Drug Facts

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).

Tagged under:appetite changes, digestive tract, elderly patients, excessive drowsiness, lithobid side effects, prescription medications stomach pain

Type of Drug:

Antinauseants; antiemetics; drugs used to prevent nausea and vomiting.

How the Drug Works:

Dolasetron, granisetron, and ondansetron are selective serotonin 5-HT 3 receptor antagonists that block serotonin stimulation to prevent nausea and vomiting.

Uses:

Oral doseforms - To prevent nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemstherapy.

Oral dolasetron and ondansetron - To prevent postoperative nausea and vomiting.

Oral granisetron and ondansetron - To prevent nausea and vomiting associated with radiotherapy in patients receiving either total body irradiation, single high-dose fraction, or daily fractions the abdomen.

Intravenous (IV; into a vein) dolasetron - To prevent and treat postoperative nausea or vomiting.

Unlabeled Uses: Dolasetron has been used to treat radiotherapy-induced nausea and vomiting. Granisetron has been used for acute nausea and vomiting following surgery. Ondansetron has been used in the treatment of nausea and vomiting associated with acetaminophen poisoning, acute levodopa-induced psychosis, and prostacyclin therapy; to reduce bulimic episodes in patients with bulimia nervosa; to treat patients with social anxiety disorder; and as treatment of spinal or epidural morphine-induced pruritis.

Precautions:

Benzyl alcohol: Some of these products contain benzyl alcohol, which has been associated with a fatal “gasping syndrome” in premature infants. Consult your doctor or pharmacist.

Phenylketonuria: Ondansetron orally-disintegrating 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 the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: Ondansetron appears in breast milk. It is not known if other 5-HT 3 receptor antagonists appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness for use of dolasetron and the injection form of granisetron in children younger than 2 years of age have not been established. Safety and effectiveness for use of the oral form of granisetron in children of any age have not been established. Safety and effectiveness for use of ondansetron in children 3 years of age and younger 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 supplolnol1ls while taking a 5-HT 3 receptor antagonist. Doses of one or both drugs may need to be modified or a different drug may need to be prescribrd. Rifamycins (eg, rifampin) interact with ondansetron

Side Effects:

Every drug is capable of producing side effects. Many 5-HT 3 receptor antagonist 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: Diarrhea; nausea; constipation; stomach pain; appetite loss; taste disorder; indigestion; dry mouth.

Nervous System: Headache; drowsiness; weakness; agitation; fatigue; anxiety; stimulation; sleeplessness; dizziness; flushing; shivers; chills; vertigo (feeling of whirling motion); agitation.

Other: Changes in blood pressure; fever; heart rhythm changes; hair loss; abnormal blood counts; muscle, joint, chest, or bone pain; general body discomfort; injection site reaction; cold sensation; rash; tremor; itching; urinary retention; tingling or prickling sensation; deficient oxygenation of the blood.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not change the dose or stop taking, unless advised by your doctor.
• Ondansetron orally-disintegrating tablets - Remove the tablets from the package just before taking. Peel backing off blister and remove tab­let gently. Place tablet on the tongue and swallow with saliva. Tablets disintegrate rapidly on the tongue and do not require water for dissolution or swallowing.
• Contact your doctor immediately if you experience rash, itching, short­ness of breath, abnormal heart rhythm, dizziness, fainting, low blood pressure, hives, facial swelling, or difficulty breathing.
• Dolasetron injection can be mixed in apple or apple-grape juice and given orally. The mixed product may be kept up to 2 hours at room temperature (59 to 86°F).
• Store at controlled room temperature (68 to 77°F). Protect from light. Do not freeze injection vials.

Tagged under:Antiemetic Antivertigo Agents, breast milk, nausea and vomiting, phenylalanine social anxiety disorder