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Para que sirve la Cefalexina (Keflex)

La cefalexina pertenece al grupo de medicamentos llamados antibioticos de cefalosporina y se utiliza para combatir las bacterias en el cuerpo, funciona al interferir con la formacion de las bacterias de la pared celular, produciendo su ruptura y asi matandolas. La cefalexina se utiliza para tratar infecciones causadas por bacterias, como las infecciones del tracto respiratorio superior, infecciones del oido, infecciones de la piel, e infecciones del tracto urinario.

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Informacion Importante

No use esta medicina si usted es alergico a la cefalexina, o algun otro antibiotico cefalosporinas como: cefaclor, cefadroxilo, cefdinir, cefditoren, cefixima, cefprozil, ceftazidima o cefuroxima.

Antes de usar cefalexina, digale a su medico si usted es alergico a algun medicamento, especialmente penicilinas, o si tiene: enfermedad del rinon; enfermedad del higado; problema del estomago o del intestino, como colitis; diabetes; o si usted esta desnutrido. Si usted tiene alguna de estas condiciones, quizas necesite modificar su dosis o hacer pruebas especiales para poder tomar cefalexina.

La suspension liquida de la cefalexina puede contener azucar, esto puede afectarle si usted tiene diabetes.

La cefalexina no se espera que cause dano al bebe nonato. Digale a su medico si usted esta embarazada o planea quedar embarazada durante el tratamiento. La cefalexina pasa a la leche materna y le puede hacer dano al bebe que esta mamando.

Tome esta medicina por el tiempo completo recetado por su medico. Sus sintomas pueden mejorar antes de que la infeccion este completamente curada, la cefalexina no curara una infeccion viral como el resfriado comun o la gripe.

Los antibioticos como la cefalexina pueden causar diarrea, que puede ser un signo de una nueva infeccion, si tiene diarrea que es liquida o con sangre, hable con su medico. No use ninguna medicina para parar la diarrea a menos que su medico le haya indicado hacerlo.

Forma de administracion

Tome esta medicina exactamente como se lo hayan recetado. No use la medicina en cantidades mayores, o la use por mas tiempo de lo recomendado por su medico.

Tome esta medicina con un vaso lleno de agua.

Disuelva la cefalexina dispersable en una pequena cantidad de agua, aproximadamente 2 cucharillas, revuelva la mezcla y beba todo de inmediato. Para asegurarse de que recibe la dosis completa, anada un poco de agua al mismo vaso y beba de inmediato. No trague ni mastique una tableta dispersable.

Agite bien la suspension cefalexina liquido justo antes de medir una dosis. Para asegurarse de que recibe la dosis correcta, mida el liquido con una cuchara o taza para medir medicina, y no con una cuchara regular de mesa.

Esta medicina puede hacer que tenga resultados inusuales con ciertas pruebas medicas, digale a cualquier medico que lo atiende que usted esta utilizando cefalexina.

Guarde las tabletas y capsulas a temperatura ambiente fuera de la humedad y el calor y el medicamento liquido en el refrigerador. Tire a la basura cualquier medicamento sin usar despues de 14 dias.

Dosis en adultos

Cistitis: 250 mg por via oral cada 6 horas o 500 mg por via oral cada 12 horas durante 7 a 14 dias

Otitis media: 500 mg por via oral cada 6 horas durante 10 a 14 dias

Faringitis: 250 mg por via oral cada 6 horas o 500 mg por via oral cada 12 horas

Infecciones de la piel o tejidos blandos: 250 mg por via oral cada 6 horas o 500 mg por via oral cada 12 horas

Osteomielitis: 500 mg por via oral cada 6 horas, la terapia debe continuarse durante aproximadamente 4 a 6 semanas, dependiendo de la naturaleza y gravedad de la infeccion. La osteomielitis cronica puede requerir de uno o dos meses adicionales de tratamiento con antibioticos.

Prostatitis: 500 mg por via oral cada 6 horas por 14 dias

Pielonefritis: 500 mg por via oral cada 6 horas por 14 dias

Infeccion del tracto respiratorio superior: 250 a 500 mg por via oral cada 6 horas durante 7 a 10 dias

Infeccion bacteriana: 250 a 500 mg por via oral cada 6 horas, la terapia debe continuarse durante aproximadamente 7 a 21 dias, dependiendo de la naturaleza y gravedad de la infeccion.

Efectos secundarios

Busque atencion medica de emergencia si usted tiene alguno de estos sintomas de una reaccion alergica a la cefalexina: ronchas, dificultad para respirar, hinchazon de la cara, labios, lengua, o garganta.

Llame a su medico de inmediato si usted tiene alguno de estos efectos secundarios de gravedad: diarrea que es liquida o con sangre; convulsiones; fiebre, dolor de garganta, y dolor de cabeza con ampollas, descamacion, y sarpullido rojo; piel palida o color amarillo, orina oscura, fiebre, confusion o debilidad; facil aparicion de moretones o sangrado, debilidad inusual; confusion, agitacion, alucinaciones, o orinar menos de lo usual o nada en absoluto.

Efectos secundarios de menor gravedad: nausea leve, vomito, diarrea; mareo, sentirse cansado; dolor en las articulaciones, o picazon vaginal o flujo.

Esta no es una lista completa de efectos secundarios y otros tambien pueden ocurrir. Llame a su medico para consejo medico sobre efectos secundarios.

Interaccion con otros medicamentos

Antes de usar cefalexina, digale a su medico si usted esta usando alguna de los medicamentos a seguir: un anticoagulante, metformina, o probenecid.

Esta lista no es completa y puede haber otras drogas que puedan tener interacciones con la cefalexina.

Digale a su medico sobre todos los medicamentos recetados y de venta libre que usted utiliza, esto incluye vitaminas, minerales, productos herbarios, y las drogas recetadas por otros medicos. No empiece a usar una nueva medicina sin antes decirle a su medico.



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Prandimet (Repaglinide And Metformin Hcl Tablets) Side Effects, Interactions, Warning, Dosage & Uses

Lactic acidosis is a rare but serious complication that can occur due to metformin accumulation. The risk increases with conditions such as sepsis, dehydration, excess alcohol intake, hepatic impairment, renal impairment, and acute congestive heart failure.

The onset of lactic acidosis often is subtle, and accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, increasing somnolence, and nonspecific abdominal distress.

Laboratory abnormalities include low pH, increased anion gap and elevated blood lactate.

If acidosis is suspected, PrandiMet should be discontinued and the patient hospitalized immediately [see WARNINGS AND PRECAUTIONS ].

DRUG DESCRIPTION

PrandiMet (repaglinide and metformin HCl) tablets contain two oral antihyperglycemic drugs used in the management of type 2 diabetes: repaglinide and metformin HCl. The concomitant use of repaglinide and metformin has been previously approved based on clinical trials in patients with type 2 diabetes inadequately controlled on exercise, diet, and metformin HCl alone.

Repaglinide, S(+)2-ethoxy-4(2((3-methyl-1-(2-(1-piperidinyl) phenyl)-butyl) amino)-2-oxoethyl) benzoic acid, is chemically unrelated to the oral sulfonylurea insulin secretagogues. Repaglinide is a white to off-white powder with molecular formula C 27 H 36 N 2 O4 and a molecular weight of 452.6 with the structural formula as shown below. Repaglinide is freely soluble in methanol and ethanol. The pKa of repaglinide in acid is 3.9, and the pKa in amine is 6.0.

Structural formula of Repaglinide

Metformin HCl (N, N-dimethylimidodicarbonimidic diamide hydrochloride) is not chemically or pharmacologically related to any other classes of oral antihyperglycemic agents. Metformin HCl is a white to off-white crystalline compound with a molecular formula of C 4 H 11 N 5 •HCl and a molecular weight of 165.63. Metformin HCl is freely soluble in water and is practically insoluble in acetone, ether, and chloroform. The pKa of metformin HCl is 12.4. The pH of a 1% aqueous solution of metformin HCl is 6.68. The structural formula of metformin HCl is:

PrandiMet is available as a tablet for oral administration containing 1 mg repaglinide with 500 mg metformin HCl (1 mg/500 mg) or 2 mg repaglinide with 500 mg metformin HCl (2 mg/500 mg) formulated with the following inactive ingredients: poloxamer 188, microcrystalline cellulose, polacrillin potassium, magnesium stearate, hypromellose 3cp or 6cp, povidone, meglumine, sorbitol, talc, titanium dioxide, red or yellow iron oxide, and polyethylene glycol. Propylene glycol is present in the 2 mg/500 mg PrandiMet tablets.

What are the possible side effects of metformin and repaglinide (PrandiMet)?

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

Hypoglycemia, or low blood sugar, is the most common side effect of metformin and repaglinide. Symptoms include headache, hunger, weakness, sweating, tremors, irritability, trouble concentrating, rapid breathing, fast heartbeat, fainting, or seizure (severe hypoglycemia can be fatal). Carry hard candy or glucose tablets with you in case you have low blood sugar.

This medication may cause.

What are the precautions when taking repaglinide and metformin hcl tablets (Prandimet)?

See also Warning section.

Before taking this medication, tell your doctor or pharmacist if you are allergic to repaglinide or metformin; 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.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: kidney disease.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: severe breathing problems (such as obstructive lung disease, severe asthma), blood problems (such as anemia, vitamin B12 deficiency), heart problems (such as heart failure, recent heart attack).

Last reviewed on RxList: 5/7/2012 This monograph has been modified to include the generic and brand name in many instances.



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Gabanet, Gabanet

Gabanet

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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Trecator-Sc Oral Uses, Side Effects, Interactions, Pictures, Warnings - Dosing, Trecator-Sc

Trecator-SC

Uses

Ethionamide is used with other medications to treat tuberculosis (TB). Ethionamide is an antibiotic and works by stopping the growth of bacteria.

This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold. flu ). Unnecessary use or misuse of any antibiotic can lead to its decreased effectiveness.

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

This drug may also be used with other medications to help treat a certain serious infection (Mycobacterium avium complex-MAC).

How to use Trecator-SC

Take this medication by mouth with or without food, usually once daily or as directed by your doctor. If this medication causes stomach upset or nausea /vomiting. take this medication with meals. Also, discuss with your doctor if it may be helpful to divide your daily dose into smaller doses to be taken several times a day. Follow your doctor's instructions carefully.

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

Antibiotics work best when the amount of medicine in your body is kept at a constant level. Therefore, take this drug at evenly spaced intervals. To help you remember, take it at the same time(s) each day.

Continue to take this medication (and other TB medications) until the full prescribed amount is finished, even if symptoms disappear. Stopping the medication too early or skipping doses may allow the bacteria to continue to grow, which may result in a return of the infection and cause the infection to be more difficult to treat (resistant).

Your doctor may also direct you to take vitamin B6 (pyridoxine) to help prevent certain side effects (such as nerve problems) from ethionamide. Follow your doctor's instructions carefully.

Tell your doctor if your condition persists or worsens.

Side Effects

Nausea, vomiting, diarrhea. abdominal/stomach pain. increased saliva. strange metallic taste in the mouth. loss of appetite, or sores in the mouth may 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 may develop serious side effects, but with frequent visits to your doctor, this risk can be minimized.

Tell your doctor right away if any of these unlikely but serious side effects occur: unusual hunger. unusual sweating. shakiness, persistent nausea/vomiting, unusual tiredness/weakness. yellowing eyes /skin. dark urine, joint pain /swelling, slow heartbeat, mental/mood changes (such as nervousness, restlessness, depression ).

Tell your doctor right away if any of these rare but serious side effects occur: vision changes (such as blurred/decreased/double vision. color blindness ), eye pain. numbness/tingling of arms/legs.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention 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 ethionamide, 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.

Alcohol may increase the risk of liver disease or mental/mood changes. Avoid alcoholic beverages while using this medication.

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

If you have diabetes, this product may make it harder to control your blood sugar levels (cause low blood sugar). Check your blood sugar levels regularly as directed by your doctor. Tell your doctor right away if you have symptoms of low blood sugar, such as shakiness, unusual hunger, or unusual sweating. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.

To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.

Keep a list of all the products you use. Share the list with your doctor and pharmacist to reduce your risk for serious medication problems.

Overdose

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

Notes

Do not share this medication with others.

Laboratory and/or medical tests (such as sputum test, eye/vision exams, liver/thyroid function, blood glucose, complete blood count) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose

For the best possible benefit, it is important to take each scheduled dose of this medication as directed. 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.

Storage

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

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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.

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Dewasa & anak berusia lebih dari 12 tahun. 2-3 kali sehari 1-2 kaplet.

Anak berusia 6-12 tahun. 2-3 kali sehari ½-1 kaplet

PERHATIAN Pasien yang kekurangan Asam Folat, keadaan nutrisi yang buruk, atau kekurangan G6PD. Lansia dan pasien dengan penurunan fungsi ginjal. Interaksi obat . - efek dikurangi oleh asam para amino benzoat (PABA) dan anestesi lokal tipe Prokain serta dipertinggi oleh obat-obat yang berikatan kuat. - bisa mempotensiasi efek Metotreksat, Warfarin, Sulfonilurea.

COMPOSITION: Each tablet contains: Tnmethoprim 800 mg sulfamethoxazole 400 mg Each caplet contains forte: Tnmethoprim160 mg sulfamethoxazole800 mg Each 5 ml suspension contains: trimethoprim40 mg sulfamethoxazole200 mg

INDICATIONS Respiratory tract infections, kidney and urinary tract, gastrointestinal tract, skin and genitals. Septicemia (blood poisoning and pathogenic bacteria or substances produced by bacteria).

CONS INDICATION Severe impairment of hepatic or renal function, hypersensitivity to Sulfonamides, blood dyscrasias. Pregnant and breastfeeding. Infants younger than 2 months. porphyria SIDE EFFECTS Gastrointestinal disorders, Steven-Johnson syndrome and Lyell. Rare: hepatitis, blood disorders, pseudomembranous colitis.

DOSE Adults and children aged over 12 years: 2-3 times daily 1-2 caplets. Children aged 6-12 years: ½ -1 2-3 times a day caplet

CAUTION Patients Folic acid deficiency, poor nutritional state, or G6PD deficiency. Elderly and patients with decreased renal function. Drug interactions: - The effect is reduced by the amino benzoic acid (PABA) and the type of local anesthetic Procaine and enhanced by drugs that bind strongly. - May potentiate the effects of Methotrexate, Warfarin, sulfonylureas.



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Atenolol (Tenormin) Uses, Dosage, Side Effects, Therabloc

Atenolol

Atenolol (Tenormin) is in a group of drugs called beta-blockers. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).

Atenolol is used to treat angina (chest pain) and hypertension (high blood pressure). It is also used to treat or prevent heart attack.

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

Important information

Do not stop taking atenolol without first talking to your doctor. Stopping suddenly may make your condition worse.

If you need to have any type of surgery, you may need to temporarily stop using atenolol. Be sure the surgeon knows ahead of time that you are using atenolol.

Atenolol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol, which could increase drowsiness and dizziness while you are taking atenolol.

Atenolol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store atenolol at room temperature away from moisture and heat.

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

You should not use this medication if you are allergic to atenolol, or if you have certain heart conditions such as slow heartbeats, or heart block.

Before taking atenolol, tell your doctor if you have:

asthma, bronchitis, emphysema;

low blood pressure;

a heart problem such as heart block, sick sinus syndrome, slow heart rate, or congestive heart failure;

problems with circulation (such as Raynaud's syndrome).

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use atenolol if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Atenolol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take atenolol?

Take atenolol exactly as it was prescribed for you. Do not take the medication in larger amounts or for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medication with a full glass of water.

Take atenolol at the same time every day.

Do not skip doses or stop taking atenolol without first talking to your doctor. Stopping suddenly may make your condition worse.

To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Do not miss any visits to your doctor.

If you need to have any type of surgery, tell the surgeon that you are using atenolol. You may need to briefly stop using atenolol before having surgery.

Atenolol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.

If you are being treated for high blood pressure, keep using atenolol even if you feel fine. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store atenolol at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If your next dose is less than 8 hours away, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

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

Overdose symptoms may include uneven heartbeats, shortness of breath, bluish-colored fingernails, dizziness, weakness, fainting, or seizure (convulsions).

What should I avoid?

Atenolol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol, which could increase drowsiness and dizziness while you are taking atenolol.

Atenolol side effects

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

slow or uneven heartbeats;

feeling light-headed, fainting;

feeling short of breath, even with mild exertion;

swelling of your ankles or feet;

nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

cold feeling in your hands and feet.

Less serious atenolol side effects may include:

decreased sex drive, impotence, or difficulty having an orgasm;

sleep problems (insomnia);

tired feeling; or

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect atenolol?

Before taking atenolol, tell your doctor if you are using:

allergy treatments (or if you are undergoing allergy skin-testing);

amiodarone (Cordarone, Pacerone);

digoxin (digitalis, Lanoxin);

an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam);

a diabetes medication such as insulin, glyburide (Diabeta, Micronase, Glynase), glipizide (Glucotrol), chlorpropamide (Diabinese), or metformin (Glucophage);

a heart medication such as nifedipine (Procardia, Adalat), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cartia, Cardizem);

medicine for asthma or other breathing disorders, such as albuterol (Ventolin, Proventil), bitolterol (Tornalate), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire, Brethine, Bricanyl), and theophylline (Theo-Dur, Theolair); or

cold medicines, stimulant medicines, or diet pills.

If you are using any of these drugs, you may not be able to take atenolol, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect atenolol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More about atenolol

Consumer resources

Professional resources

Related treatment guides

Where can I get more information?

Your pharmacist can provide more information about atenolol.

What does my medication look like?

Atenolol is available with a prescription under the brand name Tenormin. Other brand or generic forms may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Tenormin 25 mg - round, flat, white, uncoated

Tenormin 50 mg - round, flat, white, uncoated

Tenormin 100 mg - round, flat, white, uncoated

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Copyright 1996-2016 Cerner Multum, Inc. Version: 8.03. Revision Date: 4/12/2009 4:22:13 PM.



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Your physician may help along with your acne, if you consult him at initial stages. This is perfectly normal and shows that the item is working. HIV eliminates all vitamins within inside the body therefore so that it is almost impossible for the body to stay healthy. Some women that are post-menopausal may experience more dryness than these due to low estrogen or dhea. If your skin layer is sensitive, start every third night and, whenever possible, work up over the month or so to almost every other night.

Try treating other locations also while using known facial chemical compound called Tretinoin. Stretch marks are recognized to become permanent scars for the surface of the skin. It cleans your skin by unclogging the pores and prevents future breakouts. And as the Tretinoin cream is probably not quite so hot at preventing blemishes, the Clinique body spray is. Hypertrophic Scars are raised scars that reveal themselves which has a pinkish or reddish tone.

Vitamin A (retinol) is medically proven to improve the look of skin also to improve each side fine lines that are caused by the natural aging process. So it really is rather safe and also hardwearing. hands or another object from a face to impede the inflammation from the acne and scarring of the epidermis as well. It causes severe birth defects and if a woman is of childbirth age, she is required to work with two forms of contraceptive a month before using, during usage of this medication, and up to a month after stopping isotretinoin. Among other techniques, the most common kind of laser processes for skin treatment methods are laser brasion. It is better to consult a health-care professional because of this.

Retin A Irritation and Tretinoin Gel: The Bottom Line. If you've got darker skin, be especially careful about that which you use on it. Thinning usually begins with the crown and after that spread evenly through the head. Accutane: This is available in the form of pills or tablets and considered to become a best medication which can be taken orally to help remedy the acne. Some research indicates genetics can affect the tendency to build up acne, also using certain drugs or greasy cosmetics.

This in turn leads to an excess of male hormones, which encourage the skin to excrete large amounts of sebum. I tend not to want to enter a bunch of scientific lingo that many people wouldn't understand, but simply put, this product is research. Herbal or natural methods plus they include the use of Tea tree oil, Aloe Vera oil, Almond oil and several more. The inflamed lesions have a tendency to appear more frequently in the summer months due towards the heat. There is really a lot of medications available, I is only going to list the harder commonly prescribed ones here.

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Toradol is used for the short-term (up to 5 days) treatment of moderate or severe pain (usually after surgery), alone or in combination with other medicines.

Use Toradol as directed by your doctor. Toradol may be taken with food if it upsets your stomach. Taking it with food may not decrease the risk of stomach or bowel problems (such as bleeding or ulcers) that may occur while taking Toradol. Talk with your doctor or pharmacist if you experience persistant stomach upset. Do not use this medication for more than 5 days. Toradol is not for the treatment of mild to moderate or chronic pain (e. g. headache). Ask your health care provider any questions you may have about how to use Toradol.

Drug Class and Mechanism

Toradol is an NSAID. It reduces inflammation by preventing certain chemicals (prostaglandins) from being produced by the injured tissue.

If you miss a dose of Toradol, 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 Toradol at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Keep Toradol out of the reach of children and away from pets.

Do not use Toradol if: you are allergic to any ingredient in Toradol; you have had a severe allergic reaction (e. g. severe rash, hives, breathing difficulties, dizziness) to aspirin or an NSAID (e. g. ibuprofen, naproxen, celecoxib) ; you are taking an aminoglycoside (e. g. gentamicin), heparin, methotrexate, probenecid, tacrolimus, aspirin, or another NSAID (e. g. ibuprofen, celecoxib); you are breast-feeding, in labor or delivery, or you are scheduled to have surgery; you have a history of ulcers or severe stomach problems (e. g. bleeding, perforation); you are in your second or third trimester of pregnancy; you have severe kidney problems (including risk for kidney failure), or you have or are at risk for bleeding problems (e. g. stroke, hemorrhage). Contact your doctor or health care provider right away if any of these apply to you.

Important. Toradol may cause drowsiness or dizziness. Do not drive, operate machinery or do anything else that could be dangerous until you know how you react to Toradol. Using Toradol alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks. Do not take other anti-inflammatory medicines while you are taking Toradol. This includes any medicine that contains aspirin, ibuprofen, naproxen, and many prescription medicines. If you have questions about which medicines are anti-inflammatory agents, ask your doctor or pharmacist. If you are taking aspirin, prescribed by your doctor for reasons such as heart attack or stroke prevention (usually 81 to 325 mg per day), talk with your doctor before using Toradol. If you drink more than 3 alcohol-containing drinks a day, do not take Toradol without first discussing it with your doctor. Additional monitoring of your dose or condition may be necessary if you are taking amphetamines (e. g. dextroamphetamine), bisphosphonates (e. g. alendronate), or diuretics or "water pills" (e. g. hydrochlorothiazide). Lab tests may be required to monitor therapy or to check for side effects. Be sure to follow all doctor and lab appointments. Toradol is not recommended for use in children younger than 16 years of age. Safety and effectiveness have not been confirmed. Pregnancy and breast-feeding: If you become pregnant, discuss with your doctor the benefits and risks of using Toradol during pregnancy. Toradol is excreted in breast milk. Do not breast-feed while taking Toradol.

Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome: constipation; diarrhea; dizziness; drowsiness; gas; headache; indigestion; mouth sores; nausea; purple patches under the skin; stomach fullness; stomach pain; sweating; swelling; vomiting. Seek medical attention right away if any of these severe side effects occur:

severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black stools; dark urine or pale stools; fainting; fluid retention; hallucinations; meningitis; persistent stomach/abdominal pain; pounding in the chest; psychosis; rectal bleeding; seizures; severe and continuing nausea; shortness of breath; stomach perforation; tightness in chest; tremors; ulcers; unusual bleeding or bruising; unusual fatigue; vomit that looks like coffee grounds; yellowing of the skin or eyes.

Toradol 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.

Pain Relief - Halgeze (Brand name: toradol)

Toradol is used for the short-term (up to 5 days) treatment of moderate or severe pain (usually after surgery), alone or in combination with other medicines.

Use Toradol as directed by your doctor. Toradol may be taken with food if it upsets your stomach. Taking it with food may not decrease the risk of stomach or bowel problems (such as bleeding or ulcers) that may occur while taking Toradol. Talk with your doctor or pharmacist if you experience persistant stomach upset. Do not use this medication for more than 5 days. Toradol is not for the treatment of mild to moderate or chronic pain (e. g. headache). Ask your health care provider any questions you may have about how to use Toradol.

Drug Class and Mechanism

Toradol is an NSAID. It reduces inflammation by preventing certain chemicals (prostaglandins) from being produced by the injured tissue.

If you miss a dose of Toradol, 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 Toradol at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Keep Toradol out of the reach of children and away from pets.

Do not use Toradol if: you are allergic to any ingredient in Toradol; you have had a severe allergic reaction (e. g. severe rash, hives, breathing difficulties, dizziness) to aspirin or an NSAID (e. g. ibuprofen, naproxen, celecoxib) ; you are taking an aminoglycoside (e. g. gentamicin), heparin, methotrexate, probenecid, tacrolimus, aspirin, or another NSAID (e. g. ibuprofen, celecoxib); you are breast-feeding, in labor or delivery, or you are scheduled to have surgery; you have a history of ulcers or severe stomach problems (e. g. bleeding, perforation); you are in your second or third trimester of pregnancy; you have severe kidney problems (including risk for kidney failure), or you have or are at risk for bleeding problems (e. g. stroke, hemorrhage). Contact your doctor or health care provider right away if any of these apply to you.

Important. Toradol may cause drowsiness or dizziness. Do not drive, operate machinery or do anything else that could be dangerous until you know how you react to Toradol. Using Toradol alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks. Do not take other anti-inflammatory medicines while you are taking Toradol. This includes any medicine that contains aspirin, ibuprofen, naproxen, and many prescription medicines. If you have questions about which medicines are anti-inflammatory agents, ask your doctor or pharmacist. If you are taking aspirin, prescribed by your doctor for reasons such as heart attack or stroke prevention (usually 81 to 325 mg per day), talk with your doctor before using Toradol. If you drink more than 3 alcohol-containing drinks a day, do not take Toradol without first discussing it with your doctor. Additional monitoring of your dose or condition may be necessary if you are taking amphetamines (e. g. dextroamphetamine), bisphosphonates (e. g. alendronate), or diuretics or "water pills" (e. g. hydrochlorothiazide). Lab tests may be required to monitor therapy or to check for side effects. Be sure to follow all doctor and lab appointments. Toradol is not recommended for use in children younger than 16 years of age. Safety and effectiveness have not been confirmed. Pregnancy and breast-feeding: If you become pregnant, discuss with your doctor the benefits and risks of using Toradol during pregnancy. Toradol is excreted in breast milk. Do not breast-feed while taking Toradol.

Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome: constipation; diarrhea; dizziness; drowsiness; gas; headache; indigestion; mouth sores; nausea; purple patches under the skin; stomach fullness; stomach pain; sweating; swelling; vomiting. Seek medical attention right away if any of these severe side effects occur:

severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black stools; dark urine or pale stools; fainting; fluid retention; hallucinations; meningitis; persistent stomach/abdominal pain; pounding in the chest; psychosis; rectal bleeding; seizures; severe and continuing nausea; shortness of breath; stomach perforation; tightness in chest; tremors; ulcers; unusual bleeding or bruising; unusual fatigue; vomit that looks like coffee grounds; yellowing of the skin or eyes.

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Glibenclamide

Glibenclamide is a sulfonylurea antidiabetic agent, a class of drugs used to treat type II diabetes mellitus. This disease is a chronic metabolic illness characterized by a deficiency of insulin. a hormone produced by the pancreas which controls the sugar in the blood. The lack of insulin leads to hyperglycemia, or an increase in blood sugar levels. It also causes improper metabolism of proteins, carbohydrates and fat in the body.

Glibenclamide stimulates the pancreas to produce and release insulin in order to lower and regulate blood sugar levels. It also encourages sugar in the blood to travel to cells where it is needed to convert into energy. These actions, combined with a healthy diet low in fat and sugar will help diabetes sufferers regulate their blood sugar levels effectively.

Glibenclamide is counterindicated in people who are allergic to any of its ingredients, or to sulfonamide medications and thiazide diuretics. Patients who have congenital blood diseases and mental health ailments (porphyrias) should refrain taking Glibenclamide.

While under medication, patients are advised to avoid imbibing excessive amounts of alcohol. Elderly patients should use Glibenclamide only with their doctor's advise, as this medication increases the risk of low blood sugar levels occurring during the course of treatment.

Pregnant women should consult their doctor about the use of Glibenclamide, bearing in mind that the benefits derived from the use of this medication should greatly outweigh the risks it might bring to the unborn baby. If taking Glibenclamide is unavoidable during pregnancy, the patient should stop taking the medication at least 2 weeks before the expected delivery date. As this medication also passes into breast milk, breastfeeding mothers should refrain from taking Glibenclamide, as well.

Patients should apprise their doctor about the other medications they may be taking as these may have adverse effects when taken with Glibenclamide. Some of these drugs intensify Glibenclamide's effects and may cause low blood sugar levels. These drugs include aspirin. sulphonamide antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), beta-blockers, cotrimoxazole, warfarin. ciprofloxacin. anabolic steroids, antifungal medications, testosterone, monoamine oxidase inhibitors (MAOIs), phenylbutazone and clofibrate.

Other drugs interact with Glibenclamide by reducing its effects, thus leading to high blood sugar levels. These include corticosteriods, diuretics, oral contraceptives, chlorpromazine and rifampicin.

Patients who are suffering from acidosis (acid in the blood), liver or kidney ailments, high fever. diabetic ketoacidosis (ketones in the blood), or have recently suffered severe burns, diabetic coma. severe injuries, or have undergone any major surgery should inform their doctor of these conditions as these medical problems may alter the efficacy of Glibenclamide. Other conditions which may affect the use of this drug include chronic diarrhea. severe infections, considerable mental stress, adrenal gland ailments, intestinal problems, vomiting. heart disease, and thyroid or pituitary gland disorders.

Some of the common side effects of Glibenclamide include headaches. abdominal pain, diarrhea or constipation. nausea and vomiting, joint pain. confusion. hypoglycemia (low blood sugar levels), weight gain, frequent urination. heartburn. tremors. facial swelling. skin rashes, drowsiness, palpitations, double vision, tiredness, excessive hunger or decrease in appetite, restless sleep, and some blood disorders. Although less common, convulsions and fainting may occur, and these will require immediate medical attention.

In recently published medical findings, it was suggested that Glibenclamide caused more deaths annually when it was taken in combination with metformin. an insulin-secreting drug.

Glibenclamide is sold under the brand names Glimel, Diabeta, Glynase, and Micronase. and is available in 1.25 mg, 2.5 mg and 5 mg tablets. Each patient's dosage is determined by their individual condition, particularly by the sugar levels in their blood and urine.

Glibenclamide will not cure diabetes, only control it. As soon as blood sugar levels have been established at a comfortable level, the doctor will likely prescribe Glibenclamide as a regular maintenance medication, in conjunction with proper diet, exercise, and regular testing of blood sugar levels when needed.

Glibenclamide has the following structural formula:

• Molecular formula of glibenclamide is C23H28ClN3O5S • Chemical IUPAC Name is 5-chloro-N-[2-[4-(cyclohexylcarbamoylsulfamoyl)phenyl]ethyl]-2-methoxy-benzamide • Molecular weight is 494.004 g/mol • Glibenclamide available. 2,5mg tablets, 5mg tablets

Generic name: Glyburide

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Rhinocort is used for the control of asthma in persons requiring continuous, prolonged treatment. Such patients may include those with frequent asthmatic episodes requiring bronchodilators, or those with asthmatic episodes at night.

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

Hold the device upright while using. If the inhaler device is dropped or shaken, or if you accidentally breathe into the device after the dose has been loaded, you will lose the dose. Load another dose. Do not use the inhaler if it has been damaged or if the mouthpiece has come off. Inhale this medication by mouth, usually once or twice daily or as directed by your doctor. Inhale deeply and forcefully while using the device. Turn your mouth away from the device to breathe out before inhaling.

Keep track of each dose of medication you use. Discard the device after it has delivered the labeled number of doses or when the red mark reaches the bottom of the dose indicator window. The dosage is based on your medical condition and response to treatment. Use this medication regularly to get the most benefit from it.

Do not increase your dose or use this drug more often or for longer than prescribed.

Take Rhinocort as directed by your doctor.

Budesonide is used to prevent asthmatic attacks and should not be used to treat an acute attack of asthma. The Turbuhaler is used for individuals six years of age or older. Effects can be seen within 24 hours, but maximum effects may not be seen for 1-2 weeks or longer. Doses vary widely. Adults usually receive 1 to 4 actuations (puffs) twice daily. Children usually receive 1 to 2 puffs twice daily. For those with mild asthma, treatment once daily may be sufficient.

Budesonide should be stored at room temperature, 20-25 C (68-77 F).

Before using budesonide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as lactose, milk proteins found in some brands), which can cause allergic reactions or other problems.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: eye disease (such as cataracts. glaucoma), high blood pressure, liver disease, thyroid problems, diabetis, stomach/intestinal problems, bone loss (osteoporosis), current/past infections (such as tuberculosis, positive tuberculosis test, herpes, fungal), bleeding problems, mental/mood conditions (such as psychosis, anxiety, depression).

Before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used a corticosteroid taken by mouth within the past 12 months. Tell your doctor immediately if you develop unusual/extreme tiredness or weight loss.

Tell your doctor if you are pregnant before using this medication. Infants born to mothers who have used corticosteroids for a long time may have hormone problems.

Some products that may interact with this drug include: aldesleukin, other drugs that weaken the immune system (such as azathioprine, cyclosporine, cancer, chemotherapy), mifepristone. Other medications can affect the removal of budesonide from your body, which may affect how budesonide works. Examples include azole antifungals (such as ketokonazole), boceprevir, macrolide antibiotics (such as erythromycin, rifamycins (such as rifabutin), St. John's wort, drugs used to treat seizures (such as carbamazepine. phenytoin), among others.

Dry/irritated throat, hoarseness, voice changes, bad taste in the mouth, runny nose, or nosebleeds may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Many people using this medication do not have serious side effects. Infrequently, this medication may cause severe sudden worsening of breathing problems/asthma immediately after use. If you have sudden worsening of breathing, use your quick-relief inhaler and seek immediate medical attention. Because this drug works by weakening the immune system, it may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Tell your doctor immediately if you have any signs of infection (such as ear pain, sore throat, fever, chills).

Use of this medication for prolonged or repeated periods may result in yeast infection. Contact your doctor if you notice white patches in your mouth or on your tongue.

Tell your doctor immediately if any of these rare but serious side effects occur: unusual tiredness, vision problems, easy bruising/bleeding, puffy face, unusual hair growth, mental/mood changes (such as depression, mood swings, agitation), muscle weakness/pain, thinning skin, slow wound healing, increased thirst/urination. A very serious allergic reaction to this drug is rare.

Seek immediate medical attention if you notice any symptoms of a serious allergic reaction: rash/itching, swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Rhinocort is used for the control of asthma in persons requiring continuous, prolonged treatment. Such patients may include those with frequent asthmatic episodes requiring bronchodilators, or those with asthmatic episodes at night.

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

Hold the device upright while using. If the inhaler device is dropped or shaken, or if you accidentally breathe into the device after the dose has been loaded, you will lose the dose. Load another dose. Do not use the inhaler if it has been damaged or if the mouthpiece has come off. Inhale this medication by mouth, usually once or twice daily or as directed by your doctor. Inhale deeply and forcefully while using the device. Turn your mouth away from the device to breathe out before inhaling.

Keep track of each dose of medication you use. Discard the device after it has delivered the labeled number of doses or when the red mark reaches the bottom of the dose indicator window. The dosage is based on your medical condition and response to treatment. Use this medication regularly to get the most benefit from it.

Do not increase your dose or use this drug more often or for longer than prescribed.

Take Rhinocort as directed by your doctor.

Budesonide is used to prevent asthmatic attacks and should not be used to treat an acute attack of asthma. The Turbuhaler is used for individuals six years of age or older. Effects can be seen within 24 hours, but maximum effects may not be seen for 1-2 weeks or longer. Doses vary widely. Adults usually receive 1 to 4 actuations (puffs) twice daily. Children usually receive 1 to 2 puffs twice daily. For those with mild asthma, treatment once daily may be sufficient.

Budesonide should be stored at room temperature, 20-25 C (68-77 F).

Before using budesonide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as lactose, milk proteins found in some brands), which can cause allergic reactions or other problems.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: eye disease (such as cataracts. glaucoma), high blood pressure, liver disease, thyroid problems, diabetis, stomach/intestinal problems, bone loss (osteoporosis), current/past infections (such as tuberculosis, positive tuberculosis test, herpes, fungal), bleeding problems, mental/mood conditions (such as psychosis, anxiety, depression).

Before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used a corticosteroid taken by mouth within the past 12 months. Tell your doctor immediately if you develop unusual/extreme tiredness or weight loss.

Tell your doctor if you are pregnant before using this medication. Infants born to mothers who have used corticosteroids for a long time may have hormone problems.

Some products that may interact with this drug include: aldesleukin, other drugs that weaken the immune system (such as azathioprine, cyclosporine, cancer, chemotherapy), mifepristone. Other medications can affect the removal of budesonide from your body, which may affect how budesonide works. Examples include azole antifungals (such as ketokonazole), boceprevir, macrolide antibiotics (such as erythromycin, rifamycins (such as rifabutin), St. John's wort, drugs used to treat seizures (such as carbamazepine. phenytoin), among others.

Dry/irritated throat, hoarseness, voice changes, bad taste in the mouth, runny nose, or nosebleeds may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Many people using this medication do not have serious side effects. Infrequently, this medication may cause severe sudden worsening of breathing problems/asthma immediately after use. If you have sudden worsening of breathing, use your quick-relief inhaler and seek immediate medical attention. Because this drug works by weakening the immune system, it may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Tell your doctor immediately if you have any signs of infection (such as ear pain, sore throat, fever, chills).

Use of this medication for prolonged or repeated periods may result in yeast infection. Contact your doctor if you notice white patches in your mouth or on your tongue.

Tell your doctor immediately if any of these rare but serious side effects occur: unusual tiredness, vision problems, easy bruising/bleeding, puffy face, unusual hair growth, mental/mood changes (such as depression, mood swings, agitation), muscle weakness/pain, thinning skin, slow wound healing, increased thirst/urination. A very serious allergic reaction to this drug is rare.

Seek immediate medical attention if you notice any symptoms of a serious allergic reaction: rash/itching, swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.



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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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A nagyobb biztonsag es kenyelem erdekeben ajanlott a hattamaszt mindaddig az ulesen hagyni, amig a gyermek ki nem novi. Igy meg tovabb, meg nagyobb biztonsagban van a gyermek.

A Gamma 2 sulycsoportot fed le: 15 es 22 kg kozott az auto biztonsagi ovevel autosuleskent, 22 es 36 kg kozott, a hattamla eltavolitasa utan ulesmagasitokent hasznalhato.

A nagyobb biztonsag es kenyelem erdekeben ajanlott a hattamaszt mindaddig az ulesen hagyni, amig a gyermek ki nem novi. Igy meg tovabb, meg nagyobb biztonsagban van a gyermek.

A fejtamla magassaga allithato, igy egyutt novekszik a gyermekkel, kulonleges technologiaja altal folyamatosan szelesedo a hattamla. Szeles hattamlaval, vall - es oldalvedo vazkialakitassal rendelkezik, koveti a gyermek fejlodeset.

Kenyelmes, biztonsagos utazast biztosito karfaval felszerelt, igy a gyermek ezen pihentetheti a kezet. Konnyebben el tudja magat foglalni, rajzolas, jatek kozben is hasznaveheto kiegeszito lehet a karfa a vedelmi funkcion felul.

Kiemelkedo fejvedelemmel es allithato fej - es hattamlaval ellatott a maximalis biztonsagert, es a gyermek burok erzese megmarad emiatt. O maga is biztonsagban, komfortban erezheti magat.

Huzata konnyeden leveheto, mosogepben 30 fokon moshato. Kituno minosegu huzata legatereszto anyagbol keszult. Vastagon parnazott hat, fej es uloresz, amely maximalis kenyelmet nyujt a hosszu utazasok soran is. Megfelel az ECE R44/04-es Europai szabvanynak.

Bekotese: Menetirannyal megegyezoen, az auto 3 pontos ovet a gyermek elott elvezetve, a gepjarmu elso vagy hatso ulesere. Az egyszeru hasznalat mindennel fontosabb! Rendkivul konnyen bekotheto, mindig kovesse a hasznalati utasitast!

Oldalainkon a partnereink altal szolgaltatott informaciok es arak tajekoztato jelleguek, melyek esetlegesen tartalmazhatnak teves informaciokat. A kepek csak tajekoztato jelleguek es tartalmazhatnak tartozekokat, amelyek nem szerepelnek az alapcsomagban. A termekinformaciok (kep, leiras vagy ar) elozetes ertesites nelkul megvaltozhatnak. Az esetleges hibakert, elirasokert az Arukereso nem felel.



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Buy Ptinolin Online Without Prescriptions, Ptinolin

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What is Ptinolin?

The preparation refers to the h2 antagonists medications group, demonstrating comprehensive effectiveness in elimination of zollinger-ellison syndrome, indigestion, benign tumors of the hormone producing glands, inflammation of the esophagus with erosion and heartburn. A true to the type member of amines-type of drugs, the preparation has been loaded to the drugstores in August, 1977 following a FDA approval. Since then Ptinolin has quickly acquired popularity worldwide; the demand has facilitated the development of a series of generic products, for example generic Ranitidine. In conformity with FDA license the medicament is available over the counter. Based on ranitidine active ingredient, developed and initially recorded to Sandoz, the medicine is primarily designed for oral application, and comes as tablet. Conforming to Canadian DrugBank directory stats as for August, 1977, the price range for ranitidine-based preparations starts from $0.07 and hits as high as $7.96 per unit (please, note that our platform doesn’t offer Ptinolin and the prices are indicated for info purposes only). The medication is manufactured around the globe by the leading pharmaceutical enterprises, like Alpharma Us Pharmaceuticals Division. Basing on Ptinolin effectiveness reviews by registered WebMD. com members, the medication feedback score is 8.1 out of 10. Ptinolin formula

How it works?

Ptinolin is a histamine-2 blocker reducing the amount of acid in your stomach. The drug is used to treat and prevent ulcers in the stomach and intestines. It also treats conditions in which the stomach produces too much acid, such as Zollinger-Ellison syndrome. The medication also treats gastroesophageal reflux disease (GERD) and other conditions in which acid backs up from the stomach into the esophagus, causing heartburn.

Dosage & administration

Before you administer Ptinolin, please, read the package insert. If you concerns regarding contraindications or any other aspect of Ptinolin administration, you must seek for professional assistance before taking the drug. Consult your treating doctor to select an optimal administration regimen.

Side effects

Apart from a good number of beneficial impacts, the great majority of meds cause undesired side-effects, even though the percentage of cases as a rule doesn’t go beyond 10% level. Mentioned below is the list of the most widely spread by-effects listed at Pubchem. ncbi. nlm. nih. gov, relying on 134 clinical tests and surveys:

anaphylactic shock – 8.10%

anaemia – 5.2%

alopecia – 1%

pancreatitis acute – 4.4%

diarrhoea – 9%

headache – 7.10%

angina pectoris – 3%

vomiting – 4%

agranulocytosis – 4%

If one or several aforementioned adverse effects last long, you must seek for medical attention immediately to avoid any complications. Any adverse reactions can be reported to FDA via the phone: 1-800-FDA-1088.

Contraindications

Not all the meds are suitable for people with certain conditions, and it may turn out that a medicine can only be applied if extra care is taken. Keeping this in mind, before you start taking Ptinolin, visit your therapist how to choose the dosage in case of any diseases.

Review

Michael Uribe, 54, Arlington, USA I have been applying Ptinolin for almost 2 weeks, and indeed its effect is incredible. My treating doctor has warned me about the potential agranulocytosis and angina pectoris because in my situation it was a part of sophisticated treatment. Even though I had to adjust the dosage, the treatment course was a great success. And yes it seems like Ptinolin in its generic form (generic Ranitidine) is a no less efficient preparation. You should definitely give it a try. Yasmine Pagan, 45, Paterson, USA I’ve ordered Ranitidine by recommendation of my close friend – fascinated by the drug’s treatment capabilities, I’ve purchased Ranitidine online and enrolled in in the treatment course. To tell the truth, I didn’t think the effect would be that impressive; with a higher dosage I’ve never suffered from neither diarrhoea nor pancreatitis acute. Rachel Hansen, 39, Peoria, USA Ranitidine is probably the most powerful medication that has helped me to get rid of indigestion quickly and effectively. With the price starting from as little as $0.07 and absolutely brilliant effect, this is the best you can get.

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Klaider

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The A50 Set, Raden

The A50 Set

From durable polycarbonate shells to enough volume to fit everything on the family's packing list, the set is everything you can ask for to keep you confidently connected for both your weekend trips and longer travel plans.

- Travel technology: locate, weight, charge

- Dimensions: 28”/21”/13” and 22”/14”/9”

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Color White Finish gloss

The A50 Set in White is available for same-day delivery in New York.

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The A50 Set in White ships within 1-2 business days. As demand continues to build, our backlog grows. For The A50 Set in White to ship within 1-2 business days, we suggest you place your order now.

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Fishing Amistad Reservoir, Omnistad

Amistad Reservoir

Lake Characteristics

Location: On the Rio Grande, 12 miles northwest of Del Rio in Val Verde County Surface area: 64,900 acres Maximum depth: 217 feet Impounded: 1969

Water Conditions

Current Lake Level Conservation Pool Elevation: 1117 ft. msl Fluctuation: Depends on rainfall and downstream irrigation demands. Annual fluctuations can be 5-10 feet. Historical fluctuations have dropped lake as much as 50 feet below conservation pool. Normal Clarity: Clear to slightly stained

Reservoir Controlling Authority

Aquatic Vegetation

Coverage is dependent on water level. In 1999, a survey indicated approximately 1,000 acres of aquatic vegetation, primarily hydrilla.

Predominant Fish Species

Lake Maps

A free map of the Amistad National Recreation Area is available from the National Park Service's Amistad Visitor Information Center.

Fishing Regulations

On the Texas side of the lake, all species are managed under current statewide regulations. For recreational anglers fishing Mexican waters, a Mexico fishing license is required for everyone in the boat. Mexico boat permits are no longer required. For information on Mexico's fishing regulations, visit the National Aquaculture and Fishing Commission (CONAPESCA) website.

Mexico licenses can be purchased in Del Rio at Amistad Marine (Highway 90 West, 830/775-0878) or Fisherman's Headquarters (Chevron at the intersection of of 90 & 277 N, 830/774-5670.

Angling Opportunities

Largemouth bass are the most popular and most abundant sportfish in the reservoir. Channel and blue catfish are present in good numbers with an occasional flathead showing up. Striped bass are popular and sought by anglers due to their strong fighting characteristics and their potential for trophy sizes. Frequent stockings by the Texas Parks and Wildlife Department maintain the striper population because they have not successfully reproduced in this reservoir. White bass provide popular seasonal fishing during spring spawning runs. Smallmouth bass are present; anglers report better success with this species in the Devils River arm of the lake.



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Hepatic Encephalopathy Causes, Symptoms, Diagnosis, Treatment, And More, Hepitec

Hepatic Encephalopathy

What Is Hepatic Encephalopathy?

You've had liver disease for a while, but now you notice something different about the way you act and feel. Maybe you forget things or get confused when someone's talking to you. Your friends may tell you that your speech sounds slurred or that you say things that aren't appropriate.

And it isn’t only changes in behavior. You might feel sluggish or find that you can't move your hands well anymore. Or your breath doesn't smell like it should.

What's going on? Is there a link to the liver problems you've been dealing with for years?

It could be. You may have hepatic encephalopathy (HE), a brain disorder that can happen if you have advanced liver disease. It affects a lot of things, like your behavior, mood, speech, sleep. or the way you move.

Sometimes the symptoms are so mild that it's hard for anyone to notice. But whether you have obvious signs or just a few subtle changes, it's important to see your doctor. The right treatment can keep your condition under control, but if you don't take care of yourself, you'll get worse and worse.

Causes

Your liver has several big jobs to do. One key task is to clean your blood by getting rid of harmful chemicals that your body makes.

Hepatic encephalopathy starts when your liver gets damaged from a disease you've had a long time, like hepatitis. Reye's syndrome. or cirrhosis. It doesn't work right anymore, and toxins get into your bloodstream and travel to your brain. They build up there and cause the mental and physical symptoms of HE.

Several things can trigger an episode or make your condition worse. For example, you could be at risk for problems if you have a tube called a shunt placed in your liver. You might have this done to help reroute your blood flow to treat cirrhosis or another long-term disease. There's a chance that this procedure will allow toxins to bypass your liver and move to your brain .

Other things can set off hepatic encephalopathy, too. It might happen because you:

Continued

Symptoms

There's a lot of variety in the way HE affects people. Not everyone has the same symptoms. For some folks, they may be very slight or come and go.

In some cases, the effects of hepatic encephalopathy start slowly and then get worse bit by bit. But sometimes they hit you hard all at once.

There are some mental signs to watch out for. For instance, you may:

Get confused

Forget things

Feel nervous or excited

Notice a sudden change in your personality or behavior

Speak or act inappropriately to others

Not feel interested in things

Get cranky

Of course, when it comes to changes in behavior, sometimes you're the last one to realize that something is off. So if you've got a long-term liver disease, ask your family and friends to be on the lookout for shifts in your personality. Tell them to be honest with you if they see your mood has changed or you're just not acting like your old self.

You may also notice some changes in your sleep patterns. You could feel sleepy during the day or stay up late at night.

Some physical changes can start creeping in, too. You may notice that:

Your breath smells sweet or musty.

It's hard to move or use your hands.

When you hold out your arms or hands, they shake or flap.

Your speech sounds slurred.

You feel slow or sluggish when you move your body.

Getting a Diagnosis

It may be hard to notice hepatic encephalopathy at first. Your family or friends may see changes in your behavior or movement before you do.

If you have a liver disease or had one in the past, your doctor may ask you if anyone has told you about changes in your personality. He'll examine you for signs of the physical symptoms that go along with the brain disorder.

He may also give you a blood test to check for high levels of ammonia. That's a sign that your liver is not clearing it from your bloodstream the way it should. Too much of that toxin can build up in your brain and lead to HE symptoms.

Continued

Questions for Your Doctor

If your doctor diagnoses you with hepatic encephalopathy, some things to ask him are:

What stage of the brain disorder do I have?

What treatments do you recommend?

Will my symptoms get better or go away?

Will I have to change my diet ?

Will I still be able to work, take care of myself, and drive?

Treatment

You've got a number of choices. A lot depends on your specific situation. For instance, your doctor will take into account things like:

What triggers your episodes

How severe a case you have

The types of symptoms you get

How serious your long-term liver disease is

How old you are and your overall health

Your doctor may suggest two types of drugs that reduce the toxins in your body:

Lactulose . This is a type of sugar that can make you have more bowel movements. This helps get rid of some toxins from your body, like ammonia, which can trigger HE.

Antibiotics . Drugs like neomycin (Neo-Fradin) and rifaximin (Rifagut, Xifaxan) may help. They curb bacteria that create toxins when they digest your food.

Your doctor may also ask you to take some other steps that can improve your symptoms:

Change your diet. If you eat a lot of meat, your body may make too much ammonia. Your doctor may ask you to cut back, but you still need to get enough protein from other sources. Try dairy and veggies. Also eat frequent small meals rather than three big ones a day.

Skip alcohol . Even a little bit can be risky for you because it damages your liver.

Treat infections. They can affect the way your liver works. You may need antibiotics to get rid of them.

Treat urinary blockages. If you can't pee normally, it can trigger your HE. Treatment for the infection or disease that's causing it can help.

Stop some medications. Certain medicines, such as sedatives or narcotics, may cause problems with your liver.

Treat constipation . You may need to eat less meat and more vegetables. This can help you have more regular bowel movements so you can flush toxins from your body.

Continued

Taking Care of Yourself

The best thing you can do to keep your HE under control is stick with the treatment plan that your doctor suggests.

Since you already have a lot of medical stuff to do because of your long-term liver disease, it might seem like your new treatment is a big nuisance. But it's really important. Don't skip any doses of medicines, and make sure you follow your doctor's diet advice. Ask your friends and family to help you stay on track.

If you play by the rules, you'll get results. Your symptoms can improve and sometimes go away.

What to Expect

HE can be divided into stages according to how severe your symptoms are. If you're in an early stage, the right treatment can ease your symptoms.

If you don't take care of yourself, your HE might move through four stages:

Stage 1 . Mild. You may have trouble sleeping or find it hard to concentrate.

Stage 2: Moderate. You may feel like you don't have much energy. Some personality changes start to show up, like acting odd or forgetting things. You could notice some physical changes, like slurring your speech or trouble using your hands.

Stage 3 . Severe. You may be angry or confused. You could also get extremely sleepy or pass out, though you'll wake up when someone tries to rouse you.

Stage 4: Coma . In this phase, you may pass out and become unconscious for a long time.

These stages may sound scary, but remember, HE can be treated if you act promptly. Work with your doctor closely and follow his instructions carefully.

Getting Support

Even though treatment can keep your HE from getting worse, there may be times you'll need to get some care at home to help you when your symptoms are acting up. A caregiver can help you with some daily tasks. For instance, he or she can:

Shop for food

Help you dress and wash

Watch to see if your symptoms get worse

You also need to reach out to family and friends to get emotional support. They know you best and can give you the backing you need while you manage your symptoms.

It helps to talk to people who know about liver disease and HE firsthand. They'll understand just what you're going through. The American Liver Foundation has information about how to find support groups in your area. It also has a lot of useful advice on a web site that's all about the diagnosis and treatment of hepatic encephalopathy.

WebMD Medical Reference Reviewed by Arefa Cassoobhoy, MD, MPH on January 08, 2016

Sources

American Liver Foundation: "Living With Hepatic Encephalopathy."

American Association for the Study of Liver Diseases: "Hepatic Encephalopathy in Chronic Liver Disease: 2014 Practice Guideline."

Canadian Liver Foundation: "Hepatic Encephalopathy."

© 2016 WebMD, LLC. All rights reserved.



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Mobic - Pain Relief, Flasicox

Mobic is used to relieve the pain and stiffness of osteoarthritis and rheumatoid arthritis.

Take Mobic exactly as directed by your physician. It is recommended that you take it with a glass of water and a meal (to avoid an empty stomach).

If you miss a dose of Mobic, then skip it and continue with your regular schedule. However, do not take a double dose to make up for the missed dose.

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

Some of the symptoms of a Mobic overdose include nausea, vomiting, stomach pain and bleeding. In extreme cases, it may lead to a heart attack or even coma. Seek medical attention immediately if you suspect an overdose.

Consult your doctor before starting treatment if you are allergic to aspirin, have asthma or experience difficulty breathing while using Mobic. Do not smoke, have alcohol or take steroidal medications while using this drug. Use only if prescribed.

Do not use Mobic if:

you are allergic to any ingredient in Mobic; you have had a severe allergic reaction (eg, severe rash, hives, trouble breathing, growths in the nose, dizziness) to aspirin or a nonsteroidal anti-inflammatory drug (NSAID) (eg, ibuprofen, celecoxib); you have recently had or will be having bypass heart surgery; you have a peptic ulcer; you are in the last 3 months of pregnancy. Contact your doctor or health care provider right away if any of these apply to you.

Important : Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do not take more than the recommended dose or use for longer than prescribed without checking with your doctor. Mobic is an NSAID. Before you start any new medicine, check the label to see if it has an NSAID (eg, ibuprofen) in it too. If it does or if you are not sure, check with your doctor or pharmacist. Do not take aspirin while you are using Mobic unless your doctor tells you to. Lab tests, including kidney function, complete blood cell counts, and blood pressure, may be performed while you use Mobic. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Use Mobic with caution in the elderly; they may be more sensitive to its effects, especially stomach bleeding and kidney problems. Caution is advised when using Mobic in children; they may be more sensitive to its effects, especially diarrhea, fever, headache, stomach pain, and vomiting. Mobic should be used with extreme caution in children younger than 2 years old; safety and effectiveness in these children have not been determined. Pregnancy and breast-feeding: Mobic may cause harm to the fetus. Do not use it during the last 3 months of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Mobic while you are pregnant. It is not known if Mobic is found in breast milk. Do not breast-feed while taking Mobic.

Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome:

constipation; diarrhea; dizziness; gas; headache; heartburn; nausea; stomach upset; trouble sleeping. Seek medical attention right away if any of these severe side effects occur:

severe allergic reactions (rash; hives; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; change in the amount of urine produced; chest pain; confusion; dark urine; depression; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe headache or dizziness; severe or persistent stomach pain or nausea; severe vomiting; shortness of breath; sudden or unexplained weight gain; swelling of hands, legs, or feet; unusual bruising or bleeding; unusual joint or muscle pain; unusual tiredness or weakness; vision or speech changes; vomit that looks like coffee grounds; yellowing of the skin or eyes.

Mobic 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.

Mobic is used to relieve the pain and stiffness of osteoarthritis and rheumatoid arthritis.

Take Mobic exactly as directed by your physician. It is recommended that you take it with a glass of water and a meal (to avoid an empty stomach).

If you miss a dose of Mobic, then skip it and continue with your regular schedule. However, do not take a double dose to make up for the missed dose.

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

Some of the symptoms of a Mobic overdose include nausea, vomiting, stomach pain and bleeding. In extreme cases, it may lead to a heart attack or even coma. Seek medical attention immediately if you suspect an overdose.

Consult your doctor before starting treatment if you are allergic to aspirin, have asthma or experience difficulty breathing while using Mobic. Do not smoke, have alcohol or take steroidal medications while using this drug. Use only if prescribed.

Do not use Mobic if:

you are allergic to any ingredient in Mobic; you have had a severe allergic reaction (eg, severe rash, hives, trouble breathing, growths in the nose, dizziness) to aspirin or a nonsteroidal anti-inflammatory drug (NSAID) (eg, ibuprofen, celecoxib); you have recently had or will be having bypass heart surgery; you have a peptic ulcer; you are in the last 3 months of pregnancy. Contact your doctor or health care provider right away if any of these apply to you.

Important : Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do not take more than the recommended dose or use for longer than prescribed without checking with your doctor. Mobic is an NSAID. Before you start any new medicine, check the label to see if it has an NSAID (eg, ibuprofen) in it too. If it does or if you are not sure, check with your doctor or pharmacist. Do not take aspirin while you are using Mobic unless your doctor tells you to. Lab tests, including kidney function, complete blood cell counts, and blood pressure, may be performed while you use Mobic. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Use Mobic with caution in the elderly; they may be more sensitive to its effects, especially stomach bleeding and kidney problems. Caution is advised when using Mobic in children; they may be more sensitive to its effects, especially diarrhea, fever, headache, stomach pain, and vomiting. Mobic should be used with extreme caution in children younger than 2 years old; safety and effectiveness in these children have not been determined. Pregnancy and breast-feeding: Mobic may cause harm to the fetus. Do not use it during the last 3 months of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Mobic while you are pregnant. It is not known if Mobic is found in breast milk. Do not breast-feed while taking Mobic.

Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome:

constipation; diarrhea; dizziness; gas; headache; heartburn; nausea; stomach upset; trouble sleeping. Seek medical attention right away if any of these severe side effects occur:

severe allergic reactions (rash; hives; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; change in the amount of urine produced; chest pain; confusion; dark urine; depression; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe headache or dizziness; severe or persistent stomach pain or nausea; severe vomiting; shortness of breath; sudden or unexplained weight gain; swelling of hands, legs, or feet; unusual bruising or bleeding; unusual joint or muscle pain; unusual tiredness or weakness; vision or speech changes; vomit that looks like coffee grounds; yellowing of the skin or eyes.

Mobic 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.

Mobic is used to relieve the pain and stiffness of osteoarthritis and rheumatoid arthritis.

Take Mobic exactly as directed by your physician. It is recommended that you take it with a glass of water and a meal (to avoid an empty stomach).

If you miss a dose of Mobic, then skip it and continue with your regular schedule. However, do not take a double dose to make up for the missed dose.

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

Some of the symptoms of a Mobic overdose include nausea, vomiting, stomach pain and bleeding. In extreme cases, it may lead to a heart attack or even coma. Seek medical attention immediately if you suspect an overdose.

Consult your doctor before starting treatment if you are allergic to aspirin, have asthma or experience difficulty breathing while using Mobic. Do not smoke, have alcohol or take steroidal medications while using this drug. Use only if prescribed.

Do not use Mobic if:

you are allergic to any ingredient in Mobic; you have had a severe allergic reaction (eg, severe rash, hives, trouble breathing, growths in the nose, dizziness) to aspirin or a nonsteroidal anti-inflammatory drug (NSAID) (eg, ibuprofen, celecoxib); you have recently had or will be having bypass heart surgery; you have a peptic ulcer; you are in the last 3 months of pregnancy. Contact your doctor or health care provider right away if any of these apply to you.

Important : Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do not take more than the recommended dose or use for longer than prescribed without checking with your doctor. Mobic is an NSAID. Before you start any new medicine, check the label to see if it has an NSAID (eg, ibuprofen) in it too. If it does or if you are not sure, check with your doctor or pharmacist. Do not take aspirin while you are using Mobic unless your doctor tells you to. Lab tests, including kidney function, complete blood cell counts, and blood pressure, may be performed while you use Mobic. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Use Mobic with caution in the elderly; they may be more sensitive to its effects, especially stomach bleeding and kidney problems. Caution is advised when using Mobic in children; they may be more sensitive to its effects, especially diarrhea, fever, headache, stomach pain, and vomiting. Mobic should be used with extreme caution in children younger than 2 years old; safety and effectiveness in these children have not been determined. Pregnancy and breast-feeding: Mobic may cause harm to the fetus. Do not use it during the last 3 months of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Mobic while you are pregnant. It is not known if Mobic is found in breast milk. Do not breast-feed while taking Mobic.

Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome:

constipation; diarrhea; dizziness; gas; headache; heartburn; nausea; stomach upset; trouble sleeping. Seek medical attention right away if any of these severe side effects occur:

severe allergic reactions (rash; hives; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; change in the amount of urine produced; chest pain; confusion; dark urine; depression; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe headache or dizziness; severe or persistent stomach pain or nausea; severe vomiting; shortness of breath; sudden or unexplained weight gain; swelling of hands, legs, or feet; unusual bruising or bleeding; unusual joint or muscle pain; unusual tiredness or weakness; vision or speech changes; vomit that looks like coffee grounds; yellowing of the skin or eyes.

Mobic 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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Model Market - Just Opened London, Wingyl

NAME: Model Market IT'S: Night-time Outdoor Food & Drink OPENED: April 17th 2015 WHO'S BEHIND IT: Street Feast DID YOU KNOW: Theres five bars including 'wingyl' (wine and vinyl) and desserts from Scoopsy Daisy, and from locals SE Brownie Bar LOCATION: Lewisham ADDRESS: 196 Lewisham High Street, Lewisham, London SE13 6LS TRAVEL TO: Lewisham Overground OPENING TIMES: Fridays and Saturdays, 5pm-1am until October 3rd 2015 WEBSITE: www. streetfeastlondon. com CONTACT: @StreetFeastLDN MAP: View Map

Model Market

OPENED 523 DAYS AGO

An abandoned Fifties market is reformed again for a twenty-five week summer season for 2015. Model Market in Lewisham is the best of both inside and outside ‘shopping’ – though all you’ll find to shop for is food and booze in abandoned outlets that used to house laundrettes, vinyl stores and local food shops.

A dose of New York upcycling has made it to our shores: the ‘Lewisham Highline’ is one of five bars, occupying the rooftop with tequila and craft beer – and plenty of sun for us lot to sit in and enjoy London from the south-east. There’s grown up slushies, and food-wise a collection of new and old faces – expect to find cuisines from all continents. Like last year, a vinyl shop from the Fifties serves as one of many food quarters – ask around as you go and piece together the market as it would have been mid-Century, when eating and drinking outdoors would’ve got you a darn good hiding.

NAME: Model Market IT'S: Night-time Outdoor Food & Drink OPENED: April 17th 2015 WHO'S BEHIND IT: Street Feast DID YOU KNOW: Theres five bars including 'wingyl' (wine and vinyl) and desserts from Scoopsy Daisy, and from locals SE Brownie Bar LOCATION: Lewisham ADDRESS: 196 Lewisham High Street, Lewisham, London SE13 6LS TRAVEL TO: Lewisham Overground OPENING TIMES: Fridays and Saturdays, 5pm-1am until October 3rd 2015 WEBSITE: www. streetfeastlondon. com CONTACT: @StreetFeastLDN MAP: View Map

ALSO JUST OPENED.

JUST OPENED IN YOUR INBOX



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Bloody Sacred Ground” By Zanpan, Zanpan

“Bloody Sacred Ground” by Zanpan.

It’s Daisuke “Pixel” Amaya’s birthday, and I thought it’d be nice to celebrate the Cave Story creator’s continued existence with wicked fanart. Adam Saltsman, who developed the awesome Gravity Hook Flash game we featured several months back, also has a nice piece of his own posted on Nicalis’s blog to honor the occasion.

[ Update: Wow, I had no idea Adam was handling the high-res art for the WiiWare remake. Awesome!]

Here’s another wonderful Cave Story illustration from Zanpan, this one titled “Barrack Hut”:

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Maricrio, Maricrio

Product Description Common use This medicine is a proton pump inhibitor (PPI) used to treat ulcers, heartburn, gastroesophageal reflux, erosive esophagitis, or Zollinger-Ellison syndrome and also ulcers generated by long-term use of non-steroidal anti-inflammatory drugs (NSAIDs). To treat ulcers caused by bacterial infections this medicine may be used in combination with antibiotics such as amoxicillin or clarithromycin. Prilosek significantly alleviates such their symptoms as heartburn, difficulty swallowing, coughing, and sleep problems. Prilosek works by blocking acid production in the stomach. The medicine may be used to treat other conditions diagnosed by your doctor.

Dosage and directions Follow all the directions provided by your doctor. Take this medication (15-30 mg) orally once a day in morning before a meal with a full glass of water or according to your doctor's recommendations. Swallow the tab whole, do not chew, crush, or open the capsule as may destroy the drug and/or increase side effects. Antacids drugs can be taken together with this medicine, if necessary. Dosage and duration of treatment depends on your medical condition and response to the therapy. Take it the same time each day to avoid missing a dose. In the case of aggravation or worsening of your illness notify your doctor immediately. It may take 1 - 4 days before Prilosek acts in full measure. Treatment with Prilosec should not be stopped even if certain amelioration is achieved. Improvement of symptoms is observed within 4 to 8 weeks in treatment of gastric ulcers or reflux disease. Treatment of heartburn usually lasts for 14 days. If heartburn persists after this period of time or even worsens, or if you need more than one course of treatment every 4 months, contact your doctor or pharmacist.

Precautions Prilosec is not recommended during pregnancy. Breastfeeding when using this drug is not recommended as it is not known whether it gets into breast milk. Tell your doctor if allergic reaction appears. Your doctor or pharmacist should be aware of your health problems, to provide health care, especially if you have problems such as liver disease, other stomach problems (e. g. tumors), heartburn over 3 months, unexplained weight loss, constant nausea/vomiting /stomach pain, blood in vomit or black stools. Some symptoms may witness about a more serious condition. This medicine may cause dizziness. Be careful performing work associated with concentration of attention, such as driving or operating mechanisms. Restrict consumption of alcoholic beverages. Start or interruption in taking any medicine should be be approved by your doctor. If you do not notice any improvement of your symptoms or if they even become worse, inform your doctor about it. Do not share this medicine with anybody with similar symptoms. Do not use this medicine to treat other diseases.

Possible side effects Adverse reactions that may disappear during treatment include headache, constipation, cough, dizziness, or rash. If they continue or are bothersome, let your doctor know about it. An allergic reaction to this medicine is not expected, but seek immediate medical help if it happens. Symptoms of an allergic reaction appear as rash, itching, dizziness, swelling, or difficult breathing. If you notice other reactions of your body which are not listed above, contact your doctor or pharmacist.

Prilosec can decreases elimination of diazepam, warfarin and phenytoin. These are medications metabolized in the liver by oxidation. Drugs which are metabolized with help of cytochrome P-450 system (e. g. cyclosporine, disulfiram, benzodiazepines) may also interact with Prilosec because it is metabolized the same way. Clarithromycin is also metabolized by cytochrome P450, concomitant administration of clarithromycin with Prilosec may result in increases in plasma levels of Prilosec. Concomitant use of Prilosec and clarithromycin may result in increases in plasma levels of erithromycin, and 14-hydroxy-clarithromycin. You may need additional monitoring of your condition if you are taking ampicillin, cilostazol, cyclosporine, diazepam, digoxin, disulfiram, iron, itraconazole, ketoconazole, moclobemide, phenytoin, sucralfate, vorconizole, or warfarin. This medicine may be combined with antacids if they were prescribed by your doctor. Potent acid-reducing drugs such as Prilosec diminish the effectiveness of sucralfate, and other medicaitons such as the antifungals ketoconazole and itraconazole. If instructed to take any of these medicines while taking Prilosec, consult your doctor or pharmacist regarding the proper timing of each dose, usually Prilosec is taken 30 minutes before sucralfate.

Missed dose If you missed a dose take the medication as soon as you remember. If it is almost time of your next dose, just skip its intake and return to your regular schedule.

Overdose If suppose that took too much of Prilosec contact your local poison control center or emergency room immediately. Symptoms of overdose are confusion, blurred vision, unusual sweating, or unusually fast heartbeat.

Storage Store at room temperature between 59-77 F (15-25 C). Do not expose to high humidity or keep in a bathroom. Hide Prilosec away from children and pets. If your treatment requires an extended period of time, take care about refills before your supply is over.

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



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W-Letter Archives, Wytens

Category: W-Letter

What is Wytens? The medicine belongs to the thiazide diuretics medications group, demonstrating considerable efficiency in elimination of accumulation of fluid resulting from chronic heart failure, visible water retention, fluid in the lungs due to chronic heart failure and high blood pressure. A typical representative of thiadiazines-type of drugs, the drug has hit the shelves …

What is Wysolone? The preparation refers to the glucocorticoids meds group, standing out with comprehensive results in elimination of condition caused by excess secretion of male hormones, diagnostic test for cushing’s syndrome, spleen and liver, increased calcium in the blood from cancer and infection caused by the trichinae parasite. A true to the type member …

What is Wymox? The medication represents the aminopenicillins preparations group, boasting considerable effectiveness in elimination of severe sinusitis caused by streptococcus pneumoniae, skin infection due to streptococcus bacteria, infection of the genital and urinary tract due to e. coli, strep throat and tonsillitis and throat infection caused by haemophilus influenzae. A typical member of lactams-type …

What is Wymesone? The drug represents the glucocorticoids medicaments group, demonstrating considerable efficacy in elimination of burkitt’s lymphoma, follicular lymphoma, spleen and liver, infection caused by the trichinae parasite and additional medication for treatment of tuberculosis meningitis. A true to the type representative of steroids and steroid derivatives-type of meds, the preparation has been launched …

What is Wormstop? The medicine belongs to the anthelmintics medicaments group, boasting comprehensive in elimination of pinworm infection, intestinal infection by a worm – trichuris trichiura, hookworm infection caused by necator americanus, infestation by roundworms and hookworm infection caused by ancylostoma duodenale. A true to the type member of benzene and substituted derivatives-type of drugs, …

What is Wormkuur? The preparation belongs to the anthelmintics medications group, boasting considerable in treatment of infestation by roundworms, hookworm infection caused by necator americanus, pinworm infection, hookworm infection caused by ancylostoma duodenale and intestinal infection by a worm – trichuris trichiura. A typical representative of benzene and substituted derivatives-type of medicines, the drug has been …

What is Wormin? The drug represents the anthelmintics meds group, providing comprehensive results in elimination of hookworm infection caused by ancylostoma duodenale, hookworm infection caused by necator americanus, infestation by roundworms, pinworm infection and intestinal infection by a worm – trichuris trichiura. A typical member of benzene and substituted derivatives-type of medicines, the drug has …

What is Wormgo? The medicament represents the anthelmintics preparations group, demonstrating impressive efficacy in treatment of hookworm infection caused by ancylostoma duodenale, hookworm infection caused by necator americanus, infestation by roundworms, intestinal infection by a worm – trichuris trichiura and pinworm infection. A true to the type representative of benzene and substituted derivatives-type of meds, …

What is Wormex? The drug refers to the anthelmintics drugs group, providing considerable effectiveness in treatment of hookworm infection caused by necator americanus, hookworm infection caused by ancylostoma duodenale, intestinal infection by a worm – trichuris trichiura, pinworm infection and infestation by roundworms. A typical member of benzene and substituted derivatives-type of meds, the active ingredient …

What is Wormazol? The drug represents the anthelmintics medicaments group, demonstrating considerable results in treatment of intestinal infection by a worm – trichuris trichiura, hookworm infection caused by ancylostoma duodenale, infestation by roundworms, pinworm infection and hookworm infection caused by necator americanus. A typical representative of benzene and substituted derivatives-type of meds, the preparation has been …

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That S It For Me, 1 Giganto Vs Full Base Of Stone, Dinopen

That's It For Me, 1 Giganto vs Full Base of Stone.

so that's it for me. not gonna play ark anymore. im not trying to QQ or Rant.

but basically this is like the fourth time, i could actually build a base to a certain state with 2 friends before it actually had enough defense.

i had a full stone base and dinopen and big fence and metalspikes / wooden spikes. and a stone/metal mix base and just 1 idiot kid that's in a big tribe with a giganto who trolls around and it's game over 1 month gametime with 3 people, and we played a lot like 10-14 hours a day.

im not crying about that entirely.

im literally saying im not playing until they actually balance the game and fix the bugs/lags. it serves no purpose other than testing and playing pve/privateservers/singleplayer.

i dont know how a pvp server can be called pvp. when just 1 guy with a giganto kills a full geared tribe of 3 people with epic crossbows and guns. and 16 plant turrets on top of the base, and a few metal spikes. and he just eats through every stone, u might say, oh ok just build a metalbase, we were just before upgrading to metal, and it happened to us 4 times like that, before we even can place autoturrets or tame a few cool dinos or get a metalbase, that we get raided and bullied by big tribes and not a full tribe just 1 random kid from a big tribe.

also i was on my big stone roof, and the giganto head, just sticks through the stone roof, and also even tho the head wasnt in range, my mates and me got killed like a few metre's away. just 1 bite even tho we had full flak armor with nearly 200 armor each.

im sick of this game and it's balance/bugs.

and i suggest people don't play it until summer 2016. it's just a waste of time and too much stress. and a waste of time in a bad way, not as in having fun.

-fix the lags - nerf giganto to wood we dont need stone destroying dinosaurs, or just nerf them really hard. - nerf quetzal weight and give limitations to turrets - nerf c4 or buff metal/stone. - dont allow cave/dungeon blocking - fix most of the bugs - fix the holes which you can stuck in (in between some rocks) - buff some weapons and crossbows and arrows, and allow us to snipe down a guy from a giganto. he literally took like 150 crossbow shots and we aimed at his head, might've been the lag, or it's not possible to shoot someone down from his dino. i dont even know. - the giganto destroyed not even much, but when he destroyed us, our fps dropped to like 5 fps, on a gtx970 and i didn't even have high settings i nearly played on full low. so it dropped from 100 to 5 or something.

maybe the game will be good then.

time for blade n soul soon i guess, so im not even that mad, but still i built a huge base even out of metal first on server 194, and now on 188, and before on 2 others i dont remember. with 2 people, and even tho we know most from arkwiki and got enough experience, it's just too hard to farm, even with dinosaurs, and this weight limitation on some lowlevel dino's.

also btw im only talking to people that actually intend to play on pvp official servers or pvp.

Последний раз отредактировано Matti|CheatersShuldDrinkBleach ; 4 янв в 10:32

Why didn't you tame a Giganoto. Riders can be easily plucked off the back of a Giganoto with a Ptera.

And why didn't you have areas of the base that were pure metal to hide in if you made all those metal spikes maybe cause without kibble it takes 12 hours and im not metnally disableD, plus i have nothing to knock him out in the first place?

So you want the biggest most powerful dino to be. not? i didn't say that he should be removed, i said he should get nerfed in general, he's just OP especially since he can charge towards knockback turrets and destroy them in 1 bite, and also i dont get why most stone/metal stuff like cables and pipes, act like wood/stone in the first place, why are metal cables not metal? why are metal pipes not metal? why are stone pipes not stone and can be destroyed by a stego? there's many items that are just confusing and arent the material that they actually got built with, that makes it even more confusing and bad.

plus the giganto range of bite, i dont even know it, why can he bite like more than 4 ceilings away from him even tho his mouth is so out of range? why is the aoe radius of his bite so massive? why is the damage of his bite so high? why cant i snipe down the "rider" of the dino? why is stone structure so weak? why is metal so hard to farm without packmules/ankylo or melee damage build why are defensive structures in general so hard to earn but it takes a few seconds and 1 ¦¦¦¦¦¦ on a giganto to destroy a full base?

Последний раз отредактировано Matti|CheatersShuldDrinkBleach ; 4 янв в 11:40

You played ten to fourteen hours a day with two friends and you weren't competent enough to construct a full metal base? And that's a month game time? What?

It has a few bugs, and has a few pieces of shuffled logic, you're quite right about that. But that's what we're here for, to help them weed those bugs out, to make our suggestions, and to assist in constructing a game a lot of us have come to love. While I don't agree with most of your suggestions, at least you're making them. You have every right to take a break, and I strongly encourage you to come back when you're good and ready.

But come on. "I'm not here to whine, but I'm here to whine." Come on. You're better than that.



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Aciclovir - Anti Viral, Compaclovir

Common use Aciclovir is an antiviral drug, it is a synthetic ingredient with a similar molecular structure to purine nucleoside. Aciclovir is used to treat viral infections such as cold sores, to stop the growth of Herpes simplex virus, Varicella zoster virus (caused by chickenpox and shingles), Epstein Barr Virus (caused by glandular fever), and to a lesser extent Cytomegalovirus (CMV). It is also useful in preventing genital herpes and in preventing viral infections occurring in those with a lowered immune system. This medication may also help reduce the time when pain remains after the sores heal. In addition, in people with a weakened immune system, Aciclovir can decrease the risk of the virus spreading to other parts of the body and causing serious infections.

Dosage and direction

Take this medication by mouth with or without food, usually 2 to 5 times a day as directed by your doctor. Take this medicine by mouth with a glass of water. Take your medicine at regular intervals. Do not take your medicine more often than directed. Take all of your medicine as directed even if you think your are better. If you are using the liquid form of this medication, shake the bottle well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Dosage is based on your medical condition and response to treatment. In children, dosage is also based on weight.

You should talk with your healthcare provider prior to taking Aciclovir if you have kidney disease, including kidney failure (renal failure), any allergies, including allergies to food, dyes, or preservatives. Let your healthcare provider know if you are pregnant or thinking of becoming pregnant, breastfeeding. Make sure to tell your healthcare provider about all medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. The medication passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug.

Aciclovir Injection is contraindicated for patients who develop hypersensitivity to Compaclovir or valaciclovir.

Possible side effects Side effects are potentially serious and you should report to your doctor or health care professional as soon as possible. These include, but are not limited to: allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue, chest pain, confusion, hallucinations, tremor, dark urine, increased sensitivity to the sun, redness, blistering, peeling or loosening of the skin (including inside the mouth), seizures, trouble passing urine or change in the amount of urine, unusual bleeding or bruising, or pinpoint red spots on the skin, unusually weak or tired, yellowing of the eyes or skin. Side effects that usually do not require medical attention: diarrhea, fever, headache, nausea, vomiting stomach upset. In this way report to your doctor or health care professional if they continue or are bothersome.

Drug interactions There are negative interactions that can occur when Aciclovir is combined with any of the drugs listed above. Phenytoin (Fosphenytoin) and Aciclovir: it may decrease the level of phenytoin in your blood, perhaps making it less effective. Your healthcare provider may need to measure the level of phenytoin in your blood (using a blood test) and adjust your dose as necessary. Probenecid can increase the level of Aciclovir in your blood, increasing your risk of acyclovir side effects. Your healthcare provider may need to decrease your acyclovir dosage to prevent this interaction from occurring. Acyclovir can increase the level of Tenofovir in your blood, potentially increasing your risk of side effects. Your healthcare provider may need to lower your tenofovir dosage to prevent drug interactions.

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

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include seizure (convulsions), hallucinations, and urinating less than usual or not at all.

Store at controlled room temperature of 15°C to 25°C (59°F to 77°F). Keep this medicine out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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.



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Perindopril Medical Facts From, Perindoprilum

perindopril

Perindopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.

Perindopril is used to treat high blood pressure (hypertension) and to prevent heart attack in people with coronary artery disease.

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

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

Do not use perindopril if you are pregnant. Stop using this medication and tell your doctor right away if you become pregnant.

You should not use perindopril if you have hereditary angioedema.

If you have diabetes, do not use perindopril together with any medication that contains aliskiren.

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

Do not use this medication if you are allergic to perindopril or to any other ACE inhibitor, such as benazepril, captopril, enalapril, fosinopril. lisinopril, moexipril, quinapril, ramipril, or trandolapril.

If you have diabetes, do not use perindopril together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo, Valturna).

You may also need to avoid taking perindopril with aliskiren if you have kidney disease.

You should not use perindopril if you have hereditary angioedema.

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

kidney disease (or if you are on dialysis);

heart disease or congestive heart failure;

a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis.

Do not use perindopril if you are pregnant. Stop using this medication and tell your doctor right away if you become pregnant. Perindopril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control while taking perindopril.

It is not known whether perindopril passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take perindopril?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take each dose with a full glass of water. Drink plenty of liquids while you are taking perindopril.

Perindopril can be taken with or without food.

Conditions that may cause very low blood pressure include: vomiting, diarrhea, heavy sweating, heart disease, dialysis, a low salt diet, or taking diuretics (water pills). Tell your doctor if you have a prolonged illness that causes diarrhea or vomiting.

Your blood pressure will need to be checked often. Your kidney or liver function may also need to be checked.

If you need surgery, tell the surgeon ahead of time that you are using perindopril. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

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

What happens if I overdose?

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

Overdose symptoms may include feeling extremely dizzy or light-headed, or fainting.

What should I avoid while taking perindopril?

Drinking alcohol can further lower your blood pressure and may increase certain side effects of perindopril.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Do not use salt substitutes or potassium supplements while taking perindopril, unless your doctor has told you to.

Perindopril side effects

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

Call your doctor at once if you have:

a light-headed feeling, like you might pass out;

fever, chills, body aches, flu symptoms, sores in your mouth and throat;

little or no urinating;

swelling, rapid weight gain;

high potassium (slow heart rate, weak pulse, muscle weakness, tingly feeling);

pale skin, easy bruising or bleeding; or

jaundice (yellowing of the skin or eyes).

Common side effects may include:

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

Perindopril dosing information

Usual Adult Dose for Coronary Artery Disease:

Initial dose: 4 mg orally once a day for 2 weeks, then increase to maintenance dose as tolerated. Maintenance dose: 8 mg orally once a day

Use: Treatment of patients with stable coronary artery disease to reduce the risk of cardiovascular mortality or nonfatal myocardial infarction.

Usual Adult Dose for Hypertension:

Initial dose: 4 mg orally once a day Maintenance dose: 4 to 8 mg orally per day in 1 or 2 divided doses Maximum dose: 16 mg/day

Comments: In patients treated with a diuretic, consider reducing the diuretic dose prior to starting this drug.

Usual Geriatric Dose for Coronary Artery Disease:

Greater than 70 Years: Initial dose: - Week 1: 2 mg orally once a day - Week 2: 4 mg orally once a day, then increase to maintenance dose as tolerated. Maintenance dose: 8 mg orally once a day

Use: Treatment of patients with stable coronary artery disease to reduce the risk of cardiovascular mortality or nonfatal myocardial infarction.

Usual Geriatric Dose for Hypertension:

Initial dose: 4 mg orally per day in 1 or 2 divided doses

Comments: Experience with doses above 8 mg is limited; administer with careful blood pressure monitoring and dose titration.

What other drugs will affect perindopril?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with perindopril, especially:

gold injections to treat arthritis;

NSAIDs (non-steroidal anti-inflammatory drugs)--ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;

a potassium supplement;

salt substitutes that contain potassium; or

a diuretic or "water pill."

This list is not complete. Other drugs may interact with perindopril, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

More about perindopril

Consumer resources

Professional resources

Related treatment guides

Where can I get more information?

Your pharmacist can provide more information about perindopril.

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

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

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.02. Revision Date: 2015-05-07, 5:20:56 PM.

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Product Description Common use Ampicillin is a broad-spectrum antibiotic from aminopenicillin group. Its mechanism of action is anti-bacterial and consists in inhibition of construction of bacteria cell walls sensitive to Ampicillin. It is not destroyed in acidic content of stomach, it is easily absorbed. Ampicillin is active toward gram positive microorganisms and also some gram negative ones (salmonella, schigella, proteus, E. coli, Klebsiella pneumoniae, Haemophilus influenzae, formerly called Pfeiffer's bacillus) and is used for treatment of the diseases provoked by mixed bacteria. Microorganisms producing penicillase are resistible to Ampicillin. This medication is used to treat pneumonia and other infectious diseases of respiratory, urogenital, gastrointestinal systems.

Dosage and directions Take exactly as prescribed. ampicillin capsules should be taken with a full glass of water, a half hour before or 2 hours after a meal.

Precautions If you are allergic to penicillin or cephalosporin antibiotics, contact your doctor before taking this drug. This medication may cause diarrhea so inform your doctor if you have it before taking any drug for diarrhea. Ampicillin may show a false positive result of in certain urine glucose tests. If you have taken Ampicillin for a long time before it may appear ineffective in your organism due to so called superinfection, inform your doctor if your symptoms do not improve or get worse.

Contraindications Hypersensitivity to Ampicillin. Cautiousness should be exercised if there is liver failure, asthma, hay fever.

Possible side effect Colitis, diarrhea, fever, itching, nausea, rash, sore tongue or mouth, vomiting.

Drug interaction Ampicillin enhances effect of the orally taken medications which prevent blood clot formation. This medication may interfere with the work of certain oral contraceptives.

Missed dose Never take a double dose of this medication. If you take this medication twice daily and you have missed a dose, take it as soon as you remember, take the next dose 5-6 hours later. If you take the drug thrice daily, take the missed dose as soon as you remember and do the next one in 2-4 hours.

Overdose If you suppose that you took too much Ampicillin and have symptoms of allergy (hives, rush) contact your doctor immediately.

Storage Store at room temperature between 59 and 86 degrees F (15-30 degrees C) away from light and moisture.

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 advisor or doctor in charge of the case. We disclaim all responsibility for the reliability of this information. 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.

Product Description Common use Ampicillin is a broad-spectrum antibiotic from aminopenicillin group. Its mechanism of action is anti-bacterial and consists in inhibition of construction of bacteria cell walls sensitive to Ampicillin. It is not destroyed in acidic content of stomach, it is easily absorbed. Ampicillin is active toward gram positive microorganisms and also some gram negative ones (salmonella, schigella, proteus, E. coli, Klebsiella pneumoniae, Haemophilus influenzae, formerly called Pfeiffer's bacillus) and is used for treatment of the diseases provoked by mixed bacteria. Microorganisms producing penicillase are resistible to Ampicillin. This medication is used to treat pneumonia and other infectious diseases of respiratory, urogenital, gastrointestinal systems.

Dosage and directions Take exactly as prescribed. ampicillin capsules should be taken with a full glass of water, a half hour before or 2 hours after a meal.

Precautions If you are allergic to penicillin or cephalosporin antibiotics, contact your doctor before taking this drug. This medication may cause diarrhea so inform your doctor if you have it before taking any drug for diarrhea. Ampicillin may show a false positive result of in certain urine glucose tests. If you have taken Ampicillin for a long time before it may appear ineffective in your organism due to so called superinfection, inform your doctor if your symptoms do not improve or get worse.

Contraindications Hypersensitivity to Ampicillin. Cautiousness should be exercised if there is liver failure, asthma, hay fever.

Possible side effect Colitis, diarrhea, fever, itching, nausea, rash, sore tongue or mouth, vomiting.

Drug interaction Ampicillin enhances effect of the orally taken medications which prevent blood clot formation. This medication may interfere with the work of certain oral contraceptives.

Missed dose Never take a double dose of this medication. If you take this medication twice daily and you have missed a dose, take it as soon as you remember, take the next dose 5-6 hours later. If you take the drug thrice daily, take the missed dose as soon as you remember and do the next one in 2-4 hours.

Overdose If you suppose that you took too much Ampicillin and have symptoms of allergy (hives, rush) contact your doctor immediately.

Storage Store at room temperature between 59 and 86 degrees F (15-30 degrees C) away from light and moisture.

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 advisor or doctor in charge of the case. We disclaim all responsibility for the reliability of this information. 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.

Product Description Common use Ampicillin is a broad-spectrum antibiotic from aminopenicillin group. Its mechanism of action is anti-bacterial and consists in inhibition of construction of bacteria cell walls sensitive to Ampicillin. It is not destroyed in acidic content of stomach, it is easily absorbed. Ampicillin is active toward gram positive microorganisms and also some gram negative ones (salmonella, schigella, proteus, E. coli, Klebsiella pneumoniae, Haemophilus influenzae, formerly called Pfeiffer's bacillus) and is used for treatment of the diseases provoked by mixed bacteria. Microorganisms producing penicillase are resistible to Ampicillin. This medication is used to treat pneumonia and other infectious diseases of respiratory, urogenital, gastrointestinal systems.

Dosage and directions Take exactly as prescribed. ampicillin capsules should be taken with a full glass of water, a half hour before or 2 hours after a meal.

Precautions If you are allergic to penicillin or cephalosporin antibiotics, contact your doctor before taking this drug. This medication may cause diarrhea so inform your doctor if you have it before taking any drug for diarrhea. Ampicillin may show a false positive result of in certain urine glucose tests. If you have taken Ampicillin for a long time before it may appear ineffective in your organism due to so called superinfection, inform your doctor if your symptoms do not improve or get worse.

Contraindications Hypersensitivity to Ampicillin. Cautiousness should be exercised if there is liver failure, asthma, hay fever.

Possible side effect Colitis, diarrhea, fever, itching, nausea, rash, sore tongue or mouth, vomiting.

Drug interaction Ampicillin enhances effect of the orally taken medications which prevent blood clot formation. This medication may interfere with the work of certain oral contraceptives.

Missed dose Never take a double dose of this medication. If you take this medication twice daily and you have missed a dose, take it as soon as you remember, take the next dose 5-6 hours later. If you take the drug thrice daily, take the missed dose as soon as you remember and do the next one in 2-4 hours.

Overdose If you suppose that you took too much Ampicillin and have symptoms of allergy (hives, rush) contact your doctor immediately.

Storage Store at room temperature between 59 and 86 degrees F (15-30 degrees C) away from light and moisture.

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 advisor or doctor in charge of the case. We disclaim all responsibility for the reliability of this information. 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.



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Enalapril Tablets - Fda Prescribing Information, Side Effects And Uses, Anaprilin

Enalapril Tablets

WARNING: FETAL TOXICITY

See full prescribing information for complete boxed warning.

• When pregnancy is detected, discontinue enalapril maleate as soon as possible. • Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus (see WARNINGS. Fetal Toxicity ).

Enalapril Tablets Description

Enalapril maleate, USP is the maleate salt of enalapril, the ethyl ester of a long-acting angiotensin converting enzyme inhibitor, enalaprilat. Enalapril maleate, USP is chemically described as ( S )-1-[ N - [1-(ethoxycarbonyl)-3-phenylpropyl]-L-alanyl]-L-proline, ( Z )-2-butenedioate salt (1:1), and its structural formula is:

C 20 H 28 N 2 O 5 ∙C 4 H 4 O 4 M. W. 492.53

Enalapril maleate, USP is an off-white, crystalline powder. It is sparingly soluble in water, soluble in ethanol, and freely soluble in methanol.

Enalapril is a pro-drug; following oral administration, it is bioactivated by hydrolysis of the ethyl ester to enalaprilat, which is the active angiotensin converting enzyme inhibitor.

Enalapril maleate tablets USP are supplied as 2.5 mg, 5 mg, 10 mg, and 20 mg tablets for oral administration. In addition, each tablet contains the following inactive ingredients: corn starch, lactose monohydrate, magnesium stearate, pregelatinized starch, and sodium bicarbonate. Each 2.5 mg tablet contains D&C red #27 aluminum lake, D&C yellow #10 aluminum lake, FD&C blue #1 aluminum lake, FD&C red #40 aluminum lake, and FD&C yellow #6 aluminum lake. Each 10 mg tablet contains FD&C blue #2 aluminum lake, FD&C red #40 aluminum lake and FD&C yellow #6 aluminum lake. Each 20 mg tablet contains FD&C Yellow #6.

Enalapril Tablets - Clinical Pharmacology

Mechanism of Action

Enalapril, after hydrolysis to enalaprilat, inhibits angiotensin-converting enzyme (ACE) in human subjects and animals. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. Angiotensin II also stimulates aldosterone secretion by the adrenal cortex. The beneficial effects of enalapril in hypertension and heart failure appear to result primarily from suppression of the renin-angiotensin-aldosterone system. Inhibition of ACE results in decreased plasma angiotensin II, which leads to decreased vasopressor activity and to decreased aldosterone secretion. Although the latter decrease is small, it results in small increases of serum potassium. In hypertensive patients treated with enalapril maleate alone for up to 48 weeks, mean increases in serum potassium of approximately 0.2 mEq/L were observed. In patients treated with enalapril maleate plus a thiazide diuretic, there was essentially no change in serum potassium (see PRECAUTIONS ). Removal of angiotensin II negative feedback on renin secretion leads to increased plasma renin activity.

ACE is identical to kininase, an enzyme that degrades bradykinin. Whether increased levels of bradykinin, a potent vasodepressor peptide, play a role in the therapeutic effects of enalapril maleate remains to be elucidated.

While the mechanism through which enalapril maleate lowers blood pressure is believed to be primarily suppression of the renin-angiotensin-aldosterone system, enalapril maleate is antihypertensive even in patients with low-renin hypertension. Although enalapril maleate was antihypertensive in all races studied, black hypertensive patients (usually a low-renin hypertensive population) had a smaller average response to enalapril monotherapy than non-black patients.

Pharmacokinetics and Metabolism

Following oral administration of enalapril maleate, peak serum concentrations of enalapril occur within about one hour. Based on urinary recovery, the extent of absorption of enalapril is approximately 60 percent. Enalapril absorption is not influenced by the presence of food in the gastrointestinal tract. Following absorption, enalapril is hydrolyzed to enalaprilat, which is a more potent angiotensin converting enzyme inhibitor than enalapril; enalaprilat is poorly absorbed when administered orally. Peak serum concentrations of enalaprilat occur three to four hours after an oral dose of enalapril maleate. Excretion of enalapril maleate is primarily renal. Approximately 94 percent of the dose is recovered in the urine and feces as enalaprilat or enalapril. The principal components in urine are enalaprilat, accounting for about 40 percent of the dose, and intact enalapril. There is no evidence of metabolites of enalapril, other than enalaprilat.

The serum concentration profile of enalaprilat exhibits a prolonged terminal phase, apparently representing a small fraction of the administered dose that has been bound to ACE. The amount bound does not increase with dose, indicating a saturable site of binding. The effective half-life for accumulation of enalaprilat following multiple doses of enalapril maleate is 11 hours. The disposition of enalapril and enalaprilat in patients with renal insufficiency is similar to that in patients with normal renal function until the glomerular filtration rate is 30 mL/min or less. With glomerular filtration rate ≤ 30 mL/min, peak and trough enalaprilat levels increase, time to peak concentration increases and time to steady state may be delayed. The effective half-life of enalaprilat following multiple doses of enalapril maleate is prolonged at this level of renal insufficiency (see DOSAGE AND ADMINISTRATION ). Enalaprilat is dialyzable at the rate of 62 mL/min.

Studies in dogs indicate that enalapril crosses the blood-brain barrier poorly, if at all; enalaprilat does not enter the brain. Multiple doses of enalapril maleate in rats do not result in accumulation in any tissues. Milk of lactating rats contains radioactivity following administration of 14 C-enalapril maleate. Radioactivity was found to cross the placenta following administration of labeled drug to pregnant hamsters.

Pharmacodynamics and Clinical Effects

Administration of enalapril maleate to patients with hypertension of severity ranging from mild to severe results in a reduction of both supine and standing blood pressure usually with no orthostatic component. Symptomatic postural hypotension is therefore infrequent, although it might be anticipated in volume-depleted patients (see WARNINGS ).

In most patients studied, after oral administration of a single dose of enalapril, onset of antihypertensive activity was seen at one hour with peak reduction of blood pressure achieved by four to six hours.

At recommended doses, antihypertensive effects have been maintained for at least 24 hours. In some patients the effects may diminish toward the end of the dosing interval (see DOSAGE AND ADMINISTRATION ).

In some patients achievement of optimal blood pressure reduction may require several weeks of therapy.

The antihypertensive effects of enalapril maleate have continued during long term therapy. Abrupt withdrawal of enalapril maleate has not been associated with a rapid increase in blood pressure.

In hemodynamic studies in patients with essential hypertension, blood pressure reduction was accompanied by a reduction in peripheral arterial resistance with an increase in cardiac output and little or no change in heart rate. Following administration of enalapril maleate, there is an increase in renal blood flow; glomerular filtration rate is usually unchanged. The effects appear to be similar in patients with renovascular hypertension.

When given together with thiazide-type diuretics, the blood pressure lowering effects of enalapril maleate are approximately additive.

In a clinical pharmacology study, indomethacin or sulindac was administered to hypertensive patients receiving enalapril maleate. In this study there was no evidence of a blunting of the antihypertensive action of enalapril maleate (see PRECAUTIONS. Drug Interactions ).

In trials in patients treated with digitalis and diuretics, treatment with enalapril resulted in decreased systemic vascular resistance, blood pressure, pulmonary capillary wedge pressure and heart size, and increased cardiac output and exercise tolerance. Heart rate was unchanged or slightly reduced, and mean ejection fraction was unchanged or increased. There was a beneficial effect on severity of heart failure as measured by the New York Heart Association (NYHA) classification and on symptoms of dyspnea and fatigue. Hemodynamic effects were observed after the first dose, and appeared to be maintained in uncontrolled studies lasting as long as four months. Effects on exercise tolerance, heart size, and severity and symptoms of heart failure were observed in placebo-controlled studies lasting from eight weeks to over one year.

Heart Failure, Mortality Trials

In a multicenter, placebo-controlled clinical trial, 2,569 patients with all degrees of symptomatic heart failure and ejection fraction ≤ 35 percent were randomized to placebo or enalapril and followed for up to 55 months (SOLVD-Treatment). Use of enalapril was associated with an 11 percent reduction in all-cause mortality and a 30 percent reduction in hospitalization for heart failure. Diseases that excluded patients from enrollment in the study included severe stable angina (> 2 attacks/day), hemodynamically significant valvular or outflow tract obstruction, renal failure (creatinine > 2.5 mg/dL), cerebral vascular disease (e. g. significant carotid artery disease), advanced pulmonary disease, malignancies, active myocarditis and constrictive pericarditis. The mortality benefit associated with enalapril does not appear to depend upon digitalis being present.

A second multicenter trial used the SOLVD protocol for study of asymptomatic or minimally symptomatic patients. SOLVD-Prevention patients, who had left ventricular ejection fraction ≤ 35% and no history of symptomatic heart failure, were randomized to placebo (n = 2117) or enalapril (n = 2111) and followed for up to 5 years. The majority of patients in the SOLVD-Prevention trial had a history of ischemic heart disease. A history of myocardial infarction was present in 80 percent of patients, current angina pectoris in 34 percent, and a history of hypertension in 37 percent. No statistically significant mortality effect was demonstrated in this population. Enalapril-treated subjects had 32% fewer first hospitalizations for heart failure, and 32% fewer total heart failure hospitalizations. Compared to placebo, 32 percent fewer patients receiving enalapril developed symptoms of overt heart failure. Hospitalizations for cardiovascular reasons were also reduced. There was an insignificant reduction in hospitalizations for any cause in the enalapril treatment group (for enalapril vs. placebo, respectively, 1166 vs. 1201 first hospitalizations, 2649 vs. 2840 total hospitalizations), although the study was not powered to look for such an effect.

The SOLVD-Prevention trial was not designed to determine whether treatment of asymptomatic patients with low ejection fraction would be superior, with respect to preventing hospitalization, to closer follow-up and use of enalapril at the earliest sign of heart failure. However, under the conditions of follow-up in the SOLVD-Prevention trial (every 4 months at the study clinic; personal physician as needed), 68% of patients on placebo who were hospitalized for heart failure had no prior symptoms recorded which would have signaled initiation of treatment.

The SOLVD-Prevention trial was also not designed to show whether enalapril modified the progression of underlying heart disease.

In another multicenter, placebo-controlled trial (CONSENSUS) limited to patients with NYHA Class IV congestive heart failure and radiographic evidence of cardiomegaly, use of enalapril was associated with improved survival. The results are shown in the following table.

In both CONSENSUS and SOLVD-Treatment trials, patients were also usually receiving digitalis, diuretics or both.

Clinical Pharmacology in Pediatric Patients

A multiple dose pharmacokinetic study was conducted in 40 hypertensive male and female pediatric patients aged 2 months to ≤ 16 years following daily oral administration of 0.07 to 0.14 mg/kg enalapril maleate. At steady state, the mean effective half-life for accumulation of enalaprilat was 14 hours and the mean urinary recovery of total enalapril and enalaprilat in 24 hours was 68% of the administered dose. Conversion of enalapril to enalaprilat was in the range of 63 to 76%. The overall results of this study indicate that the pharmacokinetics of enalapril in hypertensive children aged 2 months to ≤ 16 years are consistent across the studied age groups and consistent with pharmacokinetic historic data in healthy adults.

In a clinical study involving 110 hypertensive pediatric patients 6 to 16 years of age, patients who weighed < 50 kg received either 0.625, 2.5 or 20 mg of enalapril daily and patients who weighed ≥ 50 kg received either 1.25, 5, or 40 mg of enalapril daily. Enalapril administration once daily lowered trough blood pressure in a dose-dependent manner. The dose-dependent antihypertensive efficacy of enalapril was consistent across all subgroups (age, Tanner stage, gender, race). However, the lowest doses studied, 0.625 mg and 1.25 mg, corresponding to an average of 0.02 mg/kg once daily, did not appear to offer consistent antihypertensive efficacy. In this study, enalapril maleate was generally well tolerated.

In the above pediatric studies, enalapril maleate was given as tablets and for those children and infants who were unable to swallow tablets or who required a lower dose than is available in tablet form, enalapril was administered in a suspension formulation (see DOSAGE AND ADMINISTRATION. Preparation of Suspension ).

Indications and Usage for Enalapril Tablets

Hypertension

Enalapril maleate tablets USP are indicated for the treatment of hypertension.

Enalapril maleate tablets USP are effective alone or in combination with other antihypertensive agents, especially thiazide-type diuretics. The blood pressure lowering effects of enalapril maleate tablets USP and thiazides are approximately additive.

Heart Failure

Enalapril maleate tablets USP are indicated for the treatment of symptomatic congestive heart failure, usually in combination with diuretics and digitalis. In these patients enalapril maleate tablets USP improve symptoms, increase survival, and decrease the frequency of hospitalization (see CLINICAL PHARMACOLOGY. Heart Failure, Mortality Trials for details and limitations of survival trials).

Asymptomatic Left Ventricular Dysfunction

In clinically stable asymptomatic patients with left ventricular dysfunction (ejection fraction ≤ 35 percent), enalapril maleate tablets USP decrease the rate of development of overt heart failure and decrease the incidence of hospitalization for heart failure (see CLINICAL PHARMACOLOGY. Heart Failure, Mortality Trials for details and limitations of survival trials).

In using enalapril maleate tablets USP, consideration should be given to the fact that another angiotensin converting enzyme inhibitor, captopril, has caused agranulocytosis, particularly in patients with renal impairment or collagen vascular disease, and that available data are insufficient to show that enalapril maleate tablets USP do not have a similar risk (see WARNINGS ).

In considering use of enalapril maleate tablets USP, it should be noted that in controlled clinical trials ACE inhibitors have an effect on blood pressure that is less in black patients than in non-blacks. In addition, it should be noted that black patients receiving ACE inhibitors have been reported to have a higher incidence of angioedema compared to non-blacks (see WARNINGS. Anaphylactoid and Possibly Related Reactions. Head and Neck Angioedema ).

Contraindications

Enalapril maleate is contraindicated in patients who are hypersensitive to this product and in patients with a history of angioedema related to previous treatment with an angiotensin converting enzyme inhibitor and in patients with hereditary or idiopathic angioedema.

Do not coadminister aliskiren with enalapril maleate in patients with diabetes (see PRECAUTIONS. Drug Interactions ).

Warnings

Anaphylactoid and Possibly Related Reactions

Presumably because angiotensin-converting enzyme inhibitors affect the metabolism of eicosanoids and polypeptides, including endogenous bradykinin, patients receiving ACE inhibitors (including enalapril maleate) may be subject to a variety of adverse reactions, some of them serious.

Head and Neck Angioedema

Angioedema of the face, extremities, lips, tongue, glottis and/or larynx has been reported in patients treated with angiotensin converting enzyme inhibitors, including enalapril maleate. This may occur at any time during treatment. In such cases enalapril maleate should be promptly discontinued and appropriate therapy and monitoring should be provided until complete and sustained resolution of signs and symptoms has occurred. In instances where swelling has been confined to the face and lips the condition has generally resolved without treatment, although antihistamines have been useful in relieving symptoms. Angioedema associated with laryngeal edema may be fatal. Where there is involvement of the tongue, glottis or larynx, likely to cause airway obstruction, appropriate therapy, e. g. subcutaneous epinephrine solution 1:1000 (0.3 mL to 0.5 mL) and/or measures necessary to ensure a patent airway, should be promptly provided (see ADVERSE REACTIONS ).

Patients receiving coadministration of ACE inhibitor and mTOR (mammalian target of rapamycin) inhibitor (e. g. temsirolimus, sirolimus, everolimus) therapy may be at increased risk for angioedema (see PRECAUTIONS ).

Intestinal Angioedema

Intestinal angioedema has been reported in patients treated with ACE inhibitors. These patients presented with abdominal pain (with or without nausea or vomiting); in some cases there was no prior history of facial angioedema and C-1 esterase levels were normal. The angioedema was diagnosed by procedures including abdominal CT scan or ultrasound, or at surgery, and symptoms resolved after stopping the ACE inhibitor. Intestinal angioedema should be included in the differential diagnosis of patients on ACE inhibitors presenting with abdominal pain.

Patients with a history of angioedema unrelated to ACE inhibitor therapy may be at increased risk of angioedema while receiving an ACE inhibitor (see also INDICATIONS AND USAGE and CONTRAINDICATIONS ).

Anaphylactoid reactions during desensitization

Two patients undergoing desensitizing treatment with hymenoptera venom while receiving ACE inhibitors sustained life-threatening anaphylactoid reactions. In the same patients, these reactions were avoided when ACE inhibitors were temporarily withheld, but they reappeared upon inadvertent rechallenge.

Anaphylactoid reactions during membrane exposure

Anaphylactoid reactions have been reported in patients dialyzed with high-flux membranes and treated concomitantly with an ACE inhibitor. Anaphylactoid reactions have also been reported in patients undergoing low-density lipoprotein apheresis with dextran sulfate absorption.

Hypotension

Excessive hypotension is rare in uncomplicated hypertensive patients treated with enalapril maleate alone. Patients with heart failure given enalapril maleate commonly have some reduction in blood pressure, especially with the first dose, but discontinuation of therapy for continuing symptomatic hypotension usually is not necessary when dosing instructions are followed; caution should be observed when initiating therapy (see DOSAGE AND ADMINISTRATION ). Patients at risk for excessive hypotension, sometimes associated with oliguria and/or progressive azotemia, and rarely with acute renal failure and/or death, include those with the following conditions or characteristics: heart failure, hyponatremia, high dose diuretic therapy, recent intensive diuresis or increase in diuretic dose, renal dialysis, or severe volume and/or salt depletion of any etiology. It may be advisable to eliminate the diuretic (except in patients with heart failure), reduce the diuretic dose or increase salt intake cautiously before initiating therapy with enalapril maleate in patients at risk for excessive hypotension who are able to tolerate such adjustments (see PRECAUTIONS. Drug Interactions and ADVERSE REACTIONS ). In patients at risk for excessive hypotension, therapy should be started under very close medical supervision and such patients should be followed closely for the first two weeks of treatment and whenever the dose of enalapril and/or diuretic is increased. Similar considerations may apply to patients with ischemic heart or cerebrovascular disease, in whom an excessive fall in blood pressure could result in a myocardial infarction or cerebrovascular accident.

If excessive hypotension occurs, the patient should be placed in the supine position and, if necessary, receive an intravenous infusion of normal saline. A transient hypotensive response is not a contraindication to further doses of enalapril maleate, which usually can be given without difficulty once the blood pressure has stabilized. If symptomatic hypotension develops, a dose reduction or discontinuation of enalapril maleate or concomitant diuretic may be necessary.

Neutropenia/Agranulocytosis

Another angiotensin converting enzyme inhibitor, captopril, has been shown to cause agranulocytosis and bone marrow depression, rarely in uncomplicated patients but more frequently in patients with renal impairment especially if they also have a collagen vascular disease. Available data from clinical trials of enalapril are insufficient to show that enalapril does not cause agranulocytosis at similar rates. Marketing experience has revealed cases of neutropenia or agranulocytosis in which a causal relationship to enalapril cannot be excluded. Periodic monitoring of white blood cell counts in patients with collagen vascular disease and renal disease should be considered.

Hepatic Failure

Rarely, ACE inhibitors have been associated with a syndrome that starts with cholestatic jaundice and progresses to fulminant hepatic necrosis, and (sometimes) death. The mechanism of this syndrome is not understood. Patients receiving ACE inhibitors who develop jaundice or marked elevations of hepatic enzymes should discontinue the ACE inhibitor and receive appropriate medical follow-up.

Fetal Toxicity

Pregnancy Category D

Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. When pregnancy is detected, discontinue enalapril maleate tablets as soon as possible. These adverse outcomes are usually associated with use of these drugs in the second and third trimester of pregnancy. Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. Appropriate management of maternal hypertension during pregnancy is important to optimize outcomes for both mother and fetus.

In the unusual case that there is no appropriate alternative to therapy with drugs affecting the renin-angiotensin system for a particular patient, apprise the mother of the potential risk to the fetus. Perform serial ultrasound examinations to assess the intra-amniotic environment. If oligohydramnios is observed, discontinue enalapril maleate tablets, unless it is considered lifesaving for the mother. Fetal testing may be appropriate, based on the week of pregnancy. Patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury. Closely observe infants with histories of in utero exposure to enalapril maleate tablets for hypotension, oliguria, and hyperkalemia (see PRECAUTIONS. Pediatric Use ).

No teratogenic effects of enalapril were seen in studies of pregnant rats and rabbits. On a body surface area basis, the doses used were 57 times and 12 times, respectively, the maximum recommended human daily dose (MRHDD).

Precautions

General

Aortic Stenosis/Hypertrophic Cardiomyopathy:

As with all vasodilators, enalapril should be given with caution to patients with obstruction in the outflow tract of the left ventricle.

Impaired Renal Function:

As a consequence of inhibiting the renin-angiotensin-aldosterone system, changes in renal function may be anticipated in susceptible individuals. In patients with severe heart failure whose renal function may depend on the activity of the renin-angiotensin-aldosterone system, treatment with angiotensin converting enzyme inhibitors, including enalapril maleate, may be associated with oliguria and/or progressive azotemia and rarely with acute renal failure and/or death (see PRECAUTIONS. Drug Interactions ).

In clinical studies in hypertensive patients with unilateral or bilateral renal artery stenosis, increases in blood urea nitrogen and serum creatinine were observed in 20 percent of patients. These increases were almost always reversible upon discontinuation of enalapril and/or diuretic therapy. In such patients renal function should be monitored during the first few weeks of therapy.

Some patients with hypertension or heart failure with no apparent preexisting renal vascular disease have developed increases in blood urea and serum creatinine, usually minor and transient, especially when enalapril maleate has been given concomitantly with a diuretic. This is more likely to occur in patients with preexisting renal impairment. Dosage reduction and/or discontinuation of the diuretic and/or enalapril maleate may be required.

Evaluation of patients with hypertension or heart failure should always include assessment of renal function (see DOSAGE AND ADMINISTRATION ).

Elevated serum potassium (greater than 5.7 mEq/L) was observed in approximately one percent of hypertensive patients in clinical trials. In most cases these were isolated values which resolved despite continued therapy. Hyperkalemia was a cause of discontinuation of therapy in 0.28 percent of hypertensive patients. In clinical trials in heart failure, hyperkalemia was observed in 3.8 percent of patients but was not a cause for discontinuation.

Risk factors for the development of hyperkalemia include renal insufficiency, diabetes mellitus, and the concomitant use of potassium-sparing diuretics, potassium supplements and/or potassium-containing salt substitutes, which should be used cautiously, if at all, with enalapril maleate (see Drug Interactions ).

Presumably due to the inhibition of the degradation of endogenous bradykinin, persistent nonproductive cough has been reported with all ACE inhibitors, always resolving after discontinuation of therapy. ACE inhibitor-induced cough should be considered in the differential diagnosis of cough.

In patients undergoing major surgery or during anesthesia with agents that produce hypotension, enalapril may block angiotensin II formation secondary to compensatory renin release. If hypotension occurs and is considered to be due to this mechanism, it can be corrected by volume expansion.

Information for Patients

Angioedema, including laryngeal edema, may occur at any time during treatment with angiotensin converting enzyme inhibitors, including enalapril. Patients should be so advised and told to report immediately any signs or symptoms suggesting angioedema (swelling of face, extremities, eyes, lips, tongue, difficulty in swallowing or breathing) and to take no more drug until they have consulted with the prescribing physician.

Patients should be cautioned to report lightheadedness, especially during the first few days of therapy. If actual syncope occurs, the patients should be told to discontinue the drug until they have consulted with the prescribing physician. All patients should be cautioned that excessive perspiration and dehydration may lead to an excessive fall in blood pressure because of reduction in fluid volume. Other causes of volume depletion such as vomiting or diarrhea may also lead to a fall in blood pressure; patients should be advised to consult with the physician.

Patients should be told not to use salt substitutes containing potassium without consulting their physician.

Patients should be told to report promptly any indication of infection (e. g. sore throat, fever) which may be a sign of neutropenia.

Female patients of childbearing age should be told about the consequences of exposure to enalapril maleate tablets during pregnancy. Discuss treatment options with women planning to become pregnant. Patients should be asked to report pregnancies to their physicians as soon as possible.

NOTE: As with many other drugs, certain advice to patients being treated with enalapril is warranted. This information is intended to aid in the safe and effective use of this medication. It is not a disclosure of all possible adverse or intended effects.

Drug Interactions

Dual Blockade of the Renin-Angiotensin System (RAS)

Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Most patients receiving the combination of two RAS inhibitors do not obtain any additional benefit compared to monotherapy. In general, avoid combined use of RAS inhibitors. Closely monitor blood pressure, renal function, and electrolytes in patients on enalapril maleate tablets and other agents that affect the RAS.

Do not coadminister aliskiren with enalapril maleate in patients with diabetes. Avoid use of aliskiren with enalapril maleate in patients with renal impairment (GFR < 60 mL/min).

Hypotension — Patients on Diuretic Therapy

Patients on diuretics and especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with enalapril. The possibility of hypotensive effects with enalapril can be minimized by either discontinuing the diuretic or increasing the salt intake prior to initiation of treatment with enalapril. If it is necessary to continue the diuretic, provide close medical supervision after the initial dose for at least two hours and until blood pressure has stabilized for at least an additional hour (see WARNINGS and DOSAGE AND ADMINISTRATION ).

Agents Causing Renin Release:

The antihypertensive effect of enalapril maleate is augmented by antihypertensive agents that cause renin release (e. g. diuretics).

Non-Steroidal Anti-Inflammatory Agents Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors)

In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including enalapril, may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving enalapril and NSAID therapy.

In a clinical pharmacology study, indomethacin or sulindac was administered to hypertensive patients receiving enalapril maleate. In this study there was no evidence of a blunting of the antihypertensive action of enalapril maleate. However, reports suggest that NSAIDs may diminish the antihypertensive effect of ACE inhibitors.

Other Cardiovascular Agents:

Enalapril maleate has been used concomitantly with beta adrenergic-blocking agents, methyldopa, nitrates, calcium-blocking agents, hydralazine, prazosin and digoxin without evidence of clinically significant adverse interactions.

Agents Increasing Serum Potassium:

Enalapril maleate attenuates potassium loss caused by thiazide-type diuretics. Potassium-sparing diuretics (e. g. spironolactone, triamterene, or amiloride), potassium supplements, or potassium-containing salt substitutes may lead to significant increases in serum potassium. 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. Potassium sparing agents should generally not be used in patients with heart failure receiving enalapril maleate.

Lithium toxicity has been reported in patients receiving lithium concomitantly with drugs which cause elimination of sodium, including ACE inhibitors. A few cases of lithium toxicity have been reported in patients receiving concomitant enalapril maleate and lithium and were reversible upon discontinuation of both drugs. It is recommended that serum lithium levels be monitored frequently if enalapril is administered concomitantly with lithium.

Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and hypotension) have been reported rarely in patients on therapy with injectable gold (sodium aurothiomalate) and concomitant ACE inhibitor therapy including enalapril maleate.

mTOR (mammalian target of rapamycin) inhibitors:

Patients receiving coadministration of ACE inhibitor and mTOR inhibitor (e. g. temsirolimus, sirolimus, everolimus) therapy may be at increased risk for angioedema (see WARNINGS ).

Carcinogenesis, Mutagenesis, Impairment of Fertility

There was no evidence of a tumorigenic effect when enalapril was administered for 106 weeks to male and female rats at doses up to 90 mg/kg/day or for 94 weeks to male and female mice at doses up to 90 and 180 mg/kg/day, respectively. These doses are 26 times (in rats and female mice) and 13 times (in male mice) the maximum recommended human daily dose (MRHDD) when compared on a body surface area basis.

Neither enalapril maleate nor the active diacid was mutagenic in the Ames microbial mutagen test with or without metabolic activation. Enalapril was also negative in the following genotoxicity studies: rec-assay, reverse mutation assay with E. coli. sister chromatid exchange with cultured mammalian cells, and the micronucleus test with mice, as well as in an in vivo cytogenic study using mouse bone marrow.

There were no adverse effects on reproductive performance of male and female rats treated with up to 90 mg/kg/day of enalapril (26 times the MRHDD when compared on a body surface area basis).

Pregnancy

Enalapril and enalaprilat have been detected in human breast milk. Because of the potential for serious adverse reactions in nursing infants from enalapril, a decision should be made whether to discontinue nursing or to discontinue enalapril maleate, taking into account the importance of the drug to the mother.

Pediatric Use

Neonates with a history of in utero exposure to enalapril maleate:

If oliguria or hypotension occurs, direct attention toward support of blood pressure and renal perfusion. Exchange transfusions or dialysis may be required as a means of reversing hypotension and/or substituting for disordered renal function. Enalapril, which crosses the placenta, has been removed from neonatal circulation by peritoneal dialysis with some clinical benefit, and theoretically may be removed by exchange transfusion, although there is no experience with the latter procedure.

Antihypertensive effects of enalapril maleate have been established in hypertensive pediatric patients age 1 month to 16 years. Use of enalapril maleate in these age groups is supported by evidence from adequate and well-controlled studies of enalapril maleate in pediatric and adult patients as well as by published literature in pediatric patients (see CLINICAL PHARMACOLOGY. Clinical Pharmacology in Pediatric Patients and DOSAGE AND ADMINISTRATION ).

Enalapril maleate is not recommended in neonates and in pediatric patients with glomerular filtration rate < 30 mL/min/1.73 m 2. as no data are available.

Adverse Reactions

Enalapril maleate has been evaluated for safety in more than 10,000 patients, including over 1000 patients treated for one year or more. Enalapril maleate has been found to be generally well tolerated in controlled clinical trials involving 2987 patients. For the most part, adverse experiences were mild and transient in nature. In clinical trials, discontinuation of therapy due to clinical adverse experiences was required in 3.3 percent of patients with hypertension and in 5.7 percent of patients with heart failure. The frequency of adverse experiences was not related to total daily dosage within the usual dosage ranges. In patients with hypertension the overall percentage of patients treated with enalapril maleate reporting adverse experiences was comparable to placebo.

HYPERTENSION

Adverse experiences occurring in greater than one percent of patients with hypertension treated with enalapril maleate in controlled clinical trials are shown below. In patients treated with enalapril maleate, the maximum duration of therapy was three years; in placebo treated patients the maximum duration of therapy was 12 weeks.

Other serious clinical adverse experiences occurring since the drug was marketed or adverse experiences occurring in 0.5 to 1.0 percent of patients with hypertension or heart failure in clinical trials are listed below and, within each category, are in order of decreasing severity.

Cardiovascular: Cardiac arrest; myocardial infarction or cerebrovascular accident, possibly secondary to excessive hypotension in high risk patients (see WARNINGS. Hypotension ); pulmonary embolism and infarction; pulmonary edema; rhythm disturbances including atrial tachycardia and bradycardia; atrial fibrillation; palpitation, Raynaud’s phenomenon.

Digestive: Ileus, pancreatitis, hepatic failure, hepatitis (hepatocellular [proven on rechallenge] or cholestatic jaundice) (see WARNINGS. Hepatic Failure ), melena, anorexia, dyspepsia, constipation, glossitis, stomatitis, dry mouth.

Hematologic: Rare cases of neutropenia, thrombocytopenia and bone marrow depression.

Musculoskeletal: Muscle cramps.

Nervous/Psychiatric: Depression, confusion, ataxia, somnolence, insomnia, nervousness, peripheral neuropathy (e. g. paresthesia, dysesthesia), dream abnormality.

Respiratory: Bronchospasm, rhinorrhea, sore throat and hoarseness, asthma, upper respiratory infection, pulmonary infiltrates, eosinophilic pneumonitis.

Skin: Exfoliative dermatitis, toxic epidermal necrolysis, Stevens-Johnson syndrome, pemphigus, herpes zoster, erythema multiforme, urticaria, pruritus, alopecia, flushing, diaphoresis, photosensitivity.

Special Senses: Blurred vision, taste alteration, anosmia, tinnitus, conjunctivitis, dry eyes, tearing.

Urogenital: Renal failure, oliguria, renal dysfunction (see PRECAUTIONS and DOSAGE AND ADMINISTRATION ), flank pain, gynecomastia, impotence.

Miscellaneous: A symptom complex has been reported which may include some or all of the following: a positive ANA, an elevated erythrocyte sedimentation rate, arthralgia/arthritis, myalgia/myositis, fever, serositis, vasculitis, leukocytosis, eosinophilia, photosensitivity, rash and other dermatologic manifestations.

Angioedema: Angioedema has been reported in patients receiving enalapril maleate, with an incidence higher in black than in non-black patients. Angioedema associated with laryngeal edema may be fatal. If angioedema of the face, extremities, lips, tongue, glottis and/or larynx occurs, treatment with enalapril maleate should be discontinued and appropriate therapy instituted immediately (see WARNINGS ).

Hypotension: In the hypertensive patients, hypotension occurred in 0.9 percent and syncope occurred in 0.5 percent of patients following the initial dose or during extended therapy. Hypotension or syncope was a cause for discontinuation of therapy in 0.1 percent of hypertensive patients. In heart failure patients, hypotension occurred in 6.7 percent and syncope occurred in 2.2 percent of patients. Hypotension or syncope was a cause for discontinuation of therapy in 1.9 percent of patients with heart failure (see WARNINGS ).

The adverse experience profile for pediatric patients appears to be similar to that seen in adult patients.

Clinical Laboratory Test Findings

Hyperkalemia (see PRECAUTIONS ), hyponatremia.

Creatinine, Blood Urea Nitrogen:

In controlled clinical trials minor increases in blood urea nitrogen and serum creatinine, reversible upon discontinuation of therapy, were observed in about 0.2 percent of patients with essential hypertension treated with enalapril maleate alone. Increases are more likely to occur in patients receiving concomitant diuretics or in patients with renal artery stenosis (see PRECAUTIONS ). In patients with heart failure who were also receiving diuretics with or without digitalis, increases in blood urea nitrogen or serum creatinine, usually reversible upon discontinuation of enalapril maleate and/or other concomitant diuretic therapy, were observed in about 11 percent of patients. Increases in blood urea nitrogen or creatinine were a cause for discontinuation in 1.2 percent of patients.

Small decreases in hemoglobin and hematocrit (mean decreases of approximately 0.3 g percent and 1.0 vol percent, respectively) occur frequently in either hypertension or congestive heart failure patients treated with enalapril maleate but are rarely of clinical importance unless another cause of anemia coexists. In clinical trials, less than 0.1 percent of patients discontinued therapy due to anemia. Hemolytic anemia, including cases of hemolysis in patients with G-6-PD deficiency, has been reported; a causal relationship to enalapril cannot be excluded.

Liver Function Tests

Elevations of liver enzymes and/or serum bilirubin have occurred (see WARNINGS. Hepatic Failure ).

To report SUSPECTED ADVERSE REACTIONS, contact TEVA USA, PHARMACOVIGILANCE at 1-866-832-8537 or drug. [email protected] com; or FDA at 1-800-FDA-1088 or www. fda. gov/medwatch.

Overdosage

Limited data are available in regard to overdosage in humans.

Single oral doses of enalapril above 1,000 mg/kg and ≥ 1,775 mg/kg were associated with lethality in mice and rats, respectively.

The most likely manifestation of overdosage would be hypotension, for which the usual treatment would be intravenous infusion of normal saline solution.

Enalaprilat may be removed from general circulation by hemodialysis and has been removed from neonatal circulation by peritoneal dialysis (see WARNINGS. Anaphylactoid reactions during membrane exposure ).

Enalapril Tablets Dosage and Administration

Hypertension

In patients who are currently being treated with a diuretic, symptomatic hypotension occasionally may occur following the initial dose of enalapril maleate tablets. The diuretic should, if possible, be discontinued for two to three days before beginning therapy with enalapril maleate tablets to reduce the likelihood of hypotension (see WARNINGS ). If the patient's blood pressure is not controlled with enalapril maleate tablets alone, diuretic therapy may be resumed.

If the diuretic cannot be discontinued an initial dose of 2.5 mg should be used under medical supervision for at least two hours and until blood pressure has stabilized for at least an additional hour (see WARNINGS and PRECAUTIONS. Drug Interactions ).

The recommended initial dose in patients not on diuretics is 5 mg once a day. Dosage should be adjusted according to blood pressure response. The usual dosage range is 10 to 40 mg per day administered in a single dose or two divided doses. In some patients treated once daily, the antihypertensive effect may diminish toward the end of the dosing interval. In such patients, an increase in dosage or twice daily administration should be considered. If blood pressure is not controlled with enalapril maleate tablets alone, a diuretic may be added. Concomitant administration of enalapril maleate tablets with potassium supplements, potassium salt substitutes, or potassium-sparing diuretics may lead to increases of serum potassium (see PRECAUTIONS ).

Dosage Adjustment in Hypertensive Patients with Renal Impairment

The usual dose of enalapril is recommended for patients with a creatinine clearance > 30 mL/min (serum creatinine of up to approximately 3 mg/dL). For patients with creatinine clearance ≤ 30 mL/min (serum creatinine ≥ 3 mg/dL), the first dose is 2.5 mg once daily. The dosage may be titrated upward until blood pressure is controlled or to a maximum of 40 mg daily.

* See WARNINGS, Anaphylactoid reactions during membrane exposure. † Dosage on nondialysis days should be adjusted depending on the blood pressure response.

Heart Failure

Enalapril maleate tablets are indicated for the treatment of symptomatic heart failure, usually in combination with diuretics and digitalis. In the placebo-controlled studies that demonstrated improved survival, patients were titrated as tolerated up to 40 mg, administered in two divided doses.

The recommended initial dose is 2.5 mg. The recommended dosing range is 2.5 to 20 mg given twice a day. Doses should be titrated upward, as tolerated, over a period of a few days or weeks. The maximum daily dose administered in clinical trials was 40 mg in divided doses.

After the initial dose of enalapril maleate tablets, the patient should be observed under medical supervision for at least two hours and until blood pressure has stabilized for at least an additional hour (see WARNINGS and PRECAUTIONS. Drug Interactions ). If possible, the dose of any concomitant diuretic should be reduced which may diminish the likelihood of hypotension. The appearance of hypotension after the initial dose of enalapril maleate tablets does not preclude subsequent careful dose titration with the drug, following effective management of the hypotension.

Asymptomatic Left Ventricular Dysfunction

In the trial that demonstrated efficacy, patients were started on 2.5 mg twice daily and were titrated as tolerated to the targeted daily dose of 20 mg (in divided doses).

After the initial dose of enalapril maleate tablets, the patient should be observed under medical supervision for at least two hours and until blood pressure has stabilized for at least an additional hour (see WARNINGS and PRECAUTIONS. Drug Interactions ). If possible, the dose of any concomitant diuretic should be reduced which may diminish the likelihood of hypotension. The appearance of hypotension after the initial dose of enalapril maleate tablets does not preclude subsequent careful dose titration with the drug, following effective management of the hypotension.

Dosage Adjustment in Patients with Heart Failure and Renal Impairment or Hyponatremia

In patients with heart failure who have hyponatremia (serum sodium less than 130 mEq/L) or with serum creatinine greater than 1.6 mg/dL, therapy should be initiated at 2.5 mg daily under close medical supervision (see DOSAGE AND ADMINISTRATION. Heart Failure ; WARNINGS ; and PRECAUTIONS. Drug Interactions ). The dose may be increased to 2.5 mg b. i.d. then 5 mg b. i.d. and higher as needed, usually at intervals of four days or more if at the time of dosage adjustment there is not excessive hypotension or significant deterioration of renal function. The maximum daily dose is 40 mg.

Pediatric Hypertensive Patients

The usual recommended starting dose is 0.08 mg/kg (up to 5 mg) once daily. Dosage should be adjusted according to blood pressure response. Doses above 0.58 mg/kg (or in excess of 40 mg) have not been studied in pediatric patients (see CLINICAL PHARMACOLOGY. Clinical Pharmacology in Pediatric Patients ).

Enalapril maleate tablets are not recommended in neonates and in pediatric patients with glomerular filtration rate < 30 mL/min/1.73 m 2. as no data are available.

Preparation of Suspension (for 200 mL of a 1.0 mg/mL suspension)

Add 50 mL of Bicitra ® to a polyethylene terephthalate (PET) bottle containing ten 20 mg tablets of enalapril maleate tablets and shake for at least 2 minutes. Let concentrate stand for 60 minutes. Following the 60 minute hold time, shake the concentrate for an additional minute. Add 150 mL of Ora-Sweet SF ™ to the concentrate in the PET bottle and shake the suspension to disperse the ingredients. The suspension should be refrigerated at 2 to 8°C (36 to 46°F) and can be stored for up to 30 days. Shake the suspension before each use.

How is Enalapril Tablets Supplied

Enalapril maleate tablets USP, 2.5 mg are available as yellow, oval, convex tablets debossed “93” bisect “26” on one side, plain on the other side.

They are supplied as follows:

NDC 0093-0026-01 bottles of 100 (with desiccant)

NDC 0093-0026-10 bottles of 1000 (with desiccant)

Enalapril maleate tablets USP, 5 mg are available as white, oval, convex tablets debossed “93” bisect “27” on one side, plain on the other side.

They are supplied as follows:

NDC 0093-0027-01 bottles of 100 (with desiccant)

NDC 0093-0027-50 bottles of 5000 (with desiccant)

Enalapril maleate tablets USP, 10 mg are available as salmon, oval, convex tablets debossed “93 28” on one side, plain on the other side.

They are supplied as follows:

NDC 0093-0028-01 bottles of 100 (with desiccant)

NDC 0093-0028-10 bottles of 1000 (with desiccant)

NDC 0093-0028-50 bottles of 5000 (with desiccant)

Enalapril maleate tablets USP, 20 mg are available as peach, oval, convex tablets debossed “93 29” on one side, plain on the other side.

They are supplied as follows:

NDC 0093-0029-01 bottles of 100 (with desiccant)

NDC 0093-0029-10 bottles of 1000 (with desiccant)

NDC 0093-0029-50 bottles of 5000 (with desiccant)

Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].

Keep container tightly closed.

Protect from moisture.

Dispense in a tight, light-resistant container as defined in the USP, with a child-resistant closure (as required).

All brand names listed are the registered trademarks of their respective owners and are not trademarks of Teva Pharmaceuticals USA, Inc.

TEVA PHARMACEUTICALS USA, INC.

North Wales, PA 19454

Package/Label Display Panel

Enalapril Maleate Tablets USP 2.5 mg 100s Label Text

NDC 0093 -0026- 01

Enalapril Maleate Tablets USP 2.5 mg

Package/Label Display Panel

Enalapril Maleate Tablets USP 5 mg 100s Label Text

NDC 0093 -0027- 01

Enalapril Maleate Tablets USP 5 mg

Package/Label Display Panel

Enalapril Maleate Tablets USP 10 mg 100s Label Text

NDC 0093 -0028- 01

Enalapril Maleate Tablets USP 10 mg

Package/Label Display Panel

Enalapril Maleate Tablets USP 20 mg 100s Label Text

NDC 0093 -0029- 01

Enalapril Maleate Tablets USP 20 mg



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Drisdol (Ergocalciferol Capsules) Side Effects, Interactions, Warning, Dosage & Uses, Risdol

DRUG DESCRIPTION

DRISDOL brand of ergocalciferol capsules, USP, is a synthetic calcium regulator for oral administration.

Ergocalciferol is a white, colorless crystal, insoluble in water, soluble in organic solvents, and slightly soluble in vegetable oils. It is affected by air and by light. Ergosterol or provitamin D2 is found in plants and yeast and has no antirachitic activity.

There are more than 10 substances belonging to a group of steroid compounds, classified as having vitamin D or antirachitic activity.

One USP unit of vitamin D 2 is equivalent to one International Unit (IU), and 1 mcg of vitamin D 2 is equal to 40 IU.

Each capsule contains 1.25 mg (50,000 International Units vitamin D) of ergocalciferol, USP, in an edible vegetable oil.

Ergocalciferol, also called vitamin D 2 . is 9, 10-secoergosta-5,7,10 (19), 22-tetraen-3-ol, (3β,5Z,7E,22 E )-; (C 28 H 44 O) with a molecular weight of 396.65, and has the following structural formula:

Inactive Ingredients . FD&C Blue #1, FD&C Yellow #5, Gelatin, Glycerin, Parabens, Soybean Oil.

What are the possible side effects of ergocalciferol (Calcidol, Calciferol, Drisdol, Vitamin D2)?

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

Call your doctor at once if you have a serious side effect such as:

thinking problems, changes in behavior, feeling irritable;

urinating more than usual;

chest pain, feeling short of breath; or

early signs of vitamin D overdose (weakness, metallic taste in your mouth, weight loss, muscle or bone pain, constipation, nausea, and.

What are the precautions when taking ergocalciferol capsules (Drisdol)?

Before taking vitamin D, tell your doctor or pharmacist if you are allergic to it; or to other vitamin D products (such as calcitriol); or if you have any other allergies. This product may contain inactive ingredients (such as peanut/soy), 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: high calcium/vitamin D levels (hypercalcemia/hypervitaminosis D), difficulty absorbing nutrition from food (malabsorption syndrome), kidney disease, liver disease.

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

Last reviewed on RxList: 5/7/2009 This monograph has been modified to include the generic and brand name in many instances.



Buy Online Drisdol (Ergocalciferol Capsules) Side Effects, Interactions, Warning, Dosage & Uses, Risdol

Kopen Asdrin (Benadryl) Zonder Recept, Asdrin

Asdrin (Benadryl) Kopen Online Zonder Recept

Asdrin (Benadryl) Toelichting

Asdrin is zeker een antihistaminicum medicatie die primaire componenten hebben de neiging om paracetamol, diphenhydramine evenals fenylefrine zijn.

Paracetamol is echt een ongemak reliever evenals temperatuur verloopstuk.

Diphenhydramine is zeker een antihistaminicum die de eigenlijke organische chemische stof histamine in je lichaam vermindert. Histamine produceren in verband met hoesten, jeuk, tranende ogen, evenals de neus neus-gebied.

Phenylephrine is echt een decongestivum die bloedbaan vermindert binnen de neus paden. Verwijde bloedbaan kan neus verstopping (verstopte neus) veroorzaken.

De daadwerkelijke mengsel paracetamol, difenhydramine, en fenylefrine wordt gebruikt om te gaan met hoofdpijn, temperatuur, hele lichaam pijn, nasale of verstopte neus-gebied, hoesten, jeuk, drenken oog, en neus verstopping veroorzaakt door allergische reacties, de meest populaire koud, en influenza.

Asdrin ia ook wel aangeduid als Diphenhydramine, Dimedrol, Genahist, Sominex, Unisom.

General titel geassocieerd met Asdrin is eigenlijk Diphenhydramine.

Asdrin (Benadryl) Dosis

25mg normale dosis frictiemateriaal

Krijg Asdrin mondeling zonder of met maaltijden. In geval geergerd buik gebeurt, dragen maaltijden aan buik ongemak te verminderen. Met behulp van deze, samen met de maaltijden kunnen niet genezen van de waarschijnlijkheid van buik of zelfs intestinale problemen (bijvoorbeeld bloedverlies, ulcera) dat zou kunnen gebeuren tijdens het gebruik Asdrin.

Krijg Asdrin met een compleet kopje geassocieerd met het drinken van water (8 oz / 240 ml). Meestal niet leg neer met betrekking tot een half uur direct na het gebruik Asdrin.

Gebruik Asdrin net zo gericht binnen de bundel, tenzij natuurlijk gericht op een andere manier van uw arts. In het geval dat u gebruik maakt van Asdrin zonder arts voorgeschreven, zich aan elke vorm van waarschuwingen en beveiligingen binnen de tag.

Asdrin (Benadryl) ontbreekt in verband met de dosering

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

Asdrin (Benadryl) Overdose

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

Asdrin (Benadryl) Opslagruimte

Shop in een ruimte temperaturen tussen vijftien en vijfentwintig niveaus D (59 en zevenenzeventig niveaus F) tegen vocht en temperatuur. Versterken van de werkelijke na afloop dag. Handhaven van het bereiken van kinderen.

Asdrin (Benadryl) Negatieve effecten

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

slaperigheid, vermoeidheid, of zelfs vermoeidheid frictiemateriaal

hoofdpijn frictiemateriaal

uitgedroogde mond gebied frictiemateriaal

de problemen plassen of zelfs een goede grotere prostaat frictiemateriaal

Veel minder typische en ernstige nadelige gevolgen voor de hele behulp Asdrin: allergische aanval (moeilijkheidsgraad en uitademen; sluiten van de amandelen, ontsteking van de lippen, de taal, of zelfs tegenkomen, of zelfs netelroos).

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

Asdrin (Benadryl) Contra-indicaties

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

Het is lang erkend of acetaminofen, difenhydramine, en fenylefrine zeker een goede ontwikkelende foetus beschadigen. Meestal Asdrin niet gebruiken zonder begeleiding van uw eigen arts in het geval dat u verwacht of zelfs het geven van borstvoeding.

Meestal niet gebruiken Asdrin voor degenen die een goede MAO-remmer bijvoorbeeld furazolidone (Furoxone), isocarboxazide (Marplan), fenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar hebben benut ), of zelfs tranylcypromine (Parnate) in de laatste twee weken. Een ongezonde medicatie discussie zou kunnen gebeuren, wat resulteert in ernstige negatieve gevolgen.

Het kan schadelijk zijn voor benadryl overwegen voor degenen die hebben: ziekten in de lever, cirrose, of misschien een historisch verleden geassocieerd met afhankelijkheid van alcohol; de congestie in je spijsverteringsstelsel (maag of zelfs darmen); diabetische; renale ziekte; epilepsie of zelfs een ander beslag probleem; hoesten met slijm, of zelfs hoesten veroorzaakt door roken, emfyseem, of zelfs hardnekkige bronchitis; groter prostaat of zelfs plassen kwesties; lagere lage bloeddruk; feochromocytoom (een bijnier klier-tumor); of zelfs voor kalium (Cytra, Epiklor, K-Lyte, K-Phos, Kaon, Klor-Con, Polycitra, Urocit-K).

Meestal niet gebruiken Asdrin voor degenen die ernstige congestie, de congestie in je buik of zelfs darmkanaal, of zelfs in het geval u niet om naar het toilet kunnen; voor degenen die zonder behandeling of zelfs uit de hand ziektes bijvoorbeeld glaucoom, ademhalingsmoeilijkheden of zelfs COPD, hypertensie, hart-problemen, hart, of zelfs te snel werkende schildklier.

Meestal niet Asdrin krijgen met begeleiding geen arts heb je ooit meegemaakt alcohol ziekten in de lever (cirrose) of zelfs voor het geval dat je verbruikt veel meer dan drie op basis van alcohol drankjes per dag. Je zou niet de mogelijkheid hebben om medicatie die paracetamol heeft te krijgen.

Voorkom alcoholgebruik. Het kan uw kans op lever schade te verbeteren, terwijl het gebruik van paracetamol en kunnen specifieke negatieve effecten van diphenhydramine verbeteren.

Het kan schadelijk zijn voor Asdrin te voorkomen met behulp van ineens.

Asdrin (Benadryl) Veelgestelde vragen

Queen: Wat is Asdrin precies?

De: Asdrin is aangeduid als antihistaminica verschillende medicijnen. Asdrin wordt gebruikt om allergische reacties door existen temperatuur of zelfs een ander bovenste ademhalingswegen allergische reacties (huiduitslag, hoesten, nasale neus-gebied, jeukende ogen, neus gebied en keel) en tekenen en symptomen door de typische koude verlichten (loopneus neus-gebied, niezen).A

Queen: Zeer beste algemene titel in verband met Asdrin?

De: General titel geassocieerd met Asdrin is eigenlijk Diphenhydramine. A

Queen: Precies wat moet ik fag situatie als gevolg van de dosering ontbreekt?

De: Meestal hebben geen dubbele dosis krijgen. In het geval u de dosering die u nodig hebt om het te dragen als je eenmaal in het achterhoofd te houden met betrekking tot uw ontbreekt overslaan. Wanneer het tijd is voor de dosering die u nodig hebt om te dragen op je eigen normale dosering routine. A

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