Generic Name: Doxapram (DOX-uh-pram)
Brand Name: Dopram

Dopram is used for:

Stimulating or improving breathing in patients after surgery or overdose of certain medicines. It is also used to treat chronic lung disease associated with excessive carbon dioxide in the blood.

Dopram is an analeptic. It works by stimulating the breathing center of the brain by altering the natural chemicals (neurotransmitters) in the brain.

Do NOT use Dopram if:

• you are allergic to any ingredient in Dopram
• you have a history of seizures, heart problems, severe high blood pressure, or blood vessel problems
• you are having an asthma attack or you have a blockage of the airway, a blood clot in the lungs (pulmonary embolism), or other lung problems (eg, pulmonary fibrosis)
• you have had a recent chest injury, head injury, stroke, or have swelling in the brain

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

Before using Dopram:

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

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of asthma or irregular heartbeat
• if you have an overactive thyroid, adrenal gland tumors, high blood pressure, increased spinal fluid pressure, or liver or kidney problems

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

• Aminophylline, monoamine oxidase (MAO) inhibitors (eg, phenelzine), sympathomimetics (eg, phenylephrine), or theophylline because the side effects of Dopram may be increased

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

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

• Dopram is usually administered as an injection at your doctor’s office, hospital, or clinic.
• If Dopram contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
• Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.
• If you miss a dose of Dopram, contact your doctor right away.

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

Important safety information:

• Dopram may cause dizziness or light-headedness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Dopram. Using Dopram alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• Avoid drinking alcohol or taking other medications that cause drowsiness (eg, sedatives, tranquilizers) while taking Dopram. Dopram will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• LAB TESTS, including blood pressure, heart function tests, and muscle reflexes, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.
• Use Dopram with extreme caution in CHILDREN younger than 12 years of age. Safety and effectiveness in this age group have not been confirmed.
• Use of Dopram is not recommended in neonates or premature infants. Dopram contains benzyl alcohol, which may cause severe nervous system problems, seizures, breathing problems, and death in neonates and premature infants.
• PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Dopram, discuss with your doctor the benefits and risks of using Dopram during pregnancy. It is unknown if Dopram is excreted in breast milk. If you are or will be breast-feeding while you are using Dopram, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of Dopram:

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:

Abnormal skin sensations; coughing; diarrhea; dilation of pupils; dizziness; fear; flushing; headache; hiccups; itching; nausea; 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); changes in heart rate; chest pain; disorientation; fainting; fast or irregular heartbeat; fever; hyperactivity; inability to urinate; involuntary movements; loss of bladder control; muscle spasms; seizures; severe dizziness or headache; slow breathing.

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. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately. Symptoms may include agitation; confusion; cough; difficulty breathing; fast heartbeat; high blood pressure; muscle hyperactivity; reflex changes; sweating.

Proper storage of Dopram:

Dopram is usually handled and stored by a health care provider. If you are using Dopram at home, store Dopram as directed by your pharmacist or health care provider.

General information:

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

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

Generic Name: quazepam (KWAY ze pam)
Brand Names: Doral

What is Doral (quazepam)?

Quazepam is in a group of drugs called benzodiazepines (ben-zoe-dye-AZE-eh-peens). Quazepam affects chemicals in the brain that may become unbalanced and cause sleep problems (insomnia).

Quazepam is used to treat insomnia symptoms, such as trouble falling or staying asleep.

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

What is the most important information I should know about Doral (quazepam)?

Quazepam may cause a severe allergic reaction. Stop taking quazepam and 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. Take quazepam only when you are getting ready for several hours of sleep. You may fall asleep very quickly after taking the medicine.

Some people using this medicine have engaged in activity such as driving, eating, or making phone calls and later having no memory of the activity. If this happens to you, stop taking quazepam and talk with your doctor about another treatment for your sleep disorder.

Do not use this medication if you are allergic to quazepam or to other benzodiazepines, such as alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), or triazolam (Halcion). This medication can cause birth defects in an unborn baby, or withdrawal symptoms in a newborn. Do not use quazepam if you are pregnant.

Before taking quazepam, tell your doctor if you have any breathing problems, kidney or liver disease, or a history of depression, mental illness, suicidal thoughts, or addiction to drugs or alcohol.

Quazepam may be habit-forming and should be used only by the person it was prescribed for. Quazepam should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Quazepam should be used for only a short time to treat insomnia. After 7 to 10 nights of use, talk with your doctor about whether or not you should keep taking quazepam.

What should I discuss with my healthcare provider before taking Doral (quazepam)?

Some people using this medicine have engaged in activity such as driving, eating, or making phone calls and later having no memory of the activity. If this happens to you, stop taking quazepam and talk with your doctor about another treatment for your sleep disorder.

Do not use this medication if you are allergic to quazepam or to other benzodiazepines, such as alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), or triazolam (Halcion).

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take quazepam.

• asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;

• kidney or liver disease;

• a history of depression, mental illness, suicidal thoughts or behavior; or

• a history of drug or alcohol addiction.

FDA pregnancy category X. Quazepam can cause birth defects in an unborn baby. It may also cause withdrawal symptoms in a newborn if the mother takes quazepam during pregnancy. Do not use quazepam if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Quazepam can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

The sedative effects of quazepam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking quazepam.

Do not give this medication to anyone under 18 years old.

How should I take Doral (quazepam)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take quazepam only when you are getting ready for several hours of sleep. You may fall asleep very quickly after taking the medicine. Do not take quazepam with food or just after a meal. Contact your doctor if this medicine seems to stop working as well in helping you fall asleep and stay asleep. Quazepam should be used for only a short time to treat insomnia. After 7 to 10 nights of use, talk with your doctor about whether or not you should keep taking quazepam. Do not take this medication for longer than 12 weeks without your doctor’s advice.

Your insomnia symptoms may return when you stop using quazepam, especially during the first day or two. You may also have unpleasant withdrawal symptoms such as vomiting, stomach pain, muscle cramps, sweating, shaky or unpleasant feeling, or seizure (convulsions). Talk to your doctor about how to avoid withdrawal symptoms when you stop using quazepam.

Quazepam may be habit-forming and should be used only by the person it was prescribed for. Quazepam should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Store quazepam at room temperature away from moisture, heat, and light.

Keep track of how many tablets have been used from each new bottle of this medicine. Benzodiazepines are drugs of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Since quazepam is taken as needed, you are not likely to be on a dosing schedule. Take quazepam only when you have time for several hours of sleep.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of quazepam can be fatal, especially if you take it with alcohol.

Overdose symptoms may include extreme drowsiness, confusion, and fainting or coma.

What should I avoid while taking Doral (quazepam)?

Do not drink alcohol while taking quazepam. Even alcohol consumed during the day can increase the side effects of quazepam taken at bedtime. Avoid alcohol for several days after taking quazepam, as small amounts of the drug may remain in your body during that time. Quazepam can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Doral (quazepam) side effects

Quazepam may cause a severe allergic reaction. Stop taking quazepam and 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 quazepam and call your doctor at once if you have a serious side effect such as:

• worsening insomnia;

• confusion, anxiety, slurred speech, unusual thoughts or behavior;

• hallucinations, agitation, aggression;

• weak or shallow breathing;

• fast or pounding heartbeats;

• muscle stiffness in your tongue, jaw, or neck;

• problems with urination; or

• jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• daytime drowsiness (or during hours when you are not normally sleeping);

• amnesia or forgetfulness;

• muscle weakness, lack of balance or coordination;

• dizziness, vision problems;

• nightmares;

• headache, blurred vision, depressed mood;

• feeling nervous, excited, or irritable;

• impotence, loss of interest in sex;

• mild itching or skin rash;

• nausea, diarrhea, stomach pain, loss of appetite; or

• dry mouth, increased thirst.

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 Doral (quazepam)?

Cold or allergy medicine, sedatives, narcotic pain medicine, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by quazepam. Tell your doctor if you regularly use any of these medicines, or any other sleep medication.

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

• bupropion (Wellbutrin, Zyban);

• cyclophosphamide (Cytoxan, Neosar);

• efavirenz (Sustiva);

• irinotecan (Camptosar);

• promethazine (Phenergan); or

• selegiline (Eldepryl, Emsam, Zelapar).

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

Where can I get more information?

• Your pharmacist can provide more information about quazepam.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 7.02. Revision Date: 11/12/2009 2:02:34 PM.

Generic Name: donepezil (oral) (doe NEP e zil)
Brand Names: Aricept, Aricept ODT

What is donepezil?

Donepezil improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.

Donepezil is used to treat mild to moderate dementia caused by Alzheimer’s disease.

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

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

Before taking donepezil, tell your doctor if you have a heart rhythm disorder such as “sick sinus syndrome” (slow heartbeats), an enlarged prostate, urination problems, asthma, obstructive pulmonary disease, or a seizure disorder such as epilepsy.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking donepezil.

Donepezil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my healthcare provider before taking donepezil?

Do not take this medication if you are allergic to donepezil.

Before taking donepezil, tell your doctor if you are allergic to any drugs, or if you have:

• a heart rhythm disorder such as “sick sinus syndrome” (slow heartbeats);

• a history of stomach ulcers;

• an enlarged prostate or urination problems;

• epilepsy or other seizure disorder; or

• asthma or chronic obstructive pulmonary disease (COPD).

If you have any of these conditions, you may need a dose adjustment or special tests to safely take donepezil.

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

How should I take donepezil?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking donepezil. You may need to stop using the medicine for a short time.

Donepezil can be taken with or without food or milk.

Take the donepezil regular tablets with a full glass of water.

To take donepezil orally disintegrating tablet (Aricept ODT):

• Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel or cut the backing from the tablet blister. Do not push a tablet through the backing or you may damage the tablet.

• Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.

• Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

• Swallow several times as the tablet dissolves. After the tablet dissolves completely, drink a glass of water.

Donepezil is usually taken at bedtime. Follow your doctor’s instructions. Store donepezil at room temperature away from moisture and heat.

See also: Donepezil dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take 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 nausea, vomiting, drooling, sweating, blurred vision, feeling light-headed, slow heartbeat, shallow breathing, muscle weakness, fainting, or seizure (convulsions).

What should I avoid while taking donepezil?

Donepezil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Donepezil 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 donepezil and call your doctor at once if you have any of these serious side effects:

• black, bloody, or tarry stools;

• coughing up blood or vomit that looks like blood or coffee grounds;

• painful or difficult urination;

• seizure (black-out or convulsions);

Less serious side effects may include:

• nausea, vomiting, diarrhea;

• loss of appetite;

• muscle cramps;

• tired feeling; or

• sleep problems (insomnia).

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.

Donepezil Dosing Information

Usual Adult Dose for Alzheimer’s Disease:

Initial dose: 5 mg orally once a day

The dosages of donepezil shown to be effective in controlled clinical trials of the treatment of mild to moderate Alzheimer’s disease are 5 mg or 10 mg administered once per day. The higher dose of 10 mg did not provide a statistically significantly greater clinical benefit than 5 mg. However, there has been some evidence to suggest that a daily dose of 10 mg of donepezil might provide additional benefit for some patients. Accordingly, whether or not to use a dose of 10 mg is a matter of prescriber and patient preference.

Donepezil has been shown to be effective in controlled clinical trials of the treatment of severe Alzheimer’s disease at a dose of 10 mg administered once daily. Evidence from the controlled trials in mild to moderate Alzheimer’s disease has indicated that the 10 mg dose, with a one week titration, is likely to be associated with a higher incidence of cholinergic adverse events than the 5 mg dose. In open label trials using a 6-week titration, the frequency of these same adverse events was similar between the 5 mg and 10 mg dose groups. Because steady state is not achieved for 15 days and because the incidence of side effects may be influenced by the rate of dose escalation, a dose of 10 mg should not be achieved until patients have been on a daily dose of 5 mg for 4 to 6 weeks.

Donepezil should be taken in the evening, just prior to retiring. Donepezil can be taken with or without food.

The orally disintegrating tablet (marketed as Aricept ODT) should be allowed to dissolve on the tongue and then be followed with water.

What other drugs will affect donepezil?

Before taking donepezil, tell your doctor if you are taking any of the following medicines:

• atropine (Donnatal, and others);

• belladonna;

• carbamazepine (Tegretol);

• clidinium (Quarzan);

• dexamethasone (Decadron);

• dicyclomine (Bentyl);

• glycopyrrolate (Robinul);

• hyoscyamine (Anaspaz, Cystospaz, Levsin, and others);

• mepenzolate (Cantil);

• methantheline (Provocholine);

• methscopolamine (Pamine), scopolamine (Transderm-Scop);

• phenobarbital (Luminal, Solfoton);

• phenytoin (Dilantin);

• propantheline (Pro-Banthine);

• quinidine (Cardioquin, Quinidex, Quinaglute, others);

• rifampin (Rifadin, Rifamate, Rifater);

• a fungal antibiotic such as ketoconazole (Nizoral), fluconazole (Diflucan), or itraconazole (Sporanox); or

• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), piroxicam (Feldene), and others.

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

Where can I get more information?

• Your pharmacist can provide more information about donepezil.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 1.06. Revision Date: 4/12/2009 4:42:36 PM.

doe-NEP-e-zil

Commonly used brand name(s):

In the U.S.

• Aricept

Available Dosage Forms:

• Tablet, Disintegrating
• Tablet

Therapeutic Class: Central Nervous System Agent

Pharmacologic Class: Cholinesterase Inhibitor, Centrally Acting

Uses For donepezil

Donepezil is used to treat the symptoms of mild to moderate, or severe Alzheimer’s disease. Donepezil will not cure Alzheimer’s disease, and it will not stop the disease from getting worse. However, it can improve thinking ability in some patients .

donepezil is available only with your doctor’s prescription.

Before Using donepezil

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 donepezil, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to donepezil 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 donepezil have been done only in adult patients, and there is no specific information comparing use of donepezil in children with use in other age groups.

Geriatric

In studies done to date that have included older adults, some side effects of donepezil have been shown to occur more frequently in older people than in younger adults.

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

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

Using donepezil 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.

• Succinylcholine

Using donepezil 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.

• Oxybutynin
• Tolterodine

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 donepezil. Make sure you tell your doctor if you have any other medical problems, especially:

• Asthma or
• Lung disease or
• Peptic ulcers, or history of or
• Seizures, or history of or
• Urinary tract blockage—Donepezil may make these conditions worse

• Heart problems—Donepezil may have unwanted effects on heart rate

• Liver problems—Higher blood levels of donepezil may result and increase the chance of side effects

Proper Use of donepezil

Take donepezil exactly as directed by your doctor in order to improve your condition as much as possible. Do not take more of it or less of it, and do not take it more or less often than your doctor ordered.

Donepezil should be taken at bedtime unless otherwise directed by your doctor. It may be taken with or without food, on a full or empty stomach.

For patients using the oral disintegrating tablet form of donepezil:

• Make sure your hands are dry.
• Do not push the tablet through the foil backing of the package. Instead, gently peel back the foil backing and remove the tablet.
• Immediately place the tablet on top of the tongue.
• The tablet will dissolve in seconds, and you may swallow it with your saliva. You should drink a glass of water after the tablet has dissolved.

For patients taking the oral solution form of donepezil:

• Shake the bottle well before measuring the dose.
• Use a specially marked measuring spoon, a plastic syringe, or a small marked measuring cup to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.
• If your dose is 5 mg, you should take 5 mL of donepezil.
• If your dose is 10 mg, you should take 10 mL of donepezil.

Dosing

The dose of donepezil 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 donepezil. 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 (oral disintegrating tablets, oral solution, and tablets):
  • For mild to moderate Alzheimer’s disease:
    • Adults—5 milligrams (mg) taken at bedtime. Your doctor may increase your dose as needed. However, the dose usually is not more than 10 mg a day.
    • Children—Use and dose must be determined by your doctor .
  • For severe Alzheimer’s disease:
    • Adults—10 mg taken at bedtime.
    • Children—Use and dose must be determined by your doctor .

Missed Dose

If you miss a dose of donepezil, 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 donepezil

It is important that your doctor check your progress at regular visits. This is necessary to allow dose adjustments and to reduce any unwanted effects.

Before you have any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are using donepezil. Taking donepezil together with certain medicines that are used during surgery or dental or emergency treatments may increase the effects of those medicines and cause unwanted effects.

donepezil may cause some people to become dizzy or drowsy, to have blurred vision, or to have problems with clumsiness or unsteadiness. Make sure you know how you react to donepezil before you drive, use machines, or do anything else that could be dangerous if you are not alert, well-coordinated, and able to see clearly.

If you think that you or someone else may have taken an overdose of donepezil, get emergency help at once. Taking an overdose of donepezil may cause convulsions (seizures) or serious effects on your heart and your breathing. Signs of overdose include increased watering of mouth, increased sweating, low blood pressure, muscle weakness, severe nausea, severe vomiting, slow heartbeat, and troubled breathing.

donepezil 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

• Diarrhea
• loss of appetite
• muscle cramps
• nausea
• trouble in sleeping
• unusual tiredness or weakness
• vomiting

Less common

• Abnormal dreams
• constipation
• dizziness
• drowsiness
• fainting
• frequent urination
• headache
• joint pain, stiffness, or swelling
• mental depression
• pain
• unusual bleeding or bruising
• weight loss

Rare

• Black, tarry stools
• bloating
• bloody or cloudy urine
• blurred vision
• burning, prickling, or tingling sensations
• cataract
• chills
• clumsiness or unsteadiness
• confusion
• cough
• decreased urination
• difficult or painful urination
• dryness of mouth
• eye irritation
• fever
• flushing of skin
• frequent urge to urinate
• high or low blood pressure
• hives
• hot flashes
• increased heart rate and breathing
• increase in sexual desire or performance
• increased sweating
• increased urge to urinate during the night
• irregular heartbeat
• itching
• loss of bladder control
• loss of bowel control
• mood or mental changes, including abnormal crying, aggression, agitation, delusions, irritability, nervousness, or restlessness
• nasal congestion
• pain in chest, upper stomach, or throat
• problems with speech
• runny nose
• severe thirst
• shortness of breath
• sneezing
• sore throat
• sunken eyes
• tightness in chest
• tremor
• troubled breathing
• wheezing
• wrinkled skin

Incidence not known

• Back, leg, or stomach pains
• bleeding gums
• chest pain or discomfort
• coma
• convulsions
• dark urine
• difficulty breathing
• fast or irregular heartbeat
• fatigue
• general body swelling
• general tiredness and weakness
• high fever
• increased thirst
• indigestion
• light-colored stools
• muscle pain or cramps
• nausea and vomiting
• nosebleeds
• pains in stomach, side, or abdomen, possibly radiating to the back
• pale skin
• rash
• seeing, hearing, or feeling things that are not there
• seizures
• severe muscle stiffness
• severe nausea
• slow or irregular heartbeat
• stomach pain
• sweating
• swelling of face, ankles, or hands
• tiredness
• unusually pale skin
• upper right abdominal pain
• yellow eyes and skin

Symptoms of overdose

• Convulsions (seizures)
• increased sweating
• increased watering of mouth
• increasing muscle weakness
• low blood pressure
• severe nausea
• severe vomiting
• slow heartbeat
• troubled breathing

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.

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.

Generic Name: Donepezil (doe-NEP-e-zil)
Brand Name: Aricept ODT

Donepezil Orally Disintegrating Tablets are used for:

Treating dementia (eg, impairment of memory, judgment, and abstract thinking; changes in personality) caused by Alzheimer disease.

Donepezil Orally Disintegrating Tablets are a cholinesterase inhibitor. It works by increasing the amount of a certain substance (acetylcholine) in the brain, which may help reduce the symptoms of dementia in patients with Alzheimer disease.

Do NOT use Donepezil Orally Disintegrating Tablets if:

• you are allergic to any ingredient in Donepezil Orally Disintegrating Tablets

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

Before using Donepezil Orally Disintegrating Tablets:

Some medical conditions may interact with Donepezil 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 a history of certain heart problems (eg, slow or irregular heartbeat, sick sinus syndrome), stomach or bowel problems (eg, ulcer, blockage), lung or breathing problems (eg, asthma, chronic obstructive pulmonary disease [COPD]), or urinary blockage
• if you have brain lesions or tumors, increased pressure in the brain, recent head injury, or a history of seizures (eg, epilepsy)
• if you have Parkinson disease or metabolism problems

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

• Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of stomach or bowel bleeding may be increased
• Cholinergic agents (eg, bethanechol), cholinesterase inhibitors (eg, galantamine), or ketoconazole because they may increase the risk of Donepezil Orally Disintegrating Tablets’s side effects
• Carbamazepine, dexamethasone, phenobarbital, phenytoin, or rifampin because they may decrease Donepezil Orally Disintegrating Tablets’s effectiveness
• Anticholinergics (eg, scopolamine) because their effectiveness may be decreased by Donepezil Orally Disintegrating Tablets

This may not be a complete list of all interactions that may occur. Ask your health care provider if Donepezil 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 Donepezil Orally Disintegrating Tablets:

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

• Take Donepezil Orally Disintegrating Tablets by mouth in the evening right before you go to bed, unless your doctor tells you otherwise. Take Donepezil Orally Disintegrating Tablets by mouth with or without food.
• Be sure your hands are completely dry before you handle Donepezil Orally Disintegrating Tablets.
• Gently remove the tablet from the blister package. Place the tablet on the tongue and allow to dissolve. Drink a glass of water after the tablet has dissolved.
• Take Donepezil Orally Disintegrating Tablets on a regular schedule to get the most benefit from it.
• Taking Donepezil Orally Disintegrating Tablets at the same time each day will help you remember to take it.
• Continue to take Donepezil Orally Disintegrating Tablets even if you feel well. Do not miss any doses.
• If you miss a dose of Donepezil 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. Contact your doctor if you miss several doses of Donepezil Orally Disintegrating Tablets. You may need to restart your medicine at a lower dose to avoid side effects.

Ask your health care provider any questions you may have about how to use Donepezil Orally Disintegrating Tablets.

Important safety information:

• Donepezil Orally Disintegrating Tablets may cause drowsiness, dizziness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use Donepezil Orally Disintegrating Tablets with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not take more than the recommended dose without checking with your doctor.
• Tell your doctor or dentist that you take Donepezil Orally Disintegrating Tablets before you receive any medical or dental care, emergency care, or surgery.
• Donepezil Orally Disintegrating Tablets are not approved for use in CHILDREN; safety and effectiveness in children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Donepezil Orally Disintegrating Tablets while you are pregnant. It is not known if Donepezil Orally Disintegrating Tablets are found in breast milk. Donepezil Orally Disintegrating Tablets are not approved for use in women who may be breast-feeding.

Possible side effects of Donepezil Orally Disintegrating Tablets:

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:

Abnormal dreams; diarrhea; dizziness; loss of appetite; muscle cramps; nausea; tiredness; trouble sleeping; vomiting; weight loss.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; chest pain; decreased urination; depression; fainting; fever; seizures; severe dizziness or headache; shortness of breath; slow or irregular heartbeat; swelling of the hands, ankles, or feet; unusual bruising; tremor.

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. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately. Symptoms may include fainting; increased sweating or saliva production; loss of consciousness; muscle weakness; seizures; severe dizziness; severe nausea or vomiting; slow heartbeat; slow or shallow breathing.

Proper storage of Donepezil Orally Disintegrating Tablets:

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

General information:

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

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

Brand names: Aricept

Why is Donepezil hydrochloride prescribed?

Aricept is one of the few drugs that can provide some relief from the symptoms of early Alzheimer’s disease. Alzheimer’s disease causes physical changes in the brain that disrupt the flow of information and interfere with memory, thinking, and behavior. Aricept can temporarily improve brain function in some Alzheimer’s sufferers, although it does not halt the progress of the underlying disease.

Most important fact about Donepezil hydrochloride

To maintain any improvement, Aricept must be taken regularly. If the drug is stopped, its benefits will soon be lost. Patience is in order when starting the drug. It can take up to 3 weeks for any positive effects to appear.

How should you take Donepezil hydrochloride?

Aricept should be taken once a day just before bedtime. Be sure it’s taken every day. If Aricept is not taken regularly, it won’t work. It can be taken with or without food.

• If you miss a dose…
  Make it up as soon as you remember. If it is almost time for the next dose, skip the one that was missed and go back to the regular schedule. Never double the dose.

• Storage instructions…
  Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell the doctor as soon as possible. Only the doctor can determine if it is safe to continue Aricept.

Side effects are more likely with higher doses. The most common are diarrhea, fatigue, insomnia, loss of appetite, muscle cramps, nausea, and vomiting. When one of these effects occurs, it is usually mild and gets better as treatment continues.

• Other side effects may include:
  Abnormal dreams, arthritis, bruising, depression, dizziness, fainting, frequent urination, headache, pain, sleepiness, weight loss

Why should Donepezil hydrochloride not be prescribed?

There are two reasons to avoid Aricept: an allergic reaction to the drug itself, or an allergy to the group of antihistamines that includes azatadine, cyproheptadine hydrochloride, fexofenadine hydrochloride, hydroxyzine hydrochloride, and loratadine.

Special warnings about Donepezil hydrochloride

Aricept can aggravate asthma and other breathing problems, and can increase the risk of seizures. It can also slow the heartbeat, cause heartbeat irregularities, and lead to fainting episodes. Contact your doctor if any of these problems occur.

In patients who have had stomach ulcers, and those who take a nonsteroidal anti-inflammatory drug such as ibuprofen or naproxen sodium, Aricept can make stomach side effects worse. Be cautious when using Aricept and report all side effects to your doctor.

Possible food and drug interactions when taking Donepezil hydrochloride

Aricept will increase the effects of certain anesthetics. Make sure the doctor is aware of Aricept therapy prior to any surgery.

If Aricept is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Aricept with the following:

Antispasmodic drugs such as dicyclomine hydrochloride and propantheline
Bethanechol chloride
Carbamazepine
Dexamethasone
Ketoconazole
Phenobarbital
Phenytoin
Quinidine
Rifampin

Special information if you are pregnant or breastfeeding

Since it is not intended for women of child-bearing age, Aricept’s effects during pregnancy have not been studied, and it is not known whether it appears in breast milk.

Recommended dosage for Donepezil hydrochloride

ADULTS

The usual starting dose is 5 milligrams once a day at bedtime for at least 4 to 6 weeks. Do not increase the dose during this period unless directed. The doctor may then change the dosage to 10 milligrams once a day if response to the drug warrants it.

CHILDREN

The safety and effectiveness of Aricept have not been established in children.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Aricept overdose include:
  Collapse, convulsions, extreme muscle weakness (possibly ending in death if breathing muscles are affected), low blood pressure, nausea, salivation, slowed heart rate, sweating, vomiting

Generic Name: dong quai (DON KWAY)
Brand Names:

What is dong quai?

The use of dong quai in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous.

Dong quai is also known as Angelica polymorpha, tang-kuei, dang-gui, and Chinese angelica.

Dong quai has been used in the treatment of menstrual cramps and irregular menses; as a muscle relaxant; as a blood purifier; and in the management of high blood pressure, arthritis, ulcers, anemia, constipation, and allergies.

Dong quai has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of dong quai may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Dong quai may also have uses other than those listed in this medication guide.

What is the most important information I should know about dong quai?

Avoid excessive or prolonged exposure to sunlight while taking dong quai. Dong quai may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing if sun exposure is unavoidable. Do not take dong quai without first talking to your doctor if you have a bleeding or blood clotting disorder; if you are taking a medicine to prevent blood clots; or if you are taking other medications, herbs, antioxidants, or health supplements (these may also affect blood clotting). Dong quai may affect the time it takes for your blood to clot.

Dong quai has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of dong quai may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Who should not take dong quai?

Do not take dong quai without first talking to your doctor if you have a bleeding or blood clotting disorder; if you are taking a medicine to prevent blood clots; or if you are taking other medications, herbs, antioxidants, or health supplements (these may also affect blood clotting). Dong quai may affect the time it takes for your blood to clot.

Before taking dong quai, talk to your doctor, pharmacist, or health care professional if you have any other medical conditions, allergies (especially to plants), or if you take other medicines or other herbal/health supplements. Dong quai may not be recommended in some situations.

Do not take dong quai without first talking to your doctor if you are pregnant or planning a pregnancy. It is not known whether dong quai will harm an unborn baby. Do not take dong quai without first talking to your doctor if you are breast-feeding a baby. It is not known whether dong quai will harm a nursing infant. There is no information available regarding the use of dong quai by children. Do not give any herbal/health supplement to a child without first talking to the child’s doctor.

How should I take dong quai?

The use of dong quai in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous.

If you choose to take dong quai, use it as directed on the package or as directed by your doctor, pharmacist, or other health care provider.

Standardized extracts, tinctures, and solid formulations of herbal/health supplements may provide a more reliable dose of the product.

Do not use different formulations (e.g., tablets, teas, tinctures, and others) of dong quai at the same time, unless specifically directed to do so by a health care professional. Using different formulations together increases the risk of an overdose of dong quai.

Store dong quai as directed on the package. In general, dong quai should be protected from light and moisture and stored in a sealed container.

What happens if I miss a dose?

No information is available regarding a missed dose of dong quai. Consult your doctor, pharmacist, or health care professional if you require further information.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a dong quai overdose are not known.

What should I avoid while taking dong quai?

Avoid excessive or prolonged exposure to sunlight while taking dong quai. Dong quai may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing if sun exposure is unavoidable.

Dong quai side effects

Stop taking dong quai and seek emergency medical attention or notify your doctor immediately if you experience any of the following rare, but possibly serious, side effects:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

• unusual bleeding or bruising;

• a rash or a sunburn; or

• changes in skin color or moles.

Other less serious side effects have not been reported with the use of dong quai, although they may occur. Talk to your doctor, pharmacist, or health care professional about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect dong quai?

Do not take dong quai without first talking to your doctor if you are taking any of the following medicines:

• warfarin (Coumadin);

• aspirin;

• a nonsteroidal anti-inflammatory drug (NSAID) including ibuprofen (Advil, Motrin, Nuprin, others), naproxen (Aleve, Naprosyn, Naprelan, Anaprox, others), ketoprofen (Orudis KT, Orudis), indomethacin (Indocin), etodolac (Lodine), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), tolmetin (Tolectin), and others;

• ardeparin (Normiflo);

• dalteparin (Fragmin);

• danaparoid (Orgaran);

• enoxaparin (Lovenox);

• heparin; or

• other herbs, antioxidants, or health supplements (these may affect blood clotting).

You may not be able to take dong quai, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with dong quai or affect your condition. Talk to your doctor, pharmacist, or health care professional before taking any prescription or over-the-counter medicines or other herbal/health supplements.

Where can I get more information?

• Your doctor, pharmacist, or health care provider may have more information about dong quai.

• Consultation with a licensed health care professional is advisable before using any herbal/health supplement. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial and coordination of treatment among all health care providers involved may be advantageous. Remember, keep this and all other prescription drug products, over-the-counter drug products, and herbal/health supplements out of the reach of children.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 1.03. Revision Date: 2/13/04 4:08:13 PM.

Generic Name: attapulgite (Oral route)

at-a-PUL-gite

Commonly used brand name(s):

In the U.S.

• Diarrest
• Di-Gon II
• Donnagel
• Kaopectate
• Kaopek

In Canada

• Parepectolin

Available Dosage Forms:

• Tablet
• Liquid
• Tablet, Chewable
• Suspension

Therapeutic Class: Adsorbent

Uses For Donnagel

Attapulgite is taken by mouth to treat diarrhea. Attapulgite is a clay-like powder believed to work by adsorbing the bacteria or germ that may be causing the diarrhea.

This medicine was available without a prescription.

As of April 17, 2003, attapulgite is no longer commercially available.

Before Using Donnagel

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

The fluid loss caused by diarrhea may result in a severe condition. For this reason, antidiarrheals must not be given to young children (under 3 years of age) without first checking with their doctor. In older children with diarrhea, antidiarrheals may be used, but it is also very important that a sufficient amount of liquids be given to replace the fluid lost by the body. If you have any questions about this, check with your health care professional.

Geriatric

The fluid loss caused by diarrhea may result in a severe condition. For this reason, elderly persons with diarrhea, in addition to using an antidiarrheal, must receive a sufficient amount of liquids to replace the fluid lost by the body. If you have any questions about this, check with your health care professional.

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. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

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:

• Dysentery—This condition may get worse; a different kind of treatment may be needed.

Proper Use of attapulgite

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

Do not use attapulgite to treat your diarrhea if you have a fever or if there is blood or mucus in your stools. Contact your doctor.

Take this medicine after each loose bowel movement following the directions in the product package, unless otherwise directed by your doctor.

Importance of diet and fluid intake while treating diarrhea:

• In addition to using medicine for diarrhea, it is very important that you replace the fluid lost by the body and follow a proper diet. For the first 24 hours you should eat gelatin and drink plenty of clear liquids, such as ginger ale, decaffeinated cola, decaffeinated tea, and broth. During the next 24 hours you may eat bland foods, such as cooked cereals, bread, crackers, and applesauce. Fruits, vegetables, fried or spicy foods, bran, candy, and caffeine and alcoholic beverages may make the condition worse.
• If too much fluid has been lost by the body due to the diarrhea, a serious condition may develop. Check with your doctor as soon as possible if any of the following occurs:
  • Decreased urination
  • Dizziness and lightheadedness
  • Dryness of mouth
  • Increased thirst
  • Wrinkled skin

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 diarrhea:
  • For oral dosage form (suspension):
    • Adults and children 12 years of age and older—The usual dose is 1200 to 1500 milligrams (mg) taken after each loose bowel movement. No more than 9000 mg should be taken in twenty-four hours.
    • Children 6 to 12 years of age—The usual dose is 600 mg taken after each loose bowel movement. No more than 4200 mg should be taken in twenty-four hours.
    • Children 3 to 6 years of age—The usual dose is 300 mg taken after each loose bowel movement. No more than 2100 mg should be taken in twenty-four hours.
    • Children up to 3 years of age—Use and dose must be determined by your doctor.
  • For oral dosage form (tablets):
    • Adults and children 12 years of age and older—The usual dose is 1200 to 1500 mg taken after each loose bowel movement. No more than 9000 mg should be taken in twenty-four hours.
    • Children 6 to 12 years of age—The usual dose is 750 mg taken after each loose bowel movement. No more than 4500 mg should be taken in twenty-four hours.
    • Children 3 to 6 years of age—The oral suspension dosage form should be used in this age group.
  • For oral dosage form (chewable tablets):
    • Adults and children 12 years of age and older—The usual dose is 1200 mg taken after each loose bowel movement. No more than 8400 mg should be taken in twenty-four hours.
    • Children 6 to 12 years of age—The usual dose is 600 mg taken after each loose bowel movement. No more than 4200 mg should be taken in twenty-four hours.
    • Children 3 to 6 years of age—The usual dose is 300 mg taken after each loose bowel movement. No more than 2100 mg should be taken in twenty-four hours.
    • Children up to 3 years of age—Use and dose must be determined by your doctor.

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.

Precautions While Using Donnagel

Check with your doctor if your diarrhea does not stop after 1 or 2 days or if you develop a fever.

Donnagel Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. No serious side effects have been reported for this medicine. However, constipation may occur in some patients, especially if they take a lot of it. Check with your doctor as soon as possible if constipation continues or is bothersome.

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.

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.

Generic Name: kaolin and pectin (Oral route)

KAY-oh-lin, PEK-tin

Commonly used brand name(s):

In the U.S.

• Kaodene NN
• Kaolinpec
• Kapectolin

In Canada

• Donnagel-Mb
• Kao-Con
• Kaopectate

Available Dosage Forms:

• Suspension
• Tablet
• Liquid

Therapeutic Class: Adsorbent

Uses For Donnagel-Mb

Kaolin and pectin combination medicine is used to treat diarrhea.

Kaolin is a clay-like powder believed to work by attracting and holding onto the bacteria or germ that may be causing the diarrhea.

This medicine is available without a prescription.

Before Using Donnagel-Mb

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

The fluid loss caused by diarrhea may result in a severe condition. For this reason, antidiarrheals must not be given to young children (under 3 years of age) without first checking with their doctor. In older children with diarrhea, antidiarrheals may be used, but it is also very important that a sufficient amount of liquids be given to replace the fluid lost by the body. If you have any questions about this, check with your health care professional.

Geriatric

The fluid loss caused by diarrhea may result in a severe condition. For this reason, elderly persons with diarrhea, in addition to using an antidiarrheal, must receive a sufficient amount of liquids to replace the fluid lost by the body. If you have any questions about this, check with your health care professional.

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. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

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:

• Dysentery—This condition may get worse; a different kind of treatment may be needed

Proper Use of kaolin and pectin

This section provides information on the proper use of a number of products that contain kaolin and pectin. It may not be specific to Donnagel-Mb. Please read with care.

Do not use kaolin and pectin combination to treat your diarrhea if you have a fever or if there is blood or mucus in your stools. Contact your doctor.

Take this medicine, following the directions in the product package, after each loose bowel movement until the diarrhea is controlled, unless otherwise directed by your doctor.

Importance of diet and fluid intake while treating diarrhea:

• In addition to using medicine for diarrhea, it is very important that you replace the fluid lost by the body and follow a proper diet. For the first 24 hours you should eat gelatin and drink plenty of clear liquids, such as ginger ale, decaffeinated cola, decaffeinated tea, and broth. During the next 24 hours you may eat bland foods, such as cooked cereals, bread, crackers, and applesauce. Fruits, vegetables, fried or spicy foods, bran, candy, and caffeine and alcoholic beverages may make the condition worse.
• If too much fluid has been lost by the body due to the diarrhea, a serious condition may develop. Check with your doctor as soon as possible if any of the following signs or symptoms of too much fluid loss occur:
  • Decreased urination
  • Dizziness and lightheadedness
  • Dryness of mouth
  • Increased thirst
  • Wrinkled skin

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 diarrhea:
  • For oral dosage form (suspension):
    • Adults—The usual dose is 4 to 8 tablespoonfuls (60 to 120 milliliters [mL]) taken after each loose bowel movement.
    • Children 12 years of age and over—The usual dose is 3 to 4 tablespoonfuls (45 to 60 mL) taken after each loose bowel movement.
    • Children 6 to 12 years of age—The usual dose is 2 to 4 tablespoonfuls (30 to 60 mL) taken after each loose bowel movement.
    • Children 3 to 6 years of age—The usual dose is 1 to 2 tablespoonfuls (15 to 30 mL) taken after each loose bowel movement.
    • Children up to 3 years of age—Use and dose must be determined by your doctor.

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.

Precautions While Using Donnagel-Mb

Check with your doctor if your diarrhea does not stop after 1 or 2 days or if you develop a fever.

If you are taking any other medicine, do not take it within 2 to 3 hours of taking kaolin and pectin. Taking the medicines together may prevent the other medicine from being absorbed by your body. If you have any questions about this, check with your health care professional.

Donnagel-Mb Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. No serious side effects have been reported for this medicine. However, this medicine may cause constipation in some patients, especially if they take a lot of it. Check with your doctor as soon as possible if constipation continues or is bothersome.

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.

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.

Generic Name: belladonna alkaloids and phenobarbital (BEL a DON a AL ka loids and FEEN oh BAR bi tal)
Brand Names: Bellatal, D-Tal, Donnatal

What is Donnatal (belladonna alkaloids and phenobarbital)?

Phenobarbital is in a group of drugs called barbiturates (bar-BIT-chur-ates). Phenobarbital slows the activity of your brain and nervous system.

Belladonna alkaloids produce many effects in the body, including reduced muscle spasms in the digestive or urinary tract, and reduced fluid secretions from certain glands or organs.

The belladonna alkaloids included in this medication include atropine, hyoscyamine, and scopolamine.

The combination of belladonna alkaloids and phenobarbital is used to treat irritable bowel syndrome and ulcers in the intestine.

Belladonna alkaloids and phenobarbital may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Donnatal (belladonna alkaloids and phenobarbital)?

Phenobarbital may be habit-forming and should be used only by the person it was prescribed for. This medication should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Do not take this medication together with a potassium supplement unless your doctor has told you to.

Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by belladonna alkaloids and phenobarbital. This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol while taking this medication or you could have increased dizziness and drowsiness.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Belladonna alkaloids and phenobarbital can decrease perspiration and you may be more prone to heat stroke.

Call your doctor if your symptoms do not improve, or if they get worse.

What should I discuss with my healthcare provider before taking Donnatal (belladonna alkaloids and phenobarbital)?

You should not use this medication if you are allergic to atropine, hyoscyamine, scopolamine, or phenobarbital. You may not be able use this medication if you have:

• enlarged prostate, urination problems;

• a blockage in your intestines or digestive tract;

• a stomach condition called paralytic ileus;

• active bleeding;

• severe ulcerative colitis or toxic megacolon;

• a muscle disorder called myasthenia gravis;

• a hiatal hernia or reflux disease; or

• porphyria.

Before taking this medication, tell your doctor if you are allergic to any drugs or if you have:

• a colostomy or ileostomy;

• liver disease;
• kidney disease;

• glaucoma;

• a thyroid disorder;

• heart disease, high blood pressure, congestive heart failure;

• a heart rhythm disorder; or

• ulcerative colitis or stomach ulcer.

If you have any of these conditions, you may not be able to take belladonna alkaloids and phenobarbital, or you may need a dose adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether this medication passes into breast milk or if it could harm a nursing baby. However, belladonna alkaloids and phenobarbital can slow breast milk production. Do not take this medication without telling your doctor if you are breast-feeding a baby. Do not give this medication to a child without the advice of a doctor. Older adults may be more likely to have side effects such as constipation, dry mouth, problems with urination, agitation, confusion, or severe memory problems.

How should I take Donnatal (belladonna alkaloids and phenobarbital)?

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

Take the medicine with a full glass of water.

Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Call your doctor if your symptoms do not improve, or if they get worse.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using belladonna alkaloids and phenobarbital.

Store belladonna alkaloids and phenobarbital at room temperature away from moisture and heat. Keep track of how much of this medicine has been used from each new bottle. Phenobarbital is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

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

Overdose symptoms may include headache, dizziness, nausea, vomiting, dry mouth, blurred vision, hot or dry skin, trouble swallowing, feeling excited or agitated,

What should I avoid while taking Donnatal (belladonna alkaloids and phenobarbital)?

Do not take this medication together with a potassium supplement unless your doctor has told you to.

Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by belladonna alkaloids and phenobarbital. This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol while taking this medication or you could have increased dizziness and drowsiness.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Belladonna alkaloids and phenobarbital can decrease perspiration and you may be more prone to heat stroke.

Donnatal (belladonna alkaloids and phenobarbital) 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 this medication and call your doctor at once if you have any of these serious side effects:

• diarrhea;

• painful or difficult urination;

• fast or pounding heartbeats;

• blurred vision with eye pain, or seeing halos around lights;

• feeling like you might pass out; or

• mouth sores, red or bleeding gums, or tooth decay (with long-term use).

Less serious side effects may include:

• drowsiness;

• blurred vision, increased sensitivity to light;

• dry mouth;

• decreased taste sensation;

• decreased sweating or urination;

• headache, dizziness, weakness;

• sleep problems (insomnia);

• nausea, vomiting, constipation, bloating;

• feeling restless or excited; or

• impotence, loss of interest in sex, or trouble having an orgasm.

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 Donnatal (belladonna alkaloids and phenobarbital)?

The following drugs can interact with belladonna alkaloids and phenobarbital. Tell your doctor if you are using any of these:

• a blood thinner such as warfarin (Coumadin);

• ketoconazole (Nizoral);

• an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);

• atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);

• bronchodilators such as ipratroprium (Atrovent) or tiotropium (Spiriva);

• glycopyrrolate (Robinul);

• mepenzolate (Cantil);

• bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare); or

• irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine).

This list is not complete and there may be other drugs that can interact with belladonna alkaloids and phenobarbital. 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.

Where can I get more information?

• Your pharmacist can provide more information about belladonna alkaloids and phenobarbital.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 3.03. Revision Date: 12/14/2009 1:08:14 PM.