Like all medicines CYCLOCORT can have side effects although not everybody gets them. Side effects will affect your skin and may have an effect on other parts of your body if a sufficient quantity of medicine is absorbed through the skin and enters your blood stream.

If your skin condition gets worse or your skin becomes swollen during treatment. You may be allergic to the medicine or need other treatment. Stop using CYCLOCORT and tell your doctor as soon as possible.

The following side effects have been reported in patients using topical corticosteroids:

Common side effects:

• itchy skin

• local skin burning or pain

Very rare side effects:

Use of CYCLOCORT for a long period of time, over a large body surface, or use under an airtight dressing, may cause the following symptoms:

• increased weight

• moon face/rounding of the face, obesity

• skin thinning (this may cause stretch marks), skin wrinkling, skin dryness, the appearance of blood vessels under the surface of your skin (telangiectasia), changes to the colour of your skin, skin infection

• increased body hair, hair loss/lack of hair growth/damaged looking hair

• allergic reaction, irritation, itching or pain at the site of application

• inflammation of hair follicles

• worsening of condition

• redness, rash or hives

• secondary infection

• allergic contact dermatitis/dermatitis (a type of eczema)

• upper abdominal pain

• prickly heat rash

• steroid withdrawal syndrome (symptoms may include weight loss, fatigue, nausea, diarrhea and abdominal pain)

• acne

If you have psoriasis you may get raised bumps with pus under the skin. This can happen very rarely during or after treatment and is known as pustular psoriasis.

Other symptoms that may only show in blood tests or when your doctor gives you a medical examination are: decreased hormone cortisol levels in your blood, increased sugar levels in your blood or urine, high blood pressure, cloudy lens in the eye (cataract), increased pressure in the eye (glaucoma), as well as weakening of the bones through gradual mineral loss (osteoporosis) and additional tests may be needed after your medical examination to confirm whether you have osteoporosis.

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

Take each dose with a full glass of water.

DEPEN must be taken on an empty stomach, at least 1 hour before or 2 hours after a full meal, and at least 1 hour before or after any other drug, food, or milk. Taking DEPEN with anything else in the stomach greatly decreases its effectiveness.

Do not stop taking DEPEN without first talking to your doctor. Stopping therapy may cause your body to react abnormally when therapy is restarted. If you do stop taking the medication, do not restart without first talking to your doctor. You may need special monitoring.

Your doctor may want you to take a vitamin and mineral supplement during treatment with DEPEN. DEPEN may reduce vitamin B6 and iron in the body. Follow your doctor's instructions.

Store DEPEN at room temperature away from moisture and heat.

Seek emergency medical attention.

Symptoms of a DEPEN overdose are not known.

Take the missed dose on an empty stomach as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and take only your next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor. If you have missed several doses in a row, do not take any more doses without first talking to your doctor.

If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:

•an allergic reaction (shortness of breath; closing of your throat; difficulty breathing; swelling of your lips, face, or tongue; or hives);

•fever or chills;

•a sore throat;

•unusual bleeding or bruising;

•blood in the urine;

•unexplained shortness of breath, coughing, or wheezing;

•abdominal pain;

•yellow skin or eyes;

•muscle weakness; or

•double vision.

Other, less serious side effects may be more likely to occur. Continue to take DEPEN and notify your doctor if you experience

•itching or a rash;

•nausea, vomiting, diarrhea, or decreased appetite;

•ringing in the ears;

•decreased taste;

•sores in the mouth;

•poor wound healing; or

•increased wrinkling of the skin.

Notify your doctor immediately if you develop fever; chills; a sore throat; unusual bruising or bleeding; blood in your urine, unexplained shortness of breath, coughing, or wheezing; muscle weakness; or double vision. These symptoms could be early signs of dangerous side effects.

You cannot take DEPEN if you have taken it in the past and it has damaged your blood cells.

Before taking DEPEN, tell your doctor if you have kidney disease or any other serious illness. You may not be able to take DEPEN, or you may require a lower dose or special monitoring during therapy.

DEPEN may cause birth defects in an unborn baby. However, it has also been used during pregnancy with no evidence of defects. DEPEN should not be used during pregnancy except to treat Wilson's disease and some cases of cystine in the urine. Do not take this medication without first talking to your doctor if you are pregnant.

It is not known whether DEPEN passes into breast milk. Since DEPEN may harm a nursing infant, breast-feeding is not recommended during treatment with this medication.

Follow any special diet restrictions recommended by your doctor.

Do not take DEPEN if you are taking any of the following medicines:

•a gold-therapy product such as auranofin (Ridaura), aurothioglucose (Solganal), or gold sodium thiomalate (Myochrysine, Aurolate);

•an antimalarial medicine such as quinine (Quinamm), mefloquine (Lariam), chloroquine (Aralen), hydroxychloroquine (Plaquenil), primaquine, or pyrimethamine (Daraprim);

•a cancer chemotherapy medicine; or

•phenylbutazone.

Like DEPEN, the medications listed above can affect the blood and the kidneys. Combined with DEPEN, any of these medicines can be very dangerous.

Before taking DEPEN, tell your doctor if you are taking digoxin (Lanoxin, Lanoxicaps). DEPEN may decrease the effects of digoxin, and your doctor may want to adjust your dosage or monitor your therapy.

Many other drugs, especially antacids and vitamin and mineral supplements, can decrease the effects of DEPEN. Do not take any medicines or over-the-counter drugs or supplements within 1 hour of a DEPEN dose.

Drugs other than those listed here may also interact with DEPEN. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

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

Take each dose with a full glass of water.

CUPRIMINE must be taken on an empty stomach, at least 1 hour before or 2 hours after a full meal, and at least 1 hour before or after any other drug, food, or milk. Taking CUPRIMINE with anything else in the stomach greatly decreases its effectiveness.

Do not stop taking CUPRIMINE without first talking to your doctor. Stopping therapy may cause your body to react abnormally when therapy is restarted. If you do stop taking the medication, do not restart without first talking to your doctor. You may need special monitoring.

Your doctor may want you to take a vitamin and mineral supplement during treatment with CUPRIMINE. CUPRIMINE may reduce vitamin B6 and iron in the body. Follow your doctor's instructions.

Store CUPRIMINE at room temperature away from moisture and heat.

Seek emergency medical attention.

Symptoms of a CUPRIMINE overdose are not known.

Take the missed dose on an empty stomach as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and take only your next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor. If you have missed several doses in a row, do not take any more doses without first talking to your doctor.

If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:

•an allergic reaction (shortness of breath; closing of your throat; difficulty breathing; swelling of your lips, face, or tongue; or hives);

•fever or chills;

•a sore throat;

•unusual bleeding or bruising;

•blood in the urine;

•unexplained shortness of breath, coughing, or wheezing;

•abdominal pain;

•yellow skin or eyes;

•muscle weakness; or

•double vision.

Other, less serious side effects may be more likely to occur. Continue to take CUPRIMINE and notify your doctor if you experience

•itching or a rash;

•nausea, vomiting, diarrhea, or decreased appetite;

•ringing in the ears;

•decreased taste;

•sores in the mouth;

•poor wound healing; or

•increased wrinkling of the skin.

Notify your doctor immediately if you develop fever; chills; a sore throat; unusual bruising or bleeding; blood in your urine, unexplained shortness of breath, coughing, or wheezing; muscle weakness; or double vision. These symptoms could be early signs of dangerous side effects.

You cannot take CUPRIMINE if you have taken it in the past and it has damaged your blood cells.

Before taking CUPRIMINE, tell your doctor if you have kidney disease or any other serious illness. You may not be able to take CUPRIMINE, or you may require a lower dose or special monitoring during therapy.

CUPRIMINE may cause birth defects in an unborn baby. However, it has also been used during pregnancy with no evidence of defects. CUPRIMINE should not be used during pregnancy except to treat Wilson's disease and some cases of cystine in the urine. Do not take this medication without first talking to your doctor if you are pregnant.

It is not known whether CUPRIMINE passes into breast milk. Since CUPRIMINE may harm a nursing infant, breast-feeding is not recommended during treatment with this medication.

Follow any special diet restrictions recommended by your doctor.

Do not take CUPRIMINE if you are taking any of the following medicines:

•a gold-therapy product such as auranofin (Ridaura), aurothioglucose (Solganal), or gold sodium thiomalate (Myochrysine, Aurolate);

•an antimalarial medicine such as quinine (Quinamm), mefloquine (Lariam), chloroquine (Aralen), hydroxychloroquine (Plaquenil), primaquine, or pyrimethamine (Daraprim);

•a cancer chemotherapy medicine; or

•phenylbutazone.

Like CUPRIMINE, the medications listed above can affect the blood and the kidneys. Combined with CUPRIMINE, any of these medicines can be very dangerous.

Before taking CUPRIMINE, tell your doctor if you are taking digoxin (Lanoxin, Lanoxicaps). CUPRIMINE may decrease the effects of digoxin, and your doctor may want to adjust your dosage or monitor your therapy.

Many other drugs, especially antacids and vitamin and mineral supplements, can decrease the effects of CUPRIMINE. Do not take any medicines or over-the-counter drugs or supplements within 1 hour of a CUPRIMINE dose.

Drugs other than those listed here may also interact with CUPRIMINE. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

CREON comes as a delayed-release capsule to take by mouth with a meal or snack.

Follow the instructions on your prescription label carefully when taking this medicine. Don't take more or less CREON than is recommended by your doctor.

Don't hold the contents of a CREON capsule in your mouth, as this may cause irritation.

Also, don't inhale the powder of a CREON capsule or allow it to touch your skin. It can irritate your nose, lungs, and skin.

You can open the capsule and sprinkle its contents into pudding or applesauce, if needed. Swallow the mixture immediately without chewing it. Don't save any of the mixture for later.

The contents of a CREON capsule must be swallowed right after the capsule is opened. Discard any unused medicine.

Don't crush or chew CREON capsules.

Pancrelipase is sold under brand names other than CREON. Don't switch to a different brand of the medicine without first talking with your healthcare provider.

Taking CREON regularly results in the greatest benefit. Be sure to get your prescription refilled before you run out of medicine.

Common Side Effects of CREON

Tell your doctor if any of the following side effects become severe or don't go away:

•Headache

•Cough or sore throat

•Dizziness

•Nausea or upset stomach

•Nosebleed

•Neck pain

•Feeling full after eating a small amount of food

•Constipation

•Diarrhea

•Greasy stools

•Heartburn

•Gas

•Sore mouth or tongue

•Irritation around the rectum

•Weight loss

Serious Side Effects of CREON

Tell your doctor right away if you experience any of the following serious side effects:

•Signs of an allergic reaction (may include hives, rash, itching, chest tightness, or swelling of the face, lips, tongue, or throat)

•Hoarseness

•Severe nausea or vomiting

•Severe or unusual stomach pain

•Difficulty having bowel movements

•Pain or swelling in your joints, especially in your big toe

Before taking CREON, tell your doctor if you have, or have ever had:

•Diabetes

•Gout or high levels of uric acid in the blood

•Surgery on your intestines

•A blockage, thickening, or scarring of your intestines

•Cancer

•Kidney disease

•Lactose intolerance

•Trouble swallowing capsules

•Allergies to medications

CREON is made from the pancreas of pigs. Tell your doctor if you're allergic to pork products.

It may be possible to get a viral infection from products that come from pigs, but this has never been reported with CREON.

CREON may raise your risk of developing a rare bowel disorder called fibrosing colonopathy. You can reduce this risk by following the dosing instructions that your doctor provides.

Don't take CREON if you have a sudden onset of pancreatitis, or experience worsening of a problem with your pancreas.

Your doctor may recommend that you follow a specific diet plan while taking this medicine. Follow your doctor's instructions carefully.

Pregnancy and CREON

It's not known whether CREON can harm an unborn baby.

Tell your doctor if you're pregnant, or plan to become pregnant while taking this medicine.

It's also not known whether CREON passes into breast milk or could hurt a breastfeeding baby.

Talk to your doctor before using this drug while breastfeeding.

Tell your doctor about all prescription, nonprescription, illegal, recreational, herbal, nutritional, or dietary drugs you're taking before starting on CREON.

Take COTAZYM exactly as prescribed by your healthcare provider.

• You should not switch COTAZYM with any other pancreatic enzyme product without first talking to your doctor.

• Do not take more capsules in a day than the number your doctor tells you to take (total daily dose).

• Always take COTAZYM with a meal or snack and enough liquid to swallow COTAZYM completely. If you eat a lot of meals or snacks in a day, be careful not to go over your total daily dose.

• If the capsules are opened, try to avoid sprinkling them on dairy products such as milk, custard or ice cream.

• Your doctor may change your dose based on the amount of fatty foods you eat or based on your weight.

• Do not crush or chew COTAZYM capsules or its contents, and do not hold the capsule or capsule contents in your mouth. Crushing, chewing or holding the COTAZYM capsules in your mouth may cause irritation in your mouth or change the way it works in your body.

Usual dose:

BEFORE you use COTAZYM talk to your doctor or pharmacist if you:

• Are allergic to pork (pig) products

• Have a history of intestinal blockage or scarring or thickening of your bowel wall (fibrosing colonopathy)

• Have gout, kidney disease, or high blood uric acid (hyperuricemia or hyperuricosuria)

• Have trouble swallowing capsules

• Have any other medical condition

• Are pregnant, plan to become pregnant, are breast-feeding or plan to breast-feed. It is not known if COTAZYM will harm your unborn baby or if COTAZYM passes into your breast milk. Enzymes such as COTAZYM are broken down in your gastrointestinal tract, and thus are not absorbed into the body as intact enzymes.

Tell your doctor all the medications that you take, including prescription and nonprescription drugs, natural health products, vitamins and herbs.

Talk to your doctor if the following occurs while taking COTAZYM:

• stomach area (abdominal) pain

• bloating

• trouble passing stool (having bowel movements)

• nausea, vomiting, or diarrhea

Take COTAZYM exactly as prescribed. Do not take more or less COTAZYM than directed by your doctor.

As with all other pancrelipase lipase preparations, interactions with COTAZYM is possible. Therefore, tell your doctor all the medications that you take, including prescription and nonprescription drugs, natural health products, vitamins and herbs.

You should take this medication exactly as it's prescribed by your doctor.

Do not take larger or smaller amounts than recommended.

Your recommended dosage will depend on a range of factors, including your overall health status and the disease or condition for which CORTONE is prescribed.

CORTONE Overdose

If you suspect an overdose, you should contact a poison-control center or emergency room immediately.

Less Serious Side Effects of CORTONE

Some less serious side effects of CORTONE may include:

•Acne, dry skin, or thinning skin

•Bruising or discoloration of skin

•Insomnia

•Mood changes

•Increased sweating

•Headache

•Dizziness

•Nausea, stomach pain, or bloating

•Slow wound healing

•Changes in the shape or location of body fat

Serious Side Effects of CORTONE

You should get emergency medical treatment if you experience any signs of anaphylaxis, a severe allergic reaction that may include hives; difficulty breathing; or swelling of the face, lips, tongue, or throat.

You should call your doctor at once if you experience any of the following serious side effects of CORTONE:

•Vision problems

•Swelling

•Rapid weight gain

•Shortness of breath

•Severe depression or unusual thoughts or behaviors

•Seizures

•Bloody or tarry stools

•Coughing up blood

•Symptoms of pancreatitis (severe pain in your upper stomach that spreads to your back; nausea and vomiting; or fast heart rate)

•Low potassium

•Dangerously high blood pressure

If you have either type 1 or type 2 diabetes, then your blood glucose levels may increase while taking CORTONE.

Talk to your doctor about the best way to test and treat this common side effect of CORTONE.

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

CORTONE can weaken your immune system, which could worsen an existing infection or make you more likely to get new infections. You should not use CORTONE if you have a fungal infection.

In addition, before taking it, you should tell your doctor if you've experienced a recent illness or infection. You should also avoid being in contact with people who are sick or have infections while taking CORTONE.

You should not receive any "live" virus vaccines while taking CORTONE. Live vaccines include measles, mumps, rubella (MMR), bacillus Calmette-Guerin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and the nasal flu vaccine.

Inactivated, or "non-live," vaccines can be taken. Ask your doctor if it's okay to be near other people who have been vaccinated with live vaccines.

Contact your doctor right away if you are exposed to chicken pox or measles while taking CORTONE. These conditions can be serious and even life-threatening if you are on corticosteroids.

Steroids may affect growth in kids. You should tell your doctor if you think your child is not growing at a normal rate while taking CORTONE.

Before taking CORTONE, you should tell your doctor if you have any of the following medical conditions:

•A thyroid disorder

•Diabetes

•Liver disease

•Kidney disease

•Tuberculosis

•A history of malaria

•Osteoporosis

•Any muscle disorder (such as myasthenia gravis)

•Herpes infection of the eyes

•Cataracts or glaucoma

•Depression or mental illness

•Congestive heart failure

•High blood pressure

•Stomach ulcers, ulcerative colitis, or diverticulitis

You could experience withdrawal symptoms if you stop taking this medication suddenly.

Don't stop taking CORTONE without first talking to your doctor.

You should tell all healthcare providers or medical workers that you are taking CORTONE.

It's also a good idea for you to wear a medical alert tag or carry an ID card that says you are taking the drug.

Pregnancy and CORTONE

It's not known whether CORTONE can harm an unborn baby.

You should talk to your doctor if you are pregnant or might become pregnant while taking this drug.

CORTONE can pass into breast milk and could harm a breastfeeding baby. Don't breastfeed while taking this medication.

You should tell your doctor about all prescription, nonprescription, illegal, recreational, herbal, nutritional, or dietary drugs you're taking while on CORTONE, especially:

•Aspirin

•Diuretics (water pills)

•Blood thinners such as warfarin (Coumadin, Jantoven)

•Cyclosporine (Restasis, Gengraf, Neoral, Sandimmune)

•Insulin or other diabetes medications you take by mouth

•Ketoconazole (Nizoral)

•Rifampin (Rifadin)

•Seizure medications such as phenytoin (Dilantin) or phenobarbital (Luminal, Solfoton)

CORTONE and Alcohol

You should limit your consumption of alcoholic beverages while taking CORTONE.

CORTONE and Other Interactions

This medication may make you dizzy.

You should not drive, operate machinery, or perform any activity that requires alertness until you are sure you can do so safely.

Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure.

• The recommended dose is one tablet in the morning preferably after breakfast.
• Swallow the tablet whole with a glass of water. The tablet must not be broken, crushed or chewed.
• Usually you will take this medicine daily for a maximum of eight weeks.
• Keep taking CORTIMENT tablets as your doctor has told you, even if you start feeling better.

Usual adult dose:

One 9 mg tablet once daily in the morning preferably after breakfast, for up to eight weeks.

Overdose:

If you take more CORTIMENT tablets than you should, inform your doctor immediately.

If you think you have taken too much CORTIMENT contact your healthcare professional, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms.

Missed dose:

If you forget to take CORTIMENT tablet, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose. Do not double dose to make up for the forgotten tablet.

Like all medicine, this medicine can cause side effects although not everybody gets them.

This medication usually has fewer side effects than other corticosteroid because CORTIMENT works in the gut and only small amount are absorbed into the body.

If you have an allergic reaction, see a doctor right away. Signs may include hives, swelling of the face, lips, mouth, tongue and throat. This can make it difficult to breathe.

The following side effects may happen with this medicine. Common side effects that may affect up to 1 in 10 people include:

• feeling sick.
• abdominal pain.
• bloated stomach.
• dry mouth.
• headache.
• feeling tired.
• Insomnia.
• muscle pain.
• upset stomach.

Other side effects include: dizziness, back pain, and muscle cramps.

If these side effects become bothersome, contact your doctor.These are not all the possible side effects you may feel when taking CORTIMENT. If you experience any side effects not listed here, contact your healthcare professional.

Medicines like CORTIMENT (corticosteroids) may affect the normal production of steroid hormones in your body. The effects include:

• changes to bone mineral density (thinning of the bones).
• glaucoma (increased pressure in the eye pressure).
• effects on the adrenal gland (small gland near the kidney).

CORTIMENT may lower your ability to fight infections and you should:

• avoid contact with people who have chicken pox or measles.
• contact your doctor if you have signs of infection such as:
  • fever.
  • pain.
  • ache, chills, feeling tired.
  • nausea, vomiting.

Using corticosteroid for a long time reduces your ability to handle stress. Before having an operation or emergency, contact your doctor if you are under stress and have symptoms such as:

• tiredness, weakness, feeling faint.
• Nausea, vomiting.

Using a corticosteroid may cause you to have too much steroid in your blood (hypercorticism). Talk to your doctor if you have symptoms of too much medicine such as:

• rounded face (moon face).
• fatty pad between your shoulders (buffalo hump).
• acne, bruise easily, ankle swelling.
• more or thicker hair on the body and face.

If you take other steroid medicines for allergies, switching to CORTIMENT may cause these allergies to come back. Contact your doctor if any allergies get worse.

Mental health problems may occur when taking steroids like CORTIMENT. This happens rarely when high doses are taken for a long time. Talk to a doctor if you or someone you know develops mental problems, especially depression or thoughts of self-harm (suicide) when taking CORTIMENT.

Talk about any health conditions or problems you may have, including if you:

• have liver or kidney problems.
• are about to have an operation.
• have chicken pox or measles or have recently have been near anyone with chicken pox.
• have an infection.
• have or had history of diabetes.
• have or had cataracts or increased pressure in the eye (glaucoma).
• have or had tuberculosis.
• have high blood pressure.
• have brittle bone.
• have stomach ulcers.
• have any other medical condition.
• are pregnant or plan to become pregnant. It is not known if CORTIMENT tablets can harm your unborn baby.
• are breastfeeding or plan to beast-feed. CORTIMENT can pass into breast milk and may harm your baby. You and your healthcare provider should decide if you will take CORTIMENT or breastfeed. You do not do both.
• are on other steroid therapy.

CORTIMENT is not recommended for use in children.

The following may interact with CORTIMENT:

• steroids, such as prednisolone or dexamethasone.
• cholestyramine, used to lower cholesterol levels or reduce itching caused by liver problems, antacids. Therefore these drugs should be taken two hours before or after CORTIMENT.
• ketoconazole or itraconazole, used to treat fungal infections.
• medicines that contain estrogens, such as hormone replacement therapy (HRT) and some oral contraceptives.
• cardiac glycosides and diuretics.
• HIV protease inhibitors such as ritonavir and nelfinavir.
• carbamazepine, used to treat epilepsy.

Do not eat grapefruit or drink grapefruit juice while taking CORTIMENT. These can increase the levels of CORTIMENT in your blood.

CORTIMENT contains lactose monohydrate, a type of sugar. If you have been told by your doctor that you have intolerance to some sugars, contact your doctor before taking this medicine.

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.