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Wednesday, 19 September 2012

pneumococcal polysaccharides vaccine (PPSV), 23-valent

Generic Name: pneumococcal polysaccharides vaccine (PPSV), 23-valent (NOO moe KOK al POL ee SAK a rides, 23-VAY lent)

Brand Names: Pneumovax 23

What is pneumococcal polysaccharides vaccine (PPSV)?

Pneumococcal disease is a serious infection caused by a bacteria. Pneumococcal bacteria can infect the sinuses and inner ear. It can also infect the lungs, blood, and brain and these conditions can be fatal.

Pneumococcal polysaccharides vaccine (PPSV) is used to prevent infection caused by pneumococcal bacteria. PPSV contains 23 of the most common types of pneumococcal bacteria.

PPSV works by exposing you to a small dose of the bacteria or a protein from the bacteria, which causes your body to develop immunity to the disease. PPSV will not treat an active infection that has already developed in the body.

PPSV is for use only in adults and children who are at least 2 years old. For children younger than 2 years old, another vaccine called Prevnar (pneumococcal conjugate vaccine [PCV] 7-valent) is used, usually given between the ages of 2 months and 15 months.

Like any vaccine, PPSV may not provide protection from disease in every person.

What is the most important information I should know about this vaccine?

PPSV should be given at least 2 weeks before the start of any treatment that can weaken your immune system. PPSV is also given at least 2 weeks before you undergo a splenectomy (surgical removal of the spleen).

The timing of this vaccination is very important for it to be effective. Follow your doctor's instructions.

You can still receive a vaccine if you have a cold or fever. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.

You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.

Keep track of any and all side effects you have after receiving this vaccine. If you ever need to receive a booster dose, you will need to tell your doctor if the previous shot caused any side effects.

Becoming infected with pneumococcal disease (such as pneumonia or meningitis) is much more dangerous to your health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is extremely low.

What should I discuss with my healthcare provider before receiving this vaccine?

You should not receive this vaccine if you have ever had a life-threatening allergic reaction to any pneumococcal polysaccharides vaccine.

Before receiving this vaccine, tell your doctor if you are allergic to any drugs, or if you have a bleeding or blood clotting disorder such as hemophilia, or easy bruising.

The timing and number of PPSV doses you receive will depend on whether you have any of these other conditions:

cancer, leukemia, lymphoma, or multiple myeloma;

HIV or AIDS;

sickle cell disease;

a kidney condition called nephrotic syndrome;

a history of organ or bone marrow transplant;

if you are receiving chemotherapy;

if you have been using steroid medication for a long period of time;

if you are scheduled to have your spleen removed (splenectomy); or

if you have received a pneumococcal vaccine within the past 3 to 5 years.

You can still receive a vaccine if you have a cold or fever. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.

Vaccines may be harmful to an unborn baby and generally should not be given to a pregnant woman. However, not vaccinating the mother could be more harmful to the baby if the mother becomes infected with a disease that this vaccine could prevent. Your doctor will decide whether you should receive this vaccine, especially if you have a high risk of infection with pneumococcal disease. It is not known whether PPSV passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How is this vaccine given?

PPSV is given as an injection (shot) under the skin or into a muscle of your arm or thigh. You will receive this injection in a doctor's office or other clinic setting.

PPSV is usually given as a routine vaccination in adults who are 65 years and older.

PPSV may also be given to people between the ages 2 and 64 years old who have:

heart disease, lung disease, or diabetes;

a cerebrospinal fluid leak, or a cochlear implant (an electronic hearing device);

alcoholism or liver disease (including cirrhosis);

sickle cell disease or a disorder of the spleen;

a weak immune system caused by HIV, AIDS, cancer, kidney failure, organ transplantation, or a damaged spleen; or

a weak immune system caused by taking steroids or receiving chemotherapy or radiation treatment.

PPSV may also be given to people between the ages 19 and 64 years old who smoke or have asthma.

The timing of this vaccination is very important for it to be effective. Follow your doctor's instructions.

Your doctor may recommend treating fever and pain with an aspirin-free pain reliever such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil, and others) when the shot is given and for the next 24 hours. Follow the label directions or your doctor's instructions about how much of this medicine to take.

If your doctor has prescribed an antibiotic (such as penicillin) to help prevent infection with pneumococcal bacteria, do not stop using the antibiotic after you receive the PPSV. Take the antibiotic for the entire length of time prescribed by your doctor.

Most people receive only one PPSV shot during their lifetime. However, people in certain age groups or with certain disease conditions that put them at risk of infection may need to receive more than one vaccine. Before receiving this vaccine, tell your doctor if you have received a pneumococcal vaccine within the past 3 to 5 years.

What happens if I miss a dose?

Since PPSV is usually given only one time, you will most likely not be on a dosing schedule. If you are receiving a repeat PPSV shot, be sure to tell your doctor if it has been less than 5 years since you last received a pneumococcal vaccine.

What happens if I overdose?

An overdose of this vaccine is not likely to occur.

What should I avoid' before or after receiving this vaccine ?

PPSV should not be given within 4 weeks before or after you receive a herpes zoster vaccine (Zostavax).

This vaccine side effects

You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.

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

high fever (103 degrees or higher);

easy bruising or bleeding;

swollen glands with skin rash or itching, joint pain, and general ill feeling;

pale or yellowed skin, dark colored urine, confusion or weakness;

numbness or tingly feeling in your feet and spreading upward, severe lower back pain;

changes in behavior, problems with vision, speech, swallowing, or bladder and bowel functions; or

slow heart rate, trouble breathing, feeling like you might pass out.

Less serious side effects are more likely to occur, such as:

low fever (102 degrees or less), chills, tired feeling;

swelling, pain, tenderness, or redness anywhere on your body;

headache, nausea, vomiting;

joint or muscle pain;

swelling or stiffness in the arm or leg the vaccine was injected into;

mild skin rash; or

mild soreness, warmth, redness, swelling, or a hard lump where the shot was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

Pneumococcal polysaccharides vaccine (PPSV), 23-valent Dosing Information

Usual Adult Dose for Pneumococcal Disease Prophylaxis:

0.5 mL dose injected subcutaneously or intramuscularly (preferably in the deltoid muscle or lateral mid-thigh).

Usual Pediatric Dose for Pneumococcal Disease Prophylaxis:

>= 2 years: 0.5 mL dose injected subcutaneously or intramuscularly (preferably in the deltoid muscle or lateral mid-thigh).

What other drugs will affect pneumococcal polysaccharides vaccine (PPSV)?

Before receiving this vaccine, tell the doctor about all other vaccines you have recently received.

Also tell the doctor if you have recently received drugs or treatments that can weaken the immune system, including:

an oral, nasal, inhaled, or injectable steroid medicine;

medications to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders, such as azathioprine (Imuran), etanercept (Enbrel), leflunomide (Arava), and others; or

medicines to treat or prevent organ transplant rejection, such as basiliximab (Simulect), cyclosporine (Sandimmune, Neoral, Gengraf), muromonab-CD3 (Orthoclone), mycophenolate mofetil (CellCept), sirolimus (Rapamune), or tacrolimus (Prograf).

If you are using any of these medications, you may not be able to receive the vaccine, or may need to wait until the other treatments are finished.

This list is not complete and other drugs may interact with PPSV. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More pneumococcal polysaccharides vaccine (PPSV), 23-valent resources

Pneumococcal polysaccharides vaccine (PPSV), 23-valent Dosage
Pneumococcal polysaccharides vaccine (PPSV), 23-valent Use in Pregnancy & Breastfeeding
Pneumococcal polysaccharides vaccine (PPSV), 23-valent Drug Interactions
Pneumococcal polysaccharides vaccine (PPSV), 23-valent Support Group
0 Reviews for Pneumococcal polysaccharides vaccine (PPSV), 23-valent - Add your own review/rating

Compare pneumococcal polysaccharides vaccine (PPSV), 23-valent with other medications

Pneumococcal Disease Prophylaxis

Where can I get more information?

Your doctor or pharmacist may have additional information about pneumococcal polysaccharides vaccine. You may also find additional information from your local health department or the Centers for Disease Control and Prevention.

Tuesday, 18 September 2012

Tums 500

Generic Name: calcium carbonate (KAL see um KAR boe nate)

Brand Names: Alka-Mints, Cal-Gest, Calcarb, Calci Mix, Calci-Chew, Calci-Mix, Calcium Concentrate, Calcium Liquid Softgel, Calcium Oyster Shell, Caltrate, Chooz, Extra Strength Mylanta Calci Tabs, Icar Prenatal Chewable Calcium, Maalox Antacid Barrier, Maalox Childrens', Maalox Quick Dissolve, Maalox Quick Dissolve Maximum Strength, Maalox Regular Strength, Mylanta Child, Nephro Calci, Os-Cal 500, Oysco 500, Oyst Cal 500, Oyster Cal, Oyster Calcium, Oyster Shell, Pepto Children's, Rolaids Sodium Free, Rolaids Soft Chew, Titralac, Tums, Tums 500, Tums E-X, Tums Kids, Tums QuikPak, Tums Ultra

What is Tums 500 (calcium carbonate)?

Calcium is a mineral that is found naturally in foods. Calcium is necessary for many normal functions of the body, especially bone formation and maintenance. Calcium can also bind to other minerals (such as phosphate) and aid in their removal from the body.

Calcium carbonate is used to prevent and to treat calcium deficiencies.

Calcium carbonate may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Tums 500 (calcium carbonate)?

Do not take calcium carbonate or antacids that contain calcium without first asking your doctor if you also take other medicines. Calcium can make it harder for your body to absorb certain medicines. Calcium carbonate works best if you take it with food.

What should I discuss with my healthcare provider before taking Tums 500 (calcium carbonate)?

To make sure you can safely take calcium carbonate, tell your doctor if you have any of these other conditions:

a history of kidney stones; or

a parathyroid gland disorder.

Talk to your doctor before taking calcium carbonate if you are pregnant. Talk to your doctor before taking calcium carbonate if you are breast-feeding a baby.

How should I take Tums 500 (calcium carbonate)?

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.

Calcium carbonate works best if you take it with food. Swallow the calcium carbonate tablet or capsule with a full glass of water.

The chewable tablet should be chewed before you swallow it.

Use the calcium carbonate powder as directed. Allow the powder to dissolve completely, then consume the mixture.

Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. Store at room temperature away from moisture and heat.

What happens if I miss a dose?

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 the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, vomiting, decreased appetite, constipation, confusion, delirium, stupor, and coma.

What should I avoid while taking Tums 500 (calcium carbonate)?

Follow your healthcare provider's instructions about any restrictions on food, beverages, or activity.

Tums 500 (calcium carbonate) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Less serious side effects may include:

nausea or vomiting;

decreased appetite;

constipation;

dry mouth or increased thirst; or

urinating more than usual.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs can affect Tums 500 (calcium carbonate)?

Calcium carbonate can make it harder for your body to absorb other medications you take by mouth. Tell your doctor if you are taking:

digoxin (Lanoxin, Lanoxicaps);

antacids or other calcium supplements;

calcitriol (Rocaltrol) or vitamin D supplements; or

doxycycline (Adoxa, Doryx, Oracea, Vibramycin), minocycline (Dynacin, Minocin, Solodyn, Vectrin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap).

This list is not complete and other drugs may interact with calcium carbonate. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More Tums 500 resources

Tums 500 Side Effects (in more detail)
Tums 500 Use in Pregnancy & Breastfeeding
Tums 500 Drug Interactions
Tums 500 Support Group
1 Review for Tums 500 - Add your own review/rating

Calcium Carbonate MedFacts Consumer Leaflet (Wolters Kluwer)

Titralac Consumer Overview

Titralac MedFacts Consumer Leaflet (Wolters Kluwer)

Tums Chewable Tablets MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Tums 500 with other medications

Duodenal Ulcer
Erosive Esophagitis
GERD
Indigestion
Stomach Ulcer

Where can I get more information?

Your doctor or pharmacist can provide more information about calcium carbonate.

See also: Tums 500 side effects (in more detail)

Sunday, 16 September 2012

Tham

Generic Name: Tromethamine
Class: Alkalinizing Agents
VA Class: TN900
CAS Number: 77-86-1

Introduction

Alkalinizing agent.^a ¹⁰⁰

Uses for Tham

Acidosis

Prevention and correction of metabolic acidosis associated with cardiac bypass surgery.^a ¹⁰⁰

Adjustment of excess acidity of stored blood (blood preserved with anticoagulant citrate dextrose [ACD] solution) used to prime pump-oxygenator during cardiac bypass surgery.^a ¹⁰⁰

May use as an alkalinizing agent in cardiac arrest;¹⁰⁰ ¹⁰¹ ¹⁰² only limited data indicate that buffers may improve outcome of cardiac arrest.¹⁰¹ ¹⁰²

Restoration of oxygen content with appropriate ventilation with oxygen, support of some tissue perfusion and cardiac output with good chest compressions, and then rapid return of spontaneous circulation (ROSC) are mainstays of restoring acid-base balance during cardiac arrest.¹⁰²

May be beneficial in cardiac arrest, but generally use only after more proven methods for ACLS (e.g., defibrillation, cardiac compression, support of ventillation including intubation, vasopresssor therapy) have been ineffective.¹⁰¹

Non-carbon dioxide generating buffers (e.g., tromethamine) may minimize some adverse effects of sodium bicarbonate (e.g., carbon dioxide generation, hyperosmolarity, hypernatremia, hypoglycemia, intracellular acidosis, myocardial acidosis, overshoot alkalosis) in certain CPR situations; however, clinical experience is limited.¹⁰²

May be preferable to sodium bicarbonate in treatment of severe metabolic acidosis in patients in whom sodium or carbon dioxide elimination is restricted.^a

May not be preferable to sodium bicarbonate in treatment of patients intoxicated with salicylates, barbiturates, or other weak acids.^a

Has been used in the treatment of metabolic acidosis associated with status asthmaticus† and neonatal respiratory distress syndrome†.^a

Maintain ventilation by artificial means if respiratory acidosis accompanies metabolic acidosis; not recommended in patients with respiratory acidosis alone, since the drug may depress ventilation by decreasing carbon dioxide tension.^a

Tham Dosage and Administration

Administration

Administer by slow IV infusion, by addition to the pump-oxygenator ACD blood or other priming fluid, or by injection into the ventricular cavity during cardiac arrest.^a ¹⁰⁰

Do not administer for >1 day, except in life-threatening situations.^a ¹⁰⁰

May be used along with standard resuscitative measures.¹⁰⁰ ^a

Containers are for single use only.¹⁰⁰

Commercially available tromethamine (Tham) is a 0.3 M solution of the drug.^a Do not extemporaneously prepare solutions in a concentration >0.3 M.^a

IV Administration

Infuse the drug slowly via a large needle into the largest antecubital vein or via an indwelling catheter placed in a large vein of an elevated limb.^a ¹⁰⁰ IV catheters are recommended.^a ¹⁰⁰

Rate of Administration

Administer slowly.¹⁰⁰

Dosage

Dosage depends on severity and progression of acidosis.^a ¹⁰⁰

Carefully supervise dosage and rate of administration to avoid overtreatment (alkalosis).¹⁰⁰ Determine blood pH, arterial oxygen pressure (PaO₂), carbon dioxide tension (PaCO₂), bicarbonate, glucose and electrolyte concentrations, and urinary output before, during, and following administration of the drug.^a ¹⁰⁰ Monitor dosage and progress of treatment, as needed.^a ¹⁰⁰

Consider the possibility of some accumulation of drug, especially in patients with impaired renal function.¹⁰⁰

Dosage is the least amount of a 0.3 M solution that is required to increase blood pH to within normal limits (7.35–7.45) and correct acid-base derangements.^a ¹⁰⁰

Dosage calculations are based on base deficit as determined by means of the Siggaard-Andersen nomogram.^a ¹⁰⁰ Calculate dosage of tromethamine in metabolic acidosis using the following empiric formula as a guide:

mL of 0.3 M tromethamine solution = body weight (in kg) × base deficit (in mEq/L) × 1.1^a ¹⁰⁰ (Factor of 1.1 accounts for an approximate reduction of 10% in buffering capacity due to presence of sufficient acetic acid to lower pH of 0.3 M solution to approximately 8.6.)^a ¹⁰⁰

Thus, total dose of tromethamine solution for a 70-kg adult having a base deficit of 5 mEq/L is 385 mL of 0.3 M solution (approximately 13.9 g of tromethamine).^a ¹⁰⁰ Need for additional doses is determined by serial measurements of existing base deficit.¹⁰⁰

Pediatric Patients

Acidosis

Metabolic Acidosis Associated with Respiratory Distress Syndrome

Neonates and Infants: Initial dose based on initial pH and weight of child at birth.¹⁰⁰ Usually, initial dose is about 1 mL per kg for each pH unit below 7.4.¹⁰⁰ Additional doses may be given according to changes in PaO₂, blood pH, and PaCO₂.¹⁰⁰

Adults

Acidosis

Metabolic Acidosis Associated with Cardiac Bypass Surgery

Total single dose of a 0.3 M solution for most adults is 500 mL.^a ¹⁰⁰ A single dose of up to 1000 mL may be necessary in unusually severe cases.^a ¹⁰⁰ Do not administer individual doses >500 mg/kg per hour (about 1078 mL of 0.3 M solution per hour for a 70-kg adult).^a ¹⁰⁰ ¹⁰³

Acidity of ACD Blood in Cardiac Bypass Surgery

Usually, add 15–77 mL of a 0.3 M solution to each 500 mL of ACD blood, depending on the pH of the blood.^a ¹⁰⁰ Clinical experience indicates that 62 mL of a 0.3 M solution added to 500 mL of ACD blood usually is adequate.^a ¹⁰⁰

Metabolic Acidosis Associated with Cardiac Arrest

If chest is not open, administer 111–333 mL of a 0.3 M solution into a large peripheral vein.^a ¹⁰⁰ Additional tromethamine may be required to control acidosis that persists after resuscitation.^a ¹⁰⁰

Intraventricular

If chest is open, 62–185 mL of a 0.3 M solution has been injected into the ventricular cavity (not into the cardiac muscle).^a ¹⁰⁰

Prescribing Limits

Pediatric Patients

Do not administer for >1 day, except in life-threatening situations.^a ¹⁰⁰ ¹⁰³

Adults

Do not administer for >1 day, except in life-threatening situations.^a ¹⁰⁰ ¹⁰³

Acidosis

Metabolic Acidosis Associated with Cardiac Bypass Surgery

Maximum (individual dose) 500 mg/kg per hour.^a ¹⁰⁰ ¹⁰³

Special Populations

Renal Impairment

Use with caution.¹⁰⁰ (See Renal and Electrolyte Effects under Cautions.)

Geriatric Patients

Select dosage with caution, usually initiating therapy at the low end of the dosing range, because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.¹⁰⁰ (See Geriatric Use under Cautions.)

Cautions for Tham

Contraindications

Anuria or uremia.¹⁰⁰ ^a

Neonates with chronic respiratory acidosis and salicylate intoxication.^a ¹⁰⁰

Warnings/Precautions

Warnings

If an adverse effect occurs, discontinue infusion, evaluate patient, institute appropriate therapeutic countermeasures, and save remainder of fluid for examination (if deemed necessary).¹⁰⁰

Respiratory Effects

Possible respiratory depression, as a result of increased blood pH and reduced carbon dioxide concentrations associated with administration of large doses of tromethamine;¹⁰⁰ also in those with chronic hypoventilation or in those receiving other drugs that depress respiration.^a

Carefully adjust dosage so that blood pH does not increase above normal; have facilities readily available to provide mechanical ventilation during administration of tromethamine.^a ¹⁰⁰ May be used with mechanical ventilatory support if respiratory acidosis is present concomitantly with metabolic acidosis.¹⁰⁰

Local Effects

Possible local irritation and tissue inflammation or infection at the site of injection, febrile response, chemical phlebitis, venospasm, hypervolemia, and IV thrombosis.^a ¹⁰⁰

Administer slowly through a large needle or indwelling catheter to minimize venous irritation.^a ¹⁰⁰ Use with caution to prevent perivascular infiltration, since extravasation may result in inflammation, necrosis, and sloughing of overlying skin.^a ¹⁰⁰

If perivascular infiltration occurs, discontinue tromethamine immediately and initiate appropriate countermeasures.^a ¹⁰⁰ Infiltration of the affected area with 1% procaine hydrochloride (to which hyaluronidase has been added) will often reduce venospasm and also will dilute any tromethamine remaining locally in tissues.^a Local infiltration of an α-adrenergic blocking agent (e.g., phentolamine mesylate) into the vasospastic area has been recommended.^a Perform nerve block of autonomic fibers to the affected area, if necessary.^a

Metabolic Effects

Possible transient decreases in blood glucose concentration.^a ¹⁰⁰ When larger than recommended doses are used or when administration is too rapid, hypoglycemia may persist for several hours.^a ¹⁰⁰

Administer tromethamine slowly and in amounts sufficient only to correct the existing acidosis; avoid overdosage and alkalosis.¹⁰⁰

Frequently determine blood glucose concentrations during and following therapy.¹⁰⁰

Renal and Electrolyte Effects

Possible hyperkalemia and accumulation of tromethamine in patients with renal disease or reduced urinary output; use with extreme caution, montior ECG, and frequently determine serum potassium concentrations.^a ¹⁰⁰

Possible hydropic degeneration of renal tubular cells in adults who received hypertonic solution (1.5 M) of tromethamine.^a

Fluid and/or Solute Overload

Possible fluid and/or solute overload following IV administration resulting in dilution of serum electrolyte concentrations, overhydration, congested conditions, or pulmonary edema.¹⁰⁰

Duration of Administration

Do not administer for >1 day, except in life-threatening situations.^a ¹⁰⁰ Clinical experience generally limited to short-term use.¹⁰⁰

General Precautions

Laboratory Monitoring

Determine blood pH, PaCO₂, and bicarbonate, glucose, and electrolyte concentrations before, during, and following administration of tromethamine.^a ¹⁰⁰

Hematologic Effects

Possible increased blood coagulation time.^a ¹⁰⁰

Hepatic Effects

Hemorrhagic necrosis of the liver reported in seriously ill neonates who received hypertonic (1.2 M) preparations of tromethamine via the umbilical vein.^a

Hydropic degeneration of hepatic cells reported in adults who received hypertonic solution (1.5 M) of tromethamine.^a

Specific Populations

Pregnancy

Category C.¹⁰⁰

Lactation

Not known whether distributed into human milk.¹⁰⁰ Use with caution.¹⁰⁰

Pediatric Use

Safety and efficacy based on extensive (over 30 years) clinical experience documented in medical literature and by safety surveillance.^a ¹⁰⁰

May be used in the treatment of severe cases of metabolic acidosis with concurrent respiratory acidosis in neonates and infants with respiratory failure, because unlike sodium bicarbonate, tromethamine does not elevate PaCO₂.^a ¹⁰⁰

Also may be used in neonates and infants with hypernatremia and metabolic acidosis to avoid the additional sodium given with the bicarbonate.^a ¹⁰⁰

Because osmotic effects of tromethamine are greater and large continuous doses of the drug are required, sodium bicarbonate is preferred to tromethamine in the treatment of acidosis in neonates and infants with respiratory distress syndrome (RDS).^a ¹⁰⁰

Possible occurrences of hepatocellular necrosis associated with IV infusions of tromethamine via low-lying umbilical venous catheters.^a ¹⁰⁰

Hypoglycemia may occur in premature and even in full-term neonates.^a ¹⁰⁰

Contraindicated in neonates with chronic respiratory acidosis and salicylate intoxication.¹⁰⁰

Geriatric Use

Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger patients.¹⁰⁰ Other reported clinical experience has not identified differences in response between geriatric patients and younger adults.¹⁰⁰

Select dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.¹⁰⁰ (See Geriatric Patients under Dosage and Administration.)

Substantially eliminated by kidneys; risk of toxic reactions may be greater in patients with impaired renal function.¹⁰⁰ Monitor renal function and adjust dosage accordingly since geriatric patients are more likely to have decreased renal function.¹⁰⁰

Renal Impairment

Substantially eliminated by kidneys; risk of toxic reactions may be greater in patients with impaired renal function.¹⁰⁰ (See Renal and Electrolyte Effects under Cautions.)

Common Adverse Effects

Adverse effects may include respiratory depression, local irritation, tissue inflammation, injection site infection, febrile response, chemical phlebitis, venospasm, hypervolemia, IV thrombosis, extravasation (with possible necrosis and sloughing of tissues), transient decreases in blood glucose concentrations, hypoglycemia, and hepatocellular necrosis with infusion via low-lying umbilical venous catheters.¹⁰⁰ (See Warnings under Cautions.)

Interactions for Tham

No formal drug interaction studies performed to date.¹⁰⁰

Tham Pharmacokinetics

Distribution

Extent

Not known whether distributed into human milk.¹⁰⁰

Elimination

Metabolism

Not appreciably metabolized.^a

Elimination Route

Excreted principally in urine (rate depends on infusion rate).^a ¹⁰⁰ Urinary excretion continues over a period of 3 days; 75% or more appears in the urine after 8 hours.¹⁰⁰

Stability

Storage

Parenteral

Injection

20–25°C; do not freeze.¹⁰⁰ Discard unused portions.¹⁰⁰

ActionsActions

Organic amine buffer; proton (hydrogen ion) acceptor.^a ¹⁰⁰

Weak base.^a Prevents or corrects acidosis by actively binding with hydrogen ions and their associated acid anions; the resulting salts are excreted in urine.^a ¹⁰⁰

Combines with lactic, pyruvic, and other metabolic acids and with carbonic acid.^a ¹⁰⁰

Approximately 70% of tromethamine present in plasma at pH 7.4 is in ionized (protonated) form; if pH is decreased from pH 7.4, ionized fraction of drug is increased.^a ¹⁰⁰ Ionized fraction of tromethamine reacts only with acid in extracellular fluids; fraction of drug that remains un-ionized at physiologic pH may be capable of penetrating cell membrane to combine with intracellular acid.^a ¹⁰⁰

Does not appear to affect ventilatory rate; may reduce tidal volume leading to a decrease in minute ventilation and carbon dioxide output; may decrease arterial oxygen saturation by about 5%.^a

Weak osmotic diuretic; increases flow of alkaline urine containing increased amounts of electrolytes.^a ¹⁰⁰

Advice to Patients

Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses.¹⁰⁰

Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.¹⁰⁰

Importance of informing patients of other important precautionary information.¹⁰⁰ (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Tromethamine
Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Parenteral	Injection	36 mg/mL (18 g)	Tham	Hospira

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions June 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

100. Hospira, Inc. Tham Solution (tromethamine) injection prescribing information. Lake Forest, IL; 2005 Oct.

101. American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Part 6: advanced cardiovascular life support. Circulation. 2000; 102(Suppl I):186-171.

102. The American Heart Association. Guidelines 2005 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2005; 112(Suppl I): IV1-211. [PubMed 16314375]

103. Cherk E (Hospira, Inc., Lake Forest, IL): Personal communication; 2007 Mar 20.

a. AHFS Drug Information 2007. McEvoy GK, ed. Tromethamine. Bethesda, MD: American Society of Health-System Pharmacists; 2007: 2646-7.

More Tham resources

Tham Side Effects (in more detail)
Tham Drug Interactions
Tham Support Group
0 Reviews for Tham - Add your own review/rating

Tham Concise Consumer Information (Cerner Multum)

Tham Prescribing Information (FDA)

Tromethamine Professional Patient Advice (Wolters Kluwer)

Compare Tham with other medications

Metabolic Acidosis

Friday, 14 September 2012

Trituss-A Drops

Pronunciation: kar-bi-NOX-a-meen/dex-troe-meth-OR-fan/fen-i-LEF-rin
Generic Name: Carbinoxamine/Dextromethorphan/Phenylephrine
Brand Name: Examples include DMax Pediatric and Trituss-A

Trituss-A Drops are used for:

Relieving sinus congestion, runny nose, sneezing, and cough due to colds, upper respiratory infections, and allergies. It may also be used for other conditions as determined by your doctor.

Trituss-A Drops are a decongestant, antihistamine, and cough suppressant combination. It works by constricting blood vessels and reducing swelling in the nasal passages, which helps you breathe more easily. The antihistamine works by blocking the action of histamine, which helps reduce symptoms such as watery eyes and sneezing, while the cough suppressant works in the brain to reduce the cough reflex.

Do NOT use Trituss-A Drops if:

you are allergic to any ingredient in Trituss-A Drops

you have severe high blood pressure, severe heart blood vessel disease, rapid heartbeat, or severe heart problems

you are unable to urinate or are having an asthma attack

you are taking sodium oxybate (GHB) or you have taken furazolidone or a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the last 14 days

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

Before using Trituss-A Drops:

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

if you are pregnant, plan 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 a fast, slow, or irregular heartbeat

if you have a history of adrenal gland problems (eg, tumor); heart problems; high blood pressure; diabetes; heart blood vessel problems; stroke; glaucoma; a blockage of your stomach, intestines, or bladder; ulcers; trouble urinating; an enlarged prostate or other prostate problems; seizures; or an overactive thyroid

if you have a history of asthma, chronic cough, chronic obstructive pulmonary disease (COPD), or other lung problems (eg, chronic bronchitis, emphysema), or if your cough produces large amounts of mucus

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

Beta-blockers (eg, propranolol), COMT inhibitors (eg, tolcapone), furazolidone, indomethacin, MAO inhibitors (eg, phenelzine), sodium oxybate (GHB), or tricyclic antidepressants (eg, amitriptyline) because side effects of Trituss-A Drops may be increased

Digoxin or droxidopa because the risk of irregular heartbeat or heart attack may be increased

Bromocriptine or hydantoins (eg, phenytoin) because the risk of side effects may be increased by Trituss-A Drops

Guanadrel, guanethidine, mecamylamine, methyldopa, or reserpine because their effectiveness may be decreased by Trituss-A Drops

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

Use Trituss-A Drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Trituss-A Drops may be taken with or without food.

Use the dropper that comes with Trituss-A Drops to measure your dose. Ask your pharmacist for help if you are unsure of how to measure your dose.

If you miss a dose of Trituss-A Drops, 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 Trituss-A Drops.

Important safety information:

Trituss-A Drops may cause dizziness, drowsiness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Trituss-A Drops. Using Trituss-A Drops alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.

Do not take appetite suppressants while you are taking Trituss-A Drops without checking with your doctor.

Trituss-A Drops contains phenylephrine. Before you begin taking any new prescription or nonprescription medicine, read the ingredients to see if it also contains phenylephrine. If it does or if you are uncertain, contact your doctor or pharmacist.

Do NOT exceed the recommended dose or take Trituss-A Drops for longer than prescribed without checking with your doctor.

If your symptoms do not improve within 5 to 7 days or if they become worse, check with your doctor.

Trituss-A Drops may cause increased sensitivity to the sun. Avoid exposure to the sun, sunlamps, or tanning booths until you know how you react to Trituss-A Drops. Use a sunscreen or protective clothing if you must be outside for a prolonged period.

If you are scheduled for allergy skin testing, do not take Trituss-A Drops for several days before the test because it may decrease your response to the skin tests.

Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Trituss-A Drops.

Use Trituss-A Drops with caution in the ELDERLY because they may be more sensitive to its effects.

Caution is advised when using Trituss-A Drops in CHILDREN because they may be more sensitive to its effects.

PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Trituss-A Drops, discuss with your doctor the benefits and risks of using Trituss-A Drops during pregnancy. It is unknown if Trituss-A Drops are excreted in breast milk. Do not breast-feed while taking Trituss-A Drops.

Possible side effects of Trituss-A Drops:

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:

Constipation; diarrhea; dizziness; drowsiness; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; vomiting; weakness.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; seizures; severe dizziness, lightheadedness, or headache; tremor; trouble sleeping; 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. 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.

See also: Trituss-A side effects (in more detail)

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. Symptoms may include blurred vision; confusion; hallucinations; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; unusually fast, slow, or irregular heartbeat; vomiting.

Proper storage of Trituss-A Drops:

Store Trituss-A Drops 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 Trituss-A Drops out of the reach of children and away from pets.

General information:

If you have any questions about Trituss-A Drops, please talk with your doctor, pharmacist, or other health care provider.

Trituss-A Drops are 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 is a summary only. It does not contain all information about Trituss-A Drops. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Trituss-A resources

Trituss-A Side Effects (in more detail)
Trituss-A Use in Pregnancy & Breastfeeding
Trituss-A Drug Interactions
Trituss-A Support Group
0 Reviews for Trituss-A - Add your own review/rating

Dacex-A Concise Consumer Information (Cerner Multum)

Compare Trituss-A with other medications

Cough and Nasal Congestion

Thursday, 13 September 2012

Androxy

Pronunciation: floo-ox-i-MES-te-rone
Generic Name: Fluoxymesterone
Brand Name: Androxy

Androxy is used for:

Treating a deficiency of the male hormone testosterone when the body does not make enough. It is also used to stimulate puberty in males with delayed puberty.Treating advanced breast cancer in women who are 1 to 5 years past menopause.

Androxy is an androgen.It works by stimulating normal growth and development of the male sex organs and maintaining normal secondary sex characteristics.It is unknown exactly how Androxy works to treat breast cancer.

Do NOT use Androxy if:

you are allergic to any ingredient in Androxy

you are pregnant or planning to become pregnant

you have breast cancer or prostate cancer

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

Before using Androxy:

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

if you 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 prostate problems, high blood calcium levels, or heart, liver, or kidney disease

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

Anticoagulants (eg, warfarin), carbamazepine, corticosteroids (eg, prednisone), macrolide immunosuppressants (eg, tacrolimus), or oxyphenbutazone because the actions and side effects of these medicines may be increased

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

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

Androxy may be taken with or without food. If stomach upset occurs, take with food to reduce stomach irritation.

If you miss a dose of Androxy, 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 Androxy.

Important safety information:

Androxy may contain tartrazine dye (FD&C Yellow No. 5), which can cause allergic reactions in certain patients. If you have previously had an allergic reaction to tartrazine, contact your pharmacist to determine if the medicine you are taking contains tartrazine.

Diabetes patients - Androxy 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 liver function and blood cholesterol, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.

Young males who are taking Androxy for delayed puberty should be checked for bone development every 6 months.

Use Androxy with caution in the ELDERLY because they may be more sensitive to its effects, especially prostate problems.

Androxy is not recommended for use in CHILDREN. Safety and effectiveness have not been confirmed.

PREGNANCY and BREAST-FEEDING: Do not use Androxy if you are pregnant. If you suspect that you could be pregnant, contact your doctor immediately. It is unknown if Androxy is excreted in breast milk. Do not breast-feed while taking Androxy.

Possible side effects of Androxy:

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:

Changes in sexual desire; absence of menstrual flow; acne; breast swelling or tenderness; deepening of voice; growth of facial hair; headache; irregular menstrual flow; mood changes; painful, prolonged erection; swelling of the clitoris.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); ankle swelling; change in skin color; nausea; vomiting; weight gain.

See also: Androxy side effects (in more detail)

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 Androxy:

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

General information:

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

Androxy 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 is a summary only. It does not contain all information about Androxy. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

More Androxy resources

Androxy Side Effects (in more detail)
Androxy Use in Pregnancy & Breastfeeding
Androxy Drug Interactions
Androxy Support Group
0 Reviews for Androxy - Add your own review/rating

Androxy Concise Consumer Information (Cerner Multum)

Androxy Prescribing Information (FDA)

Fluoxymesterone Professional Patient Advice (Wolters Kluwer)

Fluoxymesterone Monograph (AHFS DI)

Halotestin Prescribing Information (FDA)

Compare Androxy with other medications

Breast Cancer
Breast Cancer, Palliative
Delayed Puberty, Male
Hypogonadism, Male
Postmenopausal Symptoms

Wednesday, 12 September 2012

spironolactone

spir-on-oh-LAK-tone

Oral route(Tablet)

Spironolactone has been shown to be a tumorigen in chronic toxicity studies in rats. Spironolactone should be used only in those conditions specified as indications for use. Unnecessary use of this drug should be avoided .

Commonly used brand name(s)

In the U.S.

Aldactone

Available Dosage Forms:

Tablet

Therapeutic Class: Cardiovascular Agent

Pharmacologic Class: Aldosterone Receptor Antagonist

Uses For spironolactone

Spironolactone is used in combination with other medicines to treat high blood pressure (hypertension) and heart failure. It may also be used to treat water retention (edema) in patients with congestive heart failure, liver cirrhosis, or a kidney disorder called nephrotic syndrome.

Spironolactone is also used to diagnose and treat hyperaldosteronism, a condition in which the adrenal gland produces too much hormone called aldosterone.

Spironolactone is a type of a diuretic medicine (water pill) that prevents your body from absorbing too much salt and keeps your potassium levels from getting too low. It can be used to prevent or treat hypokalemia (low potassium levels in the blood).

spironolactone is available only with your doctor’s prescription.

Before Using spironolactone

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For spironolactone, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to spironolactone or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of spironolactone in the pediatric population. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of spironolactone in geriatric patients.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking spironolactone, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using spironolactone with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Eplerenone

Triamterene

Using spironolactone with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Alacepril

Arginine

Arsenic Trioxide

Benazepril

Captopril

Cilazapril

Delapril

Digoxin

Droperidol

Enalaprilat

Enalapril Maleate

Fosinopril

Imidapril

Levomethadyl

Lisinopril

Lithium

Moexipril

Pentopril

Perindopril

Potassium

Quinapril

Ramipril

Sotalol

Spirapril

Tacrolimus

Temocapril

Trandolapril

Zofenopril

Using spironolactone with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aceclofenac

Acemetacin

Alclofenac

Apazone

Benoxaprofen

Bromfenac

Bufexamac

Carprofen

Clometacin

Clonixin

Dexketoprofen

Diclofenac

Diflunisal

Digitoxin

Dipyrone

Droxicam

Etodolac

Etofenamate

Felbinac

Fenbufen

Fenoprofen

Fentiazac

Floctafenine

Flufenamic Acid

Flurbiprofen

Gossypol

Ibuprofen

Indomethacin

Indoprofen

Isoxicam

Ketoprofen

Ketorolac

Licorice

Lornoxicam

Meclofenamate

Mefenamic Acid

Meloxicam

Nabumetone

Naproxen

Niflumic Acid

Nimesulide

Oxaprozin

Oxyphenbutazone

Phenylbutazone

Pirazolac

Piroxicam

Pirprofen

Propyphenazone

Proquazone

Sulindac

Suprofen

Tenidap

Tenoxicam

Tiaprofenic Acid

Tolmetin

Zomepirac

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of spironolactone

In addition to the use of spironolactone, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium (salt) and potassium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that spironolactone will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Dosing

The dose of spironolactone will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of spironolactone. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):
- For edema:
  - Adults—At first, 100 milligrams (mg) per day, given in either single or divided doses. Your doctor may adjust your dose if needed.
  - Children—Use and dose must be determined by your doctor.
- For heart failure:
  - Adults—At first, 25 milligrams (mg) per day. Your doctor may adjust your dose if needed and tolerated.
  - Children—Use and dose must be determined by your doctor.
- For high blood pressure:
  - Adults—At first, 50 to 100 milligrams (mg) per day, given in either single or divided doses. Your doctor may adjust your dose if needed.
  - Children—Use and dose must be determined by your doctor.
- For low potassium in the blood:
  - Adults—25 to 100 milligrams (mg) per day.
  - Children—Use and dose must be determined by your doctor.
- For too much aldosterone in the body:
  - Adults—400 milligrams (mg) for 4 days, or 400 mg per day for 3 to 4 weeks to diagnose the condition. Then, 100 to 400 mg per day after the diagnosis is confirmed.
  - Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of spironolactone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using spironolactone

It is very important that your doctor check your progress at regular visits to make sure spironolactone is working properly and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects.

Do not take other medicines unless they have been discussed with your doctor. This especially includes potassium supplements or salt substitutes containing potassium; or certain diuretics such as amiloride (Midamor®, Moduretic®), triamterene (Dyazide®, Dyrenium®, Maxzide®), or other products containing spironolactone (Aldactazide®).

spironolactone may increase the amount of potassium in your blood (hyperkalemia). Stop using spironolactone and check with your doctor right away if you are having abdominal or stomach pain; confusion; difficulty with breathing; irregular heartbeat; nausea or vomiting; nervousness; numbness or tingling in the hands, feet, or lips; shortness of breath; or weakness or heaviness of the legs.

Check with your doctor right away if you become sick while taking spironolactone, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt.

Check with your doctor right away if you experience dizziness, fainting, confusion, muscle pain, weakness, and/or a fast heartbeat. Use extra care if you exercise or if the weather is hot. Heavy sweating can cause dehydration (loss of too much water) or electrolyte imbalances (loss of sodium, potassium, or magnesium in the body).

spironolactone may cause swelling of the breasts (gynecomastia) and breast pain in some patients. If you have questions about this, talk to your doctor.

Make sure any doctor or dentist who treats you knows that you are using spironolactone. You may need to stop using spironolactone several days before having medical tests. The results of some tests may be affected by spironolactone.

spironolactone may cause the formation of certain tumors in your body. Check with your doctor right away if you notice an unusual lump anywhere in your body or if you have any unusual signs or symptoms while you are using spironolactone.

spironolactone Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

Abdominal or stomach cramping, burning, or tenderness

bloody or black, tarry stools

bloody urine

chills

clay-colored stools

clear or bloody discharge from the nipple

cloudy urine

constipation

cough or hoarseness

dark urine

decrease in urine output or decrease in urine-concentrating ability

decreased appetite

diarrhea

difficulty with swallowing

dimpling of the breast skin

dizziness

fast heartbeat

fever with or without chills

general feeling of tiredness or weakness

headache

heartburn

hives

increased blood pressure

increased thirst

indigestion

inverted nipple

itching

loss of appetite

lower back or side pain

lump in the breast or under the arm

nausea and vomiting

painful or difficult urination

persistent crusting or scaling of the nipple

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

redness or swelling of the breast

severe stomach pain

shakiness and unsteady walk

shortness of breath

skin rash

sore on the skin of the breast that does not heal

sore throat

sores, ulcers, or white spots on the lips or in the mouth

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

swollen, painful, or tender lymph glands in the neck, armpit, or groin

tightness in the chest

troubled breathing

unpleasant breath odor

unsteadiness, trembling, or other problems with muscle control or coordination

unusual bleeding or bruising

unusual tiredness or weakness

vomiting of blood or material that looks like coffee grounds

weight gain

wheezing

yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Coma

confusion

convulsions

difficulty with breathing

drowsiness

irregular heartbeat

muscle pain or cramps

nervousness

numbness or tingling in the hands, feet, or lips

rash with flat lesions or small raised lesions on the skin

reddened skin

swelling of the ankles or hands

weakness or heaviness of the legs

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Burning feeling in the chest or stomach

sores, welting, or blisters

stomach upset

swelling of the breasts or breast soreness in both females and males

unusual dullness or feeling of sluggishness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: spironolactone side effects (in more detail)

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More spironolactone resources

Spironolactone Side Effects (in more detail)
Spironolactone Dosage
Spironolactone Use in Pregnancy & Breastfeeding
Drug Images
Spironolactone Drug Interactions
Spironolactone Support Group
46 Reviews for Spironolactone - Add your own review/rating

Spironolactone Prescribing Information (FDA)

Spironolactone Professional Patient Advice (Wolters Kluwer)

Spironolactone Monograph (AHFS DI)

Spironolactone MedFacts Consumer Leaflet (Wolters Kluwer)

Aldactone Prescribing Information (FDA)

Aldactone Consumer Overview

Compare spironolactone with other medications

Acne
Alopecia
Edema
Heart Failure
High Blood Pressure
Hirsutism
Hypokalemia
Primary Hyperaldosteronism
Primary Hyperaldosteronism Diagnosis

Influbene C

Influbene C may be available in the countries listed below.

Ingredient matches for Influbene C

Ascorbic Acid

Ascorbic Acid is reported as an ingredient of Influbene C in the following countries:

Switzerland

Paracetamol

Paracetamol is reported as an ingredient of Influbene C in the following countries:

Switzerland

International Drug Name Search