What is amphetamine? Amphetamine is a central nervous system stimulant that affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control. Amphetamine is used to treat attention deficit hyperactivity disorder (ADHD). The Evekeo brand of amphetamine is used to treat ADHD and also narcolepsy. Evekeo is sometimes used to treat obesity in people who have not lost weight with diets or other treatments. Amphetamine is not approved for use in children less than 6 years of age, with the exception of Evekeo (approved for children age 3 and older). Warnings Amphetamine may be habit-forming, and this medicine is a drug of abuse. Tell your doctor if you have had problems with drug or alcohol abuse. Stimulants have caused stroke, heart attack, and sudden death in people with high blood pressure, heart disease, or a heart defect. Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine. Amphetamine may cause new or worsening psychosis (unusual thoughts or behavior), especially if you have a history of depression, mental illness, or bipolar disorder. Amphetamine may cause blood circulation problems that can cause numbness, pain, or discoloration in your fingers or toes. Call your doctor right away if you have: signs of heart problems - chest pain, feeling light-headed or short of breath; signs of psychosis - paranoia, aggression, new behavior problems, seeing or hearing things that are not real; signs of circulation problems - unexplained wounds on your fingers or toes. Before taking this medicine You should not use amphetamine if you are allergic to any stimulant medicine, or if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine. You may not be able to use amphetamine if you have: chest pain or breathing problems caused by heart disease; hardening of the arteries; moderate to severe high blood pressure; overactive thyroid; a history of drug abuse; or if you are agitated. Tell your doctor if you also take opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with amphetamine could cause a serious condition called serotonin syndrome. Stimulants have caused stroke, heart attack, and sudden death in certain people. Tell your doctor if you have: heart problems or a congenital heart defect; high blood pressure; or a family history of heart disease or sudden death. Amphetamine is not approved for use by anyone younger than 3 years old. To make sure this medicine is safe for you, tell your doctor if you or anyone in your family has had: depression, mental illness, bipolar disorder, psychosis, or suicidal thoughts or actions; problems with drug or alcohol abuse; motor tics (muscle twitches) or Tourette's syndrome; kidney disease; a thyroid disorder; seizures or epilepsy; an abnormal brain wave test (EEG); coronary artery disease (clogged arteries); or blood circulation problems in the hands or feet. Taking amphetamine during pregnancy can cause premature birth, low birth weight, or withdrawal symptoms in the newborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Amphetamine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby. How should I take amphetamine? Take amphetamine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Amphetamine may be habit-forming. Misuse can cause addiction, overdose, or death. Keep the medicine where others cannot get to it. Selling or giving away this medicine is against the law. Take with or without food. Shake the oral suspension (liquid). Measure a dose with the supplied syringe or a dose-measuring device (not a kitchen spoon). Allow the orally disintegrating tablet to dissolve in your mouth without chewing. Your dose needs may change if you switch to a different brand, strength, or form of this medicine. Avoid medication errors by using only the medicine your doctor prescribes. Your doctor will need to check your progress on a regular basis. Tell any doctor who treats you that you are using this medicine. Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. Keep your medicine in a place where no one can use it improperly. Do not keep leftover amphetamine. Ask your pharmacist where to locate a drug take-back disposal program.   What happens if I miss a dose? Take the missed dose as soon as you remember, but not late in the day. Skip the missed dose if it is almost evening. 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. An overdose of amphetamine could be fatal. Overdose symptoms may include restlessness, tremor, muscle twitches, rapid breathing, hostility, violence, panic, muscle pain or weakness, stomach cramps, vomiting, or diarrhea. These symptoms may be followed by depression and tiredness. Overdose may also cause seizure or coma. What should I avoid while taking amphetamine? Avoid drinking alcohol. Avoid drinking fruit juices or taking vitamin C at the same time you take amphetamine. These can make you absorb less amphetamine. Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired. Amphetamine side effects Get emergency medical help if you have signs of an allergic reaction to amphetamine: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: signs of heart problems - chest pain, trouble breathing, feeling like you might pass out; signs of psychosis - hallucinations (seeing or hearing things that are not real), new behavior problems, aggression, hostility, paranoia; signs of circulation problems - numbness, pain, cold feeling, unexplained wounds, or skin color changes (pale, red, or blue appearance) in your fingers or toes; a seizure (convulsions); muscle twitches (tics); pain or burning when you urinate; or changes in your vision. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Amphetamine can affect growth. Tell your doctor if your child is not growing at a normal rate. Common amphetamine side effects may include: increased heart rate; mood changes, anxiety, feeling restless or nervous; trouble sleeping; dry mouth, stomach pain, nausea, vomiting, diarrhea, constipation; loss of appetite, weight loss; painful urination; sexual problems, impotence; headache, dizziness; fever, weakness; or itching. 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 amphetamine? Many drugs can interact with amphetamine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you use.

What is diazepam? Diazepam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen)). It is thought that benzodiazepines work by enhancing the activity of certain neurotransmitters in the brain. Diazepam is used to treat anxiety disorders, or alcohol withdrawal symptoms. Diazepam is sometimes used with other medications to treat muscle spasms and stiffness, or seizures. Warnings Diazepam can slow or stop your breathing, especially if you have recently used an opioid medication, alcohol, or other drugs that can slow your breathing. MISUSE OF DIAZEPAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Keep the medication in a place where others cannot get to it. Fatal side effects can occur if you use this medicine with opioid medicine, alcohol, or other drugs that cause drowsiness or slow your breathing. You should not use this medicine if you are allergic to diazepam or similar medicines (Klonopin>, Xanax, and others), or if you have myasthenia gravis, severe liver disease, narrow-angle glaucoma, a severe breathing problem, or sleep apnea. Do not stop using this medicine without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Some withdrawal symptoms may last up to 12 months or longer. Get medical help right away if you stop using diazepam and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide. Before taking this medicine You should not use diazepam if you are allergic to it, or if you have: myasthenia gravis (a muscle weakness disorder); a severe breathing problem; sleep apnea (breathing stops during sleep); narrow-angle glaucoma; untreated or uncontrolled open-angle glaucoma; or severe liver disease. Diazepam should not be given to a child younger than 6 months old. Do not give this medicine to a child without a doctor's advice. To make sure this medicine is safe for you, tell your doctor if you have ever had: breathing problems; glaucoma; kidney or liver disease; seizures (unless you are taking diazepam to treat a seizure disorder); a drug or alcohol addiction; or depression, a mood disorder, or suicidal thoughts or behavior. Some people have thoughts about suicide while taking diazepam. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior. May harm an unborn baby. Do not use if you are pregnant or may become pregnant. If you use diazepam during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks. Do not start or stop seizure medication during pregnancy without your doctor's advice. Diazepam may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Preventing seizures may outweigh these risks. Tell your doctor right away if you become pregnant. There may be other seizure medications that are safer to use during pregnancy. You should not breastfeed. How should I take diazepam? Take diazepam exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides or instruction sheets. Never use diazepam in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more of this medicine. Never share this medicine with another person, especially someone with a history of drug addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine where others cannot get to it. Selling or giving away this medicine is against the law. Measure liquid medicine with the supplied measuring device (not a kitchen spoon). Diazepam should be used for only a short time. Do not take this medicine for longer than 4 months without your doctor's advice. Do not stop using diazepam without asking your doctor. You may have increased seizures or life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. You will need frequent medical tests. Store at room temperature away from moisture, heat, and light. Keep your medicine in a place where no one can use it improperly.   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. An overdose of diazepam can be fatal if you take it with alcohol, opioid medicine, or other drugs that cause drowsiness or slow your breathing. Overdose symptoms may include extreme drowsiness, loss of balance or coordination, limp or weak muscles, slow breathing, or coma. What should I avoid while taking diazepam? Avoid drinking alcohol. Dangerous side effects or death could occur. Grapefruit may interact with diazepam and lead to unwanted side effects. Avoid the use of grapefruit products. Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Diazepam side effects Get emergency medical help if you have signs of an allergic reaction to diazepam: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Diazepam can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: severe drowsiness or dizziness; trouble breathing; confusion, paranoia; or new or worsening seizures. Drowsiness or dizziness may last longer in older adults. Use caution to avoid falling or accidental injury. Common diazepam side effects may include: drowsiness; feeling tired; muscle weakness; or problems with balance or muscle movement. After you stop using diazepam, get medical help right away if you have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, suicidal thoughts or actions. Some withdrawal symptoms may last up to 12 months or longer after stopping this medicine suddenly. Tell your doctor if you have ongoing anxiety, depression, problems with memory or thinking, trouble sleeping, ringing in your ears, a burning or prickly feeling, or a crawling sensation under your skin. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect diazepam? Taking diazepam with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Other drugs may interact with diazepam, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

What is diclofenac? Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID). This medicine works by reducing substances in the body that cause pain and inflammation. Diclofenac is used to treat mild to moderate pain, or signs and symptoms of osteoarthritis or rheumatoid arthritis. Voltaren is also indicated for the treatment of ankylosing spondylitis. The Cataflam brand of this medicine is also used to treat menstrual cramps. Diclofenac powder (Cambia) is used to treat a migraine headache attack. Cambia will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks. Warnings You should not use diclofenac if you have a history of allergic reaction to aspirin or NSAIDs (non-steroidal anti-inflammatory drugs). Diclofenac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults. Before taking this medicine Diclofenac can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults. You should not use diclofenac if you are allergic to it, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID. Do not use Cambia to treat a cluster headache. Do not use Zipsor if you are allergic to beef or beef protein. To make sure this medicine is safe for you, tell your doctor if you have: heart disease, high blood pressure; ulcers or bleeding in your stomach; asthma; liver or kidney disease; or if you smoke. Diclofenac can affect ovulation and it may be harder to get pregnant while you are using this medicine. If you are pregnant, you should not take diclofenac unless your doctor tells you to. Taking a NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy. It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk. Diclofenac is not approved for use by anyone younger than 18 years old. How should I take diclofenac? Take diclofenac exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides. Your doctor may occasionally change your dose. Use the lowest dose that is effective in treating your condition. Different brands of diclofenac contain different amounts of diclofenac, and may have different uses. If you switch brands, your dose needs may change. Follow your doctor's instructions about how much medicine to take. Ask your pharmacist if you have any questions about the brand you receive at the pharmacy. Swallow the tablet whole and do not crush, chew, or break it. Take Zorvolex on an empty stomach, at least 1 hour before or 2 hours after a meal. Dissolve the powder form of this medicine (Cambia) with 1 to 2 ounces of water. Do not use any other type of liquid. Stir this mixture and drink all of it right away. Cambia works best if you take it on an empty stomach. Call your doctor if your headache does not completely go away after taking Cambia. If you use diclofenac long-term, you may need frequent medical tests. Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. Dosing information Usual Adult Dose for Osteoarthritis: Diclofenac free acid capsules: 35 mg orally 3 times a day Diclofenac potassium immediate-release tablets: 50 mg orally 2 or 3 times a day Diclofenac sodium enteric-coated tablets: 50 mg orally 2 or 3 times a day or 75 mg orally 2 times a day Maximum dose: 150 mg daily Diclofenac sodium extended-release tablets: 100 mg orally once a day Use: For the relief of signs and symptoms of osteoarthritis. Usual Adult Dose for Ankylosing Spondylitis: Diclofenac sodium enteric-coated and delayed-release tablets: 25 mg orally 4 times a day. An additional 25 mg dose may be administered at bedtime, if necessary Maximum dose: 125 mg per day Use: For acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis. Usual Adult Dose for Dysmenorrhea: Diclofenac potassium immediate-release tablets: 50 mg orally 3 times a day Comments: An initial dose of 100 mg orally followed by 50 mg oral doses may provide better relief for some patients; initiate treatment upon appearance of the first symptoms and continue for a few days. Use: For the relief of signs and symptoms of primary dysmenorrhea. Usual Adult Dose for Rheumatoid Arthritis: Diclofenac potassium immediate-release tablets: 50 mg orally 3 or 4 times a day Diclofenac sodium enteric-coated and delayed-release tablets: 50 mg orally 3 to 4 times a day or 75 mg orally twice a day Maximum dose: 225 mg daily Diclofenac sodium extended-release tablets: 100 mg orally once a day Maximum dose: 100 mg orally 2 times a day; this would be for the rare patient in whom the benefits outweigh the clinical risks. For the relief of signs and symptoms of rheumatoid arthritis Usual Adult Dose for Migraine: Diclofenac potassium for oral solution packets: 50 mg (1 packet) orally once Comments: This drug is not indicated for the prophylactic therapy of migraine or for use in cluster headaches; the safety and efficacy of a second dose has not been established. Use: For acute treatment of migraine with or without aura. Usual Adult Dose for Pain: Oral: Diclofenac potassium liquid-filled capsules: 25 mg orally 4 times a day Diclofenac free acid capsules: 18 mg or 35 mg orally 3 times a day Diclofenac potassium immediate-release tablets: 50 mg orally 3 times a day; an initial dose of 100 mg orally followed by 50 mg oral doses may provide better relief in some patients. Parenteral: 37.5 mg IV bolus over 15 seconds every 6 hours as needed for pain Maximum Dose: 150 mg per day Comment: Patients should be well hydrated prior to IV administration of this drug in order to reduce the risk of adverse renal reactions. Uses: For the management of mild to moderate acute pain (oral, IV) and moderate to severe pain alone or in combination with opioid analgesics (IV). What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.   What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What to avoid Avoid drinking alcohol. It may increase your risk of stomach bleeding. Avoid taking aspirin or other NSAIDs unless your doctor tells you to. Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to diclofenac (such as aspirin, ibuprofen, ketoprofen, or naproxen). Diclofenac side effects Get emergency medical help if you have signs of an allergic reaction to diclofenac (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath. Stop using this medicine and call your doctor at once if you have: the first sign of any skin rash, no matter how mild; flu-like symptoms; heart problems - swelling, rapid weight gain, feeling short of breath; kidney problems - little or no urinating, painful or difficult urination, swelling in your arms or legs, feeling tired or short of breath; liver problems - nausea, diarrhea, stomach pain (upper right side), tiredness, itching, dark urine, jaundice (yellowing of the skin or eyes); or signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds. Common diclofenac side effects may include: indigestion, gas, nausea, vomiting, stomach pain; diarrhea, constipation; headache, dizziness, drowsiness; abnormal lab tests; itching, sweating; stuffy nose; increased blood pressure; or swelling or pain in your arms or legs. 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 diclofenac? Ask your doctor before using diclofenac if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily. Tell your doctor about all your other medicines, especially: heart or blood pressure medication, including a diuretic or "water pill"; other forms of diclofenac (Arthrotec, Flector, Pennsaid, Solaraze, Voltaren Gel); a blood thinner - warfarin, Coumadin, Jantoven; or other NSAIDs - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), indomethacin, meloxicam, and others. This list is not complete. Other drugs may interact with diclofenac, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

What is diclofenac? Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID). This medicine works by reducing substances in the body that cause pain and inflammation. Diclofenac is used to treat mild to moderate pain, or signs and symptoms of osteoarthritis or rheumatoid arthritis. Voltaren is also indicated for the treatment of ankylosing spondylitis. The Cataflam brand of this medicine is also used to treat menstrual cramps. Diclofenac powder (Cambia) is used to treat a migraine headache attack. Cambia will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks. Warnings You should not use diclofenac if you have a history of allergic reaction to aspirin or NSAIDs (non-steroidal anti-inflammatory drugs). Diclofenac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults. Before taking this medicine Diclofenac can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults. You should not use diclofenac if you are allergic to it, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID. Do not use Cambia to treat a cluster headache. Do not use Zipsor if you are allergic to beef or beef protein. To make sure this medicine is safe for you, tell your doctor if you have: heart disease, high blood pressure; ulcers or bleeding in your stomach; asthma; liver or kidney disease; or if you smoke. Diclofenac can affect ovulation and it may be harder to get pregnant while you are using this medicine. If you are pregnant, you should not take diclofenac unless your doctor tells you to. Taking a NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy. It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk. Diclofenac is not approved for use by anyone younger than 18 years old. How should I take diclofenac? Take diclofenac exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides. Your doctor may occasionally change your dose. Use the lowest dose that is effective in treating your condition. Different brands of diclofenac contain different amounts of diclofenac, and may have different uses. If you switch brands, your dose needs may change. Follow your doctor's instructions about how much medicine to take. Ask your pharmacist if you have any questions about the brand you receive at the pharmacy. Swallow the tablet whole and do not crush, chew, or break it. Take Zorvolex on an empty stomach, at least 1 hour before or 2 hours after a meal. Dissolve the powder form of this medicine (Cambia) with 1 to 2 ounces of water. Do not use any other type of liquid. Stir this mixture and drink all of it right away. Cambia works best if you take it on an empty stomach. Call your doctor if your headache does not completely go away after taking Cambia. If you use diclofenac long-term, you may need frequent medical tests. Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. Dosing information Usual Adult Dose for Osteoarthritis: Diclofenac free acid capsules: 35 mg orally 3 times a day Diclofenac potassium immediate-release tablets: 50 mg orally 2 or 3 times a day Diclofenac sodium enteric-coated tablets: 50 mg orally 2 or 3 times a day or 75 mg orally 2 times a day Maximum dose: 150 mg daily Diclofenac sodium extended-release tablets: 100 mg orally once a day Use: For the relief of signs and symptoms of osteoarthritis. Usual Adult Dose for Ankylosing Spondylitis: Diclofenac sodium enteric-coated and delayed-release tablets: 25 mg orally 4 times a day. An additional 25 mg dose may be administered at bedtime, if necessary Maximum dose: 125 mg per day Use: For acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis. Usual Adult Dose for Dysmenorrhea: Diclofenac potassium immediate-release tablets: 50 mg orally 3 times a day Comments: An initial dose of 100 mg orally followed by 50 mg oral doses may provide better relief for some patients; initiate treatment upon appearance of the first symptoms and continue for a few days. Use: For the relief of signs and symptoms of primary dysmenorrhea. Usual Adult Dose for Rheumatoid Arthritis: Diclofenac potassium immediate-release tablets: 50 mg orally 3 or 4 times a day Diclofenac sodium enteric-coated and delayed-release tablets: 50 mg orally 3 to 4 times a day or 75 mg orally twice a day Maximum dose: 225 mg daily Diclofenac sodium extended-release tablets: 100 mg orally once a day Maximum dose: 100 mg orally 2 times a day; this would be for the rare patient in whom the benefits outweigh the clinical risks. For the relief of signs and symptoms of rheumatoid arthritis Usual Adult Dose for Migraine: Diclofenac potassium for oral solution packets: 50 mg (1 packet) orally once Comments: This drug is not indicated for the prophylactic therapy of migraine or for use in cluster headaches; the safety and efficacy of a second dose has not been established. Use: For acute treatment of migraine with or without aura. Usual Adult Dose for Pain: Oral: Diclofenac potassium liquid-filled capsules: 25 mg orally 4 times a day Diclofenac free acid capsules: 18 mg or 35 mg orally 3 times a day Diclofenac potassium immediate-release tablets: 50 mg orally 3 times a day; an initial dose of 100 mg orally followed by 50 mg oral doses may provide better relief in some patients. Parenteral: 37.5 mg IV bolus over 15 seconds every 6 hours as needed for pain Maximum Dose: 150 mg per day Comment: Patients should be well hydrated prior to IV administration of this drug in order to reduce the risk of adverse renal reactions. Uses: For the management of mild to moderate acute pain (oral, IV) and moderate to severe pain alone or in combination with opioid analgesics (IV). What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.   What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What to avoid Avoid drinking alcohol. It may increase your risk of stomach bleeding. Avoid taking aspirin or other NSAIDs unless your doctor tells you to. Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to diclofenac (such as aspirin, ibuprofen, ketoprofen, or naproxen). Diclofenac side effects Get emergency medical help if you have signs of an allergic reaction to diclofenac (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath. Stop using this medicine and call your doctor at once if you have: the first sign of any skin rash, no matter how mild; flu-like symptoms; heart problems - swelling, rapid weight gain, feeling short of breath; kidney problems - little or no urinating, painful or difficult urination, swelling in your arms or legs, feeling tired or short of breath; liver problems - nausea, diarrhea, stomach pain (upper right side), tiredness, itching, dark urine, jaundice (yellowing of the skin or eyes); or signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds. Common diclofenac side effects may include: indigestion, gas, nausea, vomiting, stomach pain; diarrhea, constipation; headache, dizziness, drowsiness; abnormal lab tests; itching, sweating; stuffy nose; increased blood pressure; or swelling or pain in your arms or legs. 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 diclofenac? Ask your doctor before using diclofenac if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily. Tell your doctor about all your other medicines, especially: heart or blood pressure medication, including a diuretic or "water pill"; other forms of diclofenac (Arthrotec, Flector, Pennsaid, Solaraze, Voltaren Gel); a blood thinner - warfarin, Coumadin, Jantoven; or other NSAIDs - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), indomethacin, meloxicam, and others. This list is not complete. Other drugs may interact with diclofenac, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

What is diclofenac? Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID). This medicine works by reducing substances in the body that cause pain and inflammation. Diclofenac is used to treat mild to moderate pain, or signs and symptoms of osteoarthritis or rheumatoid arthritis. Voltaren is also indicated for the treatment of ankylosing spondylitis. The Cataflam brand of this medicine is also used to treat menstrual cramps. Diclofenac powder (Cambia) is used to treat a migraine headache attack. Cambia will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks. Warnings You should not use diclofenac if you have a history of allergic reaction to aspirin or NSAIDs (non-steroidal anti-inflammatory drugs). Diclofenac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults. Before taking this medicine Diclofenac can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults. You should not use diclofenac if you are allergic to it, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID. Do not use Cambia to treat a cluster headache. Do not use Zipsor if you are allergic to beef or beef protein. To make sure this medicine is safe for you, tell your doctor if you have: heart disease, high blood pressure; ulcers or bleeding in your stomach; asthma; liver or kidney disease; or if you smoke. Diclofenac can affect ovulation and it may be harder to get pregnant while you are using this medicine. If you are pregnant, you should not take diclofenac unless your doctor tells you to. Taking a NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy. It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk. Diclofenac is not approved for use by anyone younger than 18 years old. How should I take diclofenac? Take diclofenac exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides. Your doctor may occasionally change your dose. Use the lowest dose that is effective in treating your condition. Different brands of diclofenac contain different amounts of diclofenac, and may have different uses. If you switch brands, your dose needs may change. Follow your doctor's instructions about how much medicine to take. Ask your pharmacist if you have any questions about the brand you receive at the pharmacy. Swallow the tablet whole and do not crush, chew, or break it. Take Zorvolex on an empty stomach, at least 1 hour before or 2 hours after a meal. Dissolve the powder form of this medicine (Cambia) with 1 to 2 ounces of water. Do not use any other type of liquid. Stir this mixture and drink all of it right away. Cambia works best if you take it on an empty stomach. Call your doctor if your headache does not completely go away after taking Cambia. If you use diclofenac long-term, you may need frequent medical tests. Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. Dosing information Usual Adult Dose for Osteoarthritis: Diclofenac free acid capsules: 35 mg orally 3 times a day Diclofenac potassium immediate-release tablets: 50 mg orally 2 or 3 times a day Diclofenac sodium enteric-coated tablets: 50 mg orally 2 or 3 times a day or 75 mg orally 2 times a day Maximum dose: 150 mg daily Diclofenac sodium extended-release tablets: 100 mg orally once a day Use: For the relief of signs and symptoms of osteoarthritis. Usual Adult Dose for Ankylosing Spondylitis: Diclofenac sodium enteric-coated and delayed-release tablets: 25 mg orally 4 times a day. An additional 25 mg dose may be administered at bedtime, if necessary Maximum dose: 125 mg per day Use: For acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis. Usual Adult Dose for Dysmenorrhea: Diclofenac potassium immediate-release tablets: 50 mg orally 3 times a day Comments: An initial dose of 100 mg orally followed by 50 mg oral doses may provide better relief for some patients; initiate treatment upon appearance of the first symptoms and continue for a few days. Use: For the relief of signs and symptoms of primary dysmenorrhea. Usual Adult Dose for Rheumatoid Arthritis: Diclofenac potassium immediate-release tablets: 50 mg orally 3 or 4 times a day Diclofenac sodium enteric-coated and delayed-release tablets: 50 mg orally 3 to 4 times a day or 75 mg orally twice a day Maximum dose: 225 mg daily Diclofenac sodium extended-release tablets: 100 mg orally once a day Maximum dose: 100 mg orally 2 times a day; this would be for the rare patient in whom the benefits outweigh the clinical risks. For the relief of signs and symptoms of rheumatoid arthritis Usual Adult Dose for Migraine: Diclofenac potassium for oral solution packets: 50 mg (1 packet) orally once Comments: This drug is not indicated for the prophylactic therapy of migraine or for use in cluster headaches; the safety and efficacy of a second dose has not been established. Use: For acute treatment of migraine with or without aura. Usual Adult Dose for Pain: Oral: Diclofenac potassium liquid-filled capsules: 25 mg orally 4 times a day Diclofenac free acid capsules: 18 mg or 35 mg orally 3 times a day Diclofenac potassium immediate-release tablets: 50 mg orally 3 times a day; an initial dose of 100 mg orally followed by 50 mg oral doses may provide better relief in some patients. Parenteral: 37.5 mg IV bolus over 15 seconds every 6 hours as needed for pain Maximum Dose: 150 mg per day Comment: Patients should be well hydrated prior to IV administration of this drug in order to reduce the risk of adverse renal reactions. Uses: For the management of mild to moderate acute pain (oral, IV) and moderate to severe pain alone or in combination with opioid analgesics (IV). What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.   What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What to avoid Avoid drinking alcohol. It may increase your risk of stomach bleeding. Avoid taking aspirin or other NSAIDs unless your doctor tells you to. Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to diclofenac (such as aspirin, ibuprofen, ketoprofen, or naproxen). Diclofenac side effects Get emergency medical help if you have signs of an allergic reaction to diclofenac (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath. Stop using this medicine and call your doctor at once if you have: the first sign of any skin rash, no matter how mild; flu-like symptoms; heart problems - swelling, rapid weight gain, feeling short of breath; kidney problems - little or no urinating, painful or difficult urination, swelling in your arms or legs, feeling tired or short of breath; liver problems - nausea, diarrhea, stomach pain (upper right side), tiredness, itching, dark urine, jaundice (yellowing of the skin or eyes); or signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds. Common diclofenac side effects may include: indigestion, gas, nausea, vomiting, stomach pain; diarrhea, constipation; headache, dizziness, drowsiness; abnormal lab tests; itching, sweating; stuffy nose; increased blood pressure; or swelling or pain in your arms or legs. 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 diclofenac? Ask your doctor before using diclofenac if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily. Tell your doctor about all your other medicines, especially: heart or blood pressure medication, including a diuretic or "water pill"; other forms of diclofenac (Arthrotec, Flector, Pennsaid, Solaraze, Voltaren Gel); a blood thinner - warfarin, Coumadin, Jantoven; or other NSAIDs - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), indomethacin, meloxicam, and others. This list is not complete. Other drugs may interact with diclofenac, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

What is dicyclomine? Dicyclomine is used to treat functional bowel or irritable bowel syndrome. Dicyclomine may also be used for purposes not listed in this medication guide. Warnings Many drugs can affect dicyclomine. Tell your doctor about all your current medicines. Before taking this medicine You should not use dicyclomine if you are allergic to it, or if you have: glaucoma; a bladder obstruction or other urination problems; a blockage in your digestive tract (stomach or intestines); severe ulcerative colitis; gastroesophageal reflux disease (GERD); a serious heart condition and active bleeding; myasthenia gravis; or if you are breastfeeding a baby. Not approved for use by anyone younger than 18 years old. Dicyclomine should never be given to a child younger than 6 months old. Tell your doctor if you have ever had: heart problems or high blood pressure; a stroke; ulcerative colitis; an ileostomy or colostomy; an enlarged prostate; or liver or kidney disease. Older adults may be more sensitive to the effects of dicyclomine. Tell your doctor if you are pregnant. Do not breastfeed. How should I take dicyclomine? 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. Dicyclomine oral is taken by mouth. Measure liquid medicine with the supplied syringe or a dose-measuring device (not a kitchen spoon). Dicyclomine injection is given in a muscle if you are unable to take the medicine by mouth. Call your doctor if your symptoms do not improve after 2 weeks. Store at room temperature away from moisture and heat. What happens if I miss a dose? Skip the missed dose and use your next dose at the regular time. 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. Overdose can cause nausea, vomiting, dilated pupils, weakness or loss of movement in any part of your body, trouble swallowing, fainting, or seizure (convulsions). What should I avoid while taking dicyclomine? May cause dizziness or blurred vision. Avoid driving or hazardous activity until you know how dicyclomine will affect you. Avoid becoming overheated or dehydrated during exercise and in hot weather. Dicyclomine can decrease sweating and you may be more prone to heat stroke. Tell your doctor if you have a fever while taking dicyclomine. Avoid using an antacid. Antacids can make it harder for your body to absorb dicyclomine oral. Dicyclomine 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: fast or slow heartbeats, pounding heartbeats or fluttering in your chest; confusion, agitation, hallucinations, unusual thoughts or behavior; problems with memory or speech; problems with balance or muscle movement; diarrhea, severe constipation, or worsening of bowel symptoms; trouble swallowing; bruising, swelling, or pain where a dicyclomine injection was given; or dehydration --dizziness, confusion, feeling very thirsty, less urination or sweating. Confusion and mood or behavior changes may be more likely in older adults. Common side effects may include: drowsiness, dizziness, weakness, nervousness; blurred vision; dry mouth; or nausea. 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.   Dicyclomine dosing information Usual Adult Dose for Irritable Bowel Syndrome: Oral: Initial dose: 20 mg orally four times a day Maintenance dose: Up to 40 mg orally four times a day, after one week with initial dose Comments: -Discontinue this drug if efficacy is not achieved within 2 weeks or side effects require doses below 80 mg per day. -Documented safety data are not available for doses above 80 mg daily for periods longer than 2 weeks. Intramuscular: 10 to 20 mg four times a day Duration of therapy: 1 or 2 weeks, when patient cannot take oral form Comments: Administer injection via IM only Uses: Treatment of patients with functional bowel/irritable bowel syndrome   What other drugs will affect dicyclomine? Using dicyclomine 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. Tell your doctor about all your current medicines. Many drugs can affect dicyclomine, especially: bronchodilator asthma medication; cold or allergy medicine (Benadryl and others); glaucoma medication; heart medication; medicine to treat depression, anxiety, mood disorders, or mental illness; medicine to treat overactive bladder; medicine to treat Parkinson's disease; or medicine to treat stomach problems, motion sickness, or irritable bowel syndrome. This list is not complete and many other drugs may affect dicyclomine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

What is dicyclomine? Dicyclomine is used to treat functional bowel or irritable bowel syndrome. Dicyclomine may also be used for purposes not listed in this medication guide. Warnings Many drugs can affect dicyclomine. Tell your doctor about all your current medicines. Before taking this medicine You should not use dicyclomine if you are allergic to it, or if you have: glaucoma; a bladder obstruction or other urination problems; a blockage in your digestive tract (stomach or intestines); severe ulcerative colitis; gastroesophageal reflux disease (GERD); a serious heart condition and active bleeding; myasthenia gravis; or if you are breastfeeding a baby. Not approved for use by anyone younger than 18 years old. Dicyclomine should never be given to a child younger than 6 months old. Tell your doctor if you have ever had: heart problems or high blood pressure; a stroke; ulcerative colitis; an ileostomy or colostomy; an enlarged prostate; or liver or kidney disease. Older adults may be more sensitive to the effects of dicyclomine. Tell your doctor if you are pregnant. Do not breastfeed. How should I take dicyclomine? 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. Dicyclomine oral is taken by mouth. Measure liquid medicine with the supplied syringe or a dose-measuring device (not a kitchen spoon). Dicyclomine injection is given in a muscle if you are unable to take the medicine by mouth. Call your doctor if your symptoms do not improve after 2 weeks. Store at room temperature away from moisture and heat. What happens if I miss a dose? Skip the missed dose and use your next dose at the regular time. 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. Overdose can cause nausea, vomiting, dilated pupils, weakness or loss of movement in any part of your body, trouble swallowing, fainting, or seizure (convulsions). What should I avoid while taking dicyclomine? May cause dizziness or blurred vision. Avoid driving or hazardous activity until you know how dicyclomine will affect you. Avoid becoming overheated or dehydrated during exercise and in hot weather. Dicyclomine can decrease sweating and you may be more prone to heat stroke. Tell your doctor if you have a fever while taking dicyclomine. Avoid using an antacid. Antacids can make it harder for your body to absorb dicyclomine oral. Dicyclomine 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: fast or slow heartbeats, pounding heartbeats or fluttering in your chest; confusion, agitation, hallucinations, unusual thoughts or behavior; problems with memory or speech; problems with balance or muscle movement; diarrhea, severe constipation, or worsening of bowel symptoms; trouble swallowing; bruising, swelling, or pain where a dicyclomine injection was given; or dehydration --dizziness, confusion, feeling very thirsty, less urination or sweating. Confusion and mood or behavior changes may be more likely in older adults. Common side effects may include: drowsiness, dizziness, weakness, nervousness; blurred vision; dry mouth; or nausea. 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.   Dicyclomine dosing information Usual Adult Dose for Irritable Bowel Syndrome: Oral: Initial dose: 20 mg orally four times a day Maintenance dose: Up to 40 mg orally four times a day, after one week with initial dose Comments: -Discontinue this drug if efficacy is not achieved within 2 weeks or side effects require doses below 80 mg per day. -Documented safety data are not available for doses above 80 mg daily for periods longer than 2 weeks. Intramuscular: 10 to 20 mg four times a day Duration of therapy: 1 or 2 weeks, when patient cannot take oral form Comments: Administer injection via IM only Uses: Treatment of patients with functional bowel/irritable bowel syndrome   What other drugs will affect dicyclomine? Using dicyclomine 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. Tell your doctor about all your current medicines. Many drugs can affect dicyclomine, especially: bronchodilator asthma medication; cold or allergy medicine (Benadryl and others); glaucoma medication; heart medication; medicine to treat depression, anxiety, mood disorders, or mental illness; medicine to treat overactive bladder; medicine to treat Parkinson's disease; or medicine to treat stomach problems, motion sickness, or irritable bowel syndrome. This list is not complete and many other drugs may affect dicyclomine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

What is digoxin? Digoxin is derived from the leaves of a digitalis plant. Digoxin helps make the heart beat stronger and with a more regular rhythm. Digoxin is used to treat heart failure. Digoxin is also used to treat atrial fibrillation, a heart rhythm disorder of the atria (the upper chambers of the heart that allow blood to flow into the heart). Warnings You should not use digoxin if you have ventricular fibrillation (a heart rhythm disorder of the ventricles, or lower chambers of the heart that allow blood to flow out of the heart). Before taking this medicine You should not use digoxin if you are allergic to it, or if you have ventricular fibrillation (a heart rhythm disorder of the ventricles, or lower chambers of the heart that allow blood to flow out of the heart). To make sure digoxin is safe for you, tell your doctor if you have ever had: a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker); a heart attack; slow heartbeats that have caused you to faint; Wolff-Parkinson-White Syndrome (sudden fast heartbeats); kidney disease; an electrolyte imbalance (such as low levels of calcium, potassium, or magnesium in your blood); a thyroid disorder; or if you have recently been sick with vomiting or diarrhea. Tell your doctor if you are pregnant. It is not known whether digoxin will harm an unborn baby. However, having heart failure or atrial fibrillation during pregnancy may cause complications such as premature birth or low birth weight, or risk of death in both mother and baby. The benefit of treating heart problems with digoxin may outweigh any risks to the baby. It may not be safe to breast-feed while using digoxin. Ask your doctor about any risk. How should I use digoxin? Take digoxin exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Try to take oral digoxin at the same time every day. Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). Take digoxin regularly even if you feel fine or have no symptoms. Get your prescription refilled before you run out of medicine completely. Digoxin injection is given as a shot into a muscle, or as an infusion into a vein. A healthcare provider will give you this injection if you are unable to take the medicine by mouth. Your blood pressure and heart rate will need to be checked daily. You may need frequent blood tests. Your kidney function may also need to be checked. You should not stop taking this medicine suddenly. Stopping suddenly may make your condition worse. Store at room temperature away from moisture and heat. Dosing information Usual Adult Dose of Digoxin for Congestive Heart Failure: Rapid Digitalization with a Loading Dose: Peak digoxin body stores of 8 to 12 mcg/kg generally provide a therapeutic effect with minimum risk of toxicity in most patients with heart failure and normal sinus rhythm. The loading dose should be administered in several fractions, with approximately half the total given as the first dose. Additional fractions of the total dose may be given at 6 to 8 hour intervals. Careful assessment of the patient's clinical response should be considered before each additional dose. If the patient's response necessitates a change from the calculated loading dose of digoxin, then calculation of the maintenance dose should be based upon the amount actually given. Tablets: Initial: 500 to 750 mcg usually produces a detectable effect in 0.5 to 2 hours with a maximal effect in 2 to 6 hours. Additional doses of 125 to 375 mcg may be given at 6 to 8 hour intervals until clinical evidence of an adequate effect is noted. The usual amount of tablets that a 70 kg patient requires to achieve 8 to 12 mcg/kg peak body stores is 750 to 1250 mcg. Capsules: Initial: 400 to 600 mcg of digoxin capsules generally produces a detectable effect in 0.5 to 2 hours with a maximal effect in 2 to 6 hours. Additional doses of 100 to 300 mcg may be given cautiously at 6 to 8 hour intervals until clinical evidence of an adequate effect is noted. The usual amount of capsules that a 70 kg patient requires to achieve 8 to 12 mcg/kg peak body stores is 600 to 1000 mcg. Injection: Initial: 400 to 600 mcg of digoxin intravenously usually produces a detectable effect in 5 to 30 minutes with a maximal effect in 1 to 4 hours. Additional doses of 100 to 300 mcg may be given cautiously at 6 to 8 hour intervals until clinical evidence of an adequate effect is noted. The usual amount of digoxin injection that a 70 kg patient requires to achieve 8 to 12 mcg/kg peak body stores is 600 to 1000 mcg. The injectable route is frequently used to achieve rapid digitalization, with conversion to digoxin tablets or digoxin capsules for maintenance therapy. Maintenance Dose: The doses of digoxin tablets used in controlled trials in patients with heart failure have ranged from 125 to 500 mcg once daily. In these studies, the dose has been generally titrated according to the patient's age, lean body weight, and renal function. Therapy is generally initiated at a dose of 250 mcg once daily in patients under age 70 with good renal function. Usual Adult Dose for Atrial Fibrillation: Peak digoxin body stores larger than the 8 to 12 mcg/kg required for most patients with heart failure and normal sinus rhythm have been used for control of ventricular rate in patients with atrial fibrillation. Doses used for the treatment of chronic atrial fibrillation should be titrated to the minimum dose that achieves the desired ventricular rate control without causing undesirable side effects. Usual Pediatric Dose for Atrial Fibrillation: Do not give full total digitalizing dose at once. Administer loading doses in several portions, give roughly half the total as the first dose. Give additional fractions of the total dose at 6 to 8 hour intervals (oral) or 4 to 8 hour intervals (parenteral). Divided daily dosing is recommended for infants and young children under 10 years of age. Parenteral administration should be used only when the need for rapid digitalization is urgent or when the drug cannot be taken orally. Intravenous administration is preferred over intramuscular injection as it can lead to severe pain at the injection site. If it is necessary to administer the drug by the intramuscular route, it should be injected deep into the muscle followed by massage. No more than 500 mcg should be injected into a single site. Calculated doses should be based on lean body weight. Premature: Digitalizing (Loading) dose: Oral elixir: 20 to 30 mcg/kg; Intravenous: 15 to 25 mcg/kg Maintenance dose: oral 5 to 7.5 mcg/kg; intravenous 4 to 6 mcg/kg Full Term: Digitalizing (Loading) dose: Oral elixir: 25 to 35 mcg/kg; Intravenous: 20 to 30 mcg/kg Maintenance dose: oral 6 to 10 mcg/kg; intravenous 5 to 8 mcg/kg 1-24 months: Digitalizing (Loading) dose: Oral elixir: 35 to 60 mcg/kg; Intravenous: 30 to 50 mcg/kg Maintenance dose: 10 to 15 mcg/kg oral; intravenous 7.5 to 12 mcg/kg 3 to 5 years: Digitalizing (Loading) dose: Oral elixir: 30 to 40 mcg/kg; Intravenous: 25 to 35 mcg/kg Maintenance dose: oral 7.5 to 10 mcg/kg; intravenous 6 to 9 mcg/kg 6 to 10 years: Digitalizing (Loading) dose: Oral elixir: 20 to 35 mcg/kg; Intravenous: 15 to 30 mcg/kg Maintenance dose: oral 5 to 10 mcg/kg; intravenous 4 to 8 mcg/kg 11 years and older: Digitalizing (Loading) dose: Oral elixir: 10 to 15 mcg/kg; Intravenous: 8 to 12 mcg/kg Maintenance dose: oral 2.5 to 5 mcg/kg; intravenous 2 to 3 mcg/kg   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 12 hours. 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. An overdose of digoxin can be fatal. Overdose symptoms may include nausea, vomiting, loss of appetite, and feeling tired. What should I avoid while using digoxin? Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Digoxin overdose can occur more easily if you are dehydrated. Digoxin side effects Get emergency medical help if you have signs of an allergic reaction to digoxin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: nausea, vomiting, diarrhea, stomach pain; fast, slow, or uneven heart rate; a light-headed feeling, like you might pass out; bloody or black, tarry stools; confusion, weakness, hallucinations, unusual thoughts or behavior; breast swelling or tenderness; blurred vision, yellowed vision; or (in babies or children) stomach pain, weight loss, growth delay, behavior changes. Serious side effects may be more likely in older adults and those who are ill or debilitated. Common digoxin side effects may include: nausea, diarrhea; feeling weak or dizzy; headache, weakness, anxiety, depression; or rash. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect digoxin? 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. Many drugs can interact with digoxin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is diltiazem? Diltiazem is a calcium channel blocker. It works by relaxing the muscles of your heart and blood vessels. Diltiazem is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders. Diltiazem may also be used for purposes not listed in this medication guide. Warnings You should not use diltiazem if you have very low blood pressure, a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker), or if you have recently had a heart attack and you have a build-up of fluid in your lungs. Before taking diltiazem, tell your doctor if you have kidney disease, liver disease, or congestive heart failure. Diltiazem may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop taking this medication without first talking to your doctor. If you stop taking diltiazem suddenly, your condition may become worse. Diltiazem may be only part of a complete program of treatment that also includes diet, exercise, and other medications. Follow your diet, medication, and exercise routines very closely. If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life. However, if you have symptoms of low blood pressure (dizziness, fainting, weakness, or blurred vision), call your doctor and stop taking diltiazem. Before taking this medicine You should not use diltiazem if you are allergic to it, or if you have: a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker); very low blood pressure; or if you have recently had a heart attack and you have a build-up of fluid in your lungs. To make sure diltiazem is safe for you, tell your doctor if you have: kidney disease; liver disease; congestive heart failure; or if you also take digoxin, or a beta blocker (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others). It is not known whether diltiazem will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Diltiazem can pass into breast milk and may harm a nursing baby. You should not breastfeed while using this medicine. How should I take diltiazem? Take diltiazem exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended. Do not crush, chew, break, or open an extended-release diltiazem tablet or capsule. Swallow it whole. To make swallowing easier, ask your doctor or pharmacist if you can open a diltiazem capsule and sprinkle the medicine into a spoonful of applesauce. Swallow right away without chewing. Do not save the mixture for later use. Use diltiazem regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. You should not stop using diltiazem suddenly. Stopping suddenly may make your condition worse. If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life. Your blood pressure will need to be checked often. You may also need frequent blood tests. Store diltiazem at room temperature away from moisture and heat.   What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of diltiazem can be fatal. Overdose symptoms may include slow heartbeat, weakness, chest pain, shortness of breath, or fainting. What to avoid Grapefruit and grapefruit juice may interact with diltiazem and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor. Diltiazem may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid drinking alcohol while taking diltiazem. Avoid taking herbal supplements containing St. John's wort at the same time you are taking diltiazem. Diltiazem side effects Get emergency medical help if you have signs of an allergic reaction to diltiazem: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: slow heartbeats; pounding heartbeats or fluttering in your chest; a light-headed feeling, like you might pass out; shortness of breath (even with mild activity), swelling, rapid weight gain; nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Common diltiazem side effects may include: swelling; dizziness, weakness; headache; nausea; or rash. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect diltiazem? Many drugs can interact with diltiazem, and your doctor may need to change your treatment plan if you use certain other medicines. The following are common drugs that interact with diltiazem; Medications used in anesthesia; Anti-anxiety medications called benzodiazepines (such as midazolam, triazolam, and others) as well as busipirone; Beta-blockers (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others); Carbamazepine; Cimetidine; Clonidine; Digitalis; Quinidine; Rifampin; and Cholesterol medication called statins (such as atorvastatin, lovastatin, simvastatin, rosuvastatin, and others) Not all possible interactions are listed in this medication guide. Other prescription and over-the-counter medicines, vitamins, and herbal products may interact with diltiazem. Tell your doctor about all medicines you use, and those you start or stop using. Give a list of all your medicines to any healthcare provider who treats you.

What is diltiazem? Diltiazem is a calcium channel blocker. It works by relaxing the muscles of your heart and blood vessels. Diltiazem is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders. Diltiazem may also be used for purposes not listed in this medication guide. Warnings You should not use diltiazem if you have very low blood pressure, a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker), or if you have recently had a heart attack and you have a build-up of fluid in your lungs. Before taking diltiazem, tell your doctor if you have kidney disease, liver disease, or congestive heart failure. Diltiazem may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop taking this medication without first talking to your doctor. If you stop taking diltiazem suddenly, your condition may become worse. Diltiazem may be only part of a complete program of treatment that also includes diet, exercise, and other medications. Follow your diet, medication, and exercise routines very closely. If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life. However, if you have symptoms of low blood pressure (dizziness, fainting, weakness, or blurred vision), call your doctor and stop taking diltiazem. Before taking this medicine You should not use diltiazem if you are allergic to it, or if you have: a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker); very low blood pressure; or if you have recently had a heart attack and you have a build-up of fluid in your lungs. To make sure diltiazem is safe for you, tell your doctor if you have: kidney disease; liver disease; congestive heart failure; or if you also take digoxin, or a beta blocker (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others). It is not known whether diltiazem will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Diltiazem can pass into breast milk and may harm a nursing baby. You should not breastfeed while using this medicine. How should I take diltiazem? Take diltiazem exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended. Do not crush, chew, break, or open an extended-release diltiazem tablet or capsule. Swallow it whole. To make swallowing easier, ask your doctor or pharmacist if you can open a diltiazem capsule and sprinkle the medicine into a spoonful of applesauce. Swallow right away without chewing. Do not save the mixture for later use. Use diltiazem regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. You should not stop using diltiazem suddenly. Stopping suddenly may make your condition worse. If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life. Your blood pressure will need to be checked often. You may also need frequent blood tests. Store diltiazem at room temperature away from moisture and heat.   What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of diltiazem can be fatal. Overdose symptoms may include slow heartbeat, weakness, chest pain, shortness of breath, or fainting. What to avoid Grapefruit and grapefruit juice may interact with diltiazem and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor. Diltiazem may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid drinking alcohol while taking diltiazem. Avoid taking herbal supplements containing St. John's wort at the same time you are taking diltiazem. Diltiazem side effects Get emergency medical help if you have signs of an allergic reaction to diltiazem: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: slow heartbeats; pounding heartbeats or fluttering in your chest; a light-headed feeling, like you might pass out; shortness of breath (even with mild activity), swelling, rapid weight gain; nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Common diltiazem side effects may include: swelling; dizziness, weakness; headache; nausea; or rash. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect diltiazem? Many drugs can interact with diltiazem, and your doctor may need to change your treatment plan if you use certain other medicines. The following are common drugs that interact with diltiazem; Medications used in anesthesia; Anti-anxiety medications called benzodiazepines (such as midazolam, triazolam, and others) as well as busipirone; Beta-blockers (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others); Carbamazepine; Cimetidine; Clonidine; Digitalis; Quinidine; Rifampin; and Cholesterol medication called statins (such as atorvastatin, lovastatin, simvastatin, rosuvastatin, and others) Not all possible interactions are listed in this medication guide. Other prescription and over-the-counter medicines, vitamins, and herbal products may interact with diltiazem. Tell your doctor about all medicines you use, and those you start or stop using. Give a list of all your medicines to any healthcare provider who treats you.

What is diltiazem? Diltiazem is a calcium channel blocker. It works by relaxing the muscles of your heart and blood vessels. Diltiazem is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders. Diltiazem may also be used for purposes not listed in this medication guide. Warnings You should not use diltiazem if you have very low blood pressure, a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker), or if you have recently had a heart attack and you have a build-up of fluid in your lungs. Before taking diltiazem, tell your doctor if you have kidney disease, liver disease, or congestive heart failure. Diltiazem may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop taking this medication without first talking to your doctor. If you stop taking diltiazem suddenly, your condition may become worse. Diltiazem may be only part of a complete program of treatment that also includes diet, exercise, and other medications. Follow your diet, medication, and exercise routines very closely. If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life. However, if you have symptoms of low blood pressure (dizziness, fainting, weakness, or blurred vision), call your doctor and stop taking diltiazem. Before taking this medicine You should not use diltiazem if you are allergic to it, or if you have: a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker); very low blood pressure; or if you have recently had a heart attack and you have a build-up of fluid in your lungs. To make sure diltiazem is safe for you, tell your doctor if you have: kidney disease; liver disease; congestive heart failure; or if you also take digoxin, or a beta blocker (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others). It is not known whether diltiazem will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Diltiazem can pass into breast milk and may harm a nursing baby. You should not breastfeed while using this medicine. How should I take diltiazem? Take diltiazem exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended. Do not crush, chew, break, or open an extended-release diltiazem tablet or capsule. Swallow it whole. To make swallowing easier, ask your doctor or pharmacist if you can open a diltiazem capsule and sprinkle the medicine into a spoonful of applesauce. Swallow right away without chewing. Do not save the mixture for later use. Use diltiazem regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. You should not stop using diltiazem suddenly. Stopping suddenly may make your condition worse. If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life. Your blood pressure will need to be checked often. You may also need frequent blood tests. Store diltiazem at room temperature away from moisture and heat.   What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of diltiazem can be fatal. Overdose symptoms may include slow heartbeat, weakness, chest pain, shortness of breath, or fainting. What to avoid Grapefruit and grapefruit juice may interact with diltiazem and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor. Diltiazem may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid drinking alcohol while taking diltiazem. Avoid taking herbal supplements containing St. John's wort at the same time you are taking diltiazem. Diltiazem side effects Get emergency medical help if you have signs of an allergic reaction to diltiazem: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: slow heartbeats; pounding heartbeats or fluttering in your chest; a light-headed feeling, like you might pass out; shortness of breath (even with mild activity), swelling, rapid weight gain; nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Common diltiazem side effects may include: swelling; dizziness, weakness; headache; nausea; or rash. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect diltiazem? Many drugs can interact with diltiazem, and your doctor may need to change your treatment plan if you use certain other medicines. The following are common drugs that interact with diltiazem; Medications used in anesthesia; Anti-anxiety medications called benzodiazepines (such as midazolam, triazolam, and others) as well as busipirone; Beta-blockers (such as atenolol, carvedilol, metoprolol, propranolol, sotalol, and others); Carbamazepine; Cimetidine; Clonidine; Digitalis; Quinidine; Rifampin; and Cholesterol medication called statins (such as atorvastatin, lovastatin, simvastatin, rosuvastatin, and others) Not all possible interactions are listed in this medication guide. Other prescription and over-the-counter medicines, vitamins, and herbal products may interact with diltiazem. Tell your doctor about all medicines you use, and those you start or stop using. Give a list of all your medicines to any healthcare provider who treats you.

What is atropine and diphenoxylate? Atropine affects the body in many different ways, such as reducing spasms in the bladder, stomach, and intestines. Diphenoxylate is an antidiarrheal medication. Atropine and diphenoxylate is a combination medicine used to treat diarrhea in adults and children who are at least 13 years old. Atropine and diphenoxylate may also be used for purposes not listed in this medication guide. Warnings Do not use atropine and diphenoxylate if you have diarrhea that is caused by bacteria or by taking an antibiotic. You should not use atropine and diphenoxylate if you have a bile duct disorder causing jaundice (yellowing of your skin or eyes). Keep this medicine where a child cannot reach it. An overdose can be fatal to a child. Before taking this medicine You should not use this medicine if you are allergic to atropine or diphenoxylate, or if you have: obstructive jaundice (a bile duct disorder that may cause yellowing of your skin or eyes); diarrhea that is caused by bacteria; or diarrhea caused by using antibiotic medication. Atropine and diphenoxylate is not approved for use by anyone younger than 6 years old. This medicine has not been proven safe or effective in children younger than 13 years old. Tell your doctor if you have ever had: a blockage in your intestines; ulcerative colitis; asthma or other breathing problems; glaucoma; urination problems; liver or kidney disease; Down's syndrome; or if you are dehydrated. It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant. It may not be safe to breast-feed a baby while you are using this medicine. Ask your doctor about any risks. How should I take atropine and diphenoxylate? 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. Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). Drink plenty of liquids to keep from getting dehydrated while you have diarrhea. Your doctor may recommend an electrolyte supplement such as Gatorade or Pedialyte. Carefully follow all care instructions. It may take up to 48 hours before your symptoms improve. Keep using the medication as directed. Call your doctor if you still have diarrhea after 10 days, or if you have a fever. Store at room temperature away from moisture and heat. Keep atropine and diphenoxylate where a child cannot reach it. An overdose of atropine and diphenoxylate can be fatal to a child. 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. An overdose of atropine and diphenoxylate can cause breathing problems and may result in death or permanent brain damage. Early overdose symptoms include weakness, blurred vision, slurred speech, feeling hot, fast heartbeats, slowed breathing, fainting, seizure, or coma. Report any early overdose symptoms to your doctor as soon as possible. What should I avoid while taking atropine and diphenoxylate? Avoid driving or hazardous activity until you know how atropine and diphenoxylate will affect you. Your reactions could be impaired. Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink. Drinking alcohol with this medicine can cause side effects. Atropine and diphenoxylate 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. Some side effects may occur up to 30 hours after you take this medicine. Stop using this medicine and call your doctor at once if you have: severe constipation, stomach pain or bloating; ongoing or worsening diarrhea; diarrhea that is watery or bloody; severe pain in your upper stomach spreading to your back; fever, flushing (warmth, redness, or tingly feeling); hallucinations, seizure; rapid breathing, weak or shallow breathing; fast heart rate; or dehydration symptoms--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin. Common side effects may include: drowsiness, dizziness, feeling restless; headache; numbness in your hands or feet; depression, not feeling well; confusion, feelings of extreme happiness; red or swollen gums; dry mouth, nose, or throat; nausea, vomiting, upset stomach, loss of appetite; or skin rash, dryness, or itching. 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.   Atropine and diphenoxylate dosing information Usual Adult Dose for Diarrhea: Initial dose: 2 tablets or 10 mL (5 mg of diphenoxylate), orally, 4 times a day Maintenance dose: Once control is achieved, reduce dose to individual requirements, to as little as 2 tablets or 10 mL once a day Maximum dose: 20 mg diphenoxylate per day Comments: -Clinical improvement is usually seen within 48 hours. -If no improvement is seen within 10 days, symptoms are unlikely to respond to further administration. Usual Pediatric Dose for Diarrhea: 2 years and older: Initial dose: 0.3 to 0.4 mg/kg of diphenoxylate, orally, in 4 divided doses Maintenance dose: Once control is achieved, reduce dose to individual requirements, to as little as one quarter of the initial daily dosage Maximum dose: 20 mg diphenoxylate per day Comments: -These doses are approximate; adjust downward according to nutritional status and degree of dehydration. -Reduce dose as soon as initial control of symptoms has been achieved. -If no response within 48 hours, this medicine is unlikely to be effective. -Use only the liquid medication in children under 13 years old; do not use tablets.   What other drugs will affect atropine and diphenoxylate? Using atropine and diphenoxylate with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, cold or allergy medicine, or medicine for anxiety, depression, or seizures. Tell your doctor about all your other medicines. Some may affect atropine and diphenoxylate, especially: medicine to treat Parkinson's disease; medicine to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome; bladder or urinary medicines; a bronchodilator; or an MAO inhibitor--isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others. This list is not complete. Other drugs may affect atropine and diphenoxylate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

What is divalproex sodium? Divalproex sodium comes in different pill forms that are for different uses. Divalproex sodium tablets and capsules are used to treat seizures in people with epilepsy who are at least 10 years old. Divalproex sodium tablets are sometimes used together with other seizure medications. Divalproex sodium tablets are also used in adults to prevent migraine headaches, or to treat manic episodes related to bipolar disorder (manic depression). Divalproex sodium may also be used for purposes not listed in this medication guide. Warnings You should not use divalproex sodium if you have liver disease, a urea cycle disorder, or a genetic disorder such as Alpers' disease or Alpers-Huttenlocher syndrome. Do not start or stop taking divalproex sodium during pregnancy without your doctor's advice. Divalproex sodium may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Do not use divalproex sodium to prevent migraine headaches if you are pregnant. Divalproex sodium can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by certain genetic disorders. Call your doctor at once if the person taking divalproex sodium has signs of liver or pancreas problems, such as: loss of appetite, upper stomach pain (that may spread to your back), ongoing nausea or vomiting, dark urine, swelling in the face, or jaundice (yellowing of the skin or eyes). Do not stop using divalproex sodium without your doctor's advice. Stopping suddenly may cause a serious, life-threatening type of seizure. Before taking this medicine You should not use divalproex sodium if you are allergic to it, or if you have: liver disease; a urea cycle disorder; or a genetic mitochondrial (MYE-toe-KON-dree-al) disorder such as Alpers' disease or Alpers-Huttenlocher syndrome, especially in a child younger than 2 years old. Divalproex sodium can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by a genetic mitochondrial disorder. Tell your doctor if you have ever had: liver problems caused by a genetic mitochondrial disorder; depression, mental illness, or suicidal thoughts or actions; or a family history of a urea cycle disorder or infant deaths with unknown cause. Some people have thoughts about suicide while taking divalproex sodium. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Using divalproex sodium during pregnancy may increase the risk of serious birth defects that can develop early in pregnancy, even before you know you are pregnant. Using this medicine during pregnancy can also affect cognitive ability (reasoning, intelligence, problem-solving) later in your child's life. However, having a seizure during pregnancy could harm both the mother and the baby. If you take divalproex sodium for seizures or manic episodes: The benefit of preventing seizures or manic episodes may outweigh any risks posed by this medicine. There may be other medications that are safer to use during pregnancy. Do not start or stop taking divalproex sodium without your doctor's advice. Do not use divalproex sodium to prevent migraine headaches if you are pregnant or you could become pregnant. If you are not pregnant, use effective birth control to prevent pregnancy while using divalproex sodium. Tell your doctor if you start or stop using hormonal contraception that contains estrogen (birth control pills, injections, implants, skin patches, and vaginal rings). Estrogen can interact with divalproex sodium and make it less effective in preventing seizures. It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk. How should I take divalproex sodium? 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. Drink plenty of water while you are taking this medication. Your dose may need to be changed if you do not get enough fluids each day. Swallow the capsule or tablet whole and do not crush, chew, break, or open it. If you cannot swallow a sprinkle capsule whole, open it and sprinkle the medicine into a spoonful of pudding or applesauce. Swallow the mixture right away. Do not save it for later use. You may need frequent blood tests. If you need surgery, tell the surgeon ahead of time that you are using divalproex sodium. In case of emergency, wear or carry medical identification to let others know you use divalproex sodium. Do not stop using divalproex sodium suddenly, even if you feel fine. Stopping suddenly may cause a serious, life-threatening type of seizure. Follow your doctor's instructions about tapering your dose. Store at room temperature away from moisture and heat.   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 divalproex sodium? Drinking alcohol may increase certain side effects of divalproex sodium. Avoid driving or hazardous activity until you know how divalproex sodium will affect you. Your reactions could be impaired. Divalproex sodium side effects Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. Call your doctor at once if the person taking this medicine has signs of liver or pancreas problems, such as: loss of appetite, upper stomach pain (that may spread to your back), ongoing nausea or vomiting, dark urine, swelling in the face, or jaundice (yellowing of the skin or eyes). Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself. Call your doctor at once if you have any of these other side effects: easy bruising, unusual bleeding (nose, mouth, or gums), purple or red pinpoint spots under your skin; fever, swollen glands, mouth sores; confusion, tiredness, cold feeling, vomiting, change in your mental state; severe drowsiness; or worsening seizures. Common side effects may include: nausea, vomiting, stomach pain, diarrhea, constipation; headache, back pain; dizziness, drowsiness, weakness, tremors; memory problems, mood changes, trouble sleeping; bruising or bleeding; runny nose, sore throat, cough, wheezing, trouble breathing; fever, flu symptoms; problems with walking or coordination; swelling in your hands or feet; blurred vision, double vision, unusual eye movements; ringing in your ears; rash, hair loss; or changes in weight or appetite. 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 divalproex sodium? 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. Many drugs can affect divalproex sodium. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Clinical Overview Use Superoxide dismutase (SOD) enzymes are found in all living cells in several common forms. These enzymes have been used for anti-inflammatory effects (in osteoarthritis, rheumatoid arthritis, and idiopathic pulmonary fibrosis), but limited clinical trials are available to support use. Clinical trials evaluating the use of SOD in cancer, cardiovascular disease, and other conditions in which antioxidant status plays a role, are also lacking. No evidence exists regarding long-term use of SOD. Dosing Oral supplementation is limited by the enzyme’s inactivation by gastric acid; however, newer formulations may overcome this limitation. Daily intravenous (IV) administration of 40 or 80 mg of lecithinized SOD over 28 days was compared with placebo in idiopathic pulmonary fibrosis. Weekly administration of an intra-articular injection of SOD 8 to 32 mg has been studied. A 500 mg dosage of plant-derived oral SOD (commercial product) taken once daily over 6 weeks was used in one clinical study. Contraindications Contraindications have not been identified. Pregnancy/Lactation Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking. Interactions None well documented. Adverse Reactions Information from large clinical studies is lacking; however, adverse effects appear to be limited. Pain and irritation at injection sites have been reported. Toxicology SOD is regarded as nontoxic, based on data from earlier studies. Data on newer formulations are lacking. Source SOD was initially biochemically extracted from the serum and liver of animals, as well as from plant sources; however, this process was inefficient.1 Induction of oxidative stress in microbes has been the mainstay of SOD production; however, a method in which recombinant Cu/Zn SOD is produced in Escherichia coli and bound to lecithin has been developed.2, 3 Commercial preparations previously relied on bovine-derived SOD (orgotein and palosein), with patents also filed for yeast- and marine-derived SOD.1 History In 1967, geneticist George J. Brewer described the protein indophenol oxidase, which was later identified as superoxide dismutase, in his work analyzing starch gels.4 The enzymatic activity of SOD was first described in 1968 by biochemists Irwin Fridovich and Joe M. McCord.5 In Germany, SOD (as orgotein) has long been used in general medicine as an anti-inflammatory agent.6 Chemistry SOD has 3 recognized forms in humans and other mammals. SOD1 and SOD2 (intracellular) contain copper and zinc, and SOD2 (found in mitochondria) relies on manganese for reactivity. The enzymatic forms found in plants also have an iron form.1, 5 SOD enzymes catalyze the conversion of superoxide, a reactive oxygen species (ROS) produced during aerobic respiration, to oxygen and hydrogen peroxide.5 Uses and Pharmacology The role of SOD as a dietary supplement is examined in this monograph; for information on SOD deficiency states, see standard medical references.1 Anti-inflammatory effects The use of SOD as an anti-inflammatory agent has been postulated because increased production of ROS is recognized to cause tissue damage associated with inflammation.7, 8, 9 Associated effects of decreased peroxynitrite production, decreased influx of neutrophils, and release of proinflammatory cytokines have been discussed.7 Animal data Anti-inflammatory effects of SOD have been demonstrated in animal models.7, 9 Parenteral SOD has been used in the treatment of soft tissue inflammation in horses and dogs; however, in a study comparing exercise with oral SOD supplementation, biomarkers of inflammation were unaffected by SOD.10 In a study of oral SOD in horses undergoing a 60-day training regimen, creatine kinase activity, a marker of hemolysis, was steady in the SOD group compared with an increase in the placebo group.11 Clinical data Limited, older clinical trials with intra-articular, bovine-derived SOD were conducted in patients with osteoarthritis.7 Superiority to placebo at 3 months has been demonstrated,12, 13 and a single trial evaluated the effectiveness of intramuscular bovine SOD in rheumatoid arthritis.14 In a double-blind, randomized, multicenter study in idiopathic pulmonary fibrosis (N = 55), daily IV administration of 40 or 80 mg of lecithinized SOD was compared with placebo over 28 days. Forced vital capacity did not improve in the treated arm; however, lactate dehydrogenase and surfactant protein-A makers were improved.15 Oral supplementation with plant-derived SOD improved SOD activity and reduced C-reactive protein in a study of 19 athletes. However, no effect on oxidative damage from exhaustive exercise was demonstrated.16 Cancer Animal data The relationship between ROS and cancer has been studied extensively, and the role of SOD expression in cancer cells has been evaluated, with most attention given to mitochondrial manganese SOD3.17, 18, 19 Animal model studies of supplemental SOD are limited.18 In vitro/in vivo data A study of recombinant manganese SOD (rMnSOD) for pediatric acute lymphoblastic leukemia found increased apoptotic death in leukemic cells, with no effect on healthy lymphocytes at low and moderate concentrations.20 Clinical data In a study evaluating the relationship between serum SOD levels and risk of cancer mortality, elevated serum SOD levels were associated with an increased risk of death from all cancers combined; this result may indicate an increased response to stress.21 Clinical studies of supplemental SOD in cancer treatment are limited. SOD has been evaluated in limited studies for its protective effects against irradiation-induced toxicities, with some reduction in late toxicity noted in one study of patients receiving pelvic radiation.9, 22 A lecithinized human recombinant SOD was not protective against the cardiotoxic effects of anthracycline treatment in breast cancer patients.23 Antiangiogenic properties of an inhibitor of Cu/Zn SOD have been evaluated in 47 patients with prostate cancer.24 Other uses Antioxidant effects, such as in reperfusion injury, have been studied in rodents.25 No evidence exists regarding long-term use of SOD. Dermatological applications have been evaluated, and a role for SOD3 supplementation has been theorized.26, 27 In a small clinical study of vitiligo (N = 25), topical application of a combination preparation containing catalase and SOD was similarly effective as compared with a topical corticosteroid.28 Limited clinical studies report equivocal results in psychometric scale measures and depression for oral administration of gliadin-SOD supplements compared with placebo.29, 30 Post hoc analysis of data in a subgroup of newborns suggested a reduction in the risk of retinopathy of prematurity with intratracheal administration of recombinant human Cu/Zn SOD.31 Combination preparations of alpha-lipoic acid and SOD are available and have been studied in diabetic neuropathy and chronic neck pain; however, attributing the observed effects to either of the compounds alone was not possible.32, 33 A rodent study reported benefit for angiotensin II–dependent hypertension using a nanozyme (nanomedicine-based delivery system) CuZnSOD; however, significance of results is limited due to limitations of the intracerebroventricular route of administration.34 Pretreatment with rMnSOD greatly reduced contrast-induced nephropathy in rats, including both intratubular cysts and tubular necrosis.35 Dosing Orally administered SOD alone (including that occurring naturally in food) is rapidly degraded by gastric acids when ingested, even if enteric coated.36, 37 Methods such as liposomal encapsulation and coating with wheat-derived gliadin attempt to overcome poor oral bioavailability.25 Daily IV administration of 40 or 80 mg of lecithinized SOD over 28 days was compared with placebo in idiopathic pulmonary fibrosis.15 Weekly administration of an intra-articular injection of SOD 8 to 32 mg has been studied.12, 13 A 500 mg dosage of plant-derived oral SOD (commercial product) taken once daily over 6 weeks was used in one clinical study.16 Pharmacokinetic studies of a recombinant-derived SOD have evaluated IV doses of up to 160 mg and report a mean terminal half-life of 25 hours (standard deviation [SD] = 4 hours) for an 80 mg dose and 31 hours (SD = 15 hours) for a single 160 mg dose.2, 3 Pregnancy / Lactation Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking. Interactions None well documented. Adverse Reactions Information from large clinical studies is lacking; however, adverse effects appear to be limited.25 Pain and irritation at injection sites have been reported.7, 8 Toxicology SOD is regarded as nontoxic, based on data from earlier studies. Data on newer formulations are lacking.38 The safety of SOD has been investigated in numerous animal models using doses up to 40,000 times the average human clinical dose of 0.1 mg/kg/day. Abnormalities were noted rarely following acute or long-term parenteral administration in mice, rats, dogs, and monkeys. SOD did not induce embryonic or teratogenic changes in rats or rabbits.39 The minimal lethal dose in animals was greater than 40,000 times the anticipated human clinical dose.40

What is docusate? Docusate is a stool softener that makes bowel movements softer and easier to pass. Docusate is used to relieve occasional constipation (irregularity). There are many brands and forms of docusate available. Not all brands are listed on this leaflet. Docusate may also be used for purposes not listed in this medication guide. Warnings You should not use docusate if you also use mineral oil, unless your doctor tells you to. Before taking this medicine You should not use docusate if you are allergic to it. Ask a doctor or pharmacist if docusate is safe to use if you have: stomach pain; nausea; vomiting; or a sudden change in bowel habits that lasts over 2 weeks. Ask a doctor before using this medicine if you are pregnant or breastfeeding. Do not give this medicine to a child without medical advice. How should I use docusate? Use exactly as directed on the label, or as prescribed by your doctor. Drink plenty of liquids while you are using docusate. Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). Do not take the rectal enema by mouth. Rectal medicine is for use only in the rectum. Wash your hands before and after using the enema. To use the enema, lie on your left side with your left leg extended and your right leg slightly bent. Remove the cap from the applicator tip and gently insert the tip into your rectum. Slowly squeeze the bottle to empty the contents into the rectum. After using the enema, lie down on your left side for at least 30 minutes to allow the liquid to distribute throughout your intestines. Avoid using the bathroom, and hold in the enema at least 1 hour, or all night if possible. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions. Docusate generally produces bowel movement in 12 to 72 hours. Call your doctor if your symptoms do not improve after 72 hours. You should not use docusate for longer than 1 week, unless your doctor tells you to. Store at room temperature away from moisture, light, and heat. Do not freeze liquid medicine. What happens if I miss a dose? Since docusate is used when needed, you may not be on a dosing schedule. Skip any missed dose if it's almost time for your next dose. 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 docusate? Avoid using mineral oil, unless told to do so by a doctor. Docusate 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. Stop using docusate and call your doctor at once if: you have rectal bleeding; no bowel movement occurs after using a laxative; you need to use a stool softener for more than 1 week; or rash occurs. Less serious side effects may be more likely, and you may have none at all. 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 is dofetilide? Dofetilide is a heart rhythm medicine, also called an antiarrhythmic. Dofetilide is used to help keep the heart beating normally in people with certain heart rhythm disorders of the atrium (the upper chambers of the heart that allow blood to flow into the heart). Dofetilide is used in people with atrial fibrillation or atrial flutter. Dofetilide may also be used for purposes not listed in this medication guide. Warnings You should not take dofetilide if you have severe kidney disease or a history of Long QT syndrome. Serious drug interactions can occur when certain medicines are used together with dofetilide. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using. You will need to spend at least 3 days in a hospital setting when you first start taking dofetilide. This is so your heart rhythm and kidney function can be monitored in case the medicine causes serious side effects. Before taking this medicine You should not take dofetilide if you are allergic to it, or if you have: severe kidney disease (or if you are on dialysis); or a history of Long QT syndrome. Some medicines can cause unwanted or dangerous effects when used with dofetilide, and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs: cimetidine; dolutegravir; ketoconazole; megestrol; prochlorperazine; trimethoprim (Proloprim, Trimpex, Bactrim, Septra); verapamil; or a diuretic (water pill) that contains hydrochlorothiazide (HCTZ), such as Accuretic, Aldactazide, Atacand HCT, Benicar HCT, Diovan HCT, Dyazide, Exforge HCT, Hyzaar, Lopressor HCT, Maxzide, Micardis HCT, Monopril HCT, Prinzide, Tekturna HCT, Vaseretic, and others. To make sure dofetilide is safe for you, tell your doctor if you have: heart disease, high blood pressure; liver or kidney disease; depression, mental illness; asthma or allergies; any active infection; skin problems; or an electrolyte imbalance (such as low levels of potassium or magnesium in your blood). It is not known whether dofetilide will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine. It is not known whether dofetilide passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using dofetilide. How should I take dofetilide? Dofetilide is available only from a hospital or specialty pharmacy. You will need to spend at least 3 days in a hospital setting when you first start taking dofetilide. This is so your heart rhythm and kidney function can be monitored in case the medicine causes serious side effects. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. You may take dofetilide with or without food. You should not skip doses or stop using dofetilide suddenly. Stopping suddenly may make your condition worse. Follow your doctor's instructions about tapering your dose. Tell your doctor if you have a prolonged illness that causes severe diarrhea, vomiting, or heavy sweating. These conditions can cause an electrolyte imbalance, making it dangerous for you to use dofetilide. Your blood pressure will need to be checked often. Your kidney function may also need to be checked with frequent blood tests. Store at room temperature away from moisture and heat. Detailed Dofetilide dosage information What happens if I miss a dose? Skip the missed dose and take your next dose at the usual time to stay on schedule. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while taking dofetilide? Grapefruit and grapefruit juice may interact with dofetilide and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor. Dofetilide side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats; loss of appetite, vomiting or severe diarrhea; or low magnesium or potassium--confusion, uneven heart rate, increased thirst or urination, sweating, jerking muscle movements, leg discomfort, muscle weakness or limp feeling. Common side effects may include: mild headache; mild dizziness; or cold symptoms such as stuffy nose, sneezing, sore throat. 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. Dofetilide side effects (more detail) What other drugs will affect dofetilide? Other drugs may interact with dofetilide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

What is donepezil? Donepezil is used to help improve mental function in people with Alzheimer's disease. Donepezil does not work the same in all people. Some people taking donepezil have improved mental function, while others may have unchanged or even worsening mental function. Donepezil is not a cure for Alzheimer's disease. This condition will progress over time, even in people who take donepezil. Donepezil may also be used for other purposes not listed in this medication guide. Warnings Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use. Before taking this medicine You should not use donepezil if you are allergic to donepezil or certain other drugs. Tell your doctor if you are allergic to any medicines. Tell your doctor if you have ever had: a heart rhythm disorder; a stomach ulcer; urination problems; asthma or other breathing disorder; liver or kidney disease; a seizure; or trouble swallowing tablets. Tell your doctor if you are pregnant or breast-feeding. How should I take donepezil? Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. You may take donepezil with or without food. Swallow the regular tablet whole and do not crush, chew, or break it. Remove an orally disintegrating tablet from the package only when you are ready to take the medicine. Place the tablet in your mouth and allow it to dissolve, without chewing. Swallow several times as the tablet dissolves. After the tablet dissolves completely, drink a glass of water. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using donepezil. You may need to stop using the medicine for a short time. You should not stop using donepezil without your doctor's advice. Store at room temperature away from moisture and heat. What happens if I miss a dose? Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time. If you miss your doses for more than 7 days in a row, call your doctor before taking the medicine again. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include severe nausea, vomiting, drooling, sweating, blurred vision, feeling light-headed, slow heartbeat, shallow breathing, muscle weakness, fainting, or seizure (convulsions). What should I avoid while taking donepezil? Avoid driving or hazardous activity until you know how donepezil will affect you. Your reactions could be impaired. Donepezil 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: slow heartbeats; a light-headed feeling, like you might pass out; new or worsening stomach pain, heartburn, nausea, or vomiting; a seizure; painful or difficult urination; new or worsening breathing problems; or signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds. Common side effects may include: nausea, vomiting, diarrhea; loss of appetite; muscle pain; sleep problems (insomnia); or feeling tired. 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.   Donepezil dosing information Usual Adult Dose for Alzheimer's Disease: Initial dose: 5 mg orally once a day, in the evening prior to retiring Mild to moderate Alzheimer's disease: -Maintenance dose: 10 mg orally once a day, after the patient has been on an initial dose of 5 mg once a day for 4 to 6 weeks Moderate to severe Alzheimer's disease: -Maintenance dose: 23 mg orally once a day, after the patient has been on a dose of 10 mg once a day for at least 3 months Comments: A higher dose of 10 mg may or may not provide a statistically significantly greater clinical benefit than a 5 mg dose. Prescriber and patient's preference should be considered. Uses: For mild, moderate, and severe Alzheimer's type dementia   What other drugs will affect donepezil? Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with donepezil may increase your risk of stomach ulcer. Other drugs may affect donepezil, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is Donnatal? Donnatal is made up of belladonna alkaloids (atropine, hyoscyamine, scopolamine) and phenobarbital. Donnatal is a combination medicine used to treat irritable bowel syndrome and ulcers in the intestine. Donnatal may also be used for purposes not listed in this medication guide. Warnings This medicine may be habit-forming. Misuse can cause addiction, overdose, or death. Before taking this medicine You should not use Donnatal if you are allergic to atropine, hyoscyamine, phenobarbital, or scopolamine. You also should not use this medicine if you have: a bladder obstruction, enlarged prostate, or other urination problems; a stomach or bowel obstruction (including paralytic ileus); chronic constipation or lack of bowel function (especially in older adults and those who are ill or debilitated); severe ulcerative colitis or toxic megacolon; glaucoma; reflux disease with a hiatal hernia; active bleeding with fast heartbeats, low blood pressure, shortness of breath, and cold hands or feet; porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system); an allergy to primidone; or a muscle disorder called myasthenia gravis. Tell your doctor if you have ever had: ulcerative colitis or a stomach ulcer; a colostomy or ileostomy; a nerve-muscle disorder; heart problems, high blood pressure; gallbladder disease; alcoholism or drug addiction; breathing problems; a thyroid disorder; or liver or kidney disease. Donnatal may harm an unborn baby, but the benefit of treating your condition with this medicine may outweigh any risk. Tell your doctor if you are pregnant or if you become pregnant. This medicine can make birth control pills less effective. Ask your doctor about using a non-hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy. It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk. This medicine can slow breast milk production. Do not give this medication to a child without the advice of a doctor. How should I take Donnatal? Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. This medicine contains phenobarbital, a barbiturate that may be habit-forming. Misuse can cause addiction, overdose, or death. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law. Swallow the extended-release tablet whole and do not crush, chew, or break it. Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). Call your doctor if your symptoms do not improve, or if they get worse. This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Donnatal. Store at room temperature away from moisture, heat, and light. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription. Do not stop using this medicine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine. Detailed Donnatal dosage information 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. Overdose symptoms may include headache, dizziness, nausea, vomiting, dry mouth, blurred vision, hot or dry skin, trouble swallowing, and feeling excited or agitated. What should I avoid while taking Donnatal? Donnatal may cause drowsiness or blurred vision and may impair your reactions. Avoid driving or hazardous activity until you know how this medicine will affect you. Drinking alcohol with this medicine can increase certain side effects. Avoid becoming overheated or dehydrated during exercise and in hot weather. This medicine can decrease sweating and you may be more prone to heat stroke. Donnatal side effects Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Stop using this medicine and call your doctor at once if you have: fast or pounding heartbeats; blurred vision, tunnel vision, eye pain, or seeing halos around lights; diarrhea (especially if you have a colostomy or ileostomy); decreased sweating and hot or dry skin; painful or difficult urination; loss of coordination, slurred speech, fainting; confusion, agitation, depression, suicidal thoughts; fever, sore throat; or pale skin, easy bruising, unusual tiredness, cold hands and feet;

What is Donnatal? Donnatal is made up of belladonna alkaloids (atropine, hyoscyamine, scopolamine) and phenobarbital. Donnatal is a combination medicine used to treat irritable bowel syndrome and ulcers in the intestine. Donnatal may also be used for purposes not listed in this medication guide. Warnings This medicine may be habit-forming. Misuse can cause addiction, overdose, or death. Before taking this medicine You should not use Donnatal if you are allergic to atropine, hyoscyamine, phenobarbital, or scopolamine. You also should not use this medicine if you have: a bladder obstruction, enlarged prostate, or other urination problems; a stomach or bowel obstruction (including paralytic ileus); chronic constipation or lack of bowel function (especially in older adults and those who are ill or debilitated); severe ulcerative colitis or toxic megacolon; glaucoma; reflux disease with a hiatal hernia; active bleeding with fast heartbeats, low blood pressure, shortness of breath, and cold hands or feet; porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system); an allergy to primidone; or a muscle disorder called myasthenia gravis. Tell your doctor if you have ever had: ulcerative colitis or a stomach ulcer; a colostomy or ileostomy; a nerve-muscle disorder; heart problems, high blood pressure; gallbladder disease; alcoholism or drug addiction; breathing problems; a thyroid disorder; or liver or kidney disease. Donnatal may harm an unborn baby, but the benefit of treating your condition with this medicine may outweigh any risk. Tell your doctor if you are pregnant or if you become pregnant. This medicine can make birth control pills less effective. Ask your doctor about using a non-hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy. It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk. This medicine can slow breast milk production. Do not give this medication to a child without the advice of a doctor. How should I take Donnatal? Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. This medicine contains phenobarbital, a barbiturate that may be habit-forming. Misuse can cause addiction, overdose, or death. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law. Swallow the extended-release tablet whole and do not crush, chew, or break it. Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). Call your doctor if your symptoms do not improve, or if they get worse. This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Donnatal. Store at room temperature away from moisture, heat, and light. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription. Do not stop using this medicine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine. Detailed Donnatal dosage information 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. Overdose symptoms may include headache, dizziness, nausea, vomiting, dry mouth, blurred vision, hot or dry skin, trouble swallowing, and feeling excited or agitated. What should I avoid while taking Donnatal? Donnatal may cause drowsiness or blurred vision and may impair your reactions. Avoid driving or hazardous activity until you know how this medicine will affect you. Drinking alcohol with this medicine can increase certain side effects. Avoid becoming overheated or dehydrated during exercise and in hot weather. This medicine can decrease sweating and you may be more prone to heat stroke. Donnatal side effects Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Stop using this medicine and call your doctor at once if you have: fast or pounding heartbeats; blurred vision, tunnel vision, eye pain, or seeing halos around lights; diarrhea (especially if you have a colostomy or ileostomy); decreased sweating and hot or dry skin; painful or difficult urination; loss of coordination, slurred speech, fainting; confusion, agitation, depression, suicidal thoughts; fever, sore throat; or pale skin, easy bruising, unusual tiredness, cold hands and feet;  

What is dorzolamide ophthalmic? Dorzolamide ophthalmic (for the eyes) is used to treat open-angle glaucoma and other causes of high pressure inside the eye. Dorzolamide ophthalmic may also be used for purposes not listed in this medication guide. Warnings Use only as directed. Tell your doctor if you use other medicines or have other medical conditions or allergies. Before taking this medicine You should not use dorzolamide ophthalmic if you are allergic to it. Tell your doctor if you have ever had: a sulfa drug allergy; narrow-angle glaucoma; kidney disease; or liver disease. Tell your doctor if you are pregnant or breastfeeding. How should I use dorzolamide ophthalmic? Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. Do not use while wearing soft contact lenses. A preservative in dorzolamide ophthalmic could permanently stain the lenses. Wait at least 15 minutes before inserting your contact lenses. Wash your hands before using the eye drops. To apply the eye drops: Pull down your lower eyelid to create a small pocket and squeeze a drop into this pocket. Close your eyes for 1 or 2 minutes. Use only the prescribed number of drops. Wait at least 10 minutes before using any other eye drops. Do not touch the dropper tip or place it directly on your eye. A contaminated dropper can infect your eye and lead to serious vision problems. Do not use the eye drops if the liquid has changed colors or has particles in it. Call your pharmacist for new medicine. Store at room temperature, in an upright position and tightly closed. Do not freeze. Tell your doctor right away if you have any eye injury, infection, or surgery. You may need to stop using dorzolamide ophthalmic for a short time. 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? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while using dorzolamide ophthalmic? dorzolamide ophthalmic may cause blurred vision and may impair your reactions. Avoid driving or hazardous activity until you know how this medicine will affect you. Do not use other eye medications unless your doctor tells you to. Dorzolamide ophthalmic side effects Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Serious side effects can occur if this medicine is absorbed into your bloodstream. Stop using this medicine and call your doctor at once if you have: swelling or redness of your eyelids; sensitivity to light; or signs of eye infection--swelling, redness, severe discomfort, crusting or drainage. Common side effects may include: burning or stinging in your eye; mild eye discomfort; or a bitter taste in your mouth. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   Dorzolamide ophthalmic dosing information Usual Adult Dose for Intraocular Hypertension: One drop in the affected eye(s) three times a day Comments: -This drug may be used concomitantly with other topical ophthalmic drug products to lower intraocular pressure. -If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart. Use: Treatment of elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma Usual Adult Dose for Glaucoma (Open Angle): One drop in the affected eye(s) three times a day Comments: -This drug may be used concomitantly with other topical ophthalmic drug products to lower intraocular pressure. -If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart. Use: Treatment of elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma Usual Pediatric Dose for Intraocular Hypertension: Safety and effectiveness have been demonstrated in pediatric patients in a 3-month, multicenter, double-masked, active-treatment-controlled trial: One drop in the affected eye(s) three times a day Comments: -This drug may be used concomitantly with other topical ophthalmic drug products to lower intraocular pressure. -If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart. Use: Treatment of elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma Usual Pediatric Dose for Glaucoma (Open Angle): Safety and effectiveness have been demonstrated in pediatric patients in a 3-month, multicenter, double-masked, active-treatment-controlled trial: One drop in the affected eye(s) three times a day Comments: -This drug may be used concomitantly with other topical ophthalmic drug products to lower intraocular pressure. -If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart. Use: Treatment of elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma   What other drugs will affect dorzolamide ophthalmic? Tell your doctor about all your other medicines, especially glaucoma medications taken by mouth. Other drugs may affect dorzolamide ophthalmic, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

What is doxazosin? Doxazosin is an alpha-adrenergic (AL-fa ad-ren-ER-jik) blockers. It relaxes your veins and arteries so that blood can more easily pass through them. It also relaxes the muscles in the prostate and bladder neck, making it easier to urinate. Doxazosin is used to treat hypertension (high blood pressure), or to improve urination in men with benign prostatic hyperplasia (enlarged prostate). The extended-release form of doxazosin (Cardura XL) is for use only in treating benign prostatic hyperplasia and should not be used to treat hypertension. Warnings Doxazosin can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that you are using doxazosin. Do not stop using this medicine before surgery unless your surgeon tells you. You should not use this medication if you are allergic to doxazosin or similar medicines such as alfuzosin (Uroxatral), prazosin (Minipress), silodosin (Rapaflo), tamsulosin (Flomax), or terazosin (Hytrin). Doxazosin may cause dizziness or fainting, especially when you first start taking it or when you start taking it again. Be careful if you drive or do anything that requires you to be alert. Avoid standing for long periods of time or becoming overheated during exercise and in hot weather. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Tell your doctor about all other medications you use, especially other blood pressure medications including diuretics (water pills). Before taking this medicine You should not use this medicine if you are allergic to doxazosin or similar medicines such as alfuzosin (Uroxatral), prazosin (Minipress), silodosin (Rapaflo), tamsulosin (Flomax), or terazosin (Hytrin). To make sure doxazosin is safe for you, tell your doctor if you have: a blockage in your digestive tract (stomach or intestines); severe constipation; liver disease; or low blood pressure. Doxazosin can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that you are using this medication. Do not stop using this medicine before surgery unless your surgeon tells you to. It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether doxazosin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine. How should I take doxazosin? Take doxazosin exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended. Doxazosin lowers blood pressure and may cause dizziness or fainting, especially when you first start taking it, or when you start taking it again. You may feel very dizzy when you first wake up. Be careful when standing or sitting up from a lying position. Call your doctor if you have severe dizziness or feel like you might pass out. While using doxazosin, your blood pressure or prostate may need to be checked often. If you stop taking doxazosin for any reason, ask your doctor before you start taking it again. You may need a dose adjustment. If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life. Store at room temperature away from moisture and heat. What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. If you miss your doses for several days in a row, call your doctor before restarting the medication. You may need a lower dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include extreme dizziness or fainting. What to avoid Doxazosin may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. To prevent dizziness, avoid standing for long periods of time or becoming overheated during exercise and in hot weather. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Drinking alcohol with this medicine can cause side effects. Doxazosin side effects Get emergency medical help if you have signs of an allergic reaction to doxazosin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: a light-headed feeling, like you might pass out; severe ongoing stomach pain or bloating; new or worsening chest pain; trouble breathing; or a penis erection that is painful or lasts 4 hours or longer. Common doxazosin side effects may include: low blood pressure, dizziness; drowsiness; headache; or feeling weak or tired. 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.   Dosing information Usual Adult Dose for Hypertension: Initial dose: 1 mg orally once a day. Maintenance dose: 1 to 16 mg orally once a day. Usual Adult Dose for Benign Prostatic Hyperplasia: Initial dose: Immediate-release: 1 mg orally once a day. Extended-release: 4 mg orally once a day with breakfast Maintenance dose: Immediate-release: 1 to 8 mg orally once a day. Extended-release: 4 to 8 mg orally once a day with breakfast. Depending on the patient's symptomatic response and tolerability, the dose may be increased to 8 mg (the maximum recommended dose). The recommended titration interval is 3 to 4 weeks. If switching from immediate-release doxazosin tablets to extended-release tablets, therapy should be initiated with the lowest dose (4 mg once daily). Prior to starting therapy with doxazosin extended-release tablets, the final evening dose of immediate-release tablets should not be taken. If doxazosin extended-release tablets are discontinued for several days, therapy should be restarted using the 4 mg once daily dose. Usual Geriatric Dose for Hypertension: Initial dose: 0.5 mg orally once a day.   What other drugs will affect doxazosin? Tell your doctor about all your current medicines and any you start or stop using, especially: an antibiotic; an antidepressant; medicine to treat HIV or AIDS; or sildenafil (Viagra) or other erectile dysfunction medicines. This list is not complete. Other drugs may interact with doxazosin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

What is doxepin? Doxepin is a tricyclic antidepressant. Doxepin capsules and oral concentrate (liquid) are used to treat symptoms of depression and/or anxiety associated with alcoholism, manic depression, or other mental illness. Doxepin tablets (Silenor) are used to treat insomnia in people who have trouble staying asleep. This medication guide provides only information about doxepin capsules and liquid. Doxepin may also be used for purposes not listed in this medication guide. Warnings You should not take doxepin if you have glaucoma or problems with urination. Do not use doxepin if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Before taking this medicine You should not use doxepin capsules or liquid if you are allergic to doxepin or similar medicines such as amoxapine or loxapine, or if you have: glaucoma; or urination problems. Do not use doxepin if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others. Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Tell your doctor if you have ever had: bipolar disorder (manic-depression). Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Tell your doctor if you are pregnant or breastfeeding. Doxepin is not approved for use by anyone younger than 12 years old. How should I take doxepin? 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. Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). Mix the measured dose with 4 ounces of water, milk, orange juice, grapefruit juice, tomato juice, prune juice, or pineapple juice. Do not mix with grape juice or a carbonated soft drink. Stir the mixture and drink all of it right away. Do not save it for later use. Do not stop using doxepin suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using doxepin. It may take up to 3 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve. 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. An overdose of doxepin can be fatal. Overdose symptoms may include irregular heart rhythm, feeling like you might pass out, seizures, or coma. What should I avoid while taking doxepin? Do not drink alcohol. Dangerous side effects or death could occur. Avoid driving or hazardous activity until you know how doxepin will affect you. Your reactions could be impaired. Doxepin side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: blurred vision, tunnel vision, eye pain or swelling, seeing halos around lights; a light-headed feeling, like you might pass out; tremors, restless muscle movements in your eyes, tongue, jaw, or neck; severe constipation; confusion, hallucinations, unusual thoughts, seizure (convulsions); or painful or difficult urination. Common side effects may include: drowsiness, dizziness; increased blood pressure; vision changes; rash, swelling; nausea, vomiting, indigestion; little or no urination; dry mouth, constipation; or decreased or increased sex drive. 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 doxepin? Using doxepin 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 doxepin, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is doxycycline? Doxycycline is a tetracycline antibiotic that fights bacteria in the body. Doxycycline is used to treat many different bacterial infections, such as acne, urinary tract infections, intestinal infections, respiratory infections, eye infections, gonorrhea, chlamydia, syphilis, periodontitis (gum disease), and others. Doxycycline is also used to treat blemishes, bumps, and acne-like lesions caused by rosacea. It will not treat facial redness caused by rosacea. Some forms of doxycycline are used to prevent malaria, to treat anthrax, or to treat infections caused by mites, ticks, or lice. Warnings You should not take doxycycline if you are allergic to any tetracycline antibiotic. Children younger than 8 years old should use doxycycline only in cases of severe or life-threatening conditions. This medicine can cause permanent yellowing or graying of the teeth in children. Using doxycycline during pregnancy could harm the unborn baby or cause permanent tooth discoloration later in the baby's life. Before taking this medicine You should not take this medicine if you are allergic to doxycycline or other tetracycline antibiotics such as demeclocycline, minocycline, tetracycline, or tigecycline. To make sure doxycycline is safe for you, tell your doctor if you have ever had: liver disease; kidney disease; asthma or sulfite allergy; increased pressure inside your skull; or if you also take isotretinoin, seizure medicine, or a blood thinner such as warfarin (Coumadin). If you are using doxycycline to treat chlamydia, your doctor may test you to make sure you do not also have gonorrhea, another sexually transmitted disease. Taking this medicine during pregnancy may affect tooth and bone development in the unborn baby. Taking doxycycline during the last half of pregnancy can cause permanent tooth discoloration later in the baby's life. Tell your doctor if you are pregnant or if you become pregnant while using this medicine. Doxycycline can make birth control pills less effective. Ask your doctor about using a non-hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy. Doxycycline can pass into breast milk and may affect bone and tooth development in a nursing infant. The extent of absorption is unknown. Do not breastfeed while you are taking this medicine. Children should not use this medicine. Doxycycline can cause permanent yellowing or graying of the teeth in children younger than 8 years old. Children should use doxycycline only in cases of severe or life-threatening conditions such as anthrax or Rocky Mountain spotted fever. The benefit of treating a serious condition may outweigh any risks to the child's tooth development. How should I take doxycycline? Take doxycycline exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Take doxycycline with a full glass of water. Drink plenty of liquids while you are taking this medicine. Most brands of doxycyline may be taken with food or milk if the medicine upsets your stomach. Different brands of doxycycline may have different instructions about taking them with or without food. Take Oracea on an empty stomach, at least 1 hour before or 2 hours after a meal. You may open a regular capsule or break up a regular tablet and sprinkle the medicine into a spoonful of applesauce to make swallowing easier. Swallow right away without chewing. Do not save the mixture for later use. Drink a full glass (8 ounces) of cool water right away. Do not crush, break, or open a delayed-release capsule or tablet. Swallow the pill whole. You may need to split a doxycycline tablet to get the correct dose. Follow your doctor's instructions. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. If you take doxycycline to prevent malaria: Start taking the medicine 1 or 2 days before entering an area where malaria is common. Continue taking the medicine every day during your stay and for at least 4 weeks after you leave the area. Use protective clothing, insect repellents, and mosquito netting around your bed to further prevent mosquito bites that could cause malaria. Doxycycline is usually given by injection only if you are unable to take the medicine by mouth. A healthcare provider will give you this injection as an infusion into a vein. Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Doxycycline will not treat a viral infection such as the flu or a common cold. If you need surgery, tell the surgeon ahead of time that you are using doxycycline. Store at room temperature away from moisture, heat and light. Throw away any unused medicine after the expiration date on the label has passed. Using expired doxycycline can cause damage to your kidneys.   What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What to avoid Do not take iron supplements, multivitamins, calcium supplements, antacids, or laxatives within 2 hours before or after taking doxycycline. Avoid taking any other antibiotics with doxycycline unless your doctor has told you to. Avoid exposure to sunlight or tanning beds. Doxycycline can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to. Doxycycline side effects Get emergency medical help if you have any signs of an allergic reaction to doxycycline: (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling). Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. This reaction may occur several weeks after you began using doxycycline. Call your doctor at once if you have: severe stomach pain, diarrhea that is watery or bloody; throat irritation, trouble swallowing; chest pain, irregular heart rhythm, feeling short of breath; little or no urination; low white blood cell counts - fever, chills, swollen glands, body aches, weakness, pale skin, easy bruising or bleeding; severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes; loss of appetite, upper stomach pain (that may spread to your back), tiredness, nausea or vomiting, fast heart rate, dark urine, jaundice (yellowing of the skin or eyes). Common doxycycline side effects may include: nausea, vomiting, upset stomach, loss of appetite; mild diarrhea; skin rash or itching; darkened skin color; or vaginal itching or discharge. 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 doxycycline? 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. Other drugs may interact with doxycycline, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

What is duloxetine? Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI). Duloxetine affects chemicals in the brain that may be unbalanced in people with depression. Duloxetine is used to treat major depressive disorder in adults. It is also used to treat general anxiety disorder in adults and children who are at least 7 years old. Duloxetine is also used in adults to treat nerve pain caused by diabetes (diabetic neuropathy), or chronic muscle or joint pain (such as low back pain and osteoarthritis pain). Some brands of duloxetine are also used to treat fibromyalgia (a chronic pain disorder). Drizalma is for treating fibromyalgia only in adults. Cymbalta may be used to treat fibromyalgia in adults and children at least 13 years old. Warnings Do not take duloxetine within 5 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others. A dangerous drug interaction could occur. People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide. Do not stop using duloxetine without first talking to your doctor. Before taking this medicine You should not use duloxetine if you are allergic to it. Do not take duloxetine within 5 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine. A dangerous drug interaction could occur. Tell your doctor if you also use stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with duloxetine could cause a serious condition called serotonin syndrome. Duloxetine is not approved for use by anyone younger than 7 years old. To make sure duloxetine is safe for you, tell your doctor if you have: heart problems, high blood pressure; liver or kidney disease; slow digestion; a seizure; bleeding problems; sexual problems; narrow-angle glaucoma; bipolar disorder (manic depression); drug addiction or suicidal thoughts; or if you drink large amounts of alcohol. People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior. Taking an SNRI antidepressant during late pregnancy could increase your risk of excessive bleeding after you give birth, and may cause serious medical complications in the baby. However, stopping the medicine may not be safe if you have a relapse of depression. Do not start or stop duloxetine without asking your doctor. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of duloxetine on the baby. If you are breastfeeding, tell your doctor if you notice drowsiness, feeding problems, and slow weight gain in the nursing baby. How should I take duloxetine? Take duloxetine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Taking duloxetine in higher doses or more often than prescribed will not make it more effective, and may increase side effects. Swallow the capsule whole and do not crush, chew, break, or open it. You may take duloxetine with or without food. Your blood pressure will need to be checked often. Tell your doctor if you have any changes in sexual function, such as loss of interest in sex, trouble having an orgasm, or (in men) problems with erections or ejaculation. Some sexual problems can be treated. Your symptoms may not improve for up to 4 weeks. Do not stop using duloxetine suddenly, or you could have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feelings). Ask your doctor before stopping the medicine. Store at room temperature away from moisture and heat. Dosing information Usual Adult Dose for Depression: Initial dose: 20 mg to 30 mg orally 2 times a day Maintenance dose: 60 mg per day, given either once a day OR 30 mg orally 2 times a day Maximum dose: 120 mg/day. Usual Adult Dose for Fibromyalgia: Initial dose: 30 mg orally once a day for at least 1 week Maintenance dose: 30 to 60 mg orally once a day. Usual Adult Dose for Generalized Anxiety Disorder: Initial dose: 60 mg orally once a day Maintenance dose: 60 to 120 mg orally once a day Maximum dose: 120 mg/day. Usual Adult Dose for Pain: Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day. Usual Adult Dose for Neuropathic Pain: Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day. Usual Adult Dose for Chronic Pain: Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day. Usual Geriatric Dose for Generalized Anxiety Disorder: Initial dose: 30 mg orally once a day for at least 2 weeks Maintenance dose: 60 mg orally once a day Maximum dose: 120 mg/day. Usual Pediatric Dose for Generalized Anxiety Disorder: 7 to 17 years: -Initial dose: 30 mg orally once a day for at least 2 weeks -Maintenance dose: 30 to 60 mg orally once a day -Maximum dose: 120 mg/day. Usual Pediatric Dose for Fibromyalgia: 13 years and older: -Initial dose: 30 mg orally once a day for at least 1 week -Maintenance dose: 30 to 60 mg orally once a day.   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. Overdose symptoms may include vomiting, dizziness or drowsiness, seizures, fast heartbeats, fainting, or coma. What should I avoid while taking duloxetine? Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with duloxetine may cause you to bruise or bleed easily. Avoid driving or hazardous activity until you know how duloxetine will affect you. Your reactions could be impaired. Dizziness or fainting can cause falls, accidents, or severe injuries. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Drinking alcohol may increase your risk of liver damage, especially if you take Drizalma. Duloxetine side effects Get emergency medical help if you have signs of an allergic reaction to duloxetine (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: pounding heartbeats or fluttering in your chest; a light-headed feeling, like you might pass out; easy bruising, unusual bleeding; vision changes; painful or difficult urination; liver problems - right-sided upper stomach pain, itching, dark urine, jaundice (yellowing of the skin or eyes); low blood sodium - headache, confusion, problems with thinking or memory, weakness, feeling unsteady; or manic episodes - racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Common duloxetine side effects may include: drowsiness; nausea, constipation, loss of appetite; dry mouth; or increased sweating. 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 duloxetine? 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. Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with duloxetine may cause you to bruise or bleed easily. Many drugs can interact with duloxetine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you use.