Kuvan should be prescribed by a doctor experienced in management of PKU. Patients with PKU who are taking Kuvan should also be treated with a Phe-restricted diet, because high blood Phe levels with PKU can result in severe neurologic damage.

Not all patients with PKU respond to treatment with Kuvan. Before you start taking Kuvan, let your doctor know about all of your medical conditions, including if you:

• Have a fever
• Are pregnant or planning to become pregnant
• Are breast feeding
• Have liver or kidney problems
• Are allergic to Kuvan or any other medications
• Have poor nutrition or are anorexic
• Are taking levodopa
• Are taking drugs that inhibit folate metabolism (e.g., methotrexate) because these drugs could affect how Kuvan works in your body
• Are taking medicines for erectile dysfunction like Viagra (sildenafil), Levitra (vardenafil), or Cialis (tadalafil)

The most common side effects reported when using Kuvan are:

• Headache
• Diarrhoea
• Abdominal pain
• Upper respiratory tract infection (like a cold)
• Throat pain
• Vomiting
• Nausea

These are not all the side effects seen with Kuvan. If you are concerned about these or any other side effects you experience while taking Kuvan, ask your doctor or pharmacist for more information.

Be sure to tell your doctor if you have any side effects when you are taking Kuvan.

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines and herbal and dietary supplements. Kuvan and many other medicines may interact with each other. Your doctor needs to know what medicines you take so he or she can decide if Kuvan is right for you.

Know the medicines you take. Keep a list of your medicines with you to show your doctor. Do not take other medicines while taking Kuvan without first talking to your doctor.

When you are taking Kuvan, any change you make to your diet may affect your blood Phe level. Follow your doctor's instructions carefully and do not make any changes to your dietary Phe intake before discussing with your doctor. Your doctor will continue to monitor your blood Phe levels during your treatment with Kuvan.

Overdose:

In the event of a suspected overdose, please contact your health care provider, hospital emergency department or regional poison control centre immediately.

Missed dose:

If you forget to take your dose of Kuvan, take it as soon as you remember that day. If you miss a day, do not double your dose the next day, just skip the missed dose.

The dose of KEFLEX prescribed will depend on the type of infection and whether the person taking it is a child or an adult.

Here are general guidelines for KEFLEX dosage:

• The usual adult dose ranges from 1 to 4 grams a day, given in divided doses.
• Typical adult doses of KEFLEX are 250 mg every 6 hours, or 500 mg every 12 hours.
• The usual dose for a child is 25 to 50 milligrams (mg) per kilogram of weight, given in divided doses.
• Keflex capsules come in 250, 333, 500, and 750 mg options.

Doses may be doubled for more severe infections.

Depending on the type of infection, treatment may last from 7 to 14 days.

If very large doses of KEFLEX are needed, another type of cephalosporin that can be given by injection or an intravenous infusion may be used.

Here are some general rules for taking KEFLEX:

• Take it with food or milk to prevent an upset stomach.
• Always take it as directed and for as long as directed. Skipping doses or not finishing your KEFLEX prescription can lead to a more dangerous and resistant infection.
• Do not chew, split, or crush KEFLEX capsules. Take them whole with a full glass of water, and with food or milk.
• Store capsules in a safe, dry place and at room temperature.
• Keep KEFLEX suspension in the refrigerator. Don't freeze it. Unused suspension should be thrown away after 14 days.
• If you are using KEFLEX suspension, make sure to shake the liquid well before each dose.
• KEFLEX use may interfere with some laboratory tests. These include blood tests and some urine testing done for diabetes. Always let your caregiver know you are taking KEFLEX before you are tested.

KEFLEX Overdose

An overdose of KEFLEX can occur.

Symptoms of an overdose include nausea, vomiting, stomach pain, diarrhea, and blood in the urine.

If you think you've taken an overdose, or if someone else may have overdosed on KEFLEX, call a poison control center.

Missed Dose of KEFLEX 

If you miss a dose, do not double your dose.

If you are close to your dose time, take your normal dose.

If you are well past your dose time, wait to take a dose until the next scheduled time.

Symptoms of an allergic reaction to KEFLEX may include:

• Rash
• Swelling under the skin
• Itching
• Throat swelling
• Wheezing
• Difficulty breathing

Digestive system side effects may include:

• Diarrhea
• Abdominal pain
• Nausea and vomiting

Other possible side effects of KEFLEX include vaginal discharge, headache, dizziness, aches and pains, confusion, mouth sores, and fatigue. Let your doctor know about any side effects you experience.

Stop taking KEFLEX and call your doctor immediately if you experience:

• Severe skin rash or swelling
• Any trouble breathing or swallowing
• Sudden bruising or bleeding

If you're allergic to penicillin, there's about a 10 percent chance that you will also be allergic to KEFLEX.

You could be at higher risk for side effects from KEFLEX if you have a history of liver, kidney, or colon disease, so tell your doctor about any of these conditions as well.

Like other antibiotics, KEFLEX may cause an overgrowth of bacteria called Clostridium difficile in your colon. Toxins produced by C. difficile can cause diarrhea and a condition called pseudomembranous colitis.

Being on other antibiotics may also increase your risk for pseudomembranous colitis, so tell your doctor about any recent antibiotic use. 

KEFLEX and Pregnancy

KEFLEX should be used only if clearly needed during pregnancy, and with caution during breastfeeding.

Tell your doctor if you are or may become pregnant or if you are breastfeeding.

KEFLEX for Dogs

Veterinarians often prescribe KEFLEX to dogs with bacterial infections including skin, bone, urinary tract, respiratory, and other infections.

The drug can be given with food and is usually well-tolerated by dogs, but some may have side effects including nausea or vomiting. 

KEFLEX should be avoided in animals that have had an allergic reaction to penicillins or other cephalosporin antibiotics. 

Always tell your doctor about any medications you are taking, including other prescription drugs, over-the-counter (OTC) drugs, vitamins, dietary supplements, and herbal remedies.

Certain drugs are known to interact with KEFLEX and may cause problems:

KEFLEX may increase blood levels of the type 2 diabetes drug metformin. This could increase your risk for side effects.

KEFLEX may build up in the blood when combined with the medication probenecid (Benemid, Probalan), which is used to treat gout.

In some cases, probenecid may be used along with antibiotics to increase antibiotic strength.

Using antibiotics may make birth control pills ineffective. A second form of contraception is recommended while you're on antibiotics.

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

• Take KEMADRIN with food or immediately after finishing a meal.
• If you miss a dose of KEMADRIN, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

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

• Blurred vision; constipation; dilated pupils; dry mouth; giddiness; lightheadedness; loss of appetite; nausea; upset stomach; vomiting.

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

• Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion; difficult or painful urination; difficulty swallowing; eye pain; fast or pounding heartbeat; mental or mood changes; uncontrolled movements.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects.

Do NOT use KEMADRIN if:

• you are allergic to any ingredient in KEMADRIN
• you have angle-closure glaucoma

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

Before using KEMADRIN:

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

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have glaucoma, mental or mood disorders, muscle weakness (eg, myasthenia gravis), ulcerative colitis, (eg, an enlarged prostate), or urination problems
• if you have a blockage of the stomach, esophagus, or urinary tract; kidney or liver problems; high blood pressure; heart or blood vessel disease; an irregular heartbeat; or uncontrolled movements of the hands, mouth, or tongue

Important safety information:

• KEMADRIN may cause lightheadedness or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to KEMADRIN. Using KEMADRIN alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• KEMADRIN may cause dizziness, lightheadedness, or fainting. Alcohol, hot weather, exercise, and fever can increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness.
• Do not become overheated in hot weather or during exercise or other activities; heatstroke may occur.
• Use KEMADRIN with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant while taking KEMADRIN, discuss with your doctor the benefits and risks of using KEMADRIN during pregnancy. It is unknown if KEMADRIN is excreted in breast milk. If you are or will be breast-feeding while you are using KEMADRIN, check with your doctor or pharmacist to discuss the risks to your baby.

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

• Phenothiazines (eg, thioridazine) because the effectiveness may be decreased by KEMADRIN

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

Usual dose:

KAYEXALATE can be given by mouth or in the rectum.

The amount of KAYEXALATE you need to take will depend upon the amount of potassium in your blood.

Once the mixture has been prepared, it should be used straight away. If it needs to be stored, it should be stored for no longer than 24 hours. Do not heat KAYEXALATE.

Your doctor will decide exactly how much KAYEXALATE you need to take. The usual doses are:

Overdose:

Taking too much KAYEXALATE may reduce your potassium in your blood below the normal level. If you take too much of this medication, you may feel irritable, confused, have muscle weakness, have diminished reflexes or paralysis.

In case of drug overdose, contact a health care practitioner, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms.

Missed dose:

Do not take a double dose to make up for the dose you have missed. If it is almost time for the dose, skip the dose you missed and take the next dose when you are meant to.

Side effects may include:

• Nausea and vomiting
• Diarrhea
• Loss of appetite

If any of these affects you severely, tell your doctor, nurse or pharmacist.

BEFORE you use KAYEXALATE, talk to your doctor, nurse or pharmacist if you have or have had any medical conditions, especially the following:

• Heart problems.
• High blood pressure.
• Problems with your bowel or constipation.
• Severe burns.
• Low blood volume, which can occur with dehydration or bleeding.
• Electrolyte imbalance. KAYEXALATE therapy can worsen these imbalances. Your doctor may want to check the levels of the electrolytes in your blood more frequently during treatment.
• Kidney problems.
• Edema (swelling of the face, hands or feet with fluid)
• You require low salt diet.
• You are pregnant or intend to become pregnant.
• You are breastfeeding. It is not known if KAYEXALATE passes into breast milk.

Magnesium containing laxatives should not be used with KAYEXALATE.

As with most medicines, interactions with other drugs are possible. Tell your doctor, nurse or pharmacist about all the medicines you take, including drugs prescribed by other doctors, vitamins, minerals, natural supplements or alternative medicines (non-prescription drugs or over the counter drugs).

The following may interact with KAYEXALATE:

• Digoxin, a medicine used for heart problems.
• Laxatives such as magnesium hydroxide or aluminium carbonate.
• Thyroxine, a medicine for hypothyroidism.
• Lithium, a medicine which can be used to treat bipolar disorder.
• Antacids containing aluminium or magnesium.
• Sorbitol (a ‘sugar free’ sweetener used to sweeten food).
• Immunosuppressant drugs.

It is important that you/your child take KALETRA every day exactly as your/your child’s doctor prescribed it. Even if you/your child feel better, do not stop taking KALETRA without talking to your/your child’s doctor. Using KALETRA as recommended should give you/your child the best chance to delay the development of resistance to the product.

It is therefore important that you/your child remain under the supervision of your/your child’s doctor while taking KALETRA.

Usual dose:

The usual dose for adults is two 200/50 mg tablets (400/100 mg) twice a day (morning and night), in combination with other anti-HIV medicines. The doctor may prescribe KALETRA as four 200/50 mg tablets (800/200 mg) once daily in combination with other anti-HIV medicines for some patients. Once daily dosing is not recommended for pregnant women.

The dose for children from 6 months to 18 years of age will be determined by your/your child’s doctor based on the child’s height and weight. KALETRA should not be administered once daily in pediatric patients less than 18 years of age.

KALETRA tablets (all strengths) can be taken with or without food. KALETRA tablets should be swallowed whole and not chewed, broken, or crushed.

Your doctor may monitor blood levels of fats (lipids), cholesterol and glucose before and during KALETRA treatment.

Overdose:

If you/your child realize you have taken more KALETRA than you/your child were supposed to, contact your/your child’s doctor or local poison control centre right away, even if you/your child have no symptoms. If you cannot reach your/your child's doctor, go to the hospital.

Missed dose:

If you/your child miss a dose of KALETRA, it should be taken as soon as possible, and the next scheduled dose taken at its regular time. If it is almost time for your/your child's next dose, do not take the missed dose. Wait and take the next dose at the regular time. Do not double the next dose.

The most commonly reported side effects of KALETRA are abdominal pain, diarrhea (abnormal stool and/or bowel movement), feeling weak or tired, headache, nausea, vomiting and rash.

• If you/your child have liver disease such as hepatitis B and hepatitis C, taking KALETRA may worsen your/your child’s liver disease.
• Some patients have large increases in triglycerides and cholesterol (forms of fat that are found in your/your child’s blood).
• Diabetes and high blood sugar (hyperglycemia) may occur in patients taking protease inhibitors such as KALETRA. Symptoms of diabetes or high blood sugar may include frequent urination or increased thirst. Let your/your child’s doctor know if you/your child have or develop these symptoms while taking KALETRA.
• Some patients with hemophilia have increased bleeding with protease inhibitors.
• Changes in your/your child’s immune system (Immune Reconstitution Inflammatory Syndrome) can happen when you/your child start taking HIV medicines. Your/your child’s immune system may get stronger and begin to fight infections that have been hidden in your/your child’s body for a long time, or you/your child could develop an autoimmune disease in which your/your child’s immune system reacts against your own body (e.g. Graves' disease (which affects the thyroid gland), Guillain-Barré syndrome (which affects the nervous system) or polymyositis (which affects the muscles) and it may develop at any time, sometimes months later after the start of HIV therapy). Sometimes symptoms can be severe, so if you/your child develop high temperature (fever), joint or muscle pain, redness, rash, swelling, or fatigue or any new symptoms contact your/your child’s doctor straight away.

Serious Warnings and Precautions

Tell your/your child’s doctor if you or your child develop symptoms such as:

• nausea

• vomiting

• abdominal pain

These may be signs of problems with your/your child’s pancreas (pancreatitis). Your/your child’s doctor must decide if these are related to pancreatitis and what to do about them.

Do not take KALETRA once daily if you/your child:

• are currently taking the anticonvulsants carbamazepine (e.g., Tegretol), phenytoin (e.g., Dilantin) and phenobarbital.
• are currently taking HIV medications efavirenz (e.g., Sustiva), nevirapine (e.g., Viramune), and nelfinavir (e.g., Viracept).

BEFORE you use KALETRA talk to your/your child’s doctor or pharmacist if you or your child:

• have liver problems or are infected with hepatitis B or hepatitis C
• have diabetes, or symptoms such as frequent urination and/or increase in thirst
• have hemophilia. Patients taking KALETRA may have increased bleeding
• are taking or planning to take other medicines, including prescription, herbal and other medicines you/your child can buy without a prescription
• have heart disease or a heart condition, including conditions of Congenital Long QT Syndrome
• have low potassium levels in your blood
• are pregnant or planning to become pregnant; pregnant women should not take KALETRA unless specifically directed by the doctor. Be sure to tell your/your child’s doctor immediately if you/your child are or may be pregnant. If you/your child take KALETRA while you/your child are pregnant, talk to your/your child's doctor about how you can be included in the Antiretroviral Pregnancy Registry
• are breastfeeding or planning to breast-feed. It is recommended that HIV-infected women should not breast-feed their infants because of the possibility the baby could be infected with HIV through the breast milk

Severe liver problems, including deaths, have been reported in those using KALETRA. This has often occurred in those with advanced HIV disease, other liver disease or those taking many medications. There is no proven link to KALETRA use.

KALETRA may interact with certain other medications with possible clinical effects. The following medicines should only be used together with KALETRA if advised by your/your child’s physician:

• medicines used to treat erectile dysfunction such as sildenafil (e.g., Viagra) or tadalafil (e.g., Cialis); vardenafil (e.g., Levitra) should not be taken with KALETRA
• medicines used to treat pulmonary arterial hypertension such as bosentan (e.g., Tracleer) or tadalafil (e.g., Adcirca)
• medicines used to lower blood cholesterol such as rosuvastatin (e.g., Crestor), atorvastatin (e.g., Lipitor); lovastatin (e.g., Mevacor) or simvastatin (e.g., Zocor) should not be taken with KALETRA
• some medicines affecting the immune system such as cyclosporin, sirolimus (e.g., Rapamune) and tacrolimus
• some medicines used to treat seasonal allergies and ear and eye infections such as dexamethasone and fluticasone propionate (e.g., Flonase)
• medicines used to treat asthma such as budesonide (e.g., Pulmicort)
• contraceptives used to prevent pregnancy (e.g., ethinyl estradiol)
• medicines used to treat AIDS and related infections such as amprenavir†, fosamprenavir (e.g., Telzir), indinavir (e.g., Crixivan), nelfinavir (e.g., Viracept), saquinavir (e.g., Invirase), didanosine (e.g., Videx), tenofovir (e.g., Viread), efavirenz (e.g., Sustiva), maraviroc (e.g., Celsentri), nevirapine (e.g., Viramune), rifabutin (e.g., Mycobutin), etravirine (e.g., Intelence), rilpivirine (e.g., Edurant, Complera), tipranavir (e.g., Aptivus) when used with low-dose ritonavir
• medicines used to treat hepatitis C virus (HCV) and related infections such as telaprevir (e.g., Incivek), boceprevir (e.g., Victrelis), simeprevir (e.g., Galexos)
• medicines used to treat depression such as trazodone and bupropion (e.g., Wellbutrin SR)
• certain heart medicines such as calcium channel antagonists including felodipine (e.g., Plendil), nifedipine (e.g., Adalat) and nicardipine†
• medicines used to correct heart rhythm such as amiodarone (e.g., Cordarone), flecainide (e.g., Tambocor), bepridil†, systemic lidocaine, propafenone hydrochloride (e.g., Rythmol), quinidine and digoxin
• antifungals such as ketoconazole (e.g., Nizoral), itraconazole (e.g., Sporanox) and voriconazole (e.g., Vfend)
• morphine-like medicines (e.g., methadone)
• anticonvulsants such as carbamazepine (e.g.,Tegretol), lamotrigine (e.g., Lamictal), phenytoin (e.g., Dilantin), phenobarbital, and valproate (e.g., Depakene)
• anticoagulants such as warfarin or rivaroxaban (e.g., Xarelto)
• certain antibiotics such as clarithromycin (e.g., Biaxin)
• medicines used to treat cancer such as dasatinib (e.g., Sprycel), nilotinib (e.g., Tasigna), vincristine and vinblastine as KALETRAmay increase the concentrations of these drugs and increase adverse effects
• fentanyl (e.g., Duragesic) in all forms as this interaction may reduce breathing
• colchicine used to treat gout
• quetiapine used to treat schizophrenia, bipolar disorder and major depressive disorder
• medicines to treat anxiety such as midazolam (injected)

If you/your child are taking KALETRA you/your child should not take products containing St. John's wort (Hypericum perforatum), as this may stop KALETRA from working properly.

KALETRA can be taken with acid-reducing agents (such as omeprazole and ranitidine) with no dose adjustment.