Type of Drug:

Narcotic analgesics (pain relievers)

How the Drug Works:

Narcotic pain relievers relieve pain by dulling the pain perception center of the brain, They may also affect other systems in the body at higher doses, Natural narcotics include opium, codeine, and morphine, Other narcotics are synthetic (opioids) and vary in potency, addictive ability, and side effects,

Uses:

For relief of mild-to-moderate pain and for coughing induced by viral, bacterial, chemical, or mechanical irritation of the respiratory system (codeine only),

For the management of chronic pain in patients requiring continuous opioid analgesia for pain that cannot be managed by lesser means such as acetaminophen-opioid combinations, nonsteroidal analgesics, or PRN (as-needed) dosing with short-acting opioids (fentanyl only),

For the management of breakthrough cancer pain in patients with malignancies who are already receiving and are tolerant to opioid therapy for their underlying persistent cancer pain (fentanyl lozenge only),

For relief of moderate-to-severe pain (hydromorphone, meperidine, methadone, morphine, oxycodone, and oxymorphone only),

For the management of opiate dependence (levomethadyl acetate only), For the management of moderate-to-severe pain or as a preoperative medication where an opioid analgesic is appropriate (levorphanol only),

For relief of severe pain, and for detoxification and temporary maintenance treatment of narcotic addiction (methadone only),

For relief of moderate-to-severe acute and chronic pain; for the management of pain not responsive to nonnarcotic analgesics; dyspnea (short­ness of breath) associated with acute left ventricle failure and pulmonary edema; used preoperatively for patient sedation; to decrease apprehension; effective in the control of postoperative pain (morphine only),

For relief of pain in patients who require copied analgesics for more than a few days (morphine sustained-release only).

For relief of mild-to-moderate pain (propoxyphene only).

Unlabeled Uses: Occasionally doctors may prescribe inject able morphine for difficult breathing associated with acute left ventricular failure and pulmonary edema.

Precautions:

Do not use in the following situations:

Drug dependence: Narcotic pain relievers have high abuse potential.

Dependence and physical tolerance may develop upon repeated use. However, most patients who receive these agents for medical reasons and do not take more than prescribed do not develop dependence.

Tolerance: Some patients may develop tolerance to narcotic pain relievers. This may develop after days or months of continuous therapy. Consult your doctor if tolerance is suspected.

Withdrawal syndrome: Severity is related to the degree of dependence, the abruptness of withdrawal and the drug used. Generally, withdrawal symptoms begin to develop at the time the next dose would ordinarily be given. For heroin and morphine, symptoms gradually increase in intensity, reach a maximum in 36 to 72 hours and subside over 5 to 10 days. In contrast, methadone withdrawal is slower in onset and the patient may not recover for 6 to 7 weeks. Meperidine withdrawal often runs its course within 4 to 5 days. Hydrocodone withdrawal symptoms peak at 48 to 72 hours. Withdrawal precipitated by narcotic antagonists (antidotes) is manifested by onset of symptoms within minutes and maximum intensity within 30 minutes. Symptoms of withdrawal include:

Early - Yawning; tearing; runny nose; restless sleep; sweating.

Intermediate - Flushing; increased heart rate; twitching; tremor; restlessness; anxiety; irritability; goosebumps; appetite loss; dilated pupils.

Late - Muscle spasm; fever; nausea; diarrhea; vomiting; spontaneous orgasm; severe backache; stomach and leg pains; stomach and muscle cramps; hot and cold flashes; sleeplessness; intestinal spasm; repetitive sneezing; excessively runny nose; increased body temperature, blood pressure, respiratory rate and heart rate; chills; bone and muscle pain.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Regular narcotic use late in pregnancy may cause with drawl reactions in newborns. Use only if clearly needed and the potential benefits outweigh the possible risks to the fetus.

Breastfeeding: Many of these narcotics appear in breast milk, but the effect on the infant may not be significant. Consult your doctor before you begin or continue breastfeeding if narcotic if narcotic therapy is required.

Children: Safety and effectiveness of fentanyl transmucosal in children younger than 16 years of age are not established. Safety and effectiveness of codeine in children younger than 3 years of age have not been established. Do not administer fentanyl trans dermal systems to children younger than 12 years of age or patients less than 18 years of age who weigh less than 50 kg except in an authorized investigational research setting. Use of levomethadyl or levorphanol is not recommended in those less than 18 years of age. Safety and effectiveness of oxymorphone in children younger than 18 years of age have not been established. Methadone is not recommended as an analgesic in children; documented clinical experience is insufficient to establish suitable dos­age regimens. Safety of propoxyphene, morphine, opium, oxycodone, and hydromorphone are not established in children.

Elderly: Appropriately reduce the initial dose in elderly and debilitated patients. Consider the effect of the initial dose in determining supplemental doses. Use caution because opioids have the ability to depress breathing.

Sulfites: Some of these products may contain sulfite preservatives which can cause allergic reactions in certain individuals (eg, asthmatics). Check package label when available or consult your doctor or pharmacist.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements with narcotic pain relievers. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with narcotic pain

• Aganist/antagonist analgesics alcohol amitriptyline (eg, Elavil)
• Anticoagulants (eg, warfarin)
• Antihistamines (eg, diphenhydramine)
• Barbiturate anesthetics (eg, thiopental)
• Carbamazepine (eg, Tegretol)
• Charcoal chloral hydrate (eg, Aquachloral)
• Chlorpromazine (eg, Thorazine)
• Clomipramine (eg, Anafranil)
• Desipramine (eg, Norpramin)
• Diazepam (eg, Valium)

Side Effects:

Every drug is capable of producing side effects. Many narcotic analgesic users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Most Serious: Respiratory depression; skeletal muscle rigidity; difficulty breathing; slow heartbeat.

Most Frequent: Lightheadedness; dizziness; sedation; nausea; vomiting; sweating.

Digestive Tract: Nausea; vomiting; diarrhea; stomach cramps or pain; taste alterations; dry mouth; appetite loss; constipation; biliary tract spasm; ileus (obstruction of the bowels); paralytic ileus; toxic megacolon in patients with inflammatory bowel disease; gas; indigestion; difficulty swallowing.

Nervous System: Exaggerated sense of well being; restless mood; delirium; sleeplessness; agitation; anxiety; hallucinations; disorientation; drowsiness; sedation; lethargy; mental and physical impairment; uncoordinated movements; coma; mood changes; weakness; headache; mental cloudiness; blurred vision; double vision; pupil constriction; tremor; convulsions; psychic dependence; toxic psychoses; depression; increased intracranial pressure; headache; abnormal skin sensations; confusion; abnormal dreams; continual rapid eye movement; muscle twitching; amnesia; paranoid reaction; drug withdrawal; suicide attempt; decreased mobility; difficulty moving; excessive movement; speech disorder; abnormal gait; abnormal skin sensations; stupor; apathy.

Circulatory System: Flushing; faintness; peripheral circulatory collapse; change in heart rate; abnormal heart rhythm; heart pounding in the chest; chest wall rigidity; change in blood pressure; dizziness or light­headedness when rising from a seated or lying position; fainting; cardiac arrest; shock.

Urinary and Reproductive Tract: Urinary retention or hesitancy; infrequent urination; antidiuretic effect; reduced libido; difficult urination; impotence; difficult ejaculation; urinary incontinence.

Other: Depression of cough reflex; chills; asthma exacerbation; vision changes; itching; rash; hives; muscle weakness; sweating; runny nose; tearing; yawning; joint pain; general body discomfort; flu syndrome; hot flashes; hiccups; coughing up blood; sore throat; back pain; runny nose; reversible jaundice, including cholestatic jaundice (propoxyphene).

Guidelines for Use:

• Dosage is individualized.
• Do not change the dose or stop taking unless advised to do so by your doctor.
• May cause drowsiness, dizziness, or blurred vision. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
• May cause dizziness or lightheadedness when rising from a seated or lying position.
• Avoid alcohol and drowsiness-causing drugs while taking a narcotic pain reliever.
• May cause nausea, vomiting, or constipation. Notify your doctor if these occur and become a problem.
• Long-term use may lead to addiction. Early signs include drug ineffectiveness. Dependence is not an issue in terminal illness where patient comfort is more important.
• If stomach upset occurs, take with food.
• May cause constipation (long-term use). Stool softeners or fiber laxatives may be required if use is prolonged.
• These drugs work best if taken on a routine basis. Narcotics are more effective in preventing pain than in treating pain after it occurs.
• Give the drug ample time to work before determining if more is needed (at least 30 minutes to 1 hour for oral agents).
• If a dose is missed, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• Sometimes these drugs are given in combination with other non narcotic pain relievers such as aspirin or acetaminophen (eg, Tylenol). Make sure your doctor knows if you have had problems taking aspirin or acetaminophen in the past.
• Notify your doctor if shortness of breath or difficulty breathing occurs.
• Do not crush or chew controlled- or sustained-release medications.
• Fentanyl transdermal system - Keep both used and unused systems out of the reach of children. Used systems should be flushed down the toilet immediately upon removal. If the application site needs to be cleansed before application, the area should be washed with clear water and allowed to dry. Do not use soaps, alcohol, or other products to cleanse skin. Do not cut the patch. Remove the old patch before applying a new one. Avoid exposing the application site to a direct external heart source, such as an electric blanket.
• Fentanyl transmucosal system - This product is extremely toxic to children. Carefully follow the storage, administration, and disposal techniques included in the patient package insert and instructional video. Remove from the foil pouch just before use.
• The one should be sucked. Do not chew. Store in foil pouch at room temperature (59 0 to 86°F). Do not freeze.

Type of Drug:

Anti-asthma drug.

How the Drug Works:

Zileuton inhibits the formation of certain chemicals (leukotrienes) that are responsible for causing some forms of asthma. Montelukast and zafirlukast block the action of certain chemicals (leukotrienes) that are responsible for causing some forms of asthma.

These drugs are useful for controlling or preventing some forms of asthma but do not help during an acute asthma attack.

Uses:

For the prevention and chronic treatment of asthma in adult and children 2 years of age and older (montelukast), 7 years of age and older (zafirlukast), and 12 years of age and older (zileuton).

Precautions:

Phenylketonuria: Montelukast chewable tablets contain phenylalanine. Consult your doctor or pharmacist.

Pregnancy: There are no adequate and well controlled studies in pregnant women. Use only if clearly needed and potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: Zafirlukast appears in breast milk. Do not breastfeed while taking zafirlukast. It is not known if zileuton or montelukast appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness for use in children younger than 12 years of age (zileuton), younger than 5 years of age (zafirlukast), and younger than 2 years of age (montelukast) are not established.

Elderly: Patients older than 65 years of age are more likely to experience infections while taking zafirlukast. These infections are usually mild to moderate and mostly affect the respiratory tract.

Lab Tests: Lab tests may be required to monitor therapy. Tests may include breathing tests. Liver enzymes will be monitored with zileuton therapy.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over­the-counter or prescription medications or dietary supplements while taking a leukotriene receptor antagonist or formation inhibitor. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes may interact with leukotriene receptor antagonists or formation inhibitors:

• Aspirin (zafirlukast only)
• Calcium channel blockers (eg, nifidipine) (zafirlukast and zileuton only)
• Cyclosporine (eg, Sandimmune) (zafirlukast and zileuton only)
• Erythromycin (eg, E-Mycin) (zafirlukast only)
• Propranolol (eg, Inderal) (zileuton only)
• Theophylline (eg, Thea-Our) (zafirlukast and zileuton only)
• Warfarin (eg, Caumadin) (zafirlukast and zileuton only)

Side Effects:

Every drug is capable of producing side effects. Many equestrienne receptor antagonist or formation inhibitor users experience no, or minor, side effects. The frequency or severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Nervous System: Headache; weakness; dizziness; sleeplessness; nervousness; drowsiness; fatigue.

Digestive Tract: Nausea; vomiting; diarrhea; stomach pain; indigestion; gas; constipation.

Other: Infection; accidental injury; generalized pain; muscle, chest, joint, leg, or back pain; fever; eye inflammation; stiffness; swollen lymph nodes; general body discomfort; neck pain; itching; urinary tract infection; inflammation of the vagina; flu; cough; nasal congestion; dental pain; rash; laryngitis; sore throat; ear pain or inflammation; sinus inflammation; viral infection; thirst; sneezing; hives; pus in the urine.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• These medicines are used for long-term control or prevention of asthma and should be taken regularly as prescribed, even during symptom­free periods. They should also be continued during acute exacerbations of asthma.
• Do not decrease the dose or stop taking any other asthma medications unless instructed by your doctor.
• Take affiliate 2 times a day on an empty stomach, at least 1 hour before or 2 hours after meals.
• Take zileuton 4 times a day with meals and at bedtime.
• Take montelukast once a day in the evening without regard to meals. Take with food if stomach upset occurs.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless advised by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• May cause dizziness. Use caution when driving or performing other tasks requiring alertness, coordination or physical dexterity.
• These medicines are not broncobusters and should not be used as “rescue medicines” to treat acute episodes of asthma.
• Do not breastfeed while taking zafirlukast.
• Contact your doctor if you need your short acting broncobusters (”rescue medicines”) more often than usual.
• Contact your doctor if you are taking zileuton and experience right upper quadrant pain, nausea, tiredness, unconsciousness, itchiness, yellowing of the skin or the whites of the eyes, “flu-like” symptoms, or unusually dark urine.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store at controlled room temperature (68° to 77°F). Protect from light and moisture.

Type of Drug:

Skeletal muscle relaxant.

How the Baclofen Product Works:

Baclofen reduces the frequency and severity of muscle spasms that occur as a result of neurological disorders such as multiple sclerosis.

Uses of The Baclofen:

Tablets: To relieve the spasticity, pain, and rigidity from muscle spasms due to multiple sclerosis. May help with spinal cord injuries and other spinal cord diseases.

Injection: To manage severe spasticity of spinal cord origin in patients who do not respond to or have side effects from the tablets.

Unlabeled Uses: Occasionally doctors may prescribe oral baclofen for trigeminal neuralgia (tic douloureux), tardive dyskinesia in combination with neuroleptics, and intractable hiccoughs; the injection form may reduce spasticity in cerebral palsy in children.

Precautions:

Abrupt withdrawal: Hallucinations and seizures have occurred when treatment with baclofen has been stopped suddenly. Except in cases of serious side effects, the dose must be reduced slowly when the drug is discontinued.

Epilepsy: Increased frequency of seizures has occurred in epileptic patients taking baclofen. Frequent physical exams and neurological tests may be required.

Ovarian cysts: Ovarian cysts are sometimes found in women who have taken baclofen for up to one year. The cysts often disappom rlosplto continued treatment.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and potential benefits outweigh the possible risks to the fetus.

Breastfeeding: Oral baclofen appears in breast milk. It is not known if injectable baclofen appears in breast milk. Consult your doctor before you begin breastfeeding.

Baclofen: Safety and effectiveness in children younger than 12 years of age (oral) and in children younger than 4 years of age (injection) have not been established.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over- the-counter or prescription medications or dietary supplements while taking this medicine. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with this medicine.

• Alcohol
• Morphine
• Narcotic pain relievers (eg, percodan)
• Sleep aids (eg, flurazepam)
• Tricyclic antidepressants (eg, amitriptyline)

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; constipation; vomiting.

Nervous System: Drowsiness; dizziness; lightheadedness; weakness; tiredness; headache; seizures; sleeplessness; numbness; tingling; slurred speech.

Skin: Rash; itching; excessive sweating.

Other: Visual disturbances; ankle swelling (edema); weak muscles; weight gain; nasal congestion; difficulty breathing; frequent urination; low blood pressure.

Guidelines for Use:

• Use exactly as prescribed.
• If a dose is missed, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose in order to “catch up” (unless advised to do so by your doctor). If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• May cause drowsiness, dizziness and tiredness. Use caution when driving or performing other tasks requiring alertness. Avoid alcohol and other drugs that cause drowsiness during use of baclofen.
• Sudden discontinuation of baclofen can result in hallucinations. Discontinue only under doctor’s supervision.
• Notify your doctor if frequent urges to urinate, painful urination, constipation, nausea, headache, insomnia, confusion, palpitations or chest pain Occurs and persists.
• Injections - Not for IV, IM, subcutaneous, or epidermal use. Visually inspect solutions for particles or discoloration.
• Store at room temperature. Do not freeze. Do not heat or sterilize solution.

Somatropin & Somatropin:

Type of Drug:

Growth hormone.

How the Somatropin Drug Works:

Mimics actions of naturally occuring growth hormone; stimulates growth of bone, tissues, blood cells and internal organs.

Uses of The Somatropin:

Growth failure associated with chronic kidney insufficiency until time of transplantation (Nutropin, Nutropin AO).

Growth failure (except Serostim).

Turner syndrome (Nutropin only).

AIDS wasting or cachexia (Serostim only). Somatotropin deficiency syndrome (Humatrope only).

Unlnbeled Uses: OCCAsionally doctors may prescribe growth hormones for short children due to growth retardation

Pregnancy:

Seriatim, Genotropin - Studies in pregnant women or in animals have been judged not to show a risk to the fetus. However, no drug should be used during pregnancy unless clearly needed.

Nutropin, Nutropin AQ, Humatrope, Norditropin - Adequate studies have not been done in pregnant women; animal studies may have shown a risk to the fetus. Use only if clearly needed and potential benefits out­weigh the possible hazards to the fetus.

Breastfeeding: It is not known if somatropin appears in breast milk. Consult your doctor before you begin breastfeeding.

Children:

Serostim - Safety and effectiveness in children with AIDS have not been established.

Benzyl alcohol - Benzyl alcohol as a preservative in bacteriostatic Water for Injection, USP has been associated with toxicity in newborns. When administering somatropin to newborns, reconstitute with sterile Water for Injection.

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy and individual susceptibility. Possible side effects include: High blood pressure; headache; high sugar in blood; antibody development; muscle pain; weakness; glucose in urine; swelling; swelling in arms and legs; breast growth; joint pain; nausea; stomach pain; vomiting; injection site reactions; leukemia.

Nutropin - Eye pain; visual changes; injection site pain; carpal tunnel syndrome; wrist pain.

Genotropin - Loss of skin fat; blood in urine.

Humatrope - Abnormal skin sensation; pain; runny nose; back pain; acne; joint disorder; flu syndrome; increased cough; decreased sensitivity to touch; respiratory disorder; sore throat.

Serostim - Musculoskeletal discomfort; fever; swelling of hands or feet; diarrhea; nerve disease; increased sweating; appetite loss; fast heartbeat; tiredness; abnormal blood counts; protein in urine; lymph node swelling; sleeplessness; carpal tunnel syndrome.

Guidelines for Use:

• Take as directed by your doctor. The daily dose varies depending on individual needs. Do not adjust the dose without consulting you pharmacist of doctor
• Follow injection procedure taught to you by your healthcare provider. Follow instructions on patient information insert. Rotate injection sites.
• Report these symptoms to the doctor: Limping; hip or knee pain; headache; weakness; muscle pain; swelling; injection site reactions.
• If local or systemic allergic reactions occur, contact your doctor.
• Lab tests and examinations will include: Blood sugar; eye exams; thyroid function tests; antibody testing; nutritional tests (Serostim only). Keep appointments.
• Storage: Serostim: Store unopened vials at room temperature (59° to 86°F) and reconstituted solution under refrigeration for no longer than 24 hours. Genotropin, Humatrope, Nutropin: Store unopened vials/cartridges under refrigeration (36 0 to 46°F); store reconstituted solutions under refrigeration (36° to 46°F) for up to 14 days except 1.5 mg cartridge of Genotropin which must be used within 24 hours. Nutropin AQ: Store under refrigeration (36° to 46 Q F). Must be used within once opened.
• Do not use if cloudy.

Vitamin combinations

Uses:

Dietary supplement

Guidelines for Use:

• Dosage will be individualized.
• Do not exceed the recommended dose, unless advised to do so by your doctor.
• Most people on regular diets do not need vitamin supplements.
• Capsules - Take with meals. Store in a cool, dry place.
• Drops - Administer directly into mouth using dropper, or mix with formula, fruit
  juice, cereal, or other food. Store at room temperature. Protect from light.
• Emulsion - Shake well before using. Store at room temperature.
• Keep out of the reach of children.

Doses:

Blood clot dissolvers

How the Drug Works:

Thrombolytic agents dissolve blood clots and restore blood circulation to affected body tissue.

Uses:

To dissolve blood clots, including those blocking coronary arteries in acute heart attacks.

Precautions:

Alteplase: To help manage acute ischemic strokes in adults to reduce the chances of disability, or to reduce the incidence of congestive heart failure (CHF) and death due to heart attack.

Streptokinase: To dissolve large blood clots in legs.

Unlabeled Uses: Occasionally doctors may prescribe alteplase for the treatment of unstable angina pectoris (chest pain).

Abnormal heartbeats: Use of thrombolytic agents to dissolve clots in coronary arteries (acute heart attack) may result in abnormal heartbeat. Heart rate will need to be monitored during and following therapy.

Pregnancy: Safety for use during pregnancy has not been established.

Use only if clearly needed and the potential benefits to the mother out­weigh the possible hazards to the fetus.

Breastfeeding: It is not known if thrombolytic agents appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness have not been established.

Lab Tests: Lab tests will be required to monitor therapy. Tests may include platelet counts, thrombin time (TT), activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen levels, hematocrit counts, as well as the monitoring of blood pressure, heart rate and rhythm, and other vital signs (eg, respirations, temperature).

Drug Interactions:

Tell your doctor or pharmacist if you are taking or will be taking any over­the-counter or prescription medications or dietary supplements while taking a thrombolytic agent. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with thrombolytic agents:

• Anticoagulants (eg, warfarin)
• Aspirin antiplatelet agents heparin (eg, Hep-Lock)
• Ndomethacin (eg, Indocin)

Side Effects:

Every drug is capable of producing side effects. Many thrombolytic agent users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Bleeding: Bleeding at puncture and incision sites; bleeding from rectum, stomach, lungs, gums, mouth, nose, or urinary tract.

Digestive Tract: Nausea; vomiting.

Circulatory System: Internal bleeding; irregular heartbeat; changes in blood pressure.

Skin: Rash; unusual bruising.

Other: Fever; chills; difficult or fast breathing; back pain.

Guidelines for Use:

• This medicine will be prepared and administered intravenously (into a vein) by your health care provider in a medical setting.
• Dosage is individualized.
• Effectiveness depends on how quickly the drug is given.
• Bleeding is a common side effect of thrombolytic agent therapy.
• Notify your doctor immediately if you experience fever, shivering, chills, rash, hives, swelling, or difficult or rapid breathing.

Dipyridamole Information - Drug Interactions

Type of Drug:

Antiplatelet agent.

How the Dipyridamole Products Works:

Platelets are components of the blood that aid in clot formation. Blood clots often form on platelets that have clumped together. Dipyridamole helps prevent blood clots from forming by preventing platelets from clumping together.

Uses of dipyridamole Products :

Given in combination with oral anticoagulants (eg, warfarin) to prevent blood clot formation after heart valve surgery.

Unlabeled Uses: Occasionally doctors may prescribe derivable with aspirin to prevent heart attacks and reduce heart attack damage.

Precautions:

Do not use in the following situations: Allergy to the drug or any of its ingredients.

Use with caution in the following situations: coronary artery disease, severe liver disease low blood pressure

Hypo tension (low blood pressure): Dipyridamole may aggravate light-headedness in people with low blood pressure. Use caution when rising from a sitting or lying position.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits out­weigh the possible risks to the fetus.

Breastfeeding: Dipyridamole appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness have not been established in children younger than 12 years of age.

Lab tests may be required to monitor therapy. Tests include liver function monitoring.

Side Effects of Pipyridamole

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Stomach ache; diarrhea; vomiting.

Other: Dizziness; light-headedness; fainting; headache; rash; flushing; itching; abnormal liver tests.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• Take without regard to food, but take with food is stomach upset occurs.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• If using this medicine in combination with oral anticoagulants (eg, warfarin), do not take aspirin, unless instructed by your doctor.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store at room temperature (59° to 86°F).

Follitropin Beta - Some Interactions which Occur

Type of Drug:

Gonadotropin; hormone that stimulates the ovaries; fertility drug.

How the Follitropin Beta Works:

Follitropin beta stimulates the ovaries to produce eggs.

Uses of The Follitropin Beta:

For the induction of ovulation and pregnancy in women whose ovaries still work but cannot form eggs (ovulate) and as a result, are not fertile (unable to become pregnant).

To stimulate the development of multiple follicles in ovulatory patients undergoing Assisted Reproductive Therapy (ART) (eg, in vitro fertilization).

Precautions:

Multiple births: Reports of multiple births have been associated with follitropin beta treatment. Discuss this with your doctor before starting therapy.

Ovarian Hyperstimulation Syndrome (OHSS): Mild to moderate ovarian enlargement, with or without bloating or stomach pain, may occur and generally goes away within 2 or 3 weeks after discontinuing this medicine. All patients who experience bloating or stomach pain should be examined for ovarian enlargement. If significant ovarian enlargement occurs after ovulation, do not engage in sexual intercourse.

Respiratory complications: Serious respiratory conditions (eg, difficulty breathing, worsening of asthma) and blood clotting have been reported.

Pregnancy: Do not use during pregnancy. The risk of use in a pregnant woman clearly outweighs any possible benefit.

Breastfeeding: It is not known if follitropin beta appears in breast milk. Consult your doctor before you begin breastfeeding.

Lab Tests: Lab tests will be required during treatment. Tests may include blood hormone levels, ultrasound, and body temperature measurement.

Side Effects of the Follitropin Beta:

Every drug is capable of producing side effects. Many factors beta users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Stomach pain; bloating; nausea; vomiting; diarrhea.

Urinary and Reproductive Tract: Miscarriage; ovarian hyper stimulation; octopi pregnancy; ovarian cyst; pelvic pain; breast tenderness; heavy or irregular vaginal bleeding; infrequent urination.

Skin: Dry skin; rash; hair loss; hives.

Other: Rapid heart beat; fast or difficult breathing; headache; dizziness; muscle or joint pain; aches; body discomfort; fever; chills; flu-like symptoms; injection site pain; weight gain.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Visually inspect the solution for discoloration or particles. Use immediately after reconstitution (mixing). Discard any unused portion.
• Carefully follow the preparation and administration technique taught to you by your health care provider.
• For subcutaneous (beneath the skin) or intra muscular (into a muscle) injection only.
• Treatment with this drug requires close monitoring for over stimulation of the ovary. Contact your doctor immediately if you experience difficulty breathing, severe pelvic pain, nausea, vomiting, weight gain, stomach pain or bloating, diarrhea, or infrequent urination.
• The couple should have intercourse daily, beginning on the day prior to human chorionic gonadotropin (HCG) administration, until ovulation occurs. Take care to ensure insemination. However, intercourse should be prohibited in patients in whom significant ovarian enlargement occurs after ovulation.
• Multiple pregnancy is possible and poses potential hazards.
• Other causes of infertility will be excluded before this medicine is used.
• Monitor for signs of pregnancy before and during treatment. If pregnancy is suspected, contact your doctor.
• Lab tests will be required to monitor treatment. Be sure to keep appointments.
• Store in refrigerator or at room temperature (36° to 77°F). Protect from light.