Mandelamine

Pronunciation: meth-EN-a-meen
Generic Name: Methenamine
Brand Name: Examples include Hiprex and Urex

Mandelamine is used for:

Preventing urinary tract infections.

Mandelamine is a urinary antiseptic. It works by concentrating in the urine as formaldehyde, which kills bacteria in the urine.

Do NOT use Mandelamine if:

• you are allergic to any ingredient in Mandelamine


• you have kidney problems


• you are taking a sulfonamide (eg, sulfamethizole)

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

Before using Mandelamine:

Some medical conditions may interact with Mandelamine. 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 diarrhea, a stomach infection, liver or kidney problems, or gout, or you are severely dehydrated

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

• Sulfonamides (eg, sulfamethizole) because they may decrease Mandelamine's effectiveness

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

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

• Take Mandelamine by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.


• Before you begin using an antacid, check with your doctor or pharmacist.


• If you miss a dose of Mandelamine, 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 Mandelamine.

Important safety information:

• It is important that your urine be acidic while you are taking Mandelamine. Check with your doctor to see if you should eat or avoid certain foods to keep your urine acidic.


• Mandelamine may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Mandelamine.


• Lab tests, including urine pH, may be performed while you use Mandelamine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• PREGNANCY and BREAST-FEEDING: It is not known if Mandelamine can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Mandelamine while you are pregnant. Mandelamine is found in breast milk. If you are or will be breast-feeding while you use Mandelamine, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Mandelamine:

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:

Nausea; upset stomach.

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); blood in the urine.

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: Mandelamine 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 Mandelamine:

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

General information:

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


• Mandelamine 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 Mandelamine. 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 Mandelamine resources

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

• Mandelamine Advanced Consumer (Micromedex) - Includes Dosage Information


• Mandelamine Concise Consumer Information (Cerner Multum)


• Methenamine Monograph (AHFS DI)


• Methenamine Prescribing Information (FDA)


• Hiprex Prescribing Information (FDA)

Compare Mandelamine with other medications

• Bladder Infection
• Prevention of Bladder infection

Fanapt

Generic Name: iloperidone (Oral route)

eye-loe-PER-i-done

Oral route(Tablet)

Elderly patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo. Although the causes of death in clinical trials were varied, most of the deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature. Observational studies suggest that antipsychotic drugs may increase mortality. It is unclear from the observational studies to what extent these mortality findings may be attributed to the antipsychotic drug as opposed to patient characteristics. Iloperidone is not approved for the treatment of patients with dementia-related psychosis .

Commonly used brand name(s)

In the U.S.

• Fanapt


• Fanapt Titration Pack

Available Dosage Forms:

• Tablet

Therapeutic Class: Antipsychotic

Chemical Class: Benzisoxazole

Uses For Fanapt

Iloperidone is used to treat the symptoms of psychotic (mental) disorders, such as schizophrenia. This medicine should NOT be used to treat behavioral problems in older adult patients who have dementia.

This medicine is available only with your doctor's prescription.

Before Using Fanapt

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 this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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 iloperidone in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of iloperidone in the elderly. However, elderly patients are more likely to have dementia or age-related liver problems, which may require caution in patients receiving iloperidone.

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

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while 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 this medicine, 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 this medicine 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.

• Cisapride


• Dronedarone


• Mesoridazine


• Metoclopramide


• Pimozide


• Posaconazole


• Sparfloxacin


• Thioridazine

Using this medicine 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.

• Acecainide


• Ajmaline


• Alfuzosin


• Amiodarone


• Amitriptyline


• Amoxapine


• Apomorphine


• Arsenic Trioxide


• Asenapine


• Astemizole


• Atazanavir


• Azimilide


• Azithromycin


• Bretylium


• Chloroquine


• Chlorpromazine


• Ciprofloxacin


• Citalopram


• Clarithromycin


• Clomipramine


• Clozapine


• Crizotinib


• Dasatinib


• Desipramine


• Disopyramide


• Dofetilide


• Dolasetron


• Droperidol


• Erythromycin


• Flecainide


• Fluconazole


• Gatifloxacin


• Gemifloxacin


• Granisetron


• Halofantrine


• Hydroquinidine


• Ibutilide


• Imipramine


• Indinavir


• Itraconazole


• Ketoconazole


• Lapatinib


• Levofloxacin


• Mefloquine


• Methadone


• Moxifloxacin


• Nefazodone


• Nelfinavir


• Nilotinib


• Norfloxacin


• Nortriptyline


• Octreotide


• Ofloxacin


• Ondansetron


• Paliperidone


• Pazopanib


• Perflutren Lipid Microsphere


• Pirmenol


• Prajmaline


• Procainamide


• Prochlorperazine


• Promethazine


• Propafenone


• Protriptyline


• Quetiapine


• Quinine


• Ranolazine


• Ritonavir


• Salmeterol


• Saquinavir


• Sematilide


• Sodium Phosphate


• Sodium Phosphate, Dibasic


• Sodium Phosphate, Monobasic


• Solifenacin


• Sorafenib


• Sotalol


• Sunitinib


• Tedisamil


• Telavancin


• Telithromycin


• Terfenadine


• Tetrabenazine


• Toremifene


• Trazodone


• Trifluoperazine


• Trimipramine


• Vandetanib


• Vardenafil


• Vemurafenib


• Voriconazole


• Ziprasidone

Using this medicine 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.

• Fluoxetine


• Paroxetine

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.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Alzheimer's disease or


• Blood vessel disease or


• Bradycardia (slow heartbeat), severe or


• Dehydration or


• Heart attack, recent or history of, or


• Heart failure, history of or


• Heart rhythm problems (e.g., prolonged QT interval), or a history of or


• Hypokalemia (low potassium in the blood) or


• Hypomagnesemia (low magnesium in the blood) or


• Hypotension (low blood pressure) or


• Hypovolemia (low amount of blood) or


• Stroke, history of—May cause side effects to become worse.

• Blood or bone marrow problems or


• Breast cancer, prolactin-dependent or


• Diabetes or


• Hyperglycemia (high blood sugar) or


• Hyperprolactinemia (high prolactin in the blood) or


• Neuroleptic malignant syndrome (NMS), history of or


• Seizures, history of—Use with caution. May make these conditions worse.

• Liver disease—Should not use in patients with this condition.

Proper Use of iloperidone

This section provides information on the proper use of a number of products that contain iloperidone. It may not be specific to Fanapt. Please read with care.

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

You may take this medicine with or without food.

Dosing

The dose of this medicine 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 this medicine. 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 treatment of schizophrenia:
    
    • Adults—At first, 1 milligram (mg) two times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 12 mg two times a day.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  

Missed Dose

If you miss a dose of this medicine, 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 Fanapt

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

This medicine can cause changes in heart rhythms, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Call your doctor right away if you have any symptoms of heart rhythm problems, such as dizziness, feeling faint, or a fast, pounding, or irregular heartbeat.

Stop taking this medicine and check with your doctor right away if you have any of the following symptoms while using this medicine: convulsions (seizures), difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have any of the following symptoms while taking this medicine: lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

This medicine may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or increased urination. If you have diabetes, you may notice a change in the results of your urine or blood sugar tests. If you have any questions, check with your doctor.

This medicine may increase your weight. Your doctor may need to check your weight on a regular basis while you are using this medicine.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position suddenly. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

Iloperidone can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.


• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.

This medicine may make it more difficult for your body to cool itself down. Use care not to become overheated during exercise or hot weather since overheating may result in heat stroke.

Iloperidone may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these side effects, tell your doctor right away.

This medicine may cause drowsiness, trouble with thinking, trouble with controlling body movements, or trouble with your vision. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to think or see well.

Avoid drinking alcohol while you are using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Fanapt 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:

More common

• Fast, pounding, or irregular heartbeat or pulse

Less common

• Blurred vision


• body aches or pain


• chills


• cold sweats


• confusion


• cough


• difficult or labored breathing


• difficulty with moving


• difficulty with speaking


• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly


• drooling


• ear congestion


• fever


• headache


• inability to sit still


• loss of balance control


• loss of voice


• muscle pain or stiffness


• muscle trembling, jerking, or stiffness


• nasal congestion


• need to keep moving


• pain in the joints


• restlessness


• runny nose


• shakiness in the legs, arms, hands, or feet


• shortness of breath


• shuffling walk


• sneezing


• sore throat


• stiffness of the limbs


• sweating


• tightness in the chest


• trembling or shaking of the hands or feet


• twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs


• uncontrolled movements, especially of the face, neck, and back


• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness


• wheezing

Rare

• Abdominal or stomach fullness


• aching or discomfort in the lower legs or sensation of crawling in the legs


• actions that are out of control


• aggressive or angry


• agitation


• anxiety


• attack, assault, or force


• back pain


• black, tarry stools


• bloody nose


• burning while urinating


• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings


• chest pain or discomfort


• coma


• confusion as to time, place, or person


• constipation


• convulsions


• decrease in the amount of urine


• decrease in the frequency of urination


• decrease in urine volume


• decreased awareness or responsiveness


• decreased urination


• decreased weight


• depression


• difficult or painful urination


• difficulty in passing urine (dribbling)


• difficulty with walking


• dilated neck veins


• dizziness


• dry mouth


• dry skin and hair


• extreme thirst


• extremely high fever or body temperature


• fainting


• false beliefs that cannot be changed by facts


• fast, shallow breathing


• feeling cold


• frequent urination


• gaseous abdominal pain


• groin pain


• hair loss


• hoarseness or husky voice


• holding false beliefs that cannot be changed by fact


• hostility


• inability to move the eyes


• increased blinking or spasms of the eyelid


• increased thirst


• irregular breathing


• irritability


• lightheadedness


• loss of appetite


• loss of bladder control


• mimicry of speech or movements


• mood swings


• muscle aching or cramping


• muscle spasms


• muscle twitching


• nausea or vomiting


• nervousness


• noisy breathing


• noisy, rattling breathing


• numbness or tingling in the hands, feet, or lips


• pale, clammy skin


• peculiar postures or movements, mannerisms, or grimacing


• pounding, slow heartbeat


• rapid breathing


• rapid weight gain


• recurrent fever


• restlessness


• seizures


• severe sleepiness


• slow movement


• slow reflexes


• sore throat


• sore tongue


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


• sticking out of tongue


• stupor


• sunken eyes


• swelling


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


• swollen glands


• swollen joints


• swollen, tender prostate


• talking, feeling, and acting with excitement


• thirst


• troubled breathing at rest


• troubled breathing with exertion


• uncontrolled twisting movements of the neck, trunk, arms, or legs


• unusual bleeding or bruising


• unusual excitement, nervousness, or restlessness


• unusual facial expressions


• weight gain


• wrinkled skin


• yellow eyes or skin

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:

More common

• Diarrhea


• sleepiness or unusual drowsiness

Less common

• Abdominal or stomach discomfort


• not able to ejaculate semen


• rash


• stuffy nose

Rare

• Absent, missed, or irregular menstrual periods


• blindness


• blurred vision


• breast pain


• burning feeling in the chest or stomach


• burning upper abdominal pain


• canker sores


• continuing ringing or buzzing or other unexplained noise in the ears


• decreased interest in sexual intercourse


• decreased vision


• delusions of persecution, mistrust, suspiciousness, or combativeness


• dry eyes


• feeling of constant movement of self or surroundings


• hearing loss


• inability to have or keep an erection


• increase in blood flow to the whites of the eyes


• increased appetite


• increased watering of the mouth


• indigestion


• irregular menstruation


• irritation or soreness of the mouth


• longer or heavier menstrual periods


• loss in sexual ability, desire, drive, or performance


• loss of bowel control


• loss of memory


• normal menstrual bleeding occurring earlier, possibly lasting longer than expected


• problems with memory


• redness, swelling, or itching of the eyelids


• sensation of spinning


• stomach upset


• stopping of menstrual bleeding


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


• swelling or inflammation of the mouth


• tenderness in the stomach area


• uncontrolled eye movements

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: Fanapt side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Fanapt resources

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

• Fanapt Prescribing Information (FDA)


• Fanapt Consumer Overview


• Fanapt Monograph (AHFS DI)


• Fanapt MedFacts Consumer Leaflet (Wolters Kluwer)


• Iloperidone Professional Patient Advice (Wolters Kluwer)

Compare Fanapt with other medications

• Psychosis
• Schizophrenia

Atropine-1

Generic Name: atropine ophthalmic (A troe peen)

Brand Names: Atropine-1, Atropine-Care, Atropisol, Isopto Atropine, Ocu-Tropine

What is Atropine-1 (atropine ophthalmic)?

Atropine ophthalmic causes the muscles in your eye to become relaxed. This widens your pupil. Your pupil will remain wide and will not respond to light.

Atropine ophthalmic is used to dilate (widen) your pupil when you have an inflammatory condition or in postsurgery situations in which this effect may be helpful.

Atropine ophthalmic may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Atropine-1 (atropine ophthalmic)?

Do not touch the dropper or tube opening to any surface, including your eyes or hands. The dropper or tube opening is sterile. If it becomes contaminated, it could cause an infection in your eye.

Apply light pressure to the inside corner of your eye (near your nose) for 1 to 3 minutes after each drop or ointment application to prevent the medicine from draining down your tear duct.

Use caution when driving, operating machinery, or performing other hazardous activities. Atropine ophthalmic may cause blurred vision. If you experience blurred vision, avoid these activities. The effects of even one drop of this medication can last for up to 2 weeks. Be sure that your vision is clear before attempting any activity that could be dangerous. Atropine ophthalmic may make your eyes more sensitive to light. Protect your eyes when you are going to be in bright light.

Who should not use Atropine-1 (atropine ophthalmic)?

Do not use atropine ophthalmic if you have glaucoma that is not being treated.

Atropine ophthalmic eye drops contain a preservative (benzalkonium chloride), so do not wear soft contact lenses when the eye drops are being inserted.

Atropine ophthalmic is in the FDA pregnancy category C. This means that it is not known whether it will harm an unborn baby. Do not use atropine ophthalmic without first talking to your doctor if you are pregnant. Atropine ophthalmic passes into breast milk in small quantities. Its effects on a nursing baby are unknown. Do not use atropine ophthalmic without first talking to your doctor if you are breast-feeding a baby. If you are over 65 years of age, there is a greater chance that you have increased pressure in your eyes. Atropine ophthalmic may worsen this condition. Your doctor will need to monitor this. Atropine ophthalmic may cause unusual reactions in children and infants since they may be more susceptible to the side effects. Use extra caution when atropine ophthalmic is being used on a child.

How should I use Atropine-1 (atropine ophthalmic)?

Use atropine ophthalmic eye drops or ointment exactly as directed by your doctor. If you do not understand these instructions, ask your doctor, pharmacist, or nurse to explain them to you.

Wash your hands before and after using your eye drops or ointment.

To apply the eye drops:

• 
  

  Tilt your head back slightly and pull down on your lower eyelid. Position the dropper above your eye. Look up and away from the dropper. Squeeze out a drop and close your eye. Apply gentle pressure to the inside corner of your eye (near your nose) for 1 to 3 minutes to prevent the liquid from draining down your tear duct. If you are using more than one drop in the same eye or drops in both eyes, repeat the process with about 5 minutes between drops.

  
  

To apply the ointment:

• 
  

  Hold the tube in your hand for a few minutes to warm it up so that the ointment comes out easily. Tilt your head back slightly and pull down gently on your lower eyelid. Apply a thin film of the ointment into your lower eyelid. Apply gentle pressure to the inside corner of your eye near your nose for 1 to 3 minutes to prevent the ointment from draining down your tear duct. Close your eye and roll your eyeball around in all directions for 1 to 2 minutes. If you are applying another eye medication, allow at least 10 minutes before your next application.

  
  

Do not touch the dropper or tube opening to any surface, including your eyes or hands. The dropper or tube opening is sterile. If it becomes contaminated, it could cause an infection in your eye. Do not use any eye drop that is discolored or has particles in it. Store atropine ophthalmic at room temperature away from moisture and heat. Keep the bottle or tube properly capped.

What happens if I miss a dose?

Apply the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the missed dose and apply the next one as directed. Do not use a double dose of this medication.

What happens if I overdose?

Flush the eye with water and seek emergency medical attention.

Symptoms of an atropine ophthalmic overdose include headache, fast heartbeat, dry mouth and skin, unusual drowsiness, flushing, coma, and death.

What should I avoid while using Atropine-1 (atropine ophthalmic)?

Use caution when driving, operating machinery, or performing other hazardous activities. Atropine ophthalmic may cause blurred vision. If you experience blurred vision, avoid these activities. The effects of even one drop of this medication can last for up to 2 weeks. Be sure that your vision is clear before attempting any activity that could be dangerous. Do not touch the dropper or tube opening to any surface, including your eyes or hands. The dropper or tube opening is sterile. If it becomes contaminated, it could cause an infection in your eye. Atropine ophthalmic may make your eyes more sensitive to light. Protect your eyes when you are going to be in bright light.

Atropine ophthalmic eye drops contain a preservative (benzalkonium chloride), so do not wear soft contact lenses when the eye drops are being inserted.

Atropine-1 (atropine ophthalmic) side effects

If you experience any of the following serious side effects, stop using atropine ophthalmic and seek emergency medical attention:

• 
  

  an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

  
  


• 
  

  an irregular or fast heart rate;

  
  


• 
  

  hallucinations or unusual behavior (especially in children); or

  
  


• 
  

  a swollen or distended stomach (in infants).

  
  

Other, less serious side effects may be more likely to occur. Continue to use atropine ophthalmic and talk to your doctor if you experience

• 
  

  blurred vision,

  
  


• 
  

  sensitivity to sunlight,

  
  


• 
  

  stinging and burning, or

  
  


• 
  

  swelling of the eyelids.

  
  

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Atropine-1 (atropine ophthalmic)?

Avoid other eye medications unless they are approved by your doctor.

Drugs other than those listed here may also interact with atropine ophthalmic. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

More Atropine-1 resources

• Atropine-1 Use in Pregnancy & Breastfeeding
• Atropine-1 Drug Interactions
• Atropine-1 Support Group
• 0 Reviews for Atropine-1 - Add your own review/rating

• Atropisol Advanced Consumer (Micromedex) - Includes Dosage Information


• Isopto Atropine Drops MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Atropine-1 with other medications

• Pupillary Dilation
• Refraction, Assessment
• Uveitis

Where can I get more information?

• Your pharmacist has additional information about atropine ophthalmic written for health professionals that you may read.

Intrinsa 300 micrograms / 24 hours transdermal patch

Intrinsa

300 micrograms/24 hours transdermal patch Testosterone

ENGLISH

Intrinsa

300 micrograms/24 hours transdermal patch Testosterone

Read all of this leaflet carefully before you start using this medicine.

• Keep this leaflet. You may need to read it again.


• If you have any further questions, ask your doctor or pharmacist.


• This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms appear to be the same as yours.


• If any of the side effects become serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

In this leaflet:

• 1. What Intrinsa is and what it is used for


• 2. What you should consider before you use Intrinsa


• 3. How to use Intrinsa


• 4. Possible side effects


• 5. How to store Intrinsa


• 6. Further information

What Intrinsa Is And What It Is Used For

Intrinsa is a transdermal patch which constantly releases small amounts of testosterone that is absorbed through your skin into the bloodstream. The testosterone in Intrinsa is the same hormone as that produced naturally in men and women.

After removal of the ovaries, testosterone drops to half of the levels compared to before the operation. Decrease in testosterone has been associated with low sexual desire, reduced sexual thoughts and reduced sexual arousal. All or any of these problems can cause personal distress or relationship difficulties. The medical term for this condition is Hypoactive Sexual Desire Disorder, also known as HSDD.

Intrinsa is used to treat HSDD. Intrinsa is intended for use by women up to the age of 60 years who:

• have a low sexual desire which is causing distress or concern, and


• have had both of their ovaries removed, and


• have had their womb removed (hysterectomy), and


• are receiving estrogen therapy.

It may take longer than one month for you to notice an improvement. If you have not experienced a positive effect of Intrinsa within 3-6 months, you should inform your doctor, who will suggest that treatment be discontinued.

What You Should Consider Before You Use Intrinsa

Do not use Intrinsa

• if you are allergic (hypersensitive) to testosterone or any of the other ingredients of Intrinsa.


• if you know that you have had in the past, currently have, or think that you might have, breast cancer or any other cancer which your doctor has described as being caused or stimulated by the female hormone estrogen, also called ‘estrogen-dependent’ cancers.


• if you have other conditions that your doctor may consider not appropriate for the use of estrogen and/or testosterone.

Take special care with Intrinsa

• if you have a history of heart, liver or kidney disease.


• if you are diabetic, as testosterone may lower blood glucose levels.


• if you have a history of excessive adult acne, body or facial hair, hair loss, enlargement of the clitoris or voice deepening or hoarseness.

If you have any of the above, tell your doctor before you start to use Intrinsa. Your doctor will advise you on what you should do.

The efficacy of Intrinsa is reduced if your estrogen therapy is of a certain type (‘conjugated equine estrogens’). Therefore, you need to discuss your type of estrogen with your doctor, who could advise you which type of estrogen is suitable together with Intrinsa. If you stop estrogen therapy you must also stop using Intrinsa. Keep in mind that estrogens should be administered for the shortest possible duration.

Use Intrinsa only as long as you experience a positive effect of the treatment. There is no information on the safety of Intrinsa beyond 12 months. There are limited data about the use in women above the age of 60.

It is not known whether Intrinsa increases the risk of breast cancer. Your doctor will carefully monitor you with regard to breast cancer.

Taking other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without prescription.

Take particular care if you are taking medicines containing any of the following active substances:

• blood-thinning (anticoagulant) treatment

Children and adolescents

Intrinsa is not for use in children and adolescents.

Pregnancy and breast-feeding

Ask your doctor or pharmacist for advice before taking any medicine. Intrinsa is only indicated for women in their menopause after the ovaries and uterus have been removed. Do not use Intrinsa if you are, or suspect that you may be pregnant or are able to become pregnant, because it may cause harm to the unborn child.

Do not use Intrinsa in case of breast-feeding because it may cause harm to the child.

Driving and using machines

You can drive and use machines while using Intrinsa.

How To Use Intrinsa

Intrinsa should be replaced twice weekly (each 3 to 4 days). The active substance is released from the patch constantly over 3 to 4 days and is absorbed through your skin. Always use Intrinsa exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure of the instructions or if you want any more information.

Where to stick the patch

• Stick the patch onto your lower abdomen, below your waist. Do not stick the patch on the breasts or bottom.
  Make sure that your skin at the application site is:
  
  
  • clean and dry (free of lotions, moisturisers, and powders)
  
  
  • as smooth as possible (no major creases or skin folds)
  
  
  • not cut or irritated (free of rashes or other skin problems)
  
  
  • unlikely to be rubbed by clothing excessively
  
  
  • preferably free from hair.
  
  

• When changing your patch, stick the new patch on to a different area of the skin of your abdomen, otherwise you are more likely to cause skin irritation.


• Only one patch is to be worn at a time.


• If you are also using estrogen patches, make sure that the patch and the estrogen patch do not overlap.


• For at least one week after removing a patch, do not place a new patch in the same area.

How to stick on the patch

Step 1 Tear open the sachet. Do not use scissors as you may accidentally damage the patch. Remove the patch. Apply the patch immediately after removing it from the sachet.

Step 2 While holding the patch, remove half of the protective liner that covers the sticky part of the patch. Avoid touching the sticky side of the patch with your fingers.

Step 3 Apply the sticky side of the patch to the selected area onto your skin. Press the sticky side of the patch firmly into place for about 10 seconds.

Step 4 Fold back the patch and carefully remove the other half of the liner. Press the entire patch firmly against your skin with the palm of your hand for about 10 seconds. Use your fingers to make sure the edges of the patch stick to the skin. If an area of the patch lifts, apply pressure to that area.

How to change your patch

• You will need to change your patch every 3 to 4 days, which means using two patches each week. This will mean that you wear one patch for 3 days and the other for 4 days. Decide which two days each week you are going to change your patch, and change the patch on the same two days each week.

For example: If you decide to start treatment on a Monday, then you have to change your patch always on a Thursday and a Monday.

• Sunday + Wednesday


• Monday + Thursday


• Tuesday + Friday


• Wednesday + Saturday


• Thursday + Sunday


• Friday + Monday


• Saturday + Tuesday

As a reminder, mark on the outer carton your chosen patch-change days.

• On the patch-change day, remove the used patch and immediately stick the new patch on to a different area of skin of your abdomen. Continue your treatment for as long as your doctor advises.


• Fold the used patch in half, sticking the patch to itself, and discard it in a safe way in order to keep it away from children (e.g. in a rubbish bin). Medicines should not be disposed of via wastewater (do not flush it down the toilet). Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

What about showering, bathing and exercising?

You may shower, bath, swim and exercise as normal while wearing the patch. The patch is designed to remain in place during these times. However, do not scrub the area where the patch has been placed too hard.

What about sunbathing?

Always make sure your patch is covered by clothing.

What if your patch becomes loose, lifts at the edges or falls off?

If a patch does begin to come off, you may be able to make it stick again by pressing on it firmly. If you cannot get the patch to stick successfully, remove the loose patch and use a new patch. Then continue with your regular schedule of patch-change days, even if this means discarding a patch after you have worn it for less than 3-4 days.

If you use more patches than you should

If you have applied more than one patch at a time

Remove all the patches sticking on to your skin and consult your doctor or pharmacist for further information on how to continue treatment with Intrinsa. Overdosing with Intrinsa is unlikely when used as directed, because once the patch is taken off testosterone is quickly removed by the body.

If you forget to use a patch

If you forget to change your patch

Change your patch as soon as you remember, and then continue with your regular schedule of patch-change days, even if this means discarding a patch after you have worn it for less than 3–4 days. Returning to your regular schedule will help you remember when to change your patch.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

Possible Side Effects

Like all medicines, Intrinsa can cause side effects, although not everybody gets them.

Tell your doctor immediately:

• if you experience hair loss, enlargement of the clitoris, an increase in the amount of hair on the chin or upper lip, voice deepening or hoarseness, although these side effects may be mild. They are usually reversible if Intrinsa treatment is discontinued.
  
  You should self assess for increased acne, increased hair growth on your face, loss of hair, deepening of your voice or enlargement of your clitoris, which all could be signs of adverse effects of testosterone, which is the active substance in Intrinsa.
  



• if you notice any skin reactions at the site of application such as redness, oedema, or blistering. In case of severe application site reaction, the treatment should be discontinued.

Very common side effects

The following side effects may occur very commonly (in more than 1 out of 10 patients).

• rash/irritation/itching/redness at the site of the skin where the patch is applied


• increase in the amount of hair on the chin or upper lip (likely to be mild and reversible)

Common side effects

The following side effects may occur commonly (in more than 1 out of 100, but less than 1 out of 10 patients), but most of them are mild in nature and reversible.

• hair loss


• acne


• migraine


• insomnia/inability to sleep properly


• voice deepening or hoarseness


• breast pain


• weight gain


• abdominal pain

If any of the side effects become serious, or if you notice any side effects mentioned above or side effects not listed in this leaflet, please tell your doctor.

How To Store Intrinsa

• Keep out of the reach and sight of children.


• Do not store above 30°C.


• Do not refrigerate or freeze.

Do not use Intrinsa after the expiry date which is stated on the carton and sachet. The expiry date refers to the last day of that month.

Further Information

What Intrinsa contains

The active substance is testosterone. Each patch contains 8.4 mg of testosterone, releasing 300 micrograms of testosterone over 24 hours.

The other ingredients are: Sorbitan oleate, 2-Ethylhexylacrylate – 1-Vinyl-2-pyrrolidone co-polymer. Backing layer: Translucent polyethylene backing film printed with proprietary ink containing sunset yellow FCF (E110), latolrubine BK (E180) and copper phthalocyanine blue pigment. Protective release liner: Siliconised polyester film.

What Intrinsa looks like and contents of the pack

Intrinsa is a thin, clear, oval patch with PG T001 stamped on the back.

The following pack sizes are available: 2, 8 and 24 patches. Not all pack sizes may be marketed.

Marketing Authorisation Holder

Procter & Gamble Pharmaceuticals UK Ltd.

Rusham Park Technical Centre

Whitehall Lane

Egham

Surrey

TW20 9NW

United Kingdom

Manufacturer

Procter & Gamble Pharmaceuticals Longjumeau

Parc d’activité de la Grande Brèche

5 rue Désir Prévost

91070 Bondoufle

France

This leaflet was last approved in 04/2008

Detailed information on this medicine is available on the European Medicines Agency (EMEA) web site: http://www.emea.europa.eu

98723127

propoxyphene and acetaminophen

a-seet-a-MIN-oh-fen, proe-POX-i-feen NAP-si-late

Oral route(Tablet)

Accidental and intentional overdose with propoxyphene products either alone or in combination with other CNS depressants, including alcohol, has occurred, and may be fatal within the first hour. Many of the fatalities have occurred in patients with previous histories of emotional disturbances or suicidal ideation/attempts and/or concomitant administration of sedatives, tranquilizers, muscle relaxants, antidepressants, or other CNS-depressant drugs. Do not prescribe propoxyphene for patients who are suicidal or have a history of suicidal ideation. The metabolism of propoxyphene may be altered by strong CYP3A4 inhibitors leading to enhanced propoxyphene plasma levels; monitor patients closely and adjust dosages if necessary in patients receiving any CYP3A4 inhibitor concomitantly .

Commonly used brand name(s)

In the U.S.

• Balacet 325


• Darvocet A500


• Darvocet-N 100


• Darvocet-N 50


• Pronap-100


• Propoxacet-N


• Propoxacet-N 100

Available Dosage Forms:

• Tablet

Therapeutic Class: Opioid/Acetaminophen Combination

Chemical Class: Propoxyphene

Uses For propoxyphene and acetaminophen

Propoxyphene and acetaminophen combination is used to relieve mild to moderate pain. Propoxyphene belongs to the group of medicines called narcotic analgesics (pain medicines). It acts on the central nervous system (CNS) to relieve pain.

Acetaminophen is used to relieve pain and reduce fever in patients. It does not become habit-forming when taken for a long time. But acetaminophen may cause other unwanted effects when taken in large doses, including liver damage.

When propoxyphene is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

Products containing propoxyphene were withdrawn from the U.S. market starting November 19, 2010.

propoxyphene and acetaminophen was available only with your doctor's prescription.

Before Using propoxyphene and acetaminophen

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 propoxyphene and acetaminophen, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to propoxyphene and acetaminophen 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 propoxyphene and acetaminophen combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of propoxyphene and acetaminophen combination in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving propoxyphene and acetaminophen combination.

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

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while 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 propoxyphene and acetaminophen, 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 propoxyphene and acetaminophen 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.

• Naltrexone


• Rasagiline


• Selegiline

Using propoxyphene and acetaminophen 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.

• Adinazolam


• Alfentanil


• Alprazolam


• Amobarbital


• Anileridine


• Aprobarbital


• Bromazepam


• Brotizolam


• Buprenorphine


• Butabarbital


• Butalbital


• Butorphanol


• Carbamazepine


• Carisoprodol


• Chloral Hydrate


• Chlordiazepoxide


• Chlorzoxazone


• Clobazam


• Clonazepam


• Clorazepate


• Codeine


• Dantrolene


• Dezocine


• Diazepam


• Estazolam


• Ethchlorvynol


• Fentanyl


• Flunitrazepam


• Flurazepam


• Fospropofol


• Halazepam


• Hydrocodone


• Hydromorphone


• Ketazolam


• Levorphanol


• Lorazepam


• Lormetazepam


• Medazepam


• Meperidine


• Mephenesin


• Mephobarbital


• Meprobamate


• Metaxalone


• Methocarbamol


• Methohexital


• Midazolam


• Morphine


• Morphine Sulfate Liposome


• Nalbuphine


• Nitrazepam


• Nordazepam


• Opium


• Oxazepam


• Oxycodone


• Oxymorphone


• Pentazocine


• Pentobarbital


• Phenobarbital


• Prazepam


• Propoxyphene


• Quazepam


• Remifentanil


• Secobarbital


• Sodium Oxybate


• Sufentanil


• Tapentadol


• Temazepam


• Thiopental


• Triazolam

Using propoxyphene and acetaminophen 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.

• Acenocoumarol


• Carbamazepine


• Doxepin


• Isoniazid


• Metoprolol


• Phenytoin


• Propranolol


• Warfarin


• Zidovudine

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. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using propoxyphene and acetaminophen with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use propoxyphene and acetaminophen, or give you special instructions about the use of food, alcohol, or tobacco.

• Ethanol

Using propoxyphene and acetaminophen with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use propoxyphene and acetaminophen, or give you special instructions about the use of food, alcohol, or tobacco.

• Cabbage

Other Medical Problems

The presence of other medical problems may affect the use of propoxyphene and acetaminophen. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse, or history of or


• Brain tumor, history of or


• Chronic obstructive pulmonary disease (COPD) or


• Cor pulmonale (serious heart condition) or


• Drug dependence, especially with narcotics, or history of or


• Gallbladder disease or gallstones or


• Head injuries, history of or


• Hypovolemia (low blood volume)—Use with caution. May increase risk for more serious side effects.

• Asthma, severe or


• Breathing problems, severe (e.g., hypoxia) or


• Paralytic ileus (intestine stops working and may be blocked) or


• Respiratory depression (very slow breathing) or


• Suicidal ideation (thoughts of hurting or killing oneself), history of—Should not be used in patients with these conditions.

• Hypotension (low blood pressure) or


• Pancreatitis (inflammation of the pancreas)—Use with caution. May make these conditions worse.

• Kidney disease or


• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of propoxyphene and acetaminophen

Take propoxyphene and acetaminophen only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. This is especially important for elderly patients, who may be more sensitive to the effects of pain medicines. If too much of propoxyphene and acetaminophen is taken for a long time, it may become habit-forming (causing mental or physical dependence). Liver damage can occur if large amounts of acetaminophen are taken for a long time.

This combination medicine contains acetaminophen (Tylenol®). Carefully check the labels of all other medicines you are using, because they may also contain acetaminophen. It is not safe to use more than 4 grams (4,000 milligrams) of acetaminophen in one day (24 hours).

propoxyphene and acetaminophen should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Dosing

The dose of propoxyphene and acetaminophen 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 propoxyphene and acetaminophen. 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 mild to moderate pain:
    
    • Adults—One or two tablets every 4 hours as needed. Your doctor may adjust your dose if needed. However, the dose is usually not more than 6 to 12 tablets per day.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  

Missed Dose

If you miss a dose of propoxyphene and acetaminophen, 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.

Throw any unused medicine by mixing it with used coffee grounds or kitty litter and place it in a sealable bag, empty can, or container.

Precautions While Using propoxyphene and acetaminophen

It is very important that your doctor check your progress while you are taking propoxyphene and acetaminophen. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Talk to your doctor first before you stop taking propoxyphene and acetaminophen and changing to another pain medicine.

propoxyphene and acetaminophen can cause changes in heart rhythms, such as conditions called PR, QRS, and QT prolongation. It may change the way your heart beats and cause fainting, dizziness, lightheadedness, or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats.

propoxyphene and acetaminophen will add to the effects of alcohol and other CNS depressants (medicines that can make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds; sedatives, tranquilizers, or sleeping medicine; other prescription pain medicine or narcotics; medicine for seizures or barbiturates; muscle relaxants; or anesthetics, including some dental anesthetics. Also, there may be a greater risk of liver damage if you drink three or more alcoholic beverages while you are taking acetaminophen. Do not drink alcoholic beverages, and check with your doctor before taking any of the medicines listed above while you are using propoxyphene and acetaminophen.

propoxyphene and acetaminophen may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

Dizziness, lightheadedness, or fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve the dizziness or lightheadedness.

propoxyphene and acetaminophen may make you dizzy, drowsy, or lightheaded. Make sure you know how you react to propoxyphene and acetaminophen before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.

Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

If you have been using propoxyphene and acetaminophen regularly for several weeks or longer, do not change your dose or suddenly stop using it without checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent worsening of your condition and reduce the possibility of withdrawal symptoms, such as abdominal or stomach cramps, anxiety, fever, nausea, runny nose, sweating, tremors, or trouble with sleeping.

Using propoxyphene and acetaminophen while you are pregnant may cause serious unwanted effects in your newborn baby. Tell your doctor right away if you think you are pregnant or if you plan to become pregnant while using propoxyphene and acetaminophen.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

propoxyphene and acetaminophen 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:

Rare

• Abdominal or stomach pain


• chills


• clay-colored stools


• dark urine


• dizziness


• fever


• headache


• itching


• loss of appetite


• nausea


• rash


• unpleasant breath odor


• unusual tiredness or weakness


• vomiting of blood


• yellow eyes or skin

Incidence not known

• Bloating


• bloody or black, tarry stools


• bloody or cloudy urine


• change in consciousness


• chest pain or discomfort


• confusion


• cough


• decreased urine output


• difficult or troubled breathing


• dilated neck veins


• drowsiness


• extreme fatigue


• fainting


• fast, slow, pounding, or irregular heartbeat or pulse


• fever with or without chills


• general feeling of discomfort or illness


• hives


• hoarseness


• irregular, fast, slow, or shallow breathing


• itching


• joint pain, stiffness, or swelling


• light-colored stools


• loss of consciousness


• low blood pressure or pulse


• muscle aches and pains


• muscle tremors


• pain or discomfort in the arms, jaw, back, or neck


• pains in the stomach, side, or abdomen, possibly radiating to the back


• pale or blue lips, fingernails, or skin


• rapid, deep breathing


• redness of the skin


• restlessness


• right upper stomach pain and fullness


• runny nose


• severe stomach pain


• shakiness and unsteady walk


• shivering


• shortness of breath


• sore throat


• stomach cramps


• sudden decrease in the amount of urine


• sweating


• swelling of the eyelids, face, fingers, lips, hands, lower legs, or feet


• thoughts of suicide


• tightness in the chest


• trouble sleeping


• troubled breathing or swallowing


• unconsciousness


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


• very slow breathing


• very slow heartbeat


• vomiting of blood or material that looks like coffee grounds


• weight gain


• wheezing

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

Symptoms of overdose

• Agitation


• bluish color of the fingernails, lips, skin, palms, or nail beds


• convulsion


• coughing that sometimes produces a pink frothy sputum


• decreased awareness or responsiveness


• depression


• difficult, fast, or noisy breathing, sometimes with wheezing


• dilated pupils


• hostility


• increased sweating


• irritability


• lethargy


• muscle tremors


• muscle twitching


• pale skin


• pounding or rapid pulse


• rapid weight gain


• rapid, deep breathing


• severe sleepiness


• sleepiness or unusual drowsiness


• slow to respond


• slurred speech


• weight loss

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:

More common

• Relaxed and calm feeling

Incidence not known

• Abnormal behavior


• blurred or loss of vision


• constipation


• diarrhea


• disturbed color perception


• double vision


• false or unusual sense of well-being


• halos around lights


• indigestion


• muscular pain, tenderness, wasting, or weakness


• night blindness


• nightmares or unusually vivid dreams


• overbright appearance of lights


• seeing, hearing, or feeling things that are not there


• swelling of the eye


• tunnel vision

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: propoxyphene and acetaminophen side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More propoxyphene and acetaminophen resources

• Propoxyphene and acetaminophen Side Effects (in more detail)
• Propoxyphene and acetaminophen Dosage
• Propoxyphene and acetaminophen Use in Pregnancy & Breastfeeding
• Drug Images
• Propoxyphene and acetaminophen Drug Interactions
• Propoxyphene and acetaminophen Support Group
• 77 Reviews for Propoxyphene and acetaminophen - Add your own review/rating

Compare propoxyphene and acetaminophen with other medications

• Osteoarthritis
• Pain

Inapsine

Generic Name: droperidol (dro PER i dol)

Brand Names: Inapsine

What is Inapsine (droperidol)?

Droperidol is a sedative, tranquilizer, and anti-nausea medication.

Droperidol is used to reduce nausea and vomiting caused by surgery or other medical procedures.

Droperidol may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Inapsine (droperidol)?

You should not use this medication if you are allergic to droperidol, or have a personal or family history of "Long QT syndrome."

Before you receive droperidol, tell your doctor if you have heart disease, high blood pressure, a heart rhythm disorder, low potassium, liver or kidney disease, adrenal gland cancer, or a history of alcohol abuse.

Before you receive droperidol, tell your doctor if you have been taking any medications to treat high blood pressure, a heart rhythm disorder, malaria, infections, a prostate disorder, depression or mental illness, or if you are using a narcotic pain medication.

What should I discuss with my health care provider before receiving Inapsine (droperidol)?

You should not be given this medication if you are allergic to droperidol, or have a personal or family history of "Long QT syndrome."

Before you receive droperidol, tell your doctor if you are allergic to any drugs, or if you have:

• 
  

  heart disease;

  
  


• 
  

  heart rhythm disorder;

  
  


• 
  

  congestive heart failure;

  
  


• 
  

  high blood pressure;

  
  


• 
  

  an electrolyte imbalance (such as low potassium);

  
  


• 
  

  liver or kidney disease;

  
  


• 
  

  adrenal gland cancer (pheochromocytoma); or

  
  


• 
  

  a history of alcohol abuse.

  
  

If you have any of these conditions, you may not be able to receive droperidol, or you may need a dose adjustment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Before you receive droperidol, tell your doctor if you are pregnant. It is not known whether droperidol passes into breast milk or if it could harm a nursing baby. Before you receive this medication, tell your doctor if you are breast-feeding a baby.

How is droperidol given?

Droperidol is given as an injection through a needle placed into a muscle or a vein. You will receive this injection in a clinic or hospital setting prior to and/or during your surgery or medical procedure.

What happens if I miss a dose?

Since droperidol is given as needed by a healthcare professional, it is not likely that you will miss a dose.

What happens if I overdose?

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

Overdose symptoms may include fast or pounding heartbeats, dizziness, uneven heart rate, or fluttering in your chest.

What should I avoid after receiving Inapsine (droperidol)?

Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by droperidol. Tell your doctor if you have been taking any of these other medicines before you receive droperidol.

Inapsine (droperidol) 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. Tell your caregivers at once if you have any of these serious side effects:

• 
  

  feeling like you might pass out;

  
  


• 
  

  dizziness, fainting, fast or pounding heartbeat, fluttering in your chest;

  
  


• 
  

  chest tightness and trouble breathing;

  
  


• 
  

  fever, stiff muscles, confusion, sweating, fast or uneven heartbeats;

  
  


• 
  

  confusion, hallucinations;

  
  


• 
  

  tremor (uncontrolled shaking); or

  
  


• 
  

  restless muscle movements in your eyes, tongue, jaw, or neck.

  
  

Less serious side effects include:

• 
  

  drowsiness, dizziness; or

  
  


• 
  

  feeling restless or anxious.

  
  

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 Inapsine (droperidol)?

The following drugs can interact with droperidol. Tell your doctor if you are using any of these:

• 
  

  arsenic trioxide (Trisenox);

  
  


• 
  

  a diuretic (water pill);

  
  


• 
  

  a laxative;

  
  


• 
  

  a drug to treat a psychiatric disorder;

  
  


• 
  

  an anti-malaria medication;

  
  


• 
  

  heart or blood pressure medications (Cartia XT, Procardia, Covera, Isoptin, Verelan and others);

  
  


• 
  

  heart rhythm medication such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), quinidine (Cardioquin, Quinaglute), sotalol (Betapace), and others;

  
  


• 
  

  drugs to treat high blood pressure or a prostate disorder, such as doxazosin (Cardura), or prazosin (Minipress);

  
  


• 
  

  an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);

  
  


• 
  

  a narcotic pain medication such as hydrocodone (Lortab, Vicodin), morphine (MS Contin), oxycodone (OxyContin, Percocet), propoxyphene (Darvocet, Darvon), and others; or

  
  


• 
  

  an antibiotic such as azithromycin (Zithromax), clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), and others.

  
  

This list is not complete and there may be other drugs that can interact with droperidol. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

More Inapsine resources

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

• Inapsine Prescribing Information (FDA)


• Inapsine MedFacts Consumer Leaflet (Wolters Kluwer)


• Inapsine Monograph (AHFS DI)


• Inapsine Advanced Consumer (Micromedex) - Includes Dosage Information


• Droperidol Prescribing Information (FDA)


• Droperidol Professional Patient Advice (Wolters Kluwer)

Compare Inapsine with other medications

• Nausea/Vomiting
• Nausea/Vomiting, Postoperative

Where can I get more information?

• Your pharmacist can provide more information about droperidol.

See also: Inapsine side effects (in more detail)

Letairis

Generic Name: ambrisentan (am bri SEN tan)

Brand Names: Letairis

What is ambrisentan?

Ambrisentan prevents thickening of the blood vessels, especially those in the lungs and heart. Ambrisentan also lowers blood pressure in your lungs, helping your heart pump blood more efficiently.

Ambrisentan is used to treat pulmonary arterial hypertension (PAH). It improves your ability to exercise and prevents your condition from getting worse.

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

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

Ambrisentan can harm an unborn baby or cause birth defects. Do not use if you are pregnant. If you are a woman of child-bearing potential, you will need to have a negative pregnancy test before you start treatment with ambrisentan. You will also be re-tested each month during your treatment. You will be required to use two forms of birth control to prevent pregnancy during your treatment, and for at least 1 month after your treatment ends. If you have had a tubal ligation or are using a copper IUD, you will not need to use a second form of birth control. Do not stop taking ambrisentan without first talking to your doctor. You may need to use less and less before you stop the medication completely.

Ambrisentan is available only under a special program called LEAP (Letairis Education and Access Program). You must be registered in the program and sign agreements to use birth control and undergo pregnancy and blood testing as required by the program. Read all program brochures and agreements carefully.

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

Your should not use this medication if you are allergic to ambrisentan, if you have moderate or severe liver disease, or if you are pregnant.

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

• 
  

  anemia (low red blood cell counts);

  
  


• 
  

  a history of liver problems; or

  
  


• 
  

  if you are pregnant or plan to become pregnant while taking ambrisentan.

  
  

If you are a woman of child-bearing potential, you will need to have a negative pregnancy test before you start treatment with ambrisentan. You will also be re-tested each month during your treatment. FDA pregnancy category X. This medication can harm an unborn baby or cause birth defects. Do not use ambrisentan if you are pregnant. Tell your doctor right away if you become pregnant during treatment. You will be required to use two forms of birth control to prevent pregnancy during your treatment, and for at least 1 month after your treatment ends. If you have had a tubal ligation or are using a copper IUD (intrauterine device), you will not need to use a second form of birth control. Recommended combinations of birth control forms include:

• 
  

  1 hormone form (birth control pill, skin patch, implant, vaginal ring, or injection) plus 1 barrier form (condom, diaphragm with spermicide, or cervical cap with spermicide).

  
  


• 
  

  a condom and a female barrier form together (diaphragm with spermicide, or cervical cap with spermicide).

  
  


• 
  

  a partner's vasectomy plus 1 hormone form or 1 barrier form.

  
  

Talk with your doctor about the use of emergency contraception if you have unprotected sex or if you believe your form of contraception has failed. It is not known whether ambrisentan passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using ambrisentan. Ambrisentan may lower a man's sperm count and could affect fertility (your ability to have children).

How should I take ambrisentan?

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.

Ambrisentan is available only under a special program called LEAP (Letairis Education and Access Program). You must be registered in the program and sign agreements to use birth control and undergo pregnancy and blood testing as required by the program. Read all program brochures and agreements carefully.

Before you start treatment with ambrisentan, your doctor may perform blood tests to make sure it is safe for you to take this medication. Your blood will need to be tested often during treatment. Visit your doctor regularly.

Ambrisentan can be taken with or without food.

Do not crush, chew, or split the tablet. Swallow the pill whole. Do not stop taking ambrisentan without first talking to your doctor. You may need to use less and less before you stop the medication completely. Store at room temperature away from moisture and heat. Keep this medicine in its original container.

See also: Letairis 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.

Overdose symptoms may include feeling like you might pass out.

What should I avoid while using ambrisentan?

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

Ambrisentan 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. Call your doctor at once if you have a serious side effect such as:

• 
  

  anxiety, sweating, pale skin, severe shortness of breath, wheezing, gasping for breath, cough with foamy mucus, chest pain, fast or uneven heart rate;

  
  


• 
  

  swelling of the feet, ankles, or legs;

  
  


• 
  

  pounding heartbeats or fluttering in your chest; or

  
  


• 
  

  nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

  
  

Less serious side effects may include:

• 
  

  headache;

  
  


• 
  

  stomach pain, vomiting, constipation;

  
  


• 
  

  stuffy nose, sinus pain, sore throat; or

  
  


• 
  

  warmth, redness, or tingly feeling under your skin.

  
  

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 ambrisentan?

Before you take ambrisentan, tell your doctor if you are using cyclosporine (Sandimmune, Neoral, Gengraf).

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

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

• Letairis Prescribing Information (FDA)


• Letairis Monograph (AHFS DI)


• Letairis Advanced Consumer (Micromedex) - Includes Dosage Information


• Letairis Consumer Overview


• Letairis MedFacts Consumer Leaflet (Wolters Kluwer)


• Ambrisentan Professional Patient Advice (Wolters Kluwer)

Compare Letairis with other medications

• Pulmonary Arterial Hypertension

Where can I get more information?

• Your doctor or pharmacist can provide more information about ambrisentan.

See also: Letairis side effects (in more detail)