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1996 Toyota 4runner Parts And Accessories - Free Shipping On Orders Over $99 At Summit Racing, Spaci

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Apartments In Carrboro, Nc - Estes Park, Carboron

Estes Park

Apartments for Rent in Carrboro - Floor Plans

We’d love to welcome you home to Estes Park. To get started please view the floor plan options below. At Estes Park in Carrboro, NC we offer 1 and 2 bedroom apartments. If you are a student, select "Apply Online Now" and choose "Yes! I am a student" to see student exclusive options. Availability and pricing change daily.

Community Features

Bike to UNC or take the UNC bus

City bus line “N” stops within the community

Specials for students and University personnel

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Mon 9:00 am - 6:00 pm

Tue 9:00 am - 7:00 pm

Wed 9:00 am - 6:00 pm

Thu 9:00 am - 7:00 pm

Fri 9:00 am - 6:00 pm

Sat 10:00 am - 5:00 pm

Sun 1:00 pm - 5:00 pm

Estes Park

Community Features

Bike to UNC or take the UNC bus

City bus line “N” stops within the community

Specials for students and University personnel

Flexible lease terms available

Sparkling swimming pool

Free Wi-Fi at the pool

Tennis court

Wooded bike/walking path nearby

Fitness center access

Easy access to I-40 and US 15-501

Convenient to Research Triangle Park

Nearby shopping at Carr Mill Mall and University Mall

Chapel Hill/Carrboro School District—the state’s best schools

24-hour emergency service

Professionally managed community

Great staff—friendly and cooperative

Apartment Features

Upgraded kitchens

Washer/dryer available in select units

Built-in breakfast bar

Dishwasher available in select units

Choose your accent wall color

Office Hours

Mon 9:00 am - 6:00 pm

Tue 9:00 am - 7:00 pm

Wed 9:00 am - 6:00 pm

Thu 9:00 am - 7:00 pm

Fri 9:00 am - 6:00 pm

Sat 10:00 am - 5:00 pm

Sun 1:00 pm - 5:00 pm

More Information About Tetracycline, Teracilin

More information about Tetracycline

Canadian Brand Names

Apo-Tetra ® ; Novo-Tetra; Nu-Tetra

Use

Treatment of susceptible bacterial infections of both gram-positive and gram-negative organisms; also infections due to Mycoplasma . Chlamydia . and Rickettsia ; indicated for acne, exacerbations of chronic bronchitis, and treatment of gonorrhea and syphilis in patients that are allergic to penicillin; as part of a multidrug regimen for H. pylori eradication to reduce the risk of duodenal ulcer recurrence

Use - Dental

Treatment of periodontitis associated with presence of Actinobacillus actinomycetemcomitans (AA); as adjunctive therapy in recurrent aphthous ulcers

Pregnancy Risk Factor

Pregnancy Implications

Tetracyclines cross the placenta and enter fetal circulation; may cause permanent discoloration of teeth if used during the last half of pregnancy.

Lactation

Enters breast milk/not recommended (AAP rates "compatible")

Contraindications

Hypersensitivity to tetracycline or any component of the formulation; do not administer to children

8 years of age; pregnancy

Warnings/Precautions

Use of tetracyclines during tooth development may cause permanent discoloration of the teeth and enamel, hypoplasia and retardation of skeletal development and bone growth with risk being the greatest for children <4 years and those receiving high doses; use with caution in patients with renal or hepatic impairment (eg, elderly); dosage modification required in patients with renal impairment since it may increase BUN as an antianabolic agent; pseudotumor cerebri has been reported with tetracycline use (usually resolves with discontinuation); outdated drug can cause nephropathy; superinfection possible; use protective measure to avoid photosensitivity

Adverse Reactions

Frequency not defined.

Central nervous system: Intracranial pressure increased, bulging fontanels in infants, pseudotumor cerebri, paresthesia

Dermatologic: Photosensitivity, pruritus, pigmentation of nails, exfoliative dermatitis

Endocrine & metabolic: Diabetes insipidus syndrome

Gastrointestinal: Discoloration of teeth and enamel hypoplasia (young children), nausea, diarrhea, vomiting, esophagitis, anorexia, abdominal cramps, antibiotic-associated pseudomembranous colitis, staphylococcal enterocolitis, pancreatitis

Renal: Acute renal failure, azotemia, renal damage

Miscellaneous: Superinfection, anaphylaxis, hypersensitivity reactions, candidal superinfection

Overdosage/Toxicology

Symptoms of overdose include nausea, anorexia, and diarrhea. Treatment is supportive.

Drug Interactions

Substrate of CYP3A4 (major); Inhibits CYP3A4 (moderate)

Antacids: May decrease tetracycline absorption; separate doses.

Calcium supplements (oral): May decrease tetracycline absorption; separate doses.

CYP3A4 inducers: CYP3A4 inducers may decrease the levels/effects of tetracycline. Example inducers include aminoglutethimide, carbamazepine, nafcillin, nevirapine, phenobarbital, phenytoin, and rifamycins.

CYP3A4 substrates: Tetracycline may increase the levels/effects of CYP3A4 substrates. Example substrates include benzodiazepines, calcium channel blockers, cyclosporine, mirtazapine, nateglinide, nefazodone, sildenafil (and other PDE-5 inhibitors), tacrolimus, and venlafaxine. Selected benzodiazepines (midazolam and triazolam), cisapride, ergot alkaloids, selected HMG-CoA reductase inhibitors (lovastatin and simvastatin), and pimozide are generally contraindicated with strong CYP3A4 inhibitors.

Didanosine: May decrease tetracycline absorption; separate doses.

Digoxin: Tetracyclines may rarely increase digoxin serum levels.

Iron: May decrease tetracycline absorption; separate doses.

Methoxyflurane anesthesia when concurrent with tetracycline may cause fatal nephrotoxicity.

Oral contraceptives: Anecdotal reports suggesting decreased contraceptive efficacy with tetracyclines have been refuted by more rigorous scientific and clinical data.

Quinapril: May decrease tetracycline absorption; separate doses.

Warfarin with tetracyclines may result in increased anticoagulation.

Ethanol/Nutrition/Herb Interactions

Food: Tetracycline serum concentrations may be decreased if taken with dairy products.

Herb/Nutraceutical: Avoid dong quai, St John's wort (may also cause photosensitization)

Stability

Outdated tetracyclines have caused a Fanconi-like syndrome; protect oral dosage forms from light

Mechanism of Action

Inhibits bacterial protein synthesis by binding with the 30S and possibly the 50S ribosomal subunit(s) of susceptible bacteria; may also cause alterations in the cytoplasmic membrane

Pharmacodynamics/Kinetics

Absorption: Oral: 75%

Distribution: Small amount appears in bile

Relative diffusion from blood into CSF: Good only with inflammation (exceeds usual MICs)

CSF:blood level ratio: Inflamed meninges: 25%

Half-life elimination: Normal renal function: 8-11 hours; End-stage renal disease: 57-108 hours

Time to peak, serum: Oral: 2-4 hours

Excretion: Urine (60% as unchanged drug); feces (as active form)

Dosage

Children >8 years: 25-50 mg/kg/day in divided doses every 6 hours

Adults: 250-500 mg/dose every 6 hours

Helicobacter pylori eradication: 500 mg 2-4 times/day depending on regimen; requires combination therapy with at least one other antibiotic and an acid-suppressing agent (proton pump inhibitor or H2 blocker)

Dosing interval in renal impairment:

Clcr 50-80 mL/minute: Administer every 8-12 hours

Clcr 10-50 mL/minute: Administer every 12-24 hours

Clcr<10 mL/minute: Administer every 24 hours

Dialysis: Slightly dialyzable (5% to 20%) via hemo - and peritoneal dialysis or via continuous arteriovenous or venovenous hemofiltration; no supplemental dosage necessary

Dosing adjustment in hepatic impairment: Avoid use or maximum dose is 1 g/day

Administration

Should be administered on an empty stomach (ie, 1 hour prior to, or 2 hours after meals) to increase total absorption. Administer at least 1-2 hours prior to, or 4 hours after antacid because aluminum and magnesium cations may chelate with tetracycline and reduce its total absorption.

Monitoring Parameters

Renal, hepatic, and hematologic function test, temperature, WBC, cultures and sensitivity, appetite, mental status

Test Interactions

False-negative urine glucose with Clinistix ®

Patient Education

Take this medication exactly as directed. Take all of the prescription even if you see an improvement in your condition. Do not use more or more often than recommended. Preferable to take on an empty stomach, 1 hour before or 2 hours after meals. Take at regularly scheduled times, around-the-clock. Avoid antacids, iron, or dairy products within 2 hours of taking tetracycline. You may experience photosensitivity (use sunscreen, wear protective clothing and eyewear, and avoid direct sunlight); dizziness or lightheadedness (use caution when driving or engaging in tasks requiring alertness until response to drug is known); or nausea/vomiting (small, frequent meals, frequent mouth care, chewing gum, or sucking lozenges may help). Report rash or intense itching, yellowing of skin or eyes, fever or chills, blackened stool, vaginal itching or discharge, foul-smelling stools, excessive thirst or urination, acute headache, unresolved diarrhea, respiratory difficulty, condition does not improve, or worsening of condition. Pregnancy/breast-feeding precautions: Do not get pregnant while taking this medication. Use appropriate barrier contraceptive measures. Breast-feeding is not recommended.

Dental Health: Effects on Dental Treatment

Key adverse event(s) related to dental treatment: Esophagitis, superinfections, and candidal superinfection. Opportunistic "superinfection" with Candida albicans ; tetracyclines are not recommended for use during pregnancy or in children

8 years of age since they have been reported to cause enamel hypoplasia and permanent teeth discoloration. The use of tetracyclines should only be used in these patients if other agents are contraindicated or alternative antimicrobials will not eradicate the organism. Long-term use associated with oral candidiasis.

Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions

Mental Health: Effects on Mental Status

Mental Health: Effects on Psychiatric Treatment

Tetracycline may decrease lithium clearance resulting in an increase in serum lithium levels and potential lithium toxicity although the clinical significance is likely minimal; monitor serum lithium levels

Dosage Forms

Capsule, as hydrochloride: 250 mg, 500 mg

Suspension, oral, as hydrochloride (Sumycin ® ): 125 mg/5 mL (480 mL) [contains sodium benzoate and sodium metabisulfite; fruit flavor]

Tablet, as hydrochloride (Sumycin ® ): 250 mg, 500 mg

References

American Academy of Pediatrics. Committee on Drugs. "Requiem for Tetracyclines," Pediatrics . 1975, 55(1):142-3.

"American Academy of Pediatrics Committee on Drugs. The Transfer of Drugs and Other Chemicals Into Human Milk," Pediatrics . 2001, 108(3):776-89.

Coronado BE, Opal SM, and Yoburn DC, "Antibiotic-Induced D-Lactic Acidosis," Ann Intern Med . 1995, 122(11):839-42.

Cuddihy J, "Case Report of Benign Intra-cranial Hypertension Secondary to Tetracycline," Ir Med J . 1994, 87(3):90.

Fox SA, Berenyi MR, and Straus B, "Tetracycline Toxicity Presenting as a Multisystem Disease," Mt Sinai J Med . 1976, 43(2):129-35.

Gardner K, Cox T, and Digre KB, "Idiopathic Intracranial Hypertension Associated With Tetracycline Use in Fraternal Twins: Case Reports and Review," Neurology . 1995, 45(1):6-10.

Gordon JM and Walker CB, "Current Status of Systemic Antibiotic Usage in Destructive Periodontal Disease," J Periodontol . 1993, 64(8 Suppl):760-71.

Lee AG, "Pseudotumor Cerebri After Treatment With Tetracycline and Isotretinoin for Acne," Cutis . 1995, 55(3):165-8.

Maroon JC and Mealy J Jr, "Benign Intracranial Hypertension. Sequel to Tetracycline Therapy in a Child," JAMA . 1979, 216(9):1479-80.

Rams TE and Slots J, "Antibiotics in Periodontal Therapy: An Update," Compendium . 1992, 13(12):1130, 1132, 1134.

Sargent E, "Tetracycline for Seal Finger," JAMA . 1980, 244(5):437.

Seymour RA and Heasman PA, "Pharmacological Control of Periodontal Disease. II. Antimicrobial Agents," J Dent . 1995, 23(1):5-14

Seymour RA and Heasman PA, "Tetracyclines in the Management of Periodontal Diseases. A Review," J Clin Periodontol . 1995, 22(1):22-35.

Smilack JD, Wilson WR, and Cockerill FR 3d, "Tetracyclines, Chloramphenicol, Erythromycin, Clindamycin, and Metronidazole," Mayo Clin Proc . 1991, 66(12):1270-80.

Walters BN and Gubbay SS, "Tetracycline and Benign Intracranial Hypertension: Report of Five Cases," Br Med J (Clin Res Ed) . 1981, 282(6257):19-20.

Wandstrat TL and Phillips J, "Pseudotumor Cerebri Responsive to Acetazolamide," Ann Pharmacother . 1995, 29(3):318.

Yoshikawa TT, "Antimicrobial Therapy for the Elderly Patient," J Am Geriatr Soc . 1990, 38(12):1353-72.

International Brand Names

Apo-Tetra ® (CA); Bactocyline ® (BD); Ciclobiotico ® (PT); Economycin ® (GB); Infex ® (BR); Novo-Tetra (CA); Nu-Tetra (CA); Pervasol ® (AR); Tancilina ® (AR); Teracilin ® (BD); Tetra-Atlantis ® (MX); Tetrabiotico ® (EC); Tetraciclina ® (BR, CL); Tetraciclina L. CH. ® (CL); Tetrana ® (TH); Tetrin ® (ID)

Croton Seeds Uses, Side Effects, Interactions And Warnings, Crotanol

CROTON SEEDS

Overview

Croton is a plant. The oil from the seeds is used to make medicine.

Despite serious safety concerns, people take croton seeds for emptying and cleansing the stomach and intestines. They also take croton seeds to treat gallbladder problems, colic. blocked intestines, and malaria .

Croton seeds are sometimes applied directly to the skin for muscle and joint pain (rheumatism), gout. nerve pain (neuralgia), and bronchitis .

How does it work?

Croton seeds contain chemicals that have a powerful irritating effect on the stomach and intestines.

Uses

Insufficient Evidence for

TAKEN BY MOUTH

Gallbladder problems.

Blocked intestines.

Malaria.

Emptying and cleansing the stomach and intestines.

Other conditions.

APPLIED TO THE SKIN

Joint pain.

Gout .

Nerve pain .

Bronchitis .

Other conditions.

More evidence is needed to rate the effectiveness of croton seeds for these uses.

Side Effects

Croton seeds are UNSAFE when taken by mouth or put on the skin. One drop of croton seed oil can cause side effects, and 20 drops of oil can cause death.

Croton seeds can cause burning of the mouth. vomiting. dizziness. stupor, painful bowel movements. abortions in pregnant women, and collapse when taken by mouth. If croton seeds are put on the skin, they can cause itching. burning, and blistering.

Special Precautions & Warnings:

Pregnancy and breast - feeding . Croton seeds are UNSAFE for anyone to use, but women who are pregnant should use extra care to avoid croton seeds because they can cause an abortion. Croton seeds are also UNSAFE to use if you are breast - feeding.

Interactions

No data available at this time.

Dosing

The appropriate dose of croton seeds depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for croton seeds. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Conditions of Use and Important Information: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version. © Therapeutic Research Faculty 2009.

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Buy Pain Relief - Tanfedin (Brand Name Tegretol) Online - Order Carbamazepine - Purchase Pain Relief

Tegretol (carbamazepine) is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and pain. Tegretol is used to treat seizures and nerve pain such as trigeminal neuralgia and diabetic neuropathy. Carbamazepine is also used to treat bipolar disorder. Tegretol may also be used for purposes not listed in this medication guide.

Take Tegretol exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.

Do not crush, chew, or break an extended-release Tegretol tablet. Swallow the pill whole. Breaking the pill would cause too much of the drug to be released at one time.

Shake the Tegretol oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and call your doctor promptly if this medicine seems to stop working as well in preventing your seizures. Tegretol can lower blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill.

To be sure Tegretol is not causing harmful effects, your blood cells and kidney function may need to be tested often. Do not miss any follow up visits to your doctor for blood or urine tests. Your doctor may also recommend having your eyes checked regularly while you are taking this medicine.

Do not stop using Tegretol without first talking to your doctor, even if you feel fine. You may have increased seizures or unpleasant withdrawal symptoms if you stop using this medicine suddenly. Wear a medical alert tag or carry an ID card stating that you take Tegretol. Any medical care provider who treats you should know that you take seizure medication.

Store this medicine at room temperature away from moisture, heat, and light.

Active Ingredient: Carbamazepine

Tegretol may cause severe or life-threatening skin rash, especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk of this skin reaction. Seek emergency medical attention if you have a fever, sore throat, headache and skin pain, followed by a red or purple skin rash that spreads and causes blistering and peeling.

You should not take Tegretol if you have a history of bone marrow suppression, if you are also taking nefazodone, or if you are allergic to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor).

Tegretol may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant while taking Tegretol for seizures. Do not start or stop taking Tegretol during pregnancy without your doctor's advice.

Before you take Tegretol, tell your doctor if you have heart disease, high blood pressure, high cholesterol, liver or kidney disease, glaucoma, a thyroid disorder, lupus, porphyria, or a history of mental illness or psychosis.

You may have thoughts about suicide while taking Tegretol. Your doctor will need to check you at regular visits. Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

There are many other drugs that can interact with Tegretol. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Do not stop using Tegretol without first talking to your doctor, even if you feel fine. You may have increased seizures or unpleasant withdrawal symptoms if you stop using Tegretol suddenly.

Do not use Tegretol if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. You should not take Tegretol if you are allergic to carbamazepine, or if you have:

a history of bone marrow suppression

if you are also taking nefazodone; or

if you are allergic to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor).

Important safety information:

Tegretol may cause severe or life-threatening skin rash, especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk of this skin reaction.

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

heart disease, high blood pressure, high cholesterol or triglycerides;

liver or kidney disease;

a thyroid disorder;

a history of mental illness or psychosis.

Patients of Asian ancestry may have a higher risk of developing a rare but serious skin reaction to Tegretol. Your doctor may recommend a blood test before you start the medication to determine your risk of this skin reaction.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

You may have thoughts about suicide while taking Tegretol. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed. Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking Tegretol. Follow your doctor's instructions about taking Tegretol while you are pregnant.

FDA pregnancy category D. Tegretol may cause harm to an unborn baby. Do not start taking this medcine without telling your doctor if you are pregnant or planning to become pregnant. Use effective birth control while you are taking this medicine. Although Tegretol may harm an unborn baby, having a seizure during pregnancy could harm both mother and baby. If you become pregnant while taking Tegretol, do not stop taking the medicine without your doctor's advice.

Carbamazepine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Tegretol. Carbamazepine can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking Tegretol.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid drinking alcohol. It can increase some of the side effects of Tegretol, and can also increase your risk of seizures.

Avoid exposure to sunlight or tanning beds. Tegretol can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Grapefruit and grapefruit juice may interact with Tegretol and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Get emergency medical help if you have any of these signs of an allergic reaction to Tegretol: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

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

pale skin, feeling light-headed, rapid heart rate, trouble concentrating;

fever, chills, sore throat, mouth and throat ulcers;

easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;

confusion, agitation, vision problems, hallucinations;

feeling short of breath, swelling of your ankles or feet;

urinating less than usual;

jaundice (yellowing of the skin or eyes); 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.

Less serious Tegretol side effects may include:

feeling dizzy, drowsy, or unsteady;

nausea, vomiting, diarrhea, constipation, stomach pain;

headache, ringing in your ears;

dry mouth, swollen tongue; or

joint or muscle pain, leg cramps.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Buy Artrifenac Diclofenac Online Without Prescriptions, Artrifenac

Diclofenac is used primarily for the treatment of inflammation and pain caused by conditions such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. It is also effective in treating soft tissue inflammations due to tendinitis and bursitis, and treating dysmenorrhea (menstrual cramps). Diclofenac is an NSAID. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes those symptoms.

Use Diclofenac as directed by your doctor!

Take Diclofenac by mouth. It may be taken with food if it upsets your stomach. Taking it with food may not lower the risk of stomach or bowel problems (eg, bleeding, ulcers). Talk with your doctor or pharmacist if you have persistent stomach upset.

Take Diclofenac with a full glass of water (8 oz/240 mL) as directed by your doctor.

If you miss a dose of Diclofenac, 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 Diclofenac.

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

Do NOT use Diclofenac if:

you are allergic to any ingredient in Diclofenac or to bovine (cow) protein

you have had a severe allergic reaction (eg, severe rash, hives, trouble breathing, growths in the nose, dizziness) to aspirin or an NSAID (eg, ibuprofen, celecoxib)

you have recently had or will be having bypass heart surgery

you have severe kidney problems

you are in the last 3 months of pregnancy.

Contact your doctor or health care provider right away if this applies to you.

Some medical conditions may interact with Diclofenac. 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 kidney or liver problems, diabetes, or stomach or bowel problems (eg, bleeding, perforation, ulcers)

if you have a history of swelling or fluid buildup, asthma, growths in the nose (nasal polyps), or mouth inflammation

if you have high blood pressure, blood disorders (eg, porphyria), bleeding or clotting problems, heart problems (eg, heart failure), or blood vessel disease, or if you are at risk for any of these diseases

if you have poor health, dehydration or low fluid volume, or low blood sodium levels, you smoke, drink alcohol, or have a history of alcohol abuse

if you are taking an antibiotic or an anti-seizure medicine. The risk of liver problems may be increased with some of these medicines.

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

Anticoagulants (eg, warfarin), aspirin, clopidogrel, corticosteroids (eg, prednisone), heparin and other blood thinners (eg, dalteparin), or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) because the risk of stomach bleeding may be increased

Acetaminophen because the risk of liver problems may be increased

Probenecid because it may increase the risk of Diclofenac's side effects

Cyclosporine, lithium, metformin, methotrexate, oral NSAIDs (eg, ibuprofen), or quinolones (eg, ciprofloxacin) because the risk of their side effects may be increased by Diclofenac

Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril) or diuretics (eg, furosemide, hydrochlorothiazide) because their effectiveness may be decreased by Diclofenac.

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

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

Serious stomach ulcers or bleeding can occur with the use of Diclofenac. Taking it in high doses, for a long time, smoking, or drinking alcohol increases the risk of these side effects. Taking Diclofenac with food will NOT reduce the risk of these effects. If you have severe stomach or back pain; black, tarry stools; vomit that looks like blood or coffee grounds; or unusual weight gain or swelling, contact your doctor or emergency room right away.

Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.

Diclofenac is an NSAID. Before you start any new medicine, check the label to see if it has an NSAID (eg, ibuprofen) in it too. If it does or if you are not sure, check with your doctor or pharmacist.

Do not take aspirin while you are using Diclofenac unless your doctor tells you to.

Check with your doctor or pharmacist before you take acetaminophen while you are taking Diclofenac. The risk of liver problems may be increased.

Do not switch between different forms of Diclofenac (eg, enteric-coated tablets, immediate-release tablets, capsules) unless your doctor tells you to. They may not provide the same amount of medicine to your body.

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

Use Diclofenac with caution in the elderly; they may be more sensitive to its effects, especially stomach bleeding and kidney problems.

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

Pregnancy and breast-feeding: Diclofenac may cause harm to the fetus. Do not use it during the last 3 months of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Diclofenac while you are pregnant. It is not known if Diclofenac is found in breast milk. Do not breastfeed while taking Diclofenac.

Buy Woman S Health - Clotrex (Brand Name Mycelex-G) Online - Order Clotrimazole - Purchase Woman S H

Mycelex-G (Clotrimazole) is an antifungal medication. It prevents fungus from growing.

Clotrimazole vaginal is used to treat vaginal candida (yeast) infections.

Clotrimazole vaginal may also be used for purposes other than those listed in this medication guide.

Use Mycelex-G exactly as directed by your doctor, or follow the directions that accompany the package. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Wash your hands before and after using this medication.

Insert the tablet, suppository, or cream into the vagina using the applicator as directed.

Use this medication continuously for the prescribed amount of time, even during your menstrual period.

You can use a sanitary napkin to prevent the medication from staining your clothing but do not use a tampon.

If the infection does not clear up after you have finished one course of therapy, or if it appears to get worse, see your doctor. You may have another type of infection.

Avoid getting this medication in your eyes, nose, or mouth. Store clotrimazole vaginal at room temperature away from moisture and heat.

Active ingredient: Clotrimazole

Clotrimazole is an antifungal medication. It prevents fungus from growing.

Clotrimazole vaginal is used to treat vaginal candida (yeast) infections.

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

Do not use clotrimazole vaginal if you have ever had an allergic reaction to it.

If this is the first time that you have ever had symptoms of a vaginal yeast infection, consult your doctor before using this medication.

Do not use clotrimazole vaginal if you have a fever, abdominal pain, foul-smelling discharge, diabetes, HIV, or AIDS. Consult your doctor. Do not use this medication without first talking to your doctor if you are pregnant. Do not use clotrimazole vaginal without first talking to your doctor if you are breast-feeding a baby. Do not use this medication if you are younger than 12 years of age.

Important safety information

Use this medication for the full amount of time prescribed by your doctor or recommended in the package even if you begin to feel better. Your symptoms may improve before the infection is completely healed.

Avoid wearing tight-fitting, synthetic clothing (e. g. panty hose) that does not allow air circulation. Wear loose-fitting clothing made of cotton and other natural fibers until the infection is healed. Avoid getting this medication in your eyes, nose, or mouth.

Stop using clotrimazole vaginal and seek emergency medical attention if you experience an allergic reaction (shortness of breath; closing of your throat; swelling of your lips, face, or tongue; or hives).

Other, less serious side effects may be more likely to occur. These include burning, itching, irritation of the skin, and an increased need to urinate.

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.

Avoid using other vaginal creams or douches at the same time as clotrimazole unless your doctor approves.

Drugs other than those listed here may also interact with clotrimazole vaginal. Talk to your doctor and pharmacist before taking any prescription or over the counter medicines.

Pharex Norfloxacin, Pharex Norfloxacin

Gastrointestinal - Pharex norfloxacin (Brand name: noroxin)

Product Description Common use Noroxin is quinolone antibiotic used for treatment of urinary tract such as pyelonephritis, cystitis, urethritis), genitals (prostatitis, cervicitis, endometritis), gastrointestinal tract (salmonellosis, shigellosis), uncomplicated gonorrhea. Mechanism of its action consists in inhibition of DNA gyrase leading to destabilization of the bacterial DNA and death of the susceptible bacteria. Noroxin is active against Staphylococcus spp. (including Staphylococcus aureus), Neisseria spp. E. coli, Citrobacter spp. Klebsiella spp. Proteus spp. Salmonella spp. Enterobacter spp. Hafnia, Shigella spp. Mycobacterium tuberculosis, Vibrio cholerae, Haemophilus influenzae, Chlamydia spp. Mycoplasma spp. and some others. Medication is active for 12 hours.

Dosage and directions To treat infections of urinary tract, take 400 mg of Noroxin two times a day during 7-10 days, to treat non-complicated cystitis treatment continues 3-7 days, and in patients with recurrent chronic infection of urinary tract it is up to 12 weeks. For prostatitis the recommended daily dose is 800 mg, divided into 2 doses, for four weeks. Usual single recommended dose to treat gonorrhea is 800 milligrams for 1 day. The maximal daily dose is 800 milligrams. Take with a full glass of water two hours after a meal or one hour before it. Drink plenty of water while taking Noroxin to avoid formation of needle-shaped crystals in your urine. The elderly and people with kidney problems may need to use a reduced dosage or have their kidney function monitored. Take exactly as prescribed by your doctor. Do not start or stop treatment without your doctor's permission.

Precautions In elderly and patients with kidney impairment, kidney function monitoring is required on a regular basis. This medication may cause photosensibilization, avoid direct sun rays during treatment. Limit consummation of alcoholic beverages as they may worsen such side effects as dizziness, drowsiness and others which may affect your ability to operate machinery and driving.

Contraindications This medication cannot be administered in patients with hypersensitivity to Noroxin, pregnant and breastfeeding women, children under 18 y. o. individuals with glucose-6-phosphate dehydrogenase deficiency. Caution is required when Noroxin is administered in individuals with cerebral arteriosclerosis, cerebrovascular dysfunctions, epilepsy, epileptic syndrome, Myasthenia gravis, kidney or liver failure.

Possible side effect The most common side effects include: weakness, headache, drowsiness, dizziness, nausea, stomach upset. Rare but serious side effects are: tremor and sun sensitivity, seizures, mental/mood changes, sore throat/fever, vision changes, hearing loss, change in amount or appearance of urine, jaundice, fainting, changes in heartbeat, easy bruising or bleeding, numbness or tingling of extremities. Tendon damage and weakening of muscles is rare but possible. Stop exercising and claim prompt medical attention if you experience pain in your joint or tendon. In case of pseudomembranous colitis (persistent diarrhea, abdominal or stomach pain/cramping, blood/mucus in your stool) which may develop even a few weeks after the treatment was discontinued, do not use anti-diarrhea products or narcotic pain medications. Tell your doctor immediately about your condition. Prolonged or repeated used of Noroxin may cause oral thrush or a new vaginal yeast infection with such symptoms as: white patches in the mouth, a change in vaginal discharge. Inform your doctor immediately if you experience allergic reaction (severe dizziness, rash, itching, swelling, trouble breathing).

Drug interaction Theophylline dose should be decreased while on Noroxin. Noroxin increases the blood concentration of indirect anticoagulants, cyclosporine, decreases effects of nitrofurans. Antacids which contain ions of Al and Mg, medications which contain Fe, Zn2+, sucralfate should be taken at least with four hour interval with Noroxin. Concomitant intake with the medicines decreasing epileptic threshold may lead to epileptic attacks. Dangerous sudden drop in blood pressure or changes in heart rhythm are possible when Noroxin is concomitantly used with the drugs for blood pressure or affecting the heart rhythm. Inform your doctor about all prescribed and over-the-counter medications and herbal products you are taking.

Missed dose If you miss a dose, take it as soon as you remember unless it is almost time of your next dose. If it is near the time of the next dose, skip the missed dose and return dosing schedule. Do not double the dose to make up the missed dose.

Overdose Symptoms of overdose include: dizziness, nausea, vomiting, drowsiness, "cold" sweating, puffy face without major changes in hemodynamic indices.

Storage Store at room temperature in a tight container, away from moisture and humidity.

Disclaimer We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at 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 adviser 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.

Esidrix Oral Uses, Side Effects, Interactions, Pictures, Warnings - Dosing, Esidrex

Esidrix

Uses

This medication is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks. and kidney problems. Hydrochlorothiazide is a "water pill" (diuretic) that causes you to make more urine. This helps your body get rid of extra salt and water.

This medication also reduces extra fluid in the body (edema ) caused by conditions such as heart failure. liver disease, or kidney disease. This can lessen symptoms such as shortness of breath or swelling in your ankles or feet.

How to use Esidrix

Take this medication by mouth as directed by your doctor, usually once daily in the morning with or without food. It is best to avoid taking this medication within 4 hours of your bedtime to prevent having to get up to urinate.

The dosage is based on your medical condition and response to treatment.

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

Cholestyramine and colestipol can decrease the absorption of hydrochlorothiazide. If you are taking either of these drugs, take them at least 4 hours before or after taking hydrochlorothiazide.

Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings increase).

Side Effects

Upset stomach. dizziness. or headache may occur as your body adjusts to the medication. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

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

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

Tell your doctor right away if you have any serious side effects, including: decrease in vision. eye pain .

This medication may cause a serious loss of body water (dehydration ) and salt/minerals. Tell your doctor right away if any of these unlikely but serious side effects occur: muscle cramps /weakness. slow/fast/irregular heartbeat. unusual decreased urination, unusual dry mouth /thirst.

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

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

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

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

Precautions

Before taking hydrochlorothiazide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as sulfites found in some brands), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes. gout. kidney disease, liver disease, lupus .

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

Severe sweating. diarrhea. or vomiting can increase the risk for a serious loss of body water (dehydration ). Report prolonged diarrhea or vomiting to your doctor. To prevent dehydration. drink plenty of fluids unless your doctor directs you otherwise.

If you have diabetes. hydrochlorothiazide may affect your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Your doctor may need to adjust your diabetes medication, exercise program. or diet.

This drug may decrease your potassium levels. Ask your doctor about foods high in potassium (such as bananas, orange juice) or about using a salt substitute containing potassium. A potassium supplement may be prescribed by your doctor.

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

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

Older adults may be more sensitive to the effects of this drug, especially dizziness.

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

This drug passes into breast milk, but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

Interactions

See also How To Use section.

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

Some products that may interact with this drug include: cisapride, dofetilide, lithium.

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

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

Overdose

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

Notes

Do not share this medication with others.

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

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

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

Missed Dose

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

Storage

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

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

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

Images

Atenor

www. atenor. be/en/ imprime le 19-09-2016

Full of contrasts and faced with multiple challenges, the city is alive and kicking. It’s become a symbol of a dynamic and progressive civilization.

The world now counts almost 3.3 billion urban dwellers; that’s 4.5 times more than in 1950. And projections suggest that by 2030, over 60% of the world’s population will live in towns and cities.

As a real-estate developer, Atenor is particularly attentive to the evolution of urban life. Active, as we are, in its inevitable and necessary transformation, Atenor continues to develop a variety of dense and mixed projects in urban centres and near communication hubs.

Atenor gives city lovers, no matter whether they live or work there, buildings that are both adapted to harmonious communal living and their evolving expectations.

Looking for a place to live or to work

Visit our projects in portfolio

Want to do Business

Architects, engineering companies, general contractors

Just Curious

Want to know more about Atenor and its expertise

WANT TO INVEST

Atenor share and financial communication

Financial annual report 2015

City Dockx has been renamed CITY DOX. More than a name change, this means a new and strong positioning, renewed branding and communication tools.

24 May 2016. 2nd edition of the Atenor cocktail around the theme :The city is worth living in!

UPPETITE - Eat it UP-site!

Annual results 2015

VACI GREENS BUDAPEST. Property Project of the Year 2015!

Atenor and Caroline Notte, an innovative partnership for the creation of unique atmospheres and settings in the UP-site (Brussels) and Port du Bon Dieu (Namur) apartments

LA SUCRERIE, ATH - OPENING OF THE NEW SHOW APARTMENT

VICTOR - Master Plan approved!

PALATIUM - Building Permit obtained on 2 December!

Discover the UP-site story.

Throughout the photographies captured by Tom D'haenens, Atenor invites you to experience the fabulous story of UP-site.

Tuesday 8 September 2015 at 6 :00 pm – Salle Boursiere Charleroi – Presentation of the semi-annual results of ATENOR by Mr Sidney D. Bens, Chief Financial Officer

On Tuesday 19 May, about a hundred guests gathered in Atenor new Business Room located on the 33th floor of the UP-site Tower, in the run-up of Realty 2015.

17 June 2015 - Second building of the Vaci Greens office complex unveiled in the presence of the Ambassador of Belgium in Hungary and Bjorn Bergabo, General Manager of GE Global Operations Europe & Russia/CIS

Ibugesic Tablets 400 Mg, Ibugesic

Ibugesic Tablets

Shipping time: 8-21 working days.

Ibugesic tablets are currently not available. We offer Brufen Tablets manufactured by Abbott (Generic Ibuprofen) instead. Please follow this link.

Ibugesic Tablets (Generic Ibuprofen) – Product Information

Ibugesic (Ibuprofen) is used for relief of the signs and symptoms of rheumatoid arthritis and osteoarthritis.

Name of Drug

Ibugesic is also known as as Motrin, Advil, Brufen, Calprofen, Ribafen, Nurofen.

Manufacturer of Ibugesic Tablets

Active Pharmaceutical Ingredient

The active pharmaceutical ingredient contained in Ibugesic (Generic Ibuprofen) Tablets is Ibuprofen

Drug Uses

Ibugesic Tablets are used for relief of the signs and symptoms of rheumatoid arthritis and osteoarthritis. Take this medicine for the relief of mild to moderate pain. Your doctor may prescribe Ibugesic for the treatment of primary dysmenorrhea.

Ibugesic Tablets – Dosage

Ibugesic must not be used for more than few days at a time. The dosage varies as per the condition being treated. The starting adult dose is usually 200 to 400 mg orally every 4 to 6 hours as needed. Do not exceed 3200 mg total daily dose. Consult your doctor for exact dosing instructions. If you experience gastrointestinal toxicity, take Ibugesic Tablets with meals or milk

Drug Class and Mechanism

Ibuprofen belongs to a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). Other members of this class include naproxen (Aleve), indomethacin (Indocin), nabumetone (Relafen) and several others. These drugs are used for the management of mild to moderate pain, fever, and inflammation. Prostaglandins are chemicals that are made by the body and are responsible for causing pain, fever and inflammation. Ibuprofen blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower levels of prostaglandins. As a consequence, inflammation, pain and fever are reduced. The FDA approved ibuprofen in 1974.

Missed Dose

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

Storage Instructions for Ibugesic Tablets

Store Ibugesic Tablets at controlled room temperature 20 to 25 degrees C (68 to 77 degrees F).

Warnings and Precautions to be taken when using Ibugesic Tablets

You should not take Ibugesic Tablets if you have previously exhibited hypersensitivity to the drug, or have the syndrome of nasal polyps, angioedema and bronchospastic reactivity to aspirin or other nonsteroidal anti-inflammatory agents. Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms.

Contraindications

Ibugesic is contraindicated for use in patients which have one or more of the below mentioned conditions.

A known hypersensitivity or idiosyncratic reaction to ibuprofen or any of the other ingredients in the product.

A known hypersensitivity to aspirin and other NSAIDs

Asthma that is aspirin or NSAID sensitive

Active gastrointestinal bleeding or peptic ulceration

Possible Side Effects of Ibugesic Tablets

The most frequent type of side effect that you may experience with Ibugesic Tablets is gastrointestinal. Other side effects that have been reported include Blurred and/or diminished vision, scotomata, and/or changes in color vision .

More Information Regarding Ibugesic Use

Contact your doctor if you experience blood in vomit or bloody, black, or tarry stools. These symptoms could indicate damage to the stomach or intestines, which could be dangerous. If you experience any of the following serious side effects, stop taking ibuprofen and seek medical attention or contact your doctor immediately:

an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

muscle cramps, numbness, or tingling;

ulcers (open sores) in the mouth;

rapid weight gain (fluid retention);

seizures;

decreased hearing or ringing in the ears;

yellowing of the skin and eyes (jaundice); or

abdominal cramping, indigestion, or heartburn.

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

dizziness or headache;

nausea, gaseousness, diarrhea, or constipation;

depression;

fatigue or weakness;

dry mouth; or

irregular menstrual periods.

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.

Buy Ibugesic (Generic Ibuprofen) Tablets 400 mg Online

You can buy Cheap online from the Swiss Pharmacy. It is available in pills of 400 mg. The 400 mg pills are priced at only $0.11 per unit if you place an order for 360 tablets.

This Product was added to our catalogue on Saturday, 09. October 2010.

Norman County, Normaln

Welcome to Norman County

We are excited about using this web site to communicate online with our citizens, businesses, and visitors. In Norman County we always strive to provide up-to-date information on: County services that enhance your quality of life.

If you find there is information missing from our site or if certain information is difficult to find, please contact the Site Administrator by clicking here. Your comments are important to the continued development of the county Web site.

Thank you for visiting the Norman County Web site!

Norman County Courthouse

Mesa Grand, Mesagran

Welcome to Mesa Grand

Mesa Grand has amassed a brilliant collection of boutiques, national retail anchors, unique eateries and traditional restaurants. For a quick bite, a special occasion, a gallon of milk, or an afternoon of retail therapy, the marketplace delivers.

Whet Your Appetite

Tease your taste buds at an assortment of upscale and casual-theme restaurants or grab a quick bite to go. Click here to view our full dining guide.

Shop Til You Drop

Fashion, home goods, electronics & more. Click here for Mesa Grand’s wide variety of shopping destinations.

Play & Services

Makeovers, movies & other lifestyle necessities. Click here for places to play and here for a full list of services.

Located on the north-east corner of Stapley & Baseline, right off US 60

Mesa Grand

Lumon Canada, Lumona

Lumon offers glass walls and patio covers for porches and condo balconies

Discover the possibilities that only a Lumon sunroom or balcony windbreak can offer.

Make your deck or patio your favourite place in your home with a retractable balcony windbreak or a sunroom from Lumon.

At Lumon, we believe that enjoying your balcony space or your patio should not happen only on days or evenings when the weather is spectacular. We believe that you should determine when and how you use your balcony or patio – not bad weather, high winds, noise from traffic, or bugs.

Thank you for making this happen! Only Steve and Lumon know what to do and do it right!

– Randy & Shelly S. from Langley, BC

Whether you're tired of being kept indoors by the endless Vancouver rain, battling swarms of mosquitoes in Winnipeg, worried about high winds on your condo balcony in Calgary, or losing sleep from traffic noise in Toronto, Lumon has a solution for your home. What's keeping you from using your deck today?

Our sunrooms, patio covers, and balcony glass systems breathe new life into unused outdoor spaces.

Never again cancel your child's birthday party because of rain with the protection of a Lumon patio cover .

Get a head start on your spring gardening with a glass sunroom or solarium .

Host a dinner party on your condo balcony without fear of high winds overturning your drinks.

The possibilities are endless.

I would definitely recommend the Lumon window enclosures for anyone who wants to make better use of their outdoor space. The Lumon staff was extremely courteous and professional. They take pride in their work and take action on your concerns. I highly recommend Lumon for your balcony or terrace solutions.

– Diane B. from Toronto, ON

We also offer balcony and patio solutions for developers, architects, contractors, and restaurant owners.

Excellent installers. exceptional attention to detail. And a very fine product. Thank you!

– Sue H. from Mission, BC

Turn your patio into a space that works for you.

The possibilities for your condo balcony are endless with a balcony windbreak.

Prexor Profile En, Prexor

Prexor born from the standing out desire of its founders. In today’s market the only way to operate, it’s producing reliable, well maintained and also considering potential client who has already purchased.

The heart of Prexor is a team of engineers from different backgrounds: system design, production and commissioning, industrial planning.

Prexor projects and fabricates waste water purification and filtration plants for many business fields such as marble and granite, aggregates, ceramics, glass, steelworks, industrial laundries, breweries, tanneries, slaughterhouses, galvanic, cheese factories.

Every detail that is not based on the treasure acquired from previous experiences in the field, is subjected to analysis by FEM systems subject to a comprehensive 3D modeling.

Thanks to a real obsession with security we are sure to provide advanced machinery and durable.

Conazol (Marcasusa Llc) Mie Nitrate 20mg In 1g Cream, Conazol

Conazol by MarcasUSA LLC

Effective Time: 20140804

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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Las Ramblas In Barcelona Essential Guide & Advice, Rablas

Las Ramblas in Barcelona. Essential Guide and Advice

Page Content

This page will give you detailed information on the famous La Rambla (Las Ramblas as it is often referred to locally), including its main attractions, sights of interest and links to hotels on the Ramblas.

Las Ramblas is often the first landmark that most tourists identify with the city. It is the central most boulevard which cuts through the heart of the city centre and is a vibrant and lively promenade filled with Barcelona action at its best (and sometimes the worst. More later on this subject).

Las Ramblas boulevard

Orientation - Las Ramblas

Las Ramblas is approximately 1.2 kilometres long with Port Vell (near the cruise port terminal) at the Southern most end and Placa Catalunya at the northern most end.

If you have your back to Port Vell and you are looking up towards Catalunya along the Ramblas on your left hand side is the Raval area and on your right-hand side is the Barri Gotic (or Gothic Quarter).

Las Ramblas can also be roughly divided into seedy and non-seedy areas. This distinction between seedy and non-seedy becomes a lot clearer during the night time when the Southern most end of the Ramblas becomes something of a red light district and is frequented by night women (prostitutes).

In this article when I mention the northern most end of the Ramblas I mean north of the Liceu theatre (which is a mid way point along Las Ramblas) and the southern most end as being south of the Liceu Theatre.

Transportation along Las Ramblas in Barcelona

La Rambla is primarily pedestrianized with only two narrow one-way traffic roads which run on either side of the central Ramblas Boulevard.

Barcelona city council have restricted traffic flow through this region and you have the overwhelming feeling that pedestrians rule in this area (which makes a welcome change). Unlike other cities that have huge roads running through the middle Barcelona has chosen to structure the road system such that the heart of the city centre is primarily pedestrianized with larger roads that service the periphery.

Japanese paintings and decoration on a building on La Rambla

Metro stops on the Barcelona Las Ramblas

The Ramblas is serviced by three Metro stops along its length making it a superb transport point to see the rest of the city.

At the Southern most end of La Rambla, near to Christopher Columbus memorial, you have the Drassanes Metro stop. ( Green Line, L3 )

Midway along the Barcelona Las Ramblas, just outside the Liceu Theatre, you have the Metro stop Liceu. ( Green Line, L3 )

At the northern most tip of the Barcelona Ramblas you have metro stop Catalunya which is serviced by the Metro on both the ( Green Line, L3 ) and ( Red Line, L1 ). Catalunya is also the point at which you can catch the Aerobus ( Express bus service to the airport) and the Barcelona Tours Bus (A Hop on Hop Off Tourist Bus) which will take you around 3 circuits of popular tourist attractions.

Accommodation on Barcelona Las Ramblas

There is plenty of accommodation along the Ramblas in the form of hotels, hostals and apartments.

Although the Ramblas offers you excellent access to the heart of the city it is worth remembering that if you choose accommodation on the Ramblas you must be prepared for noise. There is no getting away from this. Regardless of whether your hotel has double glazing or not be prepared for some noise. There will even be street noise at night when the Ramblas can be busy until 3 am or later. See our guide to hotels near Las Ramblas

Attractions along Las Ramblas Barcelona.

Attractions along the Ramblas including live performances, human statue art, artists that will draw your portrait or caricature, as well as established attractions like:

Human Statues

The Ramblas is famous for street performers including human statues.

Clopidogrel - Fda Prescribing Information, Side Effects And Uses, Klopidogrel

Clopidogrel

WARNING: DIMINISHED EFFECTIVENESS IN POOR METABOLIZERS

The effectiveness of Clopidogrel is dependent on its activation to an active metabolite by the cytochrome P450 (CYP) system, principally CYP2C19 [see Warnings and Precautions (5.1) ]. Clopidogrel at recommended doses forms less of that metabolite and has a smaller effect on platelet function in patients who are CYP2C19 poor metabolizers. Poor metabolizers with acute coronary syndrome or undergoing percutaneous coronary intervention treated with Clopidogrel at recommended doses exhibit higher cardiovascular event rates than do patients with normal CYP2C19 function. Tests are available to identify a patient’s CYP2C19 genotype; these tests can be used as an aid in determining therapeutic strategy [see Clinical Pharmacology (12.5) ]. Consider alternative treatment or treatment strategies in patients identified as CYP2C19 poor metabolizers [see Dosage and Administration (2.3) ].

Indications and Usage for Clopidogrel

Acute Coronary Syndrome (ACS)

• For patients with non-ST-segment elevation ACS [unstable angina (UA)/non-ST-elevation myocardial infarction (NSTEMI)], including patients who are to be managed medically and those who are to be managed with coronary revascularization, Clopidogrel has been shown to decrease the rate of a combined endpoint of cardiovascular death, myocardial infarction (MI), or stroke as well as the rate of a combined endpoint of cardiovascular death, MI, stroke, or refractory ischemia. • For patients with ST-elevation myocardial infarction (STEMI), Clopidogrel has been shown to reduce the rate of death from any cause and the rate of a combined endpoint of death, re-infarction, or stroke. The benefit for patients who undergo primary percutaneous coronary intervention is unknown.

The optimal duration of Clopidogrel therapy in ACS is unknown.

Recent MI, Recent Stroke, or Established Peripheral Arterial Disease

For patients with a history of recent myocardial infarction (MI), recent stroke, or established peripheral arterial disease, Clopidogrel has been shown to reduce the rate of a combined endpoint of new ischemic stroke (fatal or not), new MI (fatal or not), and other vascular death.

Clopidogrel Dosage and Administration

Acute Coronary Syndrome

Clopidogrel can be administered with or without food [see Clinical Pharmacology (12.3) ] .

• For patients with non-ST-elevation ACS (UA/NSTEMI), initiate Clopidogrel with a single 300 mg oral loading dose and then continue at 75 mg once daily. Initiate aspirin (75 to 325 mg once daily) and continue in combination with Clopidogrel [see Clinical Studies (14.1) ]. • For patients with STEMI, the recommended dose of Clopidogrel is 75 mg once daily orally, administered in combination with aspirin (75 to 325 mg once daily), with or without thrombolytics. Clopidogrel may be initiated with or without a loading dose [see Clinical Studies (14.1) ].

Recent MI, Recent Stroke, or Established Peripheral Arterial Disease

The recommended daily dose of Clopidogrel is 75 mg once daily orally, with or without food [see Clinical Pharmacology (12.3) ] .

CYP2C19 Poor Metabolizers

CYP2C19 poor metabolizer status is associated with diminished antiplatelet response to Clopidogrel. Although a higher dose regimen in poor metabolizers increases antiplatelet response [see Clinical Pharmacology (12.5) ]. an appropriate dose regimen for this patient population has not been established.

Use with Proton Pump Inhibitors (PPI)

Avoid using omeprazole or esomeprazole with Clopidogrel. Omeprazole and esomeprazole significantly reduce the antiplatelet activity of Clopidogrel. When concomitant administration of a PPI is required, consider using another acid-reducing agent with minimal or no CYP2C19 inhibitory effect on the formation of Clopidogrel active metabolite [see Warnings and Precautions (5.1). Drug Interactions (7.1) and Clinical Pharmacology (12.3) ].

Dosage Forms and Strengths

• 75 mg tablets: Pink colored, Round shaped, biconvex, film coated tablets de-bossed on one side with SG and 124 on other side. • 300 mg tablets: Pink colored, Modified oval shaped, film coated tablets de-bossed on one side with SG and 121 on other side.

Contraindications

Active Bleeding

Clopidogrel is contraindicated in patients with active pathological bleeding such as peptic ulcer or intracranial hemorrhage.

Hypersensitivity

Clopidogrel is contraindicated in patients with hypersensitivity (e. g. anaphylaxis) to Clopidogrel or any component of the product [see Adverse Reactions (6.2) ] .

Warnings and Precautions

Diminished Antiplatelet Activity Due to Impaired CYP2C19 Function

Clopidogrel is a prodrug. Inhibition of platelet aggregation by Clopidogrel is achieved through an active metabolite. The metabolism of Clopidogrel to its active metabolite can be impaired by genetic variations in CYP2C19 [see Boxed Warning ] and by concomitant medications that interfere with CYP2C19.

Proton Pump Inhibitors

Avoid concomitant use of Clopidogrel with omeprazole or esomeprazole because both significantly reduce the antiplatelet activity of Clopidogrel [see Drug Interactions (7.1) and Dosage and Administration (2.4) ].

General Risk of Bleeding

Thienopyridines, including Clopidogrel, increase the risk of bleeding. If a patient is to undergo surgery and an antiplatelet effect is not desired, discontinue Clopidogrel five days prior to surgery. In patients who stopped therapy more than five days prior to CABG the rates of major bleeding were similar (event rate 4.4% Clopidogrel + aspirin; 5.3% placebo + aspirin). In patients who remained on therapy within five days of CABG, the major bleeding rate was 9.6% for Clopidogrel + aspirin, and 6.3% for placebo + aspirin.

Thienopyridines inhibit platelet aggregation for the lifetime of the platelet (7 to 10 days), so withholding a dose will not be useful in managing a bleeding event or the risk of bleeding associated with an invasive procedure. Because the half-life of Clopidogrel’s active metabolite is short, it may be possible to restore hemostasis by administering exogenous platelets; however, platelet transfusions within 4 hours of the loading dose or 2 hours of the maintenance dose may be less effective.

Discontinuation of Clopidogrel

Avoid lapses in therapy, and if Clopidogrel must be temporarily discontinued, restart as soon as possible. Premature discontinuation of Clopidogrel may increase the risk of cardiovascular events.

Patients with Recent Transient Ischemic Attack (TIA) or Stroke

In patients with recent TIA or stroke who are at high risk for recurrent ischemic events, the combination of aspirin and Clopidogrel has not been shown to be more effective than Clopidogrel alone, but the combination has been shown to increase major bleeding.

Thrombotic Thrombocytopenic Purpura (TTP)

TTP, sometimes fatal, has been reported following use of Clopidogrel, sometimes after a short exposure (<2 weeks). TTP is a serious condition that requires urgent treatment including plasmapheresis (plasma exchange). It is characterized by thrombocytopenia, microangiopathic hemolytic anemia (schistocytes [fragmented RBCs] seen on peripheral smear), neurological findings, renal dysfunction, and fever [see Adverse Reactions (6.2) ] .

Cross-Reactivity among Thienopyridines

Hypersensitivity including rash, angioedema or hematologic reaction have been reported in patients receiving Clopidogrel, including patients with a history of hypersensitivity or hematologic reaction to other thienopyridines [see Contraindications (4.2) and Adverse Reactions (6.2) ].

Adverse Reactions

The following serious adverse reactions are discussed below and elsewhere in the labeling:

Clinical Studies Experience

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

Clopidogrel has been evaluated for safety in more than 54,000 patients, including over 21,000 patients treated for 1 year or more. The clinically important adverse reactions observed in trials comparing Clopidogrel plus aspirin to placebo plus aspirin and trials comparing Clopidogrel alone to aspirin alone are discussed below.

CURE

In CURE, Clopidogrel use with aspirin was associated with an increase in major bleeding (primarily gastrointestinal and at puncture sites) compared to placebo with aspirin (see Table 1). The incidence of intracranial hemorrhage (0.1%) and fatal bleeding (0.2%) were the same in both groups. Other bleeding events that were reported more frequently in the Clopidogrel group were epistaxis, hematuria, and bruise.

The overall incidence of bleeding is described in Table 1.

Table 1: CURE Incidence of Bleeding Complications (% Patients)

* Other standard therapies were used as appropriate. † Life-threatening and other major bleeding. ‡ Major bleeding event rate for Clopidogrel + aspirin was dose-dependent on aspirin: < 100mg = 2.6%; 100 mg to 200 mg = 3.5%; >200 mg = 4.9% Major bleeding event rates for Clopidogrel + aspirin by age were: <65 years = 2.5%,≥ 65 to <75 years = 4.1%, ≥75 years = 5.9% § Major bleeding event rate for placebo + aspirin was dose-dependent on aspirin: <100 mg = 2.0%; 100 mg to 200 mg = 2.3%; >200 mg = 4.0% Major bleeding event rates for placebo + aspirin by age were: <65 years = 2.1%, ≥65 to <75 years = 3.1%, ≥75 years = 3.6% ¶ Led to interruption of study medication

* Major bleeds were cerebral bleeds or non-cerebral bleeds thought to have caused death or that required transfusion.

** The relative rate of major noncerebral or cerebral bleeding was independent of age. Event rates for Clopidogrel + aspirin by age were: <60 years = 0.3%, ≥60 to <70 years = 0.7%,≥ 70 years = 0.8%. Event rates for placebo + aspirin by age were: <60 years = 0.4%, ≥60 to <70 years = 0.6%, ≥70 years = 0.7%.

CAPRIE (Clopidogrel vs. Aspirin)

In CAPRIE, gastrointestinal hemorrhage occurred at a rate of 2.0% in those taking Clopidogrel vs. 2.7% in those taking aspirin; bleeding requiring hospitalization occurred in 0.7% and 1.1%, respectively. The incidence of intracranial hemorrhage was 0.4% for Clopidogrel compared to 0.5% for aspirin.

Other bleeding events that were reported more frequently in the Clopidogrel group were epistaxis and hematoma.

Other Adverse Events

In CURE and CHARISMA, which compared Clopidogrel plus aspirin to aspirin alone, there was no difference in the rate of adverse events (other than bleeding) between Clopidogrel and placebo.

In CAPRIE, which compared Clopidogrel to aspirin, pruritus was more frequently reported in those taking Clopidogrel. No other difference in the rate of adverse events (other than bleeding) was reported.

Postmarketing Experience

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

• Blood and lymphatic system disorders: Agranulocytosis, aplastic anemia/pancytopenia, thrombotic thrombocytopenic purpura (TTP), acquired hemophilia A • Eye disorders: Eye (conjunctival, ocular, retinal) bleeding • Gastrointestinal disorders: Gastrointestinal and retroperitoneal hemorrhage with fatal outcome, colitis (including ulcerative or lymphocytic colitis), pancreatitis, stomatitis, gastric/duodenal ulcer, diarrhea • General disorders and administration site condition: Fever, hemorrhage of operative wound • Hepato-biliary disorders: Acute liver failure, hepatitis (non-infectious), abnormal liver function test • Immune system disorders: Hypersensitivity reactions, anaphylactoid reactions, serum sickness • Musculoskeletal, connective tissue and bone disorders: Musculoskeletal bleeding, myalgia, arthralgia, arthritis • Nervous system disorders: Taste disorders, fatal intracranial bleeding, headache • Psychiatric disorders: Confusion, hallucinations • Respiratory, thoracic and mediastinal disorders: Bronchospasm, interstitial pneumonitis, respiratory tract bleeding, eosinophilic pneumonia • Renal and urinary disorders: Increased creatinine levels • Skin and subcutaneous tissue disorders: Maculopapular, erythematous or exfoliative rash, urticaria, bullous dermatitis, eczema, toxic epidermal necrolysis, Stevens-Johnson syndrome, acute generalized exanthematous pustulosis (AGEP), angioedema, drug-induced hypersensitivity syndrome, drug rash with eosinophilia and systemic symptoms (DRESS), erythema multiforme, skin bleeding, lichen planus, generalized pruritus • Vascular disorders: Vasculitis, hypotension

Drug Interactions

CYP2C19 Inhibitors

Clopidogrel is metabolized to its active metabolite in part by CYP2C19. Concomitant use of certain drugs that inhibit the activity of this enzyme results in reduced plasma concentrations of the active metabolite of Clopidogrel and a reduction in platelet inhibition [see Warnings and Precautions (5.1) and Dosage and Administration (2.4) ] .

Proton Pump Inhibitors (PPI)

Avoid concomitant use of Clopidogrel with omeprazole or esomeprazole. In clinical studies, omeprazole was shown to reduce the antiplatelet activity of Clopidogrel when given concomitantly or 12 hours apart. A higher dose regimen of Clopidogrel concomitantly administered with omeprazole increases antiplatelet response; an appropriate dose regimen has not been established. A similar reduction in antiplatelet activity was observed with esomeprazole when given concomitantly with Clopidogrel. Consider using another acid-reducing agent with minimal or no CYP2C19 inhibitory effect on the formation of Clopidogrel active metabolite. Dexlansoprazole, lansoprazole and pantoprazole had less effect on the antiplatelet activity of Clopidogrel than did omeprazole or esomeprazole [see Dosage and Administration (2.4). Warnings and Precautions (5.1) and Clinical Pharmacology (12.3) ] .

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Coadministration of Clopidogrel and NSAIDs increases the risk of gastrointestinal bleeding.

Warfarin (CYP2C9 Substrates)

Although the administration of Clopidogrel 75 mg per day did not modify the pharmacokinetics of S-warfarin (a CYP2C9 substrate) or INR in patients receiving long-term warfarin therapy, coadministration of Clopidogrel with warfarin increases the risk of bleeding because of independent effects on hemostasis.

However, at high concentrations in vitro. Clopidogrel inhibits CYP2C9.

SSRIs and SNRIs

Since selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) affect platelet activation, the concomitant administration of SSRIs and SNRIs with Clopidogrel may increase the risk of bleeding.

USE IN SPECIFIC POPULATIONS

Pregnancy

Pregnancy Category B

Reproduction studies performed in rats and rabbits at doses up to 500 and 300 mg/kg/day, respectively (65 and 78 times the recommended daily human dose, respectively, on a mg/m 2 basis), revealed no evidence of impaired fertility or fetotoxicity due to Clopidogrel. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of a human response, Clopidogrel should be used during pregnancy only if clearly needed.

Nursing Mothers

Studies in rats have shown that Clopidogrel and/or its metabolites are excreted in the milk. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Clopidogrel, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Pediatric Use

Safety and effectiveness in pediatric populations have not been established.

A randomized, placebo-controlled trial (CLARINET) did not demonstrate a clinical benefit of Clopidogrel in neonates and infants with cyanotic congenital heart disease palliated with a systemic-to-pulmonary arterial shunt. Possible factors contributing to this outcome were the dose of Clopidogrel, the concomitant administration of aspirin and the late initiation of therapy following shunt palliation. It cannot be ruled out that a trial with a different design would demonstrate a clinical benefit in this patient population.

Geriatric Use

Of the total number of subjects in the CAPRIE and CURE controlled clinical studies, approximately 50% of patients treated with Clopidogrel were 65 years of age and older, and 15% were 75 years and older. In COMMIT, approximately 58% of the patients treated with Clopidogrel were 60 years and older, 26% of whom were 70 years and older.

The observed risk of bleeding events with Clopidogrel plus aspirin versus placebo plus aspirin by age category is provided in Table 1 and Table 2 for the CURE and COMMIT trials, respectively [see Adverse Reactions (6.1) ]. No dosage adjustment is necessary in elderly patients.

Renal Impairment

Experience is limited in patients with severe and moderate renal impairment [see Clinical Pharmacology (12.2) ] .

Hepatic Impairment

No dosage adjustment is necessary in patients with hepatic impairment [see Clinical Pharmacology (12.2) ] .

Overdosage

Platelet inhibition by Clopidogrel is irreversible and will last for the life of the platelet. Overdose following Clopidogrel administration may result in bleeding complications. A single oral dose of Clopidogrel at 1500 or 2000 mg/kg was lethal to mice and to rats and at 3000 mg/kg to baboons. Symptoms of acute toxicity were vomiting, prostration, difficult breathing, and gastrointestinal hemorrhage in animals.

Based on biological plausibility, platelet transfusion may restore clotting ability.

Clopidogrel Description

Clopidogrel bisulfate is a thienopyridine class inhibitor of P2Y 12 ADP platelet receptors. Chemically it is methyl (+)-( S )-α-(2-chlorophenyl)-6,7-dihydrothieno[3,2-c]pyridine-5(4 H )-acetate sulfate (1:1). The empirical formula of Clopidogrel bisulfate is C 16 H 16 ClNO 2 S · H 2 SO 4 and its molecular weight is 419.9.

The structural formula is as follows:

Clopidogrel bisulfate, USP is a white to off-white powder. It is freely soluble in methanol, practically insoluble in ether. It has a specific optical rotation of about +56°.

Clopidogrel tablets, USP for oral administration is provided as either pink colored, round shaped, biconvex, de-bossed, film coated tablets containing 97.875 mg of Clopidogrel bisulfate which is the molar equivalent of 75 mg of Clopidogrel base or pink colored, modified oval shaped, de-bossed film coated tablets containing 391.5 mg of Clopidogrel bisulfate which is the molar equivalent of 300 mg of Clopidogrel base.

Each tablet contains microcrystalline cellulose, mannitol, croscarmellose sodium, hydroxy propyl cellulose, hydroxy propyl methyl cellulose and hydrogenated castor oil as inactive ingredients. The film coating contains hypromellose, titanium dioxide, polyethylene glycol and red iron oxide.

Clopidogrel - Clinical Pharmacology

Mechanism of Action

Clopidogrel is an inhibitor of platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y 12 class of ADP receptors on platelets.

Pharmacodynamics

Clopidogrel must be metabolized by CYP450 enzymes to produce the active metabolite that inhibits platelet aggregation. The active metabolite of Clopidogrel selectively inhibits the binding of adenosine diphosphate (ADP) to its platelet P2Y 12 receptor and the subsequent ADP-mediated activation of the glycoprotein GPIIb/IIIa complex, thereby inhibiting platelet aggregation. This action is irreversible. Consequently, platelets exposed to Clopidogrel’s active metabolite are affected for the remainder of their lifespan (about 7 to 10 days). Platelet aggregation induced by agonists other than ADP is also inhibited by blocking the amplification of platelet activation by released ADP.

Dose-dependent inhibition of platelet aggregation can be seen 2 hours after single oral doses of Clopidogrel. Repeated doses of 75 mg Clopidogrel per day inhibit ADP-induced platelet aggregation on the first day, and inhibition reaches steady state between Day 3 and Day 7. At steady state, the average inhibition level observed with a dose of 75 mg Clopidogrel per day was between 40% and 60%. Platelet aggregation and bleeding time gradually return to baseline values after treatment is discontinued, generally in about 5 days.

Elderly (≥75 years) and young healthy subjects had similar effects on platelet aggregation.

After repeated doses of 75 mg Clopidogrel per day, patients with severe renal impairment (creatinine clearance from 5 to 15 mL/min) and moderate renal impairment (creatinine clearance from 30 to 60 mL/min) showed low (25%) inhibition of ADP-induced platelet aggregation.

After repeated doses of 75 mg Clopidogrel per day for 10 days in patients with severe hepatic impairment, inhibition of ADP-induced platelet aggregation was similar to that observed in healthy subjects.

In a small study comparing men and women, less inhibition of ADP-induced platelet aggregation was observed in women.

Pharmacokinetics

Clopidogrel is a prodrug and is metabolized to a pharmacologically active metabolite and inactive metabolites.

After single and repeated oral doses of 75 mg per day, Clopidogrel is rapidly absorbed. Absorption is at least 50%, based on urinary excretion of Clopidogrel metabolites.

Effect of Food

Clopidogrel can be administered with or without food. In a study in healthy male subjects when Clopidogrel 75 mg per day was given with a standard breakfast, mean inhibition of ADP-induced platelet aggregation was reduced by less than 9%. The active metabolite AUC 0-24 was unchanged in the presence of food, while there was a 57% decrease in active metabolite C max. Similar results were observed when a Clopidogrel 300 mg loading dose was administered with a high-fat breakfast.

Clopidogrel is extensively metabolized by two main metabolic pathways: one mediated by esterases and leading to hydrolysis into an inactive carboxylic acid derivative (85% of circulating metabolites) and one mediated by multiple cytochrome P450 enzymes. Cytochromes first oxidize Clopidogrel to a 2-oxo-Clopidogrel intermediate metabolite. Subsequent metabolism of the 2-oxo-Clopidogrel intermediate metabolite results in formation of the active metabolite, a thiol derivative of Clopidogrel. This metabolic pathway is mediated by CYP2C19, CYP3A, CYP2B6 and CYP1A2. The active thiol metabolite binds rapidly and irreversibly to platelet receptors, thus inhibiting platelet aggregation for the lifespan of the platelet.

The C max of the active metabolite is twice as high following a single 300 mg Clopidogrel loading dose as it is after four days of 75 mg maintenance dose. C max occurs approximately 30 to 60 minutes after dosing. In the 75 mg to 300 mg dose range, the pharmacokinetics of the active metabolite deviates from dose proportionality: increasing the dose by a factor of four results in 2.0- and 2.7-fold increases in C max and AUC, respectively.

Following an oral dose of 14 C-labeled Clopidogrel in humans, approximately 50% of total radioactivity was excreted in urine and approximately 46% in feces over the 5 days post-dosing. After a single, oral dose of 75 mg, Clopidogrel has a half-life of approximately 6 hours. The half-life of the active metabolite is about 30 minutes.

Clopidogrel is metabolized to its active metabolite in part by CYP2C19. Concomitant use of certain inhibitors of this enzyme results in reduced plasma concentrations of the active metabolite of Clopidogrel and a reduction in platelet inhibition.

Proton Pump Inhibitors (PPI)

The effect of proton pump inhibitors (PPI) on the systemic exposure to the Clopidogrel active metabolite following multiple doses of Clopidogrel 75 mg evaluated in dedicated drug interaction studies is presented in Figure 1.

Figure 1: Exposure to Clopidogrel Active Metabolite Following Multiple Doses of Clopidogrel 75 mg Alone or with Proton Pump Inhibitors (PPIs)

Co-administered PPI Effect on active metabolite AUC Mean and 90% confidence interval

Change relative to Clopidogrel administered alone

Pharmacodynamic and pharmacokinetic parameters measured in these studies showed that the interaction was highest with omeprazole and least with dexlansoprazole.

Pharmacogenomics

CYP2C19 is involved in the formation of both the active metabolite and the 2-oxo-Clopidogrel intermediate metabolite. Clopidogrel active metabolite pharmacokinetics and antiplatelet effects, as measured by ex vivo platelet aggregation assays, differ according to CYP2C19 genotype. Genetic variants of other CYP450 enzymes may also affect the formation of Clopidogrel’s active metabolite.

The CYP2C19*1 allele corresponds to fully functional metabolism while the CYP2C19*2 and *3 alleles are nonfunctional. CYP2C19*2 and *3 account for the majority of reduced function alleles in white (85%) and Asian (99%) poor metabolizers. Other alleles associated with absent or reduced metabolism are less frequent, and include, but are not limited to, CYP2C19*4, *5, *6, *7, and *8. A patient with poor metabolizer status will possess two loss-of-function alleles as defined above. Published frequencies for poor CYP2C19 metabolizer genotypes are approximately 2% for whites, 4% for blacks and 14% for Chinese. Tests are available to determine a patient’s CYP2C19 genotype.

A crossover study in 40 healthy subjects, 10 each in the four CYP2C19 metabolizer groups, evaluated pharmacokinetic and antiplatelet responses using 300 mg followed by 75 mg per day and 600 mg followed by 150 mg per day, each for a total of 5 days. Decreased active metabolite exposure and diminished inhibition of platelet aggregation were observed in the poor metabolizers as compared to the other groups. When poor metabolizers received the 600 mg/150 mg regimen, active metabolite exposure and antiplatelet response were greater than with the 300 mg/75 mg regimen (see Table 3 ). An appropriate dose regimen for this patient population has not been established in clinical outcome trials.

Table 3: Active Metabolite Pharmacokinetics and Antiplatelet Responses by CYP2C19 Metabolizer Status

Some published studies suggest that intermediate metabolizers have decreased active metabolite exposure and diminished antiplatelet effects.

The relationship between CYP2C19 genotype and Clopidogrel treatment outcome was evaluated in retrospective analyses of Clopidogrel-treated subjects in CHARISMA (n=2428) and TRITON-TIMI 38 (n=1477), and in several published cohort studies. In TRITON-TIMI 38 and the majority of the cohort studies, the combined group of patients with either intermediate or poor metabolizer status had a higher rate of cardiovascular events (death, myocardial infarction, and stroke) or stent thrombosis compared to extensive metabolizers. In CHARISMA and one cohort study, the increased event rate was observed only in poor metabolizers.

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment of Fertility

There was no evidence of tumorigenicity when Clopidogrel was administered for 78 weeks to mice and 104 weeks to rats at dosages up to 77 mg/kg per day, which afforded plasma exposures >25 times that in humans at the recommended daily dose of 75 mg.

Clopidogrel was not genotoxic in four in vitro tests (Ames test, DNA-repair test in rat hepatocytes, gene mutation assay in Chinese hamster fibroblasts, and metaphase chromosome analysis of human lymphocytes) and in one in vivo test (micronucleus test by oral route in mice).

Clopidogrel was found to have no effect on fertility of male and female rats at oral doses up to 400 mg/kg per day (52 times the recommended human dose on a mg/m 2 basis).

Clinical Studies

Acute Coronary Syndrome

The CURE study included 12,562 patients with ACS without ST-elevation (UA or NSTEMI) and presenting within 24 hours of onset of the most recent episode of chest pain or symptoms consistent with ischemia. Patients were required to have either ECG changes compatible with new ischemia (without ST-elevation) or elevated cardiac enzymes or troponin I or T to at least twice the upper limit of normal. The patient population was largely Caucasian (82%) and included 38% women, and 52% patients ≥65 years of age.

Patients were randomized to receive Clopidogrel (300-mg loading dose followed by 75 mg once daily) or placebo, and were treated for up to one year. Patients also received aspirin (75 to 325 mg once daily) and other standard therapies such as heparin. The use of GPIIb/IIIa inhibitors was not permitted for three days prior to randomization.

The number of patients experiencing the primary outcome (CV death, MI, or stroke) was 582 (9.3%) in the Clopidogrel-treated group and 719 (11.4%) in the placebo-treated group, a 20% relative risk reduction (95% CI of 10% to 28%; p < 0.001) for the Clopidogrel-treated group (see Table 4).

Table 4: Outcome Events in the CURE Primary Analysis

Clopidogrel (+ aspirin)* (n=6,259)

Placebo (+ aspirin)* (n=6,303)

Relative Risk Reduction (%) (95% CI)

* Other standard therapies were used as appropriate. † The individual components do not represent a breakdown of the primary and co-primary outcomes, but rather the total number of subjects experiencing an event during the course of the study.

Primary outcome (Cardiovascular death, MI, stroke)

Most of the benefit of Clopidogrel occurred in the first two months, but the difference from placebo was maintained throughout the course of the trial (up to 12 months) (see Figure 2).

Figure 2: Cardiovascular Death, Myocardial Infarction, and Stroke in the CURE Study

In CURE, the use of Clopidogrel was associated with a lower incidence of CV death, MI or stroke in patient populations with different characteristics, as shown in Figure 3. The benefits associated with Clopidogrel were independent of the use of other acute and long-term cardiovascular therapies, including heparin/LMWH, intravenous glycoprotein IIb/IIIa (GPIIb/IIIa) inhibitors, lipid-lowering drugs, beta-blockers, and ACE-inhibitors. The efficacy of Clopidogrel was observed independently of the dose of aspirin (75 mg to 325 mg once daily). The use of oral anticoagulants, non-study antiplatelet drugs, and chronic NSAIDs was not allowed in CURE.

Figure 3: Hazard Ratio for Patient Baseline Characteristics and On-Study Concomitant Medications/Interventions for the CURE Study

The use of Clopidogrel in CURE was associated with a decrease in the use of thrombolytic therapy (71 patients [1.1%] in the Clopidogrel group, 126 patients [2.0%] in the placebo group; relative risk reduction of 43%), and GPIIb/IIIa inhibitors (369 patients [5.9%] in the Clopidogrel group, 454 patients [7.2%] in the placebo group, relative risk reduction of 18%). The use of Clopidogrel in CURE did not affect the number of patients treated with CABG or PCI (with or without stenting), (2253 patients [36.0%] in the Clopidogrel group, 2324 patients [36.9%] in the placebo group; relative risk reduction of 4.0%).

In patients with STEMI, the safety and efficacy of Clopidogrel were evaluated in the randomized, placebo-controlled, double-blind study, COMMIT. COMMIT included 45,852 patients presenting within 24 hours of the onset of the symptoms of myocardial infarction with supporting ECG abnormalities (i. e. ST-elevation, ST-depression or left bundle-branch block).

Patients were randomized to receive Clopidogrel (75 mg once daily) or placebo, in combination with aspirin (162 mg per day), for 28 days or until hospital discharge, whichever came first.

The primary endpoints were death from any cause and the first occurrence of re-infarction, stroke or death.

The patient population included 28% women, 58% age ≥ 60 years (26% age ≥ 70 years), 55% patients who received thrombolytics, 68% who received ACE-inhibitors, and only 3% who underwent PCI.

As shown in Table 5 and Figure 4 and Figure 5 below, Clopidogrel significantly reduced the relative risk of death from any cause by 7% (p=0.029), and the relative risk of the combination of re-infarction, stroke or death by 9% (p=0.002).

Table 5: Outcome Events in the COMMIT Analysis

* The difference between the composite endpoint and the sum of death+non-fatal MI+non-fatal stroke indicates that 9 patients (2 Clopidogrel and 7 placebo) suffered both a non-fatal stroke and a non-fatal MI.

** Non-fatal MI and non-fatal stroke exclude patients who died (of any cause).

Figure 4: Cumulative Event Rates for Death in the COMMIT Study *

* All treated patients received aspirin.

Figure 5: Cumulative Event Rates for the Combined Endpoint Re-Infarction, Stroke or Death in the COMMIT Study*

* All treated patients received aspirin.

The effect of Clopidogrel did not differ significantly in various pre-specified subgroups as shown in Figure 6. The effect was also similar in non-prespecified subgroups including those based on infarct location, Killip class or prior MI history (see Figure 7). Such subgroup analyses should be interpreted cautiously.

Figure 6: Effects of Adding Clopidogrel to Aspirin on the Combined Primary Endpoint across Baseline and Concomitant Medication Subgroups for the COMMIT Study

* Three similar-sized prognostic index groups were based on absolute risk of primary composite outcome for each patient calculated from baseline prognostic variables (excluding allocated treatments) with a Cox regression model.

Figure 7: Effects of Adding Clopidogrel to Aspirin in the Non-Prespecified Subgroups in the COMMIT Study

Recent Myocardial Infarction, Recent Stroke, or Established Peripheral Arterial Disease

The CAPRIE trial was a 19,185-patient, 304-center, international, randomized, double-blind, parallel-group study comparing Clopidogrel (75 mg daily) to aspirin (325 mg daily). The patients randomized had: 1) recent histories of myocardial infarction (within 35 days); 2) recent histories of ischemic stroke (within 6 months) with at least a week of residual neurological signs; or 3) established peripheral arterial disease. Patients received randomized treatment for an average of 1.6 years (maximum of 3 years).

The trial's primary outcome was the time to first occurrence of new ischemic stroke (fatal or not), new myocardial infarction (fatal or not), or other vascular death. Deaths not easily attributable to nonvascular causes were all classified as vascular.

Table 6: Outcome Events in the CAPRIE Primary Analysis

As shown in Table 6, Clopidogrel was associated with a lower incidence of outcome events, primarily MI. The overall relative risk reduction (9.8% vs. 10.6%) was 8.7%, p=0.045. Similar results were obtained when all-cause mortality and all-cause strokes were counted instead of vascular mortality and ischemic strokes (risk reduction 6.9%). In patients who survived an on-study stroke or myocardial infarction, the incidence of subsequent events was lower in the Clopidogrel group.

The curves showing the overall event rate are shown in Figure 8. The event curves separated early and continued to diverge over the 3-year follow-up period.

Figure 8: Fatal or Non-Fatal Vascular Events in the CAPRIE Study

The statistical significance favoring Clopidogrel over aspirin was marginal (p=0.045). However, because aspirin is itself effective in reducing cardiovascular events in patients with recent myocardial infarction or stroke, the effect of Clopidogrel is substantial.

The CAPRIE trial included a population that was randomized on the basis of 3 entry criteria. The efficacy of Clopidogrel relative to aspirin was heterogeneous across these randomized subgroups (p=0.043). It is not clear whether this difference is real or a chance occurrence. Although the CAPRIE trial was not designed to evaluate the relative benefit of Clopidogrel over aspirin in the individual patient subgroups, the benefit appeared to be strongest in patients who were enrolled because of peripheral vascular disease (especially those who also had a history of myocardial infarction) and weaker in stroke patients. In patients who were enrolled in the trial on the sole basis of a recent myocardial infarction, Clopidogrel was not numerically superior to aspirin.

Lack of Established Benefit of Clopidogrel plus Aspirin in Patients with Multiple Risk Factors or Established Vascular Disease

The CHARISMA trial was a 15,603 subject, randomized, double-blind, parallel group study comparing Clopidogrel (75 mg daily) to placebo for prevention of ischemic events in patients with vascular disease or multiple risk factors for atherosclerosis. All subjects were treated with aspirin 75 mg to 162 mg daily. The mean duration of treatment was 23 months. The study failed to demonstrate a reduction in the occurrence of the primary endpoint, a composite of CV death, MI, or stroke. A total of 534 (6.9%) patients in the Clopidogrel group versus 573 (7.4%) patients in the placebo group experienced a primary outcome event (p=0.22). Bleeding of all severities was more common in the subjects randomized to Clopidogrel.

How Supplied/Storage and Handling

Clopidogrel tablets, USP 75 mg are available as pink colored, round shaped, biconvex, film coated tablets de-bossed on one side with SG and 124 on other side. They are available as follows:

NDC 42543-713-30: Bottles of 30 tablets

NDC 42543-713-90: Bottles of 90 tablets

NDC 42543-713-01: Bottles of 100 tablets

NDC 42543-713-05: Bottles of 500 tablets

NDC 42543-713-10: Bottles of 1000 tablets

Clopidogrel tablets, USP 300 mg are available as pink colored, modified oval shaped, film coated tablets de-bossed on one side with SG and 121 on other side. They are available as follows:

NDC 42543-714-30: Bottles of 30 tablets

NDC 42543-714-90: Bottles of 90 tablets

NDC 42543-714-01: Bottles of 100 tablets

NDC 42543-714-05: Bottles of 500 tablets

Store at 20° to 25°C (68° to 77° F); excursions permitted to 15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature].

PHARMACIST: Dispense a Medication Guide with each prescription.

Patient Counseling Information

Benefits and Risks

• Summarize the effectiveness features and potential side effects of Clopidogrel. • Tell patients to take Clopidogrel exactly as prescribed. • Remind patients not to discontinue Clopidogrel without first discussing it with the physician who prescribed Clopidogrel.

Bleeding

Inform patients that they:

• will bruise and bleed more easily. • will take longer than usual to stop bleeding. • should report any unanticipated, prolonged, or excessive bleeding, or blood in their stool or urine.

Other Signs and Symptoms Requiring Medical Attention

• Inform patients that TTP is a rare but serious condition that has been reported with Clopidogrel and other drugs in this class of drugs. • Instruct patients to get prompt medical attention if they experience any of the following symptoms that cannot otherwise be explained: fever, weakness, extreme skin paleness, purple skin patches, yellowing of the skin or eyes, or neurological changes.

Invasive Procedures

Instruct patients to:

• inform physicians and dentists that they are taking Clopidogrel before any invasive procedure is scheduled. • tell the doctor performing the invasive procedure to talk to the prescribing health care professional before stopping Clopidogrel.

Concomitant Medications

Ask patients to list all prescription medications, over-the-counter medications, or dietary supplements they are taking or plan to take [ see Warnings and Precautions (5) and Drug Interactions (7) ].

Coumadin® is a registered trademark of Bristol-Myers Squibb Pharma Company.

Prilosec® and Nexium® are registered trademark of AstraZeneca.

Jantoven® is a registered trademark of USL Pharma.

Manufactured for: Vensun Pharmaceuticals, Inc. Yardley, PA 19067

Manufactured by: ScieGen Pharmaceuticals, Inc. Hauppauge, NY 11788 USA

Rev. 02, April 2016

MEDICATION GUIDE Clopidogrel (kloe pid′ oh grel) TABLETS, USP 75 mg and 300 mg

Read this Medication Guide before you start taking Clopidogrel tablets and each time you get a refill. There may be new information. This Medication Guide does not take the place of talking with your doctor about your medical condition or your treatment.

What is the most important information I should know about Clopidogrel tablets?

1. Clopidogrel tablets may not work as well in people who:

• have certain genetic factors that affect how the body breaks down Clopidogrel. Your doctor may do genetic tests to make sure Clopidogrel tablets are right for you. • take certain medicines, especially omeprazole (Prilosec ® ) or esomeprazole (Nexium ® ). Your doctor may change the medicine you take for stomach acid problems while you take Clopidogrel tablets.

2. Clopidogrel tablets can cause bleeding which can be serious and can sometimes lead to death. Clopidogrel is a blood thinner medicine that lowers the chance of blood clots forming in your body. While you take Clopidogrel tablets:

• you may bruise and bleed more easily • you are more likely to have nose bleeds • it will take longer for any bleeding to stop

Call your doctor right away if you have any of these signs or symptoms of bleeding:

• unexpected bleeding or bleeding that lasts a long time • blood in your urine (pink, red or brown urine) • red or black stools (looks like tar) • bruises that happen without a known cause or get larger • cough up blood or blood clots • vomit blood or your vomit looks like coffee grounds

Do not stop taking Clopidogrel tablets without talking to the doctor who prescribes it for you. People who stop taking Clopidogrel tablets too soon have a higher risk of having a heart attack or dying. If you must stop Clopidogrel tablets because of bleeding, your risk of a heart attack may be higher.

What are Clopidogrel tablets?

Clopidogrel tablets are a prescription medicine used to treat people who have any of the following:

• chest pain due to heart problems • poor circulation in their legs (peripheral arterial disease) • a heart attack • a stroke

Clopidogrel tablets are used alone or with aspirin to lower your chance of having another serious problem with your heart or blood vessels such as heart attack, stroke, or blood clot that can lead to death.

Platelets are blood cells that help your blood clot normally. Clopidogrel tablets help to prevent platelets from sticking together and forming a clot that can block an artery.

It is not known if Clopidogrel tablets are safe and effective in children.

Who should not take Clopidogrel tablets?

Do not take Clopidogrel tablets if you:

• currently have a condition that causes bleeding, such as a stomach ulcer • are allergic to Clopidogrel or other ingredients in Clopidogrel tablets. See the end of this leaflet for a complete list of ingredients in Clopidogrel tablets.

What should I tell my doctor before taking Clopidogrel tablets?

Before you take Clopidogrel tablets, tell your doctor if you:

• have a history of bowel (gastrointestinal) or stomach ulcers • have a history of bleeding problems • plan to have surgery or a dental procedure. See “How should I take Clopidogrel tablets?” • are pregnant or plan to become pregnant. It is not known if Clopidogrel tablets will harm your unborn baby • are breastfeeding or plan to breastfeed. It is not known if Clopidogrel passes into your breast milk. You and your doctor should decide if you will take Clopidogrel tablets or breastfeed. You should not do both without talking to your doctor. • have had an allergy or reaction to any medicine used to treat your disease.

Tell all of your doctors and your dentist that you are taking Clopidogrel tablets. They should talk to the doctor who prescribed Clopidogrel tablets for you before you have any surgery or invasive procedure.

Tell your doctor about all the medicines you take. including prescription, non-prescription medicines, vitamins and herbal supplements.

Clopidogrel tablets may affect the way other medicines work, and other medicines may affect how Clopidogrel tablets works. See “What is the most important information I should know about Clopidogrel tablets?”

Taking Clopidogrel tablets with certain other medicines may increase your risk of bleeding.

Especially tell your doctor if you take :

• aspirin, especially if you have had a stroke. Always talk to your doctor about whether you should take aspirin along with Clopidogrel tablets to treat your condition. • Non-steroidal anti-inflammatory drugs (NSAIDs). Ask your doctor or pharmacist for a list of NSAID medicines if you are not sure. • warfarin (Coumadin ®. Jantoven ® ) • selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs). Ask your doctor or pharmacist for a list of SSRI or SNRI medicines if you are not sure.

Know the medicines you take. Keep a list of them to show your doctor or pharmacist when you get a new medicine.

How should I take Clopidogrel tablets?

• Take Clopidogrel tablets exactly as your doctor tells you. • Do not change your dose or stop taking Clopidogrel tablets without talking to your doctor first. Stopping Clopidogrel tablets may increase your risk of heart attack or stroke. • Take Clopidogrel tablets with aspirin as instructed by your doctor. • You can take Clopidogrel tablets with or without food. • If you miss a dose, take Clopidogrel tablets as soon as you remember. If it is almost time for your next dose, skip the missed dose. Take the next dose at your regular time. Do not take 2 doses of Clopidogrel tablets at the same time unless your doctor tells you to. • If you take too much Clopidogrel tablets, call your doctor or go to the nearest emergency room right away. • Talk with your doctor about stopping your Clopidogrel tablets before you have surgery. Your doctor may tell you to stop taking Clopidogrel tablets at least 5 days before you have surgery to avoid excessive bleeding during surgery.

What are the possible side effects of Clopidogrel tablets?

Clopidogrel tablets can cause serious side effects including:

• See “What is the most important information I should know about Clopidogrel tablets?” • A blood clotting problem called Thrombotic Thrombocytopenic Purpura (TTP). TTP can happen with Clopidogrel tablets, USP, sometimes after a short time (less than 2 weeks). TTP is a blood clotting problem where blood clots form in blood vessels; and can happen anywhere in the body. TTP needs to be treated in a hospital right away, because it may cause death. Get medical help right away if you have any of these symptoms and they can not be explained by another medical condition: • purplish spots (called purpura) on the skin or in the mouth (mucous membranes) due to bleeding under the skin • your skin or the whites of your eyes are yellow (jaundice) • you feel tired or weak • your skin looks very pale • fever • fast heart rate or feeling short of breath • headache • speech changes • confusion • coma • stroke • seizure • low amount of urine, or urine that is pink or has blood in it • stomach area (abdominal) pain • nausea, vomiting, or diarrhea • vision changes

Tell your doctor if you have any side effect that bothers you or that does not go away. Tell your doctor if you develop an allergic reaction including skin reactions while taking Clopidogrel tablets.

These are not all the possible side effects of Clopidogrel tablets. For more information, ask your doctor or pharmacist.

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

How should I store Clopidogrel tablets, USP?

• Store Clopidogrel tablets at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F).

Keep Clopidogrel tablets and all medicines out of the reach of children.

General information about Clopidogrel tablets

Medicines are sometimes used for purposes other than those listed in a Medication Guide. Do not take Clopidogrel tablets for a condition for which it was not prescribed. Do not give Clopidogrel tablets to other people, even if they have the same symptoms that you have. It may harm them.

This Medication Guide summarizes the most important information about Clopidogrel tablets. If you would like more information, talk to your doctor. Ask your doctor or pharmacist for information about Clopidogrel tablets that was written for healthcare professionals.

For more information, contact Vensun Pharmaceuticals, Inc. at 1-800-385-1540.

What are the ingredients in Clopidogrel tablets?

Active ingredient: Clopidogrel bisulfate, USP

Inactive ingredients: Tablet: microcrystalline cellulose, mannitol, croscarmellose sodium, hydroxy propyl cellulose, hydroxy propyl methyl cellulose and hydrogenated castor oil

Film coating: Hypromellose, titanium dioxide, polyethylene glycol and red iron oxide.

This Medication Guide has been approved by the U. S. Food and Drug Administration.

Coumadin® is a registered trademark of Bristol-Myers Squibb Pharma Company.

Prilosec® and Nexium® are registered trademark of AstraZeneca.

Jantoven® is a registered trademark of USL Pharma.

Manufactured for: Vensun Pharmaceuticals, Inc. Yardley, PA 19067

Manufactured by: ScieGen Pharmaceuticals, Inc. Hauppauge, NY 11788 USA

Rev. 01, August 2015

PRINCIPAL DISPLAY PANEL

NDC 42543-713-30 30 Tablets

Clopidogrel Bisulfate Tablets, USP 75 mg

PHARMACIST: Dispense the accompanying Medication Guide to each patient.

Rx only VENSUN PHARMACEUTICALS, INC.

PRINCIPAL DISPLAY PANEL

NDC 42543-714-30 30 Tablets

Clopidogrel Bisulfate Tablets, USP 300 mg

PHARMACIST: Dispense the accompanying Medication Guide to each patient.

Rx only VENSUN PHARMACEUTICALS, INC.

Clinorette (Estradiol, Norethisterone), Clinorette

Clinorette (estradiol, norethisterone)

What is Clinorette used for?

Hormone replacement therapy to relieve symptoms of the menopause .

How does Clinorette work?

Clinorette is a hormone replacement therapy (HRT) preparation. Each pack contains two types of tablets. The white tablets contain estradiol (previously spelt oestradiol in the UK) and the pink tablets contain estradiol and norethisterone. These are forms of the main female sex hormones, oestrogen and progesterone. Estradiol is a naturally occuring form of oestrogen and norethisterone is a synthetic form of progesterone.

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Womens'' ovaries gradually produce less and less oestrogen in the period up to the menopause, and oestrogen blood levels decline as a result. The declining levels of oestrogen can cause distressing symptoms, such as irregular periods, hot flushes, night sweats, mood swings and vaginal dryness or itching.

Oestrogen (in this case in the form of estradiol) can be given as a supplement to replace the falling levels in the body and help reduce these distressing symptoms of the menopause. This is known as hormone replacement therapy (HRT). HRT is usually only required for short-term relief from menopausal symptoms and its use should be reviewed at least once a year with your doctor.

A progestogen (in this case in the form of norethisterone) is needed as part of HRT for women who have not had a hysterectomy. This is because in women with an intact womb, oestrogen stimulates the growth of the womb lining (endometrium), which can lead to endometrial cancer if the growth is unopposed. A progestogen is given to oppose oestrogen's effect on the womb lining and reduce the risk of cancer, though it does not eliminate this risk entirely. This is known as combined HRT.

Clinorette is a sequential form of combined HRT. This means that oestrogen is taken on a continuous basis and the progestogen is added for a portion of each month. The white tablets taken in the first 16 days of each Clinorette cycle contain only estradiol. The pink tablets taken in the next 12 days of each cycle contain both estradiol and norethisterone. This type of HRT is more suitable for women who are still having irregular periods, because it usually results in a monthly bleed towards the end of taking the pink tablets.

How do I take Clinorette tablets?

Clinorette tablets come in a 28 day calendar pack. You should take one tablet every day in the order marked on the pack, starting with tablet one. You should then start the next pack without a break. Your need for continued HRT should be reviewed with your doctor at least once a year.

The tablets should be swallowed whole with a drink. They can be taken either with or without food.

Your tablet should be taken at around the same time each day; this will help you remember to take it.

If you forget to take a dose at your usual time you should take it as soon as you remember, unless it is nearly time for your next dose. In this case you should just leave out the forgotten dose and take your next dose as usual at your usual time. Don't take a double dose to make up for a missed dose.

Important information about Clinorette

This medicine will usually cause a menstrual bleed towards the end of taking the pink tablets. You may also experience spotting or breakthrough bleeding during the first few months of treatment. Missing a dose may increase the chance of this. If any breakthrough bleeding or spotting continues after a few months of taking the medicine, or after stopping treatment, you should consult your doctor so that it can be investigated.

Women taking any form of HRT should have regular medical and gynaecological check-ups. Your need for continued HRT should be reviewed with your doctor at least once a year.

It is important to be aware that all women using HRT have an increased risk of being diagnosed with breast cancer compared with women who don't use HRT. This risk needs to be weighed against the personal benefits to you of taking HRT. There is more detailed information about the risks and benefits associated with HRT in the factsheet about the menopause linked above. You should discuss these with your doctor before starting HRT. Women on HRT should have regular breast examinations and mammograms and should examine their own breasts regularly. Report any changes in your breasts to your doctor or nurse.

It is important to be aware that women using HRT have a slightly increased risk of stroke and of blood clots forming in the veins (eg deep vein thrombosis /pulmonary embolism ) compared with women who don't use HRT. The risk is higher if you have existing risk factors (eg personal or family history of blood clots, smoking, obesity, certain blood disorders - see cautions below) and needs to be weighed against the personal benefits to you of taking HRT. There is more detailed information about the risks and benefits associated with HRT in the factsheet about the menopause linked above. Discuss these with your doctor before starting treatment.

The risk of blood clots forming in the veins (thromboembolism) while taking HRT may be temporarily increased if you experience major trauma, have surgery, or are immobile for prolonged periods of time (this includes travelling for over three hours). For this reason, your doctor may recommend that you stop taking HRT for a period of time (usually four to six weeks) prior to any planned surgery, particularly abdominal surgery or orthopaedic surgery on the lower limbs, or if you are to be immobile for long periods. The risk of blood clots during long journeys may be reduced by appropriate exercise during the journey and possibly by wearing elastic hosiery. Discuss this with your doctor.

Stop taking this medicine and inform your doctor immediately if you experience any of the following symptoms: stabbing pains or swelling in one leg; pain on breathing or coughing; coughing up blood; breathlessness; sudden chest pain; sudden numbness affecting one side or part of the body; fainting; worsening of epilepsy; migraine or severe headaches; visual disturbances; severe abdominal complaints; increased blood pressure; itching of the whole body; yellowing of the skin or eyes (jaundice); or severe depression.

A woman is considered fertile for two years after her last menstrual period if she is under 50, or for one year if over 50. HRT does not provide contraception for women who fall within this group. If a potentially fertile women is taking HRT but also requires contraception, a non-hormonal method (eg condoms or contraceptive foam ) should be used.

Clinorette should be used with caution by

Women with a risk of developing cancers that are stimulated by oestrogen, for example women whose mother or sister has had breast cancer .

Women with a history of benign breast lumps (fibrocystic breast disease) .

Women with fibroids in the womb .

Women with a history of endometriosis .

Women with a history of overgrowth of the lining of the womb (endometrial hyperplasia).

Women with a personal or family history of blood clots in the veins (venous thromboembolism, eg deep vein thrombosis or pulmonary embolism ).

Women taking medicines to prevent blood clots (anticoagulants), eg warfarin.

Women who are very overweight or obese .

Women with severe varicose veins .

Smokers .

Women with high blood pressure .

Women with heart failure .

Women with kidney problems.

Women with diabetes .

Women with raised levels of fats such as cholesterol or triglycerides in their blood.

Women with a history of gallbladder disease .

Women with a long-term condition called systemic lupus erythematosus (SLE).

Women who suffer from migraines or severe headaches .

Women with epilepsy .

Women with a history of asthma .

Women with a history of depression .

Women with a history of irregular brown patches appearing on the skin, usually of the face, during pregnancy or previous use of hormone preparations such as contraceptive pills (chloasma). Women with a tendency to this condition should minimise their exposure to the sun or UV light while taking HRT.

Clinorette should not be used by

Women with known, suspected, or a past history of breast cancer .

Women with known or suspected cancer in which growth of the cancer is stimulated by oestrogen, eg cancer of the lining of the womb (endometrial cancer) .

Women with untreated overgrowth of the lining of the womb (endometrial hyperplasia).

Women with vaginal bleeding where the cause is not known.

Women with blood disorders that increase the risk of blood clots in the veins, eg antiphospholipid syndrome. factor V Leiden. protein C deficiency, protein S deficiency or antithrombin deficiency.

Women with a blood clot in a vein of the leg (deep vein thrombosis ) or in the lungs (pulmonary embolism ).

Women with inflammation of a vein caused by a blood clot (thrombophlebitis).

Women who have recently had a stroke caused by a blood clot.

Women who have recently had a heart attack .

Women with angina pectoris .

Women with active liver disease, eg hepatitis. liver cancer. or a history of liver disease when liver function has not returned to normal.

Women with inherited blood disorders called porphyrias.

Women who are pregnant or breastfeeding .

Women with rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption (Clinorette tablets contain lactose).

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used by women who are pregnant or breastfeeding. You should stop taking this medicine and consult your doctor immediately if you think you could be pregnant during treatment.

A woman is considered fertile for two years after her last menstrual period if she is under 50, or for one year if over 50. HRT does not provide contraception for women who fall within this group. If you could get pregnant while taking this HRT, you should use a non-hormonal method of contraception (eg condoms or contraceptive foam ). Seek further medical advice from your doctor.

Possible side effects of Clinorette

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. See also the important information section above. Just because a side effect is stated here, it does not mean that all women using this medicine will experience that or any side effect.

Gut disturbances, such as nausea and vomiting, abdominal pain, bloating, flatulence, indigestion.

Menstrual bleeding or spotting. See important information above.

Vaginal thrush .

Increase in the size of uterine fibroids.

Breast pain, tenderness or enlargement.

Fluid retention, causing swelling (oedema).

Headache or migraine .

Premenstrual-like symptoms.

Depression. anxiety, irritability or mood changes.

Changes in sex drive.

Fatigue.

Dizziness.

Weight changes.

Leg cramps.

Rise in blood pressure .

Steepening of corneal curvature, which may make contact lenses uncomfortable.

Skin reactions such as rash and itching.

Irregular brown patches on the skin, usually of the face (chloasma).

Disturbance in liver function and jaundice .

Gallbladder disease.

Inflammation of the pancreas (pancreatitis ).

Blood clots in the blood vessels (eg, DVT, pulmonary embolism, stroke, heart attack - see important information above).

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

If you think you have experienced a side effect from a medicine or vaccine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think it's necessary they'll report it for you.

You can also report side effects yourself using the yellow card website: www. mhra. gov. uk/yellowcard .

How can Clinorette affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe .

The following medicines may potentially reduce the blood level and effect of this medicine, which could cause irregular menstrual bleeding or your symptoms to come back:

Some women with diabetes may need small adjustments in their dose of insulin or antidiabetic tablets while taking this medicine. You should monitor your blood sugar and seek advice from your doctor or pharmacist if your blood sugar control seems to be altered after starting this medicine.

This medicine may oppose the effect of medicines used to lower high blood pressure . Your blood pressure will usually be checked periodically while you are taking HRT, but this is particularly important if you are also taking medicines for high blood pressure.

This medicine may also oppose the fluid-losing effect of diuretic medicines .

This medicine may decrease the amount of the antiepileptic medicine lamotrigine in the blood. As this could increase the risk of seizures coming back or getting worse, the medicine may not be recommended for women who take lamotrigine on its own for epilepsy.

This medicine may increase the blood levels of the following medicines and this could possibly increase the risk of their side effects:

Other medicines containing the same active ingredients

Further reading

For background information about our medicine factsheets, including the references used to produce them, click here .

Last updated 16.06.2015

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Ulzol Generic Name Omeprazole Online, Ulzol

Ulzol General Information

Ulzol - Pharmacology:

Ulzol is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of the H + /K + - ATPase in the gastric parietal cell. By acting specifically on the proton pump, omeprazole blocks the final step in acid production, thus reducing gastric acidity.

Ulzol for patients

PRILOSEC Delayed-Release Capsules should be taken before eating. Patients should be cautioned that the PRILOSEC Delayed-Release Capsule should not be opened, chewed or crushed, and should be swallowed whole.

For patients who have difficulty swallowing capsules, the contents of a PRILOSEC Delayed-Release Capsule can be added to applesauce. One tablespoon of applesauce should be added to an empty bowl and the capsule should be opened. All of the pellets inside the capsule should be carefully emptied on the applesauce. The pellets should be mixed with the applesauce and then swallowed immediately with a glass of cool water to ensure complete swallowing of the pellets. The applesauce used should not be hot and should be soft enough to be swallowed without chewing. The pellets should not be chewed or crushed. The pellets/applesauce mixture should not be stored for future use.

This description is suitable for active ingredient Omeprazole

Ulzol Interactions

Ulzol can prolong the elimination of diazepam, warfarin and phenytoin, drugs that are metabolized by oxidation in the liver. Although in normal subjects no interaction with theophylline or propranolol was found, there have been clinical reports of interaction with other drugs metabolized via the cytochrome P-450 system ( e. g., cyclosporine, disulfiram, benzodiazepines). Patients should be monitored to determine if it is necessary to adjust the dosage of these drugs when taken concomitantly with omeprazole.

Because of its profound and long lasting inhibition of gastric acid secretion, it is theoretically possible that omeprazole may interfere with absorption of drugs where gastric pH is an important determinant of their bioavailability ( e. g., ketoconazole, ampicillin esters, and iron salts). In the clinical trials, antacids were used concomitantly with the administration of omeprazole.

Combination Therapy with Clarithromycin

Co-administration of omeprazole and clarithromycin may result in increases in plasma levels of ompeprazole, clarithromycin, and 14-hydroxy-clarithromycin.

Concomitant administration of clarithromycin with cisapride, pimozide, or terfenadine is contraindicated.

There have been reports of an intereaction between erythromycin and astemizole resulting in QT prolongation and torsades de points. Concomitant administration of erythromycin and astemizole is contraindicated. Because clarithromycin is also metabolized by cytochrome P450, concomitant administration of clarithromycin with astemizole is not recommended.

Ulzol Contraindications

Tenace - Traduction - Dictionnaire Francais-Anglais, Tenace

Dictionnaires de langue en ligne

tenace adj adjectif . modifie un nom. Il est generalement place apres le nom et s'accorde avec le nom ( ex. un ballon bleu, un e balle bleu e ). En general, seule la forme au masculin singulier est donnee. Pour former le feminin . on ajoute "e" ( ex. petit > petit e ) et pour former le pluriel . on ajoute "s" ( ex. petit > petit s ). Pour les formes qui sont "irregulieres" au feminin, celles-ci sont donnees ( ex. irregulier, irreguliere > irregulier = forme masculine, irreguliere = forme feminine)

(difficile a enlever) ( stains )

resistant, stubborn, tough adj adjective . Describes a noun or pronoun--for example, "a tall girl," "an interesting book," "a big house."

Les taches de fruits sont tenaces.

tenace adj adjectif . modifie un nom. Il est generalement place apres le nom et s'accorde avec le nom ( ex. un ballon bleu, un e balle bleu e ). En general, seule la forme au masculin singulier est donnee. Pour former le feminin . on ajoute "e" ( ex. petit > petit e ) et pour former le pluriel . on ajoute "s" ( ex. petit > petit s ). Pour les formes qui sont "irregulieres" au feminin, celles-ci sont donnees ( ex. irregulier, irreguliere > irregulier = forme masculine, irreguliere = forme feminine)

(se dit d'une odeur persistante)

tenacious, clinging, persistent, sticky adj adjective . Describes a noun or pronoun--for example, "a tall girl," "an interesting book," "a big house."

Oh la la, ce parfum est vraiment tenace !

tenace adj adjectif . modifie un nom. Il est generalement place apres le nom et s'accorde avec le nom ( ex. un ballon bleu, un e balle bleu e ). En general, seule la forme au masculin singulier est donnee. Pour former le feminin . on ajoute "e" ( ex. petit > petit e ) et pour former le pluriel . on ajoute "s" ( ex. petit > petit s ). Pour les formes qui sont "irregulieres" au feminin, celles-ci sont donnees ( ex. irregulier, irreguliere > irregulier = forme masculine, irreguliere = forme feminine)

(qui se maintient, qui persiste malgre le temps)

persistent, lasting adj adjective . Describes a noun or pronoun--for example, "a tall girl," "an interesting book," "a big house."

Il garde une ranc?ur tenace envers son frere.

tenace adj adjectif . modifie un nom. Il est generalement place apres le nom et s'accorde avec le nom ( ex. un ballon bleu, un e balle bleu e ). En general, seule la forme au masculin singulier est donnee. Pour former le feminin . on ajoute "e" ( ex. petit > petit e ) et pour former le pluriel . on ajoute "s" ( ex. petit > petit s ). Pour les formes qui sont "irregulieres" au feminin, celles-ci sont donnees ( ex. irregulier, irreguliere > irregulier = forme masculine, irreguliere = forme feminine)

resolute, tenacious, persevering adj adjective . Describes a noun or pronoun--for example, "a tall girl," "an interesting book," "a big house."

stubborn, obstinate adj adjective . Describes a noun or pronoun--for example, "a tall girl," "an interesting book," "a big house."

Dae Han New Pharm Co Ltd, New Wocomin

Dae Han New Pharm Co Ltd

Being a manufacturer of human and veterinary finished products as our main business, we, Dae Han New Pharm, are also trading vaious kinds of finished pharmaceutical products.

Brand Name Dosage Form Composition Packing Adesin Tab. Tablet Adenosine Triphosphate Disodium 21.96mg Tab. (20mg as Anhydride) 100T/Box Dakacin Inj. Vial Amikacin Sulfate 500mg/2mL Inj. 10V/Box Amlo Tab. Tablet Amlodipine Maleate 6.42mg Tab. (5mg as Amlodipine) 100T/Box Trarium Inj. Ampule Atracurium Besylate 25mg/2.5mL Inj. 5A/Box Bifesin Tab. Tablet Biphenyl Dimethyl Dicarboxylate 25mg Tab. 100T/Box Bumedil Tab. Tablet Buflomedil HCl 150mg Tab. 100T/Box Bumedil Inj. Ampule Buflomedil HCl 50mg/5mL Inj. 10A/Box Calibin Soft Cap. Soft Cap. Calcitriol 0.25mcg Soft Cap. 50SC/Box Carbotin Inj. 150mg Vial Carboplatin 150mg/15mL Inj. 1V/Box Carbotin Inj. 450mg Vial Carboplatin 450mg/45mL Inj. 1V/Box Eldamin Soft Cap. Soft Cap. Carduus Marianus Ext. 200mg Soft Cap. 100SC/Box Cefler Cap. 250mg Capsule Cefaclor 250mg Cap. 20C/Box Dahaclor SR Tab. Tablet Cefaclor 500mg SR Tab. 10T/Box Oradox Cap. Capsule Cefadroxil 500mg Cap. 100C/Box Cezolin Inj. Vial Cefazolin Sodium 1g Inj. 10V/Box Dahaxim Cap. 100mg Capsule Cefixime 100mg Cap. 20C/Box Dahaxim Cap. 200mg Capsule Cefixime 200mg Cap. 20C/Box Cefezon Inj. Vial Cefoperazone Sodium 1g Inj. 10V/Box Ceftam Inj. Vial Cefoperazone Sodium 500mg + Sulbactam Sodium 500mg Inj. 10V/Box Cetaxime Inj. 1g Vial Cefotaxime Sodium 1g Inj. 10V/Box Newtiam Inj. Vial Cefotiam HCl 1g Inj. 1V/Box Famcitin Inj. Vial Cefoxitin Sodium 1g Inj. 1V/Box Daedox Tab. Tablet Cefpodoxime Proxetil 100mg Tab. 10T/Box Zadim Inj. 1g Vial Ceftazidime 1g Inj. 1V/Box Cerixone Inj. 250mg Vial Ceftriaxone Sodium 250mg Inj. 10V/Box Cerixone Inj. 500mg Vial Ceftriaxone Sodium 500mg Inj. 10V/Box Cerixone Inj. 1g Vial Ceftriaxone Sodium 1g Inj. 10V/Box Tafurex Inj. Vial Cefuroxime Sodium 750mg Inj. 10V/Box Safdin Inj. Vial Cephradine 1g Inj. 10V/Box Safdin Cap. Capsule Cephradine 500mg Cap. 100C/Box Sancotec Tab. Tablet Cetirizine 2HCl 10mg Tab. 100T/Box Cilotal Tab. Tablet Cilostazol 50mg Tab. 10T/Box Eprosin Tab. Tablet Ciprofloxacin HCl 291mg Tab. (250mg as Ciprofloxacin) 10T/Box Eprosin Tab. 500mg Tablet Ciprofloxacin HCl 582mg Tab. (500mg as Ciprofloxacin) 10T/Box Ticol Inj. Ampule Citicoline 500mg/2mL Inj. 10A/Box Azicin-Daehan Cap. Capsule Clindamycin HCl 150mg Cap. 100C/Box Daicin Inj. 300mg Ampule Clindamycin Phosphate 300mg/2mL Inj. 10A/Box Daicin Inj. 600mg Ampule Clindamycin Phosphate 600mg/4mL Inj. 10A/Box DAC Inj. 100mg Vial Dacarbazine 100mg Inj. 1V/Box DAC Inj. Vial Dacarbazine 200mg Inj. 1V/Box DAC Inj. 500mg Vial Dacarbazine 500mg Inj. 1V/Box DTM Inj. Vial Dactinomycin 0.5mg Inj. 1V/Box Luospa Inj. Ampule Difemerine HCl 2mg/2mL Inj. 10A/Box Darida Tab. Tablet Domperidone Maleate 12.72mg Tab. (10mg as Domperidone) 100T/Box Diox Inj. 10mg Vial Doxorubicin HCl 10mg Inj. 1V/Box Diox Inj. 50mg Vial Doxorubicin HCl 50mg Inj. 1V/Box Lipiden Cap. Capsule Gemfibrozil 300mg Cap. 100C/Box Gitako Soft Cap. Soft Cap. Ginkgo Biloba Ext. 40mg Soft Cap. 100SC/Box Gitako Tab. Tablet Ginkgo Biloba Ext. 40mg Tab. 100T/Box Glizide Tab. Tablet Gliclazide 80mg Tab. 100T/Box Wocomin Cap. Capsule Glucosamine Sulfate 250mg Cap. 100C/Box Hydra Cap. Capsule Hydroxyurea 500mg Cap. 100C/Box Abio Gran. Granule Lactobacillus Acidophilus 75mg Gran. 10Sachet/Box Elsyton Soft Cap. Soft Cap. L-Cystine 500mg Soft Cap. 100SC/Box Hepolive Inj. Ampule L-Ornithine-L-Aspartate 500mg/5mL Inj. 10A/Box Levicin Tab. Tablet Levofloxacin 100mg Tab. 100T/Box Linma Cap. Capsule Lincomycin HCl 500mg Cap. 100C/Box Altidin Tab. Tablet Loratadine 10mg Tab. 100T/Box Lovatadin Tab. Tablet Lovastatin 20mg Tab. 50T/Box Mercapto Tab. Tablet Mercaptopurine 50mg Tab. 100T/Box Metrex Tab. Tablet Methotrexate 2.5mg Tab. 100T/Box Mitocin Inj. 10mg Vial Mitomycin-C 10mg Inj. 1V/Box Nimax Tab. Tablet Nimesulide 100mg Tab. 100T/Box

Main Products and Service: other

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Detail Information

Contact Person: Mr. Roy Kim

Street Address: # 1062-4, Namhyun-dong, Gwanak-Gu,

Country/Region: South Korea

Mobile Phone Number: 82 1692178117

Telephone Number: 82-2-34157833

Fax Number: 82-2-5978403

Disclaimer: For Non GMC Manufacturers information, Globalmarket. com endeavour to ensure the accuracy and reliability of the above information but do not guarantee the accuracy or reliability and accept no liability for any loss or damage arising from any inaccuracy or omission.

Company Type: Trading Company

Main Products and Service: Hair Dryer

Company Type: Manufacturer

Main Products and Service: Multivitamins / Medicine

Annaul Business Volume: Above US$100 Million

Target Market: Eastern Asia,

Number of Staff: 101 - 500 People

Company Type: Manufacturer

Main Products and Service: Ursodeoxycholic acid; cephalosporins; amoxicillin; fluconazole; ketoconazole; pyrazinamide; mefenamic acid; flumoxef; voglibose

Annaul Business Volume: US$10 Million - US$50 Million

Target Market: North America,

Number of Staff: 51 - 100 People

Company Type: Manufacturer

Main Products and Service: Food additives; based on traditional bulgarian yogurt(lactobacillusbulgaricus). Cosmetics

Target Market: North America, South America, Western Europe, Eastern Europe, Eastern Asia, Southeast Asia, Mid East, Africa, Oceania

Tryptan, Tryptan

Triptans

Triptans are a class of medicines used to relieve migraine attacks and cluster headaches. They are generally used when standard painkillers such as paracetamol or ibuprofen are not effective. You should take a triptan as you start to feel a migraine headache develop and NOT before this, as they may be less effective if taken too early in a migraine attack. Side-effects associated with triptans are generally minor.

What are migraine and cluster headaches?

Migraine is a condition that causes attacks (episodes) of headaches, and often other symptoms such as feeling sick (nausea) or being sick (vomiting). Between migraine attacks, the symptoms go completely. Cluster headaches consist of attacks of severe one-sided pain in the head.

This leaflet is about triptans that are used to treat migraine attacks and cluster headaches. It is assumed that you have some general knowledge about migraine or cluster headaches, but would like to know more about triptans. (See separate leaflets called Migraine and Cluster Headaches for more details about these conditions.)

What are triptans?

Triptans are a group (class) of drugs that are used to ease the symptoms of a migraine attack or cluster headache. They include almotriptan. eletriptan. frovatriptan. naratriptan. rizatriptan. sumatriptan. zolmitriptan. and come in various different brand names. They are also known as 5HT1 agonists. They come as tablet (both to be swallowed and in dispersible form), injection and nasal spray preparations.

How do triptans work?

The cause of migraine attacks (episodes) is not clear. A theory that used to be popular was that blood vessels in parts of the brain become narrower (go into spasm) which accounted for the aura that sometimes occurs. The blood vessels were then thought to open wide (dilate) soon afterwards, which accounted for the headache. However, this theory is not the whole story. It is now thought that some chemicals in the brain increase in activity and parts of the brain may then send out confusing signals which cause the symptoms. The exact changes in brain chemicals are not known. It is also not clear why people with migraine should develop these changes. However, something may trigger a change in activity of some brain chemicals to set off a migraine attack.

The cause of cluster headaches is even less clear but changes in brain chemicals probably play a part.

5-hydroxytryptamine (5-HT), also known as serotonin, is a chemical found in the brain and other parts of the body. 5-HT works by attaching to specific sites (receptors) on various cells of the body. Once bound to these receptors it creates a set of reactions within the cells. 5-HT has various actions in the body, depending on the type of cell being stimulated. For example, one of the effects that it has is to cause blood vessels to narrow (constrict).

Triptans, or 5HT1 agonists, target the same receptors as 5-HT. Due to their chemical 'makeup' they are able to stimulate the 5-HT receptors, causing the same effects as the body's own 5-HT. For example, this means they are able to cause the constriction of widened (dilated) blood vessels, which is thought to occur during a migraine. They may also have some other effect on stabilising the change in activity of some brain chemicals that occurs during a migraine attack.

Triptans are meant to be used during a migraine attack, not to stop one from coming on. There is some evidence that taking a triptan too early in a migraine attack may make the treatment less effective. Therefore, you should wait until you feel mild discomfort (usually, the beginning of the migraine headache) rather than taking the triptan at the aura stage or when you feel that a migraine may be developing.

Related discussions

Migraines everyday, all day, for 9 months. Help.

Which is the best triptan?

There is no best one that suits everyone. All triptans would probably work well in most people with migraine. However, there is some evidence to suggest that some are slightly more effective than others; but also, that side-effects may vary between the different types. In other words, people may respond individually to each preparation, both in terms of its effectiveness and side-effects.

Therefore, if the first triptan does not work so well, or causes bothersome side-effects, it is worth trying a different type. In some people, finding the right triptan may mean trying a few different ones. The British Association for the Study of Headache (BASH) recommends that you try a triptan for three separate migraine attacks before deciding if a change to a different one is needed.

Your doctor may also advise a change in the way in which the medicine is given, as this can help to improve effectiveness in some cases. For example, if being sick (vomiting) usually occurs during your migraine attack, zolmitriptan nasal spray or self-administered sumatriptan injection may be options to consider.

Can I buy triptans or are they just on prescription?

Sumatriptan can be bought, without a prescription, from pharmacies but only after an assessment by the pharmacist. Triptans should only be taken to treat migraine that has been previously diagnosed by your doctor. The other triptans apart from sumatriptan are only available on prescription.

How do I use triptans?

You should take your triptan as you start to feel a slight headache develop and NOT before this. This is because triptans have been found to be more effective when taken in this way. Triptans are designed to work rapidly - within an hour or so.

After you have taken the first dose:

If the triptan worked to relieve your migraine headache, but then the headache returned later, you can repeat the dose after 2-4 hours. But note: each triptan has a maximum daily dose that you should not exceed. It will be written on the packet. For example, you should not take more than 300 mg of sumatriptan in 24 hours.

If the triptan did not work, a further dose is unlikely to work and so do not take a second dose. The exception to this is zolmitriptan (2.5 mg), where an additional dose may be tried after two hours even if the first dose did not work. See the patient leaflet that comes in the medicine packet for details.

Who can and cannot take triptans?

A full list of people who should not take triptans is included with the patient leaflet that comes in the medicine packet. If you are prescribed a triptan, read this to be sure you are safe to take it. In particular, you should not take a triptan if you:

Have uncontrolled hypertension .

Have, or have a high risk of developing, cardiovascular disease (angina. heart attack. etc).

Have had a stroke or transient ischaemic attack (TIA) .

Have coronary vasospasm such as Prinzmetal's angina (this is rare).

Are pregnant.

Traces of triptans are passed out in breast milk, so they should be avoided during breast-feeding, or milk should be discarded for 12-24 hours (see manufacturer's information).

A reduced dose is recommended for some triptans if you have certain kidney or liver conditions - your doctor will advise.

Triptans should not be taken at the same time as migraine treatments containing ergotamine. If you stop taking a triptan you must wait before taking anything containing ergotamine. If you are taking ergotamine you must also wait before taking a triptan. This waiting period varies between 12 and 24 hours depending on the type of triptan. Speak to your doctor or pharmacist if this applies to you.

There are age restrictions on the use of triptans:

Children younger than 12 years of age should not take triptans.

Adolescents (12-18 years of age) may be prescribed sumatriptan nasal spray (10 mg).

Triptans are not licensed for people aged over 65 years.

What about risks?

Triptans are usually safe if you do not have any of the medical conditions mentioned above. As explained earlier, these medicines can cause the constriction of blood vessels which is why they are not to be given to people with heart or blood vessel problems.

If you take triptans too often, you are at risk of developing medication-induced headache.

What is medication-induced headache?

Medication-induced headache (also called medication overuse headache) is caused by taking painkillers or triptans too often for tension-type headaches or migraine attacks (episodes). It is a common cause of headaches that occur daily, or on most days. About 1 in 50 people develop this problem at some time in their lives. The following is a typical case:

You may have a bad spell of tension headaches or migraine attacks, perhaps during a time of stress. You take painkillers or a triptan more often than usual. You continue doing this for a while. Therefore, your body becomes used to the painkillers or triptan. A withdrawal (rebound) headache then develops if you do not take a painkiller or triptan within a day or so of the last dose. You think this is just another tension headache or migraine attack, and so you take a further dose of painkiller or triptan. When the effect of each dose wears off, a further withdrawal headache develops, and so on. A vicious circle develops. In time, you may have headaches on most days, or on every day, and you end up taking painkillers or a triptan every day, or on most days.

So, some people who may think they are getting frequent migraine attacks are in fact getting medication-induced headache. If you use painkillers or a triptan on more than two days per week on a regular basis, you are at risk of developing medication-induced headache. You should talk to your doctor if you suspect that you may have medication overuse headache. See separate leaflet called Medication-induced Headache for more details.

What about side-effects?

Most people who take triptans do not have any serious side-effects. However, they can cause drowsiness. If drowsiness occurs, you should not drive or perform other skilled tasks while affected.

The other most common side-effects are feeling sick (nausea), dizziness and dry mouth.

In addition, triptans can also cause some people to experience strange sensations. These may be a tightness, tingling, flushing, and feelings of heaviness or pressure in areas such as the face and limbs, and occasionally the chest. These triptan sensations in the chest can mimic heart pains (angina) and may cause alarm. Usually these sensations are not harmful. However, if you develop intense chest pain or sensations, you should stop taking your medication and consult a doctor immediately or go directly to the nearest accident and emergency department (you may need to dial 999/112/911 for an ambulance).

For a full list of all the side-effects and possible interactions associated with your medicine, consult the leaflet that comes with your medication.

Related Wellbeing

How to use the Yellow Card Scheme

If you think you have had a side-effect to one of your medicines you can report this on the Yellow Card Scheme. You can do this online at the following web address: www. mhra. gov. uk/yellowcard .

The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that medicines or any other healthcare products may have caused. If you wish to report a side-effect, you will need to provide basic information about:

The side-effect.

The name of the medicine which you think caused it.

The person who had the side-effect.

Your contact details as the reporter of the side-effect.

It is helpful if you have your medication - and/or the leaflet that came with it - with you while you fill out the report.

Further help & information

Ribamox, Ribamox

Ribamox

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

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Domestic Violence - Workplaces Say No - Emberin, Emaberin

Domestic Violence – Workplaces Say No

When we’re looking at statistics like how on average one woman per week is killed as a result of domestic violence, it begs the question whether there’s something more we can be doing in the workplace to help our women.

According to White Ribbon, Australia’s campaign to stop violence against women, the issue is estimated to cost the Australian economy over $14.4 billion annually – making it clear that it is not just an issue that remains in the household.

It’s our job as diversity and inclusion champions to take charge of the issue at work.

As an inclusive leader, one of the big things that’s required of you is to take a step forward in educating your workforce about respectful relationships between men and women. According to White Ribbon, 94% of employees agree with this and are looking to their leaders to take the first step.

By taking this crucial step forward, you will help your women feel comfortable in the workplace and give them the confidence they need in order to stand up and ask for help.

Alongside giving your women the courage they need, you will also see a change in your organisational climate and in your employees’ sense of wellbeing. This is what will keep your workplace healthy and thriving – even in the face of adversity.

Considering that 1 in 5 women will experience harassment in the workplace, it’s your job to ensure that you nurture an environment where this is simply not acceptable.

By teaching your men to speak up and show their disapproval at sexism and harassment, you will make giant leaps toward an inclusive – and happy – work environment.

Shockingly, only 1 in 6 men surveyed by White Ribbon said that they would stand up and say something in a situation like that. You need to make sure that all of your male employees are the 1 that would make a stand.

If you do have an employee that is a victim of domestic violence, it’s key that you make them feel safe and able to speak to you about their issues.

When they feel safe, you will be able to work with them to either organise a flexible work arrangement or give them much needed time off to deal with their personal issues.

At the end of the day, ensuring the wellbeing of your employees is what it means to be an inclusive leader and how you act in these critical moments is what will define your leadership style.

If you are concerned about any of your employees, remind them that there is help available and point them in the direction of 1800 RESPECT – a domestic violence counselling hotline.

Oracoes – Oracoes Catolicas, Fortes, Reduzidas, Evangelicas, Oracap

Oracoes, Oracoes Catolicas, Fortes, Reduzidas, Evangelicas

"Sao Miguel Arcanjo, protegei-nos no combate, defendei-nos com vosso escudo contra os embustes e as ciladas do demonio. Subjugue-o Deus, insistentemente o pedimos, e Vos, Principe da Milicia Celeste, pelo divino poder, precipitai no Inferno a Satanas e a todos os espiritos malignos que vagueiam pelo mundo, para perder as almas. Amem."

A oracao consiste em manter comunhao com Deus. A fe nos faz entender que Deus existe, e um ser real que pode e quer ouvir-nos. Simplificando: orar e falar com o Senhor, expondo nossa gratidao, felicidade, adoracao, necessidades e buscando socorro quando necessario. O Espirito de Deus deixa-nos continuamente ligado ao Eterno, possibilitando-nos falar com Ele a cada instante, independente do lugar onde estejamos. Por exemplo: andando pelas ruas, dirigindo, numa fila de banco, trabalhando, etc. (Pode-se orar em voz audivel ou apenas em espirito.) Experimente e veras que tua comunhao com o Pai se estreitara maravilhosamente.

Deus tem um proposito a realizar, mas ele precisa que o homem esteja disposto a orar, para que se estabeleca Sua vontade aqui na Terra, esta e a funcao da oracao, preparar um caminho para que Deus realize Sua vontade, assim como uma locomotiva necessita dos trilhos para andar, Deus necessita da oracao do homem para levar adiante Sua vontade, sendo assim o homem deve fazer com que sua vontade seja unida com a vontade de Deus para que se estabelecam seus designos, como podemos ver em 1 Jo 5:14-15 "E esta e a confianca que temos para com ele, que, se pedirmos alguma cousa segundo a sua vontade, ele nos ouve. E, se sabemos que ele nos ouve quanto ao que lhe pedimos, estamos certos de que obtemos os pedidos que lhe temos feito.", a oracao tem como objetivo que nos venhamos a fazer com que a vontade de Deus se estabeleca aqui na terra, desta forma, devemos conhecer melhor a vontade de Deus, para que nossas oracoes sejam agradaveis a Deus e nossos propositos sejam cumpridos.

A oracao e o estabelecimento de um dialogo do homem com Deus, sendo que, devemos estar atentos a resposta de Deus, que vem atraves de nosso espirito ou atraves das circunstancias exteriores. E atraves da oracao que nos colocamos nossas ansiedades nas maos de Deus, crendo que Ele e poderoso para nos dar paz interior, e resolver nossos problemas da melhor maneira possivel para nosso crescimento espiritual. Quando somos iluminados por Deus, em nossa consciencia, de nossos pecados, nos devemos imediatamente pedir perdao a Deus, atraves da oracao.

Devemos estar sempre orando, para sermos guardados das tentativas de satanas de nos levar ao pecado. Podemos dizer que a oracao e o nosso termometro espiritual, quando nos nao conseguimos orar, indica que nao estamos bem espiritualmente. Devemos aprender a observar o falar divino, em nosso espirito, enquanto estamos orando, pois Deus se comunica conosco atraves de nossa intuicao, que e uma das partes do nosso espirito, mas cabe a nos, utilizando o nosso conhecimento biblico, discernirmos se e ou nao de Deus este falar, pois o inimigo pode tambem tentar nos enganar, lancando pensamentos em nossa mente que sutilmente nos induziram ao pecado.

A oracao e ordenada por Deus, sem oracao nao ha comunhao (“Buscai o SENHOR enquanto se pode achar, invocai-o enquanto esta perto”. Is 55.6 vejam tambem: Mt 7.7 e Fp 4.6).

Vamos analisar o trecho da Biblia mais importante sobre a oracao, que se encontra em Mt 6:5-13:

5 E, quando orardes, nao sereis como os hipocritas; porque gostam de orar em pe nas sinagogas e nos cantos das pracas, para serem vistos dos homens. Em verdade vos digo que eles ja receberam a recompensa. 6 Tu, porem, quando orares, entra no teu quarto e, fechada a porta, oraras a teu Pai, que esta em secreto; e teu Pai, que ve em secreto, te recompensara. 7 E, orando, nao useis de vas repeticoes, como os gentios; porque presumem que pelo seu muito falar serao ouvidos. 8 Nao vos assemelheis, pois, a eles; porque Deus, o vosso Pai, sabe o de que tendes necessidade, antes que lho pecais. 9 Portanto, vos orareis assim: Pai nosso, que estas nos ceus, santificado seja o teu nome; 10 venha o teu reino; faca-se a tua vontade, assim na terra como no ceu; 11 o pao nosso de cada dia da-nos hoje; 12 e perdoa-nos as nossas dividas, assim como nos temos perdoado aos nossos devedores; 13 e nao nos deixes cair em tentacao; mas livra-nos do mal pois teu e o reino, o poder e a gloria para sempre. Amem!

A oracao do justo nao fica no esquecimento, e ouvida e (“O tu que escutas a oracao” Sl 65.2) e atendida (“Moises e Arao foram sacerdotes de Deus, e Samuel orava a ele; eles clamavam a Deus, o SENHOR, e ele respondia.” Sl 99.6; “Na minha aflicao, eu clamei ao SENHOR; ele me respondeu e me livrou da angustia.” Sl 118.5). Somos ouvidos e atendidos mediante a graca de Deus (“Quando voces clamarem pedindo socorro, o SENHOR Deus ficara com pena de voces; ele os ouvira e atendera”. Is 30.19), nao e merito pessoal. Alguns de nossos clamores sao atendido de imediato (“Antes mesmo que me chamem, eu os atenderei; antes mesmo de acabarem de falar, eu responderei”. Is 65.24), outros, porem, sao demorados (“Nao fara Deus justica aos seus escolhidos, que a ele clamam dia e noite, embora pareca demorado em defende-los?” Lc 18.7). Devemos orar e clamar pelo que desejamos, no entanto, e preciso entender que o Senhor e soberano e que a Sua vontade e superior a nossa. Em alguns casos nao somos atendidos (“Por causa disto, tres vezes pedi ao Senhor que o afastasse de mim. Entao, ele me disse: A minha graca te basta, porque o poder se aperfeicoa na fraqueza. De boa vontade, pois, mais me gloriarei nas fraquezas, para que sobre mim repouse o poder de Cristo”. 2Co 12.8,9).

As nossas oracoes sao respondidas quando buscamos servir ao Senhor (“Busquei o SENHOR, e ele me acolheu; livrou-me de todos os meus temores”. Sl 34.4) de todo o coracao, isto implica, em dedicacao total (“Entao, me invocareis, passareis a orar a mim, e eu vos ouvirei. Buscar-me-eis e me achareis quando me buscardes de todo o vosso coracao”. Jr 29.12,13), que gera fe, que por sua vez nos faz paciente e capacita-nos a esperar o tempo oportuno (“Esperei com paciencia pela ajuda de Deus, o SENHOR. Ele me escutou e ouviu o meu pedido de socorro”. Sl 40.1). Quando permanecemos firme nas promessas, somos atendidos (“Se permanecerdes em mim, e as minhas palavras permanecerem em vos, pedireis o que quiserdes, e vos sera feito.” Jo 15.7), pois as nossas peticoes sao segundo o Seu coracao (“Quando estamos na presenca de Deus, temos coragem por causa do seguinte: se pedimos alguma coisa de acordo com a sua vontade, temos a certeza de que ele nos ouve.” 1Jo 5.14).

E comum encontrarmos irmaos lamentando por nao serem ouvidos pelo Senhor, dificilmente colhem frutos de suas oracoes. Onde esta o erro, no Senhor Deus? De forma alguma. Veja algumas das causas, pelas quais as oracoes nao sao atendidas: 1- Os Objetivos (“E, quando pedem, nao recebem porque os seus motivos sao maus. Voces pedem coisas a fim de usa-las para os seus proprios prazeres.” Tg 4.3); 2- Coracoes impuros, cheios dos desejos carnais (“Mas, se eu tivesse guardado maus pensamentos no coracao, o Senhor nao teria me ouvido”. Sl 66.18); 3- Vida em pecado (“Sabemos que Deus nao atende a pecadores; mas, pelo contrario, se alguem teme a Deus e pratica a sua vontade, a este atende”. Jo 9.31).

A oracao que sobe como “aroma agradavel” ate o Senhor tem as seguintes qualificacoes: 1- Atraves do Espirito Santo (“Porem voces, meus amigos, continuem a progredir na sua fe, que e a fe mais sagrada que existe. Orem guiados pelo Espirito Santo”. Jd 20); 2- Coracao cheio de fe (“Se crerem, receberao tudo o que pedirem em oracao”. Mt 21.22); 3- Vida pura e contrita (“Portanto, cheguemos perto de Deus com um coracao sincero e uma fe firme, com a consciencia limpa das nossas culpas e com o corpo lavado com agua pura”. Hb 10.22); 4- Ser sabio nas peticoes (“Vou orar com o meu espirito, mas tambem vou orar com a minha inteligencia.” 1Co 14.15); 5- Com sinceridade (“O SENHOR Deus, atende o meu pedido de justica! Escuta o meu pedido de ajuda. Ouve a oracao que faco com sinceridade”. Sl 17.1); 6- Santidade (“Quero que em todos os lugares os homens orem, homens dedicados a Deus; e que, ao orarem, eles levantem as maos, sem odio e sem brigas”. 1Tm 2.8); 7- Humildade (“se o meu povo, que se chama pelo meu nome, se humilhar, e orar, e me buscar, e se converter dos seus maus caminhos, entao, eu ouvirei dos ceus, perdoarei os seus pecados e sararei a sua terra. Estarao abertos os meus olhos e atentos os meus ouvidos a oracao que se fizer neste lugar”. 2Cr 7.14,15); 8- Incessante (“Orai sem cessar”. 1Ts 5.17 e “. poe a sua esperanca em Deus e ora, de dia e de noite, pedindo a ajuda dele”. 1Tm 5.5); 9- Orar em qualquer lugar (“Quero que em todos os lugares os homens orem, homens dedicados a Deus”. 1Tm 2.8).

A nossa ligacao com o Senhor obrigatoriamente precisa ser intima, isto implica em possuir a Sua mente, ou seja, pensarmos e agirmos de a Sua semelhanca.

“Nao se preocupem com nada, mas em todas as oracoes pecam a Deus o que voces precisam e orem sempre com o coracao agradecido”. Fp 4.6

A. Agradecimento B. Peticao C. Persuasao D. Intercessao

A. Agradecimento – e a oracao na qual se agradece a Deus por todas as coisas na sua vida. Devemos dar gracas em todas as circunstancias, agradecendo pela protecao, a provisao, a bencao de Deus e, sobretudo, pelo Seu Filho.

B. Peticao – quando pedimos a Deus aquilo que necessitamos nas nossas vidas: “o pao nosso de cada dia da-nos hoje”. Da-nos o que e preciso para sobreviver: um teto sobre as nossas cabecas, um emprego, etc. As peticoes sao, geralmente, em beneficio proprio, apresentando ao nosso Pai celeste as nossas necessidades, na certeza de que Ele provera.

C. Persuasao – oracao insistente e cheia de fervor que e feita ate que uma reviravolta aconteca, seja na sua vida pessoal, seja na vida de outra pessoa (intercessao). Exemplo: fe para uma cura emocional ou fisica.

Exemplo biblico: Lucas 19:1 a 8. Entao Jesus contou aos seus discipulos uma parabola, para mostrar-lhes que eles deviam orar sempre e nunca desanimar. Ele disse: “Em certa cidade havia um juiz que nao temia a Deus nem se importava com os homens. E havia naquela cidade uma viuva que se dirigia continuamente a ele, suplicando-lhe: ‘Faze-me justica contra o meu adversario’. Por algum tempo ele se recusou. Mas finalmente disse consigo mesmo: ‘Embora eu nao me importe com os homens, esta viuva esta me aborrecendo; tomarei providencias para que ela receba justica e nao venha me importunar’.” E o Senhor continuou: “Oucam o que diz o juiz injusto. Acaso Deus nao concedera justica aos seus escolhidos, que clamam a ele dia e noite? Continuara fazendo-os esperar? Eu lhes digo: ele tomara providencias para que eles obtenham justica, e depressa. Contudo, quando o Filho do homem vier, encontara fe na terra?”

D. Intercessao – e o amor de joelhos, em oracao pelos outros. E uma suplica em favor de uma outra pessoa, na qual nos colocamos no lugar, isto e, fazendo oracoes de confissao, etc. identificando-nos com os pecados daquela pessoa por quem oramos.

Exemplo biblico: Neemias, um homem bondoso, que se identificou com os pecados do seu povo, confessando estes pecados e pedindo ao Senhor para perdoa-los e ter misericordia, e para levantar outra vez a nacao de Israel.

Neemias 1:3 a 11 E eles me responderam: “Aqueles que sobreviveram ao cativeiro e estao la na provincia passam por grande sofrimento e humilhacao. O muro de Jerusalem foi derrubado, e suas portas foram destruidas pelo fogo.” Quando ouvi estas coisas, sentei-me e chorei. Passei dias lamentando-me, jejuando e orando ao Deus dos ceus. Entao eu disse: “Senhor, Deus dos ceus, Deus grande temivel, fiel a alianca e misericordioso com os que te amam e obedecem aos teus mandamentos, que os teus ouvidos estejam abertos para a oracao que o teu servo esta fazendo diante de ti, dia e noite, em favor de teus servos, o povo de Israel. Confesso os pecados que nos, os israelitas, temos cometido contra ti. Sim, eu e o meu povo temos pecado. Agimos de forma corrupta e vergonhosa contra ti. Nao temos obedecido aos mandamentos, aos decretos e as leis que deste ao teu servo Moises. Lembra-te agora do que disseste a Moises, teu servo: ‘Se voces forem infieis, eu os espalharei entre as nacoes, mas, se voltarem para mim, obedecerem aos meus mandamentos e os puserem em pratica, mesmo que voces estejam espalhados pelos lugares mais distantes debaixo do ceu, de la eu os reunirei e os trarei para o lugar que escolhi para estabelecer o meu nome’. Estes sao os teus servos, o teu povo. Tu os resgataste com o teu grande poder e com o teu braco forte. Senhor, que os teus ouvidos estejam atentos a oracao deste teu servo e a oracao dos teus servos que tem prazer em temer o teu nome. Faze com que hoje este teu servo seja bem-sucedido, concedendo-lhe a benevolencia deste homem.”

Para nos aproximarmos de Deus em oracao e preciso em primeiro lugar termos em mente que Ele e Deus. Por isso devemos assumir nossa pequenez, nosso nada diante dEle e orar com simplicidade e humildade, recohecendo e aceitando a Sua vontade acima da nossa.

Os lugares mais favoraveis a oracao sao o oratorio pessoal ou familiar, os mosteiros, os santuarios de peregrinacoes e, sobretudo a Igreja, que e lugar proprio da oracao liturgica para a comunidade paroquial e o lugar privilegiado da adoracao eucaristica.

E importante que nao se tenha pressa na hora da oracao. Entregue-se nas maos de Deus e ore.

E util lembrar que, na oracao do terco ou rosario, nao pedimos a Maria, mas a Jesus. O terco nos da o dom de orar com o coracao. Durante a reza do terco Maria esta orando conosco tambem, intercedendo a Jesus.

O que e a oracao

Para Santa Terezinha "e um impulso do coracao, e um simples olhar lancado ao ceu, um grito de reconhecimento e amor no meio da provacao ou no meio da alegria."

Realmente ha varias definicoes para "oracao." Santo Ambrosio define como: "A oracao e a elevacao da alma a Deus ou o pedido a Deus dos bens convenientes."

Uma outra frase que tambem explica com eficacia o que e a "oracao" e: "e uma conversa com Deus."

Cefticlor, Cefticlor

Cefaclor

Chemical Name

5-tia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid, 7-[(aminophenylacetyl)amino]-3-chloro-8-oxo-, [6R-[6?,7?(R*)]]-

Foreign Names

Cefaclorum (Latin)

Cefaclor (German)

Cefaclor (French)

Cefaclor (Spanish)

Generic Names

Cefaclor (OS: USAN, JAN, BAN)

Cefacloro (OS: DCIT)

Cefeaclor (OS: DCF)

Cephaclor (IS)

Compound 99638 (IS: Lilly)

Cefaclor (PH: JP XVI, USP 38)

Cephaclor-1-Wasser (IS)

S 6472 (IS)

Cefaclor (PH: BP 2016, Ph. Eur. 8, USP 38)

Cefaclor (PH: Ph. Eur. 8)

Cefaclor-Monohydrat (PH: Ph. Eur. 8)

Cefaclorum (PH: Ph. Eur. 8)

Brand Names

Suppression Of Respiratory Burst Of Polymorphonuclear Leukocytes By Azelastine Hydrochloride (Azepti

Suppression of respiratory burst of polymorphonuclear leukocytes by Azelastine hydrochloride (Azeptin)

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Katayama S, Akimoto N, Shionoya H, Morimoto T, Katoh Y (1981) Anti-allergic effect of azelastine hydrochloride on immediate hypersensitivity reactions in vivo and in vitro. Arzneimittelforschung 31: 1196–1203

Chand W, Pillar J, Diamantis W, Sophia RD (1985) Inhibition of allergic histamine release by azelastine and selected antiallergic drugs from rabbit leukocytes. Int Arch Allergy Appl Immunol 77: 451–455

Little MM, Casale TB (1989) Azelastine inhibits IgE-mediated human basophil histamine release. J Allergy Clin Immunol 83: 862–865

Ueta E, Osaki T, Yoneda K, Yamamoto T, Kato I (1994) A clinical trial of Azelastine in recurrent aphthous ulceration, with an analysis of its actions on leukocytes. J Oral Pathol Med 23: 123–129

Bamberger DM, Herndon BL (1990) Bacteriocidal capacity of neutrophils in rabbits with experimental acute and chronic abscess. J Infect Dis 162: 186–192

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van Oers NSC, Tao W, Watts JD, Johnson P, Aebersold R, Teh H-S (1993) Constitutive tyrosine phosphorylation of the T-cell receptor (TCR)? subunit: Regulation of TCR-associated protein tyrosine kinase activity by TCR?. Mol Cell Biol 13: 5771–5780

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Copyright information

Suppression of respiratory burst of polymorphonuclear leukocytes by Azelastine hydrochloride (Azeptin)

Spector SL, Perhach JL, Rohr AS, Rachelefsky GS, Katz RM, Siegel SC (1987) Pharmacodynamic evaluation of azelastine in subjects with asthma. J Allergy Clin Immunol 80: 75–80

Katayama S, Akimoto N, Shionoya H, Morimoto T, Katoh Y (1981) Anti-allergic effect of azelastine hydrochloride on immediate hypersensitivity reactions in vivo and in vitro. Arzneimittelforschung 31: 1196–1203

Chand W, Pillar J, Diamantis W, Sophia RD (1985) Inhibition of allergic histamine release by azelastine and selected antiallergic drugs from rabbit leukocytes. Int Arch Allergy Appl Immunol 77: 451–455

Little MM, Casale TB (1989) Azelastine inhibits IgE-mediated human basophil histamine release. J Allergy Clin Immunol 83: 862–865

Ueta E, Osaki T, Yoneda K, Yamamoto T, Kato I (1994) A clinical trial of Azelastine in recurrent aphthous ulceration, with an analysis of its actions on leukocytes. J Oral Pathol Med 23: 123–129

Bamberger DM, Herndon BL (1990) Bacteriocidal capacity of neutrophils in rabbits with experimental acute and chronic abscess. J Infect Dis 162: 186–192

Mimnaugh EG, Dusre L, Atwell J, Myers CE (1989) Differential oxygen radical susceptibility of adriamycin-sensitive and-resistant MCF-7 human breast tumor cells. Cancer Res 49: 8–15

Babior BM (1978) Oxygen-dependent microbial killing by phagocytes. N Engl J Med 298: 659–721

Ferrante A (1989) Tumor necrosis factor alpha potentiates neutrophil antimicrobial activity: increased fungicidal activity against Torulopsis glabrata and Candida albicans and associated increases in oxygen radical production and lysosomal enzyme release. Infect Immun 57: 2115–2122

van Oers NSC, Tao W, Watts JD, Johnson P, Aebersold R, Teh H-S (1993) Constitutive tyrosine phosphorylation of the T-cell receptor (TCR)? subunit: Regulation of TCR-associated protein tyrosine kinase activity by TCR?. Mol Cell Biol 13: 5771–5780

Pleiman CM, Clark MR, Timson-Gauen LK, Winitz S, Coggeshall KM, Johnson GL, Shaw AS, Cambier JC (1993) Mapping of sites on the Src family protein tyrosine kinases p55 blk. p59 fyn. and p56 lyn which interact with the effector molecules phospholipase C-? 2, micro-tubule-associated protein kinase, GTPase-activating protein, and phosphatidylinositol 3-kinase. Mol Cell Biol 13: 5877–5887

Kanner SB, Grosmaire LS, Ledbetter JA, Damle NK (1993) ? 2 - integrin LFA-1 signaling through phospholipase C-? 1 activation. Proc Natl Acad Sci USA 90: 7099–7103

Berkow RL, Dodson R (1991) Alterations in tyrosine protein kinase activities upon activation of human neutrophils. J Leukocyte Biol 49: 599–604

McColl SR, Dipersio JF, Caon AC, Ho P, Naccache PH (1991) Involvement of tyrosine kinases in the activation of human peripheral blood neutrophils by granulocyte-macrophage colony-stimulating factor. Blood 78: 1842–1852

Akimaru K, Utsumi T, Sato EF, Klostergaard J, Inoue M, Utsumi K (1992) Role of tyrosyl phosphorylation in neutrophil priming by tumor necrosis factor-? and granulocyte colony stimulating factor. Arch Biochem Biophys 298: 703–709

Strum JC, Nixon AB, Daniel LW, Wykle RL (1993) Evaluation of phospholipase C and D activity in stimulated human neutrophils using a phosphono analog of choline phosphoglyceride. Biochim Biophys Acta 1169: 25–29

Boyum A (1968) Isolation of mononuclear cells and granulocytes from human blood. Scand J Clin Lab Invest 21: 77–98

Reynolds HY, Thompson RE (1973) Pulmonary host defenses, II. Interaction of respiratory antibodies with Pseudomonas aeruginosa and alveolar macrophages. J Immunol 111: 369–380

Palmer S, Hughes KT, Lee DY, Wakelam MJ (1989) Development of a novel, Ins (1,4,5) P3-specific binding assay. Its use of determine the intracellular concentration of Ins (1,4,5) P3 in unstimulated and vasopressin-stimulated rat hepatocytes. Cell Signal 1: 147–156

Hannun YA, Loomis CR, Bell RM (1985) Activation of protein kinase C by Triton X-100 mixed micelles containing diacylglycerol and phosphatidylserine. J Biol Chem 260: 10039–10043

Wray D, Charon J (1991) Polymorphonuclear neutrophil function in recurrent aphthous stomatitis. J Oral Pathol Med 20: 392–394

Oyanagi Y (1984) Reevaluation of assay methods and establishment of kit for superoxide dismutase activity. Anal Biochem 142: 290–296

Lowry OH, Rosebrough NJ, Farr AL, Randall RJ (1951) Protein measurement with the Folin phenol reagent. J Biol Chem 193: 265–275 PubMed

Suzuki M, Inauen W, Kvietys PR et al (1989) Superoxide mediates reperfusion-induced leukocyte-endothelial cell interactions. Am J Physiol 257: H1740–1745

Smith SM, Grisham MB, Manci EA, Granger DN, Kvietys PR (1987) Gastric mucosal injury in the rat, role of iron and xanthine oxidase. Gastroenterology 92: 950–956

Repine JE (1992) Scientific perspectives on adult respiratory distress syndrome. Lancet 339: 466–469

Szabo ME, Droy-Lefaix MT, Doly M, Braquet P (1991) Free radical-mediated effects in reperfusion injury: a histologic study with superoxide dismutase and EGB 761 in rat retina. Ophthalmic Res 23: 225–234

Osaki T, Ueta E, Yoneda K, Hirota J, Yamamoto T (1994) Prophylaxis of oral mucositis associated with chemoradiotherapy for oral carcinoma by azelastine hydrochloride (Azelastine) with other antioxidants. Head Neck 16: 331–339

Petersen MM, Steadman R, Williams JD (1992) Protein kinase C activation modulates tumor necrosis factor-alpha priming of human neutrophils for zymosan-induced leukotriene B 4 release. Immunology 75: 275–280

Tsujimoto M, Yokota S, Vilcek J, Weissmann G (1986) Tumor necrosis factor provokes superoxide anion generation from neutrophils. Biochem Biophys Res Commun 137: 1094–1100

Yuo A, Kitagawa S, Azuma E, Natori Y, Togawa A, Saito M, Takaku F (1993) Tyrosine phosphorylation and intra-cellular alkalinization are early events in human neutrophils stimulated by tumor necrosis factor, granulocyte-macrophage colony-stimulating factor and granulocyte colony-stimulating factor. Biochem Biophys Acta 1156: 197–203

Utsumi T, Klostergaard J, Akimaru K, Sato EF, Yoshikawa T, Utsumi K (1992) Effect of tumor necrosis factor-? on the stimulus-coupled responses of neutrophils and their modulation by various inhibitors. Physiol Chem Phys Med NMR 24: 77–88

McColl SR, Beauseigle D, Gilbert C, Naccache PH (1990) Priming of the human neutrophil respiratory burst by granulocyte-macrophage colony-stimulating factor and tumor necrosis factor-? involves regulation at a post-cell surface receptor level. J Immunol 145: 3047–3053

Sullivan GW, Carper HT, Mandell GL (1993) The effect of three human recombinant hematopoietic growth factors (granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, and interleukin-3) on phagocyte oxydative activity. Blood 81: 1863–1870

Borish L, Rosenbaum R, Albury L, Clark S (1989) Activation of neutrophils by recombinant interleukin 6. Cell Immunol 121: 280–289

Chen W, Havell EA, Harmsen AG (1992) Importance of endogenous tumor necrosis factor alpha and gamma interferon in host resistance against pneumocystis carinii infection. Infect Immun 60: 1279–1284

Matsumoto S, Takei M, Moriyama M, Imanishi H (1987) Augmentation of antibody-dependent cellular cytotoxicity of polymorphonuclear leukocytes by interferon gamma: mechanism dependent on enhancement of Fc receptor expression and increased release of activated oxygens. Chem Pharm Bull 35: 1571–1578

Kharazmi A, Nielsen H, Rechnitzer C, Bendtzen K (1989) Interleukin 6 primes human neutrophil and monocyte oxidative burst response. Immunol Lett 21: 177–184

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Esipram (Escitalopram) Report For Patients Like You, Esipram

Esipram treatment report

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What is escitalopram?

Escitalopram is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Escitalopram affects chemicals in the brain that may become unbalanced and cause depression or anxiety.

Escitalopram is used to treat anxiety in adults and major depressive disorder in adults and adolescents who are at least 12 years old.

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

Precautions

It is dangerous to try and purchase escitalopram on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of escitalopram purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects. For more information, contact the U. S. Food and Drug Administration (FDA) or visit www. fda. gov/buyonlineguide.

Do not use escitalopram if you are using an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with escitalopram. You must wait at least 14 days after stopping an MAO inhibitor before you can take escitalopram. After you stop taking escitalopram, you must wait at least 14 days before you start taking an MAOI.

Before taking escitalopram, tell your doctor if you are allergic to any drugs, or if you have:

liver or kidney disease;

seizures or epilepsy;

bipolar disorder (manic depression); or

a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take escitalopram.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking escitalopram, do not stop taking the medication without first talking to your doctor.

Escitalopram can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give escitalopram to anyone younger than 12 years old without the advice of a doctor.

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with escitalopram may cause you to bruise or bleed easily.

Avoid drinking alcohol, which can increase some of the side effects of escitalopram.

Escitalopram can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety). They can add to sleepiness caused by escitalopram.

Instructions

Seek emergency medical attention if you think you have taken too much of this medication. Overdose symptoms may include nausea, vomiting, tremor, sweating, rapid heartbeat, confusion, dizziness, seizures, and coma.

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

Side effects

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

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, overactive reflexes;

nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination; or

headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.

Less serious side effects may include:

drowsiness, dizziness;

sleep problems (insomnia);

mild nausea, gas, heartburn, upset stomach, constipation;

weight changes;

decreased sex drive, impotence, or difficulty having an orgasm; or

dry mouth, yawning, ringing in your ears.

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.

Interactions

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with escitalopram may cause you to bruise or bleed easily.

The following drugs can interact with escitalopram. Tell your doctor if you are using any of these:

carbamazepine (Carbatrol, Tegretol);

cimetidine (Tagamet);

lithium (Lithobid, Eskalith);

a blood thinner such as warfarin (Coumadin);

any other antidepressants such as amitriptyline (Elavil), citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), or sertraline (Zoloft); or

almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig).

This list is not complete and there may be other drugs that can interact with escitalopram. 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.

Other Names

Lexapro and escitalopram

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 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

Last updated: September 19, 2016

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

Do not take escitalopram together with a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take escitalopram. After you stop taking escitalopram, you must wait at least 14 days before you start taking an MAOI.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking escitalopram, do not stop taking the medication without first talking to your doctor.

It is dangerous to try and purchase escitalopram on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of escitalopram purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects. For more information, contact the U. S. Food and Drug Administration (FDA) or visit www. fda. gov/buyonlineguide.

Warning

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

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Hytrin - Man S Health, Romaken

Hytrin is used for treating high blood pressure and treating signs and symptoms of benign prostatic hyperplasia (BPH). Hytrin is an alpha-blocker. It works by relaxing muscles in the blood vessels, resulting in lowering of blood pressure. In BPH, alpha-blockers work by relaxing muscles around the urethra (tube that drains urine from the bladder), which improves urinary symptoms.

Use Hytrin as directed by your doctor.

Take Hytrin by mouth with or without food.

Hytrin may cause a sudden drop in blood pressure after the first dose. Take your first dose at bedtime. If you get up during the night, sit up slowly, then stand slowly.

If you miss a dose of Hytrin, 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. If more than one dose is missed, contact your doctor or pharmacist.

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

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

Active Ingredient: Terazosin hydrochloride.

Do NOT use Hytrin if:

you are allergic to any ingredient in Hytrin or to similar medicines (eg, prazosin).

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

Some medical conditions may interact with Hytrin. 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 prostate cancer, angina pectoris, heart disease, or kidney or liver problems

if you will be having eye surgery.

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

Phosphodiesterase type 5 (PDE5) inhibitors (eg, sildenafil) or verapamil because severe dizziness, lightheadedness, or fainting may occur.

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

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

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

Hytrin may cause a sudden drop in blood pressure after the first dose. Take your first dose at bedtime. If you get up during the night, sit up slowly, then stand slowly. This will help to reduce your lightheadedness or dizziness. These effects are more likely to occur after the first few doses or if your dose has increased, but can occur at any time while you are taking the medicine. It can also occur if you stop taking the medicine and then restart treatment.

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

Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.

Do NOT take more than the recommended dose without checking with your doctor.

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

Tell your doctor or dentist that you take Hytrin before you receive any medical or dental care, emergency care, or surgery (including eye surgery).

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

Hytrin should not be used 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 Hytrin while you are pregnant. It is not known if Hytrin is found in breast milk. If you are or will be breast-feeding while you use Hytrin, 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:

Dizziness; drowsiness; lightheadedness; nasal congestion; nausea; weakness.

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); blurred vision or other vision changes; chest pain; decreased sexual desire or ability; fainting; fast, slow, or irregular heartbeat;painful, prolonged erection; severe or prolonged dizziness or headache; shortness of breath; swelling of the ankles, feet, or hands.

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.

Hytrin is used for treating high blood pressure and treating signs and symptoms of benign prostatic hyperplasia (BPH). Hytrin is an alpha-blocker. It works by relaxing muscles in the blood vessels, resulting in lowering of blood pressure. In BPH, alpha-blockers work by relaxing muscles around the urethra (tube that drains urine from the bladder), which improves urinary symptoms.

Use Hytrin as directed by your doctor.

Take Hytrin by mouth with or without food.

Hytrin may cause a sudden drop in blood pressure after the first dose. Take your first dose at bedtime. If you get up during the night, sit up slowly, then stand slowly.

If you miss a dose of Hytrin, 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. If more than one dose is missed, contact your doctor or pharmacist.

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

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

Active Ingredient: Terazosin hydrochloride.

Do NOT use Hytrin if:

you are allergic to any ingredient in Hytrin or to similar medicines (eg, prazosin).

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

Some medical conditions may interact with Hytrin. 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 prostate cancer, angina pectoris, heart disease, or kidney or liver problems

if you will be having eye surgery.

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

Phosphodiesterase type 5 (PDE5) inhibitors (eg, sildenafil) or verapamil because severe dizziness, lightheadedness, or fainting may occur.

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

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

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

Hytrin may cause a sudden drop in blood pressure after the first dose. Take your first dose at bedtime. If you get up during the night, sit up slowly, then stand slowly. This will help to reduce your lightheadedness or dizziness. These effects are more likely to occur after the first few doses or if your dose has increased, but can occur at any time while you are taking the medicine. It can also occur if you stop taking the medicine and then restart treatment.

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

Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.

Do NOT take more than the recommended dose without checking with your doctor.

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

Tell your doctor or dentist that you take Hytrin before you receive any medical or dental care, emergency care, or surgery (including eye surgery).

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

Hytrin should not be used 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 Hytrin while you are pregnant. It is not known if Hytrin is found in breast milk. If you are or will be breast-feeding while you use Hytrin, 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:

Dizziness; drowsiness; lightheadedness; nasal congestion; nausea; weakness.

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); blurred vision or other vision changes; chest pain; decreased sexual desire or ability; fainting; fast, slow, or irregular heartbeat;painful, prolonged erection; severe or prolonged dizziness or headache; shortness of breath; swelling of the ankles, feet, or hands.

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.

Omeprazole 40 Mg Capsules, Loseprazol

Omeprazole 40 mg Capsules

Omeprazole (Prilosec ® ) is a medication commonly used for the treatment of duodenal and gastric ulcers, gastroesophageal reflux disease (GERD ), H. pylori infections, and pathological hypersecretory conditions.

An over-the-counter (OTC) version is also available to treat frequent heartburn. Nonprescription omeprazole comes in a 20-mg tablet strength.

The prescription version of this medication comes in the following strengths:

Omeprazole 10 mg capsules

Omeprazole 20 mg capsules

Omeprazole 40 mg capsules

Omeprazole 2.5 mg packets for oral suspension

Omeprazole 10 mg packets for oral suspension.

For the treatment of gastric ulcers, it is generally recommended to take omeprazole 40 mg capsules for four to eight weeks (one tablet, once a day). For duodenal ulcers, the recommended dosage is 20 mg for four to eight weeks.

The recommended omeprazole dose for GERD is 20 mg once daily for up to four weeks. People with pathological hypersecretory conditions usually require higher omeprazole dosages (such as 60 mg once daily).

(Click Omeprazole Dosing to learn about dosing for children and to find out dosing recommendations for other conditions as well, such as for the treatment of erosive esophagitis and H. pylori infections.)

Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD

About Tanser @ Tanser, Tanser

About Tanser

Welcome to Beautiful Home & Living with Tanser

Uniquely you. Uniquely Tanser.

Here at Tanser, we pride ourselves in our exquisitely crafted products with minute detailing and flawless finish, but that’s not all. Each piece is made to fit naturally into your living spaces for an unforgettable living experience. Custom designed to be a reflection of your own personality. Every piece, as unique as you, is built to breathe new life into your home. Every product is tested for the perfect balance of strength and design – uncompromising quality and finesse go into the making of everything at Tanser because what we believe is simple – It’s not just decor, its an art.

Our range of home decor art pieces are carved with fibre or polystone and come with a multiple of finishing options –

We are art lovers and creators, and welcome people with a creative ideology. We design home art reflecting the owners taste and believe in creating products with a personal imprint.

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Pms-Pantoprazole - Uses, Side Effects, Interactions, Pms-Pantoprazole

pms-Pantoprazole

How does this medication work? What will it do for me?

Pantoprazole belongs to the family of medications called proton pump inhibitors (PPIs). Proton pump inhibitors are used to treat conditions such as stomach ulcers, intestinal ulcers, and gastroesophageal reflux disease (GERD, reflux esophagitis) by reducing the amount of acid the stomach produces. Pantoprazole is also sometimes used along with antibiotics to treat stomach ulcers that are caused by bacteria known as H. pylori.

Pantoprazole can also be used to treat or reduce the risk of stomach ulcers due to medications known as nonsteroidal anti-inflammatory drugs (NSAIDs), which irritate the stomach.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

20 mg Each yellow, round, biconvex, enteric-coated tablet printed with "PT20" on one side with black ink and plain on the other side, contains 20 mg pantoprazole (22.6 mg pantoprazole sodium sesquihydrate). Nonmedicinal ingredients: calcium stearate, crospovidone, hydroxypropyl cellulose, hydroxypropyl methylcellulose, mannitol, methacrylic acid copolymer, polyethylene glycol, sodium carbonate anhydrous, talc, titanium dioxide, triethyl citrate, yellow iron oxide, and zein F4000.

40 mg Each yellow, oval, biconvex, enteric-coated tablet printed with "PT40" on one side with black ink and plain on the other side, contains 40 mg pantoprazole (45.1 mg pantoprazole sodium sesquihydrate). Nonmedicinal ingredients: calcium stearate, crospovidone, hydroxypropyl cellulose, hydroxypropyl methylcellulose, mannitol, methacrylic acid copolymer, polyethylene glycol, sodium carbonate anhydrous, talc, titanium dioxide, triethyl citrate, yellow iron oxide, and zein F4000.

Powder for Solution for Injection

Each 10 mL vial contains 40 mg pantoprazole (equivalent to 42.3 mg pantoprazole sodium and to 45.1 mg pantoprazole sesquihydrate) as a lyophilized powder. Nonmedicinal ingredients: sodium hydroxide and water

How should I use this medication?

The recommended dose of pantoprazole to treat reflux esophagitis is 40 mg once daily in the morning for 4 to 8 weeks. Treatment may be continued at a dose of 20 mg to 40 mg once daily to prevent the symptoms from returning.

To treat GERD or heartburn, the recommended dose is 40 mg once daily for up to 4 weeks.

To prevent stomach ulcers associated with NSAID use, the dose is 20 mg once daily in the morning.

To treat duodenal (intestinal) ulcers, the recommended dose is 40 mg once daily in the morning for 2 to 4 weeks.

To treat gastric (stomach) ulcers, the recommended dose is 40 mg once daily in the morning for 4 to 8 weeks.

To treat duodenal (intestinal) ulcers caused by H. pylori in adults, the dose of pantoprazole is 40 mg twice daily taken with amoxicillin 1,000 mg twice daily and clarithromycin 500 mg twice daily, or pantoprazole 40 mg twice daily taken with metronidazole 500 mg twice daily and clarithromycin 500 mg twice daily. The usual duration of this treatment is 7 days.

Do not chew or crush the tablets. Swallow them whole with a glass of water in the morning either before, during, or after breakfast.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e. g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you are allergic to pantoprazole or any ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

any changes in vision

diarrhea (watery and severe; may also be bloody)

rash

symptoms of liver damage (such as yellow skin or eyes, abdominal pain, dark urine, clay-coloured stools, loss of appetite)

symptoms of muscle damage (unexplained muscle pain, tenderness or weakness, or brown or discoloured urine - especially if you also have a fever or a general feeling of being unwell)

Stop taking the medication and seek immediate medical attention if any of the following occur:

severe skin rash, including skin blistering and peeling (possibly with headache, fever, coughing, or aching before the rash begins)

symptoms of a serious allergic reaction (such as swelling of the face or throat, hives, or difficulty breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Diarrhea: When gastric acid is decreased, the number of bacteria normally in the digestive system increases. Occasionally, this can cause serious infection in the digestive tract. If you experience severe watery or bloody diarrhea, fever, or abdominal pain while taking pantoprazole, contact your doctor as soon as possible.

Electrolyte balance: Long term use of pantoprazole may cause the levels of electrolytes such as potassium, calcium and magnesium in the blood to decrease. If you experience symptoms of fluid and electrolyte imbalance such as muscle pains or cramps; dry mouth; numb hands, feet, or lips; or racing heartbeat, contact your doctor as soon as possible. Your doctor may do blood tests periodically to monitor the levels of these electrolytes in your blood while you are taking this medication.

Kidney function: If you have kidney disease or decreased kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: People with severe liver disease should generally not take more than 20 mg of pantoprazole daily. If you have liver disease or decreased liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Methotrexate interaction: Pantoprazole, like other medications in this group, may interact with methotrexate when the two medications are used at the same time. This combination may lead to higher than expected amounts of methotrexate in the body and can cause serious side effects, including kidney damage, irregular heartbeat, anemia, or infection. If you take pantoprazole and are also going to receive a dose of methotrexate, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Osteoporosis fractures: Long term use of pantoprazole may be related to an increased risk of bone fractures in the hip, wrist or spine, as a result of weakened bones. This risk is further increased if you are at risk of developing osteoporosis. If you have osteoporosis or have risk factors for developing osteoporosis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Severe stomach problems: If you have recurrent vomiting, difficulty swallowing, blood in the stool, significant unintentional weight loss, fatigue (anemia), or are coughing up blood, check with your doctor right away.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking pantoprazole, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication has not been established for children.

What other drugs could interact with this medication?

There may be an interaction between pantoprazole and any of the following:

amphetamines

"azole" antifungals (e. g. itraconazole, ketoconazole, voriconazole)

bisphosphonates (e. g. alendronate, etidronate, risedronate)

carbamazepine

clopidogrel

dabigatran

dabrafenib

delaviridine

HIV protease inhibitors (e. g. atazanavir, indinavir, ritonavir, saquinavir)

iron salts

ledipasvir

mesalamine

methotrexate

methylphenidate

multivitamins with minerals

mycophenolate

nilotinib

pazopanib

phenytoin

rifampin

rilpivirine

riociguat

"statin" anti-cholesterol medications (e. g. atorvastatin, lovastatin, simvastatin)

topotecan

certain tyrosine kinase inhibitors (e. g. bosutinib, dasatinib, nilotinib)

warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,

change one of the medications to another,

change how you are taking one or both of the medications, or

leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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More Information About Metoclopramide, Nofoklam

More information about Metoclopramide

Contraindications

Hypersensitivity to metoclopramide or any component of the formulation; GI obstruction, perforation or hemorrhage; pheochromocytoma; history of seizures

Warnings/Precautions

Use with caution in patients with Parkinson's disease and in patients with a history of mental illness; has been associated with extrapyramidal symptoms and depression. The frequency of EPS is higher in pediatric patients and adults <30 years of age; risk is increased at higher dosages. Extrapyramidal reactions typically occur within the initial 24-48 hours of treatment. Use caution with concurrent use of other drugs associated with EPS. Neuroleptic malignant syndrome (NMS) has been reported (rarely) with metoclopramide. Use lowest recommended doses initially; may cause transient increase in serum aldosterone; use caution in patients who are at risk of fluid overload (CHF, cirrhosis). Use caution in patients with hypertension or following surgical anastomosis/closure. Patients with NADH-cytochrome b5 reductase deficiency are at increased risk of methemoglobinemia and/or sulfhemoglobinemia. Use caution in patients with a history of seizures; risk of metoclopramide-associated seizures is increased. Abrupt discontinuation may (rarely) result in withdrawal symptoms (dizziness, headache, nervousness). Use caution and adjust dose in renal impairment.

Adverse Reactions

Adverse reactions are more common/severe at dosages used for prophylaxis of chemotherapy-induced emesis.

Central nervous system: Restlessness, drowsiness, extrapyramidal symptoms (high-dose, up to 34%; 0.2% at doses of 30-40 mg/day)

Gastrointestinal: Diarrhea (may be dose-limiting)

Neuromuscular & skeletal: Weakness

Central nervous system: Insomnia, depression, confusion, headache

Endocrine & metabolic: Breast tenderness, prolactin stimulation

Gastrointestinal: Nausea, xerostomia

<1%: Agitation, agranulocytosis, allergic reaction, amenorrhea, angioedema, anxiety, AV block, bradycardia, bronchospasm, CHF, constipation, fatigue, fluid retention, galactorrhea, gynecomastia, hepatotoxicity, hyper-/hypotension, hyperprolactinemia, jaundice, laryngeal edema, methemoglobinemia, neuroleptic malignant syndrome (NMS), neutropenia, porphyria, seizure, suicidal ideation, sulfhemoglobinemia, tachycardia, tardive dyskinesia, urticaria

Overdosage/Toxicology

Symptoms of overdose include drowsiness, ataxia, extrapyramidal symptoms, seizures, methemoglobinemia (in infants). Disorientation, muscle hypertonia, irritability, and agitation are common. Metoclopramide often causes extrapyramidal symptoms (eg, dystonic reactions) requiring management with diphenhydramine 1-2 mg/kg (adults) up to a maximum of 50-100 mg I. M. or I. V. slow push followed by a maintenance dose (25-50 mg orally every 4-6 hours) for 48-72 hours. When these reactions are unresponsive to diphenhydramine, benztropine mesylate I. V. 1-2 mg (adults) may be effective. These agents are generally effective within 2-5 minutes. Methylene blue is not recommended in patients with G6PD deficiency who experience methemoglobinemia due to metoclopramide.

Drug Interactions

Substrate (minor) of CYP1A2, 2D6; Inhibits CYP2D6 (weak)

Anticholinergic agents antagonize metoclopramide's actions

Antipsychotic agents: Metoclopramide may increase extrapyramidal symptoms (EPS) or risk when used concurrently.

Opiate analgesics may increase CNS depression

Ethanol/Nutrition/Herb Interactions

Ethanol: Avoid ethanol (may increase CNS depression).

Stability

Injection: Store intact vial at controlled room temperature; injection is photosensitive and should be protected from light during storage; parenteral admixtures in D5W or NS are stable for at least 24 hours, and do not require light protection if used within 24 hours.

Tablet: Store at controlled room temperature; protect from freezing

Compatibility

Stable in D5 1 /2NS, D5W, mannitol 20%, LR, NS; variable stability (consult detailed reference) in TPN

Y-site administration: Compatible: Acyclovir, aldesleukin, amifostine, aztreonam, bleomycin, ciprofloxacin, cisatracurium, cisplatin, cladribine, clarithromycin, cyclophosphamide, cytarabine, diltiazem, docetaxel, doxorubicin, droperidol, etoposide phosphate, famotidine, filgrastim, fluconazole, fludarabine, fluorouracil, foscarnet, gatifloxacin, gemcitabine, granisetron, heparin, idarubicin, leucovorin, levofloxacin, linezolid, melphalan, meperidine, meropenem, methotrexate, mitomycin, morphine, ondansetron, paclitaxel, piperacillin/tazobactam, remifentanil, sargramostim, sufentanil, tacrolimus, teniposide, thiotepa, topotecan, vinblastine, vincristine, vinorelbine, zidovudine. Incompatible: Allopurinol, amphotericin B cholesteryl sulfate complex, amsacrine, cefepime, doxorubicin liposome, furosemide, propofol. Variable (consult detailed reference): TPN

Compatibility in syringe: Compatible: Aminophylline, ascorbic acid injection, atropine, benztropine, bleomycin, butorphanol, chlorpromazine, cisplatin, cyclophosphamide, cytarabine, dexamethasone sodium phosphate, diamorphine, dimenhydrinate, diphenhydramine, doxorubicin, droperidol, fentanyl, fluorouracil, heparin, hydrocortisone sodium phosphate, hydrocortisone sodium succinate, hydroxyzine, insulin (regular), leucovorin, lidocaine, magnesium sulfate, meperidine, methotrimeprazine, methylprednisolone sodium succinate, midazolam, mitomycin, morphine, ondansetron, pentazocine, perphenazine, prochlorperazine edisylate, promazine, promethazine, ranitidine, scopolamine, sufentanil, vinblastine, vincristine, vitamin B complex with C. Incompatible: Ampicillin, calcium gluconate, chloramphenicol, furosemide, penicillin G potassium, sodium bicarbonate. Variable (consult detailed reference): Methotrexate

Compatibility when admixed: Compatible: Cimetidine, clindamycin, diamorphine, meperidine, meropenem, morphine, multivitamins, potassium acetate, potassium chloride, potassium phosphate, verapamil. Incompatible: Dexamethasone sodium phosphate with lorazepam and diphenhydramine, erythromycin lactobionate, floxacillin, fluorouracil, furosemide

Mechanism of Action

Blocks dopamine receptors and (when given in higher doses) also blocks serotonin receptors in chemoreceptor trigger zone of the CNS; enhances the response to acetylcholine of tissue in upper GI tract causing enhanced motility and accelerated gastric emptying without stimulating gastric, biliary, or pancreatic secretions; increases lower esophageal sphincter tone

Pharmacodynamics/Kinetics

Onset of action: Oral: 0.5-1 hour; I. V. 1-3 minutes

Duration: Therapeutic: 1-2 hours, regardless of route

Distribution: Vd: 2-4 L/kg; Crosses placenta; enters breast milk

Protein binding: 30% to 40%, primarily to

Cardizem Oral Uses, Side Effects, Interactions, Pictures, Warnings - Dosing, Cardisan

Cardizem

GENERIC NAME(S): DILTIAZEM HCL

Uses

Diltiazem is used to prevent chest pain (angina ). It may help to increase your ability to exercise and decrease how often you may get angina attacks. Diltiazem is called a calcium channel blocker. It works by relaxing blood vessels in the body and heart and lowers the heart rate. Blood can flow more easily and your heart works less hard to pump blood.

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

Diltiazem may also be used to control your heart rate if you have a fast/irregular heartbeat (such as atrial fibrillation ). Long-acting forms of diltiazem may be used to treat high blood pressure. If your doctor prescribes diltiazem to treat high blood pressure. check with your pharmacist to make sure you are getting the correct form of diltiazem.

How to use Cardizem

Take this medication by mouth before meals and at bedtime as directed by your doctor, usually 3 to 4 times a day. Swallow the tablets whole. Do not split, crush, or chew the tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Follow your doctor's directions on how to take this medication.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Your doctor may gradually increase your dose. Follow your doctor's instructions carefully.

Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day. This medication must be taken regularly to prevent angina. It should not be used to treat angina when it occurs. Use other medications (such as sublingual nitroglycerin ) to relieve an angina attack as directed by your doctor. Consult your doctor or pharmacist for details.

Tell your doctor if your condition worsens (for example, your chest pain worsens or is more frequent).

Side Effects

Dizziness. lightheadedness, weakness. nausea. flushing, constipation. and headache may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

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

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

Tell your doctor right away if you have any serious side effects, including: fainting. slow/irregular/pounding/fast heartbeat, swelling ankles /feet, shortness of breath, unusual tiredness, unexplained/sudden weight gain. mental/mood changes (such as depression. agitation), unusual dreams. severe stomach /abdominal pain. dark urine, persistent nausea/vomiting. yellowing eyes /skin .

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

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

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

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

Precautions

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

Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain types of heart rhythm problems (such as sick sinus syndrome /atrioventricular block), liver disease, kidney disease. heart failure .

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

Before having surgery, tell your doctor or dentist that you are taking this medication.

Older adults may be more sensitive to the side effects of this drug, especially dizziness, constipation. or swelling ankles/feet.

This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

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

Interactions

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

Some products that may interact with this drug include: amiodarone, digoxin, fingolimod.

Other medications can affect the removal of diltiazem from your body, which may affect how this medication works. Examples include cimetidine, quinidine, St. John's wort, azole antifungals such as ketoconazole, macrolide antibiotics such as erythromycin, rifamycins including rifabutin and rifampin.

Diltiazem may also affect how your body gets rid of many drugs (such as aprepitant/fosaprepitant, buspirone, ivabradine, certain anti-seizure drugs including carbamazepine, certain benzodiazepines including triazolam and midazolam).

Check the labels on all your medicines (such as cough-and-cold products, diet aids) because they may contain ingredients that could increase your heart rate and worsen chest pain (including caffeine, pseudoephedrine, phenylephrine). Ask your pharmacist about using these products safely.

Overdose

If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Notes

Do not share this medication with others.

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

There are different brands and types of this medication available. Many do not have the same effects. Do not change brands or types without consulting your doctor or pharmacist.

Missed Dose

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

Storage

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

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

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

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

Images

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

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

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