Adults:

The usual adult dose is 1 CLAVULIN 500 mg tablet every 12 hours. For more severe infections and infections of the lower respiratory tract, your doctor may prescribe 1 CLAVULIN 875 mg tablet every 12 hours or 1 CLAVULIN 500 mg tablet every 8 hours.

Children:

For children aged 12 weeks (3 months) and older as directed by a doctor:

Infants and children less than 12 weeks (3 months):

The recommended dose of CLAVULIN is 30 mg per kg per day in divided doses every 12 hours as directed by a doctor.

The children’s dosage should not exceed that recommended for adults. Children weighing more than 38 kg should be dosed according to the adult recommendations.

You must follow the doctor's advice and use the medicine as instructed. Your doctor will decide how much medicine you or your child need each day, and how many days you should take it for.

It is better to take CLAVULIN at the same time as a meal, but CLAVULIN still works if it is given without food.

If there is anything you do not understand please ask your doctor or pharmacist.

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.

Missed dose:

If you or your child miss a dose of CLAVULIN, take it as soon as you remember. However, if it is almost time for the next dose, do not take the missed dose. Instead, continue with your next scheduled dose. Do not try to make up for the missed dose by taking double the dose next time.

The following are very rare side-effects that may happen in people taking CLAVULIN:

• the tongue may change colour to yellow, brown or black, and it may have a hairy appearance.
• teeth discolouration while using CLAVULIN. This is less likely to happen if teeth are cleaned thoroughly, and any discolouration can usually be removed by brushing. If the discolouration does not disappear, ask your doctor or dentist for advice.

These are common side-effects that may happen in people taking CLAVULIN:

• a yeast infection of the nails, skin, mouth, vagina, stomach, urinary tract (mucocutaneous candidiasis)
• nausea (feeling sick) and vomiting (being sick) in adults and children
• diarrhoea (loose, or watery bowel movements) in children

These are uncommon side-effects that may happen in people taking CLAVULIN:

• indigestion
• headache

If you experience symptoms such as severe diarrhea (bloody or watery) with or without fever, abdominal pain, or tenderness, you may have Clostridium difficile colitis (bowel inflammation). If this occurs, stop taking Clavulin and contact your healthcare professional immediately.

BEFORE you use CLAVULIN talk to your doctor or pharmacist if you or your child:

• are allergic to amoxicillin or beta-lactam antibiotics (such as penicillins and cephalosporins) or any of the other ingredients of CLAVULIN. If you or your child have had an allergic reaction (such as a rash) when taking an antibiotic, you should talk to your doctor before taking CLAVULIN.
• develop a skin rash while taking CLAVULIN. Stop taking CLAVULIN and immediately tell your doctor.
• have glandular fever (mononucleosis) and are prescribed CLAVULIN. Please talk to your doctor before taking CLAVULIN.
• have liver or kidney problems.
• suffer from a condition called phenylketonuria (PKU). This is because CLAVULIN contains aspartame.
• are pregnant or planning to become pregnant.
• are breastfeeding or planning to breastfeed. Penicillins including amoxicillin are excreted in human breast milk. Discuss with your doctor.
• are taking a contraceptive pill as CLAVULIN may reduce the effectiveness of the contraceptive.

Some medicines may cause unwanted effects if they are taken at the same time as CLAVULIN. Please tell your doctor or pharmacist if you or your child are taking or have recently taken any other medicines or supplements, even those that can be bought without a prescription.

Tell your doctor especially if you or your child are taking or using any of the following medicines:

• allopurinol or probenecid (for treatment of gout)
• anticoagulants (used to prevent blood clots) such as warfarin
• mycophenolate mofetil (suppressed the immune system)

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

CLARINEX is usually taken once per day. Follow your doctor's instructions.

Do not crush, chew, or break the regular CLARINEX tablet. Swallow the pill whole.

Measure the liquid form of CLARINEX with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

To take CLARINEX orally disintegrating tablet (Clarinex RediTabs):

•Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.

•Using dry hands, remove the tablet and place it on your tongue. It will begin to dissolve right away.

•Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

•Swallow several times as the tablet dissolves. If desired, you may drink water to help swallow the dissolved tablet.

Store at room temperature away from moisture and heat.

Call your doctor if your symptoms do not improve.

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.

Call your doctor at once if you have any of these serious side effects:

•fast, pounding, or uneven heartbeat;

•fever, flu symptoms;

•seizure (convulsions); or

•jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

•dry mouth, sore throat, cough;

•muscle pain;

•drowsiness, tired feeling;

•nausea, diarrhea; or

•headache.

You should not take this medication if you are allergic to CLARINEX or to loratadine (Claritin).

Before taking CLARINEX, tell your doctor if you are allergic to any drugs, or if you have liver or kidney disease.

Do not give this medication to a child younger than 2 years old without the advice of a doctor.

CLARINEX disintegrating tablets (Clarinex RediTabs) may contain phenylalanine. Talk to your doctor before using this form of CLARINEX if you have phenylketonuria (PKU).

You should not take this medication if you are allergic to CLARINEX or to loratadine (Claritin).

To make sure you can safely take CLARINEX, tell your doctor if you have any of these other conditions:

•kidney disease; or

•liver disease.

FDA pregnancy category C. It is not known whether CLARINEX is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

CLARINEX can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medication to a child younger than 18 years old without the advice of a doctor.

CLARINEX disintegrating tablets (Clarinex RediTabs) may contain phenylalanine. Talk to your doctor before using this form of CLARINEX if you have phenylketonuria (PKU).

Do not give this medication to a child younger than 2 years old without the advice of a doctor.

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

There may be other drugs that can interact with CLARINEX. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

CLARINEX is usually taken once per day. Follow your doctor's instructions.

Do not crush, chew, or break the regular CLARINEX tablet. Swallow the pill whole.

Measure the liquid form of CLARINEX with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

To take CLARINEX orally disintegrating tablet (Clarinex RediTabs):

•Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.

•Using dry hands, remove the tablet and place it on your tongue. It will begin to dissolve right away.

•Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

•Swallow several times as the tablet dissolves. If desired, you may drink water to help swallow the dissolved tablet.

Store at room temperature away from moisture and heat.

Call your doctor if your symptoms do not improve.

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.

Call your doctor at once if you have any of these serious side effects:

•fast, pounding, or uneven heartbeat;

•fever, flu symptoms;

•seizure (convulsions); or

•jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

•dry mouth, sore throat, cough;

•muscle pain;

•drowsiness, tired feeling;

•nausea, diarrhea; or

•headache.

You should not take this medication if you are allergic to CLARINEX or to loratadine (Claritin).

Before taking CLARINEX, tell your doctor if you are allergic to any drugs, or if you have liver or kidney disease.

Do not give this medication to a child younger than 2 years old without the advice of a doctor.

CLARINEX disintegrating tablets (Clarinex RediTabs) may contain phenylalanine. Talk to your doctor before using this form of CLARINEX if you have phenylketonuria (PKU).

You should not take this medication if you are allergic to CLARINEX or to loratadine (Claritin).

To make sure you can safely take CLARINEX, tell your doctor if you have any of these other conditions:

•kidney disease; or

•liver disease.

FDA pregnancy category C. It is not known whether CLARINEX is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

CLARINEX can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medication to a child younger than 18 years old without the advice of a doctor.

CLARINEX disintegrating tablets (Clarinex RediTabs) may contain phenylalanine. Talk to your doctor before using this form of CLARINEX if you have phenylketonuria (PKU).

Do not give this medication to a child younger than 2 years old without the advice of a doctor.

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

There may be other drugs that can interact with CLARINEX. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

You should not use this medication if you are allergic to CLAFORAN or to similar antibiotics, such as cefdinir (Omnicef), cefprozil (Cefzil), cefuroxime (Ceftin), cephalexin (Keflex), and others.

You should not use this medicine if you are allergic to CLAFORAN, or to other cephalosporin antibiotics, such as:

•cefaclor (Raniclor);

•cefadroxil (Duricef);

•cefazolin (Ancef);

•cefdinir (Omnicef);

•cefditoren (Spectracef);

•cefpodoxime (Vantin);

•cefprozil (Cefzil);

•ceftibuten (Cedax);

•cefuroxime (Ceftin);

•cephalexin (Keflex); or

•cephradine (Velosef).

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

•an allergy to penicillin;

•kidney disease;

•liver disease;

•a stomach or intestinal disorder such as colitis;

•diabetes;

•a heart rhythm disorder; or

•if you also take furosemide.

This medicine is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

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

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

Call your doctor at once if you have:

•severe stomach pain, diarrhea that is watery or bloody;

•skin rash, bruising, severe tingling, numbness, pain, muscle weakness;

•seizure (black-out or convulsions); or

•severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

•pain, irritation, or a hard lump where the injection was given;

•mild diarrhea;

•fever; or

•itching or mild skin rash.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

CLAFORAN can harm your kidneys. This effect is increased when you also use certain other medicines, including: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, medicine to prevent organ transplant rejection, injectable osteoporosis medication, and some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).

Other drugs may interact with CLAFORAN, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

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

CLAFORAN is injected into a muscle or into a vein through an IV. It is sometimes given through a central IV line placed into a large vein in your chest. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

CLAFORAN must be mixed with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medication.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. CLAFORAN will not treat a viral infection such as the flu or a common cold.

This medication can cause unusual results with certain lab tests for glucose (sugar) in the urine. Tell any doctor who treats you that you are using CLAFORAN.

If your medicine is frozen when you receive it, keep it frozen until you are ready to use the medicine. It is best to store the medicine in a deep freezer at a temperature of 4 degrees below 0.

To use the medicine, thaw it in a refrigerator or at room temperature. Do not warm in a microwave or boiling water. Keep thawed medicine in the refrigerator and use it within 10 days after thawing it. Do not refreeze thawed medicine.

Apply a pea-sized amount of cream to each of 3 separate areas around the affected knee(s) 3 times a day. The applications should be evenly spaced out while you are awake and at least 4 hours apart.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Gently rub the cream in with one or two fingers around the entire surface of the affected knee(s) until the cream disappears. The cream should not be used on broken, irritated or compromised skin. Wash your hands with soap and warm water immediately after you apply the cream.

Do not apply the cream near the eyes, lips, or genital areas. Do not cover the area of skin where the cream has been applied with a bandage or wrap. Avoid taking a hot bath or shower before or after applying this medication as this may cause a burning sensation.

It is important to use this medication exactly as prescribed by your doctor. If you miss an application, apply it as soon as possible (as long at it is at least 4 hours until your next application) and continue with your regular schedule. If it is less than 4 hours until your next application, skip the missed application and continue with your regular dosing schedule. Do not apply a double application to make up for a missed one. If you are not sure what to do after missing an application, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children. Once the tube is open, it should be used within 6 weeks or before the expiry date, whichever is first.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• burning or warming sensation after application
• cough
• decreased skin sensation
• eye irritation
• skin irritation
• skin rash
• sneezing

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• swelling of the skin

Stop taking the medication and seek immediate medical attention if any of the following occur:

• symptoms of a severe allergic reaction (e.g., hives; difficulty breathing; swelling of the face, mouth, tongue, or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Eyes and face: Avoid contact of this medication with the eyes. If the cream gets in your eyes, wash the affected eye(s) with plenty of water. Avoid getting this cream near the face as it may cause coughing. It is important to wash your hands well after applying this medication to avoid contacting sensitive skin.

Other medical conditions: The safety and effectiveness of using this medication have not been established for knee pain caused by medical conditions other than osteoarthritis.

Other medications applied to the skin: You should avoid applying other medications to the skin where this medication is applied.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: It is not known if zucapsaicin passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 18 years of age.

There may be an interaction between zucapsaicin and any of the following:

• other medications applied to the skin (e.g., creams, ointments, gels, patches)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Treatment with these types of medications is most safe and effective when you and your doctor have good communication about how you are feeling.

Cipralex is not for use in children under 18 years of age.

New or Worsened Emotional or Behavioural Problems:

Particularly in the first few weeks or when doses are adjusted, a small number of patients taking drugs of this type may feel worse instead of better, they may experience new or worsened feelings of agitation, hostility, anxiety, or thoughts about suicide, or harm to others. Suicidal thoughts and actions can occur in any age group but may be more likely in patients 18 to 24 years old. Should this happen to you, or to those in your care, consult your doctor immediately. Close observation by a doctor is necessary in this situation. Do not discontinue your medication on your own.

You may be more likely to think like this if you have previously had thoughts about harming yourself.

You may find it helpful to tell a relative or close friend that you are depressed or have an anxiety disorder, and ask them to read this leaflet. You might ask them to tell you if they think your depression or anxiety is getting worse, or if they are worried about changes in your behaviour.

Effects on Pregnancy and Newborns:

If you are already taking/using CIPRALEX and have just found out that you are pregnant, you should talk to your doctor immediately. You should also talk to your doctor if you are planning to become pregnant.

Possible complications at birth (from taking any newer antidepressant, including CIPRALEX):

Post-marketing reports indicate that some newborns whose mothers took an SSRI (Selective Serotonin Reuptake Inhibitor) such as Cipralex or other newer antidepressant during pregnancy have developed complications at birth requiring prolonged hospitalisation, breathing support and tube feeding. Reported symptoms include: feeding and/or breathing difficulties, bluish skin, seizures, body temperature changes, vomiting, low blood sugar, tense or overly relaxed muscles, vivid reflexes, tremor, jitteriness, irritability, lethargy, sleepiness, sleeping difficulties and constant crying. In most cases, the newer antidepressant was taken during the third trimester of pregnancy. These symptoms are consistent with either a direct adverse effect of the antidepressant on the baby, or possibly a discontinuation syndrome caused by sudden withdrawal from the drug. These symptoms normally resolve over time. However, if your baby experiences any of these symptoms, contact your doctor as soon as you can.

Persistent Pulmonary Hypertension (PPHN) and newer antidepressants:

When taken during pregnancy, particularly in the last 3 months of pregnancy, medicines like CIPRALEX may increase the risk of a serious lung condition in babies, called persistent pulmonary hypertension of the newborn (PPHN), that causes breathing difficulties in newborns soon after birth, making the baby breathe faster and appear bluish. These symptoms usually begin during the first 24 hours after the baby is born. If this happens to your baby you should contact your doctor immediately.

If you are pregnant and taking an SSRI, or other newer antidepressant, you should discuss the risks and benefits of the various treatment options with your doctor. It is very important that you do NOT stop taking these medications without first consulting your doctor.

Risk of Bone Fractures:

Taking CIPRALEX may increase your risk of breaking a bone if you are elderly or have osteoporosis or have other major risk factors for breaking a bone. You should take extra care to avoid falls especially if you get dizzy or have low blood pressure.

Angle-closure Glaucoma:

CIPRALEX can cause dilation of the pupil which may trigger an acute glaucoma attack in an individual with narrow ocular angles. Having your eyes examined before you take CIPRALEX could help identify if you are at risk of having angle-closure glaucoma. Seek immediate medical attention if you experience:

• eye pain
• changes in vision
• swelling or redness in or around the eye.

Before you use CIPRALEX, tell your doctor

• All your medical conditions, including heart problems, history of seizures, manic-depressive illness, liver or kidney disease, or diabetes
• You have a bleeding disorder or have been told that you have low platelets
• If you have QT/QTc prolongation or a family history of QT/QTc prolongation
• If you have a personal history of fainting spells
• If you have a family history of sudden cardiac death at <50 years
• If you have electrolyte disturbances (e.g., low blood potassium, magnesium, or calcium levels) or conditions that could lead to electrolyte disturbances (e.g., vomiting, diarrhea, dehydration)
• If you have an eating disorder or are following a strict diet
• If you had a recent bone fracture or were told you have osteoporosis or risk factors for osteoporosis
• If you are pregnant or thinking about becoming pregnant, or if you are breast feeding
• If you are receiving electroconvulsive treatment
• Any medications (prescription or non-prescription) which you are taking or have taken within the last 14 days, especially monoamine oxidase inhibitors, pimozide, any other antidepressants, triptans used to treat migraines, lithium, tramadol or drugs containing tryptophan
• If you ever had an allergic reaction to any medication or any of the ingredients mentioned in this leaflet
• Your habits of alcohol and/or street drug consumption
• Any natural or herbal products you are taking (e.g. St. John's wort)
• If you drive a vehicle or perform hazardous tasks during your work

Cipralex may cause unwanted effects (side effects). These may include nausea, increased sweating, diarrhoea, fatigue, fever, constipation, clogged or runny nose, sleep disturbance, loss of appetite, increased appetite, increased weight, decreased interest in sex, decreased ability to reach orgasm, erectile dysfunction, anxiety, restlessness, abnormal dreams, difficulties falling asleep, drowsiness, yawning, tremor (shakiness), prickling of the skin, dizziness, dry mouth, heartburn, pain in muscles and joints, stomach pain and changes in heart rate.

Contact your doctor before stopping or reducing your dosage of CIPRALEX. Symptoms such as dizziness, abnormal dreams, electric shock sensations, agitation, anxiety, emotional indifference, difficulty concentrating, headache, migraine, tremor (shakiness), nausea, vomiting, sweating or other symptoms may occur after stopping or reducing the dosage of Cipralex. Such symptoms may also occur if a dose is missed. These symptoms usually disappear without needing treatment. Tell your doctor immediately if you have these or any other symptoms. Your doctor may adjust the dosage of escitalopram to reduce the symptoms.

Side effects are often mild and may disappear after a few days. If they are troublesome or persistent, or if you develop any other unusual side effects while taking CIPRALEX, please consult your doctor.

Usually CIPRALEX do not affect your ability to carry out normal daily activities. However, you should not drive a car or operate machinery until you are reasonably certain that CIPRALEX do not affect you adversely.

Serious Drug Interactions

Do not use CIPRALEX if you are taking or have recently taken:

• Monoamine oxidase inhibitor (e.g., phenelzine, tranylcypromine, moclobemide or selegiline)
• Pimozide
• Linezolid (an antibiotic)
• Methylene blue (intravenous)

The following list includes some, but not all, of the drugs that may increase the risk of side-effects while receiving CIPRALEX. You should check with your doctor or pharmacist before taking any other medication (prescription, non-prescription or natural/herbal) with CIPRALEX.

Other drugs that may interact with Cipralex include:

• Drugs to treat heart rhythm disturbances (antiarrhythmics)
• Antipsychotics
• Opioid painkillers
• Drugs to treat infections
• Diuretics (water pills)
• Laxatives (including enemas)
• Other SSRIs (citalopram) or any other antidepressant (e.g., imipramine, desipramine)
• Lithium
• Tryptophan
• Cimetidine
• Triptans (e.g., sumatriptan, zolmitriptan, naratriptan)
• Fluconazole
• Ketoconazole
• Itraconazole
• Racemic Citalopram (Celexa)
• Warfarin
• Omeprazole
• Any herbal product such as St. John's wort
• Certain medicines which may affect blood clotting and increase bleeding, such as oral anticoagulants (e.g., warfarin, dabigatran), acetylsalicylic acid (e.g., Aspirin) and other non-steroidal anti-inflammatory drugs (e.g., ibuprofen)
• Certain medicines used to treat pain, such as fentanyl (used in anaesthesia or to treat chronic pain), tramadol, tapentadol, meperidine, methadone, pentazocine
• Certain medicines used to treat cough, such as dextromethorphan.

Avoid drinking alcohol while taking CIPRALEX.

Drugs from the class that Cipralex belong to may increase the chance of a bleeding event such as nose bleeds, bruising and even life threatening bleeding. This is more likely if you have a history of a bleeding disorder or are taking other drugs that are known to affect your platelets.

Treatment with an SSRI in patients with diabetes may alter glycaemic control (hypoglycaemia and hyperglycaemia).

Tell your doctor all the medicines (prescription or over the counter) and natural health products that you are using or thinking of taking.

Usual dose:

• It is important that you take CIPRALEX exactly as your doctor has instructed.
• Usually your doctor will prescribe 10 mg per day, which you will take once daily preferably at the same time each day. If you are elderly, your doctor may prescribe a lower dose. This dose may be increased. Never change the dose of CIPRALEX you are taking, or that someone in your care is taking unless your doctor tells you to.
• You should continue to take CIPRALEX even if you do not feel better, as it may take several weeks for your medication to work. Improvement may be gradual.
• Continue to take CIPRALEX for as long as your doctor recommends it. Do not stop taking your tablets abruptly even if you begin to feel better, unless you are told to do so by your doctor. Your doctor may tell you to continue to take CIPRALEX for several months. Continue to follow your doctor's instructions.

Proper Handling Instructions:

Cipralex Tablets:

• Take everyday, as a single daily dose.
• Swallow the tablets whole with a drink of water. Do not chew them. Cipralex tablets can be taken with or without food.

Overdose:

• If you have accidentally taken too much CIPRALEX contact your doctor, the Regional Poison Control Centre or nearest hospital emergency department immediately, even if you do not feel sick. If you go to the doctor or the hospital, take the CIPRALEX container with you. Some of the signs of an overdose could be dizziness, tremor, agitation, convulsion, coma, nausea, vomiting, change in heart rhythm, decreased blood pressure and seizure.

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:

If you forget a dose, take the next dose as planned. Do not take a double dose to make up for a forgotten dose.

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

CETROTIDE is injected under the skin. You may be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes.

CETROTIDE is a powder medicine that must be mixed with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medicine.

Your care provider will show you the best places on your body to inject CETROTIDE. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

For best results, you will need to start using CETROTIDE injections on a certain day of your cycle. Follow your doctor's dosing instructions about when to use this medicine, and at what time of day to give your injections.

As part of your fertility treatment, you will be treated with a second medicine called human chorionic gonadotropin (hCG). You will receive an hCG injection only on days when your ovaries are ready for controlled ovulation to occur.

You will need frequent ultrasound examinations to check your ovaries for signs of readiness for ovulation. This will help your doctor determine when to give your hCG injection.

Store CETROTIDE in a refrigerator. Do not freeze. Keep the medicine in its original carton to protect it from light. Throw away any medicine not used before the expiration date on the medicine label.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Get emergency medical help if you have signs of an allergic reaction: hives or rash; cough, difficult breathing; feeling light-headed; swelling of your face, lips, tongue, or throat.

Some women using this medicine develop a condition called ovarian hyperstimulation syndrome (OHSS), especially after the first treatment. OHSS can be a life threatening condition.

Call your doctor right away if you have any of the following symptoms of OHSS:

•stomach pain, bloating;

•nausea, vomiting, diarrhea;

•rapid weight gain, especially in your face and midsection;

•little or no urination; or

•pain when you breathe, rapid heart rate, feeling short of breath (especially when lying down).

Common side effects may include:

•nausea;

•headache; or

•redness, bruising, itching, or swelling where the medicine was injected.

You should not use CETROTIDE if you have severe kidney disease, if you are pregnant or breast-feeding, or if you have ever had an allergic reaction to a medicine similar to CETROTIDE (such as Lupron, Antagon, Zoladex, Synarel, Zoladex, or others).

You should not use CETROTIDE if you are allergic to it, or if:

•you have severe kidney disease;

•you are pregnant;

•you are breast-feeding a baby;

•you are allergic to mannitol; or

•you have had an allergic reaction to other gonadotropin-releasing hormone medications (such as Lupron, Antagon, Zoladex, Synarel, Zoladex, or others).

Using CETROTIDE if you are already pregnant can cause birth defects, miscarriage, or stillbirth. Do not use if you are pregnant. You may need to have a negative pregnancy test before starting this treatment.

It is not known whether CETROTIDE passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

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

•kidney disease; or

•liver disease.

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Other drugs may interact with CETROTIDE, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.