Fenofibrate 160mg Tablets, Fenobrat

FENOFIBRATE 160MG TABLETS

Transcript

Supralip® 160 mg tablets/ Fenofibrate 160mg Tablets (fenofibrate)

Your medicine is known by either of the above names but will be referred to as Supralip 160 mg throughout this:

Patient Information Leaflet

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. • Keep this leaflet. You may need to read it again. • If you have any further questions, ask your doctor, or pharmacist or nurse. • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them even if their signs of illness are the same as yours. • If you get any side effects, talk to your doctor, or pharmacist or nurse. This includes any possible side effects not listed in this leaflet.

The risk of muscle breakdown is higher in some patients. Tell your doctor if: • you are over 70 years old • you have kidney problems • you have thyroid problems • you or a close family member has muscle problems which runs in the family • you drink large amounts of alcohol • you are taking medicines called statins to lower cholesterol such as simvastatin, atorvastatin, pravastatin, rosuvastatin or fluvastatin • you have ever had muscle problems during treatment with statins or fibrates such as fenofibrate, bezafibrate or gemfibrozil. If any of the above apply to you (or you are not sure), talk to your doctor before Supralip 160 mg.

Supralip 160 mg belongs to a group of medicines, commonly known as fibrates. These medicines are used to lower the level of fats (lipids) in the blood. For example the fats known as triglycerides.

Other medicines and Supralip 160 mg Tell your doctor if you are taking have recently taken or might take any other medicines. In particular tell your doctor or pharmacist if you are taking any of the following medicines: • anti-coagulants to thin your blood (such as warfarin) • other medicines to control fat levels in the blood (such as, statins or fibrates). Taking a statin at the same time as Supralip 160 mg may increase the risk of muscle problems • a particular class of medicines to treat diabetes (such as rosiglitazone or pioglitazone) • ciclosporin (an immunosuppressant) If any of the above apply to you (or you are not sure), talk to your doctor or pharmacist before taking Supralip 160 mg.

Supralip 160 mg is used, alongside a low fat diet and other non-medical treatments such as exercise and weight loss, to lower levels of fats in the blood.

Supralip 160 mg with food, drink and alcohol It is important to take the tablet with food - it will not work as well if your stomach is empty.

Supralip 160 mg can be used in addition to other medicines (statins) in some circumstances when levels of fats in the blood are not controlled with a statin alone

Pregnancy, breast-feeding and fertility • Tell your doctor if you are pregnant, think you may be pregnant or are planning to have a baby. As there is not enough experience with the use of Supralip 160mg during pregnancy, you should use Supralip 160mg only, if your doctor considers it absolutely necessary. • It is not known, whether the active substance in Supralip 160mg passes into breast-milk. Therefore, you should not use Supralip 160mg if you are breast-feeding or planning to breast-feed your baby. Ask your doctor or pharmacist for advice before taking this medicine.

What is in this leaflet: 1) What Supralip 160 mg is and what it is used for 2) What you need to know before you take Supralip 160 mg 3) How to take Supralip 160 mg 4) Possible side effects 5) How to store Supralip 160 mg 6) Contents of the pack and other information

1) What Supralip 160 mg is and what it is used for

2) What you need to know before you take Supralip 160 mg

Do not take Supralip 160 mg if: • you are allergic to fenofibrate or any of the other ingredients of this medicine (listed in Section 6: Contents of the pack and other information) • you are allergic (hypersensitive) to peanut or arachis oil or soya lecithin or related products • while taking other medicines, you have had an allergic reaction or skin damage from sunlight or UV light (these medicines include other fibrates and an anti-inflammatory medicine called ‘ketoprofen’) • you have severe liver, kidney or gallbladder problems • you have pancreatitis (an inflamed pancreas which causes abdominal pain) which is not caused by high levels of fat in the blood Do not take Supralip 160 mg if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Supralip 160 mg. Warnings and precautions Talk to your doctor or pharmacist or nurse before taking Supralip 160 mg if: • you have any liver or kidney problems • you may have an inflamed liver (hepatitis) - signs include yellowing of the skin and the whites of the eyes (jaundice), an increase in liver enzymes (shown in blood tests), stomach pain and itching • you have an under-active thyroid gland (hypo-thyroidism) If any of the above apply to you (or you are not sure), talk to your doctor or pharmacist before taking Supralip 160 mg. Effects on muscles Stop taking Supralip 160 mg and see a doctor straight away if you get unexplained cramps or painful, tender or weak muscles while taking this medicine. • This is because this medicine may cause muscle problems, which may be serious. • These problems are rare but include muscle inflammation and breakdown. This can cause kidney damage or even death. Your doctor may do a blood test to check your muscles before and after starting treatment.

Driving and using machines This medicine will not affect you being able to drive or use tools or machines. Supralip 160 mg contains lactose (a type of sugar). If you have been told by your doctor that you cannot tolerate or digest some sugars (have an intolerance to some sugars), talk to your doctor before taking this medicine. Supralip 160 mg contains soya oil. If you are allergic to peanut or soya, do not use this medicinal product.

3) How to take Supralip 160 mg Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. Taking this medicine • Swallow the tablet with a glass of water. • Do not crush or chew the tablet. • Take the tablet with food - it will not work as well if your stomach is empty. How much to take The recommended dose is one tablet a day. If you are currently taking one capsule of Lipantil Micro 200 mg, you can change to one tablet of Supralip 160 mg. People with kidney problems If you have kidney problems, your doctor may tell you to take a lower dose. Ask your doctor or pharmacist about this.

Use in children and adolescents The use of Supralip 160mg is not recommended in children and adolescents under 18 years of age. If you take more Supralip 160 mg than you should If you take more Supralip 160 mg than you should or if someone else has taken your medicine, tell your doctor or contact your nearest hospital. If you forget to take Supralip 160 mg • If you forget a dose, take the next dose with your next meal. • Then take your next tablet at the normal time. • Do not take a double dose to make up for a forgotten dose. If you are worried about this talk to your doctor. If you stop taking Supralip 160 mg Do not stop taking Supralip 160 mg unless your doctor tells you to, or the tablets make you feel unwell. This is because abnormal levels of fats in the blood need treating for a long period of time. Remember that as well as taking Supralip 160 mg it is also important that you: • have a low fat diet • take regular exercise. If your doctor stops your medicine, do not keep any left over tablets unless your doctor tells you to. If you have any further questions on the use of this medicine, ask your doctor or pharmacist or nurse.

4) Possible side effects Like all medicines, this medicine can cause side effects, although not everybody gets them. Stop t aking Supralip 1 60 mg a nd s ee a doc tor s traight a way, i f you notice any of the following serious side effects – you may need urgent medical treatment: • allergic reaction - the signs may include swelling of the face, lips, tongue or throat, which may cause difficulty in breathing • cramps or painful, tender or weak muscles - these may be signs of muscle inflammation or breakdown, which can cause kidney damage or even death • stomach pain - this may be a sign that your pancreas is inflamed (pancreatitis) • chest pain and feeling breathless - these may be signs of a blood clot in the lung (pulmonary embolism) • pain, redness or swelling in the legs - these may be signs of a blood clot in the leg (deep vein thrombosis) • yellowing of the skin and whites of the eyes (jaundice), or an increase in liver enzymes - these may be signs of an inflamed liver (hepatitis). Stop taking Supralip 160 mg and see a doctor straight away, if you notice any of the side effects above. Other side effects include: Common (affects less than 1 in 10 people): • diarrhoea • stomach pain • wind (flatulence) • feeling sick (nausea) • being sick (vomiting) • raised levels of liver enzymes in the blood – shown in tests. Uncommon (affects less than 1 in 100 people): • headache • gallstones • reduced sex drive • increase in creatinine (produced by the kidneys) – shown in tests • pancreatitis (inflammation of the pancreas leading to abdominal pain) • thromboembolism: pulmonary embolism (blood clot in the lung causing chest pain and breathlessness), deep vein thrombosis (blood clot in the leg causing pain, redness or swelling) • muscle pain, muscle inflammation, muscle cramps and weakness. Rare (affects less than 1 in 1,000 people): • hair loss • feeling dizzy (vertigo) • feeling exhausted (fatigue)

• increase in urea (produced by the kidneys) – shown in tests • increased sensitivity of your skin to sunlight, sun lamps and sunbeds • drop in haemoglobin (that carries oxygen in blood) and white blood cells – shown in tests • hepatitis (inflammation of the liver), symptoms of which may be mild jaundice (yellowing of the skin and whites of the eyes), stomach pain and itching • hypersensitivity (allergic reaction). Side effect where the chance of it happening are not known • severe form of skin rash with reddening, peeling and swelling of the skin that resembles severe burns • long-term lung problems • muscle breakdown • complications of gallbladder stones. • If you get any unusual breathing discomfort, tell your doctor straight away. Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www. mhra. gov. uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

5) How to store Supralip 160 mg

• Keep out of the sight and reach of children. • Do not use after the expiry date printed on the carton, label or blister strip. • Do not store this medicine above 30° C. Store in the original package to protect from moisture. • If your doctor tells you to stop taking the tablets, please take them back to the pharmacist for safe disposal. Only keep them if your doctor tells you to. • If the tablets become discoloured or show any other signs of deterioration, you should seek the advice of your pharmacist who will tell you what to do. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

6) Contents of the pack and other Information

What Supralip 160 mg contains: Each film coated tablet contains 160 milligrams (mg) of fenofibrate. This is the active ingredient. Each tablet also contains the following inactive ingredients: sodium laurilsulfate, lactose monohydrate, povidone, crospovidone, microcrystalline cellulose, silica colloidal anhydrous, sodium stearyl fumarate. The tablet coating Opadry® consists of the following excipients (inactive) ingredients: polyvinyl alcohol, titanium dioxide (E 171), talc, soybean lecithin, xanthan gum. What Supralip 160 mg looks like and contents of the pack Supralip 160mg are white, oblong, film-coated tablets engraved “160” on one side and “fournier logo” on the other side. Supralip 160mg comes in blister packs of 30 tablets PL 10383/1669

Supralip® 160mg Tablets/ Fenofibrate 160mg Tablets

Who makes and repackages your medicine? Your medicine is manufactured by Recipharm Fontaine, Rue des Pres Potets, 21121 Fontaine-les-Dijon, France. Procured from within the EU and repackaged by the Product Licence Holder Primecrown Ltd. 4/5 Northolt Trading Estate, Belvue Road, Northolt, Middlesex, UB5 5QS. Leaflet date: 17.03.2016 Supralip is a registered trademark of Fournier Industrie et Sante (Societe par Actions Simplifiee), France.

Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

Diviplus, Diviplus

История

В двух словах Aruba's Premier All Inclusive Resort Just Steps From A Mile-Long White Sand Beach

Коротко о себе The mile-long beach is just the start. Enjoy breezy, sunny days strolling along the shore or relaxing pool side with a cocktail. The Divi Aruba All-Inclusive Resort is a refuge of relaxation, where you can do as little or as much as you like. The atmosphere is laid-back both day and night. There are activities ranging from pool volleyball, to snorkeling to sunfish sailing. The nights heat up with theme shows including carnival, limbo and salsa dance lessons. Select from a variety of restaurants, bars and lounges, most right by the water's edge. Guests enjoy the use of all services and facilities of the neighboring Tamarijn Aruba All Inclusive - 9 dining options, 7 bars, 3 freshwater pools and more.

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Coaching classes and homelesson are available for the following classes,

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Behealth, Behealth

A Unique Combination of Investing, Executive Management & Entrepreneurial Experience

Background

BelHealth Investment Partners (“BelHealth”), based in New York, is a healthcare private equity firm focused on lower middle market companies. BelHealth has a unique combination of investing, executive management and entrepreneurial experience.

BelHealth acquires majority positions in entrepreneur-owned companies that it believes would benefit from its extensive operating and private equity investment expertise. The firm typically invests $20-50 million per platform company across three healthcare segments: Services, Products and Distribution.

Collectively, the BelHealth Team, consisting of its investment professionals, Operating Partners and Advisory Board, has completed over 100 healthcare transactions, eclipsing several billion dollars in aggregate value.

Copyright © 2016 BelHealth Investment Partners, LLC. All Rights Reserved. Powered by OGK Creative.

Welcome to

Welcome! Thank you for stopping by — we hope this web site will inform and inspire you to immediately begin taking GHR, a health supplement now recognized as the bridge to a much longer and healthier life! Soon after you begin taking this product, you and others will start noticing some profound changes in your appearance and overall health. Most importantly, you’ll feel terrific!

GHR is a natural health supplement that stimulates the body’s natural Human Growth Hormone (HgH) back to youthful levels. Scientists have now discovered a relationship between this decline of HgH in the body and aging. In fact, the decline is directly responsible for many of the most common signs of growing old, such as wrinkling of the skin, gray hair, decreased energy, and diminished sexual function. Lack of growth hormone contributes to increasing body fat, cardiovascular disease, osteoporosis, and an inclination toward other aging-related diseases.

Human growth hormone was first discovered in 1920 and has long been thought by the medical community to be necessary only to stimulate the body to full adult size and therefore unnecessary past the age of 20. Recent studies, however, have overturned this notion completely, discovering instead that the natural decline of HgH, from ages 21 to 61 (the average age at which there is only a trace left in the body) and is one of the main reasons why the the body ages and fails to regenerate itself to its young adult state. Modern medical science now regards aging as a disease that is treatable and can be delayed, and that “aging”, the disease, is actually a compilation of various diseases and pathologies, from everything, like a rise in blood glucose and pressure to diabetes, skin wrinkling and so on. All of these aging symptoms can be stopped and rolled back by maintaining Growth Hormone levels in the blood at the same levels HgH existed in the blood when we were a young adult.

In 1997, a group of doctors and scientists, developed an all-natural source product Growth Hormone Releaser (GHR) which would cause your own natural HgH to be released again and do all the remarkable things it did for you in your 20’s. Now available to every adult for about the price of a coffee and donut a day. GHR is now available in America, just in time for the aging Baby Boomers and everyone else from age 30 to 100 who doesn’t want to age rapidly but would rather stay young, beautiful and healthy all of the time. The new HgH releasers are winning converts from the synthetic HgH users as well, since GHR is just as effective for anti-aging purposes, is in capsules (oral), instead of self-injectable, and is very affordable and non-prescription. GHR is a natural releaser, has no known side effects, unlike the synthetic version and has no known drug interactions. With GHR, your body controls how much HgH is released and shuts it down at a very safe level, so the safety of the product is very high. Progressive doctors admit that this is the direction medicine is seeking to go, to get the body to heal itself instead of employing drugs. GHR is truly a revolutionary paradigm shift in medicine and, like any modern leap frog advance, many others will be left in the dust holding their limited, or useless drugs and remedies. It is now thought that HgH is so comprehensive in its healing and regenerative potential that it is today, where the computer industry was twenty years ago, that it will displace so many prescription and non-prescription drugs and health remedies that it is staggering to think of.

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Indeed, GHR has been shown to be the bridge to a much longer, healthier life and productive life. Soon after you begin taking this product, you and others will start noticing some profound changes in your appearance and overall health. Most importantly, you’ll feel terrific!

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Dr. Milton Franklin – Optometrist

Belvidere NJ 07823 - 81 years old

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Leon Pennington / Donaldsonville LA - On the product for 1 month. 70 years old

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Ruth Meissner - 40 years old / Carpinteria CA

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READING GLASSES GONE

June Proctor (wife) / Pleasant Grove CA

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Diane Matthew - Burlington ON Canada

60 years of age on GHR for 10 months

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Debbie Hanson - Fort Mcloud AB

39 years old on GHR for two weeks

For 25 years, Debbie Hanson has suffered what she calls "winter depression" and was on heavy medications. Usually, this time dur­ing wintertime season, she's very quiet person with a very heavy heart. After taking the GHR for only a week, she feels all her symptoms are withdrawn. She feels energized and feels happy every day as if it were spring again!

INCREASED MUSCLE MASS

Snyder, Crompton & Assoc.

"I wanted to thank your company for the tremendous results that I have achieved in the past seven months while using your product. I have more energy and gained more muscle mass than in previous years. I am 39 years old and have been weight lifting for the past 19 years. 1 feel like 1 am in my 20's again."

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She takes the GHR with warm water once a day right before she sleeps. "after taking the GHR for 3 months, I've lost 5 inch­es in my waist and 1 inch in my hips. My arms aren't as flabby, I can feel them becoming more solid. I'm now pulling out clothes that I've stored in the closet that I've reserved for the day I could fit into them again! I've also noticed that I sleep much better than I did before, and my face is firming up looking much healthier and younger than before."

HAIR COLOUR RESTORED

Robert Gress - McMurray PA - 68 years old

On GHR for 6 months

"The GHR has turned my hair from gray to brown. I'm playing tennis five times a week and competing in tournaments with men half my age. My overall health has improved and I'm sleeping much better."

Larry Biehn - Lancaster CA

"I firmly believe in GHR. I first took the "Super HGH" for six months, then I discover GHR. Wow, I sell and service fitness equipment in a population of 350,000 people. As a man 64 years of age, I want to stay young and healthy. With my exercise and GHR this is happening."

Elaine Basham / Kansas City MO - On the product for 3 months

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Elaine Nurse - 42 years old / Calgary Alberta. Canada

"I've been on the product for only two months. and not only do I feel great, I feel the GHR has helped me think and speak more clearly when conversing with others."

MORE ENERGY - LESS STRESS

Norma Mareno / Renton WA

"My husband, my daughter and myself are all on the GHR. We feel terrific and have so much more energy. My daughter has told me she feels more at ease, a lot less stressed out."

ARTHRITIS RELIEF & BETTER SLEEP

Norbert Staus - Calgary Alberta

"I haven't slept well for 3 years due to arthritis pain in my knees and back. Every night I would toss and turn 30-40 times. Within two days of trying the GHR, I shockingly noticed that I slept better. Well, I thought that night was just coincidence. Not so! Ever since that day, I turn a couple of times and I fall right to sleep!"

BETTER SEX DRIVE

Garv Diel - Monroeville PA

Not only is he feeling energetic, sleeps good: he feels 20 years younger in just two weeks. He says he slept with his wife five times in a 3 hour period and even has a couple of pimples, of which he never had since 1979! He is a current distributor and he even has added this to his website.

"My husband and I are both on GHR (going on 4th week) and already I have seen an increase in energy. As I have fibromyalgia and do not want to use drugs I am happy to report better sleep and improved energy. If GHR takes away the muscle pain I will remain a customer for life!."

MENOPAUSAL SYMPTOMS RELIEF

"Just a note on my experiences with GHR. I have been using this product for only one month. I am a 52 year old female, and even though I am health, I started to experience cold sweats and hot flashes due to my entering menopause. This problem was caus­ing me great, distress. I would break out in a cold sweat, steam up my glasses in meetings, driving the car, you name it. After just one week on this product [menopause symptoms] stopped completely. At one time I even considered taking hormone replacement as a last resort. I feel great now. I can't wait to see what other changes will occur after 2 and 3 months. Thanks for the great product.'"

"I read the advertisement in the paper and ordered 3 months supply. I am so happy that I did. The next day, after the first dose I worked like I did when I was much younger, without the dragged out feeling over in the late evening. I am really impressed with the product and I have shared it with my friends who really appreciate knowing about it."

LOWER BLOOD PRESSURE AND CHOLESTEROL AND FACELIFT EFFECT

Bernice Riley - 66 years old / Dana Point CA - Been on GHR for 4 months "I've just come back from a check up with my doctor and I feel great! Since I've been on the GHR my blood pressure and cho­lesterol level has improved, my hair has darkened, and my friends have accused me of a face lift. People think I'm 10 years younger than my age! GHR is truly working as promised."

OLD AGE LEG SYNDROME

Betty Wolfe - 60 years old / Fort Worth Texas

"I've been on GHR for about a month and a half. The old age leg syndrome is being conquered. I can walk much better. In fact, not only can I now walk up and down stairs, but I can do this without holding onto the rail, I don't like this product because of what I've heard, but because of what I've felt."

HEART BYPASS RECOVERY

Vivian J. Tretheway - Bermuda Dunes CA

Husband on GHR for 3 months

Her husband had three heart bypass surgeries. He has poor health with a lot of medication. After being on GHR for 3 months, his doctors felt he didn't need any of his medications. His gray skin is turning to it's natural color. You can also hear his improvement in his high energetic voice.

REDUCED PROSTATE SIZE

Lester Whalley - Torrance CA

This gentleman had an enlarged prostate and was battling this problem for some time. After one month of taking the GHR, his prostate completely shrunk down to it's normal, healthy level. Also, his hair started darkening up and was growing faster. After the third month he noticed some new hair growth. Then, in an effort to save money, he tried the "Ultimate HGH" and within weeks he started growing white hair again and losing some valuable benefits. He has no doubt in his mind that GHR is the best perform­ing GHR supplement out there.

HEART MUSCLE STRONGER AND EYESIGHT

Douglas Carr - Los Angeles CA 73 Years old

"Due to having a heart bypass surgery, I'm very picky with what I put into my body. Knowing that the GHR is all-natural, I thought I'd give it a try. After a few months on the product I've noticed impressive results. My own Cardiologist can testify to that! He said that my heart is in great condition. On top of that, my vision has improved to the extent that I'm able to see things so clear that I forget to wear my glasses. I also have fewer mood swings, and even my physical muscles are becoming more defined."

HIP SURGERY RECOVERY

Vivian J. Tretheway - Bermuda Dunes CA

Husband on GHR for 3 months - "He doesn't have to uses his cane that he had to maintain his balance for the last 3 1/2 years due to hip surgery. Due to this problem, he couldn't do much physically. Now, he has plenty of energy and is more physically active. Also, his tired voice he once had is gone!"

LUPUS. CHRONIC FATIGUE. RHEUMATOID ARTHRITIS

"Thank you! Thank you! Thank you! Five years ago when I was 32 years old, I was diagnosed with Lupus, Chronic Fatigue Syndrome (CFS), and Rheumatoid Arthritis (RA). To make a long story short, I refused the treatments offered by the doctors (they could only treat the symptoms, not reverse or cure the diseases). I then chose to take matters into my own hands. Within one month the swelling in my joints was gone, and the pain associated with RA was mostly gone. But I still struggled with CFS and some Lupus symptoms. Over the last five years I've tried every "snake oil treatment" available to mankind. Although all of my Lupus symptoms have slowly disappeared over time, probably due to diet changes, I have had a chronic disabling problem with lack of energy and multiple daily blackouts due to chronic low blood pressure problems. (My lowest BP on record was when I was preg­nant with my 4th child: 74/undetectable!) How ever, I began taking GHR in early August 2000. Within two weeks I realized I was not having any more black outs! I am now able to do things "normal" people can do without passing out! I haven't even had head rushes or anything! In fact, I have no symptoms of any diseases at all anymore!

MS SYMPTOM RELIEF

Rita Zenner / Edmonton AB Canada

On GHR for 3 months "I've had MS for the past 15 years. Although my body has been going down hill ever since, after taking GHR I feel wonderful. Not only do I feel better physically, but mentally. I'm feeling less anxiety and more at ease. In turn, I've reduced my Prozac dosage to a minimum. I feel if this product is helping me, what potential it must have for others with similar problems.

John Hone -53 years old / Palmetto FL

On the product for 4 weeks. "I am feeling much more energy throughout the day. I don't have problems with hemorrhoids any­more. I don't have to get up in the middle of the night to go to the bathroom, instead I'm sleeping deeply through the night. Over all I just feel great!"

Robert Stupps - 49 years old / Fairfield CA

On the product for 4 weeks. "I'm only 49 years of age and many restaurants are already offering me senior discounts. For many years I was involved in farming vineyards and suffered from insecticide poisoning. Ever since then, I have been extremely sluggish. Since I've been on the GHR. this situation has been reversed. I have so much more energy to accomplish the things I need to take care of throughout the day. I have gotten my appetite back and have already noticed a slight increase in muscle mass. I truly didn't think this would work so fast!"

PERRY ORAL DERMATITIS

Rhoda Asbra/Placentia CA

She's been on the GHR for one full year. For several years Rhoda has suffered from "Perry Oral Dermatitis" a skin disorder only women get. Every three to four months she would get this blemish around her mouth and need to take antibiotics to alleviate this problem. Ever since she's been on the GHR (for a full year), [Perry Oral Dermatitis] has not occurred. Nor has she even been sick.

David Warren / Canton MI

David has HIV He started the GHR about seven months ago. He feels his condition is improving. So far his viral levels have gone down and his cd-4 cells went up.

I am 60 years old. Two months ago, I was offered a check of my biological age by a major international hospital (based on metabolic rate) they said it was 38! One reason is that I had just completed a 1800,Km mountain bike ride across mountains in Thailand and Laos. But another is surely that I was taking the BIE product. Ten years ago, I retired prematurely due to major heart problem and high blood pressure.

I am Gloria R. Asure, your customer who has been on the Bie Health products for 11 months now. I am referring a friend, Augustina Bediatco to your outfit.

I am allergic to medication so I don’t take any at all. But after reading about the Bie Health products being all natural, I decided to buy it and Wow!

So and Behold! There is been great improvement to my health and life. Things I couldn’t do before could now be done. Thanks to the entire management.

Reduce Diabetes Symptoms

I have been taking GHR now for about two months. I first noticed about five weeks from beginning taking GHR that the “snake” skin on the back of my had disappeared. I am 62 years old and a disabled vet. On a semi annual visit I had complete blood work done two days before my visit. Let me preface this by saying my core and leg muscle, could not walk and spent into a comma for four months after I ‘Woke’ learning to walk again. Prior to the surgery my diabetes was out of control and I was on 375 units of insulin a day. My weight was 430 pounds and I was ravaged with gout and water retention. I lost 150 pounds in the coma. Needless to say, I am very fortunate to be alive.

My doctor reviewed my test result and could not believe what he saw. My A1C was normal! He could not believe it. I had been exposed to Agent Orange while stationed in Vietnam in 1968 and 1969; the result was the diabetes and a host of other problems. My bad cholesterol had dropped remarkably, my good cholesterol climbed. My blood work done again because he thought it was an error in the results. But I had other blood work done a couple of weeks for another doctor before and they were the same results. He was extremely happy with what he saw.

Besides the GHR, I take a daily vitamin, DHEA, Vitamin B12 complex and fish oil, and I feel great. I will always have some problems as a result of the Agent Orange exposure that won’t go away; but I feel better than I have in a very long time. I know GHR has played a major role is my results. Also, I’m on a blood thinner because of a heart arrhythmia. Each time I had a blood test to check it’ results I was either way too high or way too low. The past two months I have been dead on perfect! The Cumadin Clinic had even noticed the improved results of all my blood work. Again, I contribute that improvement to GHR.

Thank you so much for your fantastic products. I have shared my GHR with wife, and after only three weeks she is beginning to see positive results. GHR has enhanced out lives and health; we are very grateful. Again, thank you so much.

MENOPAUSE RELIEF & MORE

Thank you very much. Your product is fantastic! I no longer have the horrible menopause. It’s also helped my husband with his knees and feet.

Holly & Blaine Moore

I’m having my first good sleep in many year. I am in my 80s. Thanks to your product. I have used 1 bottle only.

ELDER CARE GOING EASIER

Here is another check for your product as my father believes in it. I really appreciate your help in giving my father a reason to keep trying in life, he had been depressed for quite awhile and since he has been taking your product he gets up earlier and he was staying in bed until late in the afternoon. I have been noticing things like his color in his face looks healthier and his migraines have lessen. To me that is wonderful as J take care of him and when he feels good 1feel good! Thanks so much again

MYASTHENIA RELIEF & MORE

To all who are responsible for developing and distributing GHR-15, Thank you. I was diagnosed with myasthenia gravis. This is extreme weakness of muscles. It affects people to different degrees. I was put on 2 drugs called Mestinone and Prednisone, the latter having many side effects I was not prepared to deal with. Again, I thank you. GHR-15 helps me as much, if not more than Mestinone and Prednisone.

SENIORS MAGAZINE REVIEW

I just wanted to drop you a short note to let you know that this GHR-15 really does what it claims.

I've been taking GHR-l 5 faithfully now just as recommended for 3 months and can't believe some of the effects. I lost about 7lbs. in the first 2 weeks. That may not sound like much, but I don't have a weight problem. Every time I've lost weight in the past, it was because I stopped going to the gym to weight train for a short period, so the loss was muscle mass. This time, however, the weight loss was an inch or so offmy waist (fat). And where I used to have trouble using the same weights, this time my strength and endurance increased. I'm even seeing abdominal definition again - and I'm 63 years old.

Being in 'business and under the usual pressures of sales, etc. I would get uptight. the doctor said my blood pressure was at the point that I needed to take medication (water pills). Even to the point where he gave me a prescrip - tion for Inhabace. I now take only 1/2 a 5 mg. water pill and did not go on the Inhabace. Last week, my doctor took my blood pressure in both arms, looked at me and said, "perfect."

One mote thing I have noticed is my memory is sharper than it had been. With all this happening, I can't wait to see if more benefits come with loyal use of GHR•15.

By January 2003, I was extremely ill (75% bedridden). I had tried every supplement offered in health food stores as well as various prescriptions from my many Doctors.

I decided to try ghr15 as a last resort (having had spent thousands of dollars on other supplements suggested by a Naturopath). Advertised in the magazine 3Health CENVitality", assurances were given for noticeable changes within 3 months as well as a list of possible improvements. I decided (due to the severity of my illness to try taking ghr15 for 6 months before expecting any improvements.

By mid June, 2003, I was scheduled to go to Ottawa and Montreal to see the specialist for the Central Nervous System disease that I have. Quite a number of tests were taken which were repeats of 1997 and 1999. Some of the afflictions that had been previously listed (ie. nodules on my thyroid) had disappeared, circulating red blood volumne had improved from 36% to 81 %, Plasma vol from 33% to 77%. Previous heart tests had shown a scar from a previous undetected heart attack, the June 2003 tests showed a heart with no scars, improved holter monitor readings and excellent coronary circulation. A slight improvement was visible on the SPEC scan done on my brain. I have lost 40 of the 50 pounds that I gained when first ill in 1995, and might I add that neither my activity level nor the amount offood eaten daily has changed since 1995. My sleep patterns have gone from disastrous (pills to fall asleep-wake up in 1 to 2 hours) now sleeping 8 to 10 hours with no interruptions a night, sometimes I even sleep 12 to 14 hours' if I have been using my brain too much and am over tired. I now have the stamina and strength endurance to go to a gentle yoga class once a week for 1 hour.

AND. the most amazing part. my husband who had a heart attack in 1996, has asked to go on the ghr15 to help him because he has seen the daily improving of my life since I started ghr 15.

I can't wait for another 3 to 6 months to see where I and my husband's health will be by then.

INCREASED MOBILITY & MORE - SENIORS

My husband and I are both using GHR now. I has greatly helped my mobility and I think it will help him also. Thank you very much.

HEPATITIS AND CHRONIC FATIGUE RELIEF

I am really surprised at how it worked on my chronic fatigue due to my HepC. Before I could sleep all day & night. Now with at least 8 hours sleep, I’m full of life. Only things that keeps me in is our poor spring. I can hardly wait to start gardening. It won’t be long as the snow is finally gone and the gardens are drying up. Thanks for your great product.

MULITPLE SCHLEROSIS SYMPTOM RELIEF

I have MS and the only difference I see is that I can stay on my feet longer. I can walk farther without resting. I use a cane. I still can’t walk too far in a shopping mall but it is better than I used to do. My day to day activities around the house are easier also.

BETTER SLEEP & ENERGY

My friend and I have really found our health has improved greatly. We sleep much better also have only have to get up once during the night. And we have more energy.

KIDNEY STONE GONE

I have been taking your GHR 15 for the last three months now and I’m feeling great. I had a kidney stone operation on my left side which was a great success. I had a stone on my right side which was to be removed later in the year. When I went back for my six week check up, there was no trace of a stone in my right kidney. My doctor was quite upset and said I must have a scan to find it. Nothing showed. I am losing weight and my hair is growing in black instead of white.

More Letters from Our Customers

It has been 3 weeks -- my mom looks like she had a facelift and her hair is growing in auburn. This is amazing. Her scheduled eye surgery has been cancelled The skin above the eyes has resumed its elasticity and no longer is intrusive on her eyesight. Wow!"

"I wanted to thank your company for the tremendous results that I achieved in the past seven months while using your product. I have more energy and gained more muscle mass then in previous years. I am 39 years old and have been weight lifting for the past 19 years. I feel like I am in my 20's again."

"My husband and I are both on GHR (going on 4th week) and already I have seen an increase in energy. As I have fibromyalgia and do not want to use drugs, I am happy to report better sleep and improved energy. If GHR takes away the muscle pain I will remain a customer for life!!"

"Our doctor recommended the GHR to my husband. At the time I was skeptical and did not try the product. However, my husband did try it and because of his fabulous results, I've just started on the program. He was scheduled to have surgery on his feet due to his hammered toes. Since he has been on the GHR, his toes have rapidly healed and are almost cured. We were happy to cancel the scheduled surgery. He has gotten much more energy, he's sleeping through the night, he was able to cut down on his insulin and his feet no longer throb!"

Judith and Lewis Foutz

"I personally love GHR. Since I started taking it (the first of September, '99), I feel like a new person. I've lost 15 ugly pounds, I exercise daily (before I would hurt too much). Don't tell anyone, but I was doing my hair color once a month (gray doesn't show), now I have to do my hair every two weeks (brown does show). I'm a student at FAU and in the spring I barely made it (all kinds of physical problems). I was beginning to wonder if I would make it through college. This semester I feel great, and I have no doubts about finishing in the spring. I will continue telling everyone who will listen about this great product."

"I wanted to write and thank you personally for introducing me to GHR. I was a bit skeptical when I first began taking the product, but after your claims of a better night sleep, I wanted to give it a try.

In all honesty. I have to say WOW! After three weeks of taking GHR, I began sleeping the entire night. I have so much energy and my thought process is clearer than it has ever been.

I have noticed some: other things happening to my body as a whole that I would like to share with you. I had been working out two or three times per week without noticeable results. I hired a personal trainer and still nothing remarkable. After beginning the GHR, my arms have increased 2 inches and my legs are now well defined. My skin and hair look better and I've lost about 6 pounds. All this after only two months.

This product has overwhelmed me. I've already start recommending it to my patients. Again, thank you so much for letting me in on your secret. I love it."

"I've just completed my first two weeks of using the GHR product. I accidentally found out about the product from listening to a PBS radio station one weekend, and the benefits touted caught my attention, especially as a sleeping aide.

I'm a 53 year old white male in general good health, although probably overweight by 20 pounds (5'10"/210 lbs). Most people think I look less than being in my 50's. In fact, my Father's family history is one of healthy longevity--- he just turned 90 and most of his siblings survived into their 90s. Since taking this HGH "releaser" I've noticed I have more energy (not as tired after working my stressful management job each day, and my graying hair now has some color returning. Also, after having some sleeping problems during the last 7 years, I'm now sleeping through the night even though I must get up 1-3 times a night to empty my bladder (enlarged prostrate condition).

In the past, after I'd return to bed from the bathroom, I'd have trouble getting back to sleep---not any more. To sleep at night, I had been using Advil or Benadryl Allergy when I've had sleep problems. I guess using that stuff too often isn't the best, but I've always rationalized that lack of sleep is even a worse alternative. Haven't used any of this Advil or Benadryl stuff now for two weeks. I've also had problems over the last several years with weak, painful knee joints---I've noticed they don't bother me very much any more now. I'm also hoping that this product will help me reduce my weight as it claims by reducing my body fat and increasing muscle mass.

I'm not endorsing or recommending GHR to anyone, only sharing what I've noticed since I've been taking it for two weeks. I know my body pretty well, so I'm confident on what I've noticed about these changes."

"I had an interesting experience recently. My youngest daughter was standing behind me discussing something or another when she started running her fingers through my hair. Now I've been bald from the middle of my head to my forehead for about twenty years, and the remaining hair was pretty thin.

'Dad! Something is different about your hair,' my daughter said. 'It's thicker, maybe?'

After three months on your Growth Hormone Releaser (GHR) there is definitely a difference in the way my hair looks. Solid white for years, my hair is darker, has more body, and I have hair in that bald spot at the front of my head. I started noticing these changes after less than a month on GHR.

As I have aged (I just turned 54), I also noticed undesirable changes in facial hair -- dark, hard whiskers that caused blemishes and increased hair on and in the ears. With GHR, these changes have mostly reversed.

In addition, in the first month I lost about ten pounds without changing my eating habits that I was aware of. I'm disappointed that I haven't lost any more weight, but I have noticed that I've taken my belt up a notch and trousers that once were on the verge of too tight are now comfortable. I suppose somehow my body is rearranging the weight it carries?

There may be other, more subtle changes, but they are difficult to pin down. In any case, I intend to stay on GHR indefinitely. I believe it is that good. Thanks for introducing me to this product.

Tom Badgett, Tennessee

"I had to write this letter because I am truly shocked at what GHR is doing for me. Like any new products that sound too good to be true, I was full of skepticism. But, having taken GHR for my first 3-month cycle, I can say without hesitation that the product does, in fact, release my own human growth hormone.

Coincidentally, at the same time I started taking the product I had blood work done as part of my routine physical exam. While there, I asked to have my IGF-1 measured as a starting point. It was at 235. After three months, I had my blood drawn again and tested for the IGF-1 level. It had soared to over 380. This confirmed why I felt so good.

The best part is the 39 pounds I lost with no intentional change in my daily routine. I say "intentional change" because I had no intention of changing my routine when I started on the product. But, the incredible energy I experienced virtually forced me to become more active. And I cannot express in words how good I feel because of GHR. This product simply makes me feel great all over. My husband and two brothers and their wives are all taking GHR now because of what they have seen in me.

Thanks again and good luck."

Teresa Wilson, Oregon

Dialose, Dialose

dialysate

Done with a machine called an automated cycler that automatically fills the abdomen with dialysate. dwells there and drains into a bag

Method for determining middle and protein bound uremic toxins in the spent dialysate was proposed using fluorescence spectroscopy.

a) Match the pre-dialysis sodium concentration to the amount of sodium present in the dialysate

Double-beam spectrophotometer (in Linkoping UVIKON 943, Kontron, Italy; in Tallinn Shimatsu UV-2401 PC, Japan) was used for the determination of UV-absorbance in the collected spent dialysate samples.

Inoculation of peritoneal dialysate fluid into blood culture bottles improves culture rates.

Dialysate (150 [micro]L) was mixed with 150 [micro]L IS working solution in a 96-well polypropylene plate (Phenomenex).

The cooler dialysate was well tolerated, with no shivering reported by the seven patients in the study, said Dr.

Only a very small amount of bleeding is required to make dialysate appear bloody.

The next morning, the flow rate was increased to 1 [micro]L/min, and 30-min dialysate samples were collected for neurochemical analyses.

Many people who receive APD also have dialysate in their abdominal cavity during their waking hours.

t] is the substance concentration in total dialysate collection tank and [W.

Each study is a prospective, randomized, placebo-controlled, multicenter study to demonstrate efficacy and safety of SFP-iron, delivered via dialysate. in adult CKD patients requiring hemodialysis.

Benadryl Allergy Oral Uses, Side Effects, Interactions, Pictures, Warnings - Dosing, Benaday

Benadryl Allergy

Uses

This medication works by blocking a certain natural substance (histamine ) that your body makes during an allergic reaction. Its drying effects on such symptoms as watery eyes and runny nose are caused by blocking another natural substance made by your body (acetylcholine).

Cough - and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some products (such as long-acting tablets/capsules) are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely.

These products do not cure or shorten the length of the common cold and may cause serious side effects. To decrease the risk for serious side effects, carefully follow all dosage directions. Do not use this product to make a child sleepy. Do not give other cough - and-cold medication that might contain the same or similar ingredients (see also Drug Interactions section). Ask the doctor or pharmacist about other ways to relieve cough and cold symptoms (such as drinking enough fluids, using a humidifier or saline nose drops/spray).

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Diphenhydramine is also used alone or with other medications to treat shaking (tremor) and muscle stiffness caused by Parkinson's disease. It may also be used to treat side effects of certain psychiatric drugs such as involuntary movements and muscle stiffness (such as EPS ). It works by blocking acetylcholine (See also Uses section).

How to use Benadryl Allergy

Follow all directions on the product package. If your doctor has prescribed this medication, take it as directed. If you are uncertain about any of the information, consult your doctor or pharmacist.

Take the tablet, capsule, or liquid form by mouth with or without food. Measure liquid forms of this medication using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. If you have a single-dose form of this medication (such as a single-use whistle), you do not need to measure the dose.

The rapidly-dissolving tablet or strip should be allowed to dissolve on the tongue and then swallowed, with or without water. The chewable tablets should be chewed thoroughly before being swallowed.

The dosage is based on your age, medical condition, and response to treatment. There are many brands and forms of diphenhydramine available. Read the dosing instructions carefully for each product because the amount of diphenhydramine may be different between products. Do not increase your dose or take this medication more often than directed.

To prevent motion sickness, take your dose 30 minutes before starting activity such as travel. To help you sleep. take your dose about 30 minutes before bedtime. If you continue to have difficulty sleeping for longer than 2 weeks, contact your doctor.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

Drowsiness, dizziness, constipation. stomach upset, blurred vision. or dry mouth /nose/throat may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To relieve dry mouth. suck (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: mental/mood changes (such as restlessness, confusion), difficulty urinating, fast/irregular heartbeat .

Get medical help right away if you have any very serious side effects, including: seizures .

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash. itching /swelling (especially of the face/tongue /throat), severe dizziness, trouble breathing .

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www. fda. gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking diphenhydramine, tell your doctor or pharmacist if you are allergic to it; or to dimenhydrinate; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as asthma, emphysema), high pressure in the eye (glaucoma), heart problems, high blood pressure, liver disease, seizures, stomach/intestine problems (such as ulcers, blockage), overactive thyroid (hyperthyroidism), difficulty urinating (for example, due to enlarged prostate).

This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Avoid alcoholic beverages.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Liquid products, chewable tablets, or dissolving tablets/strips may contain sugar and/or aspartame. Liquid products may also contain alcohol. Caution is advised if you have diabetes, liver disease, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely.

Children may be more sensitive to the side effects of this drug. This drug can often cause excitement in young children instead of drowsiness.

Older adults may be more sensitive to the side effects of this drug, especially drowsiness, dizziness, confusion, constipation, or trouble urinating. Drowsiness, dizziness, and confusion can increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: antihistamines applied to the skin (such as diphenhydramine cream, ointment, spray).

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, other antihistamines (such as chlorpheniramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

This medication may interfere with certain laboratory tests (including allergy skin test), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Overdose

If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, seizures, widened pupils. In children, mental/mood changes (such as restlessness, irritability, hallucinations) may occur before drowsiness.

Notes

Keep all regular medical and laboratory appointments.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of your next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature away from moisture and light. Do not store in the bathroom. Do not freeze liquid forms of this medication. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised October 2015. Copyright(c) 2015 First Databank, Inc.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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Titralac

Titralac

Generic Name: calcium carbonate (KAL see um CAR boe nate) Brand Names: Alka-Mints, Alkets, Alkums, Amilac, Amitone, Cal Oys, Cal-Gest, Calcarb, Calci Mix, Calci-Chew, Calcitab, Caltrate, Caltro, Chooz, Dicarbosil, Equilet, Mylanta Child, Nephro Calci, OsCal 500, Oysco 500, Oyst Cal, Oyst Cal 500, Oyster Cal 500, Oyster Calcium, Oyster Shell, Oyster Shell Calcium 500, Rolaids Sodium Free, Super Calcium, Titralac, Tums, Tums 500, Tums E-X, Tums Ultra

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

Do not take Titralac or antacids containing calcium without first talking to your doctor if you take other medications. Calcium can decrease the effects of many other medicines by binding to them or by changing the acidity of the stomach or the urine.

Take calcium with meals to increase its absorption by the body, unless otherwise directed by your doctor.

What is Titralac?

Calcium is a mineral that is found naturally in foods. Calcium is necessary for many normal functions of the body, especially bone formation and maintenance. Calcium can also bind to other minerals (such as phosphate) and aid in their removal from the body.

Calcium carbonate is used to prevent and to treat calcium deficiencies.

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

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

Before taking this medication, tell your doctor if you

have had kidney stones;

have parathyroid gland disease;

take antacids or other calcium supplements; or

take a tetracycline antibiotic such as tetracycline (Sumycin, Achromycin V, and others), demeclocycline (Declomycin), doxycycline (Vibramycin, Monodox, Doxy, and others), minocycline (Minocin, Dynacin, and others), or oxytetracycline (Terramycin, and others).

You may not be able to take calcium carbonate, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions, or take any of the medications, listed above.

Talk to your doctor before taking Titralac if you are pregnant.

Talk to your doctor before taking Titralac if you are breast-feeding.

How should I take Titralac?

Take Titralac exactly as directed by your doctor or follow the directions on the package. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Swallow the calcium carbonate tablets and capsules with a full glass of water.

Chew the chewable forms of calcium carbonate completely before swallowing.

Use the calcium carbonate powder as directed. Allow the powder to dissolve completely, then consume the mixture.

Shake the calcium carbonate suspension well before measuring a dose. To ensure that you get the correct dose, use a dose-measuring spoon or cup, not a regular table spoon to measure the liquid. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Take calcium with meals to increase its absorption by the body, unless otherwise directed by your doctor.

Store Titralac at room temperature away from moisture and heat.

What happens if I miss a dose?

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

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of a calcium overdose include nausea, vomiting, decreased appetite, constipation, confusion, delirium, stupor, and coma.

What should I avoid?

If you take other medicines, do not take Titralac without first talking to your doctor.

What are the possible side effects of calcium carbonate?

Stop taking calcium carbonate and seek emergency medical attention if you experience a rare allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives).

Other, less serious side effects may be more likely to occur. Continue to take calcium carbonate and notify your doctor if you experience

nausea or vomiting;

decreased appetite;

constipation;

dry mouth or increased thirst; or

increased urination.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Titralac?

Before taking Titralac, tell your doctor if you are taking

digoxin (Lanoxin, Lanoxicaps);

antacids containing calcium or aluminum;

another calcium supplement;

calcitriol (Rocaltrol) or vitamin D supplements; or

a tetracycline antibiotic such as tetracycline (Sumycin, Achromycin V, and others), demeclocycline (Declomycin), doxycycline (Vibramycin, Monodox, Doxy, and others), minocycline (Minocin, Dynacin, and others), or oxytetracycline (Terramycin, and others).

You may not be able to take calcium carbonate, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

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

More about Titralac (calcium carbonate)

Consumer resources

Other formulations

Related treatment guides

Where can I get more information?

Your doctor, pharmacist, or health care provider may have more information about Titralac.

Consultation with a licensed health care professional is advisable before using any herbal/health supplement. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial and coordination of treatment among all health care providers involved may be advantageous. Remember, keep this and all other prescription drug products, over-the-counter drug products, and herbal/health supplements out of the reach of children.

Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2016 Cerner Multum, Inc. Version: 2.03. Revision date: 7/3/03.

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Sumigran, Sumigran

Sumatriptan

Click for further information on drug naming conventions and International Nonproprietary Names .

Important Notice: The Drugs. com international database is in BETA release. This means it is still under development and may contain inaccuracies. It is not intended as a substitute for the expertise and judgement of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that the use of any medication in any country is safe, appropriate or effective for you. Consult with your healthcare professional before taking any medication.

Divalproex Sodium Side Effects In Detail, Diproex

Divalproex sodium Side Effects

Commonly reported side effects of divalproex sodium include: nausea, abdominal pain, vomiting, dizziness, weakness, drowsiness, thrombocytopenia, and anorexia. Other side effects include: alopecia, ataxia, nystagmus, weight loss, abnormality in thinking, tremor, skin rash, and fever. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to divalproex sodium: oral capsule delayed release, oral syrup, oral tablet delayed release, oral tablet enteric coated, oral tablet extended release

In addition to its needed effects, some unwanted effects may be caused by divalproex sodium. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking divalproex sodium:

More common:

Black, tarry stools

bleeding gums

bloating or swelling of the face, arms, hands, lower legs, or feet

blood in the urine or stools

confusion

cough or hoarseness

crying

delusions

dementia

depersonalization

diarrhea

difficult or labored breathing

dysphoria

euphoria

fever or chills

general feeling of discomfort or illness

headache

joint pain

loss of appetite

lower back or side pain

mental depression

muscle aches and pains

nausea

nervousness

painful or difficult urination

paranoia

pinpoint red spots on the skin

quick to react or overreact emotionally

rapid weight gain

rapidly changing moods

runny nose

shakiness in the legs, arms, hands, or feet

shivering

sleepiness or unusual drowsiness

sore throat

sweating

tightness in the chest

tingling of the hands or feet

trembling or shaking of the hands or feet

trouble sleeping

unusual bleeding or bruising

unusual tiredness or weakness

unusual weight gain or loss

vomiting

Less common:

Abnormal dreams

absence of or decrease in body movement

anxiety

bloody nose

blurred vision

bruising burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

change in personality

change in walking and balance

changes in patterns and rhythms of speech

chest pain

chills

cloudy urine

clumsiness or unsteadiness

cold sweats

constipation

darkened urine

degenerative disease of the joint

difficulty with moving

dizziness

dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly

dry mouth

excessive muscle tone

fast, irregular, pounding, or racing heartbeat or pulse

feeling of warmth or heat

flushing or redness of the skin, especially on the face and neck

frequent urge to urinate

heavy non-menstrual vaginal bleeding

hyperventilation

increased need to urinate

indigestion

lack of coordination

large, flat, blue or purplish patches in the skin

leg cramps

lip smacking or puckering

loss of bladder control

loss of strength or energy

multiple swollen and inflamed skin lesions

muscle pain or stiffness

muscle tension or tightness

normal menstrual bleeding occurring earlier, possibly lasting longer than expected

pains in the stomach, side, or abdomen, possibly radiating to the back

passing urine more often

pounding in the ears

puffing of the cheeks

rapid or worm-like movements of the tongue

rapid weight gain

restlessness

seeing, hearing, or feeling things that are not there

shakiness and unsteady walk

slurred speech

small red or purple spots on the skin

sweating

swollen joints

trouble with speaking

twitching

uncontrolled chewing movements

uncontrolled movements of the arms and legs

unsteadiness, trembling, or other problems with muscle control or coordination

vomiting of blood or material that looks like coffee grounds

yellow eyes or skin

If any of the following symptoms of overdose occur while taking divalproex sodium, get emergency help immediately:

Symptoms of overdose:

Change in consciousness

fainting

loss of consciousness

slow or irregular heartbeat

Minor Side Effects

Some of the side effects that can occur with divalproex sodium may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:

Acid or sour stomach

belching

body aches or pain

change in vision

congestion

continuing ringing or buzzing or other unexplained noise in the ears

hair loss or thinning of the hair

hearing loss

heartburn

impaired vision

lack or loss of strength

loss of memory

problems with memory

rash

seeing double

tender, swollen glands in the neck

trouble with swallowing

uncontrolled eye movements

voice changes

weight gain

weight loss

Less common:

Absent, missed, or irregular menstrual periods

back pain

burning, dry, or itching eyes

change in taste or bad unusual or unpleasant (after) taste

coin-shaped lesions on the skin

cough producing mucus

cramps

dandruff

discharge or excessive tearing

dry skin

earache

excess air or gas in the stomach or intestines

eye pain

feeling of constant movement of self or surroundings

full feeling

heavy bleeding

increased appetite

itching of the vagina or genital area

itching skin

loss of bowel control

neck pain

oily skin

pain

pain during sexual intercourse

pain or tenderness around the eyes and cheekbones

passing gas

rash with flat lesions or small raised lesions on the skin

redness or swelling in the ear

redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid

redness, swelling, or soreness of the tongue

sensation of spinning

sneezing

stiff neck

stopping of menstrual bleeding

thick, white vaginal discharge with no odor or with a mild odor

For Healthcare Professionals

Applies to divalproex sodium: oral delayed release capsule, oral delayed release tablet, oral tablet extended release

Gastrointestinal

Very common (10% or more): Abdominal pain, diarrhea, dyspepsia, gingival disorder, nausea, vomiting Common (1% to 10%): Constipation, dry mouth, eructation, fecal incontinence, flatulence, gastralgia, gastroenteritis, glossitis, periodontal abscess, hematemesis, stomatitis Uncommon (0.1% to 1%): Pancreatitis (life-threatening) [Ref ]

Hepatic

Common (1% to 10%): Increased liver enzymes (particularly early in treatment), liver injury, SGOT increased, SGPT increased Frequency not reported: Severe liver damage (including hepatic failure sometimes resulting in death), increased serum bilirubin, abnormal changes in other liver function tests [Ref ]

Nervous system

Very common (10% or more): Dizziness, headache, somnolence, tremor Common (1% to 10%): Abnormal gait, amnesia, catatonic reaction, convulsion, disturbance in attention, dysarthria, extrapyramidal disorder, hypertonia, hypokinesia, incoordination, increased reflexes, memory impairment, nystagmus, paresthesia, speech disorder, stupor, tardive dyskinesia, taste perversion Uncommon (0.1% to 1%): Ataxia, coma, encephalopathy, lethargy, reversible Parkinsonism Rare (less than 0.1%): Cognitive disorder, reversible dementia associated with reversible cerebral atrophy Frequency not reported: Cerebral atrophy, dementia [Ref ]

Hematologic

Very common (10% or more): Thrombocytopenia Common (1% to 10%): Anemia, hemorrhage Uncommon (0.1% to 1%): Leucopenia, pancytopenia Rare (less than 0.1%): Abnormal coagulation tests (e. g. prolonged prothrombin time, prolonged activated partial thromboplastin time, prolonged thrombin time, prolonged INR), agranulocytosis, bone marrow failure, decreased coagulation factors, including pure red cell aplasia, macrocytosis Frequency not reported: Aplastic anemia, bone marrow suppression, bruising, eosinophilia, frank hemorrhage, hypofibrinogenemia, anemia including macrocytic with or without folate deficiency, relative lymphocytosis [Ref ]

Respiratory

Very common (10% or more): Flu syndrome, respiratory infection Common (1% to 10%): Bronchitis, dyspnea, epistaxis, increased cough, pharyngitis, pneumonia, rhinitis, sinusitis Uncommon (0.1% to 1%): Pleural effusion [Ref ]

Renal

Rare (less than 0.1%): Reversible Fanconi's syndrome, tubulointerstitial nephritis [Ref ]

Cardiovascular

Common (1% to 10%): Edema, hypertension, hypotension, palpitations, postural hypotension, peripheral edema, tachycardia, vasodilation Frequency not reported: Bradycardia, cutaneous vasculitis, hematoma formation [Ref ]

Endocrine

Uncommon (0.1% to 1%): Hyperandrogenism, syndrome of inappropriate ADH secretion Rare (less than 0.1%): Hypothyroidism Frequency not reported: Abnormal thyroid function tests, elevated serum testosterone concentrations, parotid gland swelling [Ref ]

Dermatologic

Very common (10% or more): Alopecia Common (1% to 10%): Discoid lupus erythematosus, dry skin, ecchymosis, furunculosis, maculopapular rash, petechia, pruritus, rash, seborrhea Uncommon (0.1% to 1%): Abnormal hair texture, abnormal hair growth, hair color changes, sweating Rare (0.01% to 0.1%): Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis Very rare (less than 0.01%): Acne, hirsutism Frequency not reported: Angioedema, generalized pruritus, photosensitivity [Ref ]

Genitourinary

Common (1% to 10%): Amenorrhea, cystitis, dysmenorrhea, dysuria, enuresis, metrorrhagia, urinary incontinence, urinary frequency, vaginal hemorrhage, vaginitis Very rare (less than 0.01%): Gynecomastia Frequency not reported: Breast enlargement, galactorrhea, polycystic ovary disease [Ref ]

Hypersensitivity

Frequency not reported: Allergic reaction, anaphylaxis, hypersensitivity [Ref ]

Metabolic

Very common (10% or more): Anorexia Common (1% to 10%): Weight loss/gain, increased appetite, hyponatremia Rare (less than 0.1%): Hyperammonemia Frequency not reported: Acute intermittent porphyria, minor elevations of LDH (dose related), decreased carnitine concentrations, hyperglycinemia [Ref ]

Musculoskeletal

Common (1% to 10%): Arthralgia, arthrosis, leg cramps, myalgia, myasthenia, twitching Uncommon (0.1% to 1%): Decreased bone mineral density, osteopenia, osteoporosis and fractures on long term therapy Rare (less than 0.1%): Rhabdomyolysis, systemic lupus erythematosus Frequency not reported: Bone pain [Ref ]

Ocular

Very common (10% or more): Amblyopia/blurred vision, diplopia Common (1% to 10%): Abnormal vision, conjunctivitis, diplopia, dry eyes, eye pain [Ref ]

Oncologic

Rare (less than 0.1%): Myelodysplastic syndrome [Ref ]

Other

Very common (10% or more): Asthenia Common (1% to 10%): Back pain, chills, deafness, ear disorder, ear pain, face edema, fever, malaise, otitis media, tinnitus, vertigo Frequency not reported: Hypothermia, weakness [Ref ]

Psychiatric

Very common (10% or more): Nervousness Common (1% to 10%): Abnormal dreams, agitation, anxiety, aggression, confusion, depression, emotional lability, hallucinations, insomnia, personality disorder, thinking abnormalities Rare (less than 0.1%): Abnormal behavior, learning disorder, psychomotor hyperactivity Frequency not reported: Behavioral deterioration, hostility, psychosis [Ref ]

References

1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. "Product Information. Depakote (divalproex sodium)." Abbott Pharmaceutical, Abbott Park, IL.

Not all side effects for divalproex sodium may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here .

Ibugesic Review, Ibugesic

This is a Ibuprofen and Paracetamol suspension precribed for Analgesic and Antipyretic usage for children. This medicine has been my saver everytime my baby has fallen ill due to Viral infection and lower dosage of Junimol has not beeneffective with her.

Initially when she was below 1 year, during viral fever around 2.5ml of Junimol thrice a day would contain her fever.

But this February around her first birthday she was severly ill with viral fever nad temperatures rising around 102 degree farenheit. Even Junimol was unable to contain her fever for 3 days. I mean the fever would reduce after the medication but then again lapse after 6 hours. We were just not able to understand what was wrong with her. Then.

my Paed prescribed IBUGESIC PLUS around 2.5 ml only when she has high fever. Beleive me just 2 dosages of this medication nad my baby was absolutely ok. Infact her fever did not lapse and she was trotting around the home as usual as if nothing had happened to her.

The doc told me that although this medicine is good but

it is quite strong and not prescribed easily to infants below 1 year due to side effects on kidney. However now once more she has very high fever around May and this time the doctor gave Ibugesic at first instance only as it had been quite effective for my baby earlier also. Check this medicine properly with your doc before going ahead with it.

List Of Muscle Relaxants, Remoxin

Muscle relaxants

Exondys 51 Eteplirsen is a morpholino antisense oligomer for the treatment of Duchenne muscular dystrophy.

Yosprala Yosprala (aspirin and omeprazole) is a platelet aggregation inhibitor and proton pump inhibitor.

Cuvitru Cuvitru (immune globulin subcutaneous (human)) is indicated as replacement therapy in the treatment.

Erelzi Erelzi (etanercept-szzs) is a tumor necrosis factor (TNF) blocker biosimilar to Enbrel indicated.

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Drugs. com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include Micromedex® (updated Sep 2nd, 2016), Cerner Multum™ (updated Sep 5th, 2016), Wolters Kluwer™ (updated Aug 8th, 2016) and others. To view content sources and attributions, please refer to our editorial policy .

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Buy Dapagut - Paroxetine - Online Without Prescriptions, Dapagut

Paroxetine (Dapagut)

Paroxetine is used for treating depression or obsessive-compulsive disorder (OCD). It may be used to treat panic disorder or posttraumatic stress disorder (PTSD). It may also be used to treat generalized anxiety disorder or social anxiety disorder. Paroxetine is a selective serotonin reuptake inhibitor (SSRI). It works by restoring the balance of serotonin, a natural substance in the brain, which helps to improve certain mood problems.

Use Paroxetine as directed by your doctor.

Take Paroxetine by mouth with or without food.

Swallow Paroxetine whole. Do not break, crush, or chew before swallowing.

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

Continue to take Paroxetine even if you feel well. Do not miss any dose.

Do not suddenly stop taking Paroxetine without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Paroxetine and whenever a change in dose is made.

If you miss a dose of Paroxetine, take it as soon as possible. If it almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Store Paroxetine at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Paroxetine out of the reach of children and away from pets.

Do NOT use Paroxetine if:

you are allergic to any ingredient in Paroxetine

you are taking or have taken linezolid, a monoamine oxidase inhibitor (MAOI) (eg, phenelzine), selegiline, or St. John's wort within the last 14 days

you are taking a fenfluramine derivative (eg, dexfenfluramine), nefazodone, pimozide, a serotonin norepinephrine reuptake inhibitor (SNRI) (eg, venlafaxine), another SSRI (eg, fluoxetine), sibutramine, thioridazine, or tryptophan.

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

Some medical conditions may interact with Paroxetine. 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 or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse

if you have a history of seizures, heart problems, liver problems, severe kidney problems, stomach or bowel bleeding, narrow-angle glaucoma, diabetes, or metabolism problems

if you are dehydrated, have low blood sodium levels, or drink alcohol

if you will be having electroconvulsive therapy (ECT).

Some medicines may interact with Paroxetine. Tell your health care provider if you are taking any other medicines, especially any of the following:

Anorexiants (eg, phentermine), cimetidine, fenfluramine derivatives (eg, dexfenfluramine), linezolid, lithium, MAOIs (eg, phenelzine), metoclopramide, nefazodone, selegiline, serotonin 5-HT 1 receptor agonists (eg, sumatriptan), sibutramine, SNRIs (eg, venlafaxine), another SSRI (eg, fluoxetine), St. John's wort, tramadol, trazodone, or tryptophan because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, or coma, may occur

Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased

Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased

Antiarrhythmics (eg, flecainide, propafenone, quinidine), H 1 antagonists (eg, astemizole, terfenadine), or phenothiazines (eg, chlorpromazine, thioridazine) because severe heart problems, including irregular heartbeat, may occur

Cyproheptadine, HIV protease inhibitors (eg, ritonavir), phenobarbital, or phenytoin because they may decrease Paroxetine's effectiveness

Aripiprazole, atomoxetine, clozapine, fluoxetine, pimozide, procyclidine, risperidone, theophylline, or tricyclic antidepressants (eg, amitriptyline) because the risk of their side effects may be increased by Paroxetine

Digoxin or tamoxifen because their effectiveness may be decreased by Paroxetine.

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

Important safety information:

Paroxetine may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Paroxetine with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.

Do not drink alcohol while you are taking Paroxetine.

Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Paroxetine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.

Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose, change your dose, or use Paroxetine for longer than prescribed without checking with your doctor.

Children, teenagers, and young adults who take Paroxetine may be at increased risk for suicidal thoughts or actions. Closely watch all patients who take Paroxetine. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.

If your doctor tells you to stop taking Paroxetine, you will need to wait for several weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone). Ask your doctor when you should start to take your new medicines after you have stopped taking Paroxetine.

Paroxetine may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.

Serotonin syndrome is a possibly fatal syndrome that can be caused by Paroxetine. Your risk may be greater if you take Paroxetine with certain other medicines (eg, "triptans," MAOIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.

Neuroleptic malignant syndrome (NMS) is a possibly fatal syndrome that can be caused by Paroxetine. Your risk may be greater if Paroxetine is used with certain other medicines called antipsychotics (eg, aripiprazole, risperidone). Symptoms may be similar to serotonin syndrome and may include fever, rigid muscles, blood pressure changes, and mental changes. Contact your doctor at once if you have any of these symptoms.

Use Paroxetine with caution in the elderly; they may be more sensitive to its effects, especially low blood sodium levels.

Caution is advised when using Paroxetine in children; they may be more sensitive to its effects, especially increased risk of suicidal thoughts and actions.

Paroxetine may cause weight changes. Children and teenagers may need regular weight and growth checks while they take Paroxetine.

Pregnancy and breast-feeding: Paroxetine may cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Paroxetine while you are pregnant. Paroxetine is found in breast milk. If you are or will be breast-feeding while you use Paroxetine, check with your doctor. Discuss any possible risks to your baby.

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:

Anxiety; blurred vision; constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; gas; increased sweating; increased urination; loss of appetite; nausea; nervousness; numbness or tingling of the skin; stomach upset; trouble concentrating; trouble sleeping; weakness; yawning.

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); bizarre behavior; black or bloody stools; chest pain; confusion; decreased concentration; decreased coordination; exaggerated reflexes; fainting; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; memory loss; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent or severe ringing in the ears; persistent, painful erection; red, swollen, blistered, or peeling skin; seizures; severe or persistent anxiety or trouble sleeping; severe or persistent headache or dizziness; significant weight loss; stomach pain; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual or severe mental or mood changes; unusual weakness; vision changes; worsening of depression.

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.

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Nabumetone Oral Uses, Side Effects, Interactions, Pictures, Warnings - Dosing, Nabumetona

nabumetone

GENERIC NAME(S): NABUMETONE

Warnings

Nonsteroidal anti-inflammatory drugs (including nabumetone ) may rarely increase the risk for a heart attack or stroke. The risk may be greater if you have heart disease or increased risk for heart disease (for example, due to smoking. family history of heart disease. or conditions such as high blood pressure or diabetes ), or with longer use. This drug should not be taken right before or after heart bypass surgery (CABG).

Also, this drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. This effect can occur without warning symptoms at any time while taking this drug. Older adults may be at higher risk for this effect. (See also Precautions and Drug Interactions sections.)

Stop taking nabumetone and get medical help right away if you notice any of the following rare but serious side effects: bloody or black/tarry stools, persistent stomach /abdominal pain. vomit that looks like coffee grounds, chest/jaw/left arm pain, shortness of breath, unusual sweating. weakness on one side of the body, sudden vision changes, slurred speech.

Talk with your doctor or pharmacist about the risks and benefits of treatment with this medication .

Uses

Nabumetone is used to reduce pain, swelling, and joint stiffness from arthritis. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID).

If you are treating a chronic condition such as arthritis. ask your doctor about non-drug treatments and/or using other medications to treat your pain. See also Warning section.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used to treat gout attacks.

How to use nabumetone

Read the Medication Guide provided by your pharmacist before you start using nabumetone and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually once or twice daily with a full glass of water (8 ounces or 240 milliliters). Do not lie down for at least 10 minutes after taking this drug. To prevent stomach upset, take it with food, milk, or an antacid.

Dosage is based on your medical condition and response to treatment. To minimize side effect risks (such as stomach bleeding), use this medication at the lowest effective dose for the shortest possible length of time. Do not increase your dose or take it more often than prescribed. For chronic conditions such as arthritis, continue taking it as directed by your doctor. Discuss the risks and benefits with your doctor or pharmacist.

In certain conditions (such as arthritis), it may take up to 2 weeks when this drug is taken regularly before you notice the full benefits.

If you are taking this drug on an "as needed" basis (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.

Tell your doctor if your condition worsens.

Side Effects

See also Warning section.

Upset stomach. nausea, vomiting. constipation. diarrhea. gas, dizziness. drowsiness, or headache may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if any of these unlikely but serious side effects occur: swelling of the hands or feet (edema ), sudden or unexplained weight gain. hearing changes (such as ringing in the ears ), mental/mood changes, difficult/painful swallowing, unusual tiredness.

Get medical help right away if any of these rare but very serious side effects occur: signs of kidney problems (such as change in the amount of urine), unexplained stiff neck .

This drug may rarely cause serious (possibly fatal) liver disease. If you notice any of the following highly unlikely but very serious side effects, stop taking nabumetone and consult your doctor or pharmacist right away: dark urine, persistent nausea/vomiting, severe stomach/abdominal pain, yellowing eyes or skin .

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction. including: rash. itching /swelling (especially of the face/tongue /throat), severe dizziness, trouble breathing .

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www. fda. gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

See also Warning section.

Before taking nabumetone, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen. naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), bleeding or clotting problems, growths in the nose (nasal polyps), heart disease (such as previous heart attack), high blood pressure, liver disease, stroke, stomach/intestinal/esophagus problems (such as bleeding, ulcers, recurring heartburn).

Kidney problems can sometimes occur with the use of NSAID medications, including nabumetone. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have any unusual change in the amount of urine.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely.

This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.

This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths or sunlamps. Use a sunscreen and wear protective clothing when outdoors.

Caution is advised when using this drug in the elderly because they may be more sensitive to its side effects, especially stomach bleeding and kidney problems.

Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks (such as miscarriage, trouble getting pregnant). Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery.

It is unknown if this drug passes into breast milk. Breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as losartan, valsartan), cidofovir, corticosteroids (such as prednisone), lithium, methotrexate, "water pills" (diuretics such as furosemide).

This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib, ibuprofen, or ketorolac). These drugs are similar to nabumetone and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Overdose

If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe stomach pain, vomit that looks like coffee grounds, extreme drowsiness, loss of consciousness, slowed or shallow breathing.

Notes

Do not share this medication with others.

Laboratory and/or medical tests (such as blood pressure, complete blood count, liver and kidney function tests) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Non-drug treatment for arthritis that is approved by your doctor (such as weight loss if needed, strengthening and conditioning exercises) may help improve your flexibility, range of motion, and joint function. Consult your doctor for specific instructions.

Missed Dose

If you are prescribed this drug on a regular schedule (not just "as needed") and you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details.

Information last revised May 2016. Copyright(c) 2016 First Databank, Inc.

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Meflotas Side Effects, Price, Pharmacology - Alternatives, Meflotas

MEFLOTAS

Package Tablet Qty/Strength/Unit 250 mg Price

Possible Side Effects of MEFLOTAS

Abdominal cramps

Ataxia

Bitter taste

Diarrhoea

Dizziness

Hallucination

Nausea

Pruritis

Vomiting

Home Delivery for MEFLOTAS in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including meflotas.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for meflotas and other medicines and health products. Home delivery services for meflotas may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take meflotas only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for meflotas before they complete the sale. You can get this information while placing the order for meflotas with the pharmacy.

If the pharmacy that's willing to deliver medicines to your home doesn't have meflotas in stock, you can ask for one of the alternative medicines for meflotas. Alternatively, you can ask the pharmacist to recommend good options for the Mefloquine generic medicine (which is what meflotas essentially is).

Recently Added Pharmacies

Important Links:

Ministry of Health & Family Welfare-Government of India Department of Health Research (DHR), Government of India Department of Indian Systems of Medicine and Homoeopathy Pharmacopoeial Laboratory for Indian Medicine (PLIM) Medicine Information Centre

Bioequivalence Of Zoloft Odt To Jzoloft In Healthy Japanese Subjects - Full Text View, Jzoloft

Bioequivalence Of Zoloft ODT To Jzoloft In Healthy Japanese Subjects

Allocation: Randomized Endpoint Classification: Bio-equivalence Study Intervention Model: Crossover Assignment Masking: Open Label Primary Purpose: Basic Science

Phase 1, Open-Label, Randomized, Single-Dose, 3-Way Crossover Assessing Bioequivalence Of Zoloft ODT 50 Mg Under Fasting Condition With And Without Water To Jzoloft Tablet 50 Mg Under Fasting Condition With Water In Healthy Japanese Subjects

Resource links provided by NLM:

Further study details as provided by Pfizer:

Primary Outcome Measures:

AUC from zero to the last sampling point (AUCt) of sertraline after dose of sertraline ODT 50 mg without water to Japanese commercial oral tablet of JZoloft 50 mg under fasted conditions [ Time Frame: 0, 1, 2, 4, 6, 7, 8, 10, 12, 24, 36, 48 and 72 hours post-dose ] [ Designated as safety issue: No ]

Maximum plasma concentration (Cmax) of sertraline after dose of sertraline ODT 50 mg without water to Japanese commercial oral tablet of JZoloft 50 mg under fasted conditions [ Time Frame: 0, 1, 2, 4, 6, 7, 8, 10, 12, 24, 36, 48 and 72 hours post-dose ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Cmax and AUCt of sertraline after dose of sertraline ODT 50 mg with water to Japanese commercial oral tablet of JZoloft 50 mg under fasted conditions [ Time Frame: 0, 1, 2, 4, 6, 7, 8, 10, 12, 24, 36, 48 and 72 hours post-dose ] [ Designated as safety issue: No ]

Time of maximum plasma concentration of sertraline ODT 50 mg with water to Japanese commercial oral tablet of JZoloft 50 mg under fasted conditions [ Time Frame: 0, 1, 2, 4, 6, 7, 8, 10, 12, 24, 36, 48 and 72 hours post-dose ] [ Designated as safety issue: No ]

AUC from zero to infinity or last measurable concentration of sertraline after dose of sertraline ODT 50 mg with and without water to Japanese commercial oral tablet of JZoloft 50 mg under fasted conditions [ Time Frame: 0, 1, 2, 4, 6, 7, 8, 10, 12, 24, 36, 48 and 72 hours post-dose ] [ Designated as safety issue: No ]

Terminal elimination rate constant (kel), half-life (t½) and mean residence time (MRT) of sertraline ODT 50 mg with and without water to Japanese commercial oral tablet of JZoloft 50 mg under fasted conditions [ Time Frame: 0, 1, 2, 4, 6, 7, 8, 10, 12, 24, 36, 48 and 72 hours post-dose ] [ Designated as safety issue: No ]

Safety laboratory tests, vital signs, and adverse events (AEs) [ Time Frame: From Periods 1 to 3 ] [ Designated as safety issue: Yes ]

Healthy Japanese subjects between the ages of 20 and 55 years.

Body Mass Index (BMI) of 17.5 to 30.5 kg/m2; and a total body weight >50 kg (110 lbs).

Significant psychiatric disorder, recurrent episodes of severe depression, or subjects with serious suicidal risk per criteria.

Pregnant or nursing females; females of childbearing potential who are unwilling or unable to use an acceptable method of nonhormonal contraception as outlined in this protocol from at least 14 days prior to the first dose of study medication and for 28 days after the last dose of study medication.

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials. gov identifier: NCT01699724

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Gabapentin - Fda Prescribing Information, Side Effects And Uses, Gabapentina

Gabapentin

Indications and Usage for Gabapentin

Gabapentin is indicated for:

Management of postherpetic neuralgia in adults

Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization, in adults and pediatric patients 3 years and older with epilepsy

Gabapentin Dosage and Administration

Dosage for Postherpetic Neuralgia

In adults with postherpetic neuralgia, Gabapentin may be initiated on Day 1 as a single 300 mg dose, on Day 2 as 600 mg/day (300 mg two times a day), and on Day 3 as 900 mg/day (300 mg three times a day). The dose can subsequently be titrated up as needed for pain relief to a dose of 1800 mg/day (600 mg three times a day). In clinical studies, efficacy was demonstrated over a range of doses from 1800 mg/day to 3600 mg/day with comparable effects across the dose range; however, in these clinical studies, the additional benefit of using doses greater than 1800 mg/day was not demonstrated.

Dosage for Epilepsy with Partial Onset Seizures

Patients 12 years of age and above

The starting dose is 300 mg three times a day. The recommended maintenance dose of Gabapentin is 300 mg to 600 mg three times a day. Dosages up to 2400 mg/day have been well tolerated in long-term clinical studies. Doses of 3600 mg/day have also been administered to a small number of patients for a relatively short duration, and have been well tolerated. Administer Gabapentin three times a day using 300 mg or 400 mg capsules, or 600 mg or 800 mg tablets. The maximum time between doses should not exceed 12 hours.

Pediatric Patients Age 3 to 11 years

The starting dose range is 10 mg/kg/day to 15 mg/kg/day, given in three divided doses, and the recommended maintenance dose reached by upward titration over a period of approximately 3 days. The recommended maintenance dose of Gabapentin in patients 3 to 4 years of age is 40 mg/kg/day, given in three divided doses. The recommended maintenance dose of Gabapentin in patients 5 to 11 years of age is 25 mg/kg/day to 35 mg/kg/day, given in three divided doses. Gabapentin may be administered as the oral solution, capsule, or tablet, or using combinations of these formulations. Dosages up to 50 mg/kg/day have been well tolerated in a long-term clinical study. The maximum time interval between doses should not exceed 12 hours.

Dosage Adjustment in Patients with Renal Impairment

Dosage adjustment in patients 12 years of age and older with renal impairment or undergoing hemodialysis is recommended, as follows (see dosing recommendations above for effective doses in each indication):

TABLE 1. Gabapentin Dosage Based on Renal Function

Renal Function Creatinine Clearance (mL/min)

Creatinine clearance (CLCr) is difficult to measure in outpatients. In patients with stable renal function, creatinine clearance can be reasonably well estimated using the equation of Cockcroft and Gault:

The use of Gabapentin in patients less than 12 years of age with compromised renal function has not been studied.

Dosage in Elderly

Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and dose should be adjusted based on creatinine clearance values in these patients.

Administration Information

Administer Gabapentin orally with or without food.

Gabapentin capsules should be swallowed whole with water.

Inform patients that, should they divide the scored 600 mg or 800 mg Gabapentin tablet in order to administer a half-tablet, they should take the unused half-tablet as the next dose. Half-tablets not used within 28 days of dividing the scored tablet should be discarded.

If the Gabapentin dose is reduced, discontinued, or substituted with an alternative medication, this should be done gradually over a minimum of 1 week (a longer period may be needed at the discretion of the prescriber).

Dosage Forms and Strengths

100 mg: white hard gelatin capsules printed with "G" on one side and "5026" on the other

300 mg: yellow hard gelatin capsules printed with "G" on one side and "5027" on the other

400 mg: orange hard gelatin capsules printed with "G" on one side and "5028" on the other

600 mg: white elliptical film-coated scored tablets debossed with "G" and "21" on one side

800 mg: white elliptical film-coated scored tablets debossed with "G" and "22" on one side

Oral solution: 250 mg per 5 mL (50 mg per mL), clear colorless to slightly yellow solution

Contraindications

Gabapentin is contraindicated in patients who have demonstrated hypersensitivity to the drug or its ingredients.

Warnings and Precautions

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)/Multiorgan Hypersensitivity

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), also known as multiorgan hypersensitivity, has occurred with Gabapentin. Some of these reactions have been fatal or life-threatening. DRESS typically, although not exclusively, presents with fever, rash, and/or lymphadenopathy, in association with other organ system involvement, such as hepatitis, nephritis, hematological abnormalities, myocarditis, or myositis sometimes resembling an acute viral infection. Eosinophilia is often present. This disorder is variable in its expression, and other organ systems not noted here may be involved.

It is important to note that early manifestations of hypersensitivity, such as fever or lymphadenopathy, may be present even though rash is not evident. If such signs or symptoms are present, the patient should be evaluated immediately. Gabapentin should be discontinued if an alternative etiology for the signs or symptoms cannot be established.

Anaphylaxis and Angioedema

​ Gabapentin can cause anaphylaxis and angioedema after the first dose or at any time during treatment. Signs and symptoms in reported cases have included difficulty breathing, swelling of the lips, throat, and tongue, and hypotension requiring emergency treatment. Patients should be instructed to discontinue Gabapentin and seek immediate medical care should they experience signs or symptoms of anaphylaxis or angioedema.

Effects on Driving and Operating Heavy Machinery

Patients taking Gabapentin should not drive until they have gained sufficient experience to assess whether Gabapentin impairs their ability to drive. Driving performance studies conducted with a prodrug of Gabapentin (Gabapentin enacarbil tablet, extended release) indicate that Gabapentin may cause significant driving impairment. Prescribers and patients should be aware that patients' ability to assess their own driving competence, as well as their ability to assess the degree of somnolence caused by Gabapentin, can be imperfect. The duration of driving impairment after starting therapy with Gabapentin is unknown. Whether the impairment is related to somnolence [see Warnings and Precautions (5.4) ] or other effects of Gabapentin is unknown.

Moreover, because Gabapentin causes somnolence and dizziness [see Warnings and Precautions (5.4) ]. patients should be advised not to operate complex machinery until they have gained sufficient experience on Gabapentin to assess whether Gabapentin impairs their ability to perform such tasks.

Somnolence/Sedation and Dizziness

During the controlled epilepsy trials in patients older than 12 years of age receiving doses of Gabapentin up to 1800 mg daily, somnolence, dizziness, and ataxia were reported at a greater rate in patients receiving Gabapentin compared to placebo: i. e. 19% in drug versus 9% in placebo for somnolence, 17% in drug versus 7% in placebo for dizziness, and 13% in drug versus 6% in placebo for ataxia. In these trials somnolence, ataxia and fatigue were common adverse reactions leading to discontinuation of Gabapentin in patients older than 12 years of age, with 1.2%, 0.8% and 0.6% discontinuing for these events, respectively.

During the controlled trials in patients with post-herpetic neuralgia, somnolence and dizziness were reported at a greater rate compared to placebo in patients receiving Gabapentin, in dosages up to 3600 mg per day: i. e. 21% in Gabapentin-treated patients versus 5% in placebo-treated patients for somnolence and 28% in Gabapentin-treated patients versus 8% in placebo-treated patients for dizziness. Dizziness and somnolence were among the most common adverse reactions leading to discontinuation of Gabapentin.

Patients should be carefully observed for signs of central nervous system (CNS) depression, such as somnolence and sedation, when Gabapentin is used with other drugs with sedative properties because of potential synergy. In addition, patients who require concomitant treatment with morphine may experience increases in Gabapentin concentrations and may require dose adjustment [ see Drug Interactions (7.2) ].

Withdrawal Precipitated Seizure, Status Epilepticus

Antiepileptic drugs should not be abruptly discontinued because of the possibility of increasing seizure frequency.

In the placebo-controlled epilepsy studies in patients >12 years of age, the incidence of status epilepticus in patients receiving Gabapentin was 0.6% (3 of 543) vs. 0.5% in patients receiving placebo (2 of 378). Among the 2074 patients >12 years of age treated with Gabapentin across all epilepsy studies (controlled and uncontrolled), 31 (1.5%) had status epilepticus. Of these, 14 patients had no prior history of status epilepticus either before treatment or while on other medications. Because adequate historical data are not available, it is impossible to say whether or not treatment with Gabapentin is associated with a higher or lower rate of status epilepticus than would be expected to occur in a similar population not treated with Gabapentin.

Suicidal Behavior and Ideation

Antiepileptic drugs (AEDs), including Gabapentin, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.

Pooled analyses of 199 placebo-controlled clinical trials (mono - and adjunctive therapy) of 11 different AEDs showed that patients randomized to one of the AEDs had approximately twice the risk (adjusted Relative Risk 1.8, 95% CI:1.2, 2.7) of suicidal thinking or behavior compared to patients randomized to placebo. In these trials, which had a median treatment duration of 12 weeks, the estimated incidence rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% among 16,029 placebo-treated patients, representing an increase of approximately one case of suicidal thinking or behavior for every 530 patients treated. There were four suicides in drug-treated patients in the trials and none in placebo-treated patients, but the number is too small to allow any conclusion about drug effect on suicide.

The increased risk of suicidal thoughts or behavior with AEDs was observed as early as one week after starting drug treatment with AEDs and persisted for the duration of treatment assessed. Because most trials included in the analysis did not extend beyond 24 weeks, the risk of suicidal thoughts or behavior beyond 24 weeks could not be assessed.

The risk of suicidal thoughts or behavior was generally consistent among drugs in the data analyzed. The finding of increased risk with AEDs of varying mechanisms of action and across a range of indications suggests that the risk applies to all AEDs used for any indication. The risk did not vary substantially by age (5–100 years) in the clinical trials analyzed. Table 2 shows absolute and relative risk by indication for all evaluated AEDs.

TABLE 2 Risk by Indication for Antiepileptic Drugs in the Pooled Analysis

Placebo Patients with Events Per 1000 Patients

Drug Patients with Events Per 1000 Patients

The relative risk for suicidal thoughts or behavior was higher in clinical trials for epilepsy than in clinical trials for psychiatric or other conditions, but the absolute risk differences were similar for the epilepsy and psychiatric indications.

Anyone considering prescribing Gabapentin or any other AED must balance the risk of suicidal thoughts or behavior with the risk of untreated illness. Epilepsy and many other illnesses for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Should suicidal thoughts and behavior emerge during treatment, the prescriber needs to consider whether the emergence of these symptoms in any given patient may be related to the illness being treated.

Patients, their caregivers, and families should be informed that AEDs increase the risk of suicidal thoughts and behavior and should be advised of the need to be alert for the emergence or worsening of the signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Behaviors of concern should be reported immediately to healthcare providers.

Neuropsychiatric Adverse Reactions (Pediatric Patients 3–12 Years of Age)

Gabapentin use in pediatric patients with epilepsy 3–12 years of age is associated with the occurrence of central nervous system related adverse reactions. The most significant of these can be classified into the following categories: 1) emotional lability (primarily behavioral problems), 2) hostility, including aggressive behaviors, 3) thought disorder, including concentration problems and change in school performance, and 4) hyperkinesia (primarily restlessness and hyperactivity). Among the Gabapentin-treated patients, most of the reactions were mild to moderate in intensity.

In controlled clinical epilepsy trials in pediatric patients 3–12 years of age, the incidence of these adverse reactions was: emotional lability 6% (Gabapentin-treated patients) vs. 1.3% (placebo-treated patients); hostility 5.2% vs. 1.3%; hyperkinesia 4.7% vs. 2.9%; and thought disorder 1.7% vs. 0%. One of these reactions, a report of hostility, was considered serious. Discontinuation of Gabapentin treatment occurred in 1.3% of patients reporting emotional lability and hyperkinesia and 0.9% of Gabapentin-treated patients reporting hostility and thought disorder. One placebo-treated patient (0.4%) withdrew due to emotional lability.

Tumorigenic Potential

In an oral carcinogenicity study, Gabapentin increased the incidence of pancreatic acinar cell tumors in rats [see Nonclinical Toxicology (13.1) ]. The clinical significance of this finding is unknown. Clinical experience during Gabapentin's premarketing development provides no direct means to assess its potential for inducing tumors in humans.

In clinical studies in adjunctive therapy in epilepsy comprising 2085 patient-years of exposure in patients >12 years of age, new tumors were reported in 10 patients (2 breast, 3 brain, 2 lung, 1 adrenal, 1 non-Hodgkin's lymphoma, 1 endometrial carcinoma in situ ), and preexisting tumors worsened in 11 patients (9 brain, 1 breast, 1 prostate) during or up to 2 years following discontinuation of Gabapentin. Without knowledge of the background incidence and recurrence in a similar population not treated with Gabapentin, it is impossible to know whether the incidence seen in this cohort is or is not affected by treatment.

Sudden and Unexplained Death in Patients with Epilepsy

During the course of premarketing development of Gabapentin, 8 sudden and unexplained deaths were recorded among a cohort of 2203 epilepsy patients treated (2103 patient-years of exposure) with Gabapentin.

Some of these could represent seizure-related deaths in which the seizure was not observed, e. g. at night. This represents an incidence of 0.0038 deaths per patient-year. Although this rate exceeds that expected in a healthy population matched for age and sex, it is within the range of estimates for the incidence of sudden unexplained deaths in patients with epilepsy not receiving Gabapentin (ranging from 0.0005 for the general population of epileptics to 0.003 for a clinical trial population similar to that in the Gabapentin program, to 0.005 for patients with refractory epilepsy). Consequently, whether these figures are reassuring or raise further concern depends on comparability of the populations reported upon to the Gabapentin cohort and the accuracy of the estimates provided.

Adverse Reactions

The following serious adverse reactions are discussed in greater detail in other sections:

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)/Multiorgan Hypersensitivity [see Warnings and Precautions (5.1) ]

Anaphylaxis and Angioedema [see Warnings and Precautions (5.2) ]

Somnolence/Sedation and Dizziness [see Warnings and Precautions (5.4) ]

Withdrawal Precipitated Seizure, Status Epilepticus [see Warnings and Precautions (5.5) ]

Suicidal Behavior and Ideation [see Warnings and Precautions (5.6) ]

Neuropsychiatric Adverse Reactions (Pediatric Patients 3–12 Years of Age) [see Warnings and Precautions (5.7) ]

Sudden and Unexplained Death in Patients with Epilepsy [ see Warnings and Precautions (5.9) ]

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

The most common adverse reactions associated with the use of Gabapentin in adults, not seen at an equivalent frequency among placebo-treated patients, were dizziness, somnolence, and peripheral edema.

In the 2 controlled trials in postherpetic neuralgia, 16% of the 336 patients who received Gabapentin and 9% of the 227 patients who received placebo discontinued treatment because of an adverse reaction. The adverse reactions that most frequently led to withdrawal in Gabapentin-treated patients were dizziness, somnolence, and nausea.

Table 3 lists adverse reactions that occurred in at least 1% of Gabapentin-treated patients with postherpetic neuralgia participating in placebo-controlled trials and that were numerically more frequent in the Gabapentin group than in the placebo group.

TABLE 3. Adverse Reactions in Pooled Placebo-Controlled Trials in Postherpetic Neuralgia

Other reactions in more than 1% of patients but equally or more frequent in the placebo group included pain, tremor, neuralgia, back pain, dyspepsia, dyspnea, and flu syndrome.

There were no clinically important differences between men and women in the types and incidence of adverse reactions. Because there were few patients whose race was reported as other than white, there are insufficient data to support a statement regarding the distribution of adverse reactions by race.

Epilepsy with Partial Onset Seizures (Adjunctive Therapy)

The most common adverse reactions with Gabapentin in combination with other antiepileptic drugs in patients >12 years of age, not seen at an equivalent frequency among placebo-treated patients, were somnolence, dizziness, ataxia, fatigue, and nystagmus.

The most common adverse reactions with Gabapentin in combination with other antiepileptic drugs in pediatric patients 3 to 12 years of age, not seen at an equal frequency among placebo-treated patients, were viral infection, fever, nausea and/or vomiting, somnolence, and hostility [see Warnings and Precautions (5.5) ] .

Approximately 7% of the 2074 patients >12 years of age and approximately 7% of the 449 pediatric patients 3 to 12 years of age who received Gabapentin in premarketing clinical trials discontinued treatment because of an adverse reaction. The adverse reactions most commonly associated with withdrawal in patients >12 years of age were somnolence (1.2%), ataxia (0.8%), fatigue (0.6%), nausea and/or vomiting (0.6%), and dizziness (0.6%). The adverse reactions most commonly associated with withdrawal in pediatric patients were emotional lability (1.6%), hostility (1.3%), and hyperkinesia (1.1%).

Table 4 lists adverse reactions that occurred in at least 1% of Gabapentin-treated patients >12 years of age with epilepsy participating in placebo-controlled trials and were numerically more common in the Gabapentin group. In these studies, either Gabapentin or placebo was added to the patient's current antiepileptic drug therapy.

TABLE 4. Adverse Reactions in Pooled Placebo-Controlled Add-On Trials In Epilepsy Patients >12 years of age

Among the adverse reactions occurring at an incidence of at least 10% in Gabapentin-treated patients, somnolence and ataxia appeared to exhibit a positive dose-response relationship.

The overall incidence of adverse reactions and the types of adverse reactions seen were similar among men and women treated with Gabapentin. The incidence of adverse reactions increased slightly with increasing age in patients treated with either Gabapentin or placebo. Because only 3% of patients (28/921) in placebo-controlled studies were identified as nonwhite (black or other), there are insufficient data to support a statement regarding the distribution of adverse reactions by race.

Table 5 lists adverse reactions that occurred in at least 2% of Gabapentin-treated patients, age 3 to 12 years of age with epilepsy participating in placebo-controlled trials, and which were numerically more common in the Gabapentin group.

TABLE 5. Adverse Reactions in a Placebo-Controlled Add-On Trial in Pediatric Epilepsy Patients Age 3 to 12 Years

* Plus background antiepileptic drug therapy

Body As A Whole

Nausea and/or Vomiting

Other reactions in more than 2% of pediatric patients 3 to 12 years of age but equally or more frequent in the placebo group included: pharyngitis, upper respiratory infection, headache, rhinitis, convulsions, diarrhea, anorexia, coughing, and otitis media.

Postmarketing Experience

The following adverse reactions have been identified during postmarketing use of Gabapentin. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Hepatobiliary disorders: jaundice

Investigations: elevated creatine kinase, elevated liver function tests

Metabolism and nutrition disorders: hyponatremia

Musculoskeletal and connective tissue disorder: rhabdomyolysis

Nervous system disorders: movement disorder

Reproductive system and breast disorders: breast enlargement, changes in libido, ejaculation disorders and anorgasmia

Skin and subcutaneous tissue disorders: angioedema [see Warnings and Precautions (5.2) ]. erythema multiforme, Stevens-Johnson syndrome.

Adverse reactions following the abrupt discontinuation of Gabapentin have also been reported. The most frequently reported reactions were anxiety, insomnia, nausea, pain, and sweating.

Drug Interactions

Other Antiepileptic Drugs

Gabapentin is not appreciably metabolized nor does it interfere with the metabolism of commonly coadministered antiepileptic drugs [see Clinical Pharmacology (12.3) ] .

Opioids

Coadministration of Gabapentin with hydrocodone decreases hydrocodone exposure [see Clinical Pharmacology (12.3) ]. The potential for alteration in hydrocodone exposure and effect should be considered when Gabapentin is started or discontinued in a patient taking hydrocodone.

When Gabapentin is administered with morphine, patients should be observed for signs of central nervous system (CNS) depression, such as somnolence, sedation and respiratory depression [see Clinical Pharmacology (12.3) ] .

Maalox ® (aluminum hydroxide, magnesium hydroxide)

The mean bioavailability of Gabapentin was reduced by about 20% with concomitant use of an antacid (Maalox ® ) containing magnesium and aluminum hydroxides. It is recommended that Gabapentin be taken at least 2 hours following Maalox administration [see Clinical Pharmacology (12.3) ] .

Drug/Laboratory Test Interactions

Because false positive readings were reported with the Ames N-Multistix SG ® dipstick test for urinary protein when Gabapentin was added to other antiepileptic drugs, the more specific sulfosalicylic acid precipitation procedure is recommended to determine the presence of urine protein.

USE IN SPECIFIC POPULATIONS

Pregnancy

Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. In nonclinical studies in mice, rats, and rabbits, Gabapentin was developmentally toxic when administered to pregnant animals at doses similar to or lower than those used clinically. Gabapentin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

When pregnant mice received oral doses of Gabapentin (500, 1000, or 3000 mg/kg/day) during the period of organogenesis, embryo-fetal toxicity (increased incidences of skeletal variations) was observed at the two highest doses. The no-effect dose for embryo-fetal developmental toxicity in mice was 500 mg/kg/day or approximately ½ of the maximum recommended human dose (MRHD) of 3600 mg/kg on a body surface area (mg/m 2 ) basis.

In studies in which rats received oral doses of Gabapentin (500 to 2000 mg/kg/day), during pregnancy, adverse effect on offspring development (increased incidences of hydroureter and/or hydronephrosis) were observed at all doses. The lowest effect dose for developmental toxicity in rats is approximately equal to the MRHD on a mg/m 2 basis.

When pregnant rabbits were treated with Gabapentin during the period of organogenesis, an increase in embryo-fetal mortality was observed at all doses tested (60, 300, or 1500 mg/kg). The lowest effect dose for embryo-fetal developmental toxicity in rabbits is less than the MRHD on a mg/m 2 basis.

In a published study, Gabapentin (400 mg/kg/day) was administered by intraperitoneal injection to neonatal mice during the first postnatal week, a period of synaptogenesis in rodents (corresponding to the last trimester of pregnancy in humans). Gabapentin caused a marked decrease in neuronal synapse formation in brains of intact mice and abnormal neuronal synapse formation in a mouse model of synaptic repair. Gabapentin has been shown in vitro to interfere with activity of the α2δ subunit of voltage-activated calcium channels, a receptor involved in neuronal synaptogenesis. The clinical significance of these findings is unknown.

To provide information regarding the effects of in utero exposure to Gabapentin, physicians are advised to recommend that pregnant patients taking Gabapentin enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry. This can be done by calling the toll free number 1-888-233-2334, and must be done by patients themselves. Information on the registry can also be found at the website http://www. aedpregnancyregistry. org/.

Nursing Mothers

Gabapentin is secreted into human milk following oral administration. A nursed infant could be exposed to a maximum dose of approximately 1 mg/kg/day of Gabapentin. Because the effect on the nursing infant is unknown, Gabapentin should be used in women who are nursing only if the benefits clearly outweigh the risks.

Pediatric Use

Safety and effectiveness of Gabapentin in the management of postherpetic neuralgia in pediatric patients have not been established.

Effectiveness as adjunctive therapy in the treatment of partial seizures in pediatric patients below the age of 3 years has not been established [see Clinical Studies (14.2) ] .

Geriatric Use

The total number of patients treated with Gabapentin in controlled clinical trials in patients with postherpetic neuralgia was 336, of which 102 (30%) were 65 to 74 years of age, and 168 (50%) were 75 years of age and older. There was a larger treatment effect in patients 75 years of age and older compared with younger patients who received the same dosage. Since Gabapentin is almost exclusively eliminated by renal excretion, the larger treatment effect observed in patients ≥75 years may be a consequence of increased Gabapentin exposure for a given dose that results from an age-related decrease in renal function. However, other factors cannot be excluded. The types and incidence of adverse reactions were similar across age groups except for peripheral edema and ataxia, which tended to increase in incidence with age.

Clinical studies of Gabapentin in epilepsy did not include sufficient numbers of subjects aged 65 and over to determine whether they responded differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and dose should be adjusted based on creatinine clearance values in these patients [see Dosage and Administration (2.4). Adverse Reactions (6). and Clinical Pharmacology (12.3) ] .

Renal Impairment

Dosage adjustment in adult patients with compromised renal function is necessary [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ]. Pediatric patients with renal insufficiency have not been studied.

Drug Abuse and Dependence

Controlled Substance

Gabapentin is not a scheduled drug.

Abuse

Gabapentin does not exhibit affinity for benzodiazepine, opiate (mu, delta or kappa), or cannabinoid 1 receptor sites. A small number of postmarketing cases report Gabapentin misuse and abuse. These individuals were taking higher than recommended doses of Gabapentin for unapproved uses. Most of the individuals described in these reports had a history of poly-substance abuse or used Gabapentin to relieve symptoms of withdrawal from other substances. When prescribing Gabapentin carefully evaluate patients for a history of drug abuse and observe them for signs and symptoms of Gabapentin misuse or abuse (e. g. development of tolerance, self-dose escalation, and drug-seeking behavior).

Dependence

There are rare postmarketing reports of individuals experiencing withdrawal symptoms shortly after discontinuing higher than recommended doses of Gabapentin used to treat illnesses for which the drug is not approved. Such symptoms included agitation, disorientation and confusion after suddenly discontinuing Gabapentin that resolved after restarting Gabapentin. Most of these individuals had a history of poly-substance abuse or used Gabapentin to relieve symptoms of withdrawal from other substances. The dependence and abuse potential of Gabapentin has not been evaluated in human studies.

Overdosage

A lethal dose of Gabapentin was not identified in mice and rats receiving single oral doses as high as 8000 mg/kg. Signs of acute toxicity in animals included ataxia, labored breathing, ptosis, sedation, hypoactivity, or excitation.

Acute oral overdoses of Gabapentin up to 49 grams have been reported. In these cases, double vision, slurred speech, drowsiness, lethargy, and diarrhea were observed. All patients recovered with supportive care. Coma, resolving with dialysis, has been reported in patients with chronic renal failure who were treated with Gabapentin.

Gabapentin can be removed by hemodialysis. Although hemodialysis has not been performed in the few overdose cases reported, it may be indicated by the patient's clinical state or in patients with significant renal impairment.

If overexposure occurs, call your poison control center at 1-800-222-1222.

Gabapentin Description

The active ingredient in Gabapentin capsules, tablets, and oral solution is Gabapentin, which has the chemical name 1-(aminomethyl)cyclohexaneacetic acid.

The molecular formula of Gabapentin is C 9 H 17 NO 2 and the molecular weight is 171.24. The structural formula of Gabapentin is:

Gabapentin is a white to off-white crystalline solid with a pK a1 of 3.7 and a pK a2 of 10.7. It is freely soluble in water and both basic and acidic aqueous solutions. The log of the partition coefficient (n-octanol/0.05M phosphate buffer) at pH 7.4 is –1.25.

Each Gabapentin capsule contains 100 mg, 300 mg, or 400 mg of Gabapentin and the following inactive ingredients: lactose, cornstarch, talc, gelatin, titanium dioxide, FD&C Blue No. 2, yellow iron oxide (300 mg and 400 mg only), and red iron oxide (400 mg only).

Each Gabapentin tablet contains 600 mg or 800 mg of Gabapentin and the following inactive ingredients: poloxamer 407, copovidone, cornstarch, magnesium stearate, hydroxypropyl cellulose, talc, and candelilla wax.

Gabapentin oral solution contains 250 mg of Gabapentin per 5 mL (50 mg per mL) and the following inactive ingredients: glycerin, xylitol, purified water, and artificial cool strawberry anise flavor.

Gabapentin - Clinical Pharmacology

Mechanism of Action

The precise mechanisms by which Gabapentin produces its analgesic and antiepileptic actions are unknown. Gabapentin is structurally related to the neurotransmitter gamma-aminobutyric acid (GABA) but has no effect on GABA binding, uptake, or degradation. In vitro studies have shown that Gabapentin binds with high-affinity to the α2δ subunit of voltage-activated calcium channels; however, the relationship of this binding to the therapeutic effects of Gabapentin is unknown.

Pharmacokinetics

All pharmacological actions following Gabapentin administration are due to the activity of the parent compound; Gabapentin is not appreciably metabolized in humans.

Gabapentin bioavailability is not dose proportional; i. e. as dose is increased, bioavailability decreases. Bioavailability of Gabapentin is approximately 60%, 47%, 34%, 33%, and 27% following 900, 1200, 2400, 3600, and 4800 mg/day given in 3 divided doses, respectively. Food has only a slight effect on the rate and extent of absorption of Gabapentin (14% increase in AUC and C max ).

Less than 3% of Gabapentin circulates bound to plasma protein. The apparent volume of distribution of Gabapentin after 150 mg intravenous administration is 58±6 L (mean ±SD). In patients with epilepsy, steady-state predose (C min ) concentrations of Gabapentin in cerebrospinal fluid were approximately 20% of the corresponding plasma concentrations.

Gabapentin is eliminated from the systemic circulation by renal excretion as unchanged drug. Gabapentin is not appreciably metabolized in humans.

Gabapentin elimination half-life is 5 to 7 hours and is unaltered by dose or following multiple dosing. Gabapentin elimination rate constant, plasma clearance, and renal clearance are directly proportional to creatinine clearance. In elderly patients, and in patients with impaired renal function, Gabapentin plasma clearance is reduced. Gabapentin can be removed from plasma by hemodialysis.

The effect of age was studied in subjects 20–80 years of age. Apparent oral clearance (CL/F) of Gabapentin decreased as age increased, from about 225 mL/min in those under 30 years of age to about 125 mL/min in those over 70 years of age. Renal clearance (CLr) and CLr adjusted for body surface area also declined with age; however, the decline in the renal clearance of Gabapentin with age can largely be explained by the decline in renal function. [see Dosage and Administration (2.4) and Use in Specific Populations (8.5) ] .

Although no formal study has been conducted to compare the pharmacokinetics of Gabapentin in men and women, it appears that the pharmacokinetic parameters for males and females are similar and there are no significant gender differences.

Pharmacokinetic differences due to race have not been studied. Because Gabapentin is primarily renally excreted and there are no important racial differences in creatinine clearance, pharmacokinetic differences due to race are not expected.

Gabapentin pharmacokinetics were determined in 48 pediatric subjects between the ages of 1 month and 12 years following a dose of approximately 10 mg/kg. Peak plasma concentrations were similar across the entire age group and occurred 2 to 3 hours postdose. In general, pediatric subjects between 1 month and <5 years of age achieved approximately 30% lower exposure (AUC) than that observed in those 5 years of age and older. Accordingly, oral clearance normalized per body weight was higher in the younger children. Apparent oral clearance of Gabapentin was directly proportional to creatinine clearance. Gabapentin elimination half-life averaged 4.7 hours and was similar across the age groups studied.

A population pharmacokinetic analysis was performed in 253 pediatric subjects between 1 month and 13 years of age. Patients received 10 to 65 mg/kg/day given three times a day. Apparent oral clearance (CL/F) was directly proportional to creatinine clearance and this relationship was similar following a single dose and at steady state. Higher oral clearance values were observed in children <5 years of age compared to those observed in children 5 years of age and older, when normalized per body weight. The clearance was highly variable in infants <1 year of age. The normalized CL/F values observed in pediatric patients 5 years of age and older were consistent with values observed in adults after a single dose. The oral volume of distribution normalized per body weight was constant across the age range.

These pharmacokinetic data indicate that the effective daily dose in pediatric patients with epilepsy ages 3 and 4 years should be 40 mg/kg/day to achieve average plasma concentrations similar to those achieved in patients 5 years of age and older receiving Gabapentin at 30 mg/kg/day [see Dosage and Administration (2.1) ] .

Adult Patients with Renal Impairment

Subjects (N=60) with renal impairment (mean creatinine clearance ranging from 13–114 mL/min) were administered single 400 mg oral doses of Gabapentin. The mean Gabapentin half-life ranged from about 6.5 hours (patients with creatinine clearance >60 mL/min) to 52 hours (creatinine clearance <30 mL/min) and Gabapentin renal clearance from about 90 mL/min (>60 mL/min group) to about 10 mL/min (<30 mL/min). Mean plasma clearance (CL/F) decreased from approximately 190 mL/min to 20 mL/min [see Dosage and Administration (2.3) and Use in Specific Populations (8.6) ]. Pediatric patients with renal insufficiency have not been studied.

In a study in anuric adult subjects (N=11), the apparent elimination half-life of Gabapentin on nondialysis days was about 132 hours; during dialysis the apparent half-life of Gabapentin was reduced to 3.8 hours. Hemodialysis thus has a significant effect on Gabapentin elimination in anuric subjects [see Dosage and Administration (2.3) and Use in Specific Populations (8.6) ] .

Because Gabapentin is not metabolized, no study was performed in patients with hepatic impairment.

In Vitro Studies

In vitro studies were conducted to investigate the potential of Gabapentin to inhibit the major cytochrome P450 enzymes (CYP1A2, CYP2A6, CYP2C9, CYP2C19, CYP2D6, CYP2E1, and CYP3A4) that mediate drug and xenobiotic metabolism using isoform selective marker substrates and human liver microsomal preparations. Only at the highest concentration tested (171 mcg/mL; 1 mM) was a slight degree of inhibition (14%–30%) of isoform CYP2A6 observed. No inhibition of any of the other isoforms tested was observed at Gabapentin concentrations up to 171 mcg/mL (approximately 15 times the C max at 3600 mg/day).

In Vivo Studies

The drug interaction data described in this section were obtained from studies involving healthy adults and adult patients with epilepsy.

Phenytoin In a single (400 mg) and multiple dose (400 mg three times a day) study of Gabapentin in epileptic patients (N=8) maintained on phenytoin monotherapy for at least 2 months, Gabapentin had no effect on the steady-state trough plasma concentrations of phenytoin and phenytoin had no effect on Gabapentin pharmacokinetics. Carbamazepine Steady-state trough plasma carbamazepine and carbamazepine 10, 11 epoxide concentrations were not affected by concomitant Gabapentin (400 mg three times a day; N=12) administration. Likewise, Gabapentin pharmacokinetics were unaltered by carbamazepine administration. Valproic Acid The mean steady-state trough serum valproic acid concentrations prior to and during concomitant Gabapentin administration (400 mg three times a day; N=17) were not different and neither were Gabapentin pharmacokinetic parameters affected by valproic acid. Phenobarbital Estimates of steady-state pharmacokinetic parameters for phenobarbital or Gabapentin (300 mg three times a day; N=12) are identical whether the drugs are administered alone or together. Naproxen Coadministration (N=18) of naproxen sodium capsules (250 mg) with Gabapentin (125 mg) appears to increase the amount of Gabapentin absorbed by 12% to 15%. Gabapentin had no effect on naproxen pharmacokinetic parameters. These doses are lower than the therapeutic doses for both drugs. The magnitude of interaction within the recommended dose ranges of either drug is not known. Hydrocodone Coadministration of Gabapentin (125 to 500 mg; N=48) decreases hydrocodone (10 mg; N=50) C max and AUC values in a dose-dependent manner relative to administration of hydrocodone alone; C max and AUC values are 3% to 4% lower, respectively, after administration of 125 mg Gabapentin and 21% to 22% lower, respectively, after administration of 500 mg Gabapentin. The mechanism for this interaction is unknown. Hydrocodone increases Gabapentin AUC values by 14%. The magnitude of interaction at other doses is not known. Morphine A literature article reported that when a 60 mg controlled-release morphine capsule was administered 2 hours prior to a 600 mg Gabapentin capsule (N=12), mean Gabapentin AUC increased by 44% compared to Gabapentin administered without morphine. Morphine pharmacokinetic parameter values were not affected by administration of Gabapentin 2 hours after morphine. The magnitude of interaction at other doses is not known. Cimetidine In the presence of cimetidine at 300 mg QID (N=12), the mean apparent oral clearance of Gabapentin fell by 14% and creatinine clearance fell by 10%. Thus, cimetidine appeared to alter the renal excretion of both Gabapentin and creatinine, an endogenous marker of renal function. This small decrease in excretion of Gabapentin by cimetidine is not expected to be of clinical importance. The effect of Gabapentin on cimetidine was not evaluated. Oral Contraceptive Based on AUC and half-life, multiple-dose pharmacokinetic profiles of norethindrone and ethinyl estradiol following administration of tablets containing 2.5 mg of norethindrone acetate and 50 mcg of ethinyl estradiol were similar with and without coadministration of Gabapentin (400 mg three times a day; N=13). The C max of norethindrone was 13% higher when it was coadministered with Gabapentin; this interaction is not expected to be of clinical importance. Antacid (Maalox ® ) (aluminum hydroxide, magnesium hydroxide) Antacid (Maalox ® ) containing magnesium and aluminum hydroxides reduced the mean bioavailability of Gabapentin (N=16) by about 20%. This decrease in bioavailability was about 10% when Gabapentin was administered 2 hours after Maalox. Probenecid Probenecid is a blocker of renal tubular secretion. Gabapentin pharmacokinetic parameters without and with probenecid were comparable. This indicates that Gabapentin does not undergo renal tubular secretion by the pathway that is blocked by probenecid.

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment of Fertility

Gabapentin was administered orally to mice and rats in 2-year carcinogenicity studies. No evidence of drug-related carcinogenicity was observed in mice treated at doses up to 2000 mg/kg/day. At 2000 mg/kg, the plasma Gabapentin exposure (AUC) in mice is approximately 2 times that in humans at the MRHD of 3600 mg/day. In rats, increases in the incidence of pancreatic acinar cell adenoma and carcinoma were found in male rats receiving the highest dose (2000 mg/kg), but not at doses of 250 or 1000 mg/kg/day. At 1000 mg/kg, the plasma Gabapentin exposure (AUC) in rats is approximately 5 times that in humans at the MRHD.

Studies designed to investigate the mechanism of Gabapentin-induced pancreatic carcinogenesis in rats indicate that Gabapentin stimulates DNA synthesis in rat pancreatic acinar cells in vitro and, thus, may be acting as a tumor promoter by enhancing mitogenic activity. It is not known whether Gabapentin has the ability to increase cell proliferation in other cell types or in other species, including humans.

Gabapentin did not demonstrate mutagenic or genotoxic potential in three in vitro and four in vivo assays. It was negative in the Ames test and the in vitro HGPRT forward mutation assay in Chinese hamster lung cells; it did not produce significant increases in chromosomal aberrations in the in vitro Chinese hamster lung cell assay; it was negative in the in vivo chromosomal aberration assay and in the in vivo micronucleus test in Chinese hamster bone marrow; it was negative in the in vivo mouse micronucleus assay; and it did not induce unscheduled DNA synthesis in hepatocytes from rats given Gabapentin.

No adverse effects on fertility or reproduction were observed in rats at doses up to 2000 mg/kg. At 2000 mg/kg, the plasma Gabapentin exposure (AUC) in rats is approximately 8 times that in humans at the MRHD.

Clinical Studies

Postherpetic Neuralgia

Gabapentin was evaluated for the management of postherpetic neuralgia (PHN) in two randomized, double-blind, placebo-controlled, multicenter studies. The intent-to-treat (ITT) population consisted of a total of 563 patients with pain for more than 3 months after healing of the herpes zoster skin rash (Table 6).

TABLE 6. Controlled PHN Studies: Duration, Dosages, and Number of Patients

Each study included a 7- or 8-week double-blind phase (3 or 4 weeks of titration and 4 weeks of fixed dose). Patients initiated treatment with titration to a maximum of 900 mg/day Gabapentin over 3 days. Dosages were then to be titrated in 600 to 1200 mg/day increments at 3- to 7-day intervals to the target dose over 3 to 4 weeks. Patients recorded their pain in a daily diary using an 11-point numeric pain rating scale ranging from 0 (no pain) to 10 (worst possible pain). A mean pain score during baseline of at least 4 was required for randomization. Analyses were conducted using the ITT population (all randomized patients who received at least one dose of study medication).

Both studies demonstrated efficacy compared to placebo at all doses tested.

The reduction in weekly mean pain scores was seen by Week 1 in both studies, and were maintained to the end of treatment. Comparable treatment effects were observed in all active treatment arms. Pharmacokinetic/pharmacodynamic modeling provided confirmatory evidence of efficacy across all doses. Figures 1 and 2 show pain intensity scores over time for Studies 1 and 2.

Figure 1. Weekly Mean Pain Scores (Observed Cases in ITT Population): Study 1

Figure 2. Weekly Mean Pain Scores (Observed Cases in ITT Population): Study 2

The proportion of responders (those patients reporting at least 50% improvement in endpoint pain score compared with baseline) was calculated for each study (Figure 3).

Figure 3. Proportion of Responders (patients with ≥50% reduction in pain score) at Endpoint: Controlled PHN Studies

Epilepsy for Partial Onset Seizures (Adjunctive Therapy)

The effectiveness of Gabapentin as adjunctive therapy (added to other antiepileptic drugs) was established in multicenter placebo-controlled, double-blind, parallel-group clinical trials in adult and pediatric patients (3 years and older) with refractory partial seizures.

Evidence of effectiveness was obtained in three trials conducted in 705 patients (age 12 years and above) and one trial conducted in 247 pediatric patients (3 to 12 years of age). The patients enrolled had a history of at least 4 partial seizures per month in spite of receiving one or more antiepileptic drugs at therapeutic levels and were observed on their established antiepileptic drug regimen during a 12-week baseline period (6 weeks in the study of pediatric patients). In patients continuing to have at least 2 (or 4 in some studies) seizures per month, Gabapentin or placebo was then added on to the existing therapy during a 12-week treatment period. Effectiveness was assessed primarily on the basis of the percent of patients with a 50% or greater reduction in seizure frequency from baseline to treatment (the "responder rate") and a derived measure called response ratio, a measure of change defined as (T - B)/(T + B), in which B is the patient's baseline seizure frequency and T is the patient's seizure frequency during treatment. Response ratio is distributed within the range -1 to +1. A zero value indicates no change while complete elimination of seizures would give a value of -1; increased seizure rates would give positive values. A response ratio of -0.33 corresponds to a 50% reduction in seizure frequency. The results given below are for all partial seizures in the intent-to-treat (all patients who received any doses of treatment) population in each study, unless otherwise indicated.

One study compared Gabapentin 1200 mg/day, in three divided doses with placebo. Responder rate was 23% (14/61) in the Gabapentin group and 9% (6/66) in the placebo group; the difference between groups was statistically significant. Response ratio was also better in the Gabapentin group (-0.199) than in the placebo group (-0.044), a difference that also achieved statistical significance.

A second study compared primarily Gabapentin 1200 mg/day, in three divided doses (N=101), with placebo (N=98). Additional smaller Gabapentin dosage groups (600 mg/day, N=53; 1800 mg/day, N=54) were also studied for information regarding dose response. Responder rate was higher in the Gabapentin 1200 mg/day group (16%) than in the placebo group (8%), but the difference was not statistically significant. The responder rate at 600 mg (17%) was also not significantly higher than in the placebo, but the responder rate in the 1800 mg group (26%) was statistically significantly superior to the placebo rate. Response ratio was better in the Gabapentin 1200 mg/day group (-0.103) than in the placebo group (-0.022); but this difference was also not statistically significant (p = 0.224). A better response was seen in the Gabapentin 600 mg/day group (-0.105) and 1800 mg/day group (-0.222) than in the 1200 mg/day group, with the 1800 mg/day group achieving statistical significance compared to the placebo group.

A third study compared Gabapentin 900 mg/day, in three divided doses (N=111), and placebo (N=109). An additional Gabapentin 1200 mg/day dosage group (N=52) provided dose-response data. A statistically significant difference in responder rate was seen in the Gabapentin 900 mg/day group (22%) compared to that in the placebo group (10%). Response ratio was also statistically significantly superior in the Gabapentin 900 mg/day group (-0.119) compared to that in the placebo group (-0.027), as was response ratio in 1200 mg/day Gabapentin (-0.184) compared to placebo.

Analyses were also performed in each study to examine the effect of Gabapentin on preventing secondarily generalized tonic-clonic seizures. Patients who experienced a secondarily generalized tonic-clonic seizure in either the baseline or in the treatment period in all three placebo-controlled studies were included in these analyses. There were several response ratio comparisons that showed a statistically significant advantage for Gabapentin compared to placebo and favorable trends for almost all comparisons.

Analysis of responder rate using combined data from all three studies and all doses (N=162, Gabapentin; N=89, placebo) also showed a significant advantage for Gabapentin over placebo in reducing the frequency of secondarily generalized tonic-clonic seizures.

In two of the three controlled studies, more than one dose of Gabapentin was used. Within each study, the results did not show a consistently increased response to dose. However, looking across studies, a trend toward increasing efficacy with increasing dose is evident (see Figure 4 ).

Figure 4. Responder Rate in Patients Receiving Gabapentin Expressed as a Difference from Placebo by Dose and Study: Adjunctive Therapy Studies in Patients ≥12 Years of Age with Partial Seizures

In the figure, treatment effect magnitude, measured on the Y axis in terms of the difference in the proportion of Gabapentin and placebo-assigned patients attaining a 50% or greater reduction in seizure frequency from baseline, is plotted against the daily dose of Gabapentin administered (X axis).

Although no formal analysis by gender has been performed, estimates of response (Response Ratio) derived from clinical trials (398 men, 307 women) indicate no important gender differences exist. There was no consistent pattern indicating that age had any effect on the response to Gabapentin. There were insufficient numbers of patients of races other than Caucasian to permit a comparison of efficacy among racial groups.

A fourth study in pediatric patients age 3 to 12 years compared 25 – 35 mg/kg/day Gabapentin (N=118) with placebo (N=127). For all partial seizures in the intent-to-treat population, the response ratio was statistically significantly better for the Gabapentin group (-0.146) than for the placebo group (-0.079). For the same population, the responder rate for Gabapentin (21%) was not significantly different from placebo (18%).

A study in pediatric patients age 1 month to 3 years compared 40 mg/kg/day Gabapentin (N=38) with placebo (N=38) in patients who were receiving at least one marketed antiepileptic drug and had at least one partial seizure during the screening period (within 2 weeks prior to baseline). Patients had up to 48 hours of baseline and up to 72 hours of double-blind video EEG monitoring to record and count the occurrence of seizures. There were no statistically significant differences between treatments in either the response ratio or responder rate.

How Supplied/Storage and Handling

Gabapentin capsules, tablets, and oral solution are supplied as follows:

100 mg capsules:

White hard gelatin capsules printed with "G" on one side and "5026" on the other; available in: Bottles of 100: NDC 59762-5026-1

300 mg capsules:

Yellow hard gelatin capsules printed with "G" on one side and "5027" on the other; available in: Bottles of 100: NDC 59762-5027-1 Bottles of 500: NDC 59762-5027-2

400 mg capsules:

Orange hard gelatin capsules printed with "G" on one side and "5028" on the other; available in: Bottles of 100: NDC 59762-5028-1

White elliptical film-coated scored tablets debossed with "G" and "21" on one side; available in: Bottles of 100: NDC 59762-5023-1

White elliptical film-coated scored tablets debossed with "G" and "22" on one side; available in: Bottles of 100: NDC 59762-5024-1

250 mg per 5 mL oral solution:

Clear colorless to slightly yellow solution; each 5 mL of oral solution contains 250 mg of Gabapentin; available in: Bottles containing 470 mL: NDC 59762-5025-1

Store Gabapentin tablets and capsules at 25°C (77°F); excursions permitted between 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature].

Store Gabapentin oral solution refrigerated, 2°C to 8°C (36°F to 46°F).

Patient Counseling Information

Advise the patient to read the FDA-approved patient labeling (Medication Guide).

Inform patients that Gabapentin is taken orally with or without food. Inform patients that, should they divide the scored 600 mg or 800 mg tablet in order to administer a half-tablet, they should take the unused half-tablet as the next dose. Advise patients to discard half-tablets not used within 28 days of dividing the scored tablet.

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)/Multiorgan Hypersensitivity

Prior to initiation of treatment with Gabapentin, instruct patients that a rash or other signs or symptoms of hypersensitivity (such as fever or lymphadenopathy) may herald a serious medical event and that the patient should report any such occurrence to a physician immediately [see Warnings and Precautions (5.1) ] .

Anaphylaxis and Angioedema

Advise patients to discontinue Gabapentin and seek medical care if they develop signs or symptoms of anaphylaxis or angioedema [ see Warnings and Precautions (5.2) ] .

Dizziness and Somnolence and Effects on Driving and Operating Heavy Machinery

Advise patients that Gabapentin may cause dizziness, somnolence, and other symptoms and signs of CNS depression. Other drugs with sedative properties may increase these symptoms. Accordingly, although patients' ability to determine their level of impairment can be unreliable, advise them neither to drive a car nor to operate other complex machinery until they have gained sufficient experience on Gabapentin to gauge whether or not it affects their mental and/or motor performance adversely. Inform patients that it is not known how long this effect lasts [see Warnings and Precautions (5.3) and Warnings and Precautions (5.4) ] .

Suicidal Thinking and Behavior

Counsel the patient, their caregivers, and families that AEDs, including Gabapentin, may increase the risk of suicidal thoughts and behavior. Advise patients of the need to be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Instruct patients to report behaviors of concern immediately to healthcare providers [see Warnings and Precautions (5.6) ] .

Use in Pregnancy

Instruct patients to notify their physician if they become pregnant or intend to become pregnant during therapy, and to notify their physician if they are breast feeding or intend to breast feed during therapy [see Use in Specific Populations (8.1) and (8.3) ] .

Encourage patients to enroll in the NAAED Pregnancy Registry if they become pregnant. This registry is collecting information about the safety of antiepileptic drugs during pregnancy. To enroll, patients can call the toll free number 1-888-233-2334 [see Use in Specific Populations (8.1) ] .

This product's label may have been updated. For full prescribing information, please visit www. greenstonellc. com .

MEDICATION GUIDE

Capsules, Tablets, and Oral Solution

Read the Medication Guide before you start taking Gabapentin and each time you get a refill. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or treatment.

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

Do not stop taking Gabapentin without first talking to your healthcare provider.

Stopping Gabapentin suddenly can cause serious problems.

Gabapentin can cause serious side effects including:

1. Suicidal Thoughts. Like other antiepileptic drugs, Gabapentin may cause suicidal thoughts or actions in a very small number of people, about 1 in 500.

Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you:

thoughts about suicide or dying

attempts to commit suicide

new or worse depression

new or worse anxiety

feeling agitated or restless

panic attacks

trouble sleeping (insomnia)

new or worse irritability

acting aggressive, being angry, or violent

acting on dangerous impulses

an extreme increase in activity and talking (mania)

other unusual changes in behavior or mood

How can I watch for early symptoms of suicidal thoughts and actions?

Pay attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings.

Keep all follow-up visits with your healthcare provider as scheduled.

Call your healthcare provider between visits as needed, especially if you are worried about symptoms.

Do not stop taking Gabapentin without first talking to a healthcare provider.

Stopping Gabapentin suddenly can cause serious problems. Stopping a seizure medicine suddenly in a patient who has epilepsy can cause seizures that will not stop (status epilepticus).

Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes.

2. Changes in behavior and thinking - Using Gabapentin in children 3 to 12 years of age can cause emotional changes, aggressive behavior, problems with concentration, restlessness, changes in school performance, and hyperactivity. 3. Gabapentin may cause serious or life-threatening allergic reactions that may affect your skin or other parts of your body such as your liver or blood cells. This may cause you to be hospitalized or to stop Gabapentin. You may or may not have a rash with an allergic reaction caused by Gabapentin. Call a healthcare provider right away if you have any of the following symptoms:

skin rash

hives

difficulty breathing

fever

swollen glands that do not go away

swelling of your face, lips, throat, or tongue

yellowing of your skin or of the whites of the eyes

unusual bruising or bleeding

severe fatigue or weakness

unexpected muscle pain

frequent infections

These symptoms may be the first signs of a serious reaction. A healthcare provider should examine you to decide if you should continue taking Gabapentin.

What is Gabapentin?

Gabapentin is a prescription medicine used to treat:

Pain from damaged nerves (postherpetic pain) that follows healing of shingles (a painful rash that comes after a herpes zoster infection) in adults.

Partial seizures when taken together with other medicines in adults and children 3 years of age and older with seizures.

Who should not take Gabapentin?

Do not take Gabapentin if you are allergic to Gabapentin or any of the other ingredients in Gabapentin. See the end of this Medication Guide for a complete list of ingredients in Gabapentin.

What should I tell my healthcare provider before taking Gabapentin?

Before taking Gabapentin, tell your healthcare provider if you :

have or have had kidney problems or are on hemodialysis

have or have had depression, mood problems, or suicidal thoughts or behavior

have diabetes

are pregnant or plan to become pregnant. It is not known if Gabapentin can harm your unborn baby. Tell your healthcare provider right away if you become pregnant while taking Gabapentin. You and your healthcare provider will decide if you should take Gabapentin while you are pregnant.

If you become pregnant while taking Gabapentin, talk to your healthcar

Vermin Dictionary Definition, Vermin

Sentence Examples

It is frequently raised at once by sowing the acorns on the ground where the trees are required, the fruit being gathered in the autumn as soon as shed, and perfectly ripe seeds selected; but the risk of destruction by mice and other vermin is so great that transplanting from a nursery-bed is in most cases to be preferred.

The comparatively rapid growth of the tree is its great recommendation to the planter; it is best raised from acorns sown on the spot, as they are very bitter and little liable to the attacks of vermin ; the tree sends down a long tap-root, which should be curtailed by cutting or early transplanting, if the young trees are to be removed.

The various species of rapacious animals are disappearing, together with the colonies of marmots; the insectivores are also becoming scarce in consequence of the destruction of insects; while vermin . such as the suslik, or pouched marmot (Spermophilus), and the destructive insects which are a scourge to agriculture, become a real plague.

One day there appeared upon the scene a piper clad in a fantastic suit, who offered for a certain sum of money to charm all the vermin into the Weser.

The blackbird feeds chiefly on fruits, worms, the larvae of insects and snails, extracting the last from their shells by dexterously chipping them on stones; and though it is generally regarded as an enemy of the garden, it is probable that the amount of damage by it to the fruit is largely compensated for by its undoubted services as a vermin-killer .

Related

Common Side Effects Of Norvasc (Amlodipine Besylate) Drug Center, Alopine

For Patients

Last reviewed on RxList 4/2/2015

Norvasc (amlodipine) is a medication that belongs to the calcium channel blockers (CCBs) class of drugs. Norvasc is available as a generic drug, and is prescribed for the prevention and treatment of heart pain or chest pain from angina, and for the treatment of high blood pressure. Less serious side effects of Norvasc may include headache, swelling (edema) of the lower extremities, dizziness, drowsiness, tired feeling, stomach pain, or flushing.

The usual initial antihypertensive oral dose of Norvasc is 5 mg once daily, and the maximum dose is 10 mg once daily. Norvasc dosages may need to be lowered in patients with liver dysfunction. Drug interactions and warnings in patients with severe coronary artery disease can increase the frequency and severity of angina or actually cause a heart attack on rare occasions. Excessive lowering of blood pressure during initiation of Norvasc treatment can occur (especially in patients taking another blood pressure medication with Norvasc). Norvasc may interact with simvastatin, ketoconazole, itraconazole, ritonavir, diltiazem, and cyclosporine. Norvasc is generally avoided during pregnancy and is not recommended for use while breastfeeding.

Our Norvasc Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

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 is Patient Information in Detail?

Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.

Norvasc in Detail - Patient Information: Side Effects

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

Call your doctor at once if you have a serious side effect such as:

feeling like you might pass out;

swelling in your hands, ankles, or feet;

pounding heartbeats or fluttering in your chest; or

chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling.

Less serious side effects may include:

headache;

dizziness, drowsiness;

tired feeling;

stomach pain; or

flushing (warmth, redness, or tingly feeling).

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.

Read the entire detailed patient monograph for Norvasc (Amlodipine Besylate)

What is Patient Information Overview?

A concise overview of the drug for the patient or caregiver from First DataBank.

Norvasc Overview - Patient Information: Side Effects

SIDE EFFECTS: Dizziness, lightheadedness, swelling ankles/feet, nausea, abdominal/stomach pain, or flushing may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: fast/irregular/pounding heartbeat, fainting.

Although this medication is effective in preventing chest pain (angina), some people who already have severe heart disease may rarely develop worsening chest pain or a heart attack after starting this medication or increasing the dose. Get medical help right away if you experience: worsening chest pain, symptoms of a heart attack (such as chest/jaw/left arm pain, shortness of breath, unusual sweating).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

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

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Read the entire patient information overview for Norvasc (Amlodipine Besylate)

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Norvasc FDA Prescribing Information: Side Effects (Adverse Reactions)

SIDE EFFECTS

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

NORVASC has been evaluated for safety in more than 11,000 patients in U. S. and foreign clinical trials. In general, treatment with NORVASC was well-tolerated at doses up to 10 mg daily. Most adverse reactions reported during therapy with NORVASC were of mild or moderate severity. In controlled clinical trials directly comparing NORVASC (N=1730) at doses up to 10 mg to placebo (N=1250), discontinuation of NORVASC because of adverse reactions was required in only about 1.5% of patients and was not significantly different from placebo (about 1%). The most commonly reported side effects more frequent than placebo are reflected in the table below. The incidence (%) of side effects that occurred in a dose related manner are as follows:

The following events occurred in < 1% but > 0.1% of patients in controlled clinical trials or under conditions of open trials or marketing experience where a causal relationship is uncertain; they are listed to alert the physician to a possible relationship:

General: allergic reaction, asthenia. 1 back pain, hot flushes, malaise. pain, rigors, weight gain, weight decrease.

Psychiatric: sexual dysfunction (male 1 and female), insomnia, nervousness, depression, abnormal dreams. anxiety, depersonalization.

Skin and Appendages: angioedema. erythema multiforme, pruritus. 1 rash, 1 rash erythematous, rash maculopapular.

Urinary System: micturition frequency, micturition disorder, nocturia .

Autonomic Nervous System: dry mouth. sweating increased.

Metabolic and Nutritional: hyperglycemia. thirst.

NORVASC therapy has not been associated with clinically significant changes in routine laboratory tests. No clinically relevant changes were noted in serum potassium. serum glucose, total triglycerides. total cholesterol. HDL cholesterol. uric acid. blood urea nitrogen. or creatinine.

In the CAMELOT and PREVENT studies [see Clinical Studies ], the adverse event profile was similar to that reported previously (see above), with the most common adverse event being peripheral edema.

Postmarketing Experience

Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

The following postmarketing event has been reported infrequently where a causal relationship is uncertain: gynecomastia. In postmarketing experience, jaundice and hepatic enzyme elevations (mostly consistent with cholestasis or hepatitis ), in some cases severe enough to require hospitalization, have been reported in association with use of amlodipine.

Postmarketing reporting has also revealed a possible association between extrapyramidal disorder and amlodipine.

1 These events occurred in less than 1% in placebo-controlled trials, but the incidence of these side effects was between 1% and 2% in all multiple dose studies.

Read the entire FDA prescribing information for Norvasc (Amlodipine Besylate)

Comprar Thevier (Synthroid) Sin Receta, Thevier

compra Thevier (Synthroid) en linea sin receta

Thevier (Synthroid) Explicacion

Thevier es realmente un tratamiento ideal dentro de la batalla hacia problemas de la glandula tiroides, por ejemplo, el bocio, la tiroiditis, la glandula tiroides malignidad, asi como n? Ud. Ademas, extras deficiencia de la glandula tiroides, asi como sus signos y sintomas.

Thevier utilidad esta dentro de sustitucion con respecto a las victimas, en cuyo grado de glandula tiroides basura que se crea por glandular de la glandula tiroides no es muy regular.

Thevier tambien puede ser referido como levotiroxina, Lethyrox, Eltroxin, Evotrox, Thyrax, Euthyrox, Levaxin, L-tiroxina, Thyrox, Eutirox, Levoxyl.

titulo general asociada con Thevier es en realidad levotiroxina.

Marcas asociadas con Thevier tienden a ser Unithroid, Levoxyl, Thevier, Levothroid.

Thevier (Synthroid) Dosis

Thevier viene en:

25mcg Baja material de friccion Dosis

50 mcg material de friccion dosis regular

material de friccion 200 mcg Dosis Maxima

Obtener pastillas Thevier por via oral antes de la cena.

Por lo general, no moler o incluso masticar esto.

Get Thevier diaria al mismo tiempo, cada manana junto con el agua potable.

Por lo general, no dejar de usar Thevier de repente.

Thevier (Synthroid) Careciendo asocia con dosis

Por lo general, no reciben doble dosis. En caso de que salte la dosis que necesita para llevar una vez se tiene en cuenta en lo que respecta a su deficiente. Cuando es hora de la dosis que necesita para llevar a cabo su propia rutina de dosificacion normal.

Thevier (Synthroid)

En el caso de que la sobredosis de Thevier y que tambien se evita gran usted necesita comprobar hacia fuera su medico o incluso el medico de inmediato. Asociado con Thevier sobredosis: nauseas o vomitos, calidos, problemas del corazon, latido del corazon rapido, cada vez mas asociado con el hambre, la respiracion breve, insomnio, sudoracion, cefalea, diarrea, malestar infrecuente.

Thevier (Synthroid) Espacio de almacenamiento

Tienda en temperaturas de espacio entre 10 y 30 niveles de D (59, asi como ochenta y seis niveles F) de la humedad, la iluminacion, asi como la temperatura. Mantener cuadro de texto firmemente cerrada. Fortalecer cualquier tipo de medicamento sin tocar a partir del dia de vencimiento. Mantener desde el lograr de los ninos.

Thevier (Synthroid) Efectos negativos

Thevier ofrece los efectos negativos. El mas tipico tienden a ser:

vomitando material de friccion

nauseas o vomitos material de friccion

insuficiente considerar material de friccion

material de friccion temblores

material de friccion migrana

ansiedad

modificaciones, junto con material de friccion hambre

material de friccion insomnio

material de friccion caliente

dentro de material de friccion menstruacion

sensibilidad hacia el material de friccion temperatura

material de friccion calvicie

inferior de la pierna calambres material de friccion

material de friccion diarrea

material de friccion exudacion

Mucho menos tipicos y graves efectos negativos en toda utilizando Thevier:

respuestas reaccion alergica (urticaria, inhalando y exhalando cuestiones, alergia, asi como la erupcion) material de friccion

cardiaco anormal vencio

problemas cardiacos friccion de material

Los efectos negativos indicaciones se basan en medicamentos que podrian estar utilizando pero, ademas, se basan en su condicion de bienestar y otros aspectos

Thevier (Synthroid) Contraindicaciones

Por lo general no lo hacen Thevier utilizar en caso de que usted es sensible a fin de elementos Thevier.

Thevier se podria utilizar si usted esta esperando otra manera tiene la intencion de tener un hijo, si no que realmente eres una mama medica. No dana al nino.

Por lo general, no tome ventaja de este medicamento junto con pildoras de perdida de peso dentro de la subsanacion de tener sobrepeso o incluso para perder peso.

Tenga cuidado junto con Thevier en caso de que usted esta tomando medicamentos para reducir el colesterol (por ejemplo colestipol (tales porque Colestid), colestiramina (Questran)); salicilatos de dosificacion mas altos (por ejemplo, porque la aspirina); rifamicinas (por ejemplo, debido a la rifampicina); sulfato ferroso; yoduro; glucocorticoides (por ejemplo, debido a la prednisona, dexametasona); teofilina; El fenobarbital; digoxina; citoquinas (por ejemplo, debido a la interleuquina-2, interferon-alfa); amiodarona; antiacidos que tienen aluminio de peso ligero; medicamentos para la diabetes (por ejemplo, debido a la rosiglitazona, la insulina, glipizida); antidepresivos (por ejemplo, debido a la sertralina, amitriptilina, maprotilina); medicamentos anti-tiroideos (por ejemplo, porque el propiltiouracilo, metimazol); warfarina; ketamina; sucralfato medicamento ulcera (tales Carafate); HGH; bloqueadores beta (propranolol), porque tales articulos, hormonas femeninas, de litio.

Get Thevier con cuidado en caso de que se ven afectados por infarto de miocardio; deficiencia suprarrenal, problemas de la glandula tiroides (enfermedad nodular de la glandula tiroides, no toxico disipa bocio); diabetica; enfermedades cardiovasculares (enfermedad de las arterias coronarias, presion arterial alta, fallo cardiovascular, arritmias, o incluso angina); huesos fragiles; problemas de basura (por ejemplo, porque los sintomas poliglandulares autoinmunes, deficiencias basura hipotalamicas); esterilidad femenina o masculina, tirotoxicosis; coagulacion torrente sanguineo, los problemas que hielan.

Tenga cuidado junto con Thevier si quieres tener un tratamiento quirurgico.

Puede ser danino para evitar el uso de Thevier, de repente.

Thevier (Synthroid) Preguntas comunes

Queen: ?Que es exactamente Thevier?

El: Thevier es realmente un tratamiento ideal dentro de la batalla hacia problemas de la glandula tiroides, por ejemplo, el bocio, la tiroiditis, la glandula tiroides malignidad, asi como n ud. Ademas, extras deficiencia de la glandula tiroides, asi como sus signos y sintomas. Es

Reina: ?Como puede realmente hace carrera Thevier?

El: Thevier utilidad esta dentro de sustitucion con respecto a las victimas en cuyo grado de glandula tiroides basura que se crea por glandular de la glandula tiroides no es realmente regular. A

Queen: ?Cuales son exactamente efectos negativos Thevier?

El: Thevier ofrece los tipicos efectos negativos, por ejemplo, vomitos, nauseas o vomitos, el peso corporal insuficiente, temblores, migrana, ansiedad, modificaciones, junto con el hambre, la falta de sueno, caliente, dentro de la menstruacion, la sensibilidad hacia la temperatura, calvicie, calambres en las piernas inferiores, la diarrea, la exudacion. Sin embargo en la situacion que se asocia con el rechazo asociado con elementos Thevier que son capaces de encontrar efectos negativos mas graves: ritmo cardiaco anormal, problemas cardiacos, asociados con la respuesta de reaccion alergica (urticaria, problemas con la inhalacion y la exhalacion, la alergia, la inflamacion, el cierre). La probabilidad de efectos negativos a aparecer depende de la posicion de bienestar, asi como, naturalmente, en la receta Thevier posterior correcta medications. A

Queen: ?Cuales son exactamente general, asi como las marcas asociadas con Thevier?

El: titulo general asociada con Thevier es en realidad levotiroxina. Marcas asociadas con Thevier tienden a ser Unithroid, Levoxyl, Thevier, Levothroid. A

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Blind Fasteners, Advel

Engineered Fastening Innovation

Avdel has been a technology leader for more than 75 years and our range of blind fasteners and tooling is one of the widest in the market:

Avdel is a global organisation offering expertise and know-how at a local level. The aim is to have a better understanding of our customers' needs and wants while developing strong business partnerships that lead to hand-in-hand growth and success. Quality, Innovation and Expertise are the 'buzz words' in the organisation and we aim to deliver all three as part of our total solution philosophy. To achieve this we are going to great lengths to continuously improve our levels of customer service, on-time delivery and quality performance and procedures. In parallel to our continuous improvement approach, greater levels of resource and dedication are now focused on identifying new and improved products for our customers. We are committed to developing new fastening solutions and bringing them to market faster by utilising the wealth of experience in our personnel and maximising output and profitability for our customers.

Avdel® has been producing assembly systems since 1936 and offers a comprehensive range of fasteners and tooling.

Find details on standards, specifications, corrosion, FAQs as well as a glossary to explain some of the terminology used in our product literature.

The Avdel® brand name dates back over 75 years. The name is derived from 'Aviation Developments', the company's original name when it was founded in 1936.

In our news section you can access current news and information about Avdel and our branded products.

Oronazol Krema, Oronazol

Oronazol krema (ketokonazol )

NAVODILO ZA UPORABO

Oronazol 20 mg/g krema

Pred uporabo natancno preberite navodilo, ker vsebuje za vas pomembne podatke!

Zdravilo je na voljo brez recepta. Kljub temu ga morate uporabljatipazljivo in skrbno, da vam bo kar najbolj koristilo.

Navodilo shranite. Morda ga boste zeleli ponovno prebrati.

Posvetujte se s farmacevtom, ce potrebujete dodatne informacije ali nasvet.

Ce se znaki vase bolezni poslabsajo ali ne izboljsajo v 2 do 6 tednih, se posvetujte z zdravnikom.

Ce katerikoli nezeleni ucinek postane resen ali ce opazite katerikoli nezeleni ucinek, ki ni omenjen v tem navodilu, obvestite svojega zdravnika ali farmacevta.

1. Kaj je zdravilo Oronazol in za kaj ga uporabljamo

2. Kaj morate vedeti, preden boste uporabili zdravilo Oronazol

3. Kako uporabljati zdravilo Oronazol

4. Mozni nezeleni ucinki

5. Shranjevanje zdravila Oronazol

6. Dodatne informacije

1. Kaj je zdravilo Oronazol in za kaj ga uporabljamo

Zdravilo Oronazol vsebuje ketokonazol, ki fungicidno ali fungistaticno deluje predvsem proti dermatofitom ( Microsporum sp. Trichophyton sp. Epidermophyton sp.), kvasovkam ( Candida sp. Cryptococcus sp. Torulopsis sp. Pityriosporum sp.), dimorfnim glivam ( Histoplasma capsulatum . Coccidioides sp. Paracoccidioides sp.) in drugim glivam.

Z njim zdravimo glivicne okuzbe koze in seboroicni dermatitis.

2. Kaj morate vedeti, preden boste uporabili zdravilo Oronazol

Ne uporabljajte zdravila Oronazol

ce ste alergicni (preobcutljivi) na ketokonazol ali katerokoli sestavino zdravila Oronazol.

Bodite posebno pozorni pri uporabi zdravila Oronazol

ce zacnete uporabljati kremo Oronazol po dolgotrajnem zdravljenju s kremami ali z mazili, ki vsebujejo kortikosteroide. V tem primeru priporocamo loceno uporabo obeh zdravil (najbolje eno kremo zjutraj, drugo zvecer) se 2 do 3 tedne. Da bi preprecili poslabsanje bolezenskih znakov (povratni ali "rebound" ucinek), uporabo lokalnega kortikosteroida postopoma zmanjsujte.

Oronazol krema ni primerna za uporabo na oceh, zato ne sme priti v stik z ocmi.

Uporaba drugih zdravil

Obvestite svojega zdravnika ali farmacevta, ce jemljete ali ste pred kratkim jemali katerokoli zdravilo, tudi ce ste ga dobili brez recepta.

Porocil o medsebojnem delovanju zdravil pri lokalni uporabi ketokonazola ni.

Nosecnost in dojenje

Posvetujte se z zdravnikom ali s farmacevtom, preden vzamete katerokoli zdravilo.

Ketokonazol pri lokalni uporabi ne prehaja v kri, vendar ga med nosecnostjo priporocamo le, ce zdravnik presodi, da je korist zdravljenja za mater vecja od tveganja za otroka.

Ketokonazol pri lokalni uporabi ne prehaja v kri, vendar se o uporabi kreme med dojenjem kljub temu posvetujte z zdravnikom ali s farmacevtom.

Vpliv na sposobnost upravljanja vozil in strojev

Zdravilo Oronazol nima vpliva na sposobnost voznje in upravljanja s stroji.

Pomembne informacije o nekaterih sestavinah zdravila Oronazol

Propilenglikol lahko povzroci drazenje koze.

Stearilalkohol in cetilalkohol lahko povzrocita lokalne kozne reakcije (npr. kontaktni dermatitis).

3. Kako uporabljati zdravilo Oronazol

Pri uporabi zdravila Oronazol natancno upostevajte zdravnikova navodila. Ce ste negotovi, se posvetujte z zdravnikom ali s farmacevtom.

Kremo nanesite na obolelo mesto in okolico enkrat do dvakrat na dan, navadno zjutraj in zvecer. Zdravljenje naj traja 2 do 6 tednov. Z njim morate, da bi preprecili ponovno obolenje, nadaljevati se nekaj dni po prenehanju vseh znakov. Kremo lahko uporabljajo le odrasli.

Samo za zunanjo uporabo!

Ce ste uporabili vecji odmerek zdravila Oronazol, kot bi smeli

Prekomeren nanos pri topikalni uporabi lahko povzroci rdecino (eritem), oteklino (edem) in pekoc obcutek. Ti simptomi izginejo po prenehanju zdravljenja.

Zauzitje kreme bi pri odraslih le malo verjetno lahko povzrocilo hujse tezave, lahko pa se pojavijo pri otrocih kot slabost, bruhanje in driska. Uvesti je potrebno podporne in simptomatske ukrepe.

Ce ste pozabili uporabiti zdravilo Oronazol

Ne uporabite dvojnega odmerka, ce ste pozabili uporabiti prejsnji odmerek.

Kremo nanesite vsak dan ob priblizno istem casu. Ce jo pozabite, jo nanesite takoj, ko je to mogoce, urnika odmerjanja pa vam ni treba spreminjati.

Ce ste prenehali uporabljati zdravilo Oronazol

Znaki obolenja pogosto izginejo ze v nekaj dneh, a je okuzba morda se prisotna in se lahko ponovi, ce se prezgodaj prenehate zdraviti.

Ce imate dodatna vprasanja o uporabi zdravila, se posvetujte z zdravnikom ali s farmacevtom.

4. Mozni nezeleni ucinki

Kot vsa zdravila ima lahko tudi zdravilo Oronazol nezelene ucinke, ki pa se ne pojavijo pri vseh bolnikih.

Pogosti: pojavijo se lahko pri najvec 1 od 10 bolnikov

drazec ali pekoc obcutek na kozi

rdecina in srbenje na mestu aplikacije

Obcasni: pojavijo se lahko pri najvec 1 od 100 bolnikov

lokalna preobcutljivostna reakcija

mehurjast izpuscaj, kontaktni dermatitis, izpuscaj, luscenje koze, lepljiva koza

krvavitev, neprijeten obcutek, izsusenost koze, vnetje, drazenje, ter mravljincenje in zbadanje (parestezija) na mestu aplikacije

Neznana pogostnost: pogostnosti iz razpolozljivih podatkov ni mogoce oceniti

Ce katerikoli nezeleni ucinek postane resen ali ce opazite katerikoli nezeleni ucinek, ki ni omenjen v tem navodilu, obvestite svojega zdravnika ali farmacevta.

5. Shranjevanje zdravila Oronazol

Zdravilo shranjujte nedosegljivo otrokom!

Zdravila Oronazol ne smete uporabljati po datumu izteka roka uporabnosti, ki je naveden na ovojnini. Datum izteka roka uporabnosti se nanasa na zadnji dan navedenega meseca.

Shranjujte pri temperaturi do 25 °C.

Zdravila ne smete odvreci v odpadne vode ali med gospodinjske odpadke. O nacinu odstranjevanja zdravila, ki ga ne potrebujete vec, se posvetujte s farmacevtom. Taksni ukrepi pomagajo varovati okolje.

6. Dodatne informacije

Kaj vsebuje zdravilo Oronazol

Zdravilna ucinkovina je ketokonazol. 1 g kreme vsebuje 20 mg ketokonazola.

Pomozne snovi so propilenglikol, stearilalkohol, cetilalkohol, sorbitan monostearat, polisorbat 60, izopropilmiristat, brezvodni natrijev sulfit, polisorbat 80 in preciscena voda.

Izgled zdravila Oronazol in vsebina pakiranja

Krema je bele barve, homogena.

Na voljo so skatle s 30 g kreme v tubi.

Nacin in rezim izdaje zdravila Oronazol

Izdaja zdravila je brez recepta v lekarnah.

Imetnik dovoljenja za promet z zdravilom in izdelovalec

KRKA, tovarna zdravil, d. d. Novo mesto, Smarjeska cesta 6, 8501 Novo mesto, Slovenija

Navodilo je bilo odobreno

Zaradi zakonskih dolocil so strani z informacijami o zdravilih, ki se izdajajo samo na recept, dostopne le strokovni javnosti in na voljo le registriranim uporabnikom. Za dostop se prijavite tukaj .

Datoteke

Opisi zdravil in izdelkov so namenjeni seznanjanju z njihovimi znacilnostmi, niso pa prodajni katalog.

Besedilo obravnava zdravilo, ki se sme izdajati le na zdravniski recept. O primernosti zdravila za uporabo pri posameznem bolniku lahko presoja le zdravnik. Dodatne informacije dobite pri svojem zdravniku ali farmacevtu.

Prijava nezelenih ucinkov Ce zelite prijaviti nezelene ucinke, nam posljite izpolnjeni obrazec za prijavo nezelenih ucinkov .

Krka, d. d. Novo mesto

Program Farmacevtika Dunajska cesta 65 1000 Ljubljana Telefon 01 475 11 00 Telefaks 01 436 25 23 E-naslov zdravila@krka. biz www. krka. si

Vse avtorske pravice pridrzane. Krka, tovarna zdravil, d. d. Novo mesto | Pravna obvestila

Nasa spletna stran uporablja piskotke. Z uporabo te spletne stani se strinjate, da lahko uporabljamo piskotke. Vec o piskotkih lahko preberete tu .

Alindrin, Alindrin

Alindrin

Important Notice: The Drugs. com international database is in BETA release. This means it is still under development and may contain inaccuracies. It is not intended as a substitute for the expertise and judgement of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that the use of any medication in any country is safe, appropriate or effective for you. Consult with your healthcare professional before taking any medication.

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Lisinopril Oral Uses, Side Effects, Interactions, Pictures, Warnings - Dosing, Lisiprol

lisinopril

Warnings

This drug can cause serious (possibly fatal) harm to an unborn baby if used during pregnancy. Therefore, it is important to prevent pregnancy while taking this medication. Consult your doctor for more details and to discuss the use of reliable forms of birth control while taking this medication. If you are planning pregnancy, become pregnant, or think you may be pregnant, contact your doctor right away.

Uses

Lisinopril is an ACE inhibitor and works by relaxing blood vessels so that blood can flow more easily.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used to help protect the kidneys from harm due to diabetes .

How to use lisinopril

Take this medication by mouth with or without food as directed by your doctor, usually once daily.

If you are using the suspension form of this medication, shake the bottle well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

The dosage is based on your medical condition and response to treatment. For children, the dosage is also based on weight .

Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

For the treatment of high blood pressure, it may take 2 to 4 weeks before you get the full benefit of this medication. For the treatment of heart failure, it may take weeks to months before you get the full benefit of this medication. Tell your doctor if your condition does not improve or if it worsens (such as your blood pressure readings remain high or increase).

Side Effects

Dizziness. lightheadedness, tiredness, or headache may occur as your body adjusts to the medication. Dry cough may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: fainting. symptoms of a high potassium blood level (such as muscle weakness. slow/irregular heartbeat ).

Although lisinopril may be used to prevent kidney problems or treat people who have kidney problems, it may also rarely cause serious kidney problems or make them worse. Your doctor will check your kidney function while you are taking lisinopril. Tell your doctor right away if you have any signs of kidney problems such as a change in the amount of urine.

This drug may rarely cause serious (possibly fatal) liver problems. Tell your doctor right away if you notice any of the following rare but serious side effects: yellowing eyes /skin. dark urine, severe stomach /abdominal pain. persistent nausea /vomiting .

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction. including: rash. itching /swelling (especially of the face/tongue /throat), severe dizziness, trouble breathing .

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www. fda. gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking lisinopril, tell your doctor or pharmacist if you are allergic to it; or to other ACE inhibitors (such as benazepril ); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: history of an allergic reaction which included swelling of the face/lips/tongue /throat (angioedema), blood filtering procedures (such as LDL apheresis, dialysis ), high level of potassium in the blood.

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Too much sweating, diarrhea, or vomiting may cause loss of too much body water (dehydration) and increase your risk of lightheadedness. Report prolonged diarrhea or vomiting to your doctor. Be sure to drink enough fluids to prevent dehydration unless your doctor directs you otherwise.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This product may increase your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist.

Older adults may be more sensitive to the side effects of this drug, including dizziness and increases in potassium level.

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details. (See also Warning section.)

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Interactions

See also Precautions section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: aliskiren, certain drugs that weaken the immune system/increase the risk of infection (such as everolimus, sirolimus), lithium, drugs that may increase the level of potassium in the blood (such as ARBs including losartan/valsartan, birth control pills containing drospirenone), sacubitril.

Check the labels on all your medicines (such as cough-and-cold products, diet aids, or NSAIDs such as ibuprofen, naproxen) because they may contain ingredients that could increase your blood pressure or worsen your heart failure. Ask your pharmacist for more details.

A very serious reaction may occur if you are getting injections for bee/wasp sting allergy (desensitization) and are also taking lisinopril. Make sure all your doctors know which medicines you are using.

Overdose

If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting.

Notes

Do not share this medication with others.

Lifestyle changes such as stress reduction programs, exercise and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

Laboratory and/or medical tests (such as kidney function, potassium levels) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Check your blood pressure regularly while taking this medication. Learn how to monitor your own blood pressure at home, and share the results with your doctor.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store the tablets and suspension at room temperature away from light and moisture. Do not store in the bathroom. Discard any unused suspension after 4 weeks. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Information last revised March 2016. Copyright(c) 2016 First Databank, Inc.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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Medazol, Medazol

Paraguay

MEDAZOL пїЅ

AntihelmпїЅntico de amplio espectro.

ComposiciпїЅn.

MEDAZOL пїЅ 500: cada comprimido contiene: metronidazol 500mg. Excipientes cs. MEDAZOL пїЅ 1: cada comprimido contiene: metronidazol 1g. Excipientes cs. MEDAZOL пїЅ cada 5ml de suspensiпїЅn oral contiene: metronidazol 250mg. Excipientes cs.

Indicaciones.

Profilaxis de infecciones perioperatorias y tratamiento de infecciones bacterianas por anaerobios. Amebiasis y tricomoniasis. Vaginitis por Gardnerella vaginalis . giardiasis y algunas infecciones por protozoos, anaerobios, enfermedad intestinal inflamatoria, helmintiasis. El metronidazol es eficaz contra la mayorпїЅa de las infecciones anaerпїЅbicas. Es especialmente efectivo en: Bacteroides fragilis, Fuso Bacterium y Clostridium y sus especies.

DosificaciпїЅn.

Los comprimidos deben ser ingeridos con las comidas. 1- Infecciones bacterianas anaerпїЅbicas. MEDAZOL пїЅ 500mg 3 veces por dпїЅa o MEDAZOL пїЅ 1g 2 veces por dпїЅa. 2- Infecciones ginecolпїЅgicas por tricomonas. 1 solo dпїЅa de tratamiento, 2g en 24 horas en 1 пїЅ 2 tomas. Debe administrarse a la pareja en forma simultпїЅnea. 3- Profilaxis de cirugпїЅa colorrectal y pпїЅlvica. MEDAZOL пїЅ 500mg / 1g diarios. 4- Tratamiento de la enfermedad de Crohn. 500mg 2 veces por dпїЅa o 1g una vez por dпїЅa durante 3 a 4 meses. 5- Giardiasis intestinal. Adultos: 2g diariamente durante 3 dпїЅas. NiпїЅos: 25-35mg/kg/dпїЅa en 2 tomas diarias. 6- Tratamiento de las infecciones dentales 250 a 500mg 3 veces por dпїЅa a 1g diario durante 3 a 7 dпїЅas.

Contraindicaciones.

Sensibilidad conocida al metronidazol. Enfermedades neurolпїЅgicas severas, incluyendo convulsiones. Insuficiencia hepпїЅtica grave. No consumir bebidas alcohпїЅlicas durante el tratamiento.

PresentaciпїЅn.

MEDAZOL пїЅ 500mg: envase conteniendo 20 comprimidos. MEDAZOL пїЅ 1g: envase conteniendo 4 comprimidos. MEDAZOL пїЅ SuspensiпїЅn: envase conteniendo 100ml (agitar antes de usar).

Orfiril, Orfiril

Orfiril®

Enterotabletter. 1 enterotablet indeholder 300 mg eller 600 mg valproat (som natriumsalt). Orfiril® Retard, depottabletter. 1 depottablet (filmovertrukken) indeholder 300 mg valproat (som natriumsalt). Orfiril® Long, depotkapsler, harde. 1 depotkapsel indeholder 150 mg eller 300 mg valproat (som natriumsalt). Orfiril® Long, depotgranulat i endosisbeholder. 1 endosisbeholder indeholder 500 mg eller 1.000 mg valproat (som natriumsalt). Oral oplosning. 1 ml indeholder 60 mg valproat (som natriumsalt). Injektionsv?ske, oplosning. 1 ml indeholder 100 mg valproat (som natriumsalt).

Doseringsforslag

Epilepsi

Voksne. Initialt. 600 mg dgl. som enkeltdosis. Dosis oges til vedligeholdelsesdosis 600-1.200 mg dgl. fordelt pa 1-2 doser.

Born. Vedligeholdelsesdosis . 20-30 mg/kg legemsv?gt i dognet, fordelt pa 2 doser.

Mani

Voksne . Individuelt. S?dvanligvis initialt 750 mg dgl. eller 20 mg/kg legemsv?gt dgl. Dosis justeres herefter til laveste effektive dosis. Plasmaniveau bor v?re 350-700 mikromol/ml. Noje monitorering af patienten ved doser over 45 mg/kg legemsv?gt dgl.

Enterotabletter:

Skal synkes hele.

Bor indtages umiddelbart efter et maltid.

Depottabletter:

Skal synkes hele.

Matriksen i depottabletterne udskilles i tabletlignende form med f?ces.

Depotkapsler:

Skal synkes hele.

Kan evt. abnes, og indholdet drysses pa fx yoghurt eller opsl?mmes/udrores i v?ske.

Ma ikke tygges eller knuses.

Depotgranulat:

Skal synkes helt.

Kan evt. udrores i mad eller drikke.

Ma ikke tygges eller knuses.

Matriksen i depotgranulatet udskilles i tabletlignende form med f?ces.

Voksne . Individuelt. S?dvanligvis 20 mg/kg legemsv?gt i dognet.

Unge. Individuelt. S?dvanligvis 25 mg/kg legemsv?gt i dognet. Dosis gives som langsom i. v. injektion over 3-5 min. eller som infusion eller gentagne injektioner, maksimalt 6.000 mg i dognet.

Born . 30 mg/kg legemsv?gt i dognet. Dosis kan oges til 40 mg/kg legemsv?gt i dognet. Plasmakoncentrationen bor i sa fald kontrolleres hyppigt. Man bor overga til oral behandling sa hurtigt som muligt.

Kontraindikationer

Leverlidelse, ogsa nedsat leverfunktion hos n?re sl?gtninge efter valproat - eller anden medikamentel behandling

Trombocytopeni

H?moragisk diatese

Porfyri

Defekter i urinstofcyklus

Samtidig behandling med carbapenemer.

Lisinopril Advanced Patient Information, Sinopren

lisinopril (Oral route)

Pharmacologic Class: ACE Inhibitor

Uses For lisinopril

Lisinopril is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure can reduce the risk of strokes and heart attacks.

Lisinopril works by blocking a substance in the body that causes the blood vessels to tighten. As a result, lisinopril relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

Lisinopril is also used to help treat heart failure. It is also used in some patients after a heart attack. After a heart attack, some of the heart muscle is damaged and weakened. The heart muscle may continue to weaken as time goes by. This makes it more difficult for the heart to pump blood. Lisinopril may be started within 24 hours after a heart attack to increase survival rate.

lisinopril is available only with your doctor's prescription.

Before Using lisinopril

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For lisinopril, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to lisinopril or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of lisinopril to treat hypertension in children 6 to 16 years of age. However, safety and efficacy have not been established in children younger than 6 years of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of lisinopril in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving lisinopril.

Pregnancy

Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking lisinopril, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using lisinopril with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using lisinopril with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Alteplase, Recombinant

Amiloride

Azathioprine

Azilsartan

Azilsartan Medoxomil

Candesartan Cilexetil

Canrenoate

Eplerenone

Eprosartan

Everolimus

Irbesartan

Lithium

Losartan

Mercaptopurine

Olmesartan Medoxomil

Potassium

Sirolimus

Spironolactone

Telmisartan

Triamterene

Trimethoprim

Valsartan

Using lisinopril with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aceclofenac

Acemetacin

Amtolmetin Guacil

Aspirin

Azosemide

Bemetizide

Bendroflumethiazide

Benzthiazide

Bromfenac

Bufexamac

Bumetanide

Bupivacaine

Bupivacaine Liposome

Buthiazide

Capsaicin

Celecoxib

Chlorothiazide

Chlorthalidone

Choline Salicylate

Clonixin

Clopamide

Cyclopenthiazide

Cyclothiazide

Dexibuprofen

Dexketoprofen

Diclofenac

Diflunisal

Dipyrone

Ethacrynic Acid

Etodolac

Etofenamate

Etoricoxib

Felbinac

Fenoprofen

Fepradinol

Feprazone

Floctafenine

Flufenamic Acid

Flurbiprofen

Furosemide

Gold Sodium Thiomalate

Hydrochlorothiazide

Hydroflumethiazide

Ibuprofen

Indapamide

Indomethacin

Ketoprofen

Ketorolac

Lornoxicam

Loxoprofen

Lumiracoxib

Meclofenamate

Mefenamic Acid

Meloxicam

Methyclothiazide

Metolazone

Morniflumate

Nabumetone

Naproxen

Nepafenac

Nesiritide

Niflumic Acid

Nimesulide

Oxaprozin

Oxyphenbutazone

Parecoxib

Phenylbutazone

Piketoprofen

Piretanide

Piroxicam

Polythiazide

Proglumetacin

Propionic Acid

Propyphenazone

Proquazone

Quinethazone

Rofecoxib

Salicylic Acid

Salsalate

Sodium Salicylate

Sulindac

Tenoxicam

Tiaprofenic Acid

Tizanidine

Tolfenamic Acid

Tolmetin

Torsemide

Trichlormethiazide

Valdecoxib

Xipamide

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of lisinopril. Make sure you tell your doctor if you have any other medical problems, especially:

Angioedema (swelling of the face, lips, tongue, throat, arms, or legs) with other ACE inhibitors, history of—May increase risk of this condition occurring again.

Collagen vascular disease (an autoimmune disease) together with kidney disease—Increased risk of blood problems.

Diabetes or

Kidney problems—Increased risk of potassium levels in the body becoming too high.

Diabetes patients who are also taking aliskiren (Tekturna®) or

Hereditary or idiopathic angioedema or

Patients who have kidney problems and are also taking aliskiren (Tekturna®)—Should not be used in patients with these conditions.

Electrolyte imbalance (eg, low sodium in the blood) or

Fluid imbalances (caused by dehydration, vomiting, or diarrhea) or

Heart or blood vessel problems (eg, aortic stenosis, hypertrophic cardiomyopathy) or

Liver disease—Use with caution. May make these conditions worse.

Proper Use of lisinopril

In addition to the use of lisinopril, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that lisinopril will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

If your child cannot swallow the tablets, an oral liquid may be given. Shake the oral liquid well just before each use. Ask your doctor or pharmacist about this.

Dosing

The dose of lisinopril will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of lisinopril. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):

For high blood pressure:

Adults—At first, 10 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 40 mg per day.

Children 6 years of age and older—Dose is based on body weight and must be determined by your doctor. The starting dose is usually 0.07 mg per kilogram (kg) of body weight per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 0.61 mg per kg of body weight or 40 mg per day.

Children younger than 6 years of age—Use is not recommended.

For heart failure:

Adults—At first, 5 milligrams (mg) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 40 mg per day.

Children—Use and dose must be determined by your doctor.

For immediate treatment after a heart attack:

Adults—At first, 5 milligrams (mg), followed by 5 mg after 24 hours, followed by 10 mg after 48 hours, and then 10 mg once a day.

Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of lisinopril, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Store the mixed oral liquid at or below room temperature for up to 4 weeks.

Precautions While Using lisinopril

It is very important that your doctor check your progress at regular visits to make sure lisinopril is working properly. Blood tests may be needed to check for unwanted effects.

Using lisinopril while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using lisinopril, tell your doctor right away.

lisinopril may cause serious types of allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat while you are using lisinopril.

Call your doctor right away if you have severe stomach pain (with or without nausea or vomiting). This could be a symptom of intestinal angioedema.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up from a lying or sitting position or if you have been taking a diuretic (water pill). Make sure you know how you react to the medicine before you drive, use machines, or do other things that could be dangerous if you are dizzy or not alert . If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you become sick while taking lisinopril, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

Check with your doctor if you have a fever, chills, or sore throat. These could be symptoms of an infection resulting from low white blood cells.

Hyperkalemia (high potassium in the blood) may occur while you are using lisinopril. Check with your doctor right away if you have the following symptoms: abdominal or stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, shortness of breath, or weakness or heaviness of the legs. Do not use supplements or salt substitutes containing potassium without first checking with your doctor .

Check with your doctor right away if you have upper stomach pain, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

lisinopril may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor.

Make sure any doctor or dentist who treats you knows that you are using lisinopril. You may need to stop using lisinopril several days before having surgery.

lisinopril may be less effective in black patients. Black patients also have an increased risk of angioedema (swelling of the hands, arms, face, mouth, or throat).

Do not take other medicines unless they have been discussed with your doctor. This includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

lisinopril Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Blurred vision

cloudy urine

confusion

decrease in urine output or decrease in urine-concentrating ability

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

sweating

unusual tiredness or weakness

Less common

Abdominal or stomach pain

body aches or pain

chest pain

chills

common cold

cough

diarrhea

difficulty breathing

ear congestion

fever

headache

loss of voice

nasal congestion

nausea

runny nose

sneezing

sore throat

vomiting

Rare

Arm, back, or jaw pain

chest discomfort, tightness, or heaviness

fast or irregular heartbeat

general feeling of discomfort or illness

joint pain

loss of appetite

muscle aches and pains

shivering

trouble sleeping

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Decreased interest in sexual intercourse

inability to have or keep an erection

lack or loss of strength

loss in sexual ability, desire, drive, or performance

rash

Rare

Acid or sour stomach

belching

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

feeling of constant movement of self or surroundings

heartburn

indigestion

muscle cramps

sensation of spinning

stomach discomfort or upset

swelling

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

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

The information contained in the Truven Health Micromedex products as delivered by Drugs. com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs. com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products.

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Fidiflex, Prasek Za Peroralno Raztopino, Fidiflex

Veseli nas, da ste izbrali Petrolovo pot do Lekarnarja

Ce oznacite polje podajate izrecno soglasje, da bo PETROL d. d. Ljubljana vase posredovane osebne podatke obdeloval, za namene trzenja. Podano soglasje lahko kadarkoli preklicete. Vec.

Stranka z izpolnitvijo in potrdilom obrazca poda izrecno soglasje, da Petrol kot upravljavec zbirke osebnih podatkov zbira in obdeluje osebne podatke in sicer za naslednje kategorije osebnih podatkov: podatke, ki se nanasajo na imetnika, med drugim: ime in priimek, kraj, ulica in hisna stevilka, postna stevilka in posta, telefon, elektronski naslov, podatke o gospodinjstvu, velikosti stanovanja, o poslovni dejavnosti, nacinu placila in predvidenem roku nakupa novega izdelka, o ogrevanju, spolu, datumu rojstva, zaposlitvenem statusu, vrsti stavbe. Stranka s potrdilom podaja soglasje, da Petrol za potrebe segmentiranega in ciljnega trzenja obdeluje vse podatke, ki jih hrani o posamezniku in jih je pridobil ob njegovih nakupih, sklepanju pogodb ali med drugimi oblikami interakcije s potrosnikom.

Stranka z ustrezno izpolnitvijo in potrdilom soglasa, da Petrol te podatke obdeluje in zbira za spodaj nastete namene: statisticnih obdelav, posiljanja ponudb, izvajanja trzenjskih raziskav, posiljanja oglasnih gradiv, obvescanja o novostih v dobaviteljevi ponudbi in poslovanju dobavitelja ter njegovih poslovnih partnerjev, dolocanja odjemalcevega okvira porabe, obdelave preteklega nakupnega obnasanja, za telefonsko in pisno anketiranje, izgradnje baze podatkov za potrebe upravljanja odnosov s kupci, neposrednega, segmentiranega in ciljnega trzenja.

Stranka lahko kadarkoli preklice dovoljenje za posiljanje oglasnega gradiva. obvescanja o novostih v ponudbi in poslovanju dobavitelja ter njegovih poslovnih partnerjev. Dovoljenje se lahko preklice pisno na naslov: Petrol d. d. Ljubljana, Dunajska 50, 1000 Ljubljana. s pripisom Petrol klub, na elektronskem naslovu klub@petrol. si ali na brezplacni telefonski stevilki 080 22 66. Odjava je mozna tudi s klikom ob vsakokratnem elektronskem posiljanju oglasnih sporocil ali v primeru brezplacnega SMS sporocila s SMS sporocilom »Petrol stop« ali »Stop« na stevilko 4246.

Petrol zagotavlja, da bo prejete osebne podatke stranke in vse ostale podatke obdelane pri uresnicevanju svojih zakonitih interesov, ki prevladajo nad interesi stranke, scitil pred nepooblascenim razkritjem in posredovanjem nepooblascenim tretjim osebam, in sicer v skladu z veljavnimi predpisi, ki urejajo varstvo osebnih podatkov. Petrol bo hranil osebne podatke do preklica soglasja za obdelovanje osebnih podatkov. Podatki o poslanih oglasnih sporocilih se hranijo do preklica dovoljenja za posiljanje reklamnih sporocil. Stranka z dano privolitvijo hkrati soglasa in pooblasca Petrol, da za namene: dolocene v teh pravilih, posreduje podatke o stranki svojim podizvajalcem na ozemlju Republike Slovenije, s katerimi ima sklenjene pogodbe o obdelavi podatkov in ki podatke obdelujejo v njegovem imenu in za njegov racun, navedene zgoraj, posreduje svojim odvisnim, pridruzenim ter skupaj obvladovanim druzbam dane imetnikove osebne podatke. Druzbe iz te alineje so navedene na strani http://www. petrol. si/o-podjetju/petrol/skupina-petrol. Stranka s potrdilom tega obrazca soglasa, da je seznanjen z vsemi relevantnimi pravicami, kot so npr. pravica do vpogleda, prepisa, kopiranja, popravkov, blokiranja in izbrisa njegovih osebnih podatkov, v skladu z veljavnim zakonom, ki ureja varstvo osebnih podatkov. Manj.

Naprej

FidiFlex, prasek za peroralno raztopino

Pred uporabo natancno preberite navodilo! O tveganju in nezelenih ucinkih se posvetujte z zdravnikom ali farmacevtom.

Kaj je zdravilo in za kaj ga uporabljamo FIDIFLEX je zdravilo v obliki praška za peroralno raztopino. Vsaka vrecica vsebuje en odmerek. Spada v skupino nesteroidnih protivnetnih in protirevmaticnih zdravil. FIDIFLEX se uporablja za ublazitev simptomov pri blagi in zmerni osteoartrozi kolena. Zdravila ne uporabljajte Ne jemljite zdravila FIDIFLEX:

ce ste alergicni na glukozamin ali katerokoli sestavino tega zdravila (navedeno v poglavju 6).

ce ste alergicni na lupinarje (školjke, polze, rake), ker je glukozamin pridobljen iz lupinarjev.

Bodite posebno pozorni pri uporabi zdravila Pred zacetkom jemanja zdravila FIDIFLEX se posvetujte z zdravnikom ali farmacevtom.

Bodite posebno pozorni pri uporabi zdravila FIDIFLEX:

ce trpite zaradi motene tolerance za glukozo. Ob zacetku zdravljenja z glukozaminom bo mogoce pri vas potrebna pogostejša kontrola koncentracije glukoze v krvi.

ce imate okvarjeno ledvicno ali jetrno delovanje. Zaradi pomanjkanja študij pri takšnih bolnikih ni posebnih priporocil za odmerjanje.

ce pri vas obstaja tveganje za srcnozilne bolezni, saj obstaja verjetnost povišanja vrednosti holesterola in trigliceridov v krvi, zato je priporocljivo, da med zdravljenjem z zdravilom FIDIFLEX veckrat preverite vrednost teh parametrov v vaši krvi.

ce trpite za astmo. Morate se zavedati, da se simptomi lahko poslabšajo ob zacetku zdravljenja.

Nosecnost in dojenje Ce ste noseci ali dojite, menite, da bi lahko bili noseci ali nacrtujete zanositev, se posvetujte z zdravnikom ali farmacevtom, preden vzamete to zdravilo. Zdravila FIDIFLEX se med nosecnostjo ne sme uporabljati. Uporaba glukozamina med dojenjem ni priporocljiva. Posvetujte se z zdravnikom ali s farmacevtom, preden vzamete katerokoli zdravilo.

Vpliv na sposobnost upravljanja vozil in strojev Študije o vplivu na sposobnost voznje in upravljanja s stroji niso bile izvedene. Ne uporabljajte vozil ali strojev, ce po zauzitju zdravila FIDIFLEX obcutite vrtoglavico ali zaspanost.

Pomembne informacije o zdravilu Pri bolnikih, ki so zdravilo jemali brez prekinitev daljši cas (vec mesecev ali let), se je zdravljenje z glukozaminom pokazalo enako varno kakor intervalno zdravljenje.

Glukozamin ni indiciran za zdravljenje akutnih bolecinskih simptomov. Zdravljenje lahko traja nekaj tednov, v nekaterih primerih celo dlje, preden nastopi olajšanje bolecine in drugih simptomov. Ce olajšanje bolecine ne nastopi po 2–3 mesecih zdravljenja ali se stanje poslabša, se posvetujte z vašim zdravnikom.

Odmerjanje zdravila Pri jemanju tega zdravila natancno upoštevajte napotke v tem navodilu ali navodila zdravnika. Ce ste negotovi, se posvetujte z zdravnikom ali farmacevtom. Odrasli: Obicajni odmerek zdravila FIDIFLEX je ena vrecica na dan (1178 mg glukozamina) za obdobje 3 mesecev, ki mu lahko sledi dvomesecna prekinitev. Nato z zdravljenjem ponovno zacnemo in ciklus se ponovi.

Nacin uporabe zdravila Vsebino ene vrecice stresite v pol kozarca vode; mešajte, dokler se ne raztopi, in takoj izpijte.

Aciclovir Cream 5%, Poviral

ACICLOVIR CREAM 5%

Transcript

Aciclovir cream 5% Read all of this leaflet carefully because it contains important information for you. • Keep this leaflet. You may need to read it again. • Ask your doctor or pharmacist if you need more information or advice. • You must contact a doctor if your symptoms worsen or do not improve. • If you have any unusual effects after using this product, tell your doctor or pharmacist.

What is Aciclovir cream is and what is it used for? Before you use Aciclovir cream How to use Aciclovir cream Possible side effects How to store Aciclovir cream Further information

What is Aciclovir cream and what is it used for?

Aciclovir cream is used in the treatment of genital herpes and cold sores. Once genital herpes or a cold sore has appeared, treatment with Aciclovir cream can accelerate the healing process. The active substance in Aciclovir cream is aciclovir. Aciclovir is an antiviral agent that has been shown to be effective in treating infections caused by the herpes simplex virus, such as genital herpes and cold sores.

Before you use Aciclovir cream

Do not use Aciclovir cream and tell your doctor: • If you are allergic (hypersensitive) to aciclovir, valaciclovir or any of the other ingredients of Aciclovir cream (listed in section 6, Further Information). Cetyl alcohol, propylene glycol or sorbic acid may cause local skin reactions or irritation (e. g. contact dermatitis). • In the eyes, inside the mouth or genitals. Check with your doctor or pharmacist before using Aciclovir cream if: • Your immune system is not working properly (for instance you have had a bone marrow transplant or you have AIDS). Taking other medicines: Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. This is especially important if you are taking: • Probenecid (used for gout). Pregnancy and breast-feeding: As with all medicines, Aciclovir cream should not be used during pregnancy or breast-feeding, unless you are advised to do so by your doctor. Ask you doctor or pharmacist for advice before taking any medicine. 3.

How to use Aciclovir cream

It is important to start treatment as soon as possible. Always use Aciclovir cream exactly as your doctor has told you. You should check with your doctor or pharmacist if you are unsure how to use this medicine. Adults and the elderly: • Wash your hands before and after applying the cream. This will prevent your cold sore or genital herpes from getting worse or spreading, or you infecting someone else. • Apply the cream to the affected area 5 times daily (about every four hours)

for 5 days. If your cold sore or genital herpes has not healed after five days of treatment you can continue using the cream for another five days.

If you forget to use Aciclovir cream: If you forget to apply the cream, apply it as soon as you remember and then apply the next treatment at the usual time. If you accidentally swallow Aciclovir cream: Aciclovir cream is for use on cold sores on the lips and surrounding skin and herpes on the genitals only. You are very unlikely to suffer any bad effects if you accidentally swallow Aciclovir cream. However, if you notice any unusual effects or are worried tell your doctor or contact the Accident and Emergency Department of your nearest hospital. 4.

Possible side effects

Like all medicines, Aciclovir cream can cause side effects, although not everybody gets them. Some people may experience side effects, particularly when they first start using the product. Stop using Aciclovir cream and contact your doctor immediately if you have • an allergic reaction: urticaria/hives (pale/red raised skin with severe itching) or any swelling of the face, mouth, tongue or airways or difficulty breathing. Uncommon (affects 1 to 10 users in 1,000): • burning or stinging where the cream has been applied, mild dry flaking of the skin, itching. Rare (affects 1 to 10 users in 10,000): • erythema (redness of the skin) If any of these side effects become troublesome or you react badly to the cream in any other way, tell your doctor or pharmacist immediately. 5.

How to store Aciclovir cream

Keep out of the reach and sight of children. Store below 25?C. Do not refrigerate or freeze. Do not use Aciclovir cream after the expiry date which is stated at one end of the carton and on the tube. The expiry date refers to the last day of that month. Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

What Aciclovir cream contains: • The active substance is aciclovir (5% w/w). • The other ingredients are cetyl alcohol, dimethicone, heavy liquid paraffin, polyethylene glycol - 5 glyceryl stearate, propylene glycol, sorbic acid, white soft paraffin and water. What Aciclovir cream looks like and contents of the pack: Aciclovir cream is available in tubes containing 2g or 10g of a smooth white to off-white cream. Marketing Authorisation Holder: Actavis, Barnstaple, EX32 8NS, UK Manufacturer: Patheon UK Limited, Swindon, SN3 5BZ, England This leaflet was last revised in March 2011

Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

Akbar - A Neighborhood Oasis, Akabar

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4356 W Sunset Blvd, Los Angeles, CA 90029 » (323) 665-6810 « » OPEN 4:00pm - 2:00am daily «

Mission Statement

We are AKBAR. We believe in the power of rock and roll. We love guitars. We abhor homophobia. And hetero-phobia. We enjoy a cold beer. We cannot abide a mean drunk. We don’t get organized religion. We like disco. We despise racism. We cannot respect disrespectful behavior. We do not condone “velvet ropes.” We do not care who is a celebrity and who is not. We love our friends. We can be silly. We do not understand gay Republicans. We wing it. We try to obey traffic laws. We do believe variety is the spice of life. We do not enjoy excessive profanity. Damn it. We think we’re Ginger, but we’re really Mary Anne. We love a parade. We would like to see Bush and Cheney brought to court. We are AKBAR. Love it or leave it. We can tolerate a happy drunk but not a sloppy drunk. We do not like shrill voices, especially indoors. We are happy to open the door for you. We love a good martini. We sometimes fall down. We admire musicians. We are distrustful of rabid fans. We enjoy a night on the town. We think we all need more exercise. We skinny dip. We love L. A. and we ♥ N. Y. We’re partial to scruff. We miss our dearly departed friends and family. We look forward to making new friends and family. We like to travel. We love coming home to AKBAR .

Toprol Xl - Heart Disease, Azumetop

Toprol XL, a type of medication known as a beta blocker, is used in the treatment of high blood pressure, angina pectoris (chest pain, usually caused by lack of oxygen to the heart due to clogged arteries), and heart attack. When prescribed for high blood pressure, it is effective when used alone or in combination with other high blood pressure medications. Beta blockers decrease the force and rate of heart contractions, thereby reducing the demand for oxygen and lowering blood pressure.

Take Toprol XL 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.

Take Toprol XL at the same time every day.

Toprol XL should be taken with food or just after a meal. A Toprol XL tablet can be divided in half if your doctor has told you to do so. The half tablet should be swallowed whole, without chewing or crushing. Chewing or crushing the pill could cause too much of the drug to be released at one time.

Do not skip doses or stop taking Toprol XL without first talking to your doctor. Stopping suddenly may make your condition worse.

Your blood pressure will need to be checked often. Visit your doctor regularly.

If you need surgery, tell the surgeon ahead of time that you are using Toprol XL.

Toprol XL is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

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.

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

Store Toprol XL at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Toprol XL out of the reach of children and away from pets.

Active Ingredient: Metoprolol succinate.

Do NOT use Toprol XL if:

you are allergic to any ingredient in Toprol XL or to another beta-blocker

you have a very slow heart rate (eg, bradycardia), certain types of irregular heartbeat (eg, atrioventricular [AV] block, sick sinus syndrome), moderate to severe heart failure, very low systolic blood pressure (less than 100 mm Hg), or severe blood circulation problems.

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

Some medical conditions may interact with Toprol XL. 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 an adrenal gland tumor (pheochromocytoma), have an overactive thyroid, or are scheduled to have surgery

if you have low blood pressure or a history of heart attack, slow or irregular heartbeat, heart failure, or other heart problems; chest pain or angina; blood circulation problems; or liver problems

if you have diabetes mellitus, chronic obstructive pulmonary disease (COPD), bronchitis, breathing problems, or a history of asthma.

Some medicines may interact with Toprol XL. Tell your health care provider if you are taking any other medicines, especially any of the following:

digoxin (digitalis, Lanoxin);

clonidine (Catapres);

ritonavir (Norvir);

terbinafine (Lamisil);

a diuretic (water pill);

cold medicines, stimulant medicines, or diet pills;

anti-malaria medications such as chloroquine (Aralen) or hydroxychloroquine (Plaquenil, Quineprox);

medicine to treat depression or mental illness, such as bupropion (Wellbutrin, Zyban), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), thioridazine (Mellaril), and others;

an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam);

a diabetes medication such as insulin, glyburide (Diabeta, Micronase, Glynase), glipizide (Glucotrol), chlorpropamide (Diabinese), or metformin (Glucophage);

a heart medication such as nifedipine (Procardia, Adalat), quinidine (Quinaglute, Quinidex), propafenone (Rythmol), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cartia, Cardizem); or

medicine for asthma or other breathing disorders, such as albuterol (Ventolin, Proventil), bitolterol (Tornalate), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire, Brethine, Bricanyl), and theophylline (Theo-Dur, Theolair).

This may not be a complete list of all interactions that may occur. Ask your health care provider if Toprol XL 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.

Important safety information:

Toprol XL may cause drowsiness, dizziness, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Toprol XL with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.

Toprol XL 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.

Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.

Do not suddenly stop using Toprol XL without first talking your doctor. If your doctor decides you should no longer use Toprol XL, you will need to stop Toprol XL gradually according to your doctor's instructions.

If your doctor has instructed you to check your blood pressure and heart rate regularly, be sure to do so.

Do not take any medicines used to treat colds or congestion without first consulting with your doctor or pharmacist.

Diabetes patients - Toprol XL may hide signs of low blood sugar, such as rapid heartbeat. Be sure to watch for other signs or low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your vision change; give you a headache, chills, or tremors; or make you more hungry. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.

Tell your doctor or dentist that you take Toprol XL before you receive any medical or dental care, emergency care, or surgery.

If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk for an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are using Toprol XL.

Lab tests, including liver and kidney function, blood pressure, and complete blood cell counts, may be performed while you use Toprol XL. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Toprol XL should be used with extreme caution in children; safety and effectiveness in children 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 Toprol XL while you are pregnant. Toprol XL is found in breast milk. If you are or will be breast-feeding while you use Toprol XL, check with your doctor. Discuss any possible risks to your baby.

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

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

chest pain, pounding heartbeats or fluttering in your chest;

feeling light-headed, fainting;

feeling short of breath, even with mild exertion;

swelling of your hands or feet;

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

easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

wheezing, trouble breathing;

depression, confusion, memory problems, hallucinations; or

cold feeling in your hands and feet.

Less serious side effects may include:

dry mouth, constipation, heartburn, vomiting, diarrhea;

decreased sex drive, impotence, or difficulty having an orgasm;

headache, drowsiness, tired feeling;

sleep problems (insomnia); or

anxiety, nervousness.

This is not a complete list of side effects and others may occur.

Toprol XL, a type of medication known as a beta blocker, is used in the treatment of high blood pressure, angina pectoris (chest pain, usually caused by lack of oxygen to the heart due to clogged arteries), and heart attack. When prescribed for high blood pressure, it is effective when used alone or in combination with other high blood pressure medications. Beta blockers decrease the force and rate of heart contractions, thereby reducing the demand for oxygen and lowering blood pressure.

Take Toprol XL 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.

Take Toprol XL at the same time every day.

Toprol XL should be taken with food or just after a meal. A Toprol XL tablet can be divided in half if your doctor has told you to do so. The half tablet should be swallowed whole, without chewing or crushing. Chewing or crushing the pill could cause too much of the drug to be released at one time.

Do not skip doses or stop taking Toprol XL without first talking to your doctor. Stopping suddenly may make your condition worse.

Your blood pressure will need to be checked often. Visit your doctor regularly.

If you need surgery, tell the surgeon ahead of time that you are using Toprol XL.

Toprol XL is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

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.

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

Store Toprol XL at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Toprol XL out of the reach of children and away from pets.

Active Ingredient: Metoprolol succinate.

Do NOT use Toprol XL if:

you are allergic to any ingredient in Toprol XL or to another beta-blocker

you have a very slow heart rate (eg, bradycardia), certain types of irregular heartbeat (eg, atrioventricular [AV] block, sick sinus syndrome), moderate to severe heart failure, very low systolic blood pressure (less than 100 mm Hg), or severe blood circulation problems.

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

Some medical conditions may interact with Toprol XL. 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 an adrenal gland tumor (pheochromocytoma), have an overactive thyroid, or are scheduled to have surgery

if you have low blood pressure or a history of heart attack, slow or irregular heartbeat, heart failure, or other heart problems; chest pain or angina; blood circulation problems; or liver problems

if you have diabetes mellitus, chronic obstructive pulmonary disease (COPD), bronchitis, breathing problems, or a history of asthma.

Some medicines may interact with Toprol XL. Tell your health care provider if you are taking any other medicines, especially any of the following:

digoxin (digitalis, Lanoxin);

clonidine (Catapres);

ritonavir (Norvir);

terbinafine (Lamisil);

a diuretic (water pill);

cold medicines, stimulant medicines, or diet pills;

anti-malaria medications such as chloroquine (Aralen) or hydroxychloroquine (Plaquenil, Quineprox);

medicine to treat depression or mental illness, such as bupropion (Wellbutrin, Zyban), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), thioridazine (Mellaril), and others;

an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam);

a diabetes medication such as insulin, glyburide (Diabeta, Micronase, Glynase), glipizide (Glucotrol), chlorpropamide (Diabinese), or metformin (Glucophage);

a heart medication such as nifedipine (Procardia, Adalat), quinidine (Quinaglute, Quinidex), propafenone (Rythmol), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cartia, Cardizem); or

medicine for asthma or other breathing disorders, such as albuterol (Ventolin, Proventil), bitolterol (Tornalate), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire, Brethine, Bricanyl), and theophylline (Theo-Dur, Theolair).

This may not be a complete list of all interactions that may occur. Ask your health care provider if Toprol XL 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.

Important safety information:

Toprol XL may cause drowsiness, dizziness, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Toprol XL with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.

Toprol XL 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.

Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.

Do not suddenly stop using Toprol XL without first talking your doctor. If your doctor decides you should no longer use Toprol XL, you will need to stop Toprol XL gradually according to your doctor's instructions.

If your doctor has instructed you to check your blood pressure and heart rate regularly, be sure to do so.

Do not take any medicines used to treat colds or congestion without first consulting with your doctor or pharmacist.

Diabetes patients - Toprol XL may hide signs of low blood sugar, such as rapid heartbeat. Be sure to watch for other signs or low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your vision change; give you a headache, chills, or tremors; or make you more hungry. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.

Tell your doctor or dentist that you take Toprol XL before you receive any medical or dental care, emergency care, or surgery.

If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk for an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are using Toprol XL.

Lab tests, including liver and kidney function, blood pressure, and complete blood cell counts, may be performed while you use Toprol XL. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Toprol XL should be used with extreme caution in children; safety and effectiveness in children 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 Toprol XL while you are pregnant. Toprol XL is found in breast milk. If you are or will be breast-feeding while you use Toprol XL, check with your doctor. Discuss any possible risks to your baby.

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

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

chest pain, pounding heartbeats or fluttering in your chest;

feeling light-headed, fainting;

feeling short of breath, even with mild exertion;

swelling of your hands or feet;

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

easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

wheezing, trouble breathing;

depression, confusion, memory problems, hallucinations; or

cold feeling in your hands and feet.

Less serious side effects may include:

dry mouth, constipation, heartburn, vomiting, diarrhea;

decreased sex drive, impotence, or difficulty having an orgasm;

headache, drowsiness, tired feeling;

sleep problems (insomnia); or

anxiety, nervousness.

This is not a complete list of side effects and others may occur.

Pressolat, Pressolat

Pressolat

Important Notice: The Drugs. com international database is in BETA release. This means it is still under development and may contain inaccuracies. It is not intended as a substitute for the expertise and judgement of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that the use of any medication in any country is safe, appropriate or effective for you. Consult with your healthcare professional before taking any medication.

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Luxury Pearl Jewelry, Perls

World's Best Designer Pearl Jewelry

View a unique collection of pearls that have been hand carved by master artist Chi Galatea.

Freshwater Pearl Jewelry

Today's freshwater pearls are round, lustrous, gorgeous genuine pearls at surprisingly-affordable prices.

Akoya Pearl Jewelry

The gold-standard of pearls. Not huge (7-8mm is typically the max), but with amazing luster and roundness.

Tahitian Pearl Jewelry

Exotic pearls of the South Pacific. Tahitian Pearl srange from Black to Silver to Peacock.

South Sea Pearl Jewelry

Offering amazing luster and large sizes, South Sea pearls range from White to Golden in color.

Reticor Tretinoin 0, Reticor

RETICOR TRETINOIN 0.1% CREAM | 15g

Properties and indications:

Reticor® contains a derivative of Vitamin A retinoid – tretinoin in a concentration of 0.1 %;

is used to treat acne, dark spots, associated with hyperpigmentation and also for general rejuvenation of skin;

when processing open acne, reduces inflammation and removes the consequences in the form of redness and dark spots;

when processing closed blackheads helps them opening or transition to the papules, followed by healing (no scarring);

significantly reduces oiliness and exfoliates dead skin cells;

decreases and smoothing out facial wrinkles;

suitable for dry and sensitive skin;

the best time of the application – the autumn-winter;

approved by FDA.

The composition and release form:

cream for external use 15 g

1 g of cream contains 0.1% tretinoin (1 mg) on a cream base q. s.

children under 12 years;

pregnancy;

lactation;

acute inflammation (including eczema) lesions of the skin (dermatitis, seborrhea, and others);

rosacea;

skin lesions (wounds, burns, etc.);

photosensitivity;

diseases of the rectum;

hypersensitivity to any component of the gel (discontinue use and consult a doctor if you have any of these signs of an allergic reaction: hives, difficulty breathing, swelling of the face, lips, tongue, or throat).

Side effects of the preparation

Frequently: reaches a peak within the first week of treatment, and then spontaneously go - scaling, dryness, burning, redness; increased sensitivity to sunlight and UV rays;

Rarely (in 5-12% of cases): erythema, itching, temporary hyperpigmentation and hypopigmentation (possible with multiple application of tretinoin);

Rarely (in 1-2% of cases): allergic contact dermatitis.

Dosage and how to use:

apply the cleanser ;

wait until complete drying of the skin (30 minutes);

topically applied a thin layer on the entire affected surface 1 times day in the evening. avoiding contact with eyes and mucous membrane of the lips. Later may be applied 1-2 times a day for 1-6 hours and then washed off with warm water;

for people with fair and dry skin exposure time at the beginning of the treatment is 30 minutes, then duration of exposure can be gradually increased;

after necessary to wash your hands;

avoid the use of other products on the treated areas (at least 1 hour after application of tretinoin);

if there is dry (after an hour of applying the cream), apply a moisturizer ;

the result will be seen after 1-4 weeks of treatment;

treatment time – 3-4 months. Retreatment after consultation with a physician.

do not use if you have wounds, burns or symptoms of eczema, dermatitis or rosacea ;

do not use if you are allergic to any of the ingredients of the drug. If any of the symptoms of allergy - contact your doctor immediately;

do not use for a week or two after the irritating procedures ( peels. hair removal, etc.);

the use of excessive amounts does not give rapid effect, but on the contrary can make the skin more irritable and dry;

may use non-comedogenic cosmetics, but the area where it was applied, should be thoroughly cleaned;

transient sense of warmth and a slight burning sensation may be noted after application;

excessive dryness of the skin after Reticor cream, it is a sign that we should reduce the frequency of applications, and possibly hes numbers. If this does not work, apply the gel on 5-40 minutes and rinse with water. Your skin should gradually adapt to it. Also if there are dry, it is necessary to use moisturizer for better therapy;

people with hypersensitivity to the sun should exercise particular caution. When applied topically should be protect skin from exposure to sunlight and artificial UV-exposure, wind, cold;

having a tan, treatment should begin after the weakening of tanning;

in contact with mucous membranes of the mouth, rinse with water;

do not use with products which have irritation or desiccating properties (for example, sulfur, resorcinol, salicylic acid, containing alcohol and others.).

avoid contact with the peel of lime;

in the early weeks of therapy, may occur exacerbation of inflammatory lesions, but this should not be considered as a reason to discontinue therapy.

Your #1 Choice For Boats For Sale In Maine, Omformin

Your #1 Choice for Boats for Sale in Maine

Hamlin’s Marine wants you to enjoy every moment on the water.

For over twenty years Hamlin’s Marine has delivered on a simple promise… ”If you purchase a boat from Hamlin’s Marine, we’ll always be there when you need us.” Hamlin’s Marine offers convenience and assurance with our locations in Waterville and Hampden, staff of twenty-five dedicated employees, and a fleet of service trucks.

At Hamlin’s we only sell boats that we can stand behind. Our manufacturers include Bennington Pontoons. Stingray. Mastercraft. Cutwater. Northcoast. Puffin. Alumacraft. Achilles. Scout Boats. and Yamaha Outboards. These manufacturers lead the industry in quality construction, and make it easier to serve you when it matters most.

So come on in and choose from our selection of new and used Pontoon Boats, Tow Boats or any other fishing boats or family fun boats. With two easy locations in Waterville, Maine (Boat Sales and Service) or Hampden, Maine (Boat Sales, Service, and Marina) it couldn't get any more convenient. Choose Hamlin’s Marine as your boat dealer, service center, marina, and indoor storage facility, and we promise you’ll make wonderful memories on the water in Maine.

At Hamlin's Marine we stand behind all of our boats for sale in Maine .

Why Buy From Hamlin's Marine:

31 Years in Business

#1 Yamaha Outboard Dealer in New England for 5 Years in a Row

Alumacraft is America's #1 selling Deep V Aluminum Fishing Boat

Multiple Locations to serve you

Fleet of ten service and delivery trucks

Hydrangea Paniculata - Peegee Hydrangea, Peegee

HYDRANGEA PANICULATA PEEGEE AND FAMILY

Paniculata hydrangeas will grow and bloom in a wide variety of climates (hardy to Zone 3!). Unlike mopheads, they need several hours of sun to do well. If your weather is too cold to grow the pink and blue hydrangeas or if your landscape doesn't have much shade, consider growing one of the many types of paniculatas. North or south, we can all enjoy them.

Another desirable trait of all paniculatas is their tolerance for pruning. One can prune them at any time except when they begin forming bloom heads in the summer. The paniculata is the ONLY hydrangea that can be pruned into a tree form.

The name "paniculata" comes from the fact that many of the blooms are panicle-shaped (somewhat cone shaped) rather than ball-shaped. Many paniculata blooms develop a lovely pink shade as the blooms age, extending their beauty into the fall.

Paniculatas often get very large. 8-10 feet tall and wide is not unusual. Some, as seen in pictures below, get even taller.

A beautiful paniculata, and one of the most popular is 'Limelight' which can be grown in all parts of the United States except those areas which receive no freezing weather.

The best known Hydrangea paniculata is PeeGee. This hydrangea gets its nickname from its botanical name, H. paniculata 'Grandiflora' (PG). Although PG refers only to the 'Grandiflora' variety . many nurserymen have started referring to all paniculatas as PeeGees. This may be causing some slight confusion, but if you would like a further explanation, please e-mail me.

Northern Virginia PGs

The picture at the top of the page and the five below are PeeGees blooming in Northern Virginia. Two of the pictures below demonstrate the PeeGee's tendency to turn pink as the blooms age.

Comprar Barato Online Lanzep, Lanzep

Comprar Lanzep

Sexualstorungen sind in der Glucovance der Falle psychisch bedingt oder mitbedingt. Aus den Abbildungen nach Masters und Johnson mediczmentos hervor, dass in den verschiedenen Phasen des Reaktionszyklus zwischen Mann und Frau deutliche Unterschiede bestehen.

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Articulos de interes:

Buscar/Search/Chercher:

Donde/Where/Ou

Bendit, planchas de asar.

Mosen Cinto Verdaguer, 3 25100 Almacelles (Lleida) Tel. (34) 973 26 93 96 bendit@bendit. es www. bendit. es

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Sexualstorungen sind in der Glucovance der Falle psychisch bedingt oder mitbedingt. Aus den Abbildungen nach Masters und Johnson mediczmentos hervor, dass in den verschiedenen Phasen des Reaktionszyklus zwischen Mann und Frau deutliche Unterschiede bestehen.

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Buy Necamin Mebendazole Online Without Prescriptions, Necamin

Vermox is used to treat infections caused by worms such as whipworm, pinworm, roundworm, and hookworm. It is also used to treat infections caused by more than one of these worms at the same time. Vermox is an "antihelmintic," or anti-worm, medication. It prevents worms from growing or multiplying in your body.

Use Vermox as directed by your doctor.

Take Vermox with a full glass of water.

Vermox tablets may be swallowed, chewed, or crushed and mixed with food.

Take all of the Vermox that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated.

It may be up to 3 days after treatment before the worm is removed from your stomach and intestines. The amount of time it takes to cure the infection depends on how susceptible the worm is to Vermox, and how quickly your own digestive system is moving. If the infection has not been cured within 3 weeks, a second treatment may be necessary.

Fasting, laxatives, and purging will not help cure this infection.

Treatment of family members and other close contacts may be necessary. Pinworm is spread very easily to others in close contact with the infected person.

To prevent reinfection, toilets must be disinfected daily, and clothing, linens, towels, and pajamas must be changed and washed daily.

If you miss a dose of Vermox, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Store Vermox at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Vermox out of the reach of children and away from pets.

Active Ingredient: Mebendazole.

Do NOT use Vermox if:

you are allergic to any ingredient in Vermox.

Some medical conditions may interact with Vermox. 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 certain problems resulting from worm infection (eg, hydatid disease)

if others in your home also have worm infection.

Some medicines may interact with Vermox. However, no specific interactions with Vermox are known at this time.

Important safety information:

If your symptoms do not get better within 3 weeks, or if they get worse, check with your doctor.

Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.

Pinworm infection spreads easily to family members and close contacts. To prevent reinfection: Disinfect toilet and change and wash underwear, bed linens, towels, clothes, and pajamas daily. Do not shake clothes, towels, or bed linens before washing. Wash hands with soap often during the day, especially before eating and after using the toilet. Do not scratch the infected area or place your fingers in your mouth. Wear shoes.

The entire household may need to be treated if one individual in the household has pinworms. Check with your doctor for more information.

For several days after treatment with Vermox, clean the bedroom floor by vacuuming or damp mopping. Avoid dry sweeping because it may stir up dust.

Lab tests, including complete blood cell counts and liver function, may be performed while you use Vermox. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Vermox should be used with extreme caution in children younger 2 years; safety and effectiveness in these children have not been confirmed.

Pregnancy and breast-feeding: Vermox may cause harm to the fetus. Do not become pregnant while you are using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Vermox while you are pregnant. It is not known if Vermox is found in breast milk. If you are or will be breast-feeding while you use Vermox, check with your doctor. Discuss any possible risks to your baby.

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:

Diarrhea; stomach pain.

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); fever, chills, or persistent sore throat; hoarseness; seizures; yellowing of the eyes or skin.

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.

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Acetensa Marketing Information

Acetensa Description

Acetensa is a perfect remedy, which helps to fight against the symptoms of high blood pressure and to reduce the risk of stroke in people with hypertension.

Its target is to treat kidney problems in people with type 2 diabetes.

Acetensa acts by preventing the hormone angiotensin II from constricting the blood vessels, which tends to raise blood pressure. It is angiotensin II receptor antagonists.

Generic name of Acetensa is Losartan Potassium.

Brand name of Acetensa is Acetensa.

Acetensa Dosage

Acetensa is available in:

25mg Low Dosage50mg Standard Dosage100mg Increased Dosage

Take Acetensa tablets orally with or without food.

Do not crush or chew it.

Take Acetensa once or twice a day at the same time.

If you want to achieve most effective results do not stop taking Acetensa suddenly.

Acetensa Missing of dose

Do not take double dose. If you miss a dose you should take it as soon as you remember about your missing. If it is the time for the next dose you should continue your regular dosing schedule.

Acetensa Overdose

If you overdose Acetensa and you don't feel good you should visit your doctor or health care provider immediately. Symptoms of Acetensa overdosage: fainting, feeling lightheaded, rapid heartbeat.

Acetensa Side effects

Acetensa has its side effects. The most common are:

sore throatlightheadednessrunny nose

Less common but more serious side effects during taking Acetensa:

allergy reactions (urticaria, breathing difficulties, rash, and eruption)huskinessfaintingdifficulty with swallowing

Side effects manifestations are not only depend on medicine you are taking but also depend on your health state and on the other factors.

Acetensa Contra-indications

Do not take Acetensa if you are allergic to Acetensa components.

Do not take Acetensa if you're pregnant or you plan to have a baby, or you are a nursing mother. Acetensa can harm your baby.

Do not use Acetensa if you are taking salt substitutes or potassium supplements, other blood pressure medicine, diuretic (water pill).

It can be dangerous to use Acetensa if you suffer from or have a history of liver disease, kidney disease, heart failure.

If you want to achieve most effective results without any side effects it is better to avoid alcohol.

Avoid machine driving.

Do not stop taking Acetensa suddenly.

Acetensa Frequently asked questions

Q: What is the important Acetensa information should I know?

A: Acetensa is an effective medication which helps to fight with the symptoms of high blood pressure and to reduce the risk of stroke in people with hypertension. It is used in the treatment of kidney problems in people with type 2 diabetes. Do not use Acetensa if you are taking salt substitutes or potassium supplements, other blood pressure medicine, diuretic (water pill). Do not stop taking it suddenly. Avoid alcohol and machine driving. Do not take Acetensa in case of allergy to this medicine or to its components. Do not use Acetensa while you are pregnant or have nurseling. It can be dangerous to use Acetensa if you suffer from or have a history of liver disease, kidney disease, heart failure.

Q: What are Acetensa side effects?

A: Acetensa has its common side effects such as sore throat, lightheadedness, runny nose. But in case of rejection of Acetensa ingredients you can experience more serious side effects: huskiness, fainting, allergic symptoms (difficulties with breathing, throat closing, swelling, rash, hives), difficulty with swallowing. Possibility of side effects appearing depends on health status and, of course, on your right following Acetensa prescriptions.

Q: What are generic and brand names of Acetensa?

A: Generic name of Acetensa is Losartan Potassium. Brand name of Acetensa is Acetensa.

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Nirox Sculpture Park, Cradle of Humankind

Buried beneath the ampitheatre at Nirox Sculpture Park are concrete structures that were used as reservoirs for trout farming by the former owners of the land.

About an hour’s drive from Johannesburg, deep in the Cradle of Humankind, artist Richard Penn wraps some vegetables in foil and places them carefully on a braai (barbecue). 'My brother is flying in from Manchester, and he’s going to come through for a braai,' he says.

Dressed in shorts and a T-shirt, you’d think he was on holiday – after all, we are in area that is increasingly becoming a weekend retreat from the big city. But this is the Nirox Foundation complex and Penn is here to work.

Penn is part of the Nirox Foundation’s residency programme, which invites renowned artists to stay on its property, giving them access to the region’s extraordinary heritage.

Working in collaboration with United Kingdom-based writer Guinevere Glasford-Brown, they are busy on a project that will see Penn’s art merge with Glasford-Brown’s writing to create a unique work that is neither quite book nor art piece.

The project involves them exchanging two books every day, with each entry in each book a response to the other’s drawing or writing. Working on the theme of 'Origins', they say they have been inspired by their current surroundings. Their entries are, therefore, closely linked to the scenery and feelings evoked by it.

That scenery is the Nirox Sculpture Park, a 15ha lush expanse of land that was once a commercial trout farm. Now with a serene atmosphere, walkways and water features surrounded by a sea of greenery, it belies the fact that it is part of Gauteng, the most densely populated province in the country.

According to curator at Nirox Mary Jane Darroll, the sculpture park was the brainchild of Benjy Liebmann, the owner of an adjacent farm who in 2006 had bought a sculpture by Edoardo Villa and displayed it on his farm. 'He was so impressed by the work of the artist that he offered him accommodation and a studio on his farm. Villa declined the offer, but said, however, that he would love to exhibit there,' she says.

Following that exhibition, Liebmann, along with the owners of two other pieces of land bordering the former trout farm, purchased the land. They tore down their fences to give their animals access to the land, and turned it into what is now the Nirox Sculpture Park.

'If you are lucky, you might see some zebras or antelopes grazing,' Darroll says. 'We tell our artists to make their installations strong as the monkeys come out to play on them.'

As you stroll into the garden, you meet Layers of Being by Angus Taylor – the giant kneeling figure made of rammed earth fascinated art lovers in the Netherlands during an exhibition entitled The Rainbow Nation .

The installation took Taylor four days to assemble in the park, but its presence is so overwhelming, it looks as though it emerged from the earth from which it is made.

Further down the garden, Fractals – also by Taylor and comprising nine heads on top of each other – echoes the earlier piece.

As we continue our walk, each piece is met with a new reaction – shock, horror, fascination, wonder.

Perhaps the most fascinating aspect about the garden is that none of the works are permanent fixtures. To a first-time visitor, each work looks firmly grounded to its spot, yet one day each will disappear, to be replaced by the works of other artists. Each trip to the park is certain to be a new, unpredictable experience.

Darroll says the project aims to make sculptures as an art form more accessible to the public. 'More people buy paintings for their homes, yet if you look at the history of Africa, sculptures are a more natural form of art,' she says.

The Nirox Foundation also promotes performing arts. There’s an amphitheatre where events such jazz concerts and poetry readings are held regularly.

At such times, and when there are exhibitions taking place, the park is open to the general public. At other times, visitors need to make an appointment.

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