Online PLR Article Directory Tokelau: March 2012

Thursday, March 29, 2012

Claritin Reditabs Orally Disintegrating Tablets

Pronunciation: lor-A-ta-deen
Generic Name: Loratadine
Brand Name: Examples include Claritin Reditabs and Triaminic Allerchews

Claritin Reditabs Orally Disintegrating Tablets are used for:

Relieving symptoms of seasonal allergies such as runny nose; sneezing; itchy, watery eyes; or itching of the nose and throat. It may also be used for other conditions as determined by your doctor.

Claritin Reditabs Orally Disintegrating Tablets are an antihistamine. It works by blocking a substance in the body called histamine. This helps to decrease allergy symptoms.

Do NOT use Claritin Reditabs Orally Disintegrating Tablets if:

you are allergic to any ingredient in Claritin Reditabs Orally Disintegrating Tablets

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

Before using Claritin Reditabs Orally Disintegrating Tablets:

Some medical conditions may interact with Claritin Reditabs Orally Disintegrating Tablets. 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 problems, or phenylketonuria (PKU)

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

Amiodarone because the risk of severe irregular heartbeat may be increased

Ask your health care provider if Claritin Reditabs Orally Disintegrating Tablets may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Claritin Reditabs Orally Disintegrating Tablets:

Use Claritin Reditabs Orally Disintegrating Tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take Claritin Reditabs Orally Disintegrating Tablets by mouth with or without food.

Be sure that your hands are completely dry before you handle Claritin Reditabs Orally Disintegrating Tablets. Use the tablet right away after you remove it from the tablet blister.

To open the tablet blister, peel back the foil, then gently remove the tablet. Place the tablet on the tongue. The tablet will dissolve quickly. You may take Claritin Reditabs Orally Disintegrating Tablets with or without water.

If you miss a dose of Claritin Reditabs Orally Disintegrating Tablets, 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 Claritin Reditabs Orally Disintegrating Tablets.

Important safety information:

Taking Claritin Reditabs Orally Disintegrating Tablets in high doses may cause drowsiness. Do NOT take more than the recommended dose without checking with your doctor.

Claritin Reditabs Orally Disintegrating Tablets may interfere with skin allergy tests. If you are scheduled for a skin test, talk to your doctor. You may need to stop taking Claritin Reditabs Orally Disintegrating Tablets for a few days before the tests.

Some of these products contain phenylalanine. If you must have a diet that is low in phenylalanine, ask your pharmacist if it is in your product.

Claritin Reditabs Orally Disintegrating Tablets should not be used in CHILDREN younger than 6 years old without checking with the child's doctor; safety and effectiveness in these children have not been confirmed.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Claritin Reditabs Orally Disintegrating Tablets while you are pregnant. Claritin Reditabs Orally Disintegrating Tablets are found in breast milk. If you are or will be breast-feeding while you use Claritin Reditabs Orally Disintegrating Tablets, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Claritin Reditabs Orally Disintegrating Tablets:

All medicines may cause side effects, but many people have no, or minor, side effects. No COMMON side effects have been reported with this product. Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); severe or persistent dizziness.

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

See also: Claritin Reditabs side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fast or irregular heartbeat; severe drowsiness or headache.

Proper storage of Claritin Reditabs Orally Disintegrating Tablets:

Store Claritin Reditabs Orally Disintegrating Tablets at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Do not use a tablet if the blister unit is open or torn. Use within 6 months of opening the foil pouch. Keep Claritin Reditabs Orally Disintegrating Tablets out of the reach of children and away from pets.

General information:

If you have any questions about Claritin Reditabs Orally Disintegrating Tablets, please talk with your doctor, pharmacist, or other health care provider.

Claritin Reditabs Orally Disintegrating Tablets are to be used only by the patient for whom it is prescribed. Do not share it with other people.

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

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

This information is a summary only. It does not contain all information about Claritin Reditabs Orally Disintegrating Tablets. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Claritin Reditabs resources

Claritin Reditabs Side Effects (in more detail)
Claritin Reditabs Use in Pregnancy & Breastfeeding
Drug Images
Claritin Reditabs Drug Interactions
Claritin Reditabs Support Group
0 Reviews for Claritin Reditabs - Add your own review/rating

Compare Claritin Reditabs with other medications

Hay Fever
Urticaria

Nostril Nasal Decongestant

Generic Name: phenylephrine nasal (FEN il EFF rin)

Brand Names: Afrin 4 Hour Extra Moisturizing, Alconefrin-12, Alconefrin-25, Neo-Synephrine Nasal, Nostril Nasal Decongestant, Rhinall, Sinex Nasal Spray, Sinex Ultra Fine Mist

What is Nostril Nasal Decongestant (phenylephrine nasal)?

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

Phenylephrine nasal is used to treat nasal congestion and sinus pressure caused by allergies, the common cold, or the flu. Phenylephrine may be used to treat congestion of the tubes that drain fluid from your inner ears, called the eustachian (yoo-STAY-shun) tubes.

Phenylephrine nasal may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Nostril Nasal Decongestant (phenylephrine nasal)?

Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children.

You should not use this medication if you are allergic to phenylephrine.

Do not use phenylephrine nasal if you have used linezolid (Zyvox) or procarbazine (Matulane), or if you have taken a monoamine oxidase inhibitor (MAOI) such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) in the last 14 days. Serious, life-threatening side effects can occur if you use phenylephrine before these other drugs have cleared from your body.

Before using phenylephrine nasal, tell your doctor if you are allergic to any decongestants, or if you have heart disease, heart rhythm disorder, high blood pressure, diabetes, glaucoma, a thyroid disorder, or an enlarged prostate or urination problems.

Phenylephrine may interact with heart or blood pressure medications, antidepressants, diabetes medications, and other decongestants.

Never use more of this medicine than directed on the label or prescribed by your doctor.

Call your doctor if your symptoms do not improve after 3 days of using phenylephrine nasal, or if they get worse and you also have a fever. Using phenylephrine nasal too long can damage the lining of your nasal passages and lead to chronic nasal congestion.

What should I discuss with my healthcare provider before using Nostril Nasal Decongestant (phenylephrine nasal)?

You should not use this medication if you are allergic to phenylephrine.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use phenylephrine nasal:

heart disease, heart rhythm disorder;

high blood pressure;

diabetes;

glaucoma;

a thyroid disorder; or

an enlarged prostate or urination problems.

FDA pregnancy category C. Is not known whether this medication will harm an unborn baby. Before using phenylephrine nasal, tell doctor if you are pregnant. Phenylephrine nasal may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medication.

How should I use Nostril Nasal Decongestant (phenylephrine nasal)?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.

Phenylephrine nasal is usually used every 4 hours. Follow the directions on the medicine label. Never use more of this medicine than directed on the label or prescribed by your doctor. Using phenylephrine nasal too long can damage the lining of your nasal passages and lead to chronic nasal congestion.

Gently blow your nose to clear any mucus before using this medication.

To use the nasal spray, insert the tip of the spray bottle into your nostril, past the middle of the inside of your nose (the nasal septum). Gently press your other nostril closed with your finger.

Keep your head upright, and squeeze the bottle while breathing in deeply through your nose. Sniff quickly a few times to get the medicine deep into your nasal passages.

Repeat these steps to use the medicine in your other nostril if needed.

After each use, clean the tip of the spray bottle with a clean tissue or rinse it with hot water, making sure that no water gets into the medicine bottle. Keep the cap on the bottle when not in use.

To use the nasal drops, lie on your back with your head tilted back. Insert the correct number of drops and remain lying in this position for several minutes. Gently turn your head from side to side.

Call your doctor if your symptoms do not improve after 3 days of using phenylephrine nasal, or if they get worse and you also have a fever.

If you need to have any type of surgery, tell the surgeon ahead of time if you have used phenylephrine nasal within the past few days.

Store phenylephrine nasal at room temperature away from moisture and heat. To prevent the spread of infection, do not share this medication with anyone else.

What happens if I miss a dose?

Since phenylephrine nasal is usually used only when needed, you may not be on a dosing schedule. If you are using the medication regularly, apply the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and apply the medicine at your next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

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

Overdose symptoms may include severe dizziness or drowsiness, slow heart rate, and fainting.

What should I avoid while using Nostril Nasal Decongestant (phenylephrine nasal)?

Avoid getting this medication in your eyes. Do not use any other over-the-counter cold, allergy, or cough medication without first asking your doctor or pharmacist. Phenylephrine is contained in many medicines available over the counter. If you use certain products together you may accidentally get too much phenylephrine. Read the label of any other medicine you are using to see if it contains phenylephrine or another decongestant.

Nostril Nasal Decongestant (phenylephrine nasal) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using phenylephrine and call your doctor at once if you have a serious side effect such as:

severe sneezing, runny or stuffy nose, redness or swelling in your nose, or other worsening nasal symptoms (may be a sign of overuse of phenylephrine nasal);

severe stinging, burning, or irritation inside your nose;

severe dizziness, restless feeling, nervousness, or insomnia;

mood changes, unusual thoughts or behavior;

feeling like you might pass out;

slow, fast, or pounding heartbeat;

tremors or shaking; or

urinating less than usual or not at all.

Less serious side effects may include:

temporary sneezing;

mild burning, dryness, cold feeling, or irritation inside your nose;

headache, dizziness, weakness;

sweating, nausea;

feeling excited or restless (especially in children); or

mild sleep problems.

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 Nostril Nasal Decongestant (phenylephrine nasal)?

Tell your doctor about all other medications you use, especially:

other decongestants;

medicine to treat diabetes;

medicines to treat high blood pressure such as reserpine, guanethidine (Ismelin), methyldopa (Aldomet), and others; or

an antidepressant such as amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Janimine, Tofranil), and others.

This list is not complete and there may be other drugs that can interact with phenylephrine nasal. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

More Nostril Nasal Decongestant resources

Nostril Nasal Decongestant Use in Pregnancy & Breastfeeding
Nostril Nasal Decongestant Drug Interactions
0 Reviews for Nostril Nasal Decongestant - Add your own review/rating

Rhinall Advanced Consumer (Micromedex) - Includes Dosage Information

Rhinall Solution MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Nostril Nasal Decongestant with other medications

Nasal Congestion

Where can I get more information?

Your pharmacist can provide more information about phenylephrine nasal.

Wednesday, March 28, 2012

cefpodoxime

sef-poe-DOX-eem PROX-e-til

Commonly used brand name(s)

In the U.S.

Vantin

Available Dosage Forms:

Powder for Suspension

Tablet

Therapeutic Class: Antibiotic

Pharmacologic Class: 3rd Generation Cephalosporin

Uses For cefpodoxime

Cefpodoxime is used to treat bacterial infections in many different parts of the body. It belongs to the class of medicines known as cephalosporin antibiotics. It works by killing bacteria or preventing their growth. However, cefpodoxime will not work for colds, flu, or other virus infections.

cefpodoxime is available only with your doctor's prescription.

Before Using cefpodoxime

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For cefpodoxime, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to cefpodoxime or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of cefpodoxime in children. However, safety and efficacy have not been established in infants younger than 2 months of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of cefpodoxime in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving cefpodoxime.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	B	Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking cefpodoxime, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using cefpodoxime with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Cimetidine

Famotidine

Nizatidine

Probenecid

Ranitidine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of cefpodoxime

Take cefpodoxime only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

You or your child must take the tablets with food, while the oral liquid may be taken with or without food.

Shake the oral liquid well before each use. Measure the medicine with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.

Keep using cefpodoxime for the full treatment time, even if you or your child feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

Dosing

The dose of cefpodoxime will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of cefpodoxime. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage forms (suspension or tablets):
- For bronchitis:
  - Adults and teenagers 12 years of age and older—200 milligrams (mg) every 12 hours.
  - Children younger than 12 years of age—Use and dose must be determined by your doctor.
- For ear infections:
  - Infants and children 2 months to 12 years of age—Dose is based on body weight and must be determined by your doctor. The dose is usually 5 milligrams (mg) per kilogram (kg) of body weight every 12 hours.
  - Infants younger than 2 months of age—Use and dose must be determined by your doctor.
- For gonorrhea:
  - Adults and teenagers 12 years of age and older—200 milligrams (mg) taken as a single dose.
  - Children younger than 12 years of age—Use and dose must be determined by your doctor.
- For pneumonia:
  - Adults and teenagers 12 years of age and older—200 milligrams (mg) every 12 hours.
  - Children younger than 12 years of age—Use and dose must be determined by your doctor.
- For sinusitis:
  - Adults and teenagers 12 years of age and older—200 milligrams (mg) every 12 hours.
  - Infants and children 2 months to 12 years of age—Dose is based on body weight and must be determined by your doctor. The dose is usually 5 milligrams (mg) per kilogram (kg) of body weight every 12 hours.
  - Infants younger than 2 months of age—Use and dose must be determined by your doctor.
- For skin infections:
  - Adults and teenagers 12 years of age and older—400 milligrams (mg) every 12 hours.
  - Children younger than 12 years of age—Use and dose must be determined by your doctor.
- For sore throat and tonsillitis:
  - Adults and teenagers 12 years of age and older—100 milligrams (mg) every 12 hours.
  - Infants and children 2 months to 12 years of age—Dose is based on body weight and must be determined by your doctor. The dose is usually 5 milligrams (mg) per kilogram (kg) of body weight every 12 hours.
  - Infants younger than 2 months of age—Use and dose must be determined by your doctor.
- For urinary tract infections:
  - Adults and teenagers 12 years of age and older—100 milligrams (mg) every 12 hours.
  - Children younger than 12 years of age—Use and dose must be determined by your doctor.

Missed Dose

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

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the tablets in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Store the oral liquid in the refrigerator. Throw away any unused medicine after 14 days.

Precautions While Using cefpodoxime

If your symptoms or your child's symptoms do not improve within a few days, or if they become worse, check with your doctor.

Cefpodoxime may cause diarrhea, and in some cases it can be severe. Do not take any medicine or give medicine to your child to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

Before you or your child have any medical tests, tell the medical doctor in charge that you are using cefpodoxime. The results of some tests may be affected by cefpodoxime.

cefpodoxime Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Diarrhea

loose stools

Less common

Change in the color, amount, or odor of vaginal discharge

Rare

Abdominal or stomach cramps or tenderness

black, tarry stools

bladder pain

bleeding gums

bloating or swelling of the face, arms, hands, lower legs, or feet

bloody nose

bloody or cloudy urine

blurred vision

burning while urinating

chest pain

collection of blood under the skin

confusion

continuing ringing or buzzing or other unexplained noise in the ears

cough or hoarseness

cough producing mucus

dark urine

decreased urination

decreased urine output

deep, dark purple bruise

diarrhea, watery and severe, which may also be bloody

difficult or labored breathing

difficult, burning, or painful urination

difficulty with breathing or troubled breathing

dilated neck veins

dizziness

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

dry mouth

extreme fatigue

fainting

fast, irregular, pounding, or racing heartbeat or pulse

feeling of warmth or heat

fever or chills

flushing or redness of the skin, especially on the face and neck

frequent urge to urinate

general body swelling

headache

hearing loss

heavier menstrual periods

increase in heart rate

increased thirst

increased urge to urinate during the night

increased weight

irregular breathing

irregular heartbeat

itching of the vagina or genital area

itching, pain, redness, or swelling

loss of appetite

lower back or side pain

nausea or vomiting

nervousness

noisy breathing

nosebleeds

pain

pain during sexual intercourse

pain or swelling of the treated skin

pain or tenderness around the eyes and cheekbones

pain, warmth, or burning in the fingers, toes, and legs

pale skin

pinpoint red spots on the skin

pounding in the ears

problems with vision or hearing

rapid breathing

rapid weight gain

runny nose

shortness of breath or troubled breathing

skin rash

slow or fast heartbeat

sneezing

sore throat

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

stuffy or runny nose

sunken eyes

sweating

swelling of the face, fingers, feet, or lower legs

swelling or puffiness of the face

swollen glands

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

thirst

tightness of the chest or wheezing

tingling of the hands or feet

troubled breathing

troubled breathing with exertion

unusual bleeding or bruising

unusual tiredness or weakness

unusual weight gain or loss

waking to urinate at night

weight gain

wheezing

wrinkled skin

yellowing of the eyes or skin

Incidence not known

Abdominal or stomach pain

blistering, peeling, or loosening of the skin

bloody, black, or tarry stools

clay-colored stools

feeling of discomfort

fever with or without chills

general feeling of tiredness or weakness

high fever

inflammation of the joints

irritation or inflammation of the eyelid

itching

joint or muscle pain

muscle aches

rectal bleeding

red skin lesions, often with a purple center

red, irritated eyes

seizures

sudden decrease in the amount of urine

swollen lymph glands

swollen or painful glands

unpleasant breath odor

vomiting of blood

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare

Accumulation of pus

acid or sour stomach

ankle, knee, or great toe joint pain

bad, unusual, or unpleasant (after) taste

belching

blemishes on the skin

bloated or full feeling

burning feeling in the chest or stomach

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

change in taste

constipation

cracks in the skin

decreased appetite

difficulty with moving

dry skin

excess air or gas in the stomach or intestines

fear or nervousness

feeling of constant movement of self or surroundings

frequent urge to defecate

general feeling of discomfort or illness

hair loss

headache, severe and throbbing

heartburn

hives or welts

increase in body movements

increased sweating

increased thirst

indigestion

irritation or soreness of the mouth

joint stiffness or swelling

lack or loss of strength

loss of heat from the body

lower back or side pain

muscle aching or cramping

muscle pains or stiffness

passing of gas

peeling of the skin

pimples

poor concentration

pressure in the stomach

red, sore eyes

red, swollen skin

redness of the skin

scaly skin

seeing, hearing, or feeling things that are not there

sensation of spinning

sleepiness or unusual drowsiness

sleeplessness

sore mouth or tongue

soreness or redness around the fingernails and toenails

stomach discomfort, upset, or pain

stomach upset

straining while passing stool

swelling of the abdominal or stomach area

swelling or inflammation of the mouth

swollen, red, or tender area of infection

trouble with sleeping

unable to sleep

white patches in the mouth, tongue, or throat

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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

See also: cefpodoxime side effects (in more detail)

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More cefpodoxime resources

Cefpodoxime Side Effects (in more detail)
Cefpodoxime Use in Pregnancy & Breastfeeding
Drug Images
Cefpodoxime Drug Interactions
Cefpodoxime Support Group
2 Reviews for Cefpodoxime - Add your own review/rating

cefpodoxime Concise Consumer Information (Cerner Multum)

Cefpodoxime MedFacts Consumer Leaflet (Wolters Kluwer)

Cefpodoxime Proxetil Monograph (AHFS DI)

Vantin Prescribing Information (FDA)

Compare cefpodoxime with other medications

Bladder Infection
Bronchitis
Gonococcal Infection, Disseminated
Gonococcal Infection, Uncomplicated
Kidney Infections
Otitis Media
Pneumonia
Sinusitis
Skin Infection
Tonsillitis/Pharyngitis
Upper Respiratory Tract Infection

carmustine Implantation

kar-MUS-teen

Commonly used brand name(s)

In the U.S.

Gliadel

Available Dosage Forms:

Implant

Therapeutic Class: Antineoplastic Agent

Pharmacologic Class: Alkylating Agent

Chemical Class: Nitrosourea

Uses For carmustine

Carmustine belongs to the group of medicines known as alkylating agents. It is used to treat certain types of brain cancer.

Carmustine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by carmustine, other effects may also occur.

carmustine is available only with your doctor's prescription.

Before Using carmustine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For carmustine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to carmustine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on carmustine have been done only in adult patients, and there is no specific information comparing use of carmustine in children with use in other age groups.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of carmustine in the elderly with its use in younger adults.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking carmustine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using carmustine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Rotavirus Vaccine, Live

Using carmustine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Adenovirus Vaccine Type 4, Live

Adenovirus Vaccine Type 7, Live

Bacillus of Calmette and Guerin Vaccine, Live

Cimetidine

Influenza Virus Vaccine, Live

Measles Virus Vaccine, Live

Mumps Virus Vaccine, Live

Rotavirus Vaccine, Live

Rubella Virus Vaccine, Live

Smallpox Vaccine

Typhoid Vaccine

Varicella Virus Vaccine

Yellow Fever Vaccine

Interactions with Food/Tobacco/Alcohol

Proper Use of carmustine

Dosing

The dose of carmustine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of carmustine. If your dose is different, do not change it unless your doctor tells you to do so.

Precautions While Using carmustine

It is important that your doctor check your progress at regular visits to make sure carmustine is working properly and to check for unwanted effects.

carmustine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

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

More common

Blood in urine

burning, painful, or difficult urination

convulsions (seizures)

fever

inability to move legs or arms

lower back or side pain

Less common

Confusion

extremely severe sleepiness

headache

nausea and vomiting

pain

problems in speaking

rash

stiff neck

More common

Drowsiness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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

See also: carmustine Implantation side effects (in more detail)

More carmustine Implantation resources

Carmustine Implantation Side Effects (in more detail)
Carmustine Implantation Use in Pregnancy & Breastfeeding
Carmustine Implantation Drug Interactions
Carmustine Implantation Support Group
0 Reviews for Carmustine Implantation - Add your own review/rating

Compare carmustine Implantation with other medications

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Non-Hodgkin's Lymphoma

Tuesday, March 27, 2012

Catapres-TTS-1

Generic Name: clonidine (Oral route)

KLOE-ni-deen

Commonly used brand name(s)

In the U.S.

Catapres

Kapvay

Nexiclon XR

Available Dosage Forms:

Tablet, Extended Release

Suspension, Extended Release

Tablet

Therapeutic Class: Antihypertensive

Pharmacologic Class: Alpha-2 Adrenergic Agonist

Uses For Catapres-TTS-1

Clonidine is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk for heart attacks. These problems may be less likely to occur if the blood pressure is controlled.

Clonidine belongs to the class of medicines called antihypertensives. It works in the brain to change some of the nerve impulses. As a result, the blood vessels relax and blood passes through them more easily, which lowers blood pressure. When the blood pressure is lowered, the amount of blood and oxygen going to the heart is increased.

This medicine will not cure your high blood pressure, but it does help control it. Therefore, you must continue to use it as directed if you expect to lower your blood pressure and keep it down. You might have to take high blood pressure medicine for the rest of your life.

Kapvay® extended-release tablets is used alone or together with other medicines to treat attention deficit hyperactivity disorder (ADHD). It works by increasing attention and decreasing restlessness in children and adults who are overactive, cannot concentrate for very long, or are easily distracted and impulsive. This medicine is used as part of a total treatment program that also includes social, educational, and psychological treatment.

This medicine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, clonidine is used in certain patients with the following medical conditions:

Gilles de la Tourette's syndrome (tic disorder).

Menopause or menstrual discomfort symptoms.

Withdrawal symptoms from alcohol, nicotine, or narcotic pain relievers.

Before Using Catapres-TTS-1

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of clonidine in children younger than 18 years of age and Kapvay® extended-release tablets in children younger than 6 years of age. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of clonidine in geriatric patients. However, elderly patients are more likely to have age-related heart or kidney problems, which may require caution and an adjustment in the dose for patients receiving clonidine.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Nexiclon™ XR extended-release suspension and tablets in the elderly. However, elderly patients are more likely to have age-related heart or kidney problems, which may require an adjustment in the dose for patients receiving this medicine.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acebutolol

Amitriptyline

Amoxapine

Atenolol

Betaxolol

Bevantolol

Bisoprolol

Carteolol

Celiprolol

Clomipramine

Desipramine

Dilevalol

Diltiazem

Dothiepin

Doxepin

Esmolol

Imipramine

Levobunolol

Lofepramine

Metipranolol

Metoprolol

Mirtazapine

Nadolol

Nebivolol

Nortriptyline

Oxprenolol

Penbutolol

Pindolol

Propranolol

Protriptyline

Sotalol

Tertatolol

Timolol

Trimipramine

Verapamil

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Cyclosporine

Fluphenazine

Mepivacaine

Naloxone

Yohimbine

Interactions with Food/Tobacco/Alcohol

Proper Use of clonidine

This section provides information on the proper use of a number of products that contain clonidine. It may not be specific to Catapres-TTS-1. Please read with care.

Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to use it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Swallow the extended-release tablet whole. Do not cut, crush, or chew it. You may take the tablet with or without food.

Clonidine extended-release tablets works differently than clonidine immediate-release tablets. Do not switch from the extended-release tablets to the immediate-release tablets unless your doctor tells you to.

For patients using the extended-release oral suspension:

Shake the bottle well for 5 to 10 seconds before each use.

Insert the adapter into the neck of the bottle.

Insert the syringe tip into the adapter and turn the bottle upside down.

Get the amount of medicine as prescribed by your doctor.

Place the medicine directly into the mouth.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

This medicine usually comes with patient information leaflet. Read them carefully and make sure you understand them before taking this medicine. If you have any questions, ask your doctor.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

For attention deficit hyperactivity disorder (ADHD):
- For oral dosage form (extended-release tablets):
  - Teenagers and children 6 years of age and older—At first, 0.1 milligram (mg) once a day, given at bedtime. Your doctor will increase your dose as needed.
  - Children younger than 6 years of age—Use and dose must be determined by your doctor.

For high blood pressure:
- For oral dosage form (extended-release suspension):
  - Adults—At first, 0.17 milligram (mg) or 2 milliliter (mL) once a day, given at bedtime. Your doctor may adjust your dose as needed. The usual dose is 0.17 (2 mL) to 0.52 mg (6 mL) per day.
  - Children—Use and dose must be determined by your doctor.
- For oral dosage form (extended-release tablets):
  - Adults—At first, 0.17 milligram (mg) once a day, given at bedtime. Your doctor may adjust your dose as needed. The usual dose is 0.17 to 0.52 mg per day.
  - Children—Use and dose must be determined by your doctor.
- For oral dosage form (tablets):
  - Adults—0.1 milligram (mg) two times a day, taken in the morning and at bedtime. Your doctor may adjust your dose as needed. The usual dose is 0.2 mg to 0.6 mg per day, divided and given two times a day.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss more than one dose of clonidine tablets, check with your doctor right away. If your body goes without this medicine for too long, your blood pressure may go up to a very high level and cause serious side effects.

If you miss a dose of clonidine extended-release tablets, skip the missed dose and take the next dose as scheduled. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Catapres-TTS-1

It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for any unwanted effects.

Do not interrupt or stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. Your blood pressure may become worse when the medicine is stopped suddenly, which can cause serious side effects.

Make sure that you have enough clonidine on hand to last through weekends, holidays, or vacations. You should not miss any doses. You may want to ask your doctor for a second written prescription for clonidine to carry in your wallet or purse. You can have it filled if you run out of medicine when you are away from home.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. You should avoid over-the-counter [OTC] medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Clonidine will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system and may cause drowsiness. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates or medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

Clonidine may cause some people to become drowsy or less alert than they are normally. This is more likely to happen when you begin to take it or when you increase the amount of medicine you are taking. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine.

This medicine may cause dryness of the eyes. If you wear contact lenses, this may be a problem for you. Talk to your doctor if you wear contact lenses, and discuss how to treat the dryness.

Dizziness, lightheadedness, or fainting may occur after you take this medicine, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help, but if the problem continues or gets worse, check with your doctor.

The dizziness, lightheadedness, or fainting is also more likely to occur if you drink alcohol, stand for long periods of time, exercise, or if the weather is hot. While you are taking clonidine, be careful to limit the amount of alcohol you drink. Also, use extra care not to become dehydrated or overheated during exercise or hot weather or if you must stand for a long time.

If you develop a skin rash, hives, or any allergic reaction to this medicine, stop taking the medicine and check with your doctor as soon as possible.

Clonidine may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Catapres-TTS-1 Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

Mental depression

swelling of the feet and lower legs

Rare

Anxiety

blistering, burning, crusting, dryness, or flaking of the skin

chest pain or discomfort

confusion as to time, place, or person

decreased urine output

dilated neck veins

drowsiness

dry mouth

fast, pounding, or irregular heartbeat or pulse

fever

general feeling of discomfort or illness

holding false beliefs that cannot be changed by fact

hyperventilation

irregular breathing

irritability

itching, scaling, severe redness, soreness, or swelling of the skin

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

lightheadedness, dizziness, or fainting

mental depression

paleness or cold feeling in the fingertips and toes

pounding, slow heartbeat

problems in urination or increase in the amount of urine

raised red swellings on the skin, lips, tongue, or in the throat

restlessness

seeing or hearing things that are not there

shaking

shortness of breath

skin rash

swelling of the face, fingers, feet, or lower legs

tightness in the chest

tingling or pain in the fingers or toes when exposed to cold

trouble with sleeping

troubled breathing

unusual excitement, nervousness, or restlessness

unusual tiredness or weakness

vivid dreams or nightmares

weight gain

wheezing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Dizziness (extreme) or faintness

feeling cold

pinpoint pupils of the eyes

unusual tiredness or weakness (extreme)

More common

Constipation

Less common

Darkening of the skin

decreased sexual ability

dry, itching, or burning eyes

loss of appetite

nausea or vomiting

Rare

Blurred vision

decreased interest in sexual intercourse

hair loss or thinning of the hair

inability to have or keep an erection

leg cramps

loss in sexual ability, desire, drive, or performance

muscle or joint pain

pale skin

swelling of the breasts or breast soreness in both females and males

weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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

See also: Catapres-TTS-1 side effects (in more detail)

More Catapres-TTS-1 resources

Catapres-TTS-1 Side Effects (in more detail)
Catapres-TTS-1 Use in Pregnancy & Breastfeeding
Drug Images
Catapres-TTS-1 Drug Interactions
Catapres-TTS-1 Support Group
4 Reviews for Catapres-TTS-1 - Add your own review/rating

Catapres MedFacts Consumer Leaflet (Wolters Kluwer)

Catapres Consumer Overview

Catapres Prescribing Information (FDA)

Clonidine Monograph (AHFS DI)

Clonidine MedFacts Consumer Leaflet (Wolters Kluwer)

Duraclon Prescribing Information (FDA)

Kapvay Prescribing Information (FDA)

Kapvay Extended-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

Kapvay Consumer Overview

Nexiclon XR Prescribing Information (FDA)

Nexiclon XR MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Catapres-TTS-1 with other medications

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Tuesday, March 20, 2012

Pilocarpine Hydrochloride

Class: Miotics
VA Class: OP102
CAS Number: 92-13-7
Brands: Isopto Carpine, Pilopine HS

Introduction

Miotic; direct-acting parasympathomimetic agent.^a ^c ^d ^e

Uses for Pilocarpine Hydrochloride

Open-angle Glaucoma

Reduction of elevated intraocular pressure (IOP)^c ^d ^e in patients with primary open-angle (chronic simple, noncongestive) glaucoma.^b

May use concomitantly with other miotics, sympathomimetic agents, β-adrenergic blocking agents, carbonic anhydrase inhibitors, or hyperosmotic agents.^c ^d ^e

Angle-closure Glaucoma

Reduction of IOP in the emergency treatment of acute (congestive) angle-closure glaucoma prior to surgery.^b Because it may preclude successful surgery, do not use for long periods prior to surgical treatment.^b

Lack of response may be caused by paralysis of the iris sphincter by the extremely high IOP; systemic administration of acetazolamide or hyperosmotic solutions (e.g., glycerin or mannitol) may be required.^b

Ocular Surgery

Reduction of IOP and protection of the lens by causing miosis prior to goniotomy or iridectomy, including laser iridectomy.^b

May use to control glaucoma which persists after surgery.^b

Ophthalmologic Examinations

Production of miosis to counteract mydriatic effects of sympathomimetic agents (e.g., phenylephrine) after ophthalmoscopic examinations in glaucoma patients.^b

Pilocarpine Hydrochloride Dosage and Administration

Administration

Ophthalmic Administration

Avoid contamination of the solution or gel container.^c ^d ^e

Ophthalmic solutions are preferred when an acute reduction in IOP and/or an intense miotic effect are necessary (e.g., prior to surgery, following ophthalmologic examinations).^a

Tonometric measurements recommended before and during therapy.^a

Ophthalmic Solution

Apply topically to the conjunctival sac of affected eye(s) as directed by clinician, usually 3–4 times daily; more frequent administration may be necessary in some patients.^a ^c ^e Not for injection.^c ^e

Following topical instillation, apply finger pressure on the lacrimal sac for 1–2 minutes to minimize drainage into nose and throat and reduce risk of absorption and systemic reactions.^a Remove excess solution around the eye with a tissue and rinse off any medication on hands immediately.^a

Ophthalmic Gel

Apply topically to the lower conjunctival sac of affected eye(s) once daily at bedtime.^d

Measure IOP just before next dose following initiation of therapy to ensure adequate control of IOP throughout the 24-hour dosing interval.^a

If used concomitantly with ophthalmic solutions, instill solutions first and apply gel ≥5 minutes later.^a

Dosage

Available as pilocarpine hydrochloride; dosage expressed in terms of the salt.^a

Adjust concentration and frequency of solution instillation according to patient requirements and response, as determined by tonometric readings.^a

In patients with heavily pigmented irides, higher solution concentrations may be required.^c ^e

Adjust dosage of ophthalmic gel based on periodic tonometric readings.^a

Adults

Open-Angle Glaucoma

Ophthalmic

1–2 drops of a 1–4% solution in the eye(s) every 4–12 hours.^a Solution concentrations >4% are only occasionally more effective than lower concentrations.^a

Apply a 1.3-cm (0.5-inch) ribbon of a 4% gel into lower conjunctival sac once daily at bedtime.^d

Acute Angle-Closure Glaucoma

Ophthalmic

1 drop of a 2% solution in the affected eye every 5–10 minutes for 3–6 doses, followed by 1 drop every 1–3 hours until pressure is controlled.^a To prevent a bilateral attack, 1 drop of a 1–2% solution in the unaffected eye every 6–8 hours.^a

Ocular Surgery

Iridectomy

Ophthalmic

1 drop of a 2% solution 4 times immediately prior to iridectomy has been used.^a

Congenital Glaucoma (Goniotomy)

Ophthalmic

1 drop of a 2% solution every 6 hours prior to surgery has been used.^a

May use a 2% solution to fill the gonioscopic lens prior to goniotomy, or may administer 1 drop of a 2% solution every 6 hours plus 3 times in the 30 minutes immediately preceding goniotomy, with or without concomitant administration of acetazolamide.^a

Ophthalmologic Examinations

Ophthalmic

1 drop of a 1% solution in the affected eye(s).^a

Cautions for Pilocarpine Hydrochloride

Contraindications

Known hypersensitivity to pilocarpine or any ingredient in the formulation.^c ^d ^e

Conditions in which pupillary constriction is undesirable (e.g., acute iritis, pupillary block).^c ^d ^e

Warnings/Precautions

Sensitivity Reactions

Hypersensitivity

Allergic conjunctivitis, dermatitis, or keratitis reported occasionally with miotics; these reactions are usually alleviated by changing to another miotic.^b In some instances, allergic reactions may be caused by preservatives in the preparations.^b

General Precautions

Ocular Effects

Retinal detachment reported rarely;^c ^d ^e use with extreme caution, if at all, in patients with a history or risk of retinal detachment, especially those who are young or aphakic.^b Carefully examine retinal periphery at least annually to detect an impending detachment.^b

Use with caution in patients with corneal abrasion to avoid excessive penetration and systemic toxicity.^b

Possible spasm of accommodation and poor vision in dim light, particularly in geriatric patients and patients with lens opacities.^c ^d ^e (See Advice to Patients.)

Follicular conjunctival hypertrophy may occur with prolonged therapy.^b

Possible transient increase in IOP even when the angle is open.^b ^e In some patients with angle-closure glaucoma receiving miotics, IOP may be increased and acute attacks may be precipitated.^b

Possible corneal opacities.^c ^d

Regular slit-lamp examinations recommended; discontinue therapy, at least temporarily, if iris cysts, iritis, synechiae, or lens opacities occur.^b

Specific Populations

Pregnancy

Category C.^c

Lactation

Not known whether pilocarpine is distributed into milk.^c ^d ^e Use with caution.^c ^d ^e

Pediatric Use

Safety and efficacy not established.^d ^e

Geriatric Use

Reduced visual acuity in dim light frequently experienced in geriatric patients.^d ^e

Common Adverse Effects

Ocular irritation (burning or discomfort), lacrimation, temporal or periorbital headache, painful ciliary or accommodative spasm, blurred vision or myopia, conjunctival vascular congestion, superficial keratitis, poor vision in dim light.^a ^b ^c ^d ^e

Interactions for Pilocarpine Hydrochloride

Specific Drugs

Drug	Interaction	Comments
Ocular hypotensive agents	Additive IOP lowering effects^b	Used to therapeutic advantage^b
Anticholinesterase miotics	Competitive inhibition of miotic effect and presumably IOP-lowering effect^b	Concomitant administration generally not recommended^b Some clinicians recommend administration of pilocarpine at onset of long-acting anticholinesterase therapy followed by gradual taper of pilocarpine so that antagonism between the drugs allows full effects of the anticholinesterase to be obtained gradually^b

Pilocarpine Hydrochloride Pharmacokinetics

Absorption

Bioavailability

Penetrates cornea rapidly.^b Application of ophthalmic gel results in increased corneal bioavailability secondary to decreased elimination of pilocarpine from precorneal areas compared with a topically applied solution.^a IOP reduction and pupillary diameter are similar to values obtained following application of a solution.^a

Onset

Following topical application of a 1% solution to the conjunctival sac, miosis occurs within 10–30 minutes and is maximal within 30 minutes.^a Reduction in IOP is detectable within 60 minutes and is maximal within 75 minutes.^a Spasms of accommodation begin in approximately 15 minutes.^a

Duration

Following topical application of a 1% solution to the conjunctival sac, miosis usually persists 4–8 hours or rarely up to 20 hours.^a Reduced IOP persists 4–14 hours, depending on concentration of drug used.^a Spasms of accommodation persist 2–3 hours.^a

Application of ophthalmic gel results in an increased duration of ocular effects compared with a topically applied solution.^a Following topical application of gel, IOP decreases for about 18–24 hours after application.^a

Distribution

Extent

Bound to serum and ocular tissues.^b

Not known whether pilocarpine is distributed into milk.^c ^d ^e

Elimination

Metabolism

Mechanism by which pilocarpine is inactivated in the body is unclear.^b

Stability

Storage

Ophthalmic

Solution

8–27°C,^c unless otherwise specified by manufacturer.

Gel

2–27°C.^d Avoid excessive heat; do not freeze.^d

ActionsActions

Directly stimulates cholinergic receptors, resulting in muscarinic and nicotinic effects.^b ^c

Contracts the iris sphincter and the ciliary muscle, which produces constriction of the pupil (miosis) and spasm of accommodation, respectively.^b ^c ^e

Reduces IOP in normal and glaucomatous eyes.^b ^c

Facilitates aqueous humor outflow by contracting the ciliary muscle and widening the trabecular meshwork.^b ^c

Decreases activity of extraocular muscles of convergence and causes vasodilation of blood vessels of the conjunctiva, iris, and ciliary body and increased permeability of the blood-aqueous barrier, which may lead to vascular congestion and ocular inflammation.^b

Advice to Patients

Importance of learning and adhering to proper administration techniques to avoid contamination of the solution or gel container.^b

Importance of removing soft contact lenses before administration (since pilocarpine may be absorbed by or preservatives in preparations may have a deleterious effect on the lenses).^b

Caution advised if driving at night or performing hazardous tasks in dim light.^c ^d ^e

Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.^b

Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.^b ^c ^d ^e

Importance of informing patients of other precautionary information.^a (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Pilocarpine Hydrochloride
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Bulk	Powder
Ophthalmic	Gel	4%	Pilopine HS (with benzalkonium chloride and edetate disodium)	Alcon
	Solution	0.5%*	Pilocarpine Hydrochloride Ophthalmic Solution	Bausch & Lomb
		1%*	Isopto Carpine (with benzalkonium chloride)	Alcon
			Pilocarpine Hydrochloride Ophthalmic Solution	Akorn, Bausch & Lomb, Falcon
		2%*	Isopto Carpine (with benzalkonium chloride)	Alcon
			Pilocarpine Hydrochloride Ophthalmic Solution	Akorn, Bausch & Lomb, Falcon
		3%*	Pilocarpine Hydrochloride Ophthalmic Solution	Bausch & Lomb
		4%*	Isopto Carpine (with benzalkonium chloride)	Alcon
			Pilocarpine Hydrochloride Ophthalmic Solution	Akorn, Bausch & Lomb, Falcon
		6%*	Pilocarpine Hydrochloride Ophthalmic Solution	Bausch & Lomb, Falcon

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Isopto Carpine 1% Solution (ALCON VISION): 15/$36.99 or 45/$100.97

Isopto Carpine 2% Solution (ALCON VISION): 15/$36.99 or 45/$103.97

Pilocarpine HCl 1% Solution (FALCON PHARMACEUTICALS): 15/$37.99 or 30/$66.97

Pilocarpine HCl 2% Solution (FALCON PHARMACEUTICALS): 15/$37.99 or 30/$68.97

Pilopine HS 4% Gel (ALCON VISION): 4/$79.99 or 12/$225.97

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

References

a. AHFS Drug Information 2003. McEvoy GK, ed. Pilocarpine. Bethesda, MD: American Society of Health-System Pharmacists; 2003:2679-82.

b. AHFS Drug Information 2003. McEvoy GK, ed. Miotics General Statement. Bethesda, MD: American Society of Health-System Pharmacists; 2003:2674-77.

c. Falcon. Pilocarpine hydrochloride 1%, 2%, 4%, or 6% Ophthalmic Solution prescribing information. Fort Worth, TX; 2003 Aug.

d. Alcon. Pilopine HS (pilocarpine hydrochloride) 4% Ophthalmic Gel prescribing information. Fort Worth, TX; 1999 Mar.

e. Alcon. Isopto Carpine (pilocarpine hydrochloride) ophthalmic solution prescribing information. Fort Worth, TX; 2003 Oct.

More Pilocarpine Hydrochloride resources

Pilocarpine Hydrochloride Use in Pregnancy & Breastfeeding
Pilocarpine Hydrochloride Drug Interactions
Pilocarpine Hydrochloride Support Group
0 Reviews for Pilocarpine Hydrochloride - Add your own review/rating

Pilocarpine Prescribing Information (FDA)

Pilocarpine Professional Patient Advice (Wolters Kluwer)

pilocarpine Concise Consumer Information (Cerner Multum)

Pilocarpine MedFacts Consumer Leaflet (Wolters Kluwer)

pilocarpine Advanced Consumer (Micromedex) - Includes Dosage Information

Salagen Prescribing Information (FDA)

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Important safety information:

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If OVERDOSE is suspected:

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