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Umbrella Health Care Systems - Medicines

Our pharmacy offers prescription drugs at discounted prices.

Azathioprine tablet

Immunosuppressant / Arthritis

What is azelastine nasal? Azelastine nasal (for the nose) is an antihistamine that is used to treat sneezing, runny or stuffy nose, itching, and other nasal symptoms of allergies. Azelastine nasal is for use in adults and children at least 6 years old. Azelastine nasal may also be used for purposes not listed in this medication guide. Warnings Follow all directions on the label and package. Use exactly as directed. Before taking this medicine Ask a doctor before using azelastine nasal if you are pregnant or breastfeeding. How should I use azelastine nasal? Use exactly as directed on the label, or as prescribed by your doctor. Before your first use, squeeze the bottle 2 or more times away from your face, until a fine mist appears. Repeat this whenever the nasal spray hasn't been used for longer than 3 days. To use the nasal spray: With your head upright insert the tip of the bottle into the nostril and press your other nostril closed. Breathe in and gently spray the medicine into your nose. Use in your other nostril if directed. If the spray gets in your eyes or mouth or on your skin, rinse with water. Do not blow your nose for a few minutes. Do not allow a young child to use this medicine without help from an adult. Call your doctor if your symptoms do not improve, or if they get worse. Store this medicine in an upright position at room temperature. Do not freeze. Throw away the medicine after you have used 200 sprays, even if there is still medicine left in the bottle. What happens if I miss a dose? Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time. What happens if I overdose? Using too much azelastine nasal spray may cause drowsiness. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medicine. Swallowing azelastine nasal could cause serious harm to a child. What should I avoid while taking azelastine nasal? Avoid getting azelastine nasal in your eyes. Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired. Avoid drinking alcohol. Azelastine nasal side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have signs of an ear infection: ear pain or full feeling; drainage from the ear; trouble hearing; or fever. Common side effects may include: drowsiness, tiredness; a bitter taste in your mouth; mouth or throat pain; nasal pain or discomfort, nosebleeds; cold symptoms such as stuffy nose, sneezing, cough, sore throat; fever, headache; vomiting; or skin itching around your nose. 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.   Azelastine nasal dosing information Usual Adult Dose for Allergic Rhinitis: 0.1% spray: 1 or 2 sprays in each nostril twice a day 0.15% spray: 1 or 2 sprays in each nostril twice a day or 2 sprays in each nostril once a day Use: Seasonal allergic rhinitis 0.15% spray: 2 sprays in each nostril twice a day Use: Perennial allergic rhinitis Usual Pediatric Dose for Allergic Rhinitis: 2 to 5 years: 0.1% spray: 1 spray in each nostril twice a day 6 to 11 years: 0.1% spray and 0.15% spray: 1 spray in each nostril twice a day Use: Seasonal allergic rhinitis 6 months to 5 years: 0.1% spray: 1 spray in each nostril twice a day 6 to 11 years: 0.1% spray and 0.15% spray: 1 spray in each nostril twice a day Use: Perennial allergic rhinitis   What other drugs will affect azelastine nasal? Using azelastine nasal with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Other drugs may affect azelastine nasal, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

Mycophenolate Mofetil capsule

Immunosuppressant / Arthritis

What is mycophenolate mofetil? Mycophenolate mofetil is used with other medicines to prevent organ transplant rejection. Mycophenolate mofetil is for use with a liver or heart transplant in adults. mycophenolate mofetil is for use with a kidney transplant in adults and children at least 3 months old. Mycophenolate mofetil may also be used for purposes not listed in this medication guide. Warnings This medicine can cause a miscarriage or birth defects when used during pregnancy. Both men and women should use effective birth control to prevent pregnancy during and shortly after treatment with mycophenolate mofetil. Using mycophenolate mofetil may increase your risk of cancer, serious infections, or kidney transplant failure. Call your doctor right away if you have symptoms such as: fever, swollen glands, weight loss, vomiting or diarrhea, painful urination, a new skin lesion, any change in your mental state, weakness on one side of your body, or pain near your transplanted kidney. Before taking this medicine You should not use mycophenolate mofetil if you are allergic to mycophenolate mofetil, mycophenolic acid, or polysorbate 80. Talk with your doctor about the risks and benefits of mycophenolate mofetil. This medicine may increase your risk of cancer, serious or fatal infections, or a viral infection that can cause kidney transplant failure. Tell your doctor if you have ever had: a stomach ulcer or problems with digestion; diabetes; hepatitis B or C or other viral infection (may become active or get worse while you are using mycophenolate mofetil); phenylketonuria, or PKU (the liquid form of this medicine may contain phenylalanine); or a rare inherited enzyme deficiency such as Lesch-Nyhan syndrome or Kelley-Seegmiller syndrome. This medicine can cause a miscarriage or birth defects, especially during the first 3 months of pregnancy. You will need to have a negative pregnancy test before and during treatment with this medicine. If you are able to get pregnant, you must use specific forms of birth control to prevent pregnancy while using mycophenolate mofetil, and for at least 6 weeks after your last dose. Sexually active men and their partners should use effective contraception during treatment and for at least 90 days after the last dose. Mycophenolate mofetil can make birth control pills less effective. Ask your doctor about using an additional barrier form of birth control (condom, diaphragm, cervical cap, or contraceptive sponge) to prevent pregnancy. You do not need to use additional birth control if you use an intrauterine device (IUD), if you have had a tubal ligation, or if your sexual partner has had a vasectomy. This medicine comes with patient instructions about the most effective non-hormonal forms of birth control to use. Follow these directions carefully. Ask your doctor if you have any questions. If a pregnancy occurs during treatment, do not stop taking mycophenolate mofetil. Call your doctor for instructions. Also call the Mycophenolate Pregnancy Registry (1-800-617-8191). Mycophenolate mofetil is sometimes given to pregnant women. Your doctor will decide whether you should use this medicine if you are unable to use other needed transplant medications. You should not breastfeed while using mycophenolate mofetil. How should I use mycophenolate mofetil? Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. You must remain under the care of a doctor while you are using mycophenolate mofetil. Mycophenolate mofetil injection is given as an infusion into a vein. A healthcare provider will give you this injection. Take oral mycophenolate mofetil on an empty stomach, at least 1 hour before or 2 hours after a meal. Swallow the capsule or tablet whole and do not crush, chew, break, or open it. Tell your doctor if you have trouble swallowing a tablet or capsule. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions. Shake the oral suspension (liquid) before you measure a dose. Use only the dosing syringe provided with this medicine. Mycophenolate mofetil (CellCept) and mycophenolic acid (Myfortic) are not absorbed equally in the body. Avoid medication errors by using only the brand, form, and strength of this medicine that your doctor has prescribed. You will need frequent medical tests. Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. Throw away any unused liquid that is older than 60 days. The liquid medicine may also be stored in the refrigerator. Do not freeze. What happens if I miss a dose? Use the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 2 hours. Do not use two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while using mycophenolate mofetil? Avoid driving or hazardous activity until you know how mycophenolate mofetil will affect you. Your reactions could be impaired. Mycophenolate mofetil can make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Do not receive a "live" vaccine while using mycophenolate mofetil. The vaccine may not work as well and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine. You must not donate blood or sperm while using this medicine, and for at least 6 weeks (for blood) or 90 days (for sperm) after your last dose. Mycophenolate mofetil side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Mycophenolate mofetil may cause a serious brain infection that can lead to disability or death. Call your doctor right away if you have problems with speech, thought, vision, or muscle movement. These symptoms may start gradually and get worse quickly. Mycophenolate mofetil affects your immune system and may increase your risk of cancer or serious infection. Call your doctor right away if you have: fever of 100.5 degrees F or higher, swollen glands, painful mouth sores, cold or flu symptoms, headache, ear pain; stomach pain, vomiting, diarrhea, weight loss; weakness on one side of your body, loss of muscle control; confusion, thinking problems, loss of interest in things that normally interest you; pain around the transplanted kidney; pain or burning when you urinate; dark urine, jaundice (yellowing of the skin or eyes); tingly or painful blistering rash on one side of your body; swelling, warmth, redness, or oozing around a skin wound; or a new skin lesion, or a mole that has changed in size or color. Also call your doctor at once if you have: bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds; or low blood cell counts--fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath. Common side effects may include: stomach pain, nausea, vomiting, diarrhea, constipation; swelling in your ankles or feet; rash; headache, dizziness, tremors; fever, sore throat, cold symptoms, or other signs of infections; abnormal blood tests, high blood sugar; pain anywhere in your body; low blood cell counts; or high or low blood pressure, fast heart rate. 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.   Mycophenolate mofetil dosing information Usual Adult Dose for Organ Transplant -- Rejection Prophylaxis: -RENAL TRANSPLANTATION: 1 g orally or IV 2 times a day (2 gm per day); [in clinical trials, 1.5 g orally or IV 2 times a day (3 gm per day) was used effectively, however, the safety profile for 3 gm a day was lower] -CARDIAC TRANSPLANTATION: 1.5 g orally or IV 2 times a day (3 gm per day) -HEPATIC TRANSPLANTATION: 1.5 gm orally or 1 gm IV 2 times a day (3 gm per day orally or 2 gm per day IV) Comments: -This drug should be used concomitantly with cyclosporine and corticosteroids. -The IV formulation should be administered over no less than 2 hours. -IV administration is recommended in patients unable to take oral medication; oral administration should be initiated as soon as possible. Usual Geriatric Dose for Organ Transplant -- Rejection Prophylaxis: -RENAL TRANSPLANTATION: 1 g orally or IV 2 times a day (2 gm per day) -CARDIAC TRANSPLANTATION: 1.5 g orally or IV 2 times a day (3 gm per day) -HEPATIC TRANSPLANTATION: 1.5 gm orally or 1 gm IV 2 times a day (3 gm per day orally or 2 gm per day IV) Comments: -This drug should be used concomitantly with cyclosporine and corticosteroids. -The IV formulation should be administered over no less than 2 hours. -IV administration is recommended in patients unable to take oral medication; oral administration should be initiated as soon as possible. Usual Pediatric Dose for Organ Transplant -- Rejection Prophylaxis: -RENAL TRANSPLANTATION: 3 months to 18 years of age: Oral Suspension: 600 mg/m2 orally 2 times a day up to a maximum of 2 grams per day -Pediatric patients with a body surface area of 1.25 to 1.5 m2 may be dosed with the oral capsules at 750 mg orally 2 times a day (1.5 g per day) -Pediatric patients with a body surface area greater than 1.5 m2 may be dosed with the oral capsules at 1 g orally 2 times a day (2 g per day) Comments: -This drug should be used concomitantly with cyclosporine and corticosteroids. -The IV formulation should be administered over no less than 2 hours.-IV administration is recommended in patients unable to take oral medication; oral administration should be initiated as soon as possible.   What other drugs will affect mycophenolate mofetil? If you take sevelamer or an antacid, take your oral mycophenolate mofetil dose 2 hours before you take these other medicines. Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Tell your doctor about all your current medicines. Many drugs can affect mycophenolate mofetil, especially: azathioprine; cholestyramine; antiviral medicine--acyclovir, ganciclovir, valacyclovir, valganciclovir; an antibiotic--amoxicillin, ciprofloxacin, metronidazole, norfloxacin, rifampin, sulfa drugs; or a stomach acid reducer--esomeprazole, lansoprazole, omeprazole, Nexium, Prevacid, Prilosec, Protonix, and others. This list is not complete and many other drugs may affect mycophenolate mofetil. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Mycophenolate Mofetil tablet

Immunosuppressant / Arthritis

What is mycophenolate mofetil? Mycophenolate mofetil is used with other medicines to prevent organ transplant rejection. Mycophenolate mofetil is for use with a liver or heart transplant in adults. mycophenolate mofetil is for use with a kidney transplant in adults and children at least 3 months old. Mycophenolate mofetil may also be used for purposes not listed in this medication guide. Warnings This medicine can cause a miscarriage or birth defects when used during pregnancy. Both men and women should use effective birth control to prevent pregnancy during and shortly after treatment with mycophenolate mofetil. Using mycophenolate mofetil may increase your risk of cancer, serious infections, or kidney transplant failure. Call your doctor right away if you have symptoms such as: fever, swollen glands, weight loss, vomiting or diarrhea, painful urination, a new skin lesion, any change in your mental state, weakness on one side of your body, or pain near your transplanted kidney. Before taking this medicine You should not use mycophenolate mofetil if you are allergic to mycophenolate mofetil, mycophenolic acid, or polysorbate 80. Talk with your doctor about the risks and benefits of mycophenolate mofetil. This medicine may increase your risk of cancer, serious or fatal infections, or a viral infection that can cause kidney transplant failure. Tell your doctor if you have ever had: a stomach ulcer or problems with digestion; diabetes; hepatitis B or C or other viral infection (may become active or get worse while you are using mycophenolate mofetil); phenylketonuria, or PKU (the liquid form of this medicine may contain phenylalanine); or a rare inherited enzyme deficiency such as Lesch-Nyhan syndrome or Kelley-Seegmiller syndrome. This medicine can cause a miscarriage or birth defects, especially during the first 3 months of pregnancy. You will need to have a negative pregnancy test before and during treatment with this medicine. If you are able to get pregnant, you must use specific forms of birth control to prevent pregnancy while using mycophenolate mofetil, and for at least 6 weeks after your last dose. Sexually active men and their partners should use effective contraception during treatment and for at least 90 days after the last dose. Mycophenolate mofetil can make birth control pills less effective. Ask your doctor about using an additional barrier form of birth control (condom, diaphragm, cervical cap, or contraceptive sponge) to prevent pregnancy. You do not need to use additional birth control if you use an intrauterine device (IUD), if you have had a tubal ligation, or if your sexual partner has had a vasectomy. This medicine comes with patient instructions about the most effective non-hormonal forms of birth control to use. Follow these directions carefully. Ask your doctor if you have any questions. If a pregnancy occurs during treatment, do not stop taking mycophenolate mofetil. Call your doctor for instructions. Also call the Mycophenolate Pregnancy Registry (1-800-617-8191). Mycophenolate mofetil is sometimes given to pregnant women. Your doctor will decide whether you should use this medicine if you are unable to use other needed transplant medications. You should not breastfeed while using mycophenolate mofetil. How should I use mycophenolate mofetil? Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. You must remain under the care of a doctor while you are using mycophenolate mofetil. Mycophenolate mofetil injection is given as an infusion into a vein. A healthcare provider will give you this injection. Take oral mycophenolate mofetil on an empty stomach, at least 1 hour before or 2 hours after a meal. Swallow the capsule or tablet whole and do not crush, chew, break, or open it. Tell your doctor if you have trouble swallowing a tablet or capsule. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions. Shake the oral suspension (liquid) before you measure a dose. Use only the dosing syringe provided with this medicine. Mycophenolate mofetil (CellCept) and mycophenolic acid (Myfortic) are not absorbed equally in the body. Avoid medication errors by using only the brand, form, and strength of this medicine that your doctor has prescribed. You will need frequent medical tests. Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. Throw away any unused liquid that is older than 60 days. The liquid medicine may also be stored in the refrigerator. Do not freeze. What happens if I miss a dose? Use the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 2 hours. Do not use two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while using mycophenolate mofetil? Avoid driving or hazardous activity until you know how mycophenolate mofetil will affect you. Your reactions could be impaired. Mycophenolate mofetil can make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Do not receive a "live" vaccine while using mycophenolate mofetil. The vaccine may not work as well and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine. You must not donate blood or sperm while using this medicine, and for at least 6 weeks (for blood) or 90 days (for sperm) after your last dose. Mycophenolate mofetil side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Mycophenolate mofetil may cause a serious brain infection that can lead to disability or death. Call your doctor right away if you have problems with speech, thought, vision, or muscle movement. These symptoms may start gradually and get worse quickly. Mycophenolate mofetil affects your immune system and may increase your risk of cancer or serious infection. Call your doctor right away if you have: fever of 100.5 degrees F or higher, swollen glands, painful mouth sores, cold or flu symptoms, headache, ear pain; stomach pain, vomiting, diarrhea, weight loss; weakness on one side of your body, loss of muscle control; confusion, thinking problems, loss of interest in things that normally interest you; pain around the transplanted kidney; pain or burning when you urinate; dark urine, jaundice (yellowing of the skin or eyes); tingly or painful blistering rash on one side of your body; swelling, warmth, redness, or oozing around a skin wound; or a new skin lesion, or a mole that has changed in size or color. Also call your doctor at once if you have: bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds; or low blood cell counts--fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath. Common side effects may include: stomach pain, nausea, vomiting, diarrhea, constipation; swelling in your ankles or feet; rash; headache, dizziness, tremors; fever, sore throat, cold symptoms, or other signs of infections; abnormal blood tests, high blood sugar; pain anywhere in your body; low blood cell counts; or high or low blood pressure, fast heart rate. 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.   Mycophenolate mofetil dosing information Usual Adult Dose for Organ Transplant -- Rejection Prophylaxis: -RENAL TRANSPLANTATION: 1 g orally or IV 2 times a day (2 gm per day); [in clinical trials, 1.5 g orally or IV 2 times a day (3 gm per day) was used effectively, however, the safety profile for 3 gm a day was lower] -CARDIAC TRANSPLANTATION: 1.5 g orally or IV 2 times a day (3 gm per day) -HEPATIC TRANSPLANTATION: 1.5 gm orally or 1 gm IV 2 times a day (3 gm per day orally or 2 gm per day IV) Comments: -This drug should be used concomitantly with cyclosporine and corticosteroids. -The IV formulation should be administered over no less than 2 hours. -IV administration is recommended in patients unable to take oral medication; oral administration should be initiated as soon as possible. Usual Geriatric Dose for Organ Transplant -- Rejection Prophylaxis: -RENAL TRANSPLANTATION: 1 g orally or IV 2 times a day (2 gm per day) -CARDIAC TRANSPLANTATION: 1.5 g orally or IV 2 times a day (3 gm per day) -HEPATIC TRANSPLANTATION: 1.5 gm orally or 1 gm IV 2 times a day (3 gm per day orally or 2 gm per day IV) Comments: -This drug should be used concomitantly with cyclosporine and corticosteroids. -The IV formulation should be administered over no less than 2 hours. -IV administration is recommended in patients unable to take oral medication; oral administration should be initiated as soon as possible. Usual Pediatric Dose for Organ Transplant -- Rejection Prophylaxis: -RENAL TRANSPLANTATION: 3 months to 18 years of age: Oral Suspension: 600 mg/m2 orally 2 times a day up to a maximum of 2 grams per day -Pediatric patients with a body surface area of 1.25 to 1.5 m2 may be dosed with the oral capsules at 750 mg orally 2 times a day (1.5 g per day) -Pediatric patients with a body surface area greater than 1.5 m2 may be dosed with the oral capsules at 1 g orally 2 times a day (2 g per day) Comments: -This drug should be used concomitantly with cyclosporine and corticosteroids. -The IV formulation should be administered over no less than 2 hours.-IV administration is recommended in patients unable to take oral medication; oral administration should be initiated as soon as possible.   What other drugs will affect mycophenolate mofetil? If you take sevelamer or an antacid, take your oral mycophenolate mofetil dose 2 hours before you take these other medicines. Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Tell your doctor about all your current medicines. Many drugs can affect mycophenolate mofetil, especially: azathioprine; cholestyramine; antiviral medicine--acyclovir, ganciclovir, valacyclovir, valganciclovir; an antibiotic--amoxicillin, ciprofloxacin, metronidazole, norfloxacin, rifampin, sulfa drugs; or a stomach acid reducer--esomeprazole, lansoprazole, omeprazole, Nexium, Prevacid, Prilosec, Protonix, and others. This list is not complete and many other drugs may affect mycophenolate mofetil. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Mycophenolic Acid DR tablet

Immunosuppressant / Arthritis

What is mycophenolic acid? Mycophenolic acid is used with other medicines to prevent organ rejection after a kidney transplant. mycophenolic acid is for use in adults and children at least 5 years old. Mycophenolic acid may also be used for purposes not listed in this medication guide. Warnings This medicine can cause a miscarriage or birth defects when used during pregnancy. Both men and women should use effective birth control to prevent pregnancy during and shortly after treatment with mycophenolic acid. Using mycophenolic acid may increase your risk of cancer, serious infections, or kidney transplant failure. Call your doctor right away if you have symptoms such as: fever, swollen glands, weight loss, vomiting or diarrhea, painful urination, a new skin lesion, any change in your mental state, weakness on one side of your body, or pain near your transplanted kidney. Before taking this medicine You should not use mycophenolic acid if you are allergic to mycophenolic acid, mycophenolate mofetil, or mycophenolate sodium. Talk with your doctor about the risks and benefits of mycophenolic acid. This medicine can affect your immune system, which may increase your risk of cancer, serious or fatal infections, or kidney transplant failure. Tell your doctor if you have ever had: a stomach ulcer or problems with digestion; hepatitis B or C or other a viral infection (may become active or get worse while you are using mycophenolic acid); or a rare inherited enzyme deficiency such as Lesch-Nyhan syndrome or Kelley-Seegmiller syndrome. This medicine can cause a miscarriage or birth defects, especially during the first 3 months of pregnancy. You will need to have a negative pregnancy test before and during treatment with this medicine. If you are able to get pregnant, you must use specific forms of birth control to prevent pregnancy while using mycophenolic acid, and for at least 6 weeks after your last dose. Sexually active men and their partners should use effective contraception during treatment and for at least 90 days after the last dose. Mycophenolic acid can make birth control pills less effective. Ask your doctor about using an additional barrier form of birth control (condom, diaphragm, cervical cap, or contraceptive sponge) to prevent pregnancy. You do not need to use additional birth control if you use an intrauterine device (IUD), if you have had a tubal ligation, or if your sexual partner has had a vasectomy. This medicine comes with patient instructions about the most effective non-hormonal forms of birth control to use. Follow these directions carefully. Ask your doctor if you have any questions. If a pregnancy occurs during treatment, do not stop taking mycophenolic acid. Call your doctor for instructions. Also call the Mycophenolate Pregnancy Registry (1-800-617-8191). Mycophenolic acid is sometimes given to pregnant women. Your doctor will decide whether you should use this medicine if you are unable to use other needed transplant medications. It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk. How should I take mycophenolic acid? Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. Take this medicine on an empty stomach, at least 1 hour before or 2 hours after a meal. Swallow the tablet whole and do not crush, chew, or break it. Mycophenolic acid (Myfortic) and mycophenolate mofetil (CellCept) are not absorbed equally in the body. Avoid medication errors by using only the brand, form, and strength of this medicine that your doctor has prescribed. You will need frequent medical tests. Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while taking mycophenolic acid? Avoid taking an antacid together with mycophenolic acid. Mycophenolic acid can make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Do not receive a "live" vaccine while using mycophenolic acid. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), and zoster (shingles). Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection. You must not donate blood or sperm while using mycophenolic acid, and for at least 6 weeks (for blood) or 90 days (for sperm) after your last dose. Mycophenolic acid side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Mycophenolic acid may cause a serious brain infection that can lead to disability or death. Call your doctor right away if you have problems with speech, thought, vision, or muscle movement. These symptoms may start gradually and get worse quickly. Mycophenolic acid affects your immune system and may increase your risk of cancer or serious infection. Call your doctor right away if you have: fever of 100.5 degrees F or higher, swollen glands, painful mouth sores, cold or flu symptoms, headache, ear pain; stomach pain, vomiting, diarrhea, weight loss; weakness on one side of your body, loss of muscle control; confusion, thinking problems, loss of interest in things that normally interest you; pain or burning when you urinate; dark urine, jaundice (yellowing of the skin or eyes); pain or tenderness around the transplanted kidney; tingly or painful blistering rash on one side of your body; swelling, warmth, redness, or oozing around a skin wound; or a new skin lesion, or a mole that has changed in size or color. Also call your doctor at once if you have: bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds; or low blood cell counts--fever, chills, tiredness, flu-like symptoms, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath. Common side effects may include: upset stomach, nausea, vomiting; diarrhea, constipation; low blood cell counts, infections; sleep problems (insomnia); painful urination; or pain after surgery. 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.   Mycophenolic acid dosing information Usual Adult Dose for Organ Transplant -- Rejection Prophylaxis: 720 mg orally 2 times daily Comments: -This drug should be used in combination with cyclosporine and corticosteroids. -Take on an empty stomach 1 hour before or 2 hours after food. -Swallow tablets whole; do not crush, chew, or divide. Use: For prophylaxis of organ rejection in kidney transplant Usual Pediatric Dose for Organ Transplant -- Rejection Prophylaxis: 5 years and older: -In conversion (at least 6 months posttransplant): 400 mg/m2 orally 2 times a day (up to a maximum dose of 720 mg 2 times a day) Note: Pediatric patients with a BSA of 1.19 to 1.58 m2 may be dosed either with three of the 180 mg tablets, or one 180 mg tablet plus one 360 mg tablet 2 times a day. Patients with a BSA greater than 1.58 m2 may be dosed either with four of the 180 mg tablets, or two of the 360 mg tablets twice daily. Pediatric doses for patients with BSA less than 1.19 m2 cannot be accurately administered using currently available formulations of this drug. Comments: -This drug should be used in combination with cyclosporine and corticosteroids. -Take on an empty stomach 1 hour before or 2 hours after food. -Swallow tablets whole; do not crush, chew, or divide. Use: For the prophylaxis of organ rejection in pediatric patients 5 years of age and older who are at least 6 months post kidney transplant   What other drugs will affect mycophenolic acid? Tell your doctor about all your other medicines, especially: azathioprine; cholestyramine; or antiviral medicine--acyclovir, ganciclovir. This list is not complete. Other drugs may affect mycophenolic acid, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Tacrolimus capsule

Immunosuppressant / Arthritis

What is tacrolimus? Tacrolimus is used together with other medicines in people who have had a heart, kidney, liver, or lung transplant. Tacrolimus weakens your immune system to prevent your body from "rejecting" the transplanted organ. Tacrolimus may also be used for purposes not listed in this medication guide. Warnings Tacrolimus may increase your risk of developing a serious infection, skin cancer, or lymphoma. Talk with your doctor about the risks and benefits of using tacrolimus. Call your doctor right away if you have any signs of infection such as fever, chills, flu symptoms, cough, sweating, painful skin sores, skin warmth or redness, or muscle aches. Before taking this medicine You should not use this medicine if you are allergic to tacrolimus or hydrogenated castor oil, or if you have used cyclosporine (Neoral, Sandimmune, Gengraf) within the past 24 hours. Using tacrolimus may increase your risk of developing serious infections or certain types of cancer, such as lymphoma or skin cancer. Your risk may be higher if you are treated over long periods of time with drugs that weaken the immune system. Ask your doctor about this risk and about symptoms to watch for. Some people taking tacrolimus after a kidney transplant have developed diabetes. This effect has been seen most commonly in people who are Hispanic or African-American. Tell your doctor if you have ever had: problems with your liver, kidney, or heart that are not related to your transplant; long QT syndrome (in you or a family member); or if you are scheduled to receive a vaccine; Tell your doctor if you plan to get pregnant. Tacrolimus may harm an unborn baby, and can worsen conditions such as diabetes or high blood pressure in the mother. Use effective birth control before and during treatment with tacrolimus. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of tacrolimus on the baby. If you are a man, use birth control before and during treatment with tacrolimus if your sex partner is able to get pregnant. Pregnancy may be less likely to occur while the mother or the father is using this medicine. Both men and women should still use birth control to prevent pregnancy because the medicine can harm an unborn baby. Ask a doctor if it is safe to breastfeed while using this medicine. How should I take tacrolimus? Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. You may receive an injection of tacrolimus shortly after your transplant. Tacrolimus injection is given until you are ready to take the pill form of tacrolimus. Take oral tacrolimus at the same time each day, with a full glass of water. Swallow the tablet or capsule whole and do not crush, chew, break, or open it. Mix tacrolimus oral granules with water right before you take them. Do not save this mixture for later use. Do not get the powder or mixture on your skin or in your eyes. If this happens, wash your skin with soap and water or rinse your eyes with water. Take Astragraf XL or Envarsus XR in the morning on an empty stomach, at least 1 hour before or 2 hours after a meal. You may take Prograf with or without food, but take it the same way each time. Your dose needs may change if you switch to a different brand, strength, or form of tacrolimus. All forms of tacrolimus are not equivalent and may not have the same dose or schedule. Avoid medication errors by using only the form and strength your doctor prescribes. You will need frequent medical tests, and your blood pressure will need to be checked often. Store at room temperature away from moisture and heat.   What happens if I miss a dose? For Prograf: Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. For Astragraf XL: Take the medicine as soon as you can, but skip the missed dose if you are more than 14 hours late for the dose. For Envarsus XR: Take the medicine as soon as you can, but skip the missed dose if you are more than 15 hours late for the dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while taking tacrolimus? Avoid receiving a "live" vaccine. The vaccine may not work as well while you are using tacrolimus. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), and zoster (shingles). Grapefruit may interact with tacrolimus and cause side effects. Avoid consuming grapefruit products. Tacrolimus side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. You may get infections more easily, even serious or fatal infections. Call your doctor right away if you have signs of infection such as: fever, chills, flu symptoms, cough, sweating, painful skin sores, skin warmth or redness, or muscle aches. Also call your doctor at once if you have: general ill feeling, pain or swelling near your transplanted organ; headaches, vision changes, pounding in your neck or ears; confusion, behavior changes; tremors, a seizure; fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out); chest pain, cough, trouble breathing (even while lying down); high blood sugar--increased thirst, increased urination, hunger, fruity breath odor, nausea, loss of appetite, drowsiness, confusion; high potassium level--nausea, weakness, chest pain, irregular heartbeats, loss of movement; kidney problems--swelling, urinating less, feeling tired or short of breath; low magnesium or phosphate--bone pain, jerky muscle movements, muscle weakness or limp feeling, slow reflexes; or low blood cell counts--fever, flu symptoms, tiredness, pale skin, cold hands and feet. Common side effects may include: low blood cell counts, infections; fever; nausea, diarrhea, constipation, stomach pain; weakness, pain; fluid around your heart; tremors; headache; cough, breathing problems; high blood sugar, high potassium levels, high cholesterol or triglycerides levels; low levels of magnesium or phosphate; numbness or tingling in your hands and feet; sleep problems (insomnia); or swelling in your hands, legs, ankles, or feet. 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 tacrolimus? Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Tacrolimus can harm your kidneys, especially if you also use certain medicines for infections, cancer, osteoporosis, organ transplant rejection, bowel disorders, high blood pressure, or pain or arthritis (including Advil, Motrin, and Aleve). Tell your doctor about all your current medicines. Many drugs can affect tacrolimus, especially: amiodarone; cisplatin; cyclosporine; sirolimus; antibiotic, antifungal, or antiviral medicines; or heart or blood pressure medication, such as a diuretic or "water pill." This list is not complete and many other drugs may affect tacrolimus. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

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