praziquantel

Generic Name: praziquantel (PRAZ i KWON tel)

Brand Names: Biltricide

What is praziquantel?

Praziquantel is an anthelmintic (an-thel-MIN-tik) or anti-worm medication. It prevents newly hatched insect larvae (worms) from growing or multiplying in your body.

Praziquantel is used to treat infections caused by Schistosoma worms, which enter the body through skin that has come into contact with contaminated water. Schistosoma worms are found in Africa, South America, Middle Eastern countries, the Caribbean, and parts of Asia.

Praziquantel is also used to treat infection with liver flukes, caused by a type of worm found in East Asia. This worm enters the body while eating contaminated fish.

Praziquantel should not be used to treat parasitic infections in the eye.

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

What is the most important information I should know about praziquantel?

You should not take this medicine if you are allergic to praziquantel, or if you have take rifampin (Rifadin, Rifater, Rifamate) in the last 4 weeks.

Before taking praziquantel, tell your doctor if you have kidney disease, heart disease, liver disease, or a history of seizures or epilepsy.

Do not give this medication to a child younger than 4 years old. Praziquantel may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Praziquantel should be taken with a meal. Do not crush or chew the praziquantel tablet. Swallow the pill whole. Take this medication with a full glass (8 ounces) of water.

What should I discuss with my healthcare provider before taking praziquantel?

You should not take this medicine if you are allergic to praziquantel, or if you have take rifampin (Rifadin, Rifater, Rifamate) in the last 4 weeks.

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

• 
  

  headaches, confusion;

  
  


• 
  

  seizures (or a history of seizures or epilepsy);

  
  


• 
  

  lumps (nodules) under your skin;

  
  


• 
  

  kidney disease;

  
  


• 
  

  heart disease; or

  
  


• 
  

  liver disease.

  
  

FDA pregnancy category B. Praziquantel is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Praziquantel can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medication to a child younger than 4 years old.

How should I take praziquantel?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take this medication with a full glass (8 ounces) of water.

Praziquantel is usually taken 3 times in one day. Your doses should be taken 4 to 6 hours apart on that day.

Praziquantel should be taken with a meal.

You may need to break a praziquantel tablet in order to get the correct dose. Follow your doctor's instructions.

Do not crush or chew the praziquantel tablet or portion of a tablet. Swallow the pill whole. Store at room temperature away from moisture and heat.

See also: Praziquantel dosage (in more detail)

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.

What should I avoid while taking praziquantel?

Praziquantel may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Grapefruit and grapefruit juice may interact with praziquantel and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Praziquantel 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:

• 
  

  tired feeling;

  
  


• 
  

  headache, dizziness;

  
  


• 
  

  nausea, upset stomach;

  
  


• 
  

  mild fever; or

  
  


• 
  

  mild skin rash.

  
  

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.

Praziquantel Dosing Information

Usual Adult Dose for Nanophyetus salmincola:

20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Schistosoma japonicum:

20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Schistosoma mekongi:

20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Schistosoma haematobium:

20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Some clinicians recommend 20 mg/kg orally every 4 hours for 2 doses (as a 1 day treatment).

Usual Adult Dose for Schistosoma mansoni:

20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Some clinicians recommend 20 mg/kg orally every 4 hours for 2 doses (as a 1 day treatment).

Usual Adult Dose for Fasciolopsis buski (Intestinal Fluke):

25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Heterophyes heterophyes (Intestinal Fluke):

25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Metagonimus yokogawai (Intestinal Fluke):

25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Opisthorchis viverrini (Liver Fluke):

25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Clornorchis sinensis (Liver Fluke):

25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Paragonimus westermani (Lung Fluke):

25 mg/kg orally every 4 hours for 6 doses (3 doses per day for 2 consecutive days)

Case Report (n=1)
75 mg/kg/day for 3 days

Usual Adult Dose for Diphyllobothrium latum (Fish Tapeworm):

5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Adult Dose for Dipylidium caninum (Dog Tapeworm):

5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Adult Dose for Taenia saginata (beef tapeworm):

5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Adult Dose for Taenia solium (pork tapeworm):

5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Adult Dose for Hymenolepis nana (Dwarf Tapeworm):

25 mg/kg orally one time

Since eradication may be difficult, retreatment is recommended if the infection persists.

Usual Adult Dose for Cysticercus cellulosae (Cysticercosis):

50 mg/kg/day orally in 3 divided doses for 15 days

Concomitant use of corticosteroids during praziquantel therapy for neurocysticercosis may reduce the frequency and severity of an inflammatory response to degeneration of cysts in the central nervous system.

Repeated courses of therapy may be considered in patients with only partial resolution of cysts 3 months after a course or whose condition deteriorates.

Usual Adult Dose for Echinococcus Infection:

Study (n=19)
50 mg/kg once daily, in combination with albendazole, to a maximum of 9 months

Patients unable to tolerate side effects took praziquantel once, twice weekly or once every two weeks.

Usual Pediatric Dose for Nanophyetus salmincola:

4 years or older: 20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Schistosoma japonicum:

4 years or older: 20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Schistosoma mekongi:

4 years or older: 20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Schistosoma haematobium:

4 years or older: 20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Some clinicians recommend 20 mg/kg orally every 4 hours for 2 doses (as a 1 day treatment).

Usual Pediatric Dose for Schistosoma mansoni:

4 years or older: 20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Some clinicians recommend 20 mg/kg orally every 4 hours for 2 doses (as a 1 day treatment).

Usual Pediatric Dose for Fasciolopsis buski (Intestinal Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Heterophyes heterophyes (Intestinal Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Metagonimus yokogawai (Intestinal Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Opisthorchis viverrini (Liver Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Clornorchis sinensis (Liver Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Paragonimus westermani (Lung Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 6 doses (3 doses per day for 2 consecutive days)

Usual Pediatric Dose for Diphyllobothrium latum (Fish Tapeworm):

4 years or older: 5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Pediatric Dose for Dipylidium caninum (Dog Tapeworm):

4 years or older: 5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Pediatric Dose for Taenia saginata (beef tapeworm):

4 years or older: 5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Pediatric Dose for Taenia solium (pork tapeworm):

4 years or older: 5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Pediatric Dose for Hymenolepis nana (Dwarf Tapeworm):

4 years or older: 25 mg/kg orally one time

Since eradication may be difficult, retreatment is recommended if the infection persists.

Usual Pediatric Dose for Cysticercus cellulosae (Cysticercosis):

4 years or older: 50 mg/kg/day orally in 3 divided doses for 15 days

Concomitant use of corticosteroids during praziquantel therapy for neurocysticercosis may reduce the frequency and severity of an inflammatory response to degeneration of cysts in the central nervous system.

What other drugs will affect praziquantel?

Tell your doctor about all other medications you are using, especially:

• 
  

  cimetidine (Tagamet);

  
  


• 
  

  chloroquine (Aralen);

  
  


• 
  

  itraconazole (Sporanox) or ketoconazole (Extina, Ketozole, Nizoral, Xolegal);

  
  


• 
  

  dexamethasone (Decadron, Hexadrol);

  
  


• 
  

  erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin);

  
  


• 
  

  St. John's wort;

  
  


• 
  

  rifabutin (Mycobutin) or rifapentine (Priftin);

  
  


• 
  

  a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Solfoton);

  
  


• 
  

  HIV medication such as efavirenz (Sustiva, Atripla), etravirine (Intelence), nevirapine (Viramune), or ritonavir (Norvir, Kaletra);

  
  


• 
  

  medicines to treat narcolepsy, such as armodafanil (Nuvigil) or modafanil (Progivil); or

  
  


• 
  

  seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), or phenytoin (Dilantin), or primidone (Mysoline).

  
  

This list is not complete and other drugs may interact with praziquantel. 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 praziquantel resources

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

• praziquantel Advanced Consumer (Micromedex) - Includes Dosage Information


• Praziquantel Professional Patient Advice (Wolters Kluwer)


• Praziquantel Monograph (AHFS DI)


• Praziquantel MedFacts Consumer Leaflet (Wolters Kluwer)


• Biltricide Prescribing Information (FDA)

Compare praziquantel with other medications

• Cysticercus cellulosae
• Dog Tapeworm
• Echinococcus
• Fasciolopsis buski, Intestinal Fluke
• Fish Tapeworm Infection
• Heterophyes heterophyes, Intestinal Fluke
• Hymenolepis nana, Dwarf Tapeworm
• Liver Fluke
• Metagonimus yokogawai, Intestinal Fluke
• Naophyetus salmincola
• Opisthorchis viverrini, Liver Fluke
• Paragonimus westermani, Lung Fluke
• Schistosoma haematobium
• Schistosoma japonicum
• Schistosoma mansoni
• Schistosoma mekongi
• Taenia saginata, beef tapeworm
• Taenia solium, pork tapeworm

Where can I get more information?

• Your pharmacist can provide more information about praziquantel.

See also: praziquantel side effects (in more detail)

GTN 400mcg Spray

What You Should Know About

GLYCERYL TRINITRATE SPRAY 400mcg/dose

Please read this carefully before you start to use Glyceryl Trinitrate Spray. If you have any questions or are not sure about anything ask your doctor or pharmacist.

What Is In Your Medicine?

Your medicine is called Glyceryl Trinitrate Spray.

It is a metered aerosol which delivers 400 micrograms of glyceryl trinitrate, the active ingredient, each time the button is pressed.

It contains the following inactive ingredients: peppermint oil, 1,1,1,2 tetrafluoroethane, ethanol.

Each aerosol can contains 180 doses.

Glyceryl trinitrate is one of a group of medicines called nitrates which relax the muscle walls of the blood vessels and reduce the workload of the heart.

Manufactured by:

Pharmasol Limited

North Way

Andover

Hants

SP10 5AZ

UK

Product Licence Holder:

Ayrton Saunders Ltd

Reeds Lane

Moreton

Wirral

CH46 1DW

UK

Distributed by:

Winthrop Pharmaceuticals

PO Box 611

Guildford

Surrey

GU1 4YS

UK

What Is Your Medicine For?

You may use Glyceryl Trinitrate Spray to relieve the pain of an angina attack as soon as it has started or to prevent it starting by using immediately before events which may set off your angina, for instance physical effort, emotional stress or exposure to cold.

Before Using Your Medicine

If you can answer yes to any of the following questions, do not use Glyceryl Trinitrate Spray without first talking to your doctor:

• 1. Are you hypersensitive to nitrates or any of the other ingredients of Glyceryl Trinitrate Spray?


• 2. Are you pregnant or likely to become so?


• 3. Are you breast-feeding your baby?


• 4. Do you have a very low blood pressure or heart rate, severe anaemia, abnormality of the heart valves or heart muscle, head injury, bleeding from the brain or fluid on the lungs?


• 5. Are you taking any medication, particularly heart, blood pressure or water tablets or Viagra? If Viagra (sildenafil - for male erectile dysfunction) is used by patients taking nitrate preparations such as Glyceryl Trinitrate Spray, a severe and possibly dangerous fall in blood pressure can occur. This would result in collapse, unconsciousness and could be fatal.You should not take Viagra whilst on Glyceryl Trinitrate Spray.

Continuous use of nitrates may result in reduced effectiveness.

You may wish to use Glyceryl Trinitrate Spray urgently or in the dark, so if you have never used it before, practice spraying a few puffs into the air.

Never use Glyceryl Trinitrate Spray near a naked flame e.g., cigarette.

Glyceryl Trinitrate Spray should not be taken with alcohol.

Driving or using machines should be avoided during use of Glyceryl Trinitrate Spray.

Using Your Medicine

Always check the label for directions on how to take your medicine.Your pharmacist will help if you are not sure.

If possible, it is recommended that you sit down to use your medicine.

Remove the cap. Hold the canister upright with forefinger on top of the white button.

There is no need to shake the canister.

Open your mouth and bring the Glyceryl Trinitrate Spray nozzle as close as possible, aiming it under your tongue.

Press the button firmly, directing the spray under your tongue while holding your breath. Keep the button held down until all the dose has been released. Close your mouth immediately but do not inhale the spray.

If necessary, repeat for a second time following the steps above. No more than three doses are recommended at one
time.

Always replace the cap after use.

If you use Glyceryl Trinitrate Spray during an attack, sit down and rest until the pain disappears.

After Using Your Medicine

Glyceryl Trinitrate Spray can frequently cause headaches. Other side effects that may be encountered are facial flushing, faintness, abnormal heart rate, dizziness and nausea. In addition, allergic skin rashes may occasionally occur. Rarely, patients have collapsed as a result of a great fall in blood pressure.You may only need to consult your doctor if these symptoms become troublesome. These symptoms may be made worse if you have been drinking alcohol or are taking prescribed medicine for high blood pressure.

If you experience any other ill effects, tell your doctor or pharmacist immediately and ask if you should continue with your medication. If you find that your medication is becoming less effective, discuss this with your doctor or pharmacist as increasing the dose would be of no added value and could be dangerous.

Keeping Your Medicine Safe

Do not store above 25°C. Do not freeze.

Do not use any medicine after the expiry date stated on the packaging.

Keep Glyceryl Trinitrate Spray out of the reach of children.

Do not attempt to puncture, break or burn the canister, even if it appears to be empty.

Make sure you have a Glyceryl Trinitrate Spray with you at all times.

Make sure you get a new one before the old one runs out. Ideally, keep a spare handy.

REMEMBER this medicine is for you. Never give it to others. It may harm them even if their symptoms are the same as yours.

Date of preparation or last review: February 2005.

‘Winthrop’ is a registered trademark. © 2005 Winthrop Pharmaceuticals.

Inova 8/2

Generic Name: benzoyl peroxide and salicylic acid topical (BEN zoe il per OX ide and sal i SIL ik A sid)

Brand Names: Cleanse & Treat, Inova 4/1, Inova 8/2

What is Inova 8/2 (benzoyl peroxide and salicylic acid topical)?

Benzoyl peroxide has an antibacterial effect. It also has a mild drying effect that allows excess oil and dirt to be washed away.

Salicylic acid is a peeling agent that causes shedding of the outer layer of skin.

The combination of benzoyl peroxide and salicylic acid is used to treat severe acne.

Benzoyl peroxide and salicylic acid may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Inova 8/2 (benzoyl peroxide and salicylic acid topical)?

Do not use this medication if you are allergic to benzoyl peroxide (Benzagel, Clear by Design, Fostex, Oxy-10, Panoxyl, and others) or to salicylic acid (aspirin, Compound W, Duofilm, Stri-Dex, and others).

This medication is not for use in treating mild forms of acne. The strength of benzoyl peroxide contained in this medication is higher than that used in many over-the-counter acne products. Severe skin irritation can result from improper use of this product.

Do not share this medication with anyone, even if they have the same symptoms you do. Do not use this medication on anyone under 18 years old without the advice of a doctor.

What should I discuss with my health care provider before using Inova 8/2 (benzoyl peroxide and salicylic acid topical)?

Do not use this medication if you are allergic to benzoyl peroxide (Benzagel, Clear by Design, Fostex, Oxy-10, Panoxyl, and others) or to salicylic acid (aspirin, Compound W, Duofilm, Stri-Dex, and others).

Before using benzoyl peroxide and salicylic acid, tell your doctor if you are allergic to any drugs.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether benzoyl peroxide and salicylic acid 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.

This medication is not for use in treating mild forms of acne. The strength of benzoyl peroxide contained in this medication is higher than that used in many over-the-counter acne products. Severe skin irritation can result from improper use of this product.

Do not share this medication with anyone, even if they have the same symptoms you do. Do not use this medication on anyone under 18 years old without the advice of a doctor.

How should I use Inova 8/2 (benzoyl peroxide and salicylic acid topical)?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.

Apply the medicated pad to clean, dry skin. Use only mild skin cleansers or those your doctor has prescribed.

This medication can bleach or discolor fabric, hair, or other surfaces it comes in contact with. Use with care to avoid damaging colored surfaces.

If this medication causes skin irritation, apply a cool compress to your skin (such as a washcloth wet with cold water) and call your doctor.

Store this medication at room temperature away from moisture and heat.

Keep each medicated pad in its foil pouch until you are ready to use it.

What happens if I miss a dose?

Use the medication as soon as you remember the missed dose. If it is almost time for your next dose, skip the missed dose and use the medicine at your next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Symptoms of a benzoyl peroxide and salicylic acid overdose may include scaly or peeling skin, redness, or swelling.

What should I avoid while using Inova 8/2 (benzoyl peroxide and salicylic acid topical)?

Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Benzoyl peroxide and salicylic acid can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

Avoid using skin products that can cause irritation, such as harsh soaps, shampoos, or skin cleansers, hair coloring or permanent chemicals, hair removers or waxes, or skin products with alcohol, spices, astringents, or lime. Do not use other medicated skin products unless your doctor has told you to.

Avoid getting this medication in your eyes, mouth, and nose, or on your lips. If it does get into any of these areas, wash with water. Do not use benzoyl peroxide topical on sunburned, windburned, dry, chapped, irritated, or broken skin.

Inova 8/2 (benzoyl peroxide and salicylic acid topical) 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. Stop using this medication and call your doctor at once if you have severe skin irritation.

Less serious side effects may include dry skin or mild irritation.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Inova 8/2 (benzoyl peroxide and salicylic acid topical)?

There may be other drugs that can interact with benzoyl peroxide and salicylic acid. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More Inova 8/2 resources

• Inova 8/2 Side Effects (in more detail)
• Inova 8/2 Use in Pregnancy & Breastfeeding
• Inova 8/2 Drug Interactions
• 0 Reviews for Inova 8/2 - Add your own review/rating

Compare Inova 8/2 with other medications

• Acne

Where can I get more information?

• Your pharmacist can provide more information about benzoyl peroxide and salicylic acid.

See also: Inova 8/2 side effects (in more detail)

Gilenya

Pronunciation: fin-GOL-i-mod
Generic Name: Fingolimod
Brand Name: Gilenya

Gilenya is used for:

Reducing the number of relapses and delaying disability in certain patients with multiple sclerosis (MS).

Gilenya is a sphingosine 1-phosphate receptor modulator. Exactly how it works is not known, but it is thought to work by decreasing the number of certain white blood cells (lymphocytes) that enter the central nervous system (CNS).

Do NOT use Gilenya if:

• you are allergic to any ingredient in Gilenya


• you have an active infection

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

Before using Gilenya:

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

• if you are pregnant, planning 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 slow heart rate (less than 55 beats per minute), high blood pressure, or heart problems (eg, irregular heartbeat, heart block, sick sinus syndrome, prolonged QT interval, heart failure)


• if you have a history of long-term infection or an infection that keeps coming back, fainting, eye problems (eg, an inflammation called uveitis, macular edema), lung or breathing problems, liver or kidney problems, or diabetes


• if you have a weakened immune system, a fever, or you have not had chickenpox or the chickenpox vaccination


• if you have had a vaccine within 1 month before you start Gilenya

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

• Antiarrhythmics (eg, amiodarone, procainamide, quinidine, sotalol), beta-blockers (eg, atenolol), or calcium channel blockers (eg, diltiazem) because the risk of slow or irregular heartbeat may be increased


• Medicine for cancer, medicine that may weaken your immune system, or other medicines for MS (eg, mitoxantrone, natalizumab) because the risk of infection may be increased


• Ketoconazole because it may increase the risk of Gilenya's side effects

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

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

• Gilenya comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Gilenya refilled.


• Take Gilenya by mouth with or without food.


• Your first dose of Gilenya will be given in a doctor's office, hospital, or clinic. You will be observed for 6 hours following your first dose.


• Take Gilenya on a regular schedule to get the most benefit from it. Taking Gilenya at the same time each day will help you remember to take it.


• Continue to take Gilenya even if you feel well. Do not miss any doses.


• If you miss a dose of Gilenya, 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. If you miss taking Gilenya for more than 2 weeks, contact your doctor before you start to take it again.

Ask your health care provider any questions you may have about how to use Gilenya.

Important safety information:

• Slow heartbeat may occur after you start Gilenya, especially after your first dose. Your health care provider will watch you for symptoms of slow heartbeat for 6 hours after your first dose. If you experience slow heartbeat, your heart rate will usually return to normal within 1 month after you start Gilenya. Tell your doctor right away if you experience dizziness, slow or irregular heartbeat, or unusual tiredness.


• Do NOT take more than the recommended dose without checking with your doctor.


• Gilenya may lower the ability of your body to fight infection while you take it and for up to 2 months after you stop taking it. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.


• If you have not had chickenpox, shingles, or measles, avoid contact with anyone who does.


• Do not receive a live vaccine (eg, measles, mumps) while you are taking Gilenya and for up to 2 months after you stop taking it. Talk with your doctor before you receive any vaccine.


• Cases of a certain type of blood cancer (lymphoma) have occurred in patients taking Gilenya. It is not known if these cases were related to Gilenya. Contact your doctor with any questions or concerns.


• Women who may become pregnant should use an effective form of birth control while they take Gilenya and for 2 months after they stop taking Gilenya. If you have questions about effective birth control, talk with your doctor.


• Gilenya may interfere with certain lab tests, including peripheral blood lymphocyte counts. Be sure your doctor and lab personnel know you are taking Gilenya.


• Lab tests, including electrocardiogram (ECG), complete blood cell counts, blood pressure, lung function, liver function, and eye exams, may be performed while you use Gilenya. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Gilenya should be used with extreme caution in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: Gilenya may cause harm to the fetus. Do not become pregnant while you are using it or for 2 months after you stop using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Gilenya while you are pregnant. It is not known if Gilenya is found in breast milk. Do not breast-feed while taking Gilenya.

Possible side effects of Gilenya:

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:

Back pain; cough; diarrhea; headache; mild hair loss; weakness.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion; dizziness; eye pain; new or worsening breathing problems (eg, shortness of breath); one-sided weakness; severe or persistent headache; slow or irregular heartbeat; slurred speech; symptoms of infection (eg, fever, chills, sore throat, severe or persistent cough, body aches, nausea or vomiting, increased or painful urination); symptoms of liver problems (eg, dark urine; loss of appetite; pale stools; severe or persistent nausea, vomiting, or stomach pain; yellowing of the skin or eyes); unexpected weight loss; unusual tiredness or weakness; vision changes (eg, blurred vision, decreased clearness of vision, blind spot, sensitivity to light, unusually colored or tinted vision).

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: Gilenya 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 chest tightness or discomfort.

Proper storage of Gilenya:

Store Gilenya at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store in the original blister pack away from heat, moisture, and light. Do not store in the bathroom. Keep Gilenya out of the reach of children and away from pets.

General information:

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


• Gilenya 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 Gilenya. 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

Copyright © 2012 Wolters Kluwer Health, Inc.

More Gilenya resources

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

• Gilenya Prescribing Information (FDA)


• Gilenya Monograph (AHFS DI)


• Gilenya Advanced Consumer (Micromedex) - Includes Dosage Information


• Gilenya Consumer Overview

Compare Gilenya with other medications

• Multiple Sclerosis

Otic anti-infectives

A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes.

Otic anti-infectives are generally available as ear drops and contain anti-infective agents that either have antibacterial or antifungal activity. These agents either kill or inhibit bacterial or fungal growth. They are used to treat bacterial or fungal infections of the ear.

See also

Medical conditions associated with otic anti-infectives:

• Acute Otitis Externa
• Bacterial Infection
• Otitis Externa
• Otitis Media

Drug List:

Zinotic-Drops

Acetasol-Otic

Borofair-Solution

Cetraxal

Chlorpram-Z-Drops

Cresylate-Drops

Domeboro-Otic

Floxin-Otic

Star-Otic

Vosol

Zinotic-Es-Drops

Vitafol-OB+DHA

Generic Name: prenatal multivitamins (PRE nay tal VYE ta mins)

Brand Names: Advance Care Plus, Bright Beginnings, Cavan Folate, Cavan One, Cavan-Heme OB, Cenogen Ultra, CitraNatal Rx, Co Natal FA, Complete Natal DHA, Complete-RF, CompleteNate, Concept OB, Docosavit, Dualvit OB, Duet, Edge OB, Elite OB 400, Femecal OB, Folbecal, Folcaps Care One, Folivan-OB, Foltabs, Gesticare, Icar Prenatal, Icare Prenatal Rx, Inatal Advance, Infanate DHA, Kolnatal DHA, Lactocal-F, Marnatal-F, Maternity, Maxinate, Mission Prenatal, Multi-Nate 30, Multinatal Plus, Nata 29 Prenatal, Natachew, Natafort, Natelle, Neevo, Nestabs, Nexa Select with DHA, Novanatal, NovaStart, O-Cal Prenatal, OB Complete, OB Natal One, Ob-20, Obtrex DHA, OptiNate, Paire OB Plus DHA, PNV Select, PNV-Total, PR Natal 400, Pre-H-Cal, Precare, PreferaOB, Premesis Rx, PrenaCare, PrenaFirst, PrenaPlus, Prenatabs OBN, Prenatabs Rx, Prenatal 1 Plus 1, Prenatal Elite, Prenatal Multivitamins, Prenatal Plus, Prenatal S, Prenatal-U, Prenate Advanced Formula, Prenate DHA, Prenate Elite, Prenavite FC, PreNexa, PreQue 10, Previte Rx, PrimaCare, Pruet DHA, RE OB Plus DHA, Renate, RightStep, Rovin-NV, Se-Care, Se-Natal One, Se-Plete DHA, Se-Tan DHA, Select-OB, Seton ET, Strongstart, Stuart Prenatal with Beta Carotene, Tandem OB, Taron-BC, Tri Rx, TriAdvance, TriCare, Trimesis Rx, Trinate, Triveen-PRx RNF, UltimateCare Advance, Ultra-Natal, Vemavite PRX 2, VeNatal FA, Verotin-BY, Verotin-GR, Vinacal OR, Vinatal Forte, Vinate Advanced (New Formula), Vinate AZ, Vinate Care, Vinate Good Start, Vinate II (New Formula), Vinate III, Vinate One, Vitafol-OB, VitaNatal OB plus DHA, Vitaphil, Vitaphil Aide, Vitaphil Plus DHA, Vitaspire, Viva DHA, Vol-Nate, Vol-Plus, Vol-Tab Rx, Vynatal F.A., Zatean-CH, Zatean-PN

What are Vitafol-OB+DHA (prenatal multivitamins)?

There are many brands and forms of prenatal vitamin available and not all brands are listed on this leaflet.

Prenatal vitamins are a combination of many different vitamins that are normally found in foods and other natural sources.

Prenatal vitamins are used to provide the additional vitamins needed during pregnancy. Minerals may also be contained in prenatal multivitamins.

Prenatal vitamins may also be used for purposes not listed in this medication guide.

What is the most important information I should know about prenatal vitamins?

There are many brands and forms of prenatal vitamin available and not all brands are listed on this leaflet.

Never take more than the recommended dose of a multivitamin. Avoid taking any other multivitamin product within 2 hours before or after you take your prenatal vitamins. Taking similar vitamin products together at the same time can result in a vitamin overdose or serious side effects.

Many multivitamin products also contain minerals such as calcium, iron, magnesium, potassium, and zinc. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. Read the label of any multivitamin product you take to make sure you are aware of what it contains.

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of vitamins A, D, E, or K can cause serious or life-threatening side effects and can also harm your unborn baby. Certain minerals contained in a prenatal multivitamin may also cause serious overdose symptoms or harm to the baby if you take too much.

Overdose symptoms may include stomach pain, vomiting, diarrhea, constipation, loss of appetite, hair loss, peeling skin, tingly feeling in or around your mouth, changes in menstrual periods, weight loss, severe headache, muscle or joint pain, severe back pain, blood in your urine, pale skin, and easy bruising or bleeding.

Do not take this medication with milk, other dairy products, calcium supplements, or antacids that contain calcium. Calcium may make it harder for your body to absorb certain ingredients of the multivitamin.

What should I discuss with my healthcare provider before taking prenatal vitamins?

Many vitamins can cause serious or life-threatening side effects if taken in large doses. Do not take more of this medication than directed on the label or prescribed by your doctor.

Before taking prenatal vitamins, tell your doctor about all of your medical conditions.

You may need to continue taking prenatal vitamins if you breast-feed your baby. Ask your doctor about taking this medication while breast-feeding.

How should I take prenatal vitamins?

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.

Never take more than the recommended dose of prenatal vitamins.

Many multivitamin products also contain minerals such as calcium, iron, magnesium, potassium, and zinc. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. Read the label of any multivitamin product you take to make sure you are aware of what it contains.

Take your prenatal vitamin with a full glass of water.

Swallow the regular tablet or capsule whole. Do not break, chew, crush, or open it.

The chewable tablet must be chewed or allowed to dissolve in your mouth before swallowing. You may also allow the chewable tablet to dissolve in drinking water, fruit juice, or infant formula (but not milk or other dairy products). Drink this mixture right away.

Use prenatal vitamins regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store at room temperature away from moisture and heat. Keep prenatal vitamins in their original container. Storing vitamins in a glass container can ruin the medication.

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 if you think you have used too much of this medicine. An overdose of vitamins A, D, E, or K can cause serious or life-threatening side effects and can also harm your unborn baby. Certain minerals contained in a prenatal multivitamin may also cause serious overdose symptoms or harm to the baby if you take too much.

Overdose symptoms may include stomach pain, vomiting, diarrhea, constipation, loss of appetite, hair loss, peeling skin, tingly feeling in or around your mouth, changes in menstrual periods, weight loss, severe headache, muscle or joint pain, severe back pain, blood in your urine, pale skin, and easy bruising or bleeding.

What should I avoid while taking prenatal vitamins?

Avoid taking any other multivitamin product within 2 hours before or after you take your prenatal vitamins. Taking similar vitamin products together at the same time can result in a vitamin overdose or serious side effects.

Avoid the regular use of salt substitutes in your diet if your multivitamin contains potassium. If you are on a low-salt diet, ask your doctor before taking a vitamin or mineral supplement.

Do not take this medication with milk, other dairy products, calcium supplements, or antacids that contain calcium. Calcium may make it harder for your body to absorb certain ingredients of the prenatal vitamin.

Prenatal vitamins 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.

When taken as directed, prenatal vitamins are not expected to cause serious side effects. Less serious side effects may include:

• 
  

  upset stomach;

  
  


• 
  

  headache; or

  
  


• 
  

  unusual or unpleasant taste in your mouth.

  
  

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 will affect prenatal vitamins?

Vitamin and mineral supplements can interact with certain medications, or affect how medications work in your body. Before taking a prenatal vitamin, tell your doctor if you also use:

• 
  

  diuretics (water pills);

  
  


• 
  

  heart or blood pressure medications;

  
  


• 
  

  tretinoin (Vesanoid);

  
  


• 
  

  isotretinoin (Accutane, Amnesteen, Clavaris, Sotret);

  
  


• 
  

  trimethoprim and sulfamethoxazole (Cotrim, Bactrim, Gantanol, Gantrisin, Septra, TMP/SMX); or

  
  


• 
  

  an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others.

  
  

This list is not complete and other drugs may interact with prenatal vitamins. 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 Vitafol-OB+DHA resources

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

• Cal-Nate MedFacts Consumer Leaflet (Wolters Kluwer)


• CareNatal DHA MedFacts Consumer Leaflet (Wolters Kluwer)


• CitraNatal 90 DHA MedFacts Consumer Leaflet (Wolters Kluwer)


• CitraNatal Assure Prescribing Information (FDA)


• CitraNatal Harmony Prescribing Information (FDA)


• Concept DHA Prescribing Information (FDA)


• Docosavit Prescribing Information (FDA)


• Duet DHA with Ferrazone MedFacts Consumer Leaflet (Wolters Kluwer)


• Folbecal MedFacts Consumer Leaflet (Wolters Kluwer)


• Folcal DHA Prescribing Information (FDA)


• Folcaps Care One Prescribing Information (FDA)


• Gesticare DHA Prescribing Information (FDA)


• Gesticare DHA MedFacts Consumer Leaflet (Wolters Kluwer)


• Inatal Advance Prescribing Information (FDA)


• Inatal Ultra Prescribing Information (FDA)


• Multi-Nate DHA Prescribing Information (FDA)


• Multi-Nate DHA Extra Prescribing Information (FDA)


• MultiNatal Plus MedFacts Consumer Leaflet (Wolters Kluwer)


• Natelle One Prescribing Information (FDA)


• Neevo Caplets MedFacts Consumer Leaflet (Wolters Kluwer)


• Neevo DHA MedFacts Consumer Leaflet (Wolters Kluwer)


• OB Complete 400 MedFacts Consumer Leaflet (Wolters Kluwer)


• Paire OB Plus DHA Prescribing Information (FDA)


• PreNexa MedFacts Consumer Leaflet (Wolters Kluwer)


• PreNexa Prescribing Information (FDA)


• PreferaOB Prescribing Information (FDA)


• Prenatal Plus Prescribing Information (FDA)


• Prenatal Plus Iron Prescribing Information (FDA)


• Prenate Elite Prescribing Information (FDA)


• Prenate Elite MedFacts Consumer Leaflet (Wolters Kluwer)


• Prenate Elite tablets


• Prenate Essential Prescribing Information (FDA)


• PrimaCare Advantage MedFacts Consumer Leaflet (Wolters Kluwer)


• PrimaCare ONE capsules


• PrimaCare One MedFacts Consumer Leaflet (Wolters Kluwer)


• Renate DHA Prescribing Information (FDA)


• Se-Natal 19 Chewable Tablets MedFacts Consumer Leaflet (Wolters Kluwer)


• Se-Natal 19 Prescribing Information (FDA)


• Tandem DHA Prescribing Information (FDA)


• Tandem OB Prescribing Information (FDA)


• TriAdvance Prescribing Information (FDA)


• Triveen-One MedFacts Consumer Leaflet (Wolters Kluwer)


• Triveen-PRx RNF Prescribing Information (FDA)


• UltimateCare ONE NF Prescribing Information (FDA)


• Ultra NatalCare MedFacts Consumer Leaflet (Wolters Kluwer)


• Vinate AZ Prescribing Information (FDA)


• Vitafol-One MedFacts Consumer Leaflet (Wolters Kluwer)


• Zatean-CH Prescribing Information (FDA)

Compare Vitafol-OB+DHA with other medications

• Vitamin/Mineral Supplementation during Pregnancy/Lactation

Where can I get more information?

• Your pharmacist can provide more information about prenatal vitamins.

See also: Vitafol-OB+DHA side effects (in more detail)

Barbiturate anticonvulsants

A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes.

Barbiturate anticonvulsants are a group of drugs derived from barbituric acid and they act by suppressing activity of the central nervous system. Barbiturate anticonvulsants enhance the action of GABA, which is an inhibitory neurotransmitter, and inhibits initiation of discharge that would start the seizure. Barbiturates facilitate GABA-mediated opening of chloride channels and increases effectiveness of GABA.

Barbiturates are used to treat all types of seizures except absence seizures.

See also

Medical conditions associated with barbiturate anticonvulsants:

• Benign Essential Tremor
• Epilepsy
• Hyperbilirubinemia
• Insomnia
• Sedation
• Seizures

Drug List:

Mebaral

Mysoline

Luminal

Solfoton