Boots Paracetamol Pain Relief 6 Years + 250mg / 5ml Suspension Strawberry Flavour

1. Name Of The Medicinal Product

Boots Paracetamol 6 Years Plus 250mg/5ml Suspension.

2. Qualitative And Quantitative Composition

Active ingredients	Per 5 ml
Paracetamol	250 mg

3. Pharmaceutical Form

Oral Suspension

4. Clinical Particulars

4.1 Therapeutic Indications

To relieve mild to moderate pain and reduce fever in many conditions including headache, toothache, feverishness, colds and influenza.

4.2 Posology And Method Of Administration

For oral use only.

It is important to shake the bottle for at least 10 seconds before use.

Child's Age	How Much	How Often (in 24 hours)
6-8 years	5 ml	4 times
8-10 years	7.5 ml	4 times
10-12 years	10 ml	4 times
Do not give more than 4 doses in any 24 hour period. Leave at least 4 hours between doses. Do not give this medicine to your child for more than 3 days without speaking to your doctor or pharmacist. Do not give to children under the age of 6 years.

Children aged 12-16 years: 10-15 ml up to 4 times a day.

Adults and children over 16 years: 10-20 ml up to 4 times a day.

Elderly: Dosage may need to be reduced because of the longer elimination half life and reduced plasma clearance of paracetamol.

4.3 Contraindications

Hypersensitivity to paracetamol or any of the other ingredients.

4.4 Special Warnings And Precautions For Use

Caution in patients with severely impaired liver or kidney function.

The label should contain the following statements:

Contains paracetamol.

Do not give this medicine with any other paracetamol-containing product.

For oral use only.

Never give more medicine than shown in the table.

Always use the syringe supplied with the pack.

Do not give to children under 6 years of age.

Do not give more than 4 doses in any 24 hour period.

Leave at least 4 hours between doses.

Do not give this medicine to your child for more than 3 days without speaking to your doctor or pharmacist.

As with all medicines, if your child is currently taking any medicine consult your doctor or pharmacist before taking this product.

Do not store above 25°C. Store in the original package.

Keep out of the reach and sight of children.

Immediate medical advice should be sought in the event of an overdose, even if the child seems well.

Do not exceed the stated dose.

If symptoms persist consult your doctor.

Leaflet or combined label/leaflet:

Immediate medical advice should be sought in the event of an overdose, even if the child seems well, because of the risk of delayed, serious liver damage.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

The speed of absorption of paracetamol may be increased by metoclopramide or domperidone and absorption reduced by cholestyramine.

The anticoagulant effect of warfarin and other coumarins may be enhanced by prolonged regular use of paracetamol with increased risk of bleeding; occasional doses have no significant effect.

Patients who have taken barbiturates, tricyclic antidepressants and alcohol may show diminished ability to metabolise large doses of paracetamol, the plasma half-life of which can be prolonged.

Alcohol can increase the hepatotoxicity of paracetamol overdosage and may have contributed to the acute pancreatitis reported in one patient who had taken an overdose of paracetamol.

Chronic ingestion of anticonvulsants or oral steroid contraceptives induce liver enzymes and may prevent attainment of therapeutic paracetamol levels by increasing first pass metabolism or clearance.

4.6 Pregnancy And Lactation

Epidemiological studies in human pregnancy have shown no ill effects due to paracetamol used in the recommended dosage, but patients should follow the advice of their doctor regarding its use.

Paracetamol is excreted in breast milk but not in a clinically significant amount. Available published data do not contraindicate breast feeding.

4.7 Effects On Ability To Drive And Use Machines

No adverse effects known.

4.8 Undesirable Effects

Adverse effects of paracetamol are rare but hypersensitivity including skin rash may occur. Very rarely there have been reports of blood dyscrasias including thrombocytopenia and agranulocytosis, but these were not necessarily causally related to paracetamol.

4.9 Overdose

Symptoms of paracetamol overdosage in the first 24 hours include pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may become apparent 12 to 48 hours after ingestion as liver function tests become abnormal. Abnormalities of glucose metabolism and metabolic acidosis may occur. In severe cases liver failure may lead to encephalopathy, coma and death. Acute renal failure with acute tubular necrosis may develop with or without severe liver damage. Cardiac arrhythmias and pancreatitis have been reported.

Liver damage is likely in adults who have taken 10 g or more of paracetamol. It is considered that excess quantities of a toxic metabolite (usually adequately detoxified by glutathione when normal doses of paracetamol are ingested), become irreversibly bound to liver tissue.

Immediate treatment is essential in the management of paracetamol overdose. Despite a lack of significant early symptoms, patients should be referred to hospital urgently for immediate medical attention and any patient who has ingested around 7.5 g or more of paracetamol in the preceding 4 hours should undergo gastric lavage. Administration of oral methionine or intravenous N-acetylcysteine which may have a beneficial effect up to at least 48 hours after the overdose, may be required. General supportive measures must be available.

5. Pharmacological Properties

5.1 Pharmacodynamic Properties

Paracetamol is a peripherally acting analgesic with antipyretic activity.

5.2 Pharmacokinetic Properties

Paracetamol is readily absorbed from the gastrointestinal tract with peak plasma concentrations occurring about 30 minutes to 2 hours after ingestion. Paracetamol is metabolised in the liver and excreted in the urine mainly as the glucuronide and sulphate conjugates, with about 10% as glutathione conjugates. Less than 5% is excreted as unchanged paracetamol.

Plasma protein binding is negligible at usual therapeutic concentrations, although this is dose dependent. The plasma elimination half life varies from about one to four hours.

5.3 Preclinical Safety Data

There are no preclinical data of relevance to the prescriber which are additional to that already included.

6. Pharmaceutical Particulars

6.1 List Of Excipients

Sorbitol solution

Glycerol

Dispersible cellulose (containing microcrystalline cellulose and sodium carboxymethylcellulose)

Hydroxyethylcellulose

Acesulfame potassium

Methyl hydroxybenzoate

Strawberry flavour ABJH9 (containing benzyl alcohol, ethyl benzoate, propylene glycol)

Cream flavour ACP3P (containing propylene glycol)

Purified water

6.2 Incompatibilities

Not applicable.

6.3 Shelf Life

24 months

6.4 Special Precautions For Storage

Do not store above 25ºC.

6.5 Nature And Contents Of Container

70ml, 80ml, 90ml, 100ml, 120ml, 130ml, 140ml, 150ml, 200ml, 250ml 300ml amber PET bottle with polypropylene child resistant closure with expanded polyethylene liner or polyethylene plug.

Syringe composed of a natural polypropylene barrel and a polyethylene pigmented white plunger.

Not all pack sizes may be marketed.

6.6 Special Precautions For Disposal And Other Handling

Not applicable.

7. Marketing Authorisation Holder

The Boots Company PLC

1 Thane Road West

Nottingham NG2 3AA

Trading as BCM

8. Marketing Authorisation Number(S)

PL 00014/0619

9. Date Of First Authorisation/Renewal Of The Authorisation

27 November 2000

10. Date Of Revision Of The Text

September 2011

Dopamine 40 mg / ml Sterile Concentrate

1. Name Of The Medicinal Product

Dopamine 40 mg/ml Sterile Concentrate

2. Qualitative And Quantitative Composition

Each ml of concentrate contains 40 mg dopamine hydrochloride

Each 5 ml ampoule of concentrate contains 200 mg dopamine hydrochloride

For excipients, see 6.1.

3. Pharmaceutical Form

Concentrate for solution for infusion

Ampoules containing a clear colourless or pale yellow solution

4. Clinical Particulars

4.1 Therapeutic Indications

Dopamine is indicated for the correction of haemodynamic imbalance present in:

1) Acute hypotension or shock associated with myocardial infarction, endotoxic septicaemia, trauma and renal failure.

2) As an adjunct after open heart surgery where there is persistent hypotension after correction of hypovolaemia.

3) In chronic cardiac decompensation as in congestive failure.

4.2 Posology And Method Of Administration

To be administered by intravenous infusion only after dilution with the appropriate diluents.

ADULTS

Where appropriate, the circulating blood volume must be restored with a suitable plasma expander or whole blood, prior to administration of dopamine hydrochloride.

Begin infusion of dopamine hydrochloride solution at doses of 2.5 microgram/kg/min in patients who are likely to respond to modest increments of heart force and renal perfusion.

In more severe cases, administration may be initiated at a rate of 5 microgram/kg/min and increased gradually in 5- to 10 microgram/kg/min increments up to 20 to 50 microgram/kg/min as needed. If doses in excess of 50 microgram/kg/min are required, it is advisable to check urine output frequently.

Should urinary flow begin to decrease in the absence of hypotension, reduction of dopamine dosage should be considered. It has been found that more than 50% of patients have been satisfactorily maintained on doses less than 20 microgram/kg/min.

In patients who do not respond to these doses, additional increments of dopamine may be given in an effort to achieve adequate blood pressure, urine flow and perfusion generally.

Treatment of all patients requires constant evaluation of therapy in terms of blood volume, augmentation of cardiac contractility, and distribution of peripheral perfusion and urinary output.

Dosage of dopamine should be adjusted according to the patient's response, with particular attention to diminution of established urine flow rate, increasing tachycardia or development of new dysrhythmias as indications for decreasing or temporarily suspending the dosage.

CHILDREN

The safety and efficacy of dopamine in paediatric patients has not been established.

GERIATRIC

No variation in dosage is suggested for geriatric patients. However, close monitoring is suggested for blood pressure, urine flow and peripheral tissue perfusion.

4.3 Contraindications

Dopamine should not be used in patients with phaeochromocytoma or hyperthyroidism.

Dopamine should not be used in the presence of uncorrected atrial or ventricular tachyarrhythmias or ventricular fibrillation.

Cyclopropane and halogenated hydrocarbon anaesthetics should be avoided.

4.4 Special Warnings And Precautions For Use

Dopamine should not be used in the presence of uncorrected tachyarrhythmias or ventricular fibrillation. Nor should be used in patients with phaeochromocytoma or hyperthroidism. Cyclopropane and halogenated hydrocarbon anaesthetics should be avoided.

Patients who have been treated with MAO inhibitors prior to dopamine should be given reduced doses; the starting dose should be one tenth (¹/₁₀th) of the usual dose.

Excess administration of potassium-free solutions may result in significant hypokalaemia.

The intravenous administration of these solutions can cause fluid and/or solute overloading resulting in dilution of serum electrolyte concentrations, overhydration, congested states or pulmonary oedema.

Precautions:

Hypovolaemia should be corrected where necessary prior to dopamine infusion. Low doses should be used in shock due to acute myocardial infarction.

If a disproportionate rise in diastolic pressure (i.e. a marked decrease in pulse pressure) is observed, the infusion rate should be decreased and the patients observed carefully for further evidence of predominant vasoconstriction activity, unless such an effect is desired.

Patients with a history of peripheral vascular disease should be closely monitored for any changes in colour or temperature of the skin of the extremities. If change of skin colour or temperature occurs and is thought to be the result of compromised circulation to the extremities, the benefits of continued dopamine infusion should be weighed against the risk of possible necrosis. These changes may be reversed by decreasing the rate or discontinuing the infusion. IV administration of phentolamine mesylate 5-10 mg may reverse the ischaemia.

Dopamine hydrochloride in 5% dextrose injection should be infused into a large vein whenever possible to prevent the possibility of infiltration of perivascular tissue adjacent to the infusion site. Extravasation may cause necrosis and sloughing of the surrounding tissue. Ischaemia can be reversed by infiltration of the affected area with 10-15 ml of saline containing 5 to 10 mg phentolamine mesylate. A syringe with a fine hypodermic needle should be used to liberally infiltrate the ischaemic area as soon as extravasation is noted.

Dopamine should be used with extreme caution in patients inhaling cyclopropane or halogenated hydrocarbon anaesthetics due to the arterial arrhythmogenic potential.

Dextrose solutions should be used with caution in patients with known subclinical or overt diabetes mellitus.

As the effect of dopamine on impaired renal and hepatic function is not known, close monitoring is advised.

Dopamine infusion should be withdrawn gradually, to avoid unnecessary hypotension.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

i) Anaesthetics:

The myocardium is sensitised by the effect of dopamine, cyclopropane or halogenated hydrocarbon anaesthetics, and these should be avoided. This interaction applies both to pressor activity and cardiac beta adrenergic stimulation.

ii) Alpha and Beta Blockers:

The cardiac effects of dopamine are antagonised by β -adrenergic blocking agents such as propanolol and metoprolol, and the peripheral vasoconstriction caused by high doses of dopamine is antagonised by α adrenergic blocking agents. Dopamine-induced renal and mesenteric vasodilation is not antagonised by either α or β-adrenergic blocking agents, but, in animals, is antagonised by haloperidol or other butrophenones, phenothiazines, and opiates.

iii) Monoamine Oxidase (MAO) Inhibitors:

MAO inhibitors potentiate the effect of dopamine and its duration of action. Patients who have been treated with MAO inhibitors prior to administration of dopamine will therefore require a substantially reduced dosage. (The starting dose should be reduced to at least ¹/₁₀th of the usual dose.

(iv) Phenytoin:

Administration of IV phenytoin to patients receiving dopamine has resulted in hypotension and bradycardia; some clinicians recommend that phenytoin be used with extreme caution, if at all, in patients receiving dopamine.

Dopamine may increase the effect of diuretic agents.

The ergot alkaloids should be avoided because of the possibility of excessive vasoconstriction. Tricyclic antidepressants and guanethidine may potentiate the pressor response to dopamine.

4.6 Pregnancy And Lactation

Use in Pregnancy:

Animal studies have shown no evidence of teratogenic effects with dopamine. However, the effect of dopamine on the human foetus is unknown. Therefore the drug should be used in pregnant women only when the expected benefits outweigh the potential risk to the foetus.

Use in Lactation:

It is not known if dopamine is excreted in breast milk, nor is the effect on the infant known.

4.7 Effects On Ability To Drive And Use Machines

Not applicable.

4.8 Undesirable Effects

Adverse reactions to dopamine are related to its pharmacological action.

More common reactions include:-
Cardiovascular:	Ectopic heart beats, tachycardia, anginal pain, palpitation, hypotension, vasoconstriction.
Gastrointestinal:	Nausea, vomiting
Nervous System:	Headache
Respiratory:	Dyspnoea.
Less common reactions include:-
Biochemical Abnormalities:	Azotaemia
Cardiovascular:	Aberrant conduction, bradycardia, widened QRS complex, hypertension, gangrene, fatal ventricular arrhythmias have been reported on rare occasions.
Eye Disorders:	Mydriasis
Nervous System:	Piloerection.
Serious or Life-threatening Reactions:
Gangrene of the feet has occurred following doses of 10-14 microgram/kg/min and higher in a few patients with pre-existing vascular disease.

4.9 Overdose

Excessive elevation of blood pressure and vasoconstriction can occur due to the alpha adrenergic actions of dopamine, especially in patients with a history of occlusive vascular disease. If desired, this condition can be rapidly reversed by dose reduction or discontinuing the infusion, since dopamine has a half-life of less than 2 minutes in the body.

Should these measures fail, an infusion of an alpha adrenergic blocking agent, e.g., phentolamine mesylate, should be considered.

Dopamine at the infusion site can cause local vasoconstriction hence the desirability of infusing into a large vein. The resulting ischaemia can be reversed by infiltration of the affected area with 10-15 ml of saline containing 5 mg to 10 mg phentolamine mesylate. A syringe with a fine hypodermic needle should be used to liberally infiltrate the ischaemic area as soon as extravasation is noted.

Accidental Overdosage:

Accidental overdosage as evidenced by excessive blood pressure elevation can be controlled by dose reduction or discontinuing the dopamine infusion for a short period, since the duration of action of dopamine is short.

Should these measures fail, an infusion of phentolamine mesylate should be considered.

5. Pharmacological Properties

5.1 Pharmacodynamic Properties

Dopamine stimulates adrenergic receptors of the sympathetic nervous system. The drug has principally a direct stimulatory effect on β₁-adrenergic receptors, but also appears to have an indirect effect by releasing norepinephrine from its storage sites. Dopamine also appears to act on specific dopaminergic receptors in the renal, mesenteric, coronary, and intracerebral vascular beds to cause vasodilation. The drug has little or no effect on β₂-adrenergic receptors.

In IV doses of 0.5-2 microgram/kg per minute, the drug acts predominantly on dopaminergic receptors; in IV doses of 2-10 microgram/kg per minute, the drug also stimulates β₁-adrenergic receptors. In higher therapeutic doses, α-adrenergic receptors are stimulated and the net effect of the drug is the result of α-adrenergic, β₁-adrenergic, and dopaminergic stimulation. The main effects of dopamine depend on the dose administered. In low doses, cardiac stimulation and renal vascular dilation occur and in larger doses vasoconstriction occurs. It is believed that α-adrenergic effects result from inhibition of the production of cyclic adenosine -31, 51-monophosphate (cAMP) by inhibition of the enzyme adenyl cyclase, whereas β-adrenergic effects result from stimulation of adenyl cyclase activity.

5.2 Pharmacokinetic Properties

Absorption:

Orally administered dopamine is rapidly metabolised in the G.I. tract. Following IV administration, the onset of action of dopamine occurs within 5 minutes, and the drug has a duration of action of less than 10 minutes.

Distribution:

The drug is widely distributed in the body but does not cross the blood-brain barrier to a substantial extent. It is not known if dopamine crosses the placenta.

Elimination:

Dopamine has a plasma half-life of about 2 minutes. Dopamine is metabolised in the liver, kidneys, and plasma by monoamine oxidase (MAO) and catechol-0-methyltransferase to the inactive compounds homovanillic acid (HVA) and 3,4-dihydroxyphenylacetic acid. In patients receiving MAO inhibitors, the duration of action of dopamine may be as long as 1 hour. About 25% of a dose of dopamine is metabolised to norepinephrine within the adrenergic nerve terminals.

Dopamine is excreted in urine principally as HVA and its sulphate and glucuroide conjugates and as 3,4-dihydroxyphenylacetic acid. A very small fraction of a dose is excreted unchanged. Following administration of radio labelled dopamine, approximately 80% of the radioactivity reportedly is excreted in urine within 24 hours.

5.3 Preclinical Safety Data

There is no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC.

6. Pharmaceutical Particulars

6.1 List Of Excipients

Sodium metabisulphite and Water for Injections

6.2 Incompatibilities

Dopamine Sterile Concentrate should not be added to any alkaline intravenous solutions, i.e. sodium bicarbonate. Any solution which exhibits physical or chemical incompatibility through a colour change or precipitate should not be administered.

It is suggested that admixtures containing gentamicin sulphate, cephalothin sodium, cephalothin sodium neutral or oxacillin sodium should be avoided unless all other viable alternatives have been exhausted.

Admixtures of ampicillin and dopamine in 5% glucose solution are alkaline and incompatible and result in decomposition of both drugs. They should not be admixed.

Admixtures of dopamine, amphotericin B in 5% glucose solution are incompatible as a precipitate forms immediately on mixing.

6.3 Shelf Life

As packaged for sale: 3 years.

In-use: Following dilution in the recommended diluents (see Section 6.6), chemical and physical in-use stability has been demonstrated for 48 hours at a temperature not above 25^oC.

However, from a microbiological point of view, the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would normally not be longer than 24 hours at 2-8^oC unless dilution has taken place in controlled and validated aseptic conditions.

6.4 Special Precautions For Storage

As packaged for sale: Do not store above 30^oC. Keep container in the outer carton.

In use: See 6.3.

6.5 Nature And Contents Of Container

Clear, type I, glass ampoules. Pack Size : 5's and 50's ampoules

6.6 Special Precautions For Disposal And Other Handling

For single use. Discard any unused contents.

Do not use if the solution is discoloured.

Preparation of Infusion Solutions

Suggested Dilution

Aseptically transfer Dopamine Sterile Concentrate into the IV solution as shown in the following table :-

Strength of Concentrate	Volume of concentrate	IV Solution Volume	Final Concentration
	ml	ml	microgram/ml
200 mg/5 ml	5	500	400
200 mg/5 ml	5	250	800
200 mg/5 ml	10	250	1600
200 mg/5 ml	20	500	1600
800 mg/5 ml	5	500	1600
800 mg/5 ml	5	250	3200

Dopamine hydrochloride can be diluted with:-

Sodium Chloride (0.9%) Intravenous Infusion

Dextrose (5%), sodium chloride (0.45%) solution

Sodium Lactate Intravenous Infusion, Compound (Hartmann's Solution for Injection)

7. Marketing Authorisation Holder

Hospira UK Limited

Queensway

Royal Leamington Spa

Warwickshire, CV31 3RW

United Kingdom

8. Marketing Authorisation Number(S)

PL 04515/0011

9. Date Of First Authorisation/Renewal Of The Authorisation

09 September 2005

10. Date Of Revision Of The Text

02 January 2008

Burning Mouth Syndrome (Glossopyrosis) Medications

Definition of Burning Mouth Syndrome: Burning mouth syndrome is a condition that involves a sensation of burning and pain in the tongue, gums, roof of the mouth, and cheeks.

Drugs associated with Burning Mouth Syndrome

The following drugs and medications are in some way related to, or used in the treatment of Burning Mouth Syndrome. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

Drug List:

Aventyl

Capzasin-Quick-Relief

Dentipatch

Dr-S-Cream

Elavil

Fanatrex

Gabarone

Gnp-Capsaicin-Lotion

Klonopin

Klonopin-Wafer-Orally-Disintegrating-Tablets

Neurontin

Pamelor

Trixaicin

Vanatrip

Zostrix-Diabetic-Foot-Pain

Zostrix-Foot-Pain

Zostrix-Neuropathy

Potiga

Generic Name: ezogabine (Oral route)

e-ZOG-a-been

Commonly used brand name(s)

In the U.S.

• Potiga

Available Dosage Forms:

• Tablet

Uses For Potiga

Ezogabine is used together with other medicines to control partial seizures (convulsions) in the treatment of epilepsy.

Ezogabine belongs to a class of medicines called anticonvulsants. It acts in the brain to prevent seizures. However, this medicine cannot cure epilepsy and will only work to control seizures for as long as you continue to take it.

This medicine is available only with your doctor's prescription.

Before Using Potiga

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of ezogabine in the pediatric population. Safety and efficacy have not been established.

Geriatric

Although appropriate studies on the relationship of age to the effects of ezogabine have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have age-related prostate and kidney problems, which may require caution and an adjustment in the dose for patients receiving ezogabine.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

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

• Carbamazepine


• Digoxin


• Lamotrigine


• Phenytoin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Congestive heart failure or


• Depression or


• Drug abuse or dependence, history of or


• Electrolyte imbalance (e.g., low magnesium or potassium in the blood) or


• Enlarged prostate or


• Heart disease or


• Heart rhythm problems (e.g., QT prolongation, long QT syndrome) or


• Mental illness or


• Urinating problems (e.g., urinary retention, benign prostatic hypertrophy)—Use with caution. May make these conditions worse.

• Kidney disease, moderate to severe or receiving dialysis or


• Liver disease, moderate to severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body. Your doctor will adjust your dose if you have this condition.

Proper Use of Potiga

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

You may take this medicine with or without food.

Swallow the tablet whole. Do not break, crush, dissolve, or chew it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  
  • For seizures:
    
    • Adults—At first, 100 milligrams (mg) three times a day (300 mg per day). Your doctor may gradually increase your dose over several weeks as needed and tolerated. However, the dose is usually not more than 400 mg three times a day (1200 mg per day).
    
    
    • Older Adults—At first, 50 mg three times a day (150 mg per day). Your doctor may gradually increase your dose over several weeks as needed and tolerated. However, the dose is usually not more than 250 mg three times a day (750 mg per day).
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Potiga

It is very important that your doctor check your progress at regular visits. This is necessary to allow dose adjustments and to check for serious unwanted effects. Blood tests may also be needed to check for unwanted effects.

If you develop any unusual or strange thoughts and behavior while using this medicine, be sure to discuss it with your doctor. Other changes might be confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

This medicine may cause problems with urination. Call you doctor right away if you have trouble emptying your bladder, a weak urine system, pain while urinating, or if you are unable to start urinating.

Ezogabine may cause some people to become dizzy, drowsy, or have blurred or double vision. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or not able to see well. If these reactions are especially bothersome, check with your doctor.

This medicine can cause changes in heart rhythms, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or uneven heartbeats.

Do not suddenly stop taking this medicine without checking first with your doctor. If you have been instructed to stop taking ezogabine, ask your doctor how to slowly decrease the dose. This will decrease your chance of having more seizures to occur again.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

It is important to tell your doctor if you become pregnant while taking this medicine. Your doctor may want you to join the North American Antiepileptic Drug Pregnancy Registry. The registry is used by pregnant patients who are taking this medicine.

Avoid drinking alcohol while you are using this medicine.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests (e.g., serum and urine bilirubin) may be affected by this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Potiga Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Decrease in the frequency of urination


• decrease in the urine volume


• difficulty with passing urine (dribbling)


• painful urination


• shakiness in the legs, arms, hands, or feet

Less common

• Bloating or swelling of the face, arms, hands, lower legs, or feet


• blood in the urine


• burning while urinating


• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings


• difficult urination


• general feeling of discomfort or illness


• muscle twitching or jerking


• rapid weight gain


• rhythmic movement of the muscles


• tingling of the hands or feet


• trouble with urinating


• unusual tiredness or weakness


• unusual weight gain or loss

Incidence not known

• Agitation


• back pain


• black, tarry stools


• bleeding gums


• blurred vision


• change in consciousness


• chest pain


• chills


• cloudy urine


• confusion


• cough


• difficult or labored breathing


• dizziness


• drowsiness


• fainting


• fever


• headache


• irritability


• loss of consciousness


• pain in the lower back or side


• pinpoint red spots on the skin


• shortness of breath


• sore throat


• sores, ulcers, or white spots on the lips or in the mouth


• stiff neck


• swollen glands


• tightness in the chest


• unusual bleeding or bruising


• vomiting


• wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Being forgetful


• clumsiness or unsteadiness


• dizziness or lightheadedness


• double vision


• feeling of constant movement of self or surroundings


• seeing double


• sensation of spinning


• sleepiness or unusual drowsiness

Less common

• Absence of or decrease in the body movement


• acid or sour stomach


• belching


• changes in patterns and rhythms of speech


• confusion about identity, place, and time


• cough


• diarrhea


• difficulty having a bowel movement (stool)


• difficulty with swallowing


• dry mouth


• fear or nervousness


• feeling that others are watching you or controlling your behavior


• feeling that others can hear your thoughts


• feeling, seeing, or hearing things that are not there


• heartburn


• increased appetite


• increased sweating


• indigestion


• joint pain


• lack or loss of strength


• loss of appetite


• loss of memory


• muscle aches and pains


• problems with memory problems with speech or speaking


• runny nose


• severe mood or mental changes


• shivering


• slurred speech


• stomach discomfort, upset, or pain


• sweating


• trouble with sleeping


• trouble with speaking


• trouble with walking


• unusual behavior


• weight gain

Incidence not known

• False or unusual sense of well-being


• hair loss or thinning of the hair


• muscle spasms


• rash


• uncontrolled eye movements

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

Allfen

Pronunciation: gwye-FEN-eh-sin/poe-TASS-ee-um gwye-a-kole-SUL-foe-nate
Generic Name: Guaifenesin/Potassium Guaiacolsulfonate
Brand Name: Allfen and Humibid LA

Allfen is used for:

Relieving symptoms of cough and mucus in the chest due to respiratory infections, asthma, colds, or hay fever. It may also be used for other conditions as determined by your doctor.

Allfen is a combination of 2 expectorants. It works by thinning mucus (phlegm) in the lungs and making it less sticky and easier to cough up. This reduces chest congestion by making coughs more productive.

Do NOT use Allfen if:

• you are allergic to any ingredient in Allfen

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

Before using Allfen:

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

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have a chronic cough that occurs with smoking, asthma, chronic bronchitis, or emphysema, or if cough occurs with large amounts of mucus

Some MEDICINES MAY INTERACT with Allfen. Tell your health care provider if you are taking any other medicines. However, no specific interactions with Allfen are known at this time.

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

How to use Allfen:

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

• Allfen may be taken with or without food.


• Drinking extra fluids while you are taking Allfen is recommended. Check with your doctor for instructions.


• Swallow Allfen whole. Do not break, crush, or chew before swallowing.


• If you miss a dose of Allfen and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

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

Important safety information:

• Allfen may cause dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Allfen. Using Allfen alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.


• If cough persists for more than 1 week or is accompanied by a fever, contact your health care provider. A persistent cough could be a sign of a serious condition.


• Allfen may interfere with some lab tests. Make sure your doctor and lab personnel know you are taking Allfen.


• Use Allfen with extreme caution in CHILDREN younger than 12 years of age. Safety and effectiveness in this age group have not been confirmed.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Allfen during pregnancy. It is unknown if Allfen is excreted in breast milk. If you are or will be breast-feeding while you are using Allfen, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of Allfen:

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

Dizziness; headache; nausea; upset stomach; vomiting.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); lower back or side pain.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch .

See also: Allfen side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Allfen:

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

General information:

• If you have any questions about Allfen, please talk with your doctor, pharmacist, or other health care provider.


• Allfen is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Allfen. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Allfen resources

• Allfen Side Effects (in more detail)
• Allfen Use in Pregnancy & Breastfeeding
• Allfen Drug Interactions
• Allfen Support Group
• 0 Reviews for Allfen - Add your own review/rating

• Allfen Advanced Consumer (Micromedex) - Includes Dosage Information


• Guaifenesin Monograph (AHFS DI)


• Guaifenesin NR Prescribing Information (FDA)


• Mucinex Prescribing Information (FDA)


• Mucinex Consumer Overview


• Organidin NR Prescribing Information (FDA)


• Tussin Consumer Overview

Compare Allfen with other medications

• Cough

ipratropium and albuterol Inhalation, oral/nebulization

ip-ra-TROE-pee-um BROE-mide, al-BUE-ter-ol SUL-fate

Commonly used brand name(s)

In the U.S.

• Combivent


• Combivent Respimat


• Duoneb

In Canada

• Ratio-Ipra Sal Udv

Available Dosage Forms:

• Aerosol Powder


• Solution


• Spray


• Aerosol Liquid

Therapeutic Class: Bronchodilator

Pharmacologic Class: Ipratropium

Uses For ipratropium and albuterol

Ipratropium and albuterol combination is used to help control the symptoms of lung diseases, such as asthma, chronic bronchitis, and emphysema. It is also used to treat air flow blockage and prevent the worsening of chronic obstructive pulmonary disease (COPD) in patients who need another medicine.

Ipratropium and albuterol belong to the family of medicines known as bronchodilators. Bronchodilators are medicines that are breathed in through the mouth to open up the bronchial tubes (air passages) in the lungs.

ipratropium and albuterol is available only with your doctor's prescription.

Before Using ipratropium and albuterol

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ipratropium and albuterol, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ipratropium and albuterol or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of ipratropium and albuterol combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Combivent® Respimat® spray in the elderly.

No information is available on the relationship of age to the effects of Combivent® in geriatric patients.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ipratropium and albuterol, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

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

• Acebutolol


• Alprenolol


• Arotinolol


• Atenolol


• Atomoxetine


• Befunolol


• Betaxolol


• Bevantolol


• Bisoprolol


• Bopindolol


• Brofaromine


• Bucindolol


• Bupranolol


• Carteolol


• Carvedilol


• Celiprolol


• Clorgyline


• Dilevalol


• Esmolol


• Furazolidone


• Iproniazid


• Isocarboxazid


• Labetalol


• Landiolol


• Lazabemide


• Levobetaxolol


• Levobunolol


• Linezolid


• Mepindolol


• Metipranolol


• Metoprolol


• Moclobemide


• Nadolol


• Nebivolol


• Nialamide


• Nipradilol


• Oxprenolol


• Pargyline


• Penbutolol


• Phenelzine


• Pindolol


• Procarbazine


• Propranolol


• Rasagiline


• Selegiline


• Sotalol


• Talinolol


• Tertatolol


• Timolol


• Toloxatone


• Tranylcypromine

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

• Betel Nut

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of ipratropium and albuterol. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergy to soya lecithin, soybean, or peanuts, history of—Combivent® brand should not be used in patients with this condition.

• Blood circulation problems or


• Heart or blood vessel disease or


• Heart rhythm problems (e.g., arrhythmia) or


• Hypertension (high blood pressure)—Use with caution. May increase risk for serious side effects.

• Diabetes or


• Difficult urination or


• Enlarged prostate or


• Hyperthyroidism (an overactive thyroid) or


• Hypokalemia (low potassium in the blood) or


• Narrow-angle glaucoma or


• Seizures or


• Urinary bladder blockage—Use with caution. May make these conditions worse.

Proper Use of ipratropium and albuterol

ipratropium and albuterol usually comes with patient directions or instructions. Read them carefully before using the medicine. If you do not understand the directions or you are not sure how to use the inhaler or nebulizer, ask your doctor to show you how to use it.

Use ipratropium and albuterol only as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. Also, do not stop using ipratropium and albuterol without telling your doctor. To do so may cause your lung condition to become worse.

When you use the inhalation solution, make sure you use a jet nebulizer that is connected to an air compressor with a good air flow. Use a face mask or mouthpiece to inhale the medicine.

Keep the spray away from your eyes. ipratropium and albuterol may cause eye pain or discomfort, irritation, blurred vision, or start seeing halos or odd colors when you look at things. If it does come into contact with your eyes, check with your doctor right away.

To use the Combivent® inhaler:

• Insert the metal canister firmly and fully into the clear end of the Combivent® Inhalation Aerosol mouthpiece. This mouthpiece should not be used with other inhaled medicines.


• Remove the cap and look at the mouthpiece to make sure it is clean.


• Shake the inhaler for at least 10 seconds and test spray it in the air 3 times before using it for the first time or if the inhaler has not been used for 24 hours.


• To inhale ipratropium and albuterol, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece just in front of your mouth with the canister upright.


• Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down once on the top of the canister.


• Hold your breath for about 10 seconds, then breathe out slowly.


• If you are supposed to use more than one puff, wait 1 to 2 minutes before inhaling the second puff. Repeat these steps for the second puff, starting with shaking the inhaler.


• When you have finished all of your doses, rinse your mouth with water.


• Clean the inhaler mouthpiece every day with hot water. Dry it thoroughly before use.

To use the Combivent® Respimat® spray:

• Insert the cartridge into the Combivent® Respimat® inhaler.


• Before using the inhaler, prime it by spraying the medicine towards the ground (away from your face), until an aerosol cloud is visible. Repeat 3 more times. The inhaler is now ready for use.


• If the inhaler is not used for more than 3 days, prime the inhaler once to prepare it for use. If it not used for more than 21 days, prime the inhaler 3 times.


• To inhale ipratropium and albuterol, breathe out fully, trying to get as much air out of the lungs as possible.


• Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down once the release button of the inhaler.


• Hold your breath for about 10 seconds, then breathe out slowly.


• After using the inhaler, clean the mouthpiece with a damp cloth or tissue at least once a week.


• This inhaler has a dose indicator window that shows how much medicine is left. When the pointer enters the red area of the scale, it is time that you need to refill your prescription.


• Throw away the inhaler 3 months from its first use or when the inhaler is locked (after 120 puffs).

Use only the brand of ipratropium and albuterol that your doctor prescribed. Different brands may not work the same way.

Dosing

The dose of ipratropium and albuterol will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ipratropium and albuterol. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For symptoms of chronic obstructive pulmonary disease (COPD):
  
  • For inhalation aerosol dosage form (used with an inhaler):
    
    • Adults—2 puffs four times a day and as needed. Do not use more than 12 puffs in any 24-hour period.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  
  • For inhalation solution dosage form (used with a nebulizer):
    
    • Adults—Use one 3 milliliter (mL) vial in the nebulizer four times a day. You may use 2 additional treatments per day if needed.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  
  • For inhalation spray dosage form (used with an inhaler):
    
    • Adults—One puff four times a day. You may take additional doses per day if needed. Do not use more than 6 puffs in any 24-hour period.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  

Missed Dose

If you miss a dose of ipratropium and albuterol, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the canister at room temperature, away from heat and direct light. Do not freeze. Do not keep ipratropium and albuterol inside a car where it could be exposed to extreme heat or cold. Do not poke holes in the canister or throw it into a fire, even if the canister is empty.

Keep the medicine in the foil pouch until you are ready to use it. Store at room temperature, away from heat and direct light. Do not freeze.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using ipratropium and albuterol

It is very important that your doctor check your progress closely while you are using ipratropium and albuterol to see if it is working properly and to help reduce any unwanted effects.

ipratropium and albuterol may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. Paradoxical bronchospasm may be life-threatening. Stop using ipratropium and albuterol and check with your doctor right away if you have coughing, difficulty breathing, shortness of breath, or wheezing after using ipratropium and albuterol.

Check with your doctor at once if difficulty with breathing continues after using a dose of ipratropium and albuterol or if your condition gets worse.

ipratropium and albuterol may cause serious types of allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hives; hoarseness; trouble with breathing; trouble with swallowing; or any swelling of your hands, face, or mouth while you are using ipratropium and albuterol.

Tell your doctor right away if you feel chest pain, notice any changes in your blood pressure (such as feeling lightheaded or changes in vision), or notice your heart beating faster or slower .

Take all of your COPD medicines as your doctor ordered. If you use any type of corticosteroid medicine to control your breathing, keep using it as ordered by your doctor. This includes corticosteroid medicines that are taken by mouth or inhaled (such as prednisone, Azmacort®, or Flovent®). If any of your COPD medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.

ipratropium and albuterol may cause dizziness, blurred vision, or trouble in seeing clearly. Make sure you know how you react to ipratropium and albuterol before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to see well.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, and herbal or vitamin supplements. .

ipratropium and albuterol Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Body aches or pain


• chills


• cough


• cough producing mucus


• difficulty with breathing


• ear congestion


• fever


• headache


• loss of voice


• runny nose


• shortness of breath


• sneezing


• sore throat


• stuffy nose


• tightness in the chest


• unusual tiredness or weakness


• wheezing

Less common

• Bladder pain


• bloody or cloudy urine


• blurred vision


• burning while urinating burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings


• chest pain


• congestion


• diarrhea


• difficult, burning, or painful urination


• dizziness


• fainting


• fast, slow, irregular, pounding, or racing heartbeat or pulse


• frequent urge to urinate


• general feeling of discomfort or illness


• hoarseness


• increased sputum


• joint pain


• loss of appetite


• lower back or side pain


• muscle aches and pains


• nausea


• nervousness


• noisy breathing


• pain


• pain or tenderness around the eyes and cheekbones


• pounding in the ears


• shakiness in the legs, arms, hands, or feet


• shivering


• sweating


• swelling


• tender, swollen glands in the neck


• trembling or shaking of the hands or feet


• trouble with sleeping


• trouble with swallowing


• voice changes


• vomiting

Rare

• Skin rash or hives


• swelling of the face, lips, eyelids, mouth, or throat

Incidence not known

• Chest discomfort


• decrease in the frequency of urination


• decrease in urine volume


• difficulty in passing urine (dribbling)


• difficulty with swallowing


• itching skin


• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs


• pain or discomfort in the arms, jaw, back, or neck


• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue


• redness of the skin


• welts

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Acid or sour stomach


• bad, unusual, or unpleasant (after) taste


• belching


• change in taste


• diarrhea


• difficulty with moving


• dry mouth


• heartburn


• hoarseness


• indigestion


• muscle pain or stiffness


• sleeplessness


• stomach discomfort, upset, or pain


• trouble sleeping


• unable to sleep


• voice changes

Less common or rare

• Nervousness


• tremor

Incidence not known

• Bigger, dilated, or enlarged pupils (black part of the eye)


• blindness


• change in near or distance vision


• decreased vision


• difficulty in focusing eyes


• dry throat


• eye pain


• increased sensitivity of the eyes to light


• itching, redness, tearing, or other sign of eye irritation not present before use of ipratropium and albuterol or becoming worse during use


• lack or loss of strength


• noisy breathing


• redness of the white part of the eyes or inside of the eyelids


• swelling of the eye


• swelling or inflammation of the mouth


• tearing

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: ipratropium and albuterol Inhalation,/nebulization side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More ipratropium and albuterol Inhalation, oral/nebulization resources

• Ipratropium and albuterol Inhalation, oral/nebulization Side Effects (in more detail)
• Ipratropium and albuterol Inhalation, oral/nebulization Use in Pregnancy & Breastfeeding
• Ipratropium and albuterol Inhalation, oral/nebulization Drug Interactions
• Ipratropium and albuterol Inhalation, oral/nebulization Support Group
• 9 Reviews for Ipratropium and albuterol Inhalation,/nebulization - Add your own review/rating

Compare ipratropium and albuterol Inhalation, oral/nebulization with other medications

• COPD, Maintenance

Yocon

Generic Name: yohimbine (yo HIM bean)

Brand Names: Erex, Testomar, Yocon, Yohimar, Yohimbe, Yohimex

What is Yocon (yohimbine)?

Yohimbine increases the amount of blood that is allowed to flow into the penis and prevents blood from flowing out of the penis. It can cause an erection.

Yohimbine is used to treat and diagnose some types of impotence.

Yohimbine may also be used for purposes other than those listed in this product guide.

What is the most important information I should know about Yocon (yohimbine)?

Use caution when driving, operating machinery, or performing other hazardous activities. Yohimbine may cause dizziness. If you experience dizziness, avoid these activities.

Use caution when rising from a sitting or lying position. Yohimbine may be more likely to cause dizziness when changing positions.

What should I discuss with my healthcare provider before taking Yocon (yohimbine)?

Before taking this medication, tell your doctor if you

• have kidney disease;


• 
  

  have peptic ulcer disease (stomach ulcers);

  
  


• 
  

  are suffering from depression;

  
  


• 
  

  are being treated for a psychiatric condition; or

  
  


• 
  

  have any type of heart disease.

  
  

You may not be able to take yohimbine, or you may require a lower dose or special monitoring during therapy if you have any of the conditions listed above.

Yohimbine should not be used by women. Do not take this medication if you are pregnant or are breast-feeding. Yohimbine should not be used by children.

How should I take Yocon (yohimbine)?

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

Take each dose with a full glass of water.

Yohimbine is usually taken three times a day. Follow your doctor's instructions.

Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra yohimbine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Symptoms of a yohimbine overdose include increased blood pressure (severe headache, blurred vision, flushing); a fast heart rate; numbness or tingling; runny nose; tremor; anxiety; poor coordination; and confusion or abnormal behavior.

What should I avoid while taking Yocon (yohimbine)?

Use caution when driving, operating machinery, or performing other hazardous activities. Yohimbine may cause dizziness. If you experience dizziness, avoid these activities.

Use caution when rising from a sitting or lying position. Yohimbine may be more likely to cause dizziness when you change positions.

Yocon (yohimbine) side effects

If you experience any of the following serious side effects, stop taking yohimbine and seek emergency medical attention:

• 
  

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

  
  


• 
  

  a very irregular or fast heartbeat; or

  
  


• 
  

  confusion or unusual behavior.

  
  

Other, less serious side effects are more likely to occur. Continue to take yohimbine and talk to your doctor if you experience

• 
  

  dizziness;

  
  


• 
  

  anxiety, irritability, or nervousness;

  
  


• 
  

  tremor (shaking);

  
  


• 
  

  headache; or

  
  


• 
  

  skin flushing.

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Yocon (yohimbine)?

Before taking this medication, tell your doctor if you are taking a medicine for depression, mania, or another psychiatric condition. Generally, yohimbine should not be used with these medicines.

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

More Yocon resources

• Yocon Side Effects (in more detail)
• Yocon Use in Pregnancy & Breastfeeding
• Yocon Drug Interactions
• Yocon Support Group
• 0 Reviews for Yocon - Add your own review/rating

• Yocon MedFacts Consumer Leaflet (Wolters Kluwer)


• yohimbine Advanced Consumer (Micromedex) - Includes Dosage Information


• Yohimbe Natural MedFacts for Professionals (Wolters Kluwer)


• Yohimbe Natural MedFacts for Consumers (Wolters Kluwer)

Compare Yocon with other medications

• Erectile Dysfunction
• Sexual Dysfunction, SSRI Induced

Where can I get more information?

• Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.

See also: Yocon side effects (in more detail)