Drug Facts

Emphasis on appearance and body structure is the common factor in all the world cultures. Location, religion, culture, and language become irrelevant when it comes to achieving the ideal body structure. People try various things-diet control, exercises, yoga, and weight loss supplements in their quest for a fabulous body.

Weight loss supplements have become very popular over the last decade. Although their effectiveness is questioned by several medical professionals, they seemed to have helped several people lose weight. Several weight loss supplements claim to provide results overnight. Such claims may be dubious, but there is no denying the fact that these supplements are here to stay.

Of the various weight loss supplements, the most popular are supplements containing chitosan, chromium, citrus aurantium, conjugated linoleic acid, and plantago psyllium.

Chitosan, derived from lobster’s shell, works by binding the fat. There are very few side effects of chitosan, such as constipation and allergies. Chromium helps weight loss by increasing the lean mass and decreasing the body fat. Citrus aurantium is a herbal extract. Although there is no study reporting the usefulness of this for weight loss, several people swear by it. Conjugated linoleic acid, a chief constituent of beef and dairy also increases lean mass. Plantago psyllium is a water soluble fiber obtained from Plantago Ovato seeds. This primarily works as a appetite suppressant, it gives you a sense of fullness when taken prior to a meal.

There are several safety hazards of taking weight loss supplements which are approved by FDA. Many of these supplements may not only be ineffective, they may cause serious side effects. The most common side effects are constipation, effect on the blood pressure and heart, and allergies. It is advisable to take a medical opinion before weight loss supplements are used. Supplements not supported by research studies should be summarily avoided.

It is important to realize that over prolonged use, weight loss supplements may cause severe patho-physiological consequences. It makes more sense to look for ways to lead a healthy lifestyle by incorporating a healthy diet and some sort of an exercise regimen.

Type of Drug:

Fertility drug.

How the Choriogonaootropin Alfa Works:

Choriogonadotropin alfa contains some of the same proteins that are in the naturally occurring hormones human chorionic gonadotropin (HCG), follicle stimulating hormone (FSH), and aluminizing hormone (LH).

Uses of Choriogonaootropin Alfa:

For use in women in assisted reproductive technology (ART) programs.

Choriogonadotropin alfa is given when monitoring indicates that the follicles have developed adequately. Choriogonadotropin alfa induces ovulation.

To bring about ovulation and pregnancy in infertile patients with irregular cycles.

Precautions:

Ovarian enlargement/hyperstimulation: Choriogonadotropin alfa may cause ovarian enlargement or ovarian hyperstimulation syndrome (OHSS). OHSS can develop rapidly (within 24 hours to several days) and can become a serious medical event. Contact your doctor immediately if you experience severe pelvic pain, nausea, vomiting, and weight gain.

Multiple births: Choriogonadotropin alfa treatment has been associated with multiple births. Consult your doctor.

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 choriogonadotropin alfa appears in breast milk. Do not breastfeed while taking this medicine.

Children: Safety and effectiveness in children have not been established. Lab tests will be required to monitor 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 choriogonadotropin alfa. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed.

Side Effects of the Choriogonaootropin Alfa:

Every drug is capable of producing side effects. Many choriogonadotropin alfa 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; nausea; vomiting.

Other: Injection site pain; bruising; post-operative pain.

Guidelines for Use:

• This medicine is injected subcutaneous (SC; under the skin). Use exactly as prescribed.
• Follow the injecting procedure taught to you by your health care provider.
• Visually inspect the solution. Do not use if discolored or contains particles.
• Overstimulation of the ovary may OCCur (ovarian hyper stimulation syndrome; OHSS). Contact your doctor immediately if you experience severe pelvic pain, nausea, vomiting, Or weight gain.
• Use immediately after reconstitution. Discard unused solution.
• Lab tests will be required to monitor therapy. Be sure to keep appointments.
• Store vials at controlled room temperature (68° to 77°F) or refrigerate (36° to 46°F). Protect from fight.

Type of Drug:

Endothelin receptor antagonist; pulmonary artery vasodilator.

How the Bosentan Works:

Endothelin-1 is a hormone that attaches to the blood vessels in the lung and causes them to constrict (narrow). This constriction causes blood pressure in the lungs to increase (pulmonary artery hypertension). Bosentan interferes with the attachment of endothelin-1 and results in a lowering of the elevated blood pressure in the lungs.

Uses of the Bosentan:

For the treatment of pulmonary arterial hypertension in patients with WHO Class III or IV symptoms, to improve exercise ability and decrease the rate of clinical worsening.

Precautions:

Pregnancy: Do not use during pregnancy. The risk of use in a pregnant woman clearly outweighs any possible benefit. Effective contraception must be used in women of child-bearing potential.

Breastfeeding: It is not known if bosentan appears 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 during treatment. Tests include liver enzymes, urine or serum pregnancy tests, or hemoglobin level tests.

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 this drug. Drug doses may need to be modified or a different drug prescribed. The following drugs and drug classes interact with this drug:

• Cyclosporine A (eg, Neoral)
• Glyburide (eg, Micronase)
• HMG-CoA reductase inhibitors (eg, lovastatin)
• Hormonal contraceptives (eg, Ortho-Novum)
• Ketoconazole (eg, Nizoral)
• Warfarin (eg,)

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: nasal and throat inflammation; flushing; abnormal liver function; swelling; low blood pressure; itching; headache; fatigue; indigestion; anemia; pounding in the chest (palpitations).

Guidelines for Use:

• Read the medication guide provided before starting therapy.
• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• May be taken with or without food. 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 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.
• Stop taking and notify your doctor immediately if you experience fever, persistent stomach pain, nausea, vomiting, yellowing of the skin or eyes, or unusual lethargy or fatigue.
• Contraceptive measures (birth control) are recommended during treatment to prevent pregnancy. Taking this medicine while pregnant can result in severe birth defects. Contact your doctor immediately if pregnancy is suspected.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store at room temperature (59° to 86°F).

Type of Drug:

Typical (conventional) antipsychotics.

How the Drug Works:

The mechanism of action is not well defined, but thought to be related to central dopamine receptor antagonist activity.

Uses:

Haloperidol is used in the management of manifestations of serious psychotic disorders, including schizophrenia.

Pimozide and haloperidol may be used to suppress motor and phonic tics in patients with Turreted disorder who have failed to respond to standard treatment.

Unlabeled Uses: Bipolar disorder; management of patients with demetiarelated psychotic symptoms.

Tardive dyskinesia: Involuntary and uncontrollable movements may develop in patients treated with antipsychotic drugs. Occurrence is highest in the elderly, especially women. However, it is impossible to predict which patients are likely to develop the syndrome. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short­term treatment at low doses. The syndrome is character rhythmcal, involuntary movements of tongue, face, mouth, of jaw (eg,protrusion of tongue, puffing of Cheeks, plucking of mouth chewing movement sometimes accompanied by involuntary movements of the arms and ages. Fine worm-like movement of the tongue may be an early sign of the syndrome. If the medication is stopped at this time, the syndrome may not develop further. There is no known treatment for established cases of tardive dyskinesia, although the syndrome may stop, partially or completely, if the drug is withdrawn. Anti psychotic treatment, however, may suppress or partially suppress the signs and symptoms of the syndrome and thereby may possibly mask the underlying disease process. The effect that symptomatic suppression has upon the long-term course of the syndrome is unknown.

Neuroleptic Malignant Syndrome (NMS) Is a potentially fatal syndrome associated with antipsychotic drugs. Symptoms include fever, muscle rigidity, altered mental abilities, irregular pulse and blood pressure, increased heart rate, sweating, and irregular heart rhythm.

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

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

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

Elderly: A lower starting dose is recommended for elderly patients.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over the-counter or prescription medications or dietary supplements with these drugs. 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 these drugs:

• Alcohol amphetamines (eg, dextroamphetamine) (pimozide only)
• Antiarrhythmic agents (eg, quinidine) (pimozide only)
• Azole antifungals (eg, fluconazole) (pimozide only)
• Blood pressure-lowering medicines (eg, clonidine)
• Carbamazepine (eg, Tegretol)
• Clozapine (eg, Clozaril)
• Dopamine (eg, Intropin)
• Fluoxetine (eg, Prozac)
• Levodopa (eg, Larodopa)
• Macrolide antibiotics (eg, clarithromycin) (pimozide only)
• Methylphenidate (eg, Ritalin) (pimozide only)
• Nefazodone (Serzone) (pimozide only)

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: Constipation; dry mouth; diarrhea; nausea; indigestion; vomiting; stomach pain; decreased or increased saliva; toothache; appetite changes.

Nervous System: Tremor; restlessness; headache; dizziness; sleepless­ness; agitation; anxiety; drowsiness; aggressive reaction; increased sleep duration; increased dream activity; nervousness; depression; excitement.

Respiratory System: Upper respiratory infection; sinus irritation; congested or runny nose; coughing; sore throat; difficulty breathing.

Urinary and Reproductive Tract: Frequent urination; heavy menstrual bleeding; difficulty with orgasm; vaginal dryness; difficulty with erection; decreased sexual desire; impotence; lactation; breast enlargement.

Skin: Rash; dry skin; excessively oily skin; dark spots on the skin; sensitivity to sunlight; hair loss.

Other: Fast heartbeat; back, chest, or joint pain; muscle stiffness or rigidity; difficult or abnormal movement; clumsiness; difficulty walking; involuntary muscle contractions; fatigue; dizziness or light-headedness upon rising or standing; visual changes; weight gain; fever; sweating.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• Can be taken with or without food. Take with food if stomach upset occurs. Avoid grapefruit juice while taking pimozide.
• Generally, low starting doses are used and then the dose is increased to achieve the best effects.
• Contact your doctor immediately if you experience skin rash, sexual days function, difficulty breathing, involuntary muscle movements, muscle rigidity, fever, irregular or fast heartbeat, or profuse sweating.
• May cause dizziness, light-headedness, or fainting when rising or standing, particularly during initial use. Get up slowly and avoid sudden changes in posture.
• May cause drowsiness. Use caution while driving or performing other tasks requiring alertness, coordination, and physical dexterity.
• Avoid alcohol while you are taking this medicine.
• May cause sensitivity to sunlight. Avoid prolonged exposure to the sun or other forms of ultraviolet (UV) light (eg, tanning beds). Use sunscreens and wear protective clothing.
• Consult your doctor or pharmacist before taking prescription or OTC drugs or dietary supplements with phenylbutylpiperadine derivatives.
• Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or are breastfeeding.
• Store tablets at controlled room temperature (59 to 86°F) in a tightly closed container and protect from light. Store oral solution at controlled room temperature (59 to 86°F) and protect from light. Do not freeze.

Type of Drug:

Combination oral antidiabetic agent used in the treatment of type 2 diabetes mellitus (previously referred to as non-insulin-dependent diabetes mellitus [NIDDM]).

How the Drug Works:

Glyburide stimulates the release of insulin from the pancreas acutely and lowers glucose chronically by unknown mechanisms. Metformin reduces the amount of sugar produced by the liver and the amount absorbedby the intestines and enhances insulin sensitivity.

Uses:

Used as initial therapy, along with diet and exercise, to treat type 2 diabetes. Also used as second-line therapy when diet, exercise, and initial treatment with a sulfonylurea or metformin used alone is not sufficient.

Precautions:

Latic acidosis: Lactic acidosis is a rare but serious side effect that can occur when taking this medication, particularly if kidney function is impaired. Stop taking this medicine and contact your doctor immediately if you experience general body discomfort, muscle pain, difficulty breathing, drowsiness, stomach pain, chills, dizziness, lightheadedness, or slow heartbeat.

Diet and exercise: Diet and exercise are the primary managements of type diabetes. Glyburide/metformin is used with, not as a substitute for, diet nd exercise.

Heart problems: This medicine may increase the risk of heart problems compared to treatment with, diet alone or diet plus Insulin.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Pregnant women with diabetes should be treated with insulin. Glyburide/metformin is not recommended for control of blood sugar levels in pregnant women.

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

Children: Safety and effectiveness in children have not been established.

Elderly: Elderly and debilitated patients are more likely to develop hypoglycemia (low blood sugar levels). Use with caution.

Lab Tests: Lab tests will be required to monitor therapy. Tests include blood glucose, glycosylated hemoglobin (HbA )’ and kidney function tests.

Side Effects:

Every drug is capable of producing side effects. Many glyburide/metformin 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: Chills; drowsiness; light-headedness; headache; dizziness; shakiness.

Digestive Tract: Diarrhea; nausea; vomiting; stomach pain.

Other: Upper respiratory infection; difficulty breathing; muscle pain; rash; changes in taste perception; low blood pressure; sweating; hunger.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Take with meals.
• Follow the diet and exercise program exactly as prescribed by your doctor.
• 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 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.
• Contact your doctor immediately if you experience difficulty breathing, muscle pain, general body discomfort, drowsiness, dizziness, light­headedness, slow heartbeat, stomach pain, or chills.
• Nausea, vomiting, and diarrhea generally stop with continued use. If they continue, contact your doctor immediately.
• Avoid drinking alcohol while undergoing therapy with glyburide/ metformin.
• The effectiveness of this medicine may decrease over time. If you feel that it is losing its effectiveness, contact your doctor.
• Lab tests will be required to monitor therapy. Be sure to keep appointments .
• Store below 77°F. Protect from light.

Type of Drug:

Calcium channel blockers (eg, slow channel blockers, calcium ion antagonists); drugs that inhibit the movement of calcium across the cell membrane of cardiac muscle and vascular smooth muscle.

How the Drug Works:

Calcium is involved in blood vessel and heart muscle contraction, nerve impulse transmission and energy storage, and energy use in the heart. Calcium channel blocking agents dilate arteries of the heart and other arteries, may increase or decrease heart rate, may decrease heart con­traction, slow ability of the heart to contract, and slow the rate at which nerve impulses are conducted through the heart.

Uses:

To treat angina due to coronary artery spasm (Prinzmetal angina) (amlodipine, nifedipine, nifedipine sustained-release, verapamil).

To treat chronic stable (stress-associated) angina in patients who cannot tolerate or are unresponsive to beta-adrenergic blockers or nitrates (amlodipine, bepridil, diltiazem, nicardipine, nifedipine, nifedipine sustained-release, verapamil only).

To treat unstable angina (verapamil only).

To treat arrhythmias (irregular heartbeats) at rest and during stress in association with digitalis (verapamil only).

To treat high blood pressure (amlodipine, diltiazem sustained-release, felodipine, isradipine, nicardipine, nifedipine sustained-release, nisoldipine, verapamil only).

To improve neurological deficiencies caused by spasms following subarachnoid hemorrhage (SAH) (ruptured vessels in the brain). Therapy must begin within 96 hours and continue for 21 days (nimodipine only).

Unlabeled Uses: Occasionally doctors may prescribe diltiazem to treat unstable angina, Raynaud syndrome, and tardive dyskinesia, and to prevent certain types of heart attack.

Isradipine may be useful in the treatment of chronic stable angina. Nicardipine may be useful in the treatment of congestive heart failure and in combination with aminocaproic acid for SAH.

Occasionally doctors may prescribe nifedipine to lower blood pressure in hypertensive emergencies; to prevent or treat migraine head­aches; and to treat primary pulmonary (lung) and pregnancy-associated hypertension, asthma, preterm labor, disorders of the esophagus, certain types of heart disorders, coronary artery disease, congestive heart failure, Raynaud syndrome, biliary and renal colic, and cardiomyopathy.

Nimodipine appears to be beneficial in some patients with common and classic migraine and chronic cluster headache.

Occasionally doctors may prescribe verapamil to prevent migraine headache, cluster headache, and exercise-induced asthma; to treat manic-depressive states, night leg cramps, and hypertrophic cardiomyopathy. Verapamil has also been used for paroxysmal supraventricular tachycardia.

Precautions:

New serious arrhythmias: Bepridil has been associated with the occurrence of new serious arrhythmias. Use should be limited to patients in whom other antianginal drugs have failed.

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

Breastfeeding: Bepridil, diltiazem, nifedipine, and verapamil appear in breast milk. It is not known if amlodipine, felodipine, isradipine, nicardipine, nimodipine, or nisoldipine appear in breast milk. Decide whether to discontinue nursing or the drug, taking into account the importance of the drug to the mother. Consult your doctor.

Children: Safety and effectiveness have not been eastablished in children.

Elderly: Felodipine , nifedipine, and verapamil may result in greater lowering of blooding pressure than younger patients.

Lab Tests: Lab tests may be required periodically during treatment. Tests may include electrocardiograms, serum potassium levels, liver and kidney function tests, blood pressure, and blood and platelet counts.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over the-counter or prescription medications or dietary supplements with calcium channel blocking agents. 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 calcium channel blocking agents:

• Alcohol (verapamil only)
• Anesthetics antiarrhythmics (eg, flecainide) (verapamil only)
• Antihistamines, nonsedating (eg, loratadine) (bepridil only)
• Antihypertensives (eg, diuretics) (verapamil only)
• Azole antifungals (eg, ketoconazole, itraconazole) (felodipine, nisoldipine only)
• Barbiturates (eg, phenobarbital) (felodipine, nifedipine only)
• Benzodiapines (eg, midazolam) (diltiazem only)
• Beta-blockers (eg, propranolol) calcium salts (verapamil only)
• Carbamazepine (eg, Tegretol) (diltiazem, felodipine, verapamil only)
• Cardiac glycosides (eg, digoxin) (bepridil only)
• Cimetidine (eg, Tagamet)
• Cyclosporine (eg, Neoral) (diltiazem, nicardipine, verapamil only)
• Digoxin (eg, Lanoxin)
• Diltiazem (eg, Cardizem) (nifedipine only)
• Encainide (Enkaid) (diltiazem only)
• Erythromycin (eg, E-Mycin) (felodipine only)
• Fentanyl (eg, Duragesic)
• Grapefruit juice (felodipine, nifedipine, nisoldipine only)
• HMG-CoA reductase inhibitors (eg, lovastatin) (diltiazem, verapamil only)
• Lithium (eg, Eskalith) (verapamil only)
• Euromuscular blockers (eg, atracurium) (verapamil only)
• Nifedipine (eg, Procardia) (diltiazem only)
• Nondepolarizing muscle relaxants (eg, pancuronium) (verapamil only)
• Phenytoin (eg, Dilantin) (felodipine, nisoldipine only)
• Prazosin (eg, Minipress) (verapamil only)
• Primidone (eg, Mysoline) (nifedipine only)
• Procainamide (eg, pronesty) (bepridil only)
• Quinidine (eg, Quinora) (bepridil, nisoldipine, verapamil only)
• Rifampin (eg, Rifadin) (diltiazem, isradipine, nifedipine, verapamil only)
• Tacrolimus (Prograf) (diltiazem only)
• Theophyllines (eg, aminophylline)(diltiazem, verapamil only)
• Tricyclic antidepressants (eg, amitriptyline)(bepridil only)

Side Effects:

Every drug is capable of producing side effects. Many calcium channels blocking 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:

Nervous System: Headache; dizziness; giddiness (felodipine only); light­headedness; fainting; weakness; fatigue; nervousness; anxiety; tremor; general body discomfort; impaired movement; excessive movement (nicardipine only); confusion; irritability; drowsiness; sleep disturbances; difficulty sleeping; abnormal dreams; psychiatric disturbances (eg, depression, amnesia, paranoia, psychosis).

Digestive Tract: Nausea; vomiting; diarrhea; constipation; gas; stomach pain or cramps; indigestion; changes in taste perception; dry mouth; swollen gums (felodipine only); appetite changes (bepridil only).

Respiratory System: Congestion; runny nose; sinus infection; cough; short­ness of breath; wheezing; sore throat; sneezing; bronchitis; fluid retention in lungs.

Circulatory System: Fluid retention; low blood pressure; high blood pressure; anemia; pounding in the chest; chest pain; decreased heart rate; increased heart rate; abnormal heart rhythm; abnormal electrocardiogram readings; myocardial infarction; AV block; congestive heart failure.

Skin: Rash; skin irritation; flushing; sweating; acne (nimodipine only); itching; hives; abnormal skin sensations (eg, burning, prickling, tingling); hair loss.

Other: Fever; chills; flulike symptoms; muscle cramps or pain; joint stiff­ness or pain; back pain (felodipine only); weight loss; weight gain; nose­bleed; ringing in ears; pain; blurred vision; difficult urination; painful urination; frequent urination; sexual difficulties; infection (nicardipine only).

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not change the dose or stop taking this medicine unless advised to do so by your doctor. Abrupt withdrawal may result in increased angina attacks.
• All of the products listed are calcium channel blockers; however, they are not interchangeable. For example, diltiazem cannot be used for nimodipine.
• Extended- or sustained-release - Swallow whole; do not chew, crush, or divide. An empty tablet may appear in stool; this is no cause for concern.
• Amlodipine, felodipine, isradipine, nicardipine - May be taken with or without food. Do not take felodipine with grapefruit juice.
• Verapamil- Verapamil extended-release is usually taken at bedtime with or without food. Take verapamil sustained-release with food in the morning. If heart failure is not severe or rate-related, use digitalis and diuretics before verapamil.

• Oiltiazem sustained-release - The usual dose is taken in the morning on an empty stomach.
• Bepridil- If stomach upset occurs, take with meals or at bedtime. Notify any doctor who treats that you are taking bepridil, as well as any other medications you may be taking. Bepridil use has been associated with the occurrence of new arrhythmias. Use should be limited to patients in whom other anti anginal drugs have failed.
• Nimodipine - Take preferably less than 1 hour before or 2 hours after meals. Therapy to improve neurological deficiencies caused by spasms following SAH must begin within 96 hours and continue for 21 days. If capsule cannot be swallowed (eg, time of surgery, unconsciousness), a hole can be made in both ends of the capsule with an 18 gauge needle, and the contents extracted into a syringe for oral administration.
• Nisoldipine - Do not take with grapefruit juice or with high-fat meals.
• Adalat CC - Take once daily on an empty stomach.
• Felodipine - May cause swollen or bleeding gums. Good dental hygiene decreases incidence and severity of this condition.
• Calcium channel blockers may interfere with normal blood-clotting mechanisms. Contact your doctor if unusual bleeding or bruising of the skin occurs.
• Low blood pressure may occur, but is usually well tolerated. It is more likely to occur in patients who are also taking beta-blockers (eg, propranolol).
• Beta-blockers should be tapered slowly rather than stopped abruptly before starting nicardipine or nifedipine therapy. When starting nicardipine therapy, taper beta-blockers over 8 to 10 days with coadministration.
• Maintain use of potassium supplementation or potassium-sparing diuretics.
• 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 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.
• Notify your doctor if you experience irregular heartbeat, increased frequency or severity of angina, shortness of breath, swelling of hands and feet, dizziness, constipation, nausea, or low blood pressure (eg, light­headedness).
• Notify your doctor if you experience symptoms of an allergic reaction (eg, itching, rash, hives, difficulty breathing).
• Inform your doctor if you are pregnant, become pregnant, plan on becoming pregnant, or are breastfeeding.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store at controlled room temperature (59 to 77 F) in a tightly sealed container. Keep away from light and moisture. Protect nimodipine from freezing.