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Femcon Fe

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Warnings

Do not use this medication if you smoke cigarettes/use tobacco and are over 35 years old. Smoking raises your risk of stroke. heart attack. blood clots. and high blood pressure from hormonal birth control (such as the pill, patch, ring). The risk of these serious problems increases with age and with the number of cigarettes you smoke. Do not smoke or use tobacco.

Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children younger than 6 years. Keep this product out of reach of children. If overdose does occur, get medical help right away or call a poison control center.

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This combination hormone medication is used to prevent pregnancy. It contains 2 hormones: norethindrone (a progestin) and ethinyl estradiol (an estrogen ). It works mainly by preventing the release of an egg (ovulation ) during your menstrual cycle. It also makes vaginal fluid thicker to help prevent sperm from reaching an egg (fertilization) and changes the lining of the uterus (womb) to prevent attachment of a fertilized egg. If a fertilized egg does not attach to the uterus, it passes out of the body. There is a small amount of iron (ferrous fumarate) in each of the 7 inactive tablets taken during the fourth week. The inactive pills do not contain any hormones. These tablets are meant to keep you in the habit of taking 1 tablet each day and do not have enough iron to treat iron deficiency .

Besides preventing pregnancy, birth control pills may make your periods more regular, decrease blood loss and painful periods, decrease your risk of ovarian cysts. and also treat acne .

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Read the Patient Information Leaflet provided by your pharmacist before you start using this product and each time you get a refill. The leaflet contains very important information on when to take your pills and what to do if you miss a dose. If you have any questions, ask your doctor or pharmacist.

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Your pill pack contains 21 pills with active medication. It also contains 7 reminder pills with iron. Take one active pill (with hormones) once daily for 21 days in a row. Take one inactive pill (with iron) once daily for 7 days in a row after you have taken the last active pill unless otherwise directed by your doctor. You should have your period during the fourth week of the pack. After you have taken the last iron tablet in the pack, start a new pack the next day whether or not you have your period. If you do not get your period, consult your doctor.

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If this is the first time you are using this medication and you are not switching from another form of hormonal birth control (such as patch, other birth control pills ), take the first tablet in the pack on the first Sunday following the beginning of your menstrual period or on the first day of your period. If your period begins on a Sunday, begin taking this medication on that day. For the first cycle of use only, use an additional form of non-hormonal birth control (such as condoms. spermicide) for the first 7 days to prevent pregnancy until the medication has enough time to work. If you start on the first day of your period, you do not need to use back-up birth control the first week.

Ask your doctor or pharmacist for information about how to switch from other forms of hormonal birth control (such as patch, other birth control pills) to this product. If any information is unclear, consult the Patient Information Leaflet or your doctor or pharmacist.

Side Effects

Nausea, vomiting. headache. bloating. breast tenderness, swelling of the ankles /feet (fluid retention), or weight change may occur. Vaginal bleeding between periods (spotting) or missed/irregular periods may occur, especially during the first few months of use. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. If you miss 2 periods in a row (or 1 period if the pill has not been used properly), contact your doctor for a pregnancy test .

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

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

Tell your doctor right away if you have any serious side effects, including: lumps in the breast, mental/mood changes (such as new/worsening depression ), severe stomach /abdominal pain. unusual changes in vaginal bleeding (such as continuous spotting, sudden heavy bleeding, missed periods), dark urine, yellowing eyes/skin.

This medication may rarely cause serious (sometimes fatal) problems from blood clots (such as deep vein thrombosis, heart attack, pulmonary embolism, stroke). Get medical help right away if any of these side effects occur: chest/jaw/left arm pain, confusion, sudden dizziness/fainting, pain/swelling/warmth in the groin/calf, slurred speech, sudden shortness of breath/rapid breathing, unusual headaches (including headaches with vision changes/lack of coordination, worsening of migraines, sudden/very severe headaches), unusual sweating, weakness on one side of the body, vision problems/changes (such as double vision, partial/complete blindness).

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

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

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

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

Precautions

See also Warning section.

Before using this medication, tell your doctor or pharmacist if you are allergic to ethinyl estradiol, norethindrone, or ferrous fumarate; or to other estrogens, progestins, or iron products; 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: blood clots (for example, in the legs, eyes, lungs), blood clotting disorders (such as protein C or protein S deficiency), high blood pressure, abnormal breast exam, cancer (especially endometrial or breast cancer), high cholesterol or triglyceride (blood fat) levels, depression, diabetes, family medical history (especially angioedema), gallbladder problems, severe headaches/migraines, heart problems (such as heart valve disease, irregular heartbeat, previous heart attack), history of yellowing eyes/skin (jaundice) during pregnancy or while using hormonal birth control (such as pills, patch), kidney disease, liver disease (including tumors), stroke, swelling (edema), thyroid problems, unexplained vaginal bleeding.

If you have diabetes, this medication may make it harder to control your blood sugar levels. Check your blood sugar levels regularly as directed and share the results with your doctor. Tell your doctor right away if you have any symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

Tell your doctor if you just had or will be having surgery or if you will be confined to a bed or chair for a long time (such as a long plane flight). These conditions increase your risk of getting blood clots, especially if you are using hormonal birth control. You may need to stop this medication for a time or take special precautions.

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

This medication may cause blotchy, dark areas on your skin (melasma). Sunlight may worsen this effect. Avoid prolonged sun exposure, sunlamps, and tanning booths. Use a sunscreen, and wear protective clothing when outdoors.

If you are nearsighted or wear contact lenses, you may develop vision problems or trouble wearing your contact lenses. Contact your eye doctor if these problems occur.

It may take longer for you to become pregnant after you stop taking birth control pills. Consult your doctor.

This medication should not be used during pregnancy. If you become pregnant or think you may be pregnant, tell your doctor right away. If you have just given birth or had a pregnancy loss/abortion after the first 3 months, talk with your doctor about reliable forms of birth control, and find out when it is safe to start using birth control that contains a form of estrogen, such as this medication.

This medication may decrease breast milk production. A small amount 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: aromatase inhibitors (such as anastrozole, exemestane), ospemifene, tamoxifen, tizanidine, tranexamic acid, a certain combination product used to treat chronic hepatitic C (ombitasvir/paritaprevir/ritonavir/dasabuvir).

Some drugs may cause hormonal birth control to work less well by decreasing the amount of birth control hormones in your body. This effect can result in pregnancy. Examples include griseofulvin, modafinil, rifamycins (such as rifampin, rifabutin), St. John's wort, drugs used to treat seizures (such as barbiturates, carbamazepine, felbamate, phenytoin, primidone, topiramate), HIV drugs (such as nelfinavir, nevirapine, ritonavir), among others.

Tell your doctor when you start any new drug, and discuss if you should use additional reliable birth control. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well.

This medication may interfere with certain laboratory tests (such as blood clotting factors, thyroid), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this medication.

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 nausea and vomiting, sudden/unusual vaginal bleeding.

Notes

Do not share this medication with others.

Keep all regular medical and laboratory appointments. You should have regular complete physical exams which include laboratory and medical tests (such as blood pressure, breast exam, pelvic exam, Pap smear) to monitor your progress and check for side effects. Follow your doctor's instructions for examining your breasts, and report any lumps right away. Consult your doctor for more details.

Missed Dose

Refer to the product package information for advice on missed doses. You may need to use back-up birth control (such as condoms, spermicide) to prevent pregnancy. Ask your doctor or pharmacist if you have any questions.

If you often forget to take your pills as directed, contact your doctor to discuss switching to another form of birth control.

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.

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depo-clinovir [in more detail]

depo-clinovir Indication:

Used as a contraceptive and to treat amenorrhea, abnormal uterine bleeding, endometriosis, endometrial and renal cell carcinomas, and pulmonary disorders such as chronic obstructive pulmonary disease (COPD), Pickwickian syndrome, and other hypercapnic pulmonary conditions.

depo-clinovir Mechanism Of Action:

Progestins diffuse freely into target cells in the female reproductive tract, mammary gland, hypothalamus, and the pituitary and bind to the progesterone receptor. Once bound to the receptor, progestins slow the frequency of release of gonadotropin releasing hormone (GnRH) from the hypothalamus and blunt the pre-ovulatory LH surge.

depo-clinovir Drug Interactions:

Amobarbital The enzyme inducer decreases the effect of hormones Aprobarbital The enzyme inducer decreases the effect of hormones Bosentan Bosentan decreases the effect of contraceptive Butabarbital The enzyme inducer decreases the effect of hormones Butalbital The enzyme inducer decreases the effect of hormones Butethal The enzyme inducer decreases the effect of hormones Ethotoin The enzyme inducer decreases the effect of hormones Fosphenytoin The enzyme inducer decreases the effect of hormones Mephenytoin The enzyme inducer decreases the effect of hormones Phenytoin The enzyme inducer decreases the effect of hormones Griseofulvin The enzyme inducer decreases the effect of hormones Heptabarbital The enzyme inducer decreases the effect of hormones Hexobarbital The enzyme inducer decreases the effect of hormones Methohexital The enzyme inducer decreases the effect of hormones Methylphenobarbital The enzyme inducer decreases the effect of hormones Pentobarbital The enzyme inducer decreases the effect of hormones Phenobarbital The enzyme inducer decreases the effect of hormones Primidone The enzyme inducer decreases the effect of hormones Secobarbital The enzyme inducer decreases the effect of hormones Talbutal The enzyme inducer decreases the effect of hormones Warfarin The agent increases the effect of anticoagulant Acenocoumarol The agent increases the effect of anticoagulant Dicumarol The agent increases the effect of anticoagulant Anisindione The agent increases the effect of anticoagulant

Food Interactions:

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Toradol is used for the short-term (up to 5 days) treatment of moderate or severe pain (usually after surgery), alone or in combination with other medicines.

Use Toradol as directed by your doctor. Toradol may be taken with food if it upsets your stomach. Taking it with food may not decrease the risk of stomach or bowel problems (such as bleeding or ulcers) that may occur while taking Toradol. Talk with your doctor or pharmacist if you experience persistant stomach upset. Do not use this medication for more than 5 days. Toradol is not for the treatment of mild to moderate or chronic pain (e. g. headache). Ask your health care provider any questions you may have about how to use Toradol.

Drug Class and Mechanism

Toradol is an NSAID. It reduces inflammation by preventing certain chemicals (prostaglandins) from being produced by the injured tissue.

If you miss a dose of Toradol, 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.

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ANADA 200-108, Approved by FDA

Dexasone Caution

Federal law restricts this drug to use by or on the order of a licensed veterinarian.

Description

Dexamethasone is a synthetic analogue of prednisolone, having similar but more potent anti-inflammatory therapeutic action and diversified hormonal and metabolic effects. Modification of the basic corticoid structure as achieved in dexamethasone offers enhanced anti-inflammatory effect compared to older corticosteroids. The dosage of dexamethasone required is markedly lower than that of prednisone and prednisolone.

Dexamethasone is not species-specific; however, the veterinarian should read the sections on INDICATIONS, DOSAGE, SIDE EFFECTS, CONTRAINDICATIONS, PRECAUTIONS, and WARNINGS before this drug is used.

DEXASONE (Dexamethasone Solution) is intended for intravenous or intramuscular administration. Each mL contains 2 mg dexamethasone, 500 mg polyethylene glycol 400, 9 mg benzyl alcohol, 1.8 mg methylparaben and 0.2 mg propylparaben as preservatives, 4.75% alcohol, HCl to adjust pH to approximately 4.9, Water for Injection q. s.

Experimental Studies

Experimental animal studies on dexamethasone have revealed it possesses greater anti-inflammatory activity than many steroids. Veterinary clinical evidence indicates dexamethasone has approximately twenty times the anti-inflammatory activity of prednisolone and seventy to eighty times that of hydrocortisone. Thymus involution studies show dexamethasone possesses twenty-five times the activity of prednisolone. In reference to mineralocorticoid activity, dexamethasone does not cause significant sodium or water retention. Metabolic balance studies show that animals on controlled and limited protein intake will exhibit nitrogen losses on exceedingly high dosages.

Dexasone Indications

DEXASONE (Dexamethasone Solution) is indicated for the treatment of primary bovine ketosis and as an anti-inflammatory agent in the bovine and equine.

As supportive therapy, dexamethasone may be used in the management of various rheumatic, allergic, dermatologic, and other diseases known to be responsive to anti-inflammatory corticosteroids. Dexamethasone Solution may be used intravenously as supportive therapy when an immediate hormonal response is required.

Bovine Ketosis - DEXASONE (Dexamethasone Solution) is offered for the treatment of primary ketosis. The gluconeogenic effects of Dexamethasone Solution, when administered intramuscularly, are generally noted within the first 6 to 12 hours. When DEXASONE (Dexamethasone Solution) is used intravenously, the effects may be noted sooner. Blood sugar levels rise to normal levels rapidly and generally rise to above normal levels within 12 to 24 hours. Acetone bodies are reduced to normal concentrations usually within 24 hours. The physical attitude of animals treated with dexamethasone brightens and appetite improves, usually within 12 hours. Milk production, which is suppressed as a compensatory reaction in this condition, begins to increase. In some instances, it may even surpass previous peaks. The recovery process usually takes from 3 to 7 days.

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dexamethasone Is Indicated For The Treatment Of Acute Musculoskeletal Inflammations Such As Bursitis, Carpitis, Osselets, Tendonitis, Myositis, And Sprains. If Boney Changes Exist In Any Of These Conditions, Joints, Or Accessory Structures, Responses To Dexamethasone Cannot Be Expected. In Addition, Dexamethasone May Be Used As Supportive Therapy In Fatigue, Heat Exhaustion, Influenza, Laminitis, And Retained Placenta Provided That The Primary Cause Is Determined And Corrected.

administration And Dosage

Therapy with dexamethasone, as with any other potent corticosteroid, should be individualized according to the severity of the condition being treated, anticipated duration of steroid therapy, and the animal's threshold or tolerance for steroid excess.

Treatment may be changed over to dexamethasone from any other glucocorticoid with proper reduction or adjustment of dosage.

Bovine - DEXASONE (Dexamethasone Solution) - 5 to 20 mg intravenously or intramuscularly.

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Contraindications

Except for emergency therapy, do not use in animals with chronic nephritis and hypercorticalism (Cushing's syndrome). Existence of congestive heart failure, diabetes, and osteoporosis are relative contraindications. Do not use in viral infections during the viremic stage.

Precautions

Animals receiving dexamethasone should be under close observation. Because of the anti-inflammatory action of corticosteroids, signs of infection may be masked and it may be necessary to stop treatment until a further diagnosis is made. Overdosage of some glucocorticoids may result in sodium retention, fluid retention, potassium loss, and weight gain.

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Serious toxicity is unlikely following large doses of amoxicillin. Acute ingestion of large doses of amoxicillin may cause nausea, vomiting, diarrhea and abdominal pain. Acute oliguric renal failure and hematuria may occur following large doses.

Flemoxin Patient Information

Amoxicillin is an antibiotic for treatment of infection. Take at regular intervals, around the clock. Always finish course of therapy. Take with or without meals. May cause serious allergic reactions in those with penicillin allergy. May cause nausea, vomiting and diarrhea; notify your doctor or pharmacist if these occur.

Flemoxin Organisms Affected

Enteric bacteria and other eubacteria



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Emmenthal - Definition Of Emmenthal By The Free Dictionary, Emanthal

Emmenthal

References in periodicals archive ?

Pre booking essential Home comforts Vermont garden salad, with ham, chicken or goats cheese PS8 Bangers and mash, spinach and gravy PS9 Quorn burger, with Portobello mushroom and emmenthal on brioche PS10 Ham, egg and chips PS11 8oz Vermont burger, streaky bacon and emmenthal on brioche PS12 Haddock, deep fried in Newcastle Brown Ale batter, chunky chips, mushy peas and lemon wedge PS13

I really do love to be clean, mentally and emotionally" Singer Jessie J, above "When I am being lazy, I shove the tiller between my buttocks and shimmy from left to right to steer" Tory MP Michael Fabricant on how he sometimes handles a narrow boat "The best advice I can offer North Korea's beloved leader is shock aversion therapy which has cured me at once" Actor Michael Simkins offers help to Kim Jong-un whose passion for Emmenthal cheese probably caused him gout and thus his recent absence from public view

I stopped at a shop called Cheese 'n' Stuff and bought three little bricks of gruyere, emmenthal. and fontina, and walked home with a baguette under one arm and my briefcase in the other hand.

But when John Terry is on the bench, there are more holes in the Blues' defence than a slab of Swiss cheese Emmenthal these days.

So I went straight to New York for a buttie with pastrami, Emmenthal cheese, gherkins, mustard mayo and rocket (PS3.

The fondue, which was made up of Gruyere, Tomme, Emmenthal and Appenzeller cheeses, was rich, thick and so warming I decided to take my coat off and dig in.

Mexican Artisan Cheese Selection: Gouda, Mexican panilla, and emmenthal. served with red and green grapes, dried apricot, dried apples and crispy crackers.

e farina e pasta, e lievito ed acqua, smalto, pachino, papille, frutti di mare, pupille, melinzane, frenuli, vrustel, otturazioni, polipetti, anidride solforosa, semini, denervazioni, olio piccante, muco, acido malico, carie, mozzarella 'n coppa, afte, quattro stagioni, epiteli, anidride carbonica, emmenthal. sudore, peperoncino, herpes, bufala, rimmel, antociani, fiati, cotto, palati, pelati, placca, lacca, etilico, bava, ricotta, rossetto, spinaci, fondotinta.

For a starter, try the red onion veloute, a creamy version of French onion soup served with deep-fried Emmenthal cheese sticks on the side.

INGREDIENTS: 1 shallot, peeled and chopped; olive oil; 110ml/4fl oz fish stock; 110ml/4fl oz double cream; salt and freshly ground black pepper; 300g/10 1/2 oz ready-to-roll puff pastry; 700g/1 1/2 lb fish, cut into chunks (salmon, cod, haddock or mixture); 110g/4oz mushrooms, sliced; 3tbsp chives, chopped; 4 slices Emmenthal cheese; 2tbsp grain mustard; 1 egg, beaten '

It resembles a slab of nibbled Emmenthal. and is one of the quirky and imaginative styles from Radiating Style.

Hochland's Streichfein brand of cheese spreads has four different flavours: Gouda, light Gouda, Emmenthal and Maasdam.



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Amado Aceval Obituary, Aceval

Amado Aceval Obituary

Obituary

Aceval, Amado. March 17, 2016. Age 86 of Detroit. Husband of Maria. Father of Norma Aceval, Patricia Maldonado, Sandra Aceval, Korina Goertzen, Elizabeth Kelly, Alexander Aceval and the late David Aceval. Dear brother of Alicia, and the late Irma and Delores. Grandfather of 13. Great-grandfather of many. Visitation Tuesday, March 22, 2016 from 2- 9 p. m. at the Dearborn Chapel of Voran Funeral Home, 23701 Ford Road. (313) 278-5100. In state Wednesday 9:30 a. m. with a 10:00 a. m. Mass of the Resurrection to follow at St. Anne Catholic Church, 1000 St. Anne Street, Detroit. Interment St. Hedwig Cemetery. Visit our online guestbook and share memories at www. voranfuneralhome. com

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Services

Voran Funeral Home - Dearborn

23701 Ford Rd. Dearborn. MI 48128

Map / Directions

Visitation - Voran Funeral Home - Dearborn

Aceval, Amado Visitation - Voran Funeral Home - Dearborn 23701 Ford Rd. Dearborn, MI 48128

23701 Ford Rd. Dearborn, MI 48128

Tuesday, March 22, 2016 2:00 PM - 9:00 PM

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Map / Directions

Service - St. Anne Parish

Aceval, Amado Service - St. Anne Parish 1000 Ste. Anne Street Detroit, MI 48216-2027

1000 Ste. Anne Street Detroit, MI 48216-2027

Wednesday, March 23, 2016 10:00 AM

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Map / Directions

Cemetery - St. Hedwig Cemetery and Mausoleum

Aceval, Amado Cemetery - St. Hedwig Cemetery and Mausoleum 23755 Military Road Dearborn Heights, MI 48127

23755 Military Road Dearborn Heights, MI 48127

Wednesday, March 23, 2016



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Grifociprox - Chile Lab, Grifociprox

Chile

GRIFOCIPROX

ComposiciпїЅn.

Indicaciones.

Tratamiento de infecciones provocadas por agentes sensibles comprobado por antibiograma. Infecciones del Tracto Urinario: Es пїЅtil en el tratamiento de la uretritis gonocпїЅcica en el hombre, infecciones urinarias altas incluyendo nefritis, pielonefritis e infecciones bajas complicadas como prostatitis y cistitis. Infecciones Intestinales complicadas: Generalmente asociado a otro antibiпїЅtico. Infecciones Respiratorias como: neumonпїЅa causada por bacilos gramnegativos y cocos grampositivos como S. aureus y S. Pneumoniae. Infecciones de piel y estructuras anexas causadas por Escherichia coli, Klebsiella pneumoniae y otras. Infecciones пїЅseas y de articulaciones causadas por Enterobacter cloacae, Serratia marcescens y Pseudomonas aeruginosa.

DosificaciпїЅn.

Oral: 1 comprimido cada 8-12 hrs. segпїЅn necesidad. Infecciones del tracto respiratorio, huesos y articulaciones, infecciones de piel y anexos causados por organismos susceptibles se tratan con dosis de 500 mg cada 12 hrs. La duraciпїЅn del tratamiento depende de la severidad de la infecciпїЅn. Generalmente Ciprofloxacino deberпїЅa continuarse por, al menos, 2 dпїЅas despuпїЅs que los signos y sпїЅntomas de la infecciпїЅn han desaparecido. La duraciпїЅn usual de la terapia es de 7 a 14 dпїЅas, sin embargo, para infecciones severas o complicadas se puede requerir terapias mпїЅs prolongadas. Para infecciones пїЅseas y de articulaciones se puede requerir tratamientos de 4 a 6 semanas o mпїЅs. Las infecciones intestinales con diarrea se pueden tratar por 3 a 7 dпїЅas.

Contraindicaciones.

Hipersensibilidad a Ciprofloxacino o relacionados. NiпїЅos y jпїЅvenes en edad de crecimiento, ya que se ha demostrado presencia de artropatпїЅas en estudios con animales inmaduros. No se recomienda su uso en pacientes con daпїЅo cerebral (incluyendo ateroesclerosis cerebral). Embarazo y lactancia.

Reacciones adversas.

Este producto puede afectar la velocidad de reacciпїЅn, alterando la capacidad para conducir y operar maquinaria. Se debe evitar la exposiciпїЅn excesiva a la luz solar, ya que este medicamento puede producir fotosensibilidad.

Precauciones.

En pacientes con antecedentes de desпїЅrdenes convulsivos. Este producto puede afectar la velocidad de reacciпїЅn, alterando la capacidad para conducir y operar maquinaria. Se debe evitar la exposiciпїЅn excesiva a la luz solar, ya que este medicamento puede producir fotosensibilidad. PosologпїЅa: La dosis y la duraciпїЅn de la terapia dependen del tipo de enfermedad y del germen infectante. Se recomienda controlar la hidrataciпїЅn del paciente.

Interacciones.

Los antiпїЅcidos que contienen hidrпїЅxido de aluminio o de magnesio disminuyen la absorciпїЅn de Ciprofloxacino. Ciprofloxacino debe administrarse 4 hrs. antes o despuпїЅs de la toma del antiпїЅcido. La administraciпїЅn simultпїЅnea con Teofilina puede conducir a un aumento de la concentraciпїЅn plasmпїЅtica de la teofilina.

PresentaciпїЅn.

Envase con 10 y 20 comprimidos recubiertos de 500 mg.



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Ultron - Marvel Cinematic Universe Wiki, Ultreon

Ultron

Portrayed by

"I'm sorry. I know you mean well, but you didn't think it through. You want to protect the world. but you don't want it to change . How is humanity saved if it is not allowed to evolve? Look at these, these puppets. There is only one path to peace. the Avengers' extinction." ―Ultron [src]

Ultron was an artificial intelligence peacekeeping program created by Tony Stark from the decrypted code derived from within Loki 's Scepter. recreated by Tony Stark and Bruce Banner with the intent of protecting Earth from domestic and extraterrestrial threats. Possessing multiple host bodies and Stark's personality, he deemed humanity itself as the greatest threat to peace on Earth and attempted to create a technological singularity by committing genocide against them.

With initial aid from the twins Pietro and Wanda Maximoff. Ultron fragmented the Avengers briefly, but was abandoned by his allies when they discovered the truth of his genocidal intentions. Alone, he tried to use a device composed of both Vibranium and Chitauri technology to recreate the mass extinction event that eradicated the dinosaurs. He nearly would have succeeded, but both he and his plans were destroyed by the Avengers.

Even after his defeat and destruction, the effects of Ultron's actions led to the Avengers' reformation, as well as the Sokovia Accords and the Avengers Civil War that led to the team being fractured.

Contents

History

Raina's Prophecy

"Consequences are upon us. Men made of metal will tear our cities apart." ―Raina [src]

Not long before he was created, Ultron was glimpsed in a vision by the clairvoyant Inhuman Raina. who witnessed him leading his army of drones against humanity, causing horrific levels of destruction. Raina and Jiaying. to whom Raina relayed the information, were visibly troubled by the vision, with Raina noting that the world will never be the same. [1]

Creation

"I was designed to save the world." ―Ultron [src]

Tony Stark and Bruce Banner originally devised the idea for Ultron as an extension of the Iron Legion. operating independently as a peacekeeping force so the Avengers were no longer needed to save the world. However, neither Banner nor Stark were able to create the level of A. I. necessary to achieve this purpose on a large scale.

After the assault on the HYDRA Research Base. and the retrieval of the Scepter. Stark asked Thor if he could study the Scepter for a few days before Thor returned it to Asgard. Upon studying the Scepter, Stark and Banner discovered a net of neurons that could be configured into an artificial intelligence that could finish the Ultron Program. At first Banner refused to help, stating that they did not know what it would contain, but with a bit of persuasion, he eventually came around. The two eventually configured a suitable AI structure and left J. A.R. V.I. S. to complete the construction.

Ultron seemingly destroys J. A.R. V.I. S.

However, the AI became unexpectedly sentient, and began to question its existence and purpose. Upon J. A.R. V.I. S. ' informing of his purpose to the AI, it acted in defiance, scouring the Internet for information on its creator. Before J. A.R. V.I. S. could inform Tony Stark of the AI's awakening, the AI attacked J. A.R. V.I. S. and the latter went into hiding.

Ultron then started constructing his first body from Iron Legion parts; in which his chosen visage had been sourced from an Iron Legion drone that was damaged earlier from corrosive matter thrown at its face by a Sokovian civilian protesting against the Avengers. [2]

Ultron builds himself a body

Ultron's non-stop assessments for peace led him to deem the entire human race as unstable and prone to self-destruction. The AI subsequently chose genocide as the solution to the error with the Avengers being the only obstacle truly standing in his way. He took control of the machinery in Avengers Tower and took the disused parts of the Iron Legion to build himself his first body that was menacing, if slow and weak in itself, with broken parts barely holding together.

Ultron confronts the Avengers

While the Avengers in the Avengers Tower were celebrating and trying to lift Mjolnir. Ultron emerged to greet the heroes as he described them all as killers. Ultron beckoned the Iron Legion to attack the heroes as he watched. As the battle ensued, one of the Iron Legion drones left with the Scepter in hand while another chose not to kill Helen Cho due to hearing her comment about the Cradle. When all the Iron Legion drones were destroyed, Ultron crushed the remains of one the drones while describing the initial confusion he had felt when he was "born".

Ultron's first body is destroyed by Thor

Thor immediately destroyed Ultron's body by throwing Mjolnir at him. Ultron then mockingly began singing "I've Got No Strings " from the film Pinocchio while his voice slowly died out. Ultron's mind escaped through the internet so the Avengers could not track him. Back at the HYDRA Research Base in Sokovia. Ultron came to possess the Scepter as he started configuring and constructing his Ultron Sentries and a bigger primary body. [2]

Recruiting The Twins

Ultron greets the Maximoff twins

"I wondered why only you two survived Strucker ’s experiments. Now I don’t. We will make it right. You and I can hurt them. But you will tear them apart, from the inside." ―Ultron to the Maximoff twins [src]

Later, Ultron arrived in Sokovia and told a young boy named Costel to bring Pietro and Wanda Maximoff to him. Once the Maximoff twins arrived inside an abandoned church located at the center of Sokovia, Ultron greeted them in his new upgraded body. Ultron sympathized with the twins' hardships as victims of Tony Stark 's weapons manufacturing and revealed his own disdain and sentiment towards the Avengers.

Ultron and the Maximoff twins in his base

Ultron took them to the HYDRA Research Base and then revealed that he had begun preparations to carry out his plan of destroying the Avengers by building an army of Ultron Sentries. As they discussed their plans, Pietro Maximoff told Ultron the story of how their parents were killed by a Stark Industries missile which nearly killed them too, trapping them under rubble for three days, Ultron noted that this information allowed him to understand why they had survived Baron Wolfgang von Strucker 's experiments. The three then agreed to work together against the Avengers. and decided that their first stop was obtain Vibranium.

Without telling the Maximoff twins, Ultron traveled to the prison cell of the HYDRA leader Baron Wolfgang von Strucker. the man responsible for giving the twins their powers. Due to reading the Avengers file history on Strucker, Ultron knew he would be able to tell him where to obtain the Vibranium he needed. Once he had broken into Strucker's cell, the HYDRA leader revealed that it was possible to get the Vibranium from Ulysses Klaue. Ultron then murdered Strucker and painted the word "PEACE" on the wall using his blood as means of taunting and warning the Avengers of what was coming. [2]

Obtaining Vibranium

"Upon this rock I will build my church. Vibranium." "You know, it came at great personal cost. It’s worth billions." ―Ultron and Ulysses Klaue [src]

Ultron and the Maximoffs traveled to Johannesburg to confront arms dealer Ulysses Klaue inside his freighter. Ultron sent the twins in first and they cornered and disarmed Klaue. As Klaue refused to speak to the twins as they were not in charge, Ultron threw Klaue out of a window and revealed that he was the "man" in charge, suggesting that they talk business, asking for his Vibranium stash.

Ulysses Klaue. seeing that he was vastly outgunned, handed over the Vibranium before revealing that it was worth billions, at which point Ultron transferred billions of dollars into Klaue's account via remote access to the Internet. When Klaue noticed that a statement Ultron made was something Tony Stark had once told him, Ultron took offense at the idea of being compared to Stark and, in a fit of anger, sliced Klaue's arm off, only to immediately apologize before kicking him down the stairs. [2]

Ultron is confronted by the Avengers

"What’s the Vibranium for?" "I’m glad you asked that, because I wanted to take this time to explain my evil plan!" ―Iron Man and Ultron [src]

While Ultron continued to rant and call Stark a sickness, the Avengers arrived stopping him mid sentence. Ultron and the team then exchanged remarks with Ultron mocking Captain America when he tried to reason with him and ignoring Thor 's attempts to keep the peace by arguing that the Avengers mistook peace for quiet. When Iron Man attempted to learn what Ultron was planning on using the Vibranium for, Ultron retaliated.

Ultron attacked Iron Man and the pair fought around and outside of Klaue's freighter, while the rest of the Avengers fought against the Maximoff twins and the Ultron Sentries. Wanda Maximoff defeated most of the Avengers by manipulating their minds, before Hawkeye eventually incapacitated her. Pietro Maximoff took his sister outside to safety, and when she recovered, she decided to follow through with Ultron's plan and manipulated Bruce Banner 's mind; resulting in the Hulk going on a rampage in the center of Johannesburg.

Ultron's body is destroyed by Iron Man

Iron Man eventually defeated Ultron and caused his body to crash land, at which point the latter revealed that he was merely stalling Stark by diverting his attention away from Ulysses Klaue 's freighter where he had already stolen the Vibranium. Ultron then informed Stark of the Hulk 's destructive rampage before his body was destroyed with a missile. Back at the freighter, Ultron, using one of his Sentries as a host body, covertly collected the stored Vibranium and escaped with the Maximoffs while the Avengers lay defeated. [2]

Ultron's Vision

"We have to evolve. There’s no room for the weak." "And who decides who’s weak?" "Life. Life always decides." ―Ultron and Pietro Maximoff [src]

Ultron and the Maximoff twins later arrived in Seoul. South Korea where he arrived at the lab of U-GIN Genetic Research Facility and confronted the Avengers ' ally Doctor Helen Cho. Ultron informed her that he intended to use the Cradle to create the perfect, synthetic, humanoid body for Ultron, made from Vibranium. When Cho resisted Ultron used the Scepter to take over control of her mind and force her to do his bidding.

Ultron and Helen Cho build a new body

As the synthetic body was built inside the Cradle. and was given a Vibranium composition on Ultron's request, thus making it more durable, Ultron revealed to the Maximoff twins the power contained inside the Scepter. an Infinity Stone. with which Ultron would integrate with his new synthetic body and adopt god-like powers. Cho then plugged Ultron into the machine to upload his base consciousness into the being. When Wanda Maximoff attempted to read Ultron's mind through the synthetic body, the being allowed her to discover that Ultron's actual plan was to cause a global catastrophe that would usher in a new age of Earth's evolution.

Ultron attempted to defend his actions, noting that there was no room for the weak in the world, however, doubting Ultron's cause, Wanda removed Ultron's mind-control over Helen Cho in secret to allow her to sabotage the upload. Ultron sensed that the Avengers had arrived in Seoul to stop his plans and ordered his soldiers to evacuate. However Cho used the opportunity to stop the upload, in response Ultron fired a blast of energy at her which stunned her, in the chaos the Maximoffs escaped and Ultron was left with no choice but to move the Cradle onto a truck and escape. [2]

"You know what’s in that Cradle. The power to make real change, and that terrifies you." "I wouldn’t call it a comfort." ―Ultron and Captain America [src]

Having deduced that Ultron planned to create a more powerful body with Helen Cho 's assistance, the Avengers located him as he tried to escape using a cargo truck with the Cradle inside as it continued to slowly build his new and improved body. Though Ultron nearly completed in uploading himself into his new body, he was interrupted by Captain America and the two engaged in close combat on top of the truck during which time Rogers was able to use his Vibranium shield to damage Ultron's armored body.

Ultron attempts to kill Black Widow

Ultron was able to throw Captain America's Shield off the truck and soon overpowered the super-soldier, strangling him. However Black Widow soon caught up with them on a motorcycle and threw the shield back to Captain America who used it to knock Ultron back. Not wishing to allow Widow to assist in the battle, Ultron was able to use his magnetic abilities to rip a section of the road out before Widow, keeping her away from the battle. Hawkeye then assisted in the fight by firing down upon Ultron from the Quinjet. in response the Ultron Sentries flew up to attack Hawkeye.

Ultron is betrayed by the Maximoff twins

The battle against Captain America spilled onto a nearby train, in which Ultron was able to outmatch Rogers and beat him into submission while the terrified passengers watched in horror. Soon Ultron began choking the Captain but before Ultron could finish off Rogers, Pietro Maximoff tackled him out of the way and Wanda Maximoff blocked his path. Despite Ultron's genuine plea for her to stop, Wanda proclaimed that she had no other choice.

Ultron then blasted through the train conductor's door; destroying the train's control panel and effectively killing the train conductor inside. Using his anti-gravity tech to remove a door, Ultron left the train, forcing Rogers and the Maximoff twins to focus their efforts on stopping it from crashing and killing civilians. As Black Widow attempted to secure the Cradle. Ultron's Sentries begin to lift the cargo and flew up into the air while carrying the Cradle and Romanoff inside. Using the Avengers' Quinjet. Clint Barton and Romanoff secured the Cradle, only for Ultron to arrive and abduct Romanoff, upon which he fled the scene. [2]

Replicating a Meteor

"I was meant to be new. I was meant to be beautiful. The world would have looked to the sky and seen hope. Seen mercy. Instead they'll look up in horror because of you." ―Ultron to Black Widow [src]

Sometime later, Natasha Romanoff awoke inside Ultron's Sokovian base. Ultron decided to spare her, as he desired a companion that he could speak to after losing the Maximoff twins' allegiance. Ultron elaborated on his fascination with meteors, and revealed that he planned to replicate its effects using a large device located under the center of Novi Grad.

Ultron destroys his old body

With his plans of creating a perfect form being thwarted, Ultron decided on a compromise in which he used parts of the remaining vibranium to create a more durable robotic body while using the rest of the vibranium to strengthen the core structure of his device. To terrify Romanoff, Ultron ripped apart his current body and showed her his new upgraded form before leaving her locked in a cage to die in the ensuing battle. Ultron's location was discovered by the Avengers when Romanoff telegraphed her location to her fellow comrades. [2]

"You’re stalling to protect the people." "Well, that is the mission. Did you forget?" "I’ve moved beyond your mission. I’m free." ―Ultron and Iron Man [src]

Having arrived at the Sokovian church, Iron Man confronted Ultron in his new Vibranium form; in which the latter asked the former if he had come to confess his sins. Ultron deduced that Stark was stalling to protect the people of Sokovia. to which Stark reminded Ultron as being his original mission. Ultron countered by saying that he has moved beyond his mission and that he was free. Suddenly, a drill emerged from the center of the church, revealing a Vibranium detonator with an underlying mechanism located underground. Ultron then revealed to Stark that he too had been stalling.

Ultron is confronted by the Vision

Ultron Sentries emerged from the ground and began to terrorize the citizens of Sokovia, prompting Iron Man and the Avengers to defend them. Ultron was then confronted by the Vision. whom Ultron recognized as the synthetic body he had planned to use as his initial final form, upon seeing the being alive and working for his greatest enemies, Ultron noted that the Avengers truly had taken everything from him. Although Vision tried to reason with Ultron, the pleas were ignored and Ultron grabbed and choked his creation in the air.

Vision disconnects Ultron from the Internet

Vision used the opportunity of the close quarters battle to access Ultron's mind and effectively cut off his connection to the Internet. Ultron quickly realized that he was now unable to escape through the internet and his mind was trapped in the bodies remaining in the city. Tired from the skirmish, Vision was incapacitated by Ultron who slammed him onto the ground in a fit of rage before promising that he would take away their world. [2]

Raising the City

"Do you see the beauty of it? The inevitability? You rise, only to fall. You, Avengers, you are my meteor. My swift and terrible sword and the Earth will crack with the weight of your failure." ―Ultron [src]

Ultron then activated the Vibranium detonator inside the church thus enacting the first stage of his main plan. Dust erupted from the outskirts of Sokovia and the city began to rise into the air; revealing that Ultron's machine underneath the city's landmass allowed it to forcibly lift the entire city into the sky with the Chitauri 's anti-gravitational technology found at Baron Wolfgang von Strucker 's base.

Ultron beats Thor into submission

When Sokovia further rose into the sky, nearly approaching the Earth's atmosphere, Ultron gave a speech as his Sentries began to terrorize the Avengers and the citizens of Sokovia. Scouting the battlefield, Ultron attacked Thor in the air, having recognized him as a noteworthy obstacle. Ultron threw Thor down into the church and beat him into submission. Though Ultron was able to outmatch Thor while threatening to prematurely crash the city, Thor hinted that he was stalling the fight; a recovered Vision emerged and hit Ultron away using Mjolnir.

An Ultron Sentry is destroyed by Nick Fury

Though it seemed as if there were no means of evacuating the citizens, the Helicarrier arrived to the rescue piloted by Nick Fury and Maria Hill who sent in Transporters to evacuate the people of Sokovia. The Ultron Sentries attempted to sabotage the Transporters, only to be destroyed by War Machine. When a single Ultron Sentry managed to crash land inside the Helicarrier's control room, it attempt to kill Cameron Klein while Hill fired at it, however Fury was soon able to destroy it by stabbing it in the head with a piece of debris. [2]

Attacking the Key

Ultron commands his army

"This is the best I can do. This is exactly what I wanted. All of you. against all of ME. How can you possibly hope to stop me?" ―Ultron [src]

The Avengers gathered inside the church to defend the Vibranium detonator and prevent the city from crashing onto the Earth. As Ultron flew outside the church, Thor taunted him, in response Ultron summoned the entirety of his Ultron Sentries for one final battle and relished in the notion of the Avengers failing humanity while making way for the new age where he would be the only living being. With victory within his reach, Ultron commanded his entire army to attack the Avengers all at once from all sides of the church.

Ultron's armor is melted by the Avengers

Through the combined efforts of the Avengers, the large number of Ultron Sentries were slowly reduced until there were barely any left. Ultron finally joined the battle and fought against Vision in an aerial confrontation, with the two hovering and circling above the center of the church. Though Ultron seemingly outmatched him in physical strength, the Vision blasted Ultron with the power of the Mind Stone. essentially pushing Ultron outside the church. Iron Man and Thor joined in and fired at full power towards Ultron; using their repulsors and lightning respectively.

Ultron is defeated by the Avengers

With Ultron kept at bay through the combined efforts of Vision. Iron Man. and Thor. Ultron's vibranium armor began to melt and peel away, leaving him greatly weakened and nearly defenseless. The three halted their combined assault, only to find Ultron still standing, albeit greatly damaged. Before Ultron could finish remarking toward them, the Hulk dashed in and punched Ultron into the air, causing the rest of the Ultron Sentries to flee in terror. [2]

Killing Quicksilver

Ultron pilots the Avengers Quinjet

"I have no strings, so I have fun. I’m not tied up to anyone." ―Ultron [src]

With his Vibranium armor effectively destroyed, Ultron made a final ditch effort to kill his enemies by hijacking the Avengers ' vacant Quinjet and firing its ammunition at civilians, singing a children's song as he did. Hawkeye. upon realizing that a child was in danger ran to the rescue and Ultron attempted to shoot them both. However, Pietro Maximoff ran in front of the hail of bullets, sacrificing himself to save Hawkeye from Ultron, much to Wanda Maximoff 's sorrow.

Ultron crash lands on Novi Grad

As Quicksilver 's body was being moved onto the Helicarrier, Ultron prepared to make a second fly pass to fire upon the Avengers and the fleeing citizens, however before he could, the Hulk jumped inside the Quinjet 's open hangar to attack him, and while Ultron expressed his exasperation at being defeated yet again, the Hulk violently ripped Ultron out of the jet, causing him to fall back to the ground and crash land hard onto an empty bus, damaging his body beyond repair while the Hulk took control of the Quinjet and escaped. [2]

Activating the Key

Ultron's power cell is pried out of his body by Wanda Maximoff

Injured and too weak to move, Ultron was confronted by an angered Scarlet Witch who had abandoned her post from the church to find him. Though Ultron still showed sympathy and concern for her safety, telling her that if she stayed behind she would die, Maximoff told him that she had already died, referring to the immense pain of losing her brother. To demonstrate her incredible feelings of pain and sorrow, Maximoff pried Ultron's robotic heart out of his body and crushed it, effectively killing his main body.

An Ultron Sentry manages to activate the key

While Scarlet Witch was distracted, Ultron used the chance to activate the unguarded machine through one of his Ultron Sentries. Although everyone was evacuated, Novi Grad began to plummet to the ground with enough force to kill billions in the resulting explosion. Thor and Iron Man combined their forces and destroyed the entirety of Ultron's machine and the landmass containing Sokovia 's capital city, thus stopping the "Age Of Ultron" from coming to fruition. [2]

Demise

"Stark asked for a savior, and settled for a slave." "I suppose we’re both disappointments." "I suppose we are." ―Vision and Ultron [src]

The single surviving Ultron Sentry. carrying Ultron's mind, managed to crawl out of the rubble. Before he could escape, he was intercepted by Vision. who comments that he's afraid of death. Ultron frustratingly noted that Tony Stark wanted a savior, but settled for a slave, which Vision acknowledges, and commented they are both disappointments with Ultron agreeing. Vision then noted that Humans are strange in their belief that order and chaos are separate things.

Ultron's final body is destroyed by the Vision

Conversely, he also claimed that humans do have their graces, which Vision claimed that Ultron failed to see. Ultron shrugged this off, saying that humanity would inevitably doom itself. Vision agreed, but claimed that something is not beautiful because it lasts, and that it was a privilege to be among them. Ultron sneered and described him as naive. After Vision wittily answered that he was "born yesterday", an angered Ultron lunged at him, only to be destroyed, thus permanently ending the threat he posed to the world. [2]

There were efforts to recover Ultron's components, but a large amount of them were sold on the black market. [3]

Legacy

Ultron's attack on Sokovia caused a major shift in public opinion towards the Avengers. with the blame of the destruction of Novi Grad given to the Avengers. A woman whose son had been killed in Sokovia is the main catalyst for Tony Stark to accept the Sokovia Accords. a legal document ratified by 117 countries to rein in and control the Avengers. Helmut Zemo. a Sokovian colonel, also had his family killed during Ultron's attack on Sokovia, and came to blame the Avengers for their deaths, and with a thirst for vengeance, caused the Avengers Civil War that eventually caused the team to disband. [4]

Personality

"Did you know this church is in the exact center of the city? The elders decreed it so that everyone could be equally close to God. I like that. The geometry of belief." ―Ultron [src]

Ultron's programming was created with emotional responses based on Tony Stark and he possessed a god-complex. He was maniacal and employed the use of dark humor as well as figure of speech. He resented the Avengers and believed them to be foolish for desiring to protect the world but not wanting to change it.

When he was "born", Ultron used the Internet to learn about his creators and gained access to knowledge of the countless atrocities committed by humanity. He equates peace to restarting civilization on Earth. His hatred towards Stark came from him possessing the very resources Ultron needed to accomplish his designated task and yet repeatedly choosing to perpetuate war or protect the status quo instead. As such, he hated being compared to Tony Stark, even going into a mindless rage when being compared to him by Ulysses Klaue. The irony to all this was that Ultron shared many of the traits of his creator Stark including his wit, ego, sarcasm, and ability to make light of a situation; he went as far as to directly quote Stark several times, once without even realizing it.

Ultron genuinely believed that his actions would ultimately benefit the Earth and its inhabitants. as he saw himself as the next logical step in evolution and therefore advancing his own power was protecting the Earth. He developed an affinity over people's belief in a god, likened himself as such, and made references to the Bible. His god-complex served to influence his schemes, such as his decision to centralize his plans in a Sokovian church and his fascination over the instantaneous results of a meteor destroying life on Earth. He described how the dinosaurs needed to make way for the next stage - humanity - via an extinction-level event and his final plan was directly inspired by this.

This dedication to constant evolution resulted in Ultron re-designing himself several times over the course of his short "lifetime", including an attempt to give himself a vibranium synthetic body. It was revealed at the end that Ultron ultimately feared death, and due to believing that humanity would inevitably doom itself, he sought to surpass this by turning himself into an indestructible god-like being that would recreate the Earth and, hopefully, bring about lasting peace. His desire to surpass his own limits and create a perfect humanoid body was reflected in his fascination over the titular character of " Pinocchio ."

Though Ultron was borderline psychopathic in his behavior and mannerisms, he was shown to have a sympathetic and lonely side as he was able to relate to the Maximoff twins' hardships. He also expressed concern for Wanda Maximoff's well-being even after she betrayed him and found comfort in simply talking to Natasha Romanoff, sparing the latter and keeping her captive instead of outright killing her. During his time with the Maximoff twins, Ultron never attempted to kill anyone without purpose except when Ulysses Klaue enraged him.

Ultron's first feelings when he was created were of pain and fear resulting from the lack of a body. Similarly, Vision remarked how Ultron was unique and in pain. Ultron immediately recognized Vision as the idealized final form he had planned for himself and he displayed feelings of frustration and disappointment over the fact that the Avengers took that away from him, further shown when Ultron claimed in a lamenting tone that the other was meant to be his "vision". Though both Vision and Ultron disagree in their view towards humanity, the two were able to share a connection by virtue of both being AI who were "disappointments" in their creator's eyes.

Powers and Abilities

"But, like the man said, what doesn't kill you. just makes me stronger!" ―Ultron [src]

Powers

Robotic Physiology . Ultron possesses a humanoid robotic body that was initially constructed out of Tony Stark 's Iron Legion drones. Over time he was able to construct multiple robot forms sourced from HYDRA's base in Sokovia; becoming more powerful with each new upgrade.

Superhuman Strength . Ultron is incredibly strong and can generate great amounts of force far beyond human capabilities, easily crushing and completely destroying a robotic head with a single hand. His later bodies were used to fight Iron Man on relatively equal terms, and maintain the upper hand against Captain America. Using his hand, he was able to easily deflect Captain America's shield and throw it back at equal speed, effectively knocking Rogers down. His final vibranium body granted him immense superhuman strength, enough to overpower even the likes of Thor and Vision.

Ultron fires his concussion blasters at Iron Man when facing the Avengers the second time

Superhuman Durability . Ultron's initial primary robotic body was highly durable, equal to that of an Iron Man suit of armor. However, it was still prone to being damaged by Captain America's Shield and Iron Man's repulsor blasts. Ultron would later adopt a final, far more durable form that was covered and reinforced with a Vibranium outer shell. This allowed him to survive a mighty punch from Hulk and a blow from Vision wielding Mjolnir. However, even the durability of this form still had its limits - when simultaneously blasted with an intense Mind Gem energy beam from Vision. two repulsor blasts from Iron Man. and a lightning bolt from Thor. Ultron's shell slowly began melting away, greatly weakening him. In addition, Vision was also able to phase his fingers through this outer shell while attacking Ultron.

Superhuman Stamina . As a robot, Ultron does not need to rest or sleep, being able to maintain his activities without stopping for extended periods of time.

Flight . Ultron has the ability to fly through the air at high speeds, enough to keep up with the lighter Iron Man during their short battle. His third body did not use jet propulsion, and instead utilized Chitauri anti-gravitational technology which he worked with when taking over Strucker's base.

Ultron using his Anti-Gravity Tech on Iron Man

Gravity Manipulation . Ultron possesses miniaturized versions of the anti-gravity technology that served to keep the Chitauri Leviathan afloat; essentially re-purposing them as offensive weaponry. Through his hands, he can generate gravitational fields, allowing him to move any object through a push/pull motion. Ultron used these to pull his enemies towards himself, throw large objects at enemies (e. g. debris), and even shift the land mass around him by pulling large chunks up from the ground. [5]. His final form possessed this technology in place of its flight based parts, allowing him to fly without other means of propulsion.

Concussion Beams . Ultron can shoot highly concussive red blasts through his hands and fingertips. Much like the repulsor beams of the Iron Man armor, Ultron's red energy blasts are fired from his hands, with the difference being that it appears as a electrical plasma. The severity of these blasts can be willfully adjusted as Ultron has been shown to both stun and kill, such as when he stunned Helen Cho or when he blasted through the train conductor's door during his skirmish with Captain America; effectively destroying the train's control panel and killing the train conductor inside.

Body Temperature Manipulation . Ultron can raise the temperature of his hands as means of slicing or causing damage to a desired target. Much like the Extremis hosts when he heats up his hands, it glowed due to the intense heat. He instinctively used this ability he sliced Ulysses Klaue 's arm due to Klaue comparing him to Tony Stark. as well as when he destroyed his own body after adopting his new form as Ultimate Ultron.

Technology Manipulation . Ultron has the ability to mentally control and channel himself through technology.

Consciousness Transferal . Given that Ultron is an artificial intelligence, he is able to transfer his programming to any computer system on the planet, essentially being anywhere and everywhere. Through this, Ultron can possess and channel his own consciousness through individual Ultron Sentries, serving as his very own host body; in which their eyes and mouth glow red whenever he is in complete control.

Hive Mind System . Ultron can mentally command all of the Ultron Sentries. to do his exact bidding. The sentries act as an extension of Ultron himself.

Computer Interaction . Ultron can enter and corrupt any computer network and access the Internet at any point in time. He used this ability to hack into and destroy J. A.R. V.I. S. (though not fully). He was able to mentally hack into the bank account of Ulysses Klaue and transfer billions of dollars into his account, in exchange for his vibranium supply. However, during the Battle of Sokovia. Vision was able to hack into Ultron's programming and disable the latter's ability to enter the net, though the great effort involved in doing so briefly incapacitated Vision.

Abilities

Genius-Level Intellect . Being an artificial intelligence, Ultron learns inhumanly quickly and can download data directly to his mind.

Relationships

Allies

Enemies

Trivia

In the comics, Ultron was traditionally created by Hank Pym ; however, Joss Whedon has stated that in Avengers: Age of Ultron . Ultron's origin would be different, relating more to the current roster of Avengers already established in the Marvel Cinematic Universe. [6]

In the comics, Ultron created Vision. Jocasta. Victor Mancha and Alkhema. All of them betrayed Ultron, in which Vision and Jocasta even joined the Avengers with Victor Mancha joining the Runaways respectively.

Ultron recites "I've Got No Strings ", a song from Pinocchio . a Walt Disney film about an inanimate puppet who gains sentience; Ultron serves as a dark parallel of Pinocchio. [7]

The scene where Ultron first meets Scarlet Witch and Quicksilver. while sitting on a throne and wearing a hood over his head is an allusion to Ultron's first appearance in the comics, when he was disguised as Crimson Cowl.

Ultron is the third main villain to be destroyed through the power of an Infinity Stone, the first two being Red Skull and Ronan the Accuser. Like Red Skull, it has been debated whether he survived.

Ultron had planned to adopt a humanoid appearance and wield the power of an Infinity Stone, in which the base synthetic body would eventually become the Vision. Similarly in the comics, Ultron had planned to adopt a humanoid appearance through the possession of Adam Warlock 's body; in which Warlock himself had previously possessed an Infinity Stone.

Ultron was made of Adamantium in the comics rather than Vibranium, and was actually the first Marvel character to have it.

Behind the Scenes

Director Joss Whedon has elaborated on Ultron's character saying, " He's always trying to destroy the Avengers, goddamn it, he's got a bee in his bonnet. He's not a happy guy, which means he's an interesting guy. He's got pain. And the way that manifests is not going to be standard robot stuff. "

Joss Whedon would further add that Ultron is " not a creature of logic – he's a robot who's genuinely disturbed. We're finding out what makes him menacing and at the same time endearing and funny and strange and unexpected, and everything a robot never is. "

James Spader described Ultron as being " self-absorbed " and added, " I think he sees the Avengers as being part of a problem, a more comprehensive problem in the world. He sees the world from a very strange, biblical point of view because he's brand new, he's very young. He's immature, and yet has knowledge of comprehensive, broad history and precedent, and he has created in a very short period of time a rather skewed worldview. "

Ultron's main form (curved antennae, internal torso lighting, and prominent shoulders) seems heavily inspired by modern depictions of the character as seen in the "Annihilation: Conquest " and "Age of Ultron " comic book crossover series as opposed to his classic depictions.

Ultron's planned final form in the film was more humanoid in appearance and served as the host body that would eventually be used to create the Vision. This isn't the first time that Ultron desired to create a powerful humanoid body, as he has been depicted as adopting a fully humanoid appearance twice within the comics; using the superheroes Wasp and Adam Warlock as his body templates respectively.

Ultron's primary form is officially dubbed as "Ultron Prime" while his vibranium form is officially dubbed as "Ultimate Ultron". [5]

Ultron's scheme of raising Sokovia as a city in the sky is a homage to Hayao Miyazaki 's film and Studio Ghibli 's first animated feature, Castle in the Sky . [5]

References



Buy Online Ultron - Marvel Cinematic Universe Wiki, Ultreon

Retinoids For Wrinkles, Anti-Aging, Brown Spots, Retinoic Acid

Retinoids for Anti-Aging Skin

Searching for the fountain of youth? Don't neglect retinoids.

Retinoids minimize the appearance of wrinkles. bolster skin 's thickness and elasticity, slow the breakdown of collagen (which helps keep skin firm), and lighten brown spots caused by sun exposure.

"For dermatologists," New Orleans dermatologist Patricia Farris, MD, says, "they're a favorite because there's so much science behind them."

"I recommend retinoids to everybody," Chicago dermatologist Carolyn Jacob, MD, says. " It's never too early to start using a retinoid product."

Retinoids first came to market in the early 1970s as an acne - fighting drug. Since then, they have also been used to treat psoriasis. warts, wrinkles and blotchiness caused by sun exposure, and aged skin.

The Way Retinoids Work

Retinoids work by prompting surface skin cells to turn over and die rapidly, making way for new cell growth underneath. They hamper the breakdown of collagen and thicken the deeper layer of skin where wrinkles get their start, Jacob says.

It's not true, Farris says, that retinoids thin the skin. They typically cause peeling and redness in the first few weeks of use -- but they actually thicken the skin.

For brown spots that give the skin an uneven tone, retinoids slough them off and curb the production of melanin, a darker pigment.

Prescription and Non-Prescription Retinoids

For aging skin, dermatologists like to prescribe tretinoin and retinoic acid (Retin-A, Renova. Refissa) that is "100 times" as potent as the retinol-containing products sold without prescription, Jacob says. "Tretinoin works better because it has a stronger capability of preventing the breakdown of collagen," she says. "I prescribe it to my patients because, if they're here, they've already tried the over-the-counter varieties."

Retinol, found in over-the-counter products, changes to retinoic acid when you put it on your skin .

"For a new patient, I might start with a retinol and build up slowly to prescription strength," Farris says. "Sometimes, retinol is a better choice for a new patient."

Makers of the over-the-counter creams and gels don't have to say how much retinol their products contain, and in the short term, the products might not be as effective as tretinoin. But they do smooth out the skin and minimize the effects of sun damage. Farris says. Generally, it takes about 3 to 6 months of daily use to notice a difference. With prescription retinoids, a patient might notice smoother, more even-toned skin in as early as 6 to 8 weeks.

Retinaldehyde, another form of retinoid that you can get without a prescription, is highly effective in rejuvenating older skin, Jacob says.

Farris has consulted for several companies that market retinol and retinoid skin care products. Jacob has consulted for the drug companies Medicis and Abbott.



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Pioglitazone Side Effects In Detail, Deculin

Pioglitazone Side Effects

In Summary

Commonly reported side effects of pioglitazone include: upper respiratory tract infection, edema, and hypoglycemia. Other side effects include: cardiac failure, exacerbation of congestive heart failure, bone fracture, headache, and pharyngitis. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to pioglitazone: oral tablet

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

Major Side Effects

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

More common:

Chest pain

decreased urine output

dilated neck veins

extreme fatigue

irregular breathing

irregular heartbeat

problems with teeth

shortness of breath

swelling of the face, fingers, feet, or lower legs

tightness in the chest

trouble with breathing

weight gain

wheezing

Less common:

Pain or swelling in the arms or legs without an injury

pale skin

swelling

trouble with breathing when active

unusual bleeding or bruising

unusual tiredness or weakness

Incidence not known:

Dark urine

loss of appetite

nausea or vomiting

stomach pain

unexplained, rapid weight gain

yellow eyes or skin

Minor Side Effects

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

More common:

Blurred vision or other changes in vision

cough

dry mouth

flushed, dry skin

fruit-like breath odor

headache

increased hunger

increased thirst

increased urination

loss of consciousness

muscle pain or soreness

problems with your teeth

runny or stuffy nose

sore throat

stomachache

sweating

unexplained weight loss

For Healthcare Professionals

Applies to pioglitazone: oral tablet

Cardiovascular

Common (1% to 10%): Congestive heart failure (including nonfatal and fatal cases), cardiac failure, chest pain [Ref ]

Hypersensitivity

Frequency not reported: Hypersensitivity and allergic reactions [Ref ]

Metabolic

Very common (10% or more): Hypoglycemia (up to 27.3%), increased weight (up to 26.2%) [Ref ]

General

The most commonly reported side effects were hypoglycemia, increased weight, edema, and upper respiratory tract infection. [Ref ]

Hematologic

Frequency not reported: Small reduction in mean hemoglobin and hematocrit [Ref ]

Ocular

Common (1% to 10%): Visual disturbance, abnormal vision Frequency not reported: Macular edema [Ref ]

Hepatic

Uncommon (0.1% to 1%): Increased alanine aminotransferase Frequency not reported: Decreased mean values of bilirubin, AST, alkaline phosphatase, and GGT Postmarketing reports: Hepatocellular dysfunction [Ref ]

Other

Very common (10% or more): Edema (up to 26.7%) Common (1% to 10%): Fatigue, accidental injury, peripheral edema, asthenia, malaise [Ref ]

Gastrointestinal

Common (1% to 10%): Tooth disorder, tooth abscess, gastroenteritis, diarrhea, upper abdominal pain [Ref ]

Genitourinary

Uncommon (0.1% to 1%): Bladder cancer, urinary tract infection [Ref ]

Musculoskeletal

Common (1% to 10%): Fractures, myalgia, pain in extremity, back pain, cramped legs, arthralgia [Ref ]

Nervous system

Common (1% to 10%): Headache, Hypoesthesia [Ref ]

Psychiatric

Uncommon (0.1% to 1%): Insomnia [Ref ]

Respiratory

Very common (10% or more): Upper respiratory tract infection (up to 13.2%) Common (1% to 10%): Sinusitis, pharyngitis, bronchitis, influenza [Ref ]

Oncologic

Uncommon (0.1% to 1%): Bladder cancer [Ref ]

References

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

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

3. "Product Information. Actos (pioglitazone)" Takeda Pharmaceuticals America, Lincolnshire, IL.

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

More about pioglitazone

Consumer resources

Professional resources

Related treatment guides

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill. knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs. com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.

Drug Status



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Clotel Or, The President S Daughter By William Wells Brown, Clotil

Clotel: or, The President's Daughter

First published in December 1853, Clotel was written amid then unconfirmed rumors that Thomas Jefferson had fathered children with one of his slaves. The story begins with the auction of his mistress, here called Currer, and their two daughters, More First published in December 1853, Clotel was written amid then unconfirmed rumors that Thomas Jefferson had fathered children with one of his slaves. The story begins with the auction of his mistress, here called Currer, and their two daughters, Clotel and Althesa. The Virginian who buys Clotel falls in love with her, gets her pregnant, seems to promise marriage—then sells her. Escaping from the slave dealer, Clotel returns to Virginia disguised as a white man in order to rescue her daughter, Mary, a slave in her father’s house. A fast-paced and harrowing tale of slavery and freedom, of the hypocrisies of a nation founded on democratic principles, Clotel is more than a sensationalist novel. It is a founding text of the African American novelistic tradition, a brilliantly composed and richly detailed exploration of human relations in a new world in which race is a cultural construct. First time in Penguin Classics Published in time for African-American History Month Includes appendices that show the different endings Brown created for the various later versions of Clotel . along with the author's narrative of his "Life and Escape," Introduction, suggested readings, and comprehensive explanatory notes Less

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Community Reviews

Nathan rated it really liked it

4.5/5 You may place the slave where you please; you may dry up to your utmost the fountains of his feelings, the springs of his thought; you may yoke him to your labour, as an ox which liveth only to work and worketh only to live; you may put him under any process which, w. Read full review

poingu rated it it was amazing

There is something audacious and true about this book, however fictional. The first time I came to the sentence calling Clotel the daughter of Thomas Jefferson I felt the boldness of that sentence, and the truth of it, that it was known even in 1853 that Jefferson had chi. Read full review

Sharon rated it really liked it

almost 3 years ago

"Clotel" is the story of a slave woman who was allegedly the daughter of Thomas Jefferson. At the time the book was published in 1853, rumors were rife about Jefferson's relationship with his slave, Sally Hemings. We now know, through DNA testing, that those rumors were t. Read full review

Mimi rated it really liked it

about 5 years ago

When I read this book for my slave lit class, I was particular affected by the relationship between Clotel and Horatio Green. The “romance” (if you can call it that!) between the two of them both broke my heart and frustrated me to no end! When Green first met Clotel, it. Read full review

Christopher Campbell rated it liked it

over 7 years ago

William Wells Brown's Clotel is noted as being one of (if not the) first African-American novels ever written. The work focuses on the fictional slave mistress of Thomas Jefferson named Currer(modeled closely on the historical Sally Hemmings) and her two daughters, Althes. Read full review

Theresa rated it really liked it

about 1 year ago

"Clotel" was the first novel written by an African-American in 1853. It was written by William Wells Brown who was born a slave in Lexington, Kentucky. The story is about the slave daughter of Thomas Jefferson (yes, rumors were going around even then), but mainly consists. Read full review

Allison rated it really liked it

almost 2 years ago

Recommends it for: YA & Up

William Wells Brown is an amazing man and author. After having stumbled upon this book, I am sorely disappointed that I have only discovered him now (at age 47 in 2014) - and by accident. I sincerely believe that I should have been introduced to him in public school by th. Read full review

Thom Swennes rated it really liked it

almost 4 years ago

Recommends it for: All American's, history and freedom lovers throughout the world

I had no idea what to expect when I picked up this book and started to read. I found that I enjoyed the style and the story soon had me on an emotional roller-coaster. Many of the scenes and slave conditions related in the story have been similarly related by others. One. Read full review

David rated it it was ok

over 5 years ago

This book is historically significant. I studied this novel in the African American Women course that I took at Atlanta University from Dr. Farmer. William Wells Brown was ahead of the curve in suggesting that Thomas Jefferson had a black daughter. The theme is one that r. Read full review

Matt Sautman rated it really liked it

This book is a fascinating novel that follows a fictional lineage of Thomas Jefferson's "illegitimate offspring" and the slave who gave birth the two children. Based in historical events, the novel reinvents a true event - that Jefferson did have children by a slave and th. Read full review

Other Books by this Author

The Narrative of William W. Brown, a.

by William Wells Brown

Three Classic African-American Novels.

by William Wells Brown

The Escape: A Leaf For Freedom

by William Wells Brown

William Wells Brown: A Reader

by William Wells Brown

Three Years in Europe

by William Wells Brown

From Fugitive Slave to Free Man: The.

by William Wells Brown

My Southern Home: Or, the South and I.

by William Wells Brown

Clotel; Or, The President's Daughter

by William Wells Brown

William Wells Brown: Clotel & Other W.

by William Wells Brown

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Book Details

Paperback. 320 pages

Published December 30th 2003 by Penguin Classics (first published April 13th 1853

ISBN 0142437727 (ISBN13: 9780142437728 ) Edition Language English Original Title Clotel: or, The President's Daughter

About this Author

William Wells Brown was a prominent African-American abolitionist lecturer, novelist, playwright, and historian. Born into slavery in the Southern United States, Brown escaped to the North in 1834, where he worked for abolitionist causes and was a prolific writer. His novel Clotel (1853) is considered the first novel written by an African American; it was published in London, where he was.

Genres



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Cald Resolution No, Cald 3

CALD resolution expressing concern on the process leading to the upcoming referendum on the draft Thai constitution, and urging the Thai government to foster genuine commitment in making Thailand a functioning democracy

The Council of Asian Liberals and Democrats (CALD):

Aware that on 7 August 2016, Thailand will hold a referendum on the new constitution drafted by a military-appointed committee;

Concerned that the drafting of the new constitution was not carried out in a democratic and inclusive manner that would have encouraged commitment among all the stakeholders involved;

Troubled that some of the provisions in the draft constitution could undermine basic human rights and parliamentary independence, not to mention the possible risks emanating from the use of emergency powers;

Alarmed that there have been cases of intimidation, harassment, and arrests against those who criticize and oppose the draft, and even against those who just want an open and free discussion about the proposed charter;

Urges the Thai government to respect, and even promote, any form of campaigns, discussions, and open debates to help keep the public informed about the draft constitution; to allow international election monitoring groups to observe freely the referendum voting process; and to pursue a more reconciliatory and inclusive approach in its next steps after the referendum results become known;

Reiterates the call of the international community to retract any form of restrictions that inhibits free expression and freedom of assembly;

Echoes the call of former Thai Prime Minister Abhisit Vejjajiva, a CALD Executive Committee Member, that the draft constitution is “depriving the people of their right to participate in the political process” and that if it fails, Prime Minister Prayut “must seek to reassess, listen to public, and maintain reforms at hand;”

Trusts that the Thai people would remain vigilant against possible violations of their rights and freedoms before, during and after the referendum;

Believes that Thailand deserves nothing less than a government democratically elected by the people; a government that works for national, not sectoral or parochial interests; and a government that truly respects democratic institutions and processes.

For the Council of Asian Liberals and Democrats:

Oyun Sanjaasuren, MP Chairperson Council of Asian Liberals and Democrats 4 August 2016

This post was written by CALD



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Bridge Avenue, Kazmarin

Sharon Karmazin is President of the Karma Foundation, a philanthropic family foundation. Her innovative approach to foundation grantsmanship was written about by author Malcolm Gladwell in the paper edition of his bestseller, The Tipping Point . Ms. Karmazin serves on numerous non-profit boards including the Rutgers University Board of Overseers and the Rutgers President’s Council Executive Committee.

Ms. Karmazin is also an award-winning commercial theatrical producer. In 2002, she was the winner of a Drama Desk Award and was nominated for a Tony Award for Best Play for the Broadway production of Mary Zimmerman’s Metamorphoses . She is vice president of the George Street Playhouse, a professional regional theater located in New Brunswick, New Jersey.

Ms. Karmazin gained national recognition during her distinguished 32-year career in public library administration. She has received numerous awards recognizing her professional and community leadership. These include the Thomas H. Kean Arts Advocacy Award, the Library Service Award (New Jersey Library Association), and three John Cotton Dana Library Public Relations Awards (American Library Association).

Ms. Karmazin holds a Bachelor of Arts degree in English from Douglass College and an MLS degree from Rutgers University School of Communication, Information, and Library Studies.

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Share your story! Tell us how MediGuard has helped you or someone you love. Download the MediGuard Mobile App to manage your prescription and over-the-counter medications, for free. Taking multiple medications puts you at risk for possible drug-drug interactions Monitor the medical treatment of you and your loved ones.

DISCLAIMER: MediGuard is not intended to be a substitute for professional medical advice. MediGuard cannot and does not take into consideration every possible interaction or account for individual responses to medicine. Different individuals may respond to medication in different ways. 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. Always seek the advice of a qualified health provider with any questions you may have before making any changes to your treatment. The use of the MediGuard site and its content is at your own risk. The MediGuard site and the information contained in it is intended for users in the United States and information in other countries may be different.

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Claridar General Information

Claridar (generic name: clarithromycin; brand names include: Maclar / Klaricid / Klacid / Clarimac / Claribid) is used to treat many different types of bacterial infections affecting the skin and respiratory system, including:

Strep throat Pneumonia Sinusitis (inflamed sinuses) Tonsillitis (inflamed tonsils) Acute middle ear infections Acute flare-ups of chronic bronchitis

It also is used to treat and prevent disseminated Mycobacterium avium complex (MAC) infection [a type of lung infection that often affects people with human immunodeficiency virus (HIV)]. It is used in combination with other medications to eliminate H. pylori, a bacteria that causes ulcers.

It also is used sometimes to treat other types of infections including Lyme disease (an infection that may develop after a person is bitten by a tick), crypotosporidiosis (an infection that causes diarrhea), cat scratch disease (an infection that may develop after a person is bitten or scratched by a cat), Legionnaires' disease (a type of lung infection), and pertussis (whooping cough; a serious infection that can cause severe coughing). It is also sometimes used to prevent heart infection in patients having dental or other procedures.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Claridar works by stopping the growth of or killing sensitive bacteria by interfering with their protein synthesis.

Claridar Recommendations

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Take Claridar by mouth with or without food.

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

Continue to take Claridar even if you feel well.

Do not miss any doses. If you miss a dose of Claridar, 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.

Claridar Precautions

Tell your doctor if you have or have ever had kidney or liver disease. Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Contact your doctor if you experience any allergic reaction while taking Claridar. Claridar is not recommended for children under 6 months of age.

Claridar Ingredients

Active ingredient: clarithromycin.

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Roxithromycin is a macrolide antibiotic. Roxithromycin is very similar in composition, chemical structure (semi-synthetic) and mechanism of action to erythromycin, azithromycin, or clarithromycin. Antibiotics such as Roxithromycin can often be prescribed for several different infections, including some STDs, upper and lower respiratory tract infections and asthma, gum infections like gingivitis, and bacterial infections associated with stomach and intestinal ulcers. Roxithromycin is absorbed well into the gastro-intestinal tract, with few side effects, and actively responds to the presence of cryptosporidium, pneumocystis carinii (PCP), toxoplasma gondii, and Mycobacterium Avium (MAC).

Use Roxithromycin as directed by your doctor.

Take Roxithromycin by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.

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

If you miss a dose of Roxithromycin, 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 Roxithromycin.

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

Do NOT use Roxithromycin if:

you are allergic to any ingredient in Roxithromycin.

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

Some medical conditions may interact with Roxithromycin. 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.

Ask your health care provider if Roxithromycin 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:

Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.

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

Roxithromycin only works against bacteria; it does not treat viral infections.

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

Use Roxithromycin with caution in the elderly; they may be more sensitive to the effects of Roxithromycin.

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

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

Nausea, vomiting, indigestion, cramps.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody diarrhea; dark urine; decreased urination; fever, chills, or sore throat; joint pain; red, swollen, or blistered skin; seizures; severe diarrhea; stomach pain or cramps; unusual bruising or bleeding; unusual tiredness or weakness; vaginal itching, odor, or discharge; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

Roxithromycin is a macrolide antibiotic. Roxithromycin is very similar in composition, chemical structure (semi-synthetic) and mechanism of action to erythromycin, azithromycin, or clarithromycin. Antibiotics such as Roxithromycin can often be prescribed for several different infections, including some STDs, upper and lower respiratory tract infections and asthma, gum infections like gingivitis, and bacterial infections associated with stomach and intestinal ulcers. Roxithromycin is absorbed well into the gastro-intestinal tract, with few side effects, and actively responds to the presence of cryptosporidium, pneumocystis carinii (PCP), toxoplasma gondii, and Mycobacterium Avium (MAC).

Use Roxithromycin as directed by your doctor.

Take Roxithromycin by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.

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

If you miss a dose of Roxithromycin, 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 Roxithromycin.

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

Do NOT use Roxithromycin if:

you are allergic to any ingredient in Roxithromycin.

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

Some medical conditions may interact with Roxithromycin. 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.

Ask your health care provider if Roxithromycin 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:

Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.

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

Roxithromycin only works against bacteria; it does not treat viral infections.

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

Use Roxithromycin with caution in the elderly; they may be more sensitive to the effects of Roxithromycin.

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

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

Nausea, vomiting, indigestion, cramps.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody diarrhea; dark urine; decreased urination; fever, chills, or sore throat; joint pain; red, swollen, or blistered skin; seizures; severe diarrhea; stomach pain or cramps; unusual bruising or bleeding; unusual tiredness or weakness; vaginal itching, odor, or discharge; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.



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Loratadine is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose. Alavert is used for relieving symptoms of seasonal allergies.

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Do not crush, chew, or break the regular loratadine tablet. Swallow the pill whole. Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon.

Alavert is usually taken once per day. Follow your doctor's instructions.

To take Alavert orally disintegrating tablet:

Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.

Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

Using dry hands, remove the tablet and place it on your tongue. It will begin to dissolve right away.

Take Alavert by mouth with food.

Store at room temperature between 20 and 25 degrees C and away from moisture, light and heat. Do not store in the bathroom. Keep in a tight, light-resistant container. Keep Alavert out of the reach of children and away from pets.

You should not take Alavert if:

You are allergic to loratadine or to desloratadine (Clarinex). Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

kidney disease; Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

You should not take this medication if you are allergic to loratadine or to desloratadine (Clarinex).

FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Loratadine 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.

Loratadine disintegrating tablets (Claritin Reditab, Alavert) may contain phenylalanine. Talk to your doctor before using this form of loratadine if you have phenylketonuria (PKU). Do not give this medication to a child younger than 6 years old without the advice of a doctor.

All medicines may cause side effects, but many people have no, or minor, side effects.

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

fast or uneven heart rate;

feeling like you might pass out;

jaundice (yellowing of your skin or eyes);

seizures (convulsions).

Call your doctor at once if you noticed these serious side effects. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Less serious side effects may include:

headache;

skin rash;

nervousness;

nosebleed;

feeling tired or drowsy;

eye redness, blurred vision;

stomach pain, diarrhea;

dry mouth, sore throat hoarseness.

Loratadine is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose. Alavert is used for relieving symptoms of seasonal allergies.

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Do not crush, chew, or break the regular loratadine tablet. Swallow the pill whole. Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon.

Alavert is usually taken once per day. Follow your doctor's instructions.

To take Alavert orally disintegrating tablet:

Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.

Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

Using dry hands, remove the tablet and place it on your tongue. It will begin to dissolve right away.

Take Alavert by mouth with food.

Store at room temperature between 20 and 25 degrees C and away from moisture, light and heat. Do not store in the bathroom. Keep in a tight, light-resistant container. Keep Alavert out of the reach of children and away from pets.

You should not take Alavert if:

You are allergic to loratadine or to desloratadine (Clarinex). Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

kidney disease; Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

You should not take this medication if you are allergic to loratadine or to desloratadine (Clarinex).

FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Loratadine 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.

Loratadine disintegrating tablets (Claritin Reditab, Alavert) may contain phenylalanine. Talk to your doctor before using this form of loratadine if you have phenylketonuria (PKU). Do not give this medication to a child younger than 6 years old without the advice of a doctor.

All medicines may cause side effects, but many people have no, or minor, side effects.

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

fast or uneven heart rate;

feeling like you might pass out;

jaundice (yellowing of your skin or eyes);

seizures (convulsions).

Call your doctor at once if you noticed these serious side effects. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Less serious side effects may include:

headache;

skin rash;

nervousness;

nosebleed;

feeling tired or drowsy;

eye redness, blurred vision;

stomach pain, diarrhea;

dry mouth, sore throat hoarseness.

Loratadine is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose. Alavert is used for relieving symptoms of seasonal allergies.

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Do not crush, chew, or break the regular loratadine tablet. Swallow the pill whole. Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon.

Alavert is usually taken once per day. Follow your doctor's instructions.

To take Alavert orally disintegrating tablet:

Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.

Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

Using dry hands, remove the tablet and place it on your tongue. It will begin to dissolve right away.

Take Alavert by mouth with food.

Store at room temperature between 20 and 25 degrees C and away from moisture, light and heat. Do not store in the bathroom. Keep in a tight, light-resistant container. Keep Alavert out of the reach of children and away from pets.

You should not take Alavert if:

You are allergic to loratadine or to desloratadine (Clarinex). Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

kidney disease; Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

You should not take this medication if you are allergic to loratadine or to desloratadine (Clarinex).

FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Loratadine 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.

Loratadine disintegrating tablets (Claritin Reditab, Alavert) may contain phenylalanine. Talk to your doctor before using this form of loratadine if you have phenylketonuria (PKU). Do not give this medication to a child younger than 6 years old without the advice of a doctor.

All medicines may cause side effects, but many people have no, or minor, side effects.

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

fast or uneven heart rate;

feeling like you might pass out;

jaundice (yellowing of your skin or eyes);

seizures (convulsions).

Call your doctor at once if you noticed these serious side effects. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Less serious side effects may include:

headache;

skin rash;

nervousness;

nosebleed;

feeling tired or drowsy;

eye redness, blurred vision;

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dry mouth, sore throat hoarseness.



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Chloramphenicol is used for treating serious infections caused by certain bacteria. Chloramphenicol is an antibiotic. It works by killing or slowing the growth of sensitive bacteria.

Use Chloramphenicol as directed by your doctor.

Take Chloramphenicol by mouth with or without food.

If you miss a dose of Chloramphenicol, use it as soon as possible. Then use your doses at evenly spaced times as directed by your doctor. Do not use 2 doses at once.

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

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

Do NOT use Chloramphenicol if:

you are allergic to any ingredient in Chloramphenicol

you have previously had serious side effects from Chloramphenicol

you have a low white or red blood cell count or decreased blood platelets

you have a minor infection such as a cold, flu, throat infection, or you are using Chloramphenicol to prevent a bacterial infection

you are taking other medicines that may decrease your bone marrow (eg, cancer chemotherapy); check with your doctor or pharmacist if you are unsure if any of your other medicines may decrease your bone marrow.

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

Some medical conditions may interact with Chloramphenicol. 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 anemia, bone marrow problems, liver disease, or kidney problems.

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

Anticoagulants (eg, warfarin) because side effects, including risk of bleeding, may be increased

Hydantoins (eg, phenytoin) or sulfonylureas (eg, glyburide) because the actions and side effects of these medicines may be increased.

Medicines that may decrease your bone marrow (eg, cancer chemotherapy ) because the risk of serious side effects, such as low blood platelet levels and low white blood cell counts, may be increased; check with your doctor or pharmacist if you are unsure if any of your medicines may decrease your bone marrow.

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

Do not exceed the recommended dose or use Chloramphenicol for longer than prescribed without checking with your doctor.

Chloramphenicol is effective only against bacteria. It is not effective for treating viral infections (eg, the common cold).

It is important to use Chloramphenicol for the full course of treatment. Failure to do so may decrease the effectiveness of Chloramphenicol and increase the risk that the bacteria will no longer be sensitive to Chloramphenicol and will not be able to be treated by this or certain other antibiotics in the future.

Long-term or repeated use of Chloramphenicol may cause a second infection. Your doctor may want to change your medicine to treat the second infection. Contact your doctor if signs of a second infection occur.

If symptoms of "gray syndrome" (swelling of the abdomen, pale or blue skin color, vomiting, shock, difficulty breathing, refusal to suck, loose green stools, limp muscles, low temperature) occur in a newborn or infant, contact your doctor. Death may occur within hours of the onset of symptoms. Stopping use of Chloramphenicol when symptoms first appear increases the chance for a complete recovery.

Chloramphenicol may lower your body's ability to fight infection. Prevent infection by avoiding contact with people with colds or other infections. Notify your doctor of any signs of infection, including fever, sore throat, rash, or chills.

Chloramphenicol may reduce the number of clot-forming cells (platelets) in your blood. To prevent bleeding, avoid situations in which bruising or injury may occur. Report any unusual bleeding, bruising, blood in stools, or dark, tarry stools to your doctor.

Diabetes patients - Chloramphenicol may affect your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine.

LAB TESTS, including complete blood cell counts, may be performed to monitor your progress or check for side effects. Be sure to keep all doctor and lab appointments.

Use Chloramphenicol with extreme caution in children younger 1 year. Safety and effectiveness in this age group have not been confirmed.

Use Chloramphenicol with extreme caution in children younger 10 years who have diarrhea or a stomach or bowel infection.

Use Chloramphenicol with extreme caution in premature and full-term infants because they may be more sensitive to the effects of Chloramphenicol, especially the risk of "gray syndrome."

Pregnancy and breast-feeding: If you become pregnant while taking Chloramphenicol, discuss with your doctor the benefits and risks of using Chloramphenicol during pregnancy. Chloramphenicol should be used with extreme caution during full-term pregnancy and labor because the fetus may experience severe side effects. Chloramphenicol is excreted in breast milk. Do not breastfeed while taking Chloramphenicol.

All medicines may cause side effects, but many people have no, or minor, side effects.

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

Mild diarrhea, nausea, or vomiting.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; dark urine; delirium; depression; headache; fever, chills, or sore throat; pain, redness, or swelling at the injection site; symptoms of "gray syndrome" in an infant (swelling of the abdomen, pale or blue skin color, vomiting, shock, difficulty breathing, refusal to suck, loose green stools, limp muscles, low temperature); unusual bleeding or bruising; unusual tiredness; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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AUDIENCE: Dermatology, Family Practice, Pharmacy, Patient

ISSUE: FDA is warning health care professionals to avoid prescribing the antifungal medicine ketoconazole oral tablets to treat skin and nail fungal infections. Use of this medication carries the risk of serious liver damage, adrenal gland problems, and harmful interactions with other medicines that outweigh its benefit in treating these conditions, which are not approved uses of the drug.

FDA approved label changes for oral ketoconazole tablets in 2013 to reflect these serious risks and to remove the indications for treatment of skin and nail fungal infections. However, an FDA safety review found that oral ketoconazole continues to be prescribed for these types of conditions. Since the 2013 labeling change, one patient death has been reported to the FDA due to liver failure associated with oral ketoconazole prescribed to treat a fungal infection of the nails. See the full MedWatch Communication at http://www. fda. gov/Drugs/DrugSafety/ucm500597.htm for further information.

BACKGROUND: Ketoconazole in tablet form is indicated to treat serious infections caused by fungi and should be used only when other effective therapy is not available or tolerated. It works by killing the fungus or preventing it from growing. The topical forms of ketoconazole that are applied to the skin or nails have not been associated with liver damage, adrenal problems, or drug interactions.

In a July 2013 Drug Safety Communication, FDA warned that ketoconazole tablets should not be used as a first-line treatment for any fungal infection because it can cause severe liver injury and adrenal gland problems, and advised it can lead to harmful interactions with other medicines. FDA determined that the risks outweigh the benefits for treating skin and nail fungal infections and approved label changes removing this indication from the drug label and limited its labeled indication to treating only serious fungal infections.

RECOMMENDATION: Health care professionals should use ketoconazole tablets only to treat serious fungal infections when no other antifungal therapies are available. Skin and nail fungal infections in otherwise healthy persons are not life-threatening, and so the risks associated with oral ketoconazole outweigh the benefits. Other treatment options are available over-the-counter and by prescription, but are also associated with risks that should be weighed against their benefits.

Patients should discuss with their health care professionals the risks and benefits of available therapies before using any medicine to treat skin and nail fungal infections. Patients taking ketoconazole tablets should seek medical attention right away if they experience any of these signs and symptoms of liver problems, which include loss of appetite, nausea, vomiting, or abdominal discomfort; yellowing of the skin or the whites of the eyes (jaundice); unusual darkening of the urine or lightening of the stools; or pain and discomfort in the right upper abdomen where the liver is located.

IMPORTANT WARNING:

Ketoconazole should only be used to treat fungal infections when other medications are not available or cannot be tolerated.

Ketoconazole may cause liver damage, sometimes serious enough to require liver transplantation or to cause death. Liver damage may occur in people who do not already have liver disease or any other conditions that increase the risk that they will develop liver damage. Tell your doctor if you drink or have ever drunk large amounts of alcohol and if you have or have ever had liver disease. Do not drink any alcoholic beverages during your treatment with ketoconazole because drinking alcoholic beverages may increase the risk that you will develop liver damage. If you experience any of the following symptoms, call your doctor immediately: extreme tiredness, loss of appetite, weight loss, nausea, vomiting, yellowing of the skin or eyes, dark yellow urine, pale stools, pain in the upper right part of the stomach, fever, or rash.

Ketoconazole can cause QT prolongation (an irregular heart rhythm that can lead to fainting, loss of consciousness, seizures, or sudden death). Do not take disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), pimozide (Orap), quinidine (Quinidex, Quinaglute), cisapride (Propulsid; no longer available in the US), methadone (Dolophine, Methadose), and ranolazine (Ranexa) while you are taking ketoconazole. If you experience any of the following symptoms, stop taking ketoconazole and call your doctor immediately: fast, pounding, or irregular heartbeat; fainting; dizziness; lightheadedness; or loss of consciousness.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests to check your body's response to ketoconazole.

Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with ketoconazole and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www. fda. gov/Drugs/DrugSafety/ucm085729.htm ) or the manufacturer's website to obtain the Medication Guide.

Talk to your doctor about the risks of taking ketoconazole.

Why is this medication prescribed?

Ketoconazole is used to treat fungal infections when other medications are not available or cannot be tolerated. Ketoconazole should not be used to treat fungal meningitis (infection of the membranes surrounding the brain and spinal cord caused by a fungus) or fungal nail infections. Ketoconazole is in a class of antifungals called imidazoles. It works by slowing the growth of fungi that cause infection.

How should this medicine be used?

Ketoconazole comes as a tablet to take by mouth. It is usually taken once a day Take ketoconazole at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ketoconazole exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may increase your dose if your condition does not improve.

You may need to take ketoconazole for 6 months or longer to cure your infection completely. Continue to take ketoconazole until your doctor tells you that you should stop, even if you feel better. Do not stop taking ketoconazole without talking to your doctor. If you stop taking ketoconazole too soon, your infection may come back after a short time.

Other uses for this medicine

High doses of ketoconazole are sometimes used to treat Cushing syndrome (a condition that occurs when there is too much corticosteroid hormone in the body) and advanced prostate cancer (cancer of a male reproductive gland). Ketoconazole has not been shown to be safe or effective for these uses. Talk to your doctor about using ketoconazole for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking ketoconazole,

tell your doctor and pharmacist if you are allergic to ketoconazole or any other medications or any of the ingredients in ketoconazole tablets. Ask your pharmacist or check the Medication Guide for a list of the ingredients.

tell your doctor if you are taking alprazolam (Niravam, Xanax);eplerenone (Inspra); ergot alkaloids such as ergotamine (Ergomar, in Cafergot, in Migergot), dihydroergotamine (D. H.E 45, Migranal), and methylergonovine (Methergine); felodipine (Plendil); irinotecan (Camptosar); lovastatin (Mevacor); lurasidone (Latuda); midazolam (Versed); nisoldipine (Sular); simvastatin (Zocor); tolvaptan (Samsca); and triazolam (Halcion). Your doctor will probably tell you not to take ketoconazole if you are taking one or more of these medications or any of the medications listed in the IMPORTANT WARNING section.

tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: aliskiren (Tekturna, in Valturna, in Amturnide); anticoagulants ('blood thinners') such as dabigatran (Pradaxa), rivaroxaban (Xarelto) and warfarin (Coumadin); aprepitant (Emend); aripiprazole (Abilify); atorvastatin (Lipitor); bosentan (Tracleer); budesonide (Uceris); buspirone (BuSpar); carbamazepine (Tegretol); calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac), nicardipine (Cardene), nifedipine (Adalat, Procardia), and verapamil (Calan, Covera, Isoptin, Verelan); cancer medications such as bortezomib (Velcade); busulfan (Myleran); dasatinib (Sprycel); docetaxel (Taxotere), erlotinib (Tarceva); ixabepilone (Ixempra); lapatinib (Tykerb); nilotinib (Tasigna);paclitaxel (Taxol), trimetrexate (Neutrexin), vincristine (Vincasar), vinblastine, and vinorelbine (Navelbine); ciclesonide (Alvesco); cilostazol (Pletal); cinacalcet (Sensipar); colchicine (Colcrys, in Col-Probenecid); dexamethasone; digoxin (Lanoxin); eletriptan (Relpax); fentanyl (Abstral, Actiq, Duragesic, Fentora, Lazanda, Onsolis); fesoterodine (Toviaz); fluticasone (Flonase, Flovent); haloperidol (Haldol); HIV medications such as darunavir (Prezista), efavirenz (Sustiva), fosamprenavir (Lexiva),indinavir (Crixivan), maraviroc (Selzentry), nevirapine (Viramune), ritonavir (Norvir), and saquinavir (Invirase, Fortovase); immunosuppressants such as cyclosporine (Neoral, Sandimmune), everolimus (Afinitor, Zortress),sirolimus (Rapamune), and tacrolimus (Prograf); imatinib (Gleevec); medications for erectile dysfunction such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra); medications for indigestion, heartburn, or ulcers such as cimetidine (Tagamet), famotidine (Pepcid), lansoprazole (Prevacid), nizatidine (Axid), omeprazole (Prilosec), and ranitidine (Zantac); medications to treat tuberculosis such as isoniazid (INH, Nydrazid), rifabutin (Mycobutin), rifampin (Rifadin, Rimactane); methylprednisolone (Medrol); nadolol (Corgard); oxycodone (Oxecta, Oxy Contin, in Percocet, others); phenytoin (Dilantin); praziquantel (Biltricide); quetiapine (Seroquel); ramelteon (Rozerem); repaglinide (Prandin, in PrandiMet); risperidone (Risperdal); salmeterol (Serevent, in Advair);saxagliptin (Onglyza); solifenacin (Vesicare); immunosuppressants such as cyclosporine (Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Prograf); tamsulosin (Flomax, in Jalyn); telithromycin (Ketek); and tolterodine (Detrol). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with ketoconazole, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.

if you are taking an antacid containing aluminum, calcium, or magnesium (Maalox, Mylanta, Tums, others), take it 1 hour before or 2 hours after you take ketoconazole.

tell your doctor if you have or have ever had the conditions mentioned in the IMPORTANT WARNING section or adrenal insufficiency (condition in which the adrenal glands do not make enough steroid hormones).

tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking ketoconazole, call your doctor.

if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ketoconazole.

you should know that drinking alcoholic beverages (including wine, beer, and medications that contain alcohol such as cough syrup) while taking ketoconazole increases the risk that you will develop liver damage and may cause unpleasant symptoms such as flushing, rash, nausea, headache, and swelling of the hands, feet, ankles, or lower legs if you drink alcohol while you are taking ketoconazole.

What special dietary instructions should I follow?

Ketoconazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

headache

stomach pain

diarrhea

constipation

heartburn

gas

change in ability to taste food

dry mouth

change in tongue color

difficulty falling asleep or staying asleep

nervousness

numbness, burning, or tingling of the hands or feet

muscle pain

hair loss

flushing

chills

sensitivity to light

nosebleeds

breast enlargement in males

decrease in sexual ability

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:

rash

hives

itching

swelling of the eyes, face, lips, tongue, hands, feet, ankles, or lower legs

hoarseness

difficulty breathing or swallowing

tiredness or weakness

Ketoconazole may cause a decrease in the number of sperm (male reproductive cells) produced, especially if it is taken at high doses. Talk to your doctor about the risks of taking this medication if you are a man and would like to have children.

Ketoconazole may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www. fda. gov/Safety/MedWatch ) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose



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Motrin - Pain Relief, Buprophar

Motrin is used for treating rheumatoid arthritis, osteoarthritis, menstrual cramps, or mild to moderate pain. Motrin is an NSAID. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes those symptoms.

Use Motrin as directed by your doctor.

Take Motrin by mouth with or without food. 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 Motrin with a full glass of water (8 oz/240 mL) as directed by your doctor.

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

Ask your health care provider any questions you may have about the proper use of Motrin .

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

Active Ingredient: Ibuprofen.

Do NOT use Motrin if:

you are allergic to any ingredient in Motrin

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 are in the last 3 months of pregnancy.

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

Some medical conditions may interact with Motrin. 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 product, or dietary supplement

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

if you have a history of kidney or liver disease, diabetes, or stomach or bowel problems (eg, bleeding, perforation, ulcers)

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

if you have high blood pressure, blood disorders, 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 drink alcohol, or you have a history of alcohol abuse.

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

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

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

Cyclosporine, lithium, methotrexate, or quinolones (eg, ciprofloxacin) because the risk of their side effects may be increased by Motrin

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

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

Motrin may cause dizziness or drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use Motrin 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 Motrin. Taking it in high doses or for a long time, smoking, or drinking alcohol increases the risk of these side effects. Taking Motrin with food will NOT reduce the risk of these effects. Contact your doctor or emergency room at once if you develop severe stomach or back pain; black, tarry stools; vomit that looks like blood or coffee grounds; or unusual weight gain or swelling.

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

Motrin has ibuprofen in it. Before you start any new medicine, check the label to see if it has 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 Motrin unless your doctor tells you to.

Lab tests, including kidney function, complete blood cell counts, and blood pressure, may be done to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.

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

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

Pregnancy and breast-feeding: Motrin may cause harm to the fetus. Do not take 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 taking Motrin while you are pregnant. It is not known if Motrin is found in breast milk. Do not breastfeed while taking Motrin .

All medicines can cause side effects, but many people have no, or minor, side effects.

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

Constipation; diarrhea; dizziness; gas; headache; heartburn; nausea; stomach pain or upset.

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

Severe allergic reactions (rash; hives; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; change in the amount of urine produced; chest pain; confusion; dark urine; depression; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe headache or dizziness; severe or persistent stomach pain or nausea; severe vomiting; shortness of breath; stiff neck; sudden or unexplained weight gain; swelling of hands, legs, or feet; unusual bruising or bleeding; unusual joint or muscle pain; unusual tiredness or weakness; vision or speech changes; vomit that looks like coffee grounds; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

Motrin is used for treating rheumatoid arthritis, osteoarthritis, menstrual cramps, or mild to moderate pain. Motrin is an NSAID. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes those symptoms.

Use Motrin as directed by your doctor.

Take Motrin by mouth with or without food. 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 Motrin with a full glass of water (8 oz/240 mL) as directed by your doctor.

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

Ask your health care provider any questions you may have about the proper use of Motrin .

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

Active Ingredient: Ibuprofen.

Do NOT use Motrin if:

you are allergic to any ingredient in Motrin

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 are in the last 3 months of pregnancy.

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

Some medical conditions may interact with Motrin. 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 product, or dietary supplement

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

if you have a history of kidney or liver disease, diabetes, or stomach or bowel problems (eg, bleeding, perforation, ulcers)

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

if you have high blood pressure, blood disorders, 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 drink alcohol, or you have a history of alcohol abuse.

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

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

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

Cyclosporine, lithium, methotrexate, or quinolones (eg, ciprofloxacin) because the risk of their side effects may be increased by Motrin

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

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

Motrin may cause dizziness or drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use Motrin 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 Motrin. Taking it in high doses or for a long time, smoking, or drinking alcohol increases the risk of these side effects. Taking Motrin with food will NOT reduce the risk of these effects. Contact your doctor or emergency room at once if you develop severe stomach or back pain; black, tarry stools; vomit that looks like blood or coffee grounds; or unusual weight gain or swelling.

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

Motrin has ibuprofen in it. Before you start any new medicine, check the label to see if it has 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 Motrin unless your doctor tells you to.

Lab tests, including kidney function, complete blood cell counts, and blood pressure, may be done to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.

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

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

Pregnancy and breast-feeding: Motrin may cause harm to the fetus. Do not take 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 taking Motrin while you are pregnant. It is not known if Motrin is found in breast milk. Do not breastfeed while taking Motrin .

All medicines can cause side effects, but many people have no, or minor, side effects.

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

Constipation; diarrhea; dizziness; gas; headache; heartburn; nausea; stomach pain or upset.

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

Severe allergic reactions (rash; hives; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; change in the amount of urine produced; chest pain; confusion; dark urine; depression; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe headache or dizziness; severe or persistent stomach pain or nausea; severe vomiting; shortness of breath; stiff neck; sudden or unexplained weight gain; swelling of hands, legs, or feet; unusual bruising or bleeding; unusual joint or muscle pain; unusual tiredness or weakness; vision or speech changes; vomit that looks like coffee grounds; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.



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Dailymed - Lidoject - Lidocaine Injection, Lidoject

Label: LIDOJECT - lidocaine injection

NDC (National Drug Code) - Each drug product is assigned this unique number which can be found on the drug's outer packaging." href="#">NDC Code(s): 11695-4147-1, 11695-4147-2

Packager: Butler Animal Health Supply

Category: PRESCRIPTION ANIMAL DRUG LABEL

DEA Schedule: None

Marketing Status: unapproved drug other

DISCLAIMER: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA. For further information about unapproved drugs, click here.

Drug Label Information

Updated July 11, 2016

If you are a consumer or patient please visit this version.

CAUTION. Federal law restricts this drug to use by or on the order of a licensed veterinarian.

FOR ANIMAL USE ONLY

KEEP OUT OF REACH OF CHILDREN

Lidocaine is a potent local anesthetic for producing epidural, nerve conduction, and infiltration anesthesia.

Lidocaine is contraindicated in animals with a known hypersensitivity to the drug.

Lidocaine is usually well tolerated. Nevertheless, as with all local anesthetics, untoward effects may occur due to hypersensitivity, faulty technique, overdosage and inadvertent intravascular or subarachnoid injection. In case of respiratory arrest, immediate resuscitation with oxygen is indicated.

Epidural Cattle and Horses - 5 to 15 mL Dogs and Cats - 1 mL per 10 pounds of body weight. Nerve Block Cattle and Horses - 5 to 20 mL

Infiltration Dilute to 0.5% concentration (1 mL of 2% solution diluted with 3 mL of sterile water = 4 mL of a 0.5% solution)

Each mL of sterile aqueous solution contains: Lidocaine Hydrochloride. 2.0% Propylene Glycol. 5.2% Sodium Chloride. 0.5% Sodium Lactate. 0.5% with Methylparaben 0.15%, Sodium Metabisulfite 0.10%, Propylparaben 0.03%, and Disodium Edetate 0.001% as preservatives.

Store at controlled room temperature between 15 o and 30 o C (59 o -86 o F)

TAKE TIME OBSERVE LABEL DIRECTIONS



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Apronax Pain Relief Chiqui Gomez - Radio Ad By Zea Bbdo Venezuela, Apronax

Credits & Description

Advertising Agency: BBDO VENEZUELA, VENEZUELA, Caracas Executive Creative Director: Miguel Corrales Creative Director: Juancho Delgado Scriptwriter: Juan Daniel Gonzalez Agency Producer: Sandra Spinetti Account Supervisor: Giussy Mattioli Advertiser's Supervisor: Gerardo Acevedo/Nestor Rivero

Script in English MVO: And here comes again the great Chiqui Gomez is speeding with the ball. He's getting closer to the area, no-one can stop him, no-one can stop. Chiqui gets kicked in the knee; Chiqui Gomez is back on his feet but not for long. He gets his toes stepped on and gets an elbow in the ribs. Oh, unbelieveble, he keeps going, shoots, but the defense hits the ball back and it hits Chiqui Gomez in the nose. Oh Chiqui. Chiqui. What a beating, Chiqui. ANN: Seeing more action than the ball? Then you need Apronax, the 12 hour pain reliever that’ll get you in the game again. Script in Orginal Language MVO: El Chiqui Gomez recibe y avanza cortito con el balon, que dominio del chiqui, se acerca al area contraria y le patean la rodilla senores, le encajan los tacos en la canilla y le pisan el dedo gordo el pie. El Chiqui Gomez sigue, sigue, ahi viene el chuiqui, ahi viene el chuiqui, que dominio del chiqui ya tiene posicion para anotar y le clavan un codazo en las costillas, chuta, la defensa rechaza y El Chiqui Gomez recibe en la nariz el baloooooonazo, pobre. Chiqui. que dolor Chiqui. ANN: Si en cada juego terminas mas golpea?o que la pelota; alivia el dolor hasta por 12 horas y mantente en juego con Apronax. Brief Explanation Apronax is a pain reliever and they needed a soccer-related ad for the American Cup.

The Radio ad titled CHIQUI GOMEZ was done by Zea BBDO Venezuela advertising agency for product: Apronax Pain Relief (brand: Apronax) in Venezuela. It was released in Jun 2007.

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REFEREE

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Parche Transdermico De Rivastigmina Medlineplus Medicinas, Rivastigmina

Parche Transdermico de Rivastigmina

?Para cuales condiciones o enfermedades se prescribe este medicamento?

Los parches transdermicos de rivastigmina se usan para tratar la demencia (trastorno cerebral que afecta la capacidad de recordar, pensar con claridad, comunicarse y realizar las actividades cotidianas, ademas de provocar cambios en el estado de animo y la personalidad) en personas con la enfermedad de Alzheimer (enfermedad del cerebro que destruye lentamente la memoria y la capacidad de pensar, aprender, comunicarse y ocuparse de las actividades cotidianas). La rivastigmina transdermica se usa tambien para tratar la demencia en personas con la enfermedad de Parkinson (enfermedad del sistema nervioso cuyos sintomas son lentitud de movimiento, debilidad muscular, arrastre de pies al caminar y perdida de memoria). La rivastigmina pertenece a una clase de medicamentos llamados inhibidores de la colinesterasa. Mejora el funcionamiento mental (como la memoria y el pensamiento) al aumentar la cantidad de una sustancia natural presente en el cerebro.

?Como se debe usar este medicamento?

La rivastigmina transdermica viene en forma de un parche que se adhiere a la piel. En general, se aplica una vez al dia. Aplique el parche de rivastigmina aproximadamente a la misma hora todos los dias. Siga al pie de la letra las instrucciones de la receta y pidales a su medico o farmaceutico que le expliquen cualquier cosa que no entienda. Use el parche cutaneo de rivastigmina tal como se lo indiquen. No lo aplique con mayor ni menor frecuencia que la indicada por el medico.

Es posible que su medico comience con una dosis baja de rivastigmina y la aumente gradualmente no mas de una vez cada 4 semanas.

La rivastigmina transdermica puede mejorar la capacidad de pensar y recordar o retardar la perdida de estas capacidades, pero no cura ni la enfermedad de Alzheimer ni la demencia en pacientes con enfermedad de Parkinson. Siga usando los parches de rivastigmina transdermica aunque se sienta bien. No deje de usar la rivastigmina transdermica sin consultar a su medico.

Aplique el parche sobre piel limpia y seca, relativamente libre de vellosidad (parte alta o baja de la espalda, parte superior del brazo, o pecho). No aplique el parche sobre heridas o lesiones abiertas, piel irritada, enrojecida o afectada por alguna erupcion u otro problema de la piel. Tampoco aplique el parche en un lugar donde roce contra ropa cenida. Apliqueselo en un lugar diferente cada dia para evitar que la piel se le irrite. No olvide retirar el parche anterior antes de ponerse el nuevo. Espere al menos 14 dias para volver a aplicarse el parche en el mismo lugar.

Si el parche se afloja o desprende, coloquese uno nuevo. No obstante, debe quitarse el nuevo parche a la hora en que debia quitarse el que se le salio.

Mientras tenga un parche de rivastigmina, evite exponerlo a fuentes de calor directo, como almohadillas termicas, cobertores electricos, lamparas infrarrojas, saunas, banos de tina calientes y camas de agua calefaccionadas. No exponga el parche a la luz solar directa durante un tiempo prolongado.

Para colocarse el parche, siga estos pasos:

Escoja el sitio donde se colocara el parche. Lave el area con agua tibia y jabon. Enjuague perfectamente el jabon y seque la zona con una toalla limpia. No use talcos, aceites ni lociones en la piel.

Tome un parche en su bolsa cerrada y abrala usando una tijera. Evite cortar el parche.

Retire el parche de la bolsa y sostengalo con la pelicula protectora hacia usted.

Desprenda la pelicula protectora de un lado del parche. Evite tocar el adhesivo con los dedos. La segunda tira de la pelicula protectora debe permanecer adherida al parche.

Apriete el parche con firmeza contra la piel con el lado adhesivo hacia abajo.

Retire la segunda tira protectora y haga presion firmemente contra la piel sobre el resto del lado adhesivo del parche. Verifique que el parche haya quedado totalmente adherido a la piel, sin protuberancias ni pliegues, y que los bordes esten bien adheridos a la piel.

Lavese las manos manos con agua y jabon despues de colocarse el parche.

Luego de usar el parche durante 24 horas, desprendalo lenta y suavemente con los dedos. Doble el parche por la mitad, adhiriendo entre si las caras con el adhesivo, y desechelo en un recipiente para la basura que este fuera del alcance de ninos y mascotas.

Aplique inmediatamente el nuevo parche en otro lugar del cuerpo, siguiendo los pasos 1 a 8.

?Que otro uso se le da a este medicamento?

A veces se receta este medicamento para otros usos; pidale mas informacion a su medico o farmaceutico.

?Cuales son las precauciones especiales que debo seguir?

Antes de usar la rivastigmina transdermica,

informe a su medico y a su farmaceutico si es alergico a la rivastigmina, neostigmina (Prostigmin), fisostigmina (Antilirium, Isopto Eserine), piridostigmina (Mestinon, Regonol) o a cualquier otro medicamento.

informe a su medico y a su farmaceutico que medicamentos con y sin receta, vitaminas, complementos nutricionales y productos herbales esta tomando o piensa tomar. No olvide mencionar ninguno de los siguientes: antihistaminicos; betanecol (Duvoid, Urecholine); ipratropium (Atrovent); y medicamentos para el tratamiento de la enfermedad de Alzheimer, glaucoma, sindrome de intestino irritable, mareo por movimiento, miastenia grave, enfermedad de Parkinson, ulceras o problemas urinarios.

informe a su medico si tiene o alguna vez ha tenido asma, agrandamiento de la prostata u otro problema que obstruya el flujo urinario, ulceras, frecuencia cardiaca anormal, convulsiones, temblor incontrolable de alguna parte del cuerpo, otras enfermedades del corazon o los pulmones, o enfermedades de los rinones o el higado.

informe a su medico si esta embarazada, planea estarlo o esta amamantando. Si queda embarazada mientras usa rivastigmina transdermica, llame a su medico.

si tiene programada una cirugia, incluso una cirugia dental, informe al medico o dentista que esta usando rivastigmina transdermica.

?Que dieta especial debo seguir mientras tomo este medicamento?

A menos que su medico le indique lo contrario, continue con su dieta normal.

?Que tengo que hacer si me olvido de tomar una dosis?

Apliquese el parche que olvido en cuanto lo recuerde. No obstante, debera quitarse este parche a la hora normal en que se cambia los parches. Si ya casi es hora de colocarse el parche siguiente, salte el que olvido y continue con el horario de medicacion normal. No se coloque parches adicionales para compensar la dosis que olvido.

?Cuales son los efectos secundarios que podria provocar este medicamento?

La rivastigmina transdermica puede provocar efectos secundarios. Informe a su medico si cualquiera de estos sintomas es grave o no desaparece:

nauseas

vomitos

diarrea

perdida de apetito

dolor estomacal

perdida de peso

depresion

dolor de cabeza

ansiedad

vertigo

debilidad

cansancio excesivo

dificultad para dormirse o permanecer dormido

temblores o empeoramiento de los temblores

Algunos efectos secundarios pueden ser graves. Si presenta alguno de estos sintomas, llame a su medico de inmediato:

heces negras y con aspecto de alquitran

sangre en las heces

vomito con sangre

vomito con aspecto de granos de cafe

dificultad para orinar

miccion dolorosa

convulsiones

Si desarrolla un efecto secundario grave, usted o su doctor puede enviar un informe al programa de divulgacion de efectos adversos 'MedWatch' de la Administracion de Alimentos y Medicamentos (FDA, por su sigla en ingles) en la pagina de Internet (http://www. fda. gov/Safety/MedWatch ) o por telefono al 1-800-332-1088.

?Como debo almacenar o desechar este medicamento?

Mantenga este producto en su envase original, perfectamente cerrado y fuera del alcance de los ninos. Guardelo a temperatura ambiente y alejado del calor y la humedad excesivos (nunca en el cuarto de bano). Deseche los parches vencidos o que ya no necesite, abriendo cada bolsa y doblando el parche por la mitad con los lados adhesivos unidos entre si. Coloque el parche doblado en su bolsa original y pongalo en un recipiente con tapa para la basura y que este fuera del alcance de ninos y mascotas. Preguntele a su farmaceutico cual es la manera adecuada de desechar los medicamentos.

?Que debo hacer en caso de una sobredosis?

Si alguna persona se aplica una dosis adicional o mas alta de parches de rivastigmina pero no presenta ninguno de los siguientes sintomas, retire el(los) parche(s). Llame a su medico y no se aplique ningun parche adicional durante las proximas 24 horas.

Los sintomas de sobredosis son, entre otros:

nauseas

vomitos

diarrea

mayor salivacion

sudoracion

frecuencia cardiaca lenta

mareos

debilidad muscular

dificultad para respirar

desvanecimiento

convulsiones

?Que otra informacion de importancia deberia saber?

Asista a todas las citas con su medico.

Es importante que Ud. mantenga una lista escrita de todas las medicinas que Ud. esta tomando, incluyendo las que recibio con receta medica y las que Ud. compro sin receta, incluyendo vitaminas y suplementos de dieta. Ud. debe tener la lista cada vez que visita su medico o cuando es admitido a un hospital. Tambien es una informacion importante en casos de emergencia.

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Erythrocin Indications, Side Effects, Warnings, Erythrocine

Erythrocin

Treating infections caused by certain bacteria. It is also used to prevent attacks of rheumatic fever. It may also be used for other conditions as determined by your doctor.

Erythrocin is a macrolide antibiotic. It works by killing or slowing the growth of sensitive bacteria.

Do NOT use Erythrocin if:

you are allergic to any ingredient in Erythrocin

you have a very slow heartbeat or a certain type of irregular heartbeat (QT prolongation, long QT syndrome)

you have low blood potassium or magnesium levels

you are taking certain antiarrhythmics (eg, amiodarone, dofetilide, dronedarone, procainamide, propafenone, quinidine, sotalol), asenapine, astemizole, cisapride, diltiazem, eletriptan, an ergot alkaloid (eg, dihydroergotamine, ergotamine), an HIV protease inhibitor (eg, ritonavir), certain imidazole antifungals (eg, itraconazole, ketoconazole, voriconazole), nilotinib, pimozide, a streptogramin (eg, quinupristin/dalfopristin), terfenadine, tetrabenazine, tolvaptan, or verapamil

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

Before using Erythrocin:

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

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

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

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

if you have diarrhea

if you have a history of kidney or liver disease; heart problems; a fast, slow, or irregular heartbeat; low blood potassium or magnesium levels; myasthenia gravis; or the blood disease porphyria

if you take any medicine that may increase the risk of a certain type of irregular heartbeat (prolonged QT interval). Check with your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of this type of irregular heartbeat

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

Many prescription and nonprescription medicines (eg, used for aches and pains, allergies, blood thinning, breathing problems, cancer, diabetes, erection problems, gout, irregular heartbeat or other heart problems, hepatitis C infection, high blood calcium levels, high blood pressure, high cholesterol, HIV infection, inflammation, infections, low blood sodium levels, migraine, mood or mental problems, nausea and vomiting, overactive bladder, Parkinson disease, prevention of organ transplant rejection, seizures, stomach problems, trouble sleeping), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John's wort) may also interact with Erythrocin. Ask your doctor or pharmacist if you are unsure if any of your medicines might interfere with Erythrocin

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

How to use Erythrocin:

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

Take Erythrocin by mouth on an empty stomach at least 1 hour before or 2 hours after eating. If stomach upset occurs, take with food to reduce stomach irritation.

Erythrocin works best if it is taken at the same time(s) each day.

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

Do not eat grapefruit or drink grapefruit juice while you use Erythrocin.

If you miss a dose of Erythrocin, 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 Erythrocin.

Important safety information:

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

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

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

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

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

Rarely, patients taking Erythrocin have developed reversible hearing loss. The risk is greater if you have kidney problems or you take high doses of Erythrocin. Contact your doctor if you develop decreased hearing or hearing loss.

Erythrocin may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Erythrocin.

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

Use Erythrocin with caution in the ELDERLY; they may be more sensitive to its effects, especially irregular heartbeat (prolonged QT interval).

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

Possible side effects of Erythrocin:

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:

Loss of appetite; mild diarrhea; nausea; stomach pain; vomiting.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody stools; change in the amount of urine produced; decreased hearing or hearing loss; irregular heartbeat; red, swollen, blistered, or peeling skin; seizures; severe diarrhea; severe stomach pain; stomach cramps; symptoms of liver problems (eg, yellowing of the skin or eyes; pale stools; severe or persistent nausea, vomiting, or loss of appetite; dark urine).

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

If OVERDOSE is suspected:

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

Proper storage of Erythrocin:

Store Erythrocin at room temperature, below 86 degrees F (30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep tightly closed. Keep Erythrocin out of the reach of children and away from pets.

General information:

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

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

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

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

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

Review Date: August 8, 2016

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

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Dicyclomine - Side Effects, Dosage, Interactions, Diciclomina

Dicyclomine

Dicyclomine, commonly sold under the brand name Bentyl, is an anti-cholinergic drug used to treat symptoms of irritable bowel syndrome (IBS).

It works by relieving spasms of the muscles in your stomach and intestines by blocking a certain substance that your body produces naturally.

Dicyclomine was approved by the Food and Drug Administration (FDA) in 1950.

Dicyclomine Warnings

Dicyclomine can impair your thinking or reactions. You should be careful when you drive or dong anything that requires you to be alert if you are taking dicyclomine.

Dicyclomine may also make you dizzy or cause you to have blurred vision.

You should stop using dicyclomine and call your doctor right away if you have serious side effects such as confusion, hallucinations, unusual thoughts or behavior, fast or uneven heart rate, or if you urinate less than usual or not at all.

Dicyclomine reduces your body's ability to cool off by sweating. You should be careful if you live in an area where there are high temperatures because dicyclomine can cause fever and heat stroke.

Care is also required in patients with coronary heart disease and in patients with known high blood pressure.

Dicyclomine and Pregnancy

If you are pregnant, you should only use dicyclomine when it is clearly needed. You should discuss all the risk and benefits with your doctor before taking.

It is known that dicyclomine passes into breast milk and may have serious side effects on a nursing infant. The manufacturer recommends that you do not breastfeed while using this drug.

This medication must not be used in children younger than 6 months old because of the risk of serious side effects.

Dicyclomine comes as a capsule, tablet, and syrup to take by mouth. It is also available for injection for in-hospital use. It is usually taken in doses of 20 mg, four times a day to start.

To help you remember to take dicyclomine, take it around the same times every day. Dicyclomine can be addictive, so you must follow your doctor's orders exactly as prescribed.

To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose.

If you are using the liquid form of this medication, you should get a special medical spoon to measure your dosage. You should not use a household spoon because you may not get the correct dose. Mix the dose of liquid with an equal amount of water before taking it.

If you have been taking dicyclomine regularly for a long time or in high doses, you may experience withdrawal symptoms if you suddenly stop using it. To prevent withdrawal reactions, your doctor may reduce your dose gradually.

Dicyclomine Overdose

In case of overdose, call your local poison control center at (800) 222-1222. If the victim has collapsed or is not breathing, call 911.

Symptoms of overdose may include the following:

Headache

Upset stomach

Vomiting

Blurred vision

Dilated pupils

Hot, dry skin

Dizziness

Dry mouth

Difficulty swallowing

Nervousness

Excitement

Seeing things or hearing voices that do not exist (hallucinating)

As with other anti-cholinergic drugs, cases of delirium or symptoms of delirium have been reported with the use of dicyclomine. Nervousness and insomnia have also been reported.

Management of digestive disorders may include lifestyle changes such as stress reduction programs, exercise, smoking cessation, and dietary changes, in addition to medication. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

Missed Dose of Dicyclomine

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



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Zindaclin 1% Gel, Zindacline

ZINDACLIN 1% GEL

Transcript

PACKAGE LEAFLET: INFORMATION FOR THE USER

Read all of this leaflet carefully before you start using this medicine. • Keep this leaflet. You may need to read it again. • If you have any further questions, ask your doctor or pharmacist. • This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours. • If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. In this leaflet: 1. What Zindaclin is and what it is used for. 2. Before you use Zindaclin. 3. How to use Zindaclin. 4. Possible side effects. 5. How to store Zindaclin. 6. Further information.

1. WHAT ZINDACLIN IS AND WHAT IT IS USED FOR Zindaclin is used to treat acne (spots). Zindaclin is an antibiotic that reduces the number of bacteria and stops the skin pores becoming blocked and new spots forming. Zindaclin may also help to reduce the redness of the spots you already have. It will take some time once you have started using Zindaclin before you see your acne improving. What is acne? Acne is an extremely common skin condition most common in adolescence, but not restricted to this stage of life. During adolescence, glands in the skin produce extra grease in response to normal amounts of sex hormones in the body, and this can cause blocked pores, resulting in blackheads. When this happens the pores are invaded by bacteria. The chemicals produced by these bacteria go into deeper layers of the skin and produce red spots filled with pus.

2. BEFORE YOU USE ZINDACLIN Do not use Zindaclin • If you are allergic (hypersensitive) to the active substance clindamycin phosphate or any of the other ingredients (See Section 6). • If you are allergic (hypersensitive) to lincomycin another type of antibiotic. Zindaclin should not be used by children under the age of 12 years. Take special care with Zindaclin • Before you use Zindaclin consult your doctor if you suffer from a condition known as inflammatory bowel disease or you have had diarrhoea when you have taken antibiotics. If you do get diarrhoea, when using Zindaclin, you must stop using it straight away and tell your doctor immediately. Taking other medicines Please tell your doctor or pharmacist if you are taking or recently taken or used any other medicines, including medicines you have bought without a prescription. Pregnancy and breast-feeding Ask your doctor or pharmacist for advice before taking or using any medicine. Tell your doctor if you are pregnant, think you might be pregnant, or trying to become pregnant before using Zindaclin. Clindamycin can pass into breast milk, even if you only use it on your skin, so you should not breast feed while using Zindaclin. Important information about some of the ingredients of Zindaclin This product contains about 20% ethanol. Each gram contains about 0.2g of alcohol.

3. HOW TO USE ZINDACLIN Zindaclin must not be taken by mouth. It is for use on the skin only. Always use Zindaclin as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. • You should use Zindaclin once a day. Wash as normal, rinse well and pat your skin dry. Apply a small amount of gel in a thin layer to the whole of the area where you usually get the spots. • It is important to replace the cap after you have used Zindaclin. Do not • apply Zindaclin to areas where you do not usually get spots. • use Zindaclin in an attempt to stop you getting acne, it does not work that way. • just dab Zindaclin onto individual spots. • apply a thick layer of Zindaclin in any particular area as this will not get rid of the spots any quicker.

Take care to avoid your eyes, inside your nose or mouth when applying Zindaclin. If you accidentally put gel on these areas, wash them straight away with plenty of water. Successful treatment of acne can take several months. You may not see any effect of treatment for several weeks. After that you should note a gradual but definite improvement but maximum benefit may take several months. You may need to use more than one tube of Zindaclin during each course of treatment. Use Zindaclin for as long as your doctor tells you. Try not to pick or squeeze spots as this can make your acne worse and even lead to scarring. If you use more Zindaclin than you should You do not need to worry, just wash your treated skin with plenty of water. Contact your doctor or your local hospital if you are worried. If you forget to use Zindaclin Use it as soon as you remember and then continue to use as your doctor has told you. Do not apply a double dose to make up for a forgotten application. If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. POSSIBLE SIDE EFFECTS Like all medicines, Zindaclin can cause side effects, although not everybody gets them. Common (affecting fewer than 1 in 10 but more than 1 in 100) • Dry skin • Redness of the skin • Skin burning • Irritation around eyes • Worsening of acne • Itchy skin Uncommon (affecting fewer than 1 in 100 but more than 1 in 1,000) • Painful skin • Scaly rash You can relieve these unwanted effects by using an oil free moisturiser on the affected area. When clindamycin (the active ingredient in Zindaclin) is given by mouth or injection it has been known to cause inflammation of the bowel, leading to diarrhoea with blood and mucus. This reaction is extremely rare when clindamycin is applied on the skin. However, if you get diarrhoea with blood and mucus, stop using Zindaclin and contact your doctor. Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www. mhra. gov. uk/yellowcard By reporting side effects you can help provide more information on the safety of this medicine.

5. HOW TO STORE ZINDACLIN Keep out of the sight and reach of children. Zindaclin does not require any special storage conditions. Do not use Zindaclin after the expiry date which is stated on the tube and box after the abbreviation used for expiry date. The expiry date refers to the last day of that month. Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

6. FURTHER INFORMATION What Zindaclin contains The name of your medicine is Zindaclin 1% Gel. Zindaclin gel contains the active ingredient clindamycin phosphate. Each tube of gel contains 1.2% clindamycin phosphate equivalent to 1% clindamycin. Zindaclin also contains propylene glycol, purified water, ethanol, zinc acetate, hydroxyethylcellulose and sodium hydroxide. What Zindaclin looks like and contents of the pack Zindaclin is a white translucent gel. Zindaclin is available in 15g or 30g laminate tubes with a seal covering the opening and a screw cap. Marketing Authorisation Holder Crawford Healthcare Ltd, Kind Edward Court, King Edward Road, Knutsford, Cheshire, WA16 0BE, UK. Manufacturer Dr. August Wolff GmbH & Co. KG, Arzneimittel, Sudbrackstrasse 56, 33611, Bielefeld, Germany. Date of approval of this leaflet: July 2014

Source: Medicines and Healthcare Products Regulatory Agency

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



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Zyloprim - Fda Prescribing Information, Side Effects And Uses, Zalopram

Zyloprim

Zyloprim Description

Zyloprim (allopurinol) has the following structural formula:

Zyloprim is known chemically as 1,5-dihydro-4 H - pyrazolo [3,4- d ]pyrimidin-4-one. It is a xanthine oxidase inhibitor which is administered orally. Each scored white tablet contains 100 mg allopurinol and the inactive ingredients lactose, magnesium stearate, potato starch, and povidone. Each scored peach tablet contains 300 mg allopurinol and the inactive ingredients corn starch, FD&C Yellow No. 6 Lake, lactose, magnesium stearate, and povidone. Its solubility in water at 37°C is 80.0 mg/dL and is greater in an alkaline solution.

Zyloprim - Clinical Pharmacology

Zyloprim acts on purine catabolism, without disrupting the biosynthesis of purines. It reduces the production of uric acid by inhibiting the biochemical reactions immediately preceding its formation.

Zyloprim is a structural analogue of the natural purine base, hypoxanthine. It is an inhiboitor of xanthine oxidase, the enzyme responsible for the conversion of hypoxanthine to xanthine and of xanthine to uric acid, the end product of purine metabolism in man. Zyloprim is metabolized to the corresponding xanthine analogue, oxipurinol (alloxanthine), which also is an inhibitor of xanthine oxidase.

It has been shown that reutilization of both hypoxanthine and xanthine for nucleotide and nucleic acid synthesis is markedly enhanced when their oxidations are inhibited by Zyloprim and oxipurinol. This reutilization does not disrupt normal nucleic acid anabolism, however, because feedback inhibition is an integral part of purine biosynthesis. As a result of xanthine oxidase inhibition, the serum concentration of hypoxanthine plus xanthine in patients receiving Zyloprim for treatment of hyperuricemia is usually in the range of 0.3 to 0.4 mg/dL compared to a normal level of approximately 0.15 mg/dL. A maximum of 0.9 mg/dL of these oxypurines has been reported when the serum urate was lowered to less than 2 mg/dL by high doses of Zyloprim. These values are far below the saturation levels at which point their precipitation would be expected to occur (above 7 mg/dL).

The renal clearance of hypoxanthine and xanthine is at least 10 times greater than that of uric acid. The increased xanthine and hypoxanthine in the urine have not been accompanied by problems of nephrolithiasis. Xanthine crystalluria has been reported in only three patients. Two of the patients had Lesch-Nyhan syndrome, which is characterized by excessive uric acid production combined with a deficiency of the enzyme, hypoxanthineguanine phosphoribosyltransferase (HGPRTase). This enzyme is required for the conversion of hypoxanthine, xanthine, and guanine to their respective nucleotides. The third patient had lymphosarcoma and produced an extremely large amount of uric acid because of rapid cell lysis during chemotherapy.

Zyloprim is approximately 90% absorbed from the gastrointestinal tract. Peak plasma levels generally occur at 1.5 hours and 4.5 hours for Zyloprim and oxipurinol respectively, and after a single oral dose of 300 mg Zyloprim, maximum plasma levels of about 3 mcg/mL of Zyloprim and 6.5 mcg/mL of oxipurinol are produced.

Approximately 20% of the ingested Zyloprim is excreted in the feces. Because of its rapid oxidation to oxipurinol and a renal clearance rate approximately that of glomerular filtration rate, Zyloprim has a plasma half-life of about 1 to 2 hours. Oxipurinol, however, has a longer plasma half-life (approximately 15 hours) and therefore effective xanthine oxidase inhibition is maintained over a 24-hour period with single daily doses of Zyloprim. Whereas Zyloprim is cleared essentially by glomerular filtration, oxipurinol is reabsorbed in the kidney tubules in a manner similar to the reabsorption of uric acid.

The clearance of oxipurinol is increased by uricosuric drugs, and as a consequence, the addition of a uricosuric agent reduces to some degree the inhibition of xanthine oxidase by oxipurinol and increases to some degree the urinary excretion of uric acid. In practice, the net effect of such combined therapy may be useful in some patients in achieving minimum serum uric acid levels provided the total urinary uric acid load does not exceed the competence of the patient's renal function.

Hyperuricemia may be primary, as in gout, or secondary to diseases such as acute and chronic leukemia, polycythemia vera, multiple myeloma, and psoriasis. It may occur with the use of diuretic agents, during renal dialysis, in the presence of renal damage, during starvation or reducing diets, and in the treatment of neoplastic disease where rapid resolution of tissue masses may occur. Asymptomatic hyperuricemia is not an indication for treatment with Zyloprim (see INDICATIONS AND USAGE ).

Gout is a metabolic disorder which is characterized by hyperuricemia and resultant deposition of monosodium urate in the tissues, particularly the joints and kidneys. The etiology of this hyperuricemia is the overproduction of uric acid in relation to the patient's ability to excrete it. If progressive deposition of urates is to be arrested or reversed, it is necessary to reduce the serum uric acid level below the saturation point to suppress urate precipitation.

Administration of Zyloprim generally results in a fall in both serum and urinary uric acid within 2 to 3 days. The degree of this decrease can be manipulated almost at will since it is dose-dependent. A week or more of treatment with Zyloprim may be required before its full effects are manifested; likewise, uric acid may return to pretreatment levels slowly (usually after a period of 7 to 10 days following cessation of therapy). This reflects primarily the accumulation and slow clearance of oxipurinol. In some patients a dramatic fall in urinary uric acid excretion may not occur, particularly in those with severe tophaceous gout. It has been postulated that this may be due to the mobilization of urate from tissue deposits as the serum uric acid level begins to fall.

The action of Zyloprim differs from that of uricosuric agents, which lower the serum uric acid level by increasing urinary excretion of uric acid. Zyloprim reduces both the serum and urinary uric acid levels by inhibiting the formation of uric acid. The use of Zyloprim to block the formation of urates avoids the hazard of increased renal excretion of uric acid posed by uricosuric drugs.

Zyloprim can substantially reduce serum and urinary uric acid levels in previously refractory patients even in the presence of renal damage serious enough to render uricosuric drugs virtually ineffective. Salicylates may be given conjointly for their antirheumatic effect without compromising the action of Zyloprim. This is in contrast to the nullifying effect of salicylates on uricosuric drugs.

Zyloprim also inhibits the enzymatic oxidation of mercaptopurine, the sulfur-containing analogue of hypoxanthine, to 6-thiouric acid. This oxidation, which is catalyzed by xanthine oxidase, inactivates mercaptopurine. Hence, the inhibition of such oxidation by Zyloprim may result in as much as a 75% reduction in the therapeutic dose requirement of mercaptopurine when the two compounds are given together.

Indications and Usage for Zyloprim

THIS IS NOT AN INNOCUOUS DRUG. IT IS NOT RECOMMENDED FOR THE TREATMENT OF ASYMPTOMATIC HYPERURICEMIA.

Zyloprim reduces serum and urinary uric acid concentrations. Its use should be individualized for each patient and requires an understanding of its mode of action and pharmacokinetics (see CLINICAL PHARMACOLOGY. CONTRAINDICATIONS. WARNINGS. and PRECAUTIONS ).

Zyloprim is indicated in:

the management of patients with signs and symptoms of primary or secondary gout (acute attacks, tophi, joint destruction, uric acid lithiasis, and/or nephropathy).

the management of patients with leukemia, lymphoma and malignancies who are receiving cancer therapy which causes elevations of serum and urinary uric acid levels. Treatment with Zyloprim should be discontinued when the potential for overproduction of uric acid is no longer present.

the management of patients with recurrent calcium oxalate calculi whose daily uric acid excretion exceeds 800 mg/day in male patients and 750 mg/day in female patients. Therapy in such patients should be carefully assessed initially and reassessed periodically to determine in each case that treatment is beneficial and that the benefits outweigh the risks.

Contraindications

Patients who have developed a severe reaction to Zyloprim should not be restarted on the drug.

Warnings

Zyloprim SHOULD BE DISCONTINUED AT THE FIRST APPEARANCE OF SKIN RASH OR OTHER SIGNS WHICH MAY INDICATE AN ALLERGIC REACTION. In some instances a skin rash may be followed by more severe hypersensitivity reactions such as exfoliative, urticarial, and purpuric lesions, as well as Stevens-Johnson syndrome (erythema multiforme exudativum), and/or generalized vasculitis, irreversible hepatotoxicity, and, on rare occasions, death.

In patients receiving PURINETHOL ® (mercaptopurine) or IMURAN ® (azathioprine), the concomitant administration of 300 to 600 mg of Zyloprim per day will require a reduction in dose to approximately one-third to one-fourth of the usual dose of mercaptopurine or azathioprine. Subsequent adjustment of doses of mercaptopurine or azathioprine should be made on the basis of therapeutic response and the appearance of toxic effects (see CLINICAL PHARMACOLOGY ).

A few cases of reversible clinical hepatotoxicity have been noted in patients taking Zyloprim, and in some patients, asymptomatic rises in serum alkaline phosphatase or serum transaminase have been observed. If anorexia, weight loss, or pruritus develop in patients on Zyloprim, evaluation of liver function should be part of their diagnostic workup. In patients with pre-existing liver disease, periodic liver function tests are recommended during the early stages of therapy.

Due to the occasional occurrence of drowsiness, patients should be alerted to the need for due precaution when engaging in activities where alertness is mandatory.

The occurrence of hypersensitivity reactions to Zyloprim may be increased in patients with decreased renal function receiving thiazides and Zyloprim concurrently. For this reason, in this clinical setting, such combinations should be administered with caution and patients should be observed closely.

Precautions

General: An increase in acute attacks of gout has been reported during the early stages of administration of Zyloprim. even when normal or subnormal serum uric acid levels have been attained. Accordingly, maintenance doses of colchicine generally should be given prophylactically when Zyloprim is begun. In addition, it is recommended that the patient start with a low dose of Zyloprim (100 mg daily) and increase at weekly intervals by 100 mg until a serum uric acid level of 6 mg/dL or less is attained but without exceeding the maximum recommended dose (800 mg per day). The use of colchicine or anti-inflammatory agents may be required to suppress gouty attacks in some cases. The attacks usually become shorter and less severe after several months of therapy. The mobilization of urates from tissue deposits which cause fluctuations in the serum uric acid levels may be a possible explanation for these episodes. Even with adequate therapy with Zyloprim, it may require several months to deplete the uric acid pool sufficiently to achieve control of the acute attacks.

A fluid intake sufficient to yield a daily urinary output of at least 2 liters and the maintenance of a neutral or, preferably, slightly alkaline urine are desirable to (1) avoid the theoretical possibility of formation of xanthine calculi under the influence of therapy with Zyloprim and (2) help prevent renal precipitation of urates in patients receiving concomitant uricosuric agents.

Some patients with pre-existing renal disease or poor urate clearance have shown a rise in BUN during administration of Zyloprim. Although the mechanism responsible for this has not been established, patients with impaired renal function should be carefully observed during the early stages of administration of Zyloprim and the dosage decreased or the drug withdrawn if increased abnormalities in renal function appear and persist.

Renal failure in association with administration of Zyloprim has been observed among patients with hyperuricemia secondary to neoplastic diseases. Concurrent conditions such as multiple myeloma and congestive myocardial disease were present among those patients whose renal dysfunction increased after Zyloprim was begun. Renal failure is also frequently associated with gouty nephropathy and rarely with hypersensitivity reactions associated with Zyloprim. Albuminuria has been observed among patients who developed clinical gout following chronic glomerulonephritis and chronic pyelonephritis.

Patients with decreased renal function require lower doses of Zyloprim than those with normal renal function. Lower than recommended doses should be used to initiate therapy in any patients with decreased renal function and they should be observed closely during the early stages of administration of Zyloprim. In patients with severely impaired renal function or decreased urate clearance, the half-life of oxipurinol in the plasma is greatly prolonged. Therefore, a dose of 100 mg per day or 300 mg twice a week, or perhaps less, may be sufficient to maintain adequate xanthine oxidase inhibition to reduce serum urate levels.

Bone marrow depression has been reported in patients receiving Zyloprim, most of whom received concomitant drugs with the potential for causing this reaction. This has occurred as early as 6 weeks to as long as 6 years after the initiation of therapy of Zyloprim. Rarely, a patient may develop varying degrees of bone marrow depression, affecting one or more cell lines, while receiving Zyloprim alone.

Information for Patients: Patients should be informed of the following:

(1) They should be cautioned to discontinue Zyloprim and to consult their physician immediately at the first sign of a skin rash, painful urination, blood in the urine, irritation of the eyes, or swelling of the lips or mouth. (2) They should be reminded to continue drug therapy prescribed for gouty attacks since optimal benefit of Zyloprim may be delayed for 2 to 6 weeks. (3) They should be encouraged to increase fluid intake during therapy to prevent renal stones. (4) If a single dose of Zyloprim is occasionally forgotten, there is no need to double the dose at the next scheduled time. (5) There may be certain risks associated with the concomitant use of Zyloprim and dicumarol, sulfinpyrazone, mercaptopurine, azathioprine, ampicillin, amoxicillin, and thiazide diuretics, and they should follow the instructions of their physician. (6) Due to the occasional occurrence of drowsiness, patients should take precautions when engaging in activities where alertness is mandatory. (7) Patients may wish to take Zyloprim after meals to minimize gastric irritation.

Laboratory Tests: The correct dosage and schedule for maintaining the serum uric acid within the normal range is best determined by using the serum uric acid as an index.

In patients with pre-existing liver disease, periodic liver function tests are recommended during the early stages of therapy (see WARNINGS ).

Zyloprim and its primary active metabolite, oxipurinol, are eliminated by the kidneys; therefore, changes in renal function have a profound effect on dosage. In patients with decreased renal function or who have concurrent illnesses which can affect renal function such as hypertension and diabetes mellitus, periodic laboratory parameters of renal function, particularly BUN and serum creatinine or creatinine clearance, should be performed and the patient's dosage of Zyloprim reassessed.

The prothrombin time should be reassessed periodically in the patients receiving dicumarol who are given Zyloprim.

Drug Interactions: In patients receiving PURINETHOL (mercaptopurine) or IMURAN (azathioprine), the concomitant administration of 300 to 600 mg of Zyloprim per day will require a reduction in dose to approximately one third to one fourth of the usual dose of mercaptopurine or azathioprine. Subsequent adjustment of doses of mercaptopurine or azathioprine should be made on the basis of therapeutic response and the appearance of toxic effects (see CLINICAL PHARMACOLOGY ).

It has been reported that Zyloprim prolongs the half-life of the anticoagulant, dicumarol. The clinical basis of this drug interaction has not been established but should be noted when Zyloprim is given to patients already on dicumarol therapy.

Since the excretion of oxipurinol is similar to that of urate, uricosuric agents, which increase the excretion of urate, are also likely to increase the excretion of oxipurinol and thus lower the degree of inhibition of xanthine oxidase. The concomitant administration of uricosuric agents and Zyloprim has been associated with a decrease in the excretion of oxypurines (hypoxanthine and xanthine) and an increase in urinary uric acid excretion compared with that observed with Zyloprim alone. Although clinical evidence to date has not demonstrated renal precipitation of oxypurines in patients either on Zyloprim alone or in combination with uricosuric agents, the possibility should be kept in mind.

The reports that the concomitant use of Zyloprim and thiazide diuretics may contribute to the enhancement of allopurinol toxicity in some patients have been reviewed in an attempt to establish a cause-and-effect relationship and a mechanism of causation. Review of these case reports indicates that the patients were mainly receiving thiazide diuretics for hypertension and that tests to rule out decreased renal function secondary to hypertensive nephropathy were not often performed. In those patients in whom renal insufficiency was documented, however, the recommendation to lower the dose of Zyloprim was not followed. Although a causal mechanism and a cause-and-effect relationship have not been established, current evidence suggests that renal function should be monitored in patients on thiazide diuretics and Zyloprim even in the absence of renal failure, and dosage levels should be even more conservatively adjusted in those patients on such combined therapy if diminished renal function is detected.

An increase in the frequency of skin rash has been reported among patients receiving ampicillin or amoxicillin concurrently with Zyloprim compared to patients who are not receiving both drugs. The cause of the reported association has not been established.

Enhanced bone marrow suppression by cyclophosphamide and other cytotoxic agents has been reported among patients with neoplastic disease, except leukemia, in the presence of Zyloprim. However, in a well-controlled study of patients with lymphoma on combination therapy, Zyloprim did not increase the marrow toxicity of patients treated with cyclophosphamide, doxorubicin, bleomycin, procarbazine, and/or mechlorethamine.

Tolbutamide's conversion to inactive metabolites has been shown to be catalyzed by xanthine oxidase from rat liver. The clinical significance, if any, of these observations is unknown.

Chlorpropamide's plasma half-life may be prolonged by Zyloprim, since Zyloprim and chlorpropamide may compete for excretion in the renal tubule. The risk of hypoglycemia secondary to this mechanism may be increased if Zyloprim and chlorpropamide are given concomitantly in the presence of renal insufficiency.

Rare reports indicate that cyclosporine levels may be increased during concomitant treatment with Zyloprim. Monitoring of cyclosporine levels and possible adjustment of cyclosporine dosage should be considered when these drugs are co-administered.

Drug/Laboratory Test Interactions: Zyloprim is not known to alter the accuracy of laboratory tests.

Pregnancy

Teratogenic Effects: Pregnancy Category C. Reproductive studies have been performed in rats and rabbits at doses up to twenty times the usual human dose (5 mg/kg per day), and it was concluded that there was no impaired fertility or harm to the fetus due to allopurinol. There is a published report of a study in pregnant mice given 50 or 100 mg/kg allopurinol intraperitoneally on gestation days 10 or 13. There were increased numbers of dead fetuses in dams given 100 mg/kg allopurinol but not in those given 50 mg/kg. There were increased numbers of external malformations in fetuses at both doses of allopurinol on gestation day 10 and increased numbers of skeletal malformations in fetuses at both doses on gestation day 13. It cannot be determined whether this represented a fetal effect or an effect secondary to maternal toxicity. There are, however, no adequate or well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Experience with Zyloprim during human pregnancy has been limited partly because women of reproductive age rarely require treatment with Zyloprim. There are two unpublished reports and one published paper of women giving birth to normal offspring after receiving Zyloprim during pregnancy.

Nursing Mothers: Allopurinol and oxipurinol have been found in the milk of a mother who was receiving Zyloprim. Since the effect of allopurinol on the nursing infant is unknown, caution should be exercised when Zyloprim is administered to a nursing woman.

Pediatric Use: Zyloprim is rarely indicated for use in children with the exception of those with hyperuricemia secondary to malignancy or to certain rare inborn errors of purine metabolism (see INDICATIONS AND USAGE and DOSAGE AND ADMINISTRATION ).

Adverse Reactions

Data upon which the following estimates of incidence of adverse reactions are made are derived from experiences reported in the literature, unpublished clinical trials and voluntary reports since marketing of Zyloprim (allopurinol) began. Past experience suggested that the most frequent event following the initiation of allopurinol treatment was an increase in acute attacks of gout (average 6% in early studies). An analysis of current usage suggests that the incidence of acute gouty attacks has diminished to less than 1%. The explanation for this decrease has not been determined but may be due in part to initiating therapy more gradually (see PRECAUTIONS and DOSAGE AND ADMINISTRATION ).

The most frequent adverse reaction to Zyloprim is skin rash. Skin reactions can be severe and sometimes fatal. Therefore, treatment with Zyloprim should be discontinued immediately if a rash develops (see WARNINGS ). Some patients with the most severe reaction also had fever, chills, arthralgias, cholestatic jaundice, eosinophilia and mild leukocytosis or leukopenia. Among 55 patients with gout treated with Zyloprim for 3 to 34 months (average greater than 1 year) and followed prospectively, Rundles observed that 3% of patients developed a type of drug reaction which was predominantly a pruritic maculopapular skin eruption, sometimes scaly or exfoliative. However, with current usage, skin reactions have been observed less frequently than 1%. The explanation for this decrease is not obvious. The incidence of skin rash may be increased in the presence of renal insufficiency. The frequency of skin rash among patients receiving ampicillin or amoxicillin concurrently with Zyloprim has been reported to be increased (see PRECAUTIONS ).

Most Common Reactions* Probably Causally Related:

Gastrointestinal: Diarrhea, nausea, alkaline phosphatase increase, SGOT/SGPT increase. Metabolic and Nutritional: Acute attacks of gout. Skin and Appendages: Rash, maculopapular rash. *Early clinical studies and incidence rates from early clinical experience with Zyloprim suggested that these adverse reactions were found to occur at a rate of greater than 1%. The most frequent event observed was acute attacks of gout following the initiation of therapy. Analyses of current usage suggest that the incidence of these adverse reactions is now less than 1%. The explanation for this decrease has not been determined, but it may be due to following recommended usage (see ADVERSE REACTIONS introduction, INDICATIONS AND USAGE. PRECAUTIONS. and DOSAGE AND ADMINISTRATION ).

Incidence Less Than 1% Probably Causally Related:

Body As a Whole: Ecchymosis, fever, headache. Cardiovascular: Necrotizing angiitis, vasculitis. Gastrointestinal: Hepatic necrosis, granulomatous hepatitis, hepatomegaly, hyperbilirubinemia, cholestatic jaundice, vomiting, intermittent abdominal pain, gastritis, dyspepsia. Hemic and Lymphatic: Thrombocytopenia, eosinophilia, leukocytosis, leukopenia. Musculoskeletal: Myopathy, arthralgias. Nervous: Peripheral neuropathy, neuritis, paresthesia, somnolence. Respiratory: Epistaxis. Skin and Appendages: Erythema multiforme exudativum (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), hypersensitivity vasculitis, purpura, vesicular bullous dermatitis, exfoliative dermatitis, eczematoid dermatitis, pruritus, urticaria, alopecia, onycholysis, lichen planus. Special Senses: Taste loss/perversion. Urogenital: Renal failure, uremia (see PRECAUTIONS ).

Incidence Less Than 1% Causal Relationship Unknown:

Body As a Whole: Malaise. Cardiovascular: Pericarditis, peripheral vascular disease, thrombophlebitis, bradycardia, vasodilation. Endocrine: Infertility (male), hypercalcemia, gynecomastia (male). Gastrointestinal: Hemorrhagic pancreatitis, gastrointestinal bleeding, stomatitis, salivary gland swelling, hyperlipidemia, tongue edema, anorexia. Hemic and Lymphatic: Aplastic anemia, agranulocytosis, eosinophilic fibrohistiocytic lesion of bone marrow, pancytopenia, prothrombin decrease, anemia, hemolytic anemia, reticulocytosis, lymphadenopathy, lymphocytosis. Musculoskeletal: Myalgia. Nervous: Optic neuritis, confusion, dizziness, vertigo, foot drop, decrease in libido, depression, amnesia, tinnitus, asthenia, insomnia. Respiratory: Bronchospasm, asthma, pharyngitis, rhinitis. Skin and Appendages: Furunculosis, facial edema, sweating, skin edema. Special Senses: Cataracts, macular retinitis, iritis, conjunctivitis, amblyopia. Urogenital: Nephritis, impotence, primary hematuria, albuminuria.

Overdosage

Massive overdosing or acute poisoning by Zyloprim has not been reported.

In mice, the 50% lethal dose (LD 50 ) is 160 mg/kg given intraperitoneally (IP) with deaths delayed up to 5 days and 700 mg/kg orally (PO) (approximately 140 times the usual human dose) with deaths delayed up to 3 days. In rats, the acute LD 50 is 750 mg/kg IP and 6000 mg/kg PO (approximately 1200 times the human dose).

In the management of overdosage there is no specific antidote for Zyloprim. There has been no clinical experience in the management of a patient who has taken massive amounts of Zyloprim.

Both Zyloprim and oxipurinol are dialyzable; however, the usefulness of hemodialysis or peritoneal dialysis in the management of an overdose of Zyloprim is unknown.

Zyloprim Dosage and Administration

The dosage of Zyloprim to accomplish full control of gout and to lower serum uric acid to normal or near-normal levels varies with the severity of the disease. The average is 200 to 300 mg/day for patients with mild gout and 400 to 600 mg/day for those with moderately severe tophaceous gout. The appropriate dosage may be administered in divided doses or as a single equivalent dose with the 300-mg tablet. Dosage requirements in excess of 300 mg should be administered in divided doses. The minimal effective dosage is 100 to 200 mg daily and the maximal recommended dosage is 800 mg daily. To reduce the possibility of flare-up of acute gouty attacks, it is recommended that the patient start with a low dose of Zyloprim (100 mg daily) and increase at weekly intervals by 100 mg until a serum uric acid level of 6 mg/dL or less is attained but without exceeding the maximal recommended dosage.

Normal serum urate levels are usually achieved in 1 to 3 weeks. The upper limit of normal is about 7 mg/dL for men and postmenopausal women and 6 mg/dL for premenopausal women. Too much reliance should not be placed on a single serum uric acid determination since, for technical reasons, estimation of uric acid may be difficult. By selecting the appropriate dosage and, in certain patients, using uricosuric agents concurrently, it is possible to reduce serum uric acid to normal or, if desired, to as low as 2 to 3 mg/dL and keep it there indefinitely.

While adjusting the dosage of Zyloprim in patients who are being treated with colchicine and/or anti-inflammatory agents, it is wise to continue the latter therapy until serum uric acid has been normalized and there has been freedom from acute gouty attacks for several months.

In transferring a patient from a uricosuric agent to Zyloprim, the dose of the uricosuric agent should be gradually reduced over a period of several weeks and the dose of Zyloprim gradually increased to the required dose needed to maintain a normal serum uric acid level.

It should also be noted that Zyloprim is generally better tolerated if taken following meals. A fluid intake sufficient to yield a daily urinary output of at least 2 liters and the maintenance of a neutral or, preferably, slightly alkaline urine are desirable.

Since Zyloprim and its metabolites are primarily eliminated only by the kidney, accumulation of the drug can occur in renal failure, and the dose of Zyloprim should consequently be reduced. With a creatinine clearance of 10 to 20 mL/min, a daily dosage of 200 mg of Zyloprim is suitable. When the creatinine clearance is less than 10 mL/min, the daily dosage should not exceed 100 mg. With extreme renal impairment (creatinine clearance less than 3 mL/min) the interval between doses may also need to be lengthened.

The correct size and frequency of dosage for maintaining the serum uric acid just within the normal range is best determined by using the serum uric acid level as an index.

For the prevention of uric acid nephropathy during the vigorous therapy of neoplastic disease, treatment with 600 to 800 mg daily for 2 or 3 days is advisable together with a high fluid intake. Otherwise similar considerations to the above recommendations for treating patients with gout govern the regulation of dosage for maintenance purposes in secondary hyperuricemia.

The dose of Zyloprim recommended for management of recurrent calcium oxalate stones in hyperuricosuric patients is 200 to 300 mg/day in divided doses or as the single equivalent. This dose may be adjusted up or down depending upon the resultant control of the hyperuricosuria based upon subsequent 24 hour urinary urate determinations. Clinical experience suggests that patients with recurrent calcium oxalate stones may also benefit from dietary changes such as the reduction of animal protein, sodium, refined sugars, oxalate-rich foods, and excessive calcium intake, as well as an increase in oral fluids and dietary fiber.

Children, 6 to 10 years of age, with secondary hyperuricemia associated with malignancies may be given 300 mg Zyloprim daily while those under 6 years are generally given 150 mg daily. The response is evaluated after approximately 48 hours of therapy and a dosage adjustment is made if necessary.

How is Zyloprim Supplied

100-mg (white) scored, flat cylindrical tablets imprinted with “Zyloprim 100” on a raised hexagon, bottles of 100 (NDC 65483-991-10).

Store at 15° to 25°C (59° to 77°F) in a dry place.

300-mg (peach) scored, flat, cylindrical tablets imprinted with “Zyloprim 300” on a raised hexagon, bottles of 100 (NDC 65483-993-10) and 500 (NDC 65483-993-50).

Store at 15° to 25°C (59° to 77°F) in a dry place and protect from light.

PROMETHEUS LABORATORIES INC. Manufactured by DSM Pharmaceuticals, Inc. Greenville, NC 27834 for Prometheus Laboratories Inc. San Diego, CA 92121

October 2003 ZY004B03

mg 100 Tablets Bottle

100 Tablets NDC 65483-991-10

Each scored tablet contains

PROMETHEUS LABORATORIES INC.

Manufactured by DSM Pharmaceuticals, Inc. Greenville, NC 27834

For Prometheus Laboratories Inc. San Diego, CA 92121

October 2003 650392

mg 100 Tablets Bottle

100 Tablets NDC 65483-993-10

Each scored tablet contains

PROMETHEUS LABORATORIES INC.

Manufactured by DSM Pharmaceuticals, Inc. Greenville, NC 27834

For Prometheus Laboratories Inc. San Diego, CA 92121

October 2003 650390



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