Generic name: Latanoprost
Brand names: Xalatan

Why is Xalatan prescribed?

Xalatan is used to relieve high pressure within the eye (a hallmark of the condition known as open-angle glaucoma). It can be prescribed alone or with other glaucoma medications.

Most important fact about Xalatan

Be careful not to let the tip of the Xalatan bottle touch your eye or anything else. Otherwise, the contents could become contaminated. A contaminated solution can cause an eye infection and lead to serious damage, including loss of vision.

How should you take Xalatan?

Use Xalatan exactly as prescribed. It should be applied only once a day; more frequent administration may reduce its effectiveness. Apply one drop to the eye in the evening. If you are using other eye drops to lower pressure, allow at least 5 minutes between applications of the two medications. Contact lenses should be removed before the drug is applied. Wait 15 minutes before reinserting them.

• If you miss a dose…
  Apply it as soon as possible. If you don’t remember until the next day, skip the dose and go back to your regular schedule. Never double the dose.

• Storage instructions…
  Store unopened bottles in the refrigerator. Once opened, the bottles may be stored at room temperature for up to 6 weeks. 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. Be especially quick to report pinkeye or any effects on the eyelids. Only your doctor can determine if it is safe for you to continue using Xalatan.

• Side effects may include…
  Bloodshot eyes, blurred vision, burning, foreign body sensation, increased pigmentation of the iris, inflammatory disease of the cornea, itching, stinging, upper respiratory infection

Why should Xalatan not be prescribed?

Do not use Xalatan if you are sensitive or allergic to any of its ingredients.

Special warnings about Xalatan

Xalatan may gradually turn the eye’s iris brown. This change may not be noticed for months or years. Its long-term effects are unknown, but it may be permanent. Ask your doctor about the possibility of mismatched eye color if you will be treating only one eye with Xalatan.

Xalatan may make the eyelids darker. It can gradually change the eyelashes and fine body hair, increasing the length, thickness, color, and number of lashes or hairs. The eyelashes may also start growing in the wrong direction, possibly resulting in irritation to the eye.

If your eye sustains an injury or becomes infected, or you have eye surgery, you may need to start a new bottle of Xalatan. Be sure to check with your doctor.

Xalatan may cause blurred vision. Make certain it does not have this effect on you before you attempt to drive.

Possible food and drug interactions when taking Xalatan

Mixing Xalatan with eye drops containing thiomersal can cause the formation of solid substances in the eye. To avoid this problem, administer the drops at least 5 minutes apart.

Special information if you are pregnant or breastfeeding

The effects of Xalatan during pregnancy and breastfeeding have not been adequately studied. If you are pregnant or plan to become pregnant, notify your doctor immediately. It is not known whether Xalatan makes it way into breast milk. If you are nursing and need to use Xalatan, your doctor may advise you to discontinue breastfeeding while using the medication.

Recommended dosage for Xalatan

The usual dose is 1 drop in the affected eye once every evening.

Overdosage

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

• Symptoms of Xalatan overdose may include:
  Bloodshot eyes, eye irritation

Generic name: Ezetimibe and Simvastatin
Brand names: Vytorin

Why is Vytorin prescribed?

Vytorin is a cholesterol-lowering drug. It is used along with a special diet to lower the amount of fatty material in the blood— triglycerides and LDL (or “bad”) cholesterol—that can build up on artery walls and block blood flow. At the same time, Vytorin raises HDL (or “good”) cholesterol, which helps prevent fats from building up and clogging the arteries.

Your body needs fat to function properly, but when it accumulates as fatty deposits in the arteries, it increases your risk for heart attack, stroke, and blood-vessel disease. Your doctor may prescribe Vytorin if you are at high risk for heart disease and your cholesterol level is above 130, or if you are at low risk for heart disease and your cholesterol level is above 190.

Vytorin is a combination of two drugs, simvastatin and ezetimibe. Each works in a different way to lower levels of fat in the blood. Normally, the liver produces most of the cholesterol needed to maintain a healthy balance. Simvastatin works by interrupting the process of cholesterol production, mainly in the liver. Ezetimibe reduces the amount of cholesterol absorbed in the intestines.

Most important fact about Vytorin

Vytorin is usually prescribed only if diet, exercise, and weight loss fail to bring your cholesterol levels under control. It’s important to remember that Vytorin is a supplement—not a substitute—for those other measures. To get the full benefit of the medication, you need to stick to the diet and exercise program prescribed by your doctor. All these efforts to keep your cholesterol levels normal are important because they may lower your risk of heart disease. Vytorin has not been shown to reduce heart attacks or strokes more than simvastatin alone.

How should you take Vytorin?

Take Vytorin once a day in the evening with or without food.

If you are also using the cholesterol-lowering drug cholestyramine, take Vytorin at least 2 hours before or 4 hours after taking the other medication.

• 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 return to your regular schedule. Do not take two 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, tell your doctor as soon as possible. Only your doctor can determine if it is safe to continue using Vytorin.

• Side effects may include:
  Allergic reaction including swelling of the face, lips, throat, or tongue, difficulty breathing or swallowing, or rash; flu; gallstones; headache; inflammation of the gallbladder; inflammation of the liver; inflammation of the pancreas; muscle pain, tenderness, or weakness; nausea; numbness or pain in the hands or feet; upper respiratory infection

Why should Vytorin not be prescribed?

Do not take Vytorin if you are allergic to either ezetimibe or simvastatin. You should also not take Vytorin if you have liver disease or if blood tests suggest a liver problem.

If you are pregnant, plan to become pregnant, or have missed a period, do not take Vytorin. In addition, women who are breastfeeding should not use Vytorin.

Special warnings about Vytorin

Vytorin can cause the breakdown of muscle tissue, which can lead to serious kidney damage and, in rare cases, death from kidney failure. It is very important to stop taking Vytorin and call your doctor immediately if you have muscle pain, tenderness, or weakness that comes on while taking Vytorin, especially if you also have a fever and feel sick.

Vytorin can make certain medical conditions worse. If you have diabetes, kidney disease, any kind of muscle disorder, or if you have ever had liver problems, you must be carefully monitored while taking Vytorin.

Because Vytorin can cause liver problems, your doctor will order a blood test to check your liver enzymes before your first dose and again at regular intervals during treatment. You may have to stop taking Vytorin if your liver enzymes become too high.

Because of possible effects on the liver, it is important to limit your alcohol consumption while taking Vytorin.

Simvastatin and similar drugs have caused cataracts and other serious eye problems in animal studies. Be sure to alert your doctor if you have cataracts or any eye condition that gets worse.

Alert the doctor if you’re scheduled to have surgery. You’ll probably need to stop taking Vytorin several days beforehand.

Possible food and drug interactions when taking Vytorin

If Vytorin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. Combining it with the following increases the chance of muscle damage:
Amiodarone
Antifungal medicines such as itraconazole and ketoconazole
Benzafibrate
Clarithromycin
Clofibrate
Cholestyramine
Cyclosporine
Erythromycin
Fenofibrate
Gemfibrozil
Grapefruit juice (large quantities)
HIV medicines called protease inhibitors, such as indinavir, nelfinavir, ritonavir, and saquinavir
Nefazodone
Niacin and nicotinic acid
Verapamil

• Other drugs that may interact with Vytorin include:
  Blood-thinning drugs such as warfarin
  Digoxin
  Propranolol

You should also avoid drinking large amounts of alcohol while taking Vytorin.

Special information if you are pregnant or breastfeeding

Cholesterol is needed for a baby to develop properly. Therefore, you should not take Vytorin if you are pregnant or if you plan to become pregnant. If you find out you’re pregnant during Vytorin treatment, stop taking it and call your doctor. In addition, women who are breastfeeding should not take Vytorin.

Recommended dosage for Vytorin

ADULTS

The usual starting dose is one 10/20 tablet containing 10 milligrams of ezetimibe and 20 milligrams of simvastatin taken once a day in the evening. The doctor may prescribe a lower starting dose (10/10) if you require less aggressive treatment and a higher one (10/40) if you need a large reduction (more than 55 percent) in LDL cholesterol. Depending on your body’s response, the doctor may increase your dose at 2-week intervals up to a maximum of 10/80 milligrams a day.

If you’re taking cyclosporine, the dose of Vytorin should not exceed 10/10 milligrams a day. If you’re taking amiodarone or verapamil, the dose should not exceed 10/20 milligrams a day.

If you have severe kidney disease, the doctor may prescribe a lower dose or have you stop taking Vytorin altogether.

CHILDREN 10 YEARS OF AGE OR OLDER

Vytorin has not been studied in children or adolescents. However, one of the ingredients, simvastatin, is approved for use in children 10 years and older. The recommended starting dose is 10 milligrams once a day in the evening. The dosage may be increased every 4 weeks, as determined by the doctor, up to a maximum of 40 milligrams a day. Girls must have been menstruating for at least 1 year before starting therapy with simvastatin. The drug has not been studied in children less than 10 years old or in doses greater than 40 milligrams a day.

There is limited experience with the use of ezetimibe in children. The drug appears to be metabolized the same as in adults. Ezetimibe is not recommended for children less than 10 years old.

Because of the individual recommendations for simvastatin and ezetimibe, Vytorin is also not recommended for children less than 10 years old.

Overdosage

Although there is no specific information about Vytorin overdose, any medication taken in excess can have serious consequences. If you suspect an overdose, seek emergency treatment immediately.

Generic name: Miconazole nitrate, Zinc oxide
Brand names: Vusion

Why is Vusion prescribed?

Vusion ointment is a prescription skin medicine used to treat diaper rash that also has a yeast infection in children who have a normal immune systems.

Most important fact about Vusion

Vusion ointment contains medicines that will help treat the yeast infection and the diaper rash. Even if you use Vusion ointment, diaper rash will not go away if you do not keep your child’s diaper area clean and dry.

How should you take Vusion?

Gently, clean the skin on your child’s diaper area with warm (not hot) water. You may also use a very mild soap. Pat the area dry with a soft towel. Use your fingertips and gently apply a thin layer of Vusion ointment to your child’s diaper area at each diaper change. Do not rub Vusion ointment into your child’s skin. Rubbing the skin can cause more irritation. Wash your hands after applying Vusion ointment to your child.

• 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 Vusion.

• Side effects may include:
  Irritation (uncommon)

Why should Vusion not be prescribed?

Vusion ointment is not for treatment of all cases of diaper rash. Vusion ointment is only for diaper rash that also has a yeast infection. Most cases of diaper rash do not have yeast infections; therefore, they do not need the medicine that is in Vusion to treat a yeast infection.

Do not use Vusion on your child if he/she is allergic to any of its ingredients.

Special warnings about Vusion

Avoid using any scented soaps, shampoos, or lotions on the diaper area. Do not use Vusion ointment on your child’s diaper rash unless your doctor tells you that there is also a yeast infection. Do not use on any other children.

Tell your doctor about all prescription, over-the-counter, and herbal medications your child is taking before beginning treatment with Vusion. Also, talk to your doctor about your child’s complete medical history.

Possible food and drug interactions when taking Vusion

If Vusion ointment is used 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 Vusion with the following:

Miconazole intravaginal cream or suppository
Warfarin

Special information if you are pregnant or breastfeeding

If you are pregnant, be cautious while applying Vusion to your child.

Recommended dosage for Vusion

CHILDREN

A thin layer of Vusion ointment should be spread across the rash using your fingertip, for 7 days. Vusion ointment is applied to the skin on your child’s diaper area at each diaper change. Apply for the full 7 days even if the diaper rash starts to go away. Call your child’s doctor if the diaper rash gets worse or does not go away in 7 days.

Overdosage

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

Generic name: Albuterol sulfate Brand names: VoSpire Extended-Release Tablets, AccuNeb, Proventil HFA, Ventolin HFA, Volmax Extended-Release Tablets, Proventil Why is VoSpire Extended-Release Tablets prescribed? Drugs containing albuterol are prescribed for the prevention and relief of bronchial spasms that narrow the airway. This especially applies to the treatment of asthma. Some brands of Proventil are also used for the prevention of bronchial spasm due to exercise. Most important fact about VoSpire Extended-Release Tablets Do not take albuterol more frequently than your doctor recommends. Increasing the number of doses can be dangerous and may actually make symptoms of asthma worse. If the dose your doctor recommends does not provide relief of your symptoms, or if your symptoms become worse, consult your doctor immediately. How should you take VoSpire Extended-Release Tablets? If you are taking extended-release tablets, swallow them whole with some liquid–never chew or crush them. Shake the inhalation aerosol canister well before using and make sure it’s firmly seated in the plastic mouthpiece. Before using it for the first time, prime the canister with 4 sprays into the air away from your face. Prime it with 2 sprays whenever it has not been used for at least 4 days. Use only the adapter that comes with the product; do not use this adapter with any other product. Wash the plastic mouthpiece with warm running water at least once a week to prevent medication buildup and blockage. If you are using an inhalation solution, be sure to protect it from contamination. Keep the tip of the dropper away from the lip of the bottle or any other surface. Do not use the solution if it changes color or becomes cloudy. –If you miss a dose… Take the forgotten dose as soon as you remember; then take any remaining doses for that day at equally spaced intervals. Never take a double dose. –Storage instructions… AccuNeb, Proventil syrup, and Proventil solution for inhalation can be kept in the refrigerator or at room temperature. Proventil aerosol can be stored at temperatures as low as 60 degrees Fahrenheit, but should be at room temperature before use. Protect from excessive heat. Ventolin nebules must be used within 2 weeks of being removed from the refrigerator. Store VoSpire tablets at room temperature in a tight, light-resistant container. Volmax tablets should be kept refrigerated. VoSpire Extended-Release Tablets side effects 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 albuterol. Side effects may include: Aggression, agitation, allergic reaction, anxiety, back pain, chest pain or discomfort, chills and fever, coordination problems, cough, decreased appetite, depression, difficulty speaking, diabetes, diarrhea, dizziness, drowsiness, dry mouth and throat, excitement, fluid retention and swelling, flushing, general bodily discomfort, headache, heart palpitations, heartburn, hives, increased appetite, increased blood pressure, increased difficulty breathing, indigestion, irritability, labored breathing, leg cramps, light-headedness, muscle cramps, muscle spasm, nasal inflammation, nausea, nervousness, nightmares, nosebleed, overactivity, rapid heartbeat, rash, respiratory infection or disorder, restlessness, ringing in the ears, shakiness, sleeplessness, slowed movement, stomachache, stuffy nose, sweating, swelling of mouth and throat, taste sensation on inhalation, throat irritation, tooth discoloration, tremors, unusual taste, urinary problems, vomiting, weakness, wheezing Why should VoSpire Extended-Release Tablets not be prescribed? If you are sensitive to or have ever had an allergic reaction to albuterol or other bronchodilators, you should not take VoSpire Extended-Release Tablets. Make sure that your doctor is aware of any drug reactions that you have experienced. Special warnings about VoSpire Extended-Release Tablets When taking albuterol inhalation aerosol, you should not use other inhaled medications before checking with your doctor. Make sure the doctor is aware of it if you have a heart condition, seizure disorder, high blood pressure, abnormal heartbeat, overactive thyroid gland, or diabetes. Call your doctor immediately if you notice any change in heartbeat or pulse while taking Proventil. You may have an immediate, serious allergic reaction to the first dose of albuterol, causing symptoms such as hives, rash, and swelling of the mouth, throat, lips, and tongue. The drug has been known to cause life-threatening bronchial spasms, especially with the first dose from a new canister or vial. There have also been rare reports of skin reddening and peeling in children taking albuterol syrup. Do not exceed your doctor’s recommended dose of albuterol. If you need more than usual, check with your doctor. Your asthma may be getting unstable, and you may need another medication. Do not, however, change your medication without first consulting your doctor or pharmacist. Possible food and drug interactions when taking VoSpire Extended-Release Tablets Use albuterol inhalation aerosol with other aerosol bronchodilators only if your doctor recommends it. If albuterol 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 albuterol with the following: Antidepressants classified as MAO inhibitors, such as Nardil and Parnate, and tricyclic antidepressants such as Elavil, Norpramin, Pamelor, and Tofranil. Beta blockers (heart and blood pressure drugs such as Inderal, Tenormin, and Sectral) Digoxin (Lanoxin) Drugs similar to albuterol, such as Alupent, Brethine, Isuprel, and epinephrine Drugs that lower potassium levels (water pills such as Lasix or HydroDIURIL) Special information if you are pregnant or breastfeeding The effects of albuterol during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. It is not known whether albuterol appears in breast milk. If Proventil is essential to your health, your doctor may advise you to stop nursing your baby until your treatment is finished. Recommended dosage for VoSpire Extended-Release Tablets ADULTS Inhalation Aerosol If you are being treated for a sudden or severe bronchial spasm or the prevention of asthma symptoms, the usual dosage of albuterol inhalation aerosol is 2 inhalations repeated every 4 to 6 hours. More frequent use is not recommended. In some individuals, 1 inhalation every 4 hours may be sufficient. To prevent exercise-induced bronchial spasm, the usual dosage is 2 inhalations, 15 minutes prior to exercise. Tablets The usual starting dose for adults and children 12 years of age and older is 2 or 4 milligrams 3 to 4 times a day. Dosage should not exceed 32 milligrams per day. Syrup The usual starting dose for adults and children over 12 years of age is 1 or 2 teaspoonfuls 3 or 4 times a day. Dosage should not exceed 4 teaspoonfuls 4 times a day. Proventil Inhalation Solution The usual dosage for adults and children 12 years of age and older is 2.5 milligrams administered 3 to 4 times daily by nebulization. Do not use more often or in higher doses. To administer 2.5 milligrams, use the entire contents of a unit-dose bottle of the 0.083% solution or dilute 0.5 milliliter of the 0.5 percent solution with 2.5 milliliters of sterile normal saline solution. Proventil Repetabs, Volmax Extended-Release Tablets, and VoSpire Extended-Release Tablets The usual recommended dosage for adults and children 12 years of age and older is 8 milligrams every 12 hours. In some people, 4 milligrams every 12 hours may be sufficient. If the desired effect is not achieved with the standard dosage, your doctor may increase doses to a maximum of 32 milligrams per day, divided into two 16-milligram doses spaced 12 hours apart. Those taking standard tablets or syrup can switch to extended-release tablets. One extended-release tablet every 12 hours is equivalent to one 2-milligram standard tablet every 6 hours. CHILDREN Inhalation Aerosol The usual dose of albuterol inhalation aerosol for children aged 4 and over (12 and over for Proventil) is 2 inhalations every 4 to 6 hours. To prevent exercise-induced bronchial spasm, the dose is 2 inhalations 15 minutes prior to exercise. Tablets The usual starting dose for children 6 to 12 years of age is 2 milligrams 3 or 4 times a day. The dose can be increased with caution but should not exceed 24 milligrams per day. Safety and effectiveness in children under 6 have not been established. Syrup The usual starting dose for children 6 to 12 years of age is 1 teaspoonful 3 to 4 times a day. The dosage should not exceed 3 teaspoonfuls 4 times a day. For children 2 to 6 years of age, the starting dose is 0.1 milligram per 2.2 pounds of body weight, to a maximum of 4 milligrams, 3 times a day. Proventil Repetabs, Volmax Extended-Release Tablets, and VoSpire Extended-Release Tablets The usual starting dosage for children 6 to 12 years of age is 4 milligrams every 12 hours. The dosage can be increased with caution but should not exceed 24 milligrams per day. AccuNeb Inhalation Solution The usual starting dose for children 2 to 12 years of age is 0.63 or 1.25 milligrams 3 or 4 time daily by nebulization. To administer, use the entire contents of the prescribed unit-dose vial. The 1.25 milligram dosage may be more helpful for children 6 to 12 with more severe asthma, and for children 11 to 12. OLDER ADULTS Oral Dosage The usual starting dose of tablets or syrup is 2 milligrams 3 or 4 times a day. If needed, the dosage may be increased gradually to as much as 8 milligrams 3 or 4 times a day. Overdosage Symptoms of albuterol overdose may include: Dizziness, dry mouth, fatigue, general feeling of illness, headache, high or low blood pressure, insomnia, nausea, nervousness, radiating chest pain, rapid or irregular heartbeat, seizures, tremors Heart attack and even death have been associated with abuse of albuterol inhalation. Exaggerated side effects may also be a sign of an overdose. If you suspect an overdose, seek medical attention immediately.

Generic name: Albuterol sulfate Brand names: VoSpire Extended-Release Tablets, AccuNeb, Proventil HFA, Ventolin HFA, Volmax Extended-Release Tablets, Proventil Why is Volmax Extended-Release Tablets prescribed? Drugs containing albuterol are prescribed for the prevention and relief of bronchial spasms that narrow the airway. This especially applies to the treatment of asthma. Some brands of Proventil are also used for the prevention of bronchial spasm due to exercise. Most important fact about Volmax Extended-Release Tablets Do not take albuterol more frequently than your doctor recommends. Increasing the number of doses can be dangerous and may actually make symptoms of asthma worse. If the dose your doctor recommends does not provide relief of your symptoms, or if your symptoms become worse, consult your doctor immediately. How should you take Volmax Extended-Release Tablets? If you are taking extended-release tablets, swallow them whole with some liquid–never chew or crush them. Shake the inhalation aerosol canister well before using and make sure it’s firmly seated in the plastic mouthpiece. Before using it for the first time, prime the canister with 4 sprays into the air away from your face. Prime it with 2 sprays whenever it has not been used for at least 4 days. Use only the adapter that comes with the product; do not use this adapter with any other product. Wash the plastic mouthpiece with warm running water at least once a week to prevent medication buildup and blockage. If you are using an inhalation solution, be sure to protect it from contamination. Keep the tip of the dropper away from the lip of the bottle or any other surface. Do not use the solution if it changes color or becomes cloudy. –If you miss a dose… Take the forgotten dose as soon as you remember; then take any remaining doses for that day at equally spaced intervals. Never take a double dose. –Storage instructions… AccuNeb, Proventil syrup, and Proventil solution for inhalation can be kept in the refrigerator or at room temperature. Proventil aerosol can be stored at temperatures as low as 60 degrees Fahrenheit, but should be at room temperature before use. Protect from excessive heat. Ventolin nebules must be used within 2 weeks of being removed from the refrigerator. Store VoSpire tablets at room temperature in a tight, light-resistant container. Volmax tablets should be kept refrigerated. Volmax Extended-Release Tablets side effects 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 albuterol. Side effects may include: Aggression, agitation, allergic reaction, anxiety, back pain, chest pain or discomfort, chills and fever, coordination problems, cough, decreased appetite, depression, difficulty speaking, diabetes, diarrhea, dizziness, drowsiness, dry mouth and throat, excitement, fluid retention and swelling, flushing, general bodily discomfort, headache, heart palpitations, heartburn, hives, increased appetite, increased blood pressure, increased difficulty breathing, indigestion, irritability, labored breathing, leg cramps, light-headedness, muscle cramps, muscle spasm, nasal inflammation, nausea, nervousness, nightmares, nosebleed, overactivity, rapid heartbeat, rash, respiratory infection or disorder, restlessness, ringing in the ears, shakiness, sleeplessness, slowed movement, stomachache, stuffy nose, sweating, swelling of mouth and throat, taste sensation on inhalation, throat irritation, tooth discoloration, tremors, unusual taste, urinary problems, vomiting, weakness, wheezing Why should Volmax Extended-Release Tablets not be prescribed? If you are sensitive to or have ever had an allergic reaction to albuterol or other bronchodilators, you should not take Volmax Extended-Release Tablets. Make sure that your doctor is aware of any drug reactions that you have experienced. Special warnings about Volmax Extended-Release Tablets When taking albuterol inhalation aerosol, you should not use other inhaled medications before checking with your doctor. Make sure the doctor is aware of it if you have a heart condition, seizure disorder, high blood pressure, abnormal heartbeat, overactive thyroid gland, or diabetes. Call your doctor immediately if you notice any change in heartbeat or pulse while taking Proventil. You may have an immediate, serious allergic reaction to the first dose of albuterol, causing symptoms such as hives, rash, and swelling of the mouth, throat, lips, and tongue. The drug has been known to cause life-threatening bronchial spasms, especially with the first dose from a new canister or vial. There have also been rare reports of skin reddening and peeling in children taking albuterol syrup. Do not exceed your doctor’s recommended dose of albuterol. If you need more than usual, check with your doctor. Your asthma may be getting unstable, and you may need another medication. Do not, however, change your medication without first consulting your doctor or pharmacist. Possible food and drug interactions when taking Volmax Extended-Release Tablets Use albuterol inhalation aerosol with other aerosol bronchodilators only if your doctor recommends it. If albuterol 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 albuterol with the following: Antidepressants classified as MAO inhibitors, such as Nardil and Parnate, and tricyclic antidepressants such as Elavil, Norpramin, Pamelor, and Tofranil. Beta blockers (heart and blood pressure drugs such as Inderal, Tenormin, and Sectral) Digoxin (Lanoxin) Drugs similar to albuterol, such as Alupent, Brethine, Isuprel, and epinephrine Drugs that lower potassium levels (water pills such as Lasix or HydroDIURIL) Special information if you are pregnant or breastfeeding The effects of albuterol during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. It is not known whether albuterol appears in breast milk. If Proventil is essential to your health, your doctor may advise you to stop nursing your baby until your treatment is finished. Recommended dosage for Volmax Extended-Release Tablets ADULTS Inhalation Aerosol If you are being treated for a sudden or severe bronchial spasm or the prevention of asthma symptoms, the usual dosage of albuterol inhalation aerosol is 2 inhalations repeated every 4 to 6 hours. More frequent use is not recommended. In some individuals, 1 inhalation every 4 hours may be sufficient. To prevent exercise-induced bronchial spasm, the usual dosage is 2 inhalations, 15 minutes prior to exercise. Tablets The usual starting dose for adults and children 12 years of age and older is 2 or 4 milligrams 3 to 4 times a day. Dosage should not exceed 32 milligrams per day. Syrup The usual starting dose for adults and children over 12 years of age is 1 or 2 teaspoonfuls 3 or 4 times a day. Dosage should not exceed 4 teaspoonfuls 4 times a day. Proventil Inhalation Solution The usual dosage for adults and children 12 years of age and older is 2.5 milligrams administered 3 to 4 times daily by nebulization. Do not use more often or in higher doses. To administer 2.5 milligrams, use the entire contents of a unit-dose bottle of the 0.083% solution or dilute 0.5 milliliter of the 0.5 percent solution with 2.5 milliliters of sterile normal saline solution. Proventil Repetabs, Volmax Extended-Release Tablets, and VoSpire Extended-Release Tablets The usual recommended dosage for adults and children 12 years of age and older is 8 milligrams every 12 hours. In some people, 4 milligrams every 12 hours may be sufficient. If the desired effect is not achieved with the standard dosage, your doctor may increase doses to a maximum of 32 milligrams per day, divided into two 16-milligram doses spaced 12 hours apart. Those taking standard tablets or syrup can switch to extended-release tablets. One extended-release tablet every 12 hours is equivalent to one 2-milligram standard tablet every 6 hours. CHILDREN Inhalation Aerosol The usual dose of albuterol inhalation aerosol for children aged 4 and over (12 and over for Proventil) is 2 inhalations every 4 to 6 hours. To prevent exercise-induced bronchial spasm, the dose is 2 inhalations 15 minutes prior to exercise. Tablets The usual starting dose for children 6 to 12 years of age is 2 milligrams 3 or 4 times a day. The dose can be increased with caution but should not exceed 24 milligrams per day. Safety and effectiveness in children under 6 have not been established. Syrup The usual starting dose for children 6 to 12 years of age is 1 teaspoonful 3 to 4 times a day. The dosage should not exceed 3 teaspoonfuls 4 times a day. For children 2 to 6 years of age, the starting dose is 0.1 milligram per 2.2 pounds of body weight, to a maximum of 4 milligrams, 3 times a day. Proventil Repetabs, Volmax Extended-Release Tablets, and VoSpire Extended-Release Tablets The usual starting dosage for children 6 to 12 years of age is 4 milligrams every 12 hours. The dosage can be increased with caution but should not exceed 24 milligrams per day. AccuNeb Inhalation Solution The usual starting dose for children 2 to 12 years of age is 0.63 or 1.25 milligrams 3 or 4 time daily by nebulization. To administer, use the entire contents of the prescribed unit-dose vial. The 1.25 milligram dosage may be more helpful for children 6 to 12 with more severe asthma, and for children 11 to 12. OLDER ADULTS Oral Dosage The usual starting dose of tablets or syrup is 2 milligrams 3 or 4 times a day. If needed, the dosage may be increased gradually to as much as 8 milligrams 3 or 4 times a day. Overdosage Symptoms of albuterol overdose may include: Dizziness, dry mouth, fatigue, general feeling of illness, headache, high or low blood pressure, insomnia, nausea, nervousness, radiating chest pain, rapid or irregular heartbeat, seizures, tremors Heart attack and even death have been associated with abuse of albuterol inhalation. Exaggerated side effects may also be a sign of an overdose. If you suspect an overdose, seek medical attention immediately.

Generic name: Diclofenac sodium
Brand names: Cataflam, Voltaren

Why is Voltaren prescribed?

Voltaren and Cataflam are nonsteroidal anti-inflammatory drugs used to relieve the inflammation, swelling, stiffness, and joint pain associated with rheumatoid arthritis, osteoarthritis (the most common form of arthritis), and ankylosing spondylitis (arthritis and stiffness of the spine). Voltaren-XR, the extended-release form of Voltaren, is used only for long-term treatment. Cataflam is also prescribed for immediate relief of pain and menstrual discomfort.

Most important fact about Voltaren

You should have frequent checkups with your doctor if you take Voltaren regularly. Ulcers or internal bleeding can occur without warning.

How should you take Voltaren?

To minimize stomach upset and related side effects, your doctor may recommend taking this medicine with food, milk, or an antacid. However, this may delay onset of relief.

Take Voltaren with a full glass of water. Also, do not lie down for about 20 minutes after taking it. This will help to prevent irritation in your upper digestive tract.

Take Voltaren exactly as prescribed.

• If you miss a dose…
  If you take this medicine on a regular schedule, 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…
  Store at room temperature. Keep the container tightly closed and protect from moisture.

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 Voltaren.

• Side effects may include:
  Abdominal bleeding, abdominal pain or cramps, abdominal swelling, anemia, blood clotting problems, constipation, diarrhea, dizziness, fluid retention, gas, headache, heartburn, indigestion, itching, nausea, peptic ulcers, rash, ringing in the ears, vomiting

This side effects list is not complete. If you have any questions about side effects you should consult your doctor. Report any new or continuing symptoms to your doctor right away.

Why should Voltaren not be prescribed?

If you have an allergic reaction to Voltaren or Cataflam, or if you have had asthma attacks, hives, or other allergic reactions caused by aspirin or other nonsteroidal anti-inflammatory drugs, you should not take Voltaren. Make sure your doctor is aware of any drug reactions you have experienced.

Special warnings about Voltaren

Remember that Voltaren has been known to cause peptic ulcers and bleeding. Contact your doctor immediately if you suspect a problem.

Use Voltaren cautiously if you have kidney problems, heart disease, or high blood pressure. It can cause fluid retention.

This medication can also cause liver problems. If you develop signs of liver disease such as nausea, fatigue, lethargy, itching, yellowish eyes and skin, tenderness in the upper right area of your abdomen, or flu-like symptoms, notify your doctor at once.

Rare cases of meningitis (inflammation of the membrane enclosing the brain) have been linked to Voltaren. If symptoms such as fever and coma develop, alert the doctor immediately.

In rare instances, Voltaren may also affect your vision. If you notice any problems, stop taking the drug and check with your doctor.

Possible food and drug interactions when taking Voltaren

If Voltaren or Cataflam 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 Voltaren with the following:

Aspirin
Blood thinners such as Coumadin
Cyclosporine (Sandimmune)
Digitalis drugs such as Lanoxin
Diuretics such as Dyazide, Midamor, and Lasix
Insulin or oral antidiabetes medications such as Micronase
Lithium (Eskalith, Lithobid)
Methotrexate
Phenobarbital

Special information if you are pregnant or breastfeeding

Do not take Voltaren late in your pregnancy; it could harm the baby. Check with your doctor before taking the drug early in pregnancy; it should be used only if necessary. The drug does appear in breast milk and could affect a nursing infant. If Voltaren is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Voltaren is finished.

Recommended dosage for Voltaren

ADULTS

Osteoarthritis

The usual dose is 100 to 150 milligrams a day, divided into smaller doses of 50 milligrams 2 or 3 times a day (for Voltaren or Cataflam) or 75 milligrams twice a day (for Voltaren). The usual dose of Voltaren-XR (extended-release) is 100 milligrams taken once a day.

Rheumatoid Arthritis

The usual dose is 100 to 200 milligrams a day, divided into smaller doses of 50 milligrams 3 to 4 times a day (for Voltaren or Cataflam), 75 milligrams twice a day (for Voltaren), or 100 milligrams once or twice a day (for Voltaren-XR).

People with rheumatoid arthritis should not take more than 225 milligrams a day.

Ankylosing Spondylitis

The usual dose is 100 to 125 milligrams of Voltaren a day, divided into smaller doses of 25 milligrams 4 times a day, with another 25 milligrams at bedtime if necessary.

Pain and menstrual discomfort

The usual starting dose of Cataflam is 50 milligrams every 8 hours as needed, although to provide better relief on the first day doctors sometimes prescribe a starting dose of 100 milligrams followed by two 50-milligram doses. After the first day, you should not take more than 150 milligrams in a day.

CHILDREN

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

Overdosage

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

• The symptoms of Voltaren overdose may include:
  Acute kidney failure, drowsiness, loss of consciousness, lung inflammation, nausea, vomiting

Brand names: Poly-Vi-Flor

Why is Vitamins, Fluoride prescribed?

Poly-Vi-Flor is a multivitamin and fluoride supplement. The drops have 9 essential vitamins; the chewable tablets have 10. Poly-Vi-Flor is prescribed for children aged 2 and older to provide fluoride where the drinking water contains less than the amount recommended by the American Dental Association to build strong teeth and prevent cavities. Poly-Vi-Flor also supplies significant amounts of vitamins to help prevent deficiencies. The American Academy of Pediatrics recommends that children up to age 16 take a fluoride supplement if they live in areas where the drinking water contains less than the recommended amount of fluoride.

Most important fact about Vitamins, Fluoride

Do not give your child more than the recommended dose. Too much fluoride can cause discoloration and pitting of teeth.

How should you take Vitamins, Fluoride?

Do not give your child more than your doctor prescribes.

Poly-Vi-Flor chewable tablets should be chewed or crushed before swallowing. You can put Poly-Vi-Flor drops directly into a child’s mouth with the dropper provided or mix them into cereal, juice, or other food.

• If you miss a dose…
  Give 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 give 2 doses at once.

• Storage instructions…
  Store away from heat, light, and moisture.

What side effects may occur?

Rarely, an allergic rash has occurred.

Why should Vitamins, Fluoride not be prescribed?

Children should not take Poly-Vi-Flor if they are getting significant amounts of fluoride from other medications or sources.

Special warnings about Vitamins, Fluoride

Do not give your child more than the recommended dosage. Your child’s teeth should be checked periodically for discoloration or pitting. Notify your doctor if white, brown, or black spots appear on your child’s teeth.

The fluoride level of your drinking water should be determined before Poly-Vi-Flor is prescribed.

Let your doctor know if you change drinking water or filtering systems.

Fluoride does not replace proper dental habits, such as brushing, flossing, and having dental checkups.

Recommended dosage for Vitamins, Fluoride

The usual dose is 1 tablet or 1 milliliter every day as prescribed by the doctor; your doctor will choose the strength according to your child’s age and the amount of fluoride in the drinking water.

Overdosage

Although overdose is unlikely, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical treatment immediately.

Generic name: Hydroxyzine hydrochloride
Brand names: Vistaril, Atarax

Why is Vistaril prescribed?

Atarax is an antihistamine used to relieve the symptoms of common anxiety and tension and, in combination with other medications, to treat anxiety that results from physical illness. It also relieves itching from allergic reactions and can be used as a sedative before and after general anesthesia. Antihistamines work by decreasing the effects of histamine, a chemical the body releases that narrows air passages in the lungs and contributes to inflammation. Antihistamines reduce itching and swelling and dry up secretions from the nose, eyes, and throat.

Most important fact about Vistaril

Atarax is not intended for long-term use (more than 4 months). Your doctor should re-evaluate the prescription periodically.

How should you take Vistaril?

Take Vistaril exactly as prescribed 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. Do not take 2 doses at once.

• Storage instructions…
  Store tablets and syrup away from heat, light, and moisture. Keep the syrup from freezing.

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 Atarax.

Drowsiness, the most common side effect of Atarax, is usually temporary and may disappear in a few days or when dosage is reduced. Other side effects include dry mouth, twitches, tremors, and convulsions. The last two usually occur with higher than recommended doses of Atarax.

Why should Vistaril not be prescribed?

Atarax should not be taken in early pregnancy or if you are sensitive to or have ever had an allergic reaction to it. Make sure your doctor is aware of any drug reactions you have experienced.

Special warnings about Vistaril

Atarax increases the effects of drugs that depress the activity of the central nervous system. If you are taking narcotics, non-narcotic analgesics, or barbiturates in combination with Atarax, their dosage should be reduced.

This medication can cause drowsiness. Driving or operating dangerous machinery or participating in any hazardous activity that requires full mental alertness is not recommended until you know how you react to Atarax.

Possible food and drug interactions when taking Vistaril

Atarax may increase the effects of alcohol. Avoid alcohol while taking Vistaril.

If Atarax 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 Atarax with the following:

Barbiturates such as phenobarbital and secobarbital
Narcotics such as acetaminophen, meperidine hydrochloride, and oxycodone hydrochloride
Non-narcotic analgesics such as ibuprofen

Special information if you are pregnant or breastfeeding

Although the effects of Atarax during pregnancy have not been adequately studied in humans, birth defects have appeared in animal studies with Vistaril. You should not take Atarax in early pregnancy. If you are pregnant or plan to become pregnant, inform your doctor immediately. Atarax may appear in breast milk and could affect a nursing infant. If Vistaril is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

Recommended dosage for Vistaril

When treatment begins with injections, it can be continued in tablet form.

Your doctor will adjust your dosage based on your response to the drug. Due to an increased risk of drowsiness, older adults usually start at the low end of the dosage range.

FOR ANXIETY AND TENSION

Adults

The usual dose is 50 to 100 milligrams 4 times per day.

Children under Age 6

The total dose is 50 milligrams daily, divided into several smaller doses.

Children over Age 6

The total dose is 50 to 100 milligrams daily, divided into several smaller doses.

FOR ITCHING DUE TO ALLERGIC CONDITIONS

Adults

The usual dose is 25 milligrams 3 or 4 times a day.

Children under Age 6

The total dose is 50 milligrams daily, divided into several smaller doses.

Children over Age 6

The total dose is 50 to 100 milligrams daily, divided into several smaller doses.

BEFORE AND AFTER GENERAL ANESTHESIA

Adults

The usual dose is 50 to 100 milligrams.

Children

The usual dose is 0.6 milligram per 2.2 pounds of body weight.

Overdosage

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

The most common symptom of Atarax overdose is excessive calm; your blood pressure may drop, although it is not likely.

Generic name: Hydrocodone bitartrate, Acetaminophen
Brand names: Zydone, Norco, Maxidone, Lorcet, Lortab, Hydrocet, Co-Gesic, Anexsia, Vicodin

Why is Vicodin 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 Vicodin

Vicodin can be habit-forming. If you take Vicodin 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 Vicodin?

Take Vicodin exactly as prescribed. Do not increase the amount you take or the frequency without your doctor’s approval. Do not take Vicodin for any reason other than the one prescribed.

Do not give Vicodin 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 Vicodin 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 Vicodin. Make sure your doctor is aware of any drug reactions you have experienced.

Special warnings about Vicodin

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 Vicodin 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 Vicodin, 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 Vicodin, you are more likely to experience this effect.

Possible food and drug interactions when taking Vicodin

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 Vicodin 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 Vicodin 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 Vicodin is essential to your health, your doctor may advise you to discontinue breastfeeding your baby until your treatment is finished.

Recommended dosage for Vicodin

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

Generic name: Sildenafil citrate
Brand names: Viagra

Why is Viagra prescribed?

Viagra is an oral drug for male impotence, also known as erectile dysfunction (ED). It works by dilating blood vessels in the penis, allowing the inflow of blood needed for an erection.

Most important fact about Viagra

Viagra causes erections only during sexual excitement. It does not work in the absence of arousal.

How should you take Viagra?

Taking Viagra approximately 1 hour before sexual activity works best for most men. Depending on how and when the drug works for you, an interval of one-half hour to as much as 4 hours may prove ideal.

• If you miss a dose…
  Viagra is not for regular use. Take it only before sexual activity.

• 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 Viagra.

• Side effects may include:
  Abnormal vision (color tinge, blurring, sensitivity to light), acid indigestion, diarrhea, flushing, headache, nasal congestion, urinary tract infection

Heart attack, stroke, heart irregularities, dangerous surges in blood pressure, and sudden death have all been reported after use of Viagra, usually in men with existing cardiac risk factors, and typically during or shortly after sex.

Why should Viagra not be prescribed?

Do not take Viagra if you are taking any nitrate-based drug, including nitroglycerin patches (Nitro-Dur, Transderm-Nitro), nitroglycerin ointment (Nitro-Bid, Nitrol), nitroglycerin pills (Nitro-Bid, Nitrostat), and isosorbide pills (Dilatrate-SR, Isordil, Sorbitrate). Combining Viagra with these drugs can cause a severe drop in blood pressure.

If Viagra gives you an allergic reaction, do not use it again.

Special warnings about Viagra

If you have heart problems severe enough to make sexual activity a danger, you should avoid using Viagra. Use it cautiously—if at all—if you’ve had a heart attack, stroke, or life-threatening heart irregularities within the past 6 months. Be equally cautious if you have severe high or low blood pressure, heart failure, or unstable angina (crushing heart pain that occurs at any time).

If you take Viagra and develop cardiac symptoms (for example, dizziness, nausea, and chest pain) during sexual activity, do not continue. Alert your doctor to the problem as soon as possible.

If you have a condition that might result in long-lasting erections, such as sickle cell anemia, multiple myeloma (a disease of the bone marrow), or leukemia, use Viagra with caution. Also use cautiously if you have a genital problem or deformity such as Peyronie’s disease. If an erection lasts more than 4 hours, seek treatment immediately. Permanent damage and impotence could result.

If you have a bleeding disorder, a stomach ulcer, or the inherited eye condition known as retinitis pigmentosa, use Viagra with caution. Its safety under these circumstances has not yet been studied.

If you experience a loss of vision in one or both eyes, stop using Viagra and seek medical attention immediately.

To avoid low blood pressure, do not take the 50-milligram or 100-milligram dose of Viagra within 4 hours of taking an alpha-blocking drug such as Cardura.

Remember that Viagra offers no protection from transmission of sexually transmitted diseases, such as HIV, the virus that causes AIDS.

Possible food and drug interactions when taking Viagra

If Viagra 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 Viagra with the following:

Other impotence remedies including Caverject and Muse
Alpha-blockers such as doxazosin (Cardura)
Amlodipine (Norvasc)
Cimetidine (Tagamet)
Erythromycin (E-Mycin, Ery-Tab, PCE)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Nitrates such as Isordil, Nitro-Bid, and Nitro-Dur
Rifampin (Rifadin, Rimactane)
Ritonavir (Norvir)
Saquinavir (Fortovase, Invirase)

Special information if you are pregnant or breastfeeding

Viagra should not be used by women. Its affects during pregnancy and breastfeeding have not been studied.

Overdosage

Doses range from 25 milligrams to 100 milligrams, depending on the drug’s effect. The usual dose is 50 milligrams. If you are over 65, have liver or kidney problems, or are taking erythromycin, ketoconazole, itraconazole, ritonavir, or saquinavir a dose of 25 milligrams may be sufficient. Your doctor will adjust the dosage if the drug is not working properly for you.

Take Viagra only before sexual activity. The manufacturer recommends a maximum of 1 dose per day (1 dose every 2 days for those taking ritonavir).

To avoid low blood pressure, do not take the 50-milligram or 100-milligram dose of Viagra within 4 hours of taking an alpha-blocking drug such as Cardura.

No overdose of Viagra has been reported. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.