Brand names: AcipHex

Why is Rabeprazole sodium prescribed?

AcipHex blocks acid production in the stomach. It is prescribed for the short-term (4 to 8 weeks) treatment of sores and inflammation in the upper digestive canal (esophagus). This condition, known as gastroesophageal reflux disease (GERD), is caused by the backflow of stomach acid into the esophagus over a prolonged period of time. Because GERD can be chronic, your doctor may continue to prescribe AcipHex to prevent a relapse after your initial course of treatment and to relieve symptoms of GERD such as heartburn.

AcipHex can also be prescribed for the short-term (up to 4 weeks) treatment of duodenal ulcers (ulcers that form just outside the stomach at the top of the small intestine), and for Zollinger-Ellison syndrome, a disease which causes the stomach to produce too much acid. The drug is classified as a “proton pump inhibitor.” It works by blocking a specific enzyme essential to the production of stomach acid. It begins reducing acid within an hour of administration.

AcipHex is sometimes combined with the antibiotics amoxicillin and clarithromycin to treat infections caused by H. pylori, a type of bacteria that lives in the digestive tract and is often associated with recurrent ulcers.

Most important fact about Rabeprazole sodium

AcipHex will work even if your symptoms are caused by a serious condition such as stomach cancer. For that reason, doctors are warned to rule out cancer whenever prescribing Rabeprazole sodium.

How should you take Rabeprazole sodium?

Take AcipHex once a day, with or without food. Swallow the tablet whole; it should not be crushed, chewed, or split. You can continue taking antacids during AcipHex therapy.

If you’re using AcipHex along with amoxicillin and clarithromycin, take all three drugs at the same time twice a day, once in the morning and again in the evening. This three-drug regimen should be taken with meals.

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

• Storage instructions…
  AcipHex should be stored at room temperature and protected from moisture.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking AcipHex. Headache is the most common side effect of AcipHex, occurring in two people out of 100.

Why should Rabeprazole sodium not be prescribed?

If AcipHex gives you an allergic reaction, you will not be able to use it.

Special warnings about Rabeprazole sodium

If you have stomach ulcers caused by the H. pylori bacteria, AcipHex could make the condition slightly worse. The doctor may order a test for H. pylori before prescribing Rabeprazole sodium. If you test positive, the doctor may prescribe antibiotics along with AcipHex.

AcipHex has not been tested in children under 18 years of age.

Possible food and drug interactions when taking Rabeprazole sodium

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

Cyclosporine
Digoxin
Ketoconazole
Warfarin

Special information if you are pregnant or breastfeeding

The effects of AcipHex during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. The drug may appear in breast milk and should not be taken while you’re breastfeeding.

Recommended dosage for Rabeprazole sodium

ADULTS

Gastroesophageal Reflux Disease (GERD)

The usual dose is 20 milligrams once a day for 4 to 8 weeks. For patients who have not healed after 8 weeks, the doctor may prescribe an additional 8-week course of AcipHex therapy.

To Relieve Symptoms or Prevent a Relapse of GERD

The usual dose is 20 milligrams once a day.

Duodenal Ulcer

The usual dose is 20 milligrams taken once daily after the morning meal for a period of up to 4 weeks. Some people may require an additional 4 weeks of treatment.

Combination Drug Treatment to Eliminate H. Pylori

The recommended combination is 20 milligrams of AcipHex, 1,000 milligrams of amoxicillin, and 500 milligrams of clarithromycin taken twice a day for 7 days. It’s important to take all three drugs for the entire 7 days. Cutting the treatment short could fail to eliminate the infection and possibly lead to antibiotic resistance.

Zollinger-Ellison Syndrome

The usual starting dose is 60 milligrams once a day, although your doctor may adjust the dose based on your individual need. Doses of up to 100 milligrams once a day or 60 milligrams twice a day are sometimes prescribed.

Overdosage

Little is known about AcipHex overdose. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

Brand names: Vancenase Nasal Inhaler and PocketHaler Nasal Inhaler, Vanceril Inhalation Aerosol and Double Strength Inhalation Aerosol, Vanceril Inhaler, Beconase AQ Nasal Spray, Beconase Inhalation Aerosol, Qvar Inhalation Aerosol, Vancenase AQ Nasal Spray and Double Strength Nasal Spray, Beclomethasone, Beclovent

Why is Qvar Inhalation Aerosol prescribed?

Beclomethasone is a type of steroid used for respiratory problems. Beclovent and Vanceril are prescribed for the prevention of recurring symptoms of bronchial asthma.

Beconase and Vancenase are used to relieve the symptoms of hay fever and to prevent regrowth of nasal polyps following surgical removal.

Most important fact about Qvar Inhalation Aerosol

Beclomethasone is not a bronchodilator medication (it does not quickly open the airways); and it should not be used for relief of asthma when bronchodilators and other nonsteroid drugs prove effective. Do not expect immediate relief from beclomethasone, and do not take higher doses in an attempt to make it work. It is not intended for rapid relief, but it will help control symptoms when taken routinely.

How should you take Qvar Inhalation Aerosol?

Beclomethasone is prescribed in an oral inhalant or a nasal spray form. Use Qvar Inhalation Aerosol only as preventive therapy, and take only the dose prescribed.

Although some people begin to notice improvement within a day or two, it may take 1 or 2 weeks for the full benefits to appear. If there’s no improvement after 3 weeks, let your doctor know.

If you are already taking a steroid in tablet form for asthma, you’ll need to make a gradual transition to the oral inhalant. During the first week, you’ll probably take the usual number of tablets. After that, you’ll be instructed to slowly reduce the number of tablets, replacing them with the inhalant.

Be sure to take the drug regularly, even if you have no symptoms. Many people will require additional drugs to control asthma symptoms fully, but Qvar Inhalation Aerosol may allow other drugs to be used in smaller doses.

If you are also using a bronchodilator inhalant, take it before inhaling beclomethasone. This will improve the effect of the second drug. Take the two inhalations several minutes apart.

Spray the inhalation aerosol into the air twice before you use it for the first time and when you have not used it for more than 7 days. Use it within 6 months.

Before you use Vancenase AQ 84 microgram nasal spray, press the pump 6 times or until you see a fine spray. If you don’t use it for more than 4 days, reprime the pump by spraying once or until a fine spray appears.

To use the inhaler:

1. Remove the cap and hold inhaler upright.
2. Shake the inhaler thoroughly.
3. Take a drink of water to moisten the throat.
4. Breathe out as fully as you comfortably can. Hold the inhaler upright and close your lips around the mouthpiece, keeping your tongue below it.
5. While pressing down on the can, inhale deeply. Hold your breath as long as you can.
6. Take your finger off the can, remove the inhaler, and breathe out gently.
7. Allow at least 1 minute between inhalations.

Gargling and rinsing your mouth with water after each dose may help prevent hoarseness and throat irritation. Do not swallow the water after you rinse.

Be careful to avoid spraying the medication into your eyes. This medication comes with directions. Read them carefully before using it.

• If you miss a dose…
  Take it as soon as you remember and take the remaining doses for that day at evenly spaced intervals. If it is time for your next dose, skip the one you missed. Never take 2 doses at the same time.

• Storage instructions…
  Store at room temperature in a dry place, away from heat and cold. Do not puncture the container, store it near open flame, or dispose of it in a fire or incinerator.

What side effects may occur?

Side effects cannot be anticipated. If any develop 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 Qvar Inhalation Aerosol.

• Side effects may include:
  Acne, agitation, allergic reactions, breathing problems, bruising, cataracts, chest pain, cold sores, cough, depression, dizziness, dry mouth, ear infections, fever, fluid retention, flu-like symptoms, headache, hives, hoarseness, increased pressure within the eye (glaucoma), itching, joint pain, light-headedness, mental disturbances, moon face, mouth or throat infection, muscle pain, nasal and throat dryness and irritation, nasal burning, nausea, nose infection, nosebleed, pain, pinkeye, “pins and needles” sensation, ringing in the ears, runny nose, skin rash, skin wasting, sneezing, sore mouth or throat, stuffy nose, stunted growth, tearing eyes, unpleasant—or loss of—taste and smell, upset stomach, vomiting, weight gain, wheezing

Why should Qvar Inhalation Aerosol not be prescribed?

Your doctor will prescribe beclomethasone only if your asthma cannot be controlled with bronchodilators and other nonsteroid medications.

Beclomethasone is not used for the treatment of non-asthmatic bronchitis, or for intermittent asthma therapy.

Do not use beclomethasone nasal products if you’ve recently had nasal ulcers, nose surgery, or an injury to the nose. It could interfere with the healing process.

If you are sensitive to or have ever had an allergic reaction to beclomethasone or other steroid drugs, you should not take Qvar Inhalation Aerosol. Rare cases of immediate and delayed allergic reactions, such as hives, a rash, or wheezing, have occured. Make sure that your doctor is aware of any drug reactions that you have experienced.

Although unlikely, immediate allergic reactions to beclomethasone have been known to occur.

Special warnings about Qvar Inhalation Aerosol

When steroid drugs are taken by mouth they substitute for and decrease the body’s normal ability to make its own steroids as well as its ability to respond to stress.

There is a risk of causing a serious condition called “adrenal insufficiency” when people change from steroid tablets taken by mouth to aerosol beclomethasone. Although the aerosol may provide adequate control of asthma during the changeover period, it does not provide the normal amount of steroid the body needs during acute stress situations, such as injury, surgery, and infection—particularly stomach flu. If you are being transferred from steroid tablets to beclomethasone and you experience a period of stress or a severe asthma attack, contact your doctor immediately. He may prescribe additional treatment with steroid tablets. You should also carry a warning card indicating that you may need steroid tablets during such incidents. As you continue taking beclomethasone, your doctor may conduct periodic tests to measure your adrenal function.

Transfer from steroid tablet therapy to beclomethasone aerosol may reactivate allergic conditions that were previously suppressed by the steroid tablet therapy, such as runny nose, inflamed eyelids, and eczema. Some people also experience withdrawal side effects when they switch from tablets to aerosol. Potential symptoms include joint or muscle pain, weakness, and depression. Inform your doctor if you experience any of these symptoms.

High doses of steroids can suppress your immune system. When beclomethasone is used nasally, your chances of developing nose and throat infections increase. Also take extra care to avoid exposure to measles or chickenpox if you have never had them or never had shots. These infections can be serious or even fatal if your immune system is below par. If you are exposed, seek medical advice immediately.

Symptoms such as mental disturbances, increased bruising, weight gain, facial swelling (moon face), acne, menstrual irregularities, increased pressure in the eyes, and cataracts may occur with steroids. If you experience any of these symptoms, notify your doctor immediately. If you’ve ever had cataracts or increased eye pressure, your doctor will monitor you closely if you have any problems with your vision.

Long-term use of steroids can slow down growth in children. If your child seems to be growing more slowly than normal, call your doctor.

If bronchodilator medications seem less effective after you start taking beclomethasone, be sure to tell your doctor. Do not abruptly stop using beclomethasone on your own.

If you have tuberculosis, a herpes infection of the eye, or any untreated fungal, bacterial, viral, or parasitic infections, your doctor may not want you to use an inhaled steroid.

Special information if you are pregnant or breastfeeding

The effects of beclomethasone in pregnancy have not been adequately studied. If you are pregnant or are planning a pregnancy, let your doctor know. Steroids do appear in breast milk and could harm your baby. Your doctor may want you to avoid breastfeeding while you are using beclomethasone.

Recommended dosage for Qvar Inhalation Aerosol

ADULTS

Beclomethasone Oral Inhalant

The usual recommended dose for adults and children 12 years of age and over is 2 inhalations taken 3 to 4 times a day. Four inhalations taken twice daily have been shown to be effective in some people. If you have severe asthma, your doctor may advise you to start with 12 to 16 inhalations a day. Daily intake should not exceed 20 inhalations.

For the double-strength inhalation aerosol, the usual dose is 2 inhalations twice a day. If your asthma is severe, your doctor may have you start with 6 to 8 inhalations a day. The maximum daily dosage is 10 inhalations.

For Qvar, a CFC-free form of the drug, the recommended starting dose is 40 to 80 micrograms twice daily if you’ve been using bronchodilators alone, and 40 to 160 micrograms if you’ve been using other inhaled steroid products. Take no more than 320 micrograms twice a day.

Beclomethasone Nasal Inhalation

For adults and children 12 years of age and over, the dosage of Vancenase PocketHaler is 1 inhalation in each nostril 2 to 4 times a day. A 3-times-daily schedule is often sufficient.

Beclomethasone Nasal Spray

For adults and children 12 years of age and older, the usual dosage is 1 or 2 inhalations in each nostril 2 to 4 times a day, depending on the brand. For the double strength nasal spray, the dosage is 1 or 2 inhalations in each nostril once a day.

The usual dosage of Vancenase AQ 84 micrograms for adults and children 6 years and over is 1 or 2 inhalations in each nostril once a day.

CHILDREN

Beclomethasone Oral Inhalant

Children 6 to 12 years of age: The usual recommended dose is 1 or 2 inhalations 3 or 4 times a day. Four inhalations twice daily have been effective for some children. Daily intake should not exceed 10 inhalations.

For the double-strength inhalation aerosol, the usual dose is 2 inhalations twice daily, with a maximum of 5 inhalations a day.

For the Qvar brand, the recommended starting dose for children 5 to 11 is 40 micrograms twice daily. The highest recommended dose is 80 micrograms twice daily.

Beclomethasone Nasal Inhalation

Children 6 to 12 years of age: The usual dose of Vancenase PocketHaler is 1 inhalation 3 times a day.

Beclomethasone Nasal Spray

Children 6 to 12 years of age: The usual dosage is 1 inhalation in each nostril 2 times a day. Some children may need 2 inhalations. However, once adequate control is achieved, the dose should be decreased to 1 inhalation in each nostril twice daily. The maximum daily dose should not exceed 2 inhalations in each nostril twice daily. The dosage for the double strength nasal spray is 1 or 2 inhalations in each nostril once a day.

Beclomethasone should not be given to children under the age of 6 unless advised by your doctor.

Overdosage

Any medication taken in excess can have serious consequences. The main risk in an overdose of beclomethasone is adrenal insufficiency. If you suspect an overdose, seek medical attention immediately.

Brand names: Quinidine, Quinidine sulfate

Why is Quinidine sulfate prescribed?

Quinidine is used to correct certain types of irregular heart rhythms and to slow an abnormally fast heartbeat.

Most important fact about Quinidine sulfate

It is important to take only the prescribed amount of Quinidine sulfate—no more and no less. Try to keep your doses at regularly spaced intervals, and be sure not to miss any.

How should you take Quinidine sulfate?

Take quinidine exactly as prescribed.

• If you miss a dose…
  Take it as soon as you remember, if it is within 2 hours of your scheduled time. If you do not remember until later, skip the dose you missed and go back to your regular schedule. Do not take 2 doses at once.

• Storage instructions…
  Store at room temperature in a tightly closed container, away from light.

What side effects may occur?

Side effects cannot be anticipated. If any develop 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 quinidine.

• Side effects include:
  Abdominal pain, diarrhea, hepatitis, inflammation of the esophagus (gullet), loss of appetite, nausea, vomiting

Another possible side effect is a sensitivity reaction called cinchonism. Symptoms include blurred or double vision, confusion, delirium, diarrhea, headache, intolerance to light, hearing loss, ringing in the ears, vertigo, and vomiting.

Why should Quinidine sulfate not be prescribed?

Do not take Quinidine sulfate if you have ever had an allergic reaction to quinidine. Also avoid Quinidine sulfate if quinine or quinidine causes you to bruise easily.

Quinidine is prescribed only for certain specific types of heart irregularity, and should be avoided when other irregularities are present. It could also prove harmful if you have myasthenia gravis (abnormal muscle weakness) or a similar condition.

Special warnings about Quinidine sulfate

Quinidine is reserved for certain kinds of dangerously rapid heart irregularities. It works well for some people, providing them with significant symptomatic relief. However, you should know that—on average for all cases—it has not been shown to improve chances of long-term survival, and could actually lower the odds.

Remember, too, that under certain conditions (slow heart rate, low potassium or magnesium levels) quinidine can cause certain types of heart irregularity. It can also cause the condition known as heart block, and should be used with caution if you have partial heart block.

Also use quinidine cautiously if you have kidney or liver disease. Your doctor will check your blood count and liver and kidney function periodically during long-term therapy.

There have been rare cases of severe allergic reaction to quinidine, especially during the first few weeks of therapy. Discuss any allergic reactions you have experienced with your doctor.

Do not confuse quinidine with quinine, which, although related, is used to treat malaria.

Possible food and drug interactions when taking Quinidine sulfate

Concentrations of digoxin in your blood may increase or even double when Quinidine sulfate is taken with quinidine. Your doctor may need to reduce the amount of digoxin you take.

A decrease in your salt intake can lead to a higher blood level of quinidine. Try to keep the salt in your diet constant. Grapefruit juice may also have an impact on quinidine levels. It’s best to avoid it.

If quinidine are 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 quinidine with the following:

Amiodarone
Antacids containing magnesium
Antispasmodic drugs
Aspirin
Beta-blocking blood pressure medications
Blood thinners such as warfarin
Certain antidepressants
Certain diuretic drugs
Cimetidine
Codeine
Decamethonium
Digitoxin
Diltiazem
Disopyramide
Felodipine
Haloperidol
Hydrocodone
Ketoconazole
Major tranquilizers
Mexiletine
Nicardipine
Nifedipine
Nimodipine
Phenobarbital
Phenytoin
Physostigmine
Procainamide
Reserpine
Rifampin
Sodium bicarbonate
Sucralfate
Thiazide diuretics
Verapamil

Special information if you are pregnant or breastfeeding

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

Recommended dosage for Quinidine sulfate

ADULTS

The usual dosage is 300 milligrams quinidine every 8 to 12 hours.

Overdosage

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

• The symptoms of quinidine overdose may include:
  Abnormal heart rhythms, blurred or double vision, confusion, delirium, diarrhea, headache, intolerance to light, loss of hearing, low blood pressure, ringing in the ears, vertigo, vomiting

Brand names: Accupril

Why is Quinapril hydrochloride prescribed?

Accupril is used in the treatment of high blood pressure. It can be taken alone or in combination with a thiazide type of water pill such as hydrochlorothiazide. Accupril is in a family of drugs known as “ACE inhibitors.” It works by preventing a chemical in your blood called angiotensin I from converting into a more potent form that increases salt and water retention in your body. Accupril also enhances blood flow throughout your blood vessels. Along with other drugs, Accupril is also prescribed in the treatment of congestive heart failure.

Most important fact about Quinapril hydrochloride

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

How should you take Quinapril hydrochloride?

You can take Accupril with or without meals.

Alcohol may increase the effect of Accupril, and could cause dizziness or fainting. Avoid alcoholic beverages until you have checked with your doctor.

Take Accupril exactly as prescribed, and see your doctor regularly to make sure the drug is working properly without unwanted side effects. Do not stop taking Quinapril hydrochloride without first consulting your doctor.

• If you miss a dose…
  Take the forgotten dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never try to “catch up” by doubling the dose.

• Storage instructions…
  Accupril can be stored at room temperature. Protect from light.

What side effects may occur?

Side effects cannot be anticipated. If any develop 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 Accupril.

• Side effects may include:
  Dizziness, headache

Why should Quinapril hydrochloride not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Accupril or similar drugs, such as captopril and enalapril maleate, you should not take Quinapril hydrochloride. Make sure your doctor is aware of any drug reactions you have experienced.

Special warnings about Quinapril hydrochloride

If you develop swelling of the face, lips, tongue, or throat, or of your arms and legs, or have difficulty swallowing or breathing, you should contact your doctor immediately. You may need emergency treatment.

If you develop abdominal pain with or without nausea and vomiting, contact your doctor. ACE inhibitors such as Accupril have been known to cause intestinal swelling.

You may feel light-headed, especially during the first few days of Accupril therapy. If this occurs, notify your doctor. If you actually faint, stop taking the medication until you have consulted with your doctor.

Vomiting, diarrhea, and heavy perspiration can all deplete your body fluid; and dehydration can cause your blood pressure to drop. If this leads to light-headedness or fainting, you should check with your doctor.

Inform your doctor or dentist that you are taking Accupril before undergoing surgery or anesthesia.

Do not use potassium supplements or salt substitutes containing potassium without consulting your doctor.

If you develop a sore throat, fever, or any other sign of infection, contact your doctor immediately. It could indicate a more serious illness.

If you are taking Accupril, your doctor will do a complete assessment of your kidney function and will watch it closely as long as you are taking Quinapril hydrochloride.

If you notice a yellow tinge to your skin and the whites of your eyes, stop taking the drug and notify your doctor immediately. This could be a sign of liver damage.

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

Possible food and drug interactions when taking Quinapril hydrochloride

If Accupril 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 Accupril with the following:

Diuretics
Lithium
Magnesium
Potassium-sparing diuretics
Potassium supplements
Salt substitutes containing potassium
Tetracycline

Special information if you are pregnant or breastfeeding

ACE inhibitors such as Accupril have been shown to cause injury and even death to the unborn child when used in pregnancy during the second and third trimesters. If you are pregnant, your doctor should discontinue Accupril as soon as possible. If you plan to become pregnant, make sure your doctor knows you are taking Quinapril hydrochloride. Accupril appears in breast milk and could affect a nursing infant. If Quinapril hydrochloride is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

Recommended dosage for Quinapril hydrochloride

HIGH BLOOD PRESSURE

The usual starting dose is 10 or 20 milligrams taken once a day. If you have any problems with your kidneys or if you are also taking a diuretic, your starting dose may be lower. For adults over age 65, the usual starting dose is 10 milligrams. Depending on how your blood pressure responds, your doctor may increase your dose up to a total of 80 milligrams a day taken once a day or divided into two doses.

CONGESTIVE HEART FAILURE

The usual starting dose is 5 milligrams taken twice a day. Your doctor may increase the dose from week to week, up to as much as 20 to 40 milligrams daily, divided into 2 equal doses. If you have kidney problems, the dosage will be lower.

Overdosage

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

A severe drop in blood pressure is the primary sign of an Accupril overdose.

Brand names: Accuretic

Why is Quinapril hydrochloride, Hydrochlorothiazide prescribed?

Accuretic combines two types of blood pressure medication. The first, quinapril hydrochloride, is an ACE (angiotensin-converting enzyme) inhibitor. It works by preventing a chemical in your blood called angiotensin I from converting into a more potent form (angiotensin II) that increases salt and water retention in the body and causes the blood vessels to constrict—two actions that tend to increase blood pressure.

To aid in clearing excess water from the body, Accuretic also contains hydrochlorothiazide, a diuretic that promotes production of urine. Diuretics often wash too much potassium out of the body along with the water. However, the ACE inhibitor part of Accuretic tends to keep potassium in the body, thereby canceling this unwanted effect.

Accuretic is not used for the initial treatment of high blood pressure. It is saved for later use, when a single blood pressure medication is not sufficient for the job. In addition, some doctors are using Accuretic along with other drugs to treat congestive heart failure.

Most important fact about Quinapril hydrochloride, Hydrochlorothiazide

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

How should you take Quinapril hydrochloride, Hydrochlorothiazide?

You can take Accuretic with or without meals.

Take Accuretic exactly as prescribed, and see your doctor regularly to make sure the drug is working properly without unwanted side effects. Do not stop taking Quinapril hydrochloride, Hydrochlorothiazide without first consulting your doctor.

• If you miss a dose…
  Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

• Storage instructions…
  Store at room temperature in a tightly closed container. Protect from moisture and light.

What side effects may occur?

Side effects cannot be anticipated. If any develop 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 Accuretic.

• Side effects may include:
  Cough, dizziness, headache

Why should Quinapril hydrochloride, Hydrochlorothiazide not be prescribed?

If you are unable to urinate, avoid Quinapril hydrochloride, Hydrochlorothiazide.

You should not take Quinapril hydrochloride, Hydrochlorothiazide if you are sensitive to or have ever had an allergic reaction to any of the following: Accupril, thiazide diuretics such as hydrochlorothiazide, ACE inhibitors such as captopril and enalapril maleate, or sulfa or other sulfonamide-derived drugs such as sulfamethoxazole. If you have a history of allergies, you may be at greater risk for an allergic reaction to Quinapril hydrochloride, Hydrochlorothiazide. Make sure your doctor is aware of any drug reactions you have experienced.

Special warnings about Quinapril hydrochloride, Hydrochlorothiazide

If you develop swelling of the face, lips, tongue or throat, or of your arms and legs, or have difficulty swallowing or breathing, stop taking the medication and contact your doctor immediately. You may need emergency treatment.

If you develop abdominal pain with or without nausea and vomiting, contact your doctor. ACE inhibitors such as Accuretic have been known to cause intestinal swelling.

You may feel light-headed, especially during the first few days of Accuretic therapy. If this occurs, notify your doctor. If you actually faint, stop taking the medication until you have consulted with your doctor.

Dehydration, excessive sweating, vomiting, or diarrhea can all deplete your body’s fluids and cause your blood pressure to drop. If this leads to light-headedness or fainting, you should check with your doctor.

Inform your doctor or dentist that you are taking Accuretic before undergoing surgery or anesthesia.

Do not use potassium supplements or salt substitutes containing potassium without consulting your doctor.

If you develop any type of infection such as a sore throat or fever, contact your doctor immediately. It could indicate a more serious illness.

If you are taking Accuretic, your doctor will do a complete assessment of your kidney function and will watch it closely as long as you are taking Quinapril hydrochloride, Hydrochlorothiazide. If you have kidney disease, Accuretic should be used with caution.

Caution is warranted, too, if you have liver disease. If you notice a yellow tinge to your skin and the whites of your eyes, stop taking the drug and notify your doctor. This could be a sign of liver damage.

Accuretic may increase your blood sugar levels if you have diabetes. It can also trigger gout or the connective tissue disease lupus erythematosus. Use Accuretic cautiously if you have any of these problems.

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

Possible food and drug interactions when taking Quinapril hydrochloride, Hydrochlorothiazide

If Accuretic 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 Accuretic with the following:

Barbiturates such as phenobarbital
Cholestyramine
Colestipol
Corticosteroids such as prednisone or ACTH
Diabetes medications such as insulin or glyburide
Digoxin
Diuretics such as hydrochlorothiazide
Narcotics such as acetaminophen and oxycodone hydrochloride
Nonsteroidal anti-inflammatory drugs such as naproxen
Norepinephrine
Other high blood pressure medications such as methyldopa
Potassium-sparing diuretics such as hydrochlorothiazide and spironolactone,
Potassium supplements such as potassium chloride
Salt substitutes containing potassium
Tetracycline

Alcohol may increase the effect of Accuretic, and could cause dizziness or fainting. Check with your doctor before drinking alcoholic beverages.

Special information if you are pregnant or breastfeeding

ACE inhibitors such as the one in Accuretic have been shown to cause injury and even death to the unborn child when used in pregnancy during the second and third trimesters. If you are pregnant, your doctor should discontinue Quinapril hydrochloride, Hydrochlorothiazide as soon as possible. If you plan to become pregnant, make sure your doctor knows you are taking Quinapril hydrochloride, Hydrochlorothiazide. The diuretic component of Accuretic, when taken during pregnancy, can cause jaundice (yellowing of the skin and whites of the eyes) and abnormal bruising and bleeding in newborns.

Accuretic appears in breast milk and could affect a nursing infant. Because of potential harm to the baby, you’ll need to choose between breastfeeding and continuing your treatment with Accuretic.

Recommended dosage for Quinapril hydrochloride, Hydrochlorothiazide

ADULTS

Accuretic is usually taken once a day. Your doctor will adjust the dosage depending on how your blood pressure responds. Daily doses of up to 80 milligrams of quinapril and 50 milligrams of hydrochlorothiazide may be prescribed, but doctors aim for the smallest dose that proves effective.

Overdosage

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

• Symptoms of Accuretic overdose may include:
  A severe drop in blood pressure, dry mouth, excessive thirst, muscle pain or cramps, nausea and vomiting, weak or irregular heartbeat, weakness and dizziness

Brand names: Uni-Dur, Uniphyl, Theo-24, Theo-Dur, Theochron, T-Phyl, Slo-bid, Quibron-T/SR, Theophylline

Why is Quibron-T/SR prescribed?

Theophylline, an oral bronchodilator medication, is given to treat symptoms of asthma, chronic bronchitis, and emphysema. Theophylline is a chemical cousin of caffeine. It opens the airways by relaxing the smooth muscle that circles the tubes and blood vessels in the lungs.

Most important fact about Quibron-T/SR

Theophylline is a controlled-release medication. For an acute attack you should take an immediate-release medication instead of more theophylline. If you develop status asthmaticus (a severe breathing difficulty that does not clear up with your usual medications), do not take extra theophylline; instead, seek medical treatment immediately. Since even a little extra theophylline may constitute an overdose, you should be treated in a place where close monitoring is possible.

Individual doses are determined by a person’s response (a decrease in symptoms of asthma). In order to avoid overdosing or underdosing, your doctor will perform regular tests to determine the amount of theophylline in your bloodstream.

You should not change from one brand of theophylline to another brand without first consulting your doctor or pharmacist. Products manufactured by different companies may not be equally effective.

How should you take Quibron-T/SR?

Take theophylline exactly as prescribed. Do not change the dose, the time you take it, or how often you take it without consulting your doctor.

This drug is available in two forms. The extended-release tablets should be swallowed whole, not crushed or chewed. The tablets of some brands are scored; if the doctor prescribes a partial dosage, these tablets should be broken only at the score. You may take the tablets with or without food. If you are taking them on a once-a-day basis, do not take the dose at night.

The other form, sustained-action sprinkle capsules, must be taken either 1 hour before or 2 hours after a meal. You may take the capsule whole or open it and empty the contents onto a spoonful of food that is soft but not hot. Without chewing, immediately swallow the spoonful of food and follow it with a glass of cool water or juice. Always take the complete contents of the capsule.

When taking theophylline, you should avoid large amounts of caffeine-containing beverages, such as tea or coffee.

• If you miss a dose…
  Take the next dose at the regular time. Do not try to make up the dose you missed.

• Storage instructions…
  Store at room temperature. Keep the container tightly closed. Protect from excessive heat, light, and moisture. Make sure this medicine is kept out of reach of children.

What side effects may occur?

Side effects from theophylline cannot be anticipated. Nausea and restlessness may occur when you first start to take theophylline, but will probably disappear as your body becomes used to the drug. If side effects persist, see your doctor; the dosage may be too high.

• Other side effects may include:
  Convulsions, diarrhea, disturbances of heart rhythm, excitability, frequent urination, hair loss, headache, heart palpitations, insomnia, irritability, muscle twitching, rash, severe seizures, tremors, vomiting

Why should Quibron-T/SR not be prescribed?

Do not take theophylline if you have ever had an allergic reaction to it or similar drugs.

Do not take theophylline ur if you have an active peptic ulcer or a seizure disorder such as epilepsy.

Special warnings about Quibron-T/SR

If you are a smoker, your body will tend to process and get rid of theophylline rather quickly; thus, you may need to take more frequent doses than a nonsmoker. Tell your doctor if you start or stop smoking. Even if you quit, the quick-clearance effect may linger for 6 months to 2 years.

You should take theophylline cautiously and under close medical supervision if you are over age 60.

You should also take theophylline cautiously and under close supervision if you have had a sustained high fever, or if you have heart disease, liver disease, heartbeat irregularities, fluid in the lungs, an underactive thyroid gland, the flu or another viral illness, or the symptoms of shock.

Call your doctor immediately if you develop nausea, vomiting, a lasting headache, insomnia, restlessness, or a too-rapid heartbeat; if you develop a new illness, especially with a fever; or if an illness you already have gets worse.

Possible food and drug interactions when taking Quibron-T/SR

Theophylline interacts with a wide variety of drugs. Consult your doctor before combining any other medication with theophylline. Let your doctor know whenever another doctor starts you on a new medication or stops an old one. Let every doctor you deal with know you are taking theophylline.

Special information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, inform your doctor immediately. Theophylline should not be taken during pregnancy unless it is clearly needed, and unless the benefits to the mother outweigh the potential risk to the developing child.

Theophylline r does find its way into breast milk; it may make a nursing baby irritable or harm the baby in other ways. If you are a new mother, you will probably need to choose between breastfeeding and taking theophylline.

Recommended dosage for Quibron-T/SR

ADULTS

Extended-Release Tablet

The usual initial dose is one 150-milligram tablet every 12 hours. If this is not effective, your doctor will gradually increase the dose until you respond, up to a maximum of 600 milligrams per day. Once you have adjusted to the medication, your doctor may be able to put you on a once-a-day dose schedule.

Sprinkle Capsule

The usual initial dose is no more than 200 milligrams every 12 hours. If this is not effective, your doctor will gradually increase the dose until you respond, up to a maximum of 900 milligrams per day. If a dose every 12 hours is inconvenient, your doctor may divide the daily total into 3 small doses taken every 8 hours.

CHILDREN 6 to 16 YEARS

The doctor will calculate the proper dosage based on the child’s body weight.

OLDER ADULTS

Older adults are more likely than younger people to be seriously affected by theophylline. Anyone over age 60 should not take more than 400 milligrams a day except in special circumstances.

Overdosage

Most of the symptoms listed under “What side effects may occur?” are actually caused by slight overdosage.

Be aware that a flu shot, influenza itself, or another viral infection may make your usual dose of theophylline act like an overdose. Consult your doctor if you anticipate getting a flu shot, or if you think you have the flu; you may need a temporary dosage reduction.

A mild overdose of theophylline may cause nausea and restlessness. Taking too much over a long period of time may cause serious heartbeat irregularities, convulsions, or even death. If at any time you suspect symptoms of an overdose of theophylline, seek medical attention immediately.

Brand names: Seroquel

Why is Quetiapine fumarate prescribed?

Seroquel is prescribed for the treatment of schizophrenia, a mental disorder marked by delusions (false beliefs), hallucinations, disrupted thinking, and loss of contact with reality. It is also used for the treatment of manic and depressive episodes associated with bipolar disorder.

Seroquel belongs to one of the newer classes of antipsychotic medications. Researchers believe that it works by diminishing the action of dopamine and serotonin, two of the brain’s chief chemical messengers.

Most important fact about Quetiapine fumarate

Seroquel may cause tardive dyskinesia, a condition characterized by uncontrollable muscle spasms and twitches in the face and body. This problem can be permanent, and appears to be most common among older adults, especially women.

Seroquel is not approved for use in elderly patients with dementia (including Alzheimer’s disease) due to the increased risk of sudden death, heart failure, and pneumonia.

Antidepressants can increase the risk of suicidal thinking and behavior in children and teenagers. Both adult and pediatric patients taking antidepressants should be watched closely for changes in moods or actions, especially when they first start therapy or when their dose is increased or decreased. Patients and their families should contact the doctor immediately if new symptoms develop or seem to get worse. Signs to watch for include anxiety, hostility, insomnia, restlessness, impulsive or dangerous behavior, and thoughts about suicide or dying. Seroquel is not approved for use in pediatric patients.

How should you take Quetiapine fumarate?

Your doctor will increase your dose gradually until the drug takes effect. If you stop Seroquel for more than 1 week, you’ll need to build up to your ideal dosage once again.

• 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 once.

• Storage instructions…
  Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop 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 Seroquel.

• Side effects may include:
  Abdominal pain, constipation, diminished movement, dizziness, drowsiness, dry mouth, excessive muscle tone, headache, indigestion, low blood pressure (especially upon standing), nasal inflammation, neck rigidity, rapid or irregular heartbeat, rash, sleepiness, tremor, uncontrollable movements, weakness

Why should Quetiapine fumarate not be prescribed?

If Seroquel gives you an allergic reaction, you will not be able to use Quetiapine fumarate.

Special warnings about Quetiapine fumarate

Call your doctor immediately if you develop muscle stiffness, confusion, irregular or rapid heartbeat, excessive sweating, and high fever. These are signs of Neuroleptic Malignant Syndrome (NMS), a serious—and potentially fatal—reaction to the drug. Be especially wary if you have a history of heart attack, heart disease, heart failure, circulation problems, or irregular heartbeat.

Particularly during the first few days of therapy, Seroquel can cause low blood pressure, with accompanying dizziness, fainting, and rapid heartbeat. To minimize these effects, your doctor will increase your dose gradually. If you are prone to low blood pressure, take blood pressure medication, or become dehydrated, use Seroquel with caution.

Seroquel also tends to cause drowsiness, especially at the start of therapy, and can impair your judgment, thinking, and motor skills. Until you are certain of the drug’s effect, use caution when operating machinery or driving a car.

Certain antipsychotic drugs, including Seroquel, are associated with an increased risk of developing high blood sugar, which on rare occasions has led to coma or death. See your doctor right away if you develop signs of high blood sugar, including dry mouth, unusual thirst, increased urination, and tiredness. If you have diabetes or have a high risk of developing it, see your doctor regularly for blood sugar testing.

People at high risk of suicide attempts should be prescribed the lowest dose possible to reduce the risk of intentional overdose.

Animal studies suggest that Seroquel may increase the risk of breast cancer, although human studies have not confirmed such a risk. If you have a history of breast cancer, see your doctor regularly for checkups.

If you are having problems with your vision, tell your doctor. There is a chance that Seroquel may cause cataracts, and you may be asked to see an eye doctor when you start Seroquel therapy, and every 6 months thereafter.

Seroquel poses a very slight risk of seizures, especially if you are over 65, have epilepsy, or have a condition that increases the risk of seizures. The drug can also suppress an underactive thyroid, and generally causes a minor increase in cholesterol levels. There is also a remote chance that it will trigger a prolonged and painful erection.

Other antipsychotic medications have been known to interfere with the body’s temperature-regulating mechanism, causing patients to overheat. Although this problem has not occurred with Seroquel, caution is still advisable. Avoid exposure to extreme heat, strenuous exercise, and dehydration.

Seroquel is prescribed for the short-term treatment of rapid-onset bipolar mania; it is not approved for preventing future episodes. The effectiveness of the drug for treating mania for more than 3 weeks has not been studied.

The safety and effectiveness of Seroquel have not been studied in children.

Possible food and drug interactions when taking Quetiapine fumarate

Seroquel increases the effects of alcohol. Avoid alcoholic beverages while on Seroquel therapy.

If Seroquel 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 Seroquel with the following:

Barbiturates such as phenobarbital
Carbamazepine
Cimetidine
Erythromycin
Fluconazole
Itraconazole
Ketoconazole
Levodopa
Lorazepam
Phenytoin
Rifampin
Steroid medications such as hydrocortisone and prednisone
Thioridazine

Special information if you are pregnant or breastfeeding

The possibility of harm to a developing baby has not been ruled out. You should take Seroquel during pregnancy only if the benefits outweigh this potential risk. Notify your doctor as soon as you become pregnant or decide to become pregnant.

It is not known whether Seroquel appears in breast milk, and breastfeeding is not recommended.

Recommended dosage for Quetiapine fumarate

SCHIZOPHRENIA

Adults

The usual dosage range is 300 to 400 milligrams a day, divided into two or three smaller doses. Doses as low as 150 milligrams a day sometimes prove effective, and the dose rarely exceeds 750 milligrams per day. Doses above 800 milligrams per day have not been tested for safety. The dose is gradually increased over 4 days until the most effective dose is reached, using the following schedule: Day 1: Take 25 milligrams twice a day. Days 2, 3, and 4: The doctor will increase each daily dose by 25 to 50 milligrams, taken either two or three times a day. Day 5 and up: If needed, the doctor may increase each dose by 25 to 50 milligrams every 2 or more days.

BIPOLAR MANIA (SHORT-TERM TREATMENT OF ACUTE EPISODES)

Adults

The usual dosage range is 400 to 800 milligrams a day. Doses above 800 milligrams a day have not been tested for safety. The dosage will be gradually increased over 4 to 6 days until the most effective dose is reached, using the following schedule: Day 1: Take 50 milligrams twice a day. Day 2: The doctor will increase the dose to 100 milligrams twice a day. Day 3: The doctor will increase the dose to 150 milligrams twice a day. Day 4: The doctor will increase the dose to 200 milligrams twice a day. Days 5 and 6: If needed, the doctor may increase each dose by no more than 200-milligram increments to a total daily dose of 800 milligrams.

BIPOLAR DEPRESSION

Adults

The usual dose is 300 milligrams once a day at bedtime. The dosage will be gradually increased over 4 days using the following schedule: Day 1: Take 50 milligrams at bedtime. Day 2: The doctor will increase the dose to 100 milligrams at bedtime. Day 3: The doctor will increase the dose to 200 milligrams at bedtime. Day 4: The doctor will increase the dose to 300 milligrams at bedtime.

DOSAGE ADJUSTMENT

If you have liver problems, you may be started at 25 milligrams a day. The doctor will increase the dose as needed in increments of 25 to 50 milligrams a day based on your body’s response.

The dosage may also need to be lowered if you are weak, elderly, or prone to low blood pressure reactions. You may also need your dose adjusted if you’re taking certain drugs, including Dilantin, Tegretol, and phenobarbital.

Overdosage

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

• Symptoms of Seroquel overdose may include:
  Dizziness, drowsiness, fainting, rapid heartbeat

Generic name: Budesonide
Brand names: Pulmicort Turbuhaler

Why is Pulmicort Turbuhaler prescribed?

Budesonide, the active ingredient in Pulmicort Turbuhaler, is an anti-inflammatory steroid medication. Inhaled on a regular basis, Pulmicort helps prevent asthma attacks. It is sometimes prescribed in addition to oral steroids, and may reduce or eliminate the need for them.

Pulmicort Turbuhaler is used to treat asthma in adults and children over age 6. Children 12 months to 8 years of age can be treated with another form of budesonide, Pulmicort Respules, which is given by nebulizer. Both types of Pulmicort are preventive medicines. They will not relieve an acute or life-threatening episode of asthma.

Most important fact about Pulmicort Turbuhaler

Because steroids can suppress the immune system, people taking Pulmicort may become more susceptible to infections, and their infections could be more severe. If you are taking Pulmicort, avoid exposure to infectious diseases such as chickenpox and measles. If you are exposed, contact your doctor immediately.

How should you take Pulmicort Turbuhaler?

Use Pulmicort Turbuhaler exactly as directed. The effectiveness of Pulmicort Turbuhaler depends on its regular use. Your doctor will prescribe the lowest effective dose. Do not take more or less medication than the amount prescribed. When starting therapy, carefully read the instructions that come with the inhaler. Your asthma symptoms may begin to improve in 24 hours, although you may not see the maximum benefit for 1 to 2 weeks or longer. If your symptoms do not improve or get worse, contact your doctor.

Pulmicort Turbuhaler delivers a dose of medication in dry powder form. To assure the correct dose, the inhaler must be held in an upright position, with the mouthpiece on top, during priming and loading.

Before its first use, each new inhaler must be primed. To prime the inhaler, hold it upright and turn the brown grip fully to the right, then fully to the left until it clicks. Repeat this procedure a second time. The unit is now primed.

The inhaler must be loaded with medication immediately prior to each use. As you did when priming the unit, turn the brown grip fully to the right, then fully to the left until it clicks.

During inhalation, the inhaler must be held in an upright (mouthpiece up) or horizontal position. Do not shake the inhaler. Place the mouthpiece between your lips and inhale forcefully and deeply. The Pulmicort powder is then delivered to the lungs. Do not exhale through the inhaler.

You may not taste or sense any medication entering the lungs when inhaling from the Turbuhaler. This lack of sensation is not a cause for concern, and does not mean that you’ll fail to receive the medication’s benefits.

To decrease the risk of developing a fungus infection in the mouth, rinse it with water, without swallowing, after each dose. Do not use the inhaler with a spacer. Do not bite or chew the mouthpiece.

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

• Storage instructions…
  Keep the Pulmicort Turbuhaler clean at all times. Replace the cover securely after each opening. Store with the cover tightened in a dry place at room temperature. Discard the unit when a red mark appears in the indicator window.

What side effects may occur?

Side effects cannot be anticipated. If any develop 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 Pulmicort.

• Side effects may include:
  Aching joints, back pain, cough, fever, flu-like symptoms, fungal infection in mouth, headache, indigestion, nasal and sinus inflammation, pain, respiratory infection, sore throat, weakness

Why should Pulmicort Turbuhaler not be prescribed?

If you are allergic to budesonide, you cannot use Pulmicort. In addition, Pulmicort cannot be used to treat severe asthma attacks.

Special warnings about Pulmicort Turbuhaler

If you are switching to Pulmicort from an oral steroid medication, the doctor will be careful to reduce your oral dosage very gradually. Taking oral steroids suppresses the natural production of steroids by the adrenal gland, and it takes months for production to return to normal after the oral steroids are stopped. In the meantime, the body will be unusually vulnerable to stress.

There have been reports of death during and immediately after transfer from oral steroids to inhaled steroids, so your doctor will monitor you carefully during this period. People who have been taking high doses of oral steroids for an extended period of time are especially prone to problems, particularly when the oral steroids have been almost completely stopped. At that point, any stress from trauma, surgery, or infection (especially stomach or intestinal inflammation) is more likely to trigger adverse events.

If you experience a period of stress or a severe asthma attack during your switch to Pulmicort, you should begin taking your oral medication again (in large doses) and contact your doctor immediately. You should carry a medical identification card indicating that you may need additional medication during periods of stress or a severe asthma attack.

Transfer from oral steroids to Pulmicort may unmask allergic conditions previously controlled by those steroids, such as nasal inflammation, conjunctivitis (pinkeye), and eczema. Transfer from oral steroids may also be accompanied by withdrawal symptoms, including joint or muscle pain, fatigue, and depression, even while Pulmicort is improving your asthma symptoms.

Like other inhaled asthma medications, Pulmicort occasionally triggers an asthma attack. If this occurs, immediately use a fast-acting inhaled bronchodilator, stop using Pulmicort, and contact your doctor. You’ll need to switch to a different asthma medication. Also alert your doctor immediately if the usual doses of your fast-acting bronchodilator no longer work. You may need to take oral steroids for a while.

Steroid medications can stunt growth in children and teenagers. Your doctor will prescribe the lowest effective dose of Pulmicort in order to minimize this problem, and will monitor the child’s growth carefully.

While using Pulmicort Turbuhaler, some people develop fungal infections in the mouth and throat. If this occurs, the doctor can prescribe antifungal medication while you continue to use Pulmicort. People with tuberculosis, ocular herpes simplex, or any untreated fungal, bacterial, viral, or parasitic infection should use inhaled steroids with caution. Caution is also in order if you have liver disease.

In rare instances, inhaled steroids have been known to cause glaucoma (increased pressure in the eye) and cataracts.

Possible food and drug interactions when taking Pulmicort Turbuhaler

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

Antibiotics such as clarithromycin and erythromycin
Antifungal medications such as ketoconazole and itraconazole

Special information if you are pregnant or breastfeeding

Pulmicort does not appear to harm the developing infant during pregnancy. Nevertheless, the possibility for harm cannot be ruled out. This medication should be used during pregnancy only if it is clearly needed.

Steroids make their way into breast milk. Because they could affect the nursing infant, you’ll need to either discontinue breastfeeding or stop taking Pulmicort Turbuhaler.

Recommended dosage for Pulmicort Turbuhaler

ADULTS

The usual dosage depends on your previous treatments for asthma.

If you have previously been using only fast-acting bronchodilators, the usual starting dose is 200 to 400 milligrams twice a day. The maximum long-term dosage is 400 milligrams twice daily.

If you have previously been using inhaled steroids, the usual starting dose is 200 to 400 milligrams twice a day (or once daily in the morning or evening if your asthma has been well controlled). The maximum long-term dosage is 800 milligrams twice daily.

If you have previously been taking oral steroids, the usual starting dose is 400 to 800 milligrams twice a day. The maximum long-term dosage is 800 milligrams twice daily.

If you are taking oral steroids, you will continue to do so while starting Pulmicort Turbuhaler. After one week, the doctor will lower your dose of oral steroids, then gradually lower it further at one- or two-week intervals.

CHILDREN AGE 6 AND OLDER

As with adults, the child’s usual dosage depends on previous treatments.

If the child has previously been using only a fast-acting bronchodilator the usual starting dose is 200 milligrams twice a day. The maximum long-term dosage is 400 milligrams twice daily.

If the child has previously been using inhaled steroids, the usual starting dose is 200 milligrams twice daily. (A once-a-day dose of 200 or 400 milligrams may be prescribed instead.) The maximum long-term dosage is 400 milligrams twice daily.

If the child has previously been taking oral steroids, the highest recommended dose is 400 milligrams taken twice a day. As with adults, the dosage of oral steroids will be gradually reduced while the child continues to take Pulmicort.

Overdosage

Excessive doses of steroid medications taken for long periods can stunt growth or cause a condition called Cushing’s syndrome. Symptoms of this condition include weight gain, a “moon face,” muscle wasting, weakness, and poor wound healing. If you think a problem is developing, check with your doctor immediately.

Generic name: Diflorasone diacetate
Brand names: Psorcon

Why is Psorcon prescribed?

Psorcon is prescribed for the relief of the inflammation and itching of skin disorders that respond to the application of steroids (hormones produced by the body that have potent anti-inflammatory effects).

Psorcon is available in ointment and cream forms, and in emollient ointment and cream.

Most important fact about Psorcon

When you use Psorcon, you inevitably absorb some of the medication through your skin and into the bloodstream. Too much absorption can lead to unwanted side effects elsewhere in the body. To keep this problem to a minimum, avoid using large amounts of Psorcon over large areas, and do not cover it with airtight dressings such as plastic wrap or adhesive bandages unless specifically told to by your doctor.

How should you take Psorcon?

Use Psorcon exactly as prescribed.

Psorcon is for use only on the skin. Be careful to keep it out of your eyes.

• If you miss a dose…
  Apply 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.

• Storage instructions…
  Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop 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 Psorcon.

• Side effects may include:
  Burning, dryness, eruptions resembling acne, excessive discoloring of the skin, excessive growth of hair, inflammation of hair follicles, inflammation around the mouth, irritation, itching, prickly heat, secondary infection, severe inflammation of the skin, softening of the skin, stretch marks, stretching or thinning of the skin

Why should Psorcon not be prescribed?

If you are sensitive to or have ever had an allergic reaction to diflorasone diacetate or other drugs of this type (antifungals, steroids), you should not take Psorcon. Make sure your doctor is aware of any drug reactions you have experienced.

Special warnings about Psorcon

Remember that absorption of Psorcon through the skin can affect the whole body. Although it’s unusual (most common if Psorcon is spread over large areas of the skin), you could develop symptoms of steroid excess such as weight gain, reddening and rounding of the face and neck, growth of excess body and facial hair, high blood pressure, emotional disturbances, loss of energy due to high blood sugar, and increase in frequency of urination.

Do not use Psorcon for any disorder other than the one for which it was prescribed.

The treated skin area should not be bandaged, covered, or wrapped unless otherwise directed by your doctor. Avoid covering a treated area with waterproof diapers or plastic pants. They can cause unwanted absorption of Psorcon.

If an irritation or allergic reaction develops while you are using Psorcon, notify your doctor.

Possible food and drug interactions when taking Psorcon

No interactions with food or other drugs have been reported.

Special information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, inform your doctor before using Psorcon. In general, women who are pregnant should not use steroids extensively, in large amounts, or over long periods of time. It is not known whether Psorcon appears in breast milk. If Psorcon is essential to your health, your doctor may advise you to discontinue breastfeeding until treatment with Psorcon is finished.

Recommended dosage for Psorcon

ADULTS

Psorcon ointment should be applied as a thin film over the affected area from 1 to 3 times a day, depending on the severity or resistant nature of the condition. The emollient ointment may be applied up to 4 times daily.

Psorcon cream should be applied twice a day. The emollient cream may be applied up to 3 times a day.

Your doctor may recommend airtight bandages for the management of psoriasis (a chronic skin disorder) or other stubborn skin conditions. If an infection develops, you should stop using airtight dressings.

CHILDREN

Your doctor will limit the use of Psorcon for your child to the least amount that is effective. Long-term treatment may interfere with the growth and development of children.

Overdosage

An acute overdosage is unlikely with the use of Psorcon; however, long-term or prolonged use can produce side effects throughout your body. If you suspect an overdose, seek medical attention immediately.

Generic name: Fluoxetine hydrochloride
Brand names: Sarafem, Prozac Weekly, Prozac

Why is Prozac Weekly prescribed?

Prozac is prescribed for the treatment of depression—that is, a continuing depression that interferes with daily functioning. The symptoms of major depression often include changes in appetite, sleep habits, and mind/body coordination; decreased sex drive; increased fatigue; feelings of guilt or worthlessness; difficulty concentrating; slowed thinking; and suicidal thoughts.

Prozac is also prescribed to treat obsessive-compulsive disorder. An obsession is a thought that won’t go away; a compulsion is an action done over and over to relieve anxiety. The drug is also used in the treatment of bulimia (binge-eating followed by deliberate vomiting). It has also been used to treat other eating disorders and obesity.

In addition, Prozac is used to treat panic disorder, including panic associated with agoraphobia (a severe fear of being in crowds or public places). People with panic disorder usually suffer from panic attacks—feelings of intense fear that develop suddenly, often for no reason. Various symptoms occur during the attacks, including a rapid or pounding heartbeat, chest pain, sweating, trembling, and shortness of breath.

In children and adolescents, Prozac is used to treat major depression and obsessive-compulsive disorder.

Prozac Weekly is approved for treating major depression.

Under the brand name Sarafem, the active ingredient in Prozac is also prescribed for the treatment of premenstrual dysphoric disorder (PMDD), formerly known as premenstrual syndrome (PMS). Symptoms of PMDD include mood problems such as anxiety, depression, irritability or persistent anger, mood swings, and tension. Physical problems that accompany PMDD include bloating, breast tenderness, headache, and joint and muscle pain. Symptoms typically begin 1 to 2 weeks before a woman’s menstrual period and are severe enough to interfere with day-to-day activities and relationships.

Prozac belongs to the class of drugs called selective serotonin re-uptake inhibitors (SSRIs). Serotonin is one of the chemical messengers believed to govern moods. Ordinarily, it is quickly reabsorbed after its release at the junctures between nerves. Re-uptake inhibitors such as Prozac slow this process, thereby boosting the levels of serotonin available in the brain.

Most important fact about Prozac Weekly

Serious, sometimes fatal, reactions have been known to occur when Prozac is used in combination with other antidepressant drugs known as MAO inhibitors; and when Prozac is discontinued and an MAO inhibitor is started. Never take Prozac with one of these drugs or within at least 14 days of discontinuing therapy with one of them; and allow 5 weeks or more between stopping Prozac and starting an MAO inhibitor. Be especially cautious if you have been taking Prozac in high doses or for a long time.

In addition, Prozac should never be combined with thioridazine due to the risk of life-threatening drug interactions; and a minimum of 5 weeks should be allowed between stopping Prozac and starting Mellaril.

If you are taking any prescription or nonprescription drugs, notify your doctor before taking Prozac.

How should you take Prozac Weekly?

Prozac should be taken exactly as prescribed by your doctor.

Prozac usually is taken once or twice a day. To be effective, it should be taken regularly. Make a habit of taking it at the same time you do some other daily activity.

It may be 4 weeks before you feel any relief from your depression, but the drug’s effects should last about 9 months after a 3-month treatment regimen. For obsessive-compulsive disorder, the full effect may take 5 weeks to appear.

• If you miss a dose…
  Take the forgotten dose as soon as you remember. If several hours have passed, skip the dose. Never try to “catch up” by doubling 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, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Prozac.

• Side effects may include:
  Abnormal dreams, abnormal ejaculation, abnormal vision, anxiety, diarrhea, diminished sex drive, dizziness, dry mouth, flu-like symptoms, flushing, gas, headache, impotence, insomnia, itching, loss of appetite, nausea, nervousness, rash, sex-drive changes, sinusitis, sleepiness, sore throat, sweating, tremors, upset stomach, vomiting, weakness, yawning

Why should Prozac Weekly not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Prozac or similar drugs, you should not take Prozac Weekly. Make sure that your doctor is aware of any drug reactions that you have experienced.

Do not take Prozac Weekly while using an MAO inhibitor (see “Most important fact about Prozac Weekly”). You should also not use Prozac if you are taking thioridazine. Likewise, do not start taking thioridazine within 5 weeks of stopping Prozac.

Special warnings about Prozac Weekly

In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Prozac or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Prozac is approved for treating major depression in children 8 years and older and for treating obsessive-compulsive disorder in children 7 years and older.

Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with Prozac and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly—especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior—and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.

Unless you are directed to do so by your doctor, do not take Prozac Weekly if you are recovering from a heart attack or if you have liver disease or diabetes.

Prozac may cause you to become drowsy or less alert and may affect your judgment. Therefore, driving or operating dangerous machinery or participating in any hazardous activity that requires full mental alertness is not recommended.

While taking Prozac Weekly, you may feel dizzy or light-headed or actually faint when getting up from a lying or sitting position. If getting up slowly doesn’t help or if this problem continues, notify your doctor.

If you develop a skin rash or hives while taking Prozac, discontinue use of the medication and notify your doctor immediately.

Prozac should be used with caution if you have a history of mania or seizures. You should discuss all of your medical conditions with your doctor before taking Prozac Weekly.

Prozac can occasionally cause decreased appetite and weight loss, especially in depressed people who are already underweight and in those with bulimia. If you notice changes in your weight or appetite, tell your doctor.

Antidepressants such as Prozac could potentially cause stomach bleeding, especially when combined with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen, and ketoprofen. Consult your doctor before combining Prozac with NSAIDs or blood-thinning medications.

There have been rare reports of prolonged seizures in people who received electroconvulsive therapy (ECT) while taking Prozac. To date, there are no clinical studies establishing the benefit of combined treatment with Prozac and ECT.

As with other SSRIs, Prozac therapy should be slowly tapered instead of abruptly stopped. If abruptly discontinued, drowsiness, irritability, agitation, anxiety, headache, and insomnia may occur.

Possible food and drug interactions when taking Prozac Weekly

Never take Prozac with MAO inhibitors or thioridazine (see “Most important fact about Prozac Weekly”).

Do not drink alcohol while taking Prozac Weekly.

If Prozac 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 Prozac with the following:

Alprazolam
Any other antidepressants
Aspirin
Carbamazepine
Clozapine
Diazepam
Digitoxin
Drugs that impair brain function, such as sleep aids and narcotic painkillers
Flecainide
Haloperidol
Lithium
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen, and ketoprofen
Phenytoin
Pimozide
Sumatriptan
Tryptophan
Vinblastine
Warfarin

Special information if you are pregnant or breastfeeding

The effects of Prozac during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. There have been reports of newborns experiencing complications such as respiratory problems, bluish coloring of the skin, irregular breathing, muscular problems, vomiting, and constant crying after exposure to Prozac late in the third trimester.

This medication appears in breast milk, and breastfeeding is not recommended while you are taking Prozac.

Recommended dosage for Prozac Weekly

DEPRESSION

It may take 4 weeks before the full antidepressant effect of Prozac is seen.

Adults

The recommended starting dose is 20 milligrams a day, usually taken in the morning. If needed, the doctor may gradually increase the dose up to a maximum of 80 milligrams a day. The usual daily dose ranges from 20 to 60 milligrams. Daily doses above 20 milligrams should be taken in the morning or in two smaller doses taken in the morning and at noon.

Children 8 years and older

The usual starting dose is 10 or 20 milligrams a day. Children starting at 10 milligrams will have their dose increased to 20 milligrams a day after 1 week. Underweight children may need to remain at the 10-milligram dose.

Prozac Weekly

You need to wait at least 7 days after stopping your daily dose of Prozac before switching to the once-weekly formulation. One Prozac Weekly capsule contains 90 milligrams of medication.

OBSESSIVE-COMPULSIVE DISORDER

It may take 5 weeks before the full effects of Prozac are seen.

Adults

The recommended starting dose is 20 milligrams a day, usually taken in the morning. If needed, the doctor may gradually increase the dose up to a maximum of 80 milligrams a day. The usual daily dose ranges from 20 to 60 milligrams. Daily doses above 20 milligrams should be taken in the morning or in two smaller doses taken in the morning and at noon.

Children 7 years and older

The recommended starting dose is 10 milligrams a day. After 2 weeks, the doctor will increase the dose to 20 milligrams. If needed, the doctor may further increase the dose up to a maximum of 60 milligrams a day. The recommended dosage range for underweight children is 10 to 30 milligrams a day

BULIMIA

Adults

The recommended dose is 60 milligrams a day taken in the morning. The doctor may start you at a lower dose and gradually increase it over a period of several days.

PANIC DISORDER

Adults

The recommended starting dose is 10 milligrams a day. After 1 week, the doctor will increase the dose to 20 milligrams. If no improvement is seen after several weeks, the doctor may increase the dose to a maximum of 60 milligrams a day.

PREMENSTRUAL DYSPHORIC DISORDER

Adults

The usual dose of Sarafem is 20 milligrams a day. The doctor will instruct you to take the dose either every day of the month or only during the 2 weeks before menstruation begins (the luteal phase of your cycle). If there’s no improvement after several weeks, the dose can be increased, usually to 60 milligrams a day. The maximum dose is 80 milligrams daily.

DOSAGE ADJUSTMENT

For all indications, the doctor may need to prescribe a lower dose if you are elderly, have liver disease, or are taking other medications.

Overdosage

Any medication taken in excess can have serious consequences. An overdose of Prozac can be fatal. In addition, combining Prozac with certain other drugs can cause symptoms of overdose. If you suspect an overdose, seek medical attention immediately.

• Common symptoms of Prozac overdose include:
  Nausea, rapid heartbeat, seizures, sleepiness, vomiting

• Other symptoms of Prozac overdose include:
  Coma, delirium, fainting, high fever, irregular heartbeat, low blood pressure, mania, rigid muscles, sweating, stupor