Inha - What Does Inha Stand For The Free Dictionary, Inha

References in periodicals archive ?

I would like to express my gratitude to INHA for having given a warm home to RIdIM for over four years and to Florence Getreau and Jean-Michel Nectoux for having successfully negotiated this option for RIdIM.

We would like to also extend our gratitude to both our former board member and actual honorary member, Florence Getreau, and to Jean Michel Nectoux, INHA 's former representative on the Commission Mixte, for their enormous and essential efforts in establishing the International RIdIM Center at INHA .

RIdIM will always feel close to INHA with gratitude and friendship and will miss the particular friendly and warm relationship established during the four passing years as it was also expressed in the farewell cocktail party INHA organized for RIdIM.

After eight years of work at INHA his contract could not be extended and he therefore was appointed general editor of the Complete Works of Gabriel Faure at the Institut de Recherche sur le Patrimoine Musical en France (IRPMF).

Thanks to the agreement with INHA. RIdIM was able to appoint a RIdIM Administrator who is managing the International RIdIM Center.

Supply, printing and installation of plastic adhesive labels and paper bookmarks on documents for free access in the future INHA library.

Martinez said: "Samuel has been so influential inhas been so influential inthe day-to-day training with the players and (against Wolfsburg) he gave me the impression he is ready from a physical point of view.

John Haywood, an 18-year-old midfielder, made his debut inhas to put his comeback on hold.

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Quetiapine Side Effects In Detail, Ketiapin

Quetiapine Side Effects

In Summary

Commonly reported side effects of quetiapine include: sedation, dizziness, headache, weakness, drowsiness, constipation, increased serum triglycerides, increased serum cholesterol, increased thyroid stimulating hormone level, and xerostomia. Other side effects include: dyspepsia, weight gain, orthostatic hypotension, pharyngitis, abdominal pain, increased serum alanine aminotransferase, muscle rigidity, and tachycardia. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to quetiapine: oral tablet, oral tablet extended release

As well as its needed effects, quetiapine may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking quetiapine, check with your doctor immediately:

More common:

Chills

cold sweats

confusion

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

sleepiness or unusual drowsiness

Less common:

Black, tarry stools

blurred vision

changes in patterns and rhythms of speech

chest pain

cough

drooling

fever, muscle aches, or sore throat

inability to move the eyes

inability to sit still

increased blinking or spasms of the eyelid

lip smacking or puckering

loss of balance control

mask-like face

need to keep moving

painful or difficult urination

puffing of the cheeks

rapid or worm-like movements of the tongue

restlessness

shakiness in the legs, arms, hands, or feet

shuffling walk

slowed movements

slurred speech

sores, ulcers, or white spots on the lips or in the mouth

sticking out of the tongue

stiffness of the arms or legs

sweating

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

swollen glands

trembling and shaking of the hands and fingers

trouble with breathing, speaking, or swallowing

uncontrolled chewing movements

uncontrolled movements of the arms and legs

uncontrolled twisting movements of the neck, trunk, arms, or legs

unusual bleeding or bruising

unusual facial expressions

unusual tiredness or weakness

Rare

Dry, puffy skin

fast, pounding, or irregular heartbeat

loss of appetite

menstrual changes

tiredness

unusual secretion of milk (in females)

weight gain

Incidence not known:

Aching or discomfort in the lower legs or sensation of crawling in the legs

painful or prolonged erection of the penis

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

skin rash, hives, itching

tightness in the chest

tingling of the hands or feet

unusual weight gain or loss

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

Symptoms of overdose:

Convulsions (seizures)

decreased urine

dry mouth

increased thirst

mood changes

muscle pain or cramps

nausea or vomiting

numbness or tingling in the hands, feet, or lips

weakness

Minor Side Effects

Some quetiapine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:

Constipation

headache

Less common:

Abnormal vision

acid or sour stomach

belching

decreased appetite

decreased strength and energy

headache

heartburn

increased appetite

increased muscle tone

increased sweating

increased weight

indigestion

sneezing

stomach discomfort, upset, or pain

stuffy or runny nose

For Healthcare Professionals

Applies to quetiapine: oral tablet, oral tablet extended release

General

The most common adverse reactions reported in adults have included somnolence, dry mouth, dizziness, constipation, asthenia, abdominal pain, postural hypotension, pharyngitis, weight gain, lethargy, increased ALT, and dyspepsia. In children and adolescents, the most common adverse reactions reported have included somnolence, dizziness, fatigue, increased appetite, nausea, vomiting, dry mouth, tachycardia, and increased weight.

Psychiatric

Very common (10% or more): Discontinuation syndrome (12.1%), agitation (up to 20%) Common (1% to 10%): Anxiety, depression, irritability, hypersomnia, abnormal dreams, aggression, suicidal ideation and behavior Uncommon (0.1% to 1%): Abnormal dreams, abnormal thinking, amnesia, psychosis, hallucinations, manic reaction, depersonalization, catatonic reaction Rare (0.01% to 0.1%): Delirium, emotional lability, euphoria, somnambulism Frequency not reported: Suicides, nightmares, drug withdrawal syndrome neonate, withdrawal symptoms [Ref ]

Nervous system

Somnolence usually occurred during the first 2 weeks and resolved with continued therapy. [Ref ]

Very common (10% or more): Somnolence (up to 57%), dizziness (up to 18%), headache (21%) Common (1% to 10%): Hypertonia, incoordination, tremor, speech disorder, ataxia, lethargy, paresthesia, extrapyramidal disorder, balance disorder, hypoesthesia, restless leg syndrome, hypersomnia, tremor Uncommon (0.1% to 1%): Seizures, akathisia, dyskinesia, tardive dyskinesia, involuntary movements, hyperkinesia, abnormal gait, myoclonus, bruxism, hemiplegia, taste perversion Rare (less than 0.1%): Neuroleptic malignant syndrome, aphasia, buccoglossal syndrome, choreoathetosis, neuralgia, subdural hematoma Postmarketing reports: Retrograde amnesia [Ref ]

Hypersensitivity

Very rare (less than 0.01%): Anaphylactic reactions Frequency not reported: Hypersensitivity

Gastrointestinal

Logistic regression analysis has shown a positive dose response for dyspepsia and abdominal pain. [Ref ]

Very common (10% or more): Dry mouth (up to 44%), Common (1% to 10%): Constipation, dyspepsia, vomiting, abdominal pain, gastroenteritis, gastroesophageal reflux disease, dysphagia Uncommon (0.1% to 1%): Increased salivation, gingivitis, flatulence, hemorrhoids, stomatitis, mouth ulceration, tongue edema Rare (0.01% to 0.1%): Glossitis, hematemesis, intestinal obstruction, melena Frequency not reported: Pancreatitis [Ref ]

Cardiovascular

Collective data gathered from 17 placebo-controlled clinical studies (n=5106) involving the use of atypical antipsychotic agents, including quetiapine, for the treatment of behavioral disorders in the elderly patient with dementia showed a risk of death 1.6 to 1.7 times greater in the drug treated patient than in the placebo treated patient. The average length of duration for the trials was 10 weeks with the cause of death in the majority of cases, though not all, reported as either cardiovascular (e. g. heart failure, sudden death) or infectious (e. g. pneumonia) in nature. Similar results (i. e. increased risk of mortality with atypical antipsychotics) were reported in another meta-analysis involving elderly dementia patients that consisted of 15 randomized, placebo-controlled trials (n=3353) of 10 to 12 weeks in duration. Quetiapine is not approved by the FDA for use in the treatment of behavioral disorders in elderly patients with dementia.

An increased risk of mortality, possibly due to heart failure or sudden death, has been reported with the use of atypical antipsychotic agents in the treatment of behavioral disorders in the elderly patient with dementia.

The results of a large retrospective cohort study appear to indicate that atypical antipsychotic agents (i. e. risperidone, olanzapine, clozapine, quetiapine) increase the risk of venous thromboembolism in elderly patients; however, these events seem to be rare.

Blood pressure elevations described as systolic elevations of 20 mmHg or greater and diastolic elevations of 10 mmHg or greater were observed in 15.2% and 40.6% of children and adolescents, respectively. One child with a history of hypertension experienced a hypertensive crisis.

QT intervals have not been systematically evaluated. During clinical trials, persistent increases in QT intervals were not identified; however there have been postmarketing reports of QT prolongation in patients who overdosed on this drug, in patients with concomitant illness, and in patients taking drugs that are known to cause electrolyte imbalance or QT interval prolongation. [Ref ]

Very common (10% or more): Systolic (15.2%) and diastolic (40.6%) blood pressure elevations in pediatric patients Common (1% to 10%): Syncope, tachycardia, postural hypotension, peripheral edema, hypotension, hypertension, palpitations Uncommon (0.1% to 1%): Bundle branch block Rare (0.01% to 0.1%): Angina pectoris, atrial fibrillation, AV bloc first degree, congestive heart failure, ST elevated, T wave flattening, ST abnormality, increased QRS duration, venous thromboembolism Very rare (less than 0.01%): Hypertensive crisis Frequency not reported: Cardiomyopathy, myocarditis, bradycardia, peripheral edema Postmarketing reports: QT prolongation [Ref ]

Endocrine

Common (1% to 10%): Shifts in thyroid hormones and TSH, hyperprolactinemia, altered hormone levels, hypothyroidism Uncommon (0.1% to 1%): Hypothyroidism Rare (0.01% to 0.1%): Gynecomastia, hyperthyroidism Frequency not reported: Priapism Postmarketing reports: Syndrome of inappropriate hormone secretion (SIADH) [Ref ]

In adults, dose-related decreases in thyroid hormone levels have been observed. It appears that maximal reductions in total and free thyroxine (T4) occur in the first 6 weeks of treatment and are maintained without adaptation or progression during chronic therapy. Upon therapy discontinuation, these effects mostly return to baseline values. The mechanism by which this drug affects the thyroid axis is unclear. [Ref ]

Metabolic

Atypical antipsychotic drugs have been associated with metabolic changes that include hyperglycemia/diabetes mellitus, dyslipidemia, and weight gain. While these effects have been shown as a class effect, each agent has its own profile.

Hyperglycemia: Adults: In controlled clinical trials of 12 weeks or less, 2.4% of patients with normal (less than 100 mg/dL) fasting plasma glucose (FPG) had at least 1 FPG reading of 126 mg/dL or greater (vs. placebo 1.4%) during treatment. For patients with baseline borderline to high FPG (100 mg/dL or higher), 11.7% had at least 1 FPG reading of 126 mg/dL or greater (vs. placebo, 11.8%). In 2 longer-term trials, the mean change in blood glucose from baseline in patients treated with quetiapine (mean exposure 213 days; n=646) was 5 mg/dL (vs. placebo -0.05 mg/dL). Among patients with major depressive disorder receiving the extended-release formulation of this drug, a FBG greater than 126 mg/dL occurred in 7%, 12%, and 6% of those receiving 150 mg, 300 mg, or placebo. Pediatrics: In a study of patients 10 to 17 years old with bipolar mania, the mean change in fasting glucose was 3.62 mg/dL (n=170). No patients with a baseline fasting glucose level lower than 126 mg/dL had a treatment-emergent blood glucose level greater than 126 mg/dL.

Dyslipidemia: Across indications, adult patients who experienced shifts in total cholesterol, triglycerides, LDL-cholesterol, and HDL-cholesterol from baseline to clinically significant levels occurred in up to 18%, 22%, 6%, and 14% of patients receiving this drug compared with up to 7%, 16%, 5%, and 14% receiving placebo, respectively. For pediatric patients, the shifts were up to 12%, 22%, 8%, and 15% compared to up to 3%, 13%, 5%, and 19% for this drug and placebo, respectively.

Weight gain: Logistic regression analysis has shown a positive dose response for weight gain. Five to 10% of adult patients experienced a weight gain of 7% or greater (vs. up to 5% in placebo). Among children and adolescents, a weight gain of 7% or greater occurred in 7% to 21% of patients receiving this drug compared with up to 7% in placebo patients. Mean change in body weight was 1.7 to 2 kg in 3 to 6 week trials and 4.4 kg in 26 week trials. These results were not adjusted for normal growth. [Ref ]

Very common (10% or more): Hyperglycemia, increases in serum triglycerides, hyperlipidemia, Common (1% to 10%): Weight gain, increased appetite, thirst Uncommon (0.1% to 1%): Weight loss, alkaline phosphatase increased, hyperglycemia, hypoglycemia Rare (0.01% to 0.1%): Glycosuria, gout, hypokalemia, water intoxication, metabolic syndrome Postmarketing reports: Hyponatremia [Ref ]

Dermatologic

Common (1% to 10%): Rash, sweating, acne Uncommon (0.1% to 1%): Photosensitivity reaction, pruritus, eczema, contact dermatitis, maculopapular rash, seborrhea, skin ulcer, ecchymosis Rare (0.01% to 0.1%): Exfoliative dermatitis, psoriasis, skin discoloration Frequency not reported: Erythema multiforme Postmarketing reports: Steven-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS) [Ref ]

Respiratory

Common (1% to 10%): Pharyngitis, rhinitis, sinusitis, nasal congestion, cough, sinus congestion, epistaxis, upper respiratory tract infection Uncommon (0.1% to 1%): Pneumonia, asthma Rare (0.01% to 0.1%): Hiccup, hyperventilation Frequency not reported: Dyspnea [Ref ]

Other

Common (1% to 10%): Pain, asthenia, fever, balance disorder, Frequency not reported: Hypothermia, vertigo [Ref ]

Hematologic

Very common (10% or more): Decreased hemoglobin Common (1% to 10%): Decreased neutrophil count, leucopenia Uncommon (0.1% to 1%): Leukocytosis, anemia, eosinophilia, lymphadenopathy, decreased platelets Rare (0.01% to 0.1%): Agranulocytosis Frequency not reported: Leukopenia/neutropenia, eosinophilia [Ref ]

Ocular

Common (1% to 10%): Amblyopia, blurred vision Uncommon (0.1% to 1%): Conjunctivitis, abnormal vision, dry eyes, blepharitis, eye pain Rare (0.01% to 0.1%): Glaucoma Frequency not reported: Lens changes [Ref ]

Genitourinary

Common (1% to 10%): Urinary tract infection Uncommon (0.1% to 1%): Urinary retention, moniliasis, dysmenorrhea, vaginitis, urinary incontinence, metrorrhagia, dysuria, abnormal ejaculation, Rare (0.01% to 0.1%): Nocturia, polyuria Frequency not reported: Galactorrhea Postmarketing reports: Nocturnal enuresis [Ref ]

Musculoskeletal

Common (1% to 10%): Back pain, twitching, arthralgia, dysarthria, extremity pain, muscle rigidity, musculoskeletal stiffness Uncommon (0.1% to 1%): Pathological fracture, myasthenia, leg cramps, bone pain Frequency not reported: Elevations in serum creatine phosphokinase (not associated with NMS) Postmarketing reports: Rhabdomyolysis [Ref ]

Renal

Rare (0.01% to 0.1%): Acute renal failure [Ref ]

Hepatic

Common (1% to 10%): Increased ALT, increased AST Rare (0.01% to 0.1%): Jaundice, hepatitis Frequency not reported: Gamma GT elevations [Ref ]

Immunologic

Common (1% to 10%): Infection, tooth abscess Frequency not reported: Influenza

References

1. "Product Information. Seroquel (quetiapine)." Zeneca Pharmaceuticals, Wilmington, DE.

2. Keating GM, Robinson DM "Quetiapine. a review of its use in the treatment of bipolar depression." Drugs 67 (2007): 1077-95

3. Jonnalagada JR, Norton JW "Acute dystonia with quetiapine." Clin Neuropharmacol 23 (2000): 229-30

4. Bharadwaj R, Grover S "Parkinsonism and akathisia with quetiapine: three case reports." J Clin Psychiatry 69 (2008): 1189-91

5. "Product Information. Seroquel XR (quetiapine)." Astra-Zeneca Pharmaceuticals, Wilmington, DE.

6. Davidson M, Galderisi S, Weiser M, et al. "Cognitive Effects of Antipsychotic Drugs in First-Episode Schizophrenia and Schizophreniform Disorder: A Randomized, Open-Label Clinical Trial (EUFEST)." Am J Psychiatry (2009):

7. Pinninti NR, Mago R, Townsend J, Doghramji K "Periodic Restless Legs Syndrome Associated With Quetiapine Use: A Case Report." J Clin Psychopharmacol 25 (2005): 617-618

8. Ghelber D, Belmaker RH "Tardive dyskinesia with quetiapine." Am J Psychiat 156 (1999): 796-7

9. Ghaemi SN, Ko JY "Quetiapine-related tardive dyskinesia." Am J Psychiatry 158 (2001): 1737

10. FDA. U. S. Food and Drug Admiinistration. Center for Drug Evaluation and Research "FDA Public Health Advisory. Deaths and antipsychotics in elderly patients with behavioral disturbances. Available from: URL: http://www. fda. gov/cder/drug/advisory/antipsychotics. htm." ([2005 Apr 11]):

11. Schneider LS, Dagerman KS, Insel P "Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials." JAMA 294 (2005): 1934-43

12. Liperoti R, Pedone C, Lapane KL, Mor V, Bernabei R, Gambassi G "Venous thromboembolism among elderly patients treated with atypical and conventional antipsychotic agents." Arch Intern Med 165 (2005): 2677-82

13. Bush A, Burgess C "Fatal cardiomyopathy due to quetiapine." N Z Med J 121 (2008): U2909

14. Gianfrancesco F, Pesa J, Wang RH, Nasrallah H "Assessment of antipsychotic-related risk of diabetes mellitus in a Medicaid psychosis population: Sensitivity to study design." Am J Health Syst Pharm 63 (2006): 431-41

15. Atalay A, Turhan N, Aki OE "A challenging case of syndrome of inappropriate secretion of antidiuretic hormone in an elderly patient secondary to quetiapine." South Med J 100 (2007): 832-3

16. Liappas J, Paparrigopoulos T, Mourikis I, Soldatos C "Hypothyroidism induced by quetiapine: a case report." J Clin Psychopharmacol 26 (2006): 208-9

17. Burton, TM "New antipsychotic-drug class is tied to increase in diabetes. Available from: URL: http://online. wsj. com/article/0,,SB106150445385585800,00.html." ([2003 Aug]):

18. Greenspan A, Gharabawi G, Kwentus J "Thyroid dysfunction during treatment with atypical antipsychotics." J Clin Psychiatry 66 (2005): 1334-5

19. Melkersson K, Dahl ML "Adverse metabolic effects associated with atypical antipsychotics. literature review and clinical implications." Drugs 64 (2004): 701-23

20. Marlowe KF, Howard D, Chung A "New onset diabetes with ketoacidosis attributed to quetiapine." South Med J 100 (2007): 829-31

21. Guo JJ, Keck PE, Corey-Lisle PK, et al. "Risk of diabetes mellitus associated with atypical antipsychotic use among medicaid patients with bipolar disorder: a nested case-control study." Pharmacotherapy 27 (2007): 27-35

22. Sernyak MJ, Gulanski B, Rosenheck R "Undiagnosed hyperglycemia in patients treated with atypical antipsychotics." J Clin Psychiatry 66 (2005): 1463-7

23. Sobel M, Jaggers ED, Franz MA "New-onset diabetes mellitus associated with the initiation of quetiapine treatment." J Clin Psychiatry 60 (1999): 556-7

24. Brecher M, Leong RW, Stening G, Osterling-Koskinen L, Jones AM "Quetiapine and long-term weight change: a comprehensive data review of patients with schizophrenia." J Clin Psychiatry 68 (2007): 597-603

25. Lin GL, Chiu CH, Lin SK "Quetiapine-induced Erythema Multiforme Minor: A Case Report." J Clin Psychopharmacol 26 (2006): 668-669

26. Shelton PS, Barnett FL, Krick SE "Hyperventilation associated with quetiapine." Ann Pharmacother 34 (2000): 335-7

27. Jabeen S, Polli SI, Gerber DR "Acute respiratory failure with a single dose of quetiapine fumarate." Ann Pharmacother 40 (2006): 359-62

28. Clark N, Weissberg E, Noel J "Quetiapine and leukopenia." Am J Psychiat 158 (2001): 817-8

29. Hazra M, Culo S, Mamo D "High-dose Quetiapine and Photopsia." J Clin Psychopharmacol 26 (2006): 546-7

30. Valibhai F, Phan NB, Still DJ, True J "Cataracts and quetiapine." Am J Psychiat 158 (2001): 966

31. Montejo Gonzalez AL, Rico-Villademoros F, Tafalla M, Majadas S "A 6-Month Prospective Observational Study on the Effects of Quetiapine on Sexual Functioning." J Clin Psychopharmacol 25 (2005): 533-538

32. Davol P, Rukstalis D "Priapism associated with routine use of quetiapine: case report and review of the literature." Urology 66 (2005): 880

33. Sokolski KN, Brown BJ, Melden M "Urinary retention following repeated high-dose quetiapine." Ann Pharmacother 38 (2004): 899-900

34. Himmerich H, Ehrlinger M, Hackenberg M, Lohr B, Nickel T "Possible Case of Quetiapine-induced Rhabdomyolysis in a Patient With Depression Treated With Fluoxetine." J Clin Psychopharmacol 26 (2006): 676-677

35. Wright TM, Vandenberg AM "Risperidone - and quetiapine-induced cholestasis." Ann Pharmacother 41 (2007): 1518-23

It is possible that some side effects of quetiapine may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Cefamox - Drug Review Dosage, Side Effects, Action, Buy Cefamox, Cefamox

Cefamox

Cefamox . a broad-spectrum antibiotic, acts against an extensive variety of bacteria, including Gram-positive and Gram-negative bacteria. It belongs to a group of medicaments called cephalosporin antibiotics, used to treat many different types of bacterial infections.

Distributed under the brand name, Duricef. Cefamox is prescribed for the treatment of mild to moderate infections. It is not effective against viral infections like colds or the flu. Cefamox is also used as an antibiotic prophylaxis for dental procedures.

Cefamox acts via fast absorption in the gastrointestinal tract, even when taken with food. It travels through the body's tissues and fluids to seek out traces of bacterial infection.

Before taking this medicament, patients should inform their doctor if they are allergic to penicillin or other types of antibiotics. If patients have a history of kidney disease, or any stomach or gastrointestinal tract disorder like colitis, they are advised to tell their doctor. These conditions preclude the use of Cefamox or require a different dosage and monitoring while taking this medicament.

Patients need to inform their doctor if they have diabetes. Cefamox in liquid form (suspension) contains sucrose, which may aggravate diabetes. Although this medicament is not considered harmful to unborn babies, it is still important to let the doctor know if the patient is pregnant or plans to become pregnant during the course of treatment.

Patients should inform their doctor of any prescription or over-the-counter medicaments, including vitamin and herbal products, as these may have adverse results when taken with Cefamox. Some products may even lessen the medicament's healing effect.

Cefamox is characterized by its fast absorbing action and may affect breast milk, causing harm to nursing infants. Patients should tell their doctor if they are breastfeeding before starting Cefamox use.

Symptoms of an infection usually clear before the bacteria is completely eradicated. Cefamox should be taken for the prescribed length of time ordered by the doctor to prevent a recurrence of the same infection in the future.

Antibiotics can cause diarrhea. which is often a sign of a new infection. However, if the diarrhea is exceptionally watery or contains blood. patients should call their doctor and refrain from taking any medicament for the diarrhea unless told by a doctor to do so.

Other known side effects of Cefamox include an upset stomach, mild wamble, joint pain. and vaginal itching or discharge. If the medicament causes the patient to break out in hives. have breathing difficulties or results in swelling of the face and mouth area, emergency medical attention should be sought immediately.

In some cases, Cefamox can cause extreme blistering and peeling, a red skin rash, fever and chills, throat soreness and flu symptoms, unexplained bleeding or bruising, wamble and loss of appetite. jaundice, dark urine and grey-colored stools, and even seizures. These side effects are serious and should be reported to the doctor as soon as possible.

Cefamox is to be taken as prescribed, usually with a full glass of water or milk. The liquid form of the medicament should be measured with a measuring spoon or cup to ensure the correct dosage. Cefamox should be taken at regular intervals during the prescribed period of time for the best results.

Cefamox has the following structural formula:

• Molecular formula of cefamox is C16H17N3O5S • Chemical IUPAC Name is 7-[[2-amino-2-(4-hydroxyphenyl)acetyl]amino]-3-methyl-8-oxo - 5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid • Molecular weight is 363.3883 g/mol • Cefamox available. 250mg tablets, 500mg tablets

Generic name: Cefadroxil

Buy Betam-Ophtal - Betamethasone - Online Without Prescriptions, Betam-Ophtal

Betnovate (Betam-ophtal)

Betnovate is used to help relieve redness, itching, swelling, or other discomfort caused by skin conditions. This medicine is a corticosteroid (cortisone-like medicine or steroid).

Use Betnovate as directed by your doctor.

Betnovate is for use on the skin only. Do not get it in your eyes.

Wash your hands with soap and water before and after using this medicine.

Apply a thin layer of this medicine to the affected area of the skin. Rub it in gently.

Do not use cosmetics or other skin care products on the treated areas.

Do not bandage or otherwise wrap the skin being treated unless directed to do so by your doctor.

If the medicine is applied to the diaper area of an infant, do not use tight-fitting diapers or plastic pants unless directed to do so by your doctor.

If your doctor ordered an occlusive dressing or airtight covering to be applied over the medicine, make sure you know how to apply it. Occlusive dressings increase the amount of medicine absorbed through your skin, so use them only as directed. If you have any questions about this, check with your doctor.

Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems.

If you miss a dose of Betnovate, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

The dose of this medicine 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 this medicine. 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 redness, itching, and swelling of the skin:

Adults: Apply to the affected area of the skin one to three times per day.

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

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

Store Betnovate at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Keep Betnovate out of the reach of children and away from pets.

Active Ingredient: Betamethasone.

Do NOT use Betnovate if:

you are allergic to any ingredient in Betnovate

you are taking mifepristone

you have a systemic fungal infection

you are scheduled to have a smallpox vaccine

you have a certain bleeding disorder (idiopathic thrombocytopenic purpura).

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

Some medical conditions may interact with Betnovate. 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 a history of bleeding problems, heart problems (eg, congestive heart failure [CHF]), heart attack, high blood pressure, kidney problems, liver problems, diabetes, seizures, an underactive thyroid, adrenal gland problems, any mental or mood problems, or low blood potassium levels

if you have or have recently had a bacterial, fungal, malarial, viral, or other type of infection; herpes infection of the eye; chickenpox; measles; shingles; or a head or brain injury

if you have HIV infection or tuberculosis (TB), or if you have ever had a positive TB skin test

if you have any stomach problems (eg, ulcers), intestinal problems (eg, blockage, perforation, infection, unexplained diarrhea, diverticulitis, ulcerative colitis), recent intestinal surgery, or inflammation of the esophagus

if you have weak bones (eg, osteoporosis) or muscle problems (eg, myasthenia gravis)

if you have had any recent vaccinations (eg, smallpox)

if you have a history of joint surgery or any joint problems (eg, fracture, infection).

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

Aprepitant, clarithromycin, cyclosporine, diltiazem, erythromycin, itraconazole, ketoconazole, or troleandomycin because side effects, such as adrenal gland or nervous system problems (eg, seizures), may occur

Barbiturates (eg, phenobarbital), carbamazepine, hydantoins (eg, phenytoin), lithium, or rifampin because they may decrease Betnovate's effectiveness

Aspirin, live vaccines, mifepristone, or ritodrine because the risk of their side effects may be increased by Betnovate.

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

Betnovate may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.

If you have not had chickenpox, shingles, or measles, avoid contact with anyone who does.

Tell your doctor or dentist that you take Betnovate before you receive any medical or dental care, emergency care, or surgery.

Diabetes patients - Betnovate may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.

If you use Betnovate for an extended period of time, your body may not produce enough natural steroids for up to several months after you stop using it. Severe symptoms may occur if you experience injury, surgery, infection, or loss of blood electrolytes. Contact your doctor immediately if you experience any of these events. You may need to begin taking additional corticosteroids.

If you have had Betnovate injected into a joint and you experience increased pain along with swelling, decreased joint movement, fever, and general feeling of being unwell, contact your doctor.

Talk with your doctor before you receive any vaccine while you are using Betnovate.

Lab tests, including adrenal function tests and blood pressure monitoring, may be performed while you use Betnovate. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Betnovate may have benzyl alcohol in it. Do not use it in newborns or infants. It may cause serious and sometimes fatal nervous system problems and other side effects.

Corticosteroids may affect growth rate in children and teenagers in some cases. They may need regular growth checks while they use Betnovate.

Betnovate 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 Betnovate while you are pregnant. Betnovate is found in breast milk. If you are or will be breast-feeding while you use Betnovate, check with your doctor. Discuss any possible risks to your baby.

If you suddenly stop taking Betnovate, you may have withdrawal symptoms, These may include unbalanced hormones (in both men and women).

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:

Acne; clumsiness; dizziness; facial flushing; general body discomfort; headache; increased appetite; increased sweating; lightheadedness; nausea; nervousness; sleeplessness; upset stomach.

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); black, tarry stools; changes in body fat; changes in menstrual periods; changes in skin color; chest pain; easy bruising or bleeding; irregular heartbeat; mental or mood changes (eg, depression); muscle pain, wasting, or weakness; seizures; severe nausea or vomiting; sudden severe dizziness or headache; swelling of feet or legs; symptoms of infection (eg, chills, fever, sore throat); tendon or bone pain; thinning of the skin; unusual skin sensation; unusual weight gain; vision changes or other eye problems; vomit that looks like coffee grounds.

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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Toe Pain Check Your Symptoms And Signs, Torpain

Pain in the toe can arise due to abnormalities or injury to any of the structures in the toe, including skin, nerves, bones, blood vessels, and soft tissues. Toe pain is a fairly common symptom, since our feet are constantly exposed to injury by walking. running. or other athletic activity, and moving around. Some types of toe pain can be accompanied by numbness, burning, warmth, or other symptoms. The most common causes of toe pain include ingrown toenails, bunions. cuts or scrapes. other injuries, blisters. and corns and calluses. Arthritis (including rheumatoid arthritis. gout. and other types of arthritis) and infections are additional causes of toe pain.

Medically Reviewed by a Doctor on 1/5/2016

Health concern on your mind? Visit the Symptom Checker.

Kasper, D. et al. eds. Harrison's Principles of Internal Medicine, 19th Ed . United States: McGraw-Hill Professional, 2015.

Pictures, Images, Illustrations & Quizzes

Common Causes of Foot Pain Learn about common causes of foot pain such as bunions, corns, athlete's foot, plantar warts and more. Get the latest information. learn more »

Picture of Foot The end of the leg on which a person normally stands and walks. See a picture of Foot Anatomy and learn more about the health. learn more »

Picture of Foot Anatomy Detail The end of the leg on which a person normally stands and walks. See a picture of Foot Anatomy Detail and learn more about the. learn more »

Causes of Toe Pain

Athlete's Foot Athlete's foot (tinea pedis) is a skin infection caused by the ringworm fungus. Symptoms include itching, burning, cracking. learn more »

Broken Bone (Types of Bone Fractures) A broken bone is a fracture. There are different types of fractures, such as: compressed, open, stress, greenstick. learn more »

In This Article

Broken Bone (Types of Bone Fractures) Article

What is a broken bone (fracture)?

What causes a broken bone?

What are the most common types of broken bones?

Compression fracture

Skull fracture

Stress fracture

What are the most common bones that are broken?

Broken hand or fingers

Broken wrist

Broken hip

Broken leg

Broken toe

Broken shoulder

What are the signs and symptoms of a broken bone?

When should I call a doctor if I think I have broken a bone?

How is a broken bone diagnosed?

What is the treatment for a broken bone?

What about surgery for a broken bone?

How can fractures be prevented?

What is the prognosis for a broken bone?

Bruises A bruise, or contusion, is caused when blood vessels are damaged or broken as the result of a blow to the skin. The raised area. learn more »

In This Article

Bruises Article

Bumps and bruises facts

What is a bruise?

Why do bruises occur more frequently in some people than in others?

What are symptoms and signs of a bruise, and why does it change color?

What if the bruise doesn't get better or the area stays swollen?

What are some less common causes of bruising, and what do they indicate?

What is the treatment for bruising?

What is the prognosis (outlook) for bruising?

Bunions The common bunion, an enlargement of the inner portion of the joint at the base of the big toe, primarily affects women. The. learn more »

In This Article

Bunions Article

Bunions facts

What are bunions?

What are the causes of bunions?

Who develops bunions?

What are symptoms and signs of a bunion?

How do health-care professionals diagnose a bunion?

What is the treatment for bunions? Are there home remedies to treat bunions?

Is it possible to prevent bunions?

What is the prognosis of a bunion?

Burns (First Aid) Burn types are based on their severity: first-degree burns, second-degree burns, and third-degree burns. First-degree burns are. learn more »

In This Article

Burns (First Aid) Article

Introduction to burns

How are burns classified?

What is the significance of the amount of body area burned?

How important is the location of a burn?

What about electrical burns?

What about chemical burns?

First aid for burns

Corns Corns and calluses are sometimes painful areas of thickened skin that appear between the toes and fingers or on the soles of the. learn more »

Cuts, Scrapes and Puncture Wounds Cuts, scrapes, and puncture wounds are common, and most people will experience one of these in their lifetime. Evaluating the. learn more »

In This Article

Cuts, Scrapes and Puncture Wounds Article

Cuts, scrapes (abrasions), and puncture wounds facts

What is the best first aid for a cut or scrape?

Who should seek medical care for a cut?

What are the signs and symptoms of a wound infection ?

How are puncture wounds different?

Will I need a tetanus shot for a cut, scrape, or puncture wound?

Foot Pain Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout). learn more »

Fungal Nails Fungal nails (onychomycosis) may be caused by many species of fungi, but the most common is Trichophyton rubrum. Distal subungal. learn more »

Gout (Gouty Arthritis) Buildup of uric acid crystals in a joint causes gouty arthritis. Symptoms and signs include joint pain, swelling, heat, and. learn more »

Ingrown Toenail (Onychocryptosis) Ingrown toenails are caused by the growth of the toenail into the surrounding nail fold. Symptoms and signs include toe pain. learn more »

Morton's Neuroma A Morton's neuroma is an inflamed nerve between the bones at the ball of the foot. Symptoms include a burning, sharp pain on the. learn more »

In This Article

Morton's Neuroma Article

Morton's neuroma facts

What is Morton's neuroma?

What causes a Morton's neuroma?

What are risk factors for developing a Morton's neuroma?

What are symptoms of a Morton's neuroma?

How is a Morton's neuroma diagnosed?

How is a Morton's neuroma treated ?

What is the prognosis (outlook) for a Morton's neuroma?

Can a Morton's neuroma be prevented?

Osteomyelitis Osteomyelitis is an infection of the bone. Potential causes include injections around the bone, fractures that puncture the skin. learn more »

In This Article

Osteomyelitis Article

Osteomyelitis facts

What is osteomyelitis?

What causes osteomyelitis?

What are osteomyelitis symptoms and signs?

How is osteomyelitis diagnosed?

What is the treatment for osteomyelitis?

What is the prognosis for osteomyelitis?

Peripheral Neuropathy Peripheral neuropathy is a problem with the functioning of the nerves outside of the spinal cord. Symptoms may include numbness. learn more »

In This Article

Peripheral Neuropathy Article

Peripheral neuropathy facts

What is peripheral neuropathy?

What causes peripheral neuropathy?

What are the symptoms of peripheral neuropathy?

How is peripheral neuropathy diagnosed?

Is there any treatment for peripheral neuropathy?

Can peripheral neuropathy be prevented?

Pseudogout Pseudogout, a form of arthritis, results when deposits of crystals collect in and around the joints. Symptoms of pseudogout. learn more »

In This Article

Pseudogout Article

Pseudogout facts

What is pseudogout?

What are causes of pseudogout?

What are risk factors for pseudogout?

What are pseudogout symptoms and signs?

How does a doctor diagnose pseudogout?

What are treatments for pseudogout?

What other conditions can accompany pseudogout?

Are there special circumstances that can promote attacks of pseudogout?

What are complications of pseudogout?

What is the prognosis of pseudogout?

Is it possible to prevent pseudogout?

What specialists treat pseudogout?

Where can people get more information about pseudogout?

Rheumatoid Arthritis (RA) Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints. learn more »

In This Article

Rheumatoid Arthritis (RA) Article

Rheumatoid arthritis (RA) facts

What is rheumatoid arthritis (RA)?

Rheumatoid arthritis vs. osteoarthritis

What are rheumatoid arthritis causes and risk factors?

What are complications of rheumatoid arthritis?

What are rheumatoid arthritis symptoms and signs?

How do physicians diagnose rheumatoid arthritis?

What are the stages of rheumatoid arthritis?

What is the treatment for rheumatoid arthritis? What types of medications treat RA?

"First-line" rheumatoid arthritis medications

"Second-line" or "slow-acting" rheumatoid arthritis drugs (disease-modifying anti-rheumatic drugs or DMARDs)

What are newer rheumatoid arthritis treatments?

Rheumatoid arthritis diet . exercise, home remedies, and alternative medicine

What about rheumatoid arthritis and pregnancy?

What is the prognosis for patients with rheumatoid arthritis?

What are tips for living with rheumatoid arthritis?

Is it possible to prevent rheumatoid arthritis?

What specialists treat rheumatoid arthritis (RA)?

What new information about RA has come from the 2015 national meeting of the American College of Rheumatology?

What research is being done on rheumatoid arthritis?

Where can people get additional information on rheumatoid arthritis?

Septic Arthritis Septic arthritis, or infectious arthritis, is infection of one or more joints by bacteria, viruses, or fungi. Symptoms and signs. learn more »

In This Article

Septic Arthritis Article

Septic arthritis facts

What is septic arthritis?

What microbes cause septic arthritis?

Is septic arthritis contagious?

Who is at risk of developing septic arthritis?

What are symptoms and signs of septic arthritis?

What specialties of doctors treat septic arthritis?

How do physicians diagnose septic arthritis?

What is the treatment for septic arthritis?

Are there home remedies for septic arthritis?

What are complications of septic arthritis?

What is the prognosis of septic arthritis?

Is it possible to prevent septic arthritis?

Sprains and Strains An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be. learn more »

In This Article

Sprains and Strains Article

Sprains and strains facts

What is the difference between a sprain and a strain?

What causes a sprain or strain?

Where do sprains and strains usually occur?

What are sprain symptoms and signs?

How are sprains and strains diagnosed?

What is the treatment for sprains and strains?

What is the recovery time for sprains and strains?

Is it possible to prevent sprains and strains?

What is the prognosis of sprains and strains?

Where can people find more information about sprains and strains?

Turf Toe Turf toe is a sprain to the ligaments around the big toe joint. Symptoms and signs include: pain, swelling, a popping. learn more »

In This Article

Turf Toe Article

What is turf toe?

What is the anatomy of the big toe?

What causes turf toe?

What are turf toe symptoms and signs?

When should I seek medical treatment for turf toe?

How is turf toe diagnosed?

What is the turf toe treatment ?

What follow-up care is needed after foot pain is treated?

Is it possible to prevent turf toe?

What is the prognosis for turf toe?

Warts (Common Warts) Common warts are skin growths causes by the human papillomavirus. There are many types of warts, including plantar warts, common. learn more »

Aguilar - Surname Meaning, Agulan

Definition: One who came from Aguilas in Spain, a city near Córdoba; same origin as Aguiar, both from a Mozarabic knight of Toledo.

Surname Origin: Spanish

Alternate Surname Spellings: AGUILERA, AGUILER

More Resources for the Surname AGUILAR :

Hispanic Genealogy Search for your Hispanic ancestors in these online records, family history societies, surname databases, and research guides.

AGUILAR Family Genealogy Forum Free message board is focused on descendants of AGUILAR ancestors around the world.

FamilySearch - AGUILAR Genealogy Find records, queries, and lineage-linked family trees posted for the AGUILAR surname.

AGUILAR Surname Mailing List Free mailing list for researchers of the Aguilar surname and its variations includes subscription details and a searchable archives of past messages.

Surname Finder - AGUILAR Genealogy & Family Resources Find links to free and commercial resources for the Aguilar surname.

Cousin Connect - AGUILAR Genealogy Queries Read or post genealogy queries for the surname AGUILAR, and sign up for free notification when new Aguilar queries are added.

DistantCousin. com - AGUILAR Genealogy & Family History Free databases and genealogy links for the last name AGUILAR.

MyCinnamonToast. com - AGUILAR Genealogy in All Regions Centralized search results for family trees and other genealogy info on the AGUILAR surname.

References: Surname Meanings & Origins

Cottle, Basil. Penguin Dictionary of Surnames. Baltimore, MD: Penguin Books, 1967.

Dorward, David. Scottish Surnames. Collins Celtic (Pocket edition), 1998.

Fucilla, Joseph. Our Italian Surnames. Genealogical Publishing Company, 2003.

Hanks, Patrick and Flavia Hodges. A Dictionary of Surnames. Great Britain: Oxford University Press, 1989.

Smith, Elsdon C. American Surnames. Genealogical Publishing Company, 1997.

Looking for the meaning of a given name? Check out First Name Meanings

Lechon Manok, Andox

LECHON MANOK

My husband is not a Filipino but a pure Chinese from Malaysia. When he first visited the Philippines, he immediately fell in love with the cuisine. Among his favourites were Crispy Pata ( crisp fried pork shank ), Bulalo ( bone marrow soup ), Kari-kari ( a stew with peanut gravy ), grilled pork, clam soup, everything with ube (purple yam) . mangoes, the list goes on and on. One dish, though, stands out. It is Lechon manok . This is the poultry counterpart of roast pig. Lechon manok is Filipino rotisserie chicken cooked in an outdoor pit. As with all of our food, it is well seasoned and very tasty. Every time we visit home, there is a lechon manok on the dining table to welcome him.

Although cooked on a spit, lechon manok is so unlike rotisserie chicken. It has an aroma and taste that it quintessentially Filipino. I haven’t yet come across a recipe that gives out the secret of the famous Andok’s (a famous chain) lechon manok but this is my way of cooking it. What I’m going for is a very fragrant and extremely tasty chicken that is evocative of warm climes and rural settings.

My method of cooking lechon manok is nothing like the usual way it is cooked. After seasoning the chicken, I wrap it in banana leaves and kitchen foil before roasting. The cavity is also stuffed with garlic, ginger and pandan leaves. This results to a highly scented, flavourful and succulent chicken. Instead of the usual liver sauce that it is usually served with I opted for a fresher, zestier sauce using his favourite fruit: mango. I hope people get to like this recipe because my husband wishes to open up a lechon manok chain in the future.

1 whole chicken

2 tbsps. light soy sauce

1 tsp. salt

1 tsp. garlic powder

1 tsp. turmeric

1 tbsp. lime juice

1 tbsp. cooking oil

2 garlic cloves, smashed

a few slices of ginger

3 pandan leaves, knotted

banana leaves

aluminum foil

Ingredients for the mango-lime chilli sauce:

1 1/4 c. pure mango juice

juice and grated rind of 1 lime

5 tsps. white sugar

2 tsps. corn flour

1 tbsp. water

3 cloves of garlic, chopped

1/2 red fingr chilli, chopped

1 tsp. grated fresh ginger

4 tsps. fish sauce

Mix the soy sauce, salt, garlic powder, turmeric and lime juice. Rub the mixture all over the chicken, including the cavity. Stuff the cavity with the garlic, ginger slices and pandan leaves. Leave to marinade for 30 minutes.

Preheat the oven to 400° F / 200° C. Lay the banana leaves on top of a big sheet of aluminum foil. Lay the chicken on top of the banana leaves, rub with the 1 tbsp. of oil and wrap with the leaves then wrap tightly with the sheet of aluminum foil. Lay the wrapped chicken on a baking rack in a roasting tin. Add water to the tin so that the drippings don't burn.

Bake for 30 minutes. Lower the oven temperature to 350° F/ 180° C.

Open the chicken parcel. Cook for a further 50-60 minutes, turning at half time to brown the other side of the chicken. Brush with the drippings occasionally.

The chicken can also be cooked in a lidded barbecue instead of the oven for the last hour. Use a grilling tray so the chicken doesn't stick to the grilles.

Let rest before chopping into serving pieces.

For the sauce: Put the mango and lime juice and the sugar in a saucepan and bring to a boil. Stir until the sugar melts. Disperse the corn flour in the water and add to the mixture in the saucepan to thicken. Leave to simmer for 2 minutes. Add the rest of the ingredients, stir and bring back to a boil. Take off the heat and transfer to a jug or gravy boat to stop it cooking further. Serve with the chicken.

© 2012, Adora’s Box. All rights reserved.

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Biotornis, Biotornis

Common use It is is a broad-spectrum antibiotic which destroys bacteria. It is active against many aerobic (those developing in presence of oxygen) and anaerobic (those developing in absence of oxygen) gram positive and aerobic gram negative microorganisms including strains which produce beta-lactamase (the enzyme which destroys penicillin). Clavulanate potassium comprised in the content of this medication provides resistance of Augmentin to activity of bacterial beta-lactamases. This medication is used to treat pneumonia and other infectious diseases of respiratory, gastrointestinal systems, urogenital systems, infections which appear after surgery and others.

Dosage and directions Doses are administered individually depending on your condition, localization of infection and susceptibility of the pathogen. Do not take it in larger amounts or longer than recommended. Swallow the whole tablet. If it is the Augmentin Chewable tablet then chew it before swallowing. Augmentin should be taken at evenly spaced interval.

Precautions Do not use it if you are allergic to any other penicillin antibiotic, if you have liver or kidney failure or mononucleosis.

Contraindications Do not use the medicine if you have allergy to its components or another penicillin antibiotics, if you have infectious mononucleosis, a history of liver problems or yellowing of the eyes or skin caused by Augmentin.

Possible side effect Dyspepsia, abdominal discomfort, bloating, gas nausea, vomiting, liver function disorders, hepatitis, jaundice caused by stagnation of bile, vaginal itching and also symptoms of allergy (hives, rash, swelling). Cautiousness should be exercised in patients with liver failure. The medication is not recommended for pregnant (especially third trimester) and breastfeeding women.

Treatment with Augmentin and other antibiotics can change the normal bacteria flora of the colon and permit overgrowth of C. difficile, a bacteria which causes pseudomembranous colitis. Probenecid which is used to treat gout may slow excretion of Augmentin by kidneys and result in increase of its toxicity.

Missed dose If you missed a dose take it as soon as you remember, but not if it is almost time of the next intake by your schedule. If so skip the missed dose. Do not try to compensate a missed dose by taking an extra one.

Overdose If you suppose that took too much of Augmentin and experience such symptoms as nausea, vomiting, stomach pain, diarrhea, skin rash, drowsiness, and hyperactivity, seek immediate medical help.

Storage Store at room temperature of 59-86F (15-30C) away from light and moisture.

Disclaimer We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information on the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care advisor or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

Common use It is is a broad-spectrum antibiotic which destroys bacteria. It is active against many aerobic (those developing in presence of oxygen) and anaerobic (those developing in absence of oxygen) gram positive and aerobic gram negative microorganisms including strains which produce beta-lactamase (the enzyme which destroys penicillin). Clavulanate potassium comprised in the content of this medication provides resistance of Augmentin to activity of bacterial beta-lactamases. This medication is used to treat pneumonia and other infectious diseases of respiratory, gastrointestinal systems, urogenital systems, infections which appear after surgery and others.

Dosage and directions Doses are administered individually depending on your condition, localization of infection and susceptibility of the pathogen. Do not take it in larger amounts or longer than recommended. Swallow the whole tablet. If it is the Augmentin Chewable tablet then chew it before swallowing. Augmentin should be taken at evenly spaced interval.

Precautions Do not use it if you are allergic to any other penicillin antibiotic, if you have liver or kidney failure or mononucleosis.

Contraindications Do not use the medicine if you have allergy to its components or another penicillin antibiotics, if you have infectious mononucleosis, a history of liver problems or yellowing of the eyes or skin caused by Augmentin.

Possible side effect Dyspepsia, abdominal discomfort, bloating, gas nausea, vomiting, liver function disorders, hepatitis, jaundice caused by stagnation of bile, vaginal itching and also symptoms of allergy (hives, rash, swelling). Cautiousness should be exercised in patients with liver failure. The medication is not recommended for pregnant (especially third trimester) and breastfeeding women.

Treatment with Augmentin and other antibiotics can change the normal bacteria flora of the colon and permit overgrowth of C. difficile, a bacteria which causes pseudomembranous colitis. Probenecid which is used to treat gout may slow excretion of Augmentin by kidneys and result in increase of its toxicity.

Missed dose If you missed a dose take it as soon as you remember, but not if it is almost time of the next intake by your schedule. If so skip the missed dose. Do not try to compensate a missed dose by taking an extra one.

Overdose If you suppose that took too much of Augmentin and experience such symptoms as nausea, vomiting, stomach pain, diarrhea, skin rash, drowsiness, and hyperactivity, seek immediate medical help.

Storage Store at room temperature of 59-86F (15-30C) away from light and moisture.

Disclaimer We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information on the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care advisor or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

Avimox Kid Forte Tablet - Uses, Side-Effects, Reviews, Composition, Interactions, Precautions, Subst

Avimox Kid Forte Tablet

Avimox Kid Forte Tablet - Uses, Composition, Side Effects and Reviews

Avimox Kid Forte Tablet is indicated for the treatment of bacterial infections of respiratory tract, bacterial infections of urinary tract, bacterial infections of skin, bacterial infections of heart, bacterial infections of gums, bacterial infections of ear and other conditions. Avimox Kid Forte Tablet contains the following active ingredients: Amoxycillin. It is available in tablet form. Bhavishya Pharma manufactures Avimox Kid Forte Tablet. Detailed information related to Avimox Kid Forte Tablet's uses, composition, dosage, side effects and reviews is listed below:

Avimox Kid Forte Tablet Uses

Avimox Kid Forte Tablet is used in the treatment, control, prevention, & improvement of the following diseases, conditions and symptoms:

Bacterial infections of respiratory tract

Bacterial infections of urinary tract

Bacterial infections of skin

Bacterial infections of heart

Bacterial infections of gums

Bacterial infections of ear

Learn more: Uses (in more detail)

Avimox Kid Forte Tablet Working, Mechanism of Action and Pharmacology

Avimox Kid Forte Tablet improves the patient's condition by performing the following functions:

Avimox Kid Forte Tablet Composition and Active Ingredients

Avimox Kid Forte Tablet is composed of the following active ingredients (salts)

Please note that this medicine may be available in various strengths for each active ingredient listed above.

Avimox Kid Forte Tablet Side-effects

The following is a list of possible side effects that may occur from all constituting ingredients of Avimox Kid Forte Tablet. This is not a comprehensive list. These side effects are possible, but do not always occur. Some of the side effects may be rare but serious. Consult your doctor if you observe any of the following side effects, especially if they do not go away.

Nausea

Skin rash

Severe skin allergies

Pain

Irritation at the site of injection

Vomiting

If you notice other side effects not listed above, contact your doctor for medical advice. You may also report side effects to your local food and drug administration authority.

Learn more: Side-effects (in more detail)

Avimox Kid Forte Tablet Precautions & How to Use

Before using this drug, inform your doctor about your current list of medications, over the counter products (e. g. vitamins, herbal supplements, etc.), allergies, pre-existing diseases, and current health conditions (e. g. pregnancy, upcoming surgery, etc.). Some health conditions may make you more susceptible to the side effects of the drug. Take as directed by your doctor or follow the direction printed on the product insert. Dosage is based on your condition. Tell your doctor if your condition persists or worsens. Important counseling points are listed below.

Do not take it for more than 2 weeks

Do periodic assessment of renal, hepatic or hematopoietic functions

Keep taking medicine until treatment is finished

Space the doses evenly during the day

Take the medicine with food

Learn more: Precautions & How to Use (in more detail)

Avimox Kid Forte Tablet Frequently asked Questions

Can Avimox Kid Forte Tablet be used for Bacterial infections of respiratory tract and Bacterial infections of urinary tract?

Yes, bacterial infections of respiratory tract and bacterial infections of urinary tract are among the most common reported uses for Avimox Kid Forte Tablet. Please do not use Avimox Kid Forte Tablet for bacterial infections of respiratory tract and bacterial infections of urinary tract without consulting first with your doctor. Click here to find out what other patients report as common uses for Avimox Kid Forte Tablet.

Is it safe to drive or operate heavy machinery when consuming?

If you experience drowsiness, dizziness, hypotension or headache as side-effects when eating Avimox Kid Forte Tablet medicine then it maybe not be safe to drive a vehicle or operate heavy machinery. One should not drive a vehicle if eating the medicine makes you drowsy, dizzy or lowers your blood-pressure extensively. Pharmacists also advise patients not to drink alcohol with medicines as alcohol intensifies drowsiness side-effects. Please check for these effects on your body when using Avimox Kid Forte Tablet. Always consult with your doctor for recommendations specific to your body and health conditions.

Is this medicine or product addictive or habit forming?

Most medicines don't come with a potential for addiction or abuse. Usually, government's categorizes medicines that can be addictive as controlled substances. Examples include schedule H or X in India and schedule II-V in the US. Please consult the product package to make sure that the medicine does not belong to such special categorizations of medicines. Lastly, do not self-medicate and increase your body's dependence to medicines without the advice of a doctor.

Can it be stopped immediately or do I have to slowly ween off consumption?

Some medicines need to be tapered or cannot be stopped immediately because of rebound effects. Please consult with your doctor for recommendations specific to your body, health and other medications that you may be using.

Is Avimox Kid Forte Tablet safe to consume or apply when pregnant?

Please consult with your doctor for case-specific recommendations.

Is Avimox Kid Forte Tablet safe while breastfeeding?

Please discuss the risks and benefits with your doctor.

Consumer Survey: Avimox Kid Forte Tablet

The following are the results of on-going survey on TabletWise. com for Avimox Kid Forte Tablet. These results only indicate the perceptions of the website users. Please base your medical decisions only on the advice of a doctor or a registered medical professional.

Uses, Effectiveness and Side-effects

Following are the uses, perceived effectiveness and perceived side-effects incidence information reported by website visitor for Avimox Kid Forte Tablet:

User reported uses

No data has been collected for this survey

User reported time for results

No data has been collected for this survey

Volunteerpro - Expert Training For Volunteer Managers, Volpro

“This is a great group because of all of the information and idea sharing from knowledgeable professionals in the volunteer management field. It’s a great way to build camaraderie among professionals who may not always get the support they need from within their organizations.”

Alana Knoppow, MSW, VolunteerPro Founding Member

“Volunteer Pro serves as a nerve center for volunteer managers from all walks of life. There isn’t quite any online community like it because Tobi Johnson has such a wealth of expertise in this area that she is able to curate the community to provide depth and strategy when it comes to designing volunteer based programming. The tone and pace of new and relevant information is on point, the community is insightful and supportive, and the content is spot on when it comes to practical application. You might want to bookmark Volunteer Pro in your browser because the likelihood is, it will be a quick favorite.”

Heather Bates, VolunteerPro Founding Member

“These webinars are chock full of solid content and use humor well to make their points. Tobi and Tracey are top notch at what they do. The timeliness of the topics could not be better. I am learning so many skills that are very applicable to my work.”

Jenna Jones, CVA, Smithsonian Associates Program, Washington, DC

Jacquard Products - Procion Mx, Priocin

Products

Procion MX

Procion MX dyes are “cold water dyes” that do not require heat. This unique property sets Procion MX apart from all other dyes and establishes them as the undisputed king of backyard dyeing, batik and tie dye. Because Procion MX dyes can be used away from the stovetop, they are also perfect for shibori. ice dyeing, tub and low water immersion dyeing. printing, direct painting and other “alternative” dye applications. As a fiber reactive dye, Procion MX forms a strong covalent bond with cellulosic fibers. making it the most permanent and washfast of all dyestuffs. Mix the concentrated dye powder with warm tap water to create the most vibrant of all colors for cotton, linen and other plant-based fabrics. Procion MX dyes are typically used with a soda ash fixative, which can be added directly to the dye bath or used to pre-treat the fabric, as in tie dyeing.

- Typically, one 2/3 oz/19 g bottle will dye more than 1 lb/0.45 kg of dry fabric. (Very bright colors will require more dye and pastel colors will require less.)

Techniques tie dye, immersion dyeing, batik, screen printing, direct application, gradation/ombre dyeing, sprinkle dyeing, ice dyeing and more

Fabric/Fiber Ccellulose fibers: cotton, linen, canvas hemp, jute, ramie, sisal, paper, rayon and more. May also be used with protein fibers if acidified.

Sizes * - 43 Colors 2/3 oz/19 g (Item PMX1) 8 oz/0.23 kg (Item PMX2) 1 lb/0.45 kg (Item PMX3)

*8 oz and 1 lb sizes now available at a location near you.

Procion MX Instructions

Procion Color Mixing Chart

Procion MX Color Information

If you tie dye with friends and they take home their garments to wash, here's an easy print-out you can give them with simple instructions:

Jacquard Procion Post Party Instructions

Instructional Videos using Procion MX Watch Now on Vimeo and YouTube !

Buy Handaramin Clindamycin Online Without Prescriptions, Handaramin

Cleocin is used for treating serious infections caused by certain bacteria. Cleocin is a lincomycin antibiotic. Cleocin kills sensitive bacteria by stopping the production of essential proteins needed by the bacteria to survive.

Use Cleocin as directed by your doctor.

Take Cleocin by mouth with or without food.

Take Cleocin with a full glass of water (8 oz/240 mL).

Cleocin works best if it is taken at the same time each day.

To clear up your infection completely, take Cleocin for the full course of treatment. Keep taking it even if you feel better in a few days.

If you miss a dose of Cleocin, 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 Cleocin.

Store Cleocin at room temperature, between 68 to 77 degrees F (20 to 25 degrees C) in a tightly-closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Cleocin out of the reach of children and away from pets.

Active Ingredient: Clindamycin hydrochloride.

Do NOT use Cleocin if:

you are allergic to any ingredient in Cleocin or to lincomycin

you have certain intestinal problems (eg, antibiotic-associated colitis, Crohn disease, ulcerative colitis) or meningitis.

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

Some medical conditions may interact with Cleocin. 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 diarrhea, or a history of liver problems or stomach or bowel problems (eg, colitis)

if you are allergic to tartrazine.

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

Nondepolarizing muscle relaxants (eg, vecuronium) or succinylcholine because the risk of their side effects may be increased by Cleocin.

Erythromycin because it may decrease Cleocin's effectiveness.

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

Cleocin only works against bacteria; it does not treat viral infections (eg, the common cold).

Be sure to use Cleocin for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.

Long-term or repeated use of Cleocin may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.

This product may contain tartrazine dye. This may cause an allergic reaction in some patients. If you have ever had an allergic reaction to tartrazine, ask your pharmacist if your product has tartrazine in it.

Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.

Lab tests, including liver function, kidney function, and complete blood cell counts, may be performed while you use Cleocin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Cleocin with caution in the elderly; they may be more sensitive to its effects, especially diarrhea.

Use Cleocin with extreme caution in children younger 10 years who have diarrhea or an infection of the stomach or bowel.

Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Cleocin while you are pregnant. Cleocin is found in breast milk. If you are or will be breast-feeding while you use Cleocin, 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:

Mild diarrhea; nausea; vomiting.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or tarry stools; decreased urination; joint pain or swelling; red, swollen, blistered, or peeling skin; severe or persistent diarrhea; severe stomach cramps or pain; unusual vaginal discharge, itching, or odor; yellowing of the skin or eyes.

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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Copyright © 2004-2016 All Rights Reserved

Human Resources Trovix Recruit Introduces A New Paradigm In Candidate Search Technology, Triovix

trovix WINS Human Resource Executive ® Magazine´s TOP HR PRODUCT OF THE YEAR AWARD

MOUNTAIN VIEW, Calif. - October 3, 2006 - Trovix Inc. a leading provider of intelligent search technology, today announced that its full-featured intelligent search and applicant tracking solution, Trovix Recruit TM. has been selected by Human Resource Executive ® magazine as a Top

HR Product of the Year.

"Trovix has rapidly made its mark as an innovator in the HR industry through the company´s incorporation of cutting-edge search technology into its ATS," stated David Shadovitz, chairman of the HR Technology Conference & Exposition, and editor and publisher of Human Resource Executive . "By adding this twist to traditional recruiting, Trovix Recruit is changing the way recruiters find top candidates. As the war for talent heats up, finding the best candidates quickly is more business-critical than ever."

Trovix CEO and Founder Jeff Benrey said, "We´re thrilled to be recognized by Human Resource Executive as an innovator in the HR industry less than one year after the launch of Trovix Recruit. Winning the Top HR Product of the Year award is further validation that Trovix Recruit is and will continue to have a major impact on the way organizations recruit top talent. To get and stay at the top, organizations are dependent upon the accomplishments of their workforce. We´re extremely proud of the successes that our clients have been able to achieve through the power of Trovix Recruit."

About Trovix Recruit

Trovix Recruit is a Web-based application that combines Trovix´s Intelligent Search Technology with a full-featured applicant tracking system (ATS) to manage the entire candidate selection process: from requisition and offer approvals to career site hosing and customized reports. Trovix Intelligent Search is a powerful tool for recruiters and hiring managers because it learns based on their preferences and identifies the best qualified candidates for them.

Trovix Recruit expedites the hiring process, improves the quality of hires, reduces recruiting cost, and streamlines the overall process by quickly ranking the best candidates for each position. Designed with input from industry experts and end-users, Trovix Recruit is not only a comprehensive, easy-to-use solution, it also incorporates essential features and benefits for successful recruiting, such as automatic data capture for compliance requirements, a communications module, and custom reports.

About Trovix Inc.

Trovix Inc. is a leading provider of intelligent search technology. Its first product, Trovix Recruit, combines intelligent, personalized search technology with a full-featured applicant tracking system to help companies recruit the best talent available faster. reduce their cost-per-hire, and streamline their workflow. Trovix customers include successful and growing ventures such as Palm, Stanford University, Linksys, Juniper Networks, VMware and Rambus. Headquartered in Silicon Valley, Trovix is backed by top-tier venture capital firms including 3i, Granite Ventures and USVP. For more information, visit www. trovix. com.

Trovix and Trovix Recruit are trademarks of Trovix Inc. Other product and brand names are trademarks or registered trademarks of their respective owners.

Tel: 650.335.8311 ext. 615

The DEVON Group

Tel: 732.224.1000, ext. 18

The HR industry´s premier online community and resource for Human Resource professionals . HR, human resources, HR community, human resources community, HR best practices, best practices in human resources, online communities for HR, HR articles, HR news, human resources articles, human resources news, HR events, leadership, performance management, staffing and recruitment, benefits, compensation, staffing, recruitment, workforce acquisition, human capital management, HR management, human resources management, HR metrics and measurement, organizational development, executive coaching, HR law, employment law, labor relations, hiring employees, HR outsourcing, human resources outsourcing, training and development hr. com. human resources management resources for hr professionals. | HR menus | HR events | HR Sitemap

Seconal Indications, Side Effects, Warnings, Setanol

Seconal

Treating sleep disorders. It may also be used as a sedative prior to anesthesia for surgery.

Seconal is a barbiturate. It works by depressing the central nervous system, causing mild sedation or sleep, depending on the dose.

Do NOT use Seconal if:

you are allergic to any ingredient in Seconal

you have the blood disease porphyria or moderate to severe liver or lung problems

you are taking sodium oxybate (GHB)

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

Before using Seconal:

Some medical conditions may interact with Seconal. 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 liver problems, lung or respiratory tract disease, or a painful condition

if you have a history of substance abuse or dependence, depression, or suicidal thoughts or behavior

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

Monoamine oxidase inhibitors (MAOIs) (eg, phenelzine) or sodium oxybate (GHB) because they may increase the risk of Seconal's side effects

Anticoagulants (eg, warfarin), beta-blockers (eg, atenolol), clozapine, corticosteroids (eg, prednisone), doxycycline, estrogens (eg, micronized estradiol), griseofulvin, metronidazole, oral contraceptives (birth control pills), phenytoin, quinidine, stiripentol, theophylline, or valproic acid because their effectiveness may be decreased by Seconal

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

How to use Seconal:

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

Take Seconal by mouth with or without food.

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

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

Important safety information:

Seconal may cause drowsiness. This effect may be worse if you take it with alcohol or certain medicines. Use Seconal with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Do not drink alcohol while you are taking Seconal.

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

Do not take more than the recommended dose or take Seconal for longer than prescribed without checking with your doctor. Exceeding the recommended dose or taking Seconal for longer than prescribed may be habit-forming.

Some patients taking Seconal have performed certain activities while they were not fully awake. These have included sleep-driving, making and eating food, making phone calls, and having sex. Patients often do not remember these events after they happen. Such an event may be more likely to occur if you use a high dose of Seconal. It may also be more likely if you drink alcohol or take other medicine that may cause drowsiness while you use Seconal. Tell your doctor right away if such an event happens to you.

Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Seconal.

Seconal may decrease the effectiveness of your birth control pill. To prevent pregnancy, be sure to use an additional form of birth control while using Seconal.

Lab tests, including complete blood cell counts and kidney and liver function tests, may be performed while you use Seconal. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Seconal with caution in the ELDERLY; they may be more sensitive to its effects, especially drowsiness, depression, or confusion.

PREGNANCY and BREAST-FEEDING: If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Seconal while you are pregnant. Seconal is found in breast milk. If you are or will be breast-feeding while you use Seconal, check with your doctor. Discuss any possible risks to your baby.

When sleep medicines are used every night for more than a few weeks, they may lose their effectiveness to help you sleep. This is known as TOLERANCE. Sleep medicines should usually be used only for short periods of time, such as a few days and generally no longer than 1 or 2 weeks. If your sleep problems continue, contact your doctor.

When used for longer than a few weeks or at high doses, some people develop a need to continue taking Seconal. This is known as DEPENDENCE or addiction. If you suddenly stop taking Seconal, you may experience WITHDRAWAL symptoms, including anxiety, muscle twitching, trembling hands and fingers, weakness, dizziness, hallucinations, nausea, vomiting, sleeplessness, lightheadedness, or seizures.

Possible side effects of Seconal:

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:

Clumsiness; dizziness; excessive daytime drowsiness; lightheadedness.

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); confusion; difficulty sleeping; fainting; fever; hallucinations; severe dizziness; trouble sleeping; unusual behavior; very slow breathing.

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

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center. or emergency room immediately. Symptoms may include change in size of pupil; cold, clammy skin; deep sleep; incoordination; loss of consciousness; slowed or fast breathing; slurred speech; trouble walking; unusual eye movements.

Proper storage of Seconal:

Store Seconal 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 Seconal out of the reach of children and away from pets.

General information:

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

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

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

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

This information should not be used to decide whether or not to take Seconal or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Seconal. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Seconal. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Seconal.

Review Date: August 8, 2016

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

More about Seconal (secobarbital)

Lovatex De Aguascalientes Sa De Cv, Lovatex

Lovatex De Aguascalientes Sa De Cv

Sample shipment record for Lovatex De Aguascalientes Sa De Cv

Shipment Alert Subscription

Features

Save and Share Reports

Easily get your searches out of Import Genius and into your team’s hands for further analysis. Export your findings to XLS or CSV, or send reports via email. It’s the simple things that make our trade data even more valuable to you.

See the Supply Chain

Visual Mapping shows you exactly how your target companies and their trading partners connect. Search by shipper and see everyone they’ve shipped to. Or search by consignee and see all their suppliers. Zoom in on any company to see their own trading network. Dive deep into international trade and discover the links in anyone’s supply chain.

Get Real-time Shipment Alerts

Stay on top of your competitors, suppliers, and customers with real-time alerts. Just set up a search and get an email whenever a new shipment matches your terms. Import Genius lets you know the moment they bring in a rival product or start shipping to a new partner.

Lovatex De Aguascalientes Sa De Cv

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View All U. S. Imports

What is Import Genius

Import Genius reveals the trading activities of importers and exporters around the world.

We give you hard data about your overseas suppliers and domestic competitors. Using shipping databases from Customs agencies in the United States, Latin America, and India, Import Genius can help you find reliable new trading partners, monitor your competitors’ shipments, and keep an eye on your current suppliers and customers.

Our team of seasoned import-export veterans, cutting-edge software developers, and customer service professionals has worked for years to build the world's most powerful and accessible database of international trade intelligence.

We do this for a diverse client base that requires keen insight into international trade.

Our customers include some of the world's top importers, exporters, freight forwarders, logistics companies, manufacturers, investment banks, financial analysts, intellectual property attorneys, and more. They use our tools to:

Research the trade activity of importers and suppliers

Identify and vet new sources for any kind of product

Monitor the competition and their trade connections

Generate sales leads for transportation and logistics companies

Track the activity of publicly-traded companies

Investigate and enforce intellectual property infringement

Ensure exclusive agent compliance

Who Uses Import Genius

Sourcing Professionals.

Use our service to view shipping histories for suppliers.

We provide access to detailed customs records, letting you verify suppliers' true shipping volumes and U. S. customer lists. You can also look up your competing import firms to find where they buy their goods.

Competitive Intelligence Analysts.

Use our service to learn where rivals source products.

We give clear insights into the importing volumes, new product releases, and broader competitive dynamics of your industry.

Sales & Marketing Teams.

Use our service to generate sales prospects.

We give you the tools to target importers based on product type, location, shipping volumes, and more.

Financial Analysts.

Use our service to monitor public companies' imports.

We offer rare data on the success or failure of new product launches, shipping trends and other operating data for companies in any industry.

Available Data Fields

Import Genius Data Fields

By collecting the ocean freight bill of lading for all U. S. imports in our database, Import Genius provides unprecedented access to near real-time information on virtually every industry and company importing goods into the country.

For each shipment entering the U. S. by ocean, we provide access to the following information.

Additional Fields Available for Some Shipments:

List of Data Fields

Ja Serenil Construction, Serenil

J. A. Serenil Construction

J. A. Serenil Construction in San Antonio, TX and holds a Curb Sidewalk Contractor license (TS1260) according to the San Antonio license board.

Their BuildZoom score of 90 indicates that they are licensed or registered but we do not have additional information about them.

Their license (TS1260) was verified as active when we last checked. If you are thinking of hiring J. A. Serenil Construction, we recommend double-checking their license status with the license board and using our bidding system to get competitive quotes.

Services

Contact Info for J. A. Serenil Construction

Street Address: 9426 Arcadia Creek. San Antonio. TX 78251 Edit

Do you work for this business? Unlock this free profile to update company info and see who's viewing your profile.

J. A. Serenil Construction Reviews

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Please write a review about J. A. Serenil Construction

Citalopram Side Effects In Detail, Citopam

Citalopram Side Effects

For the Consumer

Applies to citalopram: oral solution, oral tablet

In addition to its needed effects, some unwanted effects may be caused by citalopram. 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 citalopram:

Less common:

Agitation

blurred vision

confusion

fever

increase in the frequency of urination or amount of urine produced

lack of emotion

loss of memory

menstrual changes

skin rash or itching

trouble breathing

Rare

Behavior change similar to drunkenness

bleeding gums

breast tenderness or enlargement or unusual secretion of milk (in females)

chills

convulsions (seizures)

diarrhea

difficulty with concentrating

dizziness or fainting

drowsiness

increased hunger

increased thirst

irregular heartbeat

lack of energy

lethargy

nosebleed

overactive reflexes

painful urination

poor coordination

purple or red spots on the skin

rapid weight gain

red or irritated eyes

redness, tenderness, itching, burning, or peeling of the skin

shivering

slow or irregular heartbeat (less than 50 beats per minute)

sore throat

stupor

sweating

swelling of the face, ankles, or hands

talking or acting with excitement you cannot control

trembling, shaking, or twitching

trouble with holding or releasing urine

unusual or sudden body or facial movements or postures

unusual tiredness or weakness

Incidence not known:

Abdominal or stomach pain

back or leg pains

black, tarry stools

bloating

bloody stools

chest pain

confusion as to time, place, or person

constipation

cough

darkened urine

difficult or fast breathing

difficulty with swallowing

drooling

fast, slow, or irregular heartbeat

general body swelling

hive-like swelling on the face, eyelids, lips, tongue, or throat

hives

holding false beliefs that cannot be changed by fact

impaired consciousness, ranging from confusion to coma

indigestion

itching, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

loss of appetite

loss of bladder control

loss of consciousness

muscle cramps or spasms

muscle tightness

muscle twitching or jerking

pale skin

penile erections, frequent or continuing

recurrent fainting

rhythmic movement of the muscles

seeing, hearing, or feeling things that are not there

swelling of the breasts or unusual milk production

tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over the affected area

tightness in the chest

total body jerking

twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs

uncontrolled jerking or twisting movements

unusual excitement

vomiting of blood or material that looks like coffee grounds

yellowing of the eyes or skin

Minor Side Effects

Some of the side effects that can occur with citalopram 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:

Decrease in sexual desire or ability

sleepiness or unusual drowsiness

Less common:

Body aches or pain

change in sense of taste

gas

headache (severe and throbbing)

heartburn

increased sweating

increased yawning

loss of voice

pain in the muscles or joints

sneezing

stuffy or runny nose

tingling, burning, or prickly feelings on the skin

tooth grinding

unusual increase or decrease in weight

watering of the mouth

Incidence not known:

Bruising

inability to sit still

large, flat, blue or purplish patches in the skin

need to keep moving

uncontrolled eye movements

For Healthcare Professionals

Applies to citalopram: oral solution, oral tablet

General

The side effects observed with citalopram in clinical trials were generally reported as mild and transient, occurring most frequently in the first 1 to 2 weeks of therapy, and attenuating subsequently. The most commonly reported side effects were nausea, somnolence, dry mouth, increased sweating, tremor, diarrhea, and ejaculation disorder. Side effects associated with treatment discontinuation in short-term placebo-controlled depression trials were asthenia, nausea, dry mouth, vomiting, dizziness, insomnia, somnolence, and agitation. There was a positive dose response reported for diarrhea, dry mouth, fatigue, impotence, insomnia, increased sweating, nausea, somnolence, and yawning. [Ref ]

Psychiatric

Antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment. An increased risk of suicidal thinking and behavior in children, adolescents, and young adults (aged 18 to 24 years) with major depressive disorder (MDD) and other psychiatric disorders has been reported with short-term use of antidepressant drugs.

Adult and pediatric patients receiving antidepressants for MDD, as well as for psychiatric and nonpsychiatric indications, have reported symptoms that may be precursors to emerging suicidality, including anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and mania. Causality has not been established. [Ref ]

Very common (10% or more): Insomnia Common (1% to 10%): Abnormal dreams, aggravated depression, agitation, anxiety, apathy, confusion, depression, impaired concentration, nervousness, suicide attempt Uncommon (0.1% to 1%): Aggressive reaction, delusion, depersonalization, drug dependence, emotional lability, euphoria, hallucination, mania, panic reaction, paranoid reaction, paroniria, psychosis, psychotic depression Rare (less than 0.1%): Catatonic reaction, melancholia, suicide-related events Frequency not reported: Bruxism, restlessness Postmarketing reports: Delirium, withdrawal syndrome [Ref ]

Nervous system

Very common (10% or more): Dizziness, headache, migraine, somnolence Common (1% to 10%): Amnesia, extrapyramidal disorder, paresthesia, taste perversion, tremor Uncommon (0.1% to 1%): Abnormal gait, ataxia, cerebrovascular accident, convulsions, dystonia, hypoesthesia, involuntary muscle contractions, neuralgia, speech disorder, syncope, hyperkinesia, hypertonia, hypokinesia, transient ischemic attack Rare (less than 0.1%): Abnormal coordination, dyskinesia, grand mal convulsion, hyperesthesia, stupor Frequency not reported: Akathisia, movement disorder, serotonin syndrome Postmarketing reports: Choreoathetosis, myoclonus, neuroleptic malignant syndrome, nystagmus [Ref ]

Potentially life-threatening serotonin syndrome has been reported with SSRIs and SNRIs as monotherapy, but particularly with concomitant use of other serotonergic drugs and drugs that impair the metabolism of serotonin. [Ref ]

Cardiovascular

Common (1% to 10%): Chest pain, hypotension, palpitations, postural hypotension, tachycardia Uncommon (0.1% to 1%): Angina pectoris, atrial fibrillation, bradycardia, cardiac failure, edema (extremities), extrasystoles, flushing, hematomas, hypertension, myocardial infarction, myocardial ischemia Rare (less than 0.1%): Bundle branch block, cardiac arrest, phlebitis, QT prolongation, torsades de pointes Frequency not reported: Ventricular arrhythmia Postmarketing reports: Thrombosis [Ref ]

This drug has been associated with a dose-related QT-interval prolongation; there have been reports of QT-interval prolongation and ventricular arrhythmia, including torsade de pointes, particularly in females, patients with hypokalemia, or with pre-existing QT-interval prolongation, or other cardiac disease. [Ref ]

Gastrointestinal

A study of 26,005 antidepressant users has reported 3.6 times more upper GI bleeding episodes with the use of SSRIs relative to the population who did not receive antidepressant medications. Upper gastrointestinal tract bleeding was observed in 4.1 times more frequently in patients receiving citalopram. [Ref ]

Very common (10% or more): Dry mouth, nausea Common (1% to 10%): Abdominal pain, constipation, diarrhea, dyspepsia, flatulence, increased saliva, taste loss, vomiting Uncommon (0.1% to 1%): Abnormal bleeding (predominantly of the mucous membranes), dysphagia, eructation, esophagitis, gastrointestinal bleeding, gastritis, gastroenteritis, gingivitis, hemorrhoids, stomatitis, teeth grinding Rare (less than 0.1%): Colitis, diverticulitis, duodenal ulcer, gastric ulcer, gastroesophageal reflux, gingival bleeding, glossitis, rectal hemorrhage Frequency not reported: Gastrointestinal hemorrhage Postmarketing reports: Pancreatitis [Ref ]

Metabolic

Common (1% to 10%): Anorexia, decreased/increased weight, increased appetite Uncommon (0.1% to 1%): Abnormal glucose tolerance, thirst Rare (less than 0.1%): Alcohol intolerance, dehydration, hypokalemia, hyponatremia, hypoglycemia, obesity [Ref ]

Numerous cases of hyponatremia have been reported following treatment with an SSRI. Risk factors for the development of SSRI - associated hyponatremia including advanced age, female gender, concomitant use of diuretics, low body weight, and lower baseline serum sodium levels have been identified. Hyponatremia tends to develop within the first few weeks of treatment (range 3 to 120 days) and typically resolves within 2 weeks (range 48 hours to 6 weeks) after therapy has been discontinued with some patients requiring treatment. The proposed mechanism for the development of hyponatremia involves SIADH via release of antidiuretic hormone. [Ref ]

Other

Very common (10% or more): Asthenia Common (1% to 10%): Fatigue, fever, pain, tinnitus Uncommon (0.1% to 1%): Vertigo Rare (less than 0.1%): Facial edema, malaise, rigors Postmarketing reports: Spontaneous abortion [Ref ]

Genitourinary

Urinary retention and galactorrhea have been reported with other SSRIs.

The estimates of the incidence of untoward sexual experience and performance may underestimate their actual incidence, partly because patients and physicians may be reluctant to discuss this issue. In placebo-controlled clinical trials ejaculation disorder (primarily ejaculation delay) was reported as a treatment-emergent side effect at an incidence of 6% and at least twice the incidence in placebo-treated male patients. [Ref ]

Common (1% to 10%): Abnormal orgasm (female), amenorrhea, decreased libido, dysmenorrhea, ejaculation disorders, impotence, menstrual disorders, polyuria Uncommon (0.1% to 1%): Breast enlargement, breast pain, dysuria, galactorrhea, increased libido, menorrhagia, micturition frequency, nonpuerperal lactation, vaginal bleeding, vaginal hemorrhage, urinary incontinence, urinary retention Rare (less than 0.1%): Gynecomastia, hematuria, oliguria Frequency not reported: Metrorrhagia, priapism [Ref ]

Dermatologic

One case of cutaneous leukocytoclastic vasculitis has been reported in a patient receiving escitalopram (dose not stated). The lesions disappeared one week following discontinuation of escitalopram and reappeared upon rechallenge. A similar reaction occurred when the patient was switched to paroxetine. [Ref ]

Very common (10% or more): Increased sweating Common (1% to 10%): Rash, pruritus Uncommon (0.1% to 1%): Abnormal bleeding of the skin, acne, alopecia, dermatitis, dry skin, eczema, photosensitivity reaction, psoriasis, purpura, skin discoloration, urticaria Rare (less than 0.1%): Decreased sweating, hypertrichosis, keratitis, melanosis, pruritus ani Frequency not reported: Angioedema, ecchymosis Postmarketing reports: Epidermal necrolysis, erythema multiforme [Ref ]

Endocrine

Rare (less than 0.1%): Goiter, hypothyroidism Frequency not reported: Inappropriate ADH secretion Postmarketing reports: Prolactinemia [Ref ]

Hematologic

Uncommon (0.1% to 1%): Anemia, leucopenia, leukocytosis, lymphadenopathy Rare (less than 0.1%): Coagulation disorder, granulocytopenia, hemorrhage, hypochromic anemia, lymphocytosis, lymphopenia Frequency not reported: Thrombocytopenia Postmarketing reports: Decreased prothrombin, hemolytic anemia [Ref ]

Hepatic

Common (1% to 10%): Increased alkaline phosphatase Uncommon (0.1% to 1%): Increased ALT, GGT, and AST Rare (less than 0.1%): Bilirubinemia, cholelithiasis, cholecystitis, hepatitis, jaundice Frequency not reported: Abnormal liver function test Postmarketing reports: Cholestatic hepatitis, hepatic necrosis [Ref ]

Hypersensitivity

Frequency not reported: Anaphylactic reaction, hypersensitivity not otherwise specified Postmarketing reports: Allergic reaction [Ref ]

Immunologic

Common (1% to 10%): Influenza-like symptoms Rare (less than 0.1%): Hay fever [Ref ]

Musculoskeletal

Epidemiological studies, primarily in patients aged 50 years or older, have shown an increased risk of bone fractures in patients receiving SSRIs or TCAs. [Ref ]

Common (1% to 10%): Arthralgia, back pain, myalgia Uncommon (0.1% to 1%): Arthritis, leg cramps, muscle weakness, skeletal pain Rare (less than 0.1%): Bursitis, osteoporosis Postmarketing reports: Rhabdomyolysis [Ref ]

Ocular

Common (1% to 10%): Abnormal accommodation, abnormal vision Uncommon (0.1% to 1%): Conjunctivitis, dry eyes, eye pain, mydriasis Rare (less than 0.1%): Abnormal lacrimation, cataract, diplopia, photophobia, ptosis Frequency not reported: Visual disturbance Postmarketing reports: Angle-closure glaucoma [Ref ]

Renal

Rare (less than 0.1%): Pyelonephritis, renal calculus, renal pain Postmarketing reports: Acute renal failure [Ref ]

Respiratory

Common (1% to 10%): Coughing, pharyngitis, rhinitis, sinusitis, upper respiratory tract infection, yawning Uncommon (0.1% to 1%): Bronchitis, dyspnea, epistaxis, pneumonia Rare (less than 0.1%): Asthma, bronchospasm, hiccups, increased sputum, laryngitis, pneumonitis, pulmonary embolism [Ref ]

References

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

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.

4. von Knorring AL, Olsson GI, Thomsen PH, Lemming OM, Hulten A "A Randomized, Double-blind, Placebo-controlled Study of Citalopram in Adolescents With Major Depressive Disorder." J Clin Psychopharmacol 26 (2006): 311-315

5. Ministerio de Sanidad y Consumo. Gobierno de Espana "AEMPS. Agencia Espanola de Medicamentos y Productos Sanitarios. Available from: URL: https://sinaem4.agemed. es/consaem/fichasTecnicas. do? metodo=detalleForm."

6. Dalton SO, Johansen C, Mellemkjaer L, Norgard B, Sorensen HT, Olsen JH "Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal tract bleeding: a population-based cohort study." Arch Intern Med 163 (2003): 59-64

7. Jacob S, Spinler SA "Hyponatremia associated with selective serotonin-reuptake inhibitors in older adults." Ann Pharmacother 40 (2006): 1618-22

8. Odeh M, Beny A, Oliven A "Severe symptomatic hyponatremia during citalopram therapy." Am J Med Sci 321 (2001): 159-60

9. Flores-Suarez LF, Vega-Memije ME, Chanussot-Deprez C "Cutaneous vasculitis during selective serotonin reuptake inhibitor therapy." Am J Med 119 (2006): e1-3

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

Hydrochlorothiazide - Blood Pressure, Eprotan

Blood Pressure - Eprotan (Brand name: hydrochlorothiazide)

Hydrochlorothiazide is used for treating high blood pressure. It is also used to treat fluid buildup in the body caused by certain conditions (e. g. heart failure, liver cirrhosis, kidney problems) or medicines (e. g. corticosteroids, estrogen). It may be used alone or with other medicines. It may also be used for other conditions as determined by your doctor.

Use Hydrochlorothiazide as directed by your doctor.

Take Hydrochlorothiazide by mouth with or without food. Hydrochlorothiazide may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 pm. Ask your health care provider any questions you may have about how to use Hydrochlorothiazide. Drug Class and Mechanism

Hydrochlorothiazide is a thiazide diuretic. It helps the kidneys to remove fluid from the body.

If you miss a dose of Hydrochlorothiazide and are using it regularly, 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.

Store Hydrochlorothiazide between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Hydrochlorothiazide out of the reach of children and away from pets.

Do not use Hydrochlorothiazide if:

you are allergic to any ingredient in Hydrochlorothiazide; you are unable to urinate; you are taking dofetilide or ketanserin. Contact your doctor or health care provider right away if any of these apply to you.

Important : Hydrochlorothiazide may cause dizziness or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Hydrochlorothiazide with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Hydrochlorothiazide 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. Your doctor may also prescribe a potassium supplement for you. If so, take the potassium supplement exactly as prescribed. Do not start taking additional potassium on your own or change your diet to include more potassium without first checking with your doctor. Tell your doctor or dentist that you take Hydrochlorothiazide before you receive any medical or dental care, emergency care, or surgery. Tell your doctor if you will be exposed to high temperatures. The risk of certain side effects (eg, low blood sodium levels) may be increased in hot weather. Hydrochlorothiazide may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Hydrochlorothiazide. Use a sunscreen or wear protective clothing if you must be outside for more than a short time. Hydrochlorothiazide may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away. Diabetes patients - Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Lab tests, including kidney function, blood pressure, and electrolyte levels, may be performed while you use Hydrochlorothiazide. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Pregnancy and breast-feeding: Hydrochlorothiazide may cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Hydrochlorothiazide while you are pregnant. Hydrochlorothiazide is found in breast milk. If you are or will be breast-feeding while you use Hydrochlorothiazide, check with your doctor. Discuss any possible risks to your baby.

Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome:

Constipation; diarrhea; dizziness; lightheadedness (especially when sitting up or standing); loss of appetite; nausea; temporary blurred vision. 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); confusion; dark urine; decreased urination; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; increased thirst; joint pain, swelling, warmth, or redness (especially of the big toe joint); mental or mood changes; muscle pain or cramps; numbness or tingling; red, swollen, blistered, or peeling skin; seizures; severe or persistent dizziness; severe or persistent nausea or stomach pain; shortness of breath; unusual bruising or bleeding; unusual drowsiness, restlessness, tiredness, or weakness; unusually dry mouth; vomiting; yellowing of the eyes or skin.

If you have any questions about Hydrochlorothiazide, please talk with your doctor, pharmacist, or other health care provider. Hydrochlorothiazide is to be used only by the patient for whom it is prescribed. Do not share it with other people.

Loten, Loten

Author has written 21 stories for Immortals, Tamora Pierce, and Harry Potter.

'Loten' is an Old English word, meaning moonlight bright enough to see by.

September 16th 2016: I'm alive, I promise. Just busy. Very, very busy. Buying a house, working full time busy. Almost ready to actually move now. Blog news: Final chapter of Philosopher's Stone should be up this weekend.

PTL hit 3k (quite a while ago now, I'm sorry) and there will be two one-shots for it. eventually.

I currently have a few half-finished things I don't intend to work on for a little while. I'm going to be working on something a bit different instead, something I will hopefully actually want to finish. It's a shorter project so it hopefully won't take as long. Sorry guys, I know a lot of you want to see more from me. I do too, believe me! (I'm also going to try not to forget to update this profile, oops. )

You should check out my blog, link below.

I run a blog now! With my partner Mitchell ( Explopyro ). Here it is: pointstick. wordpress. com . You should stop by and browse - we have book reviews, including the start of a complete Harry Potter shredding, some rambling, some serious topics, all sorts. You can follow it for updates via email too, I believe (I'm still figuring out how everything works, hush.)

If anything should ever happen to my account or my stories, check it out and I shall post to let everyone know what's going on and where I will be moving to. You don't need to be a member of the site to see it. Until then, this is the only place I will be posting my fics. If one appears somewhere else, tell me, because it wasn't me.

Random trivia: In parts of Scandinavia, the days are all named for saints; April 30th is St Severus' Day and September 4th is St Hermione's day. More random trivia: Severus of Avranches (one of the St. Severi) is the patron saint of migraine sufferers. Appropriate, no?

Disclaimer: I accept no responsibility for anything that occurs whilst reading my fics, including but not limited to sleep deprivation, funny looks incurred by involuntary loud noises, tasks not being completed whether academic, social or any other, and general insanity.

I have a deviantArt under the name Loten with a few bits and pieces on it. I still play a few virtual pet sites, though not much. I have a Pottermore beta test account, too (obviously I'm in Slytherin!) but I don't play enough for it to be worth giving out my username there. Fun fact - my Pottermore wand is rowan and dragon heartstring, the wand I gave Severus in PTL long before Pottermore ever existed and will continue to give him in any fic where his canon wand is broken. (I've actually abandoned Pottermore now. I covered the content of all seven books on the blog, see above, but when they redid the whole thing and it turned into Buzzfeed I walked away.)

I'm 29, I'm female, I'm a Gemini, I live in south Wales and I graduated from a Welsh university in 2008 with a degree in zoology. I work in retail, and I'm wasting a very expensive and pointless education by happily writing fanfiction. I have four tattoos, so far, and I wear glasses. I try not to take life too seriously and I'm nowhere near as complicated as I like to think I am.

I will always reply to every single signed review unless you have private messaging disabled. You took the time to review, the least I can do is answer.

I will always gladly answer questions about my fics or discuss anything about the fandoms I write for. I've been known to offer writing advice when asked, too, although how much help I've actually been is anyone's guess. Don't be afraid to message me, I don't bite.

For every 1,000 reviews for a story, I offer a prize to that reviewer, a one-shot of their choice - within limits.

I will never abandon a story half way through. I will never upload the first chapter of a story unless I have a rough draft of the entire story already completed. I will never upload the first chapter of a story unless I am happy with the rough draft and confident that I can complete it to a standard I am satisfied with.

The only things that would ever stop me completing a story are computer issues or serious real life issues. When uploading a story, I will do my best to update it every few days; once a week at the longest. I know how horrible it is to be left hanging for months waiting for an update. If I ever do stop updating, there will be a message at the top of my profile explaining why. If there isn't, and I don't reappear within a fortnight, I'm probably dead.

There isn't much I won't read. I truly hate mpreg and noncon/dubcon and I don't like incest much; I also don't see the humour in most crackfics. I won't read characters from my OTPs paired with anyone except each other, but apart from that weird pairings of any sexuality are fine as long as it makes sense in the narrative.

Finally, I'm sorry to disappoint, but Severus and Hermione will never have children in any of my HP fics. I've seen it done well, but mostly it's done really badly and OOC, and it doesn't work with my personal versions of the characters. My Severus seriously and truly dislikes children and my Hermione isn't remotely interested in being a mother, and my Severus is too emotionally damaged for it to be a good idea anyway. Hermione understands him and can deal with him, but a child wouldn't be able to. If I can't make it believable in my own head, I know I can't write it. Other authors can and have, and good luck to them, but it's not going to happen in my writing.

Awards: yes, I'm a show-off. So sue me, I'm pleased and proud that people like my work enough to nominate and vote for it!

TAMORA PIERCE, IMMORTALS Teacher: Fourth place in Knighthood of Ficship Summer 2009. Power: Second place in Knighthood of Ficship Summer 2009. Divine Intervention: Fourth place in Knighthood of Ficship Winter 2009. Lost & Found: Third place in Knighthood of Ficship Winter 2009. Little By Little: Second place in Knighthood of Ficship Summer 2010. Affirmation: Fifth place in Knighthood of Ficship Summer 2010.

Bonus Feature! Mark Oshiro of the "Mark Reads. /Mark Watches. " review sites was commissioned to read chapters 6-8 of Divine Intervention and his videos of that reading can be found here: markreads (dot) net /reviews/2013/05/mark-reads-divine-intervention-chapters-6-8/

HARRY POTTER Post Tenebras, Lux: Winner of the 2013 Hp Fanfic Fan Poll award for Best SSHG Legacy. Chasing The Sun: Second place in the 2013 Hp Fanfic Fan Poll award for Best SSHG Legacy.

Fan Art : (let me know if any of these links no longer work) - FFN hates links so this format is the best I can do right now. Eventually I'll get them all hosted on a page on my blog.

Post Tenebras, Lux After Darkness, by RaShelli . RaShelli. deviantart (dot) com /#/d39o9q2 Fan Art, by Frusie : Jeanswear. deviantart (dot) com /#/d3btyba His Patronus, by Frusie : Jeanswear. deviantart (dot) com /#/d3b76ak Post Tenebras, Lux by Tempted Sacrifice : CaughtBy. deviantart (dot) com /#/d3ccede Untitled, by Kumo: tinyurl (dot) com /bv56m2j Banner, by EreshkigalGirl : tinyurl (dot) com /3kqequ5 Untitled, by Kimber : tinyurl (dot) com /3zuruas Thank You, by A Colourless Rainbow : tinyurl (dot) com /cm2v86f Post Tenebras, Lux by RaShelli : rashelli. deviantart (dot) com /#/d3eiq0m Post Tenebras, Lux (Colour) by Ridgley Warfield: therapist-in-a-box. deviantart (dot) com /#/d3eurh9 Post Tenebras, Lux (Black and White) by Ridgley Warfield: therapist-in-a-box. deviantart (dot) com /gallery/#/d3eurwj After Darkness Light by kayeita: ravelry (dot) com /projects/softnshiny/after-darkness-light The Order of the Phoenix, by BulletTimeScully: bullettimescully. deviantart (dot) com /art/Post-Tenebras-Lux-The-Order-of-the-Phoenix-300453086 HP Fanfic Fan Poll Nomination Banner: hpfanficfanpoll. files. wordpress (dot) com /2013/10/ivebeennominated-2013fallwinter. jpg HP Fanfic Fan Poll Winner Banner: hpfanficfanpoll. files. wordpress (dot) com /2014/01/snermione-legacy-1-posttenebraslux-loten. jpg Czech translation banner by Solace: hpkizi (dot) sk/images/topics/post_tenebras1.jpg

Chasing The Sun Agony, by RaShelli: rashelli. deviantart (dot) com /art/Agony-260991601 Your Ocean, by Ukirra: arriku. deviantart (dot) com /#/d4dkfhx Elemental Magic, by frusie: jeanswear. deviantart (dot) com /gallery/#/d4flsxg Hobbies, by Ukirra: arriku. deviantart (dot) com /gallery/#/d4h83ud Late Night Brewing, by RaShelli: rashelli. deviantart (dot) com /#/d4ih3tj Hallelujah, by BulletTimeScully: bullettimescully. deviantart (dot) com /art/Hallelujah-Chasing-the-Sun-277337333 Chapter 28, by RaShelli: rashelli. deviantart (dot) com /art/Chasing-the-Sun-Chapter-28-276887565 Waiting for the Mediwitch, by Peanut . gloriouspeanut. deviantart (dot) com /art/Waiting-for-the-mediwitch-277280898 Black Mood, by Ukirra: arriku. deviantart (dot) com /art/Chasing-the-Sun-Black-moods-278947703 At The Gates, by Noweia: noweia. deviantart (dot) com /art/At-The-Gates-279410263 I'm Free, by RaShelli: rashelli. deviantart (dot) com /art/I-m-free-281125614 Plotting Revenge, by RaShelli: rashelli. deviantart (dot) com /art/Plotting-the-Revenge-on-Umbridge-282085860 A Sign of Change, by doll-fin-chick: doll-fin-chick. deviantart (dot) com /art/Loten-A-Sign-of-Change-282075209 Fox Patronus, by doll-fin-chick: doll-fin-chick. deviantart (dot) com /art/Fox-Patronus-282075421 A Surprise Patronus, by Lilandriel: lilandrial. deviantart (dot) com /art/A-surprise-Patronus-282884296 Snape Duelling, by lucife56: lucife56.deviantart (dot) com /art/Snape-dueling-283288051 Snape Duelling (Coloured), by lucife56: lucife56.deviantart (dot) com /gallery/#/d52w885 Safe and Sound, by shamandaliewolf: shamandaliewolf. deviantart (dot) com /art/Safe-and-Sound-284883628 Patronus, by djfox31: ravenwing31.deviantart (dot) com /#/d4qk9o6 Chasing the Sun, by kitty-gurl1: namara-ashina. deviantart (dot) com /art/Chasing-the-Sun-288870688 He Was Never Truly Yours, by PickedYou: pickedyou. deviantart (dot) com /art/He-was-never-truly-yours-284108001 Snape, by Noa: flyingninjapig. deviantart (dot) com /gallery/#/d4mpnzs Fox Patronus, by FionaTyne: fionatyne. deviantart (dot) com /gallery/?catpath=scraps#/d592335 Portrait of Hermione, by frusie: jeanswear. deviantart (dot) com /art/Portrait-of-Hermione-317932334 The Otter and the Fox, by TaraSindar: aquasindar. deviantart (dot) com /art/The-Otter-and-the-Fox-Chasing-The-Sun-318311312 Morning Hair, by nene27: nene27.deviantart (dot) com /#/d59qq45 May God Have Mercy . by AngelicFayth : angelic-fayth. deviantart (dot) com /art/Chasing-the-Sun-May-God-have-mercy-on-my-soul-319463662 Banner, by Solace: tinyurl (dot) com /b35cv7m German translation cover by upac: ffcdn2012.fictionpressllc. netdna-cdn (dot) com /image/713173/180/ HP Fanfic Fan Poll Nomination Banner: hpfanficfanpoll. files. wordpress (dot) com /2013/10/ivebeennominated-2013fallwinter. jpg HP Fanfic Fan Poll Second Place Banner: hpfanficfanpoll. files. wordpress (dot) com /2014/01/snermione-legacy-2-chasingthesun-loten. jpg I See No Difference, by Sophie Nobody: phia-nobody. deviantart (dot) com /art/I-see-no-Difference-426861607 Expecto Patronum, by diAngelo57 : nukasclaw. deviantart (dot) com /art/Expecto-Patronum-507109182

Silence Heated Silence, by RaShelli : rashelli. deviantart (dot) com /art/Heated-Silence-324282685 Featured Author banner from the SSHG quiz on livejournal: ic. pics. livejournal (dot) com /morethansirius/10616016/169999/169999_original. png

Crossroads Czech translation cover by Lupina75: hp. kizi (dot) sk /images/topics/rapidez. jpg A Winter's Tale Featured Author banner from the SSHG quiz on livejournal: ic. pics. livejournal (dot) com /morethansirius/10616016/344977/344977_original. png

Translations by some wonderfully talented people. I'm always happy to grant permission if you want to translate anything I've written (though if you take on one of the long ones, make sure you have time to finish it, please). If it's not on this list, I haven't authorised it. If you happen to notice that any of the long translations haven't been updated in a while, let me know - if I can't get hold of the person translating, I'm happy to let someone else take over.

Telda Lady Bittersweet has translated several fics into German: I Beg to Differ : https://www. fanfiction. net/s/11748794/1/Was-zu-beweisen-war-oder-I-beg-to-differ Perception: https://www. fanfiction. net/s/11954518/1/Lotens-Perception-Wahrnehmung and fanfiktion dot de /s/573de65d0004e22316f9f48d /1/ Lotens-Perception-Wahrnehmung Here I Am Not: fanfiktion dot de/s/575d62900004e2231286eb0c/1/Lotens-quot-Here-I-am-not-quot - Post Tenebras Lux: fanfiktion dot de /s/56b32c840004e2232aa46d3b /1/ Post-Tenebras-Lux-von-Loten-neu-uebersetzt-und-bearbeitet Chasing the Sun : fanfiktion dot de /s/570a28830004e22312becee4/1/Lotens-quot-Chasing-the-sun-quot-neu-uebersetzt

flower0719 has translated Post Tenebras Lux into Chinese on a private forum for Chinese speakers, PM her if you want to log in and look at it.

frostbffr has translated Crossroads into Chinese: tieba dot baidu dot com/p/4730831178 And Feeding Time : tieba dot baidu dot com/p/4776828935

Lupina75 has translated Chasing The Sun into Czech/Slovak at hp. kizi (dot) sk/modules (dot) php? name=News&new_topic=193 She has also translated Second Year: hp. kizi (dot) sk/modules (dot) php? name=News&file=article&sid=3320 And Feeding Time: hp. kizi (dot) sk/modules (dot) php? name=News&file=article&sid=3450 And Crossroads: hp. kizi (dot) sk/modules (dot) php? name=News&file=article&sid=3449 And I Beg To Differ: hp. kizi (dot) sk/modules (dot) php? name=News&file=article&sid=3593 And Silence: hpkizi (dot) sk/modules (dot) php? name=News&file=article&sid=3731 And Here I Am Not: hpkizi (dot) sk/modules (dot) php? name=News&file=article&sid=3831 And Picture Perfect : hpkizi (dot) sk/modules (dot) php? name=News&file=article&sid=3817 And Summer: hpkizi (dot) sk/modules (dot) php? name=News&file=article&sid=4075 And The Search: hpkizi (dot) sk/modules (dot) php? name=News&file=article&sid=4115 And Post Tenebras Lux : hpkizi (dot) sk/modules (dot) php? name=News&file=article&sid=3867 And Acceptance: hpkizi (dot) sk/modules (dot) php? name=News&file=article&sid=4277 And A Winter's Tale . Part I: hpkizi (dot) sk/modules (dot) php? name=News&file=article&sid=4367 Part II: hpkizi (dot) sk/modules (dot) php? name=News&file=article&sid=4371 And Perception: hpkizi (dot) sk/modules (dot) php? name=News&file=article&sid=4388

chrishoo has translated A Winter's Tale into Chinese (you need to be a member of the site to see it): thelosteden (dot) net/forum (dot) php? mod=viewthread&tid=705&page=1&extra=#pid12595

Anchemcom is translating Chasing the Sun into Russian: ficbook (dot) net /readfic/4372197

Adrista will be translating Chasing the Sun into Chinese.

And now for something completely different. on my blog, linked at the top of this profile, my partner and I are doing a sporking of the Harry Potter series. This spork is being translated into Chinese by lanmenglu . Link One: tieba. baidu (dot) com /p/3367563664 Link Two (registration required): thelosteden (dot) net/forum (dot) php? mod=viewthread&tid=583&extra=page%3D1

I haven't heard from any of these in a while, feel free to claim them if you like:

Disincanto294 will be translating Post Tenebras Lux into Italian.

polinaluur will be translating Post Tenebras Lux into Russian.

Darcy91 will be translating one of my long fics into Dutch.

Polypocket will be translating I Beg to Differ and Silence into French.

Future fics, a. k.a. Attack of the Killer Plotbunnies.

These ideas may not necessarily all become fics, so don't get your hopes up. HP fics have priority, I'm not sure if/when I'll ever get around to stories from other fandoms.

Harry Potter: All SS/HG unless explicitly stated otherwise. The Mark of Cain: AU post-DH EWE. After the war, Snape survives and is punished by the Ministry for his crimes, but the details are kept secret until Harry stumbles on the truth and asks Hermione for help. Quite dark in places. First draft was half finished, but it needs a lot of work and keeps changing on me. I think I know what I'm doing with it now. Seven: Dark AU post-DH EWE. Canon compliant until the final battle. The Boy Who Lived. didn't. Nor did most of the Order. Hogwarts has fallen. The few surviving members of the Order are still trying to fight, but it looks hopeless until they are contacted and realise that someone else is still fighting alongside them . Probably going to be quite dark. Edicius: AU, post-DH EWE. Life has not been kind to Severus Snape. Once the war is over, he sets about changing that, and he doesn't intend letting anyone stop him. And then Harry does something everyone will regret. Shorter and less heavy than some of my other stories. On hold at the moment. The Winding Stair: AU post-DH EWE. The world is changing, and for two people there doesn't seem to be a place for them any more. Pushed aside by the new way of life within the Order, they decide to find another way to win the war. This one needs a lot of thought but I do like the idea. Gargoyle: (working title). AU post-DH, EWE. It's easy to be forgotten down in the deep cells under Azkaban, but sometimes life has a way of making sure that things aren't that simple. This promises to be quite a strange one; I'm not sure where it's going just yet. I may even dismantle it and use the ideas I have for it in other stories instead of trying to make it hang together as a full story. (Untitled): Slightly-AU DH. Dumbledore was smart enough to tell the Order about Snape's vow before his death. What is Snape going through, and how does it affect the Trio's task? Because cluelessly flailing around in the woods was really, really stupid and it never made any sense for none of the Order to know that Dumbledore asked Snape to kill him. Things would have been easier if they'd known and could help, and we all want to know how the new Headmaster coped. Drops of Jupiter: AU post-DH EWE. Harry and his Auror colleagues need Snape's help, but he wants nothing to do with any of them. Hermione has a private history with him that might be enough to persuade him. I like the initial idea but it needs more of a plot to go with it.

Tamora Pierce Lacunae : A collection of one-shots and missing scenes from between the books of the Immortals series. This is never going to be truly finished; I'll keep adding to it whenever inspiration strikes. Black and Gold: Some stories about Arram's time at university and how he arrived in Tortall and became Numair . This is a very long way down the priority list at the moment - I may well beat Tammy to it, though, especially since Exile has once again been delayed. I have a few tentative notes, but that's it so far.

Trudi Canavan Bitter Glass: The High Lord, rewritten from Akkarin's point of view . This needs a great deal of work. I had written about half of it, but looking back I don't like the writing and in some places I'm not happy with my grasp of his character. I have started rewriting it but it's not a priority. Title is only tentative. The Sound of Silence: I want to try my own take on the ' what-if-Akkarin-didn't-die ' theme that is so popular in this fandom; I've got some ideas for this, but I don't want to start it until the first story is finished. It's going to need a bit of work; I'm not sure what I want to do with it yet. Title is only tentative.

Wheel of Time Nothing concrete, but I'm tentatively batting around a few ideas for short Lan-based pieces. Because Lan is unbelievably cool and really doesn't get the attention he deserves. This is probably just going to be a little side project, something I'll work on to get over writer's block or to stop me getting too bogged down in any of my very long intense fics from other series. Not sure where I'll be going with it. Also I have now concluded that in Randland's future, Malkier will rule the world.

God help me, part of me really wants to try a novelisation of the first three Thief games, too. (The fourth one doesn't exist, shut up.) Why do I do this to myself?

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Debax, La Feodalite Languedocienne, Debax

Indiana University

Debax, Helene. La feodalite languedocienne XI-XII siecles: serments, sommages et fiefs dans le Languedoc des Trencavel . Tolouse: Presses Universitaires du Mirail, 2003. Pp. 403. $44.00. ISBN: 2-85816-651-X.

Fredric L. Cheyette Amherst College flcheyette@amherst. edu

It is a pleasure to welcome the revised version of Debax's thesis nouveau regime to print. For this reviewer it is also an astonishing experience. The thesis was presented in 1997, when I had completed all but the first and last chapters of my own Ermengard of Narbonne and the World of the Troubadours (Cornell University Press, 2001). I heard about its subject (without any details) from a colleague in Toulouse, but could neither get to Toulouse to read it nor trust my eyesight to the only likely alternative, a thousand or more pages of microfilmed typescript. I therefore knew nothing about its contents until I sat down a few weeks ago to review it. Ermengard appeared in autumn 2001. Debax could not have read it until sometime in 2002 when she must have been preparing the final version of her book for printing (it came off the press in January 2003). She had it in her hands in time to include the title in her bibliography and to scan it for statements she could disagree with in her footnotes, sometimes pointedly. (More about this later.) Surely, however, her basic arguments and almost all the details were already set by then. Thus we worked separately, without contact with each other, over databases that are in part the same and in part parallel. My next statement will strain credulity, but it is true. The structure and arguments of much of the heart of her thesis, chapters 2-4 on oaths of fidelity and security and chapter 5 on the settlement of conflicts, exactly parallel--sometimes down to small details--the arguments I presented in chapters 10 through 12 of Ermengard. It goes without saying that what she presents in 170 pages is far richer in detail and fuller in annotation than my own 47 pages. This is, after, a thesis, and Debax in proper form has left no document she has read un-reported. Nevertheless, on the essential issues, where we were dealing with the same questions, we say essentially the same thing. What Debax and I seem to have unwittingly accomplished is an historiographical repeatable experiment, demonstrating against at least some post-modernists that historical propositions, even propositions of considerable generality, can be independently arrived at and verified. It is a thrilling, and startling, discovery. I preface my review with all this to warn the reader that I am not unbiased.

The basic source from which Debax draws her data is ms. 10 of the Societe Archeologique de Montpellier, the so-called "Trencavel Cartulary" (hereafter CT). This manuscript, containing 615 acts dating from the early eleventh century to 1206, was for long virtually inaccessible to scholars. In 1969 I gained access to it for four weeks, but only after eighteen months of negotiations. Sometime during the 1970s the manuscript was microfilmed (Archives departementales de l'Herault 1 MI 6), and sometime after 1983 a photographic copy was deposited at the Archives departmentales de l'Aude (3 J 555). Debax therefore had the time to read it carefully for the many texts that the Benedictine scholars, Devic and Vaissete, left unpublished or published in only truncated form or inaccurately in their Histoire generale de Languedoc. (From her notes it appears that errors are not uncommon in the texts they transcribed.) She has proved to be a reader more than worthy of the cartulary's riches.

To all save specialists in Occitan history and literature, the Trencavels are virtually unknown. (I once urged J. R. Strayer to include an article on them in the Dictionary of the Middle Ages and later urged W. W. Kibler to include one in the Garland encyclopedia on medieval France, both times in vain.) Yet in the mid-twelfth century, at their height, they exercised power over a region that stretched from Albi and the southern hills of Rouergue to the Mediterranean and from the neighborhood of Toulouse to the edge of the Rhone valley. They were the principal regional players in what Debax refers to as the "hundred years war" between Toulouse and Barcelona for hegemony in what is now southern France. Because the last of the reigning line died in prison within a few months of the start of the Albigensian Crusades, from the point of view of teleological history--the making of the State (to which Debax pays surprising homage near the end of her book)--their story has been thought to be of only local significance and has, in consequence, been largely ignored.

In her first long chapter (pp. 23-99) Debax presents a political history of Occitania in the eleventh and twelfth century, focusing on the counts of Carcassonne and their successors, the Trencavels (who, with the exception of two suspect charters, never display a title more august than viscount). The difficulty of Debax's task here should not be underestimated. There are no contemporary narrative sources to provide even a basic chronology. The entire project must be based on charters alone--treaties, quit-claims, and other records of dispute settlements, occasional mention of political events in gifts to saints, and the like. In a world where the fund of given names was tiny, family names were unknown, and among those who boasted titles only the house of Toulouse regularly attached city names to their countships, even figuring out who were the participants in a particular treaty, alliance, or pacification, is sometimes difficult. The practice of co-lordship and shared titles within the families of the high aristocracy only complicates matters. Debax cuts her way through this jungle with painstaking attention both to detail and to developing a general understanding of the underpinnings of dynastic politics. As a result, her account of eleventh-century regional politics is probably as good as one may ever expect.

The house of Toulouse, she argues, was already in decline in the early eleventh century, at least in their western territories. Drawn to their lordships in the Rhone valley, they never really established a stable power center in and around Toulouse. Those who had been their viscounts in the region in the tenth century gradually established their independence, among them the family that would form one branch of the Trencavel ancestry in the Albigeois, the southern Rouergue, and Nimes. The other great lords of western Occitania were counts in Carcassonne and its region and in control of the mountainous region to the south and west. It is in her reconstruction of the complex conflicts among the multiple branches of this family that Debax truly shows her mettle. She presents a careful and fully plausible account of the relations between the two main branches of this family, the houses of Foix and Carcassonne, before the death of count Roger in 1067, as well as the involvement of both branches in the affairs of Narbonne and the neighboring Pyreneean counties. Her account of the critical turning point in this story in 1067-70--when Ermengard, count Roger's sister, and her husband Raymond-Bernard Trencavel allied themselves with the count of Barcelona to lay claim to the Carcassonne inheritance--in general follows the one I presented in 1988 [[1]], while modifying some important details. Her narrative thins out, however, in the twelfth century, especially the period after 1130, when the documents in CT no longer provide as rich a harvest. (There is no footnote reference to my own extended treatment of the subject in Ermengard. one of the many signs that, hard pressed for time, she could give the book only a cursory look.)

Chapters 2-5 are the core of her book, announced as la feodalite in her title, a study of the 322 oaths of fidelity and security, 82 infeudations, and 55 concords which form the bulk of CT. Debax uses the word feodalite narrowly to mean fief-holding, the oaths associated with it, the attendant obligations, and the customary rules surrounding these practices. Her opponent here is primarily E. Magnou-Nortier. Because Debax focuses almost exclusively on the CT, and the fief roturier. a common form of landholding in pre-Crusades Occitania is but slightly represented there, the center of her concern is not primarily with fiefs as such but with the oaths. She distinguishes two forms, oaths of fidelity and oaths of security, while admitting that the boundaries between the two are fluid; indeed, the lack of strict typology in the formulation of these oaths made them flexible instruments for eleventh - and twelfth-century Occitan lords and here makes them particularly fruitful documents for Debax's analysis. Oaths of fidelity were given for castles; they contained the critical promise to render on demand the castle for which the oath was given. Oaths of security were more general promises not to injure and, often, to offer aid when requested. The former created the social/political hierarchy among lords and the fighting men who served them. The latter were the instruments of peace-making and alliance.

Because of the peculiar features of the oaths, Debax chooses to treat them as rituals. (In Ermengard. I used the rather stronger term "liturgy.") The castles for which oaths of fidelity were given, she notes, may often in fact be only parts of castles, either physical parts or possession for part of the year--one of the several consequences of the practice of co-lordship within families. Debax therefore calls the "castles"at the center of the oaths "unites de compte." (On p. 157, n. 86, she criticizes me for, among other things, calling them "tokens," which I believe is the equivalent.) In the documented cases where castles were given "ad alodem" and then received back "ad feudum" we are looking at "un habillage juridique" for the act of entering into dependence or alliance (exactly the point I am making in the text she criticizes on p. 157). These fiefs could be bequeathed or alienated to someone outside the family; they were "un bien parmi d'autres," she writes on p. 170 (after criticizing me, p. 156 n. 83, for saying the same thing). Gradually, during the course of the twelfth century, certain practices developed to restrict or control these transfers and alienations, though it would be "abusive," she writes, to call these practices "customary law."

Other aspects of the oaths that point to their ritual character are their apparent "negative" character (the oath-taker promises not to do certain things), the identification of both the oath-taker and the oath-receiver by their given names and the names of their mothers, and the language of the oaths as they are recorded (often either entirely or partially in Occitan). On the first topic she insists that the "obsession with treason" in the texts points to an implicit code of fidelity, whose positive content is to be found in the lyrics of the troubadours (only the briefest discussion of this last on p. 127, without reference to my Ermengard. chapter 13). On the second topic she rejects previous attempts at explanation (including my own reference to ancient Mediterranean magical practices which continued through the Middle Ages at least in the Jewish community) and argues instead, with considerable imagination, that this was a way to remove the two participants from their normal familial context and turn the oath-created nexus into an alternative familial relationship. On the third topic she argues that the language reflects (though it does not record) the language in which the oath was taken because there was no existing legal practice or rite derived from Roman tradition whose Latin formula could be used. The novelty of the practice pushed in the direction of scribal innovation, especially since those who recorded the oaths may not have been clergy but literate laymen.

Within this framework Debax then unpacks in considerable detail the terms of the oaths homo, miles, fideles, senior, auxilium et consilium. etc.), the complexity of practices associated with them (homage, multiple fidelities, forfeiture), and the development of terms to distinguish honorable, aristocratic fief-holding from that of commoners.

In Chapter 5 she turns to modes of dispute settlement by agreement, mediation, and arbitration. The general pattern she presents is the one long explored by Stephen D. White, Barbara Rosenwein, Patrick Geary, and myself, but here again laid out in detail, every stage described and documented with examples from CT. Chapter 6 is devoted first to the divisions among the Trencavel brothers and cousins during the twelfth century and then to a rather thin account of the sources of their power. The thinness is attributable to Debax's decision to limit herself to what is documented in the CT. (The text there that is most informative about lordly over peasants concerns a village lordship of the monastery of St-Pons-de-Thomires, not the Trencavels themselves.[[2]]

After her long discussion of the complexities of noble fidelity, it is a bit odd to see Debax arguing in her last chapter that true power must rest on fear and command. She quotes with approval Thomas Bisson's remark that "men appointed to guard castles. behaved not as agents as lords on the make. Nowhere was it possible to delegate power." Thus she interprets the lines in which the poet of the Chanson de la Croisade describes the young Raymond Roger Trencavel--"Those of his country, over whom he was lord had no fear of him, but played with as if he were their companion"--as a demonstration of weakness rather than strength. She does not consider the same poet's description of the king of Aragon's companions as "his men, his friends, and his lovers." [[3]] In consequence she does not explore the possible alternative sources of strength that twelfth-century (rather than later "state" forms of government) might have had. These remain to be explored using the CT and other documents from the region: the multi-generational loyalty of many of the "faithful," the role of the vicarii as castellans as well as agents, the local wealth and familial ties of these agents, and the tools of patronage which lords of Trencavel status and wealth could exploit, all of which served to build those networks of men, friends, and lovers. It is to be hoped that Debax will find the time to attend to these questions, since none but she has such full command of the documentation.

Of errors I note only a few, and these simple oversights; I mention them only so that people exploring particular topics will not be inadvertently misled. The Trencavel genealogy makes Raymond Bernard Trencavel rather than his wife Ermengard the offspring of Rangard de la Marche (correct in the genealogy of the counts of Carcassonne). On p. 171 Debax states that Cecilia was the only Trencavel widow to receive oaths of fidelity and security in her own name, when on several different occasions in the book she mentions the oaths given to Ermengard of Carcassonne. (Here in passing is another problem to be explored: why is there only one woman castellan documented in the CT, when we know of so many others from other documentation?) And as interesting as it would be to find the Book of Miracles of Sainte Foy mentioning arbitration (p. 239), I think that "arbitria" in the phrase "Tum ut fiat ubi arbitria hominum habentur pro legibus" is to be translated "will," or even better "willfulness." These are minor slips in an otherwise exceptional thesis, well deserving the praise that Pierre Bonnassie, her thesis director, lavishes upon it in his preface.

[[1]] F. L Cheyette, "The 'Sale' of Carcassonne to the Counts of Barcelona (1067-1070) and the Rise of the Trencavels," Speculum 63 (1988): 826-64.

[[2]] See Ermengard. pp. 134-9.

[[3]] William of Tudela, Chanson de la croisade. 1: 70.

Copyright (c) 2004 Fredric L. Cheyette

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Amaryl works best if it is taken at the same time each day.

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

If you miss a dose of Amaryl, take it as soon as possible. If it is almost time for your next dose, skip the missed dose. 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 Amaryl.

Store Amaryl 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 Amaryl out of the reach of children and away from pets.

Active Ingredient: Glimepiride.

Do NOT use Amaryl if:

you are allergic to any ingredient in Amaryl

you have certain severe problems associated with diabetes (eg, diabetic coma, diabetic ketoacidosis)

you have moderate to severe burns, or very high blood acid levels (acidosis)

you are taking bosentan.

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

Some medical conditions may interact with Amaryl. 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 had a severe allergic reaction (eg, a severe rash, hives, breathing difficulties, dizziness) to any other sulfonamide medicine, such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glipizide, probenecid, sulfamethoxazole, valdecoxib, or zonisamide

if you have a history of stroke or liver, kidney, thyroid, heart, or blood vessel problems

if you have stomach or bowel problems (eg, stomach or bowel blockage, stomach paralysis), drink alcohol, or have had poor nutrition

if you have type 1 diabetes, anemia, very poor health, a high fever, a severe infection, severe diarrhea, high blood acid levels, or have had a severe injury

if you have low levels of an enzyme called glucose 6-phosphate dehydrogenase (G6PD)

if you have a history of certain hormonal problems (eg, adrenal or pituitary problems, syndrome of inappropriate secretion of antidiuretic hormone [SIADH]), or low blood sodium levels

if you will be having surgery.

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

Bosentan because liver problems may occur; the effectiveness of both medicines may be decreased

Beta-blockers (eg, propranolol) because the risk of low blood sugar may be increased. They may also hide certain signs of low blood sugar and make it more difficult to notice

Anticoagulants (eg, warfarin), azole antifungals (eg, miconazole, ketoconazole), chloramphenicol, clarithromycin, clofibrate, fenfluramine, insulin, metformin, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), phenylbutazone, probenecid, quinolone antibiotics (eg, ciprofloxacin), salicylates (eg, aspirin), or sulfonamides (eg, sulfamethoxazole) because the risk of low blood sugar may be increased

Corticosteroids (eg, prednisone), decongestants (eg, pseudoephedrine), diazoxide, diuretics (eg, furosemide, hydrochlorothiazide), estrogens, hormonal contraceptives (eg, birth control pills), isoniazid, niacin, phenothiazines (eg, promethazine), phenytoin, rifamycins (eg, rifampin), sympathomimetics (eg, albuterol, epinephrine, terbutaline), or thyroid supplements (eg, levothyroxine) because they may decrease Amaryl's effectiveness, resulting in high blood sugar

Gemfibrozil because blood sugar may be increased or decreased.

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

Amaryl may cause drowsiness, dizziness, blurred vision, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Amaryl 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 Amaryl; it may increase the risk of low blood sugar. Rarely, alcohol may interact with Amaryl and cause a serious reaction with symptoms such as flushing, nausea, vomiting, dizziness, or stomach pain. Discuss any questions or concerns with your doctor.

Proper diet, regular exercise, and regular blood sugar testing are important for best results with Amaryl. Follow the diet and exercise program given to you by your health care provider.

It may be harder to control your blood sugar during times of stress such as fever, infection, injury, or surgery. Talk with your doctor about how to control your blood sugar if any of these occur. Do not change the dose of your medicine without checking with your doctor.

Amaryl may cause low blood sugar levels. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.

Risk of low blood sugar may be increased by severe or prolonged exercise, drinking alcohol, or skipping meals.

Amaryl may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Amaryl. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.

Tell your doctor or dentist that you take Amaryl before you receive any medical or dental care, emergency care, or surgery.

Lab tests, including fasting blood glucose and hemoglobin A 1c . may be performed while you use Amaryl. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

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

Amaryl should be used with extreme caution in children; safety and effectiveness in children have not been confirmed.

Pregnancy and breast-feeding: Amaryl may cause harm to the fetus or newborn. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Amaryl while you are pregnant. It is not known if Amaryl is found in breast milk. Do not breastfeed while taking Amaryl.

When used for long periods of time, Amaryl may not work as well. If your blood sugar has been under control and then becomes hard to manage, contact your doctor. Do not change the dose of your medicine without checking with your doctor.

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:

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); chest pain or irregular heartbeat; confusion; dark urine; fainting; fever, chills, or persistent sore throat; low blood sugar symptoms (eg, anxiety, dizziness, drowsiness, fast heartbeat, headache, lightheadedness, tremors, unusual sweating, weakness); severe or persistent blurred vision or other vision problems; unusual bruising or bleeding; unusual tiredness or weakness; 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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Floxin Uses, Dosage, Side Effects - Warnings, Floroxin

Floxin

Floxin (ofloxacin) is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic that fights bacteria in the body.

Floxin is used to treat bacterial infections of the skin, lungs, prostate, or urinary tract (bladder and kidneys). It is also used to treat pelvic inflammatory disease and Chlamydia and/or gonorrhea .

Fluoroquinolone antibiotics can cause serious or disabling side effects. Floxin should be used only for infections that cannot be treated with a safer antibiotic.

Important information

You may not be able to use Floxin if you have a muscle disorder. Tell your doctor if you have a history of myasthenia gravis.

Ofloxacin may cause swelling or tearing of a tendon . especially if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant.

Stop taking Floxin and call your doctor at once if you have sudden pain, swelling, bruising, tenderness, stiffness, or movement problems in any of your joints. Rest the joint until you receive medical care or instructions.

Before taking this medicine

You should not use Floxin if you are allergic to ofloxacin or other fluoroquinolones (ciprofloxacin, gemifloxacin, levofloxacin, moxifloxacin, norfloxacin, and others).

To make sure Floxin is safe for you, tell your doctor if you have:

tendon problems, arthritis or other joint problems (especially in children);

a history of myasthenia gravis or other nerve-muscle disorder;

slow heartbeats or other heart rhythm disorder (especially if you take medication to treat it);

personal or family history of long QT syndrome;

liver or kidney disease;

a history of seizures;

diabetes (especially if you take oral diabetes medication);

low levels of potassium in your blood (hypokalemia); or

if you use a blood thinner (warfarin, Coumadin, Jantoven) and have "INR" or prothrombin time tests.

Floxin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body) . especially in the Achilles' tendon of the heel. This can happen during treatment or up to several months after you stop taking this medicine. Tendon problems may be more likely to occur if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant.

Floxin is not approved for use by anyone younger than 18 years old.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Ofloxacin can pass into breast milk and may harm a nursing baby. You should not breast-feed while using Floxin.

How should I take Floxin?

Floxin is usually taken every 12 hours. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take this medicine with water, and drink extra fluids to keep your kidneys working properly.

Floxin may be taken with or without food, but take it at the same time each day.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Floxin will not treat a viral infection such as the flu or a common cold.

Do not share this medicine with another person, even if they have the same symptoms you have.

This medicine can cause you to have a false positive drug screening test. If you provide a urine sample for drug screening, tell the laboratory staff that you are taking Floxin.

Store Floxin at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Floxin?

Certain other medicines that should not be taken at the same time as Floxin. Avoid taking the following medicines within 2 hours before or after you take Floxin. These other medicines can make ofloxacin much less effective when taken at the same time:

antacids that contain calcium, magnesium, or aluminum (such as Amphojel, Di-Gel Maalox, Milk of Magnesia, Mylanta, Pepcid Complete, Rolaids, Rulox, Tums, and others), or the ulcer medicine sucralfate (Carafate);

didanosine (Videx) powder or chewable tablets; or

vitamin or mineral supplements that contain aluminum, calcium, iron, magnesium, or zinc.

Floxin may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Avoid exposure to sunlight or tanning beds. Floxin can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Call your doctor if you have severe burning, redness, itching, rash, or swelling after being in the sun.

Floxin side effects

Get emergency medical help if you have signs of an allergic reaction to Floxin . hives, or the first sign of a skin rash; fast heartbeat, difficult breathing; swelling of your face, lips, tongue, or throat.

Ofloxacin may cause swelling or tearing of (rupture) a tendon. Ofloxacin can also have serious effects on your nerves, and may cause permanent nerve damage.

Stop using Floxin and call your doctor at once if you have:

severe stomach pain, diarrhea that is watery or bloody;

headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

muscle pain or weakness;

a seizure (convulsions);

sudden weakness or ill feeling, fever, chills, sore throat, mouth sores, easy bruising or bleeding, pale skin;

signs of tendon rupture - sudden pain, swelling, bruising, tenderness, stiffness, movement problems, or a snapping or popping sound in any of your joints (rest the joint until you receive medical care or instructions);

nerve symptoms - numbness, weakness, tingling, burning, pain, or being more sensitive to temperature, light touch, or the sense of your body position;

changes in mood or behavior - depression, confusion, hallucinations, paranoia, tremors, feeling restless or anxious, unusual thoughts or behavior, insomnia, nightmares;

liver problems - upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

increased pressure inside the skull - severe headaches, ringing in your ears, vision problems, pain behind your eyes; or

severe skin reaction - skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common Floxin side effects may include:

nausea, constipation, diarrhea;

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

What other drugs will affect Floxin?

Tell your doctor about all your current medicines and any you start or stop using, especially:

a diuretic or "water pill";

heart rhythm medication - amiodarone, disopyramide, dofetilide, dronedarone, procainamide, quinidine, sotalol, and others;

medicine to treat depression or mental illness - amitriptylline, clomipramine, clozapine, desipramine, duloxetine, iloperidone, imipramine, nortriptyline, and others; or

NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with ofloxacin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

More about Floxin (ofloxacin)

Consumer resources

Professional resources

Other formulations

Related treatment guides

Where can I get more information?

Your pharmacist can provide more information about Floxin.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Floxin only for the indication prescribed.

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: 10.01. Revision Date: 2016-07-05, 8:57:30 AM.

Paracetamol G Gam, Optipyrin

Paracetamol G Gam

Chemical Name

Chemical Formula

Other Brand Names

2-A

A-Mycin

A-Per

Abdine

Abrol

Abrolet

Acamol

Acamoli

Ace

Acecat

Acenol

Acephen

Acertol

Acet

Aceta

Acetafen

Acetagen

Acetalgin

Acetalis

Acetamin

Acetaminofen

Acetaminofen

Acetaminofen MK

Acetaminophen

Acetaminophen and Codeine Phosphate

Acetaminophen and Pentazocine hydrochloride

Acetamol

Acetazone Forte

Acetolit

Aceval

Actadol

Actol

Adalgur

Adco-Paracetamol

Adinol

Adol

Adol PM

Adol Sinus

Adolef

Adorem

Aeknil

Afebryl

Agurin

Aldolor

Algiafin

Algicalm

Alginox

Algisedal

Algocod

Algopirina

Algostase

Algostase mono

Algotropyl

Alikal

Alivax

Alphamol

Alvedon

Ametrex

Amifen

Amipar

Amol

Anacin

Anadin Paracetamol

Analgan

Analgiplus

Analper

Ananty

Andox

Anexsia

Anhiba

Anti-Gripe Asclepius

Antidol

Antigriphine

Antigrippine

Anyrume

APA

APAP

Apap C Plus

Apap Extra

Apap Noc

APC-Acetaminophen

Aphlogis

Apiret

Apiretal

Apiretal Codeina

Apo-Acetaminophen

Apo-Oxycodone/Acet

Aporex

Apotel

Apracur Granulado

Apyrene

Arfen

Arthrifen Plus

Asta

Atamel

Atasol

Atenemen

Atmiphen

ATP

Atralidon

Azur

Azur compositum

Baby Rinolo

Babyfever

Becetamol

Ben-u-ron

Benuron

Benylin Cold and Sinus

Beres Febrilin

Besemax

Besenol

Biogesic

Biogrip-T

Bodrex

Bodrex forte

Brexin

Buscopan compositum

Buscopan plus

Butapap

Calapol

Calonal

Calpol

Calpol 6 plus

Calpol Paediatric

Calsil

Capital and Codeine Phosphate

Captin

Catajap

Causalon

Cebion Febbre

Cefecon D

Cefekons

Cemol

Cetadol

Cetafrin

Cetal

Cetalgin

Cetamol

Chefarine

Children's Bufferin

Children's Panadol

Children's Tylenol

Citrosan

Claradol

Co-Becetamol

Co-Becetamol fur Kleinkinder

Co-Dafalgan

Co-Efferalgan

Cocarl

Cod Efferalgan

Codalgin

Codipar

Codipar Plus

Coditam

Coldrex Sinus

Contac

Contac Cold & Sore Throat, Non Drowsy

Contra-Schmerz P

Contraneural

Contratemp

Copyrkal

Cotibin Compuesto

Couldrex

Coxumadol

Crocin

Croix Blanche

Cupanol

Curadies Paracetamol

Curpol

Curpol Junior

Cytramon-P

Dafalgan

Dafalgan Bebe

Dafalgan C

Dafalgan Codeine

Dafalgan Enfant

Dafalgan Odis

Dafalgan Pediatrie

Dafalgan plus C

Daga

Daimeton

Daleron

Daleron C

Daleron C junior

Dalminette

Daro Hoofdpijnpoeder

Daro Paracetamol

Darvocet

Day & Night

Daygrip

Decolgen ACE

Demogripal C

Dentonibsa

Dentopain [+ Ibuprofen>

Depalgos

Depyrin

Dexamol

Dexamol Kid

Dhamol

Dialgine

Dimetapp Daytime Cold Extra Strength

Dirox

Disprol

Distalgesic

Doc Para

Docpara

Docparacod

Docpelin Paracetamol

Dolal

Dolel

Dolevar

Dolex

Dolgesic

Dolgesic Codeina

Doliprane

Dolitabs

Dolko

Dolocare

DoloCitran C

Dolofebril

Dolol Instant

Dolomedil

Dolomol

Dolomolargesico

Dolostop

Dolotec

Dolprone

Doluvital

Dolviran

Dopagan

Dopalgan

Dopalogan

Dopamol

Dorbigot

Doregrippin

Dorocol

Doxyfene

Dozol

Dristan N. D.

Dumin

Duokapton

Duorol

Dymadon

Efagesic

Eferalgan

Efetamol

Effect

Efferalgan

Efferalgan Vitamina C

Efferalganodis

Ekosetol

Emidol

Empacod

Empaped

Emtacetamol

Enddol

Endocet

Enelfa

Enelfa Dr. Henk

Erphamol

Espaven

Ethics Paracetamol

Expandox

FAP

Farmadol

Fast

Fea

Febrax

Febrectal

Febrectal Infantil

Febrex

Febricet

Febridol

Febrilix

Felibrix

Femerital

Fevac

Fevadol

Feverall

Fevrin

Fibrex

Fibrexin

Fibrimol

Filanc

Finimal

Finimal C

Fitamol

Flaviston E

Flectadol

Flogodisten

Fludeten

Fludrex

Fluental

Flutabs

Fortamol

Frenagial

Gabbrocet

Gamatherm

Gelocatil

Gelocatil Codeina

Gelonida

Geluprane

Genapap

Genebs

Geniol-P

Genspir

Geralgine-P

Getol

Gitas Plus

Go-Gesic

Gold Cross Paracetamol

Gripakin

Gripostad

Grippex

Grippostad

Grippostad Heissgetrank

Hapacol

Head-O

Hedex

Hepa

Hexplider-C

Hot Coldrex

Hydrocodone bitartrate and Acetaminophen

Ibumol

Ibupain

Infadrops

Infants' Feverall

Infants' Tylenol

Infapain

Influbene C

Influbene N

Intaflam

Iremax

Isalgen Compuesto

Itamol

Itedal

Ixprim

Jagcin

Junior Parapaed

Kafa

Kafa Flashtabs

Kafa plus Koffein

Kapake

Kelvin

Kenox

Kinderparacetamol

Kinderparacetamol CF

Kitadol

Kodipar

Kolibri

Korylan

Lanamol

Lekadol

Lemgrip

Lemsip

Lensen

Liquiprin

Lisopan

Lonarid

Lortab

Lotem

Lupocet

Lusadeina

Mafidol

Mafidol Compuesto

Maganol

Magnidol

Malex

Malidens

Mann

Medamol

Medibudget Schmerztabletten Paracetamol

Medinol

Medinol Paediatric

Medipyrin

Mejorax

Mejorax Infantil

Methoxacet

Mexalen

Midol Night-Time

Midrid

Midrone

Migraeflux MCP

Migralave + MCP

Migrane-Neuridal

Migranerton

Minafen

Minofen

Minoset

Miralgin

Momentum

Muscadol

Myogesic

Mypaid

N-Paracetamol

Nactop

Napa

Napacod

Napafen

Napamol

Naprex

Nasa

Nasamol

Nedolon

Neo Rheumacyl

Neomol

Neopap

Neopyrin

Neverdol

Niocitran

Nodipir

Nodrof

Norco

Norflex CO

Norgesic

Normotemp

Novalsung

Novo Asat

Novo-Gesic

Nufadol

Nuosic

Octadon

Omol

Optalidon Schmerztabletten

Optipyrin

Oskadon

Ottopan

Oxycet

Oxycodone and Acetaminophen

Pacimol

Painamol

Painamol Plus

Paldesic

Pamol

Pamol Flash

Panacare

Panacetamol

Panadeine

Panado

Panadol

Panadol 7+ years

Panadol Actifast

Panadol Adultos

Panadol Antigrippine

Panadol Artrose

Panadol Baby

Panadol Baby & Infant

Panadol C

Panadol Codeine

Panadol Extend

Panadol Extra

Panadol Femina

Panadol Infantil

Panadol Junior

Panadol Night

Panadol Plus

Panadol Rapide

Panadol Zapp

Panaflam

Panagesic Adultos

Panagesic Infantil

Panam Retard

Panamax

Panaram

Panasorbe

Panasorbe (Sanofi-Aventis - Produtos farmaceuticos, S.)

Panets

Panets Baby

Panodil

Panodil Zapp

Para

Para-C

Para-don

Para-G

Para-Suppo

Para-Tabs

Para-z-mol

Paracap

Paracare

Paracen

Paraceon

Paracet

Paracetam

Paracetamol / Ascorbinezuur

Paracetamol / Codeine A

Paracetamol / Codeine PCH

Paracetamol A

Paracetamol Agrand

Paracetamol AL

Paracetamol AL comp.

Paracetamol BC

Paracetamol beta

Paracetamol Brifarma

Paracetamol CF

Paracetamol Cinfamed

Paracetamol Cuve

Paracetamol DM

Paracetamol dura

Paracetamol EG

Paracetamol elac

Paracetamol Elixir

Paracetamol Extra Fort

Paracetamol Fairmed

Paracetamol FLX

Paracetamol for Chlidren

Paracetamol G. E.S.

Paracetamol Grunenthal

Paracetamol Hanseler

Paracetamol HTP

Paracetamol Infantil

Paracetamol L. CH.

Paracetamol Lch

Paracetamol Lichtenstein

Paracetamol LPH

Paracetamol Merck

Paracetamol Merck

Paracetamol MK

Paracetamol PCH

Paracetamol PT Copii

Paracetamol Q-Generics

Paracetamol Ranbaxy

Paracetamol Rosch

Paracetamol Roter

Paracetamol SAD

Paracetamol SmithKline Beecham

Paracetamol Tablets

Paracetamol Therapeuticon

Paracetamol Triangle Pharma

Paracetamol Winthrop

Paracetamol Winthrop

Paracetamol Zikidis

Paracetamolis L

Paracetamolo

Paracetol

Paracin Kid Tabs.

Paracof Roter

Paracor

Paracotene

Paradex

Paradol

Paradote

Paradrops

Parafil

Parafludeten

Parafon Forte

Parageniol

Parahexal

Parakapton

Paralen

Paralgan

Paralgin

Paralief

Paralink

Paralyoc

Paramax

Paramed A. L.S.

Paramidol

Paramol

Paramolan

Paranox

Paranox-S

Parapaed

Parapyrol

Parasedol

Parasupp

Paratab

Paratabs

Paratral

Parclen

Parol

Paroma

Parox Meltab

Parsel

Paximol

Pazital

Pe-Tam

Pediatrix

Pendol

Percocet

Perdolan

Perdolan Bebe

Perdolan Codeine

Perdolan Enfant

Perfalgan

Perfalgan Kinder

Perfalgan Paediatric

Perfusalgan

Pharex Paracetamol

Pharmacare Paracetamol

Pharmadol

Phrenilin

Pinex

Pinex Comp.

Pirofen

Piros

Plicet

Plivamed

Plovacal

Pmol

PMS-Oxycodone-Acetaminophen

Polmofen

Pontalsic

Poro

Pracetam

Praxion

Prefer

Primadol

Primiza

Profenal

Progesic

Prolief

Prontopyrin

Propoxi 66

Propoxyphene Hydrochloride and Acetaminophen

Propoxyphene napsylate and Acetaminophen

Propyretic

Pyradol

Pyral

Pyralen

Pyralgin

Pyrex

Pyrexin

Pyrexon

Pyrigesic

Ramol

Rapidol

Rapidon

ratio-Emtec-30

ratio-Oxycocet

Razimol

Relaxibys

Relaxon

Reliv

Remedeine

Remedol

Reset

Resolvebohm

Revanin

Rhinofebryl

Robaxacet

Robaxisal Compuesto [+ Methocarbamol

Rokamol

Roxicet

Roxilox

Rubophen

Salzone

Sanador

Sanaflu

Sanalgin

Sanalgin N

Sanicopyrine

Sanipirina

Sanmol

Sapramol

Saridon

Scopamin Plus

Scopma Plus

Sedalito

Sedo-Febril Pediatrico

Sensamol

Servigesic

Setamol

Sifenol

Silpa

Sinalgia

Sinapol

Sinaspril Paracetamol

Singrips

Sinmol

Sinofree

Sinuclear

Sinugesic

Sinumax

Sinutab

Sinutab Sinus Non Drowsy

Sistenol

Six Plus Parapaed

Snaplets-FR

Solpadol

Spashi Plus

Spasmend

Spectrapain

Spironolactone Altizide EG

Stop Grip

Sudafed Head Cold and Sinus Extra Strength

Sudafed PE Sinus + Pain Relief

Sudafed Sinus Pain

Sudafed Sinus Pain Relief

Supofen

Supracalm

Tachiforte

Tachipirin

Tachipirina

Tafirol

Talacen

Talgo

Talgo Codeina

Talvosilen

Tamen

Tamol

Tandamol

Tapsin

Tapsin Infantil

Tazamol

Teedex

Tempil

Tempol

Tempra

Teralgex

Termacet

Termalgin

Termalgin Codeina

Termalgin Flashtab

Termalgine

Termocatil

Termofren

Tetradox

Theraflu Zatoki

Thomapyrin

Tiffy

Tilalgin Efe

Tilderol

Timidal

Tinten

Tiptipot Aldolor

Titretta

Tramacet

Tramadol hydrochloride and Acetaminophen

Tramil

Treupel

Treupel Dolo Paracetamol

Triatec-30

Trimedil

Turpan

Tydenol

Tydol

Tylenol

Tylenol Children's Decongestant

Tylenol Cough

Tylenol Kinder

Tylenol Sinus

Tylenol Ultra Relief

Tylenol with Codeine

Tylephen

Tylex

Tylol

Tylol Plus

Tylox

Ultracet

Ultracod

Ultrafen

Ultragin

Umbral

Vegantalgin

Vermidon

Vestax

Vick

Vick Vitapyrena

Vicks Paracetamol

Viclor

Vicodin

Vimergol

Vimoli

Vivimed

Volpan

Winadol

Winasorb

Witte Kruis

Woodward's Paracetamol

Xcel

Xepamol

Xpa

Xumadol

Zaldaks

Zaldiar

Zalidar Efe

Zapain

Zaramol

Zerin

Zolben

Zolben C

Zydone

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Paferxin - ?Tu Colega Siempre En Linea, Paferxin

PAFERXIN

PAFERXIN SUSPENSION Antibiotico bactericida de amplio espectro LIFERPAL MD, S. A. de C. V.

- DENOMINACION GENERICA - FORMA FARMACEUTICA Y FORMULACION - INDICACIONES TERAPEUTICAS - FARMACOCINETICA Y FARMACODINAMIA EN HUMANOS - CONTRAINDICACIONES - PRECAUCIONES GENERALES - PRECAUCIONES O RESTRICCIONES DE USO DURANTE EL EMBARAZO O LA LACTANCIA - REACCIONES SECUNDARIAS Y ADVERSAS - INTERACCIONES MEDICAMENTOSAS Y DE OTRO GENERO - ALTERACIONES DE PRUEBAS DE LABORATORIO - PRECAUCIONES Y RELACION CON EFECTOS DE CARCINOGENESIS, MUTAGENESIS, TERATOGENESIS Y SOBRE LA FERTILIDAD - DOSIS Y VIA DE ADMINISTRACION - SOBREDOSIFICACION O INGESTA ACCIDENTAL: MANIFESTACIONES Y MANEJO (ANTIDOTOS) - PRESENTACIONES - RECOMENDACIONES PARA ALMACENAMIENTO - LEYENDAS DE PROTECCION - NOMBRE DEL LABORATORIO Y DIRECCION - NUMERO DE REGISTRO DEL MEDICAMENTO

FORMA FARMACEUTICA Y FORMULACION:

Cada capsula contiene:

Monohidrato de cefalexina equivalente a. 250 y 500 mg de cefalexina

Excipiente c. b.p. 1 capsula

Cada frasco con polvo para suspension contiene:

Monohidrato de cefalexina equivalente a. 2.5 g y 5.0 g de cefalexina

q Infecciones producidas por bacterias grampositivas y gramnegativas.

q La cefalexina es un antibiotico semisintetico que pertenece al grupo de las cefalosporinas de primera generacion. Su uso esta indicado en el tratamiento de infecciones de la piel, las vias respiratorias, el oido medio, el sistema genitourinario y determinadas infecciones de los huesos y las articulaciones.

q Los cultivos y el estudio de sensibilidad microbiana permitiran determinar con seguridad la indicacion especifica de la cefalexina en cada caso.

FARMACOCINETICA Y FARMACODINAMIA EN HUMANOS: La cefalexina por via oral se absorbe casi por completo. Los alimentos retardan su absorcion y dan lugar a concentraciones maximas mas bajas pero mas prolongadas. La cantidad total del medicamento que se absorbe es un poco menor cuando se administra con los alimentos. Tras la administracion oral de 250, 500 y 1, 000 mg, se alcanzan concentraciones sericas maximas de 9, 18 y 32 µg/ml en una hora, aproximadamente. Despues de la administracion intravenosa de 1 g de cefalexina, se alcanzan concentraciones sericas de 60 µg/ml en un termino de 15 minutos. La cefalexina se une a las proteinas sericas en proporcion de 15%. Se distribuye ampliamente en los tejidos del organismo y atraviesa la barrera placentaria. Se excreta con la orina en su forma activa y sin modificaciones y 80% o mas de una dosis oral se recupera de la misma. El medicamento se acumula en pacientes con funcion renal alterada.

En individuos normales, la vida media de la cefalexina en el suero es de 0.9 horas, pero en caso de alteraciones graves de la funcion renal aumenta aquella a 20 a 30 horas. Parte de la cefalexina se excreta en la bilis.

Este medicamento es un antibiotico de amplio espectro el cual actua inhibiendo la sintesis de las proteinas de la pared celular. Entre los microorganismos sensibles a este antimicrobiano se encuentran: Streptococcus, Staphylococcus aureus. S. pneumoniae, H. influenzae, M. catarrhalis, P. mirabilis, E. coli y Klebsiella.

CONTRAINDICACIONES: La cefalexina no debe utilizarse en pacientes con alergia o hipersensibilidad conocida a medicamentos cefalosporinicos.

PRECAUCIONES GENERALES: Existe la posibilidad de reacciones cruzadas en los pacientes alergicos a las penicilinas. El uso prolongado puede originar sobreinfeccion por organismos no susceptibles; candida, enterococos, Clostridium difficile, etc. lo que requiere la interrupcion del tratamiento. La colitis pseudomembranosa se asocia al empleo de antibioticos de amplio espectro por lo que la diarrea severa en estos pacientes debe considerarse como una posibilidad diagnostica.

PRECAUCIONES O RESTRICCIONES DE USO DURANTE EL EMBARAZO O LA LACTANCIA: En estudios realizados en ratas no se encontraron defectos congenitos ni alteraciones en la organogenesis. No se dispone de estudios adecuados en mujeres embarazadas, por lo que hay que utilizarla con precaucion durante esta etapa y solo cuando sea estrictamente necesario. La cefalexina se excreta en la leche materna y es conveniente evitar su uso durante la lactacion o suspender esta.

REACCIONES SECUNDARIAS Y ADVERSAS: Se han comunicado reacciones alergicas raras (exantemas, urticaria, prurito), cefalea, somnolencia, desvanecimiento; irritacion de la lengua o la boca, indigestion, colicos intestinales, nauseas, vomito y diarrea. Entre las reacciones adversas tambien se ha notificado fiebre medicamentosa, artralgias y reaccion anafilactica. Se han comunicado superinfecciones por hongos y diarrea grave como resultado de colitis medicamentosa. En casos raros se ha presentado nefritis intersticial reversible.

INTERACCIONES MEDICAMENTOSAS Y DE OTRO GENERO: La colestiramina reduce considerablemente la absorcion de la cefalexina y por consiguiente su efecto; el probenecid prolonga e intensifica las concentraciones sericas de la cefalexina. No se debe administrar cefalexina junto con eritromicina o tetraciclinas.

ALTERACIONES DE PRUEBAS DE LABORATORIO: La cefalexina produce reacciones falsas-positivas para la glucosuria determinada con algunas tabletas reactivas. En casos raros se ha presentado eosinofilia, neutropenia y elevacion de las transaminasas. La reaccion de Coombs directa puede ser positiva en pacientes que reciben el medicamento.

PRECAUCIONES Y RELACION CON EFECTOS DE CARCINOGENESIS, MUTAGENESIS, TERATOGENESIS Y SOBRE LA FERTILIDAD: No se han comunicado efectos carcinogenos, mutagenos o teratoge­nos. Tampoco se han comunicado hasta el momento efectos sobre la funcion sexual o la fertilidad.

DOSIS Y VIA DE ADMINISTRACION: Oral.

q Adultos: 500 mg cada seis horas.

q Dosis total maxima: 4 g/dia.

q Ninos: 25 a 100 mg/kg al dia fraccionado en 4 tomas.

q Dosis total maxima: 25 mg/kg por toma.

SOBREDOSIFICACION O INGESTA ACCIDENTAL: MANIFESTACIONES Y MANEJO (ANTIDOTOS): La sobredosis aguda se manifiesta por nausea, vomito, malestar epigastrico, diarrea y hematuria. El tratamiento consiste en induccion del vomito y lavado gastrico en caso de una sobredosis masiva, y las medidas de apoyo y sintomaticas pertinentes.

Caja con 12 y 20 capsulas de 500 mg.

Caja con 12 y 20 capsulas de 250 mg.

Frasco con polvo para reconstituir a 100 ml, 125 y 250 mg cada 5 ml.

RECOMENDACIONES PARA ALMACENAMIENTO: Conservese a temperatura ambiente a no mas de 30°C y en lugar seco.

LEYENDAS DE PROTECCION: Este medicamento es de empleo delicado, su empleo durante el embarazo queda bajo la responsabilidad del medico que lo prescribe. Literatura exclusiva para medicos. No se deje al alcance de los ninos. Su venta requiere receta medica. No se administre este medicamento sin leer instructivo impreso.

NOMBRE DEL LABORATORIO Y DIRECCION: LIFERPAL MD, S. A. de C. V. Refineria No. 1266 Colonia Alamo Industrial 44490 Guadalajara, Jal.

NUMERO DE REGISTRO DEL MEDICAMENTO: Regs. Nums. 451M98 y 485M98, S. S.A. IV HEAR-304227/R98 y IEAR-405668/R98/IPPA

Publicado en: Farmacos

Contenido etiquetado en:

Infectologia Ortopedia y traumatologia infeccion de vias urinarias bacterias grampositivas cefalexina antibiotico semisintetico Cefalosporinas infecciones de la piel

Mas Farmacos:

Ciproxan Indication, Action Of Ciproxan, Interactions, Ciproxan

Ciproxan [in more detail]

Ciproxan Indication:

For the treatment of the following infections caused by susceptible organisms: urinary tract infections, acute uncomplicated cystitis, chronic bacterial prostatitis, lower respiratory tract infections, acute sinusitis, skin and skin structure infections, bone and joint infections, complicated intra-abdominal infections (used in combination with metronidazole), infectious diarrhea, typhoid fever (enteric fever), uncomplicated cervical and urethral gonorrhea, and inhalational anthrax (post-exposure).

Ciproxan Mechanism Of Action:

The bactericidal action of ciprofloxacin results from inhibition of the enzymes topoisomerase II (DNA gyrase) and topoisomerase IV, which are required for bacterial DNA replication, transcription, repair, and recombination.

Ciproxan Drug Interactions:

Aluminium Formation of non-absorbable complexes Methotrexate Increases methotrexate toxicity Aminophylline The quinolone increases the effect of theophylline Anisindione The quinolone increases the anticoagulant effect Bismuth Formation of non-absorbable complexes Caffeine The quinolone increases the effect and toxicity of caffeine Calcium Formation of non-absorbable complexes Clozapine Ciproxan may increase clozapine serum levels Cyclosporine The quinolone increases the effect and toxicity of cyclosporine Dicumarol The quinolone increases the anticoagulant effect Dihydroxyaluminium Formation of non-absorbable complexes Dyphylline The quinolone increases the effect of theophylline Duloxetine Increases the effect/toxicity of duloxetine Dyphylline The quinolone increases the effect of theophylline Ethotoin Decreases the hydantoin effect Foscarnet Increased risk of convulsions Fosphenytoin Decreases the hydantoin effect Magnesium oxide Formation of non-absorbable complexes Magnesium Formation of non-absorbable complexes Mephenytoin Decreases the hydantoin effect Acenocoumarol The quinolone increases the anticoagulant effect Oxtriphylline The quinolone increases the effect of theophylline Phenytoin Decreases the hydantoin effect Procainamide The quinolone increases the effect of procainamide Rasagiline Increases effect/toxicity of rasagiline Ropinirole The quinolone increases the effect and toxicity of ropinirole Sevelamer Sevelamer decreases ciprofloxacin bioavailability Sildenafil The quinolone increases sildenafil levels Sucralfate Formation of non-absorbable complexes Theophylline The quinolone increases the effect of theophylline Tizanidine Increases the effect/toxicity of tizanidine Warfarin The quinolone increases the anticoagulant effect Iron Formation of non-absorbable complexes Zinc Formation of non-absorbable complexes

Food Interactions:

Take without regard to meals. Avoid milk, calcium containing dairy products, iron, magnesium, zinc, antacids, or aluminum salts 2 hours before or 6 hours after using antacids while on this medication. Take with a full glass of water. Avoid excessive quantities of coffee or tea (Caffeine).

Ciproxan Chemical Formula:

Lactulose - Side Effects, Dosage, Interactions, Constulose

Lactulose

The drug lactulose has several brand names, including Generlac and Enulose, and is used to treat constipation .

Lactulose is a type of sugar that is broken down in the large intestine into mild acids that draw water into the colon.

Doctors also prescribe the medicine to reduce the amount of ammonia in the blood of people with liver disease.

Lactulose Warnings

Before taking lactulose, you should alert your physician if you have diabetes, require a low-lactose diet, or are allergic to lactulose or any other medication.

You should stop using lactulose and call your doctor right away if you experience severe or ongoing diarrhea.

You may not have a bowel movement for up to 48 hours after taking this medicine.

If you take lactulose for a long period of time, your doctor may want to perform certain lab tests to check your body's response. Don't miss any scheduled appointments.

Tell your healthcare provider you are taking this drug before having surgery or any test on your colon or rectum, such as a colonoscopy.

Pregnancy and Lactulose

Lactulose is a Pregnancy Category B drug, which means it's not expected to harm an unborn baby. You should tell your physician if you are pregnant or plan to become pregnant while taking this medicine.

It's not known whether lactulose passes into breast milk or if it could harm a breastfeeding baby. You shouldn't use this drug while breastfeeding without first talking to your doctor.

Lactulose for Cats and Dogs

Lactulose isn't FDA-approved for use in animals, but veterinarians commonly prescribe the medication as a laxative for cats and dogs.

Lactulose comes in packets as a liquid or crystals to take by mouth. It may also be given rectally as an enema for treating symptoms associated with liver disease.

The medicine is typically taken once a day for constipation and three to four times a day by people with liver disease, usually 30 mL at a time (about 2 tablespoons).

You can mix your liquid dose with a half glass of water, fruit juice, or milk to improve the taste.

Measure the liquid medicine with a special dose-measuring cup, not a regular table spoon. You can ask your pharmacist for this device if you don't have one.

The liquid may become slightly darker in color. This is a harmless effect, but you shouldn't use the medicine if it becomes very dark, or thinner or thicker than usual.

If you're using the crystals in packets, dissolve the contents in a half glass of water or as your doctor instructs you.

You should follow the instructions on the product label carefully and ask your doctor to explain any directions you don't understand. Never take more or less of the drug than is recommended.

Lactulose Overdose

Symptoms of an overdose include the following:

Thirst

Increased urination

Irregular heart beat

Muscle weakness

If you suspect an overdose, you should contact a poison control center or emergency room immediately. You can get in touch with a poison control center at (800) 222-1222.

Missed Dose of Lactulose

If you miss a dose of lactulose, take it as soon as you remember.

However, if it's almost time for your next dose, skip the missed dose and continue on your regular medication schedule. Don't take an extra dose to make up for a missed one.

Phaeva- Tablets Beige- Film-Coated - Medicine List- Drug Usage And Diseases, Phacotrex

Phaeva - Tablets Beige - Film-Coated medicine is manufactured by Bayer Schering Pharma and mainly contains Ethinyl Estradiol

Usage

G03AA10 - Gestodene and estrogen

Available Medicines

Tablets Beige, Film-Coated; Oral; Ethinyl Estradiol 0.03 mg; Gestodene 0.05 mg / Tablet Brown, Film-Coated; Oral; Ethinyl Estradiol 0.04 mg; Gestodene 0.07 mg / Tablet White, Film-Coated; Oral; Ethinyl Estradiol 0.03 mg; Gestodene 0.1 mg

Active Ingredients

Used for the diseases

Human Medicine Oral contraceptives

Symptoms and indications

G03AA10 - Gestodene and estrogen G03CA01 - Ethinylestradiol

Manufacturers

Ultram Uses, Dosage - Side Effects, Ultran

Ultram

Ultram (tramadol) is a narcotic-like pain reliever.

Ultram is used to treat moderate to severe pain.

Ultram ER (extended-release) is for around-the-clock treatment of pain that is not controlled by other medicines.

Ultram may also be used for purposes not listed in this medication guide.

Important information

You should not take Ultram if you have used alcohol, sedatives, tranquilizers, or narcotic medications within the past few hours.

Ultram can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never take Ultram in larger amounts, or for longer than prescribed. Do not crush or break an extended-release pill. Swallow it whole to avoid exposure to a potentially fatal dose.

Seizures (convulsions) have occurred in some people taking this medicine. Ultram may be more likely to cause a seizure if you have a history of seizures or head injury, a metabolic disorder, or if you are taking certain medicines such as antidepressants, muscle relaxers, narcotic, or medicine for nausea and vomiting

Tramadol may be habit-forming, even at regular doses. Take this medicine exactly as prescribed by your doctor. Never share the medicine with another person. MISUSE OF NARCOTIC PAIN MEDICATION CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Tell your doctor if you are pregnant. Ultram may cause life-threatening withdrawal symptoms in a newborn.

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with Ultram.

Do not crush an Ultram tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.

Before taking this medicine

You should not take Ultram if you are allergic to tramadol, or if you have:

severe asthma or breathing problems;

a blockage in your stomach or intestines;

if you have recently used alcohol, sedatives, tranquilizers, or narcotic medications.

Seizures have occurred in some people taking tramadol. Talk with your doctor about your seizure risk, which may be higher if you have:

a history of head injury, epilepsy or other seizure disorder;

a history of drug or alcohol addiction;

a metabolic disorder; or

if you are also using certain medicines to treat migraine headaches, muscle spasms, depression, mental illness, or nausea and vomiting.

Some medicines can interact with tramadol and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

To make sure Ultram is safe for you, tell your doctor if you have:

liver or kidney disease;

a stomach disorder; or

a history of drug abuse, alcohol addiction, mental illness, or suicide attempt.

Ultram is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.

Tramadol may be habit forming and should be used only by the person it was prescribed for. Never share Ultram with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Selling or giving away Ultram to any other person is against the law.

It is not known whether Ultram will harm an unborn baby. If you use tramadol while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Tramadol can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are taking Ultram.

Do not give this medication to anyone younger than 16 years old without the advice of a doctor. Ultram ER should not be given to anyone younger than 18 years old.

How should I take Ultram?

Take Ultram exactly as prescribed. Follow all directions on your prescription label. Ultram can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never take Ultram in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Stop taking all other around-the-clock narcotic pain medications when you start taking Ultram.

Ultram can be taken with or without food, but take it the same way each time.

Do not crush or break an extended release Ultram ER tablet. Swallow the tablet whole to avoid exposure to a potentially fatal dose.

Never crush or break a Ultram tablet to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death with the misuse of tramadol and similar prescription drugs.

If you use the Ultram ER extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.

Do not stop using Ultram suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using Ultram.

Store at room temperature away from moisture and heat.

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

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A tramadol overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, cold and clammy skin, and fainting.

What should I avoid?

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with tramadol. Check your food and medicine labels to be sure these products do not contain alcohol.

Ultram may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Ultram side effects

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

Tramadol is not for use in children. Seek emergency medical attention if a child has taken this medicine and has: noisy breathing, sighing, slow breathing with long pauses between breaths; being unusually sleepy or hard to wake up; blue colored lips.

Call your doctor at once if you have:

weak or shallow breathing;

infertility, missed menstrual periods;

impotence, sexual problems, loss of interest in sex; or

low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness; or

severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common Ultram side effects may include:

headache, dizziness, drowsiness, tired feeling;

constipation, diarrhea, nausea, vomiting, stomach pain; or

feeling nervous or anxious.

itching, sweating, 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.

What other drugs will affect Ultram?

Some medicines can cause unwanted or dangerous effects when used with tramadol. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking Ultram with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with tramadol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

More about Ultram (tramadol)

Consumer resources

Professional resources

Other formulations

Related treatment guides

Where can I get more information?

Your pharmacist can provide more information about Ultram.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Ultram only for the indication prescribed.

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: 14.08. Revision Date: 2016-03-28, 12:53:50 PM.

Drug Status

Wholesale And Manufacturing Sales Representatives Occupational Outlook Handbook U, Repres Plus

Wholesale and Manufacturing Sales Representatives

Wholesale and manufacturing sales representatives sell goods for wholesalers or manufacturers to businesses, government agencies, and other organizations. They contact customers, explain product features, answer any questions that their customers may have, and negotiate prices.

Wholesale and manufacturing sales representatives work under pressure because their income and job security depend on the amount of merchandise they sell. Some sales representatives travel frequently.

Educational requirements vary for sales representatives and depend on the type of product sold. If the products are not scientific or technical, a high school diploma is generally enough for entry into the occupation. If the products are scientific or technical, sales representatives typically need at least a bachelor's degree.

The median annual wage for wholesale and manufacturing sales representatives was $59,080 in May 2015.

Employment of wholesale and manufacturing sales representatives is projected to grow 7 percent from 2014 to 2024, about as fast as the average for all occupations. Employment growth for sales representatives is expected to follow the economy as a whole. Employment opportunities should be best in independent agencies, which operate on a fee basis and represent several manufacturers, instead of buying and holding the product they are selling.

Explore resources for employment and wages by state and area for wholesale and manufacturing sales representatives.

Compare the job duties, education, job growth, and pay of wholesale and manufacturing sales representatives with similar occupations.

Learn more about wholesale and manufacturing sales representatives by visiting additional resources, including O*NET, a source on key characteristics of workers and occupations.

What Wholesale and Manufacturing Sales Representatives Do About this section

Some wholesale and manufacturing sales representatives specialize in technical and scientific products, ranging from agricultural and mechanical equipment to computer and pharmaceutical goods.

Wholesale and manufacturing sales representatives sell goods for wholesalers or manufacturers to businesses, government agencies, and other organizations. They contact customers, explain product features, answer any questions that their customers may have, and negotiate prices.

Duties

Wholesale and manufacturing sales representatives typically do the following:

Identify prospective customers by using business directories, following leads from existing clients, and attending trade shows and conferences

Contact new and existing customers to discuss their needs and explain how specific products and services can meet these needs

Help customers select products to meet customers' needs, product specifications, and regulations

Emphasize product features that will meet customers' needs and exhibit product capabilities and limitations

Answer customers' questions about prices, availability, and product uses

Negotiate prices and terms of sale and service agreements

Prepare sales contracts and submit orders for processing

Collaborate with colleagues to exchange information, such as selling strategies and marketing information

Follow up with customers to make sure they are satisfied with their purchases and to answer any questions or concerns

Wholesale and manufacturing sales representatives—sometimes called manufacturers’ representatives or manufacturers’ agents — generally work for manufacturers or wholesalers. Some work for a single organization, while others represent several companies and sell a range of products.

Rather than selling goods directly to consumers, wholesale and manufacturing sales representatives deal with businesses, government agencies, and other organizations. For more information about people who sell directly to consumers, see the profile on retail sales workers .

Some wholesale and manufacturing sales representatives deal with nonscientific products such as food, office supplies, and clothing. Other representatives specialize in technical and scientific products, ranging from agricultural and mechanical equipment to computer and pharmaceutical goods. For more information about people who specialize in sales of technical products and services, see the profile on sales engineers .

Wholesale and manufacturing sales representatives who lack expertise about a given product frequently team with a technical expert. In this arrangement, the technical expert—sometimes a sales engineer—attends the sales presentation to explain the product and answer questions or concerns. The sales representative makes the initial contact with customers, introduces the company's product, and obtains final agreement from the potential buyer.

By working with a technical expert, the representative is able to spend more time maintaining and soliciting accounts and less time needing to gain technical knowledge.

After the sale, representatives may make follow-up visits to ensure that equipment is functioning properly and may even help train customers' employees to operate and maintain new equipment.

Those selling consumer goods often suggest how and where merchandise should be displayed. When working with retailers, they may help arrange promotional programs, store displays, and advertising.

In addition to selling products, wholesale and manufacturing sales representatives analyze sales statistics, prepare reports, and handle administrative duties such as filing expense accounts, scheduling appointments, and making travel plans.

Staying up-to-date on new products and the changing needs of customers is important. Sales representatives accomplish this in a variety of ways, including attending trade shows at which new products and technologies are showcased. They attend conferences and conventions to meet other sales representatives and clients and to discuss new product developments. They also read about new and existing products and monitor the sales, prices, and products of their competitors.

The following are examples of types of wholesale and manufacturing sales representatives:

Inside sales representatives work mostly in offices while making sales. Frequently, they are responsible for getting new clients by “cold calling” various organizations, which means they call potential customers who are not expecting to be contacted in order to establish an initial contact. They also take incoming calls from customers who are interested in their product, and process paperwork to complete the sale.

Outside sales representatives spend much of their time traveling to and visiting with current clients and prospective buyers. During a sales call, they discuss the client's needs and suggest how they can meet those needs with merchandise or services. They may show samples or catalogs that describe items their company provides, and they may inform customers about prices, availability, and ways in which their products can save money and boost productivity. Because many sales representatives sell several complementary products made by different manufacturers, they may take a broad approach to their customers' businesses. For example, sales representatives may help install new equipment and train employees in its use.

Work Environment About this section

Sales representatives of scientific or technical products, such as pharmaceuticals or medical instruments, typically need a degree in a field related to the product sold.

Wholesale and manufacturing sales representatives held about 1.8 million jobs in 2014. The industries that employed the most wholesale and manufacturing sales representatives were as follows:

Wholesale electronic markets and agents and brokers

Grocery and related product wholesalers

Some wholesale and manufacturing sales representatives have large territories and travel considerably. Because a sales region may cover several states, representatives may be away from home for several days or weeks at a time. Sales representatives who cover a smaller region may not spend much time away from home.

Inside wholesale and manufacturing sales representatives spend a lot of their time on the phone, selling goods, taking orders, and resolving problems or complaints about the merchandise. They also use Web technology, including chat, email, and video conferencing, to contact clients.

Workers in this occupation can be under considerable stress because their income and job security often depend directly on the amount of merchandise they sell, and their companies usually set goals or quotas that they are expected to meet.

Work Schedules

Most wholesale and manufacturing sales representatives work full time. Since sales calls take place during regular working hours, many do much of the planning and paperwork involved with sales in the evening and on weekends. Although the hours are often irregular, many sales representatives may determine their own schedules.

How to Become a Wholesale or Manufacturing Sales Representative About this section

After a sale is completed, wholesale and manufacturing sales representatives follow up to make sure the product is satisfactory and answer any remaining questions.

Educational requirements vary, depending on the type of product sold. If the products are not scientific or technical, a high school diploma is generally enough for entry into the occupation. If the products are scientific or technical, sales representatives typically need at least a bachelor's degree.

Education

A high school diploma is sufficient for many positions, primarily for selling nontechnical or scientific products. However, those selling scientific and technical products typically must have a bachelor's degree. Scientific and technical products include pharmaceuticals, medical instruments, and industrial equipment. A degree in a field related to the product sold, such as chemistry, biology, or engineering, is often required.

Many sales representatives attend seminars in sales techniques or take courses in marketing, economics, communication, or even a foreign language to improve their ability to make sales.

Training

Many companies have formal training programs for beginning wholesale and manufacturing sales representatives that last up to 1 year. In some programs, trainees rotate among jobs in plants and offices to learn all phases of producing, installing, and distributing the product. In others, trainees receive formal technical instruction at the plant, followed by on-the-job training under the supervision of a field sales manager.

New employees may be trained by going along with experienced workers on their sales calls. As they gain familiarity with the firm's products and clients, the new workers gain more responsibility until they eventually get their own territory.

Licenses, Certifications, and Registrations

Many in this occupation have either the Certified Professional Manufacturers' Representative (CPMR) certification or the Certified Sales Professional (CSP) certification, both offered by the Manufacturers' Representatives Educational Research Foundation (MRERF). Certification typically involves completing formal technical training and passing an exam. In addition, the CPMR requires 10 hours of continuing education every year in order to maintain certification.

Other Experience

Although not required, sales experience can be helpful, particularly for nontechnical positions.

Advancement

Frequently, promotion takes the form of an assignment to a larger account or territory, where commissions are likely to be greater. Those who have good sales records and leadership ability may advance to higher level positions, such as sales supervisor, district manager, or vice president of sales. For more information on these positions, see the profile on sales managers .

Important Qualities

Customer-service skills. Sales representatives must be able to listen to the customer’s needs and concerns before and after the sale.

Interpersonal skills. Sales representatives must be able to work well with many types of people. They must be able to build good relationships with clients and with other members of the sales team.

Self-confidence. Sales representatives must be confident and persuasive when making sales presentations. In addition, making a call to a potential customer who is not expecting to be contacted, or “cold calling,” requires confidence and composure.

Stamina. Sales representatives are often on their feet for long periods of time and may carry heavy sample products.

Note: All Occupations includes all occupations in the U. S. Economy. Source: U. S. Bureau of Labor Statistics, Occupational Employment Statistics

The median annual wage for sales representatives, wholesale and manufacturing, technical and scientific products was $76,190 in May 2015. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $38,570, and the highest 10 percent earned more than $153,940.

The median annual wage for sales representatives, wholesale and manufacturing, except technical and scientific products was $55,730 in May 2015. The lowest 10 percent earned less than $26,830, and the highest 10 percent earned more than $118,000.

In May 2015, the median annual wages for wholesale and manufacturing sales representatives in the top industries in which they worked were as follows:

Wholesale electronic markets and agents and brokers

Professional and commercial equipment and supplies merchant wholesalers

Note: All Occupations includes all occupations in the U. S. Economy. Source: U. S. Bureau of Labor Statistics, Employment Projections program

Employment of wholesale and manufacturing sales representatives is projected to grow 7 percent from 2014 to 2024, about as fast as the average for all occupations. 

Employment growth for wholesale and manufacturing sales representatives will largely follow growth of the overall economy.

In addition to the total volume of sales, a wider range of products and technologies will lead to increased demand for sales representatives. 

Because the work of sales representatives requires a lot of face-to-face interaction with potential buyers, this type of work is not likely to be outsourced to other countries.

Employment growth is expected to be strongest for sales representatives working at independent sales agencies. Companies are increasingly shifting their sales activities to independent agencies as a way to cut costs and boost revenue. These independent companies do not buy and hold the products they are selling. Instead, they operate on a fee or commission basis in representing the product manufacturer. Employment of sales representatives in this industry—wholesale electronic markets and agents and brokers—is projected to grow 26 percent from 2014 to 2024.

Job Prospects

Job opportunities should be best for those with previous sales experience. Though the large size of the occupation creates many job openings, the relatively high pay will also likely attract a large number of applicants.

Employment projections data for wholesale and manufacturing sales representatives, 2014-24

State & Area Data About this section

Occupational Employment Statistics (OES)

The Occupational Employment Statistics (OES) program produces employment and wage estimates annually for over 800 occupations. These estimates are available for the nation as a whole, for individual states, and for metropolitan and nonmetropolitan areas. The link(s) below go to OES data maps for employment and wages by state and area.

Projections Central

Occupational employment projections are developed for all states by Labor Market Information (LMI) or individual state Employment Projections offices. All state projections data are available at www. projectionscentral. com. Information on this site allows projected employment growth for an occupation to be compared among states or to be compared within one state. In addition, states may produce projections for areas; there are links to each state’s websites where these data may be retrieved.

Career InfoNet

America’s Career InfoNet includes hundreds of occupational profiles with data available by state and metro area. There are links in the left-hand side menu to compare occupational employment by state and occupational wages by local area or metro area. There is also a salary info tool to search for wages by zip code.

Similar Occupations About this section

Tegretol, Equetro (Carbamazepine) Dosing, Indications, Interactions, Adverse Effects, And More, Eque

carbamazepine (Rx) Brand and Other Names: Tegretol, Equetro, more. Epitol, Tegretol XR, Carbagen SR, Carbamazepine Chewtabs, Carbamazepine CR, Carbatrol, Teril

Initial (oral suspension): 10-20 mg/kg/day PO q6hr

Initial (tablet): 10-20 mg/kg/day PO q8-12hr

Maintenance: For tablets or suspension may divide frequency into 3-4 times daily not to exceed 35 mg/kg/day

Initial (oral suspension): 50 mg PO q6hr

Initial (tablet, immediate - or extended-release): 100 mg PO q12hr; may increase qWeek by 100 mg/day

Maintenance: 400-800 mg/day PO q6-8hr (immediate-release); q12hr (extended-release)

Not to exceed 1000 mg/day

Initial (oral suspension): 10 mL (200 mg) PO q6hr

Initial (tablet, immediate - or extended-release): 200 mg PO q12hr

May increase by up to 200 mg/day qWeek; q12hr (extended-release tablet); q6-8hr (other formulations)

12-15 years: Dose not to exceed 1000 mg/day

>15 years: Dose not to exceed 1200 mg/day

Dosing Modifications

Glomerular filtration rate <10 mL/min: Administer 75% of dose and monitor

Peritoneal dialysis and hemodialysis: Administer 75% of dose and monitor

Use caution; drug is metabolized primarily in the liver

Dosing Considerations

Important to initiate slowly by advancing dose every 5-7 days to minimize GI upset and allow autoinduction of liver enzymes to occur (autoinduction is complete at 3-5 weeks)

Children <12 years who receive >400 mg/day may be converted to Carbatrol ER at the same dose, q12hr PO

Monitor: CBC, LFTs

Administration

Do not chew, crush, or cut extended-release tablets

Punctate cortical lens opacities

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Frequency Not Defined

Hemopoietic system: Aplastic anemia, agranulocytosis, pancytopenia, bone marrow depression, thrombocytopenia, leukopenia, leukocytosis, eosinophilia, anemia, acute intermittent porphyria, variegate porphyria, porphyria cutanea tarda

Skin: Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) (see Black Box Warnings), pruritic and erythematous rashes, urticaria, photosensitivity reactions, alterations in skin pigmentation, exfoliative dermatitis, erythema multiforme and nodosum, purpura, aggravation of disseminated lupus erythematosus, alopecia, diaphoresis, and onychomadesis

Cardiovascular system: Congestive heart failure, edema, aggravation of hypertension, hypotension, syncope and collapse, aggravation of coronary artery disease, arrhythmias and AV block, thrombophlebitis, thromboembolism, and adenopathy or lymphadenopathy

Liver: Abnormalities in liver function tests, cholestatic and hepatocellular jaundice, hepatitis; very rare cases of hepatic failure

Respiratory System: Pulmonary hypersensitivity characterized by fever, dyspnea, pneumonitis, or pneumonia

Genitourinary System: Urinary frequency, acute urinary retention, oliguria with elevated blood pressure, azotemia, renal failure, and impotence (rare reports of impaired male fertility and/or abnormal spermatogenesis)

Laboratory: Albuminuria, glycosuria, elevated BUN, decreased plasma calcium, and microscopic deposits in the urine

Nervous system: Dizziness, drowsiness, disturbances of coordination, confusion, headache, fatigue, blurred vision, visual hallucinations, transient diplopia, oculomotor disturbances, nystagmus, speech disturbances, abnormal involuntary movements, peripheral neuritis and paresthesias, depression with agitation, talkativeness, tinnitus, hyperacusis, neuroleptic malignant syndrome; isolated cases of neuroleptic malignant syndrome

Digestive system: Nausea, vomiting, gastric distress and abdominal pain, diarrhea, constipation, anorexia, and dryness of the mouth and pharynx, including glossitis, and stomatitis

Eyes: Scattered punctate cortical lens opacities, increased intraocular pressure as well as conjunctivitis

Musculoskeletal system: Aching joints and muscles, and leg cramps

Metabolism: Fever and chills; SIADH; cases of frank water intoxication, with decreased serum sodium (hyponatremia) and confusion; decreased levels of plasma calcium leading to osteoporosis

Other: Multiorgan hypersensitivity reactions occurring days to weeks or months after initiating treatment have been reported in rare cases, signs or symptoms may include fever, skin rashes, vasculitis, lymphadenopathy, disorders mimicking lymphoma, arthralgia, leukopenia, eosinophilia, hepatosplenomegaly and abnormal liver function tests

Excretion: Urine (72%); feces (28%)

Pharmacogenomics

It is estimated that 1 in 20 patients with HLA-B*1502 will have a severe dermatologic reaction (eg, TEN, SJS) when taking carbamazepine

This allele occurs almost exclusively in patients with ancestry across broad areas of Asia, including Han Chinese, Filipinos, Malaysians, South Asian Indians, and Thais

Retrospective case-control studies in patients of European, Korean, and Japanese ancestry have found a moderate association between the risk of developing hypersensitivity reactions and the presence of HLAA*3101, an inherited allelic variant of the HLA-A gene, in patients using carbamazepine; these hypersensitivity reactions include Stevens Johnson syndrome and toxic epidermal necrolysis

HLA-A*3101 is expected to be carried by more than 15% of patients of Japanese, Native American, Southern Indian (eg, Tamil Nadu) and some Arabic ancestry; up to about 10% in patients of Han Chinese, Korean, European, Latin American, and other Indian ancestry; and up to about 5% in African-Americans and patients of Thai, Taiwanese, and Chinese (Hong Kong) ancestry

Genetic testing laboratories

The following companies provide genetic testing for HLA variants

Kashi Clinical Laboratories (www. kashilab. com)

LabCorp (http://www. labcorp. com/)

Specialty Laboratories (http://www. specialtylabs. com)

Quest (http://www. questdiagnostics. com)

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Adding plans allows you to:

View the formulary and any restrictions for each plan.

Manage and view all your plans together – even plans in different states.

Compare formulary status to other drugs in the same class.

Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

View explanations for tiers and restrictions

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Hyal-1 Hyaluronidase A Potential Prognostic Indicator For Progression To Muscle Invasion And Recurre

HYAL-1 Hyaluronidase: A Potential Prognostic Indicator for Progression to Muscle Invasion and Recurrence in Bladder Cancer

Abstract

Background

For bladder cancer (BCa) patients undergoing bladder-sparing treatments, molecular markers may aid in accurately predicting progression to muscle invasion and recurrence. Hyaluronic acid (HA) is a glycosaminoglycan that promotes tumor metastasis. Hyaluronoglucosaminidase 1 (HYAL-1)–type hyaluronidase (HAase) promotes tumor growth, invasion, and angiogenesis. Urinary HA and HAase levels are diagnostic markers for BCa.

Objective

We evaluated whether HA and HYAL-1 can predict progression to muscle invasion and recurrence among patients with non–muscle-invasive BCa.

Design, setting, and participants

Based on tissue availability, tissue microarrays were prepared from a cohort of 178 BCa specimens (144 non–muscle invasive, 34 muscle invasive). Follow-up information was available on 111 patients with non–muscle-invasive BCa (mean follow-up: 69.5 mo); 58 patients recurred and 25 progressed to muscle invasion (mean time to progress: 22.3 mo).

Measurements

HA and HYAL-1 expression was evaluated by immunohistochemistry and graded for intensity and area of staining. Association of HA and HYAL-1 staining with BCa recurrence and muscle invasion was evaluated by univariate and multivariate models.

Results and limitations

HA and HYAL-1 expression correlated with tumor grade, stage, and multifocality ( p < 0.05). In non–muscle-invasive BCa specimens, HYAL-1 staining was higher (234.3 ± 52.2; 200.6 ± 61.4) if patients experienced progression to muscle invasion or recurrence when compared with no progression or recurrence (164.1 ± 48.2; 172.1 ± 57; p < 0.001). HA staining correlated with muscle invasion ( p < 0.001). In univariate analysis, age ( p = 0.014), multifocality ( p = 0.023), and HYAL-1 staining ( p < 0.001) correlated with muscle invasion, whereas only HYAL-1 correlated with recurrence ( p = 0.013). In multivariate analysis, significantly associated with muscle invasion ( p < 0.001; 76.8% accuracy) and recurrence ( p = 0.01; 67.8% accuracy).

Conclusions

HYAL-1 is a potential prognostic marker for predicting progression to muscle invasion and recurrence.

Keywords: Bladder cancer, Hyaluronic acid, Hyaluronidase, HYAL-1, non-muscle invasive bladder cancer, Prognostic markers, Tissue microarray

1. Introduction

Patients with non–muscle-invasive bladder cancer (BCa; ie, stage Ta, T1, or carcinoma in situ [CIS]) are often treated with bladder-sparing treatments. Current clinical and pathologic parameters, such as tumor grade, stage, and multifocality, are well investigated in terms of providing prognostic information regarding progression to muscle invasion and recurrence. Additional markers, however, may help in making better prognostic predictions. Prognostic information for patients undergoing bladder-sparing treatments is important, since these patients are at risk for developing new tumors in the bladder (ie, recurrence) and for disease progression to stage T2 or higher. Furthermore, if a patient fails a bladder-sparing treatment, the tumor could become muscle invasive during the course of the treatment. Several markers associated with BCa growth and progression have been tested as prognostic markers [1 –3 ].

Hyaluronic acid (HA) is a nonsulfated glycosaminoglycan that promotes tumor metastasis. HA levels are elevated in a variety of tumors [4 ,5 ]. We have shown that the measurement of urinary HA levels by HA test is approximately 85% accurate in detecting BCa [6 ]. We recently demonstrated that inhibition of HA synthesis in BCa cells inhibits tumor growth, invasion, and angiogenesis [7 ,8 ]. Hyaluronoglucosaminidase 1 (HYAL-1) is the major hyaluronidase expressed in BCa cells and is an accurate marker for high-grade BCa [6 ,9 ,10 ]. We have shown that inhibition of HYAL-1 expression in tumor cells decreases tumor growth, invasion, and angiogenesis [11 ].

Because HA and HYAL-1 promote BCa growth and progression, we investigated whether these molecules have prognostic significance for predicting disease progression and bladder tumor recurrence.

2. Materials and methods

2.1. Patient characteristics

Archival BCa specimens ( n = 178, from 178 patients), collected between 1993 and 2001, were obtained from the University of Tübingen in Germany and the University of Miami in the United States. Of those, 144 specimens were from patients with non–muscle-invasive BCa (stage Ta, T1) and 34 were from patients with muscle-invasive BCa (stages T2, T3, or T4). CIS was concomitantly present in eight patients with T1 disease. The presence of CIS was established by random biopsies based on the surgeons’ impression. The study was approved by the institutional review boards at both institutions. Patient and tumor characteristics are detailed in Table 1. In this study, specimen selection was based solely on the availability of well-preserved tumor tissue blocks ( n = 227) and the availability of enough tissue in those blocks for microarray preparation ( n = 190). Of the 190 specimens, 12 could not be evaluated due to the loss of tissue during microarray preparation or staining.

Non–muscle-invasive patients ( n = 144) were treated with transurethral resection of bladder tumor (TURBT); 78 of these patients underwent TURBT alone and 66 received intravesical therapy following TURBT. Follow-up information was available for 111 patients; 58 experienced tumor recurrence and 25 showed progression to muscle invasion. Recurrence was defined as detection of bladder tumor by cystoscopy after treatment (TURBT with or without intravesical therapy). Progression to muscle invasion was defined as the detection of a tumor stage T2 or higher in the bladder after treatment (ie, recurrence of a stage T2 or higher tumor). The mean and median time of total follow-up, time to recur, and time to progression to muscle invasion were computed from Kaplan-Meier plots. Of the 34 patients with muscle-invasive disease, follow-up information was available for 31 patients (10 developed metastasis and 21 were free of metastasis; Table 1 ).

2.2. Tissue microarray preparation

Tissue microarrays (TMAs) were prepared as previously described [12 ]. A hematoxylin and eosin (H&E) slide of each archival specimen was evaluated, and a block representing the overall tumor grade (donor block) was chosen for TMA preparation. Three 0.6-mm core biopsies were punched from the donor block and transferred to a paraffin block (TMA block). Each TMA block had a total of 75 core biopsies (ie, 25 specimens from 25 BCa patients). Sections from the TMA blocks were cut 4-µm thick and placed on positively charged slides for immunostaining. Each H&E slide of each TMA was evaluated by the study pathologist (MJ) to ensure that the 0.6-mm core was representative of the tumor grade of the specimen.

2.3. Immunohistochemistry

TMA slides were sequentially deparafinized, rehydrated, and subjected to antigen retrieval. The slides were incubated with a biotinylated HA binding protein (1 µg/ml; for HA staining) or an anti–HYAL-1 immunoglobulin G (1 µg/ml) at 4°C for 15 h [8 ,13 –17 ]. We have previously described the nature and specifics of these primary detection reagents [8 ,13 –17 ]. The positive and negative controls for HYAL-1 immunohistochemistry were tumor xenograft specimens of HT1376 human BCa cells transfected with HYAL-1 sense complementary DNA (cDNA) and HYAL-1 antisense cDNA [11 ]. For HA immunohistochemistry we used the tumor xenograft specimens of HT1376 cells transfected with HAS-1 sense cDNA (positive control) or HAS-1 cDNA (negative control) [7 ]. After incubation with primary reagents, the slides were sequentially processed using the Dako LSAB kit (Dako, Glostrup, Denmark) and 3,3′ diaminobenzidine substrate solution, and then were counterstained with hematoxylin.

2.4. Slide grading

Two researchers (MWK and RG) graded all slides independently and in a blinded fashion when both researchers were present at one institution (University of Miami). Each core was graded for staining intensity (0–3+) and then multiplied by the area of staining; thus, each specimen could receive a staining score between 0 and 300. The intensity scores of the three cores from the same specimen were averaged to obtain the mean intensity score for a specimen for each reader. The mean intensity scores of the two readers were then averaged to get the final score [12 ,18 ]. If the average staining scores of the two readers differed by ≥20% (eg, score 220 for reader 1 versus 180 for reader 2) for a specimen, the cores of that specimen were reevaluated by the same two readers and by a third reader (ASM, when he was on a research fellowship at the University of Miami). The slides were also evaluated using the IP image analysis software, and the results were comparable to the readers’ scores. It is noteworthy that, overall, there was agreement of approximately 90% between the two readers with respect to scoring of all 178 specimens and between the average scores of the readers and the results of the IP image analysis software. This was further confirmed by Pearson correlation analysis. There was significant correlation between the staining scores of the two readers (Spearman ρ: 0.876; 95% confidence interval [CI]: 0.789–0.946; p ≤ 0.001) and between the average scores of the two readers and the IP image analysis scores (Spearman ρ: 0.874; 95% CI: 0.798–0.953; p < 0.001). Because there is significant correlation between the manual evaluation of staining and the image analysis software, it may be possible to use image analysis software to evaluate HA or HYAL-1 staining in future multicenter studies.

2.5. Statistical analyses

The differences in the mean HA and HYAL-1 staining scores among various tumor grades or stages were calculated by Kruskal-Wallis test, assuming a non-normal distribution, followed by Dunn multiple comparison test. The differences in the mean HA and HYAL-1 staining scores with respect to sex, multifocality, and age (stratified at a median age of 69 yr) were calculated by Mann-Whitney test.

Because this is a retrospective cohort study, we initially tested whether the Cox proportional hazards model would be appropriate for determining the association of HA and/or HYAL-1 staining with progression to muscle invasion and recurrence in a multivariate model. We categorized HA and HYAL-1 staining inferences in tertiles and at the median. Plots of log hazard (log H) and log time showed approximately linear plots with constant separation between the groups for the tertile categorization and the median categorization, suggesting that the Cox model is appropriate. We then performed Cox proportional hazards analysis by including all pre-and postoperative parameters listed in Table 1 and HA and HYAL-1 staining scores to determine the parameters that jointly predict tumor recurrence and/or progression to muscle invasion. Kaplan-Meier plots were generated for those parameters that reached statistical significance in the multivariate models.

Receiver operating curves were generated to determine the association between staining scores and tumor recurrence or progression to muscle invasion. Cut-off values selected by a statistical program (JMP 6 software; SAS Institute, Cary, NC, USA) were used for defining high or low expression of HA (cut-off: 175) and HYAL-1 (cut-off: 210). The program selected the cut-off limit that yielded the highest sensitivity (1-Specificity) value. A staining score greater than or equal to the cut-off value was considered to be a true positive if the patient had recurrence (or progression to muscle invasion); a score lower than the cut-off value was considered to be a true negative if the patient had no recurrence (or progression to muscle invasion). The sensitivity, specificity, and accuracy for HA and HYAL-1 staining inferences were calculated as previously described [8 ,13 –15 ]. Cross-validation was performed to obtain the mean plus or minus the standard deviation (SD) and 95% CI for the sensitivity and specificity for HA and HYAL-1 staining scores, as previously described [18 ]. Statistical analyses were carried out using the JMP software program (version 6.0; SAS Institute).

3. Results

3.1. HA and HYAL-1 expression increases with tumor grade and stage

Analysis of HA and HYAL-1 staining in TMA specimens showed that HA and HYAL-1 staining intensity scores increased with tumor grade and stage ( p < 0.05 for HA staining, p < 0.01 or p < 0.001 for HYAL-1 staining; Table 2 ). While the presence of multifocality correlated with HA and HYAL-1 staining scores, concomitant presence of CIS correlated only with HYAL-1 staining.

Distribution of hyaluronic acid (HA) and hyaluronoglucosaminidase (HYAL-1) staining scores by tumor grade, stage, concomitant presence of carcinoma in situ (CIS), multifocality, gender, and age *

3.2. Correlation of HA and HYAL-1 staining scores with progression to muscle invasion and tumor recurrence

We next evaluated whether HA and or HYAL-1 staining in non–muscle-invasive specimens predicts muscle invasion and/or tumor recurrence. HA and HYAL-1 staining is low in TaG2 specimens from patients with non–muscle-invasive disease who did not recur ( Fig. 1A. panels a and c). HA and HYAL-1 staining, however, is high in TaG2 specimens from patients who later recurred with muscle-invasive BCa ( Fig. 1A. panels b and d). As we have reported previously, in these specimens, HA is localized in both the tumor-associated stroma and the tumor cells, whereas HYAL-1 is exclusively expressed in tumor cells. Figure 1B shows that among patients who progressed to muscle invasion and those who did not, the differences in the mean (plus or minus SD) staining intensity scores for both HA and HYAL-1 are statistically significant. Only the differences in the mean (plus or minus SD) HYAL-1 staining scores among those who recurred and those who did not are statistically significant.

Hyaluronic acid (HA) and hyaluronoglucosaminidase 1 (HYAL-1) expression in bladder tumor tissue and its relation to tumor recurrence and progression to muscle invasion

To determine whether any of the pre - and postoperative parameters and/or HA and HYAL-1 staining inferences predict progression to muscle invasion and/or recurrence, we performed logistic regression analysis (univariate analysis). As shown in Table 3. age, multifocality, and HYAL-1 staining inferences correlate with muscle invasion, whereas only HYAL-1 staining score significantly correlates with tumor recurrence.

Univariate analysis of pre - and postoperative parameters and hyaluronic acid (HA) and hyaluronoglucosaminidase 1 (HYAL-1) staining inferences *

3.3. HYAL-1 staining inferences independently correlate with tumor recurrence and progression to muscle invasion

To determine which of the pre - and postoperative parameters and/or HA and HYAL-1 staining inferences are independent prognostic predictors of tumor recurrence and/or muscle invasion, we used the Cox proportional hazards model. When only pre - and postoperative parameters were included in the model (ie, no HA and HYAL-1 in the model), no clinical or pathologic parameter was significant in predicting recurrence and progression to muscle invasion. When both HA and HYAL-1 were included in the model (as individual variables), together with all of the clinical and pathologic parameters, only HYAL-1 was an independent prognostic predictor of tumor recurrence. Both HYAL-1 and age were significant parameters for predicting progression to muscle invasion ( Table 4 ).

Multivariate analyses of pre - and postoperative parameters and hyaluronic acid (HA) and hyaluronoglucosaminidase 1 (HYAL-1) staining inferences to predict disease progression and tumor recurrence among patients with non–muscle-invasive bladder .

We next determined whether HYAL-1 staining inferences stratify patients with non–muscle-invasive BCa as those who recurred (or progressed to muscle invasion) versus those who did not [13 ,14 ]. The Kaplan-Meier plot shows that patients with high HYAL-1 staining scores (≥205 [the median HYAL-1 score]) in their tumor specimens recurred faster than those with low HYAL-1 staining ( Fig. 1C. panel a; log-rank test: χ 2 = 13.12; p < 0.001). Since both age and HYAL-1 staining were independent prognostic indicators in predicting progression to muscle invasion, we generated Kaplan-Meier plots by stratifying patients as low age (<69 yr; median age: 69 yr) and low HYAL-1 (<205) or high age and high HYAL-1. As shown in panel b of Figure 1C. patients with high age and high HYAL-1 progressed to muscle invasion faster (50% within 43 mo) than patients with low HYAL-1 staining (only 10% within 139 mo; log-rank test: χ 2 = 31.743; p < 0.001).

To evaluate whether HA and, more importantly, HYAL-1 can accurately predict progression to muscle invasion and recurrence, we determined the sensitivity, specificity, and accuracy of the staining inferences. As shown in Table 5. HA staining had lower sensitivity, specificity, and accuracy than HYAL-1 staining to predict tumor recurrence and progression to muscle invasion, and the cross-validation analyses support these results.

Determination of sensitivity, specificity, and accuracy of hyaluronic acid (HA) and hyaluronoglucosaminidase 1 (HYAL-1) staining inferences for predicting recurrence and progression to muscle invasion *

Among the 111 patients for whom follow-up was available, 53 patients received intravesical therapy (ie, bacillus Calmette-Guérin [BCG] treatment) following TURBT. Of these 53 patients, 32 were responders; among the 21 nonresponders, 17 experienced progression to muscle invasion. Analysis of the cohort that received intravesical therapy showed that the HYAL-1 staining score was higher in tumor specimens from patients who developed muscle-invasive disease (244.1 ± 46.1) when compared with those who did not (180.6 ± 60.2; p = 0.0005). In the multivariate analysis, HYAL-1 was the only independent prognostic indicator for predicting progression to muscle invasion (χ 2 = 10.4; p = 0.001; 95% CI: 1.00–1.05).

4. Discussion

Prognostic markers that identify patients with non–muscle-invasive BCa who will develop muscle invasive disease could help physicians in choosing more aggressive treatment options (eg, early cystectomy). Palou et al, for example, showed that ezrin, a cytoskeletal protein involved in HA signaling, predicts response to BCG treatment [19 ]. In this study, we found that HYAL-1 expression is an independent predictor of progression to muscle invasion and tumor recurrence. The prognostic significance of HA expression in tumor cells and/or tumor-associated stroma may very well be organ specific [4. 20 –25 ]. In this study, HA staining score did not associate with progression to muscle invasion and tumor recurrence in both univariate and multivariate analyses. These findings are consistent with our observation that HA levels are only marginally higher in high-grade muscle-invasive tumors when compared with low-grade non–muscle-invasive tumors ( Table 2 ) [15 ]. A marginal increase in HA levels in high-grade bladder-tumor specimens when compared with low-grade tumors may be due to elevated HYAL-1 levels in high-grade tumors. Increased HYAL-1 levels degrade tumor-associated HA, generating HA fragments. Such fragments have been detected in tumor tissues and in the urine of patients with high-grade BCa [26 ].

HYAL-1 expression was found to be an independent predictor of disease progression in breast and prostate carcinomas [13 ,14 ,27 ]. In this study, HYAL-1 expression was 77% accurate in identifying those patients with non–muscle-invasive BCa who later developed muscle-invasive BCa. Interestingly, HYAL-1 expression was higher in T1 tumors than in Ta tumors. For patients with T1G3 disease, it is often challenging to choose between cystectomy and bladder-sparing treatment that involves intravesical therapy. For such patients, early cystectomy may be a better treatment option if the tumor specimens have high HYAL-1 staining.

Our study included 34 patients with muscle-invasive disease, and of those, follow-up information was available for 31. Cox multivariate analysis that included preoperative (age, gender) and postoperative parameters (grade, stage, lymph node status) and HA and HYAL-1 staining inferences showed that HYAL-1 staining along with T-stage significantly associated with metastasis (HYAL-1, p = 0.027; stage, p = 0.039).

HYAL-1 promotes tumor invasion and metastasis. Inhibition of HYAL-1 expression in BCa and prostate cancer cells inhibits invasive activity in vitro and in xenografts [11 ,28 ]. In particular, inhibition of HYAL-1 expression in BCa xenografts inhibits skeletal muscle and lymphatic invasion [11 ]. Consistent with its role in tumor invasion and metastasis, HYAL-1 had lower sensitivity (57%) but comparable specificity (75%) to predict recurrence. This lower sensitivity was due to the poor sensitivity (approximately 40%) of HYAL-1 for predicting the recurrence of low-grade tumors.

5. Conclusions

As a whole, our study shows that, consistent with its functions in tumor invasion and metastasis, HYAL-1 has potential as an independent prognostic indicator for predicting progression to muscle invasion and metastasis. Our study, however, was a retrospective cohort study involving only two centers, and some of the patients had intravesical therapy following TURBT. Therefore, for HYAL-1 to be considered in treatment decision making [29 ] or to be included in BCa nomograms [30 ], a prospective multicenter study would have to be conducted.

Acknowledgments

Funding/Support and role of the sponsor: The US National Institutes of Health and the University of Miami’s CURED program reviewed the manuscript in support of this study.

Footnotes

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

This retrospective cohort study involved tissue microarrays of 178 bladder-tumor specimens. We found that for patients with non[en]muscle-invasive bladder cancer, hyaluronoglucosaminidase 1 (HYAL-1) expression has potential as an independent predictor of progression to muscle invasion, tumor recurrence, and metastasis.

Financial disclosures: I certify that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/ affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Mario Kramer and Judith Knapp are supported by the International Academy of Life Sciences’ Biomedical Science Exchange Program fellowship.

Vinata Lokeshwar had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Kramer, Golshani, Merseburger, Lokeshwar

Acquisition of data: Kramer, Golshani, Hennelotter, Garcia

Analysis and interpretation of data: Kramer, Golshani, Lokeshwar

Drafting of the manuscript: Lokeshwar

Critical revision of the manuscript for important intellectual content: Kuczyk, Stenzl, Soloway, Lokeshwar

Statistical analysis: Duncan, Kramer, Lokeshwar

Obtaining funding: Lokeshwar

Administrative, technical, or material support: Lokeshwar

Other (specify): Database support: Soloway; Pathology support: Jorda

References

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2. Shariat SF, Karam JA, Lerner SP. Molecular markers in bladder cancer. Curr Opin Urol. 2008; 18 :1–8. [PubMed ]

3. Ehdaie B, Theodorescu D. Predicting tumor outcomes in urothelial bladder carcinoma: turning pathways into clinical biomarkers of prognosis. Expert Rev Anticancer Ther. 2008; 8 :1103–1110. [PubMed ]

4. Tammi RH, Kultti A, Kosma VM, Pirinen R, Auvinen P, Tammi MI. Hyaluronan in human tumors: pathobiological and prognostic messages from cell-associated and stromal hyaluronan. Semin Cancer Biol. 2008; 18 :288–295. [PubMed ]

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7. Golshani R, Lopez L, Estrella V, Kramer M, Iida N, Lokeshwar VB. Hyaluronic acid synthase-1 expression regulates bladder cancer growth, invasion, and angiogenesis through CD44. Cancer Res. 2008; 68 :483–491. [PubMed ]

8. Golshani R, Hautmann SH, Estrella V, et al. HAS1 expression in bladder cancer and its relation to urinary HA test. Int J Cancer. 2007; 120 :1712–1720. [PubMed ]

9. Lokeshwar VB, Schroeder GL, Selzer MG, et al. Bladder tumor markers for monitoring recurrence and screening comparison of hyaluronic acid-hyaluronidase and BTA-Stat tests. Cancer. 2002; 95 :61–72. [PubMed ]

10. Eissa S, Kassim SK, Labib RA, et al. Detection of bladder carcinoma by combined testing of urine for hyaluronidase and cytokeratin 20 RNAs. Cancer. 2005; 103 :1356–1362. [PubMed ]

11. Lokeshwar VB, Cerwinka WH, Lokeshwar BL. HYAL1 hyaluronidase: a molecular determinant of bladder tumor growth and invasion. Cancer Res. 2005; 65 :2243–2250. [PubMed ]

12. Kramer MW, Merseburger AS, Hennenlotter J, Kuczyk M. Tissue microarrays in clinical urology--technical considerations. Scand J Urol Nephrol. 2007; 41 :478–484. [PubMed ]

13. Posey JT, Soloway MS, Ekici S, et al. Evaluation of the prognostic potential of hyaluronic acid and hyaluronidase (HYAL-1) for prostate cancer. Cancer Res. 2003; 63 :2638–2644. [PubMed ]

14. Ekici S, Cerwinka WH, Duncan R, et al. Comparison of the prognostic potential of hyaluronic acid, hyaluronidase (HYAL-1), CD44v6 and microvessel density for prostate cancer. Int J Cancer. 2004; 112 :121–129. [PubMed ]

15. Hautmann SH, Lokeshwar VB, Schroeder GL, et al. Elevated tissue expression of hyaluronic acid and hyaluronidase validates the HA-HAase urine test for bladder cancer. J Urol. 2001; 165 :2068–2074. [PubMed ]

16. Lokeshwar VB, Rubinowicz D, Schroeder GL, et al. Stromal and epithelial expression of tumor markers hyaluronic acid and HYAL1 hyaluronidase in prostate cancer. J Biol Chem. 2001; 276 :11922–11932. [PubMed ]

17. Lokeshwar VB, Young MJ, Goudarzi G, et al. Identification of bladder tumor-derived hyaluronidase: its similarity to HYAL1. Cancer Res. 1999; 59 :4464–4470. [PubMed ]

18. Caruso DJ, Carmack AJ, Lokeshwar VB, et al. Osteopontin and interleukin-8 expression is independently associated with prostate cancer recurrence. Clin Cancer Res. 2008; 14 :4111–4118. [PMC free article ] [PubMed ]

19. Palou J, Algaba F, Vera I, Rodriguez O, Villavicencio H, Sanchez-Carbayo M. Protein expression patterns of ezrin are predictors of progression in T1G3 bladder tumours treated with nonmaintenance bacillus Calmette-Guérin. Eur Urol. In press. [PubMed ]

20. Auvinen P, Tammi R, Parkkinen J, et al. Hyaluronan in peritumoral stroma and malignant cells associates with breast cancer spreading and predicts survival. Am J Pathol. 2000; 156 :529–536. [PMC free article ] [PubMed ]

21. Hiltunen EL, Anttila M, Kultti A, et al. Elevated hyaluronan concentration without hyaluronidase activation in malignant epithelial ovarian tumors. Cancer Res. 2002; 62 :6410–6413. [PubMed ]

22. Anttila MA, Tammi RH, Tammi MI, Syrjänen KJ, Saarikoski SV, Kosma VM. High levels of stromal hyaluronan predict poor disease outcome in epithelial ovarian cancer. Cancer Res. 2000; 60 :150–155. [PubMed ]

23. Corte MD, González LO, Lamelas ML, et al. Expression and clinical signification of cytosolic hyaluronan levels in invasive breast cancer. Breast Cancer Res Treat. 2006; 97 :329–337. [PubMed ]

24. Lipponen P, Aaltomaa S, Tammi R, Tammi M, Ågren U, Kosma VM. High stromal hyaluronan level is associated with poor differentiation and metastasis in prostate cancer. Eur J Cancer. 2001; 37 :849–856. [PubMed ]

25. Aaltomaa S, Lipponen P, Tammi R, et al. Strong stromal hyaluronan expression is associated with PSA recurrence in local prostate cancer. Urol Int. 2002; 69 :266–272. [PubMed ]

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27. Poola I, Abraham J, Marshalleck JJ, et al. Molecular risk assessment for breast cancer development in patients with ductal hyperplasias. Clin Cancer Res. 2008; 14 :1274–1280. [PubMed ]

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Antilip Tea, Antilip

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Dermalogica Microzone Treatments, Micozone

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Buy Oxemet Online - Self Healing Centre, Oxemet

Oxemet

Medication guide about Oxemet (Metformin)

Brand name: Oxemet Generic name: Metformin

What is the most important information I should know about Oxemet? Do not use Oxemet if you have kidney disease or congestive heart failure, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). Before taking Oxemet, tell your doctor if you have liver disease or a history of heart disease. Some people have developed a life-threatening condition called lactic acidosis while taking Oxemet. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting. If you need to have any type of x-ray or CT scan using a dye that is injected into a vein, you may need to temporarily stop taking Oxemet. Be sure the surgeon knows ahead of time that you are using this medicaton. Know the signs of low blood sugar (hypoglycemia) and how to recognize them, including hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure (convulsions), fainting, or coma (severe hypoglycemia can be fatal). Always keep a source of sugar available in case you have symptoms of low blood sugar.

What is Oxemet? Oxemet is an oral diabetes medicine that helps control blood sugar levels. Oxemet is for people with type 2 diabetes who do not use daily insulin injections. This medication is not for treating type 1 diabetes. Oxemet may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Oxemet? Some people have developed a life-threatening condition called lactic acidosis while taking Oxemet. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting. You may be more likely to develop lactic acidosis if you have congestive heart failure. Do not use Oxemet if you have kidney disease or congestive heart failure, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). Before taking this medication, tell your doctor if you have: liver disease; or a history of heart disease. If you have any of these conditions, you may not be able to use Oxemet, or you may need a dosage adjustment or special tests during treatment. FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether Oxemet passes into breast milk or if it could harm a nursing baby. Do not take Oxemet without first talking to your doctor if you are breast-feeding a baby. Older adults may have a higher risk of developing lactic acidosis. Talk with your doctor about your individual risk. Oxemet should not be given to a child younger than 10 years old. Extended-release Oxemet (Oxemet XR) should not be given to a child younger than 17 years old.

How should I take Oxemet? Take this medication exactly as it was prescribed for you. Do not take the medication in larger or smaller amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Take Oxemet once daily with your evening meal, unless your doctor tells you otherwise. Oxemet is only part of a complete program of treatment that also includes diet, exercise, and weight control. It is important to use this medicine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. Do not crush, chew, or break an extended-release tablet (Oxemet XR). Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time. To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your kidney function may also need to be tested. It is important that you not miss any scheduled visits to your doctor. Your medication needs may change if you become sick or injured, if you have a serious infection, or if you have any type of surgery. Your doctor may want you to stop taking Oxemet for a short time if any of these situations affect you. Take care not to let your blood sugar get too low, causing hypoglycemia. You may have hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress. Know the signs of low blood sugar (hypoglycemia) and how to recognize them: hunger, headache, confusion, irritability; drowsiness, weakness, dizziness, tremors; sweating, fast heartbeat; seizure (convulsions); or fainting, coma (severe hypoglycemia can be fatal). Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection. Your doctor may have you take extra vitamin B12 while you are taking Oxemet. Take only the amount of vitamin B12 that your doctor has prescribed. If you need to have any type of x-ray or CT scan using a dye that is injected into a vein, you may need to temporarily stop taking Oxemet. Be sure the surgeon knows ahead of time that you are using this medicaton. Store Oxemet at room temperature away from moisture, heat, and light.

What happens if I miss a dose? Take the missed dose as soon as you remember (be sure to take the medicine with food). If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose? Seek emergency medical attention if you think you have used too much of this medicine. You may have signs of low blood sugar, such as hunger, headache, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, seizure (convulsions), fainting, or coma. An overdose of Oxemet may cause a life-threatening condition called lactic acidosis. Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting.

What should I avoid while taking Oxemet? Avoid drinking alcohol while taking Oxemet. Alcohol lowers blood sugar and may increase the risk of lactic acidosis while you are taking this medicine.

What are the possible side effects of Oxemet? Get emergency medical help if you have any of these symptoms of lactic acidosis: weakness, increasing sleepiness, slow heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, feeling light-headed, and fainting. Stop using Oxemet and 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: feeling short of breath, even with mild exertion; swelling or rapid weight gain; or fever, chills, body aches, flu symptoms. Other less serious side effects may be more likely to occur, such as: headache; weakness; mild nausesa, vomiting, diarrhea, gas, stomach pain; or muscle pain. 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 Oxemet? You may be more likely to have hyperglycemia (high blood sugar) if you are taking Oxemet with other drugs that raise blood sugar. Drugs that can raise blood sugar include: isoniazid; diuretics (water pills); steroids (prednisone and others); phenothiazines (Compazine and others); thyroid medicine (Synthroid and others); birth control pills and other hormones; seizure medicines (Dilantin and others); and diet pills, or medicines to treat asthma, colds or allergies. You may be more likely to have hypoglycemia (low blood sugar) if you are taking Oxemet with other drugs that lower blood sugar. Drugs that can lower blood sugar include: nonsteroidal anti-inflammatory drugs (NSAIDs); aspirin or other salicylates (including Pepto-Bismol); sulfa drugs (Bactrim and others); a monoamine oxidase inhibitor (MAOI); beta-blockers (Tenormin and others); probenecid (Benemid); or a blood thinner (warfarin, Coumadin and others). Some medications may interact with Oxemet. Tell your doctor if you are using any of the following drugs: furosemide (Lasix); nifedipine (Adalat, Procardia); cimetidine (Tagamet) or ranitidine (Zantac); amiloride (Midamor) or triamterene (Dyrenium); digoxin (Lanoxin); morphine (MS Contin, Kadian, Oramorph); procainamide (Procan, Pronestyl, Procanbid); quinidine (Cardioquin, Quinidex, Quinaglute); trimethoprim (Proloprim, Primsol, Bactrim, Cotrim, Septra); or vancomycin (Vancocin, Lyphocin). If you are using any of these drugs, you may not be able to take Oxemet, or you may require a dosage adjustment or special monitoring. There may be other drugs not listed that can affect Oxemet. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Enalapril 5mg Tablets, Renapril Plus

ENALAPRIL 5MG TABLETS

Active substance(s): ENALAPRIL MALEATE

Transcript

PACKAGE LEAFLET: INFORMATION FOR THE USER ENALAPRIL 5, 10 and 20 mg Tablets Enalapril Maleate 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. • 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. This includes any possible side effects not listed in this leaflet. See section 4. What is in this leaflet: 1. What Enalapril Tablets are and what they are used for 2. What you need to know before you take Enalapril Tablets 3. How to take Enalapril Tablets 4. Possible side effects 5. How to store Enalapril Tablets 6. Contents of the pack and other information 1. WHAT ENALAPRIL TABLETS ARE AND WHAT THEY ARE USED FOR These tablets contain enalapril maleate. Enalapril belongs to a group of medicines known as ‘ACE inhibitors’, which work by widening your blood vessels. They are used to treat: • High blood pressure. • Heart failure (symptoms of which include tiredness after light exercise, breathlessness and swelling of your ankles and legs). They are also used to prevent heart failure and heart attacks in people who have heart problems but have no symptoms. 2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE ENALAPRIL TABLETS Do not take Enalapril Tablets: • if you are hypersensitive (allergic) to Enalapril or any of the other ingredients of Enalapril Tablets. The symptoms of an allergic reaction include itching, nettle rash, wheezing or swelling of the hands, throat, mouth or eyelids. You can find a list of the ingredients of this medicine in Section 6 of this leaflet • if you are more than 3 months pregnant. (It is also better to avoid Enalapril in early pregnancy - see pregnancy section) • if you have a heart condition called ‘aortic stenosis’ or ‘outflow obstruction’ (narrowing of a valve in your major artery (aorta) causing restricted blood flow around your body) • if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren. If you think any of the above points apply to you, do not take the tablets. Talk to your doctor first and follow the advice given. Warnings and precautions Tell your doctor before taking these tablets if any of the following points apply to you: • if you have kidney disease or are a dialysis patient • if you suffer from excessive vomiting or diarrhoea • if you are on a low salt diet (sometimes called a low sodium diet) • if you think you are (or might become) pregnant. Enalapril is not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at this stage (see pregnancy section) • if you are Afro-Caribbean as Enalapril may not work as well as expected. • if you are taking any of the following medicines used to treat high blood pressure: - an “angiotensin II receptor blocker” (ARBs) (also known as sartans - for example valsartan, telmisartan, irbesartan, etc.), in particular if you have diabetes-related kidney problems - aliskiren. Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e. g. potassium) in your blood at regular intervals. See also information under the heading “Do not take Enalapril tablets”. If you are due to undergo any of the following procedures you must tell the doctor who is treating you that you are taking Enalapril tablets: • treatment called LDL apheresis to remove cholesterol from your blood by a machine • any surgery or anaesthetics (even at the dentist) • desensitisation treatment to reduce the effects of an allergy to bee or wasp stings. Tests before and while taking this medicine Your doctor will monitor your blood pressure before and during your treatment with this medicine. You may also be required to have a blood test to check that your kidneys are working properly before you start taking the tablets and at intervals during your treatment. Taking other medicines Tell your doctor before taking this medicine if you are already taking any of the following: • Other medicines to lower your blood pressure such as beta blockers (e. g. Propranolol). methyldopa, calcium antagonists and diuretics (water tablets). • Potassium supplements or salt substitutes containing potassium. • Allopurinol (used to treat gout). • Procainamide (used to treat abnormal heart rhythms). • Non-steroidal anti-inflammatory drugs (NSAIDs) e. g. diclofenac, ibuprofen. • Antacids used to treat heartburn or digestive discomfort. • Immunosuppressive drugs e. g. cyclosporine or corticosteroids. • Medicines used to treat diabetes e. g. insulin. • Medicines to treat pain or to help you sleep e. g. morphine. • Medicines to treat some psychiatric illnesses e. g. antipsychotics and lithium. • Medicines to treat cancer. • Medicines such as ephedrine, noradrenaline and adrenaline. Tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. Your doctor may need to change your dose and/or to take other precautions: If you are taking an angiotensin II receptor blocker (ARB) or aliskiren (see also information under the headings “Do not take Enalapril tablets” and “Take Special care with Enalapril tablets”). Taking Enalapril Tablets with food and drink The absorption of Enalapril Tablets is not affected by food intake. Alcohol and Enalapril Tablets can have additive effects and may cause dizziness or lightheadedness. Your doctor will have told you that you should always keep your alcohol intake to a minimum. If you are concerned about how much alcohol you can drink while you are taking Enalapril Tablets, discuss this with your doctor. If you are on a low salt diet (sometimes called a low sodium diet) tell your doctor before taking these tablets. Pregnancy and breast-feeding Pregnancy You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Enalapril before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Enalapril. Enalapril is not recommended in early pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy. Breast Feeding Tell your doctor if you are breast-feeding or about to start breast-feeding. Breast-feeding newborn babies (first few weeks after birth), and especially premature babies, is not recommended whilst taking Enalapril. In case of an older baby your doctor should advise you on the benefits and risks of taking Enalapril whilst breast-feeding, compared with other treatments. Driving and using machines Enalapril Tablets can cause side effects such as dizziness, light headedness, headache, tiredness, confusion and blurred vision. Do not drive or operate machines if you experience any of these side effects. Important information about some of the ingredients of Enalapril Tablets These tablets contain Lactose which is a type of sugar. Contact your doctor before taking these tablets if you are Lactose intolerant.

3. HOW TO TAKE ENALAPRIL TABLETS Always take Enalapril Tablets exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. The dose you take will depend on your condition and whether you are taking any other treatment. Usual dose for high blood pressure: The normal starting dose is 5 mg once a day. This is gradually increased up to 10-20 mg once a day. The maximum dose is 40 mg a day. Some patients including the elderly (over 65 years of age) may start on a lower dose of 2.5 mg once a day. Usual dose for heart failure: The normal starting dose is 2.5 mg a day. This is gradually increased up to 20 mg a day, given either once daily or in 2 doses of 10 mg according to your doctor’s advice. If Taking Enalapril tablets with a diuretic (water tablet): The recommended initial dose is 2.5 mg a day. If possible, your doctor will ask you to stop taking your diuretic tablets 2-3 days before starting to take Enalapril Tablets. Take your tablet at the same time each day unless your doctor tells you otherwise. If you are taking 2 tablets a day, take one in the morning and one in the evening, unless your doctor has told you otherwise. If you take more Enalapril Tablets than you should: If you take too many tablets by mistake contact your doctor IMMEDIATELY. If you forget to take Enalapril Tablets: Do not take a double dose to make up for a forgotten tablet. If you miss a dose just carry on with the next one as normal, but make sure you tell your doctor. If you stop taking Enalapril Tablets: Your doctor will tell you when you should stop taking Enalapril Tablets. If you have any further questions on the use of this product, ask your doctor or pharmacist. 4. POSSIBLE SIDE EFFECTS Like all medicines, these tablets can cause side effects, although not everybody gets them. Serious side effects - If you get any of the side effects shown in the list below STOP TAKING the tablets and seek medical attention IMMEDIATELY: • • •

severe dizziness or light-headedness itching blistering of the skin, mouth, eyes or genitals swelling of the hands, feet, mouth, throat or face (Afro-Caribbean patients may have a higher risk of this side effect)

shortness of breath or wheezing pain or tightness in the chest, neck, shoulders or arms numbness or weakness on one side of the body (e. g. a drooping arm, leg or lower eyelid, or a dribbling mouth) slurred speech and/or blurred vision confusion or unsteadiness.

These could be the sign of kidney failure, heart attack, stroke or a serious allergic reaction (such as Stevens-Johnson syndrome or toxic epidermal necrolysis). Other serious side effects - If you get any of the side effects shown in the list below STOP TAKING the tablets and seek medical attention IMMEDIATELY: • • • •

Pancreatitis - symptoms include abdominal pain, nausea. Liver problems including hepatitis and jaundice (yellowing of the skin or eyes). Build up of fluid in the lungs causing difficulty breathing. Light-headedness when you stand up (especially at the start of treatment or when the dose is increased).

Asthma or Cough. Chest pain. Palpitations or Irregular heartbeat. Indigestion. Constipation. Diarrhoea. Digestive problems. Loss of appetite. Urinating less. Sore mouth and tongue. Dizziness or Headaches. Tiredness or Weakness. Fainting. Feeling sick or being sick. Muscle cramps. Feeling generally unwell.

Depression or Confusion. Difficulty in sleeping. Nervousness. Pins and needles. Vertigo. Sore throat and hoarseness. Sexual inability in men. Fever or Flushing. Increased sensitivity to sunlight. Runny nose. Ringing in the ears. Blurred vision. Taste alteration. Hair loss. Excessive sweating. Swollen or painful muscles or joints.

Whilst you are taking this medicine it may affect tests your doctor may perform on blood or urine samples. Please remind your doctor that you are taking Enalapril tablets if ever he/she wants to carry out such a test. 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 ENALAPRIL TABLETS Do not store above 25°C. Store in the original package. Do not put them into another container as they might get mixed up. Keep them in the pack in which they are supplied. Keep out of the reach and sight of children. Do not use Enalapril Tablets after the expiry date which is stated on the blister and the carton after EXP or EXP. DATE 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. 6. CONTENTS OF THE PACK AND OTHER INFORMATION What Enalapril Tablets contains The active substance is Enalapril Maleate. The other ingredients are Lactose, Maize Starch and Glycerol Distearate. What Enalapril Tablets look like and contents of the pack Each tablet is white, circular, biplanar and uncoated with either 5, 10 or 20 embossed on one face and a score line on the other. Enalapril 5 mg, 10 mg and 20 mg tablets are available in packs of 28. Product Licence Holder and Manufacturer The product licence holder for your tablets is PharmaDreams Ltd, Old Police Station, Church Street, Swadlincote, DE11 8LN. Your tablets are manufactured by IPG Pharma Ltd, Atrium Court, The Ring, Bracknell, Berkshire, RG12 1BW. PL 28395/0001, PL 28395/0002, PL 28395/0003 If you would like this leaflet in a different format please contact the licence holder at the following address: Atrium Court, The Ring, Bracknell, Berkshire, RG12 1BW. This leaflet was last revised in April 2015.

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.

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