Sample PLR Content Directory Saint Helena, Ascension and Tristan da Cunha

Monday, September 26, 2016

Trifluoperazine Hydrochloride

Class: Phenothiazines
VA Class: CN701
Chemical Name: 10-[3-(4-methylpiperazin-1-yl)propyl]-2-(trifluoromethyl)-10H-phenothiazine
Molecular Formula: C₂₁H₂₄F₃N₃S
CAS Number: 117-89-5

Increased Mortality in Geriatric Patients with Dementia-related Psychosis

Geriatric patients with dementia-related psychosis treated with antipsychotic agents are at an increased risk of death.^a ^e ^l ^m ^o

Analyses of 17 placebo-controlled trials in geriatric patients mainly receiving atypical antipsychotic agents revealed an approximate 1.6- to 1.7-fold increase in mortality compared with that in patients receiving placebo.^a ^l ^m

Most fatalities appeared to result from cardiovascular-related events (e.g., heart failure, sudden death) or infections (mostly pneumonia).^a ^m

Observational studies suggest that conventional or first-generation antipsychotic agents also may increase mortality in such patients.^a ^e ^l

Antipsychotic agents, including trifluoperazine, are not approved for the treatment of dementia-related psychosis.^a ^l ^m

Introduction

Propylpiperazine-derivative phenothiazine; conventional (prototypical, first-generation) antipsychotic agent.^a ^b ^c

Uses for Trifluoperazine Hydrochloride

Schizophrenia

Treatment of schizophrenia.^a ^b ^c ^e

American Psychiatric Association (APA) considers most atypical antipsychotic agents first-line drugs for management of the acute phase of schizophrenia (including first psychotic episodes).^e APA considers conventional antipsychotic agents first-line in patients with acute psychotic episodes who have been treated successfully in the past with, or who prefer, conventional agents.^e

Patients who do not respond to or tolerate one drug may be successfully treated with an agent from a different class or with a different adverse effect profile.^e ⁱ ^p ^q

Nonpsychotic Anxiety

Short-term management of nonpsychotic anxiety in patients with generalized anxiety disorder.^a ^b ^c

Not established whether trifluoperazine is useful for the management of other nonpsychotic conditions in which anxiety or manifestations that mimic anxiety are evident (e.g., physical illness, organic mental conditions, agitated depression, character pathologies).^a ^b

Because of the risks of toxicity, use only as an alternative to other less toxic anxiolytic agents (e.g., benzodiazepines) in most patients.^a ^b

Mental Retardation

Efficacy not established for the management of behavioral complications in patients with mental retardation.^a ^b

Trifluoperazine Hydrochloride Dosage and Administration

General

Adjust dosage carefully according to individual requirements and response; use the lowest possible effective dosage.^a ^b ^c

For symptomatic relief of psychotic disorders, optimum therapeutic response usually occurs within 2–3 weeks.^a ^b

Periodically evaluate patients receiving long-term therapy to determine whether maintenance dosage can be decreased or drug therapy discontinued.^a ^b ^c

Administration

Oral Administration

Administered orally.^a ^b ^c Has been given parenterally† as trifluoperazine hydrochloride, but a parenteral dosage form of the drug is no longer commercially available in the US.^b

Because of the long duration of action, may be administered once or twice daily.^a ^b

Dosage

Available as trifluoperazine hydrochloride; dosage expressed in terms of trifluoperazine.^a ^b

Pediatric Patients

Psychotic Disorders

Oral

Adjust dosage based on weight and severity of symptoms.^a ^b

Children 6–12 years of age: Initially, 1 mg once or twice daily for hospitalized or well-supervised children.^a ^b Gradually increase dosage until symptoms are controlled or adverse effects become troublesome.^a ^b Most children respond to a dosage of ≤15 mg daily.^a ^b

Dosage for children <6 years of age not established.^a ^b

Adults

Psychotic Disorders

Oral

Initially, 2–5 mg given twice daily.^a ^b Gradually increase dosage until symptoms are controlled or adverse effects become troublesome.^a ^b Although most patients exhibit optimum response with 15–20 mg daily, dosages up to 40 mg or more daily may be required in some patients.^a ^b ^e

Nonpsychotic Anxiety

Oral

Usually, 1 or 2 mg twice daily for ≤12 weeks.^a ^b

Prescribing Limits

Pediatric Patients

Psychotic Disorders

Oral

Maximum 15 mg daily for children 6–12 years of age.^a ^b Dosages >15 mg daily should be used only in older children with severe symptoms.^a ^b

Adults

Nonpsychotic Anxiety

Oral

Maximum 6 mg daily; do not administer for >12 weeks.^a ^b

Special Populations

Geriatric Patients

Generally, select dose at the lower end of recommended range; increase dosage more gradually and monitor closely.^a ^b ^e (See Geriatric Use under Cautions.)

Debilitated or Emaciated Patients

Increase dosage more gradually.^a ^b

Cautions for Trifluoperazine Hydrochloride

Contraindications

Comatose states or in the presence of large amounts of CNS depressants (e.g., alcohol, barbiturates, opiates).^a ^c (See Specific Drugs and Laboratory Tests under Interactions.)

Bone marrow depression or blood dyscrasias.^a ^c

Liver damage.^a ^c

Known hypersensitivity to phenothiazines.^a ^c

Warnings/Precautions

Warnings

Shares the toxic potentials of other phenothiazines; observe the usual precautions of phenothiazine therapy.^a ^b

Increased Mortality in Geriatric Patients with Dementia-related Psychosis

Increased risk of death with use of either conventional (first-generation) or atypical (second-generation) antipsychotics in geriatric patients with dementia-related psychosis.^a ^e ^l ^m ^o

Antipsychotic agents, including trifluoperazine, are not approved for the treatment of dementia-related psychosis.^a ^l ^m (See Increased Mortality in Geriatric Patients with Dementia-related Psychosis in Boxed Warning.)

Tardive Dyskinesia

Tardive dyskinesia, a syndrome of potentially irreversible, involuntary, dyskinetic movements, reported with use of antipsychotic agents, including trifluoperazine.^a ^c

Reserve long-term antipsychotic treatment for patients with chronic illness known to respond to antipsychotic agents, and for whom alternative, equally effective, but potentially less harmful treatments are not available or appropriate.^a In patients requiring chronic treatment, use smallest dosage and shortest duration of treatment producing a satisfactory clinical response; periodically reassess need for continued therapy.^a

APA recommends assessing patients receiving conventional antipsychotic agents for abnormal involuntary movements every 6 months; for patients at increased risk for tardive dyskinesia, assess every 3 months.^e Consider discontinuance of trifluoperazine if signs and symptoms of tardive dyskinesia appear.^a However, some patients may require treatment despite the presence of the syndrome.^a

Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome (NMS), a potentially fatal syndrome characterized by hyperpyrexia, muscle rigidity, altered mental status, and autonomic instability, reported with antipsychotic agents.^a

Immediately discontinue therapy and initiate supportive and symptomatic therapy if NMS occurs.^a Careful monitoring recommended if therapy is reinstituted following recovery; the risk that NMS can recur must be considered.^a

Concomitant Therapy with Lithium

Although most patients receiving lithium and an antipsychotic agent concurrently do not develop unusual adverse effects, an acute encephalopathic syndrome occasionally has occurred, especially when high serum lithium concentrations were present.^a ^c (See Specific Drugs and Laboratory Tests under Interactions.)

Cognitive and Motor Impairment

May impair mental and/or physical abilities, especially during the first few days of therapy.^a ^c (See Specific Drugs and Laboratory Tests under Interactions and see also Advice to Patients.)

Sensitivity Reactions

Possible sensitivity reactions (e.g., cholestatic jaundice, blood dyscrasias, skin reactions, photosensitivity).^a ^c Use generally not recommended in patients who have previously demonstrated a hypersensitivity reaction (e.g., blood dyscrasias, jaundice) to a phenothiazine, unless potential benefits outweigh the possible risks.^a ^c

Contact dermatitis occurs rarely following skin contact with trifluoperazine hydrochloride preparations; use care to avoid skin contact with preparations of the drug.^a ^b ^c

General Precautions

Hematologic Effects

Leukopenia, neutropenia, and agranulocytosis temporally related to antipsychotic agents, including trifluoperazine.^a ^r ^s Thrombocytopenia, anemia, and pancytopenia also reported in patients receiving trifluoperazine.^a ^r

Possible risk factors for leukopenia and neutropenia include preexisting low WBC count and a history of drug-induced leukopenia or neutropenia.^r ^s Monitor CBC frequently during the first few months of therapy in patients with such risk factors.^r Discontinue trifluoperazine at the first sign of a decline in WBC count in the absence of other causative factors.^r

Carefully monitor patients with clinically important neutropenia for fever or other signs and symptoms of infection and treat promptly if they occur.^r (See Advice to Patients.) In patients with severe neutropenia (ANC <1000/mm³), discontinue trifluoperazine and monitor WBC until recovery occurs.^r

Hepatic Effects

Cholestatic jaundice or liver damage reported.^a ^c

Perform hepatic function tests immediately in patients who develop fever accompanied by flu-like symptoms (e.g., nausea, vomiting, anorexia) during therapy; if hepatic function test results are abnormal, discontinue drug.^a ^c

Cardiovascular Effects

Possible hypotension and exacerbation of angina; avoid large dosages in patients with cardiovascular disorders.^a ^c If severe hypotension occurs, may use norepinephrine or phenylephrine to alleviate; epinephrine should not be used.^a ^c (See Specific Drugs and Laboratory Tests under Interactions.)

Ocular Effects

Consider possibility of pigmentary retinopathy and lenticular and corneal deposits in patients receiving prolonged therapy.^a ^c Periodic ophthalmic examinations recommended in patients receiving prolonged phenothiazine therapy with moderate to high dosages.^a ^c Discontinue drug if ophthalmic examination or visual field studies demonstrate retinal changes.^a ^c

Hyperprolactinemia

May cause elevated serum prolactin concentrations, which may persist during chronic administration and cause clinical disturbances (e.g., galactorrhea, amenorrhea, gynecomastia, impotence).^a ^c

If contemplating trifluoperazine therapy in patient with previously detected breast cancer, consider that approximately one-third of human breast cancers are prolactin-dependent in vitro.^a

Mutagenicity

Chromosomal aberrations in spermatocytes and abnormal sperm have been demonstrated in rodents.^a ^c

Body Temperature Regulation

Phenothiazines depress the hypothalamic mechanism for body temperature regulation; possible hyperthermia or hypothermia when exposed to temperature extremes.^a ^c

Use with caution in patients exposed to extreme heat or cold.^a ^c

Anticholinergic Effects

Possible anticholinergic effects (e.g., dry mouth, blurred vision, mydriasis, constipation, obstipation, nausea, adynamic ileus, atonic colon, urinary retention, decreased perspiration, impotence).^a ^c

Use with caution in patients with glaucoma.^a ^c

Other Precautions

Antiemetic effects may mask signs of overdosage of other drugs (e.g., antineoplastic agents) or obscure cause of vomiting in various disorders (e.g., intestinal obstruction, Reye’s syndrome, brain tumor).^a ^c

Specific Populations

Pregnancy

Category C.^d

Risk for extrapyramidal and/or withdrawal symptoms (e.g., agitation, hypertonia, hypotonia, tardive dyskinetic-like symptoms, tremor, somnolence, respiratory distress, feeding disorder) in neonates exposed to antipsychotic agents during the third trimester; monitor neonates exhibiting such symptoms.^a ^h ^j ^k Symptoms were self-limiting in some neonates but varied in severity; some infants required intensive support and prolonged hospitalization.^a ^h ^j ^k

Lactation

Phenothiazines are distributed into milk.^a ^c ^d Discontinue nursing or the drug.^a ^c

Pediatric Use

Safety and efficacy not established in children <6 years of age.^a ^b

Geriatric Use

Geriatric patients appear to be particularly sensitive to adverse CNS (e.g., tardive dyskinesia, parkinsonian manifestations, akathisia, sedation), anticholinergic, and cardiovascular (e.g., orthostatic hypotension) effects of antipsychotic agents.^a ^b ^c ^e

Common Adverse Effects

Extrapyramidal reactions (e.g., Parkinson-like symptoms, dystonia, akathisia), drowsiness, fatigue, muscular weakness, insomnia, blurred vision, skin reactions or rash, anorexia, dry mouth, hypotension, amenorrhea, galactorrhea.^a ^b ^c ^e

Interactions for Trifluoperazine Hydrochloride

Specific Drugs and Laboratory Tests

Drug or Test	Interaction	Comments
Anticoagulants, oral	Potential decreased effect of oral anticoagulants^a
Anticonvulsants (e.g., phenytoin)	Trifluoperazine may lower seizure threshold^a ^c Trifluoperazine may interfere with phenytoin metabolism and precipitate phenytoin toxicity^a	Dosage adjustments of anticonvulsants may be necessary^a ^c
CNS depressants (e.g., alcohol, anesthetics, opiate analgesics, sedative/hypnotics)	Possible additive effects or potentiated action of other CNS depressants^a ^c	Use with caution to avoid excessive sedation or CNS depression^a ^c
Epinephrine	Possible further lowering of BP^a ^c	Do not use epinephrine for phenothiazine-induced hypotension^a ^c (see Cardiovascular Effects under Cautions)
Guanethidine and related compounds	Potential for decreased effectiveness of guanethidine and related compounds^a
Lithium	An acute encephalopathic syndrome reported occasionally, especially when high serum lithium concentrations present^a ^c	Observe patients receiving combined therapy for evidence of adverse neurologic effects; promptly discontinue if such signs or symptoms appear^a ^c
Propranolol	Increased plasma concentrations of trifluoperazine and propranolol^a
Test for phenylketonuria (PKU)	Potential false-positive test results^a ^c
Thiazide diuretics	Potential for increased orthostatic hypotension^a

Trifluoperazine Hydrochloride Pharmacokinetics

Absorption

Bioavailability

Phenothiazines are generally well absorbed from the GI tract.^c ^f Considerable interindividual variation in peak concentrations reported.^c ^f ^g

Distribution

Extent

Not fully characterized.^c

Crosses the placenta.^c ^d Distributed into breast milk.^a ^c ^d

Plasma Protein Binding

Phenothiazines are highly bound to plasma proteins.^c

Elimination

Metabolism

Metabolic fate not fully elucidated.^c ^f Appears to be extensively metabolized, principally in the liver.^c ^f

Elimination Route

Phenothiazines and their metabolites are excreted in urine and feces.^c

Half-life

12–24 hours.^e ^f ^g

Stability

Storage

Oral

Tablets

Tight, light-resistant containers at 20–25°C; protect from moisture.^a

ActionsActions

Precise mechanism(s) of antipsychotic action not determined, but may be principally related to antidopaminergic effects.^b ^c

Exhibits weak anticholinergic and sedative effects and strong extrapyramidal effects and antiemetic activity.^b ^c

Advice to Patients

Importance of advising patients and caregivers that geriatric patients with dementia-related psychosis treated with antipsychotic agents are at an increased risk of death.^a ^e ^l ^m Inform patients and caregivers that trifluoperazine is not approved for treating geriatric patients with dementia-related psychosis.^a ^m

Potential for drug to impair mental alertness or physical coordination; use caution when driving or operating machinery until effects on individual are known.^a ^c

Importance of clinicians informing patients in whom chronic trifluoperazine use is contemplated of risk of tardive dyskinesia, taking into account clinical circumstances and competency of patient to understand information provided.^a ^c ⁿ Importance of informing patients to report any muscle movements that cannot be stopped.ⁿ

Importance of avoiding exposure to temperature extremes.^a ^c

Importance of informing clinician if sore throat or other signs of infection occur.^a ^c

Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses (e.g., cardiovascular disease).^a ^c

Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.^a ^h Importance of clinicians informing patients about the benefits and risks of taking antipsychotics during pregnancy (see Pregnancy under Cautions).^a ^h Importance of advising patients not to stop taking trifluoperazine if they become pregnant without consulting their clinician; abruptly stopping antipsychotic agents may cause complications.^h

Importance of informing patients of other important precautionary information.^a (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Trifluoperazine Hydrochloride
Routes	Dosage Forms	Strengths	Brand Names
Oral	Tablets, film-coated	1 mg (of trifluoperazine)*	Trifluoperazine Hydrochloride Tablets
		2 mg (of trifluoperazine)*	Trifluoperazine Hydrochloride Tablets
		5 mg (of trifluoperazine)*	Trifluoperazine Hydrochloride Tablets
		10 mg (of trifluoperazine)*	Trifluoperazine Hydrochloride Tablets

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 07/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Trifluoperazine HCl 10MG Tablets (SANDOZ): 60/$55.99 or 180/$135.98

Trifluoperazine HCl 2MG Tablets (MYLAN): 60/$35.99 or 180/$85.97

Trifluoperazine HCl 5MG Tablets (SANDOZ): 60/$35.99 or 180/$98.98

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions June 13, 2011. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

HID. Trissel LA. Handbook on injectable drugs. 12th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2003:622-3.

a. Sandoz Inc. Trifluoperazine hydrochloride tablets prescribing information. Princeton, NJ; 2010 Sep.

b. AHFS drug information 2007. McEvoy GK, ed. Trifluoperazine hydrochloride. Bethesda, MD: American Society of Health-System Pharmacists; 2007:2457.

c. AHFS drug information 2007. McEvoy GK, ed. Phenothiazines general statement. Bethesda, MD: American Society of Health-System Pharmacists; 2007: 2439-50.

d. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 7th ed. Philadelphia, PA: Williams & Wilkins; 2005:1626-7.

e. American Psychiatric Association. Practice guideline for the treatment of patients with schizophrenia, second edition. Am J Psychiatry. 2004; 161(Suppl):1-56.

f. Midha KK, Korchinski ED, Verbeeck RK et al. Kinetics of oral trifluoperazine disposition in man. Br J Clin Pharmacol. 1983; 15:380-2. [PubMed 6849769]

g. Midha KK, Hawes EM, Hubbard JW et al. A pharmacokinetic study of trifluoperazine in two ethnic populations. Psychopharmacol. 1988; 95:333-8.

h. US Food and Drug Administration. FDA drug safety communication: Antipsychotic drug labels updated in use during pregnancy and risk of abnormal muscle movements and withdrawal symptoms in newborns.. Rockville, MD; 2010 Feb 22. From the FDA website: .

i. Lahti AC, Tamminga CA. Recent developments in the neuropharmacology of schizophrenia. Am J Health-Syst Pharm. 1995; 52(Suppl 1):S5-8. [PubMed 7749964]

j. Sexson WR, Barak Y. Withdrawal emergent syndrome in an infant associated with maternal haloperidol therapy. J Perinatol. 1989; 9:170-2. [PubMed 2738729]

k. Coppola D, Russo LJ, Kwarta RF Jr. et al. Evaluating the postmarketing experience of risperidone use during pregnancy: pregnancy and neonatal outcomes. Drug Saf. 2007; 30:247-64. [PubMed 17343431]

l. Food and Drug Administration. Information for Healthcare Professionals: Conventional antipsychotics. Rockville, MD; 2008 Jun 16. From the FDA website: .

m. Food and Drug Administration. Public health advisory: deaths with antipsychotics in elderly patients with behavioral disturbances. Rockville, MD; 2005 Apr 11. From the FDA website: ().

n. Food and Drug Administration. Patient information sheet: aripiprazole (marketed as Abilify). 2006 Sep 6.

o. Banerjee S. The use of antipsychotic medication for people with dementia: time for action. A report for the Minister of State for Care Services. United Kingdom Department of Health. From the website: .

p. Volavka J, Citrome L. Oral antipsychotics for the treatment of schizophrenia: heterogeneity in efficacy and tolerability should drive decision-making. Expert Opin Pharmacother. 2009; 10:1917-28. [PubMed 19558339]

q. Lieberman JA. Atypical antipsychotic drugs as a first-line treatment of schizophrenia: a rationale and hypothesis. J Clin Psychiatry. 1996; 57(Suppl 11):68-71. [PubMed 8941173]

r. Mylan Pharmaceuticals Inc. Trifluoperazine hydrochloride tablets prescribing information. Morgantown, WV; 2010 Sep.

s. Qureshi SU, Rubin E. Risperidone- and aripiprazole-induced leukopenia: a case report. Prim Care Companion J Clin Psychiatry. 2008; 10:482-3. [PubMed 19287562]

More Trifluoperazine Hydrochloride resources

Trifluoperazine Hydrochloride Side Effects (in more detail)
Trifluoperazine Hydrochloride Dosage
Trifluoperazine Hydrochloride Use in Pregnancy & Breastfeeding
Drug Images
Trifluoperazine Hydrochloride Drug Interactions
Trifluoperazine Hydrochloride Support Group
3 Reviews for Trifluoperazine Hydrochloride - Add your own review/rating

Trifluoperazine MedFacts Consumer Leaflet (Wolters Kluwer)

Stelazine Concise Consumer Information (Cerner Multum)

Compare Trifluoperazine Hydrochloride with other medications

Anxiety
Schizophrenia

Friday, September 23, 2016

Hydromorphone High-Potency

Pronunciation: HYE-droe-MOR-fone
Generic Name: Hydromorphone High-Potency
Brand Name: Dilaudid-HP

Hydromorphone High-Potency is used for:

Treating moderate to severe pain in narcotic-tolerant patients who require larger than usual doses to provide adequate pain relief.

Hydromorphone High-Potency is an opioid (narcotic) analgesic. It works by binding to certain receptors in the brain and nervous system to reduce pain.

Do NOT use Hydromorphone High-Potency if:

you are allergic to any ingredient in Hydromorphone High-Potency or any other codeine- or morphine-related medicine (eg, morphine, codeine, oxycodone)

you are NOT already receiving large amounts of injectable narcotics

you have difficult or slowed breathing, chronic obstructive pulmonary disease (COPD), or right-sided heart problems (cor pulmonale), or you are having a severe asthma attack

you are in labor

you have severe diarrhea or other bowel problems caused by antibiotics or poisoning

you have a brain injury or growths in the brain along with increased pressure in the brain

you are taking sodium oxybate (GHB)

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

Before using Hydromorphone High-Potency:

Some medical conditions may interact with Hydromorphone High-Potency. Tell your health care provider if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding

if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

if you have allergies to medicines, foods, or other substances

if you are allergic to latex

if you have a history of lung or breathing problems (eg, asthma, emphysema, bronchitis), seizures (eg, epilepsy), adrenal gland problems, an enlarged prostate, heart problems, low blood pressure, dehydration, low blood volume, an underactive thyroid, or urinary blockage

if you have severe drowsiness, a recent head injury, spinal problems, growths in the brain, or increased pressure in the brain

if you have liver or kidney problems, gallbladder problems, or stomach or bowel problems (eg, inflammation), or if you have had recent stomach or bowel surgery

if you drink alcohol regularly, have symptoms of alcohol withdrawal, or have a history of suicidal thoughts or attempts

if you have a personal or family history of mental or mood problems, alcohol abuse, or other substance abuse or dependence

if you are in poor health or shock, or will be having surgery

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

Phenothiazines (eg, chlorpromazine) because the risk of low blood pressure may be increased

Barbiturate anesthetics (eg, thiopental), cimetidine, or sodium oxybate (GHB) because the risk of severe drowsiness, coma, or slowed or difficult breathing may be increased

Agonist/antagonist analgesics (eg, pentazocine) or naltrexone because they may decrease Hydromorphone High-Potency's effectiveness and withdrawal may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Hydromorphone High-Potency may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Hydromorphone High-Potency:

Use Hydromorphone High-Potency as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Hydromorphone High-Potency is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Hydromorphone High-Potency at home, a health care provider will teach you how to use it. Be sure you understand how to use Hydromorphone High-Potency. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.

Do not use Hydromorphone High-Potency if it is cloudy or discolored, or if the vial is cracked or damaged.

Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.

If you are taking Hydromorphone High-Potency for persistent pain, take it on a regular schedule to help control the pain more effectively.

Do not change your dose or suddenly stop taking Hydromorphone High-Potency without checking with your doctor.

If Hydromorphone High-Potency is no longer needed, dispose of it as soon as possible. Ask your doctor or pharmacist how to dispose of Hydromorphone High-Potency properly.

If you miss a dose of Hydromorphone High-Potency and you are taking it regularly, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised by your health care provider. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Hydromorphone High-Potency.

Important safety information:

Hydromorphone High-Potency may cause drowsiness, dizziness, blurred vision, or lightheadedness. These effects may be worse if you take it with alcohol, other opiate pain medicines, or certain other medicines. Use Hydromorphone High-Potency with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you take Hydromorphone High-Potency; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.

Hydromorphone High-Potency may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.

This product contains a very large amount of hydromorphone. Do not confuse this product with other injectable forms of hydromorphone. If you have any questions about whether you should use this product or another injectable form of hydromorphone, contact your doctor or other health care provider.

Hydromorphone High-Potency may be habit-forming. Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor. Misuse or abuse of Hydromorphone High-Potency may cause severe side effects, including severe breathing problems, seizures, coma, and possibly death.

Constipation is a common side effect of Hydromorphone High-Potency. Talk to your doctor about using laxatives or stool softeners to prevent or treat constipation while you use Hydromorphone High-Potency.

If your pain continues or becomes worse or if you have side effects that concern you, contact your doctor.

Tell your doctor or dentist that you take Hydromorphone High-Potency before you receive any medical or dental care, emergency care, or surgery.

Use Hydromorphone High-Potency with caution in the ELDERLY; they may be more sensitive to its effects, especially drowsiness and breathing problems.

Hydromorphone High-Potency should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

PREGNANCY and BREAST-FEEDING: Hydromorphone High-Potency may cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Hydromorphone High-Potency while you are pregnant. Hydromorphone High-Potency is found in breast milk. Do not breast-feed while taking Hydromorphone High-Potency.

When used for long periods of time or at high doses, Hydromorphone High-Potency may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Hydromorphone High-Potency stops working well. Do not take more than prescribed.

Some people who use Hydromorphone High-Potency for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction. Dependence is unlikely to be an issue in terminally ill patients where comfort is more important. If you are taking Hydromorphone High-Potency regularly, do not suddenly stop taking it without checking with your doctor. WITHDRAWAL symptoms have occurred when Hydromorphone High-Potency is suddenly stopped and may include anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea and vomiting; pain; rigid muscles; seeing, hearing, or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping. Contact your doctor if you notice any of these symptoms after stopping Hydromorphone High-Potency.

Possible side effects of Hydromorphone High-Potency:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dizziness, drowsiness; dry mouth; flushing; lightheadedness; nausea; sweating; vomiting.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; fast, slow, or irregular heartbeat; hallucinations; mental or mood changes; seizure; severe or persistent dizziness or drowsiness; severe or persistent headache or vomiting; shallow, slowed, or difficult breathing; tremor; trouble urinating; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Hydromorphone High-Potency side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include bluish skin; chest pain; cold and clammy skin; coma; difficult or slow breathing; excessive sweating; limp muscles; nausea and vomiting; numbness of an arm or leg; pinpoint pupils; seizures; severe drowsiness or dizziness; slow or irregular heartbeat.

Proper storage of Hydromorphone High-Potency:

Store Hydromorphone High-Potency at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Do not store Hydromorphone High-Potency in the bathroom. Keep Hydromorphone High-Potency out of the reach of children and away from pets.

General information:

If you have any questions about Hydromorphone High-Potency, please talk with your doctor, pharmacist, or other health care provider.

Hydromorphone High-Potency is to be used only by the patient for whom it is prescribed. Do not share it with other people.

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

Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Hydromorphone High-Potency. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Hydromorphone High-Potency resources

Hydromorphone High-Potency Side Effects (in more detail)
Hydromorphone High-Potency Use in Pregnancy & Breastfeeding
Drug Images
Hydromorphone High-Potency Drug Interactions
Hydromorphone High-Potency Support Group
165 Reviews for Hydromorphone High-Potency - Add your own review/rating

Compare Hydromorphone High-Potency with other medications

Anesthetic Adjunct
Cough
Pain

Tusso-C

Generic Name: codeine and guaifenesin (KOE deen and gwye FEN a sin)

Brand Names: Allfen CD, Allfen CDX, Brontex, Cheracol with Codeine, Cheratussin AC, Dex-Tuss, Diabetic Tussin C, Duraganidin NR, ExeClear-C, Guaiatussin AC, Guaifen-C, Guiatuss AC, Guiatussin with Codeine, Iophen-C NR, M-Clear WC, Mar-cof CG, Mytussin AC, Robafen AC, Robitussin-AC, Tussi-Organidin NR, Tussi-Organidin-S NR, Tussiden C, Tusso-C

What is Tusso-C (codeine and guaifenesin)?

Codeine is in a group of drugs called narcotics. It is a cough suppressant that affects the signals in the brain that trigger cough reflex.

Guaifenesin is an expectorant. It helps loosen mucus congestion in your chest and throat, making it easier to cough out through your mouth.

The combination of codeine and guaifenesin is used to treat cough and to reduce chest congestion caused by upper respiratory infections or the common cold.

Codeine and guaifenesin will not treat a cough that is caused by smoking, asthma, or emphysema.

Codeine and guaifenesin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Tusso-C (codeine and guaifenesin)?

Ask a doctor or pharmacist before using any other cough or cold medicine. Guaifenesin is contained in many combination medicines. Taking certain products together can cause you to get too much guaifenesin. Check the label to see if a medicine contains an guaifenesin, or an expectorant. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Codeine may be habit-forming and should be used only by the person it was prescribed for. This medication should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.

What should I discuss with my healthcare provider before taking Tusso-C (codeine and guaifenesin)?

You should not take this medication if you are allergic to codeine or guaifenesin.

To make sure you can safely take codeine and guaifenesin, tell your doctor if you have any of these other conditions:

heart disease, heart rhythm disorder;

asthma, COPD, emphysema, or other breathing disorders;

a history of head injury or brain tumor;

epilepsy or other seizure disorder;

a stomach or intestinal disorder;

Addison's disease or other adrenal gland disorders;

curvature of the spine;

a thyroid disorder;

liver or kidney disease;

enlarged prostate; or

a history of depression, mental illness, or drug addiction;

FDA pregnancy category C. It is not known whether codeine and guaifenesin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Codeine may be habit forming and should be used only by the person it was prescribed for. Never share this medication with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Codeine can pass into breast milk and may harm a nursing baby. The use of codeine by some nursing mothers may lead to life-threatening side effects in the baby. Do not use this medication if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medication.

Liquid forms of this medication may contain sugar or artificial sweetener (phenylalanine). Talk to your doctor before using this form of codeine and guaifenesin if you have diabetes or phenylketonuria (PKU).

How should I take Tusso-C (codeine and guaifenesin)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Cough or cold medicine is usually taken only for a short time until your symptoms clear up.

Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Take codeine and guaifenesin with food if it upsets your stomach. Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication.

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

Call your doctor if your symptoms do not improve after 7 days of treatment, or if you also have a fever, headache, or skin rash.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using codeine and guaifenesin.

Do not stop using this medication suddenly after long-term use or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using the medication. Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

Keep track of the amount of medicine used from each new bottle. Codeine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Since cough medicine is taken when needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of codeine can be fatal.

Overdose symptoms may include extreme dizziness or drowsiness, nausea, vomiting, sweating, confusion, hallucinations, cold and clammy skin, blue-colored lips or fingernails, weak or limp muscles, pinpoint pupils, weak pulse, slow breathing, fainting, or seizures (convulsions).

What should I avoid while taking Tusso-C (codeine and guaifenesin)?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Ask a doctor or pharmacist before using any other cough or cold medicine. Guaifenesin is contained in many combination medicines. Taking certain products together can cause you to get too much guaifenesin. Check the label to see if a medicine contains an guaifenesin, or an expectorant. Drinking alcohol can increase certain side effects of codeine and guaifenesin.

Tusso-C (codeine and guaifenesin) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking this medication and call your doctor at once if you have any of these serious side effects:

severe dizziness or drowsiness;

confusion, hallucinations, unusual thoughts or behavior;

urinating less than usual or not at all; or

slow heart rate, weak pulse, fainting, weak or shallow breathing.

Less serious side effects include:

dizziness, drowsiness, headache;

warmth, redness, or tingling under your skin;

nausea, vomiting, upset stomach;

constipation; or

skin rash or itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Tusso-C (codeine and guaifenesin)?

Before taking this medication, tell your doctor if you regularly use other medicines that make you sleepy (such as allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by codeine and guaifenesin.

Also tell your doctor if you are using any of the following drugs:

cimetidine (Tagamet);

quinidine (Quin-G);

naloxone (Narcan); or

naltrexone (Vivitrol).

This list is not complete and other drugs may interact with codeine and guaifenesin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More Tusso-C resources

Tusso-C Side Effects (in more detail)
Tusso-C Use in Pregnancy & Breastfeeding
Tusso-C Drug Interactions
Tusso-C Support Group
0 Reviews for Tusso-C - Add your own review/rating

Brontex MedFacts Consumer Leaflet (Wolters Kluwer)

ExeClear-C Prescribing Information (FDA)

Guiatuss AC Liquid MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Tusso-C with other medications

Cough

Where can I get more information?

Your pharmacist can provide more information about codeine and guaifenesin.

See also: Tusso-C side effects (in more detail)

Truvada

Pronunciation: EM-trye-SYE-ta-been/ten-OF-oh-vir
Generic Name: Emtricitabine/Tenofovir
Brand Name: Truvada

Severe and sometimes fatal lactic acidosis (a buildup of lactic acid in the blood) and liver problems have occurred with this type of medicine. The risk may be greater in women, patients who are very overweight, or patients who have been taking nucleoside medicines (eg, emtricitabine, tenofovir) for a long time.

Tell your doctor right away if you develop symptoms of lactic acidosis (eg, unusual weakness or tiredness; unusual muscle pain; fast or difficult breathing; stomach pain with nausea and vomiting; feeling cold, especially in the arms and legs; dizziness or light-headedness; fast or irregular heartbeat). Tell your doctor right away if you develop symptoms of liver problems (eg, yellowing of the skin or eyes, dark urine, pale stools, persistent loss of appetite, nausea, stomach pain).

Truvada has not been approved to treat hepatitis B virus (HBV) infection. The safety and effectiveness of Truvada in patients who have both HBV and HIV infection have not been confirmed. Some patients with both HBV and HIV infection who took Truvada experienced severe worsening of HBV infection after they stopped taking it. Patients who have both HBV and HIV infection need close medical follow-up to check for worsening liver problems for at least several months after they stop Truvada. Keep all doctor and lab appointments. Do not stop taking Truvada without checking with your doctor.

Truvada is used for:

Treating HIV infection in combination with other medicines. Truvada is not a cure for HIV or AIDS. It may also be used for other conditions as determined by your doctor.

Truvada is an antiviral combination of 2 reverse transcriptase inhibitors. It works by reducing the amount of HIV in the body by blocking its ability to multiply.

Do NOT use Truvada if:

you are allergic to any ingredient in Truvada

you have severe kidney problems or if you require dialysis treatments

you are taking adefovir, medicines that contain lamivudine, or another medicine that contains emtricitabine or tenofovir

you take a medicine that may harm your kidneys (eg, an aminoglycoside antibiotic [eg, gentamicin], amphotericin B, cyclosporine, a nonsteroidal anti-inflammatory drug [NSAID] [eg, ibuprofen], tacrolimus, vancomycin). Ask you doctor if you are not sure if any of your medicines might harm your kidneys

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

Before using Truvada:

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

if you are pregnant, planning to become pregnant, or are breast-feeding

if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

if you have allergies to medicines, foods, or other substances

if you have kidney problems, lactic acidosis, abnormal liver function tests or liver problems, including HBV infection

if you have osteoporosis (weak bones), a family history of osteoporosis, or other risk factors of osteoporosis (eg, smoking, poor nutrition), or if you have a history of bone problems (eg, fracture)

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

Acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, or medicines that may harm your kidneys (eg, an aminoglycoside antibiotic [eg, gentamicin], amphotericin B, cyclosporine, an NSAID eg, [ibuprofen], tacrolimus, vancomycin) because they may increase the risk of Truvada's side effects. Ask your doctor or pharmacist if you are not sure if any of your medicines may affect your kidneys

Adefovir, other medicines that contain emtricitabine or tenofovir, lamivudine, or certain protease inhibitors (eg, atazanavir, lopinavir/ritonavir, tipranavir) because they may increase the risk of Truvada's side effects

Didanosine because the risk of its side effects may be increased by Truvada

This may not be a complete list of all interactions that may occur. Ask your health care provider if Truvada may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Truvada:

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

An extra patient leaflet is available with Truvada. Talk to your pharmacist if you have questions about this information.

Take Truvada by mouth with or without food.

Continue to take Truvada even if you feel well. Do not miss any doses.

Do not suddenly stop taking Truvada without checking with your doctor. This may cause the virus to become less sensitive to this or other medicines. Some conditions (eg, hepatitis B) could become worse if you suddenly stop taking Truvada.

Taking Truvada at the same time each day will help you remember to take it.

If you miss a dose of Truvada, take it as soon as possible. If you do not remember until the next day, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Do not take more than 1 dose in the same day.

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

Important safety information:

Truvada may cause dizziness or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use Truvada with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

You should be tested for HBV infection before you start to take Truvada.

Keep a list of all the medicines that you take. Make a new list each time medicines are added or stopped. Find out about medicines that should not be taken while you are using Truvada. Be sure that each of your health care providers knows all the medicines that you are taking.

When your medicine supply is low, get more from your doctor or pharmacist as soon as you can. Do not stop taking Truvada, even for a short period of time. If you do, the virus may grow resistant to the medicine and become harder to treat.

Truvada is not a cure for HIV infection. Patients may still get illnesses and infections associated with HIV. Remain under the care of your doctor.

Truvada does not stop the spread of HIV to others through blood or sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection. Do not share needles, injection supplies, or items like toothbrushes or razors.

Truvada is not for the treatment of HBV. If you have HBV and HIV, you will need close medical follow-up for several months after stopping treatment with Truvada. Follow-up includes medical exams and blood tests to check for HBV infection that could be getting worse.

The risk of severe side effects (eg, lactic acidosis, severe liver problems) may be greater in women, patients who are very overweight (obese), and patients who have taken nucleoside medicines (eg, emtricitabine, tenofovir) for a long time. Talk with your doctor if you have questions about your risk for severe side effects from Truvada.

Changes in body fat (eg, an increased amount of fat in the upper back, neck, breast, and trunk, and loss of fat from the legs, arms, and face) may occur in some patients taking Truvada. The cause and long-term effects of these changes are unknown. Discuss any concerns with your doctor.

Truvada may improve immune system function. This may reveal hidden infections in some patients. Tell your doctor right away if you notice symptoms of infection (eg, fever, sore throat, weakness, cough, shortness of breath) after you start Truvada.

Ask your doctor if you should take a calcium and vitamin D supplement while you are taking Truvada.

Lab tests, including liver function, kidney function, and bone mineral density, may be performed while you use Truvada. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Truvada should be used with extreme caution in CHILDREN younger than 12 years old, in children weighing less than 77 lb (35 kg), and in ELDERLY patients older than 65 years old; safety and effectiveness in these patients have not been confirmed.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Truvada while you are pregnant. It is not known if Truvada is found in breast milk. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or Truvada to the baby. Do not breast-feed while taking Truvada.

Possible side effects of Truvada:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal skin sensations; back pain; cough; darkened skin color on the palms of hands or soles of feet; diarrhea; dizziness; gas; headache; indigestion; joint pain; loss of appetite; nausea; sinus drainage; skin discoloration (small spots or freckles); strange dreams; sweating; tiredness; trouble sleeping; vomiting; weakness; weight loss.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); bone pain; chest pain; fever; mental or mood changes (eg, depression); muscle pain or weakness; numbness, burning, pain, or tingling in the hands or feet; severe or persistent dizziness; severe or persistent nausea or vomiting; shortness of breath; stomach pain; symptoms of kidney problems (eg, increased or decreased urination, increased thirst); symptoms of lactic acidosis (eg, unusual weakness or tiredness; unusual muscle pain; fast or difficult breathing; stomach pain with nausea and vomiting; feeling cold, especially in the arms and legs; dizziness or light-headedness; fast or irregular heartbeat); symptoms of liver problems (eg, yellowing of the skin or eyes; dark urine; pale stools; persistent loss of appetite).

See also: Truvada side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Truvada:

Store Truvada at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Do not use Truvada if the seal over the bottle opening is broken or missing. Keep Truvada in its original container and keep the container tightly closed. Do not keep medicine that is out of date or that you no longer need. If you throw any medicines away, make sure that children or pets cannot find them. Keep Truvada out of the reach of children and away from pets.

General information:

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

Truvada is to be used only by the patient for whom it is prescribed. Do not share it with other people.

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

Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Truvada. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Truvada resources

Truvada Side Effects (in more detail)
Truvada Use in Pregnancy & Breastfeeding
Drug Images
Truvada Drug Interactions
Truvada Support Group
5 Reviews for Truvada - Add your own review/rating

Truvada Prescribing Information (FDA)

Truvada Advanced Consumer (Micromedex) - Includes Dosage Information

Truvada Consumer Overview

Compare Truvada with other medications

HIV Infection
Nonoccupational Exposure

Oyster Shell Calcium with Vitamin D

Generic Name: calcium and vitamin D combination (KAL see um and VYE ta min D)

Brand Names: Calcarb with D, Calcet, Calcio Del Mar, Calcitrate with D, Calcium 600+D, Caltrate 600 with D, Caltrate 600 with D Plus Soy, Caltrate Colon Health, Citracal + D, Citracal 250 mg + D, Citracal Creamy Bites, Citracal Maximum + D, Citracal Petites, Citrus Calcium with Vitamin D, Dical-D, Os-Cal 250 with D, Os-Cal 500 + D, Os-Cal with D, Oysco 500 with D, Oysco D, Oyst-Cal-D, Oyster Shell Calcium with Vitamin D, Oyster-D, Oystercal-D, Posture-D H/P, Risacal-D

What is Oyster Shell Calcium with Vitamin D (calcium and vitamin D combination)?

Calcium is a mineral that is found naturally in foods. Calcium is necessary for many normal functions of your body, especially bone formation and maintenance.

Vitamin D is important for the absorption of calcium from the stomach and for the functioning of calcium in the body.

Calcium and vitamin D combination is used to prevent or to treat a calcium deficiency.

Calcium and vitamin D combination may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Oyster Shell Calcium with Vitamin D (calcium and vitamin D combination)?

Before you take calcium and vitamin D combination, tell your doctor if you have kidney disease, past or present kidney stones, heart disease, circulation problems, a parathyroid disorder, or if you are pregnant or breast-feeding.

Avoid taking any other vitamin or mineral supplements that contain calcium or vitamin D without first talking to your doctor.

Before taking calcium and vitamin D combination, tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

What should I tell my healthcare provider before taking Oyster Shell Calcium with Vitamin D (calcium and vitamin D combination)?

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

kidney disease;

past or present kidney stones;

heart disease;

circulation problems; or

a parathyroid gland disorder.

Talk to your doctor before taking calcium and vitamin D combination if you are pregnant. Talk to your doctor before taking calcium and vitamin D combination if you are breast-feeding.

How should I take Oyster Shell Calcium with Vitamin D (calcium and vitamin D combination)?

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

Take the calcium and vitamin D regular tablet with a full glass of water.

The chewable tablet should be chewed before you swallow it.

Store calcium and vitamin D combination at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

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

Overdose symptoms may include irregular heartbeat, stomach pain, nausea, vomiting, dry mouth, a metallic taste in your mouth, confusion, loss of appetite, constipation, weakness, headache, confusion, or fainting.

What should I avoid while taking Oyster Shell Calcium with Vitamin D (calcium and vitamin D combination)?

Avoid taking any other vitamin or mineral supplements that contain calcium or vitamin D without first talking to your doctor.

Oyster Shell Calcium with Vitamin D (calcium and vitamin D combination) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Less serious side effects may include:

an irregular heartbeat;

nausea, vomiting, or decreased appetite;

dry mouth;

constipation;

weakness;

headache;

a metallic taste;

muscle or bone pain; or

drowsiness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Oyster Shell Calcium with Vitamin D (calcium and vitamin D combination)?

Before taking calcium and vitamin D combination, tell your doctor if you are taking:

digoxin (Lanoxin, Lanoxicaps);

antacids containing calcium, aluminum, or magnesium;

other calcium supplements;

calcitriol (Rocaltrol) or other vitamin D supplements; or

a tetracycline antibiotic such as demeclocycline (Declomycin), doxycycline (Adoxa, Doryx, Oracea, Vibramycin), minocycline (Dynacin, Minocin, Solodyn, Vectrin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap).

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

More Oyster Shell Calcium with Vitamin D resources

Oyster Shell Calcium with Vitamin D Use in Pregnancy & Breastfeeding
Oyster Shell Calcium with Vitamin D Drug Interactions
0 Reviews for Oyster Shell Calcium with Vitamin D - Add your own review/rating

Compare Oyster Shell Calcium with Vitamin D with other medications

Dietary Supplementation
Osteoporosis

Where can I get more information?

Your pharmacist can provide more information about calcium and vitamin D combination.

Intestinal Anastomoses Medications

There are currently no drugs listed for "Intestinal Anastomoses".

Drug List:

Thursday, September 22, 2016

Lutedion

Lutedion may be available in the countries listed below.

Ingredient matches for Lutedion

Chlormadinone

Chlormadinone 17α-acetate (a derivative of Chlormadinone) is reported as an ingredient of Lutedion in the following countries:

Japan

Mestranol

Mestranol is reported as an ingredient of Lutedion in the following countries:

Japan

International Drug Name Search