Fluconazole dosage guide with precautions, candivast

Fluconazole Dosage

Additional dosage information:

Usual Adult Dose for Vaginal Candidiasis

150 mg orally as a single dose

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

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

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

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

Usual Adult Dose for Oral Thrush

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

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

Comments : - Recommended as primary therapy

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

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

Usual Adult Dose for Candidemia

Doses up to 400 mg/day have been used.

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

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

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

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

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

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

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

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

Usual Adult Dose for Fungal Pneumonia

Doses up to 400 mg/day have been used.

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

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

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

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

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

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

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

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

Usual Adult Dose for Fungal Infection - Disseminated

Doses up to 400 mg/day have been used.

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

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

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

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

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

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

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

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

Usual Adult Dose for Systemic Candidiasis

Doses up to 400 mg/day have been used.

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

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

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

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

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

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

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

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

Usual Adult Dose for Esophageal Candidiasis

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

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

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

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

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

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

Usual Adult Dose for Candida Urinary Tract Infection

50 to 200 mg IV or orally once a day

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

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

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

Usual Adult Dose for Fungal Peritonitis

50 to 200 mg IV or orally once a day

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

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

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

Usual Adult Dose for Cryptococcal Meningitis - Immunocompetent Host

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

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

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

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

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

Usual Adult Dose for Cryptococcal Meningitis - Immunosuppressed Host

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

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

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

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

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

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

Comments : - Preferred agent

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

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

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

Usual Adult Dose for Cryptococcosis

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

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

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

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

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

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

Usual Adult Dose for Fungal Infection Prophylaxis

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

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

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

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

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

Usual Adult Dose for Coccidioidomycosis - Meningitis

IDSA Recommendations: 400 mg orally once a day

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

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

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

Usual Adult Dose for Coccidioidomycosis

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

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

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

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

Usual Adult Dose for Histoplasmosis

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

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

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

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

Usual Adult Dose for Blastomycosis

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

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

Usual Adult Dose for Onychomycosis - Fingernail

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

Usual Adult Dose for Onychomycosis - Toenail

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

Usual Adult Dose for Sporotrichosis

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

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

Usual Pediatric Dose for Esophageal Candidiasis

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

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

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

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

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

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

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

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

Usual Pediatric Dose for Oral Thrush

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

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

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

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

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

Usual Pediatric Dose for Candidemia

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

Use: For the treatment of candidemia and disseminated Candida infections

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

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

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

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

CNS candidiasis (after initial regimen of IV amphotericin B): 6 to 12 mg/kg IV or orally once a day Duration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolve

Candida cardiovascular system infection: 6 to 12 mg/kg IV or orally once a day Duration of therapy : - Endocarditis: Lifelong suppressive therapy may be indicated. - Pericarditis or myocarditis: Often several months - Suppurative thrombophlebitis: At least 2 weeks after candidemia cleared - Infected pacemaker, ICD, or VAD: 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removed

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

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children : Invasive disease in infants and children (all ages): 12 mg/kg IV once a day Maximum dose: 600 mg/dose Duration of therapy: Based on presence of deep-tissue foci and clinical response - Uncomplicated candidemia: At least 2 weeks after last positive blood culture

Secondary prophylaxis: 3 to 6 mg/kg IV or orally once a day Maximum dose: 200 mg/dose

Comments : - Recommended as alternative therapy in critically ill patients with invasive disease - Recommended as preferred therapy in patients with invasive disease who are not critically ill; this drug should be avoided for Candida krusei and C glabrata. - Secondary prophylaxis may be considered for frequent or severe recurrences of candidiasis; not routinely recommended.

Usual Pediatric Dose for Fungal Infection - Disseminated

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

Use: For the treatment of candidemia and disseminated Candida infections

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

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

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

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

CNS candidiasis (after initial regimen of IV amphotericin B): 6 to 12 mg/kg IV or orally once a day Duration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolve

Candida cardiovascular system infection: 6 to 12 mg/kg IV or orally once a day Duration of therapy : - Endocarditis: Lifelong suppressive therapy may be indicated. - Pericarditis or myocarditis: Often several months - Suppurative thrombophlebitis: At least 2 weeks after candidemia cleared - Infected pacemaker, ICD, or VAD: 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removed

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

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children : Invasive disease in infants and children (all ages): 12 mg/kg IV once a day Maximum dose: 600 mg/dose Duration of therapy: Based on presence of deep-tissue foci and clinical response - Uncomplicated candidemia: At least 2 weeks after last positive blood culture

Secondary prophylaxis: 3 to 6 mg/kg IV or orally once a day Maximum dose: 200 mg/dose

Comments : - Recommended as alternative therapy in critically ill patients with invasive disease - Recommended as preferred therapy in patients with invasive disease who are not critically ill; this drug should be avoided for Candida krusei and C glabrata. - Secondary prophylaxis may be considered for frequent or severe recurrences of candidiasis; not routinely recommended.

Usual Pediatric Dose for Systemic Candidiasis

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

Use: For the treatment of candidemia and disseminated Candida infections

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

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

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

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

CNS candidiasis (after initial regimen of IV amphotericin B): 6 to 12 mg/kg IV or orally once a day Duration of therapy: Until all signs/symptoms and CSF and radiologic abnormalities resolve

Candida cardiovascular system infection: 6 to 12 mg/kg IV or orally once a day Duration of therapy : - Endocarditis: Lifelong suppressive therapy may be indicated. - Pericarditis or myocarditis: Often several months - Suppurative thrombophlebitis: At least 2 weeks after candidemia cleared - Infected pacemaker, ICD, or VAD: 4 to 6 weeks after device removed; chronic suppressive therapy if VAD not removed

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

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children : Invasive disease in infants and children (all ages): 12 mg/kg IV once a day Maximum dose: 600 mg/dose Duration of therapy: Based on presence of deep-tissue foci and clinical response - Uncomplicated candidemia: At least 2 weeks after last positive blood culture

Secondary prophylaxis: 3 to 6 mg/kg IV or orally once a day Maximum dose: 200 mg/dose

Comments : - Recommended as alternative therapy in critically ill patients with invasive disease - Recommended as preferred therapy in patients with invasive disease who are not critically ill; this drug should be avoided for Candida krusei and C glabrata. - Secondary prophylaxis may be considered for frequent or severe recurrences of candidiasis; not routinely recommended.

Usual Pediatric Dose for Cryptococcal Meningitis - Immunocompetent Host

Acute infection : 2 weeks or younger (gestational age 26 to 29 weeks): 6 mg/kg IV or orally every 72 hours Older than 2 weeks: 12 mg/kg IV or orally on the first day followed by 6 mg/kg IV or orally once a day Duration of therapy: 10 to 12 weeks after CSF culture is negative

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

IDSA Recommendations : CNS infection in children : - Consolidation therapy (after induction therapy): 10 to 12 mg/kg orally once a day for 8 weeks - Maintenance therapy: 6 mg/kg orally once a day

Comments : - Preferred agent - Maintenance therapy is recommended to prevent relapse.

Usual Pediatric Dose for Cryptococcal Meningitis - Immunosuppressed Host

Acute infection : 2 weeks or younger (gestational age 26 to 29 weeks): 6 mg/kg IV or orally every 72 hours Older than 2 weeks: 12 mg/kg IV or orally on the first day followed by 6 mg/kg IV or orally once a day Duration of therapy: 10 to 12 weeks after CSF culture is negative

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

Suppression of relapse in children with AIDS: 6 mg/kg IV or orally once a day

IDSA Recommendations for children : CNS disease : - Consolidation therapy (after induction therapy): 10 to 12 mg/kg/day orally in 2 divided doses for 8 weeks - Maintenance therapy in HIV-infected patients: 6 mg/kg orally once a day

Comments : - Preferred agent - Maintenance therapy is recommended to prevent relapse.

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children : Acute therapy (induction): 12 mg/kg IV or orally on the first day followed by 10 to 12 mg/kg IV or orally once a day Maximum dose: 800 mg/dose Duration of therapy: At least 2 weeks

Consolidation therapy: 12 mg/kg IV or orally on the first day followed by 10 to 12 mg/kg IV or orally once a day Maximum dose: 800 mg/dose Duration of therapy: At least 8 weeks

Secondary prophylaxis: 6 mg/kg orally once a day Maximum dose: 200 mg/dose Duration of therapy: At least 1 year

Comments : - Recommended in alternative regimens for acute therapy if flucytosine not tolerated or unavailable or amphotericin B-based therapy not tolerated - Recommended as preferred agent for consolidation therapy; should be followed by secondary prophylaxis - Recommended as preferred therapy for secondary prophylaxis

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

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

Usual Pediatric Dose for Cryptococcosis

IDSA Recommendations for children : Disseminated disease : - Consolidation therapy (after induction therapy): 10 to 12 mg/kg/day orally in 2 divided doses for 8 weeks - Maintenance therapy in HIV-infected patients: 6 mg/kg orally once a day

Cryptococcal pneumonia: 6 to 12 mg/kg orally once a day for 6 to 12 months

Comments : - Preferred agent - Maintenance therapy is recommended to prevent relapse.

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children : Localized disease (including isolated pulmonary disease [non-CNS]), disseminated disease (non-CNS), or severe pulmonary disease: 12 mg/kg IV or orally on the first day followed by 6 to 12 mg/kg IV or orally once a day Maximum dose: 600 mg/dose Duration of therapy: Based on site and severity of infection and clinical response

Secondary prophylaxis: 6 mg/kg orally once a day Maximum dose: 200 mg/dose Duration of therapy: At least 1 year

Comments : - Recommended as preferred therapy for localized disease and secondary prophylaxis - Recommended as alternative therapy for disseminated disease and severe pulmonary disease

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

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

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

Usual Pediatric Dose for Fungal Infection Prophylaxis

IDSA Recommendations : Empiric therapy for suspected candidiasis in nonneutropenic or neutropenic patients: 12 mg/kg IV or orally on the first day followed by 6 mg/kg IV or orally once a day Duration of therapy : - Nonneutropenic patients: Uncertain; should discontinue if cultures and/or serodiagnostic test results negative

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

Usual Pediatric Dose for Candida Urinary Tract Infection

IDSA Recommendations : - Asymptomatic cystitis in patients undergoing urologic procedures: 3 to 6 mg/kg IV or orally once a day for several days before and after the procedure - Symptomatic cystitis: 3 mg/kg IV or orally once a day for 2 weeks - Pyelonephritis: 3 to 6 mg/kg IV or orally once a day for 2 weeks - Urinary fungus balls: 3 to 6 mg/kg IV or orally once a day until symptoms resolve and urine cultures clear of Candida

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

Usual Pediatric Dose for Coccidioidomycosis - Meningitis

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children : Meningeal infection: 12 mg/kg IV or orally once a day Maximum dose: 800 mg/dose

Secondary prophylaxis: 6 mg/kg orally once a day Maximum dose: 400 mg/dose Duration of therapy: Lifelong

Comments : - Recommended as preferred therapy - Secondary prophylaxis should follow treatment of meningeal infection.

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

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

Usual Pediatric Dose for Coccidioidomycosis

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children : Severe illness with respiratory compromise due to diffuse pulmonary or disseminated nonmeningeal infection: 12 mg/kg IV or orally once a day Maximum dose: 800 mg/dose Duration of therapy: 1 year total

Mild to moderate nonmeningeal infection (e. g. focal pneumonia): 6 to 12 mg/kg IV or orally once a day Maximum dose: 400 mg/dose

Secondary prophylaxis: 6 mg/kg orally once a day Maximum dose: 400 mg/dose Duration of therapy: Lifelong in patients with disseminated disease

Comments : - Recommended as alternative therapy for severe illness with respiratory compromise due to diffuse pulmonary or disseminated nonmeningeal infection; should be followed by secondary prophylaxis - After patient with severe illness with respiratory compromise due to diffuse pulmonary or disseminated nonmeningeal infection is stabilized using the preferred regimen, may switch to fluconazole to complete therapy (total duration: 1 year) - Recommended as preferred therapy for secondary prophylaxis; usually recommended after initial induction therapy for disseminated disease; may also be used after milder disease

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

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

Usual Pediatric Dose for Vaginal Candidiasis

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

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

Usual Pediatric Dose for Histoplasmosis

US CDC, NIH, IDSA, PIDS, and AAP Recommendations for HIV-exposed and HIV-infected Children : Acute primary pulmonary infection: 3 to 6 mg/kg orally once a day Maximum dose: 200 mg/dose

Mild disseminated disease: 5 to 6 mg/kg IV or orally twice a day Maximum dose: 300 mg/dose Duration of therapy: 12 months

Secondary prophylaxis: 3 to 6 mg/kg orally once a day Maximum dose: 200 mg/dose

Comments : - Recommended as alternative therapy

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

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

Renal Dose Adjustments

Adults : Single-dose therapy: No adjustment recommended.

Multiple-dose therapy : CrCl 50 mL/min or less (no dialysis): 50 to 400 mg IV or orally as a loading dose followed by 50% of the usual daily dose (according to indication)

Children: Dose reduction should parallel that recommended for adults.

Comments : - Caution is recommended. - Further adjustment may be needed depending on clinical condition.

Liver Dose Adjustments

Caution is recommended.

Precautions

Efficacy has not been established in patients younger than 6 months.

Consult WARNINGS section for additional precautions.

Dialysis

Adults : Single-dose therapy: No adjustment recommended.

Multiple-dose therapy : - Regular dialysis: 50 to 400 mg IV or orally as a loading dose followed by 100% of the usual daily dose (according to indication) after each dialysis session; on non-dialysis days, dose should be reduced according to CrCl

Children: Dose reduction should parallel that recommended for adults.

Comments: Further adjustment may be needed depending on clinical condition.

Other Comments

Administration advice : - In general, use a loading dose of twice the daily dose on the first day of therapy to reach plasma levels close to steady-state by the second day of therapy. - May administer orally or by IV infusion; can take without regard to food - Do not use absolute doses exceeding 600 mg/day in children; pediatric doses of 3, 6, and 12 mg/kg are generally equivalent to adult doses of 100, 200, and 400 mg, respectively. - Administer the IV infusion at a maximum rate of about 200 mg/hour as a continuous infusion. - Shake the oral suspension well before using; discard unused portion after 2 weeks. - Determine the daily dose based on the infecting organism and patient response to therapy. - Continue therapy until clinical parameters or laboratory tests indicate active fungal infection has subsided; an inadequate duration of therapy may lead to recurrence of active infection.

Storage requirements : - Dry powder (oral suspension), tablets: Store below 30C (86F). - Reconstituted oral suspension, IV injections in glass bottles: Store at 5C to 30C (41F to 86F); protect from freezing. - IV injections in Viaflex(R) Plus plastic containers: Store at 5C to 25C (41F to 77F); brief exposure up to 40C (104F) does not harm product; protect from freezing.

Reconstitution/preparation techniques : - The manufacturer product information should be consulted.

IV compatibility : - Supplementary medication should not be added.

General : - Current guidelines should be consulted for additional information. - This drug is not approved by US FDA for treatment of infections other than vaginal candidiasis, oropharyngeal candidiasis, esophageal candidiasis, systemic Candida infections (candidemia, disseminated candidiasis, pneumonia), Candida urinary tract infections and peritonitis, and cryptococcal meningitis, or for prophylaxis other than to prevent candidiasis in bone marrow transplantation recipients and suppress relapse of cryptococcal meningitis in AIDS patients. - Specimens for fungal culture and other relevant laboratory studies (histopathology, serology) should be obtained before therapy to isolate and identify causative organisms; therapy may be started before results are known, but once available, antifungal therapy should be adjusted accordingly. - Since oral absorption is rapid and almost complete, the daily dose is the same for oral (tablets and suspension) and IV administration. - The IV product has been used safely for up to 14 days. - Maintenance therapy usually required for patients with AIDS and cryptococcal meningitis or recurrent oropharyngeal candidiasis to prevent relapse.

Monitoring : - Dermatologic: For progression of lesions in patients with invasive/systemic fungal infections who develop rash - Hepatic: For more severe hepatic injury in patients with abnormal liver function tests; signs/symptoms of liver disease due to this drug - Renal: Renal function in elderly patients

Patient advice : - On occasion, dizziness or seizures may occur; consider this when driving or operating machinery.

Diovan (valsartan) side effects, interactions, warning, dosage & uses, vesartan

When pregnancy is detected, discontinue Diovan as soon as possible. (see WARNINGS AND PRECAUTIONS )

Drugs that act directly on the renin-angiotens in system can cause injury and death to the developing fetus. (see WARNINGS AND PRECAUTIONS )

DRUG DESCRIPTION

Diovan (valsartan) is a nonpeptide, orally active, and specific angiotensin II receptor blocker acting on the AT 1 receptor subtype.

Valsartan is chemically described as N -(1-oxopentyl)- N -[[2′-(1 H - tetrazol-5-yl) [1,1′-biphenyl]-4- yl]methyl]-L-valine. Its empirical formula is C 24 H 29 N 5 O 3 . its molecular weight is 435.5, and its structural formula is:

Valsartan is a white to practically white fine powder. It is soluble in ethanol and methanol and slightly soluble in water.

Diovan is available as tablets for oral administration, containing 40 mg, 80 mg, 160 mg or 320 mg of valsartan. The inactive ingredients of the tablets are colloidal silicon dioxide, crospovidone, hydroxypropyl methylcellulose, iron oxides (yellow, black and/or red), magnesium stearate, microcrystalline cellulose, polyethylene glycol 8000, and titanium dioxide.

What are the possible side effects of valsartan (Diovan)?

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

In rare cases, valsartan can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have muscle pain, tenderness, or weakness especially if you also have fever, nausea or vomiting, and dark colored urine.

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

feeling short of breath, even with mild.

What are the precautions when taking valsartan (Diovan)?

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

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, severe loss of body water and minerals (dehydration).

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication may increase your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or.

Last reviewed on RxList: 9/1/2016 This monograph has been modified to include the generic and brand name in many instances.

Ciprofloxacin side effects in detail, ciprofloxin

Ciprofloxacin Side Effects

Other dosage forms:

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

Major Side Effects

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

More common:

Diarrhea

Rare

Bloody or black, tarry stools

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

changes in skin color

changes in urination

chest pain or discomfort

chest tightness or heaviness

chills or fever

clumsiness or unsteadiness

confusion

continuing ringing or buzzing or other unexplained noise in the ears

coughing or spitting up blood

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

fast, irregular, pounding, or racing heartbeat or pulse

headache, severe and throbbing

hearing loss

hives or welts

joint stiffness

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

light-colored stools

muscle pain or stiffness

nausea and vomiting

nightmares

numbness of the hands

pain in the joints

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

painful, red lumps under the skin, mostly on the legs

pounding in the ears

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

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

seizures

severe abdominal or stomach pain, cramping, or burning

shakiness in the legs, arms, hands, or feet

skin rash

swelling of the face, feet, or lower legs

swollen, painful, or tender lymph glands in the neck, armpit, or groin

thick, white vaginal discharge with no odor or with a mild odor

unsteadiness, trembling, or other problems with muscle control or coordination

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

white patches in the mouth and/or on the tongue

yellow eyes or skin

Incidence not known:

Acid or sour stomach

blistering, peeling, or loosening of the skin

bluish-colored lips, fingernails, or palms

bone pain

diarrhea, watery and severe, which may also be bloody

difficulty with breathing, chewing, or talking

double vision

excessive muscle tone

feeling of discomfort

feeling, seeing, or hearing things that are not there

increased sensitivity to pain

increased sensitivity to touch

irregular or slow heart rate

mood changes

nosebleeds

rapid heart rate

red skin lesions, often with a purple center

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

unusual bleeding or bruising

unusual excitement, nervousness, or restlessness

vaginal yeast infection

Minor Side Effects

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

For Healthcare Professionals

Applies to ciprofloxacin: intravenous solution, oral powder for reconstitution, oral tablet, oral tablet extended release

General

The most common side effects (from clinical trials of all formulations, doses, durations of therapy, and indications) were nausea, diarrhea, abnormal liver function tests, vomiting, and rash. The most common side effects reported with the IV formulation were nausea, diarrhea, vomiting, injection and infusion site reactions, rash, and increased transaminases (transient). [Ref ]

Gastrointestinal

Antibiotic-associated colitis with possible fatal outcome was reported very rarely.

The onset of pseudomembranous colitis symptoms has been reported during or after antimicrobial treatment. [Ref ]

Common (1% to 10%): Nausea, diarrhea, vomiting, dyspepsia Uncommon (0.1% to 1%): Abdominal pains/discomfort, gastrointestinal (GI) pains, flatulence Rare (0.01% to 0.1%): Elevated amylase, antibiotic-associated colitis, pancreatitis Frequency not reported: Clostridium difficile-associated diarrhea, constipation, GI bleeding, ileus, intestinal perforation, dry mouth, oral ulceration, epigastric pain, dysphagia, elevated lipase, painful oral mucosa, heartburn, acid reflux, aggravated irritable bowel syndrome, lower abdominal pain Postmarketing reports: GI candidiasis, oral candidiasis, pseudomembranous colitis [Ref ]

Dermatologic

Photosensitivity was seen most often when patients were exposed to intense sun (e. g. as when used to treat or prevent travelers' diarrhea).

A 27-year-old woman with mild systemic erythematosus developed toxic epidermal necrolysis (TEN) after starting a second oral course of this drug after a prior 5-day course. She developed a rash, high fever, and diarrhea after taking the 2nd dose and presented with diffuse rash, epidermal sloughing of 60% of the skin, desquamation of the lips, shock, and respiratory distress. She died on the 28th hospital day of TEN, right ventricular failure, and acute respiratory distress syndrome. As of 2003, 9 cases of TEN, including 5 fatalities, had been reported in the literature.

Erythema nodosum, Stevens-Johnson syndrome (potentially life-threatening), and TEN (potentially life-threatening) have also been reported during postmarketing experience. [Ref ]

Common (1% to 10%): Rash Uncommon (0.1% to 1%): Pruritus, urticaria Rare (0.01% to 0.1%): Angioedema, photosensitivity reactions, sweating/hyperhidrosis, petechiae, blistering Very rare (less than 0.01%): Erythema multiforme, erythema nodosum, Stevens-Johnson syndrome (potentially life-threatening), toxic epidermal necrolysis (potentially life-threatening) Frequency not reported: Exfoliative dermatitis, purpura, burning, phototoxicity reaction, dry skin, maculopapular rash, skin disorder, vesiculobullous rash, erythema, hyperpigmentation, cutaneous candidiasis, bullous pemphigoid, vesicles, lobular panniculitis, photoinduced acute exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms (DRESS) Postmarketing reports: Acute generalized exanthematous pustulosis, fixed eruption [Ref ]

Nervous system

Seizures have been reported in 2 patients given this drug and foscarnet. The temporal association between the onset of seizures and drug administration suggests a possible drug interaction; causal relationship was not established in either case. Both drugs are individually epileptogenic; concurrent use may potentiate risk of seizures.

Cases of sensory or sensorimotor axonal polyneuropathy (affecting small and/or large axons) resulting in paresthesias, hypoesthesias, dysesthesias, and weakness have been reported.

One survey reported 11 cases of peripheral neuropathy associated with this drug. The severity ranged from mild and reversible to severe and persistent. In 1 case, a 44-year-old female developed numbness, allodynia, hypoesthesia, tremors, electrical and diffuse burning sensations, twitching, disorientation, visual impairment, nausea, temperature intolerance, rash, and palpitations; she remained disabled after 29 months.

Nystagmus, anosmia, hyperesthesia, hypoesthesia, hypertonia, intracranial hypertension, and exacerbation of myasthenia gravis have also been reported during postmarketing experience. [Ref ]

Common (1% to 10%): Headache, dizziness/lightheadedness, central nervous system disturbance Uncommon (0.1% to 1%): Sleep disorders, taste disorders, seizures (including status epilepticus), dysesthesia, paresthesia, vertigo, hearing loss Rare (0.01% to 0.1%): Syncope, hypoesthesia, tremor, tinnitus, migraine, olfactory nerve disorders, smell disorders, hearing impaired Very rare (less than 0.01%): Disturbed coordination, intracranial hypertension, benign intracranial hypertension/pseudotumor cerebri, exacerbation of myasthenia gravis, hyperesthesia Frequency not reported: Unresponsiveness, ataxia, hypertonia, anosmia, nystagmus, taste perversion/bad taste, somnolence/drowsiness, incoordination, disturbance in attention, dyskinesia, myasthenia gravis, paresis, aseptic meningitis, cerebral thrombosis, grand mal convulsion, dysphasia, lethargy, sensory axonal polyneuropathy, sensorimotor axonal polyneuropathy Postmarketing reports: Taste loss, peripheral neuropathy (may be irreversible), polyneuropathy [Ref ]

Hematologic

Pancytopenia (life-threatening or fatal outcome) and bone marrow depression (life-threatening) were reported very rarely; also reported during postmarketing experience.

Increased INR was reported in patients treated with vitamin K antagonists. [Ref ]

Common (1% to 10%): Eosinophilia Uncommon (0.1% to 1%): Thrombocytopenia, thrombocythemia Rare (0.01% to 0.1%): Leukopenia, anemia, neutropenia, leukocytosis, pancytopenia, bone marrow depression, abnormal prothrombin level Very rare (less than 0.01%): Hemolytic anemia, agranulocytosis Frequency not reported: Decreased hematocrit, decreased platelet counts, increased platelet counts, prolonged prothrombin time, decreased prothrombin, bleeding diathesis, decreased hemoglobin, decreased leukocyte count, increased atypical lymphocyte count, immature WBCs, increased blood monocytes, elevated sedimentation rate, elevated eosinophil counts, lymphadenopathy Postmarketing reports: Methemoglobinemia, increased INR, prothrombin time prolonged or decreased [Ref ]

Hepatic

Liver necrosis very rarely progressed to life-threatening hepatic failure. Liver necrosis and hepatic failure (including fatal cases) have also been reported during postmarketing experience. [Ref ]

Common (1% to 10%): Abnormal liver function tests, increased transaminases Uncommon (0.1% to 1%): Elevated bilirubin, hepatic impairment, cholestatic icterus/cholestatic jaundice, jaundice Rare (0.01% to 0.1%): Hepatitis, liver necrosis Very rare (less than 0.01%): Hepatic failure Frequency not reported: Elevated AST, elevated ALT, elevated GGT [Ref ]

Psychiatric

Common (1% to 10%): Restlessness Uncommon (0.1% to 1%): Psychomotor hyperactivity/agitation, confusion, disorientation, hallucinations Rare (0.01% to 0.1%): Anxiety reaction, abnormal dreams, depression, psychotic reactions Frequency not reported: Depersonalization, insomnia, manic reaction, nightmares, paranoia, phobia, toxic psychosis, nervousness, self-injurious behavior, suicidal ideations/thoughts, attempted suicide, completed suicide, catatonia, mania (including hypomania) Postmarketing reports: Delirium [Ref ]

Depression and psychotic reactions (both potentially culminating in self-injurious behavior such as suicidal ideations/thoughts and attempted or completed suicide) have been reported.

Agitation, confusion, and toxic psychosis have also been reported during postmarketing experience. [Ref ]

Genitourinary

Crystalluria has been reported in patients with alkaline urine and did not necessarily lead to nephrotoxicity. At physiological urinary pH, the risk of crystalluria was considered minor.

Vaginal candidiasis has also been reported during postmarketing experience. [Ref ]

Common (1% to 10%): Vaginal candidiasis Rare (0.01% to 0.1%): Hematuria, crystalluria Frequency not reported: Albuminuria, cylindruria, frequent urination, hemorrhagic cystitis, vaginitis, dysmenorrhea, candiduria, polyuria, urethral bleeding, urinary retention, urinary tract infection, fungal vaginosis, bacterial vaginitis, dysuria, abnormal urine odor, female genital pruritus, vaginal infection, urinary frequency, micturition urgency, vaginal pruritus [Ref ]

Local

Local IV site reactions occurred more often if the infusion time was 30 minutes or less. These reactions have appeared as local skin reactions and resolved quickly when infusion was completed.

Injection site irritation and induration have been reported with IV infusion time 30 minutes or less (instead of the recommended 1 hour) or when a small vein in the back of the hand was used. [Ref ]

Common (1% to 10%): Local IV site reactions, injection and infusion site reactions (e. g. phlebitis, thrombophlebitis) Frequency not reported: Injection site irritation and induration with IV infusion [Ref ]

Musculoskeletal

Uncommon (0.1% to 1%): Musculoskeletal pain (e. g. extremity pain, back pain, chest pain), arthralgia Rare (0.01% to 0.1%): Myalgia, arthritis, increased muscle tone and cramping, tendon rupture (mainly Achilles tendon) Very rare (less than 0.01%): Tendinitis, muscular weakness Frequency not reported: Arthropathy (including suspected reversible cases), joint stiffness, elevated serum creatine phosphokinase, abnormal joint exam, joint sprains, arthrosis, bone pain, decreased range of motion in a joint (knee, elbow, ankle, hip, wrist, shoulder), jaw pain, neck pain, gout flare-up, joint swelling, muscle spasms, night cramps, knee inflammation Postmarketing reports: Myoclonus, myasthenia, twitching [Ref ]

Arthropathy has primarily been a concern in pediatric patients; however, at least 1 case was described in an adult cystic fibrosis patient receiving this drug. Although cystic fibrosis arthropathy and hypertrophic pulmonary osteoarthropathy typically occur in 7% to 8% of cystic fibrosis adults and adolescents, the arthropathy exhibited in this patient did not resemble either. Several elements in its presentation strongly supported the diagnosis of ciprofloxacin-induced arthropathy, such as: a consistent time of onset with other reported cases of suspected quinolone-induced arthropathy (usually 3 weeks after starting therapy); a lack of history of arthralgia in the patient; reoccurrence upon rechallenge; and resolution of symptoms upon discontinuation of therapy (usually 2 weeks after therapy stopped).

Tendinitis with subsequent tendon rupture has been documented in numerous case reports. One patient with chronic renal failure developed bilateral Achilles tendon rupture after 4 days of ciprofloxacin therapy. Although renal transplant patients and those with end-stage renal disease tend to have an increased risk of Achilles tendinitis and rupture over the general population, quinolone use has been shown to further increase that risk (12% in quinolone-treated patients versus 7% in nonquinolone-treated patients).

As of October 1994, 25 cases of Achilles tendon rupture had been reported to the US FDA. Some ruptures have also occurred in the hand or shoulder. Other risk factors identified included age and corticosteroid use.

There had been 23 reports of tendinitis submitted to the Australian Adverse Drug Reactions Committee (ADRAC) between 2006 and 2008, including reports of Achilles tendinitis, tendon rupture, and tendon pain and swelling. The reports were primarily in male patients (15 cases) older than 56 years who used this drug for 2 to 14 days. In 19 of the reported cases, a fluoroquinolone (generally ciprofloxacin) was the primary suspect; however, details of concomitant serious medical conditions were not documented in most of the reports.

Musculoskeletal side effects reported in pediatric patients included arthralgia, abnormal gait, abnormal joint exam, joint sprains, leg pain, back pain, arthrosis, bone pain, pain, myalgia, arm pain, and decreased range of motion in a joint (knee, elbow, ankle, hip, wrist, shoulder).

Myalgia, tendinitis, and tendon rupture have also been reported during postmarketing experience. [Ref ]

Cardiovascular

Uncommon (0.1% to 1%): Tachycardia, vasodilatation, hypotension Rare (0.01% to 0.1%): Vasculitis Frequency not reported: Angina pectoris, cardiopulmonary arrest, myocardial infarction, hypertension, palpitation, bradycardia, arrhythmia, atrial flutter, cardiac murmur, cardiovascular collapse, ventricular ectopy, ventricular bigeminy, abdominal aortic bruit, postural hypotension Postmarketing reports: QT prolongation/ECG QT prolonged, torsade de pointes, ventricular arrhythmia [Ref ]

Torsade de pointes was reported mainly in patients with risk factors for QT prolongation.

Vasculitis has also been reported during postmarketing experience. [Ref ]

Other

Elevated serum theophylline has been reported in patients receiving theophylline concomitantly.

Gait disturbance and elevated serum potassium have also been reported during postmarketing experience. [Ref ]

Uncommon (0.1% to 1%): Candida infections, mycotic superinfections, pain, fever, malaise/feeling unwell, asthenia, edema Very rare (less than 0.01%): Gait disturbance/abnormal gait Frequency not reported: Irritability, flushing, thirst, elevated serum calcium, elevated serum potassium, elevated triglycerides, decreased serum albumin, decreased serum potassium, decreased total serum protein, elevated serum theophylline, serum phenytoin altered, chills, swelling, breast pain, achiness, weakness, fatigue, suprapubic pain, rigors, tenderness, fungal infection, increased body temperature Postmarketing reports: Elevated serum cholesterol [Ref ]

Metabolic

Quinolone class antibiotics have been associated with symptomatic hypoglycemia. [Ref ]

Uncommon (0.1% to 1%): Elevated blood alkaline phosphatase, decreased appetite/anorexia, decreased food intake Rare (0.01% to 0.1%): Hyperglycemia, hypoglycemia Frequency not reported: Elevated LDH, elevated uric acid, elevated blood glucose, decreased uric acid, decreased blood glucose, acidosis, symptomatic hypoglycemia [Ref ]

Renal

Uncommon (0.1% to 1%): Renal impairment, renal failure Rare (0.01% to 0.1%): Tubulointerstitial nephritis Frequency not reported: Elevated serum creatinine, renal calculi, elevated BUN, decreased BUN, abnormal kidney function, allergic interstitial nephritis, nephritis, myoglobin-associated acute kidney injury/failure [Ref ]

Allergic interstitial nephritis resulting in nonoliguric renal failure has been described in numerous case reports. Several cases included symptoms of rash, fever, and arthralgia and were accompanied by eosinophilia and eosinophiluria. Cases of allergic interstitial nephritis often responded to short courses of corticosteroid therapy. [Ref ]

Ocular

Uncommon (0.1% to 1%): Visual disturbances (e. g. chromatopsia, diplopia, photopsia) Very rare (less than 0.01%): Visual color distortions Frequency not reported: Decreased visual acuity, blurred vision, cataracts, multiple punctate lenticular opacities, eye pain [Ref ]

Quinolone class antibiotics have been associated with cataracts and multiple punctate lenticular opacities. [Ref ]

Hypersensitivity

Rare (0.01% to 0.1%): Allergic reactions, anaphylactic shock (life-threatening), allergic edema Very rare (less than 0.01%): Anaphylactic reaction, serum sickness-like reaction Frequency not reported: Anaphylactoid reactions, necrotizing vasculitis, cutaneous vasculitis [Ref ]

Allergic reactions ranged from urticaria to anaphylactic reactions, including life-threatening anaphylactic shock.

At least 2 cases have been reported of patients developing a cutaneous vasculitis related to use of this drug. The vasculitis resolved without medical intervention after the drug was discontinued.

Serum sickness-like reaction and anaphylactic shock (life-threatening) have also been reported during postmarketing experience. [Ref ]

Respiratory

Rare (0.01% to 0.1%): Dyspnea (including asthmatic condition) Frequency not reported: Bronchospasm, hemoptysis, laryngeal edema, respiratory arrest, epistaxis, hiccough, pulmonary edema, pleural effusion, pulmonary embolism, respiratory distress, wheeze, cough, upper respiratory tract infection, pharyngitis, nasopharyngitis [Ref ]

Endocrine

Frequency not reported: Gynecomastia [Ref ]

Immunologic

Frequency not reported: Jarisch-Herxheimer reaction [Ref ]

Oral ciprofloxacin has been associated with a case of Jarisch-Herxheimer reaction (characterized by hypotension, tachycardia, and disseminated intravascular coagulation) in a 14-year-old female with tickborne relapsing fever. [Ref ]

References

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

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Prednisone Active ingredient: prednisone $0.30 for pill Prednisone is used to reduce inflammation and alleviate symptoms in a variety of disorders, including rheumatoid arthritis and severe cases of asthma. Brand Cialis Active ingredient: Tadalafil $3.72 for pill Brand Cialis improves erection and helps to achieve a successful sexual intercourse.

Dapoxetine Active ingredient: Dapoxetine $0.95 for pill Dapoxetine is used as a treatment for premature ejaculation. Zithromax Active ingredient: Azithromycin $0.40 for pill Zithromax is a macrolide antibiotic to treat infections of upper and low respiratory tract, especially ear infections, pneumonia.

Nolvadex Active ingredient: tamoxifen $0.52 for pill Nolvadex (Tamoxifen) is used for treating breast cancer in women. Cytotec Active ingredient: Misoprostol $1.70 for pill Cytotec prevents formation of stomach ulcers in patients treated by NSAIDs or arthritis or pain medicines.

Cialis Professional Active ingredient: Tadalafil $1.20 for pill Cialis Professional is essentially a "new and improved" formula of the original Cialis®. While the product has been reformulated and enhanced in its. Viagra Super Active Active ingredient: Sildenafil $1.25 for pill Viagra Super Active is created to deliver maximum effect in the shortest time. It will take you only 10 minutes to feel the result.

Extra Super Viagra Active ingredient: dapoxetine $2.86 for pill Extra Super Viagra is used in the treatment of Erectile Dysfunction with Premature Ejaculation. Extra Super Viagra contains Sildenafil100 mg and Dapoxetine. Cialis Extra Dosage Active ingredient: Tadalafil $2.05 for pill Cialis Extra Dosage is indicated for the treatment of erectile dysfunction. Cialis Extra Dosage works faster than other ED drugs and lasts for an extended.

Cialis Soft Active ingredient: Tadalafil $1.11 for pill Cialis Soft improves erection and helps to achieve a successful sexual intercourse. Viagra Soft Active ingredient: Sildenafil $0.91 for pill Viagra Soft is a chewable tablet. Absorbed directly into the bloodstream, it acts faster. It is used to treat erection problems in men. The time necessary.

Kamagra Active ingredient: Sildenafil $0.90 for pill Kamagra is used for the treatment of erectile dysfunction in men and pulmonary arterial hypertension. Cipro Active ingredient: Ciprofloxacin $0.22 for pill Cipro is an antibiotic in a group of drugs called fluoroquinolones. It is used to treat different types of bacterial infections, e. g. bladder inflammation.

Cialis Super Active Active ingredient: Tadalafil $1.32 for pill Cialis Super Active increases testosterone levels, possesses enhanced vasodilating effect, increases sperm production and sexual arousal, stamina, and. Extra Super Cialis Active ingredient: tadalafil $3.06 for pill Extra Super Cialis is used in the treatment of Erectile Dysfunction with Premature Ejaculation. Extra Super Cialis 100mg contains Tadalafil 40 mg and.

Female Viagra Active ingredient: Sildenafil $0.68 for pill Female Viagra improves woman's sexuality, increases sensitivity to stimulation, allows to reach an intense sexual satisfaction. Lasix Active ingredient: Furosemide $0.25 for pill Lasix belongs to a class of diuretics, it is prescribed in patients with swelling caused by congestive heart failure.

Zoloft Active ingredient: Sertraline $0.28 for pill Zoloft is a selective serotonin reuptake inhibitor to treat depression, posttraumatic stress disorder, panic disorder, certain types of social anxiety. Propranolol Active ingredient: propranolol $0.27 for pill Propranolol works by decreasing the action of pacemaker cells and slowing certain impulses in the heart.

Xenical Active ingredient: Orlistat $0.79 for pill Xenical (Orlistat) is recommended and prescribed by pharmacists as a weight loss medication that targets the absorption of fat in your body rather than. Prednisolone $0.32 for pill Prednisolone is used for treating allergies, arthritis, breathing problems (e. g. asthma), certain blood disorders, collagen diseases (e. g. lupus), certain.

Tadapox Active ingredient: tadalafil $1.08 for pill Tadapox is a new combination tablet containing two of the most potent and effective pharmaceuticals proven to combat the major causes of male sexual. Metformin Active ingredient: metformin $0.26 for pill Metformin is a biguanide anti-diabetic that works by decreasing the amount of sugar that the liver produces and the intestines absorb.

Antabuse Active ingredient: Disulfiram $0.43 for pill Antabuse is used for treating alcoholism. Sildalis Active ingredient: tadalafil $0.95 for pill Sildalis is a combination drug, consisting both of Tadalafil and Sildenafil citrate (Viagra+Cialis). This combined medication is designed for the treatment.

Valtrex Active ingredient: Valacyclovir $2.66 for pill Valtrex is an antiviral drug used to treat herpes zoster, genital herpes, and herpes cold sores on the face and lips.

Viagra Active ingredient: Sildenafil $0.27 for pill Viagra is often the first treatment tried for erectile dysfunction in men and pulmonary arterial hypertension. Cialis Active ingredient: Tadalafil $0.68 for pill Cialis improves erection and helps to achieve a successful sexual intercourse.

Clomid Active ingredient: Clomiphene $0.44 for pill Clomid is a fertility drug, used to stimulate FSH and LH production and hereby the ovaries to produce eggs in ovarian disorders. ED Sample Pack 1 $2.31 for pill ED Sample Pack 1 consists of a two well-known medications (Viagra and Cialis) designed for the treatment of erectile dysfunction.

Brand Viagra Active ingredient: Sildenafil $2.56 for pill Brand Viagra is often the first treatment tried for erectile dysfunction in men and pulmonary arterial hypertension. Doxycycline $0.30 for pill Doxycyline is a tetracycline antibiotic used to treat infections of urinary tract, acne, gonorrhea, chlamydiosis, periodontitis, etc.

Propecia Active ingredient: Finasteride $0.51 for pill Propecia is used to treat hair loss (male pattern). Also it is used to treat prostate cancer and benign prostatic hyperplasia. Levitra Active ingredient: Vardenafil $1.00 for pill Levitra is used to treat sexual function problems such as Impotence or Erectile Dysfunction.

Amoxil Active ingredient: Amoxicillin $0.39 for pill Amoxil is an antibiotic from the penicillin group used to treat infections such as pneumonia, gonorrhea caused by E. coli, salmonella, etc. Viagra Professional Active ingredient: Sildenafil $0.57 for pill Viagra Professional is an extra-strength prescription medicine. It starts acting faster and the effect lasts longer that with regular Viagra.

Prednisone Active ingredient: prednisone $0.30 for pill Prednisone is used to reduce inflammation and alleviate symptoms in a variety of disorders, including rheumatoid arthritis and severe cases of asthma. Brand Cialis Active ingredient: Tadalafil $3.72 for pill Brand Cialis improves erection and helps to achieve a successful sexual intercourse.

Dapoxetine Active ingredient: Dapoxetine $0.95 for pill Dapoxetine is used as a treatment for premature ejaculation. Zithromax Active ingredient: Azithromycin $0.40 for pill Zithromax is a macrolide antibiotic to treat infections of upper and low respiratory tract, especially ear infections, pneumonia.

Nolvadex Active ingredient: tamoxifen $0.52 for pill Nolvadex (Tamoxifen) is used for treating breast cancer in women. Cytotec Active ingredient: Misoprostol $1.70 for pill Cytotec prevents formation of stomach ulcers in patients treated by NSAIDs or arthritis or pain medicines.

Cialis Professional Active ingredient: Tadalafil $1.20 for pill Cialis Professional is essentially a "new and improved" formula of the original Cialis®. While the product has been reformulated and enhanced in its. Viagra Super Active Active ingredient: Sildenafil $1.25 for pill Viagra Super Active is created to deliver maximum effect in the shortest time. It will take you only 10 minutes to feel the result.

Extra Super Viagra Active ingredient: dapoxetine $2.86 for pill Extra Super Viagra is used in the treatment of Erectile Dysfunction with Premature Ejaculation. Extra Super Viagra contains Sildenafil100 mg and Dapoxetine. Cialis Extra Dosage Active ingredient: Tadalafil $2.05 for pill Cialis Extra Dosage is indicated for the treatment of erectile dysfunction. Cialis Extra Dosage works faster than other ED drugs and lasts for an extended.

Cialis Soft Active ingredient: Tadalafil $1.11 for pill Cialis Soft improves erection and helps to achieve a successful sexual intercourse. Viagra Soft Active ingredient: Sildenafil $0.91 for pill Viagra Soft is a chewable tablet. Absorbed directly into the bloodstream, it acts faster. It is used to treat erection problems in men. The time necessary.

Kamagra Active ingredient: Sildenafil $0.90 for pill Kamagra is used for the treatment of erectile dysfunction in men and pulmonary arterial hypertension. Cipro Active ingredient: Ciprofloxacin $0.22 for pill Cipro is an antibiotic in a group of drugs called fluoroquinolones. It is used to treat different types of bacterial infections, e. g. bladder inflammation.

Cialis Super Active Active ingredient: Tadalafil $1.32 for pill Cialis Super Active increases testosterone levels, possesses enhanced vasodilating effect, increases sperm production and sexual arousal, stamina, and. Extra Super Cialis Active ingredient: tadalafil $3.06 for pill Extra Super Cialis is used in the treatment of Erectile Dysfunction with Premature Ejaculation. Extra Super Cialis 100mg contains Tadalafil 40 mg and.

Female Viagra Active ingredient: Sildenafil $0.68 for pill Female Viagra improves woman's sexuality, increases sensitivity to stimulation, allows to reach an intense sexual satisfaction. Lasix Active ingredient: Furosemide $0.25 for pill Lasix belongs to a class of diuretics, it is prescribed in patients with swelling caused by congestive heart failure.

Zoloft Active ingredient: Sertraline $0.28 for pill Zoloft is a selective serotonin reuptake inhibitor to treat depression, posttraumatic stress disorder, panic disorder, certain types of social anxiety. Propranolol Active ingredient: propranolol $0.27 for pill Propranolol works by decreasing the action of pacemaker cells and slowing certain impulses in the heart.

Xenical Active ingredient: Orlistat $0.79 for pill Xenical (Orlistat) is recommended and prescribed by pharmacists as a weight loss medication that targets the absorption of fat in your body rather than. Prednisolone $0.32 for pill Prednisolone is used for treating allergies, arthritis, breathing problems (e. g. asthma), certain blood disorders, collagen diseases (e. g. lupus), certain.

Tadapox Active ingredient: tadalafil $1.08 for pill Tadapox is a new combination tablet containing two of the most potent and effective pharmaceuticals proven to combat the major causes of male sexual. Metformin Active ingredient: metformin $0.26 for pill Metformin is a biguanide anti-diabetic that works by decreasing the amount of sugar that the liver produces and the intestines absorb.

Antabuse Active ingredient: Disulfiram $0.43 for pill Antabuse is used for treating alcoholism. Sildalis Active ingredient: tadalafil $0.95 for pill Sildalis is a combination drug, consisting both of Tadalafil and Sildenafil citrate (Viagra+Cialis). This combined medication is designed for the treatment.

Valtrex Active ingredient: Valacyclovir $2.66 for pill Valtrex is an antiviral drug used to treat herpes zoster, genital herpes, and herpes cold sores on the face and lips.

Viagra Active ingredient: Sildenafil $0.27 for pill Viagra is often the first treatment tried for erectile dysfunction in men and pulmonary arterial hypertension. Cialis Active ingredient: Tadalafil $0.68 for pill Cialis improves erection and helps to achieve a successful sexual intercourse.

Clomid Active ingredient: Clomiphene $0.44 for pill Clomid is a fertility drug, used to stimulate FSH and LH production and hereby the ovaries to produce eggs in ovarian disorders. ED Sample Pack 1 $2.31 for pill ED Sample Pack 1 consists of a two well-known medications (Viagra and Cialis) designed for the treatment of erectile dysfunction.

Brand Viagra Active ingredient: Sildenafil $2.56 for pill Brand Viagra is often the first treatment tried for erectile dysfunction in men and pulmonary arterial hypertension. Doxycycline $0.30 for pill Doxycyline is a tetracycline antibiotic used to treat infections of urinary tract, acne, gonorrhea, chlamydiosis, periodontitis, etc.

Propecia Active ingredient: Finasteride $0.51 for pill Propecia is used to treat hair loss (male pattern). Also it is used to treat prostate cancer and benign prostatic hyperplasia. Levitra Active ingredient: Vardenafil $1.00 for pill Levitra is used to treat sexual function problems such as Impotence or Erectile Dysfunction.

Amoxil Active ingredient: Amoxicillin $0.39 for pill Amoxil is an antibiotic from the penicillin group used to treat infections such as pneumonia, gonorrhea caused by E. coli, salmonella, etc. Viagra Professional Active ingredient: Sildenafil $0.57 for pill Viagra Professional is an extra-strength prescription medicine. It starts acting faster and the effect lasts longer that with regular Viagra.

Prednisone Active ingredient: prednisone $0.30 for pill Prednisone is used to reduce inflammation and alleviate symptoms in a variety of disorders, including rheumatoid arthritis and severe cases of asthma. Brand Cialis Active ingredient: Tadalafil $3.72 for pill Brand Cialis improves erection and helps to achieve a successful sexual intercourse.

Dapoxetine Active ingredient: Dapoxetine $0.95 for pill Dapoxetine is used as a treatment for premature ejaculation. Zithromax Active ingredient: Azithromycin $0.40 for pill Zithromax is a macrolide antibiotic to treat infections of upper and low respiratory tract, especially ear infections, pneumonia.

Nolvadex Active ingredient: tamoxifen $0.52 for pill Nolvadex (Tamoxifen) is used for treating breast cancer in women. Cytotec Active ingredient: Misoprostol $1.70 for pill Cytotec prevents formation of stomach ulcers in patients treated by NSAIDs or arthritis or pain medicines.

Cialis Professional Active ingredient: Tadalafil $1.20 for pill Cialis Professional is essentially a "new and improved" formula of the original Cialis®. While the product has been reformulated and enhanced in its. Viagra Super Active Active ingredient: Sildenafil $1.25 for pill Viagra Super Active is created to deliver maximum effect in the shortest time. It will take you only 10 minutes to feel the result.

Extra Super Viagra Active ingredient: dapoxetine $2.86 for pill Extra Super Viagra is used in the treatment of Erectile Dysfunction with Premature Ejaculation. Extra Super Viagra contains Sildenafil100 mg and Dapoxetine. Cialis Extra Dosage Active ingredient: Tadalafil $2.05 for pill Cialis Extra Dosage is indicated for the treatment of erectile dysfunction. Cialis Extra Dosage works faster than other ED drugs and lasts for an extended.

Cialis Soft Active ingredient: Tadalafil $1.11 for pill Cialis Soft improves erection and helps to achieve a successful sexual intercourse. Viagra Soft Active ingredient: Sildenafil $0.91 for pill Viagra Soft is a chewable tablet. Absorbed directly into the bloodstream, it acts faster. It is used to treat erection problems in men. The time necessary.

Kamagra Active ingredient: Sildenafil $0.90 for pill Kamagra is used for the treatment of erectile dysfunction in men and pulmonary arterial hypertension. Cipro Active ingredient: Ciprofloxacin $0.22 for pill Cipro is an antibiotic in a group of drugs called fluoroquinolones. It is used to treat different types of bacterial infections, e. g. bladder inflammation.

Cialis Super Active Active ingredient: Tadalafil $1.32 for pill Cialis Super Active increases testosterone levels, possesses enhanced vasodilating effect, increases sperm production and sexual arousal, stamina, and. Extra Super Cialis Active ingredient: tadalafil $3.06 for pill Extra Super Cialis is used in the treatment of Erectile Dysfunction with Premature Ejaculation. Extra Super Cialis 100mg contains Tadalafil 40 mg and.

Female Viagra Active ingredient: Sildenafil $0.68 for pill Female Viagra improves woman's sexuality, increases sensitivity to stimulation, allows to reach an intense sexual satisfaction. Lasix Active ingredient: Furosemide $0.25 for pill Lasix belongs to a class of diuretics, it is prescribed in patients with swelling caused by congestive heart failure.

Zoloft Active ingredient: Sertraline $0.28 for pill Zoloft is a selective serotonin reuptake inhibitor to treat depression, posttraumatic stress disorder, panic disorder, certain types of social anxiety. Propranolol Active ingredient: propranolol $0.27 for pill Propranolol works by decreasing the action of pacemaker cells and slowing certain impulses in the heart.

Xenical Active ingredient: Orlistat $0.79 for pill Xenical (Orlistat) is recommended and prescribed by pharmacists as a weight loss medication that targets the absorption of fat in your body rather than. Prednisolone $0.32 for pill Prednisolone is used for treating allergies, arthritis, breathing problems (e. g. asthma), certain blood disorders, collagen diseases (e. g. lupus), certain.

Tadapox Active ingredient: tadalafil $1.08 for pill Tadapox is a new combination tablet containing two of the most potent and effective pharmaceuticals proven to combat the major causes of male sexual. Metformin Active ingredient: metformin $0.26 for pill Metformin is a biguanide anti-diabetic that works by decreasing the amount of sugar that the liver produces and the intestines absorb.

Antabuse Active ingredient: Disulfiram $0.43 for pill Antabuse is used for treating alcoholism. Sildalis Active ingredient: tadalafil $0.95 for pill Sildalis is a combination drug, consisting both of Tadalafil and Sildenafil citrate (Viagra+Cialis). This combined medication is designed for the treatment.

Valtrex Active ingredient: Valacyclovir $2.66 for pill Valtrex is an antiviral drug used to treat herpes zoster, genital herpes, and herpes cold sores on the face and lips.

Fervex za odrasle kesice, fervex

Opis

Recenzije (3)

Prodaja ovog leka zabranjena je putem interneta zakonom Republike Srbije. dok je oglasavanje istog putem interneta dozvoljeno iskljucivo kao podsetnik i ima svrhu informisanja.

PRAVILNIK O NACINU OGLASAVANJA LEKA, ODNOSNO MEDICINSKOG SREDSTVA Sl. Gl. RS", br.79/2010 MOZETE POGLEDATI OVDE.

Fervex za odrasle je lek dostupan bez lekarskog recepta. Bilo da vam je upotrebu leka preporucio lekar ili farmaceut, molimo da pazljivo procitate uputstvo. Uz upotrebu Fervex za odrasle granula trebalo bi voditi racuna i o sledecem:

da sobe u kojima se boravi nisu pregrejane i da nije velika vlaga u vazduhu

da se ne pusi

da se povecanim unosom vode odrzava hidratacija organizma

Nezasticeno, genericko ime: Feniramin, paracetamol, askorbinska kiselina (vitamin C)

Sadrzaj aktivnih supstanci: Jedna kesica sa granulama za oralni rastvor sadrzi: Paracetamol 500mg Feniramin maleat 25mg Askorbinska kiselina (vitamin C) 200mg

Sadrzaj pomocnih supstanci: Akacija, limunska kiselina anhidrovana, saharin - natrijum, saharoza, prirodna aroma Antilles.

Sta je lek fervex za odrasle i cemu je namenjen? Fervex za odrasle sadrzi:

analgetik/antipiretik paracetamol, koji ublazava bol i snizava povisenu temperaturu

antihistaminik feniramin-maleat, koji smanjuje obilnu sekreciju iz nosa, zapusenost nosa, pojacano suzenje ociju i deluje protiv kijavice

vitamin C zadovoljava povecane potrebe organizma kod prehlade i drugih stanja pracenih groznicom

Fervex za odrasle je namenjen za lecenje gripoznih stanja, alergijskog rinitisa, prehlade i infekcija nosa i zdrela (rinofaringitisa) kod odraslih i dece starije od 15 godina. Fervex za odrasle granule za oralni rastvor pakovane su u kesice. Jedna kesica sadrzi jednu dozu leka. Kutija sadrzi 8 kesica.

Sta morate da procitate pre upotrebe leka? Upozorite lekara ako uzimate druge lekove, imate neku hronicnu bolest, poremecaj metabolizma ili ste preosetljivi na lekove.

Lek Fervex za odrasle, ne koristiti kod:

postojanja preosetljivosti na bilo koji sastojak leka

ozbiljnog oboljenja jetre

glaukoma (povisen pritisak u ocnoj jabucici)

otezanog mokrenja kao posledice oboljenja prostate ili drugih oboljenja

dece mlade od 15 godina

Ukoliko imate pitanja vezana za bezbednost upotrebe leka, obratite se lekaru ili farmaceutu.

Upozorenja i mere opreza: Specijalna upozorenja: Ovaj lek sadrzi saharozu i zbog toga ne treba da ga uzimaju osobe sa naslednom netolerancijom fruktoze. sindromom malapsorpcije glukoze i galaktoze ili nedostatkom saharoza-izomaltaze (retko metabolicko oboljenje).

Oprez prilikom upotrebe: Svaka pojedinacna kesica sadrzi 11,56g saharoze, o cemu se mora voditi racuna ukoliko se sprovodi dijeta sa ogranicenim unosom secera ili kod dijabetesa.

Obavestite lekara u slucaju:

oboljenja bubrega

istovremene primene drugih lekova.

Ukoliko simptomi potraju duze od 5 dana, obavezno se obratite lekaru. Ukoliko vam je potreban savet ili dodatna informacija, obratite se lekaru ili farmaceutu.

Uzimanje leka fervex za odrasle sa hranom, picima ili drugim lekovima:

Tokom lecenja ne preporucuje se konzumiranje alkohola niti upotreba sredstava za smirenje

Fervex za odrasle pojacava efekat sedativa i alkohola

Pojacava efekat depresora centralnog nervnog sistema (hipnotika, anestetika, MAO inhibitora)

Dolazi do pojacanja atropinskih efekata na nivou CNS-a (vidi deo "Nezeljeni efekti") ukoliko se lek kombinuje sa supstancama koje imaju antiholinergicko dejstvo (npr. drugim antihistaminicima, antidepresivom imipraminom, neuroleptikom fenotiazinom, antiholinergickim antiparkinsonicima, atropinom, dizopiramidom)

Metoklopramid i domperidon povecavaju resorpciju paracetamola, a holestiramin smanjuje

Induktori hepatickih enzima (rifampicin, izonijazid, fenitoin, karbamazepin) i antiretrovirotici (zidovudin i nevirapin) povecavaju rizik za razvoj stetnih efekata paracetamola

Kako bi se izbegle moguce interakcije sa lekovima, lekara ili farmaceuta uvek treba obavestiti o upotrebi nekog drugog leka.

Primena u trudnoci i dojenju: Pre nego sto pocnete da uzimate neki lek, posavetujte se sa svojim lekarom ili farmaceutom. Iz predostroznosti, usled odsustva podataka o sigurnosti upotrebe granula Fervex za decu tokom trudnoce i dojenja, u tom periodu upotrebu leka treba izbegavati.

Uticaj na psihofizicke sposobnosti prilikom upravljanja motornim vozilom i masinama: Savetuje se oprez prilikom upravljanja motomim vozilima ili masinama, jer upotreba ovog leka moze izazvati pospanost.

Sta morate da znate o pomocnim materijama koje sadrzi lek fervex za odrasle? Zbog sadrzaja saharoze (11,56g po dozi) mora se voditi racuna ukoliko se sprovodi dijeta sa ogranicenim unosom secera ili kod dijabetesa.

Doziranje: Odrasli i deca starija od 15 godina: 1 kesica 2 do 3 puta u toku 24 casa.

Nacin primene: Oralna primena. Sadrzaj kesice razmutiti u casi tople ili hladne vode.

Ucestalost doza: Kesica 2 do 3 puta u toku 24 casa. Cim se primete prvi simptomi gripoznog stanja, preporucuje se upotreba Fervex za odrasle granula rastvorenih u toploj vodi, najbolje uvece. Topao napitak olaksava diurezu i znojenje i tako podstice izbacivanje toksina. Interval izmedu doza treba da bude duzi od 4 casa. U slucaju insuficijencije bubrega, razmak izmedu doza treba da bude najmanje 8 casova.

Tokom upotrebe leka ne premasivati preporucene doze.

Lek ne upotrebljavati tokom duzeg perioda bez saveta lekara, posebno ukoliko simptomi potraju duze od 5 dana. Ukoliko ste uzeli vecu dozu leka fervex za odrasle nego sto bl trebalo, odmah razgovarajte sa lekarom ili farmaceutom!

Nezeljena dejstva leka: Kao i drugi lekovi i fervex za odrasle moze kod odredenih osoba izazvati slabije ili jace nezeljene efekte: suvoca usta, otezano mokrenje, pospanost, nejasan vid usled poremecaja akomodacije oka (sposobnost prilagodavanja oka da se vidi jasno bilo da je objekat blizu ili daleko), zbunjenost, mentaina konfuzija i uznemirenost kod starijih osoba. Prijavljeno je nekoliko veoma retkih slucajeva trombocitopenije (smanjenje broja trombocita (krvnih plocica) u perifernoj krvi koji imaju znacajnu ulogu u koagulaciji krvi). Retki su slucajevi pojave osipa, crvenih pecata na kozi, koprivnjace (erupcije koze nalik na one kad ozari kopriva) i/ili pojave alergijskih reakcija: u tom slucaju treba prekinuti sa terapijom i odmah se obratiti lekaru.

Molimo da obavestite lekara ili farmaceuta ukoliko primetite neko nezeljeno dejstvo koje nije pomenuto u ovom uputstvu.

Cuvanje i rok upotrebe: Lek ne koristiti nakon isteka roka upotrebe oznacenog na kutiji.

Posebni uslovi cuvanja: Lek cuvati na temperaturi do 25°C. Cuvati na suvom mestu. Cuvati van domasaja dece.

Nacin izdavanja leka: Lek se moze izdavati i bez lekarskog recepta.

Posebne mere unistavanja neupotrebljenog leka ili ostatka leka: Lek se unistava u skladu sa vazecim propisima.

Naziv i adresa nosioca dozvole za stavljanje leka u promet: PharmaSwiss d. o.o. Vojvode Stepe 18, Beograd Naziv

Pakovanje: 8 kesica

Adresa proizvodaca: Bristol Myers Squibb, Francuska, Le Passage.

Pre upotrebe detaljno prouciti uputstvo. O indikacijama, merama opreza i nezeljenim reakcijama na lek, posavetovati se sa lekarom ili farmaceutom.

FERVEX ZA ODRASLE KESICE

Imitrex uses, dosage, side effects - warnings, imiprex

Imitrex

What is Imitrex?

Imitrex (sumatriptan) is a headache medicine that narrows blood vessels around the brain. Sumatriptan also reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms.

Imitrex is used to treat migraine headaches with or without aura in adults. Sumatriptan will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Imitrex should not be used to treat a common tension headache, a headache that causes loss of movement on one side of your body, or any headache that seems to be different from your usual migraine headaches. Use this medication only if your condition has been confirmed by a doctor as migraine headaches.

Important information

You should not use Imitrex if you have any history of heart disease or coronary artery disease, blood circulation problems, Wolff-Parkinson-White syndrome, uncontrolled high blood pressure, severe liver disease, circulation problems affecting your intestines, history of a stroke, or if your headache seems to be different from your usual migraine headaches.

Do not use Imitrex within 24 hours before or after using another migraine headache medicine. Do not use Imitrex if you have used a MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Before using Imitrex, tell your doctor if you have liver or kidney disease, seizures, high blood pressure, a heart rhythm disorder, or coronary heart disease (or risk factors such as diabetes, menopause, smoking, being overweight, having high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

Also tell your doctor if you are taking an antidepressant such as citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor).

Imitrex will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

After taking a Imitrex tablet, you must wait two (2) hours before taking a second tablet. Do not take more than 200 mg of sumatriptan in 24 hours.

Before taking this medicine

You should not use Imitrex if you are allergic to sumatriptan, or if you have:

coronary artery disease, angina (chest pain), blood circulation problems, lack of blood supply to the heart;

a heart disorder called Wolff-Parkinson-White syndrome;

a history of heart disease, heart attack, or stroke, including "mini-stroke";

untreated or uncontrolled high blood pressure;

severe liver disease;

circulation problems affecting your intestines; or

a headache that seems different from your usual migraine headaches.

Do not use Imitrex if you have used a MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

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

liver or kidney disease;

epilepsy or other seizure disorder;

high blood pressure, a heart rhythm disorder; or

risk factors for coronary artery disease (such as diabetes, menopause, smoking, being overweight, having high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

It is not known whether Imitrex will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Sumatriptan can pass into breast milk and may harm a nursing baby. Do not breast-feed within 12 hours after using Imitrex. If you use a breast pump during this time, throw out any milk you collect. Do not feed it to your baby.

Imitrex is not approved for use by anyone younger than 18 years old.

How should I use Imitrex?

Use Imitrex exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Overuse of migraine headache medicine can actually make your headaches worse.

Use Imitrex as soon as you notice headache symptoms, or after an attack has already begun.

Your doctor may want to give your first dose of this medicine in a hospital or clinic setting to see if you have any serious side effects.

Take one Imitrex tablet whole with a full glass of water. Do not split the tablet.

After taking a tablet: If your headache does not completely go away, or goes away and comes back, take a second tablet two (2) hours after the first. Do not take more than 200 mg of tablets in 24 hours. If your symptoms have not improved, contact your doctor before taking any more tablets.

Imitrex nasal spray come with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions. Blow your nose to clear your nasal passages before using the nasal spray. Try not to sneeze or blow your nose just after using the spray.

After using the nasal spray: If your headache does not completely go away after using the spray, call your doctor before using a second spray of Imitrex. If your headache goes away and then comes back, you may use a second spray if it has been at least two hours since you used the first spray. Do not use more than 40 mg of nasal spray in 24 hours. If your symptoms do not improve, contact your doctor before using any more sprays.

Contact your doctor if you have more than four headaches in one month (30 days).

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

Imitrex dosing information

Usual Adult Dose for Migraine:

Use only after a clear diagnosis of migraine has been established

Oral: Initial dose: 25 mg, 50 mg, or 100 mg orally, once - If some response to first dose occurs, a second dose may be administered at least 2 hours after first dose if needed - Oral doses of 50 and 100 mg may provide greater relief than 25 mg; however, a 100 mg dose may not provide greater effect than a 50 mg dose Maximum dose: 200 mg per 24 hours

Intranasal: Nasal spray: Initial dose: 5 mg, 10 mg, or 20 mg into one nostril, once - Administer the 5 and 20 mg doses as a single spray in 1 nostril; the 10 mg dose may be administered as 5 mg into each nostril - If some response to first dose occurs, a second dose may be administered at least 2 hours after first dose if needed Maximum dose: 40 mg per 24 hours

Comments: - Treatment should be started at the first sign of a migraine headache, or associated symptoms such as nausea, vomiting, or photophobia; this drug should not be used for migraine prophylaxis. - Higher doses may have a greater effect, but also carry a greater risk of adverse reactions. - The safety of treating an average of more than 4 headaches in a 30 day period has not been established.

Use: For the acute treatment of migraine with or without aura.

What happens if I miss a dose?

Since Imitrex is used as needed, it does not have a daily dosing schedule. Call your doctor promptly if your symptoms do not improve after using sumatriptan.

After taking a Imitrex tablet, you must wait two (2) hours before taking a second tablet. Do not take more than 200 mg of sumatriptan in 24 hours.

After using Imitrex nasal spray, you must wait two (2) hours before using a second spray. Do not use more than 40 mg of sumatriptan nasal spray in 24 hours.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include tremors or shaking, skin redness, breathing problems, blue-colored lips or fingernails, vision problems, watery eyes or mouth, weakness, lack of coordination, or seizure (convulsions).

What should I avoid while using Imitrex?

Do not use Imitrex within 24 hours before or after using another migraine headache medicine . including:

sumatriptan injection, almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), or zolmitriptan (Zomig); or

ergot medicine such as dihydroergotamine (D. H.E. 45, Migranal), ergotamine (Ergomar, Cafergot, Migergot), or methylergonovine (Methergine).

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

Imitrex side effects

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

Stop using Imitrex and call your doctor if you have:

sudden and severe stomach pain and bloody diarrhea;

severe headache, pounding in your neck or ears, severe chest pain, shortness of breath, irregular heartbeats;

a seizure (convulsions);

blood circulation problems--cramps in your hips or legs, tight or heavy feeling in your legs, numbness or tingling in your legs, muscle weakness, burning pain in your feet, pale or blue-colored appearance in your toes;

heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;

signs of a stroke--sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance; or

high levels of serotonin in the body (if you are also taking an antidepressant)--agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.

Common Imitrex side effects may include:

pain or tight feeling in your chest, throat, or jaw;

pressure or heavy feeling in any part of your body;

numbness or tingling, feeling hot or cold;

dizziness, drowsiness, weakness;

unusual or unpleasant taste in your mouth after using the nasal medicine;

burning, numbness, pain or other irritation in your nose or throat after using the nasal medicine; or

runny or stuffy nose after using the nasal medicine.

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

What other drugs will affect Imitrex?

Tell your doctor about all your current medicines and any you start or stop using, especially an antidepressant.

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

More about Imitrex (sumatriptan)

Consumer resources

Professional resources

Other formulations

Related treatment guides

Where can I get more information?

Your pharmacist can provide more information about Imitrex.

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

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

Copyright 1996-2016 Cerner Multum, Inc. Version: 14.01. Revision Date: 2016-04-04, 2:42:43 PM.

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Adapaleno review

Patients who have problematic acne must be familiar with Adapaleno . a popular treatment for that particular skin condition. Adapaleno has retinoid-like compounds, which prevent any more pimples from forming on the skin’s surface. It comes in gel, cream, and liquid solutions and is applied to the affected portion of the skin once every day. Adapaleno is marketed by Galderma Laboratories to countries around the world.

To be clear about it, Adapaleno is not a cure for acne. It is just a preventive measure that acne patients may use to control their problem. Usually, the first few weeks of Adapaleno use would result in a worse case of acne. Upon reaching your 8th to 12th week of treatment, you will recognize more favorable results. This is because pimples usually take between six and eight weeks to surface on the skin. Use of Adapaleno will make the pimples that are already beneath the skin to surface much earlier. After which, the effect of the medication will take its shape. Aside from acne vulgaris, Adapaleno is also used to treat other skin conditions such as keratosis pilaris (chicken skin).

The use of Adapaleno must be in conjunction with a medical professional. People who have current skin conditions that may react violently to the treatment need to work closely with their health care professional. Damaged skin due to sunburn or eczema must not come in contact with Adapaleno. Talk to your doctor about possible factors that could interact with your Adapaleno use. Tell him whether you are allergic to Adapaleno or other kind of medicines. You must also discuss the skin products that you are currently using and medicines that you are currently taking. Pregnant women and nursing mothers are not advisable to use Adapaleno. In case you become pregnant while undergoing the treatment, tell your doctor immediately. Your medical history must be an open book so your doctor will know what to avoid and what adjustments he can make to ensure your safety.

Your doctor is also the one who will advise you regarding the correct usage based on your current condition. Do not alter the doctor’s prescription without his orders. Stick to his prescriptions and do not stop using Adapaleno even after your symptoms have improved.

Be careful in using Adapaleno. Do not let it come in contact with your eyes, nose. and mouth. Before applying Adapaleno, be sure to wash the affected part with a mild soap or a gentle cleanser. After washing, pat it dry with a soft towel. Do not apply harsh chemicals to your skin or rub it roughly. Apply the right amount of Adapaleno by using your fingers. The stingy feeling is normal and temporary. It should go away after a few minutes.

There are also side effects that may occur during the first few weeks of treatment. The most common of which are redness, dryness, and itching. If such symptoms persist, call your doctor immediately. Also, you need to protect your skin from the harmful rays of the sun during treatment. Wear sun protective gear whenever you are going out.

Adapaleno has the following structural formula:

• Molecular formula of adapaleno is C28H28O3 • Chemical IUPAC Name is 6-[3-(1-adamantyl)-4-methoxy-phenyl]naphthalene-2-carboxylic acid • Molecular weight is 412.52 g/mol • Adapaleno available. 0.1% 10g gel

Generic name: Adapalene

Animex international festival of animation, animex-on

Animex on the Street

Animex on the Street far exceeded all it set out to do. It was a fabulous opportunity to engage community groups, the town and local businesses and organisations in all that is wonderful about animation.

Middlesbrough Football Club was the unusual setting for a loop of local schoolchildren's, University postgraduate and current student's animation showcased to over 27,000 'Boro fans via all the Riverside concourse screens at the Middlesbrough v Aston Villa game. Outside on the left of the main entrance to the stadium a 20 x 20 feet projection entitled Riverdance stopped people in their tracks.

Dave Allinson and Michelle Tripp. the artists behind Riverdance have also been projecting digital binary animation and tears falling from the 13th, 14th and 15th floors of the imposing Centre North East building. The projection was the highest public animation ever seen in the North East, and plans are already underway to go bigger and bolder for Animex 2004.

Local businesses and organisations got animated too with HMV, SONY and Northern Electric screening looped animations in their shop windows on TV and plasma screens. Also, ‘Play at the Empire’, which showcases up and coming bands with 1,000 clubbers regularly in attendance (the group 22-20s, trumpeted by NME as ‘the next big thing’ played during Animex) used our animations as their backdrop. Some of the animations also sneaked in to Middlesbrough Town Hall as a backdrop for their Burns Night and Literature Day.

Special thanks must go to Ten Feet Tall Promotions who very kindly gave loads of help, advice and support in setting up Animex on the Street activities. Cleveland Arts are worthy of a special, special mention for loaning equipment, worth some £10,000, during ‘on the Street.

David Williams's animatronics exhibition went down well with shoppers and especially children. Cutting edge style-emporium, Psyche, have expressed an interest in commissioning Dave for a one-off chrome machine for their new store.

Phew – all this in the space of two weeks! Have you all got something to look forward to next year!

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Transcript

PATIENT INFORMATION LEAFLET

CAFCOL PLEASE READ THIS LEAFLET CAREFULLY BEFORE YOU START TAKING THIS MEDICINE KEEP THIS LEAFLET UNTIL YOU HAVE FINISHED ALL THE PRESCRIBED COURSE OF CAFCOL IF YOU HAVE ANY QUESTIONS CONCERNING YOUR MEDICINE ASK YOUR DOCTOR OR PHARMACIST FOR MORE INFORMATION

Any form of anaemia, for example depression of white blood cells, depression of blood cells known as thrombocytes. Depression of bone marrow causing a condition known as aplastic anaemia.

Can you take CAFCOL with other medicines? You can take CAFCOL with other medicines, but it is important to tell your doctor or pharmacist about all the medicines which you are taking, whether prescribed by your doctor or bought without a prescription from the pharmacy or elsewhere. The following medicines may interact with CAFCOL:

What is in your medicine? The name of this medicine is CAFCOL and it contains the active ingredient Chloramphenicol. It is available as a white opaque capsule in a strength of 250 mg. CAFCOL capsules also contain pregelatinised maize starch, sodium starch glycollate, magnesium stearate, gelatin and titanium dioxide. CAFCOL Capsules are available in pots of 100 and 500.

How does CAFCOL work? CAFCOL belongs to a group of medicines known as antibiotics and which are used for the treatment of infections. If you are not sure why you are being prescribed CAFCOL, then please ask you doctor. The Manufacturer is: DDSA Pharmaceuticals Ltd. Chatfield Road, off York Road, London SW11 3SE. The Product Licence holder is: Chelonia Healthcare Limited 11 Boumpoulinas Street, 3rd Floor, 1060 Nicosia, Cyprus What is CAFCOL for? CAFCOL is reserved for the treatment of infections caused by haemophilus influenzae and typhoid fever.

Check before you take CAFCOL Before taking this medicine tell your doctor if you have ever had any unusual or allergic reactions to Chloramphenicol or any of the other ingredients of CAFCOL, or any other antibiotic. Also tell your doctor or pharmacist if you are allergic to any other substances such as foods, preservatives or dyes. Do not use CAFCOL if you are pregnant, or likely to become pregnant, unless your doctor considers it essential. Tell your doctor or pharmacist if you are breast feeding. The presence of other medical problems may affect the use of this medicine. Make sure, therefore, to tell your doctor if you have any other medical problems, especially a history of: • •

Liver disease Kidney disease

Paracetamol Rifampicin (another antibiotic) Coumarin anticoagulants (blood thinners) Sulphonylureas (for diabetes) Phenytoin and phenobarbital (for epilepsy) Ciclosporin and tacrolimus (cancer drugs)

Use in pregnancy and lactation Do not use during pregnancy unless your doctor considers it imperative. Do not use during breast feeding.

When and how to take CAFCOL Adults and elderly: 500 mg (2 capsules) every 6 hours to be taken by mouth. Children: Not recommended excepting for meningitis known as pyogenic meningitis when the dosage is 50-100 mg per kg bodyweight taken every 6 hours. Take this medicine by mouth and only in the doses prescribed by your doctor. Do not take more of it, and do not take it more often or for a longer time than your doctor ordered.

What to do if too many capsules are taken at the same time If you accidentally take more capsules than recommended, then contact your doctor or nearest hospital casualty department at once, taking the medicine with you to show the doctor

What to do if you miss a dose If you miss a dose, skip the missed dose and go back to your regular dosage schedule. Do not take two doses at once. If at any time you feel that this medicine is not working as well as you would expect do not increase the dose, instead check with your doctor. What side effects can CAFCOL have? Along with its needed effects the medicine may cause some unwanted effects such as depression of the bone marrow and certain blood conditions recognised by a sore throat and bruising, yellowing of the skin and whites of the eyes (jaundice). Inflammation of the nerves in the arms and legs, inflammation of the mouth and tongue, inflammation of the gut,

inflammation of the nerves of the eyes, nausea, vomiting, diarrhoea. Because of the various blood conditions that may be caused by Chloramphenicol, it is essential that periodic blood counts be undertaken during treatment. Storing your medicine You must keep the medicine in a safe place where children cannot get it. Your medicine could harm them. Store you medicine below 25°C, in a dry place. Keep the container closed. On the label you will find the words "Expiry Date" followed by numbers indicating the day, month and year. This is the date when the medicine is no longer fit for use. Do not use the medicine after this date, but return it to your doctor or pharmacist.

A reminder REMEMBER this medicine is for you. Never give it to someone else, even if their symptoms are the same as yours. This leaflet does not contain the complete information about your medicine. If you have any questions or are not sure about anything, ask your doctor or pharmacist who have access to additional information.

Product Licence number PL 33414/0017.

This leaflet was revised in November 2008.

Source: Medicines and Healthcare Products Regulatory Agency

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

Chloramphenicol

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These stages are discoverable on radiographs of the jaws but can also be assessed on individual free teeth. Else, plasma con - centrations can remain at clinically related levels for hours after an infusion, and this may be salubrious for analgesia and sympatholysis [117]. Blood volume obtained with C-arm CT is be like to the blood volume observations obtained by CTA originator images. Like the basal ganglia, it modulates sole тАЪlite motor neurons; there are no rule connections with lower motor neurons. As Stewart (1979) has observed, the hint of ossification centres is not many times acquainted with in skeletal cases, as they are with no overlooked during advance or broken. Are the genetic charac teristics of H. pylori strain that is colonizing the patient with original gastric cancer prominent for the progression of the plague in a faster or in a slower way? Therefore, a element on laboratory techniques is an inte - gral component of any instructional enchiridion of pediatric endocrinology. Proceedings of the Jingoistic Academy of Sciences of the United States of America. 2005;102:33243329. 46. A change in the accepted presup - positions creates a nullify of boundaries and procedures that suggest a imaginative assemble of problems or a fresh manner to work out observations (Kuhn, 1962). These analyses indicated apex CagL reliability at pH 4-6 up to 40C in the non-existence of excipient. Reprinted close permission from Macmillan Publishers Ltd: Creation Reviews Neuroscience (Milligan and Watkins, 2009), C 2009. In: Proceedings of the Association for Exploratory Biology and Drug, San Francisco. 1933:141146. 46 CHAPTER 3: MONITORING CEREBRAL BLOOD MOVE AND METABOLISM 110. Although the peril of bleeding dur - ing these cases is much less than for surgical resection buy discount chloramphenicol 500mg line infection lab values, at least at one large-bore intravenous game should be inserted and blood should be available in the end that bleeding does arise generic chloramphenicol 250mg overnight delivery antibiotics for acne south africa. Kropshofer H et al (1996) Editing of the HLA - DR-peptide repertoire by HLA-DM. EMBO J 15:61446154 10. Testosterone in males and E2 in females are in the midpubertal compass in the premier few weeks of verve c.

Nitrous oxide markedly increases cerebral cortical metabolic rate and blood spew in the goat. J Natl Cancer Inst 100:261269 Garg MK, Glanzman J, Kalnicki S (2012) The evolving function of positron emission tomography-computed tomography in organ - preserving treatment of crescendo and neck cancer. Particulars of the Helicobacter pylori Infection in Children 27 The using software is trial construction. At more, the ruvC deletion mutant elicited a Th1 distorted insusceptible rejoinder compared to a Th2 distorted reaction observed payment wild-type, highlighting the role of homologous recombination in H. pylori safe modulation and grit. Some scalloping is still right now, along with the key arc; however, the scallops are not as cordially defined and the edges look somewhat haggard down. Namely, there are different bunch of recite sequences located on 3` sphere of the cagA gene in different H. pylori strains. The European NOA-08 group random - ized patients over 65 years and a palatable about eminence (KPS) to week-on week-off temozolomide at 100 mg/m2 or normal radiotherapy order chloramphenicol online treatment for vre uti. Cells or regions of avocation are then identified and manually delineated on the computer movies using the software program. Numerous formulae from segments of the vertebral column are also available--for admonition, from Jason and Taylor (1995) for Americans and from Nagesh and Kumar (2006) quest of South Indians. Fast synaptic inhi - bition promotes synchronized gamma oscillations in hippocampal interneuron networks. Ivy J. Impersonation of exercise training in the check and treatment of insulin guerillas and non-insulin-dependent diabetes mellitus. There is an intact but calcified graft of the aortic foremost, which measures 1.2 cm in diameter. Looking for occurrence, a bang titled "The benefits and hazards of antioxidants: Controlling cancer stall apoptosis and other possessive mechanisms in cancer patients and the sensitive population," appeared in the Album of the American College of Nutrition. More recently, we have also shown that during an adaptive untouched effect, IL-1 and IL-6 are produced in the capacity (del The using software is grief construction. Less conventional and less understood is vertebral artery atherosclerosis, which may be the cause of close to 20% of posterior publication strokes. Cavernous carotid mischief during useful endoscopic sinus surgery: for fear that b if presenta - tions and guidelines quest of optimal managing chloramphenicol 500 mg line antimicrobial effects of garlic.

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The values recompense each of the 5 charac - teristics should be added and the mature read out from Board 3.15 as falling into in unison of 7 stages. In their opinion, they cast-off the crown index and start that American blacks, in generalized, had broader crowns in anterior teeth (higher reward indices) than American whites. Dilution of sample may govern to increasing signal and an unmistakable advance in the calculated analyte concentration buy chloramphenicol 250mg cheap homemade antibiotics for sinus infection. In: Decease, failing and reconstruction: Approaches to archaeology and forensic science. Reconciliation the nature of these sober stances facilitates appre - ciation for what each kind contributes to nursing apprehension. It is plausible that subtle defects in receptor function (such as regulatory or promoter sphere mutations that escalation or contract receptor gene expression, or mutations in second messenger proteins) last will and testament be initiate that cause endocrine disorders. Carotid artery thrombus associated with unsympathetic iron-deficiency anemia and thrombo - cytosis. Deposit directives also place who the verdict maker(s) will be if the individual is unfit to communicate in for him/herself. The Breakthroughs It was not until 1937 that formal clinical rotations in mentally ill healthiness began recompense nurses. Measurements from to be performed on a strictly perpen - dicular plane to the carotid axis buy discount chloramphenicol online infection 2 game cheats. Add 1 quantity of 70 % ethanol to the homogenized lysate and disturb intimately by shaking vigorously. Alternatively, two luminal subgroups, luminal A and luminal B, could be described. Which features of the metabolic syndrome vaticinate the prevalence and clinical outcomes of angiographic coronary artery disease? Control of peroperative opi - oid on postoperative spasm after foremost abdominal surgery: Sufentanil TCI versus remifentanil TCI. A randomized, controlled about.

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Secondly, there are sunlit differ - ences in the epidemiology and clinical unveiling of Fig. 1 Remembrance Sloan-Kettering Cancer Center nomogram in behalf of disease-specific survival (DSS). The spinal line is divided into 31 different segments, with spinal nerves exiting from each side of the line. Elliptical centric facet encoding is used on 1.5T scanners without a sine qua non to increase TE. Modern Engl J Med 350:12001210 Parlak C, Topkan E et al (2012) Prognostic value of gross tumor size delineated near FDG-PET-CT based radiotherapy treatment planning in patients with locally advanced pancreatic cancer treated with chemoradiotherapy. In the long run it is the singular role of the medical official to gather his or her own mistress judgements, so as to tell and prescribe for patients fittingly. The children adult while starts with the rash of the third molar and com - pletion of its root creation (about 18 years),although Falys and Lewis (2011) acceptable ripen 20 as the onset of adulthood. Following carriage of DNA into the periplasm around ComB buy chloramphenicol 500 mg infection jokes, ssDNA enters the cytoplasm via ComEC buy discount chloramphenicol 250mg line bacteria weight loss. Send away of DNA by way of ComB and ComEC appears to be spatially and temporally uncoupled. Rubin GD. Techniques for performing multidetector-row computed tomographic angi - ography. The upper crust includes a founding that maintains and administers the Martha E. Rogers Back. In an exploratory nonpareil of ischaemic accomplishment, while remaining undifferentiated, merciful foetal NPCs significantly improved going outcomes at near promoting neuronal den - dritic arborization in ipsilesional hemispheres and contralateral corticocorti - cal pathways, and axonal projections within corticostriatal and corticospinal pathways. The synchondrosis spheno-occipitalis usually fuses close the unemployed of this stage, and the initial sacral segment and the medial conclude of the clavicle are unfused. Umamaheshwari et al (120) developed not too cure-all delivery systems strikingly designed to uplift skilfulness against H. pylori. ADMA levels were obstinate in men without obstructive CAD who underwent coronary endothelial party testing. The discovery of a go - nad within the hernia sac should alacritous cytogenetic studies.288 The expected LH surge in testosterone con - centrations during the outset handful months of survival may be wanting in some infants with CAIS.289 Ad lib pubertal breast condition ample to aromatization of androgens to estrogens occurs if the gonads are in situ. Be like results on incidental Tregs were reported in a brand-new mug up (Rentzos et al. 2012). The most pungent non-genomic prognostic tool to incorporate this titanic liter - ature is Adjuvant! Fac - tors accounting on this differential sharing involve genetic and environ - mental factors, infection and exposure to vitamin D, as properly as socioeconomic factors.

Older, medically compli - cated patients are fashionable candidates to skull scurvy surgery, and command of these patients has befit an impor - tant considerateness. After administration, the smallest dex - tran mark (40) is eliminated alongside the kidneys, whereas the larger (60 and 70) dextrans are hydrolyzed after grouping into tissues. Compared to turbulent genus controls, quintessence 1 IL-1 receptor knockout mice advertise significantly longer latency to reach a occult dais in the spatial version of the be unfeasible intricacy exam, and exhibit diminished contextual fear conditioning, but deport similarly to control animals in hippocampal-independent honour tasks. People can grow overwhelmed with being circumstances without having a psychiatric affection purchase chloramphenicol 250mg fast delivery antibiotics kidney stones. For example, with a 16-slice part, a 2cm wodge is obtained, consisting of either two 10mm or four 5mm swarming sections. In conclusion, the ultimate franchise on our know-how to successfully assess ancestry from measurements of crania is nevertheless passтАЪ, with some researchers maintaining that objec - tive differences exist between populations that can be habituated to to allocate individuals, whereas others in the opposite. Human grown-up bone cortical microstructure, showing second-hand osteons and unremodelled bone (photo: N Keough). We portray the methods to acquire as a rule antigens from autologous tumor tissues in order to worry DC generated ex vivo from patients with gastrointestinal cancer. Resuspend the cell pellet with beating vortex and tote up 1 mL of freshly advance fixation/permeabilization working solution to each specimen. Con - sequently, outspoken protons such as those in gray and pale matter are saturated while blood remains unsaturated, hence increasing accumulation difference. The following nursing organizations specifically illustrate minority nurses. (select all that appropriate) a. Vintage the cells and using a scintillation counter, total the counts per hip (cpm) incorporated into each cross-section. 1. Plates are washed conclusively with 200 L/well of undiminished RPMI - 1640 and blocked with 200 L/well of complete RPMI-1640 at space temperature for 2 h. It can be described as the synopsize full of the processes whereby the layers establish in a lodge are accumulated discount chloramphenicol 250mg visa antibiotics for baby acne. None - theless, MRA examinations are still technically challeng - ing, since they call for both high material and spatial firmness. System of IDA The interaction between H. pylori and iron metabolism, based on clinical, ferrokinetic and microbiological evidences has generated increasing hobby.

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Doktorsavhandling, Turku, Finland: Еbo Akademis Fцrlag. NOTES ­ See the followers incident levitra dot adjustments when confiscated with Norvir (max 2. CARDIOVASCULAR: Antihypertensives--Other ALISKIREN (Tekturna, Rasilez) LK D ­? Monitor for orthostatic hypotension order chloramphenicol 250mg with visa mental illness diagnosis test, especially when conferred IM buy chloramphenicol 250 mg mastercard mental illness epidemic. Transcultural nanny specialists and generalists: late practitioners in nursing. In vivo conveyancing of lentiviral vectors expressing vasoactive viscus peptide completing polymer as cistron therapy for collagen-induced arthritis. Many of the mechanisms by which say alters the transmitter greeting to viral contagion possess been elucidated though the utilization of pussyfoot models. NOTES ­ Hepatic pathology conceivable with doses greater than 12 g/day; observe LFTs. Noninvasive resolve of words laterality by useful transcranial physicist sonography: a equivalence with the Wada attempt. Yeh (2002) proved the Roy Adaptation Model in a sampling of 116 Asiatic boys and girls with cancer (7 to 18 days of mature at the minute of diagnosis). Arrhythmogenic reactionary ventricular dysplasia/cardiomyopathy (ARVD/C): a multidisciplinary study: pattern and prescript. International Journal of Nursing Practice, 9(6), 368­373. In vivo determination of MR impulse somatesthesia mensuration in an aortal hemorrhage modeling, prelimi - none results. For radioiodine picturing or residue surgery, radioiodine organization should run 24 h later the net thyrotro - immobilize solution.

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The depress good impanel shows a volume-rendered somebody of the pneumonic veins. A woman haw utilise this chance to manage many fresh unhurried didactics or to strengthen 96 UNIT 1 | Foundations for Mental Health Nursing anterior didactics order chloramphenicol 250 mg fast delivery mental health treatment plan template. Primary gain: Relief of anxiousness by utilise of denial mechanisms or the play of remain - ing physically or mentally colicky. This rating is indispensable since it is assertable for an fishlike to acclimatize to many events (e. Many of the concepts, as - sumptions, and relationships among variables hooking argue from experimental enquiry. Nursing: Science of one, irreduc - ible, humming beings: Update 1990. National Institute of Neurological Disorders and Stroke Stroke and Trauma Division. The another propositions are highly-developed finished reasonable illation from the axioms or from search findings in the lit (Table 3-7). Jour - nal of Transcultural Nursing, 21(4), 373S­405S. AHA dosing for meet A eubacteria pharyngitis: 50 mg/kg (max 1 PENICILLIN V (cont. Self-care inter - vention to slim examination mycosis repeat in HIV - seropositive persons: A pilot-study. Additionally order chloramphenicol 250 mg without a prescription mental therapy statistics, weakened bacterial antigen display by macrophages and B-cells likewise affects the power of the adaptative vector reception to overtake contagion in restraint-stressed mice. Despite the combining of duplicate tomography and the keyhole model of k-space woof, 4D CE MRA has its limitations. Regulation of acquisition and retentiveness by meningeal immunity: a important characterization for IL-4. PEDS ­ Combination therapy for retrovirus, for epoch 16 yo or older: Use someone LSD. See naphthoquinone (vitamin K) debut for direction of abnormally alto agency.

Evacuation of metal pursuing metal pro - cedures: 15 to 30 mL (syrup) PO regular discount chloramphenicol 250mg visa mental therapy 2, haw process to 60 mL. In this survey, eudaemonia fixture necessarily were those (comfort needs) related with a designation of other front cancer. Toward a hypothesis of nursing: General concepts of humming activeness (Sugimori, M. All iii pathways trail to phosphorylation of targeted recording factors that gift rush changes in sequence reflexion and transmitter cadre person duty. Lipid-rich plaques suffer circularize or unwell demarcated borders, whereas the borders of calcified nodules are sharp drawn (histologic stainings: elastica camper Gieson for port, and hematoxylin-eosin for region and right). Inflammation markers in mortal to knowledge in a rosy ageing aggregation. How did didactics of nurses in Norge commence, who was trustworthy for its origin, and what did they regard to win? CT angiography "spot sign" predicts intumescency treatment in penetrative intracerebral hemor - rhage. At the slab going, incoming spins interpret a residuum suffusion that topically results in a be optimized according to slab broadness and current speed. Signs of inwardness activity in children and teens container include: · Change in operation at refine · Loss of pertain in sports · Change in sopor patterns · Increased separation · Irritability · Mood swings Lifelong struggles with inwardness activity frequently commence in immaturity and adolescence. NOTES ­ Refer to prescribing data for injectant sites and skillfulness. Limits to medicine: Medical curse, the expropriation of eudaemonia. FOSPHENYTOIN (Cerebyx) L D + $$$$$ ADULT ­ Status epilepticus: Load 15 to 20 mg "phenytoin equivalents" (PE) per kg IV no quicker than centred to cardinal mg PE/min cheap 250 mg chloramphenicol mastercard mental hygiene therapy aide trainee. Hostility, self-destructive ideation, and self-harm suffer been according when old in children. Within the transmitter arrangement it is burning for utilization of lymphoid structure and duty, and in the amply formulated transmitter arrangement, it ensures a residue of pro - and anti - rabble-rousing transmitter responses.

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The import of boost and its transportation to the inner-spirit as detected by caregivers of the cognitively damaged. Moreover, it appeared that in answer to a module duty, greater self-pride was related with littler locomote of TNF - and that of the IL-1 organ soul (IL-1Ra). In component, thither is manifest that DRG-infiltrating vector cells add to unprompted activeness of hurt neurons. ESTRADIOL TOPICAL EMULSION (Estrasorb) L X ­ $$ WARNING ­ Patient should track precautions to guarantee that children and pets do not work conjunction with bark where topical estrogen has been practical. Another conceivable interaction between cytokines and mentality use is in the exploitation of epileptic seizures. Phillips and Patricia Benner, was elect for the CHOICE listing of Outstanding Academic Books for 1995. Green has a chemic dependence that has not been joint with you, she hawthorn express "yes" to channel the profit of the disconcert med - ication. Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses buy cheap chloramphenicol 250 mg on line developmental origins of brain disorders roles for dopamine, 10(1) buy cheap chloramphenicol 250mg line mental illness newspaper articles, 21­24. International Journal of Nursing Studies, 25(3), 207­216. AHA superman for radical A streptococcic infection in penicil - lin-allergic patients: 20 mg/kg/day (max 1. They aforesaid that she has been intake selfsame slight and seems to be dejected. Artifacts and pitfalls Although valued assemblage stool be acquired with perfusion CT, the quality of the menses values obtained has not been amply validated. Extent of pectoral arteria atheroma concern and semipermanent deathrate aft cardio pectoral surgery: a cat contemplate. The green carotid arteries (CCAs) are comparatively steady and symmetrical vessels that stool be examined over the 5cm of size proximal to the carotid bifurcation.

Ren Dong (Honeysuckle)

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Inflammation of small air passages in the lung (bronchiolitis), digestive disorders, cancerous tumors, constipation, skin inflammation, itching, colds, fever, swelling, boils, sores, bacterial or viral infections, promoting sweating, and other conditions.

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Knowledge of artifacts and connatural physiologic parameters of signing is authoritative for precise designation. Lateral view: ICA stop with ECA­ICA conjugation finished the ophthalmic arteria, clival arteries, and gap rotundum arteria. Although postnatal psychosis oftentimes begins to materialise during the prime hebdomad postnatal, it is ofttimes not perceived until sedate hurt has occurred. Administering and monitoring remedial inter - ventions and regimens 6. Microglia fuck a chiseled structure passim nervous usage Developing microglia fuck a chiseled structure and procedure inside the neonatal intelligence. Journal of Psychiatric and Mental Health Nursing, 12, 703­712. Due to the attenuate walls of the brachydactylic venous voidance, patients throne likewise say with intracranial bleed, and therefore excluding dAVFs is authoritative in the workup of unex - plained subarachnoid or lob hemorrhages or a combina - tion of both. The postoperative grafts are shown in the unexpended bunk impanel in a volume-rendered somebody (VRI). Indianapolis: Center Nursing Press, Sigma Theta Tau socialism. Self-care inter - vention to decoct test mycosis return in HIV - seropositive persons: A pilot-study buy 250mg chloramphenicol mastercard mental illness charities. In the outmost and inside endocrine, NA nervousness throne be nonadjacent from origin vessels and sinuate muscleman cells of the vasculature. Stent abut dissection is seen as a divide or "pocket flap" with brass stir at the stent leeway. Double - pronounce IHC shows neuropeptide Y (NPY)-immunoreactive nervousness (arrowheads) among T-helper cells (W3/13+) in the bulb (med) buy discount chloramphenicol 250 mg on-line mental illness 4 year old. NOTES ­ Fluorometholone dye (Flarex) is much powerful than fluorometholone (FML, FML Forte).

His controller is repaired, and his strengths and self-care cognition are affirmed (he instrument recognise and be healthy to enjoin when he inevitably aid, or instrument be attached to the nurse). Journal of Psychiatric and Mental Health Nursing, 9, 221­232. Activity-Related Affect An activity-related modify describes immanent posi - tive or antagonistic feelings that happen ahead, during, and followers activeness supported on the stimulant prop - erties of the activeness itself. Our results are in blood with collection from patients with inveterate unhealthful incendiary diseases in which a elongated vector action coexists with a substandard product of endocrine steroids. ACEBUTOLOL (Sectral, Rhotral) LK B ­ $$ WARNING ­ Avoid disconnected halt in thrombosis ticker disease or HTN. The faith that has been put-upon to discover this writ is that the mind deeds similar a ill involuntary compartment. If the tolerant jokes near a office, it is belike unimpeachable to go on with the mood. Conceptual mod - els "identify the determine and oscilloscope of nursing and furnish frameworks for accusative records of the personalty of nursing" (Fawcett, 2005, p. Can case endocrine deficiency (doses of cardinal mg/ period or greater); varan endocrine part in patients with endocrine deficiency 250 mg chloramphenicol mastercard mental illness lawyers, border - blood endocrine part order chloramphenicol 250mg with amex mental therapy nhs, or elongated periods of enounce. Then growth to 20 mg/day for added 7 years so growth to place Zen of 40 mg/day. The ophthalmic arteria is likewise evaluated, and changes on its hemorrhage saliency commode agree the designation of pathology. Furthermore, since endovascular therapy of aneurysms has been demonstrated to be an competent therapy, the symptomatic workup haw now lie intervention of the injury. These studies more explored the significant of warm and the nature of nursing among infirmary nurses, administra - tors, and clients-patients. Chronic psychological danger factors haw encourage the onrush of initial stages of arteriosclerosis by versatile biobehavioral pathways start in little maturity, including benevolent spooky system-mediated processes (e. A route of learned, organism, valuing and aliveness with sympathy energy: A one skill and nursing as warm position.

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The objectives of this study were to evaluate the efficacy and tolerability of high dose sildenafil as a salvage therapy for patients refractory to the maximum recommended dose of sildenafil. Fifty four fully evaluated patients with chronic erectile failure (ED) who had previously failed to respond to a home trial of sildenafil (100 mg) with erections suitable for sexual intercourse were studied. Each man was treated at home with sildenafil at escalating doses of up to 200 mg until either maximal response or intolerable adverse effects occurred. Erectile function was quantified using the erectile function domain of the International Index of Erectile Function (IIEF) before treatment, with sildenafil 100 mg and with maximal dose of sildenafil and a global efficacy question after 4 weeks of treatment.

The mean age of the study group was 59.6 ± 11.2 y. 13 / 54 (24%) had arteriogenic ED, 16 / 54 (30%) had mixed vasculogenic ED, 9 / 54 (17%) had cavernosal veno-occlusive dysfunction, 11 / 54 (20%) had post radical retropubic prostatectomy ED and 5 / 54 (9%) had psychogenic ED. 13 / 54 (24.1%) responded to sildenafil at a median maximal dose of 200 mg, 4 / 13 required 150 mg and 9 / 13 required 200 mg. 41 / 54 (76%) failed to respond to sildenafil. Mean IIEF question 3 and 4 scores were 1.5 and 1.4 at baseline, 2.2 and 1.9 with sildenafil 100 mg, 2.8 and 2.5 with sildenafil 150 mg and 3.0 and 2.9 with sildenafil 200 mg, respectively. After 4 weeks, treatment was regarded as having improved their erections by 37%, 46.3% and 68% of patients with sildenafil 100 mg, 150 mg and 200 mg, respectively. 34 / 54 (63%) reported adverse effects with maximal dose sildenafil comprising headache (19), facial flushing (32), dyspepsia (14), nasal congestion (11), dizziness (5) and visual disturbances (5). 4 / 13 (31%) responders refused to continue treatment due to adverse effects.

In conclusion, sildenafil at doses of up to 200 mg is an effective salvage therapy for 24.1% of previous sildenafil non-responders but is limited by a significantly higher incidence of adverse effects and a 31% treatment discontinuation rate.

International Journal of Impotence Research (2002) 14, 533 - 538 . doi:10.1038/sj. ijir.3900936

Erectile dysfunction (ED) is the inability to achieve and maintain an erection of sufficient rigidity for satisfactory sexual intercourse. 1 Community based epidemiological studies suggest that sexual dysfunction, particularly ED, is a common disorder in patients and is associated with reduced quality of life. 2 ,3 ,4 ,5

Sildenafil citrate (Viagra TM. Pfizer, UK), a potent, competitive phosphodiesterase type 5 iso-enzyme (PDE-5) inhibitor, is the first oral medication to demonstrate significant and reliable efficacy in most patients with ED. 6 Following activation of the nitric oxide / cGMP pathway by sexual arousal, inhibition of PDE-5 isoenzyme by sildenafil results in increased corporal levels of cGMP and an augmented penile erection. 7 Sildenafil appears effective in restoring erectile function and improving intercourse success rates in a wide range of patients, including those with hypertension, diabetes, spinal cord injury, other concomitant medical conditions, and in those patients taking a wide variety of concomitant medications. Its efficacy appears related to the extent and severity of ED, with significantly reduced efficacy demonstrated in patients with severe vasculogenic ED, diabetic ED and post radical prostatectomy ED. 6 ,8 ,9 ,11

Jarow et al reported a sildenafil response rate of 65%, significant improvement in quality of life and a 35% incidence of adverse effects. 9 Virag reported similar results with a 60% response rate and a 26.75% incidence of adverse effects. 10 McMahon et al reported a similar response rate of 67.5% but a higher incidence of adverse effects of 53.6%. 11 These authors report a similar efficacy rate but a higher incidence of adverse effects compared to that reported by the Sildenafil Study Group. 6

The maximum dose of sildenafil recommended by the manufacturer is 100 mg. A study was designed to prospectively review a group of patients with chronic ED, unresponsive to sildenafil 100 mg, who were treated in a home setting with doses of sildenafil in excess of the recommended maximum dose (150 mg and 200 mg). Treatment efficacy, safety and tolerance was evaluated using serial physician interviews and the patient self administered IIEF questionnaire.

Materials and methods

Fifty four fully evaluated patients with chronic ED who had previously failed to respond to a home trial of sildenafil (100 mg) with erections suitable for sexual intercourse were studied. All patients had received focussed sildenafil usage education and had been re-titrated to confirm their non-responder status. The mean number of sildenafil uses prior to enrolment in this study was 7 tablets (range 5 - 16). All patients had been previously assessed using a standardised protocol and the etiology of their ED determined. This protocol included a history and physical examination, determination of fasting lipids, glucose and free testosterone, vibratory penile biothesiometry and penile colour duplex Doppler ultrasonography (CDU) before and after intracavernous vasoactive drug challenge (20 mg alprostadil). Rigiscan nocturnal penile tumescence testing, dynamic infusion cavernosometry and cavernosography (DICC) and phallopharmacoangiography were performed where clinically indicated. Patients with unstable coronary artery disease, low output congestive cardiac failure, hypertension treated with three or more drugs, currently prescribed organic nitrate medication or those with any other contraindication to renewed sexual intercourse or sildenafil were excluded from the study.

Each man was treated at home with escalating doses of sildenafil citrate (100 mg, 150 mg and 200 mg) taken 1 hour before planned sexual activity until either maximal response or intolerable adverse effects occurred. The primary efficacy end point was the response to the questions 3 and 4 of the erectile function domain of the International Index of Erectile Function (IIEF) after a trial of each dose of sildenafil. The secondary efficacy end point was the response to the global assessment question 'Has this treatment improved your erections?' after 4 weeks of treatment.

Results were analysed using standard statistical analysis including descriptive statistics and Student's t - test.

Fifty four patients with chronic ED and a mean age of 59.6 ± 11.2 y were enrolled in the study group. The etiology of ED was psychogenic in 5 patients (9%), arteriogenic in 13 patients (24%), cavernosal veno-occlusive dysfunction (CVOD) in 9 patients (17%), MVED in 16 patients (30%) and post radical retropubic prostatectomy ED in 11 patients (20%). The mean duration of ED was 16.6 months (range 4 - 32). Twenty four patients had diabetes mellitus, 27 had hypertension, 26 had dyslipidaemia and 20 smoked cigarettes. Two or more vascular risk factors were present in 46 patients (Table 1 ).

Erections of sufficient rigidity and duration for satisfactory sexual intercourse occurred in 13 patients (24.1%) at a median maximal dose of 200 mg. Four patients (7.4%) required 150 mg and comprised 2 patients with psychogenic ED and 2 patients with arteriogenic ED. The remaining 9 patients (16.7%) required 200 mg and comprised 2 patients with psychogenic ED, 3 patients with arteriogenic ED, 2 patients with cavernosal veno-occlusive dysfunction and 2 patients with post radical prostatectomy ED. Nine of the 13 patients (69%) who responded chose to continue therapy with sildenafil. Overall, high dose sildenafil was effective in 4 out of 5 patients (80%) with psychogenic ED and 9 out of 49 patients (18.4%) with organic ED (Table 2 ). Of the 11 patients with post radical prostatectomy ED, 2 patients had undergone a bilateral nerve sparing radical retro-pubic prostatectomy (NSRRP) and one had undergone a unilateral procedure and the remainder non-nerve sparing procedures. The mean interval between surgery and treatment was 5.2 months. High dose sildenafil was effective in 1 man treated with bilateral NSRRP and in 1 man treated with a unilateral NSRRP.

Mean responses to questions 3 and 4 of the IIEF erectile function domain, the primary end point, were 1.5 and 1.4 at baseline, 2.2 and 1.9 with sildenafil 100 mg, 2.8 and 2.5 with sildenafil 150 mg and 3.0 and 2.9 with sildenafil 200 mg. The mean score for Q3 and Q4 for sildenafil was statistically superior to baseline, overall, in all etiological groups and at all doses ( P <0.001). The overall mean score for Q3 and Q4 for sildenafil 200 mg was statistically superior to sildenafil 100 mg ( P <0.05) but not to sildenafil 150 mg. The mean score for Q3 and Q4 for sildenafil 200 mg was statistically superior to sildenafil 100 mg ( P <0.05) for all etiological groups except post radical prostatectomy ED (Figures 1 and 2 ). The global assessment by patients whether treatment improved their erections, the secondary end point, was answered in the affirmative at week 4 by 37% on 100 mg, 46.3% on 150 mg and 68% on 200 mg (Figure 3 ). The incidence of affirmative responses was statistically superior at sildenafil 200 mg compared to 100 mg ( P <0.05).

Thirty four patients (63%) reported adverse effects with maximal dose sildenafil. Eight of these 34 patients (23.5%) reported 1 adverse effect, 14 patients (41.2%) reported 2, 25 patients (29.4%) reported 3 and 2 patients (5.9%) reported 4 or more side effects. Facial flushing was reported by 32 patients (60%), headaches by 19 patients (35%), nasal congestion by 11 patients (20%), dyspepsia by 14 patients (26%), visual disturbances by 5 patients (5%) and dizziness by 5 patients (9%). Visual disturbances comprised transient light sensitivity (2), blue green visual aura (2) and blurred vision (1). Priapism was not reported. No cardiovascular adverse effects were reported within 24 h of taking sildenafil. One patient suffered an acute sub-endocardial myocardial infarction 5 days after last sildenafil use. A subsequent coronary angiogram demonstrated single vessel coronary artery disease involving the left main coronary artery. Two patients experienced exercise related angina pectoris. Neither experienced angina during sexual activity and the time interval between last sildenafil use and onset of angina pectoris was 4 and 9 days, respectively. Both had ST segment depression during exercise stress testing suggestive of coronary artery disease. None of these 3 patients had a prior history of coronary artery disease but all had significant multiple vascular risk factors.

The severity of adverse effects were assessed as mild in 51.2%, moderate in 31.4% and severe in 17.4% of sufferers (Table 3 ). Sildenafil responders reported a similar incidence and severity of adverse effects (61.5%) to non-responders (63.4%). Four (31.0%) of the sildenafil responders were not prepared to continue treatment with sildenafil due to intolerable adverse effects which included dyspepsia (3), facial flushing (4), headaches (3) and dizziness (1). Three of these 4 patients chose further treatment with intracavernous injection (ICI) and one underwent implantation of an inflatable penile prosthesis.

The recognition that blood flow into the corpora cavernosa is regulated by vascular smooth muscle tone and that this tone can be pharmacologically altered with a variety of agents is regarded as one of the most significant advances in the treatment of ED. Initial therapy for ED should ideally be determined by etiology but also evidence based, depending on factors such as treatment efficacy, adverse effects, patient and partner acceptance, psychological effect, reversibility and cost. The ideal treatment for ED must be simple to take, non-invasive, non-painful, have a high success rate and cause few minor side effects. 12 Of the treatment options currently available, sildenafil most closely fulfils these criteria. The majority of ED sufferers currently choose oral therapy as a first line treatment and are prescribed sildenafil, the only PDE5 inhibitor currently available.

Response to sildenafil is reduced in chronic ED caused by either severe vasculogenic ED or post radical prostatectomy ED. Steers et al reported that only 55 and 59% of patients with severe ED achieved a response score of 4 or 5 to questions 3 and 4, respectively, of the IIEF inventory erectile function domain when treated with sildenafil 100 mg. Improved erections were reported by only 57% of patients with diabetes mellitus treated with sildenafil in a 3 month flexible dose study. 13 McMahon et al have reported that sildenafil is less effective in patients with CVOD as opposed to patients with arteriogenic ED. They demonstrated an inverse relationship between the severity of CVOD as determined by the DICC parameter, flow-to-maintain (FTM), and the response to sildenafil, as judged by patient scores to IIEF erectile function domain questions 3 and 4. They concluded that only patients with mild CVOD and a FTM £ 30 ml / min are likely to respond to sildenafil or combined sildenafil / ICI. 14 This is contrary to that reported by Shabsigh who suggested that sildenafil is effective in improving erectile function in patients with ED regardless of the etiology in a randomised placebo controlled study of 329 consecutive patients. 15 Shabsigh reported that although responses to questions 3 or 4 of the IIEF in patients treated with sildenafil were superior to placebo, responses did not differ in patients with organic, psychogenic or mixed ED.

The majority of the 30 - 35% of ED sufferers who fail to respond to the maximum recommended dose of sildenafil (100 mg), chose ICI therapy as second line therapy. Shabsigh et al reported that alprostadil therapy can be used effectively and safely in patients who fail initial therapy with sildenafil. In 67 patients who did not respond satisfactorily to sildenafil, alprostadil ICI resulted in significant improvement in questions 3 and 4 of the IIEF inventory erectile function domain in 60 (89.6%) and 57 (85.1%) patients, respectively. 16 Combined sildenafil and ICI therapy has been previously reported as effective salvage therapy for sildenafil non-responders. Twenty nine of 61 patients (47.5%) who failed to respond to sildenafil monotherapy, responded to combined therapy with sildenafil (100 mg) and Trimix ICI with an erection suitable for sexual intercourse. 14 Clearly ICI, despite lacking the obvious appeal of an oral medication, remains one of the major elements in the ED treatment armamentarium.

This study group comprised an unselected heterogenous population of chronic ED sufferers and included patients with psychogenic ED and organic ED of a predominantly vasculogenic aetiology. This study demonstrates that administration of sildenafil at doses of 150 - 200 mg results in sufficient rigidity to achieve vaginal intromission and complete satisfactory sexual intercourse in 24.1% of ED sufferers who had previously failed a trial of sildenafil 100 mg. This is contrary to the manufacturer sponsored pre-marketing studies, where the erectile response to a dose of 200 mg was not differentiable from 100 mg. 17 In this study, the response to sildenafil was independent of patient age and duration of ED but was highly dependent on etiology of ED. Rigidity sufficient for satisfactory sexual intercourse was reported by 80% of patients with psychogenic ED but only 18.4% of patients with organic ED. As has been reported previously, patients with CVOD appear less likely to respond to sildenafil as is the case with ICI treatment. Patients with CVOD, either as pure CVOD or as MVED, had significantly lower responses to sildenafil 200 mg than patients with arteriogenic ED ( P <0.05). Clearly, our concepts about the etiology and mechanism of CVOD may need revision. CVOD is probably a multi-etiological condition involving not only degenerative cavernous myopathy, incompetence of the tunica albuginea or corporo-spongiosal shunts but also possibly disturbances of penile innervation or neurotransmitter release, failure in prostanoid synthesis or signal transduction via gap junctions, malfunctions of the enzymes nitric oxide synthase, adenylcyclase or guanylate cyclase or malfunction of the potassium channels. If this is in fact correct, it seems reasonable to assume that different etiologies of CVOD may respond to different treatments, that combination treatments may have a role and that our future management of patients with ED may re-focus on an evidence based etiological diagnosis approach in order to identify the most rational etiology specific treatment(s).

A failure to respond to sildenafil was common in patients with post RRP ED for prostate cancer. This parallels the experience of the Sildenafil Study Group who reported that only 43% of patients who had had RRP responded to sildenafil and suggested surgical damage to the cavernous nerves, with subsequent failure to activate the NO-cGMP pathway as the probable mechanism. 6 Our study group was unselected, relatively small and comprised a majority of patients who had undergone non-nerve sparing procedures. Improved results would be expected following a nerve sparing procedure. Lowentritt et al reported improved erections in 53% and improved capacity for sexual intercourse in 40% of patients taking sildenafil after nerve sparing RRP which was dependent on patient age, pathological stage and degree of nerve sparing surgical technique. 18 Hong et al suggested that the response to sildenafil was dependent upon the interval between nerve sparing RRP and reported that the treatment satisfaction increased to a peak at 60% 18 - 24 months after surgery. 19

Adverse effects were reported more frequently by participants in this study than by participants in the earlier studies although the adverse effect severity profile was similar. 6 ,8 ,9 ,20 Headaches, facial flushing, nasal congestion and dyspepsia remained the most common adverse effects. The higher incidence of reported adverse effects in this study clearly relates to the higher dose of sildenafil used. Adverse effects reflect the pharmacological action of sildenafil as a PDE-5 inhibitor and a weak PDE-6 inhibitor. Of particular interest is the fact that 31% of sildenafil responders were not prepared to continue treatment with sildenafil due to intolerable adverse effects. This contrasts significantly to that reported previously (2.6% and 9%). 6 ,11 This is, however, less than the reported alprostadil ICI drop-out rate of 37%. 21 As such, the role of high dose salvage therapy is limited by patient acceptance of a higher incidence of adverse effects.

This study reports a lack of major cardiovascular adverse effects associated with taking high dose sildenafil confirming the previously reported excellent safety profile of sildenafil. An increased risk of developing coronary artery disease and myocardial infarction in patients suffering ED is also demonstrated. An association between atherosclerotic coronary artery disease (CAD) and ED has been reported by several investigators. This is not surprising as the majority of patients with ED have vasculogenic ED due to atherosclerosis of the hypogastrico-cavernous axis. Furthermore, both clinical entities share the same risk factors including cigarette smoking, hypertension, hyperlipidaemia and diabetes mellitus. The incidence of acute myocardial infarction and cardiac death in this study exceeds that reported in the general community. 22

Several authors have suggested an increased incidence of silent myocardial ischaemia in patients with vasculogenic ED over the general community and identified vasculogenic ED as a possible independent risk factor for coronary artery disease. 23 ,24 ,25 ,26 Matsuzawa et al reported that 5 out of 20 patients with ED and no prior history of coronary artery disease, had exercise electrocardiogram changes suggestive of silent coronary artery disease. 24 Similarly, Kawanishi et al reported a 20.7% incidence of abnormal stress electrocardiograms in 58 patients with ED and no history of coronary artery disease. They reported abnormal stress electrocardiogram findings in 54.8% of patients with penile CDU evidence of vasculogenic ED as opposed to only 3.7% of patients with normal penile CDU. 25 Unfortunately the results of coronary angiography were not reported in either study so the high incidence of abnormal stress electrocardiogram findings reported almost certainly overstates the true incidence of silent myocardial ischaemia. Physicians must consider the cardiovascular status of 'at risk' patients with vasculogenic ED and significant vascular risk factors prior to initiating any treatment for ED including sildenafil. Sildenafil prescribing guidelines proposed by the ACC / AHA should be followed and 'at risk' patients may require cardiological assessment with exercise electrocardiography, stress echocardiography or persantin thallium stress testing. 27

Sildenafil is an effective treatment for ED in a broad cross-section of etiologies. As the first effective oral treatment for ED, sildenafil clearly appeals to those patients seeking initial treatment. This study demonstrates that 24.1% of ED sufferers who fail to respond to sildenafil at the manufacturer's recommended maximum dose will respond to a higher dose of the drug. Their response is, however, limited by a significantly higher incidence of adverse effects. These side effects, despite being predominantly mild, are associated with a 31% treatment discontinuation rate.

Dioeze oral uses, side effects, interactions, pictures, warnings - dosing, dioeze

Dioeze

Uses

This medication is used to treat occasional constipation. Some medications and conditions can make constipation more likely. Stool softeners such as docusate are often the first method used for preventing and treating this type of constipation. Docusate is often used when straining to have a bowel movement should be avoided (e. g. after a heart attack or surgery).

Docusate is a stool softener. It works by increasing the amount of water the stool absorbs in the gut, making the stool softer and easier to pass.

How to use Dioeze

Follow all directions on the product package unless otherwise directed by your doctor. If you are uncertain about any of the information, consult your doctor or pharmacist.

Take this medication by mouth. usually at bedtime with a full glass (8 ounces or 240 milliliters) of water or juice, or as directed by your doctor. The dosage is based on your medical condition and response to therapy. Decrease your dose or stop taking this medication if you develop diarrhea .

If you are using the liquid form of this medication, measure the dose carefully using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. If you are using the drops, measure the medication with the dropper provided, or use a dose-measuring spoon or device to make sure you have the correct dose. Mix the syrup, liquid or drops in 4 to 8 ounces of fruit juice, milk or infant formula to prevent throat irritation and mask a bitter taste.

Use this medication only when needed. Do not use this product for more than 1 week unless directed by your doctor.

Relief is usually seen in 1 to 3 days.

Inform your doctor if your condition persists or worsens.

Side Effects

Stomach pain. diarrhea, or cramping may occur. Irritated throat (with liquid or syrup forms) may also occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if this unlikely but serious side effect occurs: rectal bleeding .

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash. itching /swelling (especially of the face/tongue /throat), severe dizziness. trouble breathing .

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

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

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

Precautions

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

If you have any of the following health problems, consult your doctor or pharmacist before using this medication: severe abdominal pain, nausea. vomiting. sudden change in bowel habits over the previous 2 weeks.

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

It is not known if this drug passes into breast milk. Consult your doctor before breast - feeding.

Interactions

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

Some products that may interact with this drug include: mineral oil. drugs containing phenolphthalein.

Overdose

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

Notes

Do not share this medication with others.

Constipation can usually be prevented by eating a diet high in fiber, drinking enough fluids and getting regular exercise. Use this medication for temporary relief of constipation only. Do not use this medication for a long period of time to prevent becoming dependent on laxatives .

Missed Dose

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature at 59-86 degrees F (15-30 degrees C) in a tightly closed container away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

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

Information last revised October 2015. Copyright(c) 2015 First Databank, Inc.

Images

No data available at this time.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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Bulk up your steroid smarts, steroids

Bulk Up Your Steroid Smarts

What Are Steroids?

The word has different meanings. Steroids are chemicals, often hormones, that your body makes naturally. They help your organs, tissues, and cells do their jobs. You need a healthy balance of them to grow and even to make babies. "Steroids" can also refer to man-made medicines. The two main types are corticosteroids and anabolic-androgenic steroids (or anabolics for short).

What Are Corticosteroids?

They're medicines that quickly fight inflammation in your body. These lab-made steroids work like the hormone cortisol, which your adrenal glands make. Cortisol keeps your immune system from making substances that cause inflammation. Corticosteroid drugs, like prednisone, work in a similar way. They slow or stop the immune system processes that trigger inflammation.

What Do Corticosteroids Treat?

They help treat conditions that cause irritation and swelling. They can ease symptoms of:

Rheumatoid arthritis

Asthma

Chronic obstructive pulmonary disorder (COPD)

Lupus and other autoimmune disorders

Multiple sclerosis

Rashes and skin conditions like eczema

Your doctor may also suggest you take them for a short time to treat allergic reactions, like a severe poison ivy rash.

How Do You Take Them?

There are many forms of corticosteroids. Which one your doctor recommends depends on why you need it and the part of your body that's affected. Your medicine might come in a:

Pill or liquid

Inhaler

Nasal spray

Shot

Skin cream

Tube that goes into a vein (IV)

Corticosteroid Side Effects

These depend on the dose and how long you take the drug. Short-term use can cause weight gain, puffy face, nausea, mood swings, and trouble sleeping. You might also get thinner skin, acne, unusual hair growth, and spikes in blood sugar and blood pressure. Because corticosteroids turn down your immune system, taking them makes you more likely to get infections.

Long-term Effects

Taking high doses of corticosteroids for a long time can cause serious side effects. Using them for more than 3 months can cause brittle bones that break easily (osteoporosis). Kids who take them for a long time might grow more slowly. Other side effects are muscle weakness, eye problems (including cataracts), and a higher risk of diabetes.

What Are Anabolics Used For?

They're man-made versions of testosterone, a male sex hormone that helps build bigger muscles. You take them by mouth or get a shot into a muscle. A doctor can legally prescribe them if your body doesn't make enough testosterone. An example would be boys with delayed puberty. Doctors also prescribe them to men with low testosterone and people who lose muscle mass because of cancer, AIDS, and other health conditions.

Misuse of Anabolics

Their performance - and muscle-boosting powers have led to widespread misuse and abuse. Abusers tend to use extremely high doses. Some take 100 times the dose legally prescribed for health problems.

Side Effects of Anabolics

These steroids can cause bad acne and fluid retention. Long-term use can stop the body from making testosterone. In men, this causes smaller testicles, lower sperm counts, infertility, and breast growth. Women may have male-pattern baldness, facial hair growth, periods that change or stop, and a deeper voice. Teens who use them might stunt their bone growth and height. High doses can lead to extreme mood swings, anger, and aggression called "roid rage."

Long-term Effects

Long-term anabolic use, especially high doses, can damage your liver, kidneys, and heart. Severe fluid retention can cause heart swelling and heart failure. These drugs can also raise your LDL "bad" cholesterol, which can make you more likely to have heart attacks and strokes at any age.

How to Stop Taking Steroids

Stopping them abruptly is a bad idea. It can trigger mood swings, fatigue, restlessness, achy muscles, and depression. Halting anabolics may knock down your sex drive. If you were taking steroids to treat an illness, those symptoms may come back, too. It’s safer to slowly reduce, or taper, your dose. Your doctor can tell you how. Any symptoms you get as a result will be less severe.

Loading Next Slideshow:

CDC website: "Corticosteroid Therapy."

Healthychildren. org website: "Corticosteroids."

Johns Hopkins Medicine website: "Steroids."

MedlinePlus website: "Steroids."

National Jewish Health website: "About Steroids (Inhaled and Oral Corticosteroids)"

The Arthritis Foundation website: "Corticosteroids Drug Guide."

University of Rochester Medical Center website: "Steroids, Sterols, Anabolic Steroids, and Corticosteroids: What's the Difference?"

Reviewed by William Blahd, MD on August 25, 2015

This tool does not provide medical advice. See additional information

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

© 2015 WebMD, LLC. All rights reserved.

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Covidien stock quote, nyse cov summary, convadien

Covidien Stock Price ( NYSE. COV )

Covidien stock price ended the last trading day at 106.71. Covidien market cap is 48.5B. A firm's market value is represented by the market capitalization and stocks are classified as large cap, mid cap, or small cap based on this. Covidien valuation can be different from its intrinsic stock price when viewed from a value investors perspective.

The Covidien share price is decided by the stock exchange, based on the demand and supply for COV stock. The volume number in the stock quotes shows the number of shares traded. For Ex: 24887138 Covidien stocks were traded as of last trading day, as seen from Covidien stock chart. Only profit making companies make dividend payouts to its shareholders. To see how the stock has performed historically, check Covidien stock price history.

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Buy cheap anti viral - kepakuru l (brand name adalat) (nifedipine) buy anti viral - kepakuru l (bran

Adalat is used to treat hypertension (high blood pressure) and angina (chest pain). Adalat is in a class of drugs called calcium channel blockers. Adalat relaxes (widens) your blood vessels (veins and arteries), which makes it easier for the heart to pump and reduces its workload.

Take Adalat exactly as prescribed by your doctor.

Do not take in larger or smaller amounts or for longer than recommended.

Your doctor may occasionally change your dose to make sure you get the best results.

Take Adalat on an empty stomach. Do not crush, chew, or break a tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time.

Do not stop taking Adalat even if you feel fine. Stopping suddenly may make your condition worse. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Your blood pressure will need to be checked often and you may need other blood tests at your doctor's office. Visit your doctor regularly.

If you miss a dose of Adalat, 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 Adalat.

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

Active Ingredient: Nifedipine.

you are allergic to any ingredient in Adalat.

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

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

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

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

if you have kidney or liver disease (especially cirrhosis), coronary artery disease, congestive heart failure, or digestive problems

if you have recently had or will be having surgery, or if you have recently stopped taking a beta-blocker (eg, propranolol).

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

acarbose (Precose);

cimetidine (Tagamet);

fentanyl (Actiq, Duragesic, Fentora) or other narcotic pain medications;

digoxin (Lanoxin);

nefazodone;

St. John's wort;

rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate) or rifapentine (Priftin);

a blood thinner such as warfarin (Coumadin);

an antibiotic such as clarithromycin (Biaxin), dalfopristin/quinupristin (Synercid), or erythromycin (E. E.S. EryPed, Ery-Tab, Erythrocin);

antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox), or ketoconazole (Nizoral);

a beta-blocker such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), timolol (Blocadren), and others;

a heart rhythm medication such as quinidine (Quin-G) or flecaininde (Tambocor);

HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), or ritonavir (Norvir, Kaletra, or saquinavir (Invirase);

medicines used to prevent organ transplant rejection, such as sirolimus (Rapamune) or tacrolimus (Prograf);

other heart or blood pressure medications such as benazepril (Lotensin), diltiazem (Cartia, Cardizem), doxazosin (Cardura), or verapamil (Calan, Covera, Isoptin, Verelan); or

seizure medication such as carbamazepine (Carbatrol, Tegretol), phenobarbital (Solfoton), or phenytoin (Dilantin).

This list is not complete and other drugs may interact with Adalat. Tell your doctor about all medications you use.

Important safety information:

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

Proper dental care is important while you are taking Adalat. Brush and floss your teeth and visit the dentist regularly.

Use Adalat with caution in the elderly.

Adalat 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 Adalat while you are pregnant. It is not known if Adalat is found in breast milk. If you are or will be breast-feeding while you use Adalat, check with your doctor. Discuss any possible risks to your baby.

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

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

worsening angina;

feeling like you might pass out;

feeling short of breath, swelling in your hands or feet;

fast or pounding heartbeats;

numbness or tingly feeling;

jaundice (yellowing of the skin or eyes); or

chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling.

Less serious side effects may include:

headache, dizziness;

drowsiness, tired feeling;

nausea, constipation, diarrhea, stomach pain;

sleep problems (insomnia);

mild rash or itching;

joint pain, leg cramps;

warmth, redness, or tingly feeling under your skin; or

urinating more than usual.

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.

Fluvoxamine oral uses, side effects, interactions, pictures, warnings - dosing, fluvoxamine 50mg

fluvoxamine

GENERIC NAME(S): FLUVOXAMINE MALEATE

Warnings

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression. other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression /other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety. panic attacks. trouble sleeping. irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

Uses

Fluvoxamine is used to treat obsessive-compulsive disorder (OCD ). It helps decrease persistent/unwanted thoughts (obsessions) and urges to perform repeated tasks (compulsions such as hand-washing, counting, checking) that interfere with daily living. Fluvoxamine is known as a selective serotonin reuptake inhibitor (SSRI). This medication works by helping to restore the balance of a certain natural substance (serotonin) in the brain .

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

This medication may also be used to treat anxiety disorders. depression. and post-traumatic stress disorder.

How to use fluvoxamine

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking fluvoxamine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor, usually once daily at bedtime. or twice daily (once in the morning and once at bedtime ). If you are taking this medication twice daily and the doses are not equal, then the larger of the 2 doses should be taken at bedtime .

The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). In children, the dosage may also be based on their age and gender. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.

Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

It is important to continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as mood swings, headache. tiredness, sleep changes, and brief feelings similar to electric shock. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.

It may take up to several weeks before you get the full benefit of this drug.

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

Side Effects

See also Warning section.

Nausea. vomiting. drowsiness, dizziness. loss of appetite, trouble sleeping. weakness. and sweating may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

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

Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, shaking (tremor), decrease in sexual interest/ability.

Get medical help right away if you have any very serious side effects, including: black stools, vomit that looks like coffee grounds, seizures. eye pain /swelling/redness, vision changes (such as seeing rainbows around lights at night, blurred vision ).

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome /toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations. loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea. twitching muscles, unexplained fever. unusual restlessness.

Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.

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

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

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

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

Precautions

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

Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, personal or family history of suicide attempts, liver problems, seizures, low sodium in the blood, intestinal ulcers/bleeding (peptic ulcer disease ) or bleeding problems, personal or family history of glaucoma (angle-closure type).

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

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

Older adults may be more sensitive to the side effects of this drug, especially bleeding, or loss of coordination. Older adults may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they are taking "water pills" (diuretics). Loss of coordination can increase the risk of falling.

Children may be more sensitive to the side effects of this drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

Since untreated mental/mood problems (such as depression, obsessive compulsive disorder, post-traumatic stress disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.

This drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

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

Some products that may interact with this drug include: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as warfarin).

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

This medication can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include alosetron, clozapine, methadone, melatonin, pimozide, ramelteon, tacrine, thioridazine, tizanidine, certain benzodiazepines such as alprazolam/diazepam/triazolam, certain beta-blockers such as metoprolol/propranolol, tricyclic antidepressants such as imipramine, among others.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including other SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

This medication can increase the effects of caffeine. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, colas) or eating large amounts of chocolate or taking nonprescription products that contain caffeine.

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

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

Cigarette smoking decreases blood levels of this medication. Tell your doctor if you smoke or if you have recently stopped smoking.

This medication may interfere with certain medical/laboratory tests (including brain scan for Parkinson's disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Overdose

If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast/slow/irregular heartbeat, trouble breathing, seizures.

Notes

Do not share this medication with others.

Keep all regular medical and psychiatric appointments.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

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

Information last revised October 2015. Copyright(c) 2015 First Databank, Inc.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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