hydrochlorothiazide and telmisartan

Generic Name: hydrochlorothiazide and telmisartan (hye droe klor oh THYE a zide and TEL mi SAR tan)

Brand Names: Micardis HCT

What is hydrochlorothiazide and telmisartan?

Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Telmisartan is in a group of drugs called angiotensin II receptor antagonists. Telmisartan keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow.

The combination of hydrochlorothiazide and telmisartan is used to treat high blood pressure (hypertension).

Hydrochlorothiazide and telmisartan may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about hydrochlorothiazide and telmisartan?

Do not use this medication if you are allergic to hydrochlorothiazide or telmisartan, or if you are unable to urinate. Do not use this medication without telling your doctor if you are pregnant. Telmisartan may cause injury and even death to the unborn baby if you take it during the second and third trimesters of pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment.

Before using hydrochlorothiazide and telmisartan, tell your doctor if you have congestive heart failure, kidney or liver disease, glaucoma, asthma, low or high blood levels of potassium, gout, lupus, diabetes, or an allergy to sulfa drugs or penicillin.

Avoid drinking alcohol. It can lower your blood pressure and may increase some of the side effects of hydrochlorothiazide and telmisartan.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Do not use potassium supplements or salt substitutes while you are taking hydrochlorothiazide and telmisartan, unless your doctor has told you to. In rare cases, hydrochlorothiazide and telmisartan can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have muscle pain, tenderness, or weakness especially if you also have fever, nausea or vomiting, and dark colored urine.

What should I discuss with my healthcare provider before taking hydrochlorothiazide and telmisartan?

Do not use this medication if you are allergic to hydrochlorothiazide or telmisartan, or if you are unable to urinate.

Before using hydrochlorothiazide and telmisartan, tell your doctor if you have:

• kidney disease;


• liver disease;


• 
  

  congestive heart failure;

  
  


• 
  

  glaucoma;

  
  


• 
  

  asthma or allergies;

  
  


• 
  

  low or high levels of magnesium or potassium in your blood;

  
  


• 
  

  gout;

  
  


• 
  

  lupus,

  
  


• 
  

  diabetes; or

  
  


• 
  

  an allergy to sulfa drugs or penicillin.

  
  

If you have any of these conditions, you may need a dose adjustment or special tests to safely take hydrochlorothiazide and telmisartan.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use this medication without telling your doctor if you are pregnant. Telmisartan may cause injury and even death to the unborn baby if you take it during the second and third trimesters of pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. It is not known whether hydrochlorothiazide and telmisartan passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take hydrochlorothiazide and telmisartan?

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

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

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

To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Do not miss any scheduled appointments.

Hydrochlorothiazide can interfere with the results of a thyroid test. Tell any doctor who treats you that you are using this medication.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store hydrochlorothiazide and telmisartan at room temperature away from moisture and heat.

See also: Hydrochlorothiazide and telmisartan dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. 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.

Overdose symptoms may include fast or slow heartbeat, feeling light-headed, or fainting.

What should I avoid while taking hydrochlorothiazide and telmisartan?

Avoid drinking alcohol. It can lower your blood pressure and may increase some of the side effects of hydrochlorothiazide and telmisartan.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Do not use potassium supplements or salt substitutes while you are taking hydrochlorothiazide and telmisartan, unless your doctor has told you to.

Hydrochlorothiazide and telmisartan 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. In rare cases, hydrochlorothiazide and telmisartan can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have muscle pain, tenderness, or weakness especially if you also have fever, nausea or vomiting, and dark colored urine. Stop using this medication and call your doctor at once if you have any other serious side effects, such as:

• 
  

  eye pain, vision problems;

  
  


• 
  

  feeling light-headed, fainting;

  
  


• 
  

  swelling, rapid weight gain;

  
  


• 
  

  fast or pounding heartbeats;

  
  


• 
  

  urinating less than usual, or not at all;

  
  


• 
  

  jaundice (yellowing of the skin or eyes); or

  
  


• 
  

  dry mouth, increased thirst, drowsiness, restless feeling, confusion, increased urination, fast heart rate, fainting, or seizure (convulsions).

  
  

Less serious side effects may include:

• 
  

  stomach pain, diarrhea;

  
  


• 
  

  back pain;

  
  


• 
  

  headache, tired feeling, dizziness;

  
  


• 
  

  skin rash;

  
  


• 
  

  stuffy nose, sore throat; or

  
  


• 
  

  dry cough.

  
  

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.

Hydrochlorothiazide and telmisartan Dosing Information

Usual Adult Dose for Hypertension:

Initial dose: The initial dosage of hydrochlorothiazide-telmisartan should be based on the patient requirements for each drug. The usual recommended dosage range for hypertension is 40 to 80 mg (telmisartan) and 12.5 mg (hydrochlorothiazide) per day.

What other drugs will affect hydrochlorothiazide and telmisartan?

Before taking hydrochlorothiazide and telmisartan, tell your doctor if you are using any of the following drugs:

• 
  

  any other blood pressure medications;

  
  


• 
  

  digoxin (digitalis, Lanoxin, Lanoxicaps);

  
  


• 
  

  a blood thinner such as warfarin (Coumadin, Jantoven);

  
  


• 
  

  steroids (prednisone and others);

  
  


• 
  

  lithium (Eskalith, Lithobid);

  
  


• 
  

  cholestyramine (Prevalite, Questran) or colestipol (Colestid);

  
  


• 
  

  insulin or diabetes medications you take by mouth;

  
  


• 
  

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

  
  


• 
  

  any other diuretics, such as amiloride (Midamor), bumetanide (Bumex), chlorthalidone (Hygroton, Thalitone), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril), indapamide (Lozol), metolazone (Mykrox, Zarxolyn), spironolactone (Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), torsemide (Demadex), and others;

  
  


• 
  

  aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others;

  
  


• 
  

  a muscle relaxer such as baclofen (Lioresal), carisoprodol (Soma), cyclobenzaprine (Flexeril), dantrolene (Dantrium), metaxalone (Skelaxin), or methocarbamol (Robaxin), orphenadrine (Norflex), or tizanidine (Zanaflex);

  
  


• 
  

  a narcotic medication such as hydrocodone (Lortab, Vicodin), hydromorphone (Dilaudid, Palladone), levorphanol (Levo-Dromoran), meperidine (Demerol), methadone (Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin), oxymorphone (Numorphan), or propoxyphene (Darvon, Darvocet).

  
  

This list is not complete and there may be other drugs that can interact with hydrochlorothiazide and telmisartan. 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 hydrochlorothiazide and telmisartan resources

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

Compare hydrochlorothiazide and telmisartan with other medications

• High Blood Pressure

Where can I get more information?

• Your pharmacist can provide more information about hydrochlorothiazide and telmisartan.

See also: hydrochlorothiazide and telmisartan side effects (in more detail)

Naftin

Generic Name: naftifine topical (NAF ti feen)

Brand Names: Naftin

What is Naftin (naftifine topical)?

Naftifine topical is an antifungal medication. Naftifine topical prevents fungus from growing on your skin.

Naftifine topical is used to treat skin infections such as athlete's foot, jock itch, and ringworm infections.

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

What is the most important information I should know about Naftin (naftifine topical)?

Use this medication for the full amount of time prescribed by your doctor even if you begin to feel better. Your symptoms may improve before the infection is completely healed.

Do not use bandages or dressings that do not allow air to circulate to the affected area (occlusive dressings) unless otherwise directed by your doctor. Wear loose-fitting clothing (preferably cotton).

Avoid getting this medication in your eyes, nose, or mouth.

Who should not use Naftin (naftifine topical)?

Do not use naftifine topical if you have had an allergic reaction to it in the past.

It is not known whether naftifine topical will harm an unborn baby. Do not use naftifine topical without first talking to your doctor if you are pregnant. It is not known whether naftifine passes into breast milk. Do not use naftifine topical without first talking to your doctor if you are breast-feeding a baby.

How should I use Naftin (naftifine topical)?

Use naftifine topical exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Wash your hands before and after using this medication.

Clean and dry the affected area. Apply the cream once daily, or the gel twice daily, as directed for the specified length of time.

Use this medication for the full amount of time prescribed by your doctor or recommended in the package even if you begin to feel better. Your symptoms may improve before the infection is completely healed.

If the infection does not clear up in 4 weeks, or if it appears to get worse, see your doctor.

Do not use bandages or dressings that do not allow air circulation over the affected area (occlusive dressings) unless otherwise directed by your doctor. A light cotton-gauze dressing may be used to protect clothing.

Avoid getting this medication in your eyes, nose, or mouth. Store naftifine topical at room temperature away from moisture and heat.

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 dose you missed and apply only the regular amount of naftifine topical. Do not use a double dose unless otherwise directed by your doctor.

What happens if I overdose?

An overdose of naftifine topical is unlikely to occur. If you do suspect that a much larger than normal dose has been used, or that naftifine topical has been ingested, contact an emergency room or a poison control center.

What should I avoid while using Naftin (naftifine topical)?

Avoid wearing tight-fitting, synthetic clothing that doesn't allow air circulation. Wear loose-fitting clothing made of cotton and other natural fibers until the infection is healed.

Naftin (naftifine topical) side effects

Serious side effects of naftifine topical use are not expected. Stop using naftifine topical and see your doctor if you experience unusual or severe blistering, itching, redness, peeling, dryness, or irritation of the skin.

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 Naftin (naftifine topical)?

Avoid using other topicals at the same time unless your doctor approves. Other skin medications may affect the absorption or effectiveness of naftifine topical.

More Naftin resources

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

• Naftin Prescribing Information (FDA)


• Naftin Monograph (AHFS DI)


• Naftin Topical Advanced Consumer (Micromedex) - Includes Dosage Information


• Naftin Cream MedFacts Consumer Leaflet (Wolters Kluwer)

Compare Naftin with other medications

• Tinea Corporis
• Tinea Cruris
• Tinea Pedis

Where can I get more information?

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

See also: Naftin side effects (in more detail)

Spectam Water Soluble Concentrate

Dosage Form: FOR ANIMAL USE ONLY
Spectam Water Soluble Concentrate (spectinomycin) NADA 038-661, Approved by FDA Bimeda, Inc. Division of Cross Vetpharm Group

Indications:

As an aid in the prevention or control of losses due to CRD associated with M. gallisepticum (PPLO).  Administer two (2) grams per gallon of water as the only source of drinking water for the first three days of life and for one day following each vaccination.


As an aid in controlling infectious synovitis due to Mycoplasma synoviae in broiler chickens.  Administer one (1) gram per gallon of water as the only source of drinking water for the first three to five days of life.


For increased rate of weight gain and improved feed efficiency in floor-raised broiler chickens.  Administer one-half (1/2) gram per gallon of water as the only source of drinking water for the first three days of life and for one day following each vaccination.

Dosage and Administration:

To provide 2 g/gal:  Dissolve contents in 250 gallons of water.  For proportioners, dissolve contents of 1/2 package in 1 gallon of water.  Meter at 1 oz/gal.

To provide 1 g/gal:  Dissolve contents in 500 gallons of water.   For proportioners, dissolve contents of 1/2 package in 2 gallons of water.  Meter at 1 oz/gal.

To provide 1/2 g/gal:  Dissolve contents of 1/2 package in 500 gallons of water.  For proportioners, dissolve contents of 1/2 package in 4 gallons of water.  Meter at one (1) oz/gal.

DO NOT administer this drug within 5 days of slaughter.  DO NOT administer to laying chickens.

Precautions:

Rarely, some individuals who handle spectinomycin develop serious reactions involving skin, nails and eyes.  Individuals who have experienced rash or other evidence of allergic reaction should avoid further contact with spectinomycin.

Storage and Handling:

Store at controlled room temperature 20degree C - 25degree C (68degree F - 77degree F), excursions permitted between 15degree C - 30degree C (59degree F - 86degree F).

General Precautions:

Take Time Observe Label Directions

FOR ANIMAL USE ONLY

KEEP OUT OF REACH OF CHILDREN

Package Label.Principle Display Panel:

Spectam Water Soluble Concentrate

(spectinomycin)

Anti-Infective

for growing chickens

Each 1000g contains:  Spectinomycin dihydrochloride pentahydrate equivalent to spectinomycin activity ..... 500.00g

FOR ANIMAL USE ONLY

KEEP OUT OF REACH OF CHILDREN

Restricted Drug (California) - Use Only as Directed

NADA 038-661, Approved by FDA

Net Contents:

1000g (35.27 oz)

Manufactured by:

Bimeda, Inc.

Le Sueur, MN 56058

Spectam Water Soluble Concentrate  spectinomycin  powder, for solution

Product Information Product Type OTC ANIMAL DRUG NDC Product Code (Source) 12487-5485 Route of Administration ORAL DEA Schedule

Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength spectinomycin (spectinomycin) spectinomycin 500.00 g  in 1000 g

Inactive Ingredients Ingredient Name Strength No Inactive Ingredients Found

Product Characteristics Color      Score      Shape Size Flavor Imprint Code Contains

Packaging # NDC Package Description Multilevel Packaging 1 12487-5485-1 1000 g In 1 JAR None

Marketing Information
Marketing Category	Application Number or Monograph Citation	Marketing Start Date	Marketing End Date
NADA	NADA038661	06/17/1969

Labeler - Osborn (043653216)

Revised: 10/2010Osborn

Librium

Generic Name: chlordiazepoxide (klor dye az e POX ide)

Brand Names: Librium

What is Librium (chlordiazepoxide)?

Chlordiazepoxide is in a group of drugs called benzodiazepines (ben-zoe-dye-AZE-eh-peens). Chlordiazepoxide affects chemicals in the brain that may become unbalanced and cause anxiety.

Chlordiazepoxide is used to treat anxiety disorders or alcohol withdrawal.

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

What is the most important information I should know about Librium (chlordiazepoxide)?

Do not use this medication if you are allergic to chlordiazepoxide or to other benzodiazepines, such as alprazolam (Xanax), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax). This medication can cause birth defects in an unborn baby. Do not use chlordiazepoxide if you are pregnant.

Before taking chlordiazepoxide, tell your doctor if you have any breathing problems, glaucoma, porphyria, kidney or liver disease, or a history of depression, suicidal thoughts, or addiction to drugs or alcohol.

Video: Treatment for Depression

Treatments for depression are getting better everyday and there are things you can start doing right away.

Do not drink alcohol while taking chlordiazepoxide. This medication can increase the effects of alcohol.

Tell your doctor if you regularly use other medicines that make you sleepy. They can add to sleepiness caused by chlordiazepoxide.

Chlordiazepoxide may be habit-forming and should be used only by the person it was prescribed for. Chlordiazepoxide should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

What should I discuss with my healthcare provider before taking Librium (chlordiazepoxide)?

Do not use this medication if you are allergic to chlordiazepoxide or to other benzodiazepines, such as alprazolam (Xanax), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).

Before taking chlordiazepoxide, tell your doctor if you are allergic to any drugs, or if you have:

• 
  

  glaucoma;

  
  


• 
  

  asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;

  
  


• 
  

  porphyria;

  
  


• 
  

  kidney or liver disease;

  
  


• 
  

  a history of depression or suicidal thoughts or behavior; or

  
  


• 
  

  a history of drug or alcohol addiction.

  
  

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

Chlordiazepoxide may be habit-forming and should be used only by the person it was prescribed for. Chlordiazepoxide should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Chlordiazepoxide can cause birth defects in an unborn baby. Do not use chlordiazepoxide without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Chlordiazepoxide may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. The sedative effects of chlordiazepoxide may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking chlordiazepoxide.

How should I take Librium (chlordiazepoxide)?

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

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Chlordiazepoxide should be used for only a short time. Do not take this medication for longer than 4 months without your doctor's advice. Contact your doctor if this medicine seems to stop working as well in treating your symptoms. Do not stop using chlordiazepoxide suddenly, or you could have seizures or unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when you stop using chlordiazepoxide.

To be sure this medication is not causing harmful effects, your blood and liver function may need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

Store chlordiazepoxide at room temperature away from moisture, heat, and light.

Keep track of how many pills have been used from each new bottle of this medicine. Benzodiazepines are drugs of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. 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 chlordiazepoxide can be fatal.

Overdose symptoms may include extreme drowsiness, confusion, excitation, muscle weakness, loss of balance or coordination, feeling light-headed, fainting, or coma.

What should I avoid while taking Librium (chlordiazepoxide)?

Do not drink alcohol while taking chlordiazepoxide. This medication can increase the effects of alcohol. Chlordiazepoxide can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, or depression can add to sleepiness caused by chlordiazepoxide. Tell your doctor if you regularly use any of these medicines, or any other anxiety medications.

Librium (chlordiazepoxide) 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 any of these serious side effects:

• 
  

  confusion;

  
  


• 
  

  depressed mood, thoughts of suicide or hurting yourself;

  
  


• 
  

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

  
  


• 
  

  hyperactivity, agitation, hostility;

  
  


• 
  

  hallucinations; or

  
  


• 
  

  jaundice (yellowing of the skin or eyes).

  
  

Less serious side effects may include:

• 
  

  drowsiness, tiredness;

  
  


• 
  

  swelling;

  
  


• 
  

  skin rash;

  
  


• 
  

  nausea, vomiting, constipation; or

  
  


• 
  

  irregular menstrual periods.

  
  

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 Librium (chlordiazepoxide)?

Before taking chlordiazepoxide, tell your doctor if you are using any of the following drugs:

• 
  

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

  
  


• 
  

  a blood thinner such as warfarin (Coumadin); or

  
  


• 
  

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

  
  


• 
  

  medicine to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), mesoridazine (Serentil), pimozide (Orap), or thioridazine (Mellaril);

  
  


• 
  

  narcotic medication such as butorphanol (Stadol), codeine, hydrocodone (Lortab, Vicodin), levorphanol (Levo-Dromoran), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin, Oramorph), naloxone (Narcan), oxycodone (OxyContin), propoxyphene (Darvon, Darvocet); or

  
  


• 
  

  an antidepressant such as amitriptyline (Elavil, Etrafon), amoxapine (Asendin), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), protriptyline (Vivactil), sertraline (Zoloft), or trimipramine (Surmontil).

  
  

This is not a complete list and there may be other drugs that can interact with chlordiazepoxide. 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 Librium resources

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

• Librium Prescribing Information (FDA)


• Librium MedFacts Consumer Leaflet (Wolters Kluwer)


• Librium Monograph (AHFS DI)


• Librium Advanced Consumer (Micromedex) - Includes Dosage Information


• Chlordiazepoxide Prescribing Information (FDA)


• Chlordiazepoxide Professional Patient Advice (Wolters Kluwer)

Compare Librium with other medications

• Alcohol Withdrawal
• Anxiety
• Light Sedation

Where can I get more information?

• Your pharmacist can provide more information about chlordiazepoxide.

See also: Librium side effects (in more detail)

Acetaminophen/Dextromethorphan/Pseudoephedrine Drops

Pronunciation: a-seet-a-MIN-oh-fen/dex-troe-meth-OR-fan/sue-doe-eh-FED-rin
Generic Name: Acetaminophen/Dextromethorphan/Pseudoephedrine
Brand Name: Tylenol Infants Plus Cold/Cough

Acetaminophen/Dextromethorphan/Pseudoephedrine Drops are used for:

Relieving pain, congestion, and cough due to colds, flu, or hay fever. It may also be used for other conditions as determined by your doctor.

Acetaminophen/Dextromethorphan/Pseudoephedrine Drops are an analgesic, decongestant, and cough suppressant combination. It works by constricting blood vessels and reducing swelling in the nasal passages, which helps you breathe more easily. The analgesic and cough suppressant work in the brain to decrease pain and reduce the cough reflex.

Do NOT use Acetaminophen/Dextromethorphan/Pseudoephedrine Drops if:

• you are allergic to any ingredient in Acetaminophen/Dextromethorphan/Pseudoephedrine Drops


• you have severe high blood pressure, rapid heartbeat, or other severe heart problems (eg, heart blood vessel disease)


• you have taken furazolidone or a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the last 14 days

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

Before using Acetaminophen/Dextromethorphan/Pseudoephedrine Drops:

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

• if you are pregnant, 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 history of glaucoma, an enlarged prostate gland or other prostate problems, heart problems, diabetes, high blood pressure, blood vessel problems, adrenal gland problems, an overactive thyroid, seizures, stroke, or liver problems, or if you consume more than 3 alcohol-containing drinks per day


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

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

• Beta-blockers (eg, propranolol), COMT inhibitors (eg, tolcapone), furazolidone, indomethacin, isoniazid, MAO inhibitors (eg, phenelzine), or tricyclic antidepressants (eg, amitriptyline) because the risk of side effects from Acetaminophen/Dextromethorphan/Pseudoephedrine Drops may be increased


• Anticoagulants (eg, warfarin), digoxin, or droxidopa because the risk of side effects such as bleeding, irregular heartbeat, or heart attack may be increased


• Bromocriptine because the risk of side effects may be increased by Acetaminophen/Dextromethorphan/Pseudoephedrine Drops


• Guanadrel, guanethidine, mecamylamine, methyldopa, or reserpine because their effectiveness may be decreased by Acetaminophen/Dextromethorphan/Pseudoephedrine Drops

This may not be a complete list of all interactions that may occur. Ask your health care provider if Acetaminophen/Dextromethorphan/Pseudoephedrine Drops may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Acetaminophen/Dextromethorphan/Pseudoephedrine Drops:

Use Acetaminophen/Dextromethorphan/Pseudoephedrine Drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Acetaminophen/Dextromethorphan/Pseudoephedrine Drops may be taken with or without food.


• Use the dropper that comes with Acetaminophen/Dextromethorphan/Pseudoephedrine Drops to measure your dose. Ask your pharmacist for help if you are unsure of how to measure your dose.


• If you miss a dose of Acetaminophen/Dextromethorphan/Pseudoephedrine Drops, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Acetaminophen/Dextromethorphan/Pseudoephedrine Drops.

Important safety information:

• Acetaminophen/Dextromethorphan/Pseudoephedrine Drops may cause dizziness or drowsiness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Acetaminophen/Dextromethorphan/Pseudoephedrine Drops. Using Acetaminophen/Dextromethorphan/Pseudoephedrine Drops alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.


• Do not take appetite suppressants while you are taking Acetaminophen/Dextromethorphan/Pseudoephedrine Drops without checking with your doctor.


• Acetaminophen/Dextromethorphan/Pseudoephedrine Drops contains acetaminophen and pseudoephedrine. Before you begin taking any new prescription or nonprescription medicine, read the ingredients to see if it also contains acetaminophen or pseudoephedrine. If it does or if you are uncertain, contact your doctor or pharmacist.


• Do NOT exceed the recommended dose or take Acetaminophen/Dextromethorphan/Pseudoephedrine Drops for longer than prescribed without checking with your doctor.


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


• Acetaminophen/Dextromethorphan/Pseudoephedrine Drops may cause liver damage. If you consume 3 or more alcohol-containing drinks every day, ask your doctor if you should take Acetaminophen/Dextromethorphan/Pseudoephedrine Drops or other pain relievers/fever reducers. Alcohol use combined with Acetaminophen/Dextromethorphan/Pseudoephedrine Drops may increase your risk for liver damage.


• Acetaminophen/Dextromethorphan/Pseudoephedrine Drops may interfere with certain lab test results. Make sure that all of your doctors and lab personnel know that you are taking Acetaminophen/Dextromethorphan/Pseudoephedrine Drops.


• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Acetaminophen/Dextromethorphan/Pseudoephedrine Drops.


• Use Acetaminophen/Dextromethorphan/Pseudoephedrine Drops with caution in the ELDERLY because they may be more sensitive to its effects.


• Caution is advised when using Acetaminophen/Dextromethorphan/Pseudoephedrine Drops in CHILDREN because they may be more sensitive to its effects.


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

Possible side effects of Acetaminophen/Dextromethorphan/Pseudoephedrine Drops:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Dizziness; excitability; headache; nausea; nervousness or anxiety; trouble sleeping; weakness.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating; fast or irregular heartbeat; hallucinations; seizures; severe dizziness, lightheadedness, or headache; stomach pain; tremor; yellowing of skin or eyes.

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: Acetaminophen/Dextromethorphan/Pseudoephedrine side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blurred vision; confusion; hallucinations; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; stomach pain; unusually fast, slow, or irregular heartbeat; vomiting; yellowing of skin or eyes.

Proper storage of Acetaminophen/Dextromethorphan/Pseudoephedrine Drops:

Store Acetaminophen/Dextromethorphan/Pseudoephedrine Drops at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Acetaminophen/Dextromethorphan/Pseudoephedrine Drops out of the reach of children and away from pets.

General information:

• If you have any questions about Acetaminophen/Dextromethorphan/Pseudoephedrine Drops, please talk with your doctor, pharmacist, or other health care provider.


• Acetaminophen/Dextromethorphan/Pseudoephedrine Drops are to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

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

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Acetaminophen/Dextromethorphan/Pseudoephedrine resources

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

Compare Acetaminophen/Dextromethorphan/Pseudoephedrine with other medications

• Cold Symptoms

Vet One Chlorhexidine

Dosage Form: FOR ANIMAL USE ONLY
MWI/Vet One 2% Chlorhexidine solution

MWI/Vet One 2% Chlorhexidine solution

ACTIVE INGREDIENTS:

2% Chlorhexidine Gluconate.

CAUTION:

Avoid contact with eyes and mucous membranes. This product is not to be used in ears. If contact is made, flush immediately and thoroughly with clean water. For use on horses and dogs.

Product No. 1CHL008

8CHL008-108


Distributed by:

MWI

Meridian, ID 83680

(888) 694-8381

MWI/Vet One 2% Chlorhexidine solution

PRODUCT DESCRIPION:

A topical aqueous cleaning solution for use on horses and dogs for application to superficial cuts, abrasions or insect stings.

DILUTE:

1 ounce (2 tablespoons) of Chlorhexidine Solution per gallon of clean water.


DIRECTIONS FOR USE:

Rinse skin area to be treated with Chlorhexidine Solution. Wipe away excess and pat dry with sterilized gauze or sponge.

MWI/Vet One 2% Chlorhexidine solution

Vet One Chlorhexidine  chlorhexidine gluconate  solution

Product Information Product Type OTC ANIMAL DRUG NDC Product Code (Source) 13985-017 Route of Administration TOPICAL DEA Schedule

Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength Chlorhexidine Gluconate (CHLORHEXIDINE) Chlorhexidine Gluconate 2 g  in 0.1 L

Inactive Ingredients Ingredient Name Strength No Inactive Ingredients Found

Product Characteristics Color      Score      Shape Size Flavor Imprint Code Contains

Packaging # NDC Package Description Multilevel Packaging 1 13985-017-80 3.785 L In 1 JUG None

Marketing Information
Marketing Category	Application Number or Monograph Citation	Marketing Start Date	Marketing End Date
unapproved drug other		01/01/2010

Labeler - MWI VETERINARY SUPPLY CO (019926120)

Revised: 01/2010MWI VETERINARY SUPPLY CO

Zolmitriptan Disintegrating Tablets

Pronunciation: ZOLE-mi-TRIP-tan
Generic Name: Zolmitriptan
Brand Name: Zomig ZMT

Zolmitriptan Disintegrating Tablets are used for:

Treating migraine headaches with or without aura (flashing lights, wavy lines, dark spots) in adults. It is not intended to prevent migraines.

Zolmitriptan Disintegrating Tablets are a serotonin 5-HT₁ receptor agonist ("triptan"). It works by narrowing blood vessels in the brain, which helps to relieve migraines.

Do NOT use Zolmitriptan Disintegrating Tablets if:

• you are allergic to any ingredient in Zolmitriptan Disintegrating Tablets


• you have certain types of irregular heartbeat (eg, symptomatic Wolff-Parkinson-White syndrome)


• you have a history of ischemic heart disease (eg, angina, a heart attack), coronary artery disease (CAD), other moderate to severe heart problems, brain blood vessel disease (eg, a stroke, a transient ischemic attack), or other blood vessel disease (eg, Raynaud syndrome, ischemic bowel disease)


• you have uncontrolled high blood pressure


• you have certain types of migraines (eg, hemiplegic, basilar)


• you have used an ergot alkaloid (eg, ergotamine) or another "triptan" migraine medicine in the last 24 hours


• you are taking sibutramine


• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the past 14 days

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

Before using Zolmitriptan Disintegrating Tablets:

Some medical conditions may interact with Zolmitriptan Disintegrating Tablets. 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 history of liver or kidney problems, seizures (eg epilepsy), heart problems (eg, irregular heartbeat), other types of headaches (eg, cluster headaches), or phenylketonuria (PKU)


• if you have shortness of breath, chest pain, or a history of high blood pressure, a heart attack, a stroke, high cholesterol, diabetes, or smoking


• if you are a woman who is past menopause


• if you are a man who is over 40 years old


• if you are very overweight


• if a family member has had heart disease or a stroke

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

• Selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, duloxetine), or sibutramine because the risk of a serious side effect called serotonin syndrome may be increased. Symptoms of serotonin syndrome may include mental or mood changes, hallucinations, fast heartbeat, fever, loss of coordination, muscle spasms, increased sweating, nausea, vomiting, or diarrhea


• Cimetidine or MAOIs (eg, phenelzine) because they may increase the risk of Zolmitriptan Disintegrating Tablets's side effects


• Ergot derivatives (eg, dihydroergotamine, methysergide) or other serotonin 5-HT₁ receptor agonists (eg, eletriptan, rizatriptan) because the risk of their side effects may be increased by Zolmitriptan Disintegrating Tablets

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

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

• An extra patient leaflet is available with Zolmitriptan Disintegrating Tablets. Talk to your pharmacist if you have questions about this information.


• Take Zolmitriptan Disintegrating Tablets by mouth with or without food.


• It is best to use Zolmitriptan Disintegrating Tablets as soon as you notice the headache symptoms of a migraine attack.


• Open tablet blister pack with dry hands and place the tablet on the tongue. Do not try to split the tablets.


• Take the tablet immediately after removing it from its blister. Do not store the removed tablet for future use. Throw away any unused tablets or portions that have been removed from the blister pack.


• The tablet will dissolve rapidly on the tongue and can be swallowed with saliva. It is not necessary to take Zolmitriptan Disintegrating Tablets with liquid.


• If your migraine symptoms go away and then come back, you may take a second dose as directed by your doctor. Wait at least 2 hours between doses.


• If your symptoms do not get better after the first dose, do not take a second dose for the same attack. Contact your doctor.


• Do NOT take more than the amount prescribed by your doctor in a 24-hour period or treat more than 3 headaches within 30 days without checking with your doctor.


• If your medicine has expired, throw it away.


• If you miss a dose of Zolmitriptan Disintegrating Tablets and you still have a headache, follow your doctor's dosing instructions. Contact your doctor if you are unsure of what to do if you miss a dose. Do NOT use Zolmitriptan Disintegrating Tablets more often than prescribed. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Zolmitriptan Disintegrating Tablets.

Important safety information:

• Zolmitriptan Disintegrating Tablets may cause dizziness or drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use Zolmitriptan Disintegrating Tablets with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Overuse of Zolmitriptan Disintegrating Tablets can cause your headache to become worse. Do NOT take more than the recommended dose or use more often than prescribed without checking with your doctor.


• Rarely, serious heart problems (eg, heart attack, irregular heartbeat) have been reported within a few hours of using Zolmitriptan Disintegrating Tablets. Contact your doctor at once if fast or irregular heartbeat; chest, jaw, or neck pain or numbness; numbness of an arm or leg; severe stomach pain, dizziness, or vomiting; fainting; or vision changes occur. Discuss any questions or concerns with your doctor.


• Serotonin syndrome is a possibly fatal syndrome that can be caused by Zolmitriptan Disintegrating Tablets. Your risk may be greater if you take Zolmitriptan Disintegrating Tablets with certain other medicines (eg, SSRIs, SNRIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.


• Zolmitriptan Disintegrating Tablets should not be used to prevent or reduce the number of migraine headaches you have. If you have a headache that is different than your usual migraine headaches, check with your doctor before using Zolmitriptan Disintegrating Tablets.


• Some of these products contain phenylalanine. If you must have a diet that is low in phenylalanine, ask your pharmacist if it is in your product.


• Lab tests, including heart function, may be performed while you use Zolmitriptan Disintegrating Tablets. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Zolmitriptan Disintegrating Tablets with caution in the ELDERLY; they may be more sensitive to its effects.


• Zolmitriptan Disintegrating Tablets should not be used in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.


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

Possible side effects of Zolmitriptan Disintegrating Tablets:

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:

Burning, numbness, or tingling of the skin; dizziness; drowsiness; dry mouth; feeling of heaviness or pressure; nausea; warm or hot sensation; 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; unusual hoarseness); bloody diarrhea; chest pain; confusion; fainting; fast or irregular heartbeat; numbness or tingling of an arm or leg; one-sided weakness; pain, tightness, or pressure in the jaw, neck, or chest; severe headache, dizziness, or vomiting; severe stomach pain; shortness of breath; speech changes; very cold or blue fingers or toes; vision changes or loss of vision; wheezing.

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: Zolmitriptan 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 unusual drowsiness.

Proper storage of Zolmitriptan Disintegrating Tablets:

Store Zolmitriptan Disintegrating Tablets at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Zolmitriptan Disintegrating Tablets out of the reach of children and away from pets.

General information:

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


• Zolmitriptan Disintegrating Tablets are to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Zolmitriptan Disintegrating Tablets. 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 Zolmitriptan resources

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

Compare Zolmitriptan with other medications

• Cluster Headaches
• Cyclic Vomiting Syndrome
• Migraine

Sudafed

Pronunciation: soo-doe-e-FED-rin
Generic Name: Pseudoephedrine
Brand Name: Examples include Sudafed and Suphedrin

Sudafed is used for:

Relieving congestion due to colds, flu, hay fever, and other allergies. It may also be used for other conditions as determined by your doctor.

Sudafed is a decongestant. It works by reducing swelling and constricting blood vessels in the nasal passages, allowing you to breathe more easily.

Do NOT use Sudafed if:

• you are allergic to any ingredient in Sudafed


• you are taking furazolidone or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine) in the last 14 days


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

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

Before using Sudafed:

Some medical conditions may interact with Sudafed. 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 history of heart problems, diabetes, glaucoma, an enlarged prostate or other prostate problems, adrenal gland problems, high blood pressure, seizures, stroke, blood vessel problems, or an overactive thyroid

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

• Rauwolfia derivatives (eg, reserpine) because the effectiveness of Sudafed may be decreased


• Beta-blockers (eg, propranolol), cocaine, furazolidone, indomethacin, methyldopa, MAO inhibitors (eg, phenelzine), oxytocic medicines (eg, oxytocin), rauwolfia derivatives (eg, reserpine), or tricyclic antidepressants (eg, amitriptyline) because the actions and side effects of Sudafed may be increased


• Bromocriptine, catechol-O-methyltransferase (COMT) inhibitors (eg, entacapone), digoxin, or droxidopa because the actions and side effects of these medicines may be increased


• Guanadrel, guanethidine, mecamylamine, methyldopa, or reserpine because its effectiveness may be decreased by Sudafed

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

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

• Take Sudafed with food, water, or milk to minimize stomach irritation.


• If you miss a dose of Sudafed and are taking it regularly, 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 Sudafed.

Important safety information:

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


• If your symptoms do not improve within 7 days or if you develop a high fever, check with your doctor.


• If you have trouble sleeping, ask your pharmacist or doctor about the best time to take Sudafed.


• Do not take diet or appetite control medicines while you are taking Sudafed.


• Sudafed contains pseudoephedrine. Before you begin taking any new prescription or nonprescription medicine, read the ingredients to see if it also contains pseudoephedrine. If it does or if you are uncertain, contact your doctor or pharmacist.


• Diabetes patients - Sudafed may affect your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine.


• Use Sudafed with caution in the ELDERLY because they may be more sensitive to its effects.


• Use Sudafed with extreme caution in CHILDREN younger than 6 years of age. Safety and effectiveness in this age group have not been confirmed.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Sudafed during pregnancy. It is unknown if Sudafed is excreted in breast milk. If you are or will be breast-feeding while you are using Sudafed, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of Sudafed:

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:

Difficulty urinating; dizziness; headache; nausea; nervousness; restlessness; sleeplessness; stomach irritation.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).

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: Sudafed 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 confusion; hallucinations; irregular or unusually slow or rapid heartbeat; rapid breathing; seizures.

Proper storage of Sudafed:

Store Sudafed at room temperature, between 59 and 77 degrees F (15 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Sudafed out of the reach of children and away from pets.

General information:

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


• Sudafed 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 Sudafed. 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 Sudafed resources

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

• Sudafed Advanced Consumer (Micromedex) - Includes Dosage Information


• Sudafed Consumer Overview


• Pseudoephedrine Monograph (AHFS DI)


• Entex Consumer Overview

Compare Sudafed with other medications

• Nasal Congestion

Pioglitazone/Metformin Extended-Release Tablets

Pronunciation: PYE-oh-GLI-ta-zone/met-FOR-min
Generic Name: Pioglitazone/Metformin
Brand Name: Actoplus Met XR

Pioglitazone/Metformin Extended-Release Tablets may rarely cause a serious and sometimes fatal condition called lactic acidosis. Most of these cases have occurred in diabetic patients who also have certain kidney problems. The risk of lactic acidosis may be greater if you have liver problems, kidney problems, or heart failure. The risk may also be greater in patients who are elderly or who drink alcohol. Lab tests, including kidney function, may be performed while you take Pioglitazone/Metformin Extended-Release Tablets.

Do not begin to take Pioglitazone/Metformin Extended-Release Tablets if you are older than 80 years old unless lab tests show that you do not have decreased kidney function. Do not take it if you have severe infection or low blood oxygen levels, or are dehydrated. Tell your doctor if you take Pioglitazone/Metformin Extended-Release Tablets before you have any surgery or lab procedures.

Contact your doctor right away if you notice symptoms such as muscle pain or tenderness, unusual drowsiness, dizziness or light-headedness, slow or irregular heartbeat, fast or difficult breathing, unusual stomach discomfort, or unusual weakness or tiredness. Contact your doctor right away if you start to feel unusually cold, or if you have a general feeling of being unwell.

Thiazolidinedione antidiabetics such as Pioglitazone/Metformin Extended-Release Tablets may cause or worsen heart failure in some patients. Tell your doctor if you have a history of heart failure. Pioglitazone/Metformin Extended-Release Tablets should not be used to treat patients with moderate to severe heart failure. You will be monitored for signs of heart failure when you start Pioglitazone/Metformin Extended-Release Tablets and when your dose increases. Contact your doctor at once if you develop swelling of the hands, ankles, or feet; shortness of breath; or sudden, unexplained weight gain. Your doctor may need to stop your medicine or change your dose.

Pioglitazone/Metformin Extended-Release Tablets are used for:

Treating type 2 diabetes. It is used along with diet and exercise. It may be used alone or with other antidiabetic medicines.

Pioglitazone/Metformin Extended-Release Tablets are a biguanide and thiazolidinedione antidiabetic combination. It works by decreasing the amount of sugar the liver produces and the intestines absorb. It also helps to make your body more sensitive to the insulin that you naturally produce.

Do NOT use Pioglitazone/Metformin Extended-Release Tablets if:

• you are allergic to any ingredient in Pioglitazone/Metformin Extended-Release Tablets


• you have type 1 diabetes


• you have bladder cancer or moderate to severe heart failure


• you have a severe infection, low blood oxygen levels, kidney or liver problems, or high blood ketone or acid levels (eg, diabetic ketoacidosis), or you are severely dehydrated


• you have had a stroke or a recent heart attack, or you are in shock


• you are 80 years old or older and have not had a kidney function test


• you will be having surgery or certain lab procedures


• you have a history of liver problems, including jaundice (yellowing of the skin or eyes), during therapy with a similar medicine called troglitazone

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

Before using Pioglitazone/Metformin Extended-Release Tablets:

Some medical conditions may interact with Pioglitazone/Metformin Extended-Release Tablets. 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 history of heart problems (eg, heart failure), abnormal liver function tests, lung or breathing problems, thyroid problems, stomach or bowel problems (eg, paralysis, blockage), adrenal or pituitary problems, eye or vision problems (eg, macular degeneration), bladder cancer, or lactic acidosis


• if you have fluid retention or swelling problems, vomiting, diarrhea, poor health or nutrition, low blood calcium or vitamin B₁₂ levels, or anemia, or if you are dehydrated


• if you have an infection, fever, recent injury, or moderate to severe burns


• if you have a history of bone fracture, weak bones (eg, osteoporosis), or low calcium intake


• if you drink alcohol or have a history of alcohol abuse


• if you will be having surgery or certain lab procedures


• if you take a beta-blocker (eg, propranolol)

Some MEDICINES MAY INTERACT with Pioglitazone/Metformin Extended-Release Tablets. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Calcium channel blockers (eg, nifedipine), corticosteroids (eg, prednisone), diuretics (eg, furosemide, hydrochlorothiazide), estrogen, hormonal contraceptives (eg, birth control pills), insulin, isoniazid, nicotinic acid, oral antidiabetics (eg, glipizide), phenothiazines (eg, chlorpromazine), phenytoin, sympathomimetics (eg, albuterol, pseudoephedrine), or thyroid hormones (eg, levothyroxine) because the risk of high or low blood sugar may be increased


• Amiloride, cimetidine, digoxin, gemfibrozil, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, or vancomycin because they may increase the risk of Pioglitazone/Metformin Extended-Release Tablets's side effects


• Rifampin because it may decrease Pioglitazone/Metformin Extended-Release Tablets's effectiveness, resulting in high blood sugar


• Anticoagulants (eg, warfarin) because their effectiveness may be decreased or the risk of their side effects may be increased by Pioglitazone/Metformin Extended-Release Tablets

This may not be a complete list of all interactions that may occur. Ask your health care provider if Pioglitazone/Metformin Extended-Release Tablets 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 Pioglitazone/Metformin Extended-Release Tablets:

Use Pioglitazone/Metformin Extended-Release Tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Pioglitazone/Metformin Extended-Release Tablets comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Pioglitazone/Metformin Extended-Release Tablets refilled.


• Take Pioglitazone/Metformin Extended-Release Tablets by mouth with the evening meal, unless your doctor tells you otherwise.


• Swallow Pioglitazone/Metformin Extended-Release Tablets whole. Do not break, crush, or chew before swallowing.


• Take Pioglitazone/Metformin Extended-Release Tablets on a regular schedule to get the most benefit from it. Taking Pioglitazone/Metformin Extended-Release Tablets at the same times each day will help you remember to take it.


• Continue to take Pioglitazone/Metformin Extended-Release Tablets even if you feel well. Do not miss any doses.


• If you miss a dose of Pioglitazone/Metformin Extended-Release Tablets, 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 Pioglitazone/Metformin Extended-Release Tablets.

Important safety information:

• Pioglitazone/Metformin Extended-Release Tablets may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Pioglitazone/Metformin Extended-Release Tablets with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Follow the diet and exercise program given to you by your health care provider.


• Talk to your doctor of health care provider before you drink alcohol while you use Pioglitazone/Metformin Extended-Release Tablets.


• Tell your doctor or dentist that you take Pioglitazone/Metformin Extended-Release Tablets before you receive any medical or dental care, emergency care, or surgery.


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


• Be careful not to become dehydrated, especially during hot weather, while you are being active, or if you have vomiting or diarrhea. Dehydration may increase your risk of side effects from Pioglitazone/Metformin Extended-Release Tablets.


• Pioglitazone/Metformin Extended-Release Tablets may cause ovulation in women who have not reached menopause but do not ovulate. Women who wish to avoid pregnancy should be sure to use effective birth control while using Pioglitazone/Metformin Extended-Release Tablets.


• Carry an ID card at all times that says you have diabetes. Check your blood sugar levels as directed by your doctor. If they are often higher or lower than they should be and you take Pioglitazone/Metformin Extended-Release Tablets exactly as prescribed, tell your doctor.


• Pioglitazone/Metformin Extended-Release Tablets does not usually cause low blood sugar. Low blood sugar may be more likely to occur if you skip a meal, exercise heavily, or drink alcohol. It may also be more likely if you take Pioglitazone/Metformin Extended-Release Tablets along with certain other medicines for diabetes (eg, sulfonylureas, insulin). It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.


• Fever, infection, injury, or surgery may increase your risk for high or low blood sugar levels. If any of these occur, check your blood sugar closely and tell your doctor right away.


• Pioglitazone/Metformin Extended-Release Tablets may commonly cause stomach upset, indigestion, nausea, or diarrhea at the beginning of treatment. If you develop unusual or unexpected stomach problems, or if you develop stomach problems later during treatment, contact your doctor at once. This may be a sign of lactic acidosis.


• An increased incidence of bone fracture has been reported in women who take Pioglitazone/Metformin Extended-Release Tablets. Tell your doctor if you have a history of bone fracture, low calcium intake, or weak bones (eg, osteoporosis). Tell your doctor right away if you experience any unusual bone pain.


• Pioglitazone/Metformin Extended-Release Tablets may be associated with an increased risk of bladder cancer. Tell your doctor right away if you notice symptoms that could be associated with bladder cancer (eg, a red color or blood in the urine, difficult or painful urination, an increased need to urinate). Discuss any questions or concerns with your doctor.


• You may notice undissolved parts of Pioglitazone/Metformin Extended-Release Tablets in your stool. This is normal and not a cause for concern.


• Lab tests, including kidney and liver function, fasting blood glucose, hemoglobin A_1c, blood counts, and eye examinations, may be performed while you use Pioglitazone/Metformin Extended-Release Tablets. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Pioglitazone/Metformin Extended-Release Tablets with caution in the ELDERLY; they may be more sensitive to its effects. Low blood sugar levels may also be more difficult to recognize in the elderly.


• Pioglitazone/Metformin Extended-Release Tablets should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Pioglitazone/Metformin Extended-Release Tablets while you are pregnant. It is not known if Pioglitazone/Metformin Extended-Release Tablets are found in breast milk. Do not breast-feed while taking Pioglitazone/Metformin Extended-Release Tablets.

Possible side effects of Pioglitazone/Metformin Extended-Release Tablets:

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:

Cold-like symptoms; diarrhea; headache; indigestion; mild weight gain; nausea; stomach upset.

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); blurred vision or other vision changes; bone pain; chest pain or discomfort; dark urine; difficult or painful urination; dizziness or light-headedness; fainting; fast or difficult breathing; feeling of being unusually cold; general feeling of being unwell; muscle pain or weakness; pale stools; persistent loss of appetite; severe or persistent headache, nausea, or vomiting; shortness of breath; slow or irregular heartbeat; sudden, unexplained weight gain; swelling of the hands, ankles, or feet; unusual stomach pain or discomfort; unusual drowsiness; unusual tiredness or weakness; yellowing of the eyes or skin.

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: Pioglitazone/Metformin 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 dizziness or light-headedness; fast or difficult breathing; feeling of being unusually cold; general feeling of being unwell; muscle pain or tenderness; slow or irregular heartbeat; unusual drowsiness; unusual stomach discomfort; unusual weakness or tiredness.

Proper storage of Pioglitazone/Metformin Extended-Release Tablets:

Store Pioglitazone/Metformin Extended-Release Tablets between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in bathroom. Keep Pioglitazone/Metformin Extended-Release Tablets out of the reach of children and away from pets.

General information:

• If you have any questions about Pioglitazone/Metformin Extended-Release Tablets, please talk with your doctor, pharmacist, or other health care provider.


• Pioglitazone/Metformin Extended-Release Tablets are to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• If using Pioglitazone/Metformin Extended-Release Tablets for an extended period of time, obtain refills before your supply runs out.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Pioglitazone/Metformin Extended-Release Tablets. 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 Pioglitazone/Metformin resources

• Pioglitazone/Metformin Side Effects (in more detail)
• Pioglitazone/Metformin Dosage
• Pioglitazone/Metformin Use in Pregnancy & Breastfeeding
• Pioglitazone/Metformin Drug Interactions
• Pioglitazone/Metformin Support Group
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