Drug Facts

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Type of Drug:

Agent for treating acute gout attacks and preventing or delaying a recurrence of symptoms.

How the Colchicine Product Works:

Gout is a hereditary form of arthritis characterized by increased blood levels of uric acid. Colchicine decreases the inflammatory response to uric acid crystals that occurs in gout. However, it does not lower uric acid levels and thus does not treat the underlying cause of gout. Colchicine relieves pain but it is not an analgesic. Its suppressive effect helps reduce the incidence of gout attacks.

Uses of The Colchicine:

Colchicine:

To relieve pain of acute gout attacks. Works most effectively if administered early in the attack.

To prevent or delay acute attacks of gout (prophylaxis).

Probenecid and colchicine combination:

For the treatment of chronic gouty arthritis when complicated by frequent, recurrent acute attacks of gout.

Unlabeled Uses: Occasionally doctors may prescribe colchicine for treatment of certain types of cirrhosis, familial Mediterranean fever, primary amyloidosis, Behcet’s disease, pseudogout, skin manifestations of scleroderma, refractory idiopathic thrombocytopenic purpura, and chronic progressive multiple sclerosis.

Precautions:

• Pregnancy: Colchicine can cause fetal harm when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking it, notify the woman of the potential hazared to the fetus.
• Breastfeeding: It is not known if colchicine appears in breast milk. Consult your doctor before you begin breastfeeding.
• Children: Safety and effectiveness for use in children have not been established. Do not use the probenecid and colchicine combination in children younger than 2 years of age.
• Elderly: Administer colchicine with great caution to elderly and debilitated patients, especially those with kidney, digestive tract, or heart disease. Reduce dosage if weakness, appetite loss, nausea, vomiting, or diarrhea appears.
• Lab Tests: Lab tests may be required during treatment with colchicine. Tests may include blood counts and uric acid levels.

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 colchicine or the probenecid and colchicine combination. 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 colchicine.

Side Effects:

Every drug is capable of producing side effects. Many colchicine 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:

Colchicine: Vomiting; nausea; diarrhea; stomach pain; muscle weakness; hair loss; sore throat; unusual bleeding or bruising; tingling in hands or feet; abnormal blood counts; bone marrow depression; rash; agranulocytosis; decreased blood platelets; red or purple spots under the skin; a plastic anemia.

Probenecid and colchicine combination: Headache; dizziness; hepatic necrosis; vomiting; nausea; appetite loss; sore gums; nephrotic syndrome; uric acid stones with or without blood in the urine; renal colic; rib and vertebra pain; frequent urination; precipitation of acute gouty arthritis; allergic reaction; fever; rash; hives; itching; aplastic anemia; decreased white blood counts; hemolytic anemia; anemia; skin inflammation; hair loss; flushing; diarrhea; stomach pain; muscle weakness; sore throat; unusual bleeding or bruising; tingling in hands or feet; agranulocytosis; red or purple spots under the skin; abnormal blood counts; bone marrow depression.

Type of Drug:

Antidepressant; mood-elevating agent.

How the Drug Works:

Citalopram blocks the uptake of a chemical found in the brain (serotonin) which increases the activity of this chemical, resulting in improved mood.

Uses:

To treat depression.

Pregnancy: Adequate studies have not been done in pregnant women. Use only if clearly needed and potential benefits outweigh the possible hazards to the fetus.

Breastfeeding: Citalopram appears in breast milk. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the risks to the infant of citalopram exposure (eg, excessive drowsiness, decreased feeding, weight loss) and the importance of the drug to the mother. Consult your doctor before you begin breastfeeding.

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

Elderly: Older individuals may be more sensitive to the effects of citalopram than younger individuals. The recommended dose for most elderly patients is 20 mg/day with titration to 40 mg/day only for nonresponding patients.

Drug Interactions:

Tell your doctor if you are taking or are planning to take any over-the­counter or prescription medications while taking citalopram. 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 citalopram: alcohol

• Carbamazepine (eg, Tegretol)
• Cimetidine (eg, Tagamet)
• CNS drugs (eg, antidepressants)
• Imipramine (eg, Tofranil)
• Lithium (eg, Lithobid)

Side Effects:

Every drug is capable of producing side effects. Many citalopram 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: Nausea; dry mouth; vomiting; diarrhea; indigestion; stomach pain; gas; increased salivation; appetite changes.

Nervous System: Dizziness; sleeplessness; drowsiness; agitation; tremor; fatigue; weakness; anxiety; impaired concentration; amnesia; apathy; worsening of depression; suicide attempt; confusion; headache.

Circulatory System: Decreased heart rate; fast heartbeat; postural (standing) low blood pressure; low blood pressure.

Respiratory System: Upper respiratory tract infection; runny nose; sinus infection; coughing.

Urinary and Reproductive Tract: Painful menstruation; absence of menstruation; excessive urination; ejaculation disorder; decreased sex drive; impotence.

Other: Rash; itching; increased sweating; fever; abnormal skin sensations (eg, burning, prickling, tingling); joint or muscle pain; yawning; weight changes; taste pereception changes.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose unless directed by your doctor.
• Usual adult starting dose is 20 mg/day as a single dose. If necessary, dose may be increased to 40 mg/day after at least 1 week.
• Take once daily, in the morning or evening, with or without food.
• For most elderly patients and patients with liver disease, 20 mg/day is the recommended dose, with titration to 40 mg/day only for non responding patients.
• If a dose is missed, inhale 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 directed by your doctor. If more than one dose is missed or if it is necessary to establish a new dosage schedule, con­tact your doctor or pharmacist.
• Contact your doctor if you experience suicidal thoughts, sexual problems, appetite loss, nausea, vomiting, weight gain, restlessness, irritability, confusion, or excessive urination.
• Citalopram should not be used in combination with an MAOI, or within 14 days of discontinuing treatment with an MAOI. At least 14 days should be allowed after stopping citalopram before starting an MAOI.
• May cause drowsiness or dizziness. Use caution while driving or per­forming other tasks requiring alertness, coordination, or physical dexterity.
• Avoid alcohol while taking citalopram.
• Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or are breastfeeding.
• Improvement in depression may be noticed in 1 to 4 weeks. Continue to take citalopram as directed even though your depression has improved.
• Contact your doctor if adverse reactions persist and become bother­some.
• Store at controlled room temperature (59° to 86 F).