Brand names: Loestrin 24 FE
Why is Norethindrone acetate, Ethinyl estradiol prescribed?
Loestrin 24 FE is an oral contraceptive pill for the prevention of pregnancy.
Most important fact about Norethindrone acetate, Ethinyl estradiol
This product (like all oral contraceptives) is intended to prevent pregnancy. It does not protect against HIV infection (AIDS) and other sexually transmitted diseases.
Cigarette smoking increases the risk of serious problems with your heart and blood vessels from oral contraceptive use. This risk increases with age and with the amount of smoking (15 or more cigarettes per day) and is apparent in women over 35 years of age. Women who use oral contraceptives should not smoke.
How should you take Norethindrone acetate, Ethinyl estradiol?
Take one pill of Loestrin 24 FE every day at the same time, with or without food.
- If you miss a dose…
If you forget to take your pill, take it as soon as you remember. It is okay to take 2 pills in one day, though it may cause you to be slightly nauseous.
- Storage instructions…
Store at room temperature in a dry area.
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 Norethindrone acetate, Ethinyl estradiol.
- Side effects may include:
Bleeding or spotting between menstrual periods, breast tenderness, difficulty wearing contact lenses, nausea, vomiting, weight gain
These side effects, especially nausea and vomiting, may decrease or subside within the first 3 months of use.
Why should Norethindrone acetate, Ethinyl estradiol not be prescribed?
Do not take Loestrin 24 FE if you have blood clotting disorders, kidney or liver disease, heart disease, headaches, or a history of breast, uterine, or ovarian cancer. Also, if you plan to have surgery that will leave you immobile for a period of time, you should not use this type of birth control. Loestrin 24 FE should not be used if you are pregnant or planning to become pregnant.
Special warnings about Norethindrone acetate, Ethinyl estradiol
Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Loestrin 24 FE. Also, talk to your doctor about your complete medical history, especially if you have high blood pressure, diabetes, heart problems, liver or kidney problems, or if you have had any type of cancer (especially breast), a heart attack, or a stroke. Your doctor should know if you have unexplained vaginal bleeding, recently had an abortion or miscarriage, recently had a baby, or you are pregnant.
Possible food and drug interactions when taking Norethindrone acetate, Ethinyl estradiol
If Loestrin 24 FE 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 Loestrin 24 FE with the following:
Antibiotics
Anticonvulsants
HIV medicines
Herbal medicine (such as St. John’s wort)
Special information if you are pregnant or breastfeeding
You should not use Loestrin 24 FE if you are pregnant, planning to become pregnant, or are breastfeeding.
Recommended dosage for Norethindrone acetate, Ethinyl estradiol
ADULTS
Loestrin 24 FE should be taken in the dosage prescribed by your doctor, every 24 hours.
Overdosage
Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.
Norethindrone acetate
30/06/10
Brand names: Aygestin
Why is Norethindrone acetate prescribed?
Aygestin contains a type of hormone known as progesterone. It is used to restore menstruation in women who have stopped having menstrual cycles (also called amenorrhea). Aygestin can also help treat endometriosis, a condition where the endometrium (the lining of the uterus) doesn’t shed properly and attaches to the outside of the uterus or other areas such as the ovaries or bowels. Aygestin also helps control unusual and heavy bleeding of the uterus caused by hormonal imbalance. However, the drug is not used to control bleeding caused by fibroids or cancer.
Most important fact about Norethindrone acetate
Aygestin increases the risk of blood clots, which can lead to phlebitis, breathing problems, vision problems, or stroke. If you experience any symptoms that might suggest the onset of a clot-related disorder—pain with swelling, warmth and redness in a leg vein, coughing or shortness of breath, loss of vision or double vision, migraine, or weakness or numbness in an arm or leg—stop taking Aygestin and see your doctor immediately.
How should you take Norethindrone acetate?
Take Aygestin as directed by 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.
What side effects may occur?
All progesterone drugs are associated with certain side effects, none of which can be anticipated. If any side effects develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine whether it is safe for you to continue taking Aygestin.
- Side effects caused by progesterone drugs may include:
Acne, allergic reaction, blood clots in the arteries, veins, eyes, or lungs, breakthrough menstrual bleeding, breast enlargement or tenderness, bulging eye, depression, double vision, cervical changes or secretions, change in menstrual flow, headache, hives, inflammation of the optic nerve, insomnia, menstrual spotting, migraine, mood swings, nausea, rash with or without itchy spots, skin discoloration, stopping of menstrual flow, swelling, vision loss, weight increase or decrease, yellowing of the skin or eyes
- Side effects caused by estrogen/progesterone combinations may include:
Appetite changes, backache, blood pressure increase, bull’s-eye rash, changes in appetite, changes in sex drive, dizziness, fatigue, hair growth or loss, headache, inflammation of the urinary tract, itching, nervousness, skin bruising, symptoms similar to premenstrual syndrome, red or tender skin nodules
Why should Norethindrone acetate not be prescribed?
Do not take Aygestin if you have ever had an allergic reaction to it.
Do not take Aygestin if you are pregnant or have had an incomplete miscarriage. Avoid it if you have ever had a blood clotting disorder or a stroke. Do not take Norethindrone acetate if you have breast cancer, unexplained vaginal bleeding, or severe liver disease.
Aygestin should not be used to test for pregnancy.
Special warnings about Norethindrone acetate
Remember that Aygestin can cause clot-related disorders. Check with your doctor immediately if you experience any of the warning signs listed in “Most important fact about Norethindrone acetate.”
To rule out cancer and other problems before you start taking Aygestin, your doctor will give you a complete physical exam, including examination of your breasts and pelvic organs. You also should have a Pap test (cervical smear).
Aygestin may cause some degree of fluid retention. If you have a medical condition that could be made worse by fluid retention—such as epilepsy, migraine, asthma, or a heart or kidney problem—make sure your doctor knows about it.
Be sure to tell your doctor if you experience any irregular or unexplained vaginal bleeding while taking Norethindrone acetate.
Aygestin makes some women depressed. If you’ve suffered from serious depression in the past, alert your doctor if you think you’re having a relapse. You will probably need to stop taking Aygestin.
The long-term effects of drugs such as Aygestin on the function of certain organs—including the pituitary, ovaries, adrenal glands, liver, and uterus—are unknown.
Aygestin may affect cholesterol and blood-sugar levels. If you have diabetes or high cholesterol, your doctor will want to watch you closely while you are taking Norethindrone acetate.
Aygestin may mask the onset of menopause. However, women who are of menopausal age are still eligible to take the drug.
If you’re being screened for cancer, make sure the doctor or lab technician knows you are taking Aygestin.
Possible food and drug interactions when taking Norethindrone acetate
If Aygestin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. Make sure your doctor knows about all the prescription and over-the-counter drugs you are taking.
In general, when you are taking a progesterone drug such as Aygestin, it is especially important to check with your doctor before taking the following:
Aminoglutethimide
Carbamazepine
Phenobarbital
Phenytoin
Rifabutin
Rifampin
Special information if you are pregnant or breastfeeding
Do not take Aygestin if you are pregnant or trying to become pregnant, since the drug may cause harm to a developing baby.
Aygestin appears in breast milk. Because the effect of Aygestin on a nursing infant is unknown, it is best to avoid the drug while breastfeeding unless it’s clearly necessary.
Recommended dosage for Norethindrone acetate
To prevent abnormal uterine bleeding due to hormonal imbalance or to restore menstrual periods
The usual dose is 2.5 to 10 milligrams a day taken for 5 to 10 days during the second half of a 28-day cycle. Your period should start 3 to 7 days after you stop taking Aygestin.
To treat endometriosis
The recommended starting dose is 5 milligrams a day for 2 weeks. The doctor may increase your dose by 2.5 milligrams a day every 2 weeks up to a maximum of 15 milligrams a day. Treatment may continue for 6 to 9 months or until intolerable breakthrough bleeding occurs.
Overdosage
Although no specific information is available on Aygestin overdose, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.
Norco
30/06/10
Generic name: Hydrocodone bitartrate, Acetaminophen
Brand names: Zydone, Norco, Maxidone, Lorcet, Lortab, Hydrocet, Co-Gesic, Anexsia, Vicodin
Why is Norco prescribed?
Vicodin combines a narcotic analgesic (painkiller) and cough reliever with a non-narcotic analgesic for the relief of moderate to moderately severe pain.
Most important fact about Norco
Vicodin can be habit-forming. If you take Norco over a long period of time, you can become mentally and physically dependent on it, and you may find the drug no longer works for you at the prescribed dosage.
How should you take Norco?
Take Vicodin exactly as prescribed. Do not increase the amount you take or the frequency without your doctor’s approval. Do not take Norco for any reason other than the one prescribed.
Do not give Norco to others who may have similar symptoms.
- If you miss a dose…
If you take Vicodin regularly, take the forgotten dose 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…
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 Vicodin.
- Side effects may include:
Dizziness, light-headedness, nausea, sedation, vomiting
If these side effects occur, it may help if you lie down after taking the medication.
Why should Norco not be prescribed?
If you are sensitive to or have ever had an allergic reaction to hydrocodone, similar narcotic painkillers, or acetaminophen (Tylenol), you should not take Norco. Make sure your doctor is aware of any drug reactions you have experienced.
Special warnings about Norco
Vicodin may make you drowsy, less alert, or unable to function well physically. Do not drive a car, operate machinery, or perform any other potentially dangerous activities until you know how Norco affects you.
Use caution in taking Vicodin if you have a head injury. Narcotics tend to increase the pressure of the fluid within the skull, and this effect may be exaggerated by head injuries. Side effects of narcotics can interfere in the treatment of people with head injuries.
Use Vicodin with caution if you have a severe liver or kidney disorder, an underactive thyroid gland, Addison’s disease (a disease of the adrenal glands), an enlarged prostate, or urethral stricture (narrowing of the tube carrying urine from the bladder).
Older adults and those in a weakened condition should be careful using Norco, since it contains a narcotic.
Narcotics such as Vicodin may interfere with the diagnosis and treatment of people with abdominal conditions.
Hydrocodone suppresses the cough reflex; therefore, be careful using Vicodin after an operation or if you have a lung disease.
High doses of hydrocodone may produce slowed breathing; if you are sensitive to Norco, you are more likely to experience this effect.
Possible food and drug interactions when taking Norco
Hydrocodone slows the nervous system. Alcohol can intensify this effect.
If hydrocodone is taken with certain other drugs, the effects of either may be increased, decreased, or altered. It is especially important to check with your doctor before combining Vicodin with the following:
Antianxiety drugs such as Valium and Librium
Antidepressant medications classified as “tricyclics,” such as Elavil and Tofranil
Antihistamines such as Tavist
Drugs classified as MAO inhibitors, including the antidepressants Nardil and Parnate
Major tranquilizers such as Thorazine and Haldol
Other narcotic analgesics such as Demerol
Other central nervous system depressants such as Halcion and Restoril
Special information if you are pregnant or breastfeeding
The effects of Vicodin in pregnancy have not been adequately studied. Do not take Norco if you are pregnant or plan to become pregnant unless you are directed to do so by your doctor. Drug dependence occurs in newborns when the mother has taken Norco regularly prior to delivery. If you take it shortly before delivery, the baby’s breathing may be slowed. Acetaminophen does, and hydrocodone may, appear in breast milk and could affect a nursing infant. If Norco is essential to your health, your doctor may advise you to discontinue breastfeeding your baby until your treatment is finished.
Recommended dosage for Norco
ADULTS
Your doctor will adjust the dosage according to the severity of the pain and the way the medication affects you.
The dosages given below are for Vicodin products only. If your doctor prescribes other brands, your daily dose may vary.
All forms of Vicodin are taken every 4 to 6 hours as needed for pain. The usual dose of Vicodin is 1 or 2 tablets, up to a maximum of 8 tablets per day. The usual dose of Vicodin HP is 1 tablet, up to a maximum of 6 tablets per day. For Vicodin ES, the usual dose is 1 tablet, up to a maximum of 5 tablets per day.
CHILDREN
The safety and effectiveness of Vicodin have not been established in children.
Overdosage
Any medication taken in excess can have serious consequences. A severe overdose of Vicodin can be fatal. If you suspect an overdose, seek emergency medical treatment immediately.
- Symptoms of a Vicodin overdose include:
Blood disorders, bluish tinge to skin, cold and clammy skin, extreme sleepiness progressing to a state of unresponsiveness or coma, general feeling of bodily discomfort, hearing impairment, heart problems, heavy perspiration, kidney problems, limp muscles, liver failure, low blood pressure, nausea, slow heartbeat, troubled or slowed breathing, vomiting
Nolvadex
30/06/10
Generic name: Tamoxifen citrate
Brand names: Nolvadex
Why is Nolvadex prescribed?
Nolvadex, an anticancer drug, is given to treat breast cancer. It also has proved effective when cancer has spread to other parts of the body. Nolvadex is most effective in stopping the kind of breast cancer that thrives on estrogen.
Nolvadex is also prescribed to reduce the risk of invasive breast cancer following surgery and radiation therapy for ductal carcinoma in situ. The drug can also be used to reduce the odds of breast cancer in women at high risk of developing the disease. It does not completely eliminate your chances, but in a five-year study of over 1,500 high-risk women, it slashed the number of cases by 44 percent.
Most important fact about Nolvadex
Although Nolvadex reduces the risk of breast cancer, it increases the possibility of developing endometrial (uterine) cancer. Women taking Nolvadex should have routine gynecological examinations and report any abnormal vaginal bleeding, changes in menstrual periods, change in vaginal discharge, or pelvic pain or pressure to the doctor immediately. Even after Nolvadex therapy has stopped, any abnormal vaginal bleeding should be reported at once.
How should you take Nolvadex?
Take Nolvadex exactly as prescribed. Do not stop taking Nolvadex without first consulting your doctor. It may be necessary to continue taking the drug for several years.
- If you miss a dose…
Do not try to make it up. Go back to your regular schedule with the next dose.
- Storage instructions…
Nolvadex may be stored at room temperature.
What side effects may occur?
Side effects from Nolvadex are usually mild and rarely require the drug to be stopped. 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 Nolvadex.
- Side effects may include:
Hot flashes, nausea, vomiting
Why should Nolvadex not be prescribed?
Do not take Nolvadex if you are sensitive to it or have ever had an allergic reaction to it.
If you are taking the blood-thinning drug warfarin or have had problems with clots in your veins or your lungs, you should not take Nolvadex to reduce the risk of breast cancer, and when taking it to treat an actual case of the disease, you should use it with caution.
Special warnings about Nolvadex
In addition to increasing the risk of uterine cancer, Nolvadex also raises the odds of developing endometriosis (the spread of endometrial tissue outside the uterus), uterine fibroids, uterine polyps, and ovarian cysts. Women who take Nolvadex also face a greater risk of stroke and blood clots lodging in their lungs. The risk increases further when Nolvadex is combined with toxic cancer drugs. Nolvadex can also cause liver damage, and should be used with caution if you already have liver problems.
If you experience visual problems while taking Nolvadex, notify your doctor immediately.
In a few women Nolvadex may raise the level of cholesterol and other fats in the blood. Your doctor may periodically do blood tests to check your cholesterol and triglyceride levels.
Nolvadex may produce an abnormally high level of calcium in the blood. Symptoms include muscle pain and weakness, loss of appetite, and, if severe, kidney failure. If you experience any of these symptoms, notify your doctor as soon as possible.
If tests show that your blood contains too few white blood cells or platelets while you are taking Nolvadex, your doctor should monitor you with special care. These problems have sometimes been found in women taking Nolvadex; whether the drug caused the blood-cell abnormalities is uncertain.
Possible food and drug interactions when taking Nolvadex
If Nolvadex 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 Nolvadex with the following:
Aminoglutethimide
Blood-thinning drugs such as warfarin
Bromocriptine
Cancer drugs such as cyclophosphamide
Letrozole
Phenobarbital
Rifampin
Special information if you are pregnant or breastfeeding
It is important to avoid pregnancy while taking Nolvadex, because the drug could harm the unborn child. Since Nolvadex is an anti-estrogen drug, you will need to use a non-hormonal form of contraception, such as a condom and/or diaphragm, and not birth control pills. If you accidentally become pregnant while taking Nolvadex, or within 2 months after you have stopped taking it, discuss this with your doctor immediately.
Because Nolvadex might cause serious harm to a nursing infant, you should not breastfeed your baby while taking Nolvadex. If Nolvadex is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.
Recommended dosage for Nolvadex
ADULTS
Breast Cancer Treatment
The daily dosage ranges from 20 to 40 milligrams. If you are taking more than 20 milligrams a day, your doctor will have you divide the total into 2 smaller doses taken in the morning and evening. Nolvadex comes in 10- and 20-milligram tablets.
Ductal Carcinoma in Situ
The recommended dose is 20 milligrams once daily for 5 years.
Breast Cancer Prevention
The recommended dose is 20 milligrams once a day for up to 5 years.
CHILDREN
Safety and efficacy in children have not been established.
Overdosage
Any medication taken in excess can have serious consequences. If you suspect an overdose of Nolvadex, seek medical attention immediately.
- Symptoms of Nolvadex overdose may include:
Dizziness, overactive reflexes, tremor, unsteady gait
Nitrostat Tablets
30/06/10
Brand names: Nitro-Bid, Nitro-Dur, Nitrolingual Spray, Nitrostat Tablets, Transderm-Nitro, Nitroglycerin
Why is Nitrostat Tablets prescribed?
Nitroglycerin is prescribed to prevent and treat angina pectoris (suffocating chest pain). This condition occurs when the coronary arteries become constricted and are not able to carry sufficient oxygen to the heart muscle. Nitroglycerin is thought to improve oxygen flow by relaxing the walls of arteries and veins, thus allowing them to dilate.
Nitroglycerin is used in different forms. As a patch or ointment, nitroglycerin may be applied to the skin. The patch and the ointment are for prevention of chest pain.
Swallowing nitroglycerin in capsule or tablet form also helps to prevent chest pain from occurring.
In the form of sublingual (held under the tongue) or buccal (held in the cheek) tablets, or in oral spray (sprayed on or under the tongue), nitroglycerin helps relieve chest pain that has already occurred. The spray can also prevent anginal pain. The type of nitroglycerin you use will depend on your condition.
Most important fact about Nitrostat Tablets
Nitroglycerin may cause severe low blood pressure (possibly marked by dizziness or light-headedness), especially if you are in an upright position or have just gotten up from sitting or lying down. You may also find your heart rate slowing and your chest pain increasing. People taking diuretic medication, or who have low systolic blood pressure (less than 90 mm Hg) should use nitroglycerin with caution.
How should you take Nitrostat Tablets?
Since nitroglycerin is available in many forms, it is crucial for you to follow your doctor’s directions for taking the type of nitroglycerin prescribed for you. Never interchange brands.
Ideally, you should take nitroglycerin while sitting down—especially if you feel dizzy or light-headed—so as to avoid a fall.
- If you miss a dose…
If you are using a skin patch or ointment:
Apply it as soon as you remember. If it is almost time for your regular dose, skip the one you missed and go back to your regular schedule. Never apply 2 skin patches at the same time. If you are taking oral tablets or capsules:
Take the forgotten dose as soon as you remember. However, if it is within 2 hours of 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…
Keep Nitrostat Tablets in the container it came in, tightly closed. Store it at room temperature. Do not refrigerate.
Avoid puncturing the spray container and keep it away from excess heat.
Do not open the container of sublingual tablets until you need a dose. Close the container tightly immediately after each use. Do not put other medications, a cotton plug, or anything else in the container. Keep the sublingual tablets handy at all times. Keep the patches in the protective pouches they come in until use.
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 nitroglycerin.
- Side effects may include:
Dizziness, flushed skin (neck and face), headache, light-headedness, worsened angina pain
Why should Nitrostat Tablets not be prescribed?
You should not be using nitroglycerin if you are allergic to it or to the adhesive in the patch, if you have a head injury, or if you have any condition caused by increased fluid pressure in your head. Nitroglycerin should not be taken if you have severe anemia or if you recently had a heart attack. The capsule form should not be used if you have closed-angle glaucoma (pressure in the eye) or suffer from postural hypotension (dizziness upon standing up). Do not take the tablets if you are using the impotence drug sildenafil.
Special warnings about Nitrostat Tablets
If your vision becomes blurry or your mouth becomes dry while taking nitroglycerin, it should be discontinued. Contact your doctor immediately if these symptoms develop.
You may develop acute headaches if you take nitroglycerin excessively. Also, some people may develop a tolerance to nitroglycerin, and it may become less beneficial over time, especially if used in excess.
Nitroglycerin tablets lose their effectiveness when exposed to air. If you are taking sublingual nitroglycerin, you may notice a burning or tingling sensation. This does not necessarily mean that tablets which have been exposed to air for a long period of time are still good.
Take no more than the smallest possible amount needed to relieve pain.
Daily headaches may be an indicator of the drug’s activity. Do not change your dose to avoid the headache, because you may reduce the drug’s effectiveness at the same time.
Before taking nitroglycerin, tell your doctor if you have had a recent heart attack, head injury, or stroke; or if you have anemia, glaucoma (pressure in the eye), or heart, kidney, liver, or thyroid disease.
If you use a patch, dispose of it carefully. There is enough drug left in a used patch to be harmful to children and pets.
Since nitroglycerin can cause dizziness, you should observe caution while driving, operating machinery, or performing other tasks that demand concentration.
The benefits of applying nitroglycerin to the skin of people experiencing heart attacks or congestive heart failure have not been established. If you are using the medication for these conditions, your doctor will monitor you to prevent low blood pressure and pounding heartbeat.
Possible food and drug interactions when taking Nitrostat Tablets
If nitroglycerin is taken with certain other drugs, the effects of either could be increased, decreased, or altered.
Taken with many high blood pressure drugs, nitroglycerin may cause extreme low blood pressure (dizziness, fainting, numbness). Take particular care with calcium channel blockers such as nifedipine and verapamil, as well as isosorbide dinitrate, isosorbide mononitrate, blood vessel dilators such as minoxidil, and beta-blocker medications such as atenolol. Nitroglycerin may also cause a severe drop in blood pressure when taken with the impotence drug sildenafil.
Aspirin can increase the effects of nitroglycerin.
Alcohol may interact with nitroglycerin and cause a swift decrease in blood pressure, possibly causing dizziness and fainting.
Also be alert for an interaction with dihydroergotamine. Check with your doctor if you are uncertain about any combination you plan to take.
Special information if you are pregnant or breastfeeding
It has not been determined whether nitroglycerin might harm a fetus or a pregnant woman. As a result, nitroglycerin should be used only when the benefits of therapy clearly outweigh the potential risks to the fetus and woman. It is not known if nitroglycerin appears in breast milk; therefore, a nursing mother should use nitroglycerin only on advice of her doctor.
Recommended dosage for Nitrostat Tablets
The following section is intended to provide guidelines for taking nitroglycerin. Follow your doctor’s instructions carefully for using nitroglycerin in the form prescribed for you.
ADULTS
Sublingual or Buccal Tablets
At the first sign of chest pain, 1 tablet should be dissolved under the tongue or inside the cheek. You may repeat the dose every 5 minutes until the pain is relieved. If your pain continues after you have taken 3 tablets in a 15-minute period, notify your doctor or seek medical attention immediately.
You may take sublingual or buccal nitroglycerin from 5 to 10 minutes before starting activities that may cause chest pain.
Patch Form
A patch is applied to the skin for 12 to 14 hours. After this time, the patch is removed; it is not applied again for 10 to 12 hours (a “patch-off” period). Apply the patch as soon as you remove it from its protective pouch.
Spray Form
At the first sign of chest pain, spray 1 or 2 pre-measured doses onto or under the tongue. You should not use more than 3 doses within a 15-minute period. If your chest pain continues, you should contact your doctor or seek medical attention immediately.
The spray can be used 5 to 10 minutes before activity that might precipitate an attack.
Ointment Form
Your initial dose may be a daily total of 1 inch of ointment. Apply one-half inch on rising in the morning, and the remaining one-half inch 6 hours later. If needed, follow your doctor’s instructions for increasing your dosage. Apply in a thin, uniform layer, regardless of the amount of your dosage. There should be a daily period where no ointment is applied. Usually, the “ointment-off” period will last from 10 to 12 hours.
Absorption varies with site of application—more is absorbed through the chest.
Sustained-Release Capsules or Tablets
The smallest effective amount should be taken 2 or 3 times a day at 8- to 12-hour intervals.
CHILDREN
The safety and effectiveness of nitroglycerin have not been established for children.
OLDER ADULTS
In general, dosages less than the above adult dosages are recommended, since the elderly may be more susceptible to low blood pressure and headaches.
Overdosage
Any medication taken in excess can have serious consequences. Severe overdosage of nitroglycerin may result in death. If you suspect an overdose, seek medical attention immediately.
- Symptoms of overdose may include:
Bluish skin, clammy skin, colic, coma, confusion, diarrhea (may be bloody), difficult and/or slow breathing, dizziness, fainting, fever, flushed skin, headache (persistent, throbbing), increased pressure within the skull, irregular pulse, loss of appetite, nausea, palpitations (an abnormally rapid throbbing or fluttering of the heart), paralysis, rapid decrease in blood pressure, seizures, slow or fast pulse/heartbeat, sweating, vertigo, visual disturbances, vomiting
Nitrolingual Spray
30/06/10
Brand names: Nitro-Bid, Nitro-Dur, Nitrolingual Spray, Nitrostat Tablets, Transderm-Nitro, Nitroglycerin
Why is Nitrolingual Spray prescribed?
Nitroglycerin is prescribed to prevent and treat angina pectoris (suffocating chest pain). This condition occurs when the coronary arteries become constricted and are not able to carry sufficient oxygen to the heart muscle. Nitroglycerin is thought to improve oxygen flow by relaxing the walls of arteries and veins, thus allowing them to dilate.
Nitroglycerin is used in different forms. As a patch or ointment, nitroglycerin may be applied to the skin. The patch and the ointment are for prevention of chest pain.
Swallowing nitroglycerin in capsule or tablet form also helps to prevent chest pain from occurring.
In the form of sublingual (held under the tongue) or buccal (held in the cheek) tablets, or in oral spray (sprayed on or under the tongue), nitroglycerin helps relieve chest pain that has already occurred. The spray can also prevent anginal pain. The type of nitroglycerin you use will depend on your condition.
Most important fact about Nitrolingual Spray
Nitroglycerin may cause severe low blood pressure (possibly marked by dizziness or light-headedness), especially if you are in an upright position or have just gotten up from sitting or lying down. You may also find your heart rate slowing and your chest pain increasing. People taking diuretic medication, or who have low systolic blood pressure (less than 90 mm Hg) should use nitroglycerin with caution.
How should you take Nitrolingual Spray?
Since nitroglycerin is available in many forms, it is crucial for you to follow your doctor’s directions for taking the type of nitroglycerin prescribed for you. Never interchange brands.
Ideally, you should take nitroglycerin while sitting down—especially if you feel dizzy or light-headed—so as to avoid a fall.
- If you miss a dose…
If you are using a skin patch or ointment:
Apply it as soon as you remember. If it is almost time for your regular dose, skip the one you missed and go back to your regular schedule. Never apply 2 skin patches at the same time. If you are taking oral tablets or capsules:
Take the forgotten dose as soon as you remember. However, if it is within 2 hours of 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…
Keep Nitrolingual Spray in the container it came in, tightly closed. Store it at room temperature. Do not refrigerate.
Avoid puncturing the spray container and keep it away from excess heat.
Do not open the container of sublingual tablets until you need a dose. Close the container tightly immediately after each use. Do not put other medications, a cotton plug, or anything else in the container. Keep the sublingual tablets handy at all times. Keep the patches in the protective pouches they come in until use.
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 nitroglycerin.
- Side effects may include:
Dizziness, flushed skin (neck and face), headache, light-headedness, worsened angina pain
Why should Nitrolingual Spray not be prescribed?
You should not be using nitroglycerin if you are allergic to it or to the adhesive in the patch, if you have a head injury, or if you have any condition caused by increased fluid pressure in your head. Nitroglycerin should not be taken if you have severe anemia or if you recently had a heart attack. The capsule form should not be used if you have closed-angle glaucoma (pressure in the eye) or suffer from postural hypotension (dizziness upon standing up). Do not take the tablets if you are using the impotence drug sildenafil.
Special warnings about Nitrolingual Spray
If your vision becomes blurry or your mouth becomes dry while taking nitroglycerin, it should be discontinued. Contact your doctor immediately if these symptoms develop.
You may develop acute headaches if you take nitroglycerin excessively. Also, some people may develop a tolerance to nitroglycerin, and it may become less beneficial over time, especially if used in excess.
Nitroglycerin tablets lose their effectiveness when exposed to air. If you are taking sublingual nitroglycerin, you may notice a burning or tingling sensation. This does not necessarily mean that tablets which have been exposed to air for a long period of time are still good.
Take no more than the smallest possible amount needed to relieve pain.
Daily headaches may be an indicator of the drug’s activity. Do not change your dose to avoid the headache, because you may reduce the drug’s effectiveness at the same time.
Before taking nitroglycerin, tell your doctor if you have had a recent heart attack, head injury, or stroke; or if you have anemia, glaucoma (pressure in the eye), or heart, kidney, liver, or thyroid disease.
If you use a patch, dispose of it carefully. There is enough drug left in a used patch to be harmful to children and pets.
Since nitroglycerin can cause dizziness, you should observe caution while driving, operating machinery, or performing other tasks that demand concentration.
The benefits of applying nitroglycerin to the skin of people experiencing heart attacks or congestive heart failure have not been established. If you are using the medication for these conditions, your doctor will monitor you to prevent low blood pressure and pounding heartbeat.
Possible food and drug interactions when taking Nitrolingual Spray
If nitroglycerin is taken with certain other drugs, the effects of either could be increased, decreased, or altered.
Taken with many high blood pressure drugs, nitroglycerin may cause extreme low blood pressure (dizziness, fainting, numbness). Take particular care with calcium channel blockers such as nifedipine and verapamil, as well as isosorbide dinitrate, isosorbide mononitrate, blood vessel dilators such as minoxidil, and beta-blocker medications such as atenolol. Nitroglycerin may also cause a severe drop in blood pressure when taken with the impotence drug sildenafil.
Aspirin can increase the effects of nitroglycerin.
Alcohol may interact with nitroglycerin and cause a swift decrease in blood pressure, possibly causing dizziness and fainting.
Also be alert for an interaction with dihydroergotamine. Check with your doctor if you are uncertain about any combination you plan to take.
Special information if you are pregnant or breastfeeding
It has not been determined whether nitroglycerin might harm a fetus or a pregnant woman. As a result, nitroglycerin should be used only when the benefits of therapy clearly outweigh the potential risks to the fetus and woman. It is not known if nitroglycerin appears in breast milk; therefore, a nursing mother should use nitroglycerin only on advice of her doctor.
Recommended dosage for Nitrolingual Spray
The following section is intended to provide guidelines for taking nitroglycerin. Follow your doctor’s instructions carefully for using nitroglycerin in the form prescribed for you.
ADULTS
Sublingual or Buccal Tablets
At the first sign of chest pain, 1 tablet should be dissolved under the tongue or inside the cheek. You may repeat the dose every 5 minutes until the pain is relieved. If your pain continues after you have taken 3 tablets in a 15-minute period, notify your doctor or seek medical attention immediately.
You may take sublingual or buccal nitroglycerin from 5 to 10 minutes before starting activities that may cause chest pain.
Patch Form
A patch is applied to the skin for 12 to 14 hours. After this time, the patch is removed; it is not applied again for 10 to 12 hours (a “patch-off” period). Apply the patch as soon as you remove it from its protective pouch.
Spray Form
At the first sign of chest pain, spray 1 or 2 pre-measured doses onto or under the tongue. You should not use more than 3 doses within a 15-minute period. If your chest pain continues, you should contact your doctor or seek medical attention immediately.
The spray can be used 5 to 10 minutes before activity that might precipitate an attack.
Ointment Form
Your initial dose may be a daily total of 1 inch of ointment. Apply one-half inch on rising in the morning, and the remaining one-half inch 6 hours later. If needed, follow your doctor’s instructions for increasing your dosage. Apply in a thin, uniform layer, regardless of the amount of your dosage. There should be a daily period where no ointment is applied. Usually, the “ointment-off” period will last from 10 to 12 hours.
Absorption varies with site of application—more is absorbed through the chest.
Sustained-Release Capsules or Tablets
The smallest effective amount should be taken 2 or 3 times a day at 8- to 12-hour intervals.
CHILDREN
The safety and effectiveness of nitroglycerin have not been established for children.
OLDER ADULTS
In general, dosages less than the above adult dosages are recommended, since the elderly may be more susceptible to low blood pressure and headaches.
Overdosage
Any medication taken in excess can have serious consequences. Severe overdosage of nitroglycerin may result in death. If you suspect an overdose, seek medical attention immediately.
- Symptoms of overdose may include:
Bluish skin, clammy skin, colic, coma, confusion, diarrhea (may be bloody), difficult and/or slow breathing, dizziness, fainting, fever, flushed skin, headache (persistent, throbbing), increased pressure within the skull, irregular pulse, loss of appetite, nausea, palpitations (an abnormally rapid throbbing or fluttering of the heart), paralysis, rapid decrease in blood pressure, seizures, slow or fast pulse/heartbeat, sweating, vertigo, visual disturbances, vomiting
Nitrofurantoin
30/06/10
Brand names: Macrobid, Macrodantin
Why is Nitrofurantoin prescribed?
Nitrofurantoin, an antibacterial drug, is prescribed for the treatment of urinary tract infections caused by certain strains of bacteria.
Most important fact about Nitrofurantoin
Breathing disorders have occurred in people taking nitrofurantoin. The drug can cause inflammation of the lungs marked by coughing, difficulty breathing, and wheezing. It has also been known to cause pulmonary fibrosis (an abnormal increase in fibrous tissue of the lungs). This condition can develop gradually without symptoms and can be fatal. An allergic reaction to Nitrofurantoin is also possible and may occur without warning. Symptoms include a feeling of ill health and a persistent cough. However, all these reactions occur rarely and generally in those receiving nitrofurantoin therapy for 6 months or longer.
Sudden and severe lung reactions are characterized by fever, chills, cough, chest pain, and difficulty breathing. These acute reactions usually occur within the first week of treatment and subside when therapy with nitrofurantoin is stopped.
Your doctor should monitor your condition closely, especially if you are receiving long-term treatment with Nitrofurantoin.
How should you take Nitrofurantoin?
To improve absorption of the drug, nitrofurantoin should be taken with food.
Your doctor will only prescribe Macrodantin to treat a bacterial infection. Macrodantin will not cure a viral infection such as the common cold. It’s important to take all of your medication as instructed by your doctor, even if you’re feeling better in a few days. Skipping doses or not finishing the complete dosage of Macrodantin may decrease the drug’s effectiveness and increase the chances of bacterial resistance to Macrodantin and similar antibiotics.
This medication works best if your urine is acidic. Ask your doctor whether you should be taking special measures to assure its acidity.
Nitrofurantoin may turn the urine brown.
- If you miss a dose…
Take the forgotten dose as soon as you remember, then space out the rest of the day’s doses at equal intervals.
- Storage instructions…
Store at room temperature. Protect from light and keep the container tightly closed.
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 nitrofurantoin.
- Side effects may include:
Lack or loss of appetite, nausea, vomiting
Why should Nitrofurantoin not be prescribed?
If you are sensitive to or have ever had an allergic reaction to nitrofurantoin or other drugs of this type, such as furazolidone, you should not take Nitrofurantoin. Make sure that your doctor is aware of any drug reactions that you have experienced.
Unless you are directed to do so by your doctor, do not take Nitrofurantoin if you have poor kidneys, producing little or no urine.
Nitrofurantoin should not be taken at term of pregnancy or during labor and delivery; it should not be given to infants under 1 month of age.
Special warnings about Nitrofurantoin
Tell your doctor if you have any unusual symptoms while you are taking Nitrofurantoin.
Fatalities have been reported from hepatitis (liver disease) during treatment with nitrofurantoin. Long-lasting, active hepatitis can develop without symptoms; therefore, if you are receiving long-term treatment with Nitrofurantoin, your doctor should test your liver function periodically.
Fatalities from peripheral neuropathy—a disease of the nerves—have also been reported in people taking nitrofurantoin. Conditions such as a kidney disorder, anemia, diabetes mellitus, a debilitating disease, or a vitamin B deficiency make peripheral neuropathy more likely. If you develop symptoms such as muscle weakness or lack of sensation, check with your doctor immediately.
If you experience diarrhea, tell your doctor. It may be a sign of serious intestinal inflammation.
Hemolytic anemia (destruction of red blood cells) has occurred in people taking nitrofurantoin.
Continued or prolonged use of Nitrofurantoin may result in growth of bacteria that do not respond to it. This can cause a renewed infection, so it is important that your doctor monitor your condition on a regular basis.
Possible food and drug interactions when taking Nitrofurantoin
If nitrofurantoin 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 nitrofurantoin with the following:
Magnesium trisilicate
The gout drugs probenecid and sulfinpyrazone and other drugs that increase the amount of uric acid in the urine
Special information if you are pregnant or breastfeeding
The safety of nitrofurantoin during pregnancy and breastfeeding has not been established. Nitrofurantoin does appear in human breast milk. If you are pregnant or breastfeeding or you plan to become pregnant or breastfeed, inform your doctor immediately.
Recommended dosage for Nitrofurantoin
Treatment with nitrofurantoin should be continued for 1 week or for at least 3 days after obtaining a urine specimen free of infection. If your infection has not cleared up, your doctor should re-evaluate your case.
ADULTS
The recommended dosage of Macrodantin is 50 to 100 milligrams taken 4 times a day. For long-term treatment, your doctor may reduce your dosage to 50 to 100 milligrams taken at bedtime.
The recommended dosage of Macrobid is one 100 milligram capsule every 12 hours for 7 days.
CHILDREN
This medication should not be prescribed for children under 1 month of age.
The recommended daily dosage of Macrodantin for infants and children over 1 month of age is 5 to 7 milligrams per 2.2 pounds of body weight, divided into 4 doses over 24 hours.
For the long-term treatment of children, the doctor may prescribe daily doses as low as 1 milligram per 2.2 pounds of body weight taken in 1 or 2 doses per day.
The dosage of Macrobid for children over 12 years of age is one 100 milligram capsule every 12 hours for 7 days. Safety and effectiveness have not been established for children under 12.
OLDER ADULTS
Doctors tend to prescribe lower doses of Macrodantin for older adults. The drug is more likely to cause lung and liver problems in members of this group; and because more older adults have poor kidneys, the risk of toxic reactions to Macrodantin is also greater.
Overdosage
An overdose of nitrofurantoin does not cause any specific symptoms other than vomiting. If vomiting does not occur soon after an excessive dose, it should be induced.
If you suspect an overdose, seek emergency medical treatment immediately.
Nifedipine
30/06/10
Brand names: Procardia XL, Adalat CC, Adalat, Procardia
Why is Nifedipine prescribed?
Procardia and Procardia XL are used to treat angina (chest pain caused by lack of oxygen to the heart due to clogged arteries or spasm of the arteries). Procardia XL is also used to treat high blood pressure. Procardia and Procardia XL are calcium channel blockers. They ease the workload of the heart by relaxing the muscles in the walls of the arteries, allowing them to dilate. This improves blood flow through the heart and throughout the body, reduces blood pressure, and helps prevent angina. Procardia XL is taken once a day and provides a steady rate of medication over a 24-hour period.
Most important fact about Nifedipine
If you have high blood pressure, you must take Procardia XL regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Procardia XL; and you must continue taking it even if you are feeling well. Procardia XL does not cure high blood pressure; it merely keeps it under control.
How should you take Nifedipine?
Procardia and Procardia XL should be taken exactly as prescribed by your doctor, even if your symptoms have disappeared.
Procardia XL tablets are specially designed to release the medication into your bloodstream slowly. As a result, something that looks like a tablet may occasionally appear in your stool. This is normal and simply means that the medication has been released, and the shell that contained the medication has been eliminated from your body.
Procardia and Procardia XL tablets should be swallowed whole. Do not break, crush, or chew.
Procardia and Procardia XL can be taken with or without food. Adalat CC should be taken on an empty stomach.
Do not substitute another brand of nifedipine for Procardia or Procardia XL unless your doctor directs.
Procardia XL should be taken once a day. You can take it in the morning or evening, but should hold to the same time each day.
- If you miss a dose…
Take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed. Never take 2 doses at the same time.
- Storage instructions…
Procardia and Procardia XL can be stored at room temperature. Protect from moisture, light, humidity, and excessive heat.
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 whether it is safe for you to continue taking Procardia or Procardia XL.
- Side effects may include:
Constipation, cough, dizziness, fatigue, flushing, giddiness, headache, heartburn, heat sensation, light-headedness, mood changes, muscle cramps, nasal congestion, nausea, sore throat, swelling of arms, legs, hands, and feet, tremors, wheezing
Why should Nifedipine not be prescribed?
Procardia should not be used if you have ever had an allergic reaction to it or are sensitive to it or other calcium channel blockers. Make sure your doctor is aware of any drug reactions you have experienced.
Special warnings about Nifedipine
Procardia and Procardia XL may cause your blood pressure to become too low, which may make you feel light-headed or faint. This is more likely to happen when you start taking the medication and when the amount you take is increased. It is also more likely to occur if you are also taking a beta-blocker heart medication. Your doctor should check your blood pressure when you start taking Procardia or Procardia XL and continue monitoring it while your dosage is being adjusted.
Procardia XL can be used for high blood pressure; plain Procardia should be used only for angina—NOT for high blood pressure.
Do not take Procardia for the first week or two following a heart attack, or if you are in danger of a heart attack.
There is a remote possibility of experiencing increased angina when you start taking Procardia or Procardia XL, or when your dosage is increased. If this happens, contact your doctor immediately.
You may have angina pain if you suddenly stop taking beta blockers when beginning Procardia therapy. Your doctor will taper you off the other drug.
If you have tight aortic stenosis (a narrowing of the aortic valve that obstructs blood flow from the heart to the body) and have been taking a beta blocker, your doctor will monitor you carefully while you are taking Procardia or Procardia XL.
If you develop swelling of the arms, hands, legs, and feet, your doctor can prescribe a diuretic (water pill) to relieve the problem.
Procardia XL should be used cautiously if you have any stomach or intestinal narrowing.
Notify your doctor or dentist that you are taking Procardia if you have a medical emergency, and before you have surgery or dental treatment.
This drug is not recommended for use in children.
Possible food and drug interactions when taking Nifedipine
If Procardia or Procardia XL 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 Procardia or Procardia XL with the following:
Acarbose
Adalat CC
Amprenavir
Atanazavir
Benazepril
Carbamazepine
Cimetidine
Coumarins
Delavirine
Diltiazem
Digoxin
Doxazosin
Erythromycin
Fluconazole
Fosamprinavir
Indinavir
Itraconazole
Ketoconazole
Metformin
Nefazodone
Nelfinavir
Phenobarbitone
Phenytoin
Quinidine
Quinupristin/Dalfopristin
Rifampin
Rifapentine
Ritonavir
St. John’s wort
Tacrolimus
Timolol
Valproic acid
Verapamil
Taking Procardia with grapefruit juice can dramatically increase the effect of the drug. Do not combine the two.
Special information if you are pregnant or breastfeeding
The effects of Procardia and Procardia XL during pregnancy have not been adequately studied, although new animal research points to possible birth defects in humans. If you are pregnant or plan to become pregnant, inform your doctor immediately. It is not known whether Procardia or Procardia XL appears in breast milk and can affect a nursing infant. If Nifedipine is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.
Recommended dosage for Nifedipine
ADULTS
The usual starting dose of Procardia and Adalat is one 10-milligram capsule, 3 times a day. The usual range is 10 to 20 milligrams 3 times a day. Some people may need 20 to 30 milligrams, 3 or 4 times a day. Usually you will not take more than 120 milligrams in a day and should take no more than 180 milligrams.
The starting dose of Procardia XL and Adalat CC is usually a 30- or 60-milligram tablet, taken once daily. Your doctor may increase the dose over 1 to 2 weeks if not satisfied with the way the drug is working. Doses above 120 milligrams per day are not recommended.
Although no serious side effects have been reported when Procardia XL is stopped, your doctor will probably have you lower the dose gradually under close supervision.
Overdosage
Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical treatment immediately.
- Symptoms of Procardia overdose may include:
Dizziness, drowsiness, nausea, severe drop in blood pressure, slurred speech, weakness
Nicotrol NS
30/06/10
Generic name: Nicotine nasal spray
Brand names: Nicotrol NS
Why is Nicotrol NS prescribed?
Nicotrol NS is used to relieve withdrawal symptoms in people who are attempting to give up smoking. It should be used as part of a comprehensive smoking cessation program.
Most important fact about Nicotrol NS
If you continue to smoke and take Nicotrol NS at the same time, you may experience side effects due to high nicotine levels in your body.
How should you take Nicotrol NS?
You should stop smoking completely before you begin using Nicotrol NS. Tilt your head back slightly when administering the spray and be careful not to sniff, swallow, or inhale through the nose.
The amount of Nicotrol NS you require depends on your individual needs. One dose is made up of 1 spray in each nostril. The recommended starting regimen is 1 or 2 doses per hour. This may be increased to a maximum of 40 doses (80 sprays) per day if you’ve been a heavy smoker. Take at least 8 doses (16 sprays) per day; anything less is unlikely to be effective.
- 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, away from children and pets.
What side effects may occur?
Problems experienced by people using Nicotrol NS include nicotine withdrawal symptoms, common complaints of smokers, and local effects of the spray. Most people report some nasal irritation, which usually diminishes with continued use of the product. Other side effects are unpredictable. 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 Nicotrol NS.
- More common side effects may include:
Abdominal pain, acne, back pain, confusion, cough, dental problems, difficulty breathing, gas, gum problems, headache, itching, joint pain, menstrual pain or disorders, muscle aches, nasal irritation, nausea, palpitations, runny nose, sneezing, throat irritation, watering eyes
- Rare side effects may include:
Abnormal vision, allergy, amnesia, asthma, bronchitis, bruises, burning of the nose or eyes, change in sense of smell, diarrhea, dry mouth, earache, eye irritation, facial flushing, hiccups, hoarseness, inability to comprehend words, increased sputum, migraine, nasal congestion, nasal ulcer or blister, nosebleeds, numbness, numbness of the nose or mouth, pain, rash, sinus irritation, sore throat, swelling due to fluid retention, taste alteration
Why should Nicotrol NS not be prescribed?
Do not use Nicotrol NS if you are allergic to nicotine or if you have ever had a hypersensitivity reaction to it.
Special warnings about Nicotrol NS
Stop smoking completely when you start using Nicotrol NS. The extra nicotine it delivers could lead to a toxic overdose. If you’re still smoking after 4 weeks of Nicotrol NS therapy, check with your doctor. You should probably stop using the product.
It is possible to become dependent on Nicotrol NS. The product is less addictive than cigarettes, but nearly a third of the people using it report some feelings of dependence, and 15 to 20 percent use the product for longer than the recommended period. Remember, though, that Nicotrol NS has not been studied for more than 6 months and long-term use is not recommended.
Use Nicotrol NS with caution if you have a heart condition or a circulation problem. Avoid it completely if you’re recovering from a heart attack or have severe angina or serious heartbeat irregularities.
Nicotrol NS is not recommended for people with asthma. It can make the condition worse. You should also avoid Nicotrol NS if you have a chronic nasal disorder such as allergy, nasal polyps, nasal inflammation, or sinusitis. Use Nicotrol NS with caution if you have a glandular problem such as hyperthyroidism, pheochromocytoma, or insulin-dependent diabetes. Nicotine affects the glands. Caution is also warranted if you have an ulcer. Nicotine delays healing of ulcers.
Use Nicotrol NS cautiously, too, if you have serious high blood pressure. The product can make this condition worse.
Possible food and drug interactions when taking Nicotrol NS
When you quit smoking, the dosage of certain drugs may have to be changed. It is especially important to check with your doctor if you are taking one of the following:
Acetaminophen-containing products
Drugs classified as beta blockers, such as acebutolol, atenolol, and propranolol
Caffeine-containing products
Certain airway-opening products such as isoproterenol, oxymetazoline, and phenylephrine
Imipramine
Insulin
Labetalol
Oxazepam
Pentazocine
Prazosin
Theophylline
Special information if you are pregnant or breastfeeding
Nicotine from any source can harm a developing baby. If you’re pregnant, it’s best to quit without a nicotine replacement product. Use Nicotrol NS only if you think it will speed the moment that you’re nicotine free.
Nicotine makes its way into breast milk. A nursing infant may be exposed to less nicotine from Nicotrol NS than from cigarette smoking, but the best course is to avoid nicotine entirely.
Recommended dosage for Nicotrol NS
ADULTS
A dose is defined as 1 spray in each nostril. When you start Nicotrol NS, one or 2 doses per hour is recommended. Take no more than 5 doses per hour or 40 doses per day. During the treatment period, a minimum of 8 doses per day is usually needed for the drug to be effective.
If you succeed in avoiding cigarettes for 8 weeks of Nicotrol NS therapy, your doctor will instruct you to discontinue the spray over the next 4 to 6 weeks. Recommended strategies for discontinuation include:
Stop “cold turkey”
Cut each dose in half (1 spray instead of 2)
Use the spray less frequently
Keep a tally of daily usage and try to decrease the amount used each day
Skip doses by not medicating every hour
Set a planned quit date for stopping use of the spray
Overdosage
Nicotine can be especially toxic to children and pets. Even the residual nicotine in a used container of Nicotrol NS can be harmful. Keep all bottles of Nicotrol NS, used and unused, out of the reach of children.
If a bottle of Nicotrol NS breaks, the spill should be cleaned up immediately with an absorbent cloth or paper towel. Avoid contact with the skin. The area of the spill should be washed several times. If even a small amount of Nicotrol NS comes in contact with the skin, lips, mouth, eyes, or ears, rinse the affected area with water. Keep pets and children away from the area of the spill.
- Symptoms of Nicotrol NS overdose may include:
Abdominal pain, cold sweats, convulsions, diarrhea, disturbed hearing and vision, dizziness, headache, heart failure, nausea, pallor, prostration, hypotension, respiratory failure, salivation, tremor, mental confusion, vomiting, weakness
If you suspect an overdose, seek medical attention immediately.
Nicotrol
30/06/10