For systemic Candida infections including candidemia, disseminated candidiasis, and pneumonia

IDSA Recommendations: Candidemia in nonneutropenic or neutropenic patients: 800 mg IV or orally on the first day followed by 400 mg IV or orally once a day Duration of therapy: - Nonneutropenic patients: 14 days after first negative blood culture and candidemia signs/symptoms resolve - Neutropenic patients: 2 weeks after Candida cleared from bloodstream (documented) and candidemia symptoms and neutropenia resolve

Chronic disseminated candidiasis in stable patients: 400 mg IV or orally once a day Duration of therapy: Until lesions have resolved (usually months) and through periods of immunosuppression

Candida osteoarticular infection: 400 mg IV or orally once a day Duration of therapy: - Osteomyelitis: 6 to 12 months - Septic arthritis: At least 6 weeks

CNS candidiasis (after initial regimen of IV amphotericin B): 400 to 800 mg IV or orally once a day Duration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolve

Candida cardiovascular system infection: 400 to 800 mg IV or orally once a day Duration of therapy: - Endocarditis: Lifelong suppressive therapy may be indicated. - Pericarditis or myocarditis: Often several months - Suppurative thrombophlebitis: At least 2 weeks after candidemia cleared - Infected pacemaker, implantable cardioverter defibrillator (ICD), or ventricular assist device (VAD): 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removed

Comments: - Candidemia in nonneutropenic patients: Recommended as primary therapy; an echinocandin is recommended for moderately severe to severe illness or recent azole exposure; switching to this drug after initial echinocandin is often appropriate. - Candidemia in neutropenic patients: Recommended as alternative therapy; an echinocandin or IV amphotericin B preferred for most patients; this drug recommended for patients without recent azole exposure and who are not critically ill. - Recommended as primary therapy for chronic disseminated candidiasis in stable patients, Candida osteoarticular infection, CNS candidiasis, pericarditis/myocarditis, and suppurative thrombophlebitis - Recommended as alternative therapy for endocarditis and infected pacemaker, ICD, or VAD

Usual Adult Dose for Fungal Pneumonia:

Doses up to 400 mg/day have been used.

Comments: - Optimal therapeutic dose and therapy duration have not been established.

Use: For systemic Candida infections including candidemia, disseminated candidiasis, and pneumonia

IDSA Recommendations: Candidemia in nonneutropenic or neutropenic patients: 800 mg IV or orally on the first day followed by 400 mg IV or orally once a day Duration of therapy: - Nonneutropenic patients: 14 days after first negative blood culture and candidemia signs/symptoms resolve - Neutropenic patients: 2 weeks after Candida cleared from bloodstream (documented) and candidemia symptoms and neutropenia resolve

Chronic disseminated candidiasis in stable patients: 400 mg IV or orally once a day Duration of therapy: Until lesions have resolved (usually months) and through periods of immunosuppression

Candida osteoarticular infection: 400 mg IV or orally once a day Duration of therapy: - Osteomyelitis: 6 to 12 months - Septic arthritis: At least 6 weeks

CNS candidiasis (after initial regimen of IV amphotericin B): 400 to 800 mg IV or orally once a day Duration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolve

Candida cardiovascular system infection: 400 to 800 mg IV or orally once a day Duration of therapy: - Endocarditis: Lifelong suppressive therapy may be indicated. - Pericarditis or myocarditis: Often several months - Suppurative thrombophlebitis: At least 2 weeks after candidemia cleared - Infected pacemaker, implantable cardioverter defibrillator (ICD), or ventricular assist device (VAD): 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removed

Comments: - Candidemia in nonneutropenic patients: Recommended as primary therapy; an echinocandin is recommended for moderately severe to severe illness or recent azole exposure; switching to this drug after initial echinocandin is often appropriate. - Candidemia in neutropenic patients: Recommended as alternative therapy; an echinocandin or IV amphotericin B preferred for most patients; this drug recommended for patients without recent azole exposure and who are not critically ill. - Recommended as primary therapy for chronic disseminated candidiasis in stable patients, Candida osteoarticular infection, CNS candidiasis, pericarditis/myocarditis, and suppurative thrombophlebitis - Recommended as alternative therapy for endocarditis and infected pacemaker, ICD, or VAD

Usual Adult Dose for Fungal Infection -- Disseminated:

Doses up to 400 mg/day have been used.

Comments: - Optimal therapeutic dose and therapy duration have not been established.

Use: For systemic Candida infections including candidemia, disseminated candidiasis, and pneumonia

IDSA Recommendations: Candidemia in nonneutropenic or neutropenic patients: 800 mg IV or orally on the first day followed by 400 mg IV or orally once a day Duration of therapy: - Nonneutropenic patients: 14 days after first negative blood culture and candidemia signs/symptoms resolve - Neutropenic patients: 2 weeks after Candida cleared from bloodstream (documented) and candidemia symptoms and neutropenia resolve

Chronic disseminated candidiasis in stable patients: 400 mg IV or orally once a day Duration of therapy: Until lesions have resolved (usually months) and through periods of immunosuppression

Candida osteoarticular infection: 400 mg IV or orally once a day Duration of therapy: - Osteomyelitis: 6 to 12 months - Septic arthritis: At least 6 weeks

CNS candidiasis (after initial regimen of IV amphotericin B): 400 to 800 mg IV or orally once a day Duration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolve

Candida cardiovascular system infection: 400 to 800 mg IV or orally once a day Duration of therapy: - Endocarditis: Lifelong suppressive therapy may be indicated. - Pericarditis or myocarditis: Often several months - Suppurative thrombophlebitis: At least 2 weeks after candidemia cleared - Infected pacemaker, implantable cardioverter defibrillator (ICD), or ventricular assist device (VAD): 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removed

Comments: - Candidemia in nonneutropenic patients: Recommended as primary therapy; an echinocandin is recommended for moderately severe to severe illness or recent azole exposure; switching to this drug after initial echinocandin is often appropriate. - Candidemia in neutropenic patients: Recommended as alternative therapy; an echinocandin or IV amphotericin B preferred for most patients; this drug recommended for patients without recent azole exposure and who are not critically ill. - Recommended as primary therapy for chronic disseminated candidiasis in stable patients, Candida osteoarticular infection, CNS candidiasis, pericarditis/myocarditis, and suppurative thrombophlebitis - Recommended as alternative therapy for endocarditis and infected pacemaker, ICD, or VAD

Usual Adult Dose for Systemic Candidiasis:

Doses up to 400 mg/day have been used.

Comments: - Optimal therapeutic dose and therapy duration have not been established.

Use: For systemic Candida infections including candidemia, disseminated candidiasis, and pneumonia

IDSA Recommendations: Candidemia in nonneutropenic or neutropenic patients: 800 mg IV or orally on the first day followed by 400 mg IV or orally once a day Duration of therapy: - Nonneutropenic patients: 14 days after first negative blood culture and candidemia signs/symptoms resolve - Neutropenic patients: 2 weeks after Candida cleared from bloodstream (documented) and candidemia symptoms and neutropenia resolve

Chronic disseminated candidiasis in stable patients: 400 mg IV or orally once a day Duration of therapy: Until lesions have resolved (usually months) and through periods of immunosuppression

Candida osteoarticular infection: 400 mg IV or orally once a day Duration of therapy: - Osteomyelitis: 6 to 12 months - Septic arthritis: At least 6 weeks

CNS candidiasis (after initial regimen of IV amphotericin B): 400 to 800 mg IV or orally once a day Duration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolve

Candida cardiovascular system infection: 400 to 800 mg IV or orally once a day Duration of therapy: - Endocarditis: Lifelong suppressive therapy may be indicated. - Pericarditis or myocarditis: Often several months - Suppurative thrombophlebitis: At least 2 weeks after candidemia cleared - Infected pacemaker, implantable cardioverter defibrillator (ICD), or ventricular assist device (VAD): 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removed

Comments: - Candidemia in nonneutropenic patients: Recommended as primary therapy; an echinocandin is recommended for moderately severe to severe illness or recent azole exposure; switching to this drug after initial echinocandin is often appropriate. - Candidemia in neutropenic patients: Recommended as alternative therapy; an echinocandin or IV amphotericin B preferred for most patients; this drug recommended for patients without recent azole exposure and who are not critically ill. - Recommended as primary therapy for chronic disseminated candidiasis in stable patients, Candida osteoarticular infection, CNS candidiasis, pericarditis/myocarditis, and suppurative thrombophlebitis - Recommended as alternative therapy for endocarditis and infected pacemaker, ICD, or VAD

Usual Adult Dose for Esophageal Candidiasis:

200 mg IV or orally on the first day followed by 100 mg IV or orally once a day Duration of therapy: At least 3 weeks and for at least 2 weeks after symptoms resolve

Comments: - Doses up to 400 mg/day may be used based on clinical judgment of patient response.

IDSA Recommendations: 200 to 400 mg IV or orally once a day for 14 to 21 days

Comments: - Recommended as primary therapy; oral fluconazole is preferred.

US CDC, NIH, and IDSA Recommendations for HIV-infected Patients: 100 to 400 mg IV or orally once a day for 14 to 21 days - Suppressive therapy: 100 to 200 mg orally once a day

Comments: - Recommended as preferred therapy - Unless frequent or severe recurrences, suppressive therapy generally not recommended

Usual Adult Dose for Candida Urinary Tract Infection:

50 to 200 mg IV or orally once a day

Use: For the treatment of Candida urinary tract infections and peritonitis

IDSA Recommendations: - Asymptomatic cystitis in patients undergoing urologic procedures: 200 to 400 mg IV or orally once a day for several days before and after the procedure - Symptomatic cystitis: 200 mg IV or orally once a day for 2 weeks - Pyelonephritis: 200 to 400 mg IV or orally once a day for 2 weeks - Urinary fungus balls: 200 to 400 mg IV or orally once a day until symptoms resolve and urine cultures clear of Candida

Comments: - Recommended as primary therapy - The suggested dose for candidemia is recommended for patients with pyelonephritis and suspected disseminated candidiasis. - Surgical removal of urinary fungus balls strongly recommended.

Usual Adult Dose for Fungal Peritonitis:

50 to 200 mg IV or orally once a day

Use: For the treatment of Candida urinary tract infections and peritonitis

IDSA Recommendations: - Asymptomatic cystitis in patients undergoing urologic procedures: 200 to 400 mg IV or orally once a day for several days before and after the procedure - Symptomatic cystitis: 200 mg IV or orally once a day for 2 weeks - Pyelonephritis: 200 to 400 mg IV or orally once a day for 2 weeks - Urinary fungus balls: 200 to 400 mg IV or orally once a day until symptoms resolve and urine cultures clear of Candida

Comments: - Recommended as primary therapy - The suggested dose for candidemia is recommended for patients with pyelonephritis and suspected disseminated candidiasis. - Surgical removal of urinary fungus balls strongly recommended.

Usual Adult Dose for Cryptococcal Meningitis -- Immunocompetent Host:

Acute infection: 400 mg IV or orally on the first day followed by 200 mg IV or orally once a day Duration of therapy: 10 to 12 weeks after CSF culture is negative

Comments: - Dose of 400 mg IV or orally once a day may be used based on clinical judgment of patient response.

IDSA Recommendations: - Consolidation therapy (after induction therapy): 400 to 800 mg orally once a day for 8 weeks - Maintenance therapy: 200 mg orally once a day for 6 to 12 months

Comments: - Preferred agent - The higher dose (800 mg/day) is recommended for consolidation therapy if the 2-week induction regimen was used. - Maintenance therapy is recommended to prevent relapse.

Cerebral cryptococcoma: - Consolidation and maintenance therapy (after induction therapy): 400 to 800 mg orally once a day for 6 to 18 months

Usual Adult Dose for Cryptococcal Meningitis -- Immunosuppressed Host:

Acute infection: 400 mg IV or orally on the first day followed by 200 mg IV or orally once a day Duration of therapy: 10 to 12 weeks after CSF culture is negative

Comments: - Dose of 400 mg IV or orally once a day may be used based on clinical judgment of patient response.

Suppression of relapse in patients with AIDS: 200 mg IV or orally once a day

IDSA Recommendations: HIV-infected patients: - Induction therapy: 800 to 2000 mg orally once a day for 6 to 12 weeks, depending on regimen - Consolidation therapy (after induction therapy): 400 mg orally once a day for at least 8 weeks - Maintenance (suppressive) and prophylactic therapy: 200 mg orally once a day for at least 12 months

Comments: - Recommended as an alternative for induction therapy; use is not encouraged. - Preferred agent for consolidation therapy and maintenance and prophylactic therapy

Organ transplant recipients: - Consolidation therapy (after induction therapy): 400 to 800 mg orally once a day for 8 weeks - Maintenance therapy: 200 to 400 mg orally once a day for 6 to 12 months

Cerebral cryptococcoma: - Consolidation and maintenance therapy (after induction therapy): 400 to 800 mg orally once a day for 6 to 18 months

US CDC, NIH, and IDSA Recommendations for HIV-infected Patients: - Induction therapy: 400 to 1200 mg IV or orally once a day for at least 2 weeks - Consolidation therapy (after at least 2 weeks successful induction therapy): 400 mg IV or orally once a day for at least 8 weeks - Maintenance therapy: 200 mg orally once a day for at least 1 year

Comments: - Recommended for use in alternative regimens for induction therapy; dose depends on regimen (i. e. used with amphotericin B, flucytosine, or alone). - Recommended as preferred regimen for consolidation therapy; should be followed by maintenance therapy - Recommended as preferred regimen for maintenance therapy

Usual Adult Dose for Cryptococcosis:

IDSA Recommendations: Mild to moderate pulmonary infection and nonmeningeal, nonpulmonary infection if CNS disease ruled out, no fungemia, single site of infection, no immunosuppressive risk factors: 400 mg orally once a day for 6 to 12 months

Severe pulmonary infection and nonmeningeal, nonpulmonary infection with cryptococcemia: - Consolidation therapy (after induction therapy): 400 to 800 mg orally once a day for at least 8 weeks - Maintenance therapy: 200 to 400 mg orally once a day for 12 months

Comments: - Preferred agent - Maintenance therapy is recommended to prevent relapse. - Primary prophylaxis not routinely recommended.

US CDC, NIH, and IDSA Recommendations for HIV-infected Patients: Non-CNS cryptococcosis with mild to moderate symptoms and focal pulmonary infiltrates: 400 mg orally once a day for 12 months

Non-CNS, extrapulmonary cryptococcosis and diffuse pulmonary disease: - Induction therapy: 400 to 1200 mg IV or orally once a day for at least 2 weeks - Consolidation therapy (after at least 2 weeks successful induction therapy): 400 mg IV or orally once a day for at least 8 weeks - Maintenance therapy: 200 mg orally once a day for at least 1 year

Comments: - Recommended for use in alternative regimens for induction therapy; dose depends on regimen (i. e. used with amphotericin B, flucytosine, or alone). - Recommended as preferred regimen for consolidation therapy; should be followed by maintenance therapy - Recommended as preferred regimen for maintenance therapy

Usual Adult Dose for Fungal Infection Prophylaxis:

400 mg IV or orally once a day Duration of therapy: 7 days after neutrophil count rises above 1000 cells/mm3

Comments: - If severe granulocytopenia (less than 500 neutrophils/mm3) is expected, prophylaxis should start several days before the likely onset of neutropenia.

Use: For prophylaxis to reduce the incidence of candidiasis in bone marrow transplantation recipients who receive cytotoxic chemotherapy and/or radiation therapy

IDSA Recommendations: Empiric therapy for suspected candidiasis in nonneutropenic or neutropenic patients: 800 mg IV or orally on the first day followed by 400 mg IV or orally once a day Duration of therapy: - Nonneutropenic patients: Uncertain; should discontinue if cultures and/or serodiagnostic test results negative

Comments: - Suspected candidiasis in nonneutropenic patients: Recommended as primary therapy; an echinocandin is preferred for moderately severe to severe illness or recent azole exposure; patient selection should be based on clinical risk factors, serologic tests, and culture data. - Suspected candidiasis in neutropenic patients: Recommended as alternative therapy; should start empiric therapy after 4 days persistent fever despite antibiotics; serodiagnostic and computed tomography (CT) imaging may help; should not use in patients with prior azole prophylaxis.

Usual Adult Dose for Coccidioidomycosis -- Meningitis:

IDSA Recommendations: 400 mg orally once a day

Comments: - Some experts start therapy with 800 to 1000 mg/day. - Patients who respond to therapy should continue this treatment indefinitely.

US CDC, NIH, and IDSA Recommendations for HIV-infected Patients: - Meningeal infection: 400 to 800 mg IV or orally once a day - Chronic suppressive therapy: 400 mg orally once a day

Comments: - Recommended as preferred therapy for meningeal infection and chronic suppressive therapy - A specialist should be consulted for meningeal infections. - Since relapse is common (80%), suppressive therapy should be lifelong.

Usual Adult Dose for Coccidioidomycosis:

IDSA Recommendations: 400 to 800 mg IV or orally once a day Duration of therapy: - Uncomplicated coccidioidal pneumonia: 3 to 6 months - Diffuse pneumonia and chronic progressive fibrocavitary pneumonia: At least 1 year

Comments: - Therapy for diffuse pneumonia is usually started with high-dose fluconazole; if therapy started with IV amphotericin B (e. g. if significant hypoxia or rapid deterioration), may switch to oral azole antifungal therapy after evident improvement; total duration of therapy should be at least 1 year; oral azole therapy should continue as secondary prophylaxis in severely immunodeficient patients. - Initial therapy with oral azole antifungals is recommended for chronic progressive fibrocavitary pneumonia. - Initial therapy for nonmeningeal disseminated infection (extrapulmonary) is generally started with oral azole antifungals, most often fluconazole or itraconazole; clinical trials used 400 mg/day; some experts recommend up to 2 g/day of fluconazole.

US CDC, NIH, and IDSA Recommendations for HIV-infected Patients: - Primary prophylaxis: 400 mg orally once a day - Mild infections (e. g. focal pneumonia): 400 mg orally once a day - Severe nonmeningeal infection (diffuse pulmonary or severely ill patients with extrathoracic disseminated disease) - acute phase: 400 mg IV or orally once a day - Chronic suppressive therapy (secondary prophylaxis): 400 mg orally once a day

Comments: - Recommended as preferred therapy for mild infection and chronic suppressive therapy - Recommended as alternative therapy for severe nonmeningeal infection; some experts add a triazole to amphotericin B (preferred therapy) and continue the triazole after amphotericin B is stopped.

Usual Adult Dose for Histoplasmosis:

IDSA Recommendations: - Disseminated infections in patients without AIDS: 200 to 800 mg IV or orally once a day for at least 12 months - CNS infection (after initial regimen of IV amphotericin B): 200 to 400 mg IV or orally once a day for 12 months

Comments: - Recommended as alternative therapy in patients unable to use itraconazole

US CDC, NIH, and IDSA Recommendations for HIV-infected Patients: - Less severe disseminated infection: 800 mg orally once a day for at least 12 months - Long-term suppressive therapy (secondary prophylaxis): 400 mg orally once a day for more than 1 year

Comments: - Recommended as alternative therapy - This drug should only be used for treatment of less severe disseminated infection in moderately ill patients intolerant of itraconazole.

Usual Adult Dose for Blastomycosis:

IDSA Recommendations: - Mild to moderate pulmonary infection or mild to moderate disseminated infection without CNS involvement: 400 to 800 mg orally once a day for at least 6 to 12 months - CNS infection (after initial regimen of IV amphotericin B): 800 mg orally once a day for at least 12 months and until CSF abnormalities resolve

Comments: - Recommended as alternative therapy for mild to moderate pulmonary infection or mild to moderate disseminated infection without CNS involvement - Recommended as follow-up therapy for CNS infection

Usual Adult Dose for Onychomycosis -- Fingernail:

Some experts recommend: 150 to 300 mg orally once a week Duration of therapy: - Fingernail infections: 3 to 6 months - Toenail infections: 6 to 12 months

Usual Adult Dose for Onychomycosis -- Toenail:

Some experts recommend: 150 to 300 mg orally once a week Duration of therapy: - Fingernail infections: 3 to 6 months - Toenail infections: 6 to 12 months

Usual Adult Dose for Sporotrichosis:

IDSA Recommendations: Cutaneous or lymphocutaneous infection: 400 to 800 mg IV or orally once a day Duration of therapy: 2 to 4 weeks after all lesions resolve (usually 3 to 6 months total)

Comments: - Recommended as alternative therapy; should only be used if other agents are not tolerated

Usual Pediatric Dose for Esophageal Candidiasis:

2 weeks or younger (gestational age 26 to 29 weeks): 3 mg/kg IV or orally every 72 hours Older than 2 weeks: 6 mg/kg IV or orally on the first day followed by 3 mg/kg IV or orally once a day Duration of therapy: At least 3 weeks and for at least 2 weeks after symptoms resolve

Comments: - Doses up to 12 mg/kg/day may be used in patients older than 2 weeks based on clinical judgment of patient response; this correlates to 12 mg/kg/72 hours in premature newborns during their first 2 weeks of life.

IDSA Recommendations: 3 to 6 mg/kg IV or orally once a day for 14 to 21 days

Comments: - Recommended as primary therapy; oral fluconazole is preferred.

US CDC, NIH, IDSA, Pediatric Infectious Diseases Society (PIDS), and American Academy of Pediatrics (AAP) Recommendations for HIV-exposed and HIV-infected Children: 6 to 12 mg/kg IV or orally once a day Maximum dose: 600 mg/dose Duration of therapy: At least 3 weeks and for at least 2 weeks after symptoms resolve

Comments: - Oral fluconazole recommended as preferred therapy; IV dosing recommended as alternative therapy for infants and children of all ages. - If neonate creatinine level is greater than 1.2 mg/dL for 3 consecutive doses, the dosing interval for the higher dose may be extended to 12 mg/kg every 48 hours until serum creatinine level is less than 1.2 mg/dL.

US CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents: 100 to 400 mg IV or orally once a day for 14 to 21 days - Suppressive therapy: 100 to 200 mg orally once a day

Comments: - Recommended as preferred therapy - Unless frequent or severe recurrences, suppressive therapy generally not recommended

Usual Pediatric Dose for Oral Thrush:

Oropharyngeal candidiasis: 2 weeks or younger (gestational age 26 to 29 weeks): 3 mg/kg IV or orally every 72 hours Older than 2 weeks: 6 mg/kg IV or orally on the first day followed by 3 mg/kg IV or orally once a day Duration of therapy: At least 2 weeks, to reduce the risk of relapse

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children: 6 to 12 mg/kg orally once a day Maximum dose: 400 mg/dose Duration of therapy: 7 to 14 days

Comments: - Recommended as preferred therapy; oral fluconazole recommended for moderate or severe oropharyngeal candidiasis.

US CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents: - Initial episodes: 100 mg orally once a day for 7 to 14 days - Suppressive therapy: 100 mg orally once a day or 3 times a week

Comments: - Recommended as preferred oral therapy - Unless frequent or severe recurrences, suppressive therapy generally not recommended

Usual Pediatric Dose for Candidemia:

2 weeks or younger (gestational age 26 to 29 weeks): 6 to 12 mg/kg IV or orally every 72 hours Older than 2 weeks: 6 to 12 mg/kg/day IV or orally

Use: For the treatment of candidemia and disseminated Candida infections

IDSA Recommendations: Neonatal candidiasis: 12 mg/kg IV or orally once a day for at least 3 weeks

Candidemia in nonneutropenic or neutropenic patients: 12 mg/kg IV or orally on the first day followed by 6 mg/kg IV or orally once a day Duration of therapy: - Nonneutropenic patients: 14 days after first negative blood culture and candidemia signs/symptoms resolve - Neutropenic patients: 2 weeks after Candida cleared from bloodstream (documented) and candidemia symptoms and neutropenia resolve

Chronic disseminated candidiasis in stable patients: 6 mg/kg IV or orally once a day Duration of therapy: Until lesions have resolved (usually months) and through periods of immunosuppression

Candida osteoarticular infection: 6 mg/kg IV or orally once a day Duration of therapy: - Osteomyelitis: 6 to 12 months - Septic arthritis: At least 6 weeks

CNS candidiasis (after initial regimen of IV amphotericin B): 6 to 12 mg/kg IV or orally once a day Duration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolve

Candida cardiovascular system infection: 6 to 12 mg/kg IV or orally once a day Duration of therapy: - Endocarditis: Lifelong suppressive therapy may be indicated. - Pericarditis or myocarditis: Often several months - Suppurative thrombophlebitis: At least 2 weeks after candidemia cleared - Infected pacemaker, ICD, or VAD: 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removed

Comments: - Recommended as primary therapy for neonatal candidiasis - Candidemia in nonneutropenic patients: Recommended as primary therapy; an echinocandin is recommended for moderately severe to severe illness or recent azole exposure; switching to this drug after initial echinocandin is appropriate in many cases. - Candidemia in neutropenic patients: Recommended as alternative therapy; an echinocandin or IV amphotericin B preferred for most patients; this drug recommended for patients without recent azole exposure and who are not critically ill. - Recommended as primary therapy for chronic disseminated candidiasis in stable patients, Candida osteoarticular infection, CNS candidiasis, pericarditis/myocarditis, and suppurative thrombophlebitis - Recommended as alternative therapy for endocarditis and infected pacemaker, ICD, or VAD

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children: Invasive disease in infants and children (all ages): 12 mg/kg IV once a day Maximum dose: 600 mg/dose Duration of therapy: Based on presence of deep-tissue foci and clinical response - Uncomplicated candidemia: At least 2 weeks after last positive blood culture

Secondary prophylaxis: 3 to 6 mg/kg IV or orally once a day Maximum dose: 200 mg/dose

Comments: - Recommended as alternative therapy in critically ill patients with invasive disease - Recommended as preferred therapy in patients with invasive disease who are not critically ill; this drug should be avoided for Candida krusei and C glabrata. - Secondary prophylaxis may be considered for frequent or severe recurrences of candidiasis; not routinely recommended.

Usual Pediatric Dose for Fungal Infection -- Disseminated:

2 weeks or younger (gestational age 26 to 29 weeks): 6 to 12 mg/kg IV or orally every 72 hours Older than 2 weeks: 6 to 12 mg/kg/day IV or orally

Use: For the treatment of candidemia and disseminated Candida infections

IDSA Recommendations: Neonatal candidiasis: 12 mg/kg IV or orally once a day for at least 3 weeks

Candidemia in nonneutropenic or neutropenic patients: 12 mg/kg IV or orally on the first day followed by 6 mg/kg IV or orally once a day Duration of therapy: - Nonneutropenic patients: 14 days after first negative blood culture and candidemia signs/symptoms resolve - Neutropenic patients: 2 weeks after Candida cleared from bloodstream (documented) and candidemia symptoms and neutropenia resolve

Chronic disseminated candidiasis in stable patients: 6 mg/kg IV or orally once a day Duration of therapy: Until lesions have resolved (usually months) and through periods of immunosuppression

Candida osteoarticular infection: 6 mg/kg IV or orally once a day Duration of therapy: - Osteomyelitis: 6 to 12 months - Septic arthritis: At least 6 weeks

CNS candidiasis (after initial regimen of IV amphotericin B): 6 to 12 mg/kg IV or orally once a day Duration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolve

Candida cardiovascular system infection: 6 to 12 mg/kg IV or orally once a day Duration of therapy: - Endocarditis: Lifelong suppressive therapy may be indicated. - Pericarditis or myocarditis: Often several months - Suppurative thrombophlebitis: At least 2 weeks after candidemia cleared - Infected pacemaker, ICD, or VAD: 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removed

Comments: - Recommended as primary therapy for neonatal candidiasis - Candidemia in nonneutropenic patients: Recommended as primary therapy; an echinocandin is recommended for moderately severe to severe illness or recent azole exposure; switching to this drug after initial echinocandin is appropriate in many cases. - Candidemia in neutropenic patients: Recommended as alternative therapy; an echinocandin or IV amphotericin B preferred for most patients; this drug recommended for patients without recent azole exposure and who are not critically ill. - Recommended as primary therapy for chronic disseminated candidiasis in stable patients, Candida osteoarticular infection, CNS candidiasis, pericarditis/myocarditis, and suppurative thrombophlebitis - Recommended as alternative therapy for endocarditis and infected pacemaker, ICD, or VAD

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children: Invasive disease in infants and children (all ages): 12 mg/kg IV once a day Maximum dose: 600 mg/dose Duration of therapy: Based on presence of deep-tissue foci and clinical response - Uncomplicated candidemia: At least 2 weeks after last positive blood culture

Secondary prophylaxis: 3 to 6 mg/kg IV or orally once a day Maximum dose: 200 mg/dose

Comments: - Recommended as alternative therapy in critically ill patients with invasive disease - Recommended as preferred therapy in patients with invasive disease who are not critically ill; this drug should be avoided for Candida krusei and C glabrata. - Secondary prophylaxis may be considered for frequent or severe recurrences of candidiasis; not routinely recommended.

Usual Pediatric Dose for Systemic Candidiasis:

2 weeks or younger (gestational age 26 to 29 weeks): 6 to 12 mg/kg IV or orally every 72 hours Older than 2 weeks: 6 to 12 mg/kg/day IV or orally

Use: For the treatment of candidemia and disseminated Candida infections

IDSA Recommendations: Neonatal candidiasis: 12 mg/kg IV or orally once a day for at least 3 weeks

Candidemia in nonneutropenic or neutropenic patients: 12 mg/kg IV or orally on the first day followed by 6 mg/kg IV or orally once a day Duration of therapy: - Nonneutropenic patients: 14 days after first negative blood culture and candidemia signs/symptoms resolve - Neutropenic patients: 2 weeks after Candida cleared from bloodstream (documented) and candidemia symptoms and neutropenia resolve

Chronic disseminated candidiasis in stable patients: 6 mg/kg IV or orally once a day Duration of therapy: Until lesions have resolved (usually months) and through periods of immunosuppression

Candida osteoarticular infection: 6 mg/kg IV or orally once a day Duration of therapy: - Osteomyelitis: 6 to 12 months - Septic arthritis: At least 6 weeks

CNS candidiasis (after initial regimen of IV amphotericin B): 6 to 12 mg/kg IV or orally once a day Duration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolve

Candida cardiovascular system infection: 6 to 12 mg/kg IV or orally once a day Duration of therapy: - Endocarditis: Lifelong suppressive therapy may be indicated. - Pericarditis or myocarditis: Often several months - Suppurative thrombophlebitis: At least 2 weeks after candidemia cleared - Infected pacemaker, ICD, or VAD: 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removed

Comments: - Recommended as primary therapy for neonatal candidiasis - Candidemia in nonneutropenic patients: Recommended as primary therapy; an echinocandin is recommended for moderately severe to severe illness or recent azole exposure; switching to this drug after initial echinocandin is appropriate in many cases. - Candidemia in neutropenic patients: Recommended as alternative therapy; an echinocandin or IV amphotericin B preferred for most patients; this drug recommended for patients without recent azole exposure and who are not critically ill. - Recommended as primary therapy for chronic disseminated candidiasis in stable patients, Candida osteoarticular infection, CNS candidiasis, pericarditis/myocarditis, and suppurative thrombophlebitis - Recommended as alternative therapy for endocarditis and infected pacemaker, ICD, or VAD

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children: Invasive disease in infants and children (all ages): 12 mg/kg IV once a day Maximum dose: 600 mg/dose Duration of therapy: Based on presence of deep-tissue foci and clinical response - Uncomplicated candidemia: At least 2 weeks after last positive blood culture

Secondary prophylaxis: 3 to 6 mg/kg IV or orally once a day Maximum dose: 200 mg/dose

Comments: - Recommended as alternative therapy in critically ill patients with invasive disease - Recommended as preferred therapy in patients with invasive disease who are not critically ill; this drug should be avoided for Candida krusei and C glabrata. - Secondary prophylaxis may be considered for frequent or severe recurrences of candidiasis; not routinely recommended.

Usual Pediatric Dose for Cryptococcal Meningitis -- Immunocompetent Host:

Acute infection: 2 weeks or younger (gestational age 26 to 29 weeks): 6 mg/kg IV or orally every 72 hours Older than 2 weeks: 12 mg/kg IV or orally on the first day followed by 6 mg/kg IV or orally once a day Duration of therapy: 10 to 12 weeks after CSF culture is negative

Comments: - Dose of 12 mg/kg IV or orally once a day may be used in patients older than 2 weeks based on clinical judgment of patient response; this correlates to 12 mg/kg IV or orally every 72 hours in premature newborns during their first 2 weeks of life.

IDSA Recommendations: CNS infection in children: - Consolidation therapy (after induction therapy): 10 to 12 mg/kg orally once a day for 8 weeks - Maintenance therapy: 6 mg/kg orally once a day

Comments: - Preferred agent - Maintenance therapy is recommended to prevent relapse.

Usual Pediatric Dose for Cryptococcal Meningitis -- Immunosuppressed Host:

Acute infection: 2 weeks or younger (gestational age 26 to 29 weeks): 6 mg/kg IV or orally every 72 hours Older than 2 weeks: 12 mg/kg IV or orally on the first day followed by 6 mg/kg IV or orally once a day Duration of therapy: 10 to 12 weeks after CSF culture is negative

Comments: - Dose of 12 mg/kg IV or orally once a day may be used in patients older than 2 weeks based on clinical judgment of patient response; this correlates to 12 mg/kg IV or orally every 72 hours in premature newborns during their first 2 weeks of life.

Suppression of relapse in children with AIDS: 6 mg/kg IV or orally once a day

IDSA Recommendations for children: CNS disease: - Consolidation therapy (after induction therapy): 10 to 12 mg/kg/day orally in 2 divided doses for 8 weeks - Maintenance therapy in HIV-infected patients: 6 mg/kg orally once a day

Comments: - Preferred agent - Maintenance therapy is recommended to prevent relapse.

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children: Acute therapy (induction): 12 mg/kg IV or orally on the first day followed by 10 to 12 mg/kg IV or orally once a day Maximum dose: 800 mg/dose Duration of therapy: At least 2 weeks

Consolidation therapy: 12 mg/kg IV or orally on the first day followed by 10 to 12 mg/kg IV or orally once a day Maximum dose: 800 mg/dose Duration of therapy: At least 8 weeks

Secondary prophylaxis: 6 mg/kg orally once a day Maximum dose: 200 mg/dose Duration of therapy: At least 1 year

Comments: - Recommended in alternative regimens for acute therapy if flucytosine not tolerated or unavailable or amphotericin B-based therapy not tolerated - Recommended as preferred agent for consolidation therapy; should be followed by secondary prophylaxis - Recommended as preferred therapy for secondary prophylaxis

US CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents: - Induction therapy: 400 to 1200 mg IV or orally once a day for at least 2 weeks - Consolidation therapy (after at least 2 weeks successful induction therapy): 400 mg IV or orally once a day for at least 8 weeks - Maintenance therapy: 200 mg orally once a day for at least 1 year

Comments: - Recommended for use in alternative regimens for induction therapy; dose depends on regimen (i. e. used with amphotericin B, flucytosine, or alone). - Recommended as preferred regimen for consolidation therapy; should be followed by maintenance therapy - Recommended as preferred regimen for maintenance therapy

Usual Pediatric Dose for Cryptococcosis:

IDSA Recommendations for children: Disseminated disease: - Consolidation therapy (after induction therapy): 10 to 12 mg/kg/day orally in 2 divided doses for 8 weeks - Maintenance therapy in HIV-infected patients: 6 mg/kg orally once a day

Cryptococcal pneumonia: 6 to 12 mg/kg orally once a day for 6 to 12 months

Comments: - Preferred agent - Maintenance therapy is recommended to prevent relapse.

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children: Localized disease (including isolated pulmonary disease [non-CNS]), disseminated disease (non-CNS), or severe pulmonary disease: 12 mg/kg IV or orally on the first day followed by 6 to 12 mg/kg IV or orally once a day Maximum dose: 600 mg/dose Duration of therapy: Based on site and severity of infection and clinical response

Secondary prophylaxis: 6 mg/kg orally once a day Maximum dose: 200 mg/dose Duration of therapy: At least 1 year

Comments: - Recommended as preferred therapy for localized disease and secondary prophylaxis - Recommended as alternative therapy for disseminated disease and severe pulmonary disease

US CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents: Non-CNS cryptococcosis with mild to moderate symptoms and focal pulmonary infiltrates: 400 mg orally once a day for 12 months

Non-CNS, extrapulmonary cryptococcosis and diffuse pulmonary disease: - Induction therapy: 400 to 1200 mg IV or orally once a day for at least 2 weeks - Consolidation therapy (after at least 2 weeks successful induction therapy): 400 mg IV or orally once a day for at least 8 weeks - Maintenance therapy: 200 mg orally once a day for at least 1 year

Comments: - Recommended for use in alternative regimens for induction therapy; dose depends on regimen (i. e. used with amphotericin B, flucytosine, or alone). - Recommended as preferred regimen for consolidation therapy; should be followed by maintenance therapy - Recommended as preferred regimen for maintenance therapy

Usual Pediatric Dose for Fungal Infection Prophylaxis:

IDSA Recommendations: Empiric therapy for suspected candidiasis in nonneutropenic or neutropenic patients: 12 mg/kg IV or orally on the first day followed by 6 mg/kg IV or orally once a day Duration of therapy: - Nonneutropenic patients: Uncertain; should discontinue if cultures and/or serodiagnostic test results negative

Comments: - Suspected candidiasis in nonneutropenic patients: Recommended as primary therapy; an echinocandin is preferred for moderately severe to severe illness or recent azole exposure; patient selection should be based on clinical risk factors, serologic tests, and culture data. - Suspected candidiasis in neutropenic patients: Recommended as alternative therapy; should start empiric therapy after 4 days persistent fever despite antibiotics; serodiagnostic and CT imaging may help; should not use in patients with prior azole prophylaxis.

Usual Pediatric Dose for Candida Urinary Tract Infection:

IDSA Recommendations: - Asymptomatic cystitis in patients undergoing urologic procedures: 3 to 6 mg/kg IV or orally once a day for several days before and after the procedure - Symptomatic cystitis: 3 mg/kg IV or orally once a day for 2 weeks - Pyelonephritis: 3 to 6 mg/kg IV or orally once a day for 2 weeks - Urinary fungus balls: 3 to 6 mg/kg IV or orally once a day until symptoms resolve and urine cultures clear of Candida

Comments: - Recommended as primary therapy - The suggested dose for candidemia is recommended for patients with pyelonephritis and suspected disseminated candidiasis. - Surgical removal of urinary fungus balls strongly recommended in non-neonates.

Usual Pediatric Dose for Coccidioidomycosis -- Meningitis:

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children: Meningeal infection: 12 mg/kg IV or orally once a day Maximum dose: 800 mg/dose

Secondary prophylaxis: 6 mg/kg orally once a day Maximum dose: 400 mg/dose Duration of therapy: Lifelong

Comments: - Recommended as preferred therapy - Secondary prophylaxis should follow treatment of meningeal infection.

US CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents: - Meningeal infection: 400 to 800 mg IV or orally once a day - Chronic suppressive therapy: 400 mg orally once a day

Comments: - Recommended as preferred therapy for meningeal infection and chronic suppressive therapy - A specialist should be consulted for meningeal infections. - Since relapse is common (80%), suppressive therapy should be lifelong.

Usual Pediatric Dose for Coccidioidomycosis:

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children: Severe illness with respiratory compromise due to diffuse pulmonary or disseminated nonmeningeal infection: 12 mg/kg IV or orally once a day Maximum dose: 800 mg/dose Duration of therapy: 1 year total

Mild to moderate nonmeningeal infection (e. g. focal pneumonia): 6 to 12 mg/kg IV or orally once a day Maximum dose: 400 mg/dose

Secondary prophylaxis: 6 mg/kg orally once a day Maximum dose: 400 mg/dose Duration of therapy: Lifelong in patients with disseminated disease

Comments: - Recommended as alternative therapy for severe illness with respiratory compromise due to diffuse pulmonary or disseminated nonmeningeal infection; should be followed by secondary prophylaxis - After patient with severe illness with respiratory compromise due to diffuse pulmonary or disseminated nonmeningeal infection is stabilized using the preferred regimen, may switch to fluconazole to complete therapy (total duration: 1 year) - Recommended as preferred therapy for secondary prophylaxis; usually recommended after initial induction therapy for disseminated disease; may also be used after milder disease

US CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents: - Primary prophylaxis: 400 mg orally once a day - Mild infections (e. g. focal pneumonia): 400 mg orally once a day - Severe nonmeningeal infection (diffuse pulmonary or severely ill patients with extrathoracic disseminated disease) - acute phase: 400 mg IV or orally once a day - Chronic suppressive therapy (secondary prophylaxis): 400 mg orally once a day

Comments: - Recommended as preferred therapy for mild infection and chronic suppressive therapy - Recommended as alternative therapy for severe nonmeningeal infection; some experts add a triazole to amphotericin B (preferred therapy) and continue the triazole after amphotericin B is stopped.

Usual Pediatric Dose for Vaginal Candidiasis:

US CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents: - Uncomplicated vulvovaginal candidiasis: 150 mg orally as a single dose - Severe or recurrent vulvovaginal candidiasis: 100 to 200 mg orally once a day for at least 7 days - Suppressive therapy for vulvovaginal candidiasis: 150 mg orally once a week

Comments: - Recommended as preferred therapy - Unless frequent or severe recurrences, suppressive therapy generally not recommended

Usual Pediatric Dose for Histoplasmosis:

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children: Acute primary pulmonary infection: 3 to 6 mg/kg orally once a day Maximum dose: 200 mg/dose

Mild disseminated disease: 5 to 6 mg/kg IV or orally twice a day Maximum dose: 300 mg/dose Duration of therapy: 12 months

Secondary prophylaxis: 3 to 6 mg/kg orally once a day Maximum dose: 200 mg/dose

Comments: - Recommended as alternative therapy

US CDC, NIH, and IDSA Recommendations for HIV-infected Adolescents: - Less severe disseminated infection: 800 mg orally once a day for at least 12 months - Long-term suppressive therapy (secondary prophylaxis): 400 mg orally once a day for more than 1 year

Comments: - Recommended as alternative therapy - This drug should only be used for treatment of less severe disseminated infection in moderately ill patients intolerant of itraconazole.

What other drugs will affect fluconazole?

Certain other drugs can cause unwanted or dangerous effects when used with fluconazole. Your doctor may need to change your treatment plan if you use any of the following drugs:

Dilacor Xr - Fda Prescribing Information, Side Effects And Uses, Dilacor Xr

Dilacor XR

Dilacor XR Description

Dilacor XR ® (diltiazem hydrochloride) is a calcium ion influx inhibitor (slow channel blocker or calcium antagonist). Chemically, diltiazem hydrochloride is 1,5-Benzothiazepin-4(5 H )one, 3-(acetyloxy)-5-[2-(dimethylamino)ethyl]-2,3-dihydro-2-(4-methoxyphenyl)-, monohydrochloride, (+)-cis-. Its molecular formula is C 22 H 26 N 2 O 4 S•HCl and its molecular weight is 450.98. Its structural formula is as follows:

Diltiazem hydrochloride is a white to off-white crystalline powder with a bitter taste. It is soluble in water, methanol, and chloroform. Dilacor XR complies with USP Drug Release Test #2.

Dilacor XR capsules contain multiple units of diltiazem HCl extended-release 60 mg, resulting in 120 mg, 180 mg, or 240 mg dosage strengths allowing for the controlled release of diltiazem HCl over a 24-hour period.

Inactive Ingredients: Dilacor XR capsules also contain mannitol, ethyl cellulose, hypromellose, hydrogenated castor oil, ferric oxides, silicon dioxide, magnesium stearate, gelatin, D&C Yellow No. 10, FD&C Red No. 40, D&C Red No. 28, and titanium dioxide. The 120 mg dosage form contains pregelatinized starch.

For oral administration.

Dilacor XR - Clinical Pharmacology

The therapeutic benefits of diltiazem hydrochloride are believed to be related to its ability to inhibit the influx of calcium ions during membrane depolarization of cardiac and vascular smooth muscles.

Mechanism of Action: Hypertension: Dilacor XR produces its antihypertensive effect primarily by relaxation of vascular smooth muscle with a resultant decrease in peripheral vascular resistance. The magnitude of blood pressure reduction is related to the degree of hypertension; thus hypertensive individuals experience an antihypertensive effect, whereas there is only a modest fall in blood pressure in normotensives.

Angina: Diltiazem HCl has been shown to produce increases in exercise tolerance, probably due to its ability to reduce myocardial oxygen demand. This is accomplished via reductions in heart rate and systemic blood pressure at submaximal and maximal work loads.

Diltiazem has been shown to be a potent dilator of coronary arteries, both epicardial and subendocardial. Spontaneous and ergonovine-induced coronary artery spasms are inhibited by diltiazem.

In animal models, diltiazem interferes with the slow inward (depolarizing) current in excitable tissue. It causes excitation-contraction uncoupling in various myocardial tissues without changes in the configuration of the action potential. Diltiazem produces relaxation of coronary vascular smooth muscle and dilation of both large and small coronary arteries at drug levels which cause little or no negative inotropic effect. The resultant increases in coronary blood flow (epicardial and subendocardial) occur in ischemic and nonischemic models and are accompanied by dose-dependent decreases in systemic blood pressure and decreases in peripheral resistance.

Hemodynamic and Electrophysiologic Effects: Like other calcium antagonists, diltiazem decreases sinoatrial and atrioventricular conduction in isolated tissues and has a negative inotropic effect in isolated preparations. In the intact animal, prolongation of the AH interval can be seen at higher doses.

In man, diltiazem prevents spontaneous and ergonovine-provoked coronary artery spasm. It causes a decrease in peripheral vascular resistance and a modest fall in blood pressure in normotensive individuals. In exercise tolerance studies in patients with ischemic heart disease, diltiazem reduces the double product (HR x SBP) for any given work load. Studies to date, primarily in patients with good ventricular function, have not revealed evidence of a negative inotropic effect. Cardiac output, ejection fraction and left ventricular end diastolic pressure have not been affected. Such data have no predictive value with respect to effects in patients with poor ventricular function. Increased heart failure has, however, been reported in occasional patients with pre-existing impairment of ventricular function. There are as yet few data on the interaction of diltiazem and beta-blockers in patients with poor ventricular function. Resting heart rate is usually slightly reduced by diltiazem.

Dilacor XR produces antihypertensive effects both in the supine and standing positions. Postural hypotension is infrequently noted upon suddenly assuming an upright position. Diltiazem decreases vascular resistance, increases cardiac output (by increasing stroke volume), and produces a slight decrease or no change in heart rate. No reflex tachycardia is associated with the chronic antihypertensive effects.

During dynamic exercise, increases in diastolic pressure are inhibited while maximum achievable systolic pressure is usually reduced. Heart rate at maximum exercise does not change or is slightly reduced.

Diltiazem antagonizes the renal and peripheral effects of angiotensin II. No increased activity of the renin-angiotensin-aldosterone axis has been observed. Chronic therapy with diltiazem produces no change or an increase in plasma catecholamines. Hypertensive animal models respond to diltiazem with reductions in blood pressure and increased urinary output and natriuresis without a change in the urinary sodium/potassium ratio. In man, transient natriuresis and kaliuresis have been reported, but only in high intravenous doses of 0.5 mg/kg of body weight.

Diltiazem-associated prolongation of the AH interval is not more pronounced in patients with first-degree heart block. In patients with sick sinus syndrome, diltiazem significantly prolongs sinus cycle length (up to 50% in some cases). Intravenous diltiazem in doses of 20 mg prolongs AH conduction time and AV node functional and effective refractory periods approximately 20%.

In two short-term, double-blind, placebo-controlled studies, 303 hypertensive patients were treated with once daily Dilacor XR in doses of up to 540 mg. There were no instances of greater than first-degree atrioventricular block, and the maximum increase in the PR interval was 0.08 seconds. No patients were prematurely discontinued from the medication due to symptoms related to prolongation of the PR interval.

Pharmacodynamics: In one short-term, double-blind, placebo-controlled study, Dilacor XR 120, 240, 360, and 480 mg/day demonstrated a dose-related antihypertensive response among patients with mild to moderate hypertension. Statistically significant decreases in trough mean supine diastolic blood pressure were seen through 4 weeks of treatment: 120 mg/day (-5.1 mmHg); 240 mg/day (-6.9 mmHg); 360 mg/day (-6.9 mmHg); and, 480 mg/day (-10.6 mmHg). Statistically significant decreases in trough mean supine systolic blood pressure were also seen through 4 weeks of treatment: 120 mg/day (-2.6 mmHg); 240 mg/day (-6.5 mmHg); 360 mg/day (-4.8 mmHg); and 480 mg/day (-10.6 mmHg). The proportion of evaluable patients exhibiting a therapeutic response (supine diastolic blood pressure <90 mmHg or decrease >10 mmHg) was greater as the dose increased: 31%, 42%, 48%, and 69% with the 120, 240, 360, and 480 mg/day diltiazem groups, respectively. Similar findings were observed for standing systolic and diastolic blood pressures. The trough (24 hours after a dose) antihypertensive effect of Dilacor XR retained more than one-half of the response seen at peak (3-6 hours after administration).

Significant reductions of mean supine blood pressure (at trough) in patients with mild to moderate hypertension were also seen in a short-term, double-blind, dose-escalation, placebo-controlled study after 2 weeks of once daily Dilacor XR 180 mg/day (diastolic: -6.1 mmHg; systolic: -4.7 mmHg) and again, 2 weeks after escalation to 360 mg/day (diastolic: -9.3 mmHg; systolic: -7.2 mmHg). However, a further increase in dose to 540 mg/day for 2 weeks provided only a minimal further increase in the antihypertensive effect (diastolic: -10.2 mmHg; systolic: -6.7 mmHg).

Dilacor XR, given at 120 mg, 240 mg, and 480 mg/day, in a randomized, multicenter, double-blind, placebo-controlled, parallel group, dose-ranging study, in 189 patients with chronic angina, demonstrated a dose-related increase in exercise time by Exercise Tolerance Test (ETT) and a reduction in rates of anginal attacks (based on individual patient diaries). The improvement in total exercise time (using the Bruce protocol), measured at trough exercise periods, for placebo, 120 mg, 240 mg, and 480 mg, was 20, 37, 49, and 56 seconds, respectively.

Pharmacokinetics and Metabolism: Diltiazem is well absorbed from the gastrointestinal tract, and is subject to an extensive first-pass effect. When given as an immediate release oral formulation, the absolute bioavailability (compared to intravenous administration) of diltiazem is approximately 40%. Diltiazem undergoes extensive hepatic metabolism in which 2% to 4% of the unchanged drug appears in the urine. Total radioactivity measurement following short IV administration in healthy volunteers suggests the presence of other unidentified metabolites which attain higher concentrations than those of diltiazem and are more slowly eliminated; half-life of total radioactivity is about 20 hours compared to 2 to 5 hours for diltiazem. In vitro binding studies show diltiazem HCl is 70% to 80% bound to plasma proteins. Competitive in vitro ligand binding studies have also shown diltiazem HCl binding is not altered by therapeutic concentrations of digoxin, HCTZ, phenylbutazone, propranolol, salicylic acid, or warfarin. The plasma elimination half-life of diltiazem is approximately 3.0 to 4.5 hours. Desacetyldiltiazem, the major metabolite of diltiazem, which is also present in the plasma at concentrations of 10% to 20% of the parent drug, is approximately 25% to 50% as potent a coronary vasodilator as diltiazem. Therapeutic blood levels of diltiazem hydrochloride appear to be in the range of 40-200 ng/mL. There is a departure from linearity when dose strengths are increased; the half-life is slightly increased with dose.

A study that compared patients with normal hepatic function to patients with cirrhosis found an increase in half-life and a 69% increase in bioavailability in the hepatically impaired patients. Patients with severely impaired renal function showed no difference in the pharmacokinetic profile of diltiazem compared to patients with normal renal function.

Dilacor XR capsules contain a degradable controlled-release tablet formulation designed to release diltiazem over a 24-hour period. Geomatrix™, a registered trademark of Jago Research AG, Zollikon, Switzerland, is a patented controlled-release system incorporated in the tablets. Controlled absorption of diltiazem begins within 1 hour, with maximum plasma concentrations being achieved 4 to 6 hours after administration. The apparent steady-state half-life of diltiazem following once daily administration of Dilacor XR capsules ranges from 5 to 10 hours. This prolongation of half-life is attributed to continued absorption of diltiazem rather than to alterations in its elimination.

The absolute bioavailability of diltiazem from a single dose of Dilacor XR (compared to intravenous administration) is 41% (± 14). The value was shown to be similar to the 40% systemic availability reported following administration of an immediate release diltiazem HCl formulation.

As the dose of Dilacor XR capsules is increased from a daily dose of 120 mg to 240 mg, there is an increase in the AUC of 2.3 fold. When the dose is increased from 240 mg to 360 mg, AUC increases 1.6 fold and when increased from 240 mg to 480 mg, AUC increases 2.4 fold.

In vivo release of diltiazem occurs throughout the gastrointestinal tract, with controlled release still occurring for up to 24 hours after administration, as determined by radio-labeled methods. As the once daily dose of Dilacor XR was increased, departures from linearity were noted. There were disproportionate increases in area under the curve for doses from 120 mg to 480 mg.

The presence of food did not affect the ability of Dilacor XR to maintain a controlled release of the drug and did not impact its sustained release properties over 24-hours after administration. However, simultaneous administration of Dilacor XR with a high-fat breakfast resulted in increases in AUC of 13% and 19%, and in C max by 37% and 51%, respectively.

Indications and Usage for Dilacor XR

Dilacor XR is indicated for the treatment of hypertension. Diltiazem hydrochloride may be used alone or in combination with other antihypertensive medications, such as diuretics.

Dilacor XR is indicated for the management of chronic stable angina.

Contraindications

Diltiazem hydrochloride is contraindicated in: (1) patients with sick sinus syndrome except in the presence of a functioning ventricular pacemaker; (2) patients with second or third degree AV block except in the presence of a functioning ventricular pacemaker; (3) patients with hypotension (less than 90 mmHg systolic); (4) patients who have demonstrated hypersensitivity to the drug; and (5) patients with acute myocardial infarction and pulmonary congestion as documented by X-ray on admission.

Warnings

Cardiac Conduction: Diltiazem hydrochloride prolongs AV node refractory periods without significantly prolonging sinus node recovery time, except in patients with sick sinus syndrome. This effect may rarely result in abnormally slow heart rates (particularly in patients with sick sinus syndrome) or second, or third degree AV block (22 of 10,119 patients, or 0.2%); 41% of these 22 patients were receiving concomitant β-adrenoceptor antagonists versus 17% of the total group. Concomitant use of diltiazem with beta-blockers or digitalis may result in additive effects on cardiac conduction. A patient with Prinzmetal’s angina developed periods of asystole (2 to 5 seconds) after a single 60 mg dose of diltiazem.

Congestive Heart Failure: Although diltiazem has a negative inotropic effect in isolated animal tissue preparations, hemodynamic studies in humans with normal ventricular function have not shown a reduction in cardiac index nor consistent negative effects on contractility (dp/dt). An acute study of oral diltiazem in patients with impaired ventricular function (ejection fraction of 24% ± 6%) showed improvement in indices of ventricular function without significant decrease in contractile function (dp/dt). Worsening of congestive heart failure has been reported in patients with preexisting impairment of ventricular function. Experience with the use of diltiazem hydrochloride in combination with beta-blockers in patients with impaired ventricular function is limited. Caution should be exercised when using this combination.

Hypotension: Decreases in blood pressure associated with diltiazem hydrochloride therapy may occasionally result in symptomatic hypotension.

Acute Hepatic Injury: Mild elevations of serum transaminases with and without concomitant elevation in alkaline phosphatase and bilirubin have been observed in clinical studies. Such elevations were usually transient and frequently resolved even with continued diltiazem treatment. In rare instances, significant elevations in alkaline phoshatase, LDH, SGOT, SGPT, and other phenomena consistent with acute hepatic injury have been noted. These reactions tended to occur early after therapy initiation (1 to 6 weeks) and have been reversible upon discontinuation of drug therapy. The relationship to diltiazem is uncertain in some cases, but probable in some others. (See PRECAUTIONS .)

Precautions

General:

Diltiazem hydrochloride is extensively metabolized by the liver and is excreted by the kidneys and in bile. As with any drug given over prolonged periods, laboratory parameters should be monitored at regular intervals. The drug should be used with caution in patients with impaired renal or hepatic function. In subacute and chronic dog and rat studies designed to produce toxicity, high doses of diltiazem were associated with hepatic damage. In special subacute hepatic studies, oral doses of 125 mg/kg and higher in rats were associated with histological changes in the liver which were reversible when the drug was discontinued. In dogs, doses of 20 mg/kg were also associated with hepatic changes; however, these changes were reversible with continued dosing.

Dermatological events (see ADVERSE REACTIONS ) may be transient and may disappear despite continued use of diltiazem hydrochloride. However, skin eruptions progressing to erythema multiforme and/or exfoliative dermatitis have also been infrequently reported. Should a dermatologic reaction persist, the drug should be discontinued.

Although Dilacor XR utilizes a slowly disintegrating matrix, caution should still be used in patients with preexisting severe gastrointestinal narrowing (pathologic or iatrogenic). There have been no reports of obstructive symptoms in patients with known strictures in association with the ingestion of Dilacor XR.

Information for Patients:

Dilacor XR capsules should be taken on an empty stomach. Patients should be cautioned that the Dilacor XR capsules should not be opened, chewed or crushed, and should be swallowed whole.

Drug Interactions:

Due to the potential for additive effects, caution and careful titration are warranted in patients receiving diltiazem hydrochloride concomitantly with any agents known to affect cardiac contractility and/or conduction. (See WARNINGS .) Pharmacologic studies indicate that there may be additive effects in prolonging AV conduction when using beta-blockers or digitalis concomitantly with diltiazem hydrochloride. (See WARNINGS .) As with all drugs, care should be exercised when treating patients with multiple medications. Diltiazem hydrochloride undergoes biotransformation by cytochrome P-450 mixed function oxidase. Co-administration of diltiazem hydrochloride with other agents which follow the same route of biotransformation may result in the competitive inhibition of metabolism. Especially in patients with renal and/or hepatic impairment, dosages of similarly metabolized drugs, particularly those of low therapeutic ratio such as cyclosporine, may require adjustment when starting or stopping concomitantly administered diltiazem hydrochloride to maintain optimum therapeutic blood levels. Concomitant administration of diltiazem with carbamazepine has been reported to result in elevated plasma levels of carbamazepine, resulting in toxicity in some cases.

Beta-Blockers: Controlled and uncontrolled domestic studies suggest that concomitant use of diltiazem hydrochloride and beta-blockers is usually well-tolerated, but available data are not sufficient to predict the effects of concomitant treatment in patients with left ventricular dysfunction or cardiac conduction abnormalities. Administration of diltiazem hydrochloride concomitantly with propranolol in five normal volunteers resulted in increased propranolol levels in all subjects and the bioavailability of propranolol was increased approximately 50%. If combination therapy is initiated or withdrawn in conjunction with propranolol, an adjustment in the propranolol dose may be warranted. (See WARNINGS .)

Cimetidine: A study in six healthy volunteers has shown a significant increase in peak diltiazem plasma levels (58%) and area-under-the-curve (53%) after a 1 week course of cimetidine at 1,200 mg per day and diltiazem 60 mg per day. Ranitidine produced smaller, nonsignificant increases. The effect may be mediated by cimetidine’s known inhibition of hepatic cytochrome P-450, the enzyme system responsible for the first-pass metabolism of diltiazem. Patients currently receiving diltiazem therapy should be carefully monitored for a change in pharmacological effect when initiating and discontinuing therapy with cimetidine. An adjustment in the diltiazem dose may be warranted.

Clonidine: Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported in association with the use of clonidine concurrently with diltiazem. Monitor heart rate in patients receiving concomitant diltiazem and clonidine.

Digitalis: Administration of diltiazem hydrochloride with digoxin in 24 healthy male subjects increased plasma digoxin concentrations approximately 20%. Another investigator found no increase in digoxin levels in 12 patients with coronary artery disease. Since there have been conflicting results regarding the effects of digoxin levels, it is recommended that digoxin levels be monitored when initiating, adjusting, and discontinuing diltiazem hydrochloride therapy to avoid possible over - or under-digitalization. (See WARNINGS .)

Anesthetics: The depression of cardiac contractility, conductivity, and automaticity as well as the vascular dilation associated with anesthetics may be potentiated by calcium channel blockers. When used concomitantly, anesthetics and calcium channel blockers should be titrated carefully.

Statins: Diltiazem is an inhibitor of CYP3A4 and has been shown to increase significantly the AUC of some statins. The risk of myopathy and rhabdomyolysis with statins metabolized by CYP3A4 may be increased with concomitant use of diltiazem. When possible, use a non-CYP3A4-metabolized statin with diltiazem; otherwise, dose adjustments for both diltiazem and the statin should be considered along with close monitoring for signs and symptoms of any statin related adverse events.

In a healthy volunteer cross-over study (N=10), co-administration of a single 20 mg dose of simvastatin at the end of a 14 day regimen with 120 mg twice daily diltiazem SR resulted in a 5-fold higher mean simvastatin AUC compared with simvastatin alone. High average steady-state exposures of diltiazem would result in a greater increase in simvastatin exposure. A daily dose of 480 mg of diltiazem would be expected to result in an 8-fold higher mean simvastatin AUC compared with simvastatin alone. If co-administration of simvastatin with diltiazem is required, limit the daily doses of simvastatin to 10 mg and diltiazem to 240 mg.

In a ten-subject randomized, open label, 4-way cross-over study, co-administration of diltiazem (120 mg twice daily diltiazem SR for 2 weeks) with a single 20 mg dose of lovastatin resulted in 3- to 4-fold higher mean lovastatin AUC and C max values compared with lovastatin alone. In the same study, there was no significant change in 20 mg single dose pravastatin AUC and C max during diltiazem co-administration.

Carcinogenesis, Mutagenesis, Impairment of Fertility:

A 24-month study in rats and an 18-month study in mice showed no evidence of carcinogenicity. There was also no mutagenic response in vitro or in vivo in mammalian cell assays or in vitro in bacteria. No evidence of impaired fertility was observed in male or female rats at oral doses of up to 100 mg/kg/day.

Pregnancy:

Category C: Reproduction studies have been conducted in mice, rats, and rabbits. Administration of doses ranging from 4 to 6 times (depending on species) the upper limit of the optimum dosage range in clinical trials (480 mg once daily or 8 mg/kg once daily for a 60 kg patient) has resulted in embryo and fetal lethality. These studies have revealed, in one species or another, a propensity to cause abnormalities of the skeleton, heart, retina, and tongue. Also observed were reductions in early individual pup weights and pup survival, prolonged delivery, and increased incidence of stillbirths.

There are no well-controlled studies in pregnant women; therefore, use diltiazem hydrochloride in pregnant women only if the potential benefit justifies the potential risk to the fetus.

Nursing Mothers:

Diltiazem is excreted in human milk. One report suggests that concentrations in breast milk may approximate serum levels. If use of diltiazem hydrochloride is deemed essential, an alternate method of infant feeding should be instituted.

Pediatric Use:

Safety and effectiveness in pediatric patients have not been established.

Adverse Reactions

Serious adverse reactions to diltiazem hydrochloride have been rare in studies with other formulations, as well as with Dilacor XR ®. It should be recognized, however, that patients with impaired ventricular function and cardiac conduction abnormalities have usually been excluded from these studies.

Hypertension: The most common adverse events (frequency ≥1%) in placebo-controlled, clinical hypertension studies with Dilacor XR using daily doses up to 540 mg, are listed in the table below with placebo-treated patients included for comparison.

MOST COMMON ADVERSE EVENTS IN DOUBLE-BLIND,

Infrequent Adverse Events: The following additional events (COSTART Terms), listed by body system, were reported infrequently (less than 1%) in all subjects, hypertensive (n=425) or angina (n=318) patients who received Dilacor XR, or with other formulations of diltiazem.

Hypertension: Cardiovascular: First-degree AV block, arrhythmia, postural hypotension, tachycardia, pallor, palpitations, phlebitis, ECG abnormality, ST elevation.

Nervous System: Vertigo, hypertonia, paresthesia, dizziness, somnolence.

Digestive System: Dry mouth, anorexia, tooth disorder, eructation.

Skin and Appendages: Sweating, urticaria, skin hypertrophy (nevus).

Respiratory System: Epistaxis, bronchitis, respiratory disorder.

Urogenital System: Cystitis, kidney calculus, impotence, dysmenorrhea, vaginitis, prostate disease.

Metabolic and Nutritional Disorders: Gout, edema.

Musculoskeletal System: Arthralgia, bursitis, bone pain.

Hemic and Lymphatic System: Lymphadenopathy.

Body as a Whole: Pain, unevaluable reaction, neck pain, neck rigidity, fever, chest pain, malaise.

Special Senses: Amblyopia (blurred vision), ear pain.

Angina: Cardiovascular: Palpitations, AV block, sinus bradycardia, bigeminal extrasystole, angina pectoris, hypertension, hypotension, myocardial infarct, myocardial ischemia, syncope, vasodilatation, ventricular extrasystole.

Nervous System: Abnormal thinking, neuropathy, paresthesia.

Digestive System: Diarrhea, dyspepsia, vomiting, colitis, flatulence, GI hemorrhage, stomach ulcers.

Skin and Appendages: Contact dermatitis, pruritus, sweating.

Respiratory System: Respiratory distress.

Urogenital System: Kidney failure, pyelonephritis, urinary tract infection.

Metabolic and Nutritional Disorders: Weight increase.

Musculoskeletal System: Myalgia.

Body as a Whole: Chest pain, accidental injury, infection.

Special Senses: Eye hemorrhage, ophthalmitis, otitis media, taste perversion, tinnitus.

There have been post-marketing reports of Stevens-Johnson syndrome and toxic epidermal necrolysis associated with the use of diltiazem hydrochloride.

OVERDOSAGE OR EXAGGERATED RESPONSE

Several literature reports have identified cases of diltiazem hydrochloride overdose, some with multiple drug ingestion, with both fatal and non-fatal outcomes. The reported events affected multiple body systems including the cardiovascular system (bradycardia, complete heart block, asystole, cardiac failure, arrhythmia, atrial fibrillation, palpitations, hypotension, ischemia, ECG changes), respiratory system (respiratory failure, hypoxia, dyspnea, pulmonary edema), central nervous system (loss of consciousness, convulsions, dizziness, confusion, agitation), gastrointestinal system (nausea, vomiting), skin and appendages (increased sweating), and other systems (hypotonia, iliac artery thrombosis, metabolic acidosis, increased blood glucose). The administration of ipecac to induce vomiting and activated charcoal to reduce drug absorption have been advocated as initial means of intervention. In addition to gastric lavage, the following measures should also be considered:

Bradycardia: administer atropine (0.6 mg to 1 mg). If there is no response to vagal blockade, administer isoproterenol cautiously.

High-Degree AV Block: Treat as for bradycardia above. Fixed high-degree AV block should be treated with cardiac pacing.

Cardiac Failure: Administer inotropic agents (dopamine or dobutamine) and diuretics.

Hypotension: Vasopressors (e. g. dopamine or levarterenol bitartrate).

Actual treatment and dosage should depend on the severity of the clinical situation as well as the judgment and experience of the treating physician.

Due to extensive metabolism, plasma concentrations after a standard dose of diltiazem can vary over tenfold, which significantly limits their value in evaluating cases of overdosage.

Charcoal hemoperfusion has been used successfully as an adjunct therapy to hasten drug elimination. Overdoses with as much as 10.8 grams of oral diltiazem have been successfully treated using appropriate supportive care.

Dilacor XR Dosage and Administration

Hypertensive or anginal patients who are treated with other formulations of diltiazem can safely be switched to Dilacor XR capsules at the nearest equivalent total daily dose. Subsequent titration to higher or lower doses may, however, be necessary and should be initiated as clinically indicated.

Studies have shown a slight increase in the rate of absorption of Dilacor XR when ingested with a high-fat breakfast; therefore, administration in the morning on an empty stomach is recommended.

Patients should be cautioned that the Dilacor XR capsules should not be opened, chewed or crushed, and should be swallowed whole.

Dosage: Hypertension: Dosages must be adjusted to each patient’s needs, starting with 180 mg or 240 mg once daily. Based on the antihypertensive effect, the dose may be adjusted as needed. Individual patients, particularly ≥60 years of age, may respond to a lower dose of 120 mg. The usual dosage range studied in clinical trials was 180 mg to 480 mg once daily.

Current clinical experience with the 540 mg dose is limited; the dose may be increased to 540 mg with little or no increased risk of adverse reactions. Doses should not exceed 540 mg once daily.

While a dose of Dilacor XR given once daily may produce an antihypertensive effect similar to the same total daily dose given in divided doses, individual dose adjustment may be needed.

Dosage: Angina: Dosages for the treatment of angina should be adjusted to each patient’s needs, starting with a dose of 120 mg once daily, which may be titrated to doses of up to 480 mg once daily. When necessary, titration may be carried out over a 7 to 14 day period.

Concomitant Use with Other Cardiovascular Agents.

Sublingual Nitroglycerin may be taken as required to abort acute anginal attacks during diltiazem hydrochloride therapy.

Prophylactic Nitrate Therapy – Diltiazem hydrochloride may be safely co-administered with short - and long-acting nitrates.

Antihypertensives – Diltiazem hydrochloride has an additive antihypertensive effect when used with other antihypertensive agents. Therefore, the dosage of diltiazem hydrochloride or the concomitant antihypertensives may need to be adjusted when adding one to the other.

How is Dilacor XR Supplied

Store at Controlled Room Temperature: 20° to 25°C (68° to 77°F) [see USP].

Keep out of the reach of children

Manufactured for: Actavis Pharma, Inc. Parsippany, NJ 07054

Manufactured by: SkyePharma Production SAS St-Quentin-Fallavier Cedex, France

Revised: April 2014 14100-06

PACKAGE LABEL PRINCIPAL DISPLAY PANEL

Dilacor XR 120 mg x 30 capsules NDC 52544-732-30 120 mg x 100 capsules NDC 52544-732-01 120 mg x 1000 capsules NDC 52544-732-10

PACKAGE LABEL PRINCIPAL DISPLAY PANEL

Dilacor XR 180 mg x 30 capsules NDC 52544-733-30 180 mg x 100 capsules NDC 52544-733-01 180 mg unit dose x 100 capsules NDC 52544-733-44 180 mg x 1000 capsules NDC 52544-733-10

PACKAGE LABEL PRINCIPAL DISPLAY PANEL

Dilacor XR 240 mg x 30 capsules NDC 52544-734-30 240 mg x 100 capsules NDC 52544-734-01 240 mg unit dose x 100 capsules NDC 52544-734-44 240 mg x 1000 capsules NDC 52544-734-10

Altace - Blood Pressure, Hartil Hct

Blood Pressure - Hartil hct (Brand name: altace)

Altace is used for treating high blood pressure or decreasing the risk of heart attack, stroke, and death in certain patients. It may be used alone or with other medicines. It is used along with other medicines to manage heart failure and improve survival after a heart attack. Altace is an angiotensin-converting enzyme (ACE) inhibitor. It works by relaxing blood vessels. This helps to lower blood pressure.

Use Altace as directed by your doctor.

Take Altace by mouth with or without food.

Swallow this tablet whole unless your doctor tells you otherwise.

Continue to take Altace even if you feel well. Do not miss any dose.

If you miss a dose of Altace, 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 Altace.

Store Altace between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Altace out of the reach of children and away from pets.

Active Ingredient: Ramipril.

Do NOT use Altace if:

you are allergic to any ingredient in Altace

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 an ACE inhibitor

you are in your second or third trimester of pregnancy.

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

Some medical conditions may interact with Altace. 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

if you are able to become pregnant

if you have a history of heart problems (eg, aortic stenosis, heart failure), blood vessel problems, blood flow problems, bone marrow problems, kidney problems, certain liver problems (eg, ascites, cirrhosis), or diabetes

if you have a history of angioedema, stroke, or recent heart attack, or you have had a kidney transplant

if you have an autoimmune disease (eg, lupus, rheumatoid arthritis, scleroderma)

if you are dehydrated or have low blood volume, high blood potassium levels, or low blood sodium levels, or if you are on a low-salt (sodium) diet

if you are receiving treatments to reduce sensitivity to bee stings

if you are on dialysis or are scheduled to have major surgery.

Some medicines may interact with Altace. Tell your health care provider if you are taking any other medicines, especially any of the following:

Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood pressure may be increased

Aldosterone blockers (eg, eplerenone), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), potassium-sparing diuretics (eg, spironolactone, triamterene), potassium supplements, or trimethoprim because the risk of high blood potassium levels may be increased

Certain gold-containing medicines (eg, sodium aurothiomalate) because flushing, nausea, vomiting, and low blood pressure may occur

Lithium or thiopurines (eg, azathioprine) because the risk of their side effects may be increased by Altace.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Altace 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.

Important safety information:

Altace may cause dizziness, lightheadedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use Altace with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.

Altace may cause dizziness, lightheadedness, 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.

Altace 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.

Altace may not work as well in black patients. They may also be at greater risk of side effects. Contact your doctor if your symptoms do not improve or if they become worse.

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.

Rarely, Altace may lower the ability of your body to fight infection. This risk may be greater if you have certain other health problems (eg, kidney problems, collagen vascular disease). Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.

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

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

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.

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.

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

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

Use Altace with caution in the elderly; they may be more sensitive to its effects.

Altace should be used with extreme caution in children; safety and effectiveness in children have not been confirmed.

Pregnancy and breast-feeding: Altace 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. It is not known if Altace is found in breast milk. Do not breastfeed while taking Altace.

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; headache; tiredness.

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 hands, eyes, mouth, face, lips, or tongue; hoarseness); chest pain; dark urine; decreased urination; difficulty swallowing; fainting; infection (eg, fever, chills, persistent sore throat); irregular heartbeat; seizures; stomach pain (with or without nausea or vomiting); symptoms of low blood pressure (eg, fainting, severe dizziness, lightheadedness); yellowing of the skin or eyes.

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.

Estalis-Sequi Advanced Patient Information, Estalis

Estalis-Sequi (Transdermal)

Generic Name: estradiol and norethindrone (Transdermal route)

es-tra-DYE-ol, nor-ETH-in-drone AS-e-tate

Transdermal route(Patch, Extended Release)

Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia. An increased risk of DVT, pulmonary embolism, stroke, myocardial infarction, and invasive breast cancer have been reported. An increased risk of probable dementia in postmenopausal women 65 years of age or older has also been reported. There is an increased risk of endometrial cancer in women with a uterus who use unopposed estrogens. Estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman .

Commonly used brand name(s)

Available Dosage Forms:

Patch, Extended Release

Therapeutic Class: Estrogen/Progestin Combination

Pharmacologic Class: Estrogen

Uses For Estalis-Sequi

Estradiol and norethindrone skin patch is used to treat moderate to severe hot flashes and other symptoms of menopause. It is also used to treat changes in and around the vagina (such as vaginal dryness, itching, and burning) caused by low estrogen levels or menopause. This medicine is also used to treat certain conditions in women before menopause if their ovaries do not make enough estrogens naturally.

This medicine is a combination of two hormones: an estrogen hormone (estradiol) and a progestin hormone (norethindrone). These hormones are absorbed through your skin into your body. It works by preventing symptoms, such as feelings of warmth in the face, neck, and chest, or sudden strong feelings of heat and sweating (hot flashes) in women during menopause.

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

Before Using Estalis-Sequi

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

Use of CombiPatch® is not indicated in children.

Geriatric

Although appropriate studies on the relationship of age to the effects of CombiPatch® have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have breast cancer, strokes, or dementia, which may require caution in patients receiving this medicine.

Pregnancy

Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.

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

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.

Aripiprazole

Bupropion

Carbamazepine

Ceritinib

Crizotinib

Dabrafenib

Darunavir

Dasabuvir

Donepezil

Eliglustat

Eslicarbazepine Acetate

Fentanyl

Idelalisib

Isotretinoin

Mitotane

Nilotinib

Ombitasvir

Paritaprevir

Piperaquine

Pixantrone

Primidone

Siltuximab

Theophylline

Tizanidine

Topotecan

Ulipristal

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.

Alprazolam

Amprenavir

Aprepitant

Atazanavir

Bacampicillin

Betamethasone

Bexarotene

Bosentan

Clarithromycin

Colesevelam

Cyclosporine

Delavirdine

Efavirenz

Etravirine

Fosamprenavir

Fosaprepitant

Fosphenytoin

Ginseng

Griseofulvin

Itraconazole

Ketoconazole

Lamotrigine

Levothyroxine

Licorice

Modafinil

Mycophenolate Mofetil

Mycophenolic Acid

Nelfinavir

Oxcarbazepine

Phenobarbital

Phenytoin

Prednisolone

Primidone

Rifabutin

Rifampin

Rifapentine

Ritonavir

Rosuvastatin

Rufinamide

Selegiline

St John's Wort

Tacrine

Telaprevir

Tipranavir

Topiramate

Troglitazone

Troleandomycin

Valdecoxib

Voriconazole

Warfarin

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 may cause an increased risk of certain side effects 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.

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:

Abnormal or unusual vaginal bleeding or

Blood clots (eg, deep vein thrombosis, pulmonary embolism), active or history of or

Breast cancer, known or suspected, or a history of or

Heart attack, history of or

Liver disease or

Protein C, protein S, or other known blood clotting disorders or

Stroke, history of or

Tumors (estrogen-dependent), known or suspected—Should not be used in patients with these conditions.

Asthma or

Bone problems or

Diabetes or

Edema (fluid retention or body swelling) or

Endometriosis or

Epilepsy (seizures) or

Gallbladder disease or

Hereditary angioedema (swelling of the face, lips, tongue, or throat) or

Hypercalcemia (high calcium in the blood) or

Hypocalcemia (low calcium in the blood) or

Hypothyroidism (an underactive thyroid) or

Jaundice during pregnancy or from using hormonal therapy in the past or

Liver tumors or

Migraine headache or

Porphyria (an enzyme problem) or

Systemic lupus erythematosus (SLE)—Use with caution. May make these conditions worse.

Heart disease or

Hypercholesterolemia (high cholesterol or fats in the blood) or

Hypertension (high blood pressure) or

Hypertriglyceridemia (high triglycerides or fats in the blood) or

Obesity, or history of or

Prolonged periods of immobilization—Use with caution. These conditions may increase risk for more serious side effects.

Proper Use of estradiol and norethindrone

This section provides information on the proper use of a number of products that contain estradiol and norethindrone. It may not be specific to Estalis-Sequi. Please read with care.

It is very important that you use this medicine exactly as directed by your doctor . Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may cause unwanted side effects.

This medicine comes with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Before starting CombiPatch® therapy, you may need to tell your doctor if you are currently using continuous estrogen or combination estrogen plus progestin therapy. This will allow your doctor to determine when to start your treatment.

You may have monthly bleeding or spotting at the completion of each cycle.

This transdermal patch system is to be applied on the skin of the lower abdomen (lower stomach area) two times a week, depending on your dosing regimen (either continuous combined regimen or continuous sequential regimen), as advised by your doctor.

To use the skin patch :

Wash your hands with soap and water before and after you use this medicine.

Carefully tear open the pouch when you are ready to put the patch on your skin. Do not cut it.

Peel off the backing from the patch and apply the patch to a clean, dry, and hair-free area of the lower stomach. This area must be free of powder, oil, or lotion for the patch to stick on to your skin.

Press the patch firmly in place with your hand for about 10 seconds.

Do not apply the patch on the breast or over any skin folds. Do not apply the patch on oily, broken, burned, or irritated skin, or areas with skin conditions (such as birth marks, tattoos). Avoid applying the patch on the waistline or other places where tight clothing may rub it off.

Wear the patch at all times until it is time to put on a new patch. Do not expose it to the sun for long periods of time.

When replacing your patch, make sure to apply the new patch to a different area of your lower abdomen. Wait at least 1 week before applying a patch to the same area.

When changing a patch, slowly peel it off from your skin. If you have any patch adhesive left on your skin, allow it to dry for 15 minutes and gently rub the sticky area with oil or lotion to remove it. It is best to change your patch on the same days of each week to help you remember.

You may take a bath, shower, or swim while using this medicine. Doing so will not affect the patch.

If a patch falls off, just put it back on a different area. If the patch does not stick completely, put on a new patch but continue to follow your original schedule for changing your patch.

To throw away a used patch: Fold the patch in half with the sticky side together and place it in a sturdy child-proof container. Throw this container in the trash away from children and pets. Do not flush the patch down the toilet.

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 transdermal dosage form (patch):

For treatment of hot flashes, atrophic vaginitis caused by menopause:

Continuous combined regimen:

Adults—Apply 1 CombiPatch® two times a week (every 3 to 4 days) for a 28-day cycle. One CombiPatch® contains 0.05 milligrams (mg) of estradiol and 0.14 or 0.25 mg of norethindrone).

Children—Use is not recommended.

Continuous sequential regimen:

Adults—Apply 0.05 milligram (mg) estradiol patch (Vivelle-Dot®) two times a week (every 3 to 4 days) for the first 14 days of the 28-day cycle. Then, apply one CombiPatch® two times a week (every 3 to 4 days) for the next 14 days of the 28-day cycle. One CombiPatch® contains 0.05 milligrams (mg) of estradiol and 0.14 or 0.25 mg of norethindrone).

Children—Use is not recommended.

Missed Dose

If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose.

Storage

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.

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

Store the unopened pouches at room temperature for up to 6 months. Do not store the patch outside of its pouch.

Precautions While Using Estalis-Sequi

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and does not cause unwanted effects. Pelvic exam, breast exam, and mammogram (breast x-ray) may be needed to check for unwanted effects, unless your doctor tells you otherwise. Be sure to keep all appointments.

It is unlikely that a postmenopausal woman may become pregnant. But, you should know that using this medicine while you are pregnant could harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.

Using this medicine may increase your risk for having blood clots, strokes, or heart attacks. This risk may continue even after you stop using the medicine. Your risk for these serious problems is even greater if you have high blood pressure, high cholesterol in your blood, diabetes or are overweight or smoke cigarettes. Contact your doctor immediately if you experience chest pain, confusion, difficulty speaking, double vision, headaches, an inability to move arms, legs or facial muscle, or an inability to speak.

Using this medicine may increase your risk of endometrial cancer, breast cancer, or uterine cancer. Talk with your doctor about this risk. Check with your doctor immediately if your experience abnormal vaginal bleeding.

Do not use this medicine if you have had your uterus (womb) removed (hysterectomy) .

Using this medicine may increase your risk of dementia, especially in women 65 years of age and older.

Check with your doctor immediately if severe headache or sudden loss of vision or any other change in vision occurs while you are using this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

This medicine may cause serious types of allergic reactions, including anaphylaxis which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, lightheadedness or dizziness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth with this medicine.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine before you have surgery or if you need to stay in bed for an extended time. This medicine may affect the results of certain medical tests.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine. Grapefruit and grapefruit juice may change the amount of this medicine that is absorbed in the body.

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 (eg, St. John's wort) or vitamin supplements.

Estalis-Sequi 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

Bloating or swelling of the face, arms, hands, lower legs, or feet

heavy non-menstrual vaginal bleeding

itching of the vagina or genital area

pain during sexual intercourse

rapid weight gain

thick, white vaginal discharge with no odor or with a mild odor

tingling of the hands or feet

unusual weight gain or loss

Less common

Cough or hoarseness

fever or chills

lower back or side pain

painful or difficult urination

Incidence not known

Abdominal or stomach bloating or fullness

abdominal or stomach pain

blurred vision

change in vaginal discharge

clay-colored stools

clear or bloody discharge from the nipple

dark urine

diarrhea

dimpling of the breast skin

dizziness

gaseous abdominal or stomach pain

headache, severe and throbbing

hives

hoarseness

inverted nipple

irritation

itching

joint pain, stiffness or swelling

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

loss of appetite

lump in the breast or under the arm

nausea and vomiting

nervousness

pain or feeling of pressure in the pelvis

persistent crusting or scaling of the nipple

pounding in the ears

rash

recurrent fever

redness of the skin

redness or swelling of the breast

severe cramping of the uterus

slow or fast heartbeat

sore on the skin of the breast that does not heal

swelling of the eyelids, face, lips, hands, or feet

tightness in the chest

troubled breathing or swallowing

unpleasant breath odor

unusual tiredness or weakness

vaginal bleeding

vomiting of blood

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

Acid or sour stomach

back pain

belching

body aches or pain

breast pain

burning, itching, redness, skin rash, swelling, or soreness at the application site

congestion

cramps

difficulty with moving

discouragement

dryness or soreness of the throat

excess air or gas in the stomach or intestines

feeling sad or empty

general feeling of discomfort or illness

headache

heartburn

heavy bleeding

increased clear or white vaginal discharge

indigestion

irritability

lack or loss of strength

loss of interest or pleasure

muscle aches and pains

muscle stiffness

pain during sexual intercourse

pain or tenderness around the eyes and cheekbones

passing gas

shivering

sneezing

stomach discomfort or upset

stuffy or runny nose

sweating

tender, swollen glands in the neck

thick, white vaginal discharge with no odor or with a mild odor

tiredness

trouble concentrating

trouble sleeping

Less common

Blemishes on the skin

difficulty having a bowel movement (stool)

longer or heavier menstrual periods

pimples

Incidence not known

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

change in color of the treated skin

decreased interest in sexual intercourse

dizziness or lightheadedness

dull ache or feeling of pressure or heaviness in the legs

feeling of constant movement of self or surroundings

inability to have or keep an erection

increased in sexual ability, desire, drive, or performance

increased interest in sexual intercourse

itching skin near damaged veins

loss in sexual ability, desire, drive, or performance

sensation of spinning

weight gain

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.

The information contained in the Truven Health 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 Truven Health 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. Truven Health 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, TRUVEN HEALTH 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. Truven Health does not assume any responsibility or risk for your use of the Truven Health products.

Copyright 2016 Truven Health Analytics, Inc. All Rights Reserved.

Dnaren Prozesuak, Dnaren

DNAren PROZESUAK

DNA zelula baten konposatu organiko garrantzitsuena da. Honen funtzioa zelulako informazioa gordetzea da.

DNA 2 katez osatuta dago eta hauetariko bakoitza nukleotido ezbedinez. Nukleotido batek 3 osagai nagusi ditu: pentosa bat (marrazkian ikusten den bezala, helizearen alboetan kokatzen dira), fosfato talde bat eta base nitrogenatu bat (marrazkian, erdirantza begira daudenak).

Base nitrogenatu 4 posible daude: Adenina (A), Timina (T), Guanina (G) eta Zitosina (C). Lehenengo biak osagarriak dira euren artean eta baita azkenengo biak ere.

DNAk bi prozesu garrantzitsu ditu: erreplikazioa eta transkripzioa . Lehenegoarekin, molekularen kopia identikoa lortuko da. Bigarrenarekin, berriz, DNAn gordeta dagoen informazioa erabiliz, zelulak behar dituen proteinak sintetizatuko dira.

Paralyoc Disease Interactions, Paralyoc

Paralyoc (acetaminophen) Disease Interactions

There are 3 disease interactions with Paralyoc (acetaminophen):

Acetaminophen (Includes Paralyoc) ↔ Alcoholism

Severe Potential Hazard, High plausibility

Applies to: Alcoholism

Chronic alcohol abusers may be at increased risk of hepatotoxicity during treatment with acetaminophen (APAP). Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously, if at all, in patients who consume three or more alcoholic drinks a day. In general, patients should avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure. They should also be advised to seek medical attention if they experience signs and symptoms of liver injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

References

Whitcomb DC, Block GD "Association of acetaminopphen hepatotoxicity with fasting and ethanol use." JAMA 272 (1994): 1845-50

Zimmerman HJ, Maddrey WC "Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure." Hepatology 22 (1995): 767-73

Bonkovsky HL "Acetaminophen hepatotoxicity, fasting, and ethanol." JAMA 274 (1995): 301

View all 11 references

Acetaminophen (Includes Paralyoc) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Acetaminophen is primarily metabolized in the liver to inactive forms. However, small quantities are converted by minor pathways to metabolites that can cause hepatotoxicity or methemoglobinemia. Patients with hepatic impairment may be at increased risk of toxicity due to increased minor metabolic pathway activity. Likewise, chronic or overuse of acetaminophen can saturate the primary hepatic enzymes and lead to increased metabolism by minor pathways. Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously in patients with hepatic insufficiency. Clinical monitoring of hepatic function is recommended. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

References

Gillette JR "An integrated approach to the study of chemically reactive metabolites of acetaminophen." Arch Intern Med 141 (1981): 375-9

"Product Information. Tylenol (acetaminophen)." McNeil Pharmaceutical, Raritan, NJ.

Clements JA, Critchley JA, Prescott LF "The role of sulphate conjugation in the metabolism and disposition of oral and intravenous paracetamol in man." Br J Clin Pharmacol 18 (1984): 481-5

View all 6 references

Acetaminophen (Includes Paralyoc) ↔ Pku

Moderate Potential Hazard, High plausibility

Applies to: Phenylketonuria

Several oral acetaminophen and acetaminophen-combination products, particularly flavored chewable tablets, contain the artificial sweetener, aspartame (NutraSweet). Aspartame is converted to phenylalanine in the gastrointestinal tract following ingestion. Chewable and effervescent formulations of acetaminophen products may also contain phenylalanine. The aspartame/phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i. e. phenylketonurics).

References

"Product Information. Tylenol (acetaminophen)." McNeil Pharmaceutical, Raritan, NJ.

Paralyoc (acetaminophen) drug Interactions

There are 166 drug interactions with Paralyoc (acetaminophen)

Paralyoc (acetaminophen) alcohol/food Interactions

There is 1 alcohol/food interaction with Paralyoc (acetaminophen)

See also.

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.

Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.

Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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