Fentanyl Patch

Pronunciation: FEN-ta-nil
Generic Name: Fentanyl
Brand Name: Duragesic

Fentanyl Patch should be used only for long-term or chronic pain requiring continuous, around-the-clock narcotic pain relief that is not helped by other less powerful pain medicines or less frequent dosing. Do not use Fentanyl Patch if you have not already been taking other prescription narcotic pain medicines (eg, morphine, codeine) on a regular schedule. Do not use Fentanyl Patch for short-term pain, mild pain, pain that occurs after surgery, or pain that does not require medicine on a regular schedule. Because serious, sometimes life-threatening, breathing problems can occur (especially in patients who have not been given narcotic medicines in the past), seek immediate medical attention in the unlikely event that very slow, shallow breathing occurs.

Tell your doctor if you are also taking ritonavir, ketoconazole, itraconazole, troleandomycin, clarithromycin, nelfinavir, nefazodone, amiodarone, amprenavir, aprepitant, diltiazem, erythromycin, fluconazole, fosamprenavir, or verapamil. Tell your doctor if you eat grapefruit or drink grapefruit juice. The risk of Fentanyl Patch's side effects may be increased.

Do not give Fentanyl Patch to children younger than 2 years old or children who have not previously received narcotic pain medicines.

When used for long periods of time or at high doses, some people develop a need to continue taking Fentanyl Patch. This is known as DEPENDENCE or addiction. Do not use more of Fentanyl Patch than prescribed by your doctor. Tell your doctor if you or a family member has a history of mental or mood problems (eg, depression) or addiction to alcohol or other substances.

Do not apply the patch to skin that is broken or damaged. Do not cut the patch. Using a cut or damaged patch may lead to a rapid release of medicine and serious, even fatal, side effects. Do not expose the patch to direct sources of heat, such as heating pads, electric blankets, heat lamps, saunas, hot tubs, or heated waterbeds. Avoid sunbathing; long, hot baths; or other sources of heat to the body. Tell your doctor if you develop a fever. The heat may cause more medicine to be released into your skin and could cause serious, even fatal, side effects.

Fentanyl Patch is used for:

Managing moderate to severe chronic pain in patients who need continuous, around-the-clock narcotic (opioid) pain relief and whose pain cannot be managed by less powerful pain medicines.

Fentanyl Patch is a narcotic (opioid) analgesic. It works in the brain to decrease pain.

Do NOT use Fentanyl Patch if:

• you are allergic to any ingredient in Fentanyl Patch, to any other fentanyl-related medicine (eg, sufentanil)


• you have not already been taking other prescription narcotic pain medicines (eg, morphine, codeine) on a regular schedule


• you have mild or short-term pain, including pain from injuries or surgery


• you do not need to take pain medicine on a regular basis


• you have trouble breathing, asthma, or a certain bowel problem (paralytic ileus)


• you are taking sibutramine or sodium oxybate (GHB)


• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the past 14 days

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

Before using Fentanyl Patch:

Some medical conditions may interact with Fentanyl Patch. 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 (eg, adhesives used on bandages)


• if you have a history of mental or mood problems (eg, depression), hallucinations, or suicidal thoughts or actions


• if you have severe drowsiness; lesions, growths, or increased pressure in the brain; or a recent head injury


• if you have lung or breathing problems (eg, asthma, slow or difficult breathing, chronic obstructive pulmonary disease [COPD]), urinary blockage, heart problems (eg, slow or irregular heartbeat, ventricle problems), liver or kidney disease, gallbladder problems, pancreas inflammation (pancreatitis), an enlarged prostate or benign prostatic hypertrophy (BPH), stomach or bowel problems (eg, constipation, inflammatory bowel disease, pseudomembranous colitis, stomach pain), an underactive thyroid, low blood pressure, or seizures


• if you or a family member has a history of alcohol, narcotic, or other substance abuse or dependence


• if you have been very ill, have a fever, have poor health or nutrition, or have had a recent surgery (eg, stomach or bowel surgery)

Some MEDICINES MAY INTERACT with Fentanyl Patch. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Amiodarone, aprepitant, azole antifungals (eg, ketoconazole, voriconazole), benzodiazepines (eg, alprazolam), calcium channel blockers (eg, diltiazem, verapamil), cimetidine, HIV protease inhibitors (eg, ritonavir), macrolide antibiotics (eg, erythromycin, clarithromycin), MAOIs (eg, phenelzine), nefazodone, other opioid medicines (eg, oxycodone), phenothiazines (eg, chlorpromazine), skeletal muscle relaxants (eg, cyclobenzaprine), sleep medicines (eg, zolpidem), sodium oxybate (GHB), telithromycin, or troleandomycin because they may increase the risk of Fentanyl Patch's side effects, including serious breathing problems, severe light-headedness or dizziness, or severe drowsiness


• Serotonin reuptake inhibitors (eg, fluoxetine) or sibutramine because a severe reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, or coma may occur


• Mixed agonist/antagonist analgesics (eg, buprenorphine, pentazocine, butorphanol), nalmefene, naloxone, or naltrexone because they may decrease Fentanyl Patch's effectiveness and withdrawal symptoms may occur


• Barbiturates (eg, phenobarbital), carbamazepine, corticosteroids (eg, prednisone), efavirenz, modafinil, nevirapine, oxcarbazepine, phenytoin, pioglitazone, rifamycins (eg, rifampin), St. John's wort, or troglitazone because they may decrease Fentanyl Patch's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Fentanyl Patch 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 Fentanyl Patch:

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

• Fentanyl Patch comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Fentanyl Patch refilled.


• Apply Fentanyl Patch right away after removing it from the sealed package. Do not use a patch if the package is not sealed. Do not apply a patch that has been cut or damaged in any way.


• The patch should be applied to a dry, smooth, undamaged, nonirradiated section of skin on a flat surface (eg, chest, back, upper arm). In young children or patients with mental impairment, place the patch on their upper back to decrease the chance that they will remove the patch and put it in their mouths.


• Before applying the patch, clip (do not shave) any hair at the application site, clean the area with clear water only, and then dry the area. Do not use soaps, oils, lotions, or any other liquid that could irritate or otherwise affect the skin.


• Press the patch firmly in place with the palm of your hand for 30 seconds. Make sure the contact is complete, especially around the edges. Wash your hands after applying the patch.


• If the patch does not stick, you may tape only the edges with first-aid tape or cover the patch with a special type of clear adhesive film dressing (eg, Bioclusive, Tegaderm). Do not cover the patch with any other bandage or tape. Ask your doctor if you are unsure of what type of dressing you can use.


• A patch may be worn continuously for 72 hours. If pain relief for more than 72 hours is needed, apply a new patch to a different skin area after removing the old patch. Do not wear more than 1 patch at a time unless your doctor tells you otherwise.


• If the patch falls off before 72 hours have passed, apply a new patch to a different skin site.


• After removing the used patch, fold it in half with the sticky sides together. Discard the patch out of the reach of children and away from pets. You should also dispose of any unused patches remaining from a prescription as soon as they are no longer needed. Ask your doctor or pharmacist how to dispose of Fentanyl Patch properly.


• Check with your doctor before you eat grapefruit or drink grapefruit juice while you are using Fentanyl Patch.


• If you forget to change your patch on the day it is due, change the patch as soon as you remember. Do NOT double your dose to catch up.

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

Important safety information:

• Fentanyl Patch may cause drowsiness, dizziness, or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use Fentanyl Patch with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Do not drink alcohol while you are using Fentanyl Patch.


• Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Fentanyl Patch; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.


• Fentanyl Patch may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.


• Fentanyl Patch is to be applied to the skin only. Fentanyl Patch may cause choking or severe and sometimes life-threatening problems if it is placed in the mouth, chewed, or swallowed. If you may have taken it by mouth, contact your poison control center or emergency room right away.


• Do NOT use more than the recommended dose or for longer than prescribed without checking with your doctor. Do not change the patch more often than directed by your doctor.


• Do not expose the patch on your skin to direct sources of heat, such as heating pads, electric blankets, heat or tanning lamps, saunas, hot tubs, or heated waterbeds. Avoid sunbathing; long, hot baths; or other sources of heat to the body. Tell your doctor if you develop a fever. The heat may cause more medicine to be released into your skin.


• The patch contains a strong narcotic pain medicine (similar to morphine, hydromorphone, methadone, oxycodone, and oxymorphone) in the form of a gel. If the gel leaks from the patch at any time, do not touch the gel. If you have unintended contact with the gel, immediately wash the affected area with large amounts of water only. If you have concerns, speak with your pharmacist or doctor for further instructions.


• If the patch comes off your skin and accidentally sticks to the skin of another person, remove the patch from their skin immediately, wash the exposed area of skin with water, and call you doctor, emergency room, or local poison control center right away.


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


• If you will be having an MRI, tell your doctor that you use Fentanyl Patch. You may need to remove the patch before having the MRI.


• Fentanyl Patch may cause constipation. Talk with your doctor about taking a stool softener or laxative to prevent or treat constipation. It is also important to maintain a diet adequate in fiber, drink plenty of water, and exercise to prevent constipation.


• Use Fentanyl Patch with caution in the ELDERLY; they may be more sensitive to its effects, especially the possibility of decreased breathing and drowsiness.


• Fentanyl Patch should not be used in CHILDREN younger than 2 years old; 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 Fentanyl Patch while you are pregnant. Fentanyl Patch is found in breast milk. Do not breast-feed while taking Fentanyl Patch.

When used for long periods of time or at high doses, Fentanyl Patch may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Fentanyl Patch stops working well. Do not take more than prescribed.

Some people who use Fentanyl Patch for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction. If you suddenly stop taking Fentanyl Patch, you may experience WITHDRAWAL symptoms including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; hallucinations (seeing, hearing, or feeling things that are not really there); shivering or tremors; sweating; and trouble sleeping. Stop using Fentanyl Patch gradually as instructed by your health care provider.

Possible side effects of Fentanyl Patch:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; dry mouth; exaggerated sense of well-being; headache; indigestion; loss of appetite; mild redness, swelling, or discomfort at the skin application site; nausea; sleeplessness; stomach pain or discomfort; sweating; vomiting.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion; coughing up blood; difficulty urinating; difficulty talking, thinking, or walking; difficult, shallow, or slow breathing; excessive or persistent dizziness or drowsiness; fainting; fast, slow, or irregular heartbeat; fatigue; fever; flu-like symptoms (eg, headache, muscle aches, tiredness); hallucinations; mood or mental changes (eg, anxiety, agitation, depression, nervousness); memory loss; muscle rigidity; numbness or tingling; persistent sore throat; seizures; shortness of breath; tremor; vision problems; weakness.

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: Fentanyl 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 bluish skin; cold and clammy skin; difficult, shallow, or slow breathing; drowsiness leading to unresponsiveness; excessive sweating; nausea and vomiting; seizures.

Proper storage of Fentanyl Patch:

Store Fentanyl Patch below 77 degrees F (25 degrees C) in its original sealed pouch. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat and light. Keep Fentanyl Patch out of the reach of children and away from pets.

General information:

• If you have any questions about Fentanyl Patch, please talk with your doctor, pharmacist, or other health care provider.


• Fentanyl Patch is to be used only by the patient for whom it is prescribed. Do not share it with other people.


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


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

This information is a summary only. It does not contain all information about Fentanyl Patch. 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

Copyright © 2012 Wolters Kluwer Health, Inc.

More Fentanyl resources

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

Compare Fentanyl with other medications

• Anesthesia
• Anesthetic Adjunct
• Breakthrough Pain
• Pain
• Postoperative Pain
• Sedation

Elmiron

Generic Name: pentosan polysulfate sodium (Oral route)

PEN-toe-san pol-ee-SUL-fate SOE-dee-um

Commonly used brand name(s)

In the U.S.

• Elmiron

Available Dosage Forms:

• Capsule

Therapeutic Class: Cystitis Agent

Uses For Elmiron

Pentosan is used to relieve the symptoms of the bladder condition called interstitial cystitis.

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

Before Using Elmiron

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

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

Geriatric

This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

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 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.

• Chamomile


• Citalopram


• Desvenlafaxine


• Escitalopram


• Fluoxetine


• Fluvoxamine


• Garlic


• Milnacipran


• Papaya


• Paroxetine


• Sertraline


• St John's Wort


• Tan-Shen


• Venlafaxine

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.

• Avocado


• Chondroitin


• Coenzyme Q10


• Curcumin


• Dong Quai


• Ginger


• Green Tea


• Vitamin A

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.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood or blood vessel disease or other blood problems or


• Blockage or obstruction of the intestine or


• Polyps or


• Stomach ulcers—The risk of bleeding may be increased.

• Liver disease or


• Spleen problems—Pentosan may not be broken down in the body as fast as it normally would; the chance of side effects may be increased.

Proper Use of Elmiron

Take this medicine on an empty stomach (at least 1 hour before or 2 hours after meals) and at least 1 hour before or after any other food, milk, or medicine. Also, always take it with a full glass (8 ounces) of water.

Sometimes pentosan must be taken for up to 3 to 6 months before you begin to feel better. Your doctor should check your progress at regular visits during this time.

It is important that you follow any special instructions from your doctor. Some foods and beverages may aggravate your condition. Also, make certain your doctor knows if you are on any special diet, such as a low-sodium or low-sugar diet.

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.

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 form (capsules):
  
  • To treat interstitial cystitis:
    
    • Adults—100 milligrams (mg) three times a day for three months. Your doctor may tell you to repeat this dose.
    
    
    • 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.

Storage

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

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Elmiron

This medicine may increase the risk of serious bleeding. Before having any kind of surgery or dental or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine.

Check with your doctor before taking anticoagulant therapy (drugs that thin your blood) such as warfarin sodium, heparin, high doses of aspirin, or antiinflammatory drugs such as ibuprofen .

Pentosan can temporarily lower the number of platelets in your blood, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take to reduce the risk of bleeding:

• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.


• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums.


• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.


• Avoid contact sports or other situations where bruising or injury could occur .

It is important that you follow any special dietary instructions from your doctor. Some foods and beverages may aggravate your condition.

Elmiron 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:

Rare

• Chills


• difficulty in breathing


• fever


• skin rash or hives


• sore throat


• unusual bleeding or bruising


• unusual tiredness or weakness


• vision impairment

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:

Less common or rare

• Abdominal pain


• bleeding gums


• constipation


• diarrhea


• difficulty or pain upon swallowing


• dizziness


• dryness of throat


• hair loss


• headache


• heartburn


• increased sensitivity of skin to sunlight


• irritated or red eyes


• itching


• loss of appetite


• nausea


• nosebleed


• ringing in the ears


• runny nose


• sores in mouth


• stomach gas


• stomach upset


• vomiting

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: Elmiron side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Elmiron resources

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

• Elmiron Prescribing Information (FDA)


• Elmiron MedFacts Consumer Leaflet (Wolters Kluwer)


• Elmiron Concise Consumer Information (Cerner Multum)


• Elmiron Monograph (AHFS DI)


• Pentosan Polysulfate Sodium Professional Patient Advice (Wolters Kluwer)

Compare Elmiron with other medications

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Proglycem Suspension

Pronunciation: dye-az-OX-ide
Generic Name: Diazoxide
Brand Name: Proglycem

Proglycem Suspension is used for:

Treating low blood sugar.

Proglycem Suspension is a glucose-elevating agent. It works by blocking the release of insulin from the pancreas, which helps to increase blood sugar.

Do NOT use Proglycem Suspension if:

• you are allergic to any ingredient in Proglycem Suspension or to other thiazides (eg, hydrochlorothiazide)


• you have functional low blood sugar

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

Before using Proglycem Suspension:

Some medical conditions may interact with Proglycem Suspension. 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 heart problems, kidney problems, low potassium levels in the blood, or high blood pressure


• if you have a history of aneurysm

Some MEDICINES MAY INTERACT with Proglycem Suspension. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Hydantoins (eg, phenytoin), sulfonylureas (eg, glipizide), or thiazide-type diuretics (eg, hydrochlorothiazide) because the effectiveness of these medicines may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Proglycem Suspension 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 Proglycem Suspension:

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

• Shake well before using.


• Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.


• Proglycem Suspension works best if it is taken on a regular schedule.


• Continue to use Proglycem Suspension even if you feel well. Do not miss any doses.


• If you miss a dose of Proglycem Suspension, 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 Proglycem Suspension.

Important safety information:

• Follow the dietary plan as provided by your doctor.


• Using a kit, test your urine or blood sugar as instructed by your doctor.


• LAB TESTS, including blood glucose determinations, platelet counts, and serum urea nitrogen, may be performed to monitor your progress. Be sure to keep all doctor and lab appointments.


• PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Proglycem Suspension, discuss with your doctor the benefits and risks of using Proglycem Suspension during pregnancy. Use Proglycem Suspension with caution during labor and delivery. It is unknown if Proglycem Suspension is excreted in breast milk. Do not breast-feed while taking Proglycem Suspension.

Possible side effects of Proglycem Suspension:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; excessive hair growth; headache; loss of appetite; nausea; weakness.

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); excessive drowsiness; excessive hunger or thirst; fast or irregular heartbeat; frequent urination; fruity breath; sudden weight gain; sweating; swelling of the feet or ankles.

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: Proglycem 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 continued loss of appetite; drowsiness; flushed, dry skin; fruit-like breath odor; increased urination; unusual thirst.

Proper storage of Proglycem Suspension:

Store Proglycem Suspension at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Proglycem Suspension out of the reach of children and away from pets.

General information:

• If you have any questions about Proglycem Suspension, please talk with your doctor, pharmacist, or other health care provider.


• Proglycem Suspension is to be used only by the patient for whom it is prescribed. Do not share it with other people.


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


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

This information is a summary only. It does not contain all information about Proglycem Suspension. 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

Copyright © 2012 Wolters Kluwer Health, Inc.

More Proglycem resources

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

Compare Proglycem with other medications

• Hypertensive Emergency
• Hypoglycemia

CaloMist nasal

Generic Name: cyanocobalamin (nasal) (sye AN oh koe BAL a min)

Brand Names: CaloMist, Nascobal

What is nasal cyanocobalamin?

Cyanocobalamin is a man-made form of vitamin B12. Vitamin B12 is important for growth, cell reproduction, blood formation, and protein and tissue synthesis.

Cyanocobalamin is used to treat vitamin B12 deficiency in people with pernicious anemia and other conditions.

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

What is the most important information I should know about nasal cyanocobalamin?

You should not use this medication if you are allergic to cobalt, or if you have Leber's disease. Cyanocobalamin can lead to optic nerve damage (and possibly blindness) in people with Leber's disease.

To treat pernicious anemia, you will have to use this medication on a regular basis for the rest of your life. Not using the medication can lead to irreversible nerve damage in your spinal cord.

Pernicious anemia is also treated with folic acid to help maintain red blood cells. However, folic acid will not treat Vitamin B12 deficiency and will not prevent possible damage to the spinal cord. Use all of your medications as directed.

Avoid eating or drinking hot foods or liquids within 1 hour before or after using the nasal form of this medication.

Tell your doctor if you develop nasal congestion, a cold, or allergies. The nasal spray may not work as well if you are congested.

Your dose needs may change if you become pregnant, if you breast-feed, or if you eat a vegetarian diet. Tell your doctor about any changes in your diet or medical condition.

What should I discuss with my healthcare provider before using nasal cyanocobalamin?

You should not use this medication if you are allergic to cobalt, or if you have Leber's disease. Cyanocobalamin can lead to optic nerve damage (and possibly blindness) in people with Leber's disease.

Before using cyanocobalamin, tell your doctor if you have:

• 
  

  any type of infection;

  
  


• 
  

  iron or folic acid deficiency;

  
  


• 
  

  kidney or liver disease; or

  
  


• 
  

  if you are receiving any medication or treatment that affects bone marrow.

  
  

Tell your doctor if you develop nasal congestion, a cold, or allergies. Nasal cyanocobalamin may not work as well if your nose is congested.

FDA pregnancy category C. It is not known whether this medication can harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Cyanocobalamin passes into breast milk, but it is not known whether cyanocobalamin could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use nasal cyanocobalamin?

Use this medication exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Your dose needs may change if you become pregnant, if you breast-feed, or if you eat a vegetarian diet. Tell your doctor about any changes in your diet or medical condition.

To use nasal cyanocobalamin.

• 
  

  Gently blow your nose to clear any mucus.

  
  


• 
  

  Prime the nasal gel pump before your first use and whenever it has been longer than 2 days between uses. Pump the gel unit several times until a gel droplet appears at the tip, then pump 2 more times.

  
  


• 
  

  Prime the nasal spray before your first use by pumping the spray a few times until a fine mist appears. Prime the pump 1 time before each use thereafter.

  
  


• 
  

  Insert the tip of the nasal pump about half an inch into your nostril, pointing it toward the back of the nose.

  
  


• 
  

  Gently press your other nostril closed with your finger, and tilt your head forward. Pump and sniff gently at the same time. Return your head to an upright position.

  
  


• 
  

  Remove the pump from your nose. Rub your nostril gently for a few seconds.

  
  


• 
  

  Clean the tip of the spray or gel pump with a clean tissue and recap.

  
  

To be sure this medication is helping your condition, your blood will need to be tested every 3 to 6 months. This will help your doctor determine the correct dose and how long to treat you with cyanocobalamin. Do not miss any scheduled appointments.

To treat pernicious anemia, you will have to use this medication on a regular basis for the rest of your life. Not using the medication can lead to irreversible nerve damage in your spinal cord.

Pernicious anemia is also treated with folic acid to help maintain red blood cells. However, folic acid will not treat Vitamin B12 deficiency and will not prevent possible damage to the spinal cord. Use all of your medications as directed.

Store this medication at room temperature away from moisture, heat, and light. Keep the nasal gel in the prescription vial when not in use. Store the nasal spray upright.

What happens if I miss a dose?

Use the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. 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. An overdose of cyanocobalamin is not likely to cause life-threatening symptoms.

What should I avoid while using nasal cyanocobalamin?

Do not drink hot liquid or eat hot food within 1 hour before or after you use nasal cyanocobalamin.

Avoid drinking large amounts of alcohol while you are being treated with cyanocobalamin.

Avoid using any other nasal medications that your doctor has not recommended or prescribed.

Nasal cyanocobalamin side effects

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

• 
  

  chest pain;

  
  


• 
  

  feeling short of breath, even with mild exertion;

  
  


• 
  

  swelling, rapid weight gain; or

  
  


• 
  

  unusual warmth, redness, or pain in an arm or leg.

  
  

Less serious side effects may include:

• 
  

  headache, dizziness, weakness;

  
  


• 
  

  nausea, upset stomach, diarrhea;

  
  


• 
  

  numbness or tingling;

  
  


• 
  

  runny nose, sneezing, sore throat, swollen tongue;

  
  


• 
  

  fever;

  
  


• 
  

  joint pain; or

  
  


• 
  

  itching or rash.

  
  

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect nasal cyanocobalamin?

Before using cyanocobalamin, tell your doctor if you are taking any of the following medications:

• 
  

  antibiotics;

  
  


• 
  

  methotrexate (Rheumatrex);

  
  


• 
  

  pyrimethamine (Daraprim);

  
  


• 
  

  colchicine; or

  
  


• 
  

  if you drank a lot of alcohol within the past 2 weeks.

  
  

This list is not complete and there may be other drugs that can interact with cyanocobalamin. 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 CaloMist resources

• CaloMist Side Effects (in more detail)
• CaloMist Use in Pregnancy & Breastfeeding
• CaloMist Drug Interactions
• CaloMist Support Group
• 1 Review for CaloMist - Add your own review/rating

Compare CaloMist with other medications

• B12 Nutritional Deficiency
• Pernicious Anemia
• Schilling Test
• Vitamin B12 Deficiency

Where can I get more information?

• Your pharmacist can provide more information about nasal cyanocobalamin.

See also: CaloMist side effects (in more detail)

Lamisil

Generic Name: terbinafine (Oral route)

TER-bin-a-feen

Commonly used brand name(s)

In the U.S.

• Lamisil


• Terbinex

Available Dosage Forms:

• Packet


• Tablet

Therapeutic Class: Antifungal

Chemical Class: Allylamine

Uses For Lamisil

Terbinafine belongs to the group of medicines called antifungals. It is used to treat fungus infections of the scalp, body, groin (jock itch), feet (athlete's foot), fingernails, and toenails.

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

Before Using Lamisil

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 terbinafine oral granules in children younger than 4 years of age with fungal infections of the scalp. Safety and efficacy have not been established.

Appropriate studies have not been performed on the relationship of age to the effects of terbinafine tablets in children with fungal infections of the fingernails or toenails. Safety and efficacy have not been established.

Geriatric

Appropriate studies on the relationship of age to the effects of terbinafine oral granules have not been performed in the geriatric population. Safety and efficacy have not been established.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of terbinafine tablets in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution in patients receiving terbinafine tablets.

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 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.

• Clozapine

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


• Metoprolol


• Nortriptyline


• Warfarin

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. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood problems (e.g., neutropenia) or


• Systemic lupus erythematosus or SLE or


• Weakened immune system—Use with caution. May make these conditions worse.

• Liver disease, active or chronic—Use is not recommended in patients with this condition.

Proper Use of terbinafine

This section provides information on the proper use of a number of products that contain terbinafine. It may not be specific to Lamisil. Please read with care.

Take this medicine exactly 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. To do so may increase the chance of side effects.

This medicine comes with a patient information leaflet. Read and follow the instructions in the leaflet carefully. Ask your doctor if you have any questions.

Terbinafine tablets may be taken with food or on an empty stomach. However, it is best to take terbinafine oral granules with food.

To help clear up your infection completely, it is very important that you keep using this medicine for the full time of treatment, even if your symptoms begin to clear up or you begin to feel better after a few days. Since fungal infections may be very slow to clear up, you may need to take this medicine for several weeks or months. If you stop taking this medicine too soon, your symptoms may return.

This medicine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, it is best to take the doses at the same times every day. If you need help in planning the best time to take your medicine, check with your doctor.

If you are using the oral granules, you may sprinkle the contents on a spoonful of pudding or other soft, non-acidic food such as mashed potatoes. This mixture must be swallowed immediately without chewing. Do not use applesauce or fruit-based foods. If you will need two packets of oral granules with each dose, you may sprinkle the content of both packets on one spoonful or two spoonfuls of non-acidic food.

Avoid caffeine (coffee, soda, chocolate) while you are using this medicine. Terbinafine may cause caffeine to stay in your body longer than usual.

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.

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 form (granules):
  
  • For tinea capitis (fungus infections of the scalp):
    
    • Adults—Dose is based on body weight and must be determined by your doctor. The dose is usually 250 milligrams (mg) once a day for 6 weeks.
    
    
    • Children 4 years of age and older and weighing over 35 kilograms (kg)—Dose is based on body weight and must be determined by your doctor. The dose is usually 250 milligrams (mg) once a day for 6 weeks.
    
    
    • Children 4 years of age and older and weighing less than 25 kg to 35 kg—Dose is based on body weight and must be determined by your doctor. The dose is usually 125 to 187.5 mg once a day for 6 weeks.
    
    
    • Children younger than 4 years of age—Use and dose must be determined by the doctor.
    
    
  
  


• For oral dosage form (tablets):
  
  • For onychomycosis (fungus infections of the fingernails):
    
    • Adults—250 milligrams (mg) once a day for 6 weeks.
    
    
    • Children—Use and dose must be determined by the doctor.
    
    
  
  
  • For onychomycosis (fungus infections of the toenails):
    
    • Adults—250 milligrams (mg) once a day for 12 weeks.
    
    
    • Children—Use and dose must be determined by the doctor.
    
    
  
  
  • For tinea corporis (ringworm of the body):
    
    • Adults and teenagers—250 milligrams (mg) once a day for 2 to 4 weeks.
    
    
    • Children—Use and dose must be determined by the doctor.
    
    
  
  
  • For tinea cruris (ringworm of the groin; jock itch):
    
    • Adults and teenagers—250 milligrams (mg) once a day for 2 to 4 weeks.
    
    
    • Children—Use and dose must be determined by the doctor.
    
    
  
  
  • For tinea pedis (ringworm of the foot; athlete's foot):
    
    • Adults and teenagers—250 milligrams (mg) once a day for 2 to 6 weeks.
    
    
    • Children—Use and dose must be determined by the 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 a dose of terbinafine tablets, take it as soon as you can. If your next regular dose is less than 4 hours away, wait until then to use the medicine and skip the missed dose.

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 Lamisil

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

If your or your child's symptoms do not improve, or if they become worse, check with your doctor. You may need to take this medicine for several weeks or months before your infection gets better.

This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Stop taking this medicine and call your doctor right away if you have a skin rash, itching, hives, trouble with breathing or swallowing, or any swelling of your hands, face, or mouth while you or your child are using this medicine.

This medicine may cause serious liver problems, including liver failure. Stop taking this medicine and check with your doctor right away if you start having nausea or vomiting, dark urine, light-colored stools, stomach pain, or yellow eyes or skin while you or your child are using this medicine.

This medicine may cause problems with your sense of taste or smell. Stop taking this medicine and tell your doctor if you or your child have change or loss of sense of smell, change in taste or loss of taste, poor appetite, or weight loss.

You may become depressed when taking this medicine. Tell your doctor right away if you or your child thinks this medicine is causing changes in your mood or behavior. Other symptoms include feeling very sad or empty, irritable, lack of appetite, loss of interest or pleasure, restlessness, trouble concentrating, or trouble sleeping.

Liver problems may be more likely to occur if you drink alcoholic beverages while you are taking this medicine. You should not drink alcoholic beverages while you are taking this medicine.

Serious skin reactions can occur with this medicine. Stop using this medicine and check with your doctor right away if you have blistering, peeling, or loosening of the skin; red skin lesions; severe acne or skin rash; sores or ulcers on the skin; or fever or chills while you or your child are using this medicine.

This medicine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you or your child get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

Stop taking this medicine and tell your doctor right away if you or your child have a red, scaly, skin rash or unusual sensitivity of the skin to the sun that can lead to a rash.

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.

Lamisil 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

• Fever

Less common

• Body aches or pain


• chills


• cough


• diarrhea


• difficulty with breathing


• ear congestion


• general feeling of discomfort or illness


• headache


• joint pain


• loss of appetite


• loss of voice


• nasal congestion


• nausea


• runny nose


• shivering


• skin rash or itching


• sneezing


• sore throat


• sweating


• trouble with sleeping


• unusual tiredness or weakness


• upper abdominal or stomach pain


• vomiting

Rare

• Dark urine


• difficulty with swallowing


• pale skin


• pale stools


• redness, blistering, peeling, or loosening of the skin


• stomach pain


• unusual bleeding or bruising


• yellow skin or eyes

Incidence not known

• Black, tarry, stools


• bleeding gums


• bloating


• blood in the urine or stools


• chest pain


• constipation


• cough or hoarseness


• dizziness


• fast heartbeat


• feeling of discomfort


• flu-like symptoms


• general feeling of tiredness or weakness


• hair loss


• high fever


• hives


• indigestion


• inflammation of the joints


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


• light-colored stools


• lower back or side pain


• muscle aches


• painful or difficult urination


• pains in the stomach, side, or abdomen, possibly radiating to the back


• persistent loss of appetite


• pinpoint red spots on the skin


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


• red skin lesions, often with a purple center


• red, irritated eyes


• red, scaling, or crusted skin


• shortness of breath or troubled breathing


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


• sores, welting, or blisters


• stomach pain, continuing


• swollen glands


• swollen lymph glands


• tightness in the chest


• troubled breathing with exertion


• ulcers, sores, or white spots in the mouth


• unexplained bleeding or bruising


• wheezing

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:

More common

• Stomach pain (mild)


• stuffy nose

Less common

• Acid or sour stomach


• bad, unusual, or unpleasant (after) taste


• belching


• change of taste or loss of taste


• heartburn


• toothache

Incidence not known

• Decreased vision


• difficulty with moving


• discouragement


• feeling sad or empty


• irritability


• lack of appetite


• loss of interest or pleasure


• loss of sense of smell


• muscle cramps or spasms


• muscle stiffness


• tiredness


• trouble concentrating

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: Lamisil side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Lamisil resources

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

• Lamisil Prescribing Information (FDA)


• Lamisil Consumer Overview


• Lamisil Monograph (AHFS DI)


• Lamisil MedFacts Consumer Leaflet (Wolters Kluwer)


• Terbinafine Prescribing Information (FDA)


• Terbinafine Professional Patient Advice (Wolters Kluwer)

Compare Lamisil with other medications

• Cutaneous Candidiasis
• Onychomycosis, Fingernail
• Onychomycosis, Toenail
• Tinea Capitis
• Tinea Corporis
• Tinea Cruris
• Tinea Pedis

Yodoxin

Generic Name: Iodoquinol
Class: Amebicides
VA Class: AP109

Introduction

Amebicide, antiprotozoal.¹¹⁰

Uses for Yodoxin

Amebiasis

Treatment of amebiasis caused by Entamoeba histolytica.^{100 102 105 106 107 110}

Used alone for treatment of asymptomatic intestinal amebiasis.^{100 102 105 106 107} Drugs of choice for asymptomatic cyst passers (intraluminal infections) are iodoquinol, paromomycin, or oral diloxanide furoate (not commercially available in the US).^{100 102 105 106 107} Paromomycin may be preferred in children or pregnant women.^{105 106}

Should not be used alone for treatment of symptomatic intestinal amebiasis or extraintestinal amebiasis (including amebic liver abscess) caused by E. histolytica.^{100 102 105 106 107} Regimen of choice for symptomatic intestinal amebiasis or extraintestinal disease (including liver abscess) is treatment with a tissue amebicide (oral metronidazole or oral tinidazole) followed by treatment with a luminal amebicide (oral iodoquinol or oral paromomycin).^{100 102 105 106 107} Paromomycin may be preferred for such follow-up treatment in children or pregnant women.^{105 106}

Some strains of Entamoeba are nonpathogenic (e.g., E. dispar, E. hartmanni) and asymptomatic intraluminal infections with these organisms generally do not require treatment.^{100 105 106 107}

Balantidiasis

Treatment of balantidiasis† caused by Balantidium coli.^{100 102 106} Tetracycline is considered the drug of choice; alternatives are iodoquinol or metronidazole.^{100 102 106}

Blastocystis hominis Infections

Has been used in the treatment of infections caused by Blastocystis hominis†.^{100 102 106 108 109}

Clinical importance of B. hominis as a cause of GI pathology is controversial;^{100 102 106 108 109} unclear when treatment is indicated.^{100 106 108} Some clinicians suggest treatment be reserved for certain individuals (e.g., immunocompromised patients) when symptoms persist and no other pathogen or process is found to explain their GI symptoms.^{100 106}

Treatment alternatives are metronidazole, co-trimoxazole, iodoquinol, or nitazoxanide.^{100 102} Metronidazole resistance may be common in some areas.¹⁰²

Dientamoeba fragilis Infections

Treatment of infections caused by Dientamoeba fragilis†.^{102 106}

Drugs of choice are iodoquinol, paromomycin, tetracycline, or metronidazole.^{102 106}

Yodoxin Dosage and Administration

Administration

Oral Administration

Administer orally after a meal.^{102 110} Tablets may be crushed and mixed with applesauce or chocolate syrup.^a

Dosage

Pediatric Patients

Amebiasis Caused by Entamoeba histolytica

Asymptomatic Amebiasis

Oral

30–40 mg/kg daily (maximum: 2 g daily) administered in 3 divided doses for 20 days.^{102 107}

Manufacturer recommends 10–13.3 mg/kg 3 times daily (up to 1.95 g daily) for 20 days.¹¹⁰

Symptomatic Intestinal Amebiasis or Extraintestinal Amebiasis (Including Amebic Liver Abscess)

Oral

30–40 mg/kg daily (maximum: 2 g daily) administered in 3 divided doses for 20 days.^{102 107}

Manufacturer recommends 10–13.3 mg/kg 3 times daily (up to 1.95 g daily) for 20 days.¹¹⁰

Used as follow-up after a tissue amebicide (oral metronidazole or oral tinidazole).^{100 102 105 106 107} (See Amebiasis under Uses.)

Balantidiasis†

Oral

30–40 mg/kg daily (maximum: 2 g daily) given in 3 divided doses for 20 days.¹⁰²

Dientamoeba fragilis Infections†

Oral

30–40 mg/kg daily (maximum: 2 g daily) given in 3 divided doses for 20 days.¹⁰²

Adults

Amebiasis Caused by Entamoeba histolytica

Asymptomatic Amebiasis

Oral

650 mg 3 times daily for 20 days.^{102 105 107 110}

Symptomatic Intestinal Amebiasis or Extraintestinal Amebiasis (Including Amebic Liver Abscess)

Oral

650 mg 3 times daily for 20 days.^{102 105 107 110}

Balantidiasis†

Oral

650 mg 3 times daily for 20 days.¹⁰²

Blastocystis hominis Infections†

Oral

650 mg 3 times daily for 20 days.^{102 109}

Dientamoeba fragilis Infections†

Oral

650 mg 3 times daily for 20 days.¹⁰²

Prescribing Limits

Pediatric Patients

Amebiasis Caused by Entamoeba histolytica

Oral

Maximum 1.95¹¹⁰ or 2 g daily.¹⁰²

Balantidiasis†

Oral

Maximum 2 g daily.¹⁰²

Dientamoeba fragilis Infections†

Oral

Maximum 2 g daily.¹⁰²

Special Populations

No special population dosage recommendations at this time.^a

Cautions for Yodoxin

Contraindications

• 
  

  Known hypersensitivity to iodine and 8-hydroxyquinolines.¹¹⁰

  
  


• 
  

  Hepatic disease.¹¹⁰

  
  

Warnings/Precautions

Warnings

Optic Neuritis and Peripheral Neurotoxicity

Avoid long-term use.¹¹⁰ Prolonged, high dosage of halogenated 8-hydroxyquinolines has resulted in optic neuritis, optic atrophy, and peripheral neuropathy .¹¹⁰

Sensitivity Reactions

Hypersensitivity

Discontinue if hypersensitivity reactions occur.¹¹⁰

General Precautions

Thyroid Disease

Use with caution in individuals with thyroid disease.¹¹⁰ (See Laboratory Tests under Interactions.)

Nonspecific Diarrhea

Do not use for the treatment of nonspecific diarrhea.¹¹⁰

Specific Populations

Pregnancy

Category C.¹¹¹

Lactation

Not known whether iodoquinol is distributed into milk,¹¹¹ safe use during lactation not established.¹¹⁰

Pediatric Use

Do not exceed maximum daily dosage.¹¹⁰

Hepatic Impairment

Contraindicated in patients with hepatic disease.¹¹⁰

Common Adverse Effects

Iodism manifested by generalized furunculosis (iodine toxicoderma) and skin reactions (papular and pustular acneiform eruptions, bullae, vegetating or tuberous iododerma), urticaria and pruritus, GI effects (anorexia, nausea, vomiting, diarrhea, abdominal cramps, pruritus ani), fever, chills, headache, vertigo, thyroid enlargement, optic neuritis, optic atrophy, peripheral neuropathy.^{110 a}

Interactions for Yodoxin

Laboratory Tests

Contains 64% organically-bound iodine.¹¹⁰ May interfere with certain thyroid function tests by increasing protein-bound serum iodine concentrations.¹¹⁰ This effect may persist for as long as 6 months after cessation of iodoquinol therapy.¹¹⁰

Yodoxin Pharmacokinetics

Absorption

Bioavailability

Poorly absorbed from the GI tract; majority of an oral dose is excreted in feces^a

Some systemic absorption may occur since increased blood concentrations of iodine have been reported.^a

Distribution

Extent

Animal studies indicate the drug is distributed into tissues.^a Free iodine appears in urine.^a

Elimination

Elimination Route

Unabsorbed drug is eliminated in feces.^a Glucuronide and sulfate conjugates of iodoquinol are eliminated in urine. ^a

Stability

Storage

Oral

Tablets

15–30°C¹¹⁰ in well-closed containers.^a

Actions and SpectrumActions

• 
  

  A luminal or contact 8-hydroxyquinoline amebicide, acts primarily in the intestinal lumen.^a Precise mechanism of action unknown.^a

  
  


• 
  

  Amebicidal against Entamoeba histolytica.¹¹⁰ Active against both the trophozoite and encysted forms.¹¹⁰ Elimination of the cyst form probably results from destruction of the trophozoites.^a

  
  

Advice to Patients

• 
  

  Importance of taking after a meal.¹¹⁰

  
  


• 
  

  Importance of completing full course of treatment, even if feeling better after a few days.^a

  
  


• 
  

  Importance of notifying clinician of persistent or worsening symptoms of infection.^a

  
  


• 
  

  Importance of informing clinicians if hypersensitivity reactions or rash occurs.^{110 a}

  
  


• 
  

  Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.¹¹⁰

  
  


• 
  

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

  
  

Preparations

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

Iodoquinol

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Oral	Tablets	210 mg	Yodoxin	Glenwood
		650 mg	Yodoxin	Glenwood

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.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions September 2009. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

100. American Academy of Pediatrics. 2006 Red Book: Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2006.

102. Anon. Drugs for parasitic infections. From the Medical Letter website. 2008 Aug.

105. Ravdin JI. Amebiasis. Clin Infect Dis. 1995; 20:1453-66. [IDIS 349015] [PubMed 7548493]

106. Aucott JN. Amebiasis and “nonpathogenic” intestinal protozoa. Infect Dis Clin North Am. 1993; 7:67-85.

107. Reed SL. Amebiasis: an update. Clin Infect Dis. 1992; 14:385-93. [IDIS 292053] [PubMed 1554822]

108. Miller RA. Blastocystis hominis: an organism in search of a disease. Rev Infect Dis. 1988; 10:930-8. [IDIS 309903] [PubMed 3055191]

109. Grossman I, Weiss LM, Simon D et al. Blastocystis hominis in hospital employees. Am J Gastroenterol. 1992; 87:729-32. [PubMed 1590309]

110. Glenwood. Yodoxin (iodoquinol) tablets prescribing information. From manufacturer’s website. Accessed 2009 May 11.

111. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 8th ed. Baltimore, MD: Williams & Wilkins; 2008:843-4.

a. AHFS drug information 2009. McEvoy GK, ed. Iodoquinol. Bethesda, MD: American Society of Health-System Pharmacists; 2009:856-7.

More Yodoxin resources

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

• Yodoxin Concise Consumer Information (Cerner Multum)


• Yodoxin Advanced Consumer (Micromedex) - Includes Dosage Information


• Yodoxin MedFacts Consumer Leaflet (Wolters Kluwer)

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Tisseel Valupak Kit

Generic Name: fibrin sealant topical (FYE brin SEE lant TOP i kal)

Brand Names: Artiss, Artiss Duo Set, Artiss Duploject, Tisseel, Tisseel Duploject Kit, Tisseel Valupak Kit

What is Tisseel Valupak Kit (fibrin sealant topical)?

Fibrinolysis inhibitor and thrombin are agents that are involved in blood clotting.

Fibrin sealant topical is used to cause blood clotting during surgery or due to trauma when natural blood clotting processes are deficient.

Fibrin sealant topical may also be used for purposes other than those listed here.

What is the most important information I should know about Tisseel Valupak Kit (fibrin sealant topical)?

Fibrin sealant topical is made from human plasma (part of the blood) and may contain infectious agents (e.g., viruses) that can cause disease. Although fibrin sealant topical is screened, tested, and treated to reduce the possibility that it carries an infectious agent, it can still potentially transmit disease. Discuss with your doctor the risks and benefits of using fibrin sealant topical.

Contact your doctor if you develop fever, drowsiness, chills, runny nose, rash, joint pain, poor appetite, tiredness, nausea, vomiting, abdominal pain, dark-colored urine, or yellowing of the skin or eyes following treatment with fibrin sealant topical. These may be symptoms of infections that may occur due to use of this product.

What should I discuss with my healthcare provider before using Tisseel Valupak Kit (fibrin sealant topical)?

Do not use fibrin sealant topical without first talking to your doctor if you are allergic to cows or products derived from cows. Fibrin sealant topical is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Do not use fibrin sealant topical without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether fibrin sealant topical will be harmful to a nursing baby. Do not use fibrin sealant topical without first talking to your doctor if you are breast-feeding a baby.

How should I use Tisseel Valupak Kit (fibrin sealant topical)?

Fibrin sealant topical will be administered by a healthcare professional as a topical application.

What happens if I miss a dose?

Due to the indications for use and the method of application of fibrin sealant topical, missing a dose is not likely to occur.

What happens if I overdose?

Due to the indications for use and the method of application of fibrin sealant topical, an overdose of the medication is unlikely to occur. Contact your doctor or a poison control center for advice if an overdose is suspected.

What should I avoid while taking Tisseel Valupak Kit (fibrin sealant topical)?

There are no restrictions on food, beverages, or activity following the use of fibrin sealant topical, unless otherwise directed by your doctor.

Tisseel Valupak Kit (fibrin sealant topical) side effects

Fibrin sealant topical is made from human plasma (part of the blood) and may contain infectious agents (e.g., viruses) that can cause disease. Although fibrin sealant topical is screened, tested, and treated to reduce the possibility that it carries an infectious agent, it can still potentially transmit disease. Discuss with your doctor the risks and benefits of using fibrin sealant topical.

Contact your doctor if you develop fever, drowsiness, chills, runny nose, rash, joint pain, poor appetite, tiredness, nausea, vomiting, abdominal pain, dark-colored urine, or yellowing of the skin or eyes following treatment with fibrin sealant topical. These may be symptoms of infections that may occur due to use of this product.

Notify your doctor immediately if you experience a rare but serious allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives) to fibrin sealant topical.

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 fibrin sealant topical

It is not known whether other medications will interact with fibrin sealant topical. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products during treatment with fibrin sealant topical.

More Tisseel Valupak Kit resources

• Tisseel Valupak Kit Use in Pregnancy & Breastfeeding
• Tisseel Valupak Kit Support Group
• 0 Reviews for Tisseel Valupak - Add your own review/rating

• Artiss Prescribing Information (FDA)


• Artiss Consumer Overview

Compare Tisseel Valupak Kit with other medications

• Closure of Colostomy
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Where can I get more information?

• Your pharmacist has additional information about fibrin sealant topical written for health professionals that you may read.