Histantil coupon, histantil

Histantil Coupon and Discount

Our Histantil coupon and discount will save you up to 75%* off your prescription. Histantil is a prescription drug that treats allergy, nausea and vomiting. The original cash price of Histantil is not available. If your insurance does not cover this cost, use our Histantil coupon to reduce the price. Choose if you would like to receive your Rebates prescription coupon by mail, email, text, or print. Continue reading below for more information on Histantil.

Drug Name: Histantil Generic Name(s): Promethazine Drug Class: Antihistamine Treats: Allergy, Nausea, Vomiting

Histantil treats nausea, vomiting, allergies, and even insomnia. Histantil works by manipulating chemical actions in the brain. This in return leads to balanced reactions and emotions. One of the conditions that is treated in that effect is Nausea and vomiting. Histantil works by altering and balancing chemical reactions mentally hence facilitating other visible actions among human.

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Histantil Uses

There are a number of effects that are instigated by manipulation of chemical actions in the brain. Note that Histantil works by manipulating such actions. This means that Histantil can play a couple roles. To begin with Histantil helps in reducing the feeling of nausea and vomit. Aside from that, the chemical composition of this drug has the capacity to control and treat allergic symptoms. This may include itches, rashes among others. On rare cases, Histantil is used in people suffering from Insomnia. Histantil may also be used for other purposes to be specified by a medical doctor only.

Nausea

Vomiting

Allergies

Insomnia

Histantil Dosage

In most cases, the main formulation of Hinstantil is an intravenous solution. In other words, the drug should be administered using injections. On very rare cases will you come across an oral dosage of the same drug. It is recommended that you watch the amount of Hinstantil you consume and avoid overdose at all costs. This is because an overdose of the said drug can lead to very serious implications.

Usual dosage for adults ahould be 25 mg and should be administered intravenously once in a day.

Children who are below the age of 2 years should not consume Hinstantil. Otherwise, pediatric cases should be treated using 0.1 mg/kg after every 6 hours.

Histantil Side Effects

Like any other drug, Histantil may cause side effects. You should contact your doctor if you suffer any severe side effects. Below you will find a list of Histantil side effects. Note that not all possible side effects are listed here. Some of the side effects include:

Chest pain

Headache

Allergic reactions

Drowsiness

Increased weight loss

Loss of appetite

Histantil Interactions

Like any other drug, Histantil may interact with other drugs and substances. You should consult with your doctor or medical professional before adding any new medication, including over the counter drugs. Below is a list of drugs that have been known to interact with Histantil. Note that this list does not include all possible drug interactions. Some of the confirmed interactions include:

Amiodarone

Acetaminophen

Sotalol

Betapace

Bupropion

Epiklor

Ed K+10

Potassioum Chloride

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Use of this website confirms your understanding that the information on Rebates. com must not be used as a substitute for Doctor directed medical instruction. The content on this website is written by a staff of researchers without medical training. Our purpose is to save you money on your Prescribed Drugs! You agree to consult a physician or professional healthcare provider for your medical and prescription drug care. We do not endorse or recommend any of the drugs mentioned on this site.

This site is provided as an educational resource and is not affiliated with the drug manufacturers in any way. All copyrighted images and trademarks are the rights of their respective owners.

*This savings represents the maximum average discount on drugs using Rebates. com for the period March 1, 2015 to March 1, 2016.

Arcoxia 60mg tablets, etoricoxib 60mg

ARCOXIA 60MG TABLETS

Source: Medicines and Healthcare Products Regulatory Agency

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

FDA Consumer Updates

Latest Drug Information Updates

Yosprala Yosprala (aspirin and omeprazole) is a platelet aggregation inhibitor and proton pump inhibitor combination.

Troxyca ER Troxyca ER (oxycodone hydrochloride and naltrexone hydrochloride) is an extended-release, abuse-deterrent.

Adlyxin Adlyxin (lixisenatide) is a once-daily prandial glucagon-like peptide-1 (GLP-1) receptor agonist indicated.

Xiidra Xiidra (lifitegrast) is a lymphocyte function-associated antigen-1 (LFA-1) antagonist indicated for the.

Epclusa Epclusa (sofosbuvir and velpatasvir) is a nucleotide analog polymerase inhibitor and pan-genotypic NS5A.

Byvalson Byvalson (nebivolol and valsartan) is a beta adrenergic blocker and an angiotensin II receptor blocker (ARB).

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Amitriptyline 50 mg tablets, amitriptyline 50mg

Amitriptyline 50 Mg Tablets

Although the prescription medicine amitriptyline hydrochloride (Elavil ® ) can be used to treat depression in a wide range of people, not everyone takes the same amount. Various factors affect how much amitriptyline a person is prescribed, as well as how often the drug is taken.

For example, in general, the starting dose of amitriptyline is 75 mg total daily. This can be divided into two or three smaller doses. Or, instead of several doses a day, a person can start with amitriptyline 50 mg tablets once a day at bedtime.

Based on your response to this medication, the amount can be slowly increased. The maximum daily amount is typically 150 mg a day; however, people in the hospital can take up to 300 mg a day. Keep in mind that it can take up to four weeks for the full effects of amitriptyline to be felt, so do not adjust your dose without discussing the matter with your healthcare provider.

(To learn more about the dosing guidelines for this medication, click Amitriptyline Dosage. This article takes a detailed look at the various strengths of this drug, when they are used, and offers helpful treatment tips.)

Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD

Fermerskij dom il roncal - cividale del friuli, italiya, ronkal

Il Roncal

Это отзыв от Гуру по городу ().

Гуру по городу — тот, кто посетил определенный город по крайней мере 3 раз и написал полезные отзывы о городе и о своем проживании.

Это отзыв от Гуру деловых поездок

Гуру деловых поездок часто бывают в командировках, а потом описывают свои наблюдения в отзывах.

Это отзыв от Гуру семейных путешествий

Гуру семейных путешествий знают все о путешествиях с детьми и всегда делятся впечатлениями о своих приключениях.

Это отзыв от Гуру групповых поездок

Гуру групповых поездок часто путешествуют компанией и любят делиться своими историями.

Это отзыв от Гуру путешествий с животными

Гуру путешествий с животными часто берут с собой в путешествие своих домашних питомцев — а потом делятся своими историями!

Отзывы гостей отражают личное мнение клиентов Booking. com, ответивших на вопросы анкеты после проживания в отеле. Данные суждения могут не совпадать с мнением Booking. com.

4 ways to deworm cats, deworm

How to Deworm Cats

Several types of worms can infect cats. The four most common are roundworms, hookworms, tapeworms, and heartworms. Not only do these worms pose a danger to your cat, but some of them can also infect humans and all of them can infect other household pets, so in addition to deworming kittens, recently adopted cats, and cats with symptoms, all cat owners should discuss a regular program of parasite testing and control with their veterinarians. Knowing when to deworm a cat is as important as knowing how to deworm it.

Steps Edit

Method One of Four: Diagnosing Your Cat's Worms Edit

Check the fecal matter. The most common sign of worms is actual worms. Look at your cat’s stool for them. Tapeworm segments often break off and come out in your cat's feces. These segments look like little rice grains. When fresh, they may even move like little worms.

Look for diarrhea. A number of issues can cause diarrhea in cats, but all intestinal worms, including roundworms, hookworms, and tapeworms could potentially cause runny fecal matter. In other instances, your cat may develop blood from colon and intestinal irritation. [1]

Take a bag and collect these worms for your vet to examine. [2]

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Look out for vomiting. Roundworms can cause vomiting in cats. [3] Cats may even vomit up adult roundworms. They’ll look like spaghetti noodles. [4] Vomiting is also a potential symptom of heartworms. Like with their fecal matter, you should try to collect it into a small bag. Your vet will want to examine their throw up for parasites or signs of other conditions. [5] Remember that vomiting is not an automatic sign of worms. It could be any number of issues.

Keep track of their weight. Cats with intestinal worms or heartworms may experience weight loss. Sometimes, the change may be drastic and other times it might be marginal. [6] It all depends on the size and quantity of the worms. In other cases, your cat may develop an extended stomach — often called a “pot-belly”. If your cat’s belly has become rounded, it may be suffering from roundworms. [7]

Check your cat’s gums. Normally, a cat’s gums should be pink. Parasites, like many worms cause gums to turn pale through anemia or sheer shock. If you cat has pale gums, schedule a vet appointment. If your cat has difficulty breathing or is lethargic, seek emergency assistance.

Learn what type of worms your cat has. It's important to know the kind of worms your cat has so that you can begin treatment. Your vet will be able to tell you this and prescribe medication and treatment accordingly. Though you don't really need to understand the intricacies of each type of worm, here are the main worms you'll be dealing with:

Roundworms are the most common parasites in cats. Nursing kittens can get them from a mother's milk while adult cats can get them from infected feces.

Tapeworms are segmented parasites that can often be seen around the fur of a cat's hind quarters. They can be acquired from ingesting fleas. [8]

Hookworms are smaller than roundworms and reside in the small intestine. A cat can be infected from skin contact or ingestion. They are more common in dogs.

Lungworms reside in a cat's lungs and are a less common parasite. They can be acquired through ingestion of a host, such as a bird or a rodent. [9]

Heartworms are possibly the most dangerous of all. Mosquitoes bite infected animals, taking little heartworm larvae in with their blood meal. The larvae grow and the next time a mosquito bites into an animal (like your cat), it injects the heartworms into the bloodstream. [10]

Take your cat to the vet. Do not think that you can cure your cat on your own — you'll need to take your cat to the vet, who will check your cat's stool sample and confirm the presence of worms. If you can, try to collect a stool sample ahead of time for this test. If your vet suspects heartworm disease, they may take a routine blood sample. [11] There are many different types of worms and the treatment for one will not work for another, so it's important to know exactly what you're dealing with before you begin a course of treatment.

Typically, deworming medication should be administered bi-weekly or monthly. The treatment is not a one-time deal.

You may see some web sites that tell you that you can treat your cat "naturally" at home with some herbs and spices. Ignore this kind of information and take your pet to an animal health care professional. [12]

Take newly-adopted or newly-born kittens to the vet for deworming. This is a routine procedure, whether or not you think that your cat actually has worms. Kittens should be dewormed every 2 weeks from 6 weeks of age until 3 months, and then monthly until they are 6 months old. Adopted kittens should be dewormed immediately, with at least 2 additional treatments two-weeks apart each. Mothers can also pass worms on to their kittens.

Give your cat regular parasite preventative medication. Consult your vet for specifics. Some medications, such as selamectin, act broadly to protect against fleas, heartworms, hookworms, roundworms, and other parasites. [26]

Consider keeping your cats indoors. Since other infected cats, fleas, or rodents carry parasites, keeping your cat indoors will reduce their opportunities to contract worms. [27] Many cat owners feel guilty for keeping their cats indoors. They feel like they are depriving their cats in some way. "Shouldn’t my cat be able to express their natural instincts in the fresh air and sunshine?" This question guides their decision. In order to make this decision properly, you should weigh the pros and cons.

Are the risks too great? Consider road conditions, disease factors, environmental issues, other animals, and other human beings when you make your decision. If you decide to keep your cat indoors to avoid such risks, remember that you can closely replicate the outdoors with scratching posts, windows, and fun things to climb on. [28]

Keep fleas out of your home and yard. In general, if your cat stays indoors, then you don’t need to worry about outdoor spaces. Cats are fairly well-adept at killing off fleas especially if they are not inundated with them constantly. So focus on where they spend most of their time.

Home . Your primary tactic in the war against fleas should be sanitation. Wash all of your cat’s favorite pillows, blankets, and anything else they tend to lay on frequently. You want to wash away fleas, their eggs, and their pupae or young fleas. Thoroughly vacuum your carpet to do the same. If your case is moderate to extreme, consider using a fogger. Make sure you choose a brand that kills fleas and flea eggs. During use, humans and all animals need to clear out of the home for the time indicated on the can. Afterwards, wipe down all surfaces and vacuum again to remove dead fleas/flea eggs as well as leftover toxins. [29]

Yard . Flea control outdoors is much harder. Start by cleaning up organic debris that might harbor fleas like grass clippings, leaves, and straw. Fleas like to hide in dark, moist, and shady areas. Purchase an environmentally safe spray and douse these areas according to the instructions indicated on the product. [30]

Frequently clean your cat's litter box. Remove feces on a regular basis to stop worms from spreading. Wear disposable plastic gloves and possibly a face mask. You don’t want to breathe in your cat’s fecal dust. Scoop all the litter into a garbage bag. Use paper towels and some natural antibacterial spray to wipe out the inside of the litter box. Consider even washing the litter box out thoroughly with soapy water. Then replace with clean litter. Do this once or twice a week depending on your cat’s litter box use. [31]

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Comprar Viagra sin receta en farmacia

Nuestra página web representa un resumen de medicamentos para disfunción erétil, caída del pelo, obesidad, tabaquismo. Con ayuda de nuestro medio informativo el cliente podrà conocerse con los prospectos de los medicamentos ofrecidos y comprar Viagra sin receta en España si necesita el tratamiento para disfunciòn erèctil u otro cualquier preparado mèdico que mejora la erecciòn. Tambièn le ofrecemos por medio de nuestro blog comprar Viagra en farmacias en España a precio que considera el mejor. Navega por nuestra fuente informativa y encontrarà el Viagra precio online o Sildenafil precio, sus efectos y contraindicaciones, interacciòn y efectos secundarios. Sòlo un click le separa de la solución del problema de erección.

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No se puede sobreestimar el papel de la salud en la vida de la gente. Una persona sana puede quedarse alegre y feliz sin prestar atención al dolor o las dificultades. Sin embargo el modo de la vida sana aumenta nuestras oportunidades de quedarnos sanos. Pero aún siguiendo todas las normas y reglas no podemos evitar totalmente los problemas con salud. Por eso cuando una persona empieza a sufrir de diferentes problemas de salud, es muy importante encontrar un remedio adecuado porque no se puede posponer el tratamiento de cualquier enfermedad, aún la más menuda. La solución mejor es consultar a su médico y recibir el tratamiento necesario, pero existen casos cuando la gente sufre de la vergüenza de visitar al médico a causa de los problemas muy personales, tales como la erecciòn dèbil. Muchos hombres prefieren quedarse solos con su problema y no visitan al doctor. Otros no pueden curar la calvicie o dejar de fumar a pesar de diferentes métodos de su tratamiento.

Exactamente por eso hemos hecho un resumen de medicamentos-soluciones de tales problemas masculinos y femeninos y ofrecemos a los pacientes comprar Viagra en farmacias en España y otros fàrmacos diferentes que pueden ayudar despedirse de: disfunción eréctil, frigidez, caída del pelo, obesidad, tabaquismo.

Para solucionar el problema de disfunción eréctil el paciente puede escoger entre numerosos medicamentos que le ofrece esta página web. Se puede comprar Viagra online en España, Cialis, Levitra, Kamagra 100, Kamagra Oral Jelly etc Son medicamentos originales y proporcionan el efecto seguro al organismo. Le ofrecemos comprar Viagra en España - un remedio eficaz contra impotencia sexual! El Sildenafil precio 100mg, el componete principal de la "pastilla azul" permite comprar Viagra online en farmacias en España sin gastar mucho dinero.

También se le ofrece comprar Viagra Genérico y otros medicamentos genèricos de Sildenafil 100mg y 50mg, Tadalafil 20 mg, Vardenafil 20 mg - tres principios activos màs fuertes en la lucha de DE. La venta se realiza sin receta mèdica. Son las copias idénticas de los medicamentos originales pero cuestan menos porque no necesitan mucho dinero en diferentes investigaciones, pruebas y su promoción. Solamente eninternet Sildenafil precio es razonable y asequible para los clientes. Comprar Viagra en farmacias - un remedio eficaz contra la disfunción eréctil. Para que el cliente pueda comprar Viagra online, las farmacias en lìnea tienen diferentes mètodos de pago: transferencia bancaria, targeta de crèdito.

Viagra precio online asequible en farmacias de España!

Tambièn el cliente puede conocerse con la informaciòn sobre las formas variadas de las medicaciones ya mencionados tales como pastillas Soft. Estos medicamentos tienen el efecto más rápido gracias a su forma especial. Así Usted puede comprar Viagra en España Soft, Cialis y Levitra Soft que actuan ya dentro de 20 minutos. Compare el precio para comprar Viagra sin receta de marca y genèrico y verà la diferencia. Los medicamentos originales siempre tienen valor màs alto aunque muchos hombres prefieren sòlo pastillas originales. Si no quiere gastar mucho dinero en las pastillas, puede aprovecharse de Viagra precio online barato del genèrico.

Si todavía no sabe què medicamento le sirve mejor o nunca antes ha comprado ninguna de estas medicinas, nuestro resumen le ofrece leer sobre paquetes de prueba que contienen diferentes medicamentos así que podrá comparar todos los preparados y sus efectos y comprar Viagra en farmacias cuyos paquetes van a incluir los preparados mèdicos que quiere. Le recordamos que comprar Viagra sin receta es posible. Recomendamos que se aproveche de Viagra precio online que se ofrece en Internet. Porque Viagra precio online que ofrecen las farmacias en Internet siempre son más bajos y ventajosos para todo el mundo.

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Tambièn hay la informaciòn para las mujeres. Dado que no sólo los hombres sufren de impotencia, las mujeres también tienen diferentes problemas sexuales. Así ofrecemos a las mujeres un medicamento - Lovegra que se llama Viagra femenina tambièn. En las farmacias en lìnea comprar Viagra femenina en España tambièn es posible sin receta. El efecto de Lovegra es muy parecido al efecto de "pastilla azul masculina", ya que también se basa en la sustancia activa sildenafil 100mg y proporciona el flujo de sangre a los genitales lo que garantiza los orgasmos fuertes y duraderos.

Las últimas décadas el problema de obesidad se ha convertido en una de las enfermedades más peligrosas del mundo. Según las estadísticas la mortalidad a causa de la obesidad ocupa el quinto lugar de riesgo. Por eso es tan importante el problema de sobrepeso. Así debe ser resuelto lo más pronto. Aquì tenemos la informaciòn completa sobre los mejores remedios adelgazantes y medicamentos para la pèrdida de peso, diferentes té para adelgazar y café que ayuda bajar de peso: Perfect Slim, Lida Daidaihua, Lida té, Lida café, Meizitang Soft Gel, Slimex, Xenical Genérico.

Los hombres que tienen la caída del pelo encontaràn aquì una solución muy productiva – Propecia Genérico. El componente princial de Propecia es Finasterida 1mg que para la caída de pelo y recupera el crecimeinto del cabello masculino. Toda la información útil, interesante y necesaria sobre Finasterida hay en las páginas de este blog.

También puede dejar de fumar tomando el medicamento Zyban Genérico. En las páginas de nuestro blog se puede leer sobre sus propiedades, efectos, contraindicaciones y modo de aplicaciòn. Más información buscad en las páginas dedicadas a la descripción de remedios arriba mencionados.

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El contenido de este blog es sòlo la informaciòn para los hombres y las mujeres que buscan todo sobre los medicamentos y buscan càmo adquirirlos en lìnea. Esperamos que informaciòn dada le haya ayudado hacer la decisiòn y comprar Viagra sin receta o adquirir cualquier otra medicaciòn de la lista. Le deseamos muchos éxitos en la lucha por su salud. Buscar más información sobre Viagra precio puede en las páginas dedicadas al medicamento.

?Que clase de Genericos Viagra hay?

De acuerdo con las diversas agencias de marketingel medicamento Viagra para el tratamiento de la impotencia durante muchos anos ha permanecido en la cabeza de las ventastanto en el mercado occidental, como en el mercado europeo. Esto se debe a que el Viagra - no solo es un farmaco eficaz para mejorar la potencia, sino tambien el producto que mas publicidad ha obtenido en el mercado farmaceutico. Cada segundo hombre que es mayor de edad habra escuchado algo sobre el medicamento Viagra. La compania Pfizer ha gastado enormes cantidades de dinero para asegurarse de que su producto farmaceutico mas importante, que es – Viagra, seconvierta en el farmaco mas reconocido en todo mundo. El resultado ha sido fantastico, pero le ha costado un monton de dinero. Como resultado, la politica de precios de la compania no sido tan beneficiosa para los hombres, como se esperaba. El precio de Viagra no se ajusta al poder adquisitivo de muchos hombres porque se posiciona en el segmento de los precios muy altos. Por lo cual si usted quiere comprar Viagra perotiene un presupuesto limitado podra optar por prestar atencion y adquirir los analogos mas baratos – Genericos Viagra. GenericosViagra en los ultimos anos se han convertido en muy populares, ya que se venden a precio varias veces mas barato que el medicamento original, perosu calidad es la misma. Los Genericos Viagra se producen principalmente las grandes empresas farmaceuticas de la India que utilizan la formula molecular Citrato de Sildenafilo para la produccion de una copia exacta de la marca Viagra. Todas las propiedades farmacologicas, del Generico Viagra son completamente identicasal farmaco original. Pero los productores ingeniososde los analogos han decidido ir aun mas lejos y presentaron a los consumidores una variedad de pastillas para la disfuncion erectil. Ahora, el barato Generico Viagra se vende en diferentes formas farmaceuticas: comprimidos, capsulas estandar, gelatina, sobres con gelatina (gelatinaesta presentada por 7 sabores diferentes), las pastillasmasticables de accion instantanea con un recubierto de agradable sabor. Ahora, los hombres no solo pueden ahorrar dinero mediante la compra de analogos baratos, sino tambien pueden probar variar en el largo y dificil proceso de tratamiento de la disfuncion erectil.

Links

Lomaira Lomaira (phentermine hydrochloride) is a sympathomimetic amine anorectic used short-term for weight reduction in overweight or obese adults.

Kyleena Kyleena (levonorgestrel-releasing intrauterine system) is a low-dose progestin-containing intrauterine system (IUS) indicated for the.

Exondys 51 Exondys 51 (eteplirsen) is a morpholino antisense oligomer for the treatment of Duchenne muscular dystrophy (DMD) amenable to exon 51.

Drugs in Development

(Not yet approved)

neratinib Neratinib is a potent irreversible tyrosine kinase inhibitor in development for the extended adjuvant treatment of HER2-positive early.

Yuvvexy Yuvvexy (estradiol) is a topical estrogen in an applicator-free, vaginal, softgel capsule formulation for the treatment of dyspareunia.

telotristat etiprate Telotristat etiprate is an oral tryptophan hydroxylase inhibitor in development for the treatment of carcinoid syndrome.

Drugs. com is the most popular, comprehensive and up-to-date source of drug information online. Providing free, peer-reviewed, accurate and independent data on more than 24,000 prescription drugs, over-the-counter medicines & natural products.

Letting kids help with gardening may sow the seeds of a lifelong healthy eating habit, according to new research. College students who gardened as a kid, or were currently gardeners, ate more fruits and vegetables than their peers without a green thumb, researchers at the University of Florida found. "This finding is particularly relevant, given the.

Researchers in Denmark have identified a new form of the superbug known as MRSA (methicillin-resistant Staphylococcus aureus) that they suspect may be spread through eating contaminated poultry. People who raise livestock are known to face a higher risk for MRSA, the researchers said. But, the new strain infected 10 urban-dwelling people who hadn't.

RARITAN, N. J. September 21, 2016 – Janssen Pharmaceuticals, Inc. (Janssen) announced today the U. S. Food and Drug Administration (FDA) has approved Invokamet XR - a once-daily, fixed-dose combination therapy of canagliflozin and metformin hydrochloride extended-release (XR)—for first-line use as an adjunct to diet and exercise to improve blood.

Basel, September 21, 2016 - Today Novartis published proof of concept study results in the New England Journal of Medicine showing that its new antimalarial compound, KAF156, demonstrated activity against both vivax and falciparum malaria, including artemisinin-resistant parasites. Malaria is a life-threatening disease primarily caused by parasites.

Patients with unsightly scars from cancer surgeries may benefit from "medical tattoos" that can help restore some of the skin's natural appearance, Dutch researchers report. The researchers surveyed 56 patients who got medical tattoos on their head and neck, and found they were pleased with the results. "The mystery until now was how well patients.

Aerial spraying of insecticides seems to be stopping the spread of the Zika virus in south Florida, health officials said Friday. Seventy-four confirmed cases of the mosquito-borne infection that causes devastating birth defects have been reported in the state, the only state in the nation to report any local infections. A combination of insecticides.

Teens who eat right may gain less weight later on, researchers report. Encouraging more young people to eat a variety of fruits and vegetables as well as lean proteins and whole grains while limiting sugar, red meat and processed foods could have a positive long-term effect on obesity rates, investigators found. The University of Minnesota researchers.

Cities that promote walking, bicycling and public transportation can expect a drop in chronic illnesses such as heart disease and diabetes, a new study suggests. The finding stems from an international study led by the University of Melbourne in Australia and the University of California, San Diego (UCSD). The goal: To see how city design -- including.

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Posted 2 days ago in Medical

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Chlorcol, chloramphenicol, chlorcol

Chlorcol

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Chloramphenicol is indicated for the topical treatment of infections due to micro-organisms sensitive to the anti-infective.

"Adults (including the Elderly) and Children One to two drops applied topically to each affected eye up to six times daily or more frequently if required. (Severe infections may require one to two drops every fifteen to twenty minutes initially, reducing the frequency of instillation gradually as the infection is controlled)."

Local Sensitivity reactions such as transient irritation, burning, stinging, itching and dermatitis, may occasionally occur. Systemic Rarely, cases of major adverse haematological events (bone marrow depression, aplastic anaemia and death) have been reported following ocular use of chloramphenicol.

Chymotrypsin will be inhibited if given simultaneously with chloramphenicol.

In severe infections topical use of chloramphenicol should be supplemented with appropriate systemic treatment. Aplastic anaemia has, very rarely, followed topical use of chloramphenicol eye drops and, whilst this hazard is an uncommon one, it should be borne in mind when the benefits of the use of chloramphenicol are assessed. Prolonged use should be avoided as it may increase the likelihood of sensitisation and the emergence of resistant organisms. Chloramphenicol should be reserved for use only in infections for which it is specifically indicated. Contact lenses should be removed during the period of treatment. Systemic absorption may be reduced by compressing the lacrimal sac at the medial canthus for a minute during and following the instillation of the drops. (This blocks the passage of the drops via the naso lacrimal duct to the wide absorptive area of the nasal and pharyngeal mucosa. It is especially advisable in children.)

SOLUTION FOR INJECTION

Di cor mio alcina at the teatro real, madrid, cor mio

Main Menu

Di cor mio: Alcina at the Teatro Real, Madrid

Morgana – Anna Christy

Ruggiero – Christine Rice

Bradamante – Sonia Prina

Melisso – Luca Tittoto

Oronte – Allan Clayton

Oberto – Erika Escriba

Orquesta Titular del Teatro Real de Madrid / Christopher Moulds.

Stage director – David Alden.

Teatro Real, Madrid. Saturday, October 31st, 2015.

For this second visit to Madrid following last month’s Roberto Devereux it was time for some baroque. Alcina is a tour de force for the soprano in the title role and tonight we had one of the greatest Handel sopranos of our time as part of a very fine cast. The production, which was previously seen in Bordeaux, was the work of David Alden. Alden’s production of La Calisto in Munich is for me his finest work and in some ways this Alcina is a cousin of it. Certainly, the way the set (Gideon Davey) was set up, with a curtained stage at the back left and the presence of animal figures at certain points, reminded me of the visuals of that particular show. Sadly, I’m not sure that this production is as successful.

Ensemble, Allan Clayton © Teatro Real/Javier del Real

The main reason for this is that I found Alden’s work hyperactive. Yes, the piece is made up of recitatives and da capo arias, but the impression that I got was that Alden didn’t trust the work and his singer-actors enough to carry the piece. So often, distracting stage business would take the attention away from arias, seemingly adding little in the way of character development and narrative progression. At its best, as in when Morgana sang ‘ama, sospira, ma non ti offende’ the stage pictures were quite effective precisely because they illustrated the micro-society in which the action took place. During his Act 1 aria, Allan Clayton’s Oronte got to demonstrate his capacity for a mean Irish jig but I’m not sure it especially added much to our understanding of his character. Yet, when Alden really focused attention on his singers, the effect was remarkable. As Christine Rice sang ‘verdi prati’ alone on stage, without distractions, it allowed us to focus completely on her character’s situation. Likewise, Gauvin’s ‘mi restano le lagrime’ was unbearable to watch because she completely incorporated her character’s despair and the focus was solely on her.

Sonia Prina, Luca Tittoto, Christine Rice, Erika Escriba © Teatro Real/Javier del Real

One element that was particularly successful was the lighting (Simon Mills). It made wonderful use of shadows to demonstrate interactions between characters and certainly helped to illustrate the narrative. There were some interesting ideas – Alcina wearing a pink glove to represent her powers and the gloves descending from the flies as if from the spirits rejecting her in ‘ombre pallide’. Above all, I found the staging didn’t quite trust the work enough to tell the story and felt compelled to add layers of extraneous detail that did nothing in the way of giving us deeper understanding of the characters and their motivations.

Actor, Karina Gauvin, Erika Escriba © Teatro Real/Javier del Real

Musically, it was a very satisfying evening on the whole. Morgana was sung by Anna Christy. She is a very musical singer and everything she does is certainly stylistically appropriate, yet in a house the size of the Real, the voice didn’t carry and wasn’t helped by Alden placing her upstage far too often. The tone sounds shallow and gains shrillness at the very top. Perhaps in a smaller house it might work much better. Certainly, the musical instincts are very much there, she has a reliable technique and she is a fine actress. It’s just that I craved a bigger voice that could carry through the house. As in Handel’s time, the choral parts were sung by the ensemble. Erika Escriba was a positive presence on the stage and sang Oberto in a bright soprano that certainly has a lot of promise.

Anna Christy © Teatro Real/Javier del Real

Sonia Prina brought her familiar clarinet-toned contralto to the role of Bradamante. She is a highly engaging actress and her ornamentation, indeed that of the whole cast, was highly stylish. The voice perhaps lacks the ultimate variety of tone colours and ‘vorrei vendicarmi’ went a little off the rails but she sang with genuine stylistic awareness and a fastidious attention to text. Luca Tittoto likewise gave us an impeccable account of his aria with a good line and satisfying ornamentation of the da capo and he was a wonderfully warm presence in the ensembles. Allan Clayton gave us some textbook Handel singing as Oronte. He dispatched ‘e un folie’ with wonderful aplomb and he also gave us an ‘un momento di contento’ of glorious tonal beauty.

Christine Rice © Teatro Real/Javier del Real

Christine Rice gave us a fabulously introspective ‘verdi prati’ completely entering into the spirit of her character, the line elegant, sung with velvety tone and a beautiful use of text. Perhaps, ‘sta nell’ircana’ could have done with slightly firmer, more heroic tone but Rice really did give us Handel singing of great distinction.

Christine Rice, Karina Gauvin © Teatro Real/Javier del Real

Then there was Gauvin’s Alcina. Here we had this wonderful feeling of hearing and seeing an artist sing music as if it had been written for her and her alone. Gauvin truly made the role her own. This was singing that was not only stylistically impeccable but also genuinely lived. Her opening ‘di cor mio’ was sung with effortlessly long lines and ornamentation that genuinely enhanced the vocal line and brought it to life. It felt that she was creating the role for us right here and now. She is a commanding stage presence, an outstanding actress, dominating the stage whenever she appears. For her opening aria, she perambulated from the back to the front of the stage and for those few minutes, it seemed like nothing else mattered. Her ‘ah mio cor’ was absolutely devastating. Taken at a slightly swifter tempo than usual, the jagged strings fed into a vocal line that was so full of pain and regret yet when she sang ‘son regina’ you genuinely believed her. It really felt tonight that we were given a masterclass in Handel singing by an artist at the peak of her powers.

Karina Gauvin © Teatro Real/Javier del Real

The house band played exceptionally well for Christopher Moulds. The biggest compliment I can pay them is that they sounded like a period band, such was the stylishness of the playing that they gave us. Attack was sharp, strings played without vibrato and the continuo group was a lively presence, making it feel that the music was being created at that very moment. Tempi were swift, but never overly so, though I might have preferred ‘sta nell’ircana’ to be a notch or two swifter. This was a major achievement for the house band, cementing the Teatro Real’s position as one of the leading houses.

Anna Christy © Teatro Real/Javier del Real

Ultimately this was a mixed evening. In some respects the production worked yet on the whole I felt that it didn’t trust the form of the piece enough to make it work fully. There was perhaps an unwillingness to allow the audience to make up their own minds about the piece and instead it felt that Alden threw everything at it in the hope that something might work. That said, the cast completely threw themselves into the staging giving it absolutely everything they had. Musically, it was an exceptional evening, one that will remain long in the memory for the outstanding assumption of the title role and the extremely fine supporting cast.

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Articles

Alfacalcidol and calcium supplement reduction in post-thyroidectomy patients

Margaret Morris, Endocrine Specialist Nurse, The Freeman Hospital, Newcastle upon Tyne

Hypocalcaemia is the most common post-operative complication following total thyroidectomy, although permanent hypoparathyroidism only occurs in 1-2% of cases. Symptoms are very well controlled with alfacalcidol (Vitamin D) and calcium supplements with regular patient monitoring.

Despite the risk of renal impairment incurred by long-term use of these medications, and the unpalatable nature of the tablets, it has been our experience that therapy is often continued in the long-term, even when it is not necessary. A supervised withdrawal of treatment in a group of 42 patients receiving the therapy indicated that 80% were able to stop or reduce their medication.

A protocol is now in place for withdrawal of established medication and the next phase of the project is to investigate the management of post-operative hypocalcaemia on wards. This will hopefully result in an evidence-based protocol to facilitate the safe and early discharge of patients who can then follow previously devised procedures to reduce/discontinue medications where possible.

Patient education and involvement has been shown to be the key to successful reduction or withdrawal of treatment and printed information for patients will be produced to facilitate this.

If this work is successful within our Trust then it is hoped the results and patient information will be disseminated nationally by publication of the results, presentation at regional and national conferences, and by providing copies of the proformas and patient information to other centres that are interested in using them. The award will be used to produce this information and any presentational aids required. Hopefully in the long term this would be supported by the BTF and the BTA.

Buy pain relief - galepsin (brand name tegretol) online - order carbamazepine - purchase pain relief

Tegretol (carbamazepine) is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and pain. Tegretol is used to treat seizures and nerve pain such as trigeminal neuralgia and diabetic neuropathy. Carbamazepine is also used to treat bipolar disorder. Tegretol may also be used for purposes not listed in this medication guide.

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

Do not crush, chew, or break an extended-release Tegretol tablet. Swallow the pill whole. Breaking the pill would cause too much of the drug to be released at one time.

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

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and call your doctor promptly if this medicine seems to stop working as well in preventing your seizures. Tegretol can lower blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill.

To be sure Tegretol is not causing harmful effects, your blood cells and kidney function may need to be tested often. Do not miss any follow up visits to your doctor for blood or urine tests. Your doctor may also recommend having your eyes checked regularly while you are taking this medicine.

Do not stop using Tegretol without first talking to your doctor, even if you feel fine. You may have increased seizures or unpleasant withdrawal symptoms if you stop using this medicine suddenly. Wear a medical alert tag or carry an ID card stating that you take Tegretol. Any medical care provider who treats you should know that you take seizure medication.

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

Active Ingredient: Carbamazepine

Tegretol may cause severe or life-threatening skin rash, especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk of this skin reaction. Seek emergency medical attention if you have a fever, sore throat, headache and skin pain, followed by a red or purple skin rash that spreads and causes blistering and peeling.

You should not take Tegretol if you have a history of bone marrow suppression, if you are also taking nefazodone, or if you are allergic to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor).

Tegretol may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant while taking Tegretol for seizures. Do not start or stop taking Tegretol during pregnancy without your doctor's advice.

Before you take Tegretol, tell your doctor if you have heart disease, high blood pressure, high cholesterol, liver or kidney disease, glaucoma, a thyroid disorder, lupus, porphyria, or a history of mental illness or psychosis.

You may have thoughts about suicide while taking Tegretol. Your doctor will need to check you at regular visits. Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

There are many other drugs that can interact with Tegretol. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Do not stop using Tegretol without first talking to your doctor, even if you feel fine. You may have increased seizures or unpleasant withdrawal symptoms if you stop using Tegretol suddenly.

Do not use Tegretol if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. You should not take Tegretol if you are allergic to carbamazepine, or if you have:

a history of bone marrow suppression

if you are also taking nefazodone; or

if you are allergic to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor).

Important safety information:

Tegretol may cause severe or life-threatening skin rash, especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk of this skin reaction.

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

heart disease, high blood pressure, high cholesterol or triglycerides;

liver or kidney disease;

a thyroid disorder;

a history of mental illness or psychosis.

Patients of Asian ancestry may have a higher risk of developing a rare but serious skin reaction to Tegretol. Your doctor may recommend a blood test before you start the medication to determine your risk of this skin reaction.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

You may have thoughts about suicide while taking Tegretol. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed. Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking Tegretol. Follow your doctor's instructions about taking Tegretol while you are pregnant.

FDA pregnancy category D. Tegretol may cause harm to an unborn baby. Do not start taking this medcine without telling your doctor if you are pregnant or planning to become pregnant. Use effective birth control while you are taking this medicine. Although Tegretol may harm an unborn baby, having a seizure during pregnancy could harm both mother and baby. If you become pregnant while taking Tegretol, do not stop taking the medicine without your doctor's advice.

Carbamazepine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Tegretol. Carbamazepine can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking Tegretol.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid drinking alcohol. It can increase some of the side effects of Tegretol, and can also increase your risk of seizures.

Avoid exposure to sunlight or tanning beds. Tegretol can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Grapefruit and grapefruit juice may interact with Tegretol and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Get emergency medical help if you have any of these signs of an allergic reaction to Tegretol: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

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

pale skin, feeling light-headed, rapid heart rate, trouble concentrating;

fever, chills, sore throat, mouth and throat ulcers;

easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;

confusion, agitation, vision problems, hallucinations;

feeling short of breath, swelling of your ankles or feet;

urinating less than usual;

jaundice (yellowing of the skin or eyes); or

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

Less serious Tegretol side effects may include:

feeling dizzy, drowsy, or unsteady;

nausea, vomiting, diarrhea, constipation, stomach pain;

headache, ringing in your ears;

dry mouth, swollen tongue; or

joint or muscle pain, leg cramps.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Diltiazem hydrochloride (professional patient advice), taztia 90mg

Diltiazem Hydrochloride

Cardizem - Tablets 30 mg - Tablets 60 mg - Tablets 90 mg - Tablets 120 mg - Powder for injection 25 mg - Injection 5 mg/mL

Cardizem CD - Capsules, ER 120 mg - Capsules, ER 180 mg - Capsules, ER 240 mg - Capsules, ER 300 mg - Capsules, ER 360 mg

Cardizem LA - Tablets, ER 120 mg - Tablets, ER 180 mg - Tablets, ER 240 mg - Tablets, ER 300 mg - Tablets, ER 360 mg - Tablets, ER 420 mg

Cartia XT - Capsules, ER 120 mg - Capsules, ER 180 mg - Capsules, ER 240 mg - Capsules, ER 300 mg

Dilacor XR - Capsules, ER 120 mg - Capsules, ER 180 mg - Capsules, ER 240 mg

Dilt-XR - Capsules, ER 120 mg - Capsules, ER 180 mg - Capsules, ER 240 mg

Diltia XT - Capsules, ER 180 mg

Diltiazem Hydrochloride Extended Release - Capsules, ER 60 mg - Capsules, ER 90 mg

Diltzac - Capsules, ER 120 mg - Capsules, ER 180 mg - Capsules, ER 240 mg - Capsules, ER 300 mg - Capsules, ER 360 mg

Matzim LA - Tablets, ER 120 mg - Tablets, ER 180 mg - Tablets, ER 240 mg - Tablets, ER 300 mg - Tablets, ER 360 mg - Tablets, ER 420 mg

Taztia XT - Capsules, ER 120 mg - Capsules, ER 180 mg - Capsules, ER 240 mg

Tiazac - Capsules, ER 120 mg - Capsules, ER 180 mg - Capsules, ER 240 mg - Capsules, ER 300 mg - Capsules, ER 360 mg - Capsules, ER 420 mg

Apo-Diltiaz (Canada) Apo-Diltiaz CD (Canada) Apo-Diltiaz Injectable (Canada) Apo-Diltiaz SR (Canada) Gen-Diltiazem (Canada) Gen-Diltiazem CD (Canada) Novo-Diltiazem (Canada) Novo-Diltiazem CD (Canada) Nu-Diltiaz (Canada) Nu-Diltiaz-CD (Canada) ratio-Diltiazem CD (Canada) Sandoz Diltiazem CD (Canada) Tiazac XC (Canada)

Pharmacology

Inhibits movement of calcium ions across the cell membrane in systemic and coronary vascular smooth muscle; slows calcium ion movement across cell membranes in both cardiac muscle and cardiac pacemaker cells, decreasing sinoatrial and atrioventricular (AV) conduction.

Pharmacokinetics

Absorption

T max is 2 to 3 h.

Extended release (ER)

T max is 10 to 14 h.

Immediate release (IR)

T max is 2 to 4 h.

Distribution

Vd approximately 305 L. 70% to 80% protein bound (approximately 40% to alpha l - acid glycoprotein and approximately 30% to albumin). Excreted in breast milk.

Metabolism

Metabolized in the liver (including via CYP-450) to several metabolites; desacetyl diltiazem is 25% to 50% as potent as diltiazem. Undergoes first-pass metabolism after oral administration.

Elimination

The half-life is approximately 3.4 h (IV), 4 to 9 h (ER), and 3 to 4.5 h (IR). 2% to 4% is excreted unchanged in the urine (oral). Systemic Cl is approximately 65 L/h (IV).

Peak

2 to 5 min (IV); 11 to 18 h (ER).

Special Populations

Renal Function Impairment

No difference in the pharmacokinetic profile of diltiazem in patients with severely impaired renal function.

Hepatic Function Impairment

Bioavailability is increased, and half-life is prolonged.

Indications and Usage

Treatment of angina pectoris caused by coronary artery spasm; chronic stable angina (classic effort-associated angina); essential hypertension (ER and sustained-release forms only).

Treatment of atrial fibrillation or flutter; paroxysmal supraventricular tachycardia.

Contraindications

Sick sinus syndrome or second - or third-degree AV block, except with functioning pacemaker; hypotension with systolic pressure less than 90 mm Hg; acute MI; pulmonary congestion; hypersensitivity to the drug; ventricular tachycardia (IV); atrial fibrillation or atrial flutter associated with an accessory bypass tract (IV); IV diltiazem and IV beta-blockers administered together (within a few hours).

Dosage and Administration

Dosage regimens should be individualized.

PO Start with 30 mg 4 times daily before meals and at bedtime. Gradually increase dosage at 1- to 2-day intervals until optimum response (average optimum dose range 180 to 360 mg/day).

Cardizem CD and Cartia XT

PO Start with 120 to 180 mg once daily. Some patients may respond to doses up to 480 mg once daily. When necessary, titrate the dose over 7 to 14 days.

Cardizem LA and Matzim LA

PO Start with 180 mg once daily. Some patients may respond to doses up to 360 mg once daily. Titrate dose over 7 to 14 days.

Dilacor XR and Diltia XT

PO Start with 120 mg once daily. Some patients may respond to doses up to 480 mg once daily. When necessary, titrate the dose over 7 to 14 days.

Diltzac and Tiazac

PO Start with 120 to 180 mg once daily. Some patients may respond to doses up to 540 mg once daily. When necessary, titrate the dose over 7 to 14 days.

Atrial Fibrillation/Flutter/Paroxysmal Supraventricular Tachycardia Adults Direct IV single bolus injection

Parenteral Initial dose is 0.25 mg/kg as a bolus administered over 2 min (reasonable dose is 20 mg for average patient). If response is inadequate after 15 min, administer as a second 0.35 mg/kg over 2 min (reasonable dose is 25 mg for average patient). Individualize subsequent IV doses. Dose low body weight patients on a mg/kg basis. Although the duration of action may be shorter, some patients may respond to an initial dose of 0.15 mg/kg.

Continuous IV infusion

Parenteral For continued reduction of heart rate (up to 24 h) in patients with atrial fibrillation or atrial flutter, IV infusion may be administered. Immediately following administration of a bolus dose of 20 mg (0.25 mg/kg) or 25 mg (0.35 mg/kg) and reduction of heart rate, begin an IV infusion. The recommended initial infusion rate is 10 mg/h; however, some patients may maintain response to an initial rate of 5 mg/h. The infusion rate may be increased in 5 mg/h increments up to 15 mg/h as needed, if further reduction in heart rate is necessary. The infusion may be maintained for up to 24 h (max, 24 h and 15 mg/h).

Hypertension Adults Extended-release capsules

PO Start with 60 to 120 mg twice daily or 180 to 240 mg once daily. Max antihypertensive effect usually occurs by 14 days of chronic therapy (optimum dose range 240 to 360 mg once daily, but some patients respond to lower doses or higher doses up to 480 mg once daily).

Cardizem CD and Cartia XT

PO 180 to 240 mg once daily; however, some patients may respond to lower doses. Maximum effect is usually achieved by 14 days of chronic therapy. Usual range is 240 to 360 mg once daily. Some patients may respond to doses up to 480 mg once daily.

Cardizem LA and Matzim LA

PO Start with 180 to 240 mg once daily; however, some patients may respond to lower doses. Max effect is usually achieved by 14 days of chronic therapy. Dose range studied in clinical trials was 120 to 540 mg once daily (max, 540 mg daily).

Dilacor XR and Diltia XT

PO 180 to 240 mg once daily (usual dose range, 180 to 480 mg once daily). Individual patients, particularly those 60 yr of age and older, may respond to lower doses of 120 mg once daily. Some patients may require doses up to 540 mg once daily.

Diltzac and Tiazac

PO Start with 120 to 240 mg once daily. Max effect is usually achieved by 14 days of chronic therapy. Usual dose range is 120 to 540 mg once daily.

General Advice

May be used alone or in combination with other CV medications for the treatment of hypertension and angina.

Swallow tablets and capsules whole. Do not crush, chew, or break.

Diltzac capsules may be opened and contents sprinkled onto a spoonful of applesauce. Swallow applesauce immediately without chewing, and follow with a glass of cool water.

For administration by IV bolus or infusion only.

For IV infusion, add prescribed dose to prescribed volume of sodium chloride 0.9%, dextrose 5% in water, or dextrose 5% in sodium chloride 0.45% following manufacturer's dilution charts.

Storage/Stability

Store tablets and capsules at controlled room temperature (59° to 86°F). Protect from moisture and avoid excessive humidity. Discard any unused solution. Do not save for future use. Store vials for injection in refrigerator (36° to 46°F). May store vials for injection at room temperature for up to 1 mo, but any unused injection must be destroyed after 1 mo. Store syringes and vials of powder for injection at room temperature (59° to 86°F). Do not freeze. Use reconstituted solution immediately or store for up to 24 h at controlled room temperature.

Drug Interactions

Depression of cardiac contractility, conductivity, and automaticity as well as vascular dilation associated with anesthetics may be potentiated.

Benzodiazepines (eg, midazolam, triazolam), buspirone, carbamazepine, cyclosporine, digitalis, lovastatin, quinidine, simvastatin

Plasma levels of these agents may be elevated by diltiazem, increasing the pharmacologic and toxic effects. The dose of simvastatin should not exceed 10 mg/day.

Beta-blockers (eg, propanolol)

May have additive negative inotropic and chronotropic effects. Use with caution.

Diltiazem levels may be increased.

Other antihypertensive agents

May have additive effects.

Coadministration lowered diltiazem plasma concentrations to undetectable levels. Avoid coadministration.

Incompatibility

Do not mix with furosemide.

Adverse Reactions

Cardiovascular

Bradycardia (4%); first-degree AV block (3%); angina, arrhythmia, AV block (second - or third-degree), bundle branch block, CHF, ECG abnormalities, hypotension, palpitations, syncope, tachycardia, ventricular extrasystoles (less than 2%); peripheral edema, asystole, MI (postmarketing).

CNS

Dizziness (6%); headache, fatigue (5%); asthenia (3%); abnormal dreams, amnesia, asthenia, depression, gait abnormalities, hallucinations, insomnia, nervousness, paresthesia, personality change, somnolence, tremor (less than 2%); extrapyramidal symptoms, lightheadedness, weakness, shakiness (postmarketing).

Dermatologic

Rash (2%); ecchymosis, petechiae, photosensitivity, pruritus (less than 2%); alopecia, erythema multiforme (including Stevens-Johnson syndrome and TEN), exfoliative dermatitis, purpura, generalized rash (postmarketing).

EENT

Sinus congestion (2%); amblyopia, epistaxis, eye irritation, nasal congestion, rhinitis, tinnitus (less than 2%); retinopathy (postmarketing).

GI

Nausea (1%); anorexia, constipation, diarrhea, dry mouth, dysgeusia, thirst, vomiting (less than 2%); abdominal discomfort, cramps, dyspepsia, gingival hyperplasia (postmarketing).

Genitourinary

Albuminuria, crystalluria, hyperuricemia, impotence, nocturia, polyuria, sexual difficulties, gynecomastia (less than 2%).

Hematologic-Lymphatic

Hemolytic anemia, increased bleeding time, leukopenia, thrombocytopenia (postmarketing).

Lab Tests

Mild elevations of ALT, AST, LDH, and alkaline phosphatase, CPK increase (less than 2%).

Metabolic-Nutritional

Hyperglycemia, weight gain (less than 2%).

Musculoskeletal

Muscle cramps, neck rigidity, osteoarticular pain (less than 2%); joint pain.

Respiratory

Cough (2%); dyspnea (less than 2%).

Miscellaneous

Lower limb edema (8%); edema (5%); flushing (1%); allergic reactions, pain (less than 2%); angioedema (postmarketing).

Betabioptal, unguent oftalmic - prospect betabioptal, unguent oftalmic, betabioptal

Betabioptal, unguent oftalmic

Producator: Farmila Farmaceutici Milano S. P.A

Vizualizari: 11317

Ce este Betabioptal si pentru ce se utilizeaza?

100 g unguent oftalmic contin cloramfenicol 0,5 g si betametazona 0,2 g si excipienti: alcool cetilic, macrogol 300, macrogol 1540, macrogol 4000, esteri ai acidului p-hidroxibenzoic, ulei de parafina, vaselina galbena.

Grupa farmacoterapeutica: produse oftalmologice; antiinflamatoare si antiinfectioase in combinatie; corticosteroizi si antiinfectioase in combinatie

Inflamatii oculare si infectii oftalmice nepurulente cu bacterii sensibile la cloramfenicol cand este utila asocierea actiunii antiinflamatoare a betametazonei ca de exemplu stari inflamatorii la nivelul segmentului anterior al ochiului, mai ales postoperatorii, conjunctivite bacteriene si alergice, iridociclite acute.

Inainte sa utilizati Betabioptal

Hipersensibilitate la substantele active sau la oricare dintre excipientii medicamentului;

Keratite herpetice epiteliale acute (cu exceptia cazurilor de asociere cu medicamente chimioterapice specifice impotriva virusului herpetic si sub stricta supraveghere a medicului oftalmolog) si alte boli virale in faza acuta ulcerativa, conjunctivite cu keratita chiar in faza initiala (test pozitiv la fluoresceina).

Infectii micobacteriene ale ochiului;

Afectiuni fungice ale structurilor oculare;

Oftalmii purulente acute, conjunctivite purulente, blefarite purulente si herpetice care pot fi mascate sau agravate de corticosteroizi;

Antecedente personale de discrazii sanguine (anemie aplastica, panmielopatie) Precautii

In cazul tratamentelor prelungite sunt indicate controale periodice ale presiunii intraoculare. Continuarea aplicarii unguentului pe o perioada mai mare de o luna fara supravegherea specialistului oftalmolog nu este recomandata deoarece poate determina aparitia unor reactii adverse.

Administrarea indelungata sau frecventa crescuta a administrarilor pot duce la hipertensiune intraoculara sau glaucom cu afectarea nervului optic si defecte ale acuitatii vizuale si campului vizual, si la formarea cataractei posterioare subcapsulare. La pacientii sensibili, cresterea presiunii intraoculare poate sa apara chiar dupa doze uzuale.

Dupa utilizarea asocierilor continand steroizi si antimicrobiene pot sa se dezvolte infectii secundare.

O atentie deosebita trebuie acordata acelor afectiuni care produc subtierea corneei si a sclerei, deoarece dupa folosirea topica a steroizilor pot sa apara perforatii ale acestor structuri.

Dupa administrarea indelungata a steroizilor exista posibilitatea aparitiei unor infectii fungice ale corneei. Posibilitatea invaziei fungice trebuie avuta in vedere in orice ulceratie corneana persistenta unde s-a administrat tratament cu steroizi. Utilizarea de lunga durata poate deprima raspunsul imun al gazdei, crescand astfel riscul infectiilor oculare bacteriene secundare. In afectiunile acute purulente ale ochiului, corticosteroizii pot masca infectia sau o pot exacerba.

Tratamentul indelungat cu antibiotice folosite topic poate determina dezvoltarea rezistentei microbiene. Sunt posibile suprainfectii, inclusiv fungice. In astfel de situatii sau daca nu s-au obtinut rezultate terapeutice semnificative dupa o perioada relativ scurta de timp tratamentul trebuie intrerupt si inlocuit cu unul adecvat.

Dupa un tratament topic indelungat cu cloramfenicol au fost raportate cazuri rare de hipoplazie medulara inclusiv anemie aplastica si deces. Din acest motiv medicamentul trebuie folosit numai pe perioade scurte de timp, cu exceptia unor indicatii speciale recomandate de medic si numai in situatii in care alte chimioterapice cu potential toxic mai mic nu sunt eficace.

Nu sunt disponibile date privind siguranta si eficacitatea medicamentului la copii cu varsta mai mica de 1 an. La copiii cu varsta de peste 1 an se administreaza numai in caz de necesitate si sub supraveghere medicala stricta.

Sarcina si alaptarea

La om nu a fost stabilita siguranta utilizarii in timpul sarcinii si in perioada alaptarii.

Betabioptal nu se va administra in timpul sarcinii decat in situatiile in care beneficiul potential matern depaseste riscul potential de actiune asupra fatului si numai sub stricta supraveghere medicala.

Deoarece multe medicamente se excreta in laptele uman, se va avea in vedere intreruperea temporara a alaptarii, pe perioada administrarii Betabioptal.

Capacitatea de a conduce vehicule sau de a folosi utilaje

Ca si in cazul administrarii altor unguente oftalmice, incetosarea tranzitorie a vederii sau alte tulburari ale vederii pot afecta capacitatea de a conduce vehicule sau de a folosi utilaje. Daca dupa administrare apare incetosarea vederii, pacientul trebuie sa astepte pana cand vederea revine la normal inainte de a conduce vehicule sau de a folosi utilaje.

Cum se utilizeaza Betabioptal

Doze si mod de administrare

Medicamentul este destinat uzului oftalmic.

Utilizarea la adolescenti si adulti, inclusiv varstnici

O cantitate mica de unguent (aproximativ 1 cm) se aplica in sacul/sacii conjunctival/conjunctivali al ochiului/ochilor afectat/afectati de maximum 3-6 ori pe zi. Frecventa administrarii va fi redusa treptat o data cu imbunatatirea semnelor clinice. Tratamentul nu va fi intrerupt prematur.

Dupa administrare se recomanda inchiderea usoara a pleoapelor. Aceasta poate reduce absorbtia sistemica a medicamentelor administrate oftalmic, avand ca rezultat scaderea reactiilor adverse sistemice.

In cazul utilizarii concomitente a mai multor medicamente cu administrare topica oftalmica, celelalte medicamente trebuie administrate separat la intervale de 10-15 minute.

Utilizarea la copii

Nu sunt disponibile date privind siguranta si eficacitatea medicamentului la copii cu varsta mai mica de un an.

La copiii cu varsta de peste 1 an se administreaza numai in caz de necesitate si sub supraveghere medicala.

Mod de administrare.

Pentru a preveni contaminarea varfului tubului si a unguentului oftalmic, se va evita atingerea acestuia de pleoape, zone invecinate sau alte suprafete.

Reactii adverse posibile

Tratamentul prelungit cu cloramfenicol in aplicare topica poate determina apritia unor fenomene de iritatie locala (intepaturi, senzatie de arsura). Sunt posibile reactii de hipersensibilitate tranzitorie inclusiv edem angioneurotic, urticarie, dermatita veziculara si maculopapulara; in aceste cazuri tratamentul trebuie interupt.

Preparatele oftalmice continand corticosrteroizi pot determina o crestere importanta a presiunii intraoculare in cazul unui numar mic de pacienti, incluzind pe aceia care au antcedente heredo-colaterale de glaucom. Subtierea corneei mergand pana la perforatie a fost de asemenea asociata cu administrarea topica de corticosteroizi. Au fost raportate cazuri de cataracta subcapsulara in cazul tratamentului prelungit cu corticoisteroizi in administrare topica oftalmica.

Aparitia reactiilor adverse datorate absorbtiei sistemice a substantelor active este putin probabila. Totusi in cazul administrarii prelungite trebuie luat in considerare riscul hipoplaziei medulare induse de cloramfenicol precum si reactiile advesre datorate unui exces de corticoizi.

Un supradozaj topic al Betabioptal poate fi indepartat din ochi cu apa calduta. Pastrare

A nu se utiliza dupa data de expirare inscrisa pe ambalaj. A se pastra la temperaturi sub 25°C, in ambalajul original. A se utiliza in maxim 30 zile de la prima deschidere a tubului. A nu se lasa la indemana copiilor.

Cum se pastreaza Betabioptal

Cutie cu un tub din aluminiu prevazut cu varf aplicator si capac din HDPE-LDPE continand 5 g unguent oftalmic.

Farmila Farmaceutici Milano S. P.A. Italia

Detinatorul Autorizatiei de punere de piata

Farmila Farmaceutici Milano S. P.A.,

Via E. Fermi 50, 20019 Settimo Milanese (Mi), Italia

Data ultimei verificari a prospectului Noiembrie, 2005

Itraconazole, itraconazole

DermNet New Zealand

Itraconazole

What is itraconazole?

Itraconazole is an triazole medicine used to treat fungal infections.

What is itraconazole used for?

Itraconazole is effective against a broad spectrum of fungi including:

Itraconazole is sometimes used for inflammatory skin diseases such as atopic eczema. seborrhoeic dermatitis or psoriasis. if a fungus or yeast is thought to be contributing to the condition.

Itraconazole has recently been observed to slow the growth of basal cell carcinoma. and is occasionally used for this purpose off-label.[1,2]

How does itracoanzole work?

Itraconazole binds to the fungal p450 enzymes and stops the cells making ergosterol, the main component of the cell wall.

How is itraconazole taken?

In New Zealand, itraconazole is available as 100 mg capsules on prescription and a 10 mg/mL liquid preparation. A generic, Itrazole, is funded under some circumstances. Sporanox™, is the registered trademark for itraconazole preparations, copyright Janssen-Cilag. Sporanox oral liquid is subsidised on Special Authority application for children with immunodeficiency and relevant infections.

The medication is better absorbed orally when it is taken with a fatty meal or acidic drink (eg orange juice). It is bound to proteins such as albumin in the circulating blood and becomes concentrated in fat cells and within skin and nails. It takes one to three days for half of the medication to be cleared from the blood stream. The rest is eliminated in faeces and urine after conversion by the liver into inactive compounds.

Skin concentrations may be 3–10-fold higher than those in the blood. It may persist in the skin for up to 4 weeks after the drug has been discontinued and in the nails for up to a year.

Dose regime for itraconazole

Various regimes for itraconazole have been found successful; typical doses are listed below. Courses can be repeated and the medication can be continued for months if necessary.

Tinea corporis. tinea cruris. 200 mg daily for one week OR 100mg daily for 2 weeks

Tinea pedis. tinea manuum. 200 mg twice daily for one week OR 100mg daily for 2-4 weeks

Vulvovaginal candidiasis. 200 mg twice daily for one day OR 200 mg daily for 3 days

Oral candidiasis. 100 mg daily for two weeks

Tinea unguium. 200 mg/day for 6-8 weeks (fingernails) or 3-4 months (toenails), OR 200 mg twice daily for 7 days, repeated monthly for 2 months (fingernails) or 3–4 months (toenails)

Pityriasis versicolor. 200 mg/day for 10 days, with a preventative dose of 200mg once monthly for 6 months.

The dose of itraconazole in children is usually 5 mg per kg body weight per day to maximum 200 mg per day, but is reserved for exceptional circumstances.

Side effects of itraconazole

Itraconazole appears to be a relatively safe drug. Side effects, usually minor, are more likely during a prolonged course of treatment.

Nausea and vomiting (5%)

Constipation

Headache

Dizziness

Abnormal liver function tests (up to 5% for those on long term therapy, 2% for pulse therapy); significant liver disease is rare

Allergic skin rash including urticaria

Endocrine effects including enlarged breasts (in males) and adrenal suppression

Tingling in the fingers and toes (very rare)

Congestive heart failure: itraconazole should be used with caution in those with heart problems.

Itraconazole is best avoided in pregnancy. Although only excreted in tiny amounts from breast milk, it should only be taken by a breast-feeding mother if essential.

Drug interactions with itraconazole

Itraconazole has important interactions with other medications.

As itraconazole needs acid for its absorption, antacids, H2 antagonists (cimetidine, famotidine, ranitidine) and omeprazole should not be taken for 2 hours after itraconazole.

Itraconazole is a P-glycoprotein inhibitor and increases the concentration of some drugs.

These drugs should not be taken by those on itraconazole:

HMG Co-A reductase inhibitors (atorvastatin, lovastatin, simvastatin); fluvastatin, rosuvastatin and pravastatin are acceptable alternatives. Toxicity due to the combination of drugs results in muscle pain and weakness, which may be serious.

Cisapride

Midazolam, triazolam

The antihistamines astemizole (Hismanal®) and terfenadine (Teldane®); these are no longer available in New Zealand.

Itraconazole may increase the risk of bleeding from anticoagulants such as warfarin or dabigatran.

The dose of these drugs should be reduced:

The dose of these drugs may need reducing if side effects arise:

Quinidine

Calcium channel blockers

Antidiabetic sulphonylurea medication (tolbutamide, glibenclamide, gliclazide, glipizide)

The following drugs decrease the concentration of itraconazole:

Related information

Budamax (budesonide) drug, budamax

Budamax

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia. This page contains answers to some common questions about Budamax. It does not contain all the information that is known about Budamax. It does not take the place of talking to your doctor or pharmacist. All medicines have risks and benefits. Your doctor has weighed the risk of you using this medicine against the benefits he/she expects it will have for you. If you have any concerns about using this medicine, ask your doctor or pharmacist. Bookmark or print this page, you may need to read it again.

What BUDAMAX is used for

Allergic rhinitis (Hayfever)

Budamax is sprayed into the nose to help prevent and treat allergic rhinitis (hayfever). Hayfever is an inflammation or swelling of the nose lining (which may cause blockage, runny nose, itching and/or sneezing). This is often, but not always, due to an allergy to something in the air (eg pollen, dust mites).

You may have symptoms only during spring or summer. This type of allergy is generally due to various pollens. Some people may experience symptoms all year round. This is usually caused by house dust mites, pets or moulds.

Budamax is also used to treat nasal polyps, which are small masses of tissue that grow from the nose lining.

Budamax contains budesonide.

This belongs to a family of medicines called corticosteroids, which are used to help reduce inflammation.

Ask your doctor if you have any questions about why Budamax has been prescribed for you.

Your doctor may have prescribed it for another reason.

Budamax is not addictive.

Budamax is available only with a doctor's prescription.

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Levomed, levomed

Benadryl is an antihistamine. Diphenhydramine blocks the effects of the naturally occurring chemical histamine in the body. It is used to treat sneezing; runny nose; itching, watery eyes; hives; rashes; and other symptoms of allergies and the common cold.

Availability: In Stock (14 packs)

Analogs of: Benadryl

Other names of Benadryl:

Benadryl is used for preventing or treating symptoms of hay fever and other upper respiratory allergies or the common cold, such as runny nose, sneezing, itching of the nose and throat, and itchy, watery eyes, and relieving cough.

Do not take Benadryl if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A very dangerous drug interaction could occur, leading to serious side effects.

Before taking Benadryl, tell your doctor if you have:

glaucoma or increased pressure in the eye;

a stomach ulcer;

an enlarged prostate, bladder problems or difficulty urinating;

an overactive thyroid (hyperthyroidism);

hypertension or any type of heart problems; or

asthma.

You may not be able to take Benadryl, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Take Benadryl exactly as directed on the package or as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Benadryl can be taken with or without food.

For motion sickness, a dose is usually taken 30 minutes before motion, then with meals and at bedtime for the duration of exposure.

As a sleep aid, Benadryl should be taken approximately 30 minutes before bedtime.

To ensure that you get a correct dose, measure the liquid forms of Benadryl with a special dose-measuring spoon or cup, not with a regular tablespoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Never take more of Benadryl than is prescribed for you. The maximum amount of diphenhydramine that you should take in any 24-hour period is 300 mg.

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of Benadryl unless otherwise directed by your doctor.

Do NOT use more than directed.

Adults and children 12 years of age and over - 25 mg to 50 mg (1 to 2 capsules).

Children 6 to under 12 years of age - 12.5 mg ** to 25 mg (1 capsule).

Children under 6 years of age - consult a doctor.

Store Benadryl at room temperature between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed container. Brief periods at temperatures of 59 to 86 degrees F (15 to 30 degrees C) are permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Benadryl out of the reach of children and away from pets.

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

Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (e. g. asthma, emphysema), glaucoma, heart problems, high blood pressure, liver disease, mental/mood changes, seizures, stomach problems (e. g. ulcers, obstruction), an overactive thyroid gland, difficulty urinating (e. g. due to an enlarged prostate gland).

Benadryl is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not take Benadryl without first talking to your doctor if you are pregnant. Infants are especially sensitive to the effects of antihistamines, and side effects could occur in a breast-feeding baby. Do not take Benadryl without first talking to your doctor if you are nursing a baby.

If you are over 60 years of age, you may be more likely to experience side effects from Benadryl. You may require a lower dose of Benadryl.

Stop taking Benadryl and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).

Other, less serious side effects may be more likely to occur. Continue to take Benadryl and talk to your doctor if you experience:

sleepiness, fatigue, or dizziness;

headache;

dry mouth; or

difficulty urinating or an enlarged prostate.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

When using this product:

marked drowsiness may occur

avoid alcoholic drinks

alcohol, sedatives, and tranquilizers may increase drowsiness

excitability may occur, especially in children

be careful when driving a motor vehicle or operating machinery

Carbidopa / levodopa Side Effects

Other dosage forms:

In addition to its needed effects, some unwanted effects may be caused by carbidopa / levodopa. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking carbidopa / levodopa:

More common:

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

Less common:

Bladder pain

bloody or cloudy urine

chest pain

confusion

difficult, burning, or painful urination

discouragement

feeling sad or empty

frequent urge to urinate

inability to move the eyes

increased blinking or spasms of the eyelid

irritability

lack of appetite

loss of interest or pleasure

lower back or side pain

seeing, hearing, or feeling things that are not there

sticking out of tongue

tiredness

trouble concentrating

trouble in breathing, speaking, or swallowing

trouble sleeping

uncontrolled twisting movements of the neck, trunk, arms, or legs

unusual facial expressions

Incidence not known:

Anxiety

black, tarry stools

bluish color

blurred vision

changes in skin color

chest discomfort

chills

convulsions

cough or hoarseness

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

dry mouth

false beliefs that cannot be changed by facts

fast, irregular, pounding, or racing heartbeat or pulse

feelings about hurting oneself or others

fever with or without chills

general feeling of tiredness or weakness

high fever

hyperventilation

increased in sexual ability, desire, drive, or performance

increased interest in sexual intercourse

increased sweating

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

loss of bladder control

lower back or side pain

nausea

pain

pain or discomfort in the arms, jaw, back, or neck

restlessness

seeing, hearing, or feeling things that are not there

severe muscle stiffness

shaking

sore throat

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

swelling of the foot or leg

swollen glands

tenderness

tiredness

unusual bleeding or bruising

unusual tiredness or weakness

unusually pale skin

vomiting

Minor Side Effects

Some of the side effects that can occur with carbidopa / levodopa may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common:

Acid or sour stomach

back or shoulder pain

belching

body aches or pain

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

diarrhea

difficulty having a bowel movement (stool)

ear congestion

headache

heartburn

indigestion

loss of voice

muscle cramps

nasal congestion

runny nose

sneezing

stomach discomfort, upset, or pain

unusual dreams

weight loss

Incidence not known:

Abdominal or stomach distress

bad, unusual, or unpleasant (after) taste

belching

change in taste

dark sweat

double vision

enlarged pupils

feeling of warmth

hair loss or thinning of the hair

lack or loss of strength

redness of the face, neck, arms, and occasionally, upper chest

seeing double

skin rash, hives or welts, itching

For Healthcare Professionals

Applies to carbidopa / levodopa: enteral suspension, oral capsule extended release, oral tablet, oral tablet disintegrating, oral tablet extended release

General

The most common adverse reactions reported include nausea, dizziness, headache, insomnia, abnormal dreams, dry mouth, dyskinesia, anxiety, constipation, vomiting, and orthostatic hypotension. [Ref ]

Nervous system

Very common (10% or more): Headache (up to 17%), dyskinesia (up to 16.5%), dizziness (up to 12%) Common (1% to 10%): Confusion, dystonia, on-off phenomena, hypoesthesia, polyneuropathy, tremor, dysgeusia, bradykinesia Uncommon (0.1% to 1%): Paresthesia, ataxia, gait disturbance, convulsion Rare (less than 0.1%): Malignant, neuroleptic syndrome Frequency not reported: Chorea, somnolence, memory impairment, sense of stimulation Postmarketing reports: Polyneuropathy [Ref ]

Psychiatric

Very common (10% or more): Anxiety, insomnia, depression (up to 11%) Common (1% to 10%): Hallucinations, psychosis, abnormal dreams, sleep disorder, agitation, impulsive behavior, sleep attacks Uncommon (0.1% to 1%): Suicide, dementia, disorientation, euphoric mood, fear Rare (less than 0.1%): Abnormal thinking [Ref ]

Gastrointestinal

Very common (10% or more): Nausea (up to 30%), constipation (up to 22%) Common (1% to 10%): Dry mouth, constipation, vomiting, hiatal hernia, postoperative ileus, diarrhea, dyspepsia, abdominal distension, dysphagia, flatulence, bitter taste Uncommon (0.1% to 1%): Salivary hypersecretion Rare (less than 0.1%): Bruxism, saliva discoloration, glossodynia, hiccups, trismus, burning tongue sensation Frequency not reported: Heartburn [Ref ]

Cardiovascular

Common (1% to 10%): Ischemic events, orthostatic hypotension, peripheral edema, hypertension, syncope, irregular heart rate, hypotension Uncommon (0.1% to 1%): Palpitations, phlebitis Frequency not reported: Chest pain, myocardial infarction [Ref ]

Cardiovascular ischemic events occurred in 2.4% (7 of 289) patients receiving carbidopa-levodopa extended-release capsules compared to 1.1% (1 of 92) of patients receiving placebo in early Parkinson's disease clinical trials. In advanced Parkinson's disease, 0.7 % (3 of 450) patients experienced cardiovascular ischemic events. These patients had a previous history of ischemic heart disease or risk factors for ischemic heart disease. [Ref ]

Dermatologic

Common (1% to 10%): Excessive granulation tissue, rash, contact dermatitis, hyperhidrosis, pruritus Uncommon (0.1% to 1%): Alopecia, erythema, urticaria Rare (less than 0.1%): Sweat discoloration, angioedema Postmarketing reports: Henoch-Schonlein purpura [Ref ]

Local

Insertion site complication was reported in 57% of patients who received this drug compared with 44% of patients who received a PEG-J tube without receiving treatment. The most common adverse reactions associated with naso-jejunal (NJ) insertion were oropharyngeal pain, abdominal distention, abdominal pain, abdominal discomfort, pain, throat irritation, gastrointestinal injury, esophageal hemorrhage, anxiety, dysphagia, and vomiting. The most common adverse reactions associated with PEG-J insertion included upper abdominal pain, duodenal ulcer, duodenal ulcer hemorrhage, erosive duodenitis, erosive gastritis, gastrointestinal hemorrhage, peritonitis, post-operative abscess, and small intestine ulcer. [Ref ]

Very common (10% or more): Insertion site complication, incision site erythema (19%), post-operative wound infection Common (1% to 10%): Incision site cellulitis, post procedural infection, device dislocation, device occlusion Uncommon (0.1% to 1%): Postoperative abscess, bezoar, ischemic colitis Postmarketing reports: Gastric perforation, gastrointestinal perforation, small intestinal ischemia, small intestinal perforation [Ref ]

Hypersensitivity

Postmarketing reports: Anaphylactic reaction, bullous lesions [Ref ]

Respiratory

Common (1% to 10%): Upper respiratory tract infection, atelectasis, dyspnea, aspiration pneumonia, oropharyngeal pain Uncommon (0.1% to 1%): Dysphonia, hoarseness Rare (less than 0.1%): Abnormal respiration Frequency not reported: Bizarre breathing pattern [Ref ]

Hepatic

Frequency not reported: Elevated alkaline phosphatases, AST, ALT, LDH, and bilirubin [Ref ]

Renal

Frequency not reported: Elevated serum urea and creatinine [Ref ]

Other

Very common (10% or more): Asthenia, fatigue Common (1% to 10%): Pyrexia, malaise Frequency not reported: Hot flashes [Ref ]

Genitourinary

Common (1% to 10%): Urinary tract infection, urinary incontinence, urinary retention Uncommon (0.1% to 1%): Urinary frequency Rare (less than 0.1%): Priapism [Ref ]

Hematologic

Common (1% to 10%): Anemia Uncommon (0.1% to 1%): Leukopenia, thrombocytopenia Rare (less than 0.1%): Hemolytic anemia Very rare (less than 0.01%): Agranulocytosis Frequency not reported: Positive Coombs test, reduced hemoglobin and hematocrit [Ref ]

Metabolic

Very common (10% or more): Decreased weight Common (1% to 10%): Anorexia, increased weight, vitamin B6 deficiency, vitamin B12 deficiency Frequency not reported: Elevated blood sugar Postmarketing reports: Folic acid deficiency [Ref ]

Musculoskeletal

Common (1% to 10%): Back pain, shoulder pain Uncommon (0.1% to 1%): Muscle cramps, neck pain Frequency not reported: Muscle twitching, leg pain [Ref ]

Ocular

Uncommon (0.1% to 1%): Blepharospasm, diplopia, optic ischemic neuropathy, blurred vision Rare (less than 0.1%): Mydriasis, oculogyric crisis, activation of a latent Horner's syndrome [Ref ]

Oncologic

Rare (less than 0.1%): Malignant melanoma [Ref ]

References

1. Cerner Multum, Inc. "Australian Product Information." O 0

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.

4. "Product Information. Parcopa (carbidopa-levodopa)." Schwarz Pharma, Mequon, WI.

5. "Product Information. Rytary (carbidopa-levodopa)." Impax Pharmaceuticals, Hayward, CA.

6. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.

7. "Product Information. Duopa (carbidopa-levodopa)." AbbVie US LLC, North Chicago, IL.

Not all side effects for carbidopa / levodopa may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here .

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