Rheumatrex (Methotrexate Sodium)

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Maxtrex

Methotrexate Sodium

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Rheumatrex (Methotrexate Sodium) Dosage and Side Effects

RHEUMATREX is used for treating certain types of cancer. It is also used to control severe psoriasis and severe rheumatoid arthritis in certain patients. It may be used alone or with other medicines. It may also be used for other conditions as determined by your doctor.

Warnings and Precautions

Do NOT use RHEUMATREX if:

  • you are allergic to any ingredient in RHEUMATREX
  • you are breast-feeding
  • you are treating psoriasis or rheumatoid arthritis and any of the following apply to you:
    • you are pregnant
    • you have alcoholism, liver problems caused by alcohol, or chronic liver problems
    • you have a weakened immune system or certain blood problems (eg, anemia, bone marrow depression, low white blood cell count, low blood platelet count)
  • you are taking acitretin
  • you have taken or will be taking palifermin within 24 hours of taking RHEUMATREX

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

Before using RHEUMATREX:

Some medical conditions may interact with RHEUMATREX. 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 breastfeeding
  • 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 are able to become pregnant or father a child
  • if you have a history of lung problems, immune system problems, nervous system problems (eg, seizures), liver problems (eg, hepatitis), kidney problems, diabetes, or blood problems (eg, anemia, low white blood cell levels, low blood platelet levels)
  • if you have an active infection, severe vomiting or diarrhea, or dehydration
  • if you have mouth sores, excess fluid in your stomach or around your lungs, stomach or bowel ulcers, bowel inflammation (eg, ulcerative colitis), or a blockage of your stomach or bowel
  • if you have a folic acid deficiency, are in very poor health or are very overweight, or have a history of alcohol abuse
  • if you are receiving chemotherapy or radiation

Important safety information:

  • RHEUMATREX may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use RHEUMATREX with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Check with your doctor before you drink alcohol while you are taking RHEUMATREX.
  • Nausea, vomiting, and loss of appetite are common with RHEUMATREX. Ask your doctor or pharmacist for ways to decrease these effects if they occur.
  • If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. Contact your doctor for instructions.
  • RHEUMATREX may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to RHEUMATREX. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • RHEUMATREX may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
  • RHEUMATREX may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
  • Do not receive a live vaccine (eg, measles, mumps) while you are taking RHEUMATREX. Talk with your doctor before you receive any vaccine.
  • RHEUMATREX may affect your ability to become pregnant or to father a child. Discuss any questions or concerns with your doctor.
  • Men who take RHEUMATREX should always use a condom when having sex with a woman who may become pregnant. Do this for as long as you take RHEUMATREX and for 3 months after you stop taking it.
  • Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
  • Lab tests, including complete blood cell counts, liver function, and kidney function, may be performed while you use RHEUMATREX. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use RHEUMATREX with caution in the ELDERLY; they may be more sensitive to its effects.
  • RHEUMATREX should be used with extreme caution in CHILDREN younger than 2 years old; safety and effectiveness in these children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: RHEUMATREX may cause birth defects and fetal or newborn death if you take it while you are pregnant. Do not become pregnant while you are using it. Use an effective form of birth control while you take RHEUMATREX and for at least 1 ovulatory cycle after you stop taking it. If you think you may be pregnant, contact your doctor right away. RHEUMATREX is found in breast milk. Do not breast-feed while taking RHEUMATREX.

Side Effects

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

  • Dizziness; drowsiness; general body discomfort; headache; loss of appetite; mild hair loss; mild stomach pain; nausea; tiredness.

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); black, tarry stools; blood in the urine; bone pain; calf or leg pain, redness, swelling, or tenderness; change in the amount of urine produced; chest pain; confusion; coughing up blood; diarrhea or vomiting; difficult or painful urination; dry cough; enlargement of the breasts (in males); fainting; fever, chills, or persistent sore throat; menstrual changes; mental or mood changes; mouth or tongue sores or swelling; muscle weakness; night sweats; one-sided weakness; red, swollen, peeling, or blistered skin; seizures; severe or persistent dizziness or light-headedness; shortness of breath; speech changes; swollen glands; symptoms of liver problems (eg, dark urine, pale stools, persistent loss of appetite, severe stomach pain, yellowing of the skin or eyes); symptoms of pancreas inflammation (eg, severe stomach pain with or without nausea or vomiting); unexplained weight loss; unusual bleeding or bruising; unusual pain and discoloration of the skin; unusual tiredness or weakness; vaginal discharge; vision loss or other vision changes (eg, blurred vision); vomit that looks like coffee grounds.

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.

Interactions with this medication

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

  • Palifermin because if mouth or tongue sores develop, they may be more severe or last longer
  • Medicines that may harm the kidney (eg, amphotericin B; tacrolimus; aminoglycoside antibiotics such as gentamicin) or the liver (eg, azathioprine; retinoids such as acitretin or isotretinoin; acetaminophen; ketoconazole; isoniazid; certain medicines for HIV infection) because the risk of kidney or liver side effects may be increased. Ask your doctor if you are unsure if any of your medicines might harm the kidney or liver
  • Chloramphenicol, ciprofloxacin, corticosteroids (eg, prednisone), cyclosporine, dantrolene, hydantoins (eg, phenytoin), hydroxychloroquine, leflunomide, NSAIDs (eg, ibuprofen, celecoxib, ketorolac), penicillamine, penicillin antibiotics (eg, amoxicillin), phenylbutazone, pristinamycin, probenecid, proton pump inhibitors (PPIs) (eg, omeprazole), salicylates (eg, aspirin), sulfonamide medicines (eg, sulfamethoxazole, sulfasalazine), tetracycline antibiotics (eg, doxycycline), trimethoprim, or vancomycin because they may increase the risk of RHEUMATREX's side effects
  • Folic acid because it may decrease RHEUMATREX's effectiveness
  • Digoxin because its effectiveness may be decreased by RHEUMATREX
  • Mercaptopurine, oral anticoagulants (eg, warfarin), or theophylline because the risk of their side effects may be increased by RHEUMATREX

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

Proper Use of this medication

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

  • Take RHEUMATREX by mouth with or without food. However, you should take it the same way each time in relation to food.
  • Drinking extra fluids while you are taking RHEUMATREX is recommended. Check with your doctor for instructions.
  • The dose of RHEUMATREX and how often you use it are based on your medical condition and response to treatment. It is very important that you follow your doctor's instructions carefully. Taking too much of RHEUMATREX may cause serious and sometimes fatal side effects. Be sure you understand exactly how much of RHEUMATREX to take and how often you should take it. Ask your doctor or pharmacist if you have any questions.
  • It may take several weeks for the full benefit of RHEUMATREX to be seen in the management of psoriasis or rheumatoid arthritis. Do not stop taking RHEUMATREX without checking with your doctor.
  • RHEUMATREX works best if each dose is taken at the scheduled time.
  • Continue to take RHEUMATREX even if you feel well. Do not miss any doses.
  • If you miss a dose of RHEUMATREX, contact your doctor right away. Do not take 2 doses at once.

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

If OVERDOSE is suspected:

Contact your local poison control center or emergency room immediately. Symptoms may include black or bloody stools; change in the amount of urine produced; seizures; severe headache, nausea, vomiting, or stomach pain; swelling or soreness of the mouth or tongue; unusual bruising or bleeding; unusual tiredness or weakness; vomit that looks like coffee grounds.

Proper storage of RHEUMATREX:

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

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Dothiepin HCL (Dothiepin)

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Dothiepin (dothiepin HCL) Dosage and Side Effects

Dothiepin is an antidepressant drug prescribed for the treatment of depression and associated anxiety/panic disorders. It is of particular use in patients with ongoing feelings of sadness, despair, worthlessness, hopelessness, fatigue, pessimism and difficulty dealing with normal daily life.

Dothiepin elevates mood, increase physical activity, improves appetite and restores interest in everyday activities.

It is also useful in treating chronic pain disorders and insomnia.

Proper Use of this medication

Take as directed by your physician.

Side Effects

Warnings and Precautions

Consult your doctor before using this drug if:

  • you have epilepsy
  • you have impaired liver or kidney function
  • you had a recent heart attack
  • you have a thyroid condition
  • you have an enlarged prostate or have difficulty in passing urine
  • you have glaucoma
  • you are taking other medication

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: Safety and efficacy of this medication has not been established for children under the age of 18 and use in these patients is not recommended.

Elderly: Caution is advised in the elderly as side effects may be more severe.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how it affects you.

Alcohol: Avoid concomitant use as alcohol may potentiate sedative effects.

Interactions with this medication

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Rimadyl (Carprofen)

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Rimadyl

Carprofen

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Rimadyl (Carprofen) Dosage and Side Effects

PET MEDICATION

Carprofen is a Non-Steroidal Anti-Inflammatory drug (NSAID) which may be used for the treatment of inflammation in pets. It is typically prescribed to treat arthritis and hip dysplasia. Carprofen is often given to dogs for post-operative pain and inflammation. It is generally not recommended for use in cats, as other NSAIDs have been more extensively studied.

Proper Use of this medication

Follow instructions provided by your veterinarian.

Side Effects

Carprofen may result in these side effects:

  • Loss of Appetite
  • Black, tarry stools
  • Vomiting
  • Abdominal pain
  • Dehydration
  • Diarrhea
  • Liver damage
  • Kidney damage
  • Ulceration of the digestive tract
  • Aggression

Carprofen may react with these drugs:

  • Digoxin
  • Furosemide
  • Methotrexate
  • Diuretics
  • Corticosteroids
  • Other NSAIDs
  • Other drugs that may cause ulceration of the digestive tract

Warnings and Precautions

USE EXTREME CAUTION WHEN ADMINISTERING THIS DRUG TO CATS - Use with extreme caution and only with the recommendation of an experienced veterinarian. Rimadyl® is not labeled for use in cats and has not been extensively researched.

USE CAUTION WHEN ADMINISTERING THIS DRUG TO PETS WITH KIDNEY OR LIVER DISEASE

Use of Carprofen in animals under 6 weeks, pregnant, or lactating pets has not been extensively researched.

Interactions with this medication

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Dostinex (Cabergoline)

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Dostinex

Cabergoline

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Cabergoline

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Cabergoline

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Dostinex (Cabergoline) Medication Information

Uses

Dostinex is used for the treatment of hyperprolactinemic disorders. 

Dosage

The oral tablets are available in 0.5 mg strength.

Side Effects

The most common side effects of Dostinex include:

  • Nausea
  • Constipation
  • Headache
  • Dizziness
  • Fatigue
  • Somnolence
  • Breast pain

For a full list of side effects that apply to you, reach out to your doctor or pharmacist

Precautions

Initial doses higher than 1.0 mg may cause low blood pressure upon standing. Special attention and monitoring should be exercised when administering Dostinex with other blood pressure-lowering medications.

Since cabergoline is metabolized in the liver, caution should be used, and careful monitoring exercised when administering Dostinex to patients with liver impairment.

Dostinex is not indicated for the suppression of lactation.

Pathological gambling, increased libido, and hypersexuality has been reported in patients treated with dopamine agonists including cabergoline.

Interactions

Common medications that interact with Dostinex are listed:

  • Phenothiazines
  • Butyrophenones
  • Thioxanthenes
  • Metoclopramide 

For more information, reach out to your doctor or pharmacist.

Storage

Store at controlled room temperature (68-77ºF). 

Pharmacist Tips

  • The initiation dose of Dostinex Tablets recommended is 0.25 mg twice a week.
  • Dosing can be increased by 0.25 mg twice weekly up to 1 mg twice a week based on the patient’s serum prolactin level.
  • Dosage increases should not occur more rapidly than every 4 weeks so that the physician can assess the patient’s response to each dosage level.

Cabergoline FAQs

Should this be given with food?

Can be given with or without food

 

Can I take this if I am pregnant?

Dopamine agonists, in general, should not be used in patients with pregnancy-induced hypertension, this drug should be used during pregnancy only if needed.

 

How quickly does Dostinex work?

The maximum effect was seen within 3 hours of the dose. 

 

What is Dostinex used for?

Dostinex is used to treat a condition where there is too much prolactin in the body. 

 

When should I take Dostinex?

This medication is taking twice a week and can be taken with or without food.

 

How effective is Dostinex?

Menses were restored in 77% of patients treated with Dostinex compared to 70% of those treated with bromocriptine.

 

Related Drugs

Reference:

Dostinex {package insert}. New York, NY: Pfizer; 2011.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020664s011lbl.pdf

PharmD Medical Writer

Author: Dr. Larisa Roybal, PharmD

Dr. Roybal is a board-certified pharmacotherapy specialist who has practiced in both ambulatory and acute care settings. Her pharmacy interests include oncology and general inpatient pharmacy.

Ditropan XL (Oxybutynin)

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Oxybutynin XL (Generic)

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Ditropan XL (Oxybutynin) Medication Information

Uses

Ditropan XL is a muscarinic antagonist used to treat overactive bladder. 

Dosage

The tablets are available in several different strengths:

  • 5 mg
  • 10 mg
  • 15 mg

Side Effects

The most common side effects of Ditropan XL include:

  • Headache
  • Dry mouth
  • Somnolence
  • Dizziness
  • Constipation
  • Diarrhea 

Speak with your doctor for a full list of side effects that apply to you if you are taking Ditropan XL.

Precautions

There have been reports of patients experiencing CNS effects with Ditropan XL use. 

Ditropan XL can aggravate several muscle conditions, use with caution in these patients. 

Because of the risk of constipation, use Ditropan XL with caution in patients who have gastrointestinal obstructions. 

Interactions

A common drug interaction with Ditropan XL includes:

  • Anticholinergic
  • Ketoconazole 
  • Clarithromycin 
  • Metoclopramide

Speak with your doctor for more information and before starting a new medication with Ditropan XL. 

Storage

Store at room temperature (59-86 ºF). Protect from moisture and humidity. 

Pharmacist Tips

  • Ditropan XL can cause urinary retention and constipation which are related to its anticholinergic activity.
  • Alcohol can increase drowsiness that is a side effect of Ditropan XL.
  • You should attempt to take Ditropan XL at the same time every day. 

Oxybutynin FAQs

How long does it take Ditropan XL to work?

It can take a few weeks to see benefit with Ditropan XL.

 

What is the best time to take Ditropan XL?

Ditropan XL is taken once a day, and it can be taken at any time, it just needs to be taken at the same time every day. 

 

What does Ditropan XL do to the bladder?

Ditropan XL is an antimuscarinic that helps to prevent muscle spasms in the bladder to reduce the urge to urinate. 

 

What are the side effects of Ditropan XL?

The most common side effects of Ditropan XL are constipation, urinary retention, headache, somnolence, and dry mouth. 

 

Is Ditropan XL a muscle relaxer?

No, Ditropan XL is not a muscle relaxer, but it works to reduce the spasms that occur in the bladder. 

Related Drugs

Reference:

Ditropan XL {package insert}. Titusville, NJ: Janssen Pharmaceuticals, Inc.; 1998.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020897s035lbl.pdf

PharmD Medical Writer

Author: Dr. Larisa Roybal, PharmD

Dr. Roybal is a board-certified pharmacotherapy specialist who has practiced in both ambulatory and acute care settings. Her pharmacy interests include oncology and general inpatient pharmacy.

Ditropan (Oxybutynin)

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Ditropan

Oxybutynin Chloride

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Ditropan (Oxybutynin) Dosage and Side Effects

DITROPAN is used to treat overactive bladder, a condition where the bladder muscles contract uncontrollably and cause the urgent need to urinate frequently.

Proper Use of this medication

DITROPAN comes in three different forms: a tablet, a syrup, and a long-acting tablet. The tablets and syrup are usually taken two to four times a day. The extended-release tablet is usually taken once a day, with or without food. Take this medication with a full glass of water. Try to take this medication at the same time each day.

If you are taking the liquid form of DITROPAN, use a dose-measuring spoon or cup to measure the correct amount of liquid for each dose, not a household spoon.

If you are taking the extended-release tablet, you may notice something that looks like a tablet in your stool - this is normal. It’s just the empty tablet shell and does not mean that you did not get your complete dose of medication.

Your doctor may start you on a low dose of DITROPAN and gradually increase your dose.

You may notice some improvement in your symptoms within the first two weeks of treatment. However, it may take six to eight weeks to experience the full benefit of DITROPAN. Talk to your doctor if your symptoms do not improve at all within eight weeks.

Your DITROPAN dose should be taken at approximately the same time each day.

DITROPAN Overdose

Overdosing with DITROPAN has been associated with negative effects on the central nervous system. Signs of an overdose include fever, vomiting, dehydration, or cardiac arrhythmia, where your heart beats either too fast or too slow.

Call a doctor or go to an emergency room immediately if you take too much DITROPAN.

Missed Dose of DITROPAN

If you miss a dose of DITROPAN, you should take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Never take a double dose to make up for the missed one.

If you are taking the extended-release tablet and you remember more than eight hours before it is time for the next dose, take the missed dose right away. However, if your next dose is due in less than eight hours, skip the missed dose and continue your regular dosing schedule.

Side Effects

DITROPAN may cause a potentially life-threatening allergic reaction called angioedema, which requires immediate medical attention. Stop using this medicine and seek medical attention right away if you or your child have any of the following symptoms:

  • Frequent, urgent, or painful urination
  • Fast, irregular, or pounding heartbeat
  • Hives or a severe rash
  • Swelling of the eyes, face, lips, tongue, or throat
  • Hoarseness
  • Difficulty breathing or swallowing
  • Fever
  • Flushing or redness of the face
  • Hallucinations (seeing, hearing, or feeling things that are not there)
  • Unusual excitement, nervousness, restlessness, or irritability

Tell your doctor immediately if any of these rare but very serious side effects occur:

  • Seizures
  • Stomach/intestinal blockage (such as persistent nausea/vomiting, prolonged constipation).

A very serious allergic reaction to DITROPAN is unlikely, but seek immediate medical attention if one occurs. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Warnings and Precautions

You should not use DITROPAN if you have untreated or uncontrolled glaucoma, a blockage in your stomach or intestines or if you are unable to urinate.

Tell your doctor if you have been diagnosed with liver or kidney disease, an enlarged prostate, or any other stomach disorder such as GERD, commonly known as reflux disease.

This medicine may cause your eyes to become more sensitive to light. Wearing sunglasses and avoiding too much exposure to bright light may help lessen the discomfort. DITROPAN may make you sweat less, causing your body temperature to increase. Use extra care not to become overheated during exercise or hot weather.

DITROPAN may control your symptoms, but it will not cure your condition. You may notice some improvement in your symptoms within the first two weeks of treatment. However, it may take up to eight weeks to experience the full benefit of DITROPAN. You should not stop taking DITROPAN without talking to your doctor.

If you are 65 years old or older, talk to your doctor about the risks and benefits of taking DITROPAN tablets or syrup. Older adults should not take DITROPAN tablets or syrup because they are not as safe and may not be as effective as other medications that can be used to treat the same condition.

You should also inform your doctor if you have kidney disease, liver disease, heart disease, bleeding problems, dementia, glaucoma, trouble swallowing, prostate problems, trouble emptying your bladder, or any kind of digestive problem, such as colitis, constipation, or  (GERD)gastroesophageal reflux disease.

DITROPAN may make you dizzy, drowsy, or cause blurred vision. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert or not able to see well.

When you first start taking DITROPAN, you may see signs of agitation, confusion, sleepiness or unusual drowsiness, or hallucinations. These symptoms should be reported to your doctor immediately.

Pregnancy and DITROPAN

Before taking DITROPAN, make sure your doctor knows if you are pregnant or breastfeeding.

Studies done on animals have shown no evidence of harm to a fetus if DITROPAN is used in pregnancy. However, there have not been any adequate studies on pregnant humans.

If you are breastfeeding, you should weigh the benefits against the potential risks and side effects to your baby before taking DITROPAN.

Interactions with this medication

If you are taking DITROPAN with other drugs such as Dramamine (dimenhydrinate) or Benadryl (diphenhydramine), you will likely experience other side effects. This could include dry mouth, constipation, blurred vision, increased heart rate, and urinary retention.

Combining pramlintide (Symlin) with DITROPAN should be avoided. This could cause severely reduce bowel movements.

DITROPAN may also delay passage of potassium tablets through the digestive system and result in ulceration or narrowing of the small intestine.

You should tell your doctor about any prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Certain antibiotics, antifungal, antihistamines along with aspirin and other nonsteroidal anti-inflammatory medications can affect how DITROPAN is absorbed in your body. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Morphine (MS Contin)
  • Morphine Sulfate XR Liposome (DepoDur)
  • Oxymorphone (Opana)
  • Umeclidinium (Anora Ellipta)

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Donepezil (Aricept)
  • Galantamine (Razadyne)
  • Ketoconazole (Nizoral)
  • Rivastigmine (Exelon)

To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. If you become constipated, consult your pharmacist for help in choosing a laxative. You should not use alcohol while taking DITROPAN.

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Divigel (Estradiol)

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Divigel (Estradiol) Medication Information

Uses

Divigel is an estrogen containing product that is used to treat symptoms of menopause. 

Dosage

The gel is available in several different strengths:

  • 0.25 mg
  • 0.5 mg
  • 1 mg

Side Effects

The most common side effects of Divigel include:

  • Nasopharyngitis
  • Upper respiratory infection
  • Vaginal mycosis
  • Breast tenderness

Speak with your doctor for a full list of side effects that apply to you if you are taking Divigel.

Precautions

In women who have not had a hysterectomy, it is important to add progestin to Divigel treatment. 

Women can experience an increase in blood pressure and triglycerides with the addition of Divigel. 

There is an increased risk of ovarian cancer with Divigel use. 

Interactions

A common drug interaction with Divigel includes:

  • Ketoconazole
  • Clarithromycin
  • Ritonavir
  • Grapefruit juice
  • Phenobarbital
  • Carbamazepine 

Speak with your doctor for more information and before starting a new medication with Divigel. 

Storage

Store at room temperature (66-77 ºF). 

Pharmacist Tips

  • Divigel is for women who have already gone through menopause.
  • The symptoms that Divigel is used to treat are hot flashes.
  • Divigel should be used for the shortest time possible to reduce your risk for serious complications. 

Estradiol FAQs

How long does it take for Divigel to work?

It can take up to 4 weeks to see effect with Divigel, and the maximum effect can take up to 12 weeks. 

 

How long after I apply the gel before I can shower?

You should wait at least an hour after applying Divigel before showering.

 

Can I use Divigel every day?

Divigel is applied once a day to the skin.

 

Where do you apply Divigel?

Divigel should be applied to the right or left upper thigh.

 

What are the side effects of Divigel?

Some common side effects of Divigel are nausea, vomiting, acne, swollen breasts, vaginal pain, and decreased sex drive.

 

Related Drugs

Reference:

Divigel {package insert}. Minneapolis, MN: Upsher-Smith Laboratories, Inc.; 2007.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/022038lbl.pdf

PharmD Medical Writer

Author: Dr. Larisa Roybal, PharmD

Dr. Roybal is a board-certified pharmacotherapy specialist who has practiced in both ambulatory and acute care settings. Her pharmacy interests include oncology and general inpatient pharmacy.

Lariam (Mefloquine)

Author , posted on July 4, 2017

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Lariam

Mefloquine Hydrochloride

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Lariam

Mefloquine Hydrochloride

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Mefloquine (Generic)

Mefloquine Hydrochloride

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Lariam (mefloquine) Dosage and Side Effects

LARIAM is a medicine used to treat malaria, a disease caused by parasites. This medicine works by interfering with the growth of parasites in the red blood cells of the human body. Parasites that cause malaria typically enter the body through the bite of a mosquito.

Proper Use of this medication

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

It is important to use this medication regularly (before, during and after travel) to best prevent malaria. If you stop using the medication early for any reason, talk to your doctor about other forms of malaria prevention.

Take LARIAM just after your main meal.

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

If you have trouble swallowing the LARIAM tablet, you may crush the tablet and mix it into a small glass of milk, water, or other beverage to make swallowing easier.

If you vomit within 30 minutes after taking LARIAM, take another full dose. If you vomit 30 to 60 minutes after taking the medicine, take another half dose. If your vomiting continues, call your doctor.

If you are taking this medicine to prevent malaria:

  • LARIAM is usually taken once per week to prevent malaria.
  • Start taking the medicine 1 to 3 weeks before entering an area where malaria is common. Continue taking the medicine once weekly during your stay and for at least 4 weeks after you leave the area.
  • Take your weekly dose on the same day each week.
  • If you stop taking the medicine early for any reason, contact a healthcare professional about another form of malaria prevention.

If you are taking LARIAM to treat malaria:

  • Take as directed by your doctor.

In addition to taking LARIAM, use protective clothing, insect repellents, and mosquito netting around your bed to further prevent mosquito bites that could cause malaria.

If you use this medication long-term, you may need frequent blood tests to check your liver function. Your vision may also need to be checked.

Contact your doctor as soon as possible if you have been exposed to malaria, or if you have fever or other symptoms of illness during or after a stay in an area where malaria is common.

No medication is 100% effective in treating or preventing malaria. For best results, keep using the medication as directed. Talk with your doctor if you have fever, vomiting, or diarrhea during your treatment.

Store at room temperature away from moisture and heat.

Seek emergency medical attention or call the Poison Help line.

Since LARIAM is often used as a single dose, you may not be on a dosing schedule. If you are on a weekly schedule, use the missed dose as soon as you remember. Then take the next dose on your next usual dosing day. Do not use extra medicine to make up the missed dose.

Call your doctor for instructions if you forget to take the medicine within 1 week before your travel.

Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking LARIAM and call your doctor right away if you any of these side effects:

  • sudden headache, ringing in your ears, dizziness, loss of balance, or problems with coordination;
  • severe anxiety, depression;
  • paranoia, hallucinations (seeing or hearing things that are not real);
  • confusion, unusual behavior; or
  • thoughts about suicide or hurting yourself.

Stop using LARIAM and call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;
  • seizure (convulsions);
  • increased blood pressure--severe headache, blurred vision, chest pain, shortness of breath, uneven heartbeats; or
  • liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

  • stomach pain, vomiting, diarrhea;
  • dizziness;
  • muscle pain;
  • fever, chills; or
  • mild skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings and Precautions

Some people taking LARIAM have had sudden serious psychiatric or nerve problems, some of which lasted long after they stopped taking this medicine. These side effects can be permanent.

Stop taking LARIAM and call your doctor right away if have any of these side effects: headache, ringing in your ears, dizziness, loss of balance, problems with coordination, anxiety, depression, paranoia, hallucinations, or thoughts about suicide or hurting yourself.

You should not take LARIAM to prevent malaria if you have a recent history of depression, an anxiety disorder, seizures, mental illness (such as schizophrenia), or psychosis.

Some people taking LARIAM have had sudden serious psychiatric or nerve problems. Some of these effects have lasted for months to years after LARIAM treatment ended, and these side effects can be permanent. Talk to your doctor if you have concerns about taking LARIAM.

You should not use this medication if you are allergic to LARIAM or similar medications such as quinine or quinidine.

You also should not use LARIAM to prevent malaria if you have a recent history of:

  • depression;
  • an anxiety disorder;
  • seizures; or
  • mental illness (such as schizophrenia) or psychosis.

However, your doctor may prescribe LARIAM to treat malaria even if you do have any of the conditions listed above.

To make sure LARIAM is safe for you, tell your doctor if you have:

  • heart disease;
  • liver disease;
  • epilepsy or other seizure disorder;
  • diabetes;
  • bleeding or blood clotting disorder;
  • a history of mental disease; or
  • if you take a blood thinner (warfarin, Coumadin, Jantoven).

FDA pregnancy category B. It is not known whether LARIAM will harm an unborn baby. Tell your doctor if you are pregnant or if you become pregnant while using this medication. Use effective birth control while you are using this medication and for at least 3 months after your treatment ends.

LARIAM can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

LARIAM should not be used to treat malaria in a child younger than 6 months without a doctor's advice. LARIAM should not be used to prevent malaria in a child who weighs less than 44 pounds.

Interactions with this medication

Do not take halofantrine or ketoconazole while you are taking LARIAM and for at least 15 weeks after you stop taking it. Serious, life-threatening side effects on your heart can occur if you take halofantrine before the LARIAM has cleared from your body.

Avoid taking chloroquine, quinine, or quinidine while you are taking LARIAM.

LARIAM can cause side effects that may impair your thinking or reactions. Be careful if you drive, operate machinery, pilot an airplane, scuba dive, or do anything that requires you to be awake and alert.

Many drugs can interact with LARIAM. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with LARIAM, especially:

  • heart or blood pressure medication;
  • medicine to treat depression or mental illness;
  • seizure medication;
  • tuberculosis medication; or
  • a "live" vaccine such as measles, mumps, and rubella (MMR).

This list is not complete and many other drugs can interact with LARIAM. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

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Risperdal M-Tab (Risperidone)

Author , posted on July 4, 2017

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Risperdal M-TAB

Risperidone

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Risperidone (ODT) (Generic)

Risperidone

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Risperdal (Risperidone) Dosage and Side Effects

RISPERDAL is used to treat the symptoms of schizophrenia and related psychotic disorders, which may include hallucinations (hearing or seeing things that are not there), delusions, unusual suspiciousness, emotional withdrawal. RISPERDAL may also be used for short-term treatment in dementia related to Alzheimer’s disease, specifically to control aggression or psychotic symptoms (such as believing things that are not true or seeing, feeling or hearing things that are not there) when there is a risk of harm to self or others. RISPERDAL may be used for the acute treatment of manic episodes associated with bipolar disorder.

Proper Use of this medication

Usual dose:

  • It is very important that you take/give RISPERDAL the way the doctor has prescribed it.
  • The doctor has decided on the best dosage for you/the patient you are caring for based on individual needs. Dosage may be increased or decreased depending on the response.
  • You may take/give RISPERDAL together with meals or between meals. Once a regular dose has been established, the total amount can be taken once a day, or divided into two intakes, one in the morning and one in the evening.
  • Try to take/give RISPERDAL at the same time each day.
  • RISPERDAL tablets should be swallowed with some water or other liquid.
  • Before taking/giving RISPERDAL oral solution, Be sure to mix the exact dose of RISPERDAL oral solution that the doctor has prescribed in 100 mL of one of the following beverages: water, coffee, orange juice or low-fat milk; DO NOT MIX it in cola or tea.
  • It is important that you keep taking/giving RISPERDAL even after your/the symptoms have improved or disappeared. Do not change or stop taking/giving RISPERDAL without consulting the doctor.

DO NOT give RISPERDAL to anyone else. The doctor has prescribed it for you/the patient you are caring for.

Directions for Use of RISPERDAL Oral Solution:

To open the bottle and use the pipette:

  1. The bottle comes with a child-proof cap, and should be opened as follows: push the plastic screw cap down while turning it counter-clockwise. Remove the unscrewed cap.
  2. Insert the pipette into the bottle. While holding the bottom ring, pull the top ring up to the mark that corresponds to the number of millilitres or milligrams you need to give.
  3. Holding the bottom ring, remove the entire pipette from the bottle. Empty the pipette into at least 100 mL (3-4 ounces) of any non-alcoholic drink (see list below), by sliding the upper ring down. Stir the mixture thoroughly before consuming.

RISPERDAL oral solution is compatible with the following beverages: water, coffee, orange juice and low-fat milk. However, it is NOT compatible with cola or tea. Close the bottle and rinse the pipette with some water.

Overdose:

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.

In overdose, one or more of the following signs may occur: reduced consciousness, sleepiness, excessive trembling, excessive muscle stiffness, fast beating heart, dizziness or light-headedness when standing up.

Missed dose:

If you miss a dose, try not to miss any more. DO NOT TAKE/GIVE TWO DOSES AT ONCE.

Side Effects

Like other medications, RISPERDAL can cause some side effects. Some side effects are minor and temporary; however, some may be serious and need medical attention. Many of the side effects are dose related, so it is important not to exceed your prescribed dose. Should you experience these symptoms, please consult your doctor.

Side effects that may occur very commonly are difficulty falling or staying asleep, trembling, decreased motor function or activity such as slight muscle stiffness, increased saliva and/or drooling, feeling sleepy or less alert, and headache.

Side effects that may occur commonly include: pneumonia, infections of eye, infections of ear, urinary tract infection, feeling like you have the flu, sleep disorder, depression, anxiety, irritability, dizziness, uncontrollable movements of the face or body, rigid muscles, slowness of movement and muscle stiffness or spasm, tremor, a sensation of tingling, prickling, or numbness of skin, blurry vision, faster heart rate, high blood pressure, abdominal pain, nausea/vomiting, constipation, diarrhea, indigestion, dry mouth, muscle spasms, loss of urine, swelling of the body, arms or legs, weakness, and fatigue.

RISPERDAL can raise your levels of a hormone called "prolactin" (measured with a blood test). In women, medicines of this type may cause changes in the regularity of their monthly period, breast discomfort, or leakage of milk from the breast even if they are not pregnant. In some men, there may be difficulty in getting or maintaining erections, or other sexual dysfunction and breast enlargement may be experienced.

Weight gain has been observed with RISPERDAL. Your doctor may check your body weight before starting RISPERDAL and during treatment.

Uncommon side effects may include: anemia, increased cholesterol in your blood, weight loss, loss of appetite resulting in malnutrition and low body weight, mania, a restless urge to move parts of your body, concentration difficulties, nightmares, itching, flushing, a sensation of tingling, pricking, or numbness of skin, muscle weakness, thirst, infection of the breathing passages, bladder infection, infection of the skin, fungal infection of the nails, crackly lung sounds, wheezing, breathing passage disorder, chills, vaginal discharge, joint swelling or stiffness, ringing in your ears, sensation of spinning (vertigo), being unresponsive to what is going on around you, difficulty with your voice, changes in taste, difficult or painful urination, bowel incontinence, gas, stomach or intestinal infection, low blood pressure, heartbeat irregularities, changes in body temperature, and increased liver transaminases in your blood.

High blood sugar, diabetes mellitus or worsening of diabetes have been reported. See your doctor if you experience symptoms such as excessive thirst or urination.

RISPERDAL may cause sudden dizziness or lightheadedness (symptoms of postural hypotension). You/the patient you are caring for should not rise rapidly after having been sitting or lying for prolonged periods, especially when you start taking RISPERDAL.

In rare cases, the following may happen: sugar in the urine, high blood triglycerides (a fat), chapped lips, eye rolling, glaucoma (increased pressure within the eyeball), eyelid margin crusting, swollen tongue, coldness in arms and legs, and low blood sugar.

Lack of bowel muscle movement that causes blockage may occur very rarely.

During cataract surgery, a condition called intraoperative floppy iris syndrome (IFIS) can happen if you take or have taken RISPERDAL. If you need to have cataract surgery, be sure to tell your eye doctor if you take or have taken RISPERDAL.

Your doctor may take blood tests before starting RISPERDAL and during treatment, and may monitor blood sugar and the number of infection-fighting white blood cells.

If you have high levels of prolactin (measured with a blood test) and a condition called hypogonadism you may be at an increased risk of breaking a bone due to osteoporosis. This occurs in both men and women.

Do not be alarmed by this list of possible side effects. You may not experience any of them. If any of these side effects are experienced, they are usually mild and temporary. However, do not hesitate to report any undesired side effects to your doctor.

If you have taken RISPERDAL in the last three months of your pregnancy and you notice that your newborn baby develops shaking, muscle stiffness and/or weakness, sleepiness, agitation, breathing problems, and difficulty in feeding, seek immediate emergency medical attention.

Warnings and Precautions

Serious Warnings and Precautions

Studies with various medicines of the group to which RISPERDAL belongs, when used in elderly patients with dementia, have been associated with an increased rate of death. Some of these studies included treatment with RISPERDAL.

BEFORE you use RISPERDAL, talk to your doctor or pharmacist if you/the patient you are caring for:

  • have/has a history of stroke, mini-strokes, high cholesterol or high blood pressure;
  • have/has diabetes or a family history of diabetes;
  • are/is pregnant or planning to become pregnant;
  • are/is breast-feeding;
  • have/has ever had blackouts or seizures;
  • have/has a history of kidney or liver problems;
  • have/has a history of problems with the heart and/or blood vessels;
  • are/is prone to hypotension;
  • have risk factors for developing blood clots such as: a family history of blood clots, age over 65, smoking, obesity, recent major surgery (such as hip or knee replacement), immobility due to air travel or other reason, or take oral contraceptives ("The Pill'');
  • have had low white blood cell counts in your blood. Let your doctor know right away if you develop a fever or infection while being treated with RISPERDAL.
  • have/has Parkinson's disease;
  • are/is taking or planning to take any other medicines (prescription or over-the-counter medicines);
  • drink/drinks alcoholic beverages or use/uses drugs;
  • have/has or have had/has had breast cancer;
  • have/has pituitary tumours;
  • suffer/suffers from Alzheimer's Disease;
  • suffer/suffers from Lewy body dementia;
  • are/is dehydrated;
  • exercise/exercises strenuously;
  • are/is planning to have an operation on the eye.

Elderly Patients with Dementia:

Studies in elderly patients with dementia have shown that RISPERDAL taken by itself or with furosemide is associated with a higher rate of death (see Serious Warnings and Precautions Box).

Tell your doctor if you are taking furosemide. Furosemide is a medicine which is sometimes used to treat high blood pressure, some heart problems, or to treat swelling of parts of the body caused by the build-up of too much fluid.

In elderly patients with dementia, a sudden change in mental state or sudden weakness or numbness of the face, arms or legs, especially on one side, or instances of slurred speech have been seen. If any of these should occur, even for a short period of time, seek medical attention right away.

If you are taking blood pressure medication:

Low blood pressure can result from using RISPERDAL together with medications used to treat high blood pressure. If you need to use both RISPERDAL and medications used to reduce blood pressure, consult your doctor.

Effects on newborns:

In some cases, babies born to a mother taking risperidone during pregnancy have experienced symptoms that are severe and require the newborn to be hospitalized. Sometimes, the symptoms may resolve on their own. Be prepared to seek immediate emergency medical attention for your newborn if they have difficulty breathing, are overly sleepy, have muscle stiffness, or floppy muscles (like a rag doll), are shaking, or are having difficulty feeding.

Other cautions:

Very rarely, a state of confusion, reduced consciousness, high fever or stiff muscles might occur. If this should happen, contact a doctor right away and tell him or her that you are receiving RISPERDAL.

During long-term treatment, RISPERDAL might cause involuntary twitching in the face. Should this happen, consult your doctor.

Since medications of this type may interfere with the ability of the body to adjust to heat, it is best to avoid becoming overheated or dehydrated (for example with vigorous exercise or exposure to extreme heat) while taking RISPERDAL.

RISPERDAL should be used with caution, and only after consultation with your doctor, if you have heart problems, particularly irregular heart rhythm, abnormalities in electrical activity of the heart, or if using medications that can change the heart's electrical activity.

Because some people experience drowsiness, you should not drive or operate machinery until you are reasonably certain that RISPERDALdoes not affect your ability to carry out these activities.

During an operation on the eye for cloudiness of the lens (cataract), the pupil (the black circle in the middle of your eye) may not increase in size as needed. Also, the iris (the colored part of the eye) may become floppy during surgery and that may lead to eye damage. If you are planning to have an operation on your eye, make sure you tell your eye doctor that you are taking this medicine.

It is important for the doctor to have all the above information before prescribing treatment and dosage. This list should be carefully reviewed by you/the caregiver and discussed with the doctor.

Interactions with this medication

Inform all doctors, dentists and pharmacists who are treating you that you are taking RISPERDAL.

Inform them if you are taking or are planning on taking any other medicine. They will tell you which medicines you can take with RISPERDAL.

RISPERDAL can increase the effect of alcohol and medicines that reduce the ability to react (e.g., “tranquillizers”, narcotic painkillers, certain antihistamines, certain antidepressants). It is recommended that you DO NOT drink alcohol when you are taking RISPERDAL. You should only take these other medicines when they have been prescribed by your doctor.

Some medicines, when they are taken together with RISPERDAL, may increase or decrease the level of RISPERDAL in your blood. Therefore, tell your doctor if you start and/or stop taking any of the below medicines, since your doctor may need to change the dose:

  • Dopamine agonists, e.g., levodopa (antiparkinsonian agent), as these may decrease the effect of RISPERDAL.
  • Phenothiazines and some heart medications (e.g., medication for high blood pressure, antiarrhythmics, or beta-blockers), as these may interact with RISPERDAL to cause your blood pressure to drop too low.
  • RISPERDAL should be used with caution when taking medications that may change the electrical activity of the heart (QT prolongation), such as but not restricted to: medicines for malaria, heart rhythm disorders, allergies, other antipsychotics, antidepressants, water tablets or other medicines affecting body salts (sodium, potassium, magnesium).
  • Carbamazepine and topiramate (anticonvulsants), as these may change the effect of RISPERDAL.
  • PROZAC (fluoxetine), PAXIL (paroxetine) (antidepressants) and CLOZARIL (clozapine), as these may increase the level ofRISPERDAL in your blood.
  • LASIX (furosemide): Studies in elderly patients with dementia have shown that taking RISPERDAL with furosemide, a medicine which is sometimes used to treat high blood pressure, some heart problems, or to treat swelling of parts of the body caused by the build-up of too much fluid, is associated with an increased rate of death
  • Itraconazole and ketoconazole, medicines for treating fungal infections.
  • Certain medicines used in the treatment of HIV/AIDS, such as NORVIR (ritonavir).
  • Verapamil, a medicine used to treat high blood pressure and/or abnormal heart rhythm.
  • Sertraline and fluvoxamine, medicines used to treat depression and other psychiatric disorders.
  • Rifampicin, a medicine for treating some infections.

RISPERDAL oral solution is not compatible with cola or tea.

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Lexiva (Fosamprenavir)

Author , posted on July 4, 2017

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Lexiva

Fosamprenavir Calcium

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Lexiva (Fosamprenavir) Dosage and Side Effects

LEXIVA is an antiviral medicine that prevents human immunodeficiency virus (HIV) cells from multiplying in your body.

Proper Use of this medication

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

LEXIVA tablets can be taken with or without food.

LEXIVA liquid should be taken with food in children and without food in adults.

Shake the oral suspension (liquid) well just before you measure a dose. 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 a child is using this medicine, tell your doctor if the child has any changes in weight. LEXIVA doses are based on weight in children, and any changes may affect your child's dose.

While using LEXIVA, you may need frequent blood tests at your doctor's office.

Use LEXIVA regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.

Store LEXIVA tablets at room temperature away from moisture and heat.

You may store LEXIVA liquid in the refrigerator but do not allow it to freeze.

Seek emergency medical attention or call the Poison Help line.

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.

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.

Stop taking LEXIVA and call your doctor at once if you have:

  • chest pain or pressure, tight feeling in your neck or jaw, pain spreading to your arm or shoulder;
  • pale or yellowed skin, dark colored urine, fever, confusion or weakness;
  • increased urination or extreme thirst;
  • sudden and severe pain in your lower back or side, blood in your urine, pain or burning when you urinate; 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.

LEXIVA may increase your risk of certain infections or autoimmune disorders by changing the way your immune system works. Symptoms may occur weeks or months after you start treatment with LEXIVA. Tell your doctor if you have:

  • signs of a new infection--fever, night sweats, swollen glands, mouth sores, diarrhea, stomach pain, weight loss;
  • chest pain (especially when you breathe), dry cough, wheezing, feeling short of breath;
  • cold sores, sores on your genital or anal area;
  • rapid heart rate, feeling anxious or irritable, weakness or prickly feeling, problems with balance or eye movement;
  • trouble speaking or swallowing, severe lower back pain, loss of bladder or bowel control; or
  • swelling in your neck or throat (enlarged thyroid), menstrual changes, impotence, loss of interest in sex.

Common side effects of LEXIVA may include:

  • fever or other signs of infection;
  • nausea, vomiting, diarrhea;
  • rash;
  • headache; or
  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings and Precautions

Some medicines can cause unwanted or dangerous effects when used with LEXIVA. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

You should not use LEXIVA if you are allergic to it.

There are certain medicines that can cause life-threatening drug interactions with LEXIVA, 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:

  • alfuzosin;
  • delavirdine;
  • pimozide;
  • rifampin;
  • St. John's wort;
  • sildenafil (Revatio) when used to treat pulmonary arterial hypertension (PAH);
  • cholesterol-lowering medicine--lovastatin, simvastatin;
  • ergot medicine--dihydroergotamine, ergotamine, ergonovine, methylergonovine;
  • heart rhythm medicine--flecainide, propafenone; or
  • a sedative--oral midazolam or triazolam.

To make sure LEXIVA is safe for you, tell your doctor if you have:

  • liver disease;
  • kidney disease;
  • diabetes;
  • a bleeding disorder such as hemophilia;
  • heart disease, history of heart attack;
  • an allergy to sulfa drugs;
  • high cholesterol or triglycerides; or
  • if you have ever used a protease inhibitor in the past.

It is not known whether LEXIVA will harm an unborn baby. However, HIV can be passed to your baby if you are not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection. Tell your doctor if you become pregnant.

Your name may need to be listed on an antiviral pregnancy registry when you start using this medicine.

LEXIVA can make birth control pills less effective. Taking LEXIVA together with ritonavir and also using birth control pills can increase your risk of abnormal liver function tests. Ask your doctor about using non hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy.

Women with HIV or AIDS should not breast-feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

LEXIVA should not be given to an infant younger than 4 weeks (28 days) old.

Interactions with this medication

Taking this medication will not prevent you from passing HIV to other people. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Many drugs can interact with LEXIVA, and some drugs should not be used together. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

  • other drugs to treat HIV or AIDS;
  • an antibiotic or antifungal medicine;
  • an antidepressant or anti-psychotic medicine;
  • antiviral medicine to treat hepatitis C;
  • a blood thinner (warfarin, Coumadin, Jantoven);
  • cholesterol-lowering medicine;
  • heart or blood pressure medicine;
  • medicine to prevent organ transplant rejection;
  • medicine to prevent or treat nausea and vomiting;
  • medicine to treat a breathing disorder;
  • narcotic medicine;
  • a sedative;
  • seizure medicine;
  • steroid medicine;
  • stomach acid reducers; or
  • Viagra and other erectile dysfunction medicines.

This list is not complete and many other drugs can interact with LEXIVA. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

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