Co lisinopril, co lisinopril

lisinopril

lisinopril

Apo-Lisinopril (CA), Carace (UK), Co-Lisinopril (CA), Dom-Lisinopril (CA), Gen-Lisinopril (CA), Novo-Lisinopril (CA), PHL-Lisinopril (CA), Prinivil, Ratio-Lisinopril (CA), Riva-Lisinopril (CA), Zestril

Pharmacologic class: Angiotensin-converting enzyme (ACE) inhibitor

Therapeutic class: Antihypertensive

Pregnancy risk category C (first trimester), D (second and third trimesters)

Pregnancy risk category C (first trimester), D (second and third trimesters)

FDA Box Warning

• When used during second or third trimester of pregnancy, drug may cause fetal harm or death. Discontinue as soon as pregnancy is detected.

Action

Inhibits conversion of angiotensin I to angiotensin II (a potent vasoconstrictor), decreasing systemic vascular resistance, blood pressure, preload, and afterload. Also inactivates bradykinin and other vasodilatory prostaglandins, increases plasma renin levels, and reduces aldosterone levels.

Availability

Tablets: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, 40 mg

⊘ Indications and dosages

Adults: Initially, 10 mg P. O. daily, increased to a maintenance dosage of 20 to 40 mg/day. Maximum daily dosage is 80 mg. In patients on diuretics, start with 5 mg/day P. O.

➣ Heart failure

Adults: 5 mg/day P. O. (Prinivil), increased in increments, as ordered, to a maximum of 20 mg/day as a single dose. Or 5 to 40 mg P. O. (Zestril) as a single daily dose given with digitalis and diuretics, increased in increments of no more than 10 mg at intervals of at least 2 weeks, to highest dosage tolerated; maximum dosage is 40 mg/day P. O.

➣ Adjunctive therapy after acute myocardial infarction

Adults: Initially, 5 mg P. O. followed by 5 mg after 24 hours, 10 mg after 48 hours, and then 10 mg daily for 6 weeks (given with standard thrombolytic, aspirin, or beta-adrenergic blocker therapy). If systolic pressure is 120 mm Hg or lower, initial dosage is 2.5 mg for 2 days, then 2.5 to 5 mg/day.

Dosage adjustment

• Impaired renal function • Heart failure with hyponatremia

Contraindications

• Hypersensitivity to drug or other ACE inhibitors • Angioedema (hereditary, idiopathic, or ACE-inhibitor induced) • Pregnancy (second and third trimesters)

Precautions

Use cautiously in: • renal impairment, hypertension, cerebrovascular or cardiac insufficiency • family history of angioedema • concurrent diuretic therapy • black patients (in whom drug may be less effective in treating hypertension) • elderly patients • pregnant patients in first trimester • breastfeeding patients • children (safety not established).

Administration

• Give once a day in morning, with or without food.

☞ Measure blood pressure before administering. Withhold drug, if appropriate, according to prescriber's blood pressure parameters. Adjust dosage according to blood pressure response. • Expect prescriber to add low-dose diuretic if lisinopril alone doesn't control blood pressure.

Adverse reactions

CNS: dizziness, fatigue, headache, asthenia

CV: hypotension, orthostatic hypotension, syncope, chest pain, angina pectoris

GI: nausea, diarrhea, abdominal pain, anorexia

GU: erectile dysfunction, decreased libido, renal dysfunction

Metabolic: hyponatremia, hyperkalemia

Respiratory: cough, upper respiratory tract infection, bronchitis, dyspnea, asthma

Skin: rash, pruritus, angioedema

Other: altered taste, fever, anaphylaxis

Interactions

Drug-drug. Cyclosporine, potassium-sparing diuretics, potassium supplements: hyperkalemia

Diuretics, other antihypertensives: excessive hypotension

Indomethacin: reduced antihypertensive effect

Lithium: increased lithium blood level, greater risk of lithium toxicity

Nonsteroidal anti-inflammatory drugs: further deterioration in patients with renal compromise, decreased antihypertensive effects

Drug-diagnostic tests. Blood urea nitrogen, creatinine, hematocrit, hemoglobin: slightly increased levels

Liver function tests, potassium: increased levels

Sodium: decreased level

Drug-food. Salt substitutes containing potassium: hyperkalemia

Drug-herbs. Capsaicin: cough

Ephedra (ma huang), licorice, yohimbine: antagonistic effects

Drug-behaviors. Acute alcohol ingestion: excessive hypotension

Patient monitoring

• Before and periodically during therapy, monitor CBC with white cell differential and kidney and liver function tests.

☞ Monitor for signs and symptoms of angioedema or anaphylaxis. If these occur, discontinue drug and contact prescriber immediately. • Check blood pressure frequently to assess drug efficacy. Monitor closely for hypotension, especially in patients also taking diuretics. • Check vital signs and ECG regularly. Assess cardiovascular status carefully. • Monitor respiratory and neurologic status. • Assess potassium intake and blood potassium level.

Patient teaching

• Advise patient to take once a day in morning, with or without food.

☞ Tell patient to immediately report fainting, continuing cough, rash, itching, swelling (especially of face, lips, tongue, or throat), severe dizziness, difficulty breathing, extreme tiredness, or continuing nausea.

☞ Instruct female patient to notify prescriber if she becomes pregnant. • Tell patient that drug may cause temporary blood pressure decrease if he stands up suddenly. Advise him to rise slowly and carefully. • Explain that drug may cause muscle aches or headache. Encourage patient to discuss activity recommendations and pain relief with prescriber. • Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness. • Instruct patient to avoid potassium-based salt substitutes or potassium supplements. • Tell patient he'll undergo regular blood testing during therapy. • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, herbs, and behaviors mentioned above.

lisinopril

lisinopril

An ACE inhibitor drug, C 21 H 31 N 3 O 5 . used in its hydrated form to treat hypertension and congestive heart failure.

lisinopril

Prinivil ® Cardiology An ACE inhibitor used to manage HTN Adverse effects Hypotension, neutropenia, anaphylactoid reactions. See GISSI-3.

lisinopril

An ANGIOTENSIN CONVERTING ENZYME inhibitor drug use to treat HEART FAILURE and high blood pressure (HYPERTENSION ).Brand names are Carace and Zestril and, in conjunction with a thiazide diuretic, Carace 10 Plus and Zestoretic.

lisinopril,

n brand name: Zestril; drug class: angiotensin-converting en-zyme (ACE) inhibitor; action: selectively suppresses renin-angiotensin-aldosterone system; inhibits ACE, which prevents conversion of angiotensin I to angiotensin II; uses: mild to moderate hypertension, post myocardial infarction if hemodynamically stable.

lisinopril

an angiotensin-converting enzyme inhibitor, similar to captopril, but with longer duration of activity. Used in the treatment of heart disease in dogs.

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CO Lisinopril

CO LISINOPRIL 20 MG TABLET

How does this medication work? What will it do for me?

Lisinopril belongs to a class of medications called angiotensin converting enzyme (ACE) inhibitors . It is used to treat high blood pressure and congestive heart failure. It works by relaxing blood vessels and helping the heart to pump blood that carries oxygen to the different parts of the body more efficiently. It is also used immediately after a heart attack in order to reduce the risk of having another heart attack.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

The recommended adult dose of lisinopril ranges from 2.5 mg to 40 mg daily, depending on the condition being treated. It is taken in one daily dose with or without food.

People who take other medications that lower blood pressure (e. g. diuretics) or people who have kidney disease may need lower doses. It may take up to 2 weeks to see the full effects of the medication.

The dose of lisinopril for children is determined by the child's body weight. Children who weight 20 to 50 kilograms should start with 2.5 mg once daily. This may be gradually increased to a daily dose of 20 mg. Children who weigh more than 50 kilograms should start with 5 mg taken once daily. This may be gradually increased to a daily dose of 40 mg.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e. g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What form(s) does this medication come in?

5 mg Each pink, round, biconvex tablet marked "L" score line "5" on one side and a symbol on the other side contains 5 mg lisinopril as lisinopril dihydarate. Nonmedicinal ingredients: calcium hydrogen phosphate dihydrate, colloidal anhydrous silica, magnesium stearate, maize starch, mannitol, pregelatinized starch, and red iron oxide.

10 mg Each pink, round, biconvex tablet marked "L" score line "10" on one side and a symbol on the other side contains 10 mg lisinopril as lisinopril dihydrate. Nonmedicinal ingredients: calcium hydrogen phosphate dihydrate, colloidal anhydrous silica, magnesium stearate, maize starch, mannitol, pregelatinized starch, and red iron oxide.

20 mg Each pink, round, biconvex tablet with "L" score line "20" on one side and a symbol on the other side contains 20 mg lisinopril as lisinopril dihydrate. Nonmedicinal ingredients: calcium hydrogen phosphate dihydrate, colloidal anhydrous silica, magnesium stearate, maize starch, mannitol, pregelatinized starch, and red iron oxide.

Who should NOT take this medication?

Do not take lisinopril if you:

are allergic to lisinopril or any ingredients of the medication

are allergic to another ACE inhibitor (e. g. captopril, enalapril, quinapril, ramipril)

are pregnant or intend to become pregnant

has a history of angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell) after taking any ACE inhibitors (e. g. captopril, enalapril, fosinopril, ramipril)

have been diagnosed with hereditary angioedema

have high blood pressure in the blood vessels leading to the kidneys

are taking aliskiren, and

have diabetes

kidney disease

high levels of potassium

congestive heart failure with low blood pressure

are taking a medication in the class of angiotensin receptor blockers (e. g. irbesartan, losartan, valsartan)

are taking another angiotensin converting enzyme inhibitor (e. g. captopril, lisinopril, ramipril)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

cough (dry, persistent)

diarrhea

mild dizziness

headache

nausea

unusual tiredness

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

chest pain

signs of liver problems (e. g. nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)

signs of low blood pressure (e. g. dizziness, lightheadedness, or fainting)

signs of too much potassium in the body (e. g. confusion; irregular heartbeat; nervousness; numbness or tingling in hands, feet, or lips; shortness of breath or difficulty breathing; weakness or heaviness of legs)

Stop taking the medication and seek immediate medical attention if any of the following occur:

signs of angioedema (e. g. swelling of face, mouth, hands, or feet)

trouble in swallowing or breathing (sudden)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

HEALTH CANADA ADVISORY

February 4, 2014

Health Canada has issued new restrictions concerning the use of lisinopril. To read the full Health Canada Advisory, visit Health Canada's web site at www. hc-sc. gc. ca .

Angioedema: Angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell) may occur with the use of lisinopril. If you experience swelling of the face, tongue, or throat, stop taking lisinopril at once and get immediate medical attention. Other medications in the class of medications known as ACE inhibitors should not be taken in the future. People who have had angioedema caused by other substances may be at increased risk of angioedema while receiving an ACE inhibitor.

Cough: People taking lisinopril may develop a dry, persistent cough that usually disappears only after stopping or lowering the lisinopril dose. Be sure to tell your doctor of any cough that does not seem to be related to a usual cause.

Diabetes: ACE inhibitors such as lisinopril may lead to hypoglycemia (low blood sugar levels) in people with diabetes. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Fluid and electrolyte balance: Increases in blood levels of potassium may occur for some patients who receive lisinopril. This rarely causes problems, but potassium levels should be monitored by your doctor.

Kidney function: Changes in kidney function have been seen for certain people (e. g. people with narrowed blood vessels in their kidneys, or those with severe congestive heart failure). The use of diuretics (water pills), nonsteroidal anti-inflammatory drugs (NSAIDs) or aliskiren may further increase risk of kidney problems for people already at risk for this problem. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you have kidney function impairment you may require lower doses of this medication.

Liver function: Lisinopril may reduce liver function and can cause liver failure. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

Low blood pressure: Occasionally, blood pressure drops too low after taking lisinopril. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for those who take water pills or the medication aliskiren, have a salt-restricted diet, are on dialysis, are suffering from diarrhea or vomiting, or have been sweating excessively and not drinking enough liquids. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

To reduce the risk of dizziness, get up slowly from a lying or sitting position. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

Potassium levels: Increases in blood levels of potassium occur for approximately 2% of people who take this medication. This rarely causes problems, but your doctor will likely want to monitor your potassium levels through blood tests. Avoid using salt substitutes that contain potassium while you are taking lisinopril.

Reduced alertness: Lisinopril may cause drowsiness or dizziness, especially at the beginning of treatment or after a dose increase. This can affect your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how this medication affects you.

Pregnancy: ACE inhibitors such as lisinopril may cause severe harm or death to the developing baby if taken by the mother during pregnancy.

This medication should not be used during pregnancy. If you become pregnant while taking this medication, stop taking lisinopril immediately and contact your doctor.

Breast-feeding: It is not known whether lisinopril passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of lisinopril for children less than 6 years of age have not been established. Lisinopril is not recommended for this age group. This medication may be used by children more than 6 years old to reduce blood pressure.

What other drugs could interact with this medication?

There may be an interaction between lisinopril and any of the following:

alfuzosin

aliskiren

allopurinol

alpha agonists (e. g. clonidine, methyldopa)

alpha blockers (e. g. alfuzosin, doxazosin, tamsulosin)

amifostine

amphetamines (e. g. dextroamphetamine, lisdexamphetamine)

angiotensin converting enzyme inhibitors (ACEIs; e. g. captopril, enalapril, ramipril)

angiotensin II receptor blockers (ARBs; e. g. candesartan, losartan)

antacids (e. g. aluminum hydroxide, calcium carbonate, magnesium hydroxide)

aprotinin

azathioprine

beta-adrenergic blockers (e. g. atenolol, propranolol, sotalol)

brimonidine

calcium channel blockers (e. g. amlodipine, diltiazem, nifedipine, verapamil)

cyclosporine

diuretics (water pills; e. g. furosemide, amiloride, spironolactone, triamterene)

duloxetine

diazoxide

everolimus

"gliptin" diabetes medications (e. g. linagliptin, saxagliptin, sitagliptin)

grass pollen allergen extract

heparin

iron dextran

isosorbide mono - and dinitrates

lithium

low molecular weight heparins (e. g. dalteparin, tinzaparin)

metformin

methylphenidate

monoamine oxidase inhibitors (MAOIs; e. g. moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)

nonsteroidal anti-inflammatory medications (NSAIDs; e. g. ibuprofen, indomethacin, naproxen)

pentoxifylline

phosphodiesterase 5 inhibitors (e. g. sildenafil, tadalafil, vardenafil)

rituximab

sirolimus

sodium phosphates

substances which increase potassium levels (e. g. potassium chloride, salt substitutes containing potassium)

temsirolimus

tizanidine

tolvaptan

trimethoprim

yohimbine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,

change one of the medications to another,

change how you are taking one or both of the medications, or

leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material © 1996-2016 MediResource Inc. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Just share lapistan, obat untuk atasi nyeri rematik hingga sakit gigi, lapistan

Deskripsi

Lapistan mengandung asam mefenamat. Asam mefenamat adalah obat anti inflamasi nonsteroid (NSAID) yang digunakan untuk mengobati nyeri ringan hingga sedang. Obat NSAID lainnya termasuk ibuprofen, indometacin, naproxen, dan diklofenak. Obat ini juga dapat digunakan untuk mengobati kram menstruasi dan kondisi lain yang ditentukan oleh dokter.

Obat ini hanya dapat diperoleh dengan resep dokter. Sebuah zat di dalam tubuh yang disebut siklooksigenase terlibat dalam produksi berbagai bahan kimia dalam tubuh, termasuk prostaglandin. Prostaglandin diproduksi sebagai respon terhadap cedera dan penyakit serta kondisi tertentu. Prostaglandin menyebabkan nyeri, pembengkakan, dan peradangan.

Asam mefenamat bekerja dengan menghalangi aksi siklooksigenase sehingga menghentikan produksi bahan kimia yang merupakan iritan.

Indikasi

1. Dysmenorrhea 2. Menorrhagia 3. Nyeri rematik 4. Nyeri otot 5. Sakit kepala 6. Migrain 7. Sakit gigi 8. Demam

Dosis

1. Dewasa dan anak lebih dari 14 tahun

Dosis awal: 500 mg Awalnya. Dosis lanjutan: 250 mg tiap 6 jam.

2. Anak lebih dari 6 bulan

Dosis umum: 6,5 mg/kg berat badan tiap 6-8 jam. Max: 7 hari.

Dosis umum: 500 mg 3 kali sehari selama 5 hari.

Komposisi

Mengandung asam mefenamat.

Cozaar (losartan potassium) 25 mg, 50 mg, and 100 mg tablets, cozaar 100mg

Cozaar (losartan potassium) 25 mg, 50 mg, and 100 mg Tablets

Detailed View: Safety Labeling Changes Approved By FDA Center for Drug Evaluation and Research (CDER)

PRECAUTIONS

Drug Interactions

Dual Blockade of the Renin-Angiotensin System (RAS)

. The Veterans Affairs Nephropathy in Diabetes (VA NEPHRON-D) trial enrolled 1448 patients with type 2 diabetes, elevated urinary-albumin-to-creatinine ratio, and decreased estimated glomerular filtration rate (GFR 30 to 89.9 ml/min), randomized them to lisinopril or placebo on a background of losartan therapy and followed them for a median of 2.2 years. Patients receiving the combination of losartan and lisinopril did not obtain any additional benefit compared to monotherapy for the combined endpoint of decline in GFR, end stage renal disease, or death, but experienced an increased incidence of hyperkalemia and acute kidney injury compared with the monotherapy group.

Closely monitor blood pressure, renal.

. Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration of lithium with angiotensin II receptor agonists or hydrochlorothiazide. Monitor serum lithium levels during concomitant use.

PATIENT INFORMATION LEAFLET

What should I tell my doctor before taking Cozaar?:

added bullet: lithium (a medicine used to treat a certain kind of depression)

BOXED WARNING

Warning: fetal toxicity

When pregnancy is detected, discontinue COZAAR 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

WARNINGS

Fetal Toxicity

Pregnancy Category D

section extensively revised - see PI

PRECAUTIONS

Female patients of childbearing age should be told about the consequences of exposure to COZAAR 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.

Neonates with a history of in utero exposure to COZAAR:

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.

PPI

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

COZAAR can cause harm or death to an unborn baby

Talk to your doctor about other ways to lower your blood pressure if you plan to become pregnant.

If you get pregnant while taking COZAAR, tell your doctor right away.

PATIENT INFORMATION/Who should not take COZAAR?

Do not take COZAAR if you have diabetes and are taking a medicine called aliskiren to reduce blood pressure

PRECAUTIONS

Dual blockade of the renin-angiotensin-aldosterone system: Dual blockade of the renin-angiotensin-aldosterone system is associated with increased risk of hypotension, syncope, hyperkalemia, and changes in renal function (including acute renal failure). Closely monitor blood pressure, renal function and electrolytes in patients.

PATIENT PACKAGE INSERT

What should I tell my doctor before taking?

Especially tell your doctor if you are taking:

other medicines to reduce blood pressure

ADVERSE REACTIONS

Post Marketing Experience

General Disorders and Administration Site Conditions: Malaise

Buy woman s health - youfenac (brand name diclofenac) online - order diclofenac - purchase woman s h

Diclofenac is used to treat pain or inflammation caused by arthritis or ankylosing spondylitis. Diclofenac may also be used for purposes other than those listed in this medication guide.

Use Diclofenac as directed by your doctor.

Take Diclofenac by mouth with or without food. Ask your health care provider any questions you may have about how to use Diclofenac.

Drug Class and Mechanism

Diclofenac is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Diclofenac works by reducing hormones that cause inflammation and pain in the body.

If you miss a dose of Diclofenac, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Store Diclofenac 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 Diclofenac out of the reach of children and away from pets.

Do not use Diclofenac if:

you are allergic to any ingredient in Diclofenac; you have had a severe allergic reaction (e. g. severe rash, hives, breathing difficulties, dizziness) to another NSAID (e. g. ibuprofen, naproxen, celecoxib) or aspirin. Contact your doctor or health care provider right away if any of these apply to you.

Important : Diclofenac may cause dizziness or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Diclofenac with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Before you start any new medicine, check the label to see if it has Youfenac or another nonsteroidal anti-inflammatory drug (NSAID) medicine in it too. If it does or if you are not sure, check with your doctor or pharmacist. Diclofenac should not be used in children; safety and effectiveness in children have not been confirmed. Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Diclofenac while you are pregnant. It is not known if Diclofenac is found in breast milk. Do not breast-feed while using Diclofenac.

Possible Side Effects

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

burning or stinging; discharge; eye redness, irritation, or itching. Seek medical attention right away if any of these severe side effects occur:

severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred or distorted vision; eye infection; eyelid swelling or redness; sensitivity to glare or light.

Diclofenac 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.

Flonar generic, flonar

Flonar

Flonar - Pharmacology: Reduces inflammation, fever, and pain by inhibiting prostaglandin synthesis, primarily via inhibition of cyclooxygenase-2 (COX-2) isoenzyme.

Indication: Relief of signs and symptoms of osteoarthritis (OA), rheumatoid arthritis (RA) in adults, and ankylosing spondylitis; management of acute pain in adults; treatment of primary dysmenorrhea; reduction of the number of adenomatous colorectal polyps in familial adenomatous polyposis (FAP), as an adjunct to usual care; relief of signs and symptoms of juvenile RA (JRA) in patients 2 yr of age and older.

Unlabeled Uses

Adjunctive therapy in the treatment of schizophrenia (inconclusive data); prevention of colorectal cancer; preterm labor.

Used for: Treating rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, juvenile arthritis, menstrual pain, or pain. It may also be used for other conditions as determined by your doctor.

Flonar is a COX-2 inhibitor NSAID. It works by blocking certain substances in the body that cause inflammation. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes those symptoms.

Flonar, a selective cyclooxygenase-2 (COX-2) inhibitor, is classified as a nonsteroidal anti-inflammatory drug (NSAID). Flonar is used to treat rheumatoid arthritis, osteoarthritis, and familial adenomatous polyposis (FAP). Because of its lack of platelet effects, Flonar is not a substitute for aspirin for cardiovascular prophylaxis. It is not known if there are any effects of Flonar on platelets that may contribute to the increased risk of serious cardiovascular thrombotic adverse events associated with the use of Flonar. Inhibition of PGE2 synthesis may lead to sodium and water retention through increased reabsorption in the renal medullary thick ascending loop of Henle and perhaps other segments of the distal nephron. In the collecting ducts, PGE2 appears to inhibit water reabsorption by counteracting the action of antidiuretic hormone.

Flonar helps relieve pain and inflammation. It may also be used to provide relief in Osteoarthritis (OA) or Rheumatoid Arthritis (RA). Flonar may also be used to treat a colon disease known as Familial Adenomatous Polyposis. (FAP).

Oral Osteoarthritis

Adult: 200 mg as a single dose or in 2 divided doses. May increase to 200 mg 2 times if necessary. Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.

Oral Rheumatoid arthritis

Adult: 100-200 mg bid.

Elderly: 100 mg bid. Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.

Oral Dysmenorrhoea

Adult: Initially, 400 mg followed by 200 mg if necessary on the 1 st day.

Maintenance: 200 mg bid. Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.

Oral Pain relief

Adult: Initially, 400 mg followed by 200 mg if necessary on the 1 st day.

Maintenance: 200 mg bid. Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.

Oral Familial adenomatous polyposis

Adult: 400 mg bid. Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.

Oral Osteoarthritis

Adult: 200 mg as a single dose or in 2 divided doses. May increase to 200 mg bid if necessary. Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.

Oral Rheumatoid arthritis

Adult: 100-200 mg bid.

Elderly: 100 mg bid. Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.

Oral Dysmenorrhoea

Adult: Initially, 400 mg followed by 200 mg if necessary on the 1 st day.

Maintenance: 200 mg bid. Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.

Oral Pain

Adult: Initially, 400 mg followed by 200 mg if necessary on the 1 st day.

Maintenance: 200 mg bid. Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.

Oral Familial adenomatous polyposis

Adult: 400 mg bid. Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.

Adult: PO Osteoarthritis 200 mg 1-2 times/day. May increase to 200 mg twice daily if needed. Rheumatoid arthritis 100-200 mg twice daily. Pain relief; Dysmenorrhoea Initial: 400 mg followed by 200 mg on the 1st day if needed.

Maintenance: 200 mg twice daily. Familial adenomatous polyposis 400 mg twice daily.

Relief of signs and symptoms of osteoarthritis (OA), rheumatoid arthritis (RA) in adults, and ankylosing spondylitis; management of acute pain in adults; treatment of primary dysmenorrhea; reduction of the number of adenomatous colorectal polyps in familial adenomatous polyposis (FAP), as an adjunct to usual care; relief of signs and symptoms of juvenile RA (JRA) in patients 2 yr of age and older. Unlabeled UsesAdjunctive therapy in the treatment of schizophrenia (inconclusive data); prevention of colorectal cancer; preterm labor.

Adult: PO Osteoarthritis 200 mg 1-2 times/day. May increase to 200 mg 2 times daily if needed. Rheumatoid arthritis 100-200 mg 2 times daily. Pain relief; Dysmenorrhea Initial: 400 mg followed by 200 mg on the 1st day if needed.

Maintenance: 200 mg 2 times daily. Familial adenomatous polyposis 400 mg 2 times daily.

Flonar is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain and help relieve symptoms of arthritis (e. g. osteoarthritis, rheumatoid arthritis, or juvenile rheumatoid arthritis), such as inflammation, swelling, stiffness, and joint pain. However, Flonar does not cure arthritis and will help you only as long as you continue to take it.

Flonar is also used to treat ankylosing spondylitis, which is a type of arthritis that affects the joints in the spine. Flonar may also be used to treat acute pain and menstrual cramps.

Flonar is available only with your doctor's prescription.

Conditions that metrazole oral treats, metazole

conditions

What conditions does Metrazole treat?

Metrazole oral is used to treat the following:

Severe Intestinal Infection due to Entamoeba Histolytica, Liver Abscess caused by Entamoeba Histolytica, Blood Infection caused by the Bacteria Bacteroides, Bacterial Blood Infection caused by Clostridium, Infection caused by Bacteroides Fragilis Bacteria, Brain Abscess caused by the Bacteria Bacteroides, Infection caused by the Bacteria Anaerobes, Infection caused by Trichomoniasis Protozoa, Meningitis caused by the Bacteria Bacteroides, Heart Valve Infection caused by the Bacteria Bacteroides, Pneumonia caused by the Bacteria Bacteroides, Pus in the Lungs caused by the Bacteria Bacteroides, Lower Respiratory Tract Infection, Infection of Abdominal Cavity Lining due to Bacteroides, Infection of Abdominal Cavity Lining due to Clostridium, Infection of the Abdominal Lining caused by Peptococcus, Peritonitis caused by Peptostreptococcus Bacteria, Infection of the Abdominal Lining caused by Eubacterium, Abscess Within the Abdomen caused by Bacteroides, Infection Within the Abdomen caused by Clostridium Bacteria, Infection Within the Abdomen caused by Eubacterium, Abscess Within the Abdomen caused by Peptococcus, Abscess Within the Abdomen caused by Peptostreptococcus, Abscess Within the Abdomen caused by Anaerobic Bacteria, Infection Within the Abdomen, Infection In or On the Liver caused by Bacteroides Species, Infection In or On the Liver caused by Clostridium Species, Infection In or On the Liver caused by Eubacterium, Infection In or On the Liver caused by Peptococcus, Infection In or On the Liver caused by Peptostreptococcus, Abscess of Fallopian Tube and Ovary caused by Bacteroides, Abscess of Fallopian Tube and Ovary caused by Clostridium, Abscess of Fallopian Tube and Ovary caused by Peptococcus, Fallopian Tube & Ovary Abscess due to Peptostreptococcus, Pelvic Inflammatory Disease, Inflammation of the Endometrium, Infection of Lining of the Uterus caused by Clostridium, Infection of Lining of the Uterus caused by Peptococcus, Infection of Uterine Lining Caused By Peptostreptococcus, Infection of Lining of the Uterus caused by Bacteroides, Infection of Tissues of the Uterus caused by Bacteroides, Infection of Tissues of the Uterus caused by Clostridium, Infection of Tissues of the Uterus caused by Peptococcus, Infection of Tissues of Uterus due to Peptostreptococcus, Infection Following Vaginal Cuff Surgery, Bacteroides Infection Following Vaginal Cuff Surgery, Clostridium Infection Following Vaginal Cuff Surgery, Peptococcus Infection Following Vaginal Cuff Surgery, Peptostreptococcus Infection After Vaginal Cuff Surgery, Skin Infection due to Bacteroides Fragilis Bacteria, Skin Infection due to Clostridium Bacteria, Skin Tissue Infection due to Peptostreptococcus Bacteria, Skin Infection due to Peptococcus Bacteria, Skin Infection due to Fusobacterium Bacteria, Infection of a Joint caused by Bacteroides, Bone Infection caused by Bacteroides

Metrazole oral may also be used to treat:

Infection caused by the Parasite Balantidium, Infection that causes Diarrhea - Giardiasis, Clostridium Difficile Bacteria Related Colitis, Infection caused by the Roundworm Dracunculus, Infection Around a Tooth, Ulcer of Duodenum caused by Bacteria Helicobacter Pylori, Peptic Ulcer due to Bacteria Helicobacter Pylori, Inflammation of the Stomach Lining caused by H. Pylori, Crohn's Disease, Diverticulitis, Vaginosis caused by Bacteria, Diabetic Foot Infection, Prevention of Perioperative Infection, Sexual Transmitted Disease Exposure from Sexual Assault

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Treatment by Condition Related to Metrazole

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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Buy loxiflam online - self healing centre, loxiflan

Loxiflam

Medication guide about Loxiflam (Meloxicam)

Brand name: Loxiflam Generic name: Meloxicam

What is the most important information I should know about Loxiflam? Contact your doctor if you experience bloody, black, or tarry stools, blood in your vomit; swelling or rapid weight gain (fluid retention); unusual fatigue or weakness; yellowing of the skin or eyes; excessive itching; flu-like symptoms; or abdominal pain or tenderness. These symptoms could indicate serious side effects. Many over-the-counter cough, cold, allergy, and pain medicines contain aspirin or other medicines similar to Loxiflam (such as ibuprofen, ketoprofen, and others). Before taking any prescription or over-the-counter medicine, talk to your doctor and pharmacist. Avoid alcohol or use it with moderation. If you drink more than three alcoholic beverages a day, Loxiflam may increase the risk of dangerous stomach bleeding. Talk to your doctor before taking Loxiflam if you drink more than 3 alcoholic beverages a day.

What is Loxiflam? Loxiflam is in a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Loxiflam works by reducing hormones that cause inflammation and pain in the body. Loxiflam is used to reduce the pain, inflammation, and stiffness caused by osteoarthritis and rheumatoid arthritis… Loxiflam may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking Loxiflam? Before taking this medication, tell your doctor if you have an allergy to aspirin or any other NSAIDs, have an ulcer or bleeding in your stomach, drink more than three alcoholic beverages a day, have liver disease; have kidney disease; have a bleeding or blood clotting disorder, have congestive heart failure, have fluid retention, have heart disease, or have high blood pressure. You may not be able to take Loxiflam, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Loxiflam is in the FDA pregnancy category C. This means it is not known whether Loxiflam will be harmful to an unborn baby. Loxiflam should not be taken late in pregnancy (the third trimester) because a similar drug is known to affect the baby’s heart. Do not take Loxiflam without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether Loxiflam passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take Loxiflam? Take Loxiflam exactly as directed. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you. Take each dose with a full glass of water. Loxiflam may be taken with or without food. Store Loxiflam at room temperature away from moisture and heat.

What happens if I miss a dose? If you are taking Loxiflam on a regular schedule, 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. If you are taking Loxiflam as needed, take the missed dose if it is needed, then wait the recommended or prescribed amount of time before taking another dose.

What happens if I overdose? Seek emergency medical attention if an overdose is suspected. Symptoms of a Loxiflam overdose include nausea, vomiting, stomach pain, loss of consciousness, drowsiness, headache, cardiac arrest, stomach pain, seizures, little or no urine production, and slow breathing.

What should I avoid while taking Loxiflam? Avoid alcohol or use it with moderation. If you drink more than three alcoholic beverages a day, Loxiflam may increase the risk of dangerous stomach bleeding. Talk to your doctor before taking Loxiflam if you drink more than 3 alcoholic beverages a day. Many over-the-counter cough, cold, allergy, and pain medicines contain aspirin or other medicines similar to Loxiflam (such as ibuprofen, ketoprofen, and others). Before taking any prescription or over-the-counter medicine, talk to your doctor and pharmacist.

What are the possible side effects of Loxiflam? Contact your doctor if you experience bloody, black, or tarry stools, blood in your vomit; swelling or rapid weight gain (fluid retention); unusual fatigue or weakness; yellowing of the skin or eyes; excessive itching; flu-like symptoms; or abdominal pain or tenderness. These symptoms could indicate serious side effects. If you experience any of the following serious side effects, stop taking Loxiflam and seek medical treatment or contact your doctor immediately: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); muscle cramps, numbness, or tingling; ulcers (open sores) in the mouth; seizures; decreased hearing or ringing in the ears; or abdominal cramping, heartburn, or indigestion. Other, less serious side effects may be more likely to occur. Continue to take Loxiflam and talk to your doctor if you experience dizziness or headache; nausea, diarrhea, or constipation; depression; fatigue or weakness; dry mouth; or irregular menstrual periods. 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 Loxiflam? Before taking Loxiflam, tell your doctor if you are taking any of the following drugs: aspirin or another salicylate (form of aspirin) such as salsalate (Disalcid), diflunisal (Dolobid), choline salicylate-magnesium salicylate (Trilisate, Tricosal, others), and magnesium salicylate (Doan’s, others); another nonsteroidal anti-inflammatory drug (NSAID) such as diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ibuprofen (Motrin, Advil, others), indomethacin (Indocin), ketoprofen (Orudis, Orudis KT), ketorolac (Toradol), naproxen (Aleve, Anaprox, Naprosyn, Naprelan, others), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), or tolmetin (Tolectin); an over-the-counter cough, cold, allergy, or pain medicine that contains aspirin, ibuprofen, Loxiflam, or ketoprofen; a diuretic such as furosemide (Lasix), bumetanide (Bumex), ethacrynic acid (Edecrin), torsemide (Demadex), hydrochlorothiazide (HCTZ, HydroDiuril, Microzide), chlorothiazide (Diuril), chlorthalidone (Hygroton, Thalitone), indapamide (Lozol), metolazone (Mykrox, Zaroxolyn), and others; an anticoagulant (blood thinner) such as warfarin (Coumadin); or lithium (Eskalith, Lithobid, others); or You may not be able to take Loxiflam, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above. Drugs other than those listed here may also interact with Loxiflam. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

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Acyclovir tablets - fda prescribing information, side effects and uses, acyclovirum

Acyclovir Tablets

Acyclovir Tablets Description

Acyclovir is a synthetic nucleoside analogue active against herpes viruses. Acyclovir Tablets are a formulation for oral administration. Each 800 mg tablet of acyclovir contains 800 mg of acyclovir and the inactive ingredients colloidal silicon dioxide, croscarmellose sodium, magnesium stearate and microcrystalline cellulose. Each 400 mg tablet of acyclovir contains 400 mg of acyclovir and the inactive ingredients colloidal silicon dioxide, croscarmellose sodium, magnesium stearate and microcrystalline cellulose.

Acyclovir is a white, crystalline powder with the molecular formula C 8 H 11 N 5 O 3 and a molecular weight of 225.2. The maximum solubility in water at 37°C is 2.5 mg/mL. The pKa’s of acyclovir are 2.27 and 9.25.

The chemical name of acyclovir is 2-amino-1,9-dihydro-9-[(2-hydroxyethoxy)methyl]-6 H - purin-6-one; it has the following structural formula:

VIROLOGY

Mechanism of Antiviral Action

Acyclovir is a synthetic purine nucleoside analogue with in vitro and in vivo inhibitory activity against herpes simplex virus types 1 (HSV-1), 2 (HSV-2), and varicella-zoster virus (VZV).

The inhibitory activity of acyclovir is highly selective due to its affinity for the enzyme thymidine kinase (TK) encoded by HSV and VZV. This viral enzyme converts acyclovir into acyclovir monophosphate, a nucleotide analogue. The monophosphate is further converted into diphosphate by cellular guanylate kinase and into triphosphate by a number of cellular enzymes. I n vitro. acyclovir triphosphate stops replication of herpes viral DNA. This is accomplished in 3 ways: 1) competitive inhibition of viral DNA polymerase, 2) incorporation into and termination of the growing viral DNA chain, and 3) inactivation of the viral DNA polymerase. The greater antiviral activity of acyclovir against HSV compared to VZV is due to its more efficient phosphorylation by the viral TK.

Antiviral Activities

The quantitative relationship between the in vitro susceptibility of herpes viruses to antivirals and the clinical response to therapy has not been established in humans, and virus sensitivity testing has not been standardized. Sensitivity testing results, expressed as the concentration of drug required to inhibit by 50% the growth of virus in cell culture (IC 50 ), vary greatly depending upon a number of factors. Using plaque-reduction assays, the IC 50 against herpes simplex virus isolates ranges from 0.02 to 13.5 mcg/mL for HSV-1 and from 0.01 to 9.9 mcg/mL for HSV-2. The IC 50 for acyclovir against most laboratory strains and clinical isolates of VZV ranges from 0.12 to 10.8 mcg/mL. Acyclovir also demonstrates activity against the Oka vaccine strain of VZV with a mean IC 50 of 1.35 mcg/mL.

Drug Resistance

Resistance of HSV and VZV to acyclovir can result from qualitative and quantitative changes in the viral TK and/or DNA polymerase. Clinical isolates of HSV and VZV with reduced susceptibility to acyclovir have been recovered from immunocompromised patients, especially with advanced HIV infection. While most of the acyclovir-resistant mutants isolated thus far from immunocompromised patients have been found to be TK-deficient mutants, other mutants involving the viral TK gene (TK partial and TK altered) and DNA polymerase have been isolated. TK-negative mutants may cause severe disease in infants and immunocompromised adults. The possibility of viral resistance to acyclovir should be considered in patients who show poor clinical response during therapy.

Acyclovir Tablets - Clinical Pharmacology

Pharmacokinetics

The pharmacokinetics of acyclovir after oral administration have been evaluated in healthy volunteers and in immunocompromised patients with herpes simplex or varicella-zoster virus infection. Acyclovir pharmacokinetic parameters are summarized in Table 1.

Table 1: Acyclovir Pharmacokinetic Characteristics (Range)

* Bioavailability decreases with increasing dose.

There was no effect of food on the absorption of acyclovir (n = 6); therefore, Acyclovir Tablets may be administered with or without food. The only known urinary metabolite is 9-[(carboxymethoxy)methyl]guanine.

Special Populations

Adults with Impaired Renal Function

The half-life and total body clearance of acyclovir are dependent on renal function. A dosage adjustment is recommended for patients with reduced renal function (see DOSAGE AND ADMINISTRATION ).

Acyclovir plasma concentrations are higher in geriatric patients compared to younger adults, in part due to age-related changes in renal function. Dosage reduction may be required in geriatric patients with underlying renal impairment (see PRECAUTIONS: Geriatric Use ).

In general, the pharmacokinetics of acyclovir in pediatric patients is similar to that of adults. Mean half-life after oral doses of 300 mg/m 2 and 600 mg/m 2 in pediatric patients aged 7 months to 7 years was 2.6 hours (range 1.59 to 3.74 hours).

Drug Interactions

Coadministration of probenecid with intravenous acyclovir has been shown to increase the mean acyclovir half-life and the area under the concentration-time curve. Urinary excretion and renal clearance were correspondingly reduced.

Clinical Trials

Initial Genital Herpes

Double-blind, placebo-controlled studies have demonstrated that orally administered acyclovir significantly reduced the duration of acute infection and duration of lesion healing. The duration of pain and new lesion formation was decreased in some patient groups.

Recurrent Genital Herpes

Double-blind, placebo-controlled studies in patients with frequent recurrences (6 or more episodes per year) have shown that orally administered acyclovir given daily for 4 months to 10 years prevented or reduced the frequency and/or severity of recurrences in greater than 95% of patients.

In a study of patients who received acyclovir 400 mg twice daily for 3 years, 45%, 52%, and 63% of patients remained free of recurrences in the first, second, and third years, respectively. Serial analyses of the 3-month recurrence rates for the patients showed that 71% to 87% were recurrence free in each quarter.

Herpes Zoster Infections

In a double-blind, placebo-controlled study of immunocompetent patients with localized cutaneous zoster infection, acyclovir (800 mg 5 times daily for 10 days) shortened the times to lesion scabbing, healing, and complete cessation of pain, and reduced the duration of viral shedding and the duration of new lesion formation.

In a similar double-blind, placebo-controlled study, acyclovir (800 mg 5 times daily for 7 days) shortened the times to complete lesion scabbing, healing, and cessation of pain; reduced the duration of new lesion formation; and reduced the prevalence of localized zoster-associated neurologic symptoms (paresthesia, dysesthesia, or hyperesthesia).

Treatment was begun within 72 hours of rash onset and was most effective if started within the first 48 hours.

Adults greater than 50 years of age showed greater benefit.

Three randomized, double-blind, placebo-controlled trials were conducted in 993 pediatric patients aged 2 to 18 years with chickenpox. All patients were treated within 24 hours after the onset of rash. In 2 trials, acyclovir was administered at 20 mg/kg 4 times daily (up to 3,200 mg per day) for 5 days. In the third trial, doses of 10, 15, or 20 mg/kg were administered 4 times daily for 5 to 7 days. Treatment with acyclovir shortened the time to 50% healing; reduced the maximum number of lesions; reduced the median number of vesicles; decreased the median number of residual lesions on day 28; and decreased the proportion of patients with fever, anorexia, and lethargy by day 2. Treatment with acyclovir did not affect varicella-zoster virus-specific humoral or cellular immune responses at 1 month or 1 year following treatment.

Indications and Usage for Acyclovir Tablets

Herpes Zoster Infections

Acyclovir Tablets are indicated for the acute treatment of herpes zoster (shingles).

Genital Herpes

Acyclovir Tablets are indicated for the treatment of initial episodes and the management of recurrent episodes of genital herpes.

Chickenpox

Acyclovir Tablets are indicated for the treatment of chickenpox (varicella).

Contraindications

Acyclovir is contraindicated for patients who develop hypersensitivity to acyclovir or valacyclovir.

Warnings

Acyclovir Tablets are intended for oral ingestion only. Renal failure, in some cases resulting in death, has been observed with acyclovir therapy (see ADVERSE REACTIONS: Observed During Clinical Practice and OVERDOSAGE ). Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS), which has resulted in death, has occurred in immunocompromised patients receiving acyclovir therapy.

Precautions

Dosage adjustment is recommended when administering acyclovir to patients with renal impairment (see DOSAGE AND ADMINISTRATION). Caution should also be exercised when administering acyclovir to patients receiving potentially nephrotoxic agents since this may increase the risk of renal dysfunction and/or the risk of reversible central nervous system symptoms such as those that have been reported in patients treated with intravenous acyclovir. Adequate hydration should be maintained.

Information for Patients

Patients are instructed to consult with their physician if they experience severe or troublesome adverse reactions, they become pregnant or intend to become pregnant, they intend to breastfeed while taking orally administered acyclovir, or they have any other questions.

Patients should be advised to maintain adequate hydration.

There are no data on treatment initiated more than 72 hours after onset of the zoster rash. Patients should be advised to initiate treatment as soon as possible after a diagnosis of herpes zoster.

Genital Herpes Infections

Patients should be informed that acyclovir is not a cure for genital herpes. There are no data evaluating whether acyclovir will prevent transmission of infection to others. Because genital herpes is a sexually transmitted disease, patients should avoid contact with lesions or intercourse when lesions and/or symptoms are present to avoid infecting partners. Genital herpes can also be transmitted in the absence of symptoms through asymptomatic viral shedding. If medical management of a genital herpes recurrence is indicated, patients should be advised to initiate therapy at the first sign or symptom of an episode.

Chickenpox in otherwise healthy children is usually a self-limited disease of mild to moderate severity. Adolescents and adults tend to have more severe disease. Treatment was initiated within 24 hours of the typical chickenpox rash in the controlled studies, and there is no information regarding the effects of treatment begun later in the disease course.

Drug Interactions

Carcinogenesis, Mutagenesis, Impairment of Fertility

The data presented below include references to peak steady-state plasma acyclovir concentrations observed in humans treated with 800 mg given orally 5 times a day (dosing appropriate for treatment of herpes zoster) or 200 mg given orally 5 times a day (dosing appropriate for treatment of genital herpes). Plasma drug concentrations in animal studies are expressed as multiples of human exposure to acyclovir at the higher and lower dosing schedules (see CLINICAL PHARMACOLOGY: Pharmacokinetics ).

Acyclovir was tested in lifetime bioassays in rats and mice at single daily doses of up to 450 mg/kg administered by gavage. There was no statistically significant difference in the incidence of tumors between treated and control animals, nor did acyclovir shorten the latency of tumors. Maximum plasma concentrations were 3 to 6 times human levels in the mouse bioassay and 1 to 2 times human levels in the rat bioassay.

Acyclovir was tested in 16 in vitro and in vivo genetic toxicity assays. Acyclovir was positive in 5 of the assays.

Acyclovir did not impair fertility or reproduction in mice (450 mg/kg/day, p. o.) or in rats (25 mg/kg/day, s. c.). In the mouse study, plasma levels were 9 to 18 times human levels, while in the rat study, they were 8 to 15 times human levels. At higher doses (50 mg/kg/day, s. c.) in rats and rabbits (11 to 22 and 16 to 31 times human levels, respectively) implantation efficacy, but not litter size, was decreased. In a rat peri - and post-natal study at 50 mg/kg/day, s. c. there was a statistically significant decrease in group mean numbers of corpora lutea, total implantation sites, and live fetuses.

No testicular abnormalities were seen in dogs given 50 mg/kg/day, IV for 1 month (21 to 41 times human levels) or in dogs given 60 mg/kg/day orally for 1 year (6 to 12 times human levels). Testicular atrophy and aspermatogenesis were observed in rats and dogs at higher dose levels.

Pregnancy

Pregnancy Category B. Acyclovir administered during organogenesis was not teratogenic in the mouse (450 mg/kg/day, p. o.), rabbit (50 mg/kg/day, s. c. and IV), or rat (50 mg/kg/day, s. c.). These exposures resulted in plasma levels 9 and 18, 16 and 106, and 11 and 22 times, respectively, human levels.

There are no adequate and well-controlled studies in pregnant women. A prospective epidemiologic registry of acyclovir use during pregnancy was established in 1984 and completed in April 1999. There were 749 pregnancies followed in women exposed to systemic acyclovir during the first trimester of pregnancy resulting in 756 outcomes. The occurrence rate of birth defects approximates that found in the general population. However, the small size of the registry is insufficient to evaluate the risk for less common defects or to permit reliable or definitive conclusions regarding the safety of acyclovir in pregnant women and their developing fetuses. Acyclovir should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nursing Mothers

Acyclovir concentrations have been documented in breast milk in 2 women following oral administration of acyclovir and ranged from 0.6 to 4.1 times corresponding plasma levels. These concentrations would potentially expose the nursing infant to a dose of acyclovir up to 0.3 mg/kg/day. Acyclovir should be administered to a nursing mother with caution and only when indicated.

Pediatric Use

Safety and effectiveness of oral formulations of acyclovir in pediatric patients younger than 2 years of age have not been established.

Geriatric Use

Of 376 subjects who received acyclovir in a clinical study of herpes zoster treatment in immunocompetent subjects ≥50 years of age, 244 were 65 and over while 111 were 75 and over. No overall differences in effectiveness for time to cessation of new lesion formation or time to healing were reported between geriatric subjects and younger adult subjects. The duration of pain after healing was longer in patients 65 and over. Nausea, vomiting, and dizziness were reported more frequently in elderly subjects. Elderly patients are more likely to have reduced renal function and require dose reduction. Elderly patients are also more likely to have renal or CNS adverse events. With respect to CNS adverse events observed during clinical practice, somnolence, hallucinations, confusion, and coma were reported more frequently in elderly patients (see CLINICAL PHARMACOLOGY. ADVERSE REACTIONS: Observed During Clinical Practice. and DOSAGE AND ADMINISTRATION ).

Adverse Reactions

Herpes Simplex

The most frequent adverse events reported during clinical trials of treatment of genital herpes with acyclovir 200 mg administered orally 5 times daily every 4 hours for 10 days were nausea and/or vomiting in 8 of 298 patient treatments (2.7%). Nausea and/or vomiting occurred in 2 of 287 (0.7%) patients who received placebo.

The most frequent adverse events reported in a clinical trial for the prevention of recurrences with continuous administration of 400 mg (two 200-mg capsules) 2 times daily for 1 year in 586 patients treated with acyclovir were nausea (4.8%) and diarrhea (2.4%). The 589 control patients receiving intermittent treatment of recurrences with acyclovir for 1 year reported diarrhea (2.7%), nausea (2.4%), and headache (2.2%).

Herpes Zoster

The most frequent adverse event reported during 3 clinical trials of treatment of herpes zoster (shingles) with 800 mg of oral acyclovir 5 times daily for 7 to 10 days in 323 patients was malaise (11.5%). The 323 placebo recipients reported malaise (11.1%).

Chickenpox

The most frequent adverse event reported during 3 clinical trials of treatment of chickenpox with oral acyclovir at doses of 10 to 20 mg/kg 4 times daily for 5 to 7 days or 800 mg 4 times daily for 5 days in 495 patients was diarrhea (3.2%). The 498 patients receiving placebo reported diarrhea (2.2%).

Observed During Clinical Practice

In addition to adverse events reported from clinical trials, the following events have been identified during post-approval use of acyclovir. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. These events have been chosen for inclusion due to either their seriousness, frequency of reporting, potential causal connection to acyclovir, or a combination of these factors.

General: Anaphylaxis, angioedema, fever, headache, pain, peripheral edema.

Nervous: Aggressive behavior, agitation, ataxia, coma, confusion, decreased consciousness, delirium, dizziness, dysarthria, encephalopathy, hallucinations, paresthesia, psychosis, seizure, somnolence, tremors. These symptoms may be marked, particularly in older adults or in patients with renal impairment (see PRECAUTIONS ).

Digestive: Diarrhea, gastrointestinal distress, nausea.

Hematologic and Lymphatic: Anemia, leukocytoclastic vasculitis, leukopenia, lymphadenopathy, thrombocytopenia.

Hepatobiliary Tract and Pancreas: Elevated liver function tests, hepatitis, hyperbilirubinemia, jaundice.

Skin: Alopecia, erythema multiforme, photosensitive rash, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria.

Special Senses: Visual abnormalities.

Urogenital: Renal failure, elevated blood urea nitrogen, elevated creatinine, hematuria (see WARNINGS).

Overdosage

Overdoses involving ingestion of up to 100 capsules (20 g) have been reported. Adverse events that have been reported in association with overdosage include agitation, coma, seizures, and lethargy. Precipitation of acyclovir in renal tubules may occur when the solubility (2.5 mg/mL) is exceeded in the intratubular fluid. Overdosage has been reported following bolus injections or inappropriately high doses and in patients whose fluid and electrolyte balance were not properly monitored. This has resulted in elevated BUN and serum creatinine and subsequent renal failure. In the event of acute renal failure and anuria, the patient may benefit from hemodialysis until renal function is restored (see DOSAGE AND ADMINISTRATION ).

Acyclovir Tablets Dosage and Administration

Acute Treatment of Herpes Zoster

800 mg every 4 hours orally, 5 times daily for 7 to 10 days.

Genital Herpes

Treatment of Initial Genital Herpes

200 mg every 4 hours, 5 times daily for 10 days.

Chronic Suppressive Therapy for Recurrent Disease

400 mg 2 times daily for up to 12 months, followed by re-evaluation. Alternative regimens have included doses ranging from 200 mg 3 times daily to 200 mg 5 times daily.

The frequency and severity of episodes of untreated genital herpes may change over time. After 1 year of therapy, the frequency and severity of the patient’s genital herpes infection should be re-evaluated to assess the need for continuation of therapy with acyclovir.

200 mg every 4 hours, 5 times daily for 5 days. Therapy should be initiated at the earliest sign or symptom (prodrome) of recurrence.

Treatment of Chickenpox

Children (2 years of age and older)

20 mg/kg per dose orally 4 times daily (80 mg/kg/day) for 5 days. Children over 40 kg should receive the adult dose for chickenpox.

Adults and Children over 40 kg

800 mg 4 times daily for 5 days.

Intravenous acyclovir is indicated for the treatment of varicella-zoster infections in immunocompromised patients.

When therapy is indicated, it should be initiated at the earliest sign or symptom of chickenpox. There is no information about the efficacy of therapy initiated more than 24 hours after onset of signs and symptoms.

Patients With Acute or Chronic Renal Impairment

In patients with renal impairment, the dose of acyclovir should be modified as shown in Table 3:

Table 3. Dosage Modification for Renal Impairment

Hemodialysis

For patients who require hemodialysis, the mean plasma half-life of acyclovir during hemodialysis is approximately 5 hours. This results in a 60% decrease in plasma concentrations following a 6-hour dialysis period. Therefore, the patient’s dosing schedule should be adjusted so that an additional dose is administered after each dialysis.

Peritoneal Dialysis

No supplemental dose appears to be necessary after adjustment of the dosing interval.

How is Acyclovir Tablets Supplied

Acyclovir Tablets, USP 800 mg are available for oral administration as white to off-white, oval, unscored tablets imprinted "Apotex Logo 5307" on one side and plain on the other side. They are supplied as follows:

300 TABLET in a BOTTLE (0440-7033-81)

Store at 20° to 25°C (68° to 77°F); excursions permitted from 15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature] and protect from moisture.

Acyclovir Tablets, USP

400 MG & 800 MG

Buy docenala - enalapril - online without prescriptions, docenala

Vasotec (Docenala)

Vasotec is used for treating high blood pressure, heart failure, and other heart problems. It may be used alone or with other medicines. Vasotec is an angiotensin-converting enzyme (ACE) inhibitor. It works by helping to relax blood vessels. This helps to lower blood pressure.

Use Vasotec as directed by your doctor.

Take Vasotec by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.

If you miss a dose of Vasotec, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

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

Active Ingredient: Enalapril maleate.

Do NOT use Vasotec if:

you are allergic to any ingredient in Vasotec or similar medicines (eg, captopril, lisinopril)

you are pregnant

you are taking dextran sulfate or a potassium-sparing diuretic (eg, amiloride).

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

Some medical conditions may interact with Vasotec. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

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

if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

if you have allergies to medicines, foods, or other substances

if you have or have ever had liver or kidney problems or kidney transplantation

if you are receiving dialysis

if you have bone marrow suppression, low blood counts, low blood sodium, high blood potassium, the blood disease porphyria, giant hives, lupus, scleroderma, or a collagen vascular disease

if you have narrowing or hardening of the arteries of the brain or heart, chest pain, or discomfort known as angina.

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

Diuretics (eg, furosemide, hydrochlorothiazide) because excessive decreases in blood pressure may occur, which may cause dizziness, especially upon standing, or fainting

Dextran sulfate because it may increase the risk of allergic reaction (eg, rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue) and lightheadedness upon standing

Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, aspirin, indomethacin) because they may decrease Vasotec's effectiveness and the risk of kidney damage may be increased

Oral diabetes medicine (eg, glyburide) because side effects, including a low blood sugar level (eg, dizziness, headache, hunger, shakiness or weakness, sweating), may be increased by Vasotec

Lithium or thiopurines (eg, azathioprine) because the risk of serious side effects may be increased by Vasotec

Certain gold-containing medicines (eg, sodium aurothiomalate) because flushing, nausea, vomiting, and low blood pressure may occur

Potassium-sparing diuretics (eg, amiloride) or potassium supplements may cause high blood potassium levels (eg, abnormal skin sensations of the arms and legs, confusion, heaviness of the limbs, listlessness, slow or irregular heartbeat, stopping of the heart) when used with Vasotec.

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

Important safety information:

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

Check with your doctor before you use a salt substitute or a product that has potassium in it.

If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. Contact your doctor for instructions.

Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.

Vasotec may not work as well in black patients. They may also be at greater risk of side effects. Contact your doctor if your symptoms do not improve or if they become worse.

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

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

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

Vasotec should not be used in newborns; safety and effectiveness in these children have not been confirmed.

Pregnancy and breast-feeding: Vasotec may cause birth defects or fetal death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. Vasotec is found in breast milk. If you are or will be breast-feeding while you use Vasotec, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

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

Diarrhea; dizziness or lightheadedness when sitting up or standing; headache; nausea; persistent, dry cough; tiredness; vomiting.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; hoarseness; infection (eg, fever, sore throat); irregular or slow heartbeat; unusual stomach pain; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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Benzonatate - fda prescribing information, side effects and uses, benz cap 100mg

Benzonatate

Benzonatate Description

Benzonatate, a non-narcotic oral antitussive agent, is 2, 5, 8, 11, 14, 17, 20, 23, 26-nonaoxaoctacosan-28-yl p-(butylamino) benzoate; with a molecular weight of 603.7.

Each Benzonatate Capsules USP contains:

Benzonatate, USP 200 mg

Benzonatate Capsules USP also contain: D&C Yellow 10, gelatin, glycerin, methylparaben, propylparaben and titanium dioxide.

Benzonatate - Clinical Pharmacology

Benzonatate Capsule acts peripherally by anesthetizing the stretch receptors located in the respiratory passages, lungs, and pleura by dampening their activity and thereby reducing the cough reflex at its source. It begins to act within 15 to 20 minutes and its effect lasts for 3 to 8 hours. Benzonatate Capsule has no inhibitory effect on the respiratory center in recommended dosage.

Indications and Usage for Benzonatate

Benzonatate Capsule is indicated for the symptomatic relief of cough.

Contraindications

Hypersensitivity to Benzonatate or related compounds.

Warnings

Hypersensitivity

Severe hypersensitivity reactions (including bronchospasm, laryngospasm and cardiovascular collapse) have been reported which are possibly related to local anesthesia from sucking or chewing the capsule instead of swallowing it. Severe reactions have required intervention with vasopressor agents and supportive measures.

Psychiatric Effects

Isolated instances of bizarre behavior, including mental confusion and visual hallucinations, have also been reported in patients taking Benzonatate Capsule in combination with other prescribed drugs.

Accidental Ingestion and Death in Children

Keep Benzonatate Capsules out of reach of children. Accidental ingestion of Benzonatate Capsules resulting in death has been reported in children below age 10. Signs and symptoms of overdose have been reported within 15-20 minutes and death has been reported within one hour of ingestion. If accidental ingestion occurs, seek medical attention immediately (see OVERDOSAGE ).

Precautions

Benzonatate is chemically related to anesthetic agents of the para-amino-benzoic acid class (e. g. procaine; tetracaine) and has been associated with adverse CNS effects possibly related to a prior sensitivity to related agents or interaction with concomitant medication.

Information for Patients:

Swallow Benzonatate Capsules whole. Do not break, chew, dissolve, cut, or crush Benzonatate Capsules. Release of Benzonatate from the capsule in the mouth can produce a temporary local anesthesia of the oral mucosa and choking could occur. If numbness or tingling of the tongue, mouth, throat, or face occurs, refrain from oral ingestion of food or liquids until the numbness has resolved. If the symptoms worsen or persist, seek medical attention.

Keep Benzonatate Capsules out of reach of children. Accidental ingestion resulting in death has been reported in children. Signs and symptoms of overdose have been reported within 15-20 minutes and death has been reported within one hour of ingestion. Signs and symptoms may include restlessness, tremors, convulsions, coma and cardiac arrest. If accidental ingestion occurs, seek medical attention immediately.

Overdosage resulting in death may occur in adults.

Do not exceed a single dose of 200 mg and a total daily dosage of 600 mg. If you miss a dose of Benzonatate Capsules, skip that dose and take the next dose at the next scheduled time. Do not take 2 doses of Benzonatate Capsules at one time.

Usage in Pregnancy: Pregnancy Category C. Animal reproduction studies have not been conducted with Benzonatate Capsules. It is also not known whether Benzonatate Capsules can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Benzonatate Capsules should be given to a pregnant woman only if clearly needed.

Nursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk caution should be exercised when Benzonatate Capsule is administered to a nursing woman.

Carcinogenesis, Mutagenesis, Impairment of Fertility: Carcinogenicity, mutagenicity, and reproduction studies have not been conducted with Benzonatate Capsules.

Pediatric Use: Safety and effectiveness in children below the age of 10 have not been established. Accidental ingestion resulting in death has been reported in children below age 10. Keep out of reach of children.

Adverse Reactions

Potential Adverse Reactions to Benzonatate Capsules may include:

Hypersensitivity reactions including bronchospasm, laryngospasm, cardiovascular collapse possibly related to local anesthesia from chewing or sucking the capsule.

CNS: sedation; headache; dizziness; mental confusion; visual hallucinations.

GI: constipation; nausea; GI upset.

Dermatologic: pruritus; skin eruptions.

Other: nasal congestion; sensation of burning in the eyes; vague “chilly” sensation; numbness of the chest; hypersensitivity.

Deliberate or accidental overdose has resulted in death, particularly in children.

Overdosage

Intentional and unintentional overdose may result in death, particularly in children.

The drug is chemically related to tetracaine and other topical anesthetics and shares various aspects of their pharmacology and toxicology. Drugs of this type are generally well absorbed after ingestion.

Signs and Symptoms:

The signs and symptoms of overdose of Benzonatate have been reported within 15-20 minutes. If capsules are chewed or dissolved in the mouth, oropharyngeal anesthesia will develop rapidly, which may cause choking and airway compromise.

CNS stimulation may cause restlessness and tremors which may proceed to clonic convulsions followed by profound CNS depression. Convulsions, coma, cerebral edema and cardiac arrest leading to death have been reported within 1 hour of ingestion.

Treatment:

In case of overdose, seek medical attention immediately. Evacuate gastric contents and administer copious amounts of activated charcoal slurry. Even in the conscious patient, cough and gag reflexes may be so depressed as to necessitate special attention to protection against aspiration of gastric contents and orally administered materials. Convulsions should be treated with a short-acting barbiturate given intravenously and carefully titrated for the smallest effective dosage. Intensive support of respiration and cardiovascular-renal function is an essential feature of the treatment of severe intoxication from overdosage.

Do not use CNS stimulants.

Benzonatate Dosage and Administration

Adults and Children over 10 years of age: Usual dose is one 100 mg or 200 mg capsule three times a day as needed for cough. If necessary to control cough, up to 600 mg daily in three divided doses may be given. Benzonatate Capsules should be swallowed whole. Benzonatate Capsules are not to be broken, chewed, dissolved, cut or crushed.

How is Benzonatate Supplied

Benzonatate Capsules USP, 200 mg are available as yellow, oval soft gelatin capsules with ‘2’ imprinted in white ink.

Bottles of 100: NDC 51224-001-50

Bottles of 500: NDC 51224-001-60

Store at 20° to 25°C (68° to 77°F) excursions permitted between 15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature].

PROTECT FROM LIGHT

Manufactured by: CSPC-NBP Pharmaceutical Co.,Ltd Shijiazhuang, Hebei, China, 052160

Manufactured for: TAGI Pharma, Inc. South Beloit, IL 61080

PRODUCT PACKAGING

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Glibezid, glibezid

Product Description Common use Amaryl is an oral blood sugar-lowering drug which belongs to the class of sulfonylureas. Active substance is Glimepiride. It is used together with diet and exercise to treat type 2 (non-insulin dependent) diabetes. The mechanism of its action is to stimulate the secretion and release of insulin from beta cells of the pancreas (pancreatic effect). Amaryl is used to treat non-insulin depending diabetes (type 2) as monotherapy or in combination with insulin (or metformin).

Dosage and direction

The best dose is determined by a physician on a basis of regular measurements of blood sugar content.

Be careful your sugar does not fall too low due to stress, skipping a meal, exercising too long, or drinking alcohol. Know signs of hypoglycemia and keep a source of sugar at hand. If your sugar level is too high you may feel very thirsty or hungry. You may also urinate more than usual. Take this medication exactly as prescribed as it is a part of a complicated program consisting of diet, medication, and exercise routines. Tell your doctor if you are pregnant or plan to become pregnant, have adrenal or pituitary gland problems before taking this medication.

Contraindication Amaryl is contraindicated in patients with history of diabetic ketoacidosis, diabetic coma and prekoma, insulin-dependent diabetes (type 1), severe renal dysfunction, severe hepatic impairment, individual hypersensitivity to Amaryl, other members of sulfonylurea class and sulfonamides.

Possible side effect If you have any signs of allergic reaction to this medication such as hives, swelling of face and throat, rash or other major symptoms (severe skin rash, itching, redness, pale skin, easy bruising or bleeding, numbness, dark urine, clay-colored stools, abdominal pain, fever, nausea)seek for immediate medical help.

Drug interaction Diuretics like hydrochlorothiazide (Hydrodiuril, Ezide, Hydro-Par, Microzide, furosemide (Lasix)), corticosteroids such as prednisone and methylprednisolone (Medrol), phenytoin (Dilantin), niacin, and sympathomimetics such as pseudoephedrine (Sudafed) are able to increase blood sugar and diminish effect of Amaryl. Propranolol (Inderal) and atenolol (Tenormin) belong to beta-blockers and also are able to affect blood levels and decrease activity of Amaryl.

Missed dose Take the missed dose as soon as you remember about it. If it is almost time of your next dose just skip it and return to your regular schedule.

Overdose Immediate medical attention is needed in case you took too much medicine. Possible side effects include: extreme weakness, confusion, blurred vision, stomach pain, trouble speaking, tremors, sweating, seizure, and coma.

Storage Store at room temperature in a tight container and keep away from sunlight, moisture, kids and pets.

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.

Product Description Common use Amaryl is an oral blood sugar-lowering drug which belongs to the class of sulfonylureas. Active substance is Glimepiride. It is used together with diet and exercise to treat type 2 (non-insulin dependent) diabetes. The mechanism of its action is to stimulate the secretion and release of insulin from beta cells of the pancreas (pancreatic effect). Amaryl is used to treat non-insulin depending diabetes (type 2) as monotherapy or in combination with insulin (or metformin).

Dosage and direction

The best dose is determined by a physician on a basis of regular measurements of blood sugar content.

Be careful your sugar does not fall too low due to stress, skipping a meal, exercising too long, or drinking alcohol. Know signs of hypoglycemia and keep a source of sugar at hand. If your sugar level is too high you may feel very thirsty or hungry. You may also urinate more than usual. Take this medication exactly as prescribed as it is a part of a complicated program consisting of diet, medication, and exercise routines. Tell your doctor if you are pregnant or plan to become pregnant, have adrenal or pituitary gland problems before taking this medication.

Contraindication Amaryl is contraindicated in patients with history of diabetic ketoacidosis, diabetic coma and prekoma, insulin-dependent diabetes (type 1), severe renal dysfunction, severe hepatic impairment, individual hypersensitivity to Amaryl, other members of sulfonylurea class and sulfonamides.

Possible side effect If you have any signs of allergic reaction to this medication such as hives, swelling of face and throat, rash or other major symptoms (severe skin rash, itching, redness, pale skin, easy bruising or bleeding, numbness, dark urine, clay-colored stools, abdominal pain, fever, nausea)seek for immediate medical help.

Drug interaction Diuretics like hydrochlorothiazide (Hydrodiuril, Ezide, Hydro-Par, Microzide, furosemide (Lasix)), corticosteroids such as prednisone and methylprednisolone (Medrol), phenytoin (Dilantin), niacin, and sympathomimetics such as pseudoephedrine (Sudafed) are able to increase blood sugar and diminish effect of Amaryl. Propranolol (Inderal) and atenolol (Tenormin) belong to beta-blockers and also are able to affect blood levels and decrease activity of Amaryl.

Missed dose Take the missed dose as soon as you remember about it. If it is almost time of your next dose just skip it and return to your regular schedule.

Overdose Immediate medical attention is needed in case you took too much medicine. Possible side effects include: extreme weakness, confusion, blurred vision, stomach pain, trouble speaking, tremors, sweating, seizure, and coma.

Storage Store at room temperature in a tight container and keep away from sunlight, moisture, kids and pets.

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.

Buy moxatid - amoxicillin, clavulanate - online without prescriptions, moxatid

Augmentin (Moxatid)

Augmentin is used for treating infections caused by certain bacteria. Augmentin is a penicillin antibiotic. It works by killing sensitive bacteria.

Use Augmentin as directed by your doctor.

Take Augmentin by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.

To clear up your infection completely, take Augmentin for the full course of treatment. Keep taking it even if you feel better in a few days.

If you miss a dose of Augmentin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Store Augmentin at or below 77 degrees F (25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Augmentin out of the reach of children and away from pets.

Active Ingredient: Amoxicillin/clavulanate potassium.

Do NOT use Augmentin if:

you are allergic to any ingredient in Augmentin or another penicillin antibiotic (eg, ampicillin)

you have a history of liver problems or yellowing of the eyes or skin caused by Augmentin

you have infectious mononucleosis (mono)

you are taking a tetracycline antibiotic (eg, doxycycline)

you have recently received or will be receiving live oral typhoid vaccine.

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

Some medical conditions may interact with Augmentin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

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

if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

if you have allergies to medicines, foods, or other substances

if you have a history of allergies, asthma, hay fever, or hives

if you have had a severe allergic reaction (eg, severe rash, hives, breathing difficulties, dizziness) to a cephalosporin (eg, cephalexin) or another beta-lactam antibiotic (eg, imipenem)

if you have kidney problems or gonorrhea

if you have a history of liver problems or yellowing of the eyes or skin.

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

Anticoagulants (eg, warfarin) because the risk of bleeding may be increased

Probenecid because it may increase the amount of Augmentin in your blood

Chloramphenicol, macrolide antibiotics (eg, erythromycin), sulfonamides (eg, sulfamethoxazole), or tetracycline antibiotics (eg, doxycycline) because they may decrease Augmentin's effectiveness

Methotrexate because the risk of its side effects may be increased by Augmentin

Live oral typhoid vaccine or hormonal birth control (eg, birth control pills) because their effectiveness may be decreased by Augmentin.

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

Important safety information:

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

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

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

Long-term or repeated use of Augmentin may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.

Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.

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

Brown, yellow, or gray tooth discoloration has occurred rarely in some patients taking Augmentin. It occurred most often in children. The discoloration was reduced or removed by brushing or dental cleaning in most cases. Contact your doctor if you experience this effect.

Diabetes patients - Augmentin may cause the results of some tests for urine glucose to be wrong. Ask your doctor before you change your diet or the dose of your diabetes medicine.

Lab tests, including liver function, kidney function, and complete blood cell counts, may be performed if you use Augmentin for a long period of time. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Augmentin with caution in the elderly; they may be more sensitive to its effects, especially patients with kidney problems.

Use Augmentin with extreme caution in children younger than 10 years old who have diarrhea or an infection of the stomach or bowel.

Augmentin should not be used in children who weigh less than 88 lbs (40 kg); safety and effectiveness in these children have not been confirmed.

Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Augmentin while you are pregnant. Augmentin is found in breast milk. If you are or will be breast-feeding while you use Augmentin, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

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

Diarrhea; nausea; vomiting.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody stools; confusion; dark urine; fever, chills, or persistent sore throat; red, swollen, blistered, or peeling skin; seizures; severe diarrhea; stomach pain or cramps; unusual bruising or bleeding; vaginal discharge or irritation; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

Customers who bought this product also bought

Augmentin (Moxatid)

Augmentin is used for treating infections caused by certain bacteria. Augmentin is a penicillin antibiotic. It works by killing sensitive bacteria.

Use Augmentin as directed by your doctor.

Take Augmentin by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.

To clear up your infection completely, take Augmentin for the full course of treatment. Keep taking it even if you feel better in a few days.

If you miss a dose of Augmentin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Store Augmentin at or below 77 degrees F (25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Augmentin out of the reach of children and away from pets.

Active Ingredient: Amoxicillin/clavulanate potassium.

Do NOT use Augmentin if:

you are allergic to any ingredient in Augmentin or another penicillin antibiotic (eg, ampicillin)

you have a history of liver problems or yellowing of the eyes or skin caused by Augmentin

you have infectious mononucleosis (mono)

you are taking a tetracycline antibiotic (eg, doxycycline)

you have recently received or will be receiving live oral typhoid vaccine.

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

Some medical conditions may interact with Augmentin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

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

if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

if you have allergies to medicines, foods, or other substances

if you have a history of allergies, asthma, hay fever, or hives

if you have had a severe allergic reaction (eg, severe rash, hives, breathing difficulties, dizziness) to a cephalosporin (eg, cephalexin) or another beta-lactam antibiotic (eg, imipenem)

if you have kidney problems or gonorrhea

if you have a history of liver problems or yellowing of the eyes or skin.

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

Anticoagulants (eg, warfarin) because the risk of bleeding may be increased

Probenecid because it may increase the amount of Augmentin in your blood

Chloramphenicol, macrolide antibiotics (eg, erythromycin), sulfonamides (eg, sulfamethoxazole), or tetracycline antibiotics (eg, doxycycline) because they may decrease Augmentin's effectiveness

Methotrexate because the risk of its side effects may be increased by Augmentin

Live oral typhoid vaccine or hormonal birth control (eg, birth control pills) because their effectiveness may be decreased by Augmentin.

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

Important safety information:

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

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

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

Long-term or repeated use of Augmentin may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.

Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.

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

Brown, yellow, or gray tooth discoloration has occurred rarely in some patients taking Augmentin. It occurred most often in children. The discoloration was reduced or removed by brushing or dental cleaning in most cases. Contact your doctor if you experience this effect.

Diabetes patients - Augmentin may cause the results of some tests for urine glucose to be wrong. Ask your doctor before you change your diet or the dose of your diabetes medicine.

Lab tests, including liver function, kidney function, and complete blood cell counts, may be performed if you use Augmentin for a long period of time. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Augmentin with caution in the elderly; they may be more sensitive to its effects, especially patients with kidney problems.

Use Augmentin with extreme caution in children younger than 10 years old who have diarrhea or an infection of the stomach or bowel.

Augmentin should not be used in children who weigh less than 88 lbs (40 kg); safety and effectiveness in these children have not been confirmed.

Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Augmentin while you are pregnant. Augmentin is found in breast milk. If you are or will be breast-feeding while you use Augmentin, check with your doctor. Discuss any possible risks to your baby.

All medicines may cause side effects, but many people have no, or minor, side effects.

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

Diarrhea; nausea; vomiting.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody stools; confusion; dark urine; fever, chills, or persistent sore throat; red, swollen, blistered, or peeling skin; seizures; severe diarrhea; stomach pain or cramps; unusual bruising or bleeding; vaginal discharge or irritation; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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Cardura xl - fda prescribing information, side effects and uses, cardugen

Cardura XL

CARDURA ® XL (doxazosin mesylate extended release tablets) is indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH).

Cardura XL is not indicated for the treatment of hypertension.

Cardura XL Dosage and Administration

General Dosing Information

The initial dose of Cardura XL, 4 mg given once daily, should be administered with breakfast. Depending on the patient's symptomatic response and tolerability, the dose may be increased to 8 mg, the maximum recommended dose. The recommended titration interval is 3–4 weeks. If Cardura XL administration is discontinued for several days, therapy should be restarted using the 4 mg once daily dose. Tablets should be swallowed whole, and must not be chewed, divided, cut, or crushed.

Patients Switching from CARDURA to Cardura XL

If switching from CARDURA immediate-release (IR) to Cardura XL, therapy should be initiated with the lowest dose (4 mg once daily). Prior to starting therapy with Cardura XL, the final evening dose of CARDURA should not be taken.

Concomitant Administration with PDE-5 Inhibitors

Concomitant administration of Cardura XL with a PDE-5 inhibitor can result in additive blood pressure lowering effects and symptomatic hypotension; therefore, PDE-5 inhibitor therapy should be initiated at the lowest dose in patients taking Cardura XL.

Dosage Forms and Strengths

White, round, film-coated tablets containing 4 mg and 8 mg doxazosin mesylate.

Contraindications

Cardura XL is contraindicated in patients with a known hypersensitivity to doxazosin, other quinazolines (e. g. prazosin, terazosin), or any of the inert ingredients. Allergic reactions to doxazosin and other quinazolines have included skin rash, urticaria, pruritus, angioedema, and respiratory symptoms [see Adverse Reactions (6.2) ].

Warnings and Precautions

Postural Hypotension

Postural hypotension with or without symptoms (e. g. dizziness) may develop within a few hours following administration of Cardura XL. However, infrequently, symptomatic postural hypotension has also been reported later than a few hours after dosing. As with other alpha-blockers, there is a potential for syncope, especially after the initial dose or after an increase in dosage strength. Patients should be warned of the possible occurrence of such events and should avoid situations where injury could result should syncope occur. Care should be taken when Cardura XL is administered to patients with symptomatic hypotension or patients who have had a hypotensive response to other medications.

Cataract Surgery

Intraoperative Floppy Iris Syndrome (IFIS) has been observed during cataract surgery in some patients on or previously treated with alpha 1 blockers. This variant of small pupil syndrome is characterized by the combination of a flaccid iris that billows in response to intraoperative irrigation currents, progressive intraoperative miosis despite preoperative dilation with standard mydriatic drugs, and potential prolapse of the iris toward the phacoemulsification incisions. The patient's surgeon should be prepared for possible modifications to their surgical technique, such as the utilization of iris hooks, iris dilator rings, or viscoelastic substances. There does not appear to be a benefit from stopping alpha 1 blocker therapy prior to cataract surgery.

Gastrointestinal Disorders

As with any other non-deformable material, caution should be used when administering Cardura XL to patients with preexisting severe gastrointestinal narrowing (pathologic or iatrogenic). There have been rare reports of obstructive symptoms in patients with known strictures in association with the ingestion of another drug in this non-deformable extended release formulation. Markedly increased GI retention times, as may occur in patients with chronic constipation, can increase systemic exposure to doxazosin and thereby potentially increase adverse reactions.

Prostate Cancer

Carcinoma of the prostate causes many of the same symptoms associated with BPH and the two disorders frequently co-exist. Carcinoma of the prostate should therefore be ruled out prior to commencing therapy with Cardura XL.

PDE-5 Inhibitors

Concomitant administration of Cardura XL with a PDE-5 inhibitor can result in additive blood pressure lowering effects and symptomatic hypotension. Pharmacodynamic interactions between Cardura XL and antihypertensive medications or other vasodilating agents have not been determined.

Patients with Hepatic Impairment

Cardura XL is not recommended for patients with severe hepatic impairment and should be administered with caution to patients with mild or moderate hepatic impairment [see Use in Specific Populations (8.6). Clinical Pharmacology (12.3) ].

Patients with Coronary Insufficiency

Patients with congestive heart failure, angina pectoris, or acute myocardial infarction within the last 6 months were excluded from the Phase 3 studies. If symptoms of angina pectoris should newly appear or worsen, Cardura XL should be discontinued.

CYP 3A4 Inhibitors

Caution should be exercised when concomitantly administering Cardura XL with a strong CYP 3A4 inhibitor, such as atanazavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, or voriconazole.

Priapism

​ Rarely (probably less frequently than once in every several thousand patients), alpha-1 antagonists, including doxazosin, have been associated with priapism (painful penile erection, sustained for hours and unrelieved by sexual intercourse or masturbation). Because this condition can lead to permanent impotence if not promptly treated, patients must be advised about the seriousness of the condition.

Adverse Reactions

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

The incidence of adverse reactions was derived from two controlled efficacy and safety trials involving 1473 BPH patients. In Study 1, Cardura XL (n=317) was compared to doxazosin IR tablets (n=322) and to placebo (n=156). In Study 2, Cardura XL (n=350) was compared just to doxazosin IR tablets (n=330). In both of these studies, Cardura XL was initiated at a dose of 4 mg, which could be increased by the investigator to 8 mg after seven weeks if an adequate response was not seen [see Clinical Studies (14.1) ]. Similarly, doxazosin IR was begun at a dose of 1 mg, which was increased in all patients to 2 mg after 1 week, followed by the option to increase to 4 mg after 4 weeks, and 8 mg after 7 weeks.

The most commonly reported adverse reactions leading to discontinuation in the Cardura XL group were: dizziness, dyspnea, asthenia, headache, hypotension, postural hypotension, and somnolence. The rates of discontinuation for adverse reactions were 6%, 7% and 3% in the Cardura XL, doxazosin IR, and placebo groups, respectively.

Table 1 lists the incidence rates of adverse reactions derived from all reported adverse events in the two controlled studies (Studies 1 and 2) combined, at a rate greater than placebo and in 1% or more of patients treated with Cardura XL.

TABLE 1 Adverse Reactions, Derived from All Adverse Events Exceeding Placebo Rate and Occurring in ≥1% of BPH Patients Treated with Cardura XL

Cardura XL (N = 666)

Additional adverse events reported with Cardura XL, reported by less than 1% of patients, and those of clinical interest include: Cardiovascular System: angina pectoris, syncope, tachycardia, chest pain, palpitations; Digestive System: diarrhea; Musculoskeletal System: arthralgia; Nervous System: libido decreased; Urogenital System: impotence, dysuria.

In general, the adverse events reported in the open-label safety extension, in approximately 295 BPH patients treated for up to 37 weeks, were similar in type and frequency to the events described above in the controlled trials.

Postmarketing Experience

The following adverse events have been identified during post-approval use of doxazosin. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Autonomic Nervous System: priapism; Cardiovascular System: cerebrovascular accidents, dizziness postural, myocardial infarction; Central and Peripheral Nervous System: hypoesthesia, paresthesia ; Endocrine System: gynecomastia; Gastrointestinal System: gastrointestinal obstruction, vomiting ; General Body System: fatigue, hot flushes, malaise ; Heart Rate/Rhythm: bradycardia, cardiac arrhythmias; Hematopoietic: leukopenia, purpura, thrombocytopenia; Liver/Biliary System: abnormal liver function tests, hepatitis, hepatitis cholestatic, jaundice; Musculoskeletal System: muscle cramps, muscle weakness; Psychiatric: agitation, anorexia, nervousness; Respiratory System: bronchospasm aggravated; Skin Disorders: alopecia, urticaria, skin rash, pruritus; Special Senses: blurred vision, Intraoperative Floppy Iris Syndrome [see Warnings and Precautions (5.2) ]; Urinary System: hematuria, micturition disorder, micturition frequency, nocturia, polyuria.

There have been rare reports of gastrointestinal irritation and gastrointestinal bleeding with use of another drug in this non-deformable sustained release formulation, although causal relationship to the drug is uncertain.

Drug Interactions

CYP 3A4 Inhibitors

No in vivo drug interaction studies were conducted with Cardura XL.

In vitro studies suggest that doxazosin is a substrate of CYP 3A4. Caution should be exercised when concomitantly administering Cardura XL with a strong CYP 3A4 inhibitor, such as atanazavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, or voriconazole [see Clinical Pharmacology (12.3) ].

Antihypertensive Medications

Pharmacodynamic interactions between Cardura XL and antihypertensive medications or other vasodilating agents have not been determined.

PDE-5 Inhibitors

Concomitant administration of Cardura XL with a PDE-5 inhibitor can result in additive blood pressure lowering effects and symptomatic hypotension [see Dosage and Administration (2.3) ].

USE IN SPECIFIC POPULATIONS

Pregnancy

Pregnancy Category C: Cardura XL is not indicated for use in women. Doxazosin base was found to cross the placenta following oral administration to pregnant rats, resulting in fetal exposure. There was no evidence of teratogenicity or embryotoxicity in rat or rabbit fetuses at exposures 32- and 13- fold greater than the AUC values for doxazosin base in men given the maximum recommended human dose (MHRD) of 8 mg Cardura XL. Maternal rat and rabbit doses were 20 mg/kg/day or 41 mg/kg/day doxazosin base, respectively, administered during major organ development. Embryolethality was observed in rabbits at a dose of 100 mg/kg/day of doxazosin mesylate when administered during major organ development. There are no adequate and well-controlled studies in pregnant women.

Nonteratogenic Effects: In pre - and postnatal development studies in rats, postnatal development was delayed, as evidenced by body weight gain suppression and a slight delay in the appearance of developmental anatomical landmarks and reflexes at a doxazosin base exposure of 26-fold above the human exposure (AUC) at the MHRD of 8 mg Cardura XL.

Nursing Mothers

Doxazosin base was secreted into the milk in lactating rats at concentrations approximately 20-fold above the exposure found in the maternal plasma following an oral dose of 1 mg/kg. It is not known if doxazosin is excreted in human breast milk. Use of Cardura XL in nursing mothers is not recommended.

Pediatric Use

The safety and effectiveness of Cardura XL in pediatric patients have not been established.

Geriatric Use

The incidence of hypotension with Cardura XL use appears to be age related and more prevalent in patients 70 years or older. At steady state, increases of 27% in maximum plasma concentrations (C max ) and 34% in the area under the concentration-time curve (AUC) were seen in the elderly (>65 years old) compared to the young [see Clinical Pharmacology (12.3) ].

Of the 666 patients with BPH who received Cardura XL in the two controlled clinical efficacy and safety studies, 325 patients (49%) were 65 years of age or older. One hundred thirty-six patients treated with Cardura XL (20%) were >70 years of age.

In these two studies, the cumulative incidence of hypotension appeared to be age related. The reason for an increased incidence of hypotension in patients older than 70 years of age may be related to a modest increase in systemic exposure to doxazosin [see Clinical Pharmacology (12.3) ], to an increased propensity to orthostasis in the elderly, or to an enhanced sensitivity to vasodilatory agents in the elderly. The incidence of hypotension reported as an adverse reaction was higher in patients 70 years of age and older (4/136; 2.9%) as compared to patients < 70 years of age (7/530; 1.3%).

Hepatic Impairment

Since there is no clinical experience in patients with severe hepatic impairment, use in these patients is not recommended. Cardura XL should be administered with caution to patients with mild or moderate hepatic impairment [see Warnings and Precautions (5.6). Clinical Pharmacology (12.3) ].

Overdosage

There is no experience with Cardura XL overdosage. Overdosage experience with the doxazosin IR is limited. Two adolescents who each intentionally ingested 40 mg doxazosin IR with diclofenac or paracetamol were treated with gastric lavage with activated charcoal and made full recoveries. A two-year-old child who accidentally ingested 4 mg doxazosin IR was treated with gastric lavage and remained normotensive during the five-hour emergency room observation period. A six-month-old child accidentally received a crushed 1 mg tablet of doxazosin IR and was reported to have been drowsy. A 32-year-old female with chronic renal failure, epilepsy, and depression intentionally ingested 60 mg doxazosin IR (blood level 0.9 µg/mL; normal values in hypertensives=0.02 µg/mL); death was attributed to a grand mal seizure resulting from hypotension. A 39-year-old female who ingested 70 mg doxazosin IR, alcohol, and Dalmane® (flurazepam) developed hypotension which responded to fluid therapy.

The most likely manifestation of overdosage would be hypotension, for which the usual treatment would be intravenous infusion of fluid, keeping the patient in the supine position, and in certain circumstances, the administration of vasopressors. As doxazosin is highly protein bound, dialysis would not be indicated.

Cardura XL Description

Cardura XL contains doxazosin mesylate which is a quinazoline compound with the chemical name 1-(4-amino-6,7-dimethoxy-2-quinazolinyl)-4-(1,4-benzodioxan-2-ylcarbonyl) piperazine methanesulfonate. The empirical formula for doxazosin mesylate is C 23 H 25 N 5 O 5 • CH 4 O 3 S and the molecular weight is 547.6. It has the following structure:

Cardura XL is an extended release tablet for oral use and is designed to deliver 4 or 8 mg of doxazosin as the free base. Each 4 and 8 mg tablet contains 5.1 and 10.2 mg doxazosin mesylate (includes a 5% overage) to provide 4 and 8 mg doxazosin as a free base, respectively. The inactive ingredients for Cardura XL are: polyethylene oxide, sodium chloride, hypromellose, red ferric oxide, titanium dioxide, magnesium stearate, cellulose acetate, Macrogol®, pharmaceutical glaze, and black iron oxide.

Cardura XL System Components and Performance

Cardura XL is similar in appearance to a conventional tablet. It consists, however, of an osmotically active drug core surrounded by a semipermeable membrane. The core itself is divided into two layers: an "active" layer containing the drug, and a "push" layer containing pharmacologically inert (but osmotically active) components. The membrane surrounding the tablet is permeable to water, but not to drug or osmotic excipients. As water from the gastrointestinal tract enters the tablet, pressure increases in the osmotic layer and "pushes" against the drug layer, resulting in the release of drug through a small, laser-drilled orifice in the membrane on the drug side of the tablet.

Cardura XL utilizes GITS (Gastrointestinal Therapeutic System) which is designed to provide a controlled rate of delivery of doxazosin into the gastrointestinal lumen which is independent of pH or gastrointestinal (GI) motility. The function of Cardura XL depends upon the existence of an osmotic gradient between the contents of the bi-layer core and fluid in the GI tract. Drug delivery is essentially constant as long as the osmotic gradient remains constant, and then gradually falls to zero. The biologically inert components of the tablet remain intact during GI transit and are eliminated in the feces as an insoluble shell.

Cardura XL - Clinical Pharmacology

Mechanism of Action

The symptoms associated with benign prostatic hyperplasia (BPH), such as urinary frequency, nocturia, weak stream, hesitancy, and incomplete emptying are related to two components, anatomical (static) and functional (dynamic). The static component is related to an increase in prostate size caused, in part, by a proliferation of smooth muscle cells in the prostatic stroma. However, the severity of BPH symptoms and the degree of urethral obstruction do not correlate well with the size of the prostate. The dynamic component of BPH is associated with an increase in smooth muscle tone in the prostate and bladder neck. The degree of tone in this area is mediated by the alpha 1 adrenoceptor, which is present in high density in the prostatic stroma, prostatic capsule, and bladder neck. Blockade of the alpha 1 receptor decreases urethral resistance and may relieve the BPH symptoms and improve urine flow. Doxazosin mesylate is a selective inhibitor of the alpha 1 - subtype of alpha adrenergic receptors. In the human prostate, doxazosin mesylate antagonizes phenylephrine (alpha 1 agonist)-induced contractions, in vitro, and binds with high affinity to the alpha 1A adrenoceptor.

Pharmacodynamics

Administration of Cardura XL to patients with symptomatic BPH resulted in a statistically significant improvement in maximum urinary flow rate [ see Clinical Studies (14.1) ].

Pharmacokinetics

The pharmacokinetics of Cardura XL is different from that of doxazosin IR. Cardura XL provides a controlled release of doxazosin over a 24-hour period.

Absorption: Pharmacokinetic parameters describing absorption following 4 and 8 mg Cardura XL daily doses are reported in Table 2 below. The relative bioavailability of Cardura XL compared with doxazosin IR was 54% at the 4 mg dose and 59% for the 8 mg dose.

TABLE 2 Mean (±SD) Plasma Concentration of Doxazosin at Steady State in Healthy Volunteers: Pharmacokinetic Parameters

Cardura XL (4 mg)

Food Effect: As illustrated in Figure 1, the plasma C max and AUC were approximately 32% and 18% higher, respectively, after Cardura XL was administered in the fed state compared with the fasted state. In order to provide the most consistent exposure, Cardura XL should be administered with breakfast [see Dosage and Administration (2.1) ].

GI Retention Time Effect: Markedly reduced GI retention times (e. g. short bowel syndrome) may influence the pharmacokinetics of Cardura XL and possibly result in lower plasma concentrations. Conversely, markedly prolonged GI retention times (e. g. chronic constipation) can increase systemic exposure to doxazosin and potentially result in increased adverse reactions [see Warnings and Precautions (5.3) ].

Distribution: At the plasma concentrations achieved by therapeutic doses, approximately 98% of the circulating drug is bound to plasma proteins.

Metabolism: Doxazosin is extensively metabolized in the liver. In vitro studies suggest that the primary pathway for elimination is via CYP 3A4; however, CYP 2D6 and CYP 2C9 metabolic pathways also exist to a lesser extent. No in vivo drug interaction studies have been performed with Cardura XL. Although several active metabolites of doxazosin have been identified, the pharmacokinetics of these metabolites has not been characterized [see Drug Interactions (7) ].

Excretion: In a study of two subjects administered radiolabeled doxazosin IR 2 mg orally and 1 mg intravenously on two separate occasions, approximately 63% of the dose was eliminated in the feces and 9% of the dose was found in the urine. On average, only 4.8% of the dose was excreted as unchanged drug in the feces and only a trace of the total radioactivity in the urine was attributed to unchanged drug. The apparent elimination half-life of Cardura XL is 15–19 hours.

No in vivo drug-drug interaction studies have been performed to assess the effect of concomitant medications on the pharmacokinetics of Cardura XL or to assess the effect of Cardura XL on the pharmacokinetics of other drugs. In vitro studies suggest that doxazosin is a substrate of CYP 3A4. Caution should be exercised when concomitantly administering Cardura XL with a strong CYP 3A4 inhibitor, such as atanazavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, or voriconazole

In one placebo-controlled trial in normal volunteers, the administration of a single 1 mg dose of doxazosin IR on day 1 of a four day regimen of cimetidine (400 mg twice daily) resulted in a 10% increase in the mean AUC of doxazosin, a 6% increase in mean C max of doxazosin, and no significant change in mean half-life of doxazosin. Based upon the differences in dose and formulation, the applicability of these results to Cardura XL is unknown. Otherwise, the interaction potential with other inhibitors or substrates of CYP enzymes has not been determined. Pharmacodynamic interactions between Cardura XL and anti-hypertensive medications or other vasodilating agents have also not been determined. Finally, drugs which reduce gastrointestinal motility leading to markedly prolonged GI retention times (e. g. anticholinergic agents) may increase systemic exposure to doxazosin.

Use in Specific Populations

Geriatric: In a study to assess the effect of age on the pharmacokinetics of Cardura XL, increases of 27% in plasma C max and 34% in the plasma AUC were seen at steady state in the elderly (>65 years old) compared to the young [see Use in Specific Populations (8.5) ].

Hepatic Impairment: Administration of a single 2 mg dose of doxazosin IR to patients with mild hepatic impairment (Child-Pugh Class A) showed a 40% increase in exposure to doxazosin compared to patients without hepatic impairment. No studies have been performed to assess the effect of hepatic impairment on the pharmacokinetics of Cardura XL. Use in patients with severe hepatic impairment is not recommended. Cardura XL should be administered with caution to patients with evidence of mild or moderately impaired hepatic function or to patients receiving drugs known to influence hepatic metabolism.

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment of Fertility

Carcinogenesis and Mutagenesis: Doxazosin mesylate was not carcinogenic to rats or mice when administered daily for 2 years at doses up to 40 mg/kg/day or 120 mg/kg/day, respectively. Systemic drug exposures, as measured by AUC, were approximately 34-fold in rats and 16-fold in mice above the exposures at the maximum human recommended dose (MHRD) of 8 mg Cardura XL.

Doxazosin base was not mutagenic in the in vitro bacterial Ames assays, the chromosomal aberration assay in human lymphocytes, or the mouse lymphoma assay. Doxazosin was not clastogenic in the in vivo mouse micronucleus assay. Doxazosin mesylate has not been evaluated for genotoxicity.

Fertility in Males. Studies in rats after oral administration of doxazosin base showed reduced fertility in males, which was reversible after two weeks of treatment termination at doxazosin base exposure of 13-fold above the human exposure (AUC) at the MHRD of 8 mg Cardura XL. There have been no reports of any effects of doxazosin on male fertility in humans.

Cardiac Toxicity in Animals

Studies in Sprague-Dawley rats after 6, 12, and 18 months, and in CD-1 mice after 18 months of dietary administration, showed an increased incidence of myocardial necrosis or fibrosis at doxazosin base exposure of 26-fold above the human exposure (AUC) at the MHRD of 8 mg Cardura XL. No cardiotoxicity was observed in dogs or Wistar rats after 12 months of oral dosing at doxazosin base exposures of 65- and 85-fold, respectively, above the human exposure (C max ) at the MHRD of 8 mg Cardura XL. There is no evidence that similar lesions occur in humans.

Clinical Studies

Studies in Patients with BPH

Two controlled clinical studies were conducted with Cardura XL in BPH patients, followed by an open-label extension study. Study 1 was a randomized, double-blind, parallel-group, placebo - and active-controlled study that compared the safety and efficacy of Cardura XL (4 or 8 mg/day) with that of doxazosin IR (1, 2, 4, or 8 mg/day) and placebo over 13 weeks in 795 BPH patients, of whom 317 were randomized to Cardura XL. Study 2 was a randomized, double-blind, parallel-group, active-controlled study that compared the safety and efficacy of Cardura XL (4 or 8 mg/day) with that of doxazosin IR (1, 2, 4, or 8 mg/day) over 13 weeks in 680 BPH patients, of whom 350 were randomized to Cardura XL.

In both studies, men aged 50–80 years with symptomatic benign prostatic hyperplasia (BPH) were enrolled. Symptomatic BPH was defined as a total score of at least 12 points on the 35-point International Prostate Symptom Score (IPSS) and a maximum urinary flow rate of ≤ 15 mL/sec but no less than 5 mL/sec (total voided volume ≥ 150 mL). In these two studies, conducted in a total of 1475 patients, the mean age was 64 years (range 47–83 years). Patients were Caucasian (96%), Black (1.5%), Asian (1.5%), and of Other ethnicity (1%).

In both studies, Cardura XL dosing was initiated after a 2 week placebo run-in period at 4 mg per day increasing to 8 mg per day after 7 weeks of treatment if adequate response (defined as having both an increase in maximum urinary flow rate of at least 3 mL/sec and a decrease in total IPSS of at least 30% from baseline) was not seen. Doxazosin IR was titrated from an initial dose of 1 mg daily to 2 mg daily after 1 week with the option to increase to 4 mg daily after 3 weeks and then to a maximum of 8 mg daily after 7 weeks if an adequate response was not seen. The final daily dose of Cardura XL was 4 mg in 43% of patients and 8 mg in 57% of patients. The final daily dose of doxazosin IR was 1 mg in 1%, 2 mg in 12%, 4 mg in 30%, and 8 mg in 57% of patients.

There were two primary efficacy variables in each of these two controlled clinical studies: the total International Prostate Symptom Score (IPSS) and the peak urinary flow rate (Q max ). The IPSS consists of seven questions that assess the severity of both irritative (frequency, urgency, nocturia) and obstructive (incomplete emptying, stopping and starting, weak stream, and pushing or straining) symptoms, with possible total scores ranging from 0 to 35. The Q max was measured in both studies just prior to the next dose. The results for total symptom score are given in Table 3, and for maximum urinary flow rate in Table 4.

TABLE 3 TOTAL INTERNATIONAL PROSTATE SYMPTOM SCORE (IPSS)*

MEAN BASELINE (±SD)

Mean changes in IPSS scores for Cardura XL and placebo in Study 1 are summarized in Figure 2.

Mean changes in maximum urinary flow rate (Q max ) for both Cardura XL and placebo in Study 1 are summarized in Figure 3.

How Supplied/Storage and Handling

Cardura XL (doxazosin mesylate extended release tablets) is available as 4 mg (white, imprinted with CXL 4) and 8 mg (white, imprinted with CXL 8) tablets.

Bottle of 30: 4 mg (NDC 0049-2710-30)

Bottle of 30: 8 mg (NDC 0049-2720-30)

Recommended Storage: Store at 25°C (77°F); excursions permitted to 15–30°C (59–86°F) [see USP Controlled Room Temperature].

Patient Counseling Information

Postural Hypotension

Patients should be told about the possible occurrence of symptoms related to postural hypotension, such as dizziness or syncope, when beginning therapy or when increasing dosage strength of Cardura XL. Patients should be cautioned about driving, operating machinery, or performing hazardous tasks during this period, until the drug's effect has been determined.

Priapism

Inform the patient about the possibility of priapism as a result of treatment with Cardura XL extended release tablets and other similar medications. Patients should be informed that this reaction is extremely rare, but if not brought to immediate medical attention, can lead to permanent erectile dysfunction.

Tablet Administration

Patients should be informed that Cardura XL extended release tablets should be swallowed whole. Patients should not chew, divide, cut, or crush tablets.

Dosing Interval

Cardura XL should be taken each day with breakfast.

Tablet Elimination

Patients should not be concerned if they occasionally notice in their stool something that looks like a tablet. In the Cardura XL extended release tablet, the medication is contained within a nonabsorbable shell designed to release the drug at a controlled rate. When this process is completed, the empty tablet is eliminated from the body.

PATIENT INFORMATION CARDURA ® XL (kar-DUR-a eks el) (doxazosin mesylate) Tablets

Read this Patient Information leaflet before you start taking Cardura XL and each time you get a refill. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.

What is Cardura XL?

Cardura XL is a prescription medicine called an "alpha-blocker." Cardura XL is used to treat the symptoms of benign prostatic hyperplasia (BPH). Cardura XL may help to relax the muscles in the prostate and the bladder which may lessen the symptoms of BPH and improve urine flow.

Before prescribing Cardura XL, your healthcare provider may examine your prostate gland and do a blood test called a prostate specific antigen (PSA) test to check for prostate cancer. Prostate cancer and BPH can cause the same symptoms. Prostate cancer needs a different treatment.

Some medicines called "alpha-blockers" are used to treat high blood pressure. Cardura XL is not for the treatment of high blood pressure.

It is not known if Cardura XL is safe and effective in children.

Who should not take Cardura XL?

Do not take Cardura XL if you are allergic to doxazosin, other medications called quinazolones, or any of the ingredients in Cardura XL. See the end of this leaflet for a complete list of ingredients in Cardura XL.

What should I tell my healthcare provider before taking Cardura XL?

Before you take Cardura XL, tell your healthcare provider if you:

have or have had low blood pressure, especially after taking another medicine. Signs of low blood pressure are fainting, dizziness, and lightheadedness.

plan to have cataract surgery

have stomach problems

have prostate cancer

have liver problems

have heart problems

Tell your healthcare provider about all the medicines you take. including prescription and non-prescription medicines, vitamins, and herbal supplements.

Cardura XL may affect the way other medicines work, and other medicines may affect how Cardura XL works.

Especially tell your healthcare provider if you take:

a medicine to treat an infection

a medicine to treat HIV

a medicine to treat depression

a medicine to treat erectile dysfunction (ED)

Ask your healthcare provider or pharmacist if you are not sure if your medicine is one of those listed above.

Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

How should I take Cardura XL?

Take Cardura XL exactly as your healthcare provider tells you to take it.

Take Cardura XL 1 time each day with your breakfast.

Take Cardura XL tablets whole. Do not chew, divide, cut, or crush Cardura XL tablets before swallowing. If you cannot swallow Cardura XL tablets whole, tell your healthcare provider. You may need a different medicine.

Cardura XL tablets have an outside shell that helps to release the medicine inside over time. You may see the empty Cardura XL tablet in your stool (bowel movement). This is normal.

If you take too much CARDURA XL, call your healthcare provider or go to the nearest hospital emergency room right away.

What should I avoid while taking Cardura XL?

Do not drive, operate machinery, or do other dangerous activities until you know how Cardura XL affects you. Cardura XL can cause dizziness, weakness, or fainting.

What are the possible side effects of Cardura XL?

Cardura XL may cause serious side effects including :

a sudden drop in blood pressure (postural hypotension). Postural hypotension can happen at any time while you take Cardura XL. The chance of having postural hypotension is higher a few hours after you take Cardura XL or if you start taking a higher dose. Symptoms of postural hypotension may happen after you stand up from a lying or sitting position and may include:

dizziness or

fainting or

feeling light-headed

You should get up slowly from a chair or bed until you know how Cardura XL will affect you. If you begin to feel dizzy or lightheaded, sit or lie down with your legs and feet up. If your symptoms do not get better call your healthcare provider.

intraoperative floppy iris syndrome (IFIS). IFIS can happen during eye surgery to people who are taking or have taken alpha-blockers such as Cardura XL. If you have an eye surgery for a clouding of the eye (cataract) planned, tell your eye doctor that you are using Cardura XL or have taken an alpha-blocker before.

blockage of the digestive tract. There have been rare reports of symptoms of blockage in the digestive tract in patients with prior history of narrowing or blockage of the digestive tract. These symptoms are severe and persistent abdominal pain/cramping/bloating. If you know you have a narrowing of your digestive tract and you experience these symptoms, contact your healthcare provider.

prolonged erection of the penis. Extremely rarely, Cardura XL and similar medications have caused painful erection of the penis, sustained for hours and unrelieved by sexual intercourse or masturbation. This condition is serious, and if untreated it can be followed by permanent inability to have an erection. If you have a prolonged abnormal erection, call your doctor or go to an emergency room as soon as possible.

The most common side effects of Cardura XL include:

Call your healthcare provider if you get any side effect that bothers you or that does not go away.

These are not all the possible side effects of Cardura XL. For more information ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How should I store Cardura XL?

Store Cardura XL at 59°F to 86°F (15°C to 30°C).

Keep Cardura XL and all medicines out of reach of children.

General information about the safe and effective use of Cardura XL.

Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use Cardura XL for a condition for which it was not prescribed. Do not give Cardura XL to other people, even if they have the same symptoms you have. It may harm them.

This Patient Information leaflet summarizes the most important information about Cardura XL. If you would like more information, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for information about Cardura XL that is written for health professionals.

For more information, call 1-800-438-1985.

What are the ingredients in Cardura XL?

Active Ingredient: doxazosin mesylate

Inactive Ingredients: polyethylene oxide, sodium chloride, hypromellose, red ferric oxide, titanium dioxide, magnesium stearate, cellulose acetate, Macrogol®, pharmaceutical glaze, and black iron oxide.

LAB-0425-2.0 June 2015

PRINCIPAL DISPLAY PANEL - 4 mg Tablet Bottle Label

Pfizer NDC 0049-2710-30

Cardura ® XL (doxazosin mesylate extended release tablets)

30 Tablets Rx only

PRINCIPAL DISPLAY PANEL - 8 mg Tablet Bottle Label

Pfizer NDC 0049-2720-30

Cardura ® XL (doxazosin mesylate extended release tablets)

30 Tablets Rx only

Esofag-d tablet micro labs use, composition, dosage, side effect, price and review - tablet tree, es

Esofag-D

Esofag D Capsule - Uses, Composition, Dosage, Side Effects & Reviews

Esofag D is specifically considered as best for the treatment of acid reflux. Acid reflux is one of the common problems nowadays which causes excessive acid production in the stomach. Sometimes, the acid produced in the stomach moves up into the esophagus. This may cause the symptoms like heartburn and if this symptom persists for more than twice a week, it may lead to gastroesophageal reflux disease. It also causes indigestion and stomach ulcers. Thus, this problems requires an effective treatment. This drug contains Domperidone and Esomeprazole as its active ingredients which work together to give you instant relief from acidity.

Now use this medicine and cure your acid reflux with its regular use. Buy it online on discount at Tablet Tree.

Esofag D Capsule Uses

Domperidone . It belongs to a class of medications called anti-emetics. It works by facilitating the bowel movement through the food pipe thus improving the digestion process. Esomeprazole . It basically acts as a proton pump inhibitor. It works by blocking the activity of proton pump in the stomach thus reducing the excessive acid production in the stomach.

Esofag D Capsule Composition

Each 30 mg / 40 mg Esofag D contains:

Domperidone. 30 mg

Esomeprazole. 40 mg

Esofag D Capsule Dosage

The recommended dose for the treatment of GERD is 20 or 40 mg given once daily for 4-8 weeks. The recommended dose for the treatment of Zollinger-Ellison syndrome is 40 mg twice daily. Please consult your doctor and follow his or her recommendations. Please do not self medicate.

Esofag D Capsule Side Effects

The side effects are the secondary or typical negative or irrelevant response of a drug on your body. The common side effects which can occur after taking this medicine are allergic reactions, anaphylactic shock, angioedema, increased prolactin levels, nervousness, convulsions, headache, rash, galactorrhoea, ventricular arrhythmias and abnormal liver function test. Consult your doctor or physician for the exact dose and duration.

Pharmaceutical Form

Precautions

Read these precautions carefully before taking this medicine:

Caution should be exercised for children, pregnant and lactating women

It may lead to liver impairment

It may lead to increased risk of developing infections

Monitor patients on warfarin or phenytoin therapy

Drug-Drug Interactions

Drug interaction is a condition in which one drug increases or decreases the activity of another drug when both are administered together. This medicine interacts with these drugs:

Contraindications

It is advisable not to use this medicine in these conditions:

Hypersensitivity to any of its components

Gastrointestinal obstruction

Gastroesophageal reflux disease

Oesophagitis

Gastric and duodenal ulcer

Package Content

Each 30 mg / 40 mg Esofag contains 10 capsules

Manufacturer

Ask questions on Esofag-D to help and support people like you.

Please login to ask a question to our registered phramacists, product experts and the TabletTree. com community. Click here to login.

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Work with Us

About

Discover

Disclaimer: In compliance with the Indian Government's Drug and Cosmetic Act and Rules, we do not process requests for Schedule X and other habit forming drugs. For Schedule H and H1 drugs, you will need to upload a valid prescription from a registered medical practitioner before we can process your order.

The information contained on this page is only an educational aid. This information does not intend to be medical advice for individual conditions or treatment. 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. This information is not a substitute for a medical exam, doctor visit or any services provided by medical or healing professionals. Only your doctor can provide you safe and effective advice based on your own physical conditions or symptoms. The use of the www. tablettree. com is at your risk. These products or information are provided as-is and without any warranties of any kind, either expressed or implied. www. tablettree. com makes no representation or warranty to the accuracy or completeness of any of the information. www. tablettree. com makes no warranties to the opinions or services or data that you may access as a result of using our website. All implied warranties are hereby excluded. www. tablettree. com does not assume any responsibility or risk for your use of www. tablettree. com.

Esofag-D

Esofag D Capsule - Uses, Composition, Dosage, Side Effects & Reviews

Esofag D is specifically considered as best for the treatment of acid reflux. Acid reflux is one of the common problems nowadays which causes excessive acid production in the stomach. Sometimes, the acid produced in the stomach moves up into the esophagus. This may cause the symptoms like heartburn and if this symptom persists for more than twice a week, it may lead to gastroesophageal reflux disease. It also causes indigestion and stomach ulcers. Thus, this problems requires an effective treatment. This drug contains Domperidone and Esomeprazole as its active ingredients which work together to give you instant relief from acidity.

Now use this medicine and cure your acid reflux with its regular use. Buy it online on discount at Tablet Tree.

Esofag D Capsule Uses

Domperidone . It belongs to a class of medications called anti-emetics. It works by facilitating the bowel movement through the food pipe thus improving the digestion process. Esomeprazole . It basically acts as a proton pump inhibitor. It works by blocking the activity of proton pump in the stomach thus reducing the excessive acid production in the stomach.

Esofag D Capsule Composition

Each 30 mg / 40 mg Esofag D contains:

Domperidone. 30 mg

Esomeprazole. 40 mg

Esofag D Capsule Dosage

The recommended dose for the treatment of GERD is 20 or 40 mg given once daily for 4-8 weeks. The recommended dose for the treatment of Zollinger-Ellison syndrome is 40 mg twice daily. Please consult your doctor and follow his or her recommendations. Please do not self medicate.

Esofag D Capsule Side Effects

The side effects are the secondary or typical negative or irrelevant response of a drug on your body. The common side effects which can occur after taking this medicine are allergic reactions, anaphylactic shock, angioedema, increased prolactin levels, nervousness, convulsions, headache, rash, galactorrhoea, ventricular arrhythmias and abnormal liver function test. Consult your doctor or physician for the exact dose and duration.

Pharmaceutical Form

Precautions

Read these precautions carefully before taking this medicine:

Caution should be exercised for children, pregnant and lactating women

It may lead to liver impairment

It may lead to increased risk of developing infections

Monitor patients on warfarin or phenytoin therapy

Drug-Drug Interactions

Drug interaction is a condition in which one drug increases or decreases the activity of another drug when both are administered together. This medicine interacts with these drugs:

Contraindications

It is advisable not to use this medicine in these conditions:

Hypersensitivity to any of its components

Gastrointestinal obstruction

Gastroesophageal reflux disease

Oesophagitis

Gastric and duodenal ulcer

Package Content

Each 30 mg / 40 mg Esofag contains 10 capsules

Manufacturer

Ask questions on Esofag-D to help and support people like you.

Please login to ask a question to our registered phramacists, product experts and the TabletTree. com community. Click here to login.

User Reviews for Esofag-D. Your feedback matters.

Please login to write a review for Esofag-D. Let your friends, family and the community know about problems, pre-cautions or side effects that you have faced using this product. Click here to login.

Work with Us

About

Discover

Disclaimer: In compliance with the Indian Government's Drug and Cosmetic Act and Rules, we do not process requests for Schedule X and other habit forming drugs. For Schedule H and H1 drugs, you will need to upload a valid prescription from a registered medical practitioner before we can process your order.

The information contained on this page is only an educational aid. This information does not intend to be medical advice for individual conditions or treatment. 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. This information is not a substitute for a medical exam, doctor visit or any services provided by medical or healing professionals. Only your doctor can provide you safe and effective advice based on your own physical conditions or symptoms. The use of the www. tablettree. com is at your risk. These products or information are provided as-is and without any warranties of any kind, either expressed or implied. www. tablettree. com makes no representation or warranty to the accuracy or completeness of any of the information. www. tablettree. com makes no warranties to the opinions or services or data that you may access as a result of using our website. All implied warranties are hereby excluded. www. tablettree. com does not assume any responsibility or risk for your use of www. tablettree. com.

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