Generic Name: dirithromycin (Oral route)

dye-rith-roe-MYE-sin

Commonly used brand name(s):

In the U.S.

• Dynabac
• Dynabac D5-Pak

Available Dosage Forms:

• Tablet, Enteric Coated

Therapeutic Class: Antibiotic

Chemical Class: Macrolide

Uses For Dynabac D5-Pak

Dirithromycin is used to treat bacterial infections in many different parts of the body. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.

Dirithromycin was available only with your doctor’s prescription.

Dirithromycin is no longer available in the United States.

Before Using Dynabac D5-Pak

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 only in adult patients, and there is no specific information comparing use of dirithromycin in children with use in other age groups.

Geriatric

This medicine has been tested in a limited number of elderly patients 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	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 this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Dihydroergotamine
• Ergoloid Mesylates
• Ergonovine
• Ergotamine
• Methylergonovine
• Methysergide
• Pimozide

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.

• Dofetilide

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
• Fentanyl

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:

• Liver disease—Patients with moderate to severe liver disease may have an increased chance of side effects.

Proper Use of dirithromycin

This section provides information on the proper use of a number of products that contain dirithromycin. It may not be specific to Dynabac D5-Pak. Please read with care.

Dirithromycin should be taken with food or within 1 hour after eating.

To help clear up your infection completely, keep taking dirithromycin for the full time of treatment, even if you begin to feel better after a few days. If you stop taking this medicine too soon, your symptoms may return.

Do not cut, crush, or chew dirithromycin tablets.

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 (tablets):
  • For bacterial infections:
    • Adults and teenagers—500 milligrams (mg) once a day for seven to fourteen days.
    • Children up to 12 years of age—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.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Dynabac D5-Pak

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

Dynabac D5-Pak 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

• Abdominal tenderness
• fever
• severe abdominal or stomach cramps and pain
• watery and severe diarrhea, which may also be bloody

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

• Diarrhea
• dizziness
• headache
• nausea
• vomiting
• weakness

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

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

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Generic Name: minocycline (mye no SYE kleen)
Brand Names: Dynacin, Minocin, Minocin PAC, Myrac, Solodyn

What is Dynacin (minocycline)?

Minocycline is a tetracycline antibiotic. It fights bacteria in the body.

Minocycline is used to treat many different bacterial infections, such as urinary tract infections, severe acne, gonorrhea, tick fever, chlamydia, and others.

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

What is the most important information I should know about Dynacin (minocycline)?

Do not use this medication if you are pregnant. It could cause harm to the unborn baby, including permanent discoloration of the teeth later in life. Minocycline can make birth control pills less effective. Use a second method of birth control while you are taking minoocycline to keep from getting pregnant. Minocycline passes into breast milk and may affect bone and tooth development in a nursing baby. Do not take this medication without telling your doctor if you are breast-feeding a baby. Do not give minocycline to a child younger than 8 years old. Minocycline can cause permanent yellowing or graying of the teeth, and it can affect a child’s growth. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Minocycline can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun. Do not take iron supplements, multivitamins, calcium supplements, antacids, or laxatives within 2 hours before or after taking minocycline. These products can make minocycline less effective. Throw away any unused minocycline when it expires or when it is no longer needed. Do not take any minocycline after the expiration date printed on the label. Using expired minocycline can cause damage to your kidneys.

What should I discuss with my healthcare provider before taking Dynacin (minocycline)?

Do not use this medication if you are allergic to minocycline, or to similar medicines such as demeclocycline (Declomycin), doxycycline (Adoxa, Doryx, Oracea, Vibramycin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap). Before taking minocycline, tell your doctor if you have liver or kidney disease. You may not be able to take minocycline, or you may require a dosage adjustment or special monitoring during therapy.

If you are using minocycline to treat gonorrhea, your doctor may test you to make sure you do not also have syphilis, another sexually transmitted disease.

FDA pregnancy category D. This medication can cause harm to an unborn baby, including permanent discoloration of the teeth later in life. Do not use minocycline without your doctor’s consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Minocycline can make birth control pills less effective. Use a non-hormonal method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while you are taking minocycline. Minocycline passes into breast milk and may affect bone and tooth development in a nursing baby. Do not take this medication without telling your doctor if you are breast-feeding a baby. Do not give minocycline to a child younger than 8 years old. Minocycline can cause permanent yellowing or graying of the teeth, and it can affect a child’s growth.

How should I take Dynacin (minocycline)?

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 each dose with a full glass (8 ounces) of water.

You may take this medication with or without food. Do not take the medication with milk or other dairy products, unless your doctor has told you to. Dairy products can make it harder for your body to absorb the medicine. Certain brands of minocycline may not have restrictions about taking them with dairy products. If your doctor has instructed you to take minocycline with milk, tell your pharmacist that you need a brand of minocycline that can be taken with milk.

Do not crush, chew, or break an extended-release tablet (Solodyn). Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time. Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Minocycline will not treat a viral infection such as the common cold or flu. Do not give this medicine to another person, even if they have the same condition you have.

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

Throw away any unused minocycline when it expires or when it is no longer needed. Do not take any minocycline after the expiration date printed on the label. Using expired minocycline can cause damage to your kidneys. Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

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

What happens if I overdose?

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

Overdose symptoms may include nausea, vomiting, and diarrhea.

What should I avoid while taking Dynacin (minocycline)?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Minocycline can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun. Do not take iron supplements, multivitamins, calcium supplements, antacids, or laxatives within 2 hours before or after taking minocycline. These products can make minocycline less effective.

Dynacin (minocycline) 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 minocycline and call your doctor at once if you have any of these serious side effects:

• severe headache, dizziness, blurred vision;

• fever, chills, body aches, flu symptoms;

• severe blistering, peeling, and red skin rash;

• urinating less than usual or not at all;

• pale or yellowed skin, dark colored urine, fever, confusion or weakness;

• severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

• loss of appetite, jaundice (yellowing of the skin or eyes); or

• easy bruising or bleeding, unusual weakness.

Less serious side effects may include:

• sores or swelling in your rectal or genital area;

• mild nausea, vomiting, diarrhea, or stomach upset;

• white patches or sores inside your mouth or on your lips;

• swollen tongue, trouble swallowing; or

• vaginal itching or discharge.

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 Dynacin (minocycline)?

Before taking minocycline, tell your doctor if you are taking any of the following drugs:

• cholesterol-lowering medications such as cholestyramine (Prevalite, Questran) or colestipol (Colestid);

• isotretinoin (Accutane);

• tretinoin (Renova, Retin-A, Vesanoid);

• an antacid such as Tums, Rolaids, Milk of Magnesia, Maalox, and others;

• a product that contains bismuth subsalicylate such as Pepto-Bismol;

• minerals such as iron, zinc, calcium, magnesium, and over-the-counter vitamin and mineral supplements;

• a blood thinner such as warfarin (Coumadin); or

• a penicillin antibiotic such as amoxicillin (Amoxil, Trimox, others), penicillin (BeePen-VK, Pen-Vee K, Veetids, others), dicloxacillin (Dynapen), carbenicillin (Geocillin), oxacillin (Bactocill), and others.

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

• 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: 10.02. Revision Date: 4/12/2009 4:35:56 PM.

Generic Name: Minocycline (MIN-oh-SYE-kleen)
Brand Name: Examples include Dynacin and Minocin

Dynacin Capsules is used for:

Treating certain infections. It may also be used with other medicines to treat severe acne, or for other conditions as determined by your doctor.

Dynacin Capsules is a tetracycline antibiotic. It works by slowing the growth of certain bacteria and allowing the body’s immune system to kill them.

Do NOT use Dynacin Capsules if:

• you are allergic to any ingredient in Dynacin Capsules
• you are taking acitretin, qisotretinoin, methoxyflurane, or a penicillin

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

Before using Dynacin Capsules:

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

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have kidney problems
• if you have an autoimmune disorder (eg, lupus)

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

• Aluminum salts (eg, carbonate) or cimetidine because they may decrease Dynacin Capsules’s effectiveness
• Acitretin, anticoagulants (eg, warfarin), digoxin, ergot alkaloids (eg, ergotamine), insulin, isotretinoin, methotrexate, methoxyflurane, or theophyllines because the risk of their side effects may be increased by Dynacin Capsules
• Live oral typhoid vaccine, oral contraceptives (birth control pills), or penicillins because their effectiveness may be decreased by Dynacin Capsules

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

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

• Some brands of Dynacin Capsules may be taken with food. Others should be taken on an empty stomach. Check with your doctor or pharmacist about how to take your brand of Dynacin Capsules.
• Some brands of Dynacin Capsules must be swallowed whole. Check with your doctor or pharmacist to see if your medicine is a brand that must be swallowed whole.
• Take Dynacin Capsules by mouth with or without food.
• Take Dynacin Capsules with a full glass of water (8 oz/240 mL). Do not lie down for 30 minutes after taking Dynacin Capsules.
• If you also take bismuth salts (eg, bismuth subsalicylate), calcium salts (eg, calcium carbonate), colestipol, iron salts (eg, iron sulfate), magnesium, urinary alkalinizers (eg, daily antacids), sucralfate, vitamins/minerals, quinapril, didanosine, or zinc salts (eg, zinc sulfate), do not take them within 2 to 3 hours before or after taking Dynacin Capsules. Check with your doctor if you have questions.
• To clear up your infection completely, take Dynacin Capsules for the full course of treatment. Keep taking it even if you feel better in a few days.
• Dynacin Capsules works best if it is taken at the same time each day.
• If you miss a dose of Dynacin Capsules, 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 Dynacin Capsules.

Important safety information:

• Dynacin Capsules may cause drowsiness, dizziness, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Dynacin Capsules with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Dynacin Capsules may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Dynacin Capsules. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
• Long-term or repeated use of Dynacin Capsules may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
• Dynacin Capsules only works against bacteria; it does not treat viral infections (eg, the common cold).
• Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.
• Tell your doctor or dentist that you take Dynacin Capsules before you receive any medical or dental care, emergency care, or surgery.
• Be sure to use Dynacin Capsules for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.
• Hormonal birth control (eg, birth control pills) may not work as well while you are using Dynacin Capsules. To prevent pregnancy, use an extra form of birth control (eg, condoms).
• Lab tests may be performed while you use Dynacin Capsules. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Dynacin Capsules with caution in the ELDERLY; they may be more sensitive to its effects.
• Use Dynacin Capsules with extreme caution in CHILDREN younger than 10 years old who have diarrhea or an infection of the stomach or bowel.
• Dynacin Capsules should not be used in CHILDREN younger than 8 years old; safety and effectiveness in these children have not been confirmed. Using Dynacin Capsules in CHILDREN younger than 8 years old or in women during the last half of pregnancy may cause a permanent change in the tooth coloring of the child.
• PREGNANCY and BREAST-FEEDING: Dynacin Capsules has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Dynacin Capsules while you are pregnant. Dynacin Capsules is found in breast milk. Do not breast-feed while taking Dynacin Capsules.

Possible side effects of Dynacin Capsules:

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:

Dizziness; drowsiness; lightheadedness; loss of appetite; nausea; stomach upset; vomiting.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody stools; blurred vision; bulging soft spots in infants; fever; headache; increased pressure in the head; inflammation of the pancreas (increased pulse, nausea, stomach tenderness, vomiting); joint pain, muscle pain or weakness; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe diarrhea; severe skin reaction to the sun; stomach pain/cramps; trouble swallowing; unusual tiredness or weakness; vaginal irritation or discharge; yellowing of the skin or eyes.

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

Proper storage of Dynacin Capsules:

Store Dynacin Capsules at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed, light-resistant container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Dynacin Capsules out of the reach of children and away from pets.

General information:

• If you have any questions about Dynacin Capsules, please talk with your doctor, pharmacist, or other health care provider.
• Dynacin Capsules 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 Dynacin Capsules. 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: pancrelipase (oral) (pan kre LYE pace)
Brand Names: Cotazym, Creon, Dygase, Ku-Zyme, Ku-Zyme HP, Kutrase, Lapase, Palcaps 10, Pancrease MT 10, Pancrease MT 16, Pancrease MT 20, Pancrease MT 4, Pancrecarb MS-16, Pancrecarb MS-4, Pancrecarb MS-8, Panocaps, Panocaps MT 16, Ultrase, Ultrase MT 12, Ultrase MT 18, Ultrase MT 20, Viokase, Viokase 16, Zenpep

What is pancrelipase?

Pancrelipase is a combination of three enzymes (proteins): lipase, protease, and amylase. These enzymes are normally produced by the pancreas and are important in the digestion of fats, proteins, and sugars.

Pancrelipase is used to replace these enzymes when the body does not have enough of its own. Certain medical conditions can cause this lack of enzymes, including cystic fibrosis, chronic inflammation of the pancreas, or blockage of the pancreatic ducts.

Pancrelipase may also be used following surgical removal of the pancreas.

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

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

You should not take pancrelipase if you are allergic to pork proteins.

Before taking pancrelipase, tell your doctor if you have gout, kidney disease, a history of intestinal blockage, a sudden onset of pancreatitis, or worsening of chronic pancreatic disease.

Use pancrelipase regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Do not hold the tablets or capsule contents in your mouth. The medication may irritate the inside of your mouth.

Do not inhale the powder from a pancrelipase capsule, or allow it to touch your skin. It may cause irritation, especially to your nose and lungs.

If you miss a dose of this medicine, skip the missed dose and wait until your next scheduled dose to take the medicine. Do not take extra medicine to make up the missed dose.

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

You should not take pancrelipase if you are allergic to pork proteins.

If you have any of these other conditions, you may need a pancrelipase dose adjustment or special tests:

• kidney disease;

• gout;

• a history of blockage in your intestines;

• a sudden onset of pancreatitis; or

• worsening of chronic pancreatic disease.

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 pancrelipase 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 pancrelipase?

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

Pancrelipase should be taken with a meal or snack. Take the medicine with a full glass of water or juice.

Do not hold the tablets or capsule contents in your mouth. The medication may irritate the inside of your mouth.

Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

You may open the pancrelipase capsule and sprinkle the medicine into a spoonful of pudding or applesauce to make swallowing easier. Swallow right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

Do not inhale the powder from a pancrelipase capsule, or allow it to touch your skin. It may cause irritation, especially to your nose and lungs.

Use pancrelipase regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store in the original container at room temperature (below 78 degrees F) for up to 12 weeks. Protect from moisture or high heat. Keep the bottle tightly closed when not in use. If the medication is exposed to temperatures between 78 and 104 degrees F, throw it away after 30 days. Do not use any pancrelipase that has been exposed to temperatures above 104 degrees F.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include diarrhea or stomach upset.

What should I avoid while taking pancrelipase?

Follow your doctor’s instructions about any restrictions on food, beverages, or activity.

Pancrelipase 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 severe or unusual stomach pain. This could be a symptom of a rare but serious bowel disorder.

Less serious side effects may include:

• nausea or vomiting;

• mild stomach pain or upset;

• diarrhea or constipation;

• bloating or gas.

• greasy stools;

• rectal irritation;

• headache, dizziness;

• cough; or

• weight loss.

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 pancrelipase?

There may be other drugs that can interact with pancrelipase. Tell your doctor about all medications you use. This includes prescription, over the counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about pancrelipase.

• 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: 5.01. Revision Date: 02/05/2010 8:53:06 AM.

Generic Name: dyphylline (dye FI lin)
Brand Names: Dilor, Dylix, Lufyllin, Neothylline

What is Dylix (dyphylline)?

Dyphylline is a bronchodilator. Dyphylline works in several ways: It relaxes muscles in your lungs and chest to allow more air in, it decreases the sensitivity of your lungs to allergens and other substances that cause inflammation, and it increases the contractions of your diaphragm to draw more air into the lungs.

Dyphylline is used to treat the symptoms of asthma, bronchitis, and emphysema.

Dyphylline may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Dylix (dyphylline)?

Call your doctor right away if you experience nausea, vomiting, insomnia, restlessness, seizures, an increased heart rate, or a headache. These could be signs of too much dyphylline in your blood.

Do not start or stop smoking without your doctor’s knowledge. Smoking may affect your dosage.

Do not take more of this medicine than is prescribed without consulting your doctor. Seek medical attention if you are having increasing difficulty breathing.

Who should not take Dylix (dyphylline)?

Before taking this medication, tell your doctor if you have

• a stomach ulcer;

• seizures;

• high blood pressure, a heart condition, or any type of heart disease;

• fluid in your lungs;

• a thyroid condition;

• liver disease; or

• kidney disease.

You may not be able to take dyphylline, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Dyphylline is in the FDA pregnancy category C. This means that it is not known whether dyphylline will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. Dyphylline passes into breast milk and could affect a nursing baby. Do not take dyphylline without first talking to your doctor if you are breast-feeding a baby. If you are over 60 years of age, you may be more likely to experience side effects from dyphylline. You may require a lower dose of this medication.

How should I take Dylix (dyphylline)?

Take dyphylline exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. You can take dyphylline with food to lessen stomach upset.

Take your doses at the same time every day to keep a constant level of dyphylline in your blood.

Shake the liquid forms of this medication well before use. To ensure that you get a correct dose, measure the liquid with a dose-measuring cup or spoon, not a regular tablespoon. If a spoon or cup is not provided with the medication and you do not have one, ask your pharmacist where you can get one.

Do not switch to another brand or a generic form of dyphylline without the approval of your doctor.

Store dyphylline at room temperature away from moisture and heat.

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 regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a dyphylline overdose include nausea, vomiting, headache, insomnia, tremor (shaking hands or twitching,), restlessness, seizures, and irregular heartbeats.

What should I avoid while taking Dylix (dyphylline)?

Use caution when driving, operating machinery, or performing other hazardous activities. Dyphylline may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Do not start or stop smoking without the approval of your doctor. Smoking changes the way your body uses dyphylline, and you may need a dose adjustment.

Avoid changing your dose or changing the time of your daily doses.

Do not change the brand, generic form, or formulation (tablet, capsule, liquid) of dyphylline that you are taking without the approval of your doctor. Different brands or formulations may require different dosages.

Avoid eating excessive amounts of grilled or char-broiled foods. Doing so may also change the dose of dyphylline that you need.

Avoid caffeinated beverages such as coffee, tea, and cola. Dyphylline is related chemically to caffeine, and you may experience some side effects if you consume too much caffeine.

Dylix (dyphylline) side effects

If you experience any of the following serious side effects, stop taking dyphylline and seek emergency medical attention:

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

• seizures;

• increased or irregular heartbeats; or

• severe nausea or vomiting.

Other, less serious side effects may occur although they are not common at appropriate doses. Continue to take dyphylline and talk to your doctor if you experience

• slight nausea, decreased appetite, or weight loss;

• restlessness, tremor, or insomnia; or

• headache, lightheadedness, or dizziness.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Dylix (dyphylline)?

Dyphylline interacts with many other drugs. Tell your doctor and pharmacist about all other medications that you are taking, including herbal remedies, vitamins, and other nonprescription items.

The following drugs may increase the levels of dyphylline in your blood, leading to dangerous side effects:

• alcohol;

• cimetidine (Tagamet, Tagamet HB);

• fluoroquinolone antibiotics such as enoxacin (Penetrex), lomefloxacin (Maxaquin), ciprofloxacin (Cipro), norfloxacin (Noroxin), and ofloxacin (Floxin);

• clarithromycin (Biaxin) and erythromycin (Ery-Tab, E.E.S., E-Mycin, others);

• disulfiram (Antabuse);

• estrogens (Ogen, Premarin, and many other types);

• fluvoxamine (Luvox);

• methotrexate (Folex, Rheumatrex);

• mexiletine (Mexitil) and propafenone (Rythmol);

• propranolol (Inderal);

• tacrine (Cognex);

• ticlopidine (Ticlid); and

• verapamil (Verelan, Calan, Isoptin).

The following drugs may decrease dyphylline levels in your blood, leading to poor asthma control:

• aminoglutethimide (Cytadren),

• carbamazepine (Tegretol),

• isoproterenol (Isuprel),

• moricizine (Ethmozine),

• phenobarbital (Luminal, Solfoton),

• phenytoin (Dilantin),

• rifampin (Rifadin), and

• sucralfate (Carafate).

Drugs other than those listed here may also interact with dyphylline or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

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

• 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: 2.04. Revision Date: 4/12/2009 4:38:08 PM.

Generic Name: Dyphylline (DYE-fi-lin)
Brand Name: Dylix

Dylix Elixir is used for:

Relieving breathing problems caused by bronchial asthma, chronic bronchitis, or emphysema.

Dylix Elixir is a bronchodilator. It works by widening the air passages and making it easier to breathe.

Do NOT use Dylix Elixir if:

• you are allergic to any ingredient in Dylix Elixir or to other xanthines (eg, theophylline)
• you are taking amprenavir, disulfiram, fluorouracil, metronidazole, intravenous (IV) dipyridamole, halothane, or sodium oxybate (GHB)

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

Before using Dylix Elixir:

Some medical conditions may interact with Dylix Elixir. 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 severe heart disease or heart damage, high blood pressure, epilepsy, kidney disease, thyroid problems, or ulcers

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

• Beta-blockers (eg, propranolol) because the effectiveness of Dylix Elixir may be decreased
• Cimetidine, ephedrine, halothane, mexiletine, probenecid, sympathomimetics (eg, albuterol), tacrine, xanthines (eg, theophylline ), or zileuton because side effects and toxic effects of Dylix Elixir may be increased
• Acetaminophen, acitretin, amprenavir, barbiturates (eg, phenobarbital), cephalosporins (eg, cefotetan), disulfiram, fluorouracil, furazolidone, insulin, metformin, metronidazole, sodium oxybate (GHB), or sulfonylureas (eg, glipizide) because actions and side effects may be increased by Dylix Elixir
• Adenosine, IV dipyridamole, lithium, or nondepolarizing muscle relaxants (eg, pancuronium) 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 Dylix Elixir 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 Dylix Elixir:

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

• Dylix Elixir may be taken with or without food. Taking it after eating may help to decrease stomach upset.
• Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
• If you miss a dose of Dylix Elixir, 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 Dylix Elixir.

Important safety information:

• Dylix Elixir will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Do not exceed the recommended dose without checking with your doctor.
• Avoid large amounts of caffeine-containing foods and beverages, such as coffee, tea, cocoa, cola drinks, and chocolate.
• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Dylix Elixir.
• Dylix Elixir may interfere with certain lab tests. Make sure your doctor and lab personnel know that you are taking Dylix Elixir.
• Use Dylix Elixir with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Dylix Elixir during pregnancy. Dylix Elixir is excreted in breast milk. If you are or will be breast-feeding while you are using Dylix Elixir, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of Dylix Elixir:

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:

Headache; nausea; upset stomach.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blood in the urine; bloody vomit; diarrhea; dizziness; excitability; fast breathing; fast/irregular heartbeat; flushing; increased thirst or urination; irritability; muscle twitching; pounding in the chest; restlessness; seizures; stomach pain; trouble sleeping; vomiting.

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; chest pain; dehydration; excessive sweating; excessive thirst; fever or chills; irregular heartbeat; loss of appetite; ringing in the ears; seizures; severe vomiting.

Proper storage of Dylix Elixir:

Store Dylix Elixir 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 Dylix Elixir out of the reach of children and away from pets.

General information:

• If you have any questions about Dylix Elixir, please talk with your doctor, pharmacist, or other health care provider.
• Dylix Elixir 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 Dylix Elixir. 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: acetohexamide (a SEET oh HEX a mide)
Brand Names: Dymelor

What is Dymelor (acetohexamide)?

Acetohexamide is an oral diabetes medicine that helps control blood sugar levels. This medication helps your body respond better to insulin produced by your pancreas.

Acetohexamide is used together with diet and exercise to treat type 2 (non-insulin dependent) diabetes.

Acetohexamide may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Dymelor (acetohexamide)?

Do not use this medication if you are allergic to acetohexamide, or if you are in a state of diabetic ketoacidosis. Call your doctor for treatment with insulin.

Before taking acetohexamide, tell your doctor if you have kidney or liver disease, a thyroid disorder, or a history of heart disease.

Take care to keep your blood sugar from getting too low, causing hypoglycemia. Symptoms of low blood sugar may include headache, nausea, hunger, confusion, drowsiness, weakness, dizziness, blurred vision, fast heartbeat, sweating, tremor, or trouble concentrating. Carry a piece of non-dietetic hard candy or glucose tablets with you in case you have low blood sugar. Also be sure your family and close friends know how to help you in an emergency.

Also watch for signs of blood sugar that is too high (hyperglycemia). These symptoms include increased thirst, loss of appetite, increased urination, nausea, vomiting, drowsiness, dry skin, and dry mouth. Check your blood sugar levels and ask your doctor how to adjust your medication doses if needed.

Acetohexamide is only part of a complete program of treatment that may also include diet, exercise, weight control, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

What should I discuss with my healthcare provider before taking Dymelor (acetohexamide)?

Do not use this medication if you are allergic to acetohexamide, or if you are in a state of diabetic ketoacidosis. Call your doctor for treatment with insulin.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before you take acetohexamide, tell your doctor if you have:

• liver disease;
• kidney disease;

• a thyroid disorder; or

• a history of heart disease.

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

How should I take Dymelor (acetohexamide)?

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

Your dose needs may change if you are ill, if you have a fever or infection, or if you have surgery or a medical emergency.

Do not change your dose of acetohexamide without first talking to your doctor. Take this medicine with a full glass of water.

Acetohexamide is usually taken once a day, with breakfast or the first main meal of the day. Follow your doctor’s instructions.

Take care not to let your blood sugar get too low, causing hypoglycemia. You may have hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress.

Know the signs of low blood sugar (hypoglycemia) and how to recognize them. Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. Severe hypoglycemia may cause loss of consciousness, seizures, or death. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection.

Watch for signs of blood sugar that is too high (hyperglycemia). These symptoms include increased thirst, loss of appetite, increased urination, nausea, vomiting, drowsiness, dry skin, and dry mouth. Check your blood sugar levels and ask your doctor how to adjust your medication doses if needed.

Check your blood sugar carefully during a time of stress or illness, if you travel, exercise more than usual, or skip meals. These things can affect your glucose levels and your dose needs may also change.

Acetohexamide is only part of a complete program of treatment that may also include diet, exercise, weight control, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

Your doctor will need to check your progress on a regular basis. Do not miss any scheduled appointments.

It is important to take acetohexamide regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store acetohexamide at room temperature away from moisture and heat.

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, wait until then to take the medicine and skip the missed dose. 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. An overdose of acetohexamide can cause severe hypoglycemia.

Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, seizure (convulsions), or coma.

What should I avoid while taking Dymelor (acetohexamide)?

Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment. Avoid exposure to sunlight, sunlamps, or tanning beds. Acetohexamide can make your skin more sensitive to sunlight, and a sunburn may result. Wear protective clothing and use sunscreen (SPF 15 or higher) when you are outdoors.

Dymelor (acetohexamide) 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.

Hypoglycemia, or low blood sugar, is the most common side effect of acetohexamide. Symptoms of low blood sugar may include headache, nausea, hunger, drowsiness, weakness, dizziness, blurred vision, fast heartbeat, sweating, tremor, trouble concentrating, confusion, or seizure (convulsions). Watch for signs of low blood sugar. Carry a piece of non-dietetic hard candy or glucose tablets with you in case you have low blood sugar.

Call your doctor at once if you have any of these serious side effects:

• swelling, rapid weight gain;

• urinating more than usual;

• pale or yellowed skin, dark colored urine, fever, confusion or weakness;

• nausea, stomach pain, loss of appetite, low fever, clay-colored stools, jaundice (yellowing of the skin or eyes); or

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash.

Less serious side effects may include:

• constipation, diarrhea;

• dizziness, drowsiness;

• mild nausea, vomiting, stomach pain;

• mild itching or rash; or

• headache.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Dymelor (acetohexamide)?

You may be more likely to have hyperglycemia (high blood sugar) if you are taking acetohexamide with other drugs that raise blood sugar. Drugs that can raise blood sugar include:

• isoniazid;

• diuretics (water pills);

• steroids (prednisone and others);

• phenothiazines (Compazine and others);

• thyroid medicine (Synthroid and others);

• birth control pills and other hormones;

• seizure medicines (Dilantin and others);

• diet pills; and

• medicines to treat asthma, colds or allergies.

You may be more likely to have hypoglycemia (low blood sugar) if you are taking acetohexamide with other drugs that lower blood sugar. Drugs that can lower blood sugar include:

• probenecid (Benemid);

• some nonsteroidal anti-inflammatory drugs (NSAIDs);

• aspirin or other salicylates (including Pepto-Bismol);

• sulfa drugs (Bactrim, Gantanol, Septra, and others);

• a monoamine oxidase inhibitor (MAOI); and

• beta-blockers (Tenormin and others).

The following drugs can interact with acetohexamide. Tell your doctor if you are using any of these:

• a blood thinner such as warfarin (Coumadin);

• cimetidine (Tagamet, Tagamet HB);

• cyclosporine (Gengraf, Neoral, Sandimmune); or

• an antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), or fluconazole (Diflucan).

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

• 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: 3.06. Revision Date: 08/19/2008 9:52:26 AM.

Generic Name: chlorhexidine topical (klor HEX ih deen TAH pih kal)
Brand Names: Betasept, Calgon Vesta, Dyna-Hex, Hibiclens, Hibistat, Spectrum-4

What is Dyna-Hex (chlorhexidine topical)?

Chlorhexidine topical is an antiseptic. Chlorhexidine topical destroys germs on the skin.

Chlorhexidine topical is used to clean the skin before surgery to reduce the risk of infection. Chlorhexidine topical may also be used to treat acne.

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

What is the most important information I should know about Dyna-Hex (chlorhexidine topical)?

Do not take this medication my mouth. It is intended for topical application on the skin. Do not use other topical products on the skin after using chlorhexidine topical unless otherwise directed by your healthcare provider.

What should I discuss with my health are provider before using Dyna-Hex (chlorhexidine topical)?

Before using chlorhexidine topical, tell your doctor if you have any other medical conditions, especially skin problems or allergies. You may not be able to use chlorhexidine topical or you may require special monitoring.

Do not use chlorhexidine topical without first talking to your doctor if you pregnant or could become pregnant during treatment. Do not use chlorhexidine topical without first talking to your doctor if you are breast-feeding a baby.

How should I use Dyna-Hex (chlorhexidine topical)?

Use chlorhexidine topical exactly as directed by your healthcare provider or as directed on the package. If you do not understand these instructions, ask your doctor, nurse, or pharmacist to explain them to you.

Apply chlorhexidine topical to the skin as directed. You may be directed to rinse the skin after application of chlorhexidine topical.

Do not take this medication my mouth. It is intended for topical application on the skin. Avoid getting this medication in the eyes, ears, nose, or mouth. Store chlorhexidine topical at room temperature away from moisture and heat.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Do not use a double dose of this product.

What happens if I overdose?

Seek emergency medical attention if chlorhexidine topical is ingested.

Symptoms of a chlorhexidine topical overdose are not known.

What should I avoid while using Dyna-Hex (chlorhexidine topical)?

Avoid getting this medication in the eyes, ears, nose, or mouth. Do not use other topical products on the skin after using chlorhexidine topical unless otherwise directed by your healthcare provider.

Dyna-Hex (chlorhexidine topical) side effects

If you experience a rare but serious allergic reaction (shortness of breath; closing of the throat; swelling of the lips, face, or tongue; hives; or a rash), stop using chlorhexidine topical and seek emergency medical attention or contact your doctor immediately.

Occasionally, mild skin irritation may occur. Continue to use chlorhexidine topical and talk to your doctor if you experience skin irritation.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Dyna-Hex (chlorhexidine topical)?

Do not use other topical products on the skin after using chlorhexidine topical unless otherwise directed by your healthcare provider.

Drugs other than those listed here may also interact with chlorhexidine topical. Talk to your doctor and pharmacist before using other topical prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

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

• 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: 1.03. Revision Date: 4/12/2009 4:39:20 PM.

Generic name: Hydrochlorothiazide, Triamterene
Brand names: Maxzide-25 MG, Maxzide, Dyazide

Why is Dyazide prescribed?

Dyazide is a combination of diuretic drugs used in the treatment of high blood pressure and other conditions that require the elimination of excess fluid from the body. When used for high blood pressure, Dyazide can be taken alone or with other high blood pressure medications. Diuretics help your body produce and eliminate more urine, which helps lower blood pressure. Triamterene, one of the ingredients of Dyazide, helps to minimize the potassium loss that can be caused by the other component, hydrochlorothiazide. Maxzide and Maxzide-25 MG contain the same combination of ingredients.

Most important fact about Dyazide

If you have high blood pressure, you must take Dyazide regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Dyazide; and you must continue taking it even if you are feeling well. Dyazide does not cure high blood pressure; it merely keeps it under control.

How should you take Dyazide?

Dyazide should be taken early in the day. To avoid stomach upset, take it with food.

• If you miss a dose…
  Take it as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at the same time.

• Storage instructions…
  Store at room temperature, away from light.

What side effects may occur?

Side effects cannot be anticipated. If any occur or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Dyazide.

• Side effects may include:
  Abdominal pain, anemia, breathing difficulty, change in potassium level (causing symptoms such as numbness, tingling, muscle weakness, slow heart rate, shock), constipation, diabetes, diarrhea, dizziness, dizziness when standing up, dry mouth, fatigue, headache, hives, impotence, irregular heartbeat, kidney stones, muscle cramps, nausea, rash, sensitivity to light, strong allergic reaction (localized hives, itching, and swelling or, in severe cases, shock), vomiting, weakness, yellow eyes and skin

Why should Dyazide not be prescribed?

If you are unable to urinate or have any serious kidney disease, if you have high potassium levels in your blood, or if you are taking other drugs that prevent loss of potassium, you should not take Dyazide.

If you are sensitive to or have ever had an allergic reaction to triamterene, hydrochlorothiazide, or sulfa drugs such as Gantrisin you should not take Dyazide.

Special warnings about Dyazide

When taking Dyazide, do not use potassium-containing salt substitutes. Take potassium supplements only if specifically directed to by your doctor. Your potassium level should be checked frequently.

If you are taking Dyazide and have kidney disease, your doctor should monitor your kidney function closely.

If you have liver disease, cirrhosis of the liver, heart failure, or kidney stones, Dyazide should be used with care. Diabetics may find that the drug increases their blood sugar levels, altering their insulin requirements.

Possible food and drug interactions when taking Dyazide

Dyazide should be used with caution if you are taking a type of blood pressure medication called an ACE inhibitor, such as captopril or enalapril.

If Dyazide 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 Dyazide with the following:

Blood-thinning medications such as warfarin
Corticosteroids such as prednisone
Drugs for diabetes such as glyburide
Gout medications such as allopurinol
Laxatives
Lithium
Methenamine
Nonsteroidal anti-inflammatory drugs such as diflunisal and indomethacin
Other drugs that minimize potassium loss or contain potassium
Other high blood pressure medications such as prazosin
Salt substitutes containing potassium
Sodium polystyrene sulfonate

Special information if you are pregnant or breastfeeding

The effects of Dyazide during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Dyazide appears in breast milk and could affect a nursing infant. If Dyazide is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

Recommended dosage for Dyazide

ADULTS

The usual dose of Dyazide is 1 or 2 capsules once daily, with appropriate monitoring of blood potassium levels by your doctor. The usual dose of Maxzide is 1 tablet daily. The recommendation for Maxzide-25 MG is 1 or 2 tablets daily taken in a single dose.

CHILDREN

Safety and effectiveness in children have not been established.

Overdosage

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

• Symptoms of Dyazide overdose may include:
  Fever, flushed face, nausea, production of large amounts of pale urine, vomiting, weakness, weariness

Generic Name: dicloxacillin (dye klox a SIL in)
Brand Names: Dycill, Dynapen

What is Dycill (dicloxacillin)?

Dicloxacillin is an antibiotic in the penicillin group of drugs. It fights bacteria in your body.

Dicloxacillin is used to treat many different types of infections caused by bacteria such as bronchitis, pneumonia, or staphylococcal (also called “staph”) infections.

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

What is the most important information I should know about Dycill (dicloxacillin)?

Do not use this medication if you are allergic to dicloxacillin or to any other penicillin antibiotic, such as amoxicillin (Amoxil), ampicillin (Omnipen, Principen), carbenicillin (Geocillin), oxacillin (Bactocill), penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids), and others.

Before using dicloxacillin, tell your doctor if you are allergic to cephalosporins such as Ceclor, Ceftin, Duricef, Keflex, and others, or if you have asthma, liver disease, kidney disease, or a history of any type of allergy.

Dicloxacillin can make birth control pills less effective, which may result in pregnancy. Before taking dicloxacillin, tell your doctor if you use birth control pills. Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Dicloxacillin will not treat a viral infection such as the common cold or flu. Do not share this medication with another person, even if they have the same symptoms you have.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

What should I discuss with my healthcare provider before taking Dycill (dicloxacillin)?

Do not use this medication if you are allergic to dicloxacillin or to any other penicillin antibiotic, such as:

• amoxicillin (Amoxil, Amoxicot, Biomox, Dispermox, Trimox);

• ampicillin (Omnipen, Principen);

• carbenicillin (Geocillin);

• oxacillin (Bactocill); or

• penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids, and others).

Before using dicloxacillin, tell your doctor if you are allergic to any drugs (especially cephalosporins such as Ceclor, Ceftin, Duricef, Keflex, and others), or if you have:

• asthma;

• liver disease;

• kidney disease;

• a bleeding or blood clotting disorder;

• a history of diarrhea caused by taking antibiotics; or

• a history of any type of allergy.

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

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Dicloxacillin can make birth control pills less effective, which may result in pregnancy. Before taking dicloxacillin, tell your doctor if you use birth control pills. Dicloxacillin 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.

How should I take Dycill (dicloxacillin)?

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 the medicine with a full glass of water. Dicloxacillin should be taken on an empty stomach, at least 1 hour before or 2 hours after eating a meal.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Dicloxacillin will not treat a viral infection such as the common cold or flu. Do not share this medication with another person, even if they have the same symptoms you have.

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

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

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 your 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 confusion, behavior changes, a severe skin rash, urinating less than usual, or seizure (black-out or convulsions).

What should I avoid while taking Dycill (dicloxacillin)?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Dycill (dicloxacillin) 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 any of these serious side effects:

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• diarrhea that is watery or bloody;

• fever, chills, body aches, flu symptoms;

• easy bruising or bleeding, unusual weakness;

• urinating less than usual or not at all;

• severe skin rash, itching, or peeling;

• agitation, confusion, unusual thoughts or behavior; or

• seizure (black-out or convulsions).

Less serious side effects may include:

• nausea, vomiting, stomach pain;

• vaginal itching or discharge;

• headache;

• swollen, black, or “hairy” tongue; or

• thrush (white patches or inside your mouth or throat).

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 Dycill (dicloxacillin)?

Before taking dicloxacillin, tell your doctor if you are using any of the following drugs:

• methotrexate (Rheumatrex, Trexall); or

• probenecid (Benemid).

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

• 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: 4.02. Revision Date: 4/12/2009 4:36:12 PM.