Stelazine (Trifluoperazine)

Author , posted on June 29, 2017

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Trifluoperazine (Generic)

Trifluoperazine Hydrochloride

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Trifluoperazine (Generic)

Trifluoperazine Hydrochloride

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Stelazine (Trifluoperazine) Dosage and Side Effects

STELAZINE (trifluoperazine) is used to treat anxiety or psychotic disorders such as schizophrenia. STELAZINE is an anti-psychotic medicine in a group of drugs called phenothiazines (FEEN-oh-THYE-a-zeens). It works by changing the actions of chemicals in your brain.

Proper Use of this medication

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Call your doctor if your symptoms do not improve, or if they get worse while using STELAZINE.

Do not stop using STELAZINE suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using STELAZINE.

Store at room temperature away from moisture, heat, and light.

Seek emergency medical attention or call the Poison Help line.

Overdose symptoms may include dry mouth, constipation, extreme drowsiness or feeling restless and agitated, changes in heart rate, fainting, and seizure (convulsions).

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 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:

  • uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);
  • stiffness in your neck, tightness in your throat, trouble breathing or swallowing;
  • feeling restless, jittery, or agitated;
  • sudden weakness or ill feeling, fever, chills, sore throat, swollen gums, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough;
  • pale skin, easy bruising or bleeding;
  • decreased night vision, tunnel vision, watery eyes, increased sensitivity to light;
  • seizure (black-out or convulsions);
  • liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Common side effects may include:

  • dizziness, drowsiness, tired feeling;
  • blurred vision;
  • dry mouth, loss of appetite;
  • sleep problems (insomnia);
  • muscle weakness;
  • itching or rash;
  • missed menstrual periods; or
  • breast swelling or discharge.

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

STELAZINE is not approved for use in psychotic conditions related to dementia. STELAZINE may increase the risk of death in older adults with dementia-related conditions.

You should not use STELAZINE if you have bone marrow suppression, liver disease, a blood cell disorder, or if you have drowsiness, slow breathing, weak pulse, or decreased alertness (such as after drinking alcohol or taking medicines that make you sleepy).

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

  • bone marrow suppression;
  • liver disease;
  • a blood cell disorder such as anemia, low white blood cell counts, or low platelets; or
  • drowsiness, slow breathing, weak pulse, or decreased alertness (such as after drinking alcohol or taking medicines that make you sleepy).

STELAZINE is not approved for use in psychotic conditions related to dementia. STELAZINE may increase the risk of death in older adults with dementia-related conditions.

Long-term use of STELAZINE can cause a serious movement disorder that may not be reversible. Symptoms of this disorder include uncontrollable muscle movements of your lips, tongue, eyes, face, arms, or legs. The longer you take STELAZINE, the more likely you are to develop this movement disorder. The risk of this side effect is higher in women and older adults.

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

  • a brain tumor;
  • heart disease, high blood pressure;
  • kidney disease;
  • blockage in your digestive tract (stomach or intestines);
  • past or present breast cancer;
  • glaucoma;
  • seizures or epilepsy;
  • pheochromocytoma (tumor of the adrenal gland);
  • an enlarged prostate or urination problems; or
  • if you also take lithium or a blood thinner (warfarin, Coumadin, Jantoven).

Tell your doctor if you will be exposed to extreme heat or cold, or to insecticide poisons while you are taking STELAZINE.

Taking antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant while taking STELAZINE, do not stop taking it without your doctor's advice.

STELAZINE can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Talk with your doctor before giving this medicine to a child who has been ill with a fever or flu symptoms.

Interactions with this medication

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Drinking alcohol can increase certain side effects of STELAZINE.

Avoid exposure to sunlight or tanning beds. STELAZINE can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking STELAZINE with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with STELAZINE. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with STELAZINE.

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Retin-A Micro Gel Pump (Tretinoin)

Author , posted on June 29, 2017

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Retin-A Micro Gel Pump

Tretinoin

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Retin-A (Tretinoin) Dosage and Side Effects

RETIN-A is prescribed to treat acne, and to make wrinkles and fine lines smoother and less noticeable. RETIN-A is also given to people that have hyperpigmentation due to aging skin.

Proper Use of this medication

RETIN-A is available in a variety of strengths, ranging from 0.01 to 0.1 percent, and a variety of forms, such as creams, gels, and solutions.

No matter which form you're using, it's best to apply a pea-sized amount to the affected areas each night after you wash your skin.

Don't expect to notice the difference right away since it might take weeks or months before you see any visible improvements.

Use RETIN-A gel, cream, or liquid once a day to the affected area on your skin before going to bed.

If you are using the liquid, apply it with your fingertip, a gauze pad or cotton swab. Don't let the liquid run into non-affected areas.

Use RETIN-A exactly as prescribed. Don't use it longer than you are supposed to or increase the frequency or amount. This won't make it work faster, but it could lead to more side effects.

Before applying RETIN-A, wash and dry the area you plan to treat and wash your hands before and after you apply it.

Don't wash the treated area again or use other skin products on the treated area for at least one hour after RETIN-A is applied.

RETIN-A Overdose

RETIN-A is not likely to cause overdose symptoms, but if you think you have applied too much get emergency medical attention right away.

Missed Dose of RETIN-A

Never use extra medication to make up for a missed dose.

If you forget to use RETIN-A, put it on as soon as you remember unless it's almost time for the next dose.

If that is the case, then skip the missed dose and resume your regular schedule.

Side Effects

If you have sensitive skin, you may experience excessive redness, or your skin could become swollen, or develop blisters or crusting.

If any of these occur, you should either stop using RETIN-A until your skin returns to normal or ask your doctor to adjust the dose.

RETIN-A might also produce temporary discolored skin in the form of hyper- or hypopigmentation, and some people will become very sensitive to sunlight.

So far, all reported problems have been reversed when the medication is discontinued.

Some of the less serious side effects that people have reported are burning, warmth, stinging, tingling, itching and peeling of the skin.

Allergic Reaction to RETIN-A

If you have any of the following signs of an allergic reaction to RETIN-A, stop using the medicine and get emergency help immediately.

  • Hives
  • Difficulty breathing
  • Swelling of the face, lips, tongue, or throat

Warnings and Precautions

Don't use this drug if you are allergic to the cancer medication tretinoin (Vesanoid).

If you're using RETIN-A to treat acne, you should be aware that your condition might get slightly worse for a short period of time after you have started using it.

Contact your doctor if you have severe skin irritation or if your acne doesn't improve in eight to 12 weeks.

While on RETIN-A, it's important to avoid sunlight as well as sunlamps or tanning beds.

The medication might increase your sensitivity to sunlight, resulting in sunburn. Be sure to use an SPF 15 (or stronger) sunscreen and wear protective clothing if you're out in the sun.

Don't get RETIN-A in your eyes, mouth, or nose or on your lips. If this happens, wash the area with water immediately.

Never put RETIN-A on sunburned, wind burned, dry, chapped, irritated, or broken skin, and try not to get it on wounds or places where you have eczema.

It's best to wait until such conditions have healed before using RETIN-A.

To help your doctor decide if RETIN-A is appropriate for you, it's important that you disclose any and all health conditions.

It's particularly important that you mention whether you have allergies, sunburn, or other skin disorders like eczema since these are all indications that RETIN-A may not be the right choice for you.

Pregnancy and RETIN-A

RETIN-A is in FDA Pregnancy Category C, meaning that harm to a developing fetus can't be ruled out.

Some reports have suggested using it during pregnancy may be associated with birth defects, but no definitive link has been established.

Researchers also don't know if RETIN-A will pass into your breast milk and/or harm a breastfeeding child.

Let your doctor know right away if you are pregnant, planning to become pregnant, or breastfeeding so you can decide together whether you should use this drug.

Interactions with this medication

You might think RETIN-A won't interact with other medications because it is used topically, but that's not the case.

Provide a comprehensive list of all medicines you're taking, including topical and oral prescription and over-the-counter (OTC) drugs, vitamins, minerals and herbal products, to your doctor to avoid interactions.

Unless advised by your doctor, never use skin products containing benzoyl peroxide, sulfur, resorcinol, or salicylic acid. Using these with RETIN-A could cause your skin to become severely irritated.

Diuretics or water pills might interact with RETIN-A, causing your skin to be more sensitive to both natural and artificial sunlight.

Other medications might also have the same effect, including:

  • Tetracycline (Sumycin, Panmycin or Robitet)
  • Minocycline (Minocin)
  • Doxycycline (Doryx or Vibramycin)
  • Demeclocycline (Declomycin)
  • Ciprofloxacin (Cipro)
  • Ofloxacin (Floxin)
  • Sulfamethoxazole Trimethoprim (Bactrim, Septra, Cotrim)

A similar interaction may result from those listed below as well:

  • Chlorpromazine (Thorazine)
  • Prochlorperazine (Compazine)
  • Fluphenazine (Permitil or Prolixin)
  • Promethazine (Phenergan or Promethegan)
  • Perphenazine (Trilafon)

RETIN-A and Other Interactions

Since RETIN-A can make your skin more sensitive to natural and artificial sunlight, it's important that you avoid sunlamps or tanning beds.

If you are going out in the sun, wear a sunscreen with a minimum SPF 15 along with protective clothing.

In addition to sunlight, your skin might also become more sensitive to cold weather and wind while you are on RETIN-A.

It's also important that you try not to use skin products that might lead to irritation like harsh soaps, shampoos or skin cleansers, hair coloring or permanent chemicals, hair removers or waxes, as well as skin products with alcohol, spices, astringents, or lime.

Never use other medicated skin products unless told to do so by your doctor.

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Catapres TTS (Clonidine)

Author , posted on June 29, 2017

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Clonidine TTS (Generic)

Clonidine

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Catapres TTS (Clonidine) Medication Information

Uses

Catapres TTS transdermal therapeutic system is indicated in the treatment of hypertension. It may be employed alone or concomitantly with other antihypertensive agents.

Dosage

There are patches available in several different strengths of clonidine total content:

  • 0.1 mg
  • 0.2 mg
  • 0.3 mg

Side Effects

The most common side effects of Catapres TTS include:

  • Dry mouth
  • Drowsiness
  • Fatigue
  • Headache
  • Lethargy
  • Sedation
  • Insomnia
  • Dizziness

Speak with your doctor or pharmacist for a full list of side effects that applies to you.

Precautions

In patients who have developed localized contact sensitization to Catapres TTS (clonidine) transdermal therapeutic system continuation of Catapres TTS transdermal therapeutic system 3 Reference or substitution of oral clonidine hydrochloride therapy may be associated with development of a generalized skin rash. 

In patients who develop an allergic reaction to Catapres TTS transdermal therapeutic system, substitution of oral clonidine hydrochloride may also elicit an allergic reaction (including generalized rash, urticaria, or angioedema). 

The sympatholytic action of clonidine may worsen sinus node dysfunction and atrioventricular (AV) block, especially in patients taking other sympatholytic drugs. There are post-marketing reports of patients with conduction abnormalities and/or taking other sympatholytic drugs who developed severe bradycardia requiring IV atropine, IV isoproterenol and temporary cardiac pacing while taking clonidine. 

In hypertension caused by pheochromocytoma, no therapeutic effect of Catapres TTS transdermal therapeutic system can be expected. 

In rare instances, loss of blood pressure control has been reported in patients using Catapres TTS transdermal therapeutic system according to the instructions for use.

Interactions

Some of the common drug interactions with Catapres TTS:

  • Alcohol
  • Barbiturates
  • TCA antidepressants
  • Digoxin
  • Beta-blockers
  • Calcium channel blockers

Speak with your doctor or pharmacist for more information. 

Storage

Store below 86ºF. 

Pharmacist Tips

  • Do not to discontinue therapy without consulting their physician. Sudden cessation of clonidine treatment has, in some cases, resulted in symptoms such as nervousness, agitation, headache, tremor, and confusion accompanied or followed by a rapid rise in blood pressure and elevated catecholamine concentrations in the plasma.
  • Catapres TTS transdermal therapeutic system should not be used in patients with known hypersensitivity to clonidine or to any other component of the therapeutic system.
  • Safety and effectiveness in pediatric patients have not been established in adequate and well controlled trials.

Clonidine FAQs

How do I use this?

Apply the square Catapres TTS patch once a week, preferably at a convenient time on the same day of the week

 

Can I take this if I am pregnant?

No adequate well-controlled studies have been conducted in pregnant women. Clonidine crosses the placental barrier. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

 

Can I take this while breastfeeding?

As clonidine is excreted in human milk, caution should be exercised when Catapres TTS (clonidine) transdermal therapeutic system is administered to a nursing woman.

 

Where should I apply the patch?

Select a hairless area such as on the upper, outer arm or upper chest.

 

How do I dispose of the patch?

During or even after use, a patch contains active medication which may be harmful to infants and children if accidentally applied or ingested. After use, fold in half with the sticky sides together. Dispose of carefully out of reach of children.

 

How do I apply the adhesive cover?

The white, round, Adhesive cover does not contain any drug and should not be used alone. The cover should be applied directly over the Catapres TTS Patch only if the Patch begins to separate from the skin, thereby ensuring that it sticks to the skin for seven full days.

Related Drugs

Reference:

Catapres TTS {package insert}. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc.; 2011.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/018891s028lbl.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.

Catapres (Clonidine)

Author , posted on June 29, 2017

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Clonidine (Generic)

Clonidine Hydrochloride

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Clonidine (Generic)

Clonidine Hydrochloride

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Catapres (Clonidine) Dosage and Side Effects

CATAPRES is a medication used to treat high blood pressure.

Warnings and Precautions

Always tell your doctor if you have allergies to any medications.

Talk to your doctor about the danger of stopping CATAPRES suddenly, especially if you have any upcoming surgical procedures.

Most likely you will continue to take CATAPRES until just before surgery, and start up again soon after surgery. Doctors should monitor your blood pressure carefully during surgery.

Use CATAPRES cautiously if you have a history of heart problems or stroke, and make sure doctor is aware you have had these conditions.

Your doctor will also want to know, before starting you on CATAPRES, if you have any of these other conditions:

•Heart disease

•Previous heart attack

•Previous stroke

•A heart rhythm abnormality such as atrial fibrillation (afib) or ventricular fibrillation (vfib)

•Kidney disease

CATAPRES and Pregnancy

If you're a woman, let your doctor know if you are or could be pregnant or if you're breastfeeding.

There's not enough evidence to determine whether CATAPRES is safe to take during pregnancy, but experts do know that CATAPRES passes into breast milk.

If you become pregnant while taking CATAPRES, let your doctor know right away. Also, ask your doctor about breastfeeding before taking CATAPRES.

Children younger than 12 should not take CATAPRES.

Side Effects

The most common side effects of CATAPRES are dry mouth, drowsiness, dizziness, and constipation.

You may experience dizziness if you get up suddenly while using CATAPRES. These side effects are usually mild and diminish over time, but if you have any side effects from CATAPRES, let your doctor know.

It's especially important to call your doctor right away if you have any of these side serious side effects of CATAPRES:

•Rash or hives

•Difficulty breathing

•Difficulty swallowing

•Hoarseness

•Swelling of the face, throat, tongue, lips, or eyes

•Swelling or the legs, ankles, or hands

Other possible side effects of CATAPRES include:

•Fatigue

•Nervousness

•Headache

•Insomnia

•Depression

•Itching

•Nausea

•Vomiting

•Loss of appetite

•Decreased interest in sex or problems having sex

•Weight gain

•Muscle aches or cramps

•Joint pain

•Dry eyes and blurred vision

•Nightmares

You may be more at risk for side effects from CATAPRES if you are 65 or older. Ask your doctor if there are safer options for you than CATAPRES.

Interactions with this medication

Some drugs may affect the way CATAPRES works, and CATAPRES may affect other drugs you are taking.

It's very important to let your doctor know about all the drugs you take, including any over-the-counter drugs, illegal or recreational drugs, herbs or herbal preparations, or dietary or nutritional supplements.

When you take CATAPRES along with sedatives like alcohol, barbiturates, and some antidepressants, side effects like drowsiness may become more severe.

Some drugs used to treat heart disease may also interact with CATAPRES and cause side effects.

Types of drugs that interact with CATAPRES include:

•Blood pressure medications called beta-blockers, such as acebutolol (Sectral), atenolol (Tenormin, in Tenoretic), and betaxolol (Kerlone)

•Heart medications called calcium channel blockers, including amlodipine (Norvasc, in Caduet and Lotrel), diltiazem (Cardizem, Dilacor, Tiazac), and felodipine (Plendil, in Lexxel)

•The heart medication digoxin (Digitek, Lanoxicaps, Lanoxin)

•Antidepressants, especially tricyclic antidepressants, such as clomipramine (Anafranil), desipramine (Norpramin), and doxepin (Sinequan)

•Sleeping pills, such as Ambien

•Allergy medications

•Medications to treat anxiety, such as Xanax or Valium

•Seizure medications, including phenytoin (Dilantin) and levetiracetam (Keppra)

Other Interactions

CATAPRES can make you drowsy, so don't drive or participate in any hazardous activities until you know how CATAPRES affects you.

Drinking alcohol or using sedatives may also increase these side effects of CATAPRES.

In addition, your doctor may advise you to be on a low-salt diet to help treat your high blood pressure.

Proper Use of this medication

CATAPRES comes in tablets of 0.1, 0.2, and 0.3 milligrams (mg), and your doctor will try to find the lowest dose of CATAPRES that works for you.

You usually take CATAPRES twice a day at about the same times. A typical dose schedule for an adult with high blood pressure is 0.1 mg taken in the morning and at bedtime.

Your doctor may increase your dose by 0.1 mg each week until you have a good response. In most cases, a daily dose will end up between 0.2 and 0.6 mg given in divided doses.

People older than 65 and those with kidney disease may need to take lower doses of CATAPRES.

CATAPRES Overdose

Symptoms of a CATAPRES overdose may include:

•High blood pressure followed by low blood pressure

•Difficulty breathing

•Low body temperature

•Drowsiness

•Weakness

•Irritability

Symptoms usually occur within 30 minutes of an overdose, and children are much more likely to have symptoms of an overdose than adults.

A large overdose can cause abnormal heart rhythms, inability to breathe, seizure, and coma.

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Stieva-A Cream (Tretinoin)

Author , posted on June 28, 2017

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Stieva-A Cream (Tretinoin) Dosage and Side Effects

STIEVA-A topical cream is used in the treatment of acne. STIEVA-A topical cream is believed to accelerate skin growth and turn-over of cells and increase the flow of cellular debris such as dead skin cells and oils to the surface for elimination, thereby helping to reduce the acne condition.

Proper Use of this medication

STIEVA-A topical cream should only be applied to your skin.

If your doctor recommends (prescribes) another topical acne product, this should be applied at a different time of day as STIEVA-A topical cream.

Do not apply STIEVA-A to areas of skin where you have problems such as eczema, severely inflamed skin or other open lesions.

Do not use on sensitive areas such as irritated skin, eyes, mouth, lips, angles of nose, and corners of eyes and mouth and mucous producing areas.

How to Apply STIEVA-A Topical Cream:

  1. Wash your hands thoroughly before applying STIEVA-A.
  2. Completely remove any make-up.
  3. Wash affected area gently with warm water and a mild, non-irritating soap or cleanser, and pat dry.
  4. Apply STIEVA-A sparingly and evenly once daily, preferably before bedtime. Use your finger-tip to apply enough to cover the required area, and smooth in. Allow your skin to dry fully before applying cosmetics.
  5. Wash your hands thoroughly after applying STIEVA-A.
  6. In the morning, wash your face gently using a mild, non-irritating soap or cleanser.

At the beginning, you may experience redness, a burning sensation, peeling, or possibly a worsening of your acne while your skin adjusts to the medication.

Your doctor may recommend a daytime moisturizer if your skin is particularly dry.

To minimize these reactions, your doctor may start you on the mildest strength of STIEVA-A and go up gradually until you reach the strength that your doctor feels is most suitable for your skin type. Your doctor may advise you to apply the STIEVA-A less frequently than every day.

It takes several weeks of regular use of STIEVA-A before you can expect noticeable improvement and 8-10 weeks for optimal results, so be patient. Treat your acne with STIEVA-A for as long as your doctor tells you.

Applying too much or applying it more frequently will not help your skin clear up more quickly, and may cause skin irritation.

It is important to understand that your doctor has given you a prescription specially suited to your particular needs and skin type. Do not allow others to use it. Always use STIEVA-A exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

Overdose:

In case of drug overdose, contact your healthcare professional, hospital emergency department, or regional Poison Control Centre immediately, even if there are no symptoms.

If you accidentally swallow STIEVA-A, seek medical advice.

Missed dose:

If you forget to apply STIEVA-A topical cream at your regular time, apply STIEVA-A at the next usual time. Do not apply more than once a day to make up for forgotten applications.

Side Effects

During the first weeks of using STIEVA-A, you may notice some skin irritation such as redness and skin flaking. These symptoms will normally subside if you use STIEVA-A less often or stop using it for a few days and then start again.

Other side effects that have been reported are: skin pain, itching/itchy skin, skin irritation, tenderness, warm skin, especially when first applied, stinging or burning sensation, dry skin, swelling at the site of application, rash at the site of application, redness at the site of application, skin blistering, skin crusting, allergic reaction, darkening of skin, lightening of skin, sensitivity to sunlight and skin thinning. Talk to your doctor if any of the side effects become severe or troublesome.

Severe skin reactions (severe burning, peeling or itching of your skin) have also been reported. Stop taking STIEVA-A and contact your doctor immediately if you get any of these symptoms.

Warnings and Precautions

BEFORE you use STIEVA-A topical cream, talk to your doctor or pharmacist if:

  • You are currently or about to start using any other acne or skin medications.
  • You have had a previous reaction to any other acne or skin medication.
  • You have a family history of skin cancer.
  • You have any other skin condition, such as eczema any inflammatory skin condition, photoallergy, sensitive skin, or a fair complexion.
  • You have any ongoing skin irritation. This irritation should be resolved before starting treatment with STIEVA-A.
  • You are pregnant or planning to become pregnant. Topical tretinoin should not be used by pregnant women as rare birth defects have been reported with the use of topical tretinoin. It is not known if the birth defects were caused by topical tretinoin.
  • You are breastfeeding or planning to breastfeed.
  • You cannot avoid extensive exposure to sunlight, e.g., due to work requirements.

If you are a female of childbearing age, you should only use STIEVA-A topical cream after consulting your doctor and seeking his/her advice for contraceptive counselling. If you are pregnant or nursing a child, you should discontinue the use of STIEVA-A topical cream and consult your doctor. There is no information on how STIEVA-A might affect fertility.

STIEVA-A topical cream is for external use only. If you accidentally get STIEVA-A on irritated skin, in the eyes, mouth, or lips, rinse the affected area immediately with plenty of water.

Avoid or minimize exposure to sunlight and sun lamps because STIEVA-A topical cream heightens the susceptibility of your skin to the adverse effects of the sun. Use of a broad spectrum sunscreen with a sun protection factor (SPF) of at least 15 and protective clothing over treated areas is recommended when exposure cannot be avoided. If you have a sunburn, allow the sunburn to settle before starting treatment with STIEVA-A. If sunburn occurs while using STIEVA-A, stop using STIEVA-A and call your doctor for advice.

Extreme weather (e.g. cold or wind) may irritate your skin, avoid or minimize exposure.

Stop treatment and see your doctor if skin irritation is severe (severe redness, dryness, itching, stinging or burning) or your acne does not improve.

Interactions with this medication

Some medicines, skin procedures, or cosmetic products may affect how STIEVA-A topical cream works and may make it more likely that you will have side effects. Some of these may include:

  • Other acne or skin preparations including peeling agents (e.g. sulfur, resorcinol, salicylic acid). If irritation or dermatitis (redness, peeling, or discomfort) occurs, reduce the number of times you apply STIEVA-A or temporarily stop using STIEVA-A. Start usingSTIEVA-A again when the irritation goes away.
  • Drugs that make you more sensitive to light (e.g. thiazides, tetracycline, fluoroquinolones, phenothiazines, sulphonamides).
  • Drugs that contain benzoyl peroxide.
  • Skin procedures such as depilation, chemical hair treatments, chemical peels, dermabrasion or laser resurfacing. Following these procedures, allow skin to recover before starting treatment with STIEVA-A.
  • Cosmetics or skin products that have a strong drying effect (e.g., products with a high alcohol content, astringents, skin drying agents, after shave lotions) as they may irritate your skin. It is best to use only water-based cosmetics.
  • Cosmetic products that have a potential irritating effect (e.g., abrasive agents, products containing spices or limes).

Tell your doctor or pharmacist about all your other medications, including those you can buy without a prescription as well as herbal and alternative medications.

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Casodex (Bicalutamide)

Author , posted on June 28, 2017

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Casodex

Bicalutamide

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Casodex

Bicalutamide

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Bicalutamide (Generic)

Bicalutamide

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Bicalutamide (Generic)

Bicalutamide

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Casodex (Bicalutamide) Medication Information

Uses

Casodex is an androgen receptor inhibitor indicated for use in combination therapy with a luteinizing hormone-releasing hormone (LHRH) analog for the treatment of Stage D2 metastatic carcinoma of the prostate

Dosage

The oral tablets are available in 50 mg strength.

Side Effects

The most common side effects of Casodex include:

  • Hot flashes
  • Pain
  • Asthenia
  • Constipation
  • Infection
  • Nausea
  • Peripheral edema
  • Dyspnea
  • Diarrhea
  • Hematuria
  • Nocturia
  • Anemia 

Speak with your doctor or pharmacist for a full list of side effects that applies to you.

Precautions

Severe hepatic injury and fatal hepatic failure have been observed. Monitor serum transaminase levels prior to starting treatment with Casodex, at regular intervals for the first four months of treatment and periodically thereafter, and for symptoms or signs suggestive of hepatic dysfunction. Use Casodex with caution in patients with hepatic impairment. 

Hemorrhage with Concomitant Use of Coumarin Anticoagulant. Closely monitor the Prothrombin Time (PT) and International Normalized Ratio (INR), and adjust the anticoagulant dose as needed.

Gynecomastia and breast pain have been reported during treatment with Casodex 150 mg when used as a single agent. 

Casodex is used in combination with an LHRH agonist. LHRH agonists have been shown to cause a reduction in glucose tolerance in males. Consideration should be given to monitoring blood glucose in patients receiving Casodex in combination with LHRH agonists. 

Monitoring Prostate Specific Antigen (PSA) is recommended. Evaluate for clinical progression if PSA increases.

Interactions

Some of the common drug interactions with Casodex:

  • Dofetilide
  • Nimodipine
  • Tacrolimus
  • Warfarin 

Speak with your doctor or pharmacist for more information. 

Storage

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

Pharmacist Tips

  • Casodex and the LHRH analog should be started at the same time and you should not interrupt or stop taking these medications without consulting your healthcare provider.
  • It is recommended that Casodex be taken at the same time each day.
  • Somnolence has been reported. Patients who experience this symptom should observe caution when driving or operating machines

Bicalutamide FAQs

Can I take this with food?

Can be taken with or without food

 

Can I take this if I am pregnant?

Casodex is contraindicated for use in pregnant women because it can cause fetal harm. Casodex is not indicated for use in females.

 

Can I take this while breastfeeding?

Casodex is not indicated for use in pregnant women

 

What if I miss a dose?

If a dose of Casodex is missed, take the next dose at the scheduled time. Do not take the missed dose and do not double the next dose.

 

Does this need to be taken with other medications?

Treatment with Casodex should be started at the same time as treatment with an LHRH analog.

 

Can photosensitivity occur with Casodex?

Photosensitivity has been reported during treatment with Casodex and you should avoid direct exposure to excessive sunlight or UV-light exposure. Consideration should be given to the use of sunscreen.

Related Drugs

Reference:

Casodex {package insert}. Wilmington, DE: AstraZeneca; 2008.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020498s019s021lbl.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.

Retin-A Gel (Tretinoin)

Author , posted on June 28, 2017

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Retin-A Gel

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Retin-A (Tretinoin) Dosage and Side Effects

RETIN-A is prescribed to treat acne, and to make wrinkles and fine lines smoother and less noticeable. RETIN-A is also given to people that have hyperpigmentation due to aging skin.

Proper Use of this medication

RETIN-A is available in a variety of strengths, ranging from 0.01 to 0.1 percent, and a variety of forms, such as creams, gels, and solutions.

No matter which form you're using, it's best to apply a pea-sized amount to the affected areas each night after you wash your skin.

Don't expect to notice the difference right away since it might take weeks or months before you see any visible improvements.

Use RETIN-A gel, cream, or liquid once a day to the affected area on your skin before going to bed.

If you are using the liquid, apply it with your fingertip, a gauze pad or cotton swab. Don't let the liquid run into non-affected areas.

Use RETIN-A exactly as prescribed. Don't use it longer than you are supposed to or increase the frequency or amount. This won't make it work faster, but it could lead to more side effects.

Before applying RETIN-A, wash and dry the area you plan to treat and wash your hands before and after you apply it.

Don't wash the treated area again or use other skin products on the treated area for at least one hour after RETIN-A is applied.

RETIN-A Overdose

RETIN-A is not likely to cause overdose symptoms, but if you think you have applied too much get emergency medical attention right away.

Missed Dose of RETIN-A

Never use extra medication to make up for a missed dose.

If you forget to use RETIN-A, put it on as soon as you remember unless it's almost time for the next dose.

If that is the case, then skip the missed dose and resume your regular schedule.

Side Effects

If you have sensitive skin, you may experience excessive redness, or your skin could become swollen, or develop blisters or crusting.

If any of these occur, you should either stop using RETIN-A until your skin returns to normal or ask your doctor to adjust the dose.

RETIN-A might also produce temporary discolored skin in the form of hyper- or hypopigmentation, and some people will become very sensitive to sunlight.

So far, all reported problems have been reversed when the medication is discontinued.

Some of the less serious side effects that people have reported are burning, warmth, stinging, tingling, itching and peeling of the skin.

Allergic Reaction to RETIN-A

If you have any of the following signs of an allergic reaction to RETIN-A, stop using the medicine and get emergency help immediately.

  • Hives
  • Difficulty breathing
  • Swelling of the face, lips, tongue, or throat

Warnings and Precautions

Don't use this drug if you are allergic to the cancer medication tretinoin (Vesanoid).

If you're using RETIN-A to treat acne, you should be aware that your condition might get slightly worse for a short period of time after you have started using it.

Contact your doctor if you have severe skin irritation or if your acne doesn't improve in eight to 12 weeks.

While on RETIN-A, it's important to avoid sunlight as well as sunlamps or tanning beds.

The medication might increase your sensitivity to sunlight, resulting in sunburn. Be sure to use an SPF 15 (or stronger) sunscreen and wear protective clothing if you're out in the sun.

Don't get RETIN-A in your eyes, mouth, or nose or on your lips. If this happens, wash the area with water immediately.

Never put RETIN-A on sunburned, wind burned, dry, chapped, irritated, or broken skin, and try not to get it on wounds or places where you have eczema.

It's best to wait until such conditions have healed before using RETIN-A.

To help your doctor decide if RETIN-A is appropriate for you, it's important that you disclose any and all health conditions.

It's particularly important that you mention whether you have allergies, sunburn, or other skin disorders like eczema since these are all indications that RETIN-A may not be the right choice for you.

Pregnancy and RETIN-A

RETIN-A is in FDA Pregnancy Category C, meaning that harm to a developing fetus can't be ruled out.

Some reports have suggested using it during pregnancy may be associated with birth defects, but no definitive link has been established.

Researchers also don't know if RETIN-A will pass into your breast milk and/or harm a breastfeeding child.

Let your doctor know right away if you are pregnant, planning to become pregnant, or breastfeeding so you can decide together whether you should use this drug.

Interactions with this medication

You might think RETIN-A won't interact with other medications because it is used topically, but that's not the case.

Provide a comprehensive list of all medicines you're taking, including topical and oral prescription and over-the-counter (OTC) drugs, vitamins, minerals and herbal products, to your doctor to avoid interactions.

Unless advised by your doctor, never use skin products containing benzoyl peroxide, sulfur, resorcinol, or salicylic acid. Using these with RETIN-A could cause your skin to become severely irritated.

Diuretics or water pills might interact with RETIN-A, causing your skin to be more sensitive to both natural and artificial sunlight.

Other medications might also have the same effect, including:

  • Tetracycline (Sumycin, Panmycin or Robitet)
  • Minocycline (Minocin)
  • Doxycycline (Doryx or Vibramycin)
  • Demeclocycline (Declomycin)
  • Ciprofloxacin (Cipro)
  • Ofloxacin (Floxin)
  • Sulfamethoxazole Trimethoprim (Bactrim, Septra, Cotrim)

A similar interaction may result from those listed below as well:

  • Chlorpromazine (Thorazine)
  • Prochlorperazine (Compazine)
  • Fluphenazine (Permitil or Prolixin)
  • Promethazine (Phenergan or Promethegan)
  • Perphenazine (Trilafon)

RETIN-A and Other Interactions

Since RETIN-A can make your skin more sensitive to natural and artificial sunlight, it's important that you avoid sunlamps or tanning beds.

If you are going out in the sun, wear a sunscreen with a minimum SPF 15 along with protective clothing.

In addition to sunlight, your skin might also become more sensitive to cold weather and wind while you are on RETIN-A.

It's also important that you try not to use skin products that might lead to irritation like harsh soaps, shampoos or skin cleansers, hair coloring or permanent chemicals, hair removers or waxes, as well as skin products with alcohol, spices, astringents, or lime.

Never use other medicated skin products unless told to do so by your doctor.

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Carnitor (Levocarnitine)

Author , posted on June 28, 2017

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Carnitor

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Carnitor (Levocarnitine) Medication Information

Uses

Carnitor is indicated in the treatment of primary systemic carnitine deficiency. Carnitor is also indicated for acute and chronic treatment of patients with an inborn error of metabolism which results in a secondary carnitine deficiency.

Dosage

There are oral tablets available in 330 mg strength.

Side Effects

The most common side effects of Carnitor include:

  • Nausea/vomiting
  • Abdominal cramps
  • Diarrhea
  • Seizures 

Speak with your doctor or pharmacist for a full list of side effects that applies to you.

Precautions

Gastrointestinal reactions may result from a too rapid consumption of carnitine. They should be consumed slowly and doses should be spaced evenly throughout the day to maximize tolerance.

The safety and efficacy of oral levocarnitine has not been evaluated in patients with renal insufficiency. Chronic administration of high doses of oral levocarnitine in patients with severely compromised renal function or in ESRD patients on dialysis may result in accumulation of the potentially toxic metabolites, trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), since these metabolites are normally excreted in the urine.

Mutagenicity tests performed in Salmonella typhimurium, Saccharomyces cerevisiae, and Schizosaccharomyces pombe indicate that levocarnitine is not mutagenic. No long-term animal studies have been performed to evaluate the carcinogenic potential of levocarnitine.

Interactions

One of the possible drug interactions with Carnitor:

  • Warfarin

Speak with your doctor or pharmacist for more information. 

Storage

Store at controlled room temperature (77ºF). 

Pharmacist Tips

  • Monitoring should include periodic blood chemistries, vital signs, plasma carnitine concentrations and overall clinical condition.
  • The recommended oral dosage for adults is 990 mg two or three times a day using the 330 mg tablets, depending on clinical response.
  • There have been no reports of toxicity from levocarnitine overdose.

Levocarnitine FAQs

Can I take this with food?

Can be taken with or without food.

 

Can I take this if I am pregnant?

There are no adequate and well controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

 

Can I take this while breastfeeding?

In nursing mothers receiving levocarnitine, any risks to the child of excess carnitine intake need to be weighed against the benefits of levocarnitine supplementation to the mother. Consideration may be given to discontinuation of nursing or of levocarnitine treatment.

 

Can this be used in an IV?

For oral use only. Not for parenteral use.

 

What is Carnitor used for?

Carnitor is indicated for acute and chronic treatment of patients with a carnitine deficiency.

 

What are the contraindications for this medication?

None are known.

Reference:

Carnitor {package insert}. Amityville, NY: Sigma-tau Pharmaceuticals, Inc.; 2006.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/018948s024,019257s011lbl.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.

Cardura (Doxazosin)

Author , posted on June 28, 2017

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Cardura

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Cardura (Doxazosin) Medication Information

Uses

Cardura is an alpha1 adrenergic antagonist indicated for: 

  • Signs and symptoms of Benign Prostatic Hyperplasia (BPH) 
  • Treatment of Hypertension

Dosage

There are oral tablets available in several different strengths:

  • 1 mg
  • 2 mg
  • 4 mg
  • 8 mg

Side Effects

The most common side effects of Cardura include:

  • Fatigue
  • Malaise
  • Hypotension
  • Dizziness

Speak with your doctor or pharmacist for a full list of side effects that applies to you.

Precautions

Postural hypotension with or without syncope may occur.

Risk of Intraoperative Floppy Iris Syndrome during cataract surgery. 

Screen for the presence of prostate cancer prior to treatment for BPH and at regular intervals afterwards. 

Interactions

Some of the common drug interactions with Cardura:

  • Amifostine
  • Amphetamine
  • Aprepitant
  • Barbiturates
  • Beta-blockers
  • Calcium channel blocker
  • Duloxetine
  • Levodopa
  • Methylphenidate
  • Nitroprusside
  • Sildenafil 

Speak with your doctor or pharmacist for more information. 

Storage

Store at controlled room temperature (59º–86ºF). 

Pharmacist Tips

  • Avoid driving or hazardous tasks for 24 hours after the first dose, after a dosage increase, and after interruption of therapy when treatment is resumed.
  • Advise patients to report symptoms to their healthcare provider.

Doxazosin FAQs

Can I take this with food?

Can be taken with or without food.

 

Can I take this if I am pregnant?

The limited available data with Cardura in pregnant women are not sufficient to inform a drug-associated risk for major birth defects and miscarriage. However, untreated hypertension during pregnancy can result in increased maternal risks

 

Can I take this while breastfeeding?

There is limited information on the presence of Cardura in human milk]. There is no information on the effects of Cardura on the breastfeed infant or the effects on milk production.

 

Should I monitor my blood pressure when starting Cardura?

Following the initial dose and with each dose increase of Cardura, monitor blood pressure for at least 6 hours following administration. If Cardura administration is discontinued for several days, therapy should be restarted using the initial dosing regimen.

 

Can the dose be titrated?

Dose may be titrated at 1 to 2 week intervals.

 

Can this cause a painful erection?

Cardura can cause a painful erection (priapism), which cannot be relieved by having sex. If this happens, get medical help right away. If priapism is not treated, you may not be able to get an erection in the future

Related Drugs

Reference:

Cardura {package insert}. New York, NY: Pfizer Inc.; 2016.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019668s028lbl.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.

Retin-A Cream (Tretinoin)

Author , posted on June 28, 2017

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Retin-A Cream

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Buy Retin-A Cream Online

Looking for ways to save on Retin-A cream cost without having to search through endless websites? At PricePro Pharmacy we make it simple to save and extend our welcome if this is your first time visiting our helpful online pharmacy.

We can help you save up to 80% on your prescription cost and have the medication shipped your door. It's really that easy.

An order can be placed online or by calling 1-855-776-0079 and speaking to a customer service agent.

Please note a prescription for Retin-A cream will be required to place an order. The Rx can be faxed, emailed, uploaded, or we can even reach out to your doctor for a copy.

Click on "CHECK PRICES" to view product details.

Retin-A Cream (Tretinoin) Medication Information

Uses

Retin-A Cream is a prescription skin cream used to treat acne.  Retin-A Cream contains the active ingredient tretinoin and belongs to the retinoid drug class.  Retinoids are chemically similar to vitamin A and help support skin health.

Acne is a common condition that happens when skin pores become clogged.  Acne breakouts (pimples or zits) on the face and body are most common in adolescence but can continue into adulthood. 

Retin-A Cream may also be prescribed off-label (non-FDA-approved uses) to help reduce the appearance of fine lines (wrinkles), acne scars, or dark spots.

Dosage

Retin-A Cream comes in two sizes (20 gram and 45 gram tubes) and contains tretinoin in one of three different strengths: 

  • 0.1%
  • 0.05%
  • 0.025%  

Apply Retin-A Cream as directed by your physician.  Retin-A Cream is usually prescribed once daily before bedtime.  For sensitive skin, your doctor may suggest applying Retin-A every other night.  

First, wash your face with mild soap and gently pat dry.  Wait 20 to 30 minutes before applying Retin-A Cream.  Skin must be completely dry to minimize possible irritation.

Precautions

Retin-A cream may not be safe for everyone with acne.  Let your doctor know before using if you have any of the following conditions:

  • Eczema
  • Pregnant or plan to become pregnant
  • Breastfeeding or plan to breastfeed  

Side Effects

Retin-A Cream can cause side effects related to skin irritation:

  • Blisters
  • Puffiness
  • Redness
  • Temporary warmth or slight stinging
  • Sunlight sensitivity

If any of these side effects occur and are bothersome, talk with your doctor.  They may advise you to temporarily stop using Retin-A until your skin heals, or prescribe a different strength or less frequent use. 

Interactions

Using certain skin products may increase the risk of skin irritation.  You shouldn’t use the following skin products at all while using Retin-A Cream:

  • Astringents
  • Resorcinol
  • Salicylic acid
  • Sulfur
  • Any cleanser or product with a strong drying effect

Storage

Store Retin-A Cream at room temperature (77°F or 25°C).

Pharmacists Tips

  • Squeeze about a half-inch or less of cream onto the fingertip. This should be enough for your whole face. The cream should become invisible almost immediately. If not, you are using too much. 
  • Keep Retin-A Cream away from the corners of the nose, mouth, and eyes. Avoid open wounds.
  • Retin-A Cream can make your skin more sensitive to the sun.  You will need to take extra precautions in the sun, avoid artificial sunlight, and apply sunscreen every day.  If you get sunburned, stop Retin-A Cream treatment until your skin has healed.

Retin-A Cream FAQs

Why is my skin breaking out?  I started using Retin-A Cream a month ago.

Some people notice new blemishes around 3 to 6 weeks after starting treatment.  This is actually a sign that Retin-A Cream is working against deep acne that was previously below the skin’s surface.

 

How long does Retin-A Cream take to work?

Retin-A Cream works deep inside your skin which takes time.  Some improvement may be noticed after 3 weeks, but the full benefits of Retin-A Cream may take more than 6 weeks. 

 

How should I incorporate Retin-A Cream into my skincare routine?

In the morning, wash your face gently with a mild, non-medicated soap.  Pat dry.  Apply sunscreen.  If desired, apply non-drying skin products and cosmetics.   

In the evening, wash your face gently, without scrubbing.  Pat dry.  Wait 20 to 30 minutes, then apply a thin layer of Retin-A Cream.  Avoid corners of the nose, mouth, eyes, and open wounds.

Related Drugs

References

  1. Retin-A Cream Prescribing Information.  Skillman, NJ:  Ortho-McNeil Pharmaceutical, Inc.;2002. https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/16921s21s22s25lbl.pdf Accessed December 12, 2020.
  2. What is Acne? National Institute of Arthritis and Musculoskeletal and Skin Diseases; 2020. https://www.niams.nih.gov/health-topics/acne Accessed December 12, 2020.
  3. Wrinkles. Manríquez, J. et al.;2014. https://pubmed.ncbi.nlm.nih.gov/25569867/ Accessed December 12, 2020.

 

PharmD Medical Writer

Author: Dr. Patricia Weiser, PharmD

Patricia Weiser, PharmD, is a licensed pharmacist and medical writer.  She has clinical experience in community and hospital pharmacy.  Patricia is a 2007 graduate of the University of Pittsburgh. She resides in Pennsylvania with her husband and two daughters.

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