Bagotam - ?Tu Colega Siempre En Linea, Bagotam

BAGOTAM

FORMA FARMACEUTICA Y FORMULACION :

Cada comprimido contiene:

Citrato de tamoxifeno equivalente a. 20 mg de tamoxifeno

Excipiente cbp. 1 comprimido

· Antineoplasico. indicado como terapia coadyuvante en el cancer de mama nodulo axilar negativo, en mujeres luego de mastectomia total o parcial, diseccion axilar o radiacion de mama. No existen datos suficientes para predecir que pacientes tienen mayor probabilidad de beneficiarse con el tratamiento y determinar si el tamoxifeno provee algun beneficio a pacientes con tumores de tamano menor a 1 cm.

· BAGOTAM ® tambien esta indicado en el tratamiento del cancer de mama nodulo axilar positivo en mujeres posmenopausicas luego de mastectomia total o parcial, diseccion axilar e irradiacion de la mama. Hay estudios que indican que los mayores beneficios se han obtenido con 4 nodulos axilares o mas.

· BAGOTAM ® esta indicado en el cancer de mama metastasico en hombres y mujeres, en mujeres premenopausicas el tamoxifeno puede utilizarse como alternativa a la ooforectomia o a la irradiacion de los ovarios. Hay evidencias que indican que las mujeres con tumor de mama y con receptor a estrogenos positivo tienen mayor probabilidad de beneficiarse con un tratamiento con tamoxifeno.

FARMACOCINETICA Y FARMACODINAMIA EN HUMANOS :

Accion farmacologica: El tamoxifeno es un agente antiestrogeno no esteroide pero con debiles efectos estrogenicos. El mecanismo exacto de la accion antineoplasica no se conoce, pero estaria relacionado a sus efectos antiestrogenicos presumiblemente mediados por su union del receptor de estradiol en organos blancos como la mama. El tamoxifeno inhibe la induccion producida por el dimetilbenzoantraceno (DMBA) en carcinomas inducidos de rata, el tamoxifeno parece ejercer su efecto antitumoral debido a la union con el receptor estrogenico. Se ha visto que tiene un efecto estrogenico leve sobre otros sitios como endometrio, huesos y metabolismo lipidico.

El tamoxifeno puede inducir ovulacion en mujeres con ciclos anovulatorios. estimulando la liberacion de la hormona hipotalamica liberadora de las gonadotropinas hipofisiarias ( Gn - RH). En varones oligospermicos. el tamoxifeno incrementa las concentraciones sericas de hormona luteinizante (LH), foliculostimulante (FSH), testosterona y estrogenos.

El tamoxifeno y algunos de sus metabolitos (N - desmetiltamoxifeno. 4 hidroxitamoxifeno ) son potentes inhibidores de oxidasas hepaticas de funcion mixta ligadas al citocromo P 450 . sin embargo, no se ha determinado el significado clinico de sus efectos.

Farmacocinetica: La biotransformacion es hepatica. Se cree que la circulacion enterohepatica esta involucrada en un mayor tiempo de duracion de la concentracion sanguinea de la droga y su excrecion fecal.

La vida media del tamoxifeno es de 7 a 14 horas, puede haber picos secundarios al cabo de 4 dias o mas tarde debido, probablemente, a la circulacion enterohepatica. La eliminacion puede demorar mas de 7 dias.

Comienzo de la accion: Generalmente, hay una respuesta dentro de las 4 a 10 semanas de iniciada la terapia, pero puede tomar varios meses en pacientes con metastasis oseas.

El efecto antagonista del receptor de estrogenos puede persistir durante varias semanas luego de una sola dosis.

La principal via de eliminacion es biliar y fecal, mayoritariamente como metabolitos. La ruta secundaria es renal pero en pequena cantidad.

BAGOTAM ® esta contraindicado en pacientes con hipersensibilidad al tamoxifeno o a cualquiera de los componentes de su formulacion.

En pacientes con cancer de mama se ha observado ocasionalmente un descenso en el numero de plaquetas, usualmente entre 50,000 a 100,000/mm 3.

Hay algunos datos que indican que puede haber leucopenia durante el tratamiento con tamoxifeno.

Se recomienda realizar recuentos sanguineos y analisis de la funcionalidad hepatica.

El uso de BAGOTAM ® en mujeres puede inducir la ovulacion.

Se han reportado trastornos visuales, incluyendo cambios en la cornea, cataratas y retinopatias en pacientes que recibieron tamoxifeno.

Como cualquier otra terapia hormonal (estrogenos y androgenos), se ha reportado a las pocas semanas de comenzado el tratamiento, hipercalcemia en algunos pacientes con cancer de mama con metastasis oseas. Si apareciera hipercalcemia deben tomarse las medidas necesarias y si llegara a ser severa conviene suspender el tratamiento.

Se ha observado un aumento de cambios endometriales incluyendo hiperplasia, polipos y cancer de endometrio asociados al tratamiento con tamoxifeno.

Debe evaluarse sin demoras toda paciente que este recibiendo, o habiendo recibido tratamiento con tamoxifeno y presente sangrado vaginal anormal.

Se observo un incremento en cancer de utero con relacion a la administracion de tamoxifeno.

RESTRICCIONES DE USO DURANTE EL EMBARAZO Y LA LACTANCIA :

Uso en el embarazo: El uso de tamoxifeno puede causar dano fetal si se administra a una mujer embarazada. Se recomienda evitar el embarazo durante el tratamiento con BAGOTAM ® y utilizar metodos anticonceptivos no hormonales hasta 2 meses despues de concluido el tratamiento.

No se sabe si el tamoxifeno aparece en la leche materna por lo tanto, se recomienda evitar la lactancia durante el tratamiento con BAGOTAM ®.

REACCIONES SECUNDARIAS Y ADVERSAS :

Por lo general, las reacciones adversas por el tratamiento con BAGOTAM ® son ligeras, siendo raras las reacciones lo suficientemente severas como para necesitar la suspension del tratamiento. Aunque la informacion disponible es limitada, el perfil de efectos secundarios en varones puede ser similar al que se observa en mujeres.

Puede haber aumento transitorio, a veces severo, del dolor oseo o tumoral enseguida de iniciada la terapia con BAGOTAM ®. pero desaparece con el tratamiento continuado.

Puede requerirse analgesicos durante esta etapa del tratamiento.

Debido a que el tamoxifeno induce la ovulacion puede haber riesgo de embarazo durante el tratamiento.

Se han reportado quistes de ovario, durante el tratamiento con tamoxifeno en mujeres premenopausicas con cancer avanzado de mama.

Reacciones adversas poco frecuentes en varones y mujeres, incluyen confusion, hepatotoxicidad (usualmente asintomatico, raramente coloracion amarillenta de los ojos o de la piel), toxicidad ocular como retinopatia, queratopatia. cataratas o neuritis optica (en principio puede ser asintomatico, vision borrosa), embolia pulmonar, trombosis, debilidad o sueno.

Solo en mujeres puede observarse hiperplasia de endometrio, polipos o carcinoma de endometrio.

INTERACCIONES MEDICAMENTOSAS Y DE OTRO GENERO :

Puede haber un aumento significativo del efecto anticoagulante cuando se utiliza tamoxifeno junto con anticoagulantes de tipo cumarinico. por esta razon se recomienda controlar el tiempo de protrombina en pacientes que reciben las 2 medicaciones. Se observo que la terapia concomitante con bromocriptina eleva los niveles sericos de tamoxifeno y N - desmetiltamoxifeno.

Los antihistaminicos como cimetidina. ranitidina. pueden interactuar con BAGOTAM ®.

El uso de estrogenos puede interferir con el efecto terapeutico del tamoxifeno.

ALTERACIONES EN LOS RESULTADOS DE PRUEBAS DE LABORATORIO :

El tamoxifeno se ha asociado con cambios en los niveles de enzima hepatica, y en raras ocasiones, con un espectro mas severo de anormalidades hepaticas como higado graso, colestasis. hepatitis y necrosis hepatica.

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

No se han demostrado efectos carcinogenicos con tamoxifeno.

No se ha reportado potencial genotoxico en pruebas in vitro e in vivo. La fertilidad de ratas hembras se redujo despues de la administracion de 0.04 mg /kg. Hubo un numero menor de implantes y todos los fetos fueron encontrados muertos.

DOSIS Y VIA DE ADMINISTRACION :

Se recomienda que BAGOTAM ® sea administrado bajo la supervision de un medico con experiencia en quimioterapicos.

Carcinoma mamario, nodulo negativo o positivo en mujeres, 10 mg. dos veces al dia (por la manana y por la tarde).

En carcinoma metastasico en varones o mujeres: 10 a 20 mg. dos veces al dia (por la manana y por la tarde).

MANIFESTACIONES Y MANEJO DE LA SOBREDOSIFICACION O INGESTA ACCIDENTAL :

Los signos observados en animales de laboratorio a las dosis mas altas para determinar la DL 50 . fueron dificultad respiratoria y convulsiones.

No se ha reportado sobredosis aguda en humanos. En un estudio de pacientes con cancer metastasico avanzado, a los que se les determino especificamente la maxima dosis tolerada de tamoxifeno se noto neurotoxicidad aguda, manifestada por temblor, hiperreflexia. marcha inestable y mareos.

Estos sintomas aparecieron entre los 3 a 5 dias de comenzada la terapia con tamoxifeno y desaparecieron a los 2-5 dias luego de suspender la medicacion.

No se observo neurotoxicidad permanente. En el mismo estudio se vio prolongacion del intervalo QT en el electrocardiograma cuando se suministraron dosis superiores a 250 mg /m 2 como dosis inicial, seguida de una dosis de mantenimiento de 80 mg /m 2 dos veces por dia.

Caja con 30, 60 y 100 comprimidos.

RECOMENDACIONES SOBRE ALMACENAMIENTO :

Conservese a temperatura ambiente a no mas de 30 °C y en lugar seco. Protejase de la luz.

Su venta requiere receta medica. No se deje al alcance de los ninos. Literatura exclusiva para medicos. No se use durante el embarazo y la lactancia. Este medicamento debe ser administrado unicamente por medicos especialistas en oncologia y con experiencia en quimioterapia antineoplasica.

LABORATORIO Y DIRECCION : ARMSTRONG LABORATORIOS DE MEXICO, S. A. de C. V . Av. Division del Norte No. 3311 Colonia Candelaria Coyoacan 04380 Mexico, D. F . ® Marca registrada

NUMERO DE REGISTRO Y CLAVE IPPA : Reg. Num. 230M2005, S. S.A. IV FEAR-04390704504/R2005/IPPA

Publicado en: Farmacos

Buy Oxrate (Trileptal) Online No Prescription, Oxrate

Buy Oxrate (Trileptal) without Prescription

Oxrate Marketing Information

Oxrate Description

Generic Oxrate is used for treating certain types of seizures in patients with epilepsy. It may be used alone or in combination with other medicines. It may also be used for other conditions.

Generic Oxrate is an anticonvulsant. It works by slowing abnormal nerve impulses in the brain.

Generic name of Generic Oxrate is Oxcarbazepine.

Brand name of Generic Oxrate is Oxrate.

Oxrate Dosage

Generic Oxrate is available in:

150mg Low Dosage300mg Standard Dosage600mg Increased Dosage

Generic Oxrate may be taken with or without food.

It is important to take all doses on time to keep the level of medicine in your blood constant. Take doses at evenly spaced intervals. Do not skip doses.

Taking Generic Oxrate at the same times each day will help you to remember to take it.

Continue to take Generic Oxrate even if you feel well.

Do not miss any doses. Generic Oxrate works best when there is a constant level of Generic Oxrate in your body.

If you want to achieve most effective results do not stop taking Generic Oxrate suddenly. If Generic Oxrate is stopped, this should be done gradually. The risk of seizures may be increased if Generic Oxrate is suddenly stopped.

Oxrate Missing of dose

Do not take double dose. If you miss a dose you should take it as soon as you remember about your missing. If it is the time for the next dose you should continue your regular dosing schedule.

Oxrate Overdose

If you overdose Generic Oxrate and you don't feel good you should visit your doctor or health care provider immediately.

Oxrate Side effects

Generic Oxrate has its side effects. The most common are:

acneconstipationdizzinessdrowsinessdry mouthheadacheindigestionnauseastomach paintirednesstremortrouble sleepingunusual walkvomiting

Less common but more serious side effects during taking Generic Oxrate:

allergy reactions (urticaria, breathing difficulties, rash, and eruption)blood in stoolchest paindark urinedecreased urinationdifficulty speakingdouble visionchanges in vision, or involuntary eye movementdulled sense of touchfever, chills, or sore throatloss of coordinationlow sodium level??joint painmental/mood changesnosebleedred, swollen, blistered, or peeling skinstomach painseizuresswollen lymph nodestrouble walkinguncontrolled muscle movementsunusual bruising or bleedingunusual weaknessyellowing of the skin or eyes

Side effects manifestations are not only depend on medicine you are taking but also depend on your health state and on the other factors.

Oxrate Contra-indications

Do not take Generic Oxrate if you are allergic to Generic Oxrate components.

Do not take Generic Oxrate if you are pregnant, planning to become pregnant, or are breast-feeding.

If you have a history of seizures, you may suddenly lose consciousness while you are taking Generic Oxrate. Avoid activities where loss of consciousness could be dangerous to you or others (driving, swimming, climbing, and operating heavy machinery).

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

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

Oxrate must be gradually decreased when discontinued. Talk to your health care provider about the proper way to stop Generic Oxrate.

Notify your health care provider if seizure control worsens.

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

Generic Oxrate should not be used in children younger than 2 years old. Safety and effectiveness in these children have not been confirmed.

It can be dangerous to stop Generic Oxrate taking suddenly.

Oxrate Frequently asked questions

Q: What does Generic Oxrate mean?

A: Generic Oxrate is used for treating certain types of seizures in patients with epilepsy. It may be used alone or in combination with other medicines. It may also be used for other conditions.

Q: What are brand and generic names of Generic Oxrate?

A: Generic name of Generic Oxrate is Oxcarbazepine. Brand name of Generic Oxrate is Oxrate.

Q: In what way does Generic Oxrate operate?

A: Generic Oxrate is an anticonvulsant. It works by slowing abnormal nerve impulses in the brain.

Meben, Meben

Call us Today! 919-563-2093

Mebane Air, Inc. was started with a desire to provide outstanding service in 1999. Our owners, Tim Braddy and David Harris, have over 50 years of combined experience in the industry. They haven't seen it all, but they have seen most of it!

We are located at 718 Mattress Factory Rd. in Mebane, NC. Our company has been steadily growing for 12 years, and we hope to continue to provide service to our present and future customers for years to come. Our unofficial motto: Fix it like it was your Mom's house.

Phone Number 919-563-2093

Fax Number 919-304-3520

Mailing Address P. O. Box 1116, Mebane, NC 27302

Physical Address 718 Mattress Factory Road, Mebane, NC 27302

Minsetil Generic, Minsetil

Minsetil

Minsetil - Minsetil affects the way that your heart beats.

Minsetil is used to treat seriously irregular heartbeats.

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

Minsetil is a local anesthetic, antiarrhythmic agent (Class Ib), structurally similar to lidocaine, but orally active. Minsetil has fast onset and offset kinetics, meaning that they have little or no effect at slower heart rates, and more effects at faster heart rates. It shortens the action potential duration, reduces refractoriness, and decreases Vmax in partially depolarized cells with fast response action potentials. Minsetil either does not change the action potential duration, or decreases the action potential duration.

Oral Ventricular arrhythmias

Adult: As hydrochloride: 400 mg as loading dose followed after 2 hr by 200-250 mg 3-4 times daily.

Maintenance: 600-900 mg daily in divided doses. Max dose: 1200 mg daily. Patient with MI: Higher loading dose e. g. 600 mg may be needed, especially if opioid analgesics were also given. Renal impairment: Dose reduction may be needed. Hepatic impairment: Dose reduction may be needed.

Intravenous Ventricular arrhythmias

Adult: As hydrochloride: 100-250 mg slow inj at 25 mg/min followed by 250 mg infusion over 1 hr, 250 mg for the next 2 hr and then 0.5 mg/min for maintenance, according to response. Transfer to oral dose of 200-250 mg 3-4 times daily when possible. Alternatively, 200 mg at 25 mg/min followed by 400 mg orally upon completion of inj, with subsequent oral dose of 200-250 mg 3-4 times daily. Renal impairment: Dose reduction may be needed. Hepatic impairment: Dose reduction may be needed.

Indications: Ventricular arrhythmia s.

Minsetil belongs to the group of medicines known as antiarrhythmics. It is used to correct irregular heartbeats to a normal rhythm.

Minsetil produces its helpful effects by slowing nerve impulses in the heart and making the heart tissue less sensitive.

Minsetil is available only with your doctor's prescription.

Sprix Nasal Uses, Side Effects, Interactions, Pictures, Warnings - Dosing, Sprix

Sprix nasal

GENERIC NAME(S): KETOROLAC TROMETHAMINE

Warnings

Do not use any ketorolac products (including this nasal spray, tablets, or injection) for more than a total of 5 days. Do not use this medication for minor or long-term painful conditions.

This drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. This effect can occur without warning at any time while using this drug. Older adults may be at higher risk for this effect. Do not use this medication if you have stomach /intestinal problems (such as ulcers, bleeding).

This drug may also increase your risk of serious bleeding in other parts of your body. Do not use this medication if you have bleeding or blood clotting problems, or are at high risk for bleeding.

Nonsteroidal anti-inflammatory drugs (including ketorolac) may rarely increase the risk for a heart attack or stroke. The risk may be greater if you have heart disease or increased risk for heart disease (for example, due to smoking. family history of heart disease. or conditions such as high blood pressure or diabetes ), or with longer use. Talk to your doctor about the benefits and risks of using this drug.

This drug should not be used right before or after heart bypass surgery (CABG) or before any surgery. It also should not be used during labor/delivery or in people with severe kidney problems or high risk for kidney problems.

Stop using ketorolac and get medical help right away if you notice any of the following rare but serious side effects: bloody or black/tarry stools, stomach/abdominal pain. vomit that looks like coffee grounds, unusual or easy bruising/bleeding, chest/jaw/left arm pain, shortness of breath, unusual sweating. weakness on one side of the body, sudden vision changes, slurred speech.

Uses

Ketorolac is used for the short-term treatment (up to 5 days) of moderate to severe pain in adults, such as after surgery. Reducing pain helps you recover more comfortably so you can return to your normal daily activities. This medication is a nonsteroidal anti-inflammatory drug (NSAID). It works by decreasing inflammation. swelling, and pain.

How to use Sprix nasal

Read the Medication Guide provided by your pharmacist before you start using ketorolac and each time you get a refill. Also read and follow the product instructions for how to properly prime and use this nasal spray. If you have any questions, ask your doctor or pharmacist.

Spray this medication in your nose as directed by your doctor, usually every 6 to 8 hours. Your doctor may adjust your dosage so that you spray the medication in only one nostril instead of both nostrils. The dosage is based on your medical condition, age, weight. and response to treatment.

To reduce your risk of stomach bleeding and other side effects, use this medication at the lowest effective dose for the shortest possible time. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.

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

If you are using this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medicine may not work as well.

Drink plenty of fluids during treatment with this medication. This will help reduce the risk of kidney problems.

Avoid getting this medication in your eyes. If this occurs, rinse your eyes with water or saline and call your doctor if eye irritation persists.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

See also Warning section.

Mild and temporary irritation/discomfort in the nose may occur. Upset stomach. nausea. dizziness. or drowsiness may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

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.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if you have any serious side effects, including: swelling hands/ankles /feet, sudden/unexplained weight gain. signs of kidney problems (such as change in the amount of urine), hearing changes (such as ringing in the ears ), mental/mood changes, persistent/severe headache. unexplained stiff neck. signs of infection (such as fever, chills, persistent sore throat ), unusual tiredness.

This drug may rarely cause serious (possibly fatal) liver disease. Stop using ketorolac and get medical help right away if you have any symptoms of liver damage, including: persistent nausea/vomiting/loss of appetite, stomach/abdominal pain, yellowing eyes /skin. dark urine.

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

See also Warning section.

Before using ketorolac, tell your doctor or pharmacist if you are allergic to it; or to aspirin; or to other NSAIDs (such as ibuprofen. naproxen, celecoxib ); or if you have any other allergies. This product may contain inactive ingredients (such as EDTA), 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: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), growths in the nose (nasal polyps), heart disease (such as previous heart attack), high blood pressure, liver disease, swelling of the hands/ankles/feet (edema).

Kidney problems can sometimes occur with the use of NSAID medications, including ketorolac. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have any unusual change in the amount of urine.

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.

Daily use of alcohol and tobacco, especially when combined with this medication, may increase your risk for stomach bleeding. Limit alcohol and stop smoking.

This medication may rarely make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors.

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 more sensitive to the side effects of this drug, especially stomach/intestinal bleeding and kidney problems.

Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks (such as miscarriage, trouble getting pregnant). Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery.

This drug passes into breast milk. 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: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as valsartan, losartan), cidofovir, probenecid, corticosteroids (such as prednisone), "water pills" (diuretics such as furosemide).

This medication may increase the risk of bleeding when used with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, pentoxifylline, among others.

Do not use this medication with other forms of ketorolac, high doses of aspirin, or other NSAIDs.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen or naproxen). These drugs are similar to ketorolac and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

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. Symptoms of overdose may include: nausea, vomiting, stomach pain, drowsiness.

Notes

Do not share this medication with others.

Laboratory and/or medical tests (including blood pressure, kidney function tests) may be performed to check for side effects. Consult your doctor for more details

Missed Dose

If you are using this medication on a regular schedule (not just "as needed") and you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Refrigerate unopened bottles. Do not freeze. Store the opened bottle in use at room temperature, away from light and direct sunlight. Since this medication does not contain preservatives, throw away the bottle 24 hours after you first use it, even if there is still some medication left in it. 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.

Images

Ecodurex, Ecodurex

Other - Ecodurex (Brand name: midamor)

Midamor (Amiloride/ Furosemide)

Midamor is a potassium-sparing diuretic (water pill) that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.

Use Midamor as directed by your doctor. Take Midamor by mouth with food. Midamor may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 p. m. Ask your health care provider any questions you may have about how to use Midamor.

Drug Class and Mechanism

Midamor is a potassium-sparing diuretic. It works by making the kidneys eliminate sodium (salt) and water from the body while retaining potassium.

If you miss a dose of Midamor and are taking it regularly, 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.

Store Midamor at room temperature, 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 in a tight, light-resistant container. Keep Midamor out of the reach of children and away from pets.

Do not use Midamor if: you are allergic to any ingredient in Midamor; you are taking potassium supplements or potassium-sparing diuretics (e. g. aldosterone, triamterene); you are unable to urinate; you have high blood potassium levels or kidney problems due to diabetes or other severe kidney disease. Contact your doctor or health care provider right away if any of these apply to you.

Important: Midamor may cause drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use Midamor with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Check with your doctor before you use a salt substitute or a product that has potassium in it. Lab tests, including electrolyte levels and blood pressure monitoring, may be performed while you use Midamor. Use Midamor with caution in the elderly; they may be more sensitive to its effects. Midamor should not be used in children; safety and effectiveness in 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 Midamor while you are pregnant. It is not known if Midamor is found in breast milk. Do not breast-feed while taking Midamor.

Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome: diarrhea; headache; loss of appetite; nausea; 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); dry mouth; excessive thirst; slowed heart rate; unusual muscle weakness; unusual tiredness; vomiting.

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

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

Ecodurex

Preparatul Ecodurex se prezinta sub forma de comprimate, un comprimat contine: 50 mg dihidroclorotiazid si 5 mg amilorid hidroclorid, lactoza si substante auxiliare.

Ecodurex este o combinatie a doua substante active diuretice, care asociate scad hipertensiunea mai eficient decat cele doua substante separat (potentare reciproca a actiunii). Datorita continutului in amilorid, produsul asigura o crestere a diurezei cu pierdere mica de potasiu si, de aceea, poate fi administrat in tratament de scurta durata.

Ecodurex se administreaza in hipertensiunea arteriala, cat si in tratamentul edemelor.

Modificarea dozei sau intreruperea tratamentului nu trebuie sa se faca fara acordul si recomandarile medicului, caci o hipertensiune necontrolata poate avea urmari grave. Medicul dvs. prescrie doza necesara, dozele descrise mai jos fiind doar orientative. Doza medie zilnica 1-2 comprimate. In functie de reactia pacientului, aceasta poate fi marita treptat la 4 comprimate. Nu modificati doza prescrisa de medic din proprie initiativa. Daca considerati ca medicamentul actioneaza prea slab sau prea puternic, consultati medicul sau farmacistul dvs.

Sensibilitate cunoscuta fata de unul din componentii produsului, boli grave renale. Nu se administreaza Ecodurex la copii.

In cazul unei functii renale reduse si la pacientii cu diabet sau suspecti de diabet trebuie respectate cu strictete recomandarile medicului. Alte medicamente pot influenta actiunea Ecodurexului. De aceea, informati medicul sau farmacistul dvs. daca suferiti si de alte boli, alergii si daca luati alte medicamente (cumparate de dvs. ca de ex. medicamente antireumatice, calmante sau somnifere). Substantele care maresc diureza pot provoca senzatii de uscaciune a gurii, slabiciune sau ameteala si dereglari pasagere ale acuitatii vizuale. Daca sunteti insarcinata sau doriti sa deveniti, veti administra acest medicament numai cu acordul medicului.

Sunt posibile reactii adverse ca tulburari gastrointestinale, greata, inapetenta, senzatie de plenitudine, dureri gastrice, constipatie si diaree. De asemenea, pot aparea stari de slabiciune si eruptii cutanate. Scaderea tensiunii poate duce la o stare de slabiciune si ameteli, cat si la tulburari pasagere ale acuitatii vizuale, aceasta scadere putand fi potentata prin administrarea de alcool si calmante sau somnifere. Uscaciunea neplacuta a gurii care apare la inceputul tratamentului poate fi redusa in toate cazurile cu grapefruit sau suc proaspat de grapefruit.

Ecodurex este disponibil in farmacii la un pret mediu de 13 lei.

Nu folositi informatiile din prezentul prospect, in scopul tratarii oricaror probleme de sanatate sau de inlocuire a medicamentelor, tratamentelor prescrise de persoanalul medical autorizat. Acest prospect reprezinta doar o sursa de informare si nu inlocuieste sfatul medicului. Pentru orice problema adresati-va medicului sau farmacistului de care apartineti.

Ultima actualizare: joi, 15 martie, 2012, 12:35 Afisari: 67

Allstate Agent, La Verne, Ca – Retirement Savings & Life Insurance, Tamone

Allstate Personal Financial Representative: Tamone Phengrasamee

About Tamone Phengrasamee - La Verne Personal Financial Representative

As a Personal Financial Representative in Glendora, I know many local families. My knowledge and understanding of the people in this community help me provide customers with an outstanding level of service. I look forward to helping families like yours protect the things that are important – I can also help you prepare a strategy to achieve your financial goals.

Request An Appointment

Want to request an appointment for a call or visit? Use the calendar to pick the date you'd like to visit and then choose a time. While we can't guarantee agency availability, your request will route to the agency inbox and we'll do our best to accommodate your schedule.

First, select a date:

Whole Life Insurance

You know life insurance is a great way to help protect your loved ones, but do you know what kind of life insurance might be best for you? If you're looking for life-long protection, predictable costs and a savings vehicle, whole life insurance might be a good fit. Take a look at this overview to see if it's something that interests you. I'd be happy to tell you more about whole life insurance and help you decide if it's the right choice for you.

Insurance Products & Services

Insurance is unlike any other product out there - you pay for it and hope you never have to use it. And that makes paying more than you need to that much more uncomfortable.

With a policy from Allstate, you can help keep your insurance costs low with the wide variety of discounts we offer. Keep in mind, not all discounts are available in every state. The best way to get all that you qualify for is to get an insurance quote specific to La Verne.

You can get a rough "ballpark" insurance quote from many companies online, but talking with an agent allows you to ask questions and get a quote for coverage that matters most to you. As an Allstate agent, I can prepare a quote that details the coverage, deductibles (your portion of a loss) and cost (premium) of your insurance policy.

Insurance products and services offered at my Allstate agency include:

Annuities

Retirement

College Savings Plan

Life Insurance

Contact

Whole Life Insurance

You know life insurance is a great way to help protect your loved ones, but do you know what kind of life insurance might be best for you? If you're looking for life-long protection, predictable costs and a savings vehicle, whole life insurance might be a good fit. Take a look at this overview to see if it's something that interests you. I'd be happy to tell you more about whole life insurance and help you decide if it's the right choice for you.

Tamone Phengrasamee is insurance licensed in the state(s) of Arizona, California, Colorado, and Idaho. If you do not reside in the state(s) of Arizona, California, Colorado, or Idaho, please go to the Find an Agent section on allstate. com to search for another Allstate Agent or Personal Financial Representative.

California Insurance License Name and Number: 0B88768 PHENGRASAMEE, TAMONE

Subject to terms, conditions & availability.

This material is intended for educational purposes only. Life insurance issued by Allstate Life Insurance Company: Northbrook, IL; and American Heritage Life Insurance Company: Jacksonville, FL. In New York, Allstate Life Insurance Company of New York: Hauppauge, NY. Securities offered by Personal Financial Representatives through Allstate Financial Services, LLC (LSA Securities in LA and PA). Registered Broker-Dealer. Member FINRA. SIPC. Main Office: 2920 South 84th Street, Lincoln, NE 68506. (877) 525-5727.

Check the background of this firm on FINRA's BrokerCheck website.

Viruhexal Rezeptfrei Kaufen ? Qualitat; ? Mit Niedrigen Preisen; ? Lieferung, Viruhexal

Aciclovir ist fur die Behandlung von HSV und VZV-Infektionen, einschlie?lich angegeben:

Genital Herpes simplex

Herpes simplex labialis

Herpes zoster (Gurtelrose)

Akute Windpocken bei immungeschwachten Patienten

Herpes-simplex-Encephalitis

Akute mukokutane HSV-Infektionen bei immungeschwachten Patienten

Herpes simplex-Keratitis (okulare Herpes)

Herpes-simplex-Blepharitis

Bell-Lahmung

Aciclovir ist eine antivirale. Es funktioniert durch Beendigung des viralen Replikation. Allerdings ist Aciclovir nicht beseitigen das Virus, ist kein Allheilmittel, und nicht verhindern Ubertragung auf andere.

Verwenden Sie Aciclovir wie von Ihrem Arzt verordnet!

Nehmen Sie Aciclovir durch den Mund mit oder ohne Nahrung.

Starten Therapie mit Aciclovir bei den ersten Anzeichen oder Symptom der Gurtelrose oder Herpes genitalis (Schmerzen, Brennen, Blaschen).

Wenn die Behandlung einer akuten Ausbruch weiterhin verwenden fur das gesamte Verlauf der Behandlung Aciclovir, auch wenn Sie sich besser in ein paar Tagen zu spuren.

Fur suppressive Therapie arbeitet Aciclovir besten, wenn es zu den gleichen Zeiten jeden Tag genommen wird.

Wenn Sie eine Dosis von Aciclovir verpassen, ihn 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 uber die Verwendung von Aciclovir haben kann.

Lagerung bei Raumtemperatur Aciclovir, zwischen 68 und 77 Grad F (20 und 25 Grad C). Lager weg von der Hitze, Feuchtigkeit und Licht. Nicht im Bad. Halten Sie au?erhalb der Reichweite von Kindern und weg von Haustieren Aciclovir.

Verwenden Sie KEINE Aciclovir, wenn:

Sie sind allergisch gegen jegliche Zutaten in Aciclovir oder Valaciclovir

Fragen Sie Ihren Arzt oder Ihre Arztin sofort, wenn einer dieser Punkte auf Sie zutreffen.

Einige medizinische Bedingungen konnen mit Aciclovir 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 Probleme mit den Nieren oder ein geschwachtes Immunsystem haben.

Einige Arzneimittel konnen mit Aciclovir interagieren. Informieren Sie Ihren Arzt, wenn Sie irgendeine andere Medizin nehmen, vor allem einer der folgenden:

Medikamente, die die Niere schadigen konnen (zB Aminoglykosid-Antibiotika [zB Gentamicin], Amphotericin B, Ciclosporin, nichtsteroidale Antirheumatika [NSAR] [z. B. Ibuprofen], Tacrolimus, Vancomycin), weil das Risiko von Nierensteinen Nebenwirkungen erhoht werden kann. Fragen Sie Ihren Arzt, wenn Sie unsicher sind, ob alle Ihre Medikamente die Nieren schadigen konnten, sind.

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

Wichtige Sicherheitshinweise:

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

Aciclovir kann Schwindel, Benommenheit oder Ohnmacht, Alkohol, hei?e Wetter, Sport, Fieber oder diese Effekte verstarkt. Um zu verhindern, sitzen oder stehen langsam, vor allem in den Morgen. Setzen oder legen Sie bei den ersten Anzeichen einer dieser Effekte.

Aciclovir kann Sie mehr leicht zu Sonnenbrand. Meiden Sie die Sonne, Hohensonne oder Solarien, bis Sie wissen, wie Sie zu Aciclovir zu reagieren. Verwenden Sie einen Sonnenschutz-und Schutzkleidung tragen mussen, wenn Sie fur mehr als eine kurze Zeit au?erhalb.

Aciclovir ist nicht eine Heilung fur Herpes genitalis und wird nicht verhindern, dass die Ausbreitung des Virus. Vermeiden Sie Geschlechtsverkehr, wenn Wunden vorhanden, um zu verhindern Infektion Ihres Partner sind. Sie konnen auch ansteckend sein und die Ausbreitung der Herpes-Virus, aber noch keine Anzeichen oder Symptome. Dies wird als asymptomatische Virusausscheidung.

Labortests, einschlie?lich der Nierenfunktion und Serum-Harnstoff-Stickstoff (BUN), kann durchgefuhrt werden, wahrend Sie Aciclovir 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 Aciclovir mit Vorsicht bei alteren Menschen, sie kann mehr empfindlich auf die Auswirkungen, vor allem Verwirrung, Benommenheit oder Halluzinationen.

Aciclovir ist nicht fur die Anwendung bei Kindern junger als 2 Jahre alt, wie Sicherheit und Wirksamkeit fur Kinder empfohlen wurden nicht bestatigt.

Schwangerschaft und Stillzeit: Wenn Sie schwanger werden, wenden Sie sich an Ihren Arzt. Sie mussen die Vorteile und Risiken der Verwendung von Aciclovir zu diskutieren, wahrend Sie schwanger sind. Aciclovir ist in der Muttermilch gefunden. Wenn Sie sind oder werden stillen, wahrend Sie Aciclovir verwenden sind, mit Ihrem Arzt uberprufen. Diskutieren Sie mogliche Risiken fur Ihr Baby.

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:

Durchfall, allgemeine korperliche Beschwerden, Kopfschmerzen, 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), aggressives Verhalten, Blut im Urin, Verwirrung, vermindertes Bewusstsein, weniger Harndrang, Halluzinationen, niedrigere Ruckenschmerzen, psychische oder Stimmungsschwankungen, rot, geschwollen, Blasen, oder Schalen der Haut, Krampfanfalle, ungewohnliche Blutergusse oder Blutungen.

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

Kunden, die diesen Artikel gekauft haben, schaffen auch folgende Artikel an.

Urheberrecht © 2004-2016 Alle Rechte vorbehalten

Filide Real-Time Road Traffic News, Filide

Filide Traffic

10 ideas to keep the kids happy on trips

Family journeys Here are 10 ideas to keep them happy whether you are travelling by plane, by train or by car.

Real-time traffic and warnings

To help you on the road this summer Summertime means holidays but also busy roads. To avoid hold-ups, here are a few tips.

Renting a car, an attractive proposition for the holidays

Renting a car Renting a car can be financially advantageous. Check out our car rental service and all its many benefits:

Michelin Guide Singapore 2016

Traffic news - Traffic information for Filide

All the information on real-time traffic conditions for Filide with ViaMichelin. Our data illustrates traffic conditions on the road and traffic conditions on the motorways in real time.

All ViaMichelin for Filide

Filide Traffic

10 ideas to keep the kids happy on trips

Family journeys Here are 10 ideas to keep them happy whether you are travelling by plane, by train or by car.

Real-time traffic and warnings

To help you on the road this summer Summertime means holidays but also busy roads. To avoid hold-ups, here are a few tips.

Renting a car, an attractive proposition for the holidays

Renting a car Renting a car can be financially advantageous. Check out our car rental service and all its many benefits:

Michelin Guide Singapore 2016

Traffic news - Traffic information for Filide

All the information on real-time traffic conditions for Filide with ViaMichelin. Our data illustrates traffic conditions on the road and traffic conditions on the motorways in real time.

All ViaMichelin for Filide

Low-Ogestrel (28) Oral Uses, Side Effects, Interactions, Pictures, Warnings - Dosing, Ogestrel

Low-Ogestrel (28)

Uses

This combination hormone medication is used to prevent pregnancy. It contains 2 hormones: a progestin and an estrogen. It works mainly by preventing the release of an egg (ovulation ) during your menstrual cycle. It also makes vaginal fluid thicker to help prevent sperm from reaching an egg (fertilization) and changes the lining of the uterus (womb) to prevent attachment of a fertilized egg. If a fertilized egg does not attach to the uterus, it passes out of the body.

Besides preventing pregnancy, birth control pills may make your periods more regular, decrease blood loss and painful periods, decrease your risk of ovarian cysts. and also treat acne .

How to use Low-Ogestrel (28)

Read the Patient Information Leaflet provided by your pharmacist before you start using this product and each time you get a refill. The leaflet contains very important information on when to take your pills and what to do if you miss a dose. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually once daily. Pick a time of day that is easy for you to remember, and take your pill at the same time each day.

It is very important to continue taking this medication exactly as prescribed by your doctor. With certain brands of birth control pills. the amount of estrogen and progestin in each active tablet will vary at different times in the cycle. Therefore, it is very important that you follow the package instructions to find the first tablet, start with the first tablet in the pack, and take them in the correct order. Do not skip any doses. Pregnancy is more likely if you miss pills, start a new pack late, or take your pill at a different time of the day than usual.

Vomiting or diarrhea can prevent your birth control pills from working well. If you have vomiting or diarrhea, you may need to use a back-up birth control method (such as condoms. spermicide). Follow the directions in the Patient Information Leaflet and check with your doctor or pharmacist for more details.

Taking this medication after your evening meal or at bedtime may help if you have stomach upset or nausea with the medication. You may choose to take this medication at another time of day that is easier for you to remember. No matter what dosing schedule you use, it is very important that you take this medication at the same time each day, 24 hours apart. Ask your doctor or pharmacist if you have any questions.

Your pill pack contains 21 pills with active medication. It may also contain 7 reminder pills with no medication. Take one active pill (with hormones) once daily for 21 days in a row. If you are using a product with 28 tablets, take an inactive pill once daily for 7 days in a row after you have taken the last active pill unless otherwise directed by your doctor. If you are using a product with 21 tablets, do not take any tablets for 7 days unless otherwise directed by your doctor. You should have your period during the fourth week of the cycle. After you have taken the last inactive tablet in the pack or gone 7 days without taking an active tablet, start a new pack the next day whether or not you have your period. If you do not get your period, consult your doctor.

If this is the first time you are using this medication and you are not switching from another form of hormonal birth control (such as patch, other birth control pills), take the first tablet in the pack on the first Sunday following the beginning of your menstrual period or on the first day of your period. If your period begins on a Sunday, begin taking this medication on that day. For the first cycle of use only, use an additional form of non-hormonal birth control (such as condoms. spermicide) for the first 7 days to prevent pregnancy until the medication has enough time to work. If you start on the first day of your period, you do not need to use back-up birth control the first week.

Ask your doctor or pharmacist about how to switch from other forms of hormonal birth control (such as patch, other birth control pills) to this product. If any information is unclear, consult the Patient Information Leaflet or your doctor or pharmacist.

Side Effects

Nausea, vomiting, headache. bloating. breast tenderness, swelling of the ankles /feet (fluid retention), or weight change may occur. Vaginal bleeding between periods (spotting) or missed/irregular periods may occur, especially during the first few months of use. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. If you miss 2 periods in a row (or 1 period if the pill has not been used properly), contact your doctor for a pregnancy test .

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.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if you have any serious side effects, including: lumps in the breast. mental/mood changes (such as new/worsening depression ), severe stomach /abdominal pain. unusual changes in vaginal bleeding (such as continuous spotting, sudden heavy bleeding, missed periods), dark urine, yellowing eyes /skin .

This medication may rarely cause serious (sometimes fatal) problems from blood clots (such as deep vein thrombosis. heart attack, pulmonary embolism. stroke). Get medical help right away if any of these side effects occur: chest/jaw/left arm pain, confusion, sudden dizziness/fainting, pain/swelling/warmth in the groin/calf, slurred speech, sudden shortness of breath/rapid breathing, unusual headaches (including headaches with vision changes/lack of coordination, worsening of migraines, sudden/very severe headaches), unusual sweating, weakness on one side of the body, vision problems/changes (such as double vision. partial/complete blindness).

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

See also Warning section.

Before using this medication, tell your doctor or pharmacist if you are allergic to any estrogens (such as ethinyl estradiol, mestranol) or any progestins (such as norethindrone, desogestrel); 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: blood clots (for example, in the legs, eyes, lungs), blood clotting disorders (such as protein C or protein S deficiency), high blood pressure, abnormal breast exam, cancer (especially endometrial or breast cancer), high cholesterol or triglyceride (blood fat) levels, depression, diabetes, family medical history (especially angioedema), gallbladder problems, severe headaches/migraines, heart problems (such as heart valve disease, irregular heartbeat, previous heart attack), history of yellowing eyes/skin (jaundice) during pregnancy or while using hormonal birth control (such as pills, patch), kidney disease, liver disease (including tumors), stroke, swelling (edema), thyroid problems, unexplained vaginal bleeding.

If you have diabetes, this medication may make it harder to control your blood sugar levels. Check your blood sugar levels regularly as directed and share the results with your doctor. Tell your doctor right away if you have any symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

Tell your doctor if you just had or will be having surgery or if you will be confined to a bed or chair for a long time (such as a long plane flight). These conditions increase your risk of getting blood clots, especially if you are using hormonal birth control. You may need to stop this medication for a time or take special precautions.

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

This medication may cause blotchy, dark areas on your skin (melasma). Sunlight may worsen this effect. Avoid prolonged sun exposure, sunlamps, and tanning booths. Use a sunscreen, and wear protective clothing when outdoors.

If you are nearsighted or wear contact lenses, you may develop vision problems or trouble wearing your contact lenses. Contact your eye doctor if these problems occur.

It may take longer for you to become pregnant after you stop taking birth control pills. Consult your doctor.

This medication should not be used during pregnancy. If you become pregnant or think you may be pregnant, tell your doctor right away. If you have just given birth or had a pregnancy loss/abortion after the first 3 months, talk with your doctor about reliable forms of birth control, and find out when it is safe to start using birth control that contains a form of estrogen, such as this medication.

This medication may decrease breast milk production. A small amount passes into breast milk and may have undesirable effects on a nursing infant. 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: aromatase inhibitors (such as anastrozole, exemestane), ospemifene, tamoxifen, tizanidine, tranexamic acid, a certain combination product used to treat chronic hepatitic C (ombitasvir/paritaprevir/ritonavir/dasabuvir).

Some drugs may cause hormonal birth control to work less well by decreasing the amount of birth control hormones in your body. This effect can result in pregnancy. Examples include griseofulvin, modafinil, rifamycins (such as rifampin, rifabutin), St. John's wort, drugs used to treat seizures (such as barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate), HIV drugs (such as nelfinavir, nevirapine, ritonavir), among others.

Tell your doctor when you start any new drug, and discuss if you should use additional reliable birth control. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well.

This medication may interfere with certain laboratory tests (such as blood clotting factors, thyroid), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this medication.

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. Symptoms of overdose may include severe nausea and vomiting, sudden/unusual vaginal bleeding.

Notes

Do not share this medication with others.

Keep all regular medical and laboratory appointments. You should have regular complete physical exams which include laboratory and medical tests (such as blood pressure, breast exam, pelvic exam, Pap smear) to monitor your progress and check for side effects. Follow your doctor's instructions for examining your breasts, and report any lumps right away. Consult your doctor for more details.

Missed Dose

Refer to the product package information for advice on missed doses. You may need to use back-up birth control (such as condoms, spermicide) to prevent pregnancy. Ask your doctor or pharmacist if you have any questions.

If you often forget to take your pills as directed, contact your doctor to discuss switching to another form of birth control.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. 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 October 2015. Copyright(c) 2015 First Databank, Inc.

Images

Leflunomide Indications, Side Effects, Warnings, Leflumide

Leflunomide

Generic Name: leflunomide (le-FLOO-noe-mide) Brand Name: Arava

Leflunomide may cause fetal harm (eg, birth defects) or fetal death. Do not take leflunomide if you are pregnant or if you may become pregnant and are not using an effective form of birth control. You must make sure you are not pregnant before you start leflunomide. Do not become pregnant while you take leflunomide or for as long as any medicine remains in your body after you stop treatment. Leflunomide may stay in the body for 2 years or longer after you stop it. Women who may become pregnant must use effective birth control while they take leflunomide and for as long as any medicine remains in the body.

After you stop leflunomide, your doctor may prescribe other medicines to help remove leflunomide from your body more quickly. Blood tests may also be performed to check if any medicine remains in the body. Talk with your doctor for more information and if you have questions about effective birth control.

Serious and sometimes fatal liver problems have been reported with leflunomide. Your doctor will monitor your liver function while you use leflunomide to check for liver problems. Do not take leflunomide if you have liver problems or if you have abnormal liver function tests before taking leflunomide. Ask your doctor if you are taking other medicines that may harm the liver. Contact your doctor right away if you develop symptoms of liver problems, such as dark urine, pale stools, yellowing of the skin or eyes, stomach pain, severe or persistent nausea or loss of appetite, or unusual tiredness.

Leflunomide is used for:

Treating rheumatoid arthritis by reducing signs and symptoms, improving physical function, and preventing the development of structural damage to the joints.

Leflunomide is a pyrimidine synthesis inhibitor. It is thought to work by blocking certain enzymes responsible for abnormal tissue development or growth.

Do NOT use leflunomide if:

you are allergic to any ingredient in leflunomide

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

you may become pregnant and are not using effective birth control

you have bone marrow problems; a severely weakened immune system; or a severe, uncontrolled infection

you have liver problems (eg, hepatic insufficiency or failure), abnormal liver function tests prior to taking leflunomide, or a history of hepatitis B or C infection

you are taking teriflunomide

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

Before using leflunomide:

Some medical conditions may interact with leflunomide. 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 weakened immune system, an infection, a history of an infection that keeps coming back, or you have recently received a vaccination

if you have a history of lung problems, tuberculosis (TB) or a positive TB test, high blood pressure, blood or bone marrow problems, diabetes, liver problems, or abnormal liver function tests, or if you drink alcoholic beverages

if you have or have a history of kidney problems or you are on dialysis

if you take or have recently taken methotrexate, another medicine to treat rheumatoid arthritis, or another medicine that may suppress your immune system

if you are taking medicine to treat or prevent malaria

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

Methotrexate because the risk of liver problems, blood problems, or infection may be increased

Rifampin or teriflunomide because they may increase the risk of leflunomide's side effects

Anticoagulants (eg, warfarin) because the risk of its side effects, including bleeding, may be increased by leflunomide

Medicines that may suppress the immune system because the risk of infection or unusual bruising or bleeding may be increased. Ask your doctor if you are unsure if any of your medicines may suppress the immune system

Medicines that may cause nerve problems, because the risk of a certain nerve side effect (burning, numbness, or tingling sensation) may be increased. Ask your doctor if you are unsure if any of you medicines may cause nerve problems

Cholestyramine because it may decrease leflunomide's effectiveness

Medicines that may harm the liver (eg, acetaminophen, methotrexate, ketoconazole, isoniazid, certain medicines for HIV infection) because the risk of liver side effects may be increased. Ask your doctor if you are unsure if any of your medicines might harm the liver

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

How to use leflunomide:

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

Take leflunomide by mouth with or without food.

It may take 4 weeks or more to notice any improvement while taking leflunomide.

If you miss a dose of leflunomide, 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 leflunomide.

Important safety information:

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

Drinking alcohol while you are taking leflunomide may increase the risk of liver problems. Talk with your doctor before drinking alcohol while taking leflunomide.

Leflunomide may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.

Leflunomide may lower the ability of your body to fight infection. 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.

Do not receive a live vaccine (eg, measles, mumps) while you are taking leflunomide. Talk with your doctor before you receive any vaccine.

The safety of leflunomide in patients with inactive TB has not been confirmed. You may need to have a TB skin test before you start leflunomide to determine if you have TB infection. Discuss any questions or concerns with your doctor.

Serious and sometimes fatal liver problems have been reported with leflunomide. Contact your doctor right away if you develop symptoms such as dark urine, pale stools, yellowing of the skin or eyes, stomach pain, severe or persistent nausea or loss of appetite, or unusual tiredness.

A serious and sometimes fatal lung problem (interstitial lung disease) has been reported with leflunomide. Contact your doctor right away if you develop new or worsening breathing problems, such as cough or shortness of breath (with or without fever).

Serious and sometimes fatal skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis) have been rarely reported with leflunomide. Contact your doctor right away if you develop a rash; red, swollen, blistered, or peeling skin; or blisters on the inside of the eyes, nose, or mouth.

Lab tests, including liver function, blood pressure, and complete blood cell counts, may be performed to monitor your progress or check for side effects. Be sure to keep all doctor and lab appointments.

Use leflunomide with caution in the ELDERLY; they may be more likely to develop burning, numbness, or tingling.

Leflunomide may remain in the body for 2 years or longer after you stop taking it. Your doctor may prescribe medicine to help remove leflunomide from your body more quickly after you finish treatment (drug elimination procedure). Talk with your doctor for more information.

The risk of harm or death to a fetus fathered by a man using leflunomide is not known. Men who take leflunomide should talk with their doctor about the need to use a condom when having sex with a woman who may become pregnant. If you wish to father a child, talk with your doctor. You may need to stop leflunomide and complete the drug elimination procedure to remove it from your blood before you father a child.

If you are able to become pregnant, you must not start leflunomide unless it has been confirmed that you are not pregnant. You will need to use an effective form of birth control while you take leflunomide and for as long as leflunomide remains in your body. If you plan to become pregnant, talk with your doctor about stopping leflunomide and completing the drug elimination procedure before you become pregnant. Talk with your doctor for more information or if you have questions about effective birth control.

PREGNANCY and BREAST-FEEDING: Do not use leflunomide if you are pregnant. It may cause birth defects or fetal death. You must have a negative pregnancy test before you start treatment with leflunomide. Do not become pregnant while you are taking it. Contact your doctor at once if your period does not occur when expected or if you suspect that you are pregnant. It is not known if this medicine is found in breast milk. Do not breast-feed while taking leflunomide.

Possible side effects of leflunomide:

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:

Back pain; diarrhea; dizziness; hair loss; headache; indigestion; muscle aches; nausea; runny nose; weakness; weight loss.

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); blisters on the inside of the eyes, nose, or mouth; burning, numbness, or tingling; chest pain; fast or irregular heartbeat; muscle cramps, including leg cramps; new or worsening breathing problems (eg, cough or shortness of breath, with or without fever); red, swollen, blistered, or peeling skin; severe or persistent vomiting; symptoms of high blood pressure (eg, severe or persistent headache or dizziness, vision changes); symptoms of infection (eg, fever, chills, sore throat, cough, increased or painful urination); symptoms of liver problems (eg, dark urine, pale stools, yellowing of the skin or eyes, stomach pain, severe or persistent nausea or loss of appetite); unusual or easy bruising or bleeding; unusual tiredness; unusually pale skin.

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

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center. or emergency room immediately.

Proper storage of leflunomide:

Store leflunomide at room temperature at 77 degrees F (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 bathroom. Keep leflunomide out of the reach of children and away from pets.

General information:

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

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

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

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

This information should not be used to decide whether or not to take leflunomide or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about leflunomide. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to leflunomide. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using leflunomide.

Review Date: August 8, 2016

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

More about leflunomide

Carbolith Drug Information, Professional, Carbolith

Carbolith

Generic Name: Lithium VA CLASSIFICATION Primary: CN750 Secondary: CN900; BL400

Commonly used brand name(s): Carbolith; Cibalith-S; Duralith; Eskalith; Eskalith CR; Lithane; Lithizine; Lithobid; Lithonate; Lithotabs.

Note: For a listing of dosage forms and brand names by country availability, see Dosage Forms section(s).

antidepressant therapy adjunct—

vascular headache prophylactic—

Note: Bracketed information in the Indications section refers to uses that are not included in U. S. product labeling. Accepted

Bipolar disorder (treatment)—Lithium is indicated as the primary agent in the treatment of acute manic and hypomanic episodes in bipolar disorder, and for maintenance therapy to help diminish the intensity and frequency of subsequent manic episodes in patients with a history of mania . —Lithium is used in some patients as the agent of choice in the prevention of bipolar depression . Clinicians have observed a diminished intensity and frequency of severe depressive episodes.

[Depression, mental (treatment)] 1 —Lithium is used alone for maintenance therapy in unipolar depression, and for acute and maintenance therapy in schizoaffective disorder. It is also used to augment the antidepressant effect of tricyclic or monoamine oxidase (MAO) inhibitor antidepressants in the treatment of major unipolar depression in patients not responsive to antidepressants alone.

[Headache, vascular (prophylaxis) ] 1 —Lithium is used to reduce the frequency of the occurrence of episodic and chronic cluster headaches .

[Neutropenia (treatment)] 1 —Lithium is used to reduce the incidence of infection in patients with chemotherapy-induced neutropenia and in patients with chronic or acquired neutropenia .

1 Not included in Canadian product labeling.

Physicochemical characteristics: Molecular weight— Lithium carbonate: 73.89 Lithium citrate: 282.00

Other characteristics A monovalent cation easily assayed in biological fluids; salts share some chemical characteristics with salts of sodium and potassium Mechanism of action/Effect:

Antimanic—Has not been established . The mood-stabilizing effect has been postulated to relate to a reduction of catecholamine neurotransmitter concentration, possibly mediated by lithium ion (Li + ) effect on Na + K + adenosine triphosphatase (Na + K + ATPase) to produce improved transneuronal membrane transport of sodium ion. An alternate postulate is that lithium may decrease cyclic adenosine monophosphate (cyclic AMP) concentrations . which would result in decreased sensitivity of hormonal-sensitive adenylcyclase receptors. Another hypothesis is the “second messenger” theory of lithium's interference with lipid inositol metabolism. This theory postulates that a group of improperly regulated neurons may be the underlying cause of manic symptoms. A phospholipase C-type enzyme hydrolyzes the plasma membrane–located lipid, phosphatidylinositol biphosphate, to diacyglycerol and inositol triphosphate, postsynaptic second messengers that contribute to chronic cell stimulation by altering electrical activity in the neuron. Inositol formed during this process is recycled by the inositol phospholipid–synthesizing enzymes in the CNS. There is evidence that cells in the CNS do not have access to plasma sources of inositol but, instead, depend on the synthesis of inositol for the transduction of neuronal signals. Lithium, in therapeutic concentrations, blocks the activity of the enzyme, inositol-1-phosphatase, resulting in a depletion of neuronal inositol and ultimately a decrease in the levels of phosphatidylinositol biphosphate. The lipid will no longer be able to stimulate the formation of adequate quantities of the second messengers or alter electrical activity. Subsequent cells in the CNS become relatively insensitive to the agonist stimulation, and clinical improvement results.

Granulopoietic—The exact mechanism of action has not been established; however, studies have shown that lithium stimulates granulopoiesis, enhances marrow proliferation, elevates neutrophil production, and increases the granulocyte pool .

Vascular headache prophylactic—Specific mechanism has not been established. It has been postulated that the action of lithium in cluster headaches may be directly related to changes in platelet serotonin and histamine concentrations.

Antidepressant—Has not been established. However, the mechanism may involve enhancement of serotonergic activity and downregulation of beta-receptors . Absorption:

Rapid ; complete within 6 to 8 hours. Absorption rate of slow-release capsules is slower and the total amount of lithium absorbed is lower than with other dosage forms. Protein binding:

Not bound to plasma proteins. Biotransformation:

Adolescents: 18 hours.

Elderly patients: Up to 36 hours.

Note: When therapy is initiated . the serum concentration decreases rapidly during the initial 5 or 6 hours, followed by a more gradual decline over the next 24 hours.

Time to peak serum concentration

Capsules or tablets—1 to 3 hours .

Extended-release tablets—4 hours.

Slow-release capsules—3 hours .

Steady-state serum concentrations—4 days. Therapeutic serum concentration

Acute: 0.8 to 1.2 mEq per liter, occasionally up to 1.5 mEq per liter .

Maintenance: 0.5 to 1.0 mEq per liter . Occasionally may require same concentration range as acute illness .

Onset of therapeutic action

Clinical improvement—1 to 3 weeks . Elimination:

Renal— 95% unchanged; rapid initially, slower with extended therapy; 80% may be actively reabsorbed in the proximal tubule ; rate of excretion decreases with age.

Sweat— 4 to 5%.

Precautions to Consider Pregnancy/Reproduction

Pregnancy— First trimester: Use of lithium is not recommended during pregnancy, especially in the first trimester, because of possible teratogenicity. Lithium crosses the placenta and is present in almost equal concentrations in the fetal and maternal serum. Data from lithium birth registers suggest an increased incidence of neonatal goiter and congenital cardiovascular malformations, especially Ebstein"s anomaly .

FDA Pregnancy Category D.

Lithium toxicity may be manifested as hypotonia, lethargy, and cyanosis in newborn infants of mothers taking lithium at term. Risk-benefit must be considered. Breast-feeding

Lithium is excreted in breast milk at a concentration about one-half that in maternal serum. Signs and symptoms of lithium toxicity such as hypotonia, hypothermia, cyanosis, and electrocardiogram (ECG) changes have been reported in some infants. With rare exceptions, infants should not be breast-fed while the mother is receiving lithium therapy. Pediatrics

Appropriate studies on the relationship of age to the effects of lithium have not been performed in the pediatric population. However, lithium may decrease bone formation or density in children by altering parathyroid hormone concentrations. Also, lithium is deposited in bone, replacing calcium in hydroxyapatite, an effect more pronounced in immature bone.

Geriatric patients and patients with organic mental disease usually require lower lithium dosage, lower serum concentration . and more frequent monitoring than younger adults because renal clearance rate and distribution volume are reduced. Lithium is more toxic to the central nervous system (CNS) in the elderly, even when serum lithium concentrations are within the therapeutic range for younger adults. Also, the elderly possibly may be more prone to develop lithium-induced goiter and clinical hypothyroidism. Excessive thirst and larger volume of urine as early side effects of lithium therapy may be more frequent in the elderly. Drug interactions and/or related problems The following drug interactions and/or related problems have been selected on the basis of their potential clinical significance (possible mechanism in parentheses where appropriate)—not necessarily inclusive ( » = major clinical significance):

Note: Combinations containing any of the following medications, depending on the amount present, may also interact with this medication.

Amphetamines (concurrent use with lithium may antagonize the CNS stimulating effects of amphetamines)

Angiotensin-converting enzyme (ACE) inhibitors (reversible increases in serum lithium concentrations and toxicity have been reported during concurrent use with ACE inhibitors; frequent monitoring of serum lithium concentrations is recommended during concurrent use)

Antidepressants, tricyclic (since tricyclics may cause a swing into mania and a rapid recycling between mania and depression, lithium plasma concentrations at or greater than 0.8 mEq per liter may be needed to prevent the tricyclic switch process )

» Acetazolamide (may lower lithium concentrations by increasing urinary lithium excretion )

» Anti-inflammatory drugs, nonsteroidal (NSAIDs) (concurrent use may increase the toxic effects of lithium by decreasing its renal excretion, thereby increasing the steady-state plasma lithium concentration by 39 to 50%; patient should be observed for symptoms of lithium toxicity, and increased monitoring of lithium plasma concentrations is recommended during concurrent use)

Atracurium or Pancuronium or Succinylcholine (neuromuscular blocking effects may be potentiated or prolonged when these medications are used concurrently with chronic lithium therapy )

Calcium channel blocking agents (concurrent use with lithium may increase the risk of neurotoxicity in the form of ataxia, tremors, nausea, vomiting, diarrhea, and/or tinnitus; caution is recommended )

» Calcium iodide or » Iodinated glycerol or » Potassium iodide (concurrent use with lithium may potentiate the hypothyroid and goitrogenic effects of either these medications or lithium)

Carbamazepine or Desmopressin or Lypressin or Posterior pituitary or Vasopressin (lithium may decrease the antidiuretic effect of these medications when used concurrently)

(lithium may prevent or decrease carbamazepine-induced leukopenia with a possible increase in therapeutic effect when carbamazepine is used to treat psychotic disorders or bipolar conditions )

» Chlorpromazine and possibly other phenothiazines (concurrent use with lithium may reduce gastrointestinal absorption of the phenothiazine, thereby decreasing its serum concentrations by as much as 40%; phenothiazines, especially chlorpromazine, increase intracellular lithium concentration ; concurrent use may increase rate of renal excretion of lithium; extrapyramidal symptoms, delirium, and cerebellar function impairment may be increased, especially in elderly patients ; also, nausea and vomiting, early indications of lithium toxicity, may be masked by the antiemetic effect of some phenothiazines; admixture of lithium citrate syrup with any liquid forms of phenothiazines may form a precipitate of the free phenothiazine )

» Diuretics (concurrent use with lithium may provoke severe lithium toxicity by delaying renal excretion of lithium and consequently increasing serum and red blood cell lithium concentrations; close monitoring of lithium plasma concentrations is essential since sodium and lithium reabsorption in the proximal tubule is increased, due to the body sodium deficit ; a reduction in lithium dosage may be necessary)

Fludrocortisone (in one published case report, lithium antagonized the mineralocorticoid effects of fludrocortisone; increased fludrocortisone dose and dietary sodium supplementation were required during concurrent use )

» Haloperidol (lithium is frequently used concurrently with haloperidol during the first 1 or 2 weeks of treatment for acute manic episodes, but lithium alone may be adequate thereafter. However, concurrent use with lithium has been reported, in a few cases, to be associated with irreversible neurological toxicity and brain damage, especially in patients with organic mental syndrome or other CNS impairment, although this interaction is controversial; extrapyramidal symptoms may be increased by enhancement of dopamine blockade by haloperidol; patients should be monitored closely during concurrent use; dosage adjustments may be necessary)

(admixture of the liquid forms of lithium and haloperidol may precipitate free haloperidol)

Methyldopa (concurrent use may increase the risk of lithium toxicity even though serum lithium concentrations remain within the recommended therapeutic range )

Metronidazole (concurrent use may promote renal retention of lithium, leading to lithium toxicity; reducing the dose or discontinuing the use of lithium may be necessary during metronidazole therapy; if not feasible to discontinue, frequent monitoring of serum creatinine, electrolyte and lithium concentrations, and urine osmolality to detect possible nephrogenic diabetes insipidus are recommended )

» Molindone (concurrent use with lithium may produce neurotoxic symptoms such as confusion, delirium, seizures, somnambulism, or abnormal electroencephalogram [EEG] changes )

Norepinephrine (concurrent use with lithium may decrease the pressor response to norepinephrine; a higher dose of norepinephrine may be required to achieve the desired effect )

Selective serotonin reuptake inhibitors . such as: Fluoxetine or Fluvoxamine or Paroxetine or Sertraline (concurrent use with lithium has been reported to result in symptoms such as agitation, confusion, diarrhea, dizziness, and tremor; lithium concentrations may be altered, leading to toxicity; close monitoring of lithium concentrations is recommended )

Sodium-containing medications or foods, especially sodium bicarbonate or sodium chloride (high sodium intake enhances lithium excretion, possibly resulting in decreased efficacy)

Urea (may increase the renal excretion of lithium, thereby decreasing its effects )

Xanthines such as: Aminophylline Caffeine Dyphylline Oxtriphylline Theophylline (concurrent use of these medications with lithium increases urinary excretion of lithium, thereby possibly reducing its therapeutic effect)

Laboratory value alterations The following have been selected on the basis of their potential clinical significance (possible effect in parentheses where appropriate)—not necessarily inclusive ( » = major clinical significance):

With physiology/laboratory test values Glucose, blood (may be increased during treatment with lithium; concentrations return to normal when lithium administration is discontinued )

Parathyroid hormone, immunoreactive and Calcium (serum concentrations may rise above normal after long-term therapy )

Medical considerations/Contraindications The medical considerations/contraindications included have been selected on the basis of their potential clinical significance (reasons given in parentheses where appropriate)— not necessarily inclusive ( » = major clinical significance).

Except under special circumstances, this medication should not be used when the following medical problem exists: » Leukemia, history of (leukemia may be reactivated by lithium )

Risk-benefit should be considered when the following medical problems exist » Cardiovascular disease (may be exacerbated; possible interference with lithium excretion)

» CNS disorders, such as epilepsy and parkinsonism (may be exacerbated; lithium-induced neurotoxicity may be masked)

» Dehydration, severe (risk of toxicity is increased; the loss of large volumes of body fluid as in prolonged vomiting, diarrhea, or profuse perspiration due to fever, exercise, saunas, or hot baths may result in increased serum lithium concentration; such loss of body fluid may necessitate dosage adjustment of lithium and/or the supplemental intake of sodium and fluids until hydration status and electrolytes are stable )

Diabetes mellitus (serum insulin concentration may be increased)

Goiter or Hypothyroidism (latent hypothyroidism may be induced in predisposed or elderly patients )

Hyperparathyroidism (calcium metabolism may be altered after long-term use)

» Infections, severe (fever with prolonged sweating, diarrhea, or vomiting may necessitate a decrease in lithium dosage to prevent lithium toxicity )

Organic mental disease or Schizophrenia (patients may be hypersensitive to lithium and exhibit increased confusion, seizures, or electroencephalogram [EEG] changes at normal serum lithium concentrations )

Psoriasis (may be aggravated by lithium; dosage adjustments of lithium and/or other medications may be necessary )

» Renal insufficiency or » Urinary retention (lithium excretion may be delayed, leading to toxicity)

Sensitivity to lithium Caution should be used also in severely debilitated patients or in patients on a sodium-restricted diet because these conditions may increase the risk of toxicity by delaying renal excretion of lithium. Patient monitoring The following may be especially important in patient monitoring (other tests may be warranted in some patients, depending on condition; » = major clinical significance):

Calcium concentrations, serum and Phosphate concentrations, serum (determinations recommended in children under 12 years of age prior to initiation of therapy and periodically during treatment since lithium increases parathyroid hormone concentrations and risk of hypercalcemia and hypophosphatemia )

» Electrocardiogram (ECG) (recommended at least once prior to therapy in all patients, and especially in patients over 40 years of age and those with a history suggestive of cardiovascular disease; should be repeated if symptoms such as palpitations, irregular pulse, weight gain with edema, or diminished consciousness occur; also, lithium may cause the benign effect of flattening of T-waves and prominent U-waves )

Electrolyte concentrations, serum (determinations recommended prior to therapy to detect preexisting hyponatremia, which will decrease lithium excretion )

Height and Weight evaluation (baseline weight measurement prior to therapy and every 3 months are recommended; weight gain, possibly due to a high intake of calorie-containing liquids as a result of lithium-induced polydipsia or to fluid retention to balance the increase in cations . may lead to a patient"s noncompliance with lithium therapy; in children, height and weight charts should be maintained, and lithium therapy re-evaluated or discontinued if there is any decrease in growth rate )

» Lithium concentrations, serum (determinations recommended once or twice weekly during treatment of acute manic episode until serum concentrations and patient"s clinical condition have stabilized; recommended at least every 2 to 3 months during remission when patient is stabilized; blood samples should be drawn in the morning immediately prior to the next dose, 10 to 14 hours following the previous dose, when there is maximal stability in serum concentration. Some side effects may occur at serum lithium concentrations below 1.5 mEq per liter, and mild to moderate toxic reactions are likely to occur at concentrations from 1.5 to 2.5 mEq per liter. Serum lithium concentrations should not be permitted to exceed 1.5 mEq per liter during the acute treatment phase; concentrations above 2.0 mEq per liter in chronic consumption of lithium can produce complex and serious clinical problems . Severe toxicity can occur at 2.5 mEq per liter . Close monitoring is recommended if lithium is used during the last trimester of pregnancy, used concurrently with any other medication, and used in the elderly when renal clearance rate and distribution volume are reduced)

Pregnancy test, beta-HCG (recommended prior to initiation of therapy in all women of child-bearing potential )

» Renal function determinations (close assessment recommended prior to initiation of lithium therapy and periodically thereafter, even in asymptomatic patients with stable serum lithium concentrations; blood urea nitrogen [BUN]; serum creatinine; and urinalysis should be performed prior to initiating therapy to determine hydration status, renal flow, and presence of pre-existing renal concentrating defect )

Thyroid function determinations (serum thyroxine and thyroxine-stimulating hormone [TSH] should be evaluated at baseline before lithium therapy is initiated and at 6-month intervals during therapy; patient should be monitored for symptoms of hypothyroidism; maintenance of adequate thyroid function is important in children to maintain a satisfactory growth rate )

» White blood cell count, total and differential (recommended prior to therapy and repeated if signs of unusual tiredness or weakness develop because of possible rare leukemia that may develop during lithium therapy; however, the association of lithium with leukemia is controversial; benign leukocytosis may be reversible on discontinuation of therapy )

Note: The occurrence and severity of lithium–associated side/adverse effects are generally related directly to the serum lithium concentrations as well as to individual patient sensitivity to lithium. Lithium–related effects tend to occur with increasing frequency and severity at higher concentrations.

The following side/adverse effects have been selected on the basis of their potential clinical significance (possible signs and symptoms in parentheses where appropriate)—not necessarily inclusive: Those indicating need for medical attention Incidence less frequent Cardiovascular problems (fainting; fast or slow heartbeat ; irregular pulse; troubled breathing [dyspnea] on exertion)

extrapyramidal symptoms (muscle dysfunction or rigidity) leukocytosis (unusual tiredness or weakness)

genitourinary effects (glucose or protein in the urine)

nephrogenic diabetes insipidus (frequent urination; increased thirst)—may persist after discontinuation of lithium

neurologic effects (blackout spells ; confusion, poor memory or stupor; dizziness ; slurred speech) weight gain

Note: Sinus node function impairment, sinoatrial block, or ventricular irritability may occur at therapeutic serum lithium concentrations; possibly reversible when lithium is discontinued. Leukocytosis is usually reversible upon discontinuation of lithium, but a rare leukemia may develop during lithium therapy .

Incidence rare Blue color and pain in fingers and toes coldness of arms and legs pseudotumor cerebri ( dizziness; eye pain; headache; nausea or vomiting; noises in ears; vision problems)

Note: If undetected, pseudotumor cerebri may result in enlargement of blind spot, constriction of visual fields, and eventual blindness, due to optic atrophy .

Note: Stress incontinence or urinary urgency is dose-related; more common in women; usually begins 2 to 7 years after start of treatment with lithium .

Overdose For specific information on the agents used in the management of lithium overdose, see: • Acetazolamide in Carbonic Anhydrase Inhibitors (Systemic) monograph; and/or • Mannitol (Systemic) monograph. For more information on the management of overdose or unintentional ingestion, contact a poison control center (see Poison Control Center Listing ). Clinical effects of overdose The following effects have been selected on the basis of their potential clinical significance (possible signs and symptoms in parentheses where appropriate)—not necessarily inclusive: Early symptoms of toxicity Diarrhea drowsiness

Treatment of overdose No specific antidote is available. Early toxic symptoms can usually be treated by reducing or stopping administration of lithium and resuming treatment at a lower dosage after 24 to 48 hours .

Treatment of more severe toxicity or acute overdose may include the following:

To decrease absorption: Inducing vomiting or using small volume (100 mL) gastric lavage (in acute overdose) .

To enhance elimination: Utilizing intermittent hemodialysis if plasma lithium does not drop more than 10% every 3 hours or half-life is greater than 36 hours . Since plasma lithium determinations immediately after dialysis do not take into account the rebound increase that occurs as lithium redistributes from tissue to blood, determinations must be obtained 6 hours later .

Possibly increasing lithium excretion with single dose of intravenous acetazolamide or using mannitol as an osmotic diuretic .

Monitoring: Measuring plasma lithium concentrations every 3 hours until lithium is less than 1.0 mEq per liter .

Monitoring patient closely.

Supportive care: Maintaining electrolyte balance and body fluids .

Maintaining adequate respiration .

Patients in whom intentional overdose is known or suspected should be referred for psychiatric consultation.

Patient Consultation As an aid to patient consultation, refer to Advice for the Patient, Lithium (Systemic)

In providing consultation, consider emphasizing the following selected information ( » = major clinical significance): Before using this medication » Conditions affecting use, especially: Sensitivity to lithium

Pregnancy—Lithium crosses placenta; contraindicated in first trimester because of possible neonatal goiter and cardiovascular malformations; at delivery, hypotonia, lethargy, and cyanosis in newborns of mothers taking lithium at term

Breast-feeding—Excreted in breast milk; may cause hypotonia, hypothermia, cyanosis, and ECG changes in some babies

Use in children—May decrease bone formation or density

Use in the elderly—Elderly more prone to develop CNS toxicity, hypothyroidism and goiter; lower doses and more frequent monitoring required Other medications, especially acetazolamide, iodine-containing preparations, nonsteroidal anti-inflammatory drugs, chlorpromazine (and possibly other phenothiazines), diuretics, haloperidol, or molindone Other medical problems, especially history of leukemia, cardiovascular disease, epilepsy, parkinsonism, severe dehydration, renal insufficiency, urinary retention, or severe infections with prolonged sweating, vomiting, or diarrhea Proper use of this medication Taking after a meal or snack to prevent laxative action and to decrease the severity of stomach upset, tremors, or weakness by slowing absorption rate

» Importance of adequate fluid (2.5 to 3 liters each day) and sodium intake

» Importance of not taking more medication than the amount prescribed

» Compliance with therapy; improvement in condition may require 1 to 3 weeks; importance of maintaining adequate blood levels even though symptoms improved

» Proper dosing Taking as soon as possible, unless within 4 hours (6 hours for extended-release tablets or slow-release capsules) of next scheduled dose; not doubling doses

» Proper storage

For extended-release or slow-release dosage form Swallowing tablet or capsule whole

Not breaking, crushing, or chewing

For syrup dosage form Diluting dose with fruit juice or other flavored beverage before taking Precautions while using this medication » Regular visits to physician to check progress during therapy; importance of serum lithium monitoring

Caution in drinking large amounts of coffee, tea, or colas because of diuretic effect

» Possible drowsiness or dizziness; caution if driving or doing jobs requiring alertness

» Caution during exercise, saunas, and hot weather

» Caution during illnesses that cause high fevers with profuse sweating, vomiting, or diarrhea

» Caution on self-imposed dieting

» Importance of patient and family knowing early symptoms of overdose or toxicity

For slow-release dosage form » Not using interchangeably with any other dosage form

Side/adverse effects » Early symptoms of lithium overdose or toxicity:

Lack of coordination

Loss of appetite

Nausea or vomiting

Side effects are more likely to occur in the elderly

Signs of potential side effects, especially cardiovascular problems, extrapyramidal symptoms, genitourinary problems, leukocytosis, nephrogenic diabetes insipidus, neurologic effects, weight gain, blue color and pain in fingers and toes, coldness of arms and legs, pseudotumor cerebri, symptoms of hypothyroidism

General Dosing Information Warning—Lithium toxicity can occur with doses at or near therapeutic serum concentrations . Facilities for prompt and accurate serum lithium determinations must be available during therapy . Accurate patient evaluation requires both clinical and laboratory analysis .

During the acute manic phase, the patient may have a greater ability to tolerate lithium. This tolerance decreases as the manic symptoms subside and often necessitates a corresponding dosage adjustment.

During the acute manic phase, lithium administration of 300 (8 mEq) to 600 mg three times a day should usually produce effective serum concentrations ranging from 0.8 to 1.2 mEq per liter . with weekly adjustments based on plasma lithium concentrations. An increase of 8 mEq a day will increase plasma concentrations by 0.3±0.1 mEq per liter . The maintenance dose of 300 mg three or four times a day usually produces effective serum concentrations ranging from 0.5 to 1.0 mEq per liter.

If a satisfactory therapeutic response to lithium at the highest tolerated serum concentrations within the therapeutic range is not achieved within 3 weeks, lithium therapy should be discontinued.

Slow-release lithium carbonate capsules and tablets are not bioequivalent to other lithium dosage forms and should not be used interchangeably with them. Diet/Nutrition Since lithium decreases sodium reabsorption by the renal tubules, a normal diet with an average consumption of salt and adequate fluid intake, 2.5 to 3 liters of fluid per day, is essential to prevent sodium depletion leading to lithium toxicity .

This medication may be taken with food, juice, or milk, if necessary, to lessen laxative action, stomach irritation, tremors, or weakness, by slowing absorption of lithium. The syrup must be diluted in juice or other flavored beverage before administration.

For treatment of adverse effects Early side effects—If slight hand tremor, mild nausea or diarrhea, unusual drowsiness, or acne do not subside with continued treatment, a reduction in lithium dosage may be necessary . If hand tremor is especially bothersome, shifting a majority of the dose to bedtime, decreasing caffeine intake, or adding a beta-blocker such as propranolol may be helpful.

Suppression of thyroid activity—May necessitate thyroid hormone replacement therapy .

Urinary incontinence—Lowering dose of lithium whenever possible, adding an anticholinergic agent or an antidepressant with anticholinergic properties, or switching to another medication for treatment of bipolar disorder .

Polyuria—Lowering dose of lithium alone, whenever possible. If the lower plasma lithium concentration is inadequate to maintain a response, adding a thiazide diuretic and reducing the lithium dose by 50%, then readjusting it to reproduce the original plasma lithium concentration, may be effective. Alternatively, extended-release or slow-release lithium products can improve the patient"s renal concentrating ability.

Weight gain—May be safely and effectively treated by limiting calorie intake with emphasis on adequate fluid and sodium intake.

Oral Dosage Forms LITHIUM CARBONATE CAPSULES USP Usual adult and adolescent dose Antimanic Acute mania: Oral, initially 300 to 600 mg (8 to 16 mEq) three times a day, the dosage being adjusted as needed and tolerated at weekly intervals .

Maintenance: Oral, 300 mg three or four times a day, the dosage being adjusted as needed and tolerated .

Note: Geriatric or debilitated patients usually require a lower dosage.

Usual adult prescribing limits Up to 2.4 grams a day. Usual pediatric dose Antimanic Children up to 12 years of age: Oral, initially 15 to 20 mg (0.4 to 0.5 mEq) per kg of body weight a day in two or three divided doses, the dosage being adjusted at weekly intervals, based on plasma lithium concentrations .

Strength(s) usually available U. S.—

150 mg (Rx)[Generic]

300 mg (Rx) [ Eskalith ] [ Lithonate ][Generic]

600 mg (Rx)[Generic]

150 mg (Rx) [ Carbolith ]

300 mg (Rx) [ Carbolith ] [ Lithane ]

Packaging and storage: Store below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), unless otherwise specified by manufacturer. Store in a well-closed container. Auxiliary labeling: • May cause drowsiness. • Take after a meal or snack.

LITHIUM CARBONATE SLOW-RELEASE CAPSULES Usual adult and adolescent dose Antimanic Acute mania: Oral, initially 600 to 900 mg a day on the first day, the dosage being increased, thereafter, to 1200 to 1800 mg a day in three divided doses, as needed and tolerated .

Maintenance: Oral, 900 to 1200 mg a day in three divided doses, the dosage being adjusted as needed and tolerated .

Usual adult prescribing limits Up to 2.4 grams a day. Usual pediatric dose Antimanic Children up to 12 years of age: Dosage has not been established .

Usual geriatric dose Antimanic Oral, 600 to 1200 mg a day in three divided doses .

Strength(s) usually available U. S.— Not commercially available.

150 mg (Rx) [ Lithizine ]

300 mg (Rx) [ Lithizine ]

Note: Not bioequivalent to other lithium dosage forms and should not be used interchangeably with them .

Packaging and storage: Store below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), unless otherwise specified by manufacturer. Store in a well-closed container. Auxiliary labeling: • Swallow whole . • May cause drowsiness.

300 mg (Rx) [ Lithotabs ][Generic]

Packaging and storage: Store below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), unless otherwise specified by manufacturer. Store in a well-closed container. Auxiliary labeling: • May cause drowsiness. • Take after a meal or snack.

LITHIUM CARBONATE EXTENDED-RELEASE TABLETS Usual adult and adolescent dose Antimanic Acute mania: Oral, 450 to 900 mg two times a day or 300 to 600 mg three times a day, the dosage being adjusted as needed and tolerated.

Maintenance: Oral, 450 mg two times a day or 300 mg three times a day, the dosage being adjusted as needed and tolerated.

Note: Geriatric or debilitated patients usually require a lower dosage.

Usual adult prescribing limits Up to 2.4 grams a day. Usual pediatric dose Antimanic Children up to 12 years of age: Dosage has not been established .

Strength(s) usually available U. S.—

450 mg (Rx) [ Eskalith CR (scored)]

300 mg (Rx) [ Duralith (scored)]

Packaging and storage: Store below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), in a well-closed container, unless otherwise specified by manufacturer. Auxiliary labeling: • Swallow whole. • May cause drowsiness. • Take after a meal or snack.

LITHIUM CITRATE SYRUP USP Usual adult and adolescent dose Antimanic Acute mania: Oral, the equivalent of 300 to 600 mg (8 to 16 mEq) of lithium carbonate three times a day, the dosage being adjusted as needed and tolerated.

Maintenance: Oral, the equivalent of 300 mg of lithium carbonate three or four times a day, the dosage being adjusted as needed and tolerated.

Note: Geriatric or debilitated patients usually require a lower dosage.

Usual adult prescribing limits Up to the equivalent of 2.4 grams of lithium carbonate a day. Usual pediatric dose Antimanic Children up to 12 years of age: Oral, initially the equivalent of 15 to 20 mg (0.4 to 0.5 mEq) of lithium carbonate per kg of body weight a day in two or three divided doses, the dosage being adjusted at weekly intervals, based on plasma lithium concentrations .

Strength(s) usually available U. S.—

8 mEq of lithium ion (equivalent to approximately 300 mg of lithium carbonate) per 5 mL (Rx) [ Cibalith-S ][Generic]

Canada— Not commercially available.

Packaging and storage: Store between 15 and 30 °C (59 and 86 °F), unless otherwise specified by manufacturer. Store in a tight container. Protect from freezing. Incompatibilities: Lithium citrate syrup should not be mixed with or administered at the same time as other medication, solid or liquid, that contains a basic form, such as chlorpromazine concentrate, haloperidol, thioridazine, or trifluoperazine, and tricyclic antidepressants . Auxiliary labeling: • May cause drowsiness. • Take after a meal or snack. • Dilute with juice or other beverage before taking.

References

Reynolds JEF, ed. Martindale, the extra pharmacopeia. 28th ed. London: The Pharmaceutical Press, 1982.

Lyman GH, Williams CC, Preston D. The use of lithium carbonate to reduce infection and leukopenia during systemic chemotherapy. N Eng J Med 1980 Jan 31; 302 (5): 257-60.

Panelist comment.

Tollefson GD. Antidepressant treatment and side effect considerations. J Clin Psychiatry 1991 May; 52 (5: suppl): 4-13.

Manufacturer comment from 11/86, used for 89 DI.

Product monograph Lithizine (Paul Maney—Canada), revised 6/81.

Manufacturer comment 12/86.

Panelist comment 1986.

Teicher MH, et al. Possible nephrogenic interaction of lithium and metronidazole [Letter]. J Am Med Assoc 1987; 257(24): 3365-6.

Raandle NW. Food or nutrient effects on drug absorption: a review. Hospital Pharmacy 22: 694.

Miller F, et al. Lithium-neuroleptic neurotoxicity in the elderly bipolar patient. J Clin Psychopharmacol 1986; 6: 176-8.

Updates, May 1986.

Brewerton TD. Lithium counteracts carbamazepine-induced leukopenia while increasing its therapeutic effect. Biol Psychiatry 1986; 21: 677-85.

Jaeger A, et al. Toxicokinetics of lithium intoxication treated by hemodialysis. Clinical Toxicology 1985-86; 23 (7&8): 501-17.

Personal communication, Miles Laboratories, 6/87.

Vetro A, et al. Therapeutic experience with lithium in childhood aggressivity. Neuropsychobiology 1985; 14: 121-7.

Kushnir SL. Lithium-antidepressant combinations in the treatment of depressed, physically ill geriatric patients. Am J Psychiatry 1986; 143: 378-9.

Julius SC, Brenner RP. Myoclonic seizures with lithium. Biol Psychiatry 1987; 22: 1184-90.

Physicians Drug Alert/ Sept 1987 [from Am J Psychiatry 144: 670-2, 1987. Samiy A, Rosnick P. Early identification of renal problems in patients receiving chronic lithium treatment].

Mallette LE, Eichhorn E. Effects of lithium carbonate on human calcium metabolism. Arch Intern Med 1986; 146: 770-6.

Hammond WP, Appelbaum F. Lithium and acute monocytic leukemia [Letter]. N Eng J Med 1980 Apr 3; 808; Nielsen JL. More on lithium and leukemia [Letter]. N Eng J Med 1980; 303(5): 283-4; Longo DL [Letter]. N Eng J Med 1980; 303 (5): 283-4; Blum SF. Lithium in hairy-cell leukemia [Letter]. N Eng J Med 1980; 303 (8): 464-5.

Physicians Drug Alert/April 1986. Lithium-related urinary incontinence. (from Rosenbaum J, Pollack M. Treatment-emergent incontinence with lithium. J Clin Psychiatry 1985; 46: 444-5.)

Medical Sciences Bulletin 1987; 10(2). Headache Part 2: cluster headaches. (From Headache 1986; 26(1): 42. and Drug Ther 1983; 37: 56, 68, 78.)

Salem RB. Recommendations for monitoring lithium therapy. Drug Intell Clin Pharm 1983; 17: 346-9.

Sponsor: Technilab Inc. Montreal. Comparative study of two lithium formulations. Caille G, et al.

Yassa R. Lithium-methyldopa interaction. Can Med Assoc Journal 1986; 134: 141-2.

Panelist comment—5/88.(Ref is Psychopharmacology: The third Generation. 1987, Raven. p 562.)

Panelist comment—5/88.

Panelist comment—5/88.

Shelly RK, et al. The relationship between bioavailability and slow-release in a series of lithium formulations. Med Sci 1986; 14: 1143-4.

Panelist comment—5/88.

Panelist comment—5/88.

Panelist comment—5/88.

Manufacturer comment—5/88.

Manufacturer comment—5/88.

Thiels C. Pharmacotherapy of psychiatric disorder in pregnancy and during breast-feeding: a review [Abstract]. Pharmacopsychiatry 1987; 20(4): 133-46.

Drummond AH. Lithium and inositol lipid-linked signalling mechanisms. TIPS 1987; 8: 129-33.

Unpublished. The University of Texas, PHR488U. Dr. SR Saklad. Lithium therapy.

Panelist comment—5/88.

Unpublished. Applied Therapeutics, 4th Edition. Saklad SR; Kastenholz KV.

Panelist comment—7/88.

Panelist comment—7/88.

Comment from Review—8/88.

Panelist comment—7/88.

Manufacturer comment—7/88.

Panelist comment—7/88.

USP DI 1990, Calcium Channel Blocking Agents (Systemic) monograph. From the following references:

1) J Am Geriatr Soc 1987 Feb; 35(2): 177-8.

2) J Clin Pharmacol 1986; 26: 717.

3) J Clin Psych 1985; 46: 540-1.

USP DI 1991, Urea (Systemic) monograph. From the following references:

1) Hospital Formulary

2) Facts & Comparisons

3) Hansten"s

Reviewer comment, 11/3/89. Reference—J Clin Psychopharmacol 1981; 1: 406.

Reviewer comment, 10/6/89.

Reviewer comment, 2/1/90.

Fluoxetine (Prozac) package insert, Lilly (US), Rev 5/24/90, Rec 6/8/90.

Shinn AF, Shrewsbury RP. EDI, Evaluation of drug interactions. 3rd ed. St Louis: Mosby, 1985: 10/443.

Tatro DS, ed. Drug interaction facts. St Louis: Facts and Comparisons, 1990: 457.

Pope HG Jr, McElroy SL, Nixon RA. Possible synergism between fluoxetine and lithium in refractory depression. Am J Psychiatr (Oct) 1988; 145(10): 1292-4.

Lithizine (Paul Maney—Canada) product monograph, CPS 1989: 553-4.

Eskalith (SKF—U. S.) product monograph, PDR 1990: 2100-2.

Lithium Carbonate (General monograph by CPS staff), CPS 1989: 551-3.

Watsky EJ, Salzman C. Psychotropic drug interactions. Hosp Comm Psychiatry 1991 Mar; 42(3): 247-54.

Stewart PM, Grieve J, Nairn IM, Padfield PL, Edwards CRW. Lithium inhibits the action of fludrocortisone on the kidney. Clin Endocrinol 1987; 27: 63-8.

Panel comment Endocrinology Panel ballot 2/12/91.

Baldwin CM, Safferman AZ. A case of lisinopril-induced lithium toxicity. DICP, Ann Pharmacotherapy 1990; 24: 946-7.

Griffin JH, Hahn SM. Lisinopril-induced lithium toxicity. DICP Ann Pharmacotherapy 1991; 25: 101.

Douste-Blazy P, Rostin M, Livarek B, Tordjman E, Montastruc JL, Galinier F. Angiotensin converting enzyme inhibitors and lithium treatment. Lancet 1986; June 21: 1448.

Capoten package insert, Squibb, Rev 2/91.

Vasotec package insert, MSD, Rev 12/90, Rec 11/91.

Prinivil package insert, MSD, Rev 12/90, Rec 11/91.

Monopril package insert, Mead Johnson 6/91.

Altace package insert, Hoechst, 2/91.

Lyman GH, Williams CC, Preston D. The use of lithium carbonate to reduce infection and leukopenia during systemic chemotherapy. N Engl J Med 1980; 302 (5): 257-60.

Steinherz PG, Rosen G, Ghavimi F, Wang Y, Miller DR. The effect of lithium carbonate on leukopenia after chemotherapy. J Pediatr 1980 May; 96(5): 923-7.

Gerner RH, Wolff SM, Fauci AS, Aduan RP. Lithium carbonate for recurrent fever and neutropenia. J Am Med Assoc 1981 Oct 2; 246 (14): 1584-6.

Anon. Lithium for cluster headache. Med Lett Drugs Ther 1979 Sep; 21 (19): 78-9.

Medina JL, Fareed J, Diamond S. Lithium carbonate therapy for cluster headache. Changes in number of platelets, and serotonin and histamine levels. Arch Neurol 1980 Sep; 37: 559-63.

Wolf ME, Mosnaim AD. Lithium and molindone interactions: Pharmacokinetic studies. Res Comm Psychol Psychiatr Behav 1986; 11(1): 23-8.

Lott RS. Lithium interactions. Drug Interactions Newsletter 1983 Apr; 3(4): 17-22.

Product Information: Eskalith, lithium carbonate. SmithKline Beecham, Philadelphia, PA, USA, Rev. 11/1996

Diclosal Gel, Gel, Diclosal

Despre afectiunea ta

Despre analizele tale

Chestionar simptome

Interpretor valori analize

DICLOSAL GEL, gel

Prospect

Compozitie 100 g gel contin diclofenac sodic 1g si excipienti: etanol 96%,propilenglicol, trolamina, carbomer 980, p-hidroxibenzonat de metil, apa purificata.

Grupa farmaceutica Antiinflamatorii nesteroidiene de uz topic. Edeme postoperatorii si posttraumatice.

Contraindicatii - hipersensibilitate la diclofenac, la alte antiinflamatoare nesteroidiene sau la oricare dintre excipientii produsului; - leziuni cutanate. cum sunt: eczeme, leziuni infectate, arsuri, plagi; Dematoze umede, leziuni cutanate suprainfectate.

Precautii Produsul nu trebuie aplicat pe mucoase, mai ales la nivel ocular. Aparitia unei eruptii cutanate dupa aplicarea Diclosal gel 1%, necesita intreruperea imediata a tratamentului.

Interactiuni Datorita absorbtiei sistemice mici a Diclosal gel 1%, in cazul utilizarii conform recomandarilor, este putin probabil sa apara interactiuni medicamentoase .

Atetionari speciale Copii Produsul se administreaza numai la adulti, datorita absentei studiilor de siguranta la copii. Sarcina si alaptarea Produsul se administreaza iprimele 5 luni de sarcina numai daca este absolut necesar, incepand din luna a 6 – a utilizarea sa este contraindicata, datorita riscului de toxicitate cardiopulmonara fetaladeterminat de eventuala sa absorbtie sistemica marcata, in caz de administrare in doze mari, aplicate frecvent si timp indelungat. In cazul altor cai de administrare, antiinflamatoriile neseroidiene se execreta in laptele matern. Prin extrapolare si ca masura de precautie, se recomanda evitarea utilizarii Diclosal Gel 1% la femeile care alapteaza. Capacitatea de a conduce vehicule sau de a folosi utilaje Diclosal Gel 1% nu influenteaza capacitatea de a conduce vehicule sau a folosi utilaje.

Doze si mod de administrare Diclosal Gel 1%, se administraza extern, 2-4 aplicatii pe zi, la nivelul zonei afectate. Produsul se administraza numai la adulti . Pentru a realiza absorbtia gelului se efectueaza un masaj usor si prelungit la nivelul zonei dureroase si/sau inflamate. Dupa fiecare utilizare, mainile se spala atent.

Reactii adverse Reactii locale: rar, apar manifestari alergice cutanate pruriginoase sau de tip eritem localizat. Reactii de hipersensibilitate: - dermatologice; - respiratorii: foarte rar apar crize de astm bronsic indeosebi la pacientii cu hipersensibilitate la antiinflamatoriile nesteroidiene (ains ); - generale: foarte rar reactii de tip anafilactic si in caz de absorbtie cutanata crescuta. Alte reactii adverse sistemice commune AINS (de ex.:digestive si renale ) pot sa apara in functie de absorbtia cutanata crescuta substantei active, cantitatea mare de gel aplicat, suprafata larga de aplicare, prezenta leziunilor cutanate. durata lunga a tratamentului si utilizarea de pansamente ocluzive.

Supradozaj In cazul administrarii Diclosal gel 1% este putin probabil sa apara supradozaj. Totusi, in acest caz. suprafata pe care s-a aplicat gelul trebuie spalata cu o cantitate mare de apa.

Pastrare A nu se utiliza dupa data inscrisa pe ambalaj. A se pastra la temperaturi sub 25sC, in ambalajul original. A nu se lasa la indemana copiilor.

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Cele mai importante informatii medicale, sfaturi de sezon si recomandari despre o viata sanatoasa

Configuring Cisco Asav 9, Ialex

Configuring Cisco ASAv 9.x on GNS3 1.4.x

Recently I went through an interesting experience of Cisco ASA setup in GNS3. I must say it was a real challenge, but finally, not an impossible task. There is a lot of particularities you must take into account, all depending from ASA version to GNS3 release. In this post, I will focus on how to configure an ASAv firewall to run as a QEMU VM in new GNS3 version suite 1.4.x. As of date of this writing I was able to access ASAv image version 9.5(2.204) and the GNS3 1.4.5 setup.

The 1.4.x suite of GNS3 is a relatively new appearing into the scene, and how is typical with new software releases, surely expected to have some bugs and/or incompatibilities. That’s why my first attempts was made in previous software suite of 1.3.x version (actually 1.3.13 version). It was a wrong way, because how I realized soon, for ASAv to be configured, a VNC console should be attached, or in 1.3.13 I didn’t found how to do that (is not excluded that I missed something). As a consequence, I quickly switched to newest GNS3 1.4.5 version. The following text assume a newly setup of GNS3 version 1.4.5 with no additional settings, except maybe only for the default location for project and binary images folder – I prefer to reconfigure these on C:GNS3Projects and respectively C:GNS3Images.

Cisco ASA virtual appliance (ASAv)

Cisco ASAv is a re-imaged version of Cisco ASA specifically designed to run as a VM on top of some hypervisor. In fact, the same ASA code is running, but in different form factor. There are versions for vSphere, Hyper-V and KVM. Just because GNS3 use QEMU as a VM emulator we will employ the KVM image of ASAv. By the way, ASAv is the image Cisco use in their notable virtual labs VIRL. Not all ASA versions are available in a VM format – I suppose only those starting with 9.x, thereby if you want to try some older versions, e. g. popular ASA 8.4(2), you will need to experience another approach (a new article devoted to this subject should come). It’s worth noting that the ASAv have some limitations compared to classical ASA, in particular you wouldn’t be able to build firewall clusters (failover or A/A), test multiple context mode feature or play with Etherchannel. For this scenarios, I usualy use an 8.4(2) ASA setup – which, by the way should run only in QEMU 0.11.0 which in turn can’t be started in GNS 1.4.x, only in previous suite 1.3.x.

So, before we start we need to obtain somewhat the ASAv image. If you are fortunate enough to have access to Cisco downloads (a service contract associated with your profile is needed) then just go to cisco. com – All downloads – Products – Security – Firewalls – Adaptive Security Appliances (ASA) – Adaptive Security Virtual Appliance (ASAv) and download the qcow2 (KVM) image of ASAv for your preferred version.

In case you do not have access to official Cisco downloads, yet I recommend to try a simple Internet search, good chances are to find somewhere a leaked image (usualy on some China resources). To be honest, I can’t understand why Cisco restrict downloads to this type of software, anyway, next after setup you will need a license key to go over the limitations of unlicensed state of appliance (bandwith limitation to 100kbps). It would be fine if Cisco would allow download and free use of appliance in unlicensed state, respectively for production usage a suitable license should be bought.

Configuring ASAv template on GNS3

A step by step guide follow:

Start new QEMU VM Template wizard with following parameters:

Type: Default

Name: ASAv-8.5(2.204) or any meaningful title

Qemu binary: qemu-system-x86_64w. exe (v2.4.0)

RAM: 2048 MB

Disk Image (hda): C:GNS3imagesQEMUasav952-204.qcow2

Note: I will recommend to store original OS images in other folder than that used by GNS3 for image storage. When you specify an image to be used by GNS3 a copy of that original file would be automatically copied to GNS3 binary image folder location.

Edit newly created QEMU Template:

General settings – Symbol :/symbols/asa. svg

General settings – Category: Security Devices

General settings – Console Type: VNC

Note0: in my testing, I tried to change vCPUs from 1 to 4, but nothing more than 1514 Illegal Instruction (core dumped) … error message got in ASAv, hence don’t touch that value, we will set the number of vCPUs in other place for ASAv to be an SMP virtual machine.

Note1: Switching the console to VNC type one it’s like directly connect with a keyboard and a monitor to the virtual machine. Initial ASAv configuration don’t allow access to the serial console port so at least at this stage, the only possible option is VNC. Don’t forget, the ASAv was designed to play in a VM with a full console. Even so, we will configure serial console port to ASAv as well.

Network – Adapters: 6x (default e1000 type)

Advanced Settings – Additional settings – Options: - cpu Haswell - smp 4,sockets=4,cores=1,threads=1

Note0: I successful used this string for all my Intel CPU. The microarchitecture (Haswell, Nehalem and so on) seems to no matter – successfully ran on different CPU generation with no problems. For AMD CPUs, community recommend to use (haven’t tested): - cpu Opteron_G5 - smp 4,sockets=4,cores=1,threads=1

Note1: the default option’s value: –nographic . should be cleared. This will be guarantee an automatic VNC console opening (for non-linked mode VM operation).

(Optional) Activate CPU throttling – Percentage of CPU allowed: 80%

Advanced Settings – uncheck: Use as a linked base VM .

?

I think I will provide some additional inputs about the setting named: Use as a linked base VM . By default, QEMU VMs works as a linked VM which means that every time you create a new QEMU VM (in our case ASAv) in your project, a linked virtual disk is created to the original qcow2 image. All the modifications are thus recorded in that new file but yet unmodified block are read from original image. Through this, we can create hundreds of new QEMU VMs without needing to clone the virtual disk (that’s the similar to the technology used in VDI). Given the fact that during the life of an ASAv VM, disk modifications are really very few, results that the disk overhead created by each new ASAv are truly negligible. If you disable linked VM mode (uncheck the: Use as a linked base VM ) the QEMU VM will interact directly with original qcow2 virtual disk (all writes will be recorded here). As a consequence a single QEMU VMs from this template can be started (just try to drag and drop a second ASAv to workspace and you will see an error message).

Why then we intentionally disabled linked base VM mode? First off, we need this only during ASAv template making and after this we will switch back to linked mode. Our interest is to do a series of configuration changes (first boot, serial console, ASDM image upload) in the original image file which we want to keep in all new ASAv instances created from this template.

Surely, the same results can be achieved by making the template in linked mode (linked qcow2 virtual disk) and then committing all the changes to the original qcow2 image via qemu-img. exe tool, but, I think it is harder. Just disabling and then re-enabling the VM’s linked mode settings seems to be much easier … the choice is yours.

To check the virtual disk that is mounted to QEMU VM just drag a new ASAv to an empty project, right click ASAv device – and choose show in file manager. An explorer window to qcow2 image opens – with linked mode disabled this would be the template image asav952-204.qcow2 located in binary image folder, whereas for linked mode this would be a qcow2 image (somewhere in project’s folder) linked to the original template – base virtual disk image. Also, additionaly you can check what qcow2 images are involved via Windows resource monitor – CPU – Associated Handles – filter by QEMU string.

Drag a new instance of ASAv 9.5(2.204) to the working space on an empty project in GNS3. No topology are needed to continue, just single, unconnected ASAv device.

Power-ON newly instantiated ASAv device ( right-click – start ) and immediately open the console ( right-click – console ). In opened VNC terminal a loading progress (Linux) can pe observed.

On Boot Loader phase choose the option: bootflash:/asa952-204-smp-k8.bin with no configuration load (anyway no configuration yet exists).

In the meantime, it would be interesting to do some analyzing in Resource Monitor. First, to confirm the SMP nature of started QEMU VM look at the number of threads/CPU associated with qemu-system-x86_64w. exe process (CPU – Processes) – should be more than 4x thread/CPU in use, and second, to confirm the non-Linked mode of operation for the ASAv VM do a search in Associated Handles for a qemu key (CPU-Associated Handles) – in non-Linked mode, the VM should interact directly with the original qcow2 image: asav952-204.qcow2 (a screen is inserted below).

At the command prompt the number of vCPU can be checked by the show cpu usage commmad:

ciscoasa# sh cpu usage CPU utilization for 5 seconds = 1%; 1 minute: 1%; 5 minutes: 0%

Virtual platform CPU resources ------------------------------ Number of vCPUs. 4 Number of allowed vCPUs. 0 vCPU Status. Noncompliant: Over-provisioned

If you carefully track the booting progress you will see that the appliance will discover that it starts for the first time ( Initial bootup detected … ) and for the system variables to be applied an automatic reboot will come. So first time booting will end up with an automatic reboot. On the second boot, also choose the option with no configuration load in Bootloader Dialog. First and second time booting could take some time to progress so be patient and wait them to complete – sometimes it may seem that the appliance hung, try to wait several minutes before doing a forced powering off.

If everything goes smoothly, after the second boot, you should reach the traditional Cisco command line prompter (empty password for privileged mode). At this stage, we will enable the serial console for the appliance. By default, the ASAv works only with traditional VM console (monitor/keyboard directly connected to x86 hardware) and additional steps needed to enable console via serial ports. More about that you can read here ASAv Quick Start Guide, 9.5. section Configure a Network Serial Console Port.

For serial console to be on, a file named use_ttyS0 should exist in root of disk0. It doesn’t matter the content, just to be present. The simplest mode to create such a file is to make a copy of an existing file – the documentation suggest to clone from coredump. cfg file, like shown below:

ciscoasa(config)# cd coredumpinfo

ciscoasa(config)# copy coredump. cfg disk0:/use_ttyS0

Theoretically, here, we can do also some additional configurations, one that we want to keep in all the ASAv instances derived from this template. For example, we can copy here the ASDM image to disk0 to not be bothered with that in the future. Anyway, I will skip this step.

Reload de appliance (type reload in privileged mode). You will see that the command prompt can’t anymore be accessed via de VNC console. I mean, the console will open, but, at one moment the interaction will be handover to the serial console and no more activity going to be possible by VNC. The last message recorded in VNC confirm that: Lina to use serial port /dev/ttyS0 for console IO.

?

Now, after all the modifications to the ASAv image, we can switch the template back to his original Linked mode of operation. Also, we will switch the console settings to telnet type . Do the configuration changes in template settings, not in ASAv instance. The ASAv device from our temporary project can be safety removed, it has already done his job.

Using newly created ASAv template

To use the newly created ASAv template, just drag the template icon to the workspace, do your connections and power-on the device. You can use multiple ASAv devices running simultaneous with no problem, on my PC (i7-4970s CPU with12GB RAM) I ran five concurrent instances, all started ok and became usable shortly (less than 1 min).

Just because we don’t mention –nographic in template’s Advanced Settings – Additional Settings the VNC console will automatically open every time you start the device. If you close that window, the appliance will power-off automatically. The VNC console don’t interfere with serial console which you can open via context menu. If you add the - nographic option, the VM will start silent without a VNC console. Anyway, my preference is to leave the VNC console to open automatically, at least for the begging, just to have an additional visibility of the process.

After you load the ASAv device, you will periodically be announced by a missing license warning message: Warning: ASAv platform license state is Unlicensed … It is because the appliance don’t have a license key applied and it works in unlicensed state. As mentioned above, for lab and test scenarios, an unlicensed state are more than sufficient. In this state, you will get all the ASAv features but at the same time be limited to 100 Kbps interface bandwith.

It is interesting to see what virtual disks files are involved for an ASAv device started from our completed template. Beacause the template was configured as a Linked Mode VM, a linked virtual disk plus the base disk should be used, a fact confirmet by the screen below:

To complete the story, bellow I insterted a screencast for the process described above (youtube link ). Enjoy.

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Comprar Sequinan Generico Sin Receta En Linea, Sequinan

Comprar Sequinan

Dabei ist es wichtig, einen Kon Dieses Dokument ist nur fur den personlichen Gebrauch bestimmt und darf in keiner Form an Dritte weitergegeben werden. Eine Neuerung besteht in der vom Bundesverband der Generico sequinan (risperdal) und Arzte beschlossenen neutralen Beratung, die vor die kunstliche Befruchtung gesetzt wurde. Diese neutrale Beratung sequinan (risperdal) india farmaceutico de formulaciones sowohl medizinische und psychologische als auch soziale Aspekte der kunstlichen Befruchtung sequihan.

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Footwear Duopack Wwfl, Duopack

Footwear DuoPack WWFL

All you need to safely clean and add water repellency to smooth leather footwear.

Clean and waterproof your smooth leather footwear with our convenient Duo-Pack.

Footwear Cleaning Gel is a soap based cleaner which can be used regularly to clean smooth leather footwear without damaging the Durable Water Repellent (DWR) coatings. Use this product instead of conventional detergents or washing powder. Waterproofing Wax for Leather Liquid adds water-repellency and revives breathability to smooth leather. Prolongs the effective lifespan and optimizes the performance of your smooth leather footwear.

Benefits of using this product

Footwear Cleaning Gel

Always apply this product to new and used footwear to keep them in clean condition. We recommend treatment before waterproofing to ensure footwear is clean. To maintain waterproofed footwear always clean with Nikwax Footwear Cleaning Gel.

Waterproofing Wax for Leather Liquid

Always apply this product to new and used footwear to keep them in perfect condition. Use Nikwax Footwear Cleaning Gel before waterproofing footwear and to maintain reproofed items regularly clean with Nikwax Footwear Cleaning Gel.

Ideal for

Footwear Cleaning Gel

All types of footwear, any material and any combination; sports or leisure

Safe to use on footwear with breathable membranes e. g. Gore-Tex, SympaTex, eVENT etc

Waterproofing Wax for Leather Liquid

All full grain leather footwear (work, fashion, leisure and sports)

Safe to use on footwear with breathable membranes e. g. Gore-Tex, SympaTex, eVENT etc

How to apply

Footwear Cleaning Gel

Rinse footwear with clean water to remove loose mud and dampen surface.

Press sponge applicator to break seal

Apply generously over the area to be cleaned

If very dirty use a brush to work in cleaner

Rinse well in clean water.

Waterproofing Wax for Leather Liquid

Brush off dirt with a damp cloth / apply Nikwax Footwear Cleaning Gel to clean

Press sponge applicator on Aqueous Wax to break seal

Apply to wet or dry leather

After 2-3 minutes, wipe away surplus with a clean cloth

Buff with a damp cloth to shine

For light coloured leather always test on a hidden area first. To dry never place in a confined hot area, near radiators and open fires and make sure to put newspaper in the toes of the footwear to maintain shape and remove moisture from the inside while drying.

Choose below to add to your Nikwax cart

Buy Scanarin - Ranitidine - Online Without Prescriptions, Scanarin

Ranitidine (Scanarin)

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.

Customers who bought this product also bought

Amitrid, Amiloride Hcl, Amitrid

Amitrid

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Info

The medicine is indicated in those patients with hypertension or with congestive heart failure who develop hypokalemia when thiazides or other kaliuretic diuretics are used alone, or in whom maintenance of normal serum potassium levels is considered to be clinically important, e. g. digitalized patients, or patients with significant cardiac arrhythmias. The use of potassium-conserving agents is often unnecessary in patients receiving diuretics for uncomplicated essential hypertension when such patients have a normal diet. This medicine may be used alone or as an adjunct to other antihypertensive drugs, such as methyldopa or beta blockers. Since this medicine enhances the action of these agents, dosage adjustments may be necessary to avoid an excessive fall in blood pressure and other unwanted side effects.

Hyperkalemia: This medicine should not be used in the presence of elevated serum potassium levels (greater than 5.5 mEq per liter). Antikaliuretic Therapy or Potassium Supplementation: This medicine should not be given to patients receiving other potassium-conserving agents, such as spironolactone or triamterene. Potassium supplementation in the form of medication, potassium-containing salt substitutes or a potassium-rich diet should not be used with this medicine except in severe and/or refractory cases of hypokalemia. Such concomitant therapy can be associated with rapid increases in serum potassium levels. If potassium supplementation is used, careful monitoring of the serum potassium level is necessary. Impaired Renal Function: Anuria, acute or chronic renal insufficiency, and evidence of diabetic nephropathy are contraindications to the use of MODURETIC. Patients with evidence of renal functional impairment (blood urea nitrogen [BUN] levels over 30 mg per 100 mL or serum creatinine levels over 1.5 mg per 100 mL) or diabetes mellitus should not receive the drug without careful, frequent and continuing monitoring of serum electrolytes, creatinine, and BUN levels. Potassium retention associated with the use of an antikaliuretic agent is accentuated in the presence of renal impairment and may result in the rapid development of hyperkalemia. Hypersensitivity: This medicine is contraindicated in patients who are hypersensitive to this product, or to other sulfonamide-derived drugs.

Amiloride — Body as a Whole: Painful extremities, neck/shoulder ache, fatigability; Cardiovascular: Palpitation; Digestive: Activation of probable pre-existing peptic ulcer, abnormal liver function, jaundice, dyspepsia, heartburn; Hematologic: Aplastic anemia, neutropenia; Integumentary: Alopecia, itching, dry mouth; Nervous System/Psychiatric: Encephalopathy, tremors, decreased libido; Respiratory: Shortness of breath, cough; Special Senses: Increased intraocular pressure, tinnitus; Urogenital: Bladder spasms, polyuria, urinary frequency. Hydrochlorothiazide — Digestive: Pancreatitis, jaundice (intrahepatic cholestatic jaundice), sialadenitis, cramping, gastric irritation; Hematologic: Aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia; Hypersensitivity: Anaphylactic reactions, necrotizing angiitis (vasculitis, cutaneous vasculitis), respiratory distress including pneumonitis and pulmonary edema, photosensitivity, fever, urticaria, purpura; Metabolic: Electrolyte imbalance, hyperglycemia, glycosuria, hyperuricemia; Nervous System/Psychiatric: Restlessness; Special Senses: Transient blurred vision, xanthopsia; Urogenital: Interstitial nephritis.

when this medicine and non-steroidal anti-inflammatory agents are used concomitantly, the patient should be observed closely to determine if the desired effect of the diuretic is obtained. Since indomethacin and potassium-sparing diuretics, including this medicine, may each be associated with increased serum potassium levels, the potential effects on potassium kinetics and renal function should be considered when these agents are administered concurrently. Amiloride HCl: When amiloride HCl is administered concomitantly with an angiotensin-converting enzyme inhibitor, an angiotensin II receptor antagonist, cyclosporine or tacrolimus, the risk of hyperkalemia may be increased. Therefore, if concomitant use of these agents is indicated because of demonstrated hypokalemia, they should be used with caution and with frequent monitoring of serum potassium. Hydrochlorothiazide: When given concurrently the following drugs may interact with thiazide diuretics. Alcohol, barbiturates, or narcotics — potentiation of orthostatic hypotension may occur. Antidiabetic drugs (oral agents and insulin) — dosage adjustment of the antidiabetic drug may be required. Other antihypertensive drugs — additive effect or potentiation. Cholestyramine and colestipol resins — Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively. Corticosteroids, ACTH — intensified electrolyte depletion, particularly hypokalemia. Pressor amines (e. g. norepinephrine) — possible decreased response to pressor amines but not sufficient to preclude their use. Skeletal muscle relaxants, nondepolarizing (e. g. tubocurarine) — possible increased responsiveness to the muscle relaxant. Lithium — generally should not be given with diuretics. Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity. Refer to the package insert for lithium preparations before use of such preparations with this medicine.

Electrolyte Imbalance and BUN Increases: Determination of serum electrolytes to detect possible electrolyte imbalance should be performed at appropriate intervals. Patients should be observed for clinical signs of fluid or electrolyte imbalance: i. e. hyponatremia, hypochloremic alkalosis, and hypokalemia. Serum and urine electrolyte determinations are particularly important when the patient is vomiting excessively or receiving parenteral fluids. Warning signs or symptoms of fluid and electrolyte imbalance, irrespective of cause, include dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, confusion, seizures, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, and gastrointestinal disturbances such as nausea and vomiting. Hyponatremia and hypochloremia may occur during the use of thiazides and other diuretics. Any chloride deficit during thiazide therapy is generally mild and may be lessened by the amiloride HCl component of this medicine. Hypochloremia usually does not require specific treatment except under extraordinary circumstances (as in liver disease or renal disease). Dilutional hyponatremia may occur in edematous patients in hot weather; appropriate therapy is water restriction, rather than administration of salt, except in rare instances when the hyponatremia is life-threatening. In actual salt depletion, appropriate replacement is the therapy of choice. Hypokalemia may develop during thiazide therapy, especially with brisk diuresis, when severe cirrhosis is present, during concomitant use of corticosteroids or ACTH, or after prolonged therapy. However, this usually is prevented by the amiloride HCl component of this medicine. Interference with adequate oral electrolyte intake will also contribute to hypokalemia. Hypokalemia may cause cardiac arrhythmia and may also sensitize or exaggerate the response of the heart to the toxic effects of digitalis (e. g. increased ventricular irritability). Thiazides have been shown to increase the urinary excretion of magnesium; this may result in hypomagnesemia. Amiloride HCl, a component of this medicine, has been shown to decrease the enhanced urinary excretion of magnesium which occurs when a thiazide or loop diuretic is used alone. Increases in BUN levels have been reported with amiloride HCl and with hydrochlorothiazide. These increases usually have accompanied vigorous fluid elimination, especially when diuretic therapy was used in seriously ill patients, such as those who had hepatic cirrhosis with ascites and metabolic alkalosis, or those with resistant edema. Therefore, when this medicine is given to such patients, careful monitoring of serum electrolyte and BUN levels is important. In patients with pre-existing severe liver disease, hepatic encephalopathy, manifested by tremors, confusion, and coma, and increased jaundice, have been reported in association with diuretic therapy including amiloride HCl and hydrochlorothiazide. In patients with renal disease, diuretics may precipitate azotemia. Cumulative effects of the components of this medicine may develop in patients with impaired renal function. If renal impairment becomes evident, medicine should be discontinued.

SOLUTION FOR INJECTION

Doxazosin - Man S Health, Genzosin

Doxazosin is used for treating high blood pressure and treating signs and symptoms of benign prostatic hyperplasia (BPH). Doxazosin is an alpha-blocker. It works by relaxing muscles in the blood vessels, resulting in lowering of blood pressure. In men with BPH, alpha-blockers work by relaxing muscles around the urethra (the tube that drains urine from the bladder), which improves urinary symptoms.

Use Doxazosin as directed by your doctor.

Take Doxazosin by mouth with or without food.

Doxazosin may cause a sudden drop in blood pressure after the first dose. Take your first dose at bedtime. If you get up during the night, sit up slowly, then stand slowly.

If you miss a dose of Doxazosin, 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 Doxazosin.

Store Doxazosin at 77 degrees F (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 Doxazosin out of reach of children and away from pets.

Do NOT use Doxazosin if:

you are allergic to any ingredient of Doxazosin or to similar medicines (eg, prazosin).

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

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

if you are 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 prostate cancer, kidney or liver problems, or high or low blood pressure

if you will be having eye surgery.

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

Phosphodiesterase type 5 inhibitors (eg, sildenafil, vardenafil) because severe low blood pressure may occur

Clarithromycin, HIV protease inhibitors (eg, ritonavir), itraconazole, ketoconazole, nefazodone, telithromycin, or voriconazole because they may increase the risk of Doxazosin's side effects.

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

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

Doxazosin may cause a sudden drop in blood pressure after the first dose. Take your first dose at bedtime. If you get up during the night, sit up slowly, then stand slowly. This will help to reduce your lightheadedness or dizziness. These effects will more likely occur after the first few doses or if your dose has increased, but can occur at any time while you are taking the medicine. It can also occur if you stop taking the medicine and then restart treatment.

Doxazosin 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.

Do NOT take more than the recommended dose without checking with your doctor.

Tell your doctor or dentist that you take Doxazosin before you receive any medical or dental care, emergency care, or surgery (including eye surgery).

Doxazosin may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.

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.

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

Use Doxazosin with caution in the elderly; they may be more sensitive to its effects, especially low blood pressure.

Doxazosin should not be used in children; safety and effectiveness in 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 Doxazosin while you are pregnant. It is not known if Doxazosin is found in breast milk. If you are or will be breast-feeding while you use Doxazosin, check with your doctor. Discuss any possible risks to your baby.

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:

Dizziness; drowsiness; lightheadedness; nasal congestion; tiredness; 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); chest pain; fainting; irregular heartbeat; prolonged, painful erection; severe or prolonged dizziness or headache; shortness of breath; swelling of the ankles, feet, or hands; vision changes.

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.

Doxazosin is used for treating high blood pressure and treating signs and symptoms of benign prostatic hyperplasia (BPH). Doxazosin is an alpha-blocker. It works by relaxing muscles in the blood vessels, resulting in lowering of blood pressure. In men with BPH, alpha-blockers work by relaxing muscles around the urethra (the tube that drains urine from the bladder), which improves urinary symptoms.

Use Doxazosin as directed by your doctor.

Take Doxazosin by mouth with or without food.

Doxazosin may cause a sudden drop in blood pressure after the first dose. Take your first dose at bedtime. If you get up during the night, sit up slowly, then stand slowly.

If you miss a dose of Doxazosin, 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 Doxazosin.

Store Doxazosin at 77 degrees F (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 Doxazosin out of reach of children and away from pets.

Do NOT use Doxazosin if:

you are allergic to any ingredient of Doxazosin or to similar medicines (eg, prazosin).

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

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

if you are 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 prostate cancer, kidney or liver problems, or high or low blood pressure

if you will be having eye surgery.

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

Phosphodiesterase type 5 inhibitors (eg, sildenafil, vardenafil) because severe low blood pressure may occur

Clarithromycin, HIV protease inhibitors (eg, ritonavir), itraconazole, ketoconazole, nefazodone, telithromycin, or voriconazole because they may increase the risk of Doxazosin's side effects.

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

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

Doxazosin may cause a sudden drop in blood pressure after the first dose. Take your first dose at bedtime. If you get up during the night, sit up slowly, then stand slowly. This will help to reduce your lightheadedness or dizziness. These effects will more likely occur after the first few doses or if your dose has increased, but can occur at any time while you are taking the medicine. It can also occur if you stop taking the medicine and then restart treatment.

Doxazosin 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.

Do NOT take more than the recommended dose without checking with your doctor.

Tell your doctor or dentist that you take Doxazosin before you receive any medical or dental care, emergency care, or surgery (including eye surgery).

Doxazosin may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.

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.

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

Use Doxazosin with caution in the elderly; they may be more sensitive to its effects, especially low blood pressure.

Doxazosin should not be used in children; safety and effectiveness in 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 Doxazosin while you are pregnant. It is not known if Doxazosin is found in breast milk. If you are or will be breast-feeding while you use Doxazosin, check with your doctor. Discuss any possible risks to your baby.

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:

Dizziness; drowsiness; lightheadedness; nasal congestion; tiredness; 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); chest pain; fainting; irregular heartbeat; prolonged, painful erection; severe or prolonged dizziness or headache; shortness of breath; swelling of the ankles, feet, or hands; vision changes.

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.

Sarafem Indications, Side Effects, Warnings, Digassim

Sarafem

Generic Name: fluoxetine (floo-OX-e-teen) Brand Name: Sarafem

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using Sarafem outweigh the risks.

Family and caregivers must closely watch patients who take Sarafem. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.

Sarafem is not approved for use in children. Talk with the doctor.

Sarafem is used for:

Treating premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome. It may also be used for other conditions as determined by your doctor.

Sarafem is a selective serotonin reuptake inhibitor (SSRI). It works by restoring the balance of serotonin, a natural substance in the brain, which helps to improve mood.

Do NOT use Sarafem if:

you are allergic to any ingredient in Sarafem

you are taking or have taken linezolid or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine, selegiline) within the last 14 days

you are taking pimozide or thioridazine

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

Before using Sarafem:

Some medical conditions may interact with Sarafem. 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 or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse

if you have a history of seizures, stroke, heart problems, high blood pressure, liver problems, kidney problems, bleeding problems, or diabetes

if you have a certain type of glaucoma (narrow-angle glaucoma) or are at risk of this condition

if you are dehydrated, have low blood sodium levels, or drink alcohol

if you will be having electroconvulsive therapy (ECT)

if you are taking a medicine that contains methylene blue

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

Anorexiants (eg, phentermine), buspirone, fenfluramine derivatives (eg, dexfenfluramine), fentanyl, linezolid, lithium, MAOIs (eg, phenelzine, rasagiline, selegiline), meperidine, methylene blue, metoclopramide, nefazodone, serotonin 5-HT 1 receptor agonists (eg, sumatriptan), sibutramine, SNRIs (eg, venlafaxine), another SSRI (eg, paroxetine), St. John's wort, tramadol, trazodone, or tryptophan because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, or coma, may occur

Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, intranasal ketorolac) because the risk of bleeding, including stomach bleeding, may be increased

Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased

HIV protease inhibitors (eg, ritonavir) because they may increase the risk of Sarafem's side effects

Cyproheptadine because it may decrease Sarafem's effectiveness

Aripiprazole, benzodiazepines (eg, alprazolam), beta-blockers (eg, propranolol), bupropion, carbamazepine, clozapine, digoxin, flecainide, haloperidol, hydantoins (eg, phenytoin), iloperidone, norepinephrine reuptake inhibitors (eg, atomoxetine), phenothiazines (eg, chlorpromazine, thioridazine), pimozide, propafenone, risperidone, tetrabenazine, tricyclic antidepressants (eg, amitriptyline), or vinblastine because the risk of their side effects may be increased by Sarafem

Tamoxifen because its effectiveness may be decreased by Sarafem, which may lead to an increased risk of breast cancer recurrence in women with a history of breast cancer

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

How to use Sarafem:

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

Sarafem comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Sarafem refilled.

Take Sarafem by mouth with or without food.

Taking Sarafem at the same time each day will help you remember to take it.

Continue to take Sarafem even if you feel well. Do not miss any doses.

Do not suddenly stop taking Sarafem without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Sarafem and whenever a change in dose is made.

If you miss a dose of Sarafem, 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 Sarafem.

Important safety information:

Sarafem may cause drowsiness or dizziness. It may also cause you to not be able to make decisions, think clearly, or react quickly. Do not drive or perform other possibly unsafe tasks until you know how you react to Sarafem.

Do not drink alcohol while you are taking Sarafem.

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

Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose, change your dose, or take Sarafem for longer than prescribed without checking with your doctor.

Children and teenagers who take Sarafem may be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who have had suicidal thoughts or actions in the past. The risk may also be greater in patients who have had bipolar (manic-depressive) illness, or if their family members have had it. Watch patients who take Sarafem closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.

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

Serotonin syndrome is a possibly fatal syndrome that can be caused by Sarafem. Your risk may be greater if you take Sarafem with certain other medicines (eg, MAOIs, SSRIs, "triptans"). Symptoms may include agitation; coma; confusion; excessive sweating; fast or irregular heartbeat; fever; hallucinations; nausea, vomiting, or diarrhea; tremor. Contact your doctor at once if you have any of these symptoms.

Certain antidepressants, including Sarafem, may increase the risk of bleeding. Sometimes, bleeding can be life-threatening. Discuss any questions or concerns with your doctor.

Some people may be at risk for eye problems from Sarafem. Your doctor may want you to have an eye exam to see if you are at risk for these eye problems. Call your doctor right away if you have eye pain, vision changes, or swelling or redness in or around the eye.

Severe and sometimes fatal reactions along with a rash have rarely happened with Sarafem. Lung, kidney, or liver problems have also happened. Call your doctor right away if you have a change in the amount of urine passed, dark urine, loss of appetite, upset stomach or stomach pain, pale stools, vomiting, yellowing of the skin or eyes, or shortness of breath.

If your doctor tells you to stop taking Sarafem, you will need to wait at least 5 weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone, thioridazine). Ask your doctor when you should start to take your new medicines after you have stopped taking Sarafem.

Low blood sodium levels may occur from treatment with Sarafem. In severe cases, this can be deadly. Call your doctor right away if you have confusion, decreased coordination, fainting, hallucinations, headache, memory problems, mental or mood changes, seizures, sluggishness, trouble concentrating, or weakness.

Other brands of medicine that contain the same ingredient (fluoxetine) are available. These other brands may be used to treat depression or other mental problems. Do not take Sarafem if you are taking any other medicine that contains fluoxetine. Discuss any questions or concerns with your doctor.

Sarafem should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

Sarafem may cause weight changes. CHILDREN and teenagers may need regular weight and growth checks while they take Sarafem.

PREGNANCY and BREAST-FEEDING: Sarafem may cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Sarafem while you are pregnant. Sarafem is found in breast milk. Do not breast-feed while you are taking Sarafem.

Possible side effects of Sarafem:

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:

Anxiety; diarrhea; dizziness; drowsiness; dry mouth; flu-like symptoms (eg, fever, chills, muscle aches); headache; increased sweating; loss of appetite; nausea; nervousness; runny or stuffy nose; sore throat; trouble sleeping; 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; unusual hoarseness); black or bloody stools; chest pain; confusion; decreased concentration; decreased coordination; decreased sexual desire or ability; exaggerated reflexes; excessive sweating; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; hallucinations; joint or wrist aches or pain; memory problems; new or worsening mental, mood, or behavior changes (eg, depression, anxiety, agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still); persistent or severe ringing in the ears; persistent trouble sleeping; red, swollen, blistered, or peeling skin; seizures; severe or persistent dizziness or headache; severe or persistent nausea, vomiting, diarrhea, or stomach pain; significant weight loss; suicidal thoughts or attempts; tremor; trouble urinating; unusual bruising or bleeding; unusual weakness; vomit that looks like coffee grounds.

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

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center. or emergency room immediately.

Proper storage of Sarafem:

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

General information:

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

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

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

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

This information should not be used to decide whether or not to take Sarafem or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Sarafem. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Sarafem. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using Sarafem.

Review Date: August 8, 2016

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

More about Sarafem (fluoxetine)

Sarafem

Generic Name: fluoxetine (floo-OX-e-teen) Brand Name: Sarafem

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using Sarafem outweigh the risks.

Family and caregivers must closely watch patients who take Sarafem. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.

Sarafem is not approved for use in children. Talk with the doctor.

Sarafem is used for:

Treating premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome. It may also be used for other conditions as determined by your doctor.

Sarafem is a selective serotonin reuptake inhibitor (SSRI). It works by restoring the balance of serotonin, a natural substance in the brain, which helps to improve mood.

Do NOT use Sarafem if:

you are allergic to any ingredient in Sarafem

you are taking or have taken linezolid or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine, selegiline) within the last 14 days

you are taking pimozide or thioridazine

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

Before using Sarafem:

Some medical conditions may interact with Sarafem. 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 or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse

if you have a history of seizures, stroke, heart problems, high blood pressure, liver problems, kidney problems, bleeding problems, or diabetes

if you have a certain type of glaucoma (narrow-angle glaucoma) or are at risk of this condition

if you are dehydrated, have low blood sodium levels, or drink alcohol

if you will be having electroconvulsive therapy (ECT)

if you are taking a medicine that contains methylene blue

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

Anorexiants (eg, phentermine), buspirone, fenfluramine derivatives (eg, dexfenfluramine), fentanyl, linezolid, lithium, MAOIs (eg, phenelzine, rasagiline, selegiline), meperidine, methylene blue, metoclopramide, nefazodone, serotonin 5-HT 1 receptor agonists (eg, sumatriptan), sibutramine, SNRIs (eg, venlafaxine), another SSRI (eg, paroxetine), St. John's wort, tramadol, trazodone, or tryptophan because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, or coma, may occur

Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, intranasal ketorolac) because the risk of bleeding, including stomach bleeding, may be increased

Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased

HIV protease inhibitors (eg, ritonavir) because they may increase the risk of Sarafem's side effects

Cyproheptadine because it may decrease Sarafem's effectiveness

Aripiprazole, benzodiazepines (eg, alprazolam), beta-blockers (eg, propranolol), bupropion, carbamazepine, clozapine, digoxin, flecainide, haloperidol, hydantoins (eg, phenytoin), iloperidone, norepinephrine reuptake inhibitors (eg, atomoxetine), phenothiazines (eg, chlorpromazine, thioridazine), pimozide, propafenone, risperidone, tetrabenazine, tricyclic antidepressants (eg, amitriptyline), or vinblastine because the risk of their side effects may be increased by Sarafem

Tamoxifen because its effectiveness may be decreased by Sarafem, which may lead to an increased risk of breast cancer recurrence in women with a history of breast cancer

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

How to use Sarafem:

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

Sarafem comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Sarafem refilled.

Take Sarafem by mouth with or without food.

Taking Sarafem at the same time each day will help you remember to take it.

Continue to take Sarafem even if you feel well. Do not miss any doses.

Do not suddenly stop taking Sarafem without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Sarafem and whenever a change in dose is made.

If you miss a dose of Sarafem, 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 Sarafem.

Important safety information:

Sarafem may cause drowsiness or dizziness. It may also cause you to not be able to make decisions, think clearly, or react quickly. Do not drive or perform other possibly unsafe tasks until you know how you react to Sarafem.

Do not drink alcohol while you are taking Sarafem.

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

Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose, change your dose, or take Sarafem for longer than prescribed without checking with your doctor.

Children and teenagers who take Sarafem may be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who have had suicidal thoughts or actions in the past. The risk may also be greater in patients who have had bipolar (manic-depressive) illness, or if their family members have had it. Watch patients who take Sarafem closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.

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

Serotonin syndrome is a possibly fatal syndrome that can be caused by Sarafem. Your risk may be greater if you take Sarafem with certain other medicines (eg, MAOIs, SSRIs, "triptans"). Symptoms may include agitation; coma; confusion; excessive sweating; fast or irregular heartbeat; fever; hallucinations; nausea, vomiting, or diarrhea; tremor. Contact your doctor at once if you have any of these symptoms.

Certain antidepressants, including Sarafem, may increase the risk of bleeding. Sometimes, bleeding can be life-threatening. Discuss any questions or concerns with your doctor.

Some people may be at risk for eye problems from Sarafem. Your doctor may want you to have an eye exam to see if you are at risk for these eye problems. Call your doctor right away if you have eye pain, vision changes, or swelling or redness in or around the eye.

Severe and sometimes fatal reactions along with a rash have rarely happened with Sarafem. Lung, kidney, or liver problems have also happened. Call your doctor right away if you have a change in the amount of urine passed, dark urine, loss of appetite, upset stomach or stomach pain, pale stools, vomiting, yellowing of the skin or eyes, or shortness of breath.

If your doctor tells you to stop taking Sarafem, you will need to wait at least 5 weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone, thioridazine). Ask your doctor when you should start to take your new medicines after you have stopped taking Sarafem.

Low blood sodium levels may occur from treatment with Sarafem. In severe cases, this can be deadly. Call your doctor right away if you have confusion, decreased coordination, fainting, hallucinations, headache, memory problems, mental or mood changes, seizures, sluggishness, trouble concentrating, or weakness.

Other brands of medicine that contain the same ingredient (fluoxetine) are available. These other brands may be used to treat depression or other mental problems. Do not take Sarafem if you are taking any other medicine that contains fluoxetine. Discuss any questions or concerns with your doctor.

Sarafem should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

Sarafem may cause weight changes. CHILDREN and teenagers may need regular weight and growth checks while they take Sarafem.

PREGNANCY and BREAST-FEEDING: Sarafem may cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Sarafem while you are pregnant. Sarafem is found in breast milk. Do not breast-feed while you are taking Sarafem.

Possible side effects of Sarafem:

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:

Anxiety; diarrhea; dizziness; drowsiness; dry mouth; flu-like symptoms (eg, fever, chills, muscle aches); headache; increased sweating; loss of appetite; nausea; nervousness; runny or stuffy nose; sore throat; trouble sleeping; 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; unusual hoarseness); black or bloody stools; chest pain; confusion; decreased concentration; decreased coordination; decreased sexual desire or ability; exaggerated reflexes; excessive sweating; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; hallucinations; joint or wrist aches or pain; memory problems; new or worsening mental, mood, or behavior changes (eg, depression, anxiety, agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still); persistent or severe ringing in the ears; persistent trouble sleeping; red, swollen, blistered, or peeling skin; seizures; severe or persistent dizziness or headache; severe or persistent nausea, vomiting, diarrhea, or stomach pain; significant weight loss; suicidal thoughts or attempts; tremor; trouble urinating; unusual bruising or bleeding; unusual weakness; vomit that looks like coffee grounds.

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

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center. or emergency room immediately.

Proper storage of Sarafem:

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

General information:

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

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

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

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

This information should not be used to decide whether or not to take Sarafem or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Sarafem. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Sarafem. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using Sarafem.

Review Date: August 8, 2016

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

More about Sarafem (fluoxetine)

Dermacortine

(Mometasona furoato 0,1%)

DERMACORTINE CREMA: Cada 100 g contienen: Mometasona furoato 0,1 g. Excipientes, c. s.p. 100 g.

DERMACORTINE LOCIÓN: Cada 100 ml contienen: Mometasona furoato 0,1 g. Excipientes, c. s.p. 100 ml.

Corticosteroide tópico. Antiinflamatorio esteroideo tópico.

Aceptado: Alopecia areata; dermatitis atópica, leve a severa; dermatitis de contacto; dermatitis exfoliativa generalizada; dermatitis numular, leve a severa; dermatitis seborreica facial y de zonas de flexión: otras dermatitis, leve a severa; otras dermatosis inflamatorias, leve a severa; granuloma anular; intértrigo; liquen plano; liquen símplex crónico; liquen estriado; lupus eritematoso discoide y cutáneo subagudo; erupción polimórfica leve; mixedema pretibial, necrobiosis lipoídica diabética; penfigoide; pénfigo; pitiriasis rosa; prurito anogenital; prurito senil; psoriasis; queloide, reducción del prurito asociado; sarcoidosis; quemadura solar o xerosis, fase inflamatoria. Mometasona está indicado en el tratamiento de los desórdenes dermatológicos que responden a corticosteroides. Puede ser necesario el uso de tratamiento sistémico o de inyecciones de corticosteroides en las lesiones, de acuerdo al tipo y severidad de la enfermedad o la respuesta inadecuada al tratamiento tópico. Se pueden requerir apósitos oclusivos para tratar los casos severos o crónicos de liquen símplex crónico, psoriasis, ezcema, dermatitis atópica, o ezcema crónico de la mano. Fimosis: Mometasona está indicada en el tratamiento de fimosis en niños.

Carcinogenicidad: No se han realizado estudios de largo plazo en animales para determinar la carcinogenicidad de los corticosteroides tópicos.

Mutagenicidad: Mometasona no ha mostrado capacidad mutagénica en las pruebas de Ames, ensayo de linfoma de ratón ni en el test de micronúcleos.

Embarazo/Reproducción: No se han realizado estudios adecuados y bien controlados en humanos.

Los corticosteroides tópicos no deben ser utilizados en grandes cantidades o por largos períodos en mujeres embarazadas o que planean embarazarse.

Estudios en animales muestran que los corticosteroides tópicos son absorbidos sistémicamente y pueden causar anormalidades fetales, especialmente cuando se aplican en grandes cantidades, con apósitos oclusivos, por periodos largos de tiempo.

Categoría Embarazo FDA: C.

Lactancia: Se desconoce si los corticosteroides tópicos se distribuyen en la leche materna. Sin embargo, no se han documentado problemas en humanos.

Los corticosteroides sistémicos se distribuyen en la leche materna y pueden causar efectos indeseados, como retraso del crecimiento en los niños.

Mometasona no debe ser aplicado en los senos antes de la lactancia.

Pediatría: Los niños y adolescentes tienen una mayor relación de área de superficie de piel respecto al peso corporal, así como una piel de menor grosor y menos desarrollada, lo cual condiciona la absorción de mayores cantidades de corticosteroides tópicos comparados con pacientes de mayor edad. La absorción en niños prematuros es mayor que en nacidos a término debido al desarrollo inadecuado del estrato córneo de la piel.

Se han documentado casos de supresión adrenal, síndrome de Cushing, hipertensión intracraneal y retraso del crecimiento en niños, debido a la absorción sistémica de los corticosteroides tópicos. Por ende, se debe tener especial cuidado con el uso de mometasona tópica en niños y adolescentes en desarrollo, especialmente si hay factores que incrementen la absorción.

Generalmente, la terapia en pacientes pediátricos que dure más de dos semanas, con dosis mayores a una aplicación diaria, deben ser reevaluados cuidadosamente por el médico tratante. Esto es especialmente importante si mometasona tópico se aplica en más de 5 al 10% de la superficie corporal o si se utiliza con apósitos oclusivos. El uso de pañales ajustados o pantalones plásticos se consideran apósitos oclusivos.

Geriatría: Aún cuando no se han realizado estudios apropiados con corticosteroides tópicos en la población geriátrica, se espera que ningún problema geriátrico específico limite la utilidad de mometasona tópico en los adultos mayores. Sin embargo, los pacientes adultos mayores pueden ser más propensos a presentar una atrofia de piel secundaria al envejecimiento. Así mismo son más propensos a presentar púrpura y laceraciones de piel (que afectan el tejido celular subcutáneo hasta la fascia profunda), con el uso de corticosteroides tópicos. Por ende, el uso de corticosteroides tópicos debe ser infrecuente, por periodos cortos, o bajo cuidadoso control médico en pacientes con atrofia de piel preexistente.

Alteraciones de exámenes auxiliares: Los siguientes ejemplos han sido incluidos basados en su potencial significancia clínica:

Valores fisiológicos: Conteo total de eosinófilos (puede disminuir si la concentración de cortisol plasmático disminuye).

Glucosa (debido a la actividad hiperglicémica intrínseca de los corticosteroides, la concentración de glucosa en sangre y orina puede elevarse si se presenta una considerable absorción sistémica del corticosteroide tópico).

Función del sistema hipotalámico-pituitario adrenal (HPA), evaluado con:

Hormona Adrenocorticotrópica (ACTH, corticotropina).

Cortisol urinaria (24 horas).

17-hidroxicorticosteroides, orina (24 horas) (pueden disminuir si hay una absorción considerable de corticosteroides, especialmente en niños).

CONTRAINDICACIONES: Las siguientes contraindicaciones han sido incluidas basadas en su potencial significancia clínica:

• Excepto bajo circunstancias especiales este fármaco no debe ser usado si el siguiente problema médico existe: Hipersensibilidad a mometasona, a alguno de los componentes de la formulación o a cualquier otro corticosteroide.

Riesgo-beneficio debe ser considerado cuando existan los siguientes problemas médicos:

• Infección de la zona de aplicación.

• Atrofia de piel preexistente.

Si se presenta una absorción considerable:

Monitoreo: Es necesario monitorizar los siguientes valores para evaluar la continuidad del tratamiento:

Evaluación de la función adrenal, incluyendo la concentración sanguínea y urinaria de cortisol o la prueba de estimulación de ACTH (se recomienda realizar una monitorización periódica durante y después de un tratamiento prolongado o si se presentan factores que incrementan la absorción percutánea).

Las siguientes reacciones adversas han sido incluidas basadas en su potencial significancia clínica:

Necesitan atención médica:

• Incidencia menos frecuente o rara: Alergia de contacto; dermatitis; foliculitis; furunculosis; pústulas; piodermia; vesículas; hiperestesia; parestesias de dedos; púrpura; atrofia de piel, infección de la piel, secundaria; descamación epidermal; telangiectasia.

• Incidencia rara: Por el uso prolongado o con factores que incrementan la absorción: Erupciones acniformes; catarata posterior subcapsular; síndrome de Cushing; dermatitis perioral; equimosis; edema; úlcera gástrica; glaucoma secundario; hirsutismo o hipertricosis; hipertensión; síndrome hipocaliémico; hipopigmentación u otros cambios en la pigmentación de la piel; infección reagudizada; miliaria rubra; decepción de proteínas; laceración de piel; maceración de piel; estrías; atrofia del tejido celular subcutáneo; pérdida inusual de pelo.

Necesitan atención médica sólo si persisten o son molestosos:

• Incidencia menos frecuente o rara: Quemazón, sequedad, irritación, prurito o enrojecimiento de la piel, leve y persistente. Incremento del enrojecimiento o tamaño de las lesiones de piel, leve y persistente. Rash cutáneo, leve y persistente.

No necesitan atención médica: Punzadas, leve y temporal.

DOSIS Y VÍA DE ADMINISTRACIÓN

• Dosis usual en adultos: Vía tópica, directamente a la piel, una vez al día.

• Dosis pediátrica usual: No ha sido establecida.

• Dosis usual en adultos: Vía tópica, directamente a la piel, una vez al día.

• Dosis pediátrica usual: No ha sido establecida.

• Únicamente para uso externo.

• Mantener alejado de los ojos.

• No usar apósitos a menos que el médico tratante lo indique.

• No usar en la cara, región inguinal o axila a menos que el médico tratante lo indique.

• Si pierde una dosis, aplíquela tan pronto como sea posible, a menos que esté cerca de la siguiente dosis.

Para mayor información sobre el manejo de la sobredosis o ingestión no intencional, contacte el Centro de Control de Envenenamientos.

Efectos clínicos de la sobredosis: Los siguientes efectos han sido seleccionados basados en su potencial significancia clínica: Crónico: Hiperadrenalismo.

Tratamiento de la sobredosis:

Para la sobredosis tópica crónica: Debido a que no existe un antídoto específico, el tratamiento es sintomático, de soporte, y consiste en discontinuar el tratamiento de corticosteroides tópicos. Puede ser necesario un retiro gradual de la preparación.

Para la sobredosis oral aguda: Debido a que no existe un antídoto específico y no se presentan efectos adversos serios, el tratamiento consiste en la dilución con fluidos.

DERMACORTINE CREMA: Caja que contiene un tubo x 15 y 30 g.

DERMACORTINE LOCIÓN: Caja que contiene un frasco x 30 ml.

Arbofarma S. A. Cra. 43 B N? 18-50. Bogotá D. C. Colombia

Scandinavia Pharma Ltda. Bogotá D. C. Colombia

LABORATORIOS ROEMMERS S. A.

Jr. Faustino Sánchez Carrión 425, Magdalena del Mar. Telf. 462-1616 Lima 17-Perú

Kolosai 4, Sisipac Ac ?elia (Kgf), Mozoc

Kolosai 4 KGF [abbreviation] подготовлено для Вас [publisher] Подробнее.

1 Ic galeŋ ini imi onac muru acguc kurumeŋiguc kuneŋgina kecʒac imi nimma weleŋ qeqe hécgina haka dindiŋanec ʒéma séc momacnec waŋ énécmimu.

Pakeŋ ac toroqeqeya.

2 Ini nalé séc seliseli wamma ʒéwelec ai mema imuac qeriaiguc ewa hia ac ézéma kicɋeli kecmu. 3 Waŋu nonac niŋac momacnec ʒéwelecma Anutunéŋ héna ac énézéwiŋ niŋac naguya aunénécmiyu Kristoac ac saŋa Anutunéŋ ʒéau nénécmiyec imi ʒéau énécmiwiŋ niŋac ʒéwelecmu. Ni ai imuac mia seŋ hésanéŋ ɋaté néŋgic kecanʒua. 4 Ini Anutu imuhuc ʒéwelec wammigic neŋ ac saŋa imi ʒémaŋac hezac séc ʒéau énécmimaŋ. 5 Ini niŋtegic qiŋtegic ginaguc tacyac wammu. Imuhuc wamma séŋgaŋgeŋ ic ionac imi nalé eŋ ménda aumu. 6 Acgina imi nalé séc seinéŋ naecmima siŋa mehiaruanʒu ésécnec goi héihéiiguc wammu. Imuhuc wamma ic méŋac méŋ, ac taséya dimuhuc meleŋmigic hia wammac imi niŋasarimu.

7 Tikikonéŋ nenac ac suruc imi waŋ énécmiyu nindacmu. Ic imi nuac ala sorocna ʒéma ai ic solaŋa inéŋ Miŋ Kewuninawac qeriaiguc nekawu weleŋ qeqe ic wamma kecʒic. 8 Ic imi nonac qerininawac hénia ʒéasarima ewa qerigina mebélacgé énécmimac niŋac ai imuac mia méliwa onac muru hazac. 9 Waŋu ai ic héla ala sorocnina Onesimo imi momacnec méli érécmizua. Ic imi onac murunec hayec. Waŋu iereŋ imi yomuac ac suruc imi mocʒoŋ waŋ énécmidacmaoc.

10 Waŋu niguc momacnec hésa ic noropocgic kekera Aristako ʒéma Banaba newura Maka (Mareko yomuac biaŋac ara ʒéwa ninʒu imuac ic yomi hamaciguc hérémimu.) ʒéma 11 Yesu Yusito ʒémimia ieneŋ acguc yaiʒézé ac énézézu. Ieneŋ ic tuŋ séwi tasé hericheric ginaguc ionac murunec, waŋu ai momac hécna wanʒu. Ieneŋ sac Anutuac héŋgaleŋ ama areŋa yandawac momacnec ai meanʒu imuac ic imuhucya eneŋ imi ewana mehiaru néŋgic. 12 Ic méŋ onac murunec hahaya Kristo Yesuac weleŋ qeqe ic Epafira inéŋ acguc yaiʒézé ac énézézac. Inéŋ nalé séc onac wamma ʒéwelecmima ini Anutuac ewa siŋiguc solaŋanima selianec ninʒéŋgéma nammu niŋac ʒéwelecanʒac. 13 Ni ic imuac héipuc ac ʒéwa niŋgic. Ic imi onac ʒéma ic embac Laodikea baeciguc kecʒu ionac ʒéma ic embac Hierapolia ama areŋa yandaiguc kecʒu ionac niŋ wamma ai kuneŋ yanda meanʒac. 14 Ala sorocnina dokta Luka ʒéma Dema acguc yaiʒézé ac énézézaoc. 15 Dacmuna hécna Laodikea ama areŋa yanda igucnec ʒéma ninʒéŋ ninʒéŋ nauŋnina Numfa ʒéma iwac amaiguc hénaoriŋ tocgéanʒu ionac nuac yaiʒézé acna énézégic nimmu. 16 Kiwi yomi sucginaiguc oloŋgic tecgéyu Laodikea hénaoriŋ énézégic olommu waŋu kiwi méŋ Laodikea igucnec hamac imi ini imuhucnec oloŋnimmu. 17 Waŋu Akipoac mia miŋ kewuninawac qeriaiguc ai buŋa qemiyu késayec imi meyacgéna ʒéma ézému.

18 Ni Paolo mérananéŋ oma yaiʒézé ac énézézua. Ni seŋ hésanéŋ ɋaténéŋgic kecanʒua imi niŋɋelima kecgic. Anutuac ewa hianéŋ onac muru hemac.

Buy Stiefotrex Isotretinoin Online Without Prescriptions, Stiefotrex

Accutane (Stiefotrex)

Accutane is given to patients for treating severe acne that do not respond to other medicines. Accutane is a retinoid. It works by reducing skin oil production, changing the characteristics of the skin oil, and preventing abnormal hardening of the skin.

Use Accutane as directed by your doctor.

Take Accutane by mouth with food.

Swallow the capsule with a full glass of water or other liquid. Do not break, crush, chew, or suck on the capsule before swallowing. This will help prevent the medication inside the capsule from irritating your throat.

For best results, take Accutane regularly. Taking Accutane at the same time each day will help you remember to take it.

If you miss a dose of Accutane, 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 Accutane.

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

Active Ingredient: Isotretinoin.

Do NOT use Accutane if:

you are allergic to any ingredient in Accutane

you are pregnant, planning to become pregnant, or become pregnant while taking Accutane

you are breast-feeding

you are taking tetracycline antibiotics or vitamin A-type medicines (eg, etretinate, vitamin A).

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

Some medical conditions may interact with Accutane. 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 woman and unable to use 2 effective forms of birth control or avoid sexual intercourse

if you have diabetes, a family history of diabetes, high blood cholesterol or triglyceride levels, psychiatric disorders, suicidal thoughts, liver disease, pancreatitis, a bone loss condition (eg, osteoporosis), decreased bone density, an eating disorder, severe diarrhea, rectal bleeding, hearing problems, ringing in the ears, or stomach pain.

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

Tetracyclines because of the risk of increasing pressure in the brain

St. John's wort because of risk of failure of hormonal contraceptives (eg, birth control pills)

Vitamin A-type medicines (eg, etretinate, vitamin A) because they may increase the risk of Accutane's side effects

Corticosteroids (eg, prednisone) or phenytoin because the risk of their side effects may be increased by Accutane

Progestin-only birth control (eg, "mini-pill") because its effectiveness may be decreased by Accutane.

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

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

A sudden decrease in night vision may occur while you are taking Accutane. Use caution when driving at night and avoid driving at night if you experience decreased night vision.

If you wear contact lenses, you may have difficulty wearing them during and after therapy.

Do not give blood while taking Accutane and for 1 month after stopping taking Accutane.

Do not drink alcohol while taking Accutane.

Worsening of acne may occur during the first part of therapy. This does not suggest failure or a need to stop the medicine.

To prevent cracking of lips, use a lip moisturizer or balm.

Do not have cosmetic procedures to smooth your skin, including waxing, dermabrasion, or laser procedures, while you are taking Accutane and for at least 6 months after you stop. Accutane can increase your chance of scarring from these procedures.

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

Some patients, while taking Accutane or soon after stopping it, have become depressed or developed serious mental problems. Stop using Accutane and tell your health care provider right away if you have any of these symptoms: feeling sad or having crying spells; feeling anxious; becoming more irritable, angry, or aggressive than usual; losing pleasure or interest in social or sports activities; sleeping too much or too little; changes in weight or appetite; feeling like you have no energy; having trouble concentrating; having thoughts about taking your own life or hurting yourself (suicidal thoughts).

Tell your health care provider if you plan vigorous physical activity (sports) during treatment with Accutane.

Sexually active women of childbearing age must use 2 effective forms of birth control at least 1 month before starting therapy, during therapy, and for 1 month after stopping the medicine. Your health care provider should conduct pregnancy tests on a monthly basis while you are taking Accutane.

Certain birth control pills (progestin-only pills, "mini pills") that do not contain estrogen may not be as effective while you are taking Accutane.

You should not take the herbal supplement St. John's wort because it makes birth control pills less effective.

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

Lab tests, including pregnancy tests, cholesterol and lipid levels, liver function, blood sugar levels, and white blood cell counts, may be performed while you use Accutane. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Accutane should not be used in children younger than 12 years old; safety and effectiveness in these children have not been confirmed.

Pregnancy and breast-feeding: Do not become pregnant. Accutane can cause serious birth defects, miscarriage, early birth, or death of the fetus. If you have sex at any time without using 2 forms of effective birth control, become pregnant, think you may be pregnant, or miss your menstrual period, stop using Accutane and call your health care provider. Do not breast-feed while taking Accutane and for 1 month after stopping Accutane. Accutane may pass through your milk and harm the baby.

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:

Abnormal hair growth; abnormal skin sensations; bleeding and redness or swelling of the gums;changes in menstrual flow; chapped lips; decreased tolerance to contact lenses; dizziness; dry eyes and mouth; dry nose that may lead to nosebleeds; dry or peeling skin; fatigue; flushing; general body discomfort; hair thinning; headache; itching; lack of energy; nervousness; respiratory tract infection; sleeplessness; sweating; temporary worsening of acne; voice changes.

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); bizarre, aggressive, or violent behavior; bowel pain; chest pain or pounding in the chest; dark urine; depression; difficult or painful swallowing; difficulty moving; excessive thirst or urination; fainting; fast heartbeat; fever; fractured or weak bones; hearing problems or ringing in the ears; increased pressure in the brain (pressure in the eye; nausea; vision changes; vomiting); joint or back pain; leg swelling; muscle weakness with or without pain; nausea; new or worsening heartburn; rectal bleeding; red patches or bruises on the legs; shortness of breath; seizures; severe birth defects; severe diarrhea; severe headache; skin infection; slurred speech; stomach pain or tenderness; stroke; stunted growth in children; sun sensitivity; swelling of the pancreas (fever; increased heartbeat; nausea; stomach tenderness; vomiting); swollen glands; thoughts of suicide; tightness in the lungs; vision changes; vomiting; weakness; yellowing of the skin or eyes.

Overdose symptoms may include headache, dizziness, vomiting, stomach pain, warmth or tingling under the skin, swelling of the lips, and loss of balance or coordination.

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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Diflucan - Anti Fungal, Anfasil

Product Description Common use Diflucan is an anti-fungal antibiotic which is used to treat fungal infections called candidiasis. This medication is prescribed for the treatment of such type of infections as vaginal, throat and fungal infections, infections of the urinary tract, peritonitis, and pneumonia. Diflucan works by killing sensitive fungi by interfering with the formation of the fungal cell membrane.

Dosage and direction Take it orally once a day, with or without food using the measuring spoon. Take it at the same time each day with a full glass of water if you want to get the best result. Diflucan make you feel better after 24 hours. However, your symptoms will go away completely just after few days. If there is no change in your health after a few days consult your doctor immediately. The dosage for adults may vary from type of infection: 1) Genital thrush - 150mg as a single dose 2) Mucosal thrush - dose depends on where the infection is located 50mg once daily during month. 3)Fungal skin infections - 50mg once daily for 2-4 weeks ; 4) Internal fungal infections 400mg on the first day then 200-400mg once daily for 6-8 weeks or longer if needed. 5) To stop you from getting fungal infections - 50-400mg once daily while you have risk to get an infection; 6) To stop infection caused by Cryptococcus from coming back - 100-200mg once daily indefinitely The dosage for children 4 weeks to 15 years old may also vary from type of infection: 1) mucosal infections - 3mg/kg once daily; 2)internal fungal infections - 6-12mg/kg once daily; 3)prevention of fungal infections - 3-12mg/kg once daily while at risk of getting an infection. For children 2-4 weeks old it is same dose as above but given once every 2 days. A maximum dose of 12mg/kg every 2 days. For children less than 2 weeks old it is same dose as above but given once every 3 days. Do not give more then 12mg/kg every 3 days. Note: this instruction presented here is just for review. It's very necessary to consult your doctor before using. It will help you to get best results.

For vaginal yeast infections, doctors usually prescribe a single dose of Diflucan. If the yeast infection does not improve after 5 days, contact your doctor as soon as possible. Be careful with this medication if your medical history include liver disease or kidney disease. Although uncommon, this drug may make you dizzy, so be more attentive while you are driving or using machinery. Limit alcohol intake. Diflucan should not be used during pregnancy, lactation or if you plan to become pregnant without a doctor's advice. Do not use before breast-feeding without a doctor's advice.

Contraindications Diflucan is not allowed to people who have hypersensitivity to Fluconazole or other anti fungal azole preparations, eg clotrimazole, ketoconazole, itraconazole and other. Also Diflucan contraindicated in: Kidney and liver disorders; Cardiovascular diseases including heart diseases(heart rate or rhythm disturbances); Low blood levels of calcium, magnesium or potassium.

Possible side effect

They may include an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Also the most possible side effects include: nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); fever, chills, body aches, flu symptoms; severe blistering, peeling, and red skin rash; easy bruising or bleeding, unusual weakness; or seizure (convulsions). Less serious include: mild nausea, vomiting, diarrhea, or upset stomach; headache; dizziness; unusual or unpleasant taste in your mouth; or skin rash or itching. If you experience one of them stop using Diflucan and tell your doctor as soon as possible. Also consult your doctor about any side effect that seems unusual.

Drug interaction Diflucan interact with such medication as: a blood thinner such as warfarin (Coumadin) cyclosporine (Gengraf, Sandimmune, Neoral); an oral diabetes medicine such as glipizide (Glucotrol), glyburide (Diabeta, Micronase, Glynase), tolbutamide (Orinase), tolazamide (Tolinase), chlorpropamide (Diabinese), and others; rifabutin (Mycobutin) or rifampin (Rifadin, Rifater, Rifamate, Rimactane); a sedative such as diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax), or midazolam (Versed); seizure medication such as phenytoin (Dilantin) or valproic acid (Depakene); tacrolimus ((Prograf); theophylline (Theo-Dur, Theolair, Theochron, Elixophyllin, Slo-Phyllin, others). Also note that interaction between two medications does not always mean that you must stop taking one of them. Usually it affects the the effect of drugs, so consult your doctor about the way these interactions are being managed or should be managed.

Missed dose If you forgot to take your dose in time, please do it as soon as you remember. But do not take if it is too late or almost time for your next dose. Do not take double or extra doses. Take your usual dose next day in the same time.

Overdose Symptoms of Diflucan overdose may include: confusion or unusual thoughts or behavior. If you experience one of them call your doctor immediately.

Storage Store at room temperature between 59-77 degrees F (15-25 degrees C) away from light and moisture, kids and pets. Do not use after expiration term.

Disclaimer We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information on 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.

Rainier Beer, Ranir

Rainier beer brings together nature’s bounty from the great Northwest. Pure spring waters combine with golden barley and verdant hops to produce a beer rich in taste and texture. Fermented slowly with a pedigree yeast culture under tightly controlled conditions, Rainier comes forth with a satisfying malty flavor over a slightly fruity background, spiced with Chinook, Mt. Hood, and Willamette hop notes.

Pale Mountain Ale

Rainier Brewing Company has been committed to brewing and offering the finest mountain fresh beers since 1878. Rainier Pale Mountain Ale is no exception. Made with two-row barley to provide a solid malt backbone and hopped with Yakima Valley hops, this light-bodied Pale Ale is well balanced with a crisp, citrus finish.

The Rainier Story is one of a pioneer city and an entrepreneurial family of legendary proportions. Seattle, the major metropolis of the Pacific Northwest, grew up fast as a center of the lumber and fishing industries. The loggers and fishermen grew thirsty and the brewing industry naturally followed. A. B. Rabbeson started Seattle’s first commercial brewing, Washington Brewery.

Rabbeson’s establishment became the Seattle Brewery in 1872, which survived until 1888.

In 1878 Rainier beer was launched – 11 years before Washington became a state.

The brand name became so ubiquitous, that many people once subscribed to the urban legend that the snowcapped 14,410-foot mountain visible from Seattle was named after the beer.

In 1883, John Kopp and Andrew Hemrich, founders of Seattle Brewing and Malting, acquired Rabbeson’s brewery, and with it, the Rainier heritage.

When Prohibition ended in the United States in 1933, Fritz and Emil came south to acquire Seattle Brewing and Malting, which had not yet resumed production of beer. The Rainier brand name was proudly re-launched.

Although the Sick empire had all but disappeared by the end of the 1960s, the 1970s brought forth decades of humorous Rainier advertising. The most memorable include the Grazing Rainiers, the original “Rainier Beer” croaking frogs, the “Rainier Beer” revving motorcycles, and pop culture parodies including early commercials featuring Mickey Rooney as a singing Mountie.

Often referred to as “Vitamin-R” by local fans, Rainier continues growing in popularity as new generations of proud Northwesterners adopt a brand that is truly committed to supporting their communities.

To celebrate and reaffirm our commitment to Rainier heritage, the classic design elements of past Jubilee Cans were brought back this holiday season with updated slogans, colors, and typography to tip our hats to the cans of decades-past.

The original “R” sat perched on the brewery for nearly 50 years, lighting the Seattle sky and serving as a warm welcome to those entering the city via I-5. On October 24 th. after a 13-year absence, the “R” was restored and placed looking back over Seattle, where it belongs. We celebrate the return of the Rainier “R”, Rainier Brewing Company and our rich heritage in the Pacific Northwest annually each October.

Rainier Brewing announced it will bring brewing operations back to its home state of Washington for the first time in 13 years. In partnership with Craft Brewing Alliance, Rainier utilize the Redhook brewery facility. This exciting new partnership will allow Rainier to continue to innovate and create new products in the future.

Rainier will begin brewing Rainier Pale Mountain Ale. Inspired by pale ales made by Rainier Brewing Company just after Prohibition, Rainier Pale Mountain Ale is handcrafted with two-row barley to provide a solid malt backbone and hopped with Washington-grown hops. This delicious Mountain Ale is well balanced with a crisp, citrus finish.

The Rainier Story is one of a pioneer city and an entrepreneurial family of legendary proportions. Seattle, the major metropolis of the Pacific Northwest, grew up fast as a center of the lumber and fishing industries. The loggers and fishermen grew thirsty and the brewing industry naturally followed. A. B. Rabbeson started Seattle’s first commercial brewing, Washington Brewery.

Rabbeson’s establishment became the Seattle Brewery in 1872, which survived until 1888.

In 1878 Rainier beer was launched – 11 years before Washington became a state.

The brand name became so ubiquitous, that many people once subscribed to the urban legend that the snowcapped 14,410-foot mountain visible from Seattle was named after the beer.

In 1883, John Kopp and Andrew Hemrich, founders of Seattle Brewing and Malting, acquired Rabbeson’s brewery, and with it, the Rainier heritage.

When Prohibition ended in the United States in 1933, Fritz and Emil came south to acquire Seattle Brewing and Malting, which had not yet resumed production of beer. The Rainier brand name was proudly re-launched.

Although the Sick empire had all but disappeared by the end of the 1960s, the 1970s brought forth decades of humorous Rainier advertising. The most memorable include the Grazing Rainiers, the original “Rainier Beer” croaking frogs, the “Rainier Beer” revving motorcycles, and pop culture parodies including early commercials featuring Mickey Rooney as a singing Mountie.

Often referred to as “Vitamin-R” by local fans, Rainier continues growing in popularity as new generations of proud Northwesterners adopt a brand that is truly committed to supporting their communities.

To celebrate and reaffirm our commitment to Rainier heritage, the classic design elements of past Jubilee Cans were brought back this holiday season with updated slogans, colors, and typography to tip our hats to the cans of decades-past.

The original “R” sat perched on the brewery for nearly 50 years, lighting the Seattle sky and serving as a warm welcome to those entering the city via I-5. On October 24 th. after a 13-year absence, the “R” was restored and placed looking back over Seattle, where it belongs. We celebrate the return of the Rainier “R”, Rainier Brewing Company and our rich heritage in the Pacific Northwest annually each October.

Rainier Brewing announced it will bring brewing operations back to its home state of Washington for the first time in 13 years. In partnership with Craft Brewing Alliance, Rainier utilize the Redhook brewery facility. This exciting new partnership will allow Rainier to continue to innovate and create new products in the future.

Rainier will begin brewing Rainier Pale Mountain Ale. Inspired by pale ales made by Rainier Brewing Company just after Prohibition, Rainier Pale Mountain Ale is handcrafted with two-row barley to provide a solid malt backbone and hopped with Washington-grown hops. This delicious Mountain Ale is well balanced with a crisp, citrus finish.

Fixacep, Fixacep

Fixacep

Important Notice: The Drugs. com international database is in BETA release. This means it is still under development and may contain inaccuracies. It is not intended as a substitute for the expertise and judgement of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that the use of any medication in any country is safe, appropriate or effective for you. Consult with your healthcare professional before taking any medication.

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FIXACEP

Tab Dws & anak >12 tahun atau >50 kg 400 mg 1 x/hari atau 200 mg 2 x/hari. GO, uretritis. & servisitis 400 mg dosis tunggal. Sir Anak <12 thn 8 mg/kg BB/hari dosis tunggal atau dalam 2 dosis terbagi (4 mg/kg BB) tiap 12 jam. Tetes Dws & anak >30 kg 50-100 mg. Infeksi lebih berat atau membandel Dosis dapat ditingkatkan hingga 200 mg. Anak 1.5-3 mg/kg BB. Infeksi lebih berat atau membandel Dosis dapat ditingkatkan hingga 6 mg/kg BB. Dosis diberikan 2 x/hari. Demam tifoid 10-15 mg/kg BB/hari selama 2 minggu. GO servikal /uretral tak terkomplikasi 400 mg sebagai dosis tunggal.

Sebaiknya diberikan bersama makanan.

Superinfeksi pada penggunaan jangka lama. Gangguan fungsi ginjal ; dialisis peritoneal & hemodialisis. Riwayat hipersensitivitas terhadap penisilin; riwayat alergi seperti asma bronkial, ruam kulit. urtikaria. & bentuk alergi lain. Nutrisi oral yang buruk, sedang mendapat nutrisi parenteral. lanjut usia & individu dalam kondisi lemah. Anak <6 bln. Hamil & laktasi.

Neck Pillow, Pronex

Get 10% Off when You Spend Over $100, Discount Code NPR10

Click to enlarge image(s)

Home Neck Traction that is Comfortable Safe and Effective

The Gold Standard for Home Neck Traction Units is the Pronex Cervical Traction Unit. This home neck traction unit comes in different sizes so that you can get the cervical unit that fits you perfectly. If you suffer from chronic neck pain due to a herniated disc, bulging disc or degenerated disc, then consider the Pronex Pneumatic Cervical traction unit.

Features of the Pronex Pnematic Cervical Traction Device

Supports the natural "C" curve in the cervical Spine

Works at the cause of stiffness in the neck, neck pain and neck achiness

Does not aggravate the TMJ joint

Simple to Use, Comfortable and Non Threatening

Portable, Convenient - the Pronex requires no assembly, no weights, no pulley system, no cables, and no springs or levers

Beautifully crafted and built to last. Made in the United States

Provides an even distraction in the anterior and posterior cervical discs

Helps Patients in breaking the chronic Pain Cycle

Indications for Using the Pronex Pneumatic Cervical Tration Neck Unit:

Pain or stiffness when moving neck

Numbness and Tingling in the hands or arms

Weakness in hands or arms

Pain and/or numbness in shoulders

Pain or numbness in chest

Arm Pain

Shooting Pains from the Neck

Pain between shoulders

Muscle spasms in neck or shoulders

Herniated Disc in the neck

Slipped Disc in the neck

Bulging Disck in the neck

Degeneration of the cervical discs in the neck

Headaches

Loss of the Neck Curve (aka loss of cervical lordosis, military neck)

How does the Pronex Pneumatic Cervical traction unit Work? The Pronex Pneumatic Cervical Traction unit is special because it cradles the reclining patient's head and neck on two soft foam cushions. One cushion supports the occiput (base of the head) and the other rests against the upper trapezius (upper shoulder area). An air-inflated bellows between them and provides more than 20 lbs of continuously adjustable traction. As the bellows expands, it lifts the head upward supporting the cervical curve and maintaining an even distraction (stretch) in the anterior (front) and posterior (back) cervical discs. Patients have total control over the amount of traction applied. Squeezing an inflator bulb increases the pressure, a release knob gently reduces it. There's no strain on the temporomandibular joint (TMJ).

Sizes Available for the Pronex Traction Unit . Regular, Large and Wide How to Determine What Size of Pronex Pneumatic Neck Traction You Will Need

Measurement of Neck Circumference

Size you should Order

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Regular, Large and Wide

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Thank you for visiting us at the Neck Pain Relief Shop. We always trying to help you get the best product that you need for your pain and discomfort. Whether you suffer from an acute condition or have chronic pain, we have many pain relief products to help you live your life as best as possible. There are many neck pillows available on the market today. Only one is going to to be right for YOU. Choosing the right one will make all the difference in the world. Same goes for sleeping aids, hot and cold therapy products, neck traction units, and even positioning products. If you need help making the right decision about what pain relief product is best for your, contact us via email or telephone.

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Leader For Regional Sustainability, Forterra

What We Do

With land as our lens—how we live, work and play on it—Forterra aims for solutions.

A decade ago Forterra launched the Agendas, nationally recognized road maps for building a sustainable region into the next century. Guided by these plans, Forterra brought about powerful, practical and positive change by conducting land transactions, stewarding land, engaging communities and conceiving and advancing forward-thinking policies. Today we continue to focus on land—from our most urban cities to our most majestic places—as a catalyst for change. We think boldly, ask ‘What if?’ and answer strategically to get results.

View of Mt, Rainier from Keechelus Ridge

Photo by Charlie Raines

In a given geography, we ask how we can address the important connections between people and land, and work to revitalize all our communities—bridging the gaps between city and rural town, working lands and wild lands. The outcome of this work is the enhancement and sustainability of the lands and communities along our great natural corridors.

We use our expertise in land—negotiation, acquisition, land banking—to help communities gracefully accommodate new growth and create a high quality of life for all residents. Through our work with cities, landowners and community partners we envision new uses for land in community hubs and work with financial institutions and developers to build healthy, green mixed-use projects.

Voices of the region is a two way conversation. We do what we do well—convene and listen to all sides and all parties to distill a compelling vision that achieves broad support. You do what you do well—care, consider and work for solutions.

Edemox Generic Name Acetazolamide Online, Edemox

Edemox General Information

Edemox - Pharmacology:

The anticonvulsant activity of Edemox may depend on a direct inhibition of carbonic anhydrase in the CNS, which decreases carbon dioxide tension in the pulmonary alveoli, thus increasing arterial oxygen tension. The diuretic effect depends on the inhibition of carbonic anhydrase, causing a reduction in the availability of hydrogen ions for active transport in the renal tubule lumen. This leads to alkaline urine and an increase in the excretion of bicarbonate, sodium, potassium, and water.

Edemox for patients

Adverse reactions common to all sulfonamide derivatives may occur: anaphylaxis, fever, rash (including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis), crystalluria, renal calculus, bone marrow depression, thrombocytopenic purpura, hemolytic anemia, leukopenia, pancytopenia, and agranulocytosis. Caution is advised for early detection of such reactions and the drug should be discontinued and appropriate therapy instituted.

In patients with pulmonary obstruction or emphysema where alveolar ventilation may be impaired, DIAMOX, which may precipitate or aggravate acidosis, should be used with caution.

Gradual ascent is desirable to try to avoid acute mountain sickness. If rapid ascent is undertaken and DIAMOX is used, it should be noted that such use does not obviate the need for prompt descent if severe forms of high altitude sickness occur, ie, high altitude pulmonary edema (HAPE) or high altitude cerebral edema.

Caution is advised for patients receiving concomitant high-dose aspirin and DIAMOX, as anorexia, tachypnea, lethargy, metabolic acidosis, coma, and death have been reported.

Both increases and decreases in blood glucose levels have been described in patients treated with acetazolamide. This should be taken into consideration in patients with impaired glucose tolerance or diabetes mellitus.

Edemox treatment may cause electrolyte imbalances, including hyponatremia and hypokalemia, as well as metabolic acidosis. Therefore, periodic monitoring of serum electrolytes is recommended. Particular caution is recommended in patients with conditions that are associated with, or predispose a patient to, electrolyte and acid/base imbalances, such as patients with impaired renal function (including elderly patients), patients with diabetes mellitus, and patients with impaired alveolar ventilation.

Some adverse reactions to acetazolamide, such as drowsiness, fatigue, and myopia, may impair the ability to drive and operate machinery.

This description is suitable for active ingredient Acetazolamide

Edemox Interactions

DIAMOX®. modifies phenytoin metabolism with increased serum levels of phenytoin. This may increase or enhance the occurrence of osteomalacia in some patients receiving chronic phenytoin therapy. Caution is advised in patients receiving chronic concomitant therapy.

By decreasing the gastrointestinal absorption of primidone, DIAMOX may decrease serum concentrations of primidone and its metabolites, with a consequent possible decrease in anticonvulsant effect. Caution is advised when beginning, discontinuing, or changing the dose of DIAMOX in patients receiving primidone.

Because of possible additive effects with other carbonic anhydrase inhibitors, concomitant use is not advisable.

Edemox may increase the effects of other folic acid antagonists.

Edemox may increase or decrease blood glucose levels. Consideration should be taken in patients being treated with antidiabetic agents.

Edemox decreases urinary excretion of amphetamine and may enhance the magnitude and duration of their effect.

Edemox reduces urinary excretion of quinidine and may enhance its effect.

Edemox may prevent the urinary antiseptic effect of methenamine.

Edemox increases lithium excretion and the lithium may be decreased.

Edemox and sodium bicarbonate used concurrently increases the risk of renal calculus formation.

Edemox may elevate cyclosporine levels.

Edemox Contraindications

Hypersensitivity to acetazolamide or any excipients in the formulation. Since acetazolamide is a sulfonamide derivative, cross sensitivity between acetazolamide, sulfonamides and other sulfonamide derivatives is possible.

DIAMOX therapy is contraindicated in situations in which sodium and/or potassium blood serum levels are depressed, in cases of marked kidney and liver disease or dysfunction, in suprarenal gland failure, and in hyperchloremic acidosis. It is contraindicated in patients with cirrhosis because of the risk of development of hepatic encephalopathy.

Long-term administration of DIAMOX is contraindicated in patients with chronic noncongestive angle-closure glaucoma since it may permit organic closure of the angle to occur while the worsening glaucoma is masked by lowered intraocular pressure.

This description is suitable for active ingredient Acetazolamide

Edemox tags categories:

Encardil Tablet ( Medley ) - Buy Encardil Tablet Online At Best Price In India, Encardil

ENCARDIL 2.5MG TABLET

What is Enalapril for:

This medication is an ACE (angiotensin-converting enzyme) inhibitor, prescribed for high blood pressure either alone or with other medications. It is also used for heart failure. It decreases certain chemicals that tighten the blood vessels.

How does Enalapril work:

Enalapril lowers blood pressure by lowering a strong chemical in the body. It helps the heart work better. It helps kidney function in patients with high blood sugar (diabetes). It helps blood flow.

How should Enalapril be used:

PO - The recommended dose is 5 ? 20mgday, once or twice daily. It comes as a tablet to take by mouth, with or without food.

Common side effects of Enalapril :

Feeling dizzy. Rise slowly over a few minutes when sitting or lying down. Be careful climbing. Headache. Bad taste in your mouth. This most often goes back to normal. Cough.

What do I do if I miss a dose

Take a missed dose as soon as you think about it. If it is close to the time for your next dose, skip the missed dose and go back to your normal time. Do not take 2 doses at the same time or extra doses. Do not change the dose or stop this drug. Talk with the doctor.

What precautions should I take when taking Enalapril :

If you have an allergy to enalapril or any other part of this drug. Tell your doctor if you are allergic to any drugs. Make sure to tell about the allergy and what signs you had. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs. If you have any of these health problems: A block in the kidneys arteries or hyperaldosteronism. If you have high blood sugar (diabetes) and are taking aliskiren. If you are pregnant or may be pregnant.

When do I need to seek medical help

If you think there was an overdose, call your local poison control center or ER right away. Signs of a very bad reaction to the drug. These include wheezing; chest tightness; fever; itching; bad cough; blue or gray skin color; seizures; or swelling of face, lips, tongue, or throat. Signs of infection. These include a fever of 100.5?F (38?C) or higher, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, wound that will not heal, or anal itching or pain. Very bad dizziness or passing out. Trouble breathing. Too much sweat, fluid loss, throwing up, or loose stools. May lead to low blood pressure. A big weight gain. Swelling in your legs or belly. Cough that does not go away. Dark urine or yellow skin or eyes. Any rash. Side effect or health problem is not better or you are feeling worse.

Can I take Enalapril with other medicines:

Sometimes drugs are not safe when you take them with certain other drugs and food. - Taking them together can cause bad side effects. - Be sure to talk to your doctor about all the drugs you take.

Are there any food restrictions

How do I store Enalapril :

Store it at room temperature and protect it from moisture.

Pregnancy Category

Category D. There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Therapeutic Classification

ACE InhibitorsDirect Renin Inhibitors

This medication is an ACE (angiotensin-converting enzyme) inhibitor, prescribed for high blood pressure either alone or with other medications. It is also used for heart failure. It decreases certain chemicals that tighten the blood vessels.

Zoflut Cream (Fluticasone), Zoflut

What is Zoflut Cream (Fluticasone) used for?

Zoflut Cream (Fluticasone) is a topical corticosteroid prescribed to treat a variety of inflammatory skin conditions such as eczema or dermatitis. It operates by preventing the release of enzymes that cause swelling and irritation to prevent the symptoms associated with these conditions from occurring. Your physician may also recommend this medication to treat other unlisted conditions.

How should I use Zoflut Cream (Fluticasone)?

Zoflut Cream (Fluticasone) is normally administered two to three times each day, but your individual instructions will be determined by your physician based on your health condition and the severity of your symptoms. Rinse the area being treated to remove any dirt or loose skin, apply a small amount of cream, gently massage it into the skin, and allow any excess medication to evaporate. Thoroughly wash your hands with soap and water after each use to prevent the medication from contacting any areas not being treated or the mucous membranes as this may cause unexpected health complications.

What are the side effects of Zoflut Cream (Fluticasone)?

Some patients using Zoflut Cream (Fluticasone) may experience side effects such as:

Mild burning or stinging sensations

Dry or flaking skin

Mild skin rash or irritation

Thinning skin or easier bruising

Serious side effects that may require emergency medical attention include severe pain, intense burning sensations, or signs of an allergic reaction such as severe skin rashes, swelling, or difficulty breathing. Contact your physician as soon as you experience any worrying symptoms to make sure any necessary alterations are made to your frequency of administration to prevent further health complications from occurring.

Do not apply Zoflut Cream (Fluticasone) to skin that is broken or severely damaged. Do not begin using this medication if you have acne, rosacea, widespread psoriasis, inflammation around the mouth or genitals, or a skin infection caused by fungus, bacteria, or a virus. Also inform your physician if you have psoriasis as this condition may cause unexpected problems during treatment requiring special alterations to your regimen.

Strictly follow all instructions provided to you by your physician or pharmacist while using Zoflut Cream (Fluticasone). Optimum and safe dosage can differ based on the patient and the condition being treated.

As this medication may be unsafe for certain patients, it is essential you always inform your physician if you are pregnant or breastfeeding, as well as if you have any allergies, other illnesses, or ongoing health conditions, and if you are taking any other form of medication, supplements, or herbal products.

Immediately seek emergency medical care if you have an allergic or hypersensitive reaction. Common signs of a reaction include hives, swelling, skin rashes, chest pains, as well as trouble breathing or swallowing.

Fluoxetin Rezeptfrei Kaufen, Fluoxifar

Fluoxetin

Fluoxetin ist ein Medikament gegen Depressionen, Zwangsst?rungen und Essst?rungen (Bulimie). Der Wirkstoff, der in diesem Medikament enthalten ist, ist Fluoxetin. Es ist unter vielen bekannte Markennamen erh?ltlich, sowie Prozac, Fluctin, Fluxet u. v.a.

Fluoxetin ist ein Selektiver-Serotonin-Wiederaufnahme-Hemmer (SSRI). SSRI's sind eine Gruppe von Antidepressiva die am Serotonin-Transporter ihre Wirkung entfalten und dabei die Serotonin-Konzentration in der Gewebefl?ssigkeit des Gehirns erh?hen. In hohen Dosen kann es auch die Wiederaufnahme von Noradrenalin hemmen.

Die empfohlene Dosierung bei Depression betr?gt 1 Kapsel oder Tablette oder 1 grosser Messl?ffel (zu 5 ml) Liquid pro Tag, am besten morgens. Bei gest?rtem Essverhalten betr?gt die empfohlene Prozac Dosis 3 Kapseln oder Tabletten oder 3 grosse Messl?ffel Liquid pro Tag.

Fluoxetin kaufen und bestellen

20 mg / 40 mg / 60 mg

Markennamen Fluoxetin Deutschland, ?sterreich und Schweiz

Felicium (A), Floccin (A), Fluctin (D), Fluctine (A, CH), Fluocim (CH), Fluoxifar (CH), Fluxet (D), Mutan (A), NuFluo (A), Positivum (A), Prozac (GB, USA), zahlreiche Generika (D, A, CH)

* Fluoxetin Information Online Artz Rezept

Um dieses Antidepressivum online bestellen zu k?nnen, gehen Sie am Besten auf die Seite wie in der oben stehenden ?bersicht angek?ndigt. Auf dieser Internetseite f?llen Sie eine Fragenliste aus und auf Basis davon bestimmt ein Onlinearzt, ob Sie in Anmerkung kommen f?r Antidepressivum online bestellen (auch genannt: Fluoxetin online kaufen).

Populare Medikamente

Xerenex Tabletas Para Que Sirve, Xerenex

XERENEX TABLETAS

Acceso rapido al contenido

Especial antencion con menores de 12 anos

Tenga especial cuidado durante el embarazo .

No usar XERENEX TABLETAS con lactantes.

Revise siempre que no sea alergico a ninguno de los componentes de XERENEX TABLETAS . 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

TABLETAS Tratamiento de la depresion

PSICOFARMA, S. A. de C. V.

DENOMINACION GENERICA:

FORMA FARMACEUTICA Y FORMULACION:

Cada tableta contiene:

Clorhidrato de paroxetina equivalente a. 20 mg de Paroxetina

Excipiente, cbp. 1 tableta

INDICACIONES TERAPEUTICAS:

XERENEX ® contiene como farmaco paroxetina, un derivado fenilpiperidinico con propiedades altamente selectivas en la inhibicion del transportador de la recaptura de serotonina, las cuales le confieren propiedades antidepresivas y ansioliticas XERENEX ® esta indicado en el tratamiento de trastornos depresivos y de ansiedad de diversos tipos tales como: trastorno depresivo mayor, trastorno depresivo unipolar, distimia, depresion en el anciano, trastorno afectivo bipolar, depresion reactiva, depresion asociada con ansiedad. XERENEX ® tambien se emplea para el tratamiento de los trastornos de ansiedad como: ataques de panico con o sin agorafobia, fobia social, trastorno obsesivo compulsivo, trastorno por estres postraumatico, trastorno de ansiedad generalizada, sindrome disforico premenstrual.

FARMACOCINETICA Y FARMACODINAMIA EN HUMANOS:

XERENEX ® se caracteriza por ofrecer un efecto terapeutico de rapido inicio y de alta potencia y tambien por su larga y sostenida duracion despues de la administracion oral cronica, asi como por presentar una mayor selectividad por el transportador de la recaptura de serotonina en comparacion con otros farmacos antidepresivos de la clase ISRS.

Tras su administracion oral paroxetina es bien absorbida en el tracto digestivo y su absorcion no se altera significativamente por la presencia de alimentos o antiacidos Su biodisponibilidad es de 50% y las concentraciones plasmaticas maximas son de 30.7 a 61.7% y son reportadas a las 5.0 a 5.2 horas. Los niveles plasmaticos estables se obtienen al cabo de 7 a 14 dias del inicio del tratamiento y la farmacocinetica no se modifica durante tratamientos prolongados.

Por ser una amina lipofilica, paroxetina tiene un gran volumen de distribucion aparente y se distribuye extensamente en los tejidos con rangos de 3.1 a 28 lt./kg. Aproximadamente, 95% se une a proteinas plasmaticas y 1% de la dosis administrada se mantiene libre en plasma.

Paroxetina experimenta un extenso metabolismo de primer paso parcialmente saturable a traves del sistema hepatico del citocromo P450 principalmente por medio de la isoenzima CYP2D6, sus metabolitos, farmacologicamente inactivos, son polares y conjugados con acido glucuronico y sulfato, este ultimo, producto de los procesos de oxidacion y metilacion.

Aproximadamente, 64% de la dosis se elimina a traves de la orina y 36% en las heces. paroxetina presenta una vida media de eliminacion de 21 a 24 horas.

Paroxetina es un antidepresivo, que refuerza la actividad serotoninergica (5-HT) en el sistema nervioso central, considerandole un potente y selectivo inhibidor del transportador de la recaptura de serotonina (ISRS) para el tratamiento de la depresion. Se ha postulado que una deficiencia de 5-hidroxitriptamina (5-HT, serotonina) en el cerebro es una de las anomalias neuroquimicas fundamentales en la depresion. Este farmaco inhibe selectivamente la recaptura de serotonina (5-HT), por interaccion competitiva en el trasporte activo de la membrana neuronal, y aumenta la concentracion de serotonina en el espacio sinaptico, facilitando la transmision serotoninergica. Paroxetina no se relaciona estructural ni quimicamente con los antidepresivos triciclicos, tetraciclicos o de otro tipo, razon por la cual ha demostrado tener menos efectos anticolinergicos y por tanto se puede esperar una minima incidencia de efectos adversos caracteristicos de este grupo de antidepresivos triciclicos.

Paroxetina, principalmente ejerce su accion a nivel de estructuras cerebrales limbicas relacionadas con la afectividad, memoria, atencion y concentracion como son la circunvolucion del cingulo, amigdala cerebral, hipocampo y corteza cerebral prefrontal. A nivel sinaptico inhibe selectivamente el transportador de la recaptura de serotonina por los receptores 5-HT1A presinapticos, evitando que la serotonina sea degradada por la enzima monoaminooxidasa (MAO). Al evitar el bombeo del neurotransmisor por el transportador hacia el interior de la neurona presinaptica en los receptores 5-HT1A se incrementa la presencia y el tiempo disponible de la serotonina sinaptica la cual actua en los receptores 5-HT2A postsinapticos, generandose una cascada de acontecimientos bioquimicos que dan por resultado la expresion de genes de supervivencia neuronal como el factor neurotrofico derivado del cerebro o BDNF evitando en consecuencia la accion apoptotica del cortisol, favoreciendo la neurogenesis, el incremento del volumen hipocampal y el control por parte del hipocampo de la amigdala cerebral produciendo en consecuencia mejoria de la sintomatologia depresiva asi como un efecto ansiolitico que da por resultado el control de las manifestaciones clinicas de ansiedad y ataque de panico.

CONTRAINDICACIONES:

Hipersensibilidad al farmaco, embarazo y lactancia, ninos y adolescentes menores de 12 anos, administracion simultanea con inhibidores de la MAO.

PRECAUCIONES GENERALES:

Como la mayoria de los antidepresivos, XERENEX ® no debe ser usado en combinacion con los inhibidores de la monoaminooxidasa (IMAOS) o en las semanas de terminado el tratamiento con IMAOS. Posteriormente, el tratamiento debe ser iniciado cuidadosamente y la dosis incrementada gradualmente hasta alcanzar una respuesta optima.

Los IMAOS no deberan ser utilizados dentro de las dos semanas de suspension de la terapia con XERENEX ® .

Con XERENEX ® se han observado cambios en el patron del sueno en encefalograma (ECG), al igual que con otros antidepresivos como la imipramina, clorimipramina, los inhibidores de la MAO y la fluoxetina, pero sin un efecto sobre la calidad de la percepcion del sueno. La dosificacion matutina en pacientes deprimidos no produce sedacion durante el dia y se asocia con una mejoria en la calidad del sueno.

La actividad farmacologica de XERENEX ® no afecta mayormente el volumen de saliva, aunque se observo un ligero aumento a dosis continuas al igual que los antidepresivos triciclicos y tetraciclicos. Paroxetina induce midrapatias a dosis unicas o repetidas, aunque esta no tiene una traduccion clinica significativa como ocurre con los antidepresivos tri y tetraciclicos como la imipramina, clorimipramina, amitriptilina, desipramina, etc; que producen vision borrosa en el paciente.

El tratamiento con XERENEX ® dentro del margen de dosis terapeutica (20 a 50 mg diarios) no esta asociado con cambios clinicamente significativos en el peso corporal. Adicionalmente, XERENEX ® tiene una propension mas reducida a producir perdida de peso en pacientes deprimidos que la fluoxetina.

Los resultados de los estudios sobre la evaluacion de paroxetina en el tracto gastrointestinal son dudosos, aunque a dosis altas (por arriba de 50 mg) pueden provocar un aumento en el transito intestinal; ademas de nausea. XERENEX ® a dosis unica o repetidas, no afecta la prolactina del plasma.

Se observan concentraciones plasmaticas mayores en los ancianos en comparacion con los sujetos mas jovenes. Sin embargo, en todos los demas casos se demuestra el mismo incremento de la misma dosis. La elevacion de las concentraciones plasmaticas se observa en los casos de dano renal y hepatico graves, sin embargo, en todos los grupos especiales, los margenes observados se trasplantan extensamente con los sujetos normales.

Estudios clinicos han demostrado la eficiencia no solo en depresion mayor sino tambien en depresion con rasgos de ansiedad, depresion grave, depresion en el anciano, la prevencion de recidivas y en la depresion resistente a otros antidepresivos.

Debido a que la serotonina se le ha involucrado en la etiologia del panico, se realizaron estudios clinicos que han demostrado eficacia comparado con la clomipramina tanto a corto como a largo plazo, pero con un mas rapido inicio de accion y con un mejor perfil de tolerancia.

Los resultados de estos estudios clinicos tanto a corto como a largo plazo, en el tratamiento de los trastornos obsesivo compulsivo, muestran que XERENEX ® es tan efectivo como la clomipramina pero con mejor tolerabilidad debido a su mecanismo de accion mas selectivo.

RESTRICCIONES DE USO DURANTE EL EMBARAZO Y LA LACTANCIA:

Aunque los estudios no han demostrado ningun efecto teratogenico o embriotoxico selectivo, no se ha establecido la seguridad de paroxetina en mujeres embarazadas, por lo que no se debe administrar durante el embarazo o la lactancia, a menos que el beneficio supere el riesgo.

REACCIONES SECUNDARIAS Y ADVERSAS:

Por lo general los efectos adversos de paroxetina son de naturaleza leve y no modifican la calidad de vida del paciente. Las experiencias adversas pueden disminuir en intensidad y frecuencia al continuar con el tratamiento y en general, no producen interrupcion del tratamiento.

Los efectos adversos mas comunes asociados con el uso de paroxetina y que no se observaron con la misma incidencia en los pacientes tratados con placebo fueron: nausea, somnolencia, sudoracion, temblor, astenia, sequedad de boca y disfuncion sexual.

La experiencia clinica ha demostrado que XERENEX ® no esta relacionado con taquicardia o hipotension postural y muestra poca incidencia de sequedad de boca, estrenimiento y somnolencia.

INTERACCIONES MEDICAMENTOSAS Y DE OTRO GENERO:

La absorcion y la farmacocinetica de XERENEX ® no son afectadas por alimentos o antiacidos.

Al igual que con otros inhibidores de la recaptura de serotonina (5-HT), estudios en animales indican que puede presentarse una interaccion entre paroxetina y triptofano, dando como resultado el “sindrome de serotonina” que se traduce en una combinacion de agitacion, insomnio y sintomas gastrointestinales, incluyendo diarrea.

Al igual que los demas inhibidores selectivos de la recaptura de serotonina, paroxetina inhibe la enzima hepatica citocromo P450 y esto puede aumentar los niveles en plasma de algunos medicamentos coadministrados y que son metabolizados tambien por estas enzimas.

Cuando paroxetina se va a administrar con un medicamento inhibidor de estas enzimas, es conveniente reducir la dosis de paroxetina al limite inferior del margen terapeutico. No se considera necesario un ajuste inicial de la dosis de XERENEX ® cuando se va a administrar con un inductor enzimatico. Cualquier ajuste de la dosis debe basarse en la respuesta clinica (tolerabilidad y eficacia).

Aunque XERENEX ® no incrementa las alteraciones de la destreza mental y motora causadas por el alcohol, no se recomienda administrar simultaneamente paroxetina y alcohol en los pacientes deprimidos.

La experiencia en un grupo de sujetos sanos ha demostrado que XERENEX ® no incrementa la sedacion y la somnolencia asociadas con haloperidol, aminobarbitona y oxazepam, cuando se administran en combinacion.

A dosis unicas de paroxetina, la evaluacion psicomotora demostro que los efectos de dosificacion aguda y cronica respecto a las dosis habituales de XERENEX ® son indistinguibles del placebo. En pruebas en las que se han demostrado los efectos sedantes de otros antidepresivos, se ha confirmando que XERENEX ® no produce alteracion de la funcion cognoscitiva o de coordinacion psicomotriz en sujetos sanos.

Al igual que otros inhibidores de la recaptura de 5-HT, estudios en animales indican que puede presentarse una interaccion entre paroxetina y los inhibidores de monoaminooxidasa (MAO), por lo que, como la mayoria de los antidepresivos, paroxetina no debe utilizarse con inhibidores de la MAO, ni dentro de un periodo de dos semanas despues de haber terminado el tratamiento con estos ultimos. Posteriormente, el tratamiento debe iniciarse con cautela y la dosis debe incrementarse gradualmente hasta que se alcance una respuesta optima.

Los inhibidores de la MAO no deben administrarse dentro de un periodo de dos semanas despues de haber suspendido el tratamiento con paroxetina.

La experiencia clinica de administracion concomitante de paroxetina y litio es limitada, por lo que debe realizarse con precaucion.

Al igual que con otros antidepresivos, la co-administracion de paroxetina y fenitoina esta relacionada con una disminucion de las concentraciones plasmaticas de los farmacos coadministrados y un aumento de los efectos adversos.

La co-administracion de paroxetina con otros anticonvulsivos tambien puede estar asociada con un aumento de la incidencia de los efectos adversos.

Datos preliminares sugieren que puede haber interaccion farmacodinamica entre la paroxetina y warfarina, que puede aumentar el riesgo de hemorragias sin que se reflejen cambios en los tiempos de protrombina; por lo tanto, paroxetina debe administrarse con mucha precaucion en pacientes que toman anticoagulantes orales.

ALTERACIONES EN LOS RESULTADOS DE PRUEBAS DE LABORATORIO:

No ha surgido ningun patron de anomalias relacionadas con XERENEX ® y los valores obtenidos en los estudios de laboratorio de sangre y orina en personas sanas.

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

En estudios con animales no se observo evidencia de efectos de carcinogenesis ni de teratogenesis. Con dosis altas en ratas machos se ha observado un efecto sobre la fertilidad, pero los datos no son extrapolables a los humanos.

DOSIS Y VIA DE ADMINISTRACION:

Dosis: una sencilla dosis unica al dia de 20 mg es recomendada, ya que la dosificacion ha demostrado ser la dosis optima para la mayoria de los pacientes.

En caso necesario, esta puede aumentarse con incrementos de 10 a 50 mg diarios de acuerdo con la respuesta del paciente. Se recomienda que XERENEX ® se administre una vez al dia por las mananas y con alimentos. La tableta debera deglutirse sin masticar.

Al igual que otros medicamentos antidepresivos, la dosis debe revisarse y ajustarse, si es necesario a las dos o tres semanas de iniciado el tratamiento y posteriormente cuando se juzgue clinicamente apropiado.

Habitualmente la dosis de mantenimiento es igual a la dosis de inicio (20 mg diarios) para la mayoria de los pacientes. Generalmente, se recomienda que el curso del tratamiento con un medicamento antidepresivo deba continuar por un periodo suficiente que habitualmente es de varios meses. Al igual que para cualquier psicofarmaco es aconsejable disminuir el tratamiento gradualmente, ya que la eliminacion abrupta o repentina puede conducir a sintomas como alteraciones del sueno, irritabilidad y vertigo.

Trastorno obsesivo compulsivo: La dosis recomendada es de 40 mg diarios. Los pacientes deberan comenzar con 20 mg y la dosis podria aumentarse 10 mg semanalmente de acuerdo a la respuesta del paciente, algunos pacientes requieren una dosis maxima diaria de 60 mg.

Ataque de panico: La dosis recomendada es de 40 mg diarios, los pacientes deberan comenzar con 10 mg diarios y la dosis aumentara 10 mg semanalmente segun la respuesta del paciente, algunos pacientes requeriran de una dosis maxima diaria de 60 mg. En general, existe la posibilidad de que los sintomas de panico empeoren al comienzo del tratamiento, de ahi que se recomienda una dosis inicial baja. Se recomienda tratar al paciente durante un tiempo suficiente hasta asegurarse de que ya no padezca sintomas. Este periodo puede durar varios meses para depresion, pudiendo ser mas largo para el trastorno obsesivo compulsivo y los sintomas del panico.

Ninos: No se recomienda el uso de paroxetina en ninos menores de 12 anos, ya que la seguridad y eficacia no se ha establecido en esta poblacion.

Ancianos: Puede presentarse aumento en las concentraciones plasmaticas de XERENEX ®. pero el margen de concentracion es similar al observado en sujetos mas jovenes.

Pacientes con nefropatia o hepatopatia: En pacientes con alteracion grave (depuracion de creatinina menor de 30 ml/minuto) o alteracion hepatica grave, se puede presentar un aumento en las concentraciones plasmaticas de XERENEX ®. por lo que se recomienda reducir la dosis al extremo inferior del margen de dosificacion.

Precauciones especiales: En enfermedades cardiovasculares, un beneficio importante es que XERENEX ® no produce cambios clinicamente significativos en la presion arterial, frecuencia cardiaca y el electrocardiograma (ECG). No obstante es necesario tomar las precauciones habituales en pacientes con cardiopatias.

Epilepsia: Al igual que otros antidepresivos XERENEX ® debe utilizarse con precaucion en pacientes con epilepsia.

Convulsiones: La incidencia global de ataque convulsivos es menor al 0.1% en pacientes tratados con XERENEX ®. el medicamento debe interrumpirse si el paciente desarrolla ataques convulsivos.

Terapia electroconvulsiva (TEC): Existe poca experiencia clinica de la administracion concomitante de la paroxetina con TEC.

Manias: Al igual que con todos los antidepresivos, paroxetina debe utilizarse con precaucion en pacientes con antecedentes de mania.

MANIFESTACIONES Y MANEJO DE LA SOBREDOSIFICACION O INGESTA ACCIDENTAL:

Los datos de sobredosis son limitados. Los sintomas de sobredosis con paroxetina incluyen nausea, vomito, temblor, pupilas dilatadas, sequedad de boca e irritabilidad. No se han descrito reportes de anormalidades en el ECG, coma o convulsiones, despues de una sobredosis de paroxetina; la recuperacion se presento sin incidentes medicos.

No se conoce un antidoto especifico. El tratamiento debe consistir en aquellas medidas generales empleadas para el manejo de sobredosis con cualquier otro antidepresivo. Sin embargo, la absorcion de paroxetina se puede bloquear mediante la pronta administracion de carbon activado, como lo prueba la ausencia de paroxetina en el plasma despues de una dosis unica de 60 mg, seguida por una dosis de carbon activado. Este puede, por lo tanto, tener un papel en el manejo de casos de sobredosis accidental o intencional.

PRESENTACIONES:

Caja con 10, 20, 30 ,60 o 100 tabletas de 20 mg.

RECOMENDACIONES SOBRE ALMACENAMIENTO:

Conservese a temperatura no mayor de 30°C en un lugar seco.

LEYENDAS DE PROTECCION:

Literatura exclusiva para medicos. Su venta requiere receta medica. No se deje al alcance de los ninos. No se use en el embarazo y la lactancia, ni en menores de 12 anos.

LABORATORIO Y DIRECCION:

Hecho en Mexico por: PSICOFARMA, S. A. de C. V. Calz. de Tlalpan Num. 4369 Colonia Toriello Guerra 14050 Mexico, D. F. ® Marca registrada

Reg. Num. 129M2000, SSA IV

ELECTROCARDIOGRAMA . Constituye una util ayuda para el diagnostico o para excluir la posibilidad que un dolor en el pecho tenga su origen en un ataque cardiaco.

SANGRE . El organismo contiene alrededor de 7 litros de sangre, compuesta en un 50% por plasma y en otro 50% por celulas.

Opiniones

M-Kast, M-Kast

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License & Identifications

A medical license is required for a doctor to practice medicine in a particular state. Requirements vary by state but most require, at a minimum, post-graduate training in the doctor’s specific specialty. An NPI number is a national identifier unique to an individual health care provider and is managed by the Center for Medicare & Medicaid Services (CMS).

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M. Kast

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Dr. John M Kast

Overview

Dr. John M Kast, MD, is the Neurosurgery Specialist in Florence, Alabama. He attended and graduated with honors from University Of Health Sciences/Chicago Medical School in 1988, having over 28 years of diverse experiences, especially in Neurosurgery. He affiliates with many hospitals including Helen Keller Memorial Hospital, Eliza Coffee Memorial Hospital, Shoals Hospital, Russellville Hospital. Dr. John M Kast also cooperates with other doctors and physicians in medical groups including North Alabama Neuroservices Llc. Dr. John M Kast accepts Medicare-approved amount as payment in full. Call (256) 764-7721 to request Dr. John M Kast the information (Medicare information, advice, payment. ) or simply to book an appointment.

Address: 426 E Dr Hicks Blvd Florence, Alabama 35630-5763

Map and Directions

Practice Locations

426 E Dr Hicks Blvd Florence, Alabama 35630-5763 Phone: (256) 764-7721 Office Hours:

Monday: 8:00 AM - 5:00 PM

Tuesday: 8:00 AM - 5:00 PM

Wednesday: 8:00 AM - 5:00 PM

Thursday: 8:00 AM - 5:00 PM

Friday: 8:00 AM - 5:00 PM

Saturday: Closed

Sunday: Closed

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This doctor profile was updated by using the public dataset from Centers for Medicare and Medicaid Services (CMS) which is publicized on Thursday, August 4, 2016 . and correspondent NPI information on the public NPPES record dated Sunday, July 8, 2007 . If you found out that something incorrect and want to change it, please follow this Update Data guide.

Contact Dr. John M Kast by phone: (256) 764-7721 for verification, detailed information, or booking an appointment before going to.

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Travel-Gum Chewing Gums 10x 20mg, Travel-Gum

TRAVEL-GUM chewing gums 10x 20mg

Pregnancy and lactation

Because of the risk of mental and somatic retardation especially in administration of high doses of dimenhydrinate, the oral gum Travel-Gum 20 mg must not be administered to pregnant and breast-feeding women.

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We recommend the chewing gum Travel-Gum to people suffering of travel sickness: kinetosis. Chew 1 oral chewing gum Travel-Gum 20 mg 15 - 30 minutes before the beginning of your journey for 10 minutes. If the sickness still occurs later, it is necessary to chew one more oral gum with the first symptoms; another one can be, in case of need, administered after 6 hours at earliest. People in whom the propensity for kinetosis have not been known should chew Travel-Gum 20 as early as possible after occurrence of the first ailments (sickness, vomiting). Adults and adolescents may use the dose of 6 - 7 oral gums a day at maximum. The preparation is intended to people older than 15 years of age; as for children, the chewing gum Travel-Gum 10 mg or half of this chewing gum 20 mg is intended.

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Tamoxifen - Woman S Health, Jenoxifen

Tamoxifen is used for treating breast cancer that has spread to other sites in the body. It is also used along with other medicines to treat other types of breast cancer. It is used in women who are at high risk of breast cancer and in women with DCIS (after surgery and radiation) to decrease the risk of developing breast cancer. It may also be used for other conditions as determined by your doctor.

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

Tamoxifen comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Tamoxifen refilled.

Tamoxifen may be taken by mouth with or without food.

Take Tamoxifen with water or another nonalcoholic liquid.

Swallow this medication whole. Do not break, crush, or chew before swallowing.

Continue taking Tamoxifen even if you feel well. Do not miss any doses. Take Tamoxifen at the same time each day.

Drug Class and Mechanism

Tamoxifen is an antiestrogen. It works by blocking the effect of estrogen on certain tumors. This may prevent the growth of tumors that are activated by estrogen.

If you miss a dose of Tamoxifen, 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.

Store Tamoxifen between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed, light-resistant container. Store away from moisture, heat, and light. Do not store in the bathroom. Do not take tablets after the expiration date printed on the label. Keep Tamoxifen out of the reach of children and away from pets.

Do NOT use Tamoxifen if: you are allergic to any ingredient in Tamoxifen you are using Tamoxifen to reduce your risk of breast cancer and you have a history of blood clots in the lung or leg you are using Tamoxifen to reduce your risk of breast cancer and you also take certain anticoagulants (eg, warfarin) you are taking anastrozole Some medical conditions may interact with Tamoxifen. 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 blood clots in the legs or lungs if you have high levels of calcium in your blood, a weakened immune system, or low levels of white blood cells or platelets in your blood if you have high cholesterol or lipid levels if you have cataracts or other vision problems if you are using cytotoxic cancer medicines if you are confined to a bed or chair

Possible Side Effects

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:

bone pain; constipation; coughing; hot flashes; muscle pain; nausea; tiredness; vaginal discharge; weight loss.

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; unexplained hoarseness); abnormal menstrual periods; abnormal vaginal bleeding or bloody discharge; chest pain; coughing up blood; dark urine; decreased sexual desire or ability; depression; fever, chills, or persistent sore throat; groin or pelvic pain or pressure; loss of appetite; loss of balance or coordination; missed menstrual period; new or increased breast tumor or pain; new or unusual lumps; one-sided weakness; pain or swelling in one or both legs; red, swollen, blistered, or peeling skin; severe or persistent tiredness or weakness; shortness of breath; skin changes; stomach pain; sudden severe headache; swelling of the arms or the legs; unusual bleeding or bruising; vision or speech problems; yellowing of the eyes or skin.

If you have any questions about Tamoxifen. please talk with your doctor, pharmacist, or other health care provider. Tamoxifen is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor.

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Amaryl (Glimepibal)

Amaryl is used for treating type 2 diabetes in patients who cannot control blood sugar levels by diet and exercise alone. It is used along with diet and exercise. It may be used alone or with other antidiabetic medicines. Amaryl is a sulfonylurea antidiabetic medicine. It works by causing the pancreas to release insulin, which helps to lower blood sugar.

Use Amaryl as directed by your doctor.

Take Amaryl by mouth with breakfast or the first main meal of the day unless your doctor tells you otherwise.

Amaryl works best if it is taken at the same time each day.

Continue to take Amaryl even if you feel well. Do not miss any dose.

If you miss a dose of Amaryl, take it as soon as possible. If it is almost time for your next dose, skip the missed dose. 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 Amaryl.

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

Active Ingredient: Glimepiride.

Do NOT use Amaryl if:

you are allergic to any ingredient in Amaryl

you have certain severe problems associated with diabetes (eg, diabetic coma, diabetic ketoacidosis)

you have moderate to severe burns, or very high blood acid levels (acidosis)

you are taking bosentan.

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

Some medical conditions may interact with Amaryl. 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 had a severe allergic reaction (eg, a severe rash, hives, breathing difficulties, dizziness) to any other sulfonamide medicine, such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glipizide, probenecid, sulfamethoxazole, valdecoxib, or zonisamide

if you have a history of stroke or liver, kidney, thyroid, heart, or blood vessel problems

if you have stomach or bowel problems (eg, stomach or bowel blockage, stomach paralysis), drink alcohol, or have had poor nutrition

if you have type 1 diabetes, anemia, very poor health, a high fever, a severe infection, severe diarrhea, high blood acid levels, or have had a severe injury

if you have low levels of an enzyme called glucose 6-phosphate dehydrogenase (G6PD)

if you have a history of certain hormonal problems (eg, adrenal or pituitary problems, syndrome of inappropriate secretion of antidiuretic hormone [SIADH]), or low blood sodium levels

if you will be having surgery.

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

Bosentan because liver problems may occur; the effectiveness of both medicines may be decreased

Beta-blockers (eg, propranolol) because the risk of low blood sugar may be increased. They may also hide certain signs of low blood sugar and make it more difficult to notice

Anticoagulants (eg, warfarin), azole antifungals (eg, miconazole, ketoconazole), chloramphenicol, clarithromycin, clofibrate, fenfluramine, insulin, metformin, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), phenylbutazone, probenecid, quinolone antibiotics (eg, ciprofloxacin), salicylates (eg, aspirin), or sulfonamides (eg, sulfamethoxazole) because the risk of low blood sugar may be increased

Corticosteroids (eg, prednisone), decongestants (eg, pseudoephedrine), diazoxide, diuretics (eg, furosemide, hydrochlorothiazide), estrogens, hormonal contraceptives (eg, birth control pills), isoniazid, niacin, phenothiazines (eg, promethazine), phenytoin, rifamycins (eg, rifampin), sympathomimetics (eg, albuterol, epinephrine, terbutaline), or thyroid supplements (eg, levothyroxine) because they may decrease Amaryl's effectiveness, resulting in high blood sugar

Gemfibrozil because blood sugar may be increased or decreased.

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

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

Do not drink alcohol while you are taking Amaryl; it may increase the risk of low blood sugar. Rarely, alcohol may interact with Amaryl and cause a serious reaction with symptoms such as flushing, nausea, vomiting, dizziness, or stomach pain. Discuss any questions or concerns with your doctor.

Proper diet, regular exercise, and regular blood sugar testing are important for best results with Amaryl. Follow the diet and exercise program given to you by your health care provider.

It may be harder to control your blood sugar during times of stress such as fever, infection, injury, or surgery. Talk with your doctor about how to control your blood sugar if any of these occur. Do not change the dose of your medicine without checking with your doctor.

Amaryl may cause low blood sugar levels. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.

Risk of low blood sugar may be increased by severe or prolonged exercise, drinking alcohol, or skipping meals.

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

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

Lab tests, including fasting blood glucose and hemoglobin A 1c . may be performed while you use Amaryl. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Amaryl with caution in the elderly; they may be more sensitive to its effects, especially low blood sugar levels.

Amaryl should be used with extreme caution in children; safety and effectiveness in children have not been confirmed.

Pregnancy and breast-feeding: Amaryl may cause harm to the fetus or newborn. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Amaryl while you are pregnant. It is not known if Amaryl is found in breast milk. Do not breastfeed while taking Amaryl.

When used for long periods of time, Amaryl may not work as well. If your blood sugar has been under control and then becomes hard to manage, contact your doctor. Do not change the dose of your medicine without checking with your doctor.

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:

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); chest pain or irregular heartbeat; confusion; dark urine; fainting; fever, chills, or persistent sore throat; low blood sugar symptoms (eg, anxiety, dizziness, drowsiness, fast heartbeat, headache, lightheadedness, tremors, unusual sweating, weakness); severe or persistent blurred vision or other vision problems; unusual bruising or bleeding; unusual tiredness or weakness; 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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Bisoprolol Medlineplus Drug Information, Bicaprol

Bisoprolol

Bisoprolol is used alone or in combination with other medications to treat high blood pressure. Bisoprolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve and decrease blood pressure.

High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

How should this medicine be used?

Bisoprolol comes as a tablet to take by mouth. It is usually taken once a day. To help you remember to take bisoprolol, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take bisoprolol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor will probably start you on a low dose of bisoprolol and gradually increase your dose.

Bisoprolol controls high blood pressure but does not cure it. It may take a few weeks before you feel the full benefit of bisoprolol. Continue to take bisoprolol even if you feel well. Do not stop taking bisoprolol without talking to your doctor. Suddenly stopping bisoprolol may cause angina (chest pain), heart attack, or irregular heartbeat. Your doctor will probably decrease your dose gradually.

Other uses for this medicine

Bisoprolol also is used sometimes to treat heart failure. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Euthyrox Oral Uses, Side Effects, Interactions, Pictures, Warnings - Dosing, Thyrax

Euthyrox

Warnings

This medication should not be used for weight loss. Normal doses of this medication will not work for weight loss, and large doses of this medication may cause serious, possibly fatal side effects, especially when taken with diet pills .

Uses

Levothyroxine is used to treat an underactive thyroid (hypothyroidism ). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. Low thyroid hormone levels can occur naturally or when the thyroid gland is injured by radiation /medications or removed by surgery. Having enough thyroid hormone is important for maintaining normal mental and physical activity. In children, having enough thyroid hormone is important for normal mental and physical development.

This medication is also used to treat other types of thyroid disorders (such as certain types of goiters, thyroid cancer ).

This medication should not be used to treat infertility unless it is caused by low thyroid hormone levels.

How to use Euthyrox

Take this medication by mouth as directed by your doctor, usually once daily on an empty stomach. 30 minutes to 1 hour before breakfast. Take this medication with a full glass of water unless your doctor directs you otherwise.

If you are taking the capsule form of this medication, swallow it whole. Do not split, crush, or chew. People who cannot swallow the capsule whole (such as infants or small children) should use the tablet form of the medication.

For infants or children who cannot swallow whole tablets, crush the tablet and mix in 1 to 2 teaspoons (5 to 10 milliliters) of water, and give using a spoon or dropper right away. Do not prepare a supply in advance or mix the tablet in soy infant formula. Consult your pharmacist for more information.

Dosage is based on your age, weight. medical condition, laboratory test results, and response to treatment.

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

Do not stop taking this medication without first consulting with your doctor. Thyroid replacement treatment is usually taken for life.

There are different brands of levothyroxine available. Do not change brands without first consulting your doctor or pharmacist.

Certain medications (such as cholestyramine. colestipol. colesevelam. antacids, sucralfate, simethicone. iron, sodium polystyrene sulfonate, calcium supplements. orlistat. sevelamer. among others) can decrease the amount of thyroid hormone that is absorbed by your body. If you are taking any of these drugs, separate them from this medication by at least 4 hours.

Symptoms of low thyroid hormone levels include tiredness, muscle aches, constipation. dry skin. weight gain, slow heartbeat, or sensitivity to cold. Tell your doctor if your condition worsens or persists after several weeks of taking this medication.

Side Effects

Hair loss may occur during the first few months of treatment. This effect is usually temporary as your body adjusts to this medication. If this effect persists or worsens, tell your doctor or pharmacist promptly.

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 any of these unlikely but serious effects of high thyroid hormone levels occur: increased sweating. sensitivity to heat, mental/mood changes (such as nervousness, mood swings), tiredness, diarrhea. shaking (tremor), headache. shortness of breath.

Get medical help right away if any of these rare but serious effects of high thyroid hormone levels occur: chest pain. fast/pounding/irregular heartbeat. swelling hands/ankles /feet, seizures .

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 levothyroxine, 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: increased thyroid hormones (thyrotoxicosis), decreased adrenal gland function, heart disease (such as coronary artery disease, irregular heartbeat), high blood pressure, diabetes.

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

Current information shows that this drug may be used during pregnancy. Tell your doctor if you are pregnant because your dose may need to be adjusted.

Levothyroxine passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

Interactions

See also How to Use Section.

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: "blood thinners" (such as warfarin), digoxin, sucroferric oxyhydroxide, theophylline.

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. Symptoms of overdose may include: fast/pounding/irregular heartbeat, loss of consciousness, confusion, seizures.

Notes

Do not share this medication with others.

Laboratory and/or medical tests (such as thyroid function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

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 and resume your usual dosing schedule. Do not double the dose to catch up unless your doctor tells you to do so. Call your doctor if you miss 2 or more doses in a row. Ask your doctor ahead of time what to do about a missed dose and follow your doctor's specific directions.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. 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 for more details about how to safely discard your product.

Information last revised October 2015. Copyright(c) 2015 First Databank, Inc.

Images

No data available at this time.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Top Picks

ADHD Drug Side Effects

Drug Overdose

Gabexine, Gabexine

Neurontin is used for treating seizures associated with epilepsy. Neurontin is an anticonvulsant.

Use Neurontin as directed by your doctor.

Take Neurontin by mouth with or without food.

Do not take an antacid containing aluminum or magnesium within 2 hours before you take Neurontin.

If you are taking half of a scored tablet as your dose, take the other half of that tablet as your next dose. Throw away any half-tablets not used within several days of breaking a scored tablet.

Do not suddenly stop taking Neurontin. You may have an increased risk of side effects (eg, seizures). If you need to stop Neurontin or add a new medicine, your doctor will gradually lower your dose.

If you miss a dose of Neurontin, 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 Neurontin.

Store Neurontin at 77 degrees F (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 Neurontin out of the reach of children and away from pets.

Active Ingredient: Gabapentin.

Do NOT use Neurontin if:

you are allergic to any ingredient in Neurontin.

Some medical conditions may interact with Neurontin. 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 kidney problems and are on dialysis

if you have a history of mental or mood problems (eg, depression), or suicidal thoughts or actions.

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

Morphine because it may increase the risk of Neurontin's side effects, including drowsiness.

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

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

Patients who take Neurontin may be at increased risk for suicidal thoughts or actions. The risk may be greater in patients who have had suicidal thoughts or actions in the past. Watch patients who take Neurontin closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.

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

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

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

Use Neurontin with caution in the elderly; they may be more sensitive to its effects.

Neurontin may cause emotional or behavioral side effects in children 3 to 12 years. If the following side effects occur, notify your doctor immediately: emotional "swings", hostile or aggressive behavior, problems concentrating, decreased performance at school, an increase in restlessness or hyperactivity.

Neurontin should be used with extreme caution in children younger 3 years; 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 Neurontin while you are pregnant. Neurontin is found in breast milk. If you are or will be breast-feeding while you use Neurontin, check with your doctor. Discuss any possible risks to your baby.

If you stop taking Neurontin suddenly, you may have withdrawal symptoms. These may include dizziness, drowsiness, clumsiness, hostility, hyperactivity, mood swings, nausea, tiredness, or vomiting.

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:

Back pain; changes in vision (double or blurred vision); clumsiness; constipation; diarrhea; dizziness; drowsiness; dry mouth; nausea; stomach upset; tiredness; vomiting; weight gain.

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 thoughts; back and forth eye movements; behavioral problems; change in school performance; chest pain; confusion; fainting; fast, slow, or irregular heartbeat; fever, chills, or sore throat; hyperactivity; loss of coordination; memory loss; new or worsening mental or mood changes (eg, depression, agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, inability to sit still); new or worsening seizures; numbness of an arm or leg; one-sided weakness; severe headache or dizziness; shortness of breath; speech changes; suicidal thoughts or actions; swelling of the hands, legs, or feet; tremor; trouble concentrating; twitching.

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.

Neurontin is used for treating seizures associated with epilepsy. Neurontin is an anticonvulsant.

Use Neurontin as directed by your doctor.

Take Neurontin by mouth with or without food.

Do not take an antacid containing aluminum or magnesium within 2 hours before you take Neurontin.

If you are taking half of a scored tablet as your dose, take the other half of that tablet as your next dose. Throw away any half-tablets not used within several days of breaking a scored tablet.

Do not suddenly stop taking Neurontin. You may have an increased risk of side effects (eg, seizures). If you need to stop Neurontin or add a new medicine, your doctor will gradually lower your dose.

If you miss a dose of Neurontin, 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 Neurontin.

Store Neurontin at 77 degrees F (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 Neurontin out of the reach of children and away from pets.

Active Ingredient: Gabapentin.

Do NOT use Neurontin if:

you are allergic to any ingredient in Neurontin.

Some medical conditions may interact with Neurontin. 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 kidney problems and are on dialysis

if you have a history of mental or mood problems (eg, depression), or suicidal thoughts or actions.

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

Morphine because it may increase the risk of Neurontin's side effects, including drowsiness.

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

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

Patients who take Neurontin may be at increased risk for suicidal thoughts or actions. The risk may be greater in patients who have had suicidal thoughts or actions in the past. Watch patients who take Neurontin closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.

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

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

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

Use Neurontin with caution in the elderly; they may be more sensitive to its effects.

Neurontin may cause emotional or behavioral side effects in children 3 to 12 years. If the following side effects occur, notify your doctor immediately: emotional "swings", hostile or aggressive behavior, problems concentrating, decreased performance at school, an increase in restlessness or hyperactivity.

Neurontin should be used with extreme caution in children younger 3 years; 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 Neurontin while you are pregnant. Neurontin is found in breast milk. If you are or will be breast-feeding while you use Neurontin, check with your doctor. Discuss any possible risks to your baby.

If you stop taking Neurontin suddenly, you may have withdrawal symptoms. These may include dizziness, drowsiness, clumsiness, hostility, hyperactivity, mood swings, nausea, tiredness, or vomiting.

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:

Back pain; changes in vision (double or blurred vision); clumsiness; constipation; diarrhea; dizziness; drowsiness; dry mouth; nausea; stomach upset; tiredness; vomiting; weight gain.

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 thoughts; back and forth eye movements; behavioral problems; change in school performance; chest pain; confusion; fainting; fast, slow, or irregular heartbeat; fever, chills, or sore throat; hyperactivity; loss of coordination; memory loss; new or worsening mental or mood changes (eg, depression, agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, inability to sit still); new or worsening seizures; numbness of an arm or leg; one-sided weakness; severe headache or dizziness; shortness of breath; speech changes; suicidal thoughts or actions; swelling of the hands, legs, or feet; tremor; trouble concentrating; twitching.

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.

Neurontin is used for treating seizures associated with epilepsy. Neurontin is an anticonvulsant.

Use Neurontin as directed by your doctor.

Take Neurontin by mouth with or without food.

Do not take an antacid containing aluminum or magnesium within 2 hours before you take Neurontin.

If you are taking half of a scored tablet as your dose, take the other half of that tablet as your next dose. Throw away any half-tablets not used within several days of breaking a scored tablet.

Do not suddenly stop taking Neurontin. You may have an increased risk of side effects (eg, seizures). If you need to stop Neurontin or add a new medicine, your doctor will gradually lower your dose.

If you miss a dose of Neurontin, 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 Neurontin.

Store Neurontin at 77 degrees F (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 Neurontin out of the reach of children and away from pets.

Active Ingredient: Gabapentin.

Do NOT use Neurontin if:

you are allergic to any ingredient in Neurontin.

Some medical conditions may interact with Neurontin. 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 kidney problems and are on dialysis

if you have a history of mental or mood problems (eg, depression), or suicidal thoughts or actions.

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

Morphine because it may increase the risk of Neurontin's side effects, including drowsiness.

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

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

Patients who take Neurontin may be at increased risk for suicidal thoughts or actions. The risk may be greater in patients who have had suicidal thoughts or actions in the past. Watch patients who take Neurontin closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.

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

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

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

Use Neurontin with caution in the elderly; they may be more sensitive to its effects.

Neurontin may cause emotional or behavioral side effects in children 3 to 12 years. If the following side effects occur, notify your doctor immediately: emotional "swings", hostile or aggressive behavior, problems concentrating, decreased performance at school, an increase in restlessness or hyperactivity.

Neurontin should be used with extreme caution in children younger 3 years; 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 Neurontin while you are pregnant. Neurontin is found in breast milk. If you are or will be breast-feeding while you use Neurontin, check with your doctor. Discuss any possible risks to your baby.

If you stop taking Neurontin suddenly, you may have withdrawal symptoms. These may include dizziness, drowsiness, clumsiness, hostility, hyperactivity, mood swings, nausea, tiredness, or vomiting.

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:

Back pain; changes in vision (double or blurred vision); clumsiness; constipation; diarrhea; dizziness; drowsiness; dry mouth; nausea; stomach upset; tiredness; vomiting; weight gain.

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 thoughts; back and forth eye movements; behavioral problems; change in school performance; chest pain; confusion; fainting; fast, slow, or irregular heartbeat; fever, chills, or sore throat; hyperactivity; loss of coordination; memory loss; new or worsening mental or mood changes (eg, depression, agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, inability to sit still); new or worsening seizures; numbness of an arm or leg; one-sided weakness; severe headache or dizziness; shortness of breath; speech changes; suicidal thoughts or actions; swelling of the hands, legs, or feet; tremor; trouble concentrating; twitching.

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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