Sporanox (Generic name: Itraconazole)

What is the most important information I should know about Sporanox?

• Do not take Sporanox if you are taking astemizole (Hismanal), cisapride (Propulsid), pimozide (Orap), triazolam (Halcion), midazolam (Versed), lovastatin (Mevacor), simvastatin (Zocor), or quinidine (Cardioquin, Quinora, Quinidex, Quinaglute, Quin-Release, Quin-G). Combined with these drugs, Sporanox could cause serious, even fatal, problems.
• In rare cases, Sporanox has caused severe liver damage, sometimes resulting in death. Notify your doctor immediately if you develop nausea, vomiting, abdominal pain, unusual fatigue, loss of appetite, yellow skin or eyes, itching, dark urine, or clay colored stools. These symptoms may be early signs of liver damage.
• In rare cases, Sporanox has been associated with the onset of congestive heart failure (CHF). Do not take Sporanox without first talking to your doctor if you have CHF or a history of CHF; other heart or heart valve disease; a lung disease such as chronic obstructive pulmonary disease; or significant swelling or water retention (edema). Contact your doctor if you develop symptoms that may indicate CHF including shortness of breath, chest pain, or swelling during treatment with Sporanox.
• Take all of the Sporanox that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated.

What is Sporanox?

• Sporanox is an antifungal medication. It is like an antibiotic but is used to treat fungal infections.
• Sporanox is used to treat fungal infections in the lungs, in the central nervous system, in other parts of the body, as well as serious fungal infections of the skin and nails. The Sporanox oral solution is used to treat yeast infections of the mouth, throat, and esophagus.
• Sporanox may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Sporanox?

• Do not take Sporanox if you are taking any of the following drugs:
  • astemizole (Hismanal);
  • cisapride (Propulsid);
  • pimozide (Orap);
  • quinidine (Cardioquin, Quinora, Quinidex, Quinaglute, Quin-Release, Quin-G);
  • midazolam (Versed) or triazolam (Halcion); or
  • lovastatin (Mevacor) or simvastatin (Zocor).
• Dangerous or life-threatening events may occur if Sporanox is taken with any of the medicines listed above.
• In rare cases, Sporanox has been associated with the onset of congestive heart failure (CHF). Do not take Sporanox without first talking to your doctor if you have CHF or a history of CHF; other heart or heart valve disease; a lung disease such as chronic obstructive pulmonary disease; or significant swelling or water retention (edema). Contact your doctor if you develop symptoms that may indicate CHF including shortness of breath, chest pain, or swelling during treatment with Sporanox.
• Before taking Sporanox, tell your doctor if you have
  • liver disease; or
  • achlorhydria (decreased stomach acid production) or if you take antacids, stomach acid reducers, or stomach ulcer medicines.
• You may not be able to take Sporanox, or you may require a dosage adjustment, special monitoring, or special directions for use during your treatment.
• Sporanox is in the FDA pregnancy category C. This means that it is not known whether Sporanox will be harmful to an unborn baby. Effective contraception is recommended for any woman who could potentially become pregnant during treatment with Sporanox and for 2 months following the end of treatment. Do not take this medication without first talking to your doctor if you are pregnant.
• Sporanox passes into breast milk and may affect a nursing infant. Do not take Sporanox without first talking to your doctor if you are breast-feeding a baby.

How should I take Sporanox?

• Take Sporanox exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each capsule with a full glass of water.
• Take Sporanox capsules after a full meal to increase absorption in your stomach.
• To treat yeast infections of the mouth, throat, or esophagus, the oral solution should be swished vigorously in the mouth for several seconds, then swallowed. Take the oral solution without food if possible.
• Sporanox capsules and oral solution are different preparations and cannot be used interchangeably.
• Take all of the Sporanox that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated.
• Grapefruit and grapefruit juice may interact with Sporanox. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
• Store Sporanox at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. If it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose as directed. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

• Seek emergency medical attention if an overdose is suspected.
• Symptoms of an Sporanox overdose are not well known but might include dizziness, ringing in the ears, headache, nausea, vomiting, diarrhea, and abdominal pain.

What should I avoid while taking Sporanox?

• Use alcohol with moderation while taking Sporanox. Alcohol and Sporanox can both affect the liver.
• Use caution when driving or performing other hazardous activities. Sporanox may cause dizziness. If you experience dizziness, avoid these activities.
• Grapefruit and grapefruit juice may interact with Sporanox. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

What are the possible side effects of Sporanox?

• If you experience any of the following serious side effects, stop taking Sporanox and seek emergency medical attention or notify your doctor immediately:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  • liver damage (pale stools, yellowish skin or eyes, abdominal pain, unusual fatigue, or dark urine);
  • symptoms of congestive heart failure including shortness of breath, chest pain, or swelling; or
  • nerve pain, numbness or tingling.
• Other, less serious side effects may be more likely to occur. If you experience any of the following side effects, continue taking Sporanox and talk to your doctor:
  • nausea, vomiting, or diarrhea;
  • headache;
  • dizziness;
  • fatigue; or
  • itching or a rash.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Sporanox?

• Do not take Sporanox if you are taking any of the following drugs:
  • astemizole (Hismanal);
  • cisapride (Propulsid);
  • pimozide (Orap);
  • quinidine (Cardioquin, Quinora, Quinidex, Quinaglute, Quin-Release, Quin-G);
  • midazolam (Versed) or triazolam (Halcion); or
  • lovastatin (Mevacor) or simvastatin (Zocor).
• Dangerous or life-threatening events may occur if Sporanox is taken with any of the medicines listed above.
• Before taking Sporanox, tell your doctor if you are taking any other medicines, especially any of the following:
  • digoxin (Lanoxin, Lanoxicaps);
  • carbamazepine (Tegretol, others) or phenytoin (Dilantin, others);
  • rifabutin (Mycobutin) or rifampin (Rifadin, Rimactane);
  • busulfan (Myleran), docetaxel (Taxotere), vinblastine sulfate (Velban), vincristine sulfate (Oncovin), or vinorelbine (Navelbine);
  • trimetrexate (Neutrexin);
  • alprazolam (Xanax) or diazepam (Valium);
  • verapamil (Isoptin, Verelan, Calan, Covera-HS), amlodipine (Norvasc), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), or nisoldipine (Sular);
  • atorvastatin (Lipitor) or cerivastatin (Baycol);
  • tacrolimus (Prograf);
  • sirolimus (Rapamune);
  • cyclosporine (Sandimmune, Neoral);
  • glipizide (Glucotrol), glyburide (Diabeta, Micronase, Glynase), tolbutamide (Orinase), tolazamide (Tolinase), chlorpropamide (Diabinese), and others;
  • indinavir (Crixivan), ritonavir (Norvir), or saquinavir (Fortovase, Invirase);
  • buspirone (Buspar);
  • antacids;
  • cimetidine (Tagamet, Tagamet HB), nizatidine (Axid, Axid AR), famotidine (Pepcid, Pepcid AC), or ranitidine (Zantac, Zantac 75);
  • omeprazole (Prilosec), lansoprazole (Prevacid), or rabeprazole (Aciphex);
  • isoniazid (Nydrazid);
  • nevirapine (Viramune);
  • methylprednisolone (Medrol, others);
  • clarithromycin (Biaxin); or
  • warfarin (Coumadin).
• You may not be able to take Sporanox, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with Sporanox or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Nizoral (Generic name: Ketoconazole)

What is the most important information I should know about Nizoral?

• Do not take Nizoral if you are taking astemizole (Hismanal), cisapride (Propulsid), triazolam (Halcion), or midazolam (Versed). Combined with these drugs, Nizoral could cause serious, even fatal, side effects.
• In rare cases, Nizoral has caused severe liver damage, sometimes resulting in death. Notify your doctor immediately if you develop nausea, vomiting, abdominal pain, unusual fatigue, loss of appetite, yellow skin or eyes, itching, dark urine, or clay colored stools. These symptoms may be early signs of liver damage.
• Take all of the Nizoral that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated.

What is Nizoral?

• Nizoral is an antifungal medication. It is like an antibiotic but is used to treat fungal infections.
• Nizoral is used to treat yeast infections of the mouth, throat, and esophagus; fungal infections throughout the whole body; and serious fungal infections of the skin and nails.
• Nizoral may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Nizoral?

• Do not take Nizoral if you are taking any of the following drugs:
  • astemizole (Hismanal),
  • cisapride (Propulsid), or
  • triazolam (Halcion) or midazolam (Versed).
• Dangerous or life-threatening events may occur if Nizoral is taken with any of the medicines listed above.
• Before taking Nizoral, tell your doctor if you have
  • liver disease; or
  • achlorhydria (decreased stomach acid production) or if you take antacids, stomach acid reducers, or stomach ulcer medicines.
• You may not be able to take Nizoral, or you may require a dosage adjustment, special monitoring, or special directions for use during your treatment.
• Nizoral is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• Nizoral passes into breast milk and may be harmful to a nursing baby. For this reason, Nizoral should not be taken by nursing mothers. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take Nizoral?

• Take Nizoral exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Nizoral is usually taken once a day. Follow your doctor's instructions.
• If you have a condition that decreases the amount of acid produced by the stomach, you may require a special mixture of this medication. Drink this solution through a straw far back in the mouth away from the teeth and follow each dose with a swish and swallow of water to prevent damage to the teeth.
• It is important to take Nizoral regularly to get the most benefit.
• Your doctor may want you to have blood tests or other medical evaluations during treatment with Nizoral to monitor progress and side effects.
• Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. If it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose as directed. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

• Seek emergency medical attention if an overdose is suspected.
• Symptoms of a Nizoral overdose are not well known but might include dizziness, ringing in the ears, headache, nausea, vomiting, diarrhea, and abdominal pain.

What should I avoid while taking Nizoral?

• Alcohol should be used with moderation while taking Nizoral. Alcohol and Nizoral can both affect the liver. Rarely, flushing, nausea, vomiting, headache, swelling, and rashes have occurred when alcohol has been used during Nizoral therapy.
• Use caution when driving or performing other hazardous activities. Nizoral may cause dizziness. If you experience dizziness, avoid these activities.

What are the possible side effects of Nizoral?

• If you experience any of the following serious side effects, stop taking Nizoral and seek emergency medical attention or contact your doctor immediately:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or
  • liver damage (pale stools, yellowish skin or eyes, abdominal pain, unusual fatigue, or dark urine).
• Other, less serious side effects may be more likely to occur. If you experience any of the following side effects, continue to take Nizoral and talk to your doctor:
  • nausea, vomiting, or abdominal pain;
  • diarrhea;
  • headache;
  • dizziness;
  • fatigue; or
  • itching.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Nizoral?

• Do not take Nizoral if you are taking any of the following drugs:
  • astemizole (Hismanal),
  • cisapride (Propulsid), or
  • triazolam (Halcion) or midazolam (Versed).
• Dangerous or life-threatening events may occur if Nizoral is taken with any of the medicines listed above.
• Before taking Nizoral, tell your doctor if you are taking any other medicines, especially any of the following:
  • cyclosporine (Sandimmune, Neoral);
  • tacrolimus ((Prograf);
  • methylprednisolone (Medrol, others);
  • antacids;
  • cimetidine (Tagamet, Tagamet HB), nizatidine (Axid, Axid AR), famotidine (Pepcid, Pepcid AC), or ranitidine (Zantac, Zantac 75);
  • omeprazole (Prilosec), lansoprazole (Prevacid), or rabeprazole (Aciphex);
  • digoxin (Lanoxin, Lanoxicaps);
  • warfarin (Coumadin);
  • phenytoin (Dilantin, others);
  • rifampin (Rifadin, Rimactane); or
  • an oral diabetes medicine such as glipizide (Glucotrol), glyburide (Diabeta, Micronase, Glynase), tolbutamide (Orinase), tolazamide (Tolinase), chlorpropamide (Diabinese), and others.
• You may not be able to take Nizoral, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with Nizoral or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Lamisil (Generic name: Terbinafine)

What is the most important information I should know about Lamisil?

• Take all of the Lamisil that has been prescribed for you even if you begin to feel better. The symptoms may begin to improve before the infection is completely treated.
• In rare cases, Lamisil has caused severe liver damage, sometimes resulting in liver transplant or death. Notify your doctor immediately if you develop nausea, vomiting, abdominal pain, unusual fatigue, loss of appetite, yellow skin or eyes, itching, dark urine, or clay colored stools. These symptoms may be early signs of liver damage.

What is Lamisil?

• Lamisil is an antifungal medication. It is like an antibiotic but is used to treat fungal infections.
• Lamisil is used to treat fungal infections of the fingernails and toenails.
• Lamisil may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Lamisil?

• Do not take Lamisil without first talking to your doctor if you have
  • ever had an allergic reaction to it,
  • liver disease,
  • kidney disease,
  • problems with your immune system, or
  • blood problems.
• You may not be able to take Lamisil, or you may require a dosage adjustment or special monitoring if you have any of the conditions listed above.
• Lamisil is in the FDA pregnancy category B. This means that it is not expected to harm an unborn baby. Do not take Lamisil without first talking to your doctor if you are pregnant.
• Lamisil passes into breast milk and may affect a nursing baby. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take Lamisil?

• Take Lamisil exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass (8 ounces) of water.
• Take all of the Lamisil that has been prescribed for you even if you begin to feel better. The symptoms may begin to improve before the infection is completely treated. It may take several months to cure a fingernail or toenail infection.
• Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication.

What happens if I overdose?

• Seek emergency medical attention.
• Symptoms of a Lamisil overdose are not well known but might include drowsiness, poor coordination, shortness of breath, abdominal pain, frequent urination, rash, and headache.

What should I avoid while taking Lamisil?

• Avoid alcohol or use it in moderation while taking Lamisil. Alcohol and Lamisil can both affect the liver.

What are the possible side effects of Lamisil?

• If you experience any of the following serious side effects, stop taking Lamisil and seek emergency medical attention:
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
  • a rash;
  • changes in vision; or
  • blood problems (detected by blood tests).
• In rare cases, Lamisil has caused severe liver damage, sometimes resulting in liver transplant or death. Notify your doctor immediately if you develop nausea, vomiting, abdominal pain, unusual fatigue, loss of appetite, yellow skin or eyes, itching, dark urine, or clay colored stools. These symptoms may be early signs of liver damage.
• Other, less serious side effects may be more likely to occur. Continue to take Lamisil and talk to your doctor if you experience
  • nausea, upset stomach, or heartburn;
  • diarrhea or flatulence;
  • headache; or
  • taste disturbances or a loss of taste.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Lamisil?

• Before taking Lamisil, tell your doctor if you are taking any of the following medicines:
  • cimetidine (Tagamet, Tagamet HB).;
  • rifampin (Rifadin, Rimactane); or
  • cyclosporine (Sandimmune, Neoral).
• You may not be able to take Lamisil, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with Lamisil. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Grisactin (Generic name: Griseofulvin)

What is the most important information I should know about Grisactin?

• Take all of the Grisactin that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated.
• Avoid prolonged exposure to sunlight. Grisactin increases sensitivity to sunlight, and severe burning may result.

What is Grisactin?

• Grisactin is an antifungal medication. It is like an antibiotic but is used to treat fungal infections.
• Grisactin is used to treat fungal infections of the skin, hair, and nails such as jock itch, athlete's foot, and barber's itch.
• Grisactin may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Grisactin?

• You cannot take Grisactin if you
  • have ever had an allergic reaction to it,
  • have porphyria, or
  • have liver disease.
• Talk to your doctor before taking Grisactin if you have any of the conditions listed above.
• Grisactin is in the FDA pregnancy category C. This means that it is not known whether Grisactin will harm an unborn baby. In rare cases, the use of Grisactin has been associated with conjoined twins. Do not take this medication without first talking to your doctor if you are pregnant.
• It is also not known whether Grisactin passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.
• Grisactin may affect sperm and sperm production. It is recommended that you avoid fathering a child during treatment with Grisactin and for 6 months following therapy.

How should I take Grisactin?

• Take Grisactin exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass (8 ounces) of water.
• Your doctor may recommend that you take Grisactin with a fatty meal to increase its absorption into your body.
• Take all of the Grisactin that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated.
• Shake the suspension well before measuring a dose. To ensure that you get a correct dose, measure the liquid form of Grisactin with a dose-measuring spoon or cup, not with a regular tablespoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
• Store Grisactin tablets, capsules, and suspension at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. Take the rest of the day's doses at evenly spaced intervals unless your doctor directs otherwise.

What happens if I overdose?

• Seek emergency medical attention.
• Symptoms of a Grisactin overdose are not well known but might include nausea, vomiting, diarrhea, headache, numbness and tingling, and confusion.

What should I avoid while taking Grisactin?

• Avoid prolonged exposure to sunlight. Grisactin increases sensitivity to sunlight, and severe burning may result. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.
• The combination of alcohol and Grisactin may cause flushing and a fast heart rate. Use alcohol cautiously during treatment with Grisactin.

What are the possible side effects of Grisactin?

• Stop taking Grisactin and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).
• Other, less serious side effects may be more likely to occur. Continue to take Grisactin and notify your doctor if you experience
  • white patches in your mouth (thrush/ yeast infection);
  • nausea, vomiting, or diarrhea;
  • headache, dizziness, or tiredness;
  • insomnia;
  • confusion;
  • numbness or tingling in your hands or feet; or
  • menstrual irregularities.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Grisactin?

• Grisactin may decrease the effects of the following drugs:
  • oral anticoagulants (blood thinners) such as warfarin (Coumadin). A decrease in the effectiveness of anticoagulants could lead to blood clotting. It may be necessary to increase anticoagulant dosage.
  • birth control pills. Decreased effectiveness could lead to break-through bleeding and possibly to an unintended pregnancy. Talk to your doctor about using of other forms of birth control during treatment with Grisactin.
  • salicylates such as aspirin, salsalate (Disalcid, Salsitab, Salflex, others), choline salicylate (Arthropan), magnesium salicylate (Doan's, Magan), and others. Larger doses of these medicines may be needed.
  • cyclosporine (Sandimmune, Neoral). Your doctor may need to adjust your cyclosporine dosage.
• The effects of Grisactin may be decreased by barbiturates such as phenobarbital (Luminal, Solfoton), pentobarbital (Nembutal), secobarbital (Seconal), amobarbital (Amytal), and butabarbital (Butisol). Larger doses of Grisactin may be necessary if you are taking any of these drugs.
• Drugs other than those listed here may also interact with Grisactin. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Fulvicin (Generic name: Gresiofulvin)

What is Fulvicin (griseofulvin)?

Griseofulvin is an antifungal medication. It is like an antibiotic but is used to treat fungal infections.

Griseofulvin is used to treat fungal infections of the skin, hair, and nails such as jock itch, athlete's foot, and barber's itch.

Griseofulvin may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Fulvicin (griseofulvin)?

Take all of the griseofulvin that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated. Avoid prolonged exposure to sunlight. Griseofulvin increases sensitivity to sunlight, and severe burning may result.

What should I discuss with my healthcare provider before taking Fulvicin (griseofulvin)?

You cannot take griseofulvin if you

• have ever had an allergic reaction to it,
• have porphyria, or
• have liver disease.

Talk to your doctor before taking griseofulvin if you have any of the conditions listed above.

Griseofulvin is in the FDA pregnancy category C. This means that it is not known whether griseofulvin will harm an unborn baby. In rare cases, the use of griseofulvin has been associated with conjoined twins. Do not take this medication without first talking to your doctor if you are pregnant. It is also not known whether griseofulvin passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. Griseofulvin may affect sperm and sperm production. It is recommended that you avoid fathering a child during treatment with griseofulvin and for 6 months following therapy.

How should I take Fulvicin (griseofulvin)?

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

Take each dose with a full glass (8 ounces) of water. Your doctor may recommend that you take griseofulvin with a fatty meal to increase its absorption into your body. Take all of the griseofulvin that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated. Shake the suspension well before measuring a dose. To ensure that you get a correct dose, measure the liquid form of griseofulvin with a dose-measuring spoon or cup, not with a regular tablespoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Store griseofulvin tablets, capsules, and suspension at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Take the rest of the day's doses at evenly spaced intervals unless your doctor directs otherwise.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a griseofulvin overdose are not well known but might include nausea, vomiting, diarrhea, headache, numbness and tingling, and confusion.

What should I avoid while taking Fulvicin (griseofulvin)?

Avoid prolonged exposure to sunlight. Griseofulvin increases sensitivity to sunlight, and severe burning may result. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable. The combination of alcohol and griseofulvin may cause flushing and a fast heart rate. Use alcohol cautiously during treatment with griseofulvin.

Fulvicin (griseofulvin) side effects

Stop taking griseofulvin and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).

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

• white patches in your mouth (thrush/yeast infection);
• nausea, vomiting, or diarrhea;
• headache, dizziness, or tiredness;
• insomnia;
• confusion;
• numbness or tingling in your hands or feet; or
• menstrual irregularities.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Fulvicin (griseofulvin)?

Griseofulvin may decrease the effects of the following drugs:

• oral anticoagulants (blood thinners) such as warfarin (Coumadin). A decrease in the effectiveness of anticoagulants could lead to blood clotting. It may be necessary to increase anticoagulant dosage.
• birth control pills. Decreased effectiveness could lead to break-through bleeding and possibly to an unintended pregnancy. Talk to your doctor about using of other forms of birth control during treatment with griseofulvin.
• salicylates such as aspirin, salsalate (Disalcid, Salsitab, Salflex, others), choline salicylate (Arthropan), magnesium salicylate (Doan's, Magan), and others. Larger doses of these medicines may be needed.
• cyclosporine (Sandimmune, Neoral). Your doctor may need to adjust your cyclosporine dosage.

The effects of griseofulvin may be decreased by barbiturates such as phenobarbital (Luminal, Solfoton), pentobarbital (Nembutal), secobarbital (Seconal), amobarbital (Amytal), and butabarbital (Butisol). Larger doses of griseofulvin may be necessary if you are taking any of these drugs.

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

Diflucan (Generic name: Fluconazole)

What is the most important information I should know about Diflucan?

• Do not take Diflucan if you are taking cisapride (Propulsid). Combined with cisapride (Propulsid), Diflucan could cause serious, even fatal, heart problems.
• In rare cases, Diflucan has caused severe liver damage, sometimes resulting in death. Notify your doctor immediately if you develop nausea, vomiting, abdominal pain, unusual fatigue, loss of appetite, yellow skin or eyes, itching, dark urine, or clay colored stools. These symptoms may be early signs of liver damage.
• In rare cases, Diflucan has also caused severe skin rash, sometimes resulting in death. Notify your doctor immediately fi you develop a rash while taking Diflucan.
• Take all of the Diflucan that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated.

What is Diflucan?

• Diflucan is an antifungal medication. It is used to treat fungal infections.
• Diflucan is used to treat yeast infections of the mouth, throat, and esophagus; vaginal yeast infections; fungal urinary tract infections; pneumonia caused by yeast; and fungal infections throughout the whole body and in the blood. Diflucan is also used to prevent fungal infections from occurring in people with suppressed immune systems such as cancer chemotherapy patients, organ transplant patients, and AIDS patients.
• Diflucan may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Diflucan?

• Do not take Diflucan if you are taking cisapride (Propulsid). Combined with cisapride (Propulsid), Diflucan could cause serious, even fatal, heart problems.
• Before taking Diflucan, tell your doctor if you have any other medical conditions, especially kidney disease, or if you take other medicines. You may not be able to take Diflucan, or you may require a dosage adjustment or special monitoring during your treatment.
• Diflucan is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Do not take Diflucan without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• Diflucan passes into breast milk and may be harmful to a nursing baby. For this reason, Diflucan should not be taken by nursing mothers. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take Diflucan?

• Take Diflucan exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• A single dose of this medication is often used to treat vaginal yeast infections.
• In multiple-dose therapy, a double dose of Diflucan is often taken on the first day of treatment to quickly get the proper amount of medicine into the body. Follow your doctor's directions.
• Shake the suspension well before measuring a dose. To ensure that you get the correct dose, measure the suspension using a dose-measuring spoon, cup, or dropper, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
• It is important to take Diflucan regularly to get the most benefit.
• Store the tablets at room temperature away from moisture and heat.
• The suspension can be stored at room temperature or in the refrigerator. Do not let it freeze. Throw away any unused suspension after 14 days.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. If it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose as directed. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

• Seek emergency medical attention if an overdose is suspected.
• Symptoms of a Diflucan overdose include confusion, hallucinations, paranoia, decreased movement, decreased breathing, tearing eyes, drooling, urinary incontinence, seizures, and death.

What should I avoid while taking Diflucan?

• Avoid alcohol or use it in moderation while taking Diflucan. Alcohol and Diflucan can both affect the liver.
• Use caution when driving or performing other hazardous activities. Diflucan may cause dizziness. If you experience dizziness, avoid these activities.

What are the possible side effects of Diflucan?

• If you experience any of the following serious side effects, stop taking Diflucan and seek emergency medical attention or contact your doctor immediately:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  • liver damage (pale stools, yellowing of the skin or eyes, abdominal pain, unusual fatigue, or dark urine); or
  • a rash.
• Other, less serious side effects may be more likely to occur. If you experience any of the following side effects, continue taking Diflucan and talk to your doctor:
  • nausea, vomiting, or abdominal pain;
  • diarrhea;
  • headache;
  • dizziness;
  • fatigue; or
  • itching.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Diflucan?

• Do not take Diflucan if you are taking cisapride (Propulsid). Combined with cisapride (Propulsid), Diflucan could cause serious, even fatal, heart problems.
• Before taking Diflucan, tell your doctor if you are taking any other medicines, especially any of the following:
  • an oral diabetes medicine such as glipizide (Glucotrol), glyburide (Diabeta, Micronase, Glynase), tolbutamide (Orinase), tolazamide (Tolinase), chlorpropamide (Diabinese), and others;
  • warfarin (Coumadin);
  • phenytoin (Dilantin, others);
  • cyclosporine (Sandimmune, Neoral);
  • cisapride (Propulsid);
  • a benzodiazepine such as diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax), estazolam (ProSom) and others;
  • tacrolimus ((Prograf);
  • rifabutin (Mycobutin) or rifampin (Rifadin, Rimactane); or
  • theophylline (Theo-Dur, Theolair, Theochron, Elixophyllin, Slo-Phyllin, others); or
  • astemizole (Hismanal).
• You may not be able to take Diflucan, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with Diflucan or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Zyprexa (Generic name: Olanzapine)

What is the most important information I should know about Zyprexa?

• Zyprexa is not for use in psychotic conditions that are related to dementia. Zyprexa has caused fatal heart attack and stroke in older adults with dementia-related conditions.
• Zyprexa may cause you to have high blood sugar (hyperglycemia). Talk to your doctor if you have any signs of hyperglycemia such as increased thirst or urination, excessive hunger, or weakness. If you are diabetic, check your blood sugar levels on a regular basis while you are taking Zyprexa.
• Do not stop taking Zyprexa without first talking to your doctor. It may be at least 4 weeks before you begin to feel better, and you may need to take the medication for longer than 4 weeks. Follow your doctor's instructions. It is important to take Zyprexa regularly to get the most benefit.
• Do not take Zyprexa for longer than 8 weeks unless your doctor has told you to.
• Zyprexa can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
• Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.
• Avoid drinking alcohol, which can increase some of the side effects of Zyprexa.
• Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by Zyprexa.
• Avoid becoming overheated or dehydrated. Drink plenty of fluids, especially in hot weather and during exercise. It is easier to become dangerously overheated and dehydrated while you are taking Zyprexa.

What is Zyprexa?

• Zyprexa is an antipsychotic medication. It works by changing the actions of chemicals in the brain.
• Zyprexa is used to treat the symptoms of psychotic conditions such as schizophrenia and bipolar disorder (manic depression).
• Zyprexa may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Zyprexa?

• Zyprexa is not for use in psychotic conditions that are related to dementia. Zyprexa has caused fatal heart attack and stroke in older adults with dementia-related conditions.
• Before taking Zyprexa, tell your doctor if you have:
  • liver disease;
  • kidney disease;
  • heart disease, high blood pressure, heart rhythm problems;
  • a history of heart attack or stroke;
  • a history of breast cancer;
  • seizures or epilepsy;
  • a personal or family history of diabetes;
  • an enlarged prostate or difficulty urinating;
  • glaucoma; or
  • trouble swallowing.
• If you have any of these conditions, you may not be able to use Zyprexa, or you may need a dosage adjustment or special tests during treatment.
• Zyprexa may cause you to have high blood sugar (hyperglycemia). Talk to your doctor if you have any signs of hyperglycemia such as increased thirst or urination, excessive hunger, or weakness. If you are diabetic, check your blood sugar levels on a regular basis while you are taking Zyprexa.
• The Zyprexa orally disintegrating tablet (Zyprexa Zydis) may contain phenylalanine. Talk to your doctor before using this form of Zyprexa if you have phenylketonuria (PKU).
• FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
• Zyprexa can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take Zyprexa?

• Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.
• Do not take Zyprexa for longer than 8 weeks unless your doctor has told you to.
• Take each tablet with a full glass of water.
• Zyprexa can be taken with or without food.
• Zyprexa is usually taken once a day. Follow your doctor's instructions.
• To take Zyprexa orally disintegrating tablets (Zyprexa Zydis):
  • Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.
  • Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.
  • Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.
  • Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet.
• It is important to take Zyprexa regularly to get the most benefit.
• Do not stop taking Zyprexa without first talking to your doctor. It may be at least 4 weeks before you begin to feel better, and you may need to take the medication for longer than 4 weeks. Follow your doctor's instructions. It is important to take Zyprexa regularly to get the most benefit.
• To be sure this medication is helping your condition, your doctor will need to check your progress on a regular basis. It is important that you not miss any scheduled visits to your doctor.
• Store Zyprexa at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

• Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of an Zyprexa overdose may include drowsiness, agitation, aggression, slurred speech, confusion, increased heart rate, jerky or uncontrolled muscle movements, trouble breathing, or fainting.

What should I avoid while taking Zyprexa?

• Zyprexa can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
• Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.
• Avoid drinking alcohol, which can increase some of the side effects of Zyprexa.
• Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by Zyprexa.
• Avoid becoming overheated or dehydrated. Drink plenty of fluids, especially in hot weather and during exercise. It is easier to become dangerously overheated and dehydrated while you are taking Zyprexa.

What are the possible side effects of Zyprexa?

• Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Stop using Zyprexa and call your doctor at once if you have any of these serious side effects:
  • fever, stiff muscles, confusion, sweating, fast or uneven heartbeats;
  • jerky muscle movements you cannot control;
  • sudden numbness or weakness, especially on one side of the body;
  • sudden headache, confusion, problems with vision, speech, or balance;
  • increased thirst, frequent urination, excessive hunger, or weakness;
  • feeling light-headed, fainting; or
  • unusual thoughts or behavior, hallucinations, or thoughts about hurting yourself.
• Continue taking Zyprexa and talk to your doctor if you have any of these less serious side effects:
  • dizziness, drowsiness, or weakness;
  • constipation;
  • dry mouth;
  • swelling in your hands or feet;
  • back pain;
  • weight gain, increased appetite; or
  • upset stomach.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Zyprexa?

• Before taking Zyprexa, tell your doctor if you are taking any of the following medicines:
  • a medication to treat high blood pressure or a heart condition;
  • carbamazepine (Tegretol);
  • fluvoxamine (Luvox); or
  • a medication to treat Parkinson's disease including levodopa (Sinemet, Larodopa, Atamet), selegiline (Eldepryl, Emsam), pramipexole (Mirapex), ropinirole (Requip), and others.
• If you are using any of these drugs, you may not be able to use Zyprexa, or you may need dosage adjustments or special tests during treatment.
• There may be other drugs not listed that can affect Zyprexa. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Wellbutrin (Generic name: Bupropion)

What is the most important information I should know about Wellbutrin?

• You should not take Wellbutrin if you have epilepsy or a seizure disorder, an eating disorder such as anorexia or bulimia, if you are using a second form of Wellbutrin, or if you have suddenly stopped using alcohol or sedatives. Do not take Wellbutrin if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.
• You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are 18 years of age or younger. Talk with your doctor about this risk. While you are taking this medication you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
• Contact your doctor if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), or thoughts of suicide or hurting yourself.
• Do not stop taking Wellbutrin without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.
• Avoid using Wellbutrin to treat more than one condition at a time. If you take Wellbutrin for depression, do not also take Zyban to quit smoking. Too much of this medicine can increase your risk of a seizure.
• Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.
• Avoid drinking alcohol while taking Wellbutrin. Alcohol may increase your risk of a seizure while you are taking Wellbutrin. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Wellbutrin can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication.
• There are many other drugs that can affect Wellbutrin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

What is Wellbutrin?

• Wellbutrin is an antidepressant medication.
• Wellbutrin is used to treat major depressive disorder and seasonal affective disorder.
• At least one brand of Wellbutrin (Zyban) is used to help people stop smoking by reducing cravings and other withdrawal effects.
• Wellbutrin may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Wellbutrin?

• Do not take Wellbutrin if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.
• You should not take Wellbutrin if you have:
  • epilepsy or a seizure disorder;
  • an eating disorder such as anorexia or bulimia;
  • if you are using a second form of Wellbutrin; or
  • if you have suddenly stopped using alcohol or sedatives (such as Valium).
• Wellbutrin may cause seizures, especially if you have any of the following conditions:
  • head injury, brain or spinal cord tumor;
  • bipolar disorder (manic depression);
  • diabetes for which you use insulin or take oral medication;
  • current use of steroids, theophylline (Theo-Dur, Slo-Bid, Bronkodyl Theolair, Respbid), or medicine to treat depression or mental illness; or
  • recent use of alcohol, sedatives (such as Valium), narcotic pain medicines, diet pills, or street drugs such as “speed” or cocaine.
• Before taking Wellbutrin, tell your doctor if you have high blood pressure, heart disease, liver disease, kidney disease, or severe liver disease (especially cirrhosis).
• You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. While you are taking Wellbutrin, you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
• Contact your doctor if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), or thoughts of suicide or hurting yourself.
• FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
• Wellbutrin passes into breast milk and could be harmful to a nursing baby. Do not take Wellbutrin without telling your doctor if you are breast-feeding a baby.
• You should not smoke if you use inhaled insulin (Exubera) to treat diabetes. Smoking may cause you to have low blood sugar (hypoglycemia) while using Exubera. Do not use Exubera unless you have been smoke-free for at least 6 months. Do not start smoking again or you will have to stop using Exubera.

How should I take Wellbutrin?

• Take Wellbutrin exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.
• Wellbutrin can be taken with or without food.
• Take each dose with a full glass of water.
• Do not crush, chew, or break the extended-release tablet (Wellbutrin SR, Wellbutrin XL, Zyban SR). Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.
• If you take Zyban to help you stop smoking, you may continue to smoke for about 1 week after you start the medicine. Set a date to quit smoking during the second week of Zyban treatment. By that time you will have enough of the medicine in your blood stream to help you quit smoking. Talk to your doctor if you are having trouble quitting after you have used Zyban for at least 7 weeks.
• Your doctor may prescribe nicotine patches or gum to help support your smoking cessation treatment. Be sure you read all directions and safety information for the nicotine product. Using nicotine with Zyban may raise your blood pressure and your doctor may want to check your blood pressure regularly. Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects.
• Do not stop taking Wellbutrin without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.
• If you use the Wellbutrin extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.
• Store Wellbutrin at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

• Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a Wellbutrin overdose may include seizures, muscle stiffness, hallucinations, fainting, fast or uneven heartbeat, shallow breathing, heart failure, or coma.

What should I avoid while taking Wellbutrin?

• Avoid drinking alcohol while taking Wellbutrin. Alcohol may increase your risk of a seizure while you are taking Wellbutrin. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Wellbutrin can cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication.
• Avoid using Wellbutrin to treat more than one condition at a time. If you take Wellbutrin for depression, do not also take Zyban to quit smoking. Too much of this medicine can increase your risk of a seizure.
• Wellbutrin can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
• You should not smoke if you use inhaled insulin (Exubera) to treat diabetes. Smoking may cause you to have low blood sugar (hypoglycemia) while using Exubera. Do not use Exubera unless you have been smoke-free for at least 6 months. Do not start smoking again or you will have to stop using Exubera.

What are the possible side effects of Wellbutrin?

• Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Stop using Wellbutrin and call your doctor at once if you have a seizure (convulsions) or fast, uneven heartbeats.
• Continue taking Wellbutrin and talk to your doctor if you have any of these less serious side effects:
  • headache or migraine;
  • sleep problems (insomnia);
  • nausea, vomiting, constipation, dry mouth;
  • confusion, dizziness, agitation, tremors (shaking);
  • appetite changes, weight loss or gain;
  • mild itching or skin rash, increased sweating; or
  • loss of interest in sex.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Wellbutrin?

• Do not take Wellbutrin if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) in the last 14 days.
• There are many other drugs that can affect Wellbutrin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Trivastal (Generic name: Piribedil)

Indications

Treatment of Parkinsons disease either as monotherapy or in combination with L-dopa therapy, in the early stages as well as in advanced stages. Treatment of Pathological cognitive deficits in the elderly. Treatment of Dizziness in the elderly. Treatment of retinal ischemic manifestations. Adjuvant treatment in intermittent claudication due to peripheral occlusive arterial disease of the lower limbs.

Contraindication

Cardiogenic shock. Acute Phase mycordial infraction.

Side Effects

Rare side effects: minor gastrointestinal disorders in predisposed individuals, or under taken between meals.

Tofranil (Generic name: Imipramine)

What is the most important information I should know about tofranil?

Do not use tofranil if you have recently had a heart attack, or if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days.

You may have suicidal thoughts or behavior when you start taking an antidepressant, especially if you are under 18 years old. You will need to be monitored for worsening symptoms of depression or suicidal thoughts. Your doctor should check you at regular visits during the first 12 weeks of treatment, or whenever your dose is changed.

Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself.

What is tofranil?

Tofranil is in a group of drugs called tricyclic antidepressants. Tofranil affects chemicals in the brain that may become unbalanced.

Tofranil is used to treat symptoms of depression.

Tofranil may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking tofranil?

Do not use this medication if you are allergic to tofranil, or if you have recently had a heart attack. Do not use tofranil if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take tofranil before the MAO inhibitor has cleared from your body.

Before taking tofranil, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease;
• a history of heart attack, stroke, or seizures;
• bipolar disorder (manic-depression);
• kidney or liver disease;
• overactive thyroid;
• diabetes (tofranil may raise or lower blood sugar);
• adrenal gland tumor (pheochromocytoma);
• glaucoma; or
• problems with urination.

If you have any of these conditions, you may not be able to use tofranil, or you may need a dosage adjustment or special tests during treatment.

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. While you are taking tofranil, you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed.

In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Tofranil can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medication. Do not give this medication to anyone under 18 years old without the advice of a doctor.

How should I take tofranil?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Follow the directions on your prescription label.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking tofranil. You may need to stop using the medicine for a short time.

Do not stop using tofranil without first talking to your doctor. You may need to use less and less before you stop the medication completely. Stopping this medication suddenly could cause you to have unpleasant side effects. It may take up to 3 weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 3 weeks of treatment. Store tofranil at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of tofranil can be fatal.

Symptoms of an tofranil overdose may include uneven heartbeats, extreme drowsiness, agitation, vomiting, blurred vision, sweating, muscle stiffness, swelling, shortness of breath, blue lips or fingernails, feeling light-headed, fainting, seizure (convulsions), or coma.

What should I avoid while taking tofranil?

Avoid drinking alcohol. It can cause dangerous side effects when taken together with tofranil.

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, medicine for seizures, or other antidepressants). They can add to sleepiness caused by tofranil.

Grapefruit and grapefruit juice may interact with tofranil. Discuss the use of grapefruit products with your doctor before increasing or decreasing the amount of grapefruit products in your diet.

Tofranil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Tofranil can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

What are the possible side effects of tofranil?

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

• fast, pounding, or uneven heart rate;
• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• feeling short of breath, even with mild exertion;
• swelling, rapid weight gain;
• confusion, hallucinations, or seizure (convulsions);
• easy bruising or bleeding, unusual weakness;
• restless muscle movements in your eyes, tongue, jaw, or neck;
• urinating more or less than usual;
• extreme thirst with headache, nausea, vomiting, and weakness;
• skin rash, bruising, severe tingling, numbness, pain, or muscle weakness.

Less serious side effects may be more likely to occur, such as:

• nausea, vomiting, stomach pain, loss of appetite;
• constipation or diarrhea;
• dry mouth, unpleasant taste;
• weight changes;
• weakness, lack of coordination;
• feeling anxious, restless, dizzy, drowsy, or tired;
• sleep problems (insomnia), nightmares;
• blurred vision, headache, ringing in your ears;
• breast swelling (in men or women); or
• decreased sex drive, impotence, or difficulty having an orgasm.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect tofranil?

Before taking tofranil, tell your doctor if you have used an SSRI antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

Before taking tofranil, tell your doctor if you are currently using any of the following drugs:

• cimetidine (Tagamet);
• clonidine (Catapres);
• guanethidine (Ismelin);
• methylphenidate (Concerta, Ritalin, Daytrana); or
• heart rhythm medications such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Cardioquin, Quinidex, Quinaglute).

If you are using any of these drugs, you may not be able to use tofranil, or you may need dosage adjustments or special tests during treatment.

There are many other medicines that can interact with tofranil. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Sinequan (Generic name: Doxepin)

What is the most important information I should know about Sinequan?

• While you are taking Sinequan you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking Sinequan. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Sinequan. Do not stop taking Sinequan.
• Use caution when driving, operating machinery, or performing other hazardous activities. Sinequan may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities.
• Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.
• Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking Sinequan.

What is Sinequan?

• Sinequan is in a class of drugs called tricyclic antidepressants. Sinequan affects chemicals in the brain that may become unbalanced and cause depression.
• Sinequan is used to relieve symptoms of depression and anxiety such as feelings of sadness, worthlessness, or guilt; loss of interest in daily activities; changes in appetite; tiredness; sleeping too much; insomnia, and thoughts of death or suicide.
• Sinequan may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Sinequan?

• Do not take Sinequan if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within the last 14 days.
• Before taking Sinequan, tell your doctor if you have
  • liver disease,
  • kidney disease,
  • asthma,
  • thyroid disease,
  • diabetes,
  • stomach or intestinal problems,
  • high blood pressure or heart disease,
  • had a heart attack in the last 6 weeks,
  • an enlarged prostate or difficulty urinating, or
  • glaucoma.
• You may not be able to take Sinequan, or you may require a dosage adjustment or special monitoring during therapy if you have any of the conditions listed above.
• While you are taking Sinequan you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking Sinequan. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Sinequan. Do not stop taking Sinequan.
• It is not known whether Sinequan will be harmful to an unborn baby. Do not take Sinequan without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• Sinequan passes into breast milk and may affect a nursing baby. Do not take Sinequan without first talking to your doctor if you are breast-feeding a baby.
• If you are over 60 years of age, you may be more likely to experience side effects such as drowsiness, dizziness, unsteadiness, feeling uncoordinated, and low blood pressure. Your doctor may prescribe a lower dose of this medication.

How should I take Sinequan?

• Take Sinequan exactly as directed by your doctor. 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 (8 oz) of water.
• Sinequan may be taken several times a day or in one daily dose (usually at bedtime). Follow your doctor's instructions.
• It may be several weeks before you start to feel better, but do not stop taking Sinequan without first talking to your doctor.
• Store Sinequan at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. If it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

• Seek emergency medical attention if an overdose is suspected.
• Symptoms of an Sinequan overdose include seizures, confusion, drowsiness, agitation, hallucinations, and low blood pressure (dizziness, fatigue, fainting).

What should I avoid while taking Sinequan?

• Use caution when driving, operating machinery, or performing other hazardous activities. Sinequan may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities.
• Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.
• Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking Sinequan.
• Do not stop taking Sinequan suddenly. This could cause symptoms such as nausea, headache, and malaise.

What are the possible side effects of Sinequan?

• If you experience any of the following serious side effects, stop taking Sinequan and contact your doctor immediately or seek emergency medical treatment:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, face, or tongue; or hives);
  • seizures;
  • a fast or irregular heartbeat;
  • a heart attack;
  • high blood pressure (blurred vision, severe headache);
  • difficulty urinating; or
  • fever with increased sweating, muscle stiffness, or severe muscle weakness.
• Other, less serious side effects may be more likely to occur. Continue to take Sinequan and talk to your doctor if you experience
  • drowsiness or dizziness;
  • dry mouth and eyes;
  • constipation;
  • mild tremor;
  • sweating;
  • mild agitation, weakness, or headache;
  • ringing in the ears;
  • nausea; or
  • loss of weight or appetite.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Sinequan?

• Do not take Sinequan if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within the last 14 days.
• Sinequan may increase the effects of other drugs that cause drowsiness, including other antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other prescription or over-the-counter medicines without first talking to your doctor.
• Drugs other than those listed here may also interact with Sinequan. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Sinemet (Generic name: Carbidopa + Levodopa)

What is the most important information I should know about Sinemet?

• Do not stop taking Sinemet suddenly. It may take several weeks before you feel the full effects of this medicine. Stopping suddenly could make your condition much worse.
• Do not crush or chew any controlled-release forms of Sinemet (Sinemet CR). They are specially formulated to release slowly into your system. If necessary, the tablets can be split in half where they are scored, then swallowed without crushing or chewing.
• Use caution when driving, operating machinery, or performing other hazardous activities. Sinemet may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Call your doctor immediately if you have uncontrollable movements of the mouth, tongue, cheeks, jaw, arms, or legs; fever; or increased body heat.

What is Sinemet?

• Sinemet is a medication used to treat Parkinson's disease. Parkinson's disease is believed to be related to low levels of a chemical called dopamine (DOE pa meen) in the brain. Levodopa is turned into dopamine in the body. Carbidopa is used with levodopa to prevent the breakdown (metabolism) of levodopa before it can reach the brain and take effect.
• Sinemet is used to treat the stiffness, tremors, spasms, and poor muscle control associated with Parkinson's disease. This medication is also used to treat the same muscular conditions when they are caused by carbon monoxide and/or manganese intoxication.
• Sinemet may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Sinemet?

• If you are already taking levodopa (Larodopa, Dopar), you will have to stop taking it at least 12 hours before you take your first dose of Sinemet.
• Do not take Sinemet if you are taking or have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the past 14 days.
• Do not take this medication if you have
  • narrow-angle glaucoma (angle closure glaucoma), or
  • current or past history of malignant melanoma (a type of skin cancer).
• Before taking this medication, tell your doctor if you have:
  • any kind of heart disease, including high blood pressure, arteriosclerosis (hardening of the arteries), a previous heart attack, or an irregular heartbeat;
  • respiratory disease, including asthma and chronic obstructive pulmonary disease (COPD);
  • liver disease;
  • kidney disease;
  • an endocrine (hormonal) disease;
  • a stomach or intestinal ulcer;
  • wide-angle glaucoma; or
  • depression or any other psychiatric disorder.
• You may not be able to take Sinemet, or you may need a lower dose or special monitoring during treatment if you have any of the conditions listed above.
• Parcopa 10/100 mg and 25/100 mg tablets each contain 3.4 mg of phenylalanine; Parcopa 25/250 mg tablet contains 8.4 mg of phenylalanine. Talk to your doctor if you have phenylketonuria or have a family history of phenylketonuria.
• Sinemet is in the FDA pregnancy category C. This means that it is not known whether Sinemet will harm an unborn baby. Do not take Sinemet without first talking to your doctor if you are pregnant.
• It is also not known whether Sinemet will harm a nursing infant. Do not take Sinemet without first talking to your doctor if you are breast-feeding a baby.

How should I take Sinemet?

• Do not stop taking Sinemet suddenly. It may take several weeks before you feel the full effects of this medicine. Stopping suddenly could make your condition much worse.
• Sinemet can be taken with or without food.
• Take Sinemet exactly as directed by your doctor. 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.
• Use dry hands to place Parcopa (Sinemet orally disintegrating tablets) onto your tongue where it will dissolve in seconds and can then be swallowed. Parcopa can be taken with or without water.
• Do not crush or chew any controlled-release forms of Sinemet (Sinemet CR). They are specially formulated to release slowly into your system. If necessary, the tablets can be split in half where they are scored, then swallowed without crushing or chewing.
• The regular-release formulations can be broken or crushed to make them easier to swallow.
• It is important to take Sinemet regularly to get the most benefit.
• Store Sinemet at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and only take your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

• Seek emergency medical attention.
• Symptoms of a Sinemet overdose include muscle spasms or weakness, spasms of the eyelid, nausea, vomiting, diarrhea, irregular heartbeat, confusion, agitation, hallucinations, and unconsciousness.

What should I avoid while taking Sinemet?

• Use caution when driving, operating machinery, or performing other hazardous activities. Sinemet may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Do not change the amount of protein in your diet without first talking to your doctor (high protein foods include meats, eggs, cheese and others). Protein may reduce the amount of Sinemet that gets absorbed into your body.

What are the possible side effects of Sinemet?

• If you experience any of the following serious side effects, stop taking Sinemet and seek emergency medical attention:
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
  • uncontrolled movements of a part of your body;
  • seizures;
  • severe nausea, vomiting, or diarrhea;
  • an irregular heartbeat or fluttering in your chest;
  • unusual changes in mood or behavior; or
  • depression or suicidal thoughts.
• Other, less serious side effects may be more likely to occur. Continue to take Sinemet and talk to your doctor if you experience
  • mild nausea, vomiting, or decreased appetite;
  • constipation, dry mouth, or blurred vision;
  • hand tremor;
  • muscle twitches;
  • dizziness or drowsiness;
  • insomnia, confusion, or nightmares;
  • agitation or anxiety;
  • darkening of your urine, sweat, or saliva; or
  • fatigue.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Sinemet?

• You cannot take Sinemet if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the past 14 days.
• If you are already taking levodopa (Larodopa, Dopar) you will have to stop taking it at least 12 hours before you take your first dose of Sinemet.
• Before taking Sinemet, tell your doctor if you are taking any of the following medicines:
  • antacids;
  • iron supplements or vitamin supplements containing iron;
  • metoclopramide (Reglan);
  • isoniazid (Nydrazid);
  • phenytoin (Dilantin);
  • a medicine to treat high blood pressure (hypertension);
  • a tricyclic antidepressant such as amitriptyline (Elavil), doxepin (Sinequan), nortriptyline (Pamelor), desipramine (Norpramin), amoxapine (Asendin), and others; or
  • a medicine used to treat psychiatric conditions (and nausea and vomiting) such as chlorpromazine (Thorazine), prochlorperazine (Compazine), promethazine (Phenergan), fluphenazine (Prolixin), mesoridazine (Serentil), thioridazine (Mellaril), trifluoperazine (Stelazine), or haloperidol (Haldol).
• You may not be able to take Sinemet, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Levodopa may interfere with urine tests for sugar and ketones. If you are diabetic and notice changes in your urine test results, talk to your doctor before making any changes in your diabetes medication.
• Drugs other than those listed here may also interact with Sinemet. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Risperdal (Generic name: Risperidone)

What is the most important information I should know about Risperdal?

• Contact your doctor immediately if you experience fever, sweating, severe muscle stiffness (rigidity), confusion, fast or irregular heart beat. These could be symptoms of a potentially fatal side effect called Neuroleptic Malignant Syndrome (NMS).
• Use caution when driving, operating machinery, or performing other hazardous activities. Risperdal may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Dizziness may be more likely to occur when rising from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.
• Avoid alcohol or use it with caution. Alcohol may increase drowsiness and dizziness while taking Risperdal.
• Avoid becoming overheated in hot weather and during exercise. Risperdal may increase the risk of heat stroke.
• Elderly patients with dementia-related psychosis treated with Risperdal are at an increased risk of death compared to placebo. Risperdal is not approved for the treatment of patients with Dementia-Related Psychosis. Talk to your doctor if you have any questions regarding the use of Risperdal.
• Do not mix the liquid form of Risperdal with cola or tea.

What is Risperdal?

• Risperdal is an antipsychotic medication. It works by changing the effects of chemicals in the brain.
• Risperdal is used for the treatment of schizophrenia and mania associated with bipolar disorder.
• Risperdal may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Risperdal?

• Before taking this medication, tell your doctor if you have
  • had a heart attack, low blood pressure, an irregular heart-beat, or any other type of heart disease;
  • epilepsy or another seizure disorder (or a history of this);
  • diabetes;
  • ever been diagnosed with breast cancer;
  • liver disease; or
  • kidney disease.
• You may not be able to take Risperdal, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Elderly patients with dementia-related psychosis treated with Risperdal are at an increased risk of death compared to placebo. Risperdal is not approved for the treatment of patients with Dementia-Related Psychosis. Talk to your doctor if you have any questions regarding the use of Risperdal.
• Hyperglycemia (increased blood sugar) has been reported in patients treated with atypical antipsychotics including Risperdal. Talk to your doctor if you experience any signs of hyperglycemia including excessive thirst, frequent urination, excessive hunger or weakness.
• The Risperdal (Risperdal) orally-disintegrating tablets contain phenylalanine. The 0.5 mg tablets contain 0.14 mg phenylalanine, the 1 mg tablets contain 0.28 mg phenylalanine, and the 2 mg tablets contain 0.5 mg phenylalanine. Individuals with phenylketonuria may need to monitor their intake of this additive.
• Risperdal is in the FDA pregnancy category C. This means that it is not known whether Risperdal will be harmful to an unborn baby. Do not take Risperdal without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• It is not known whether Risperdal passes into breast milk. Do not take Risperdal without first talking to your doctor if you are breast-feeding a baby.
• If you are over the age of 65, you may be more likely to experience side effects from Risperdal. An increased risk of stroke and transient ischemic attack (TIA, “mini-stroke”) has been associated with the use of Risperdal in elderly patients with dementia-related psychosis. Your doctor may prescribe a lower dose of the medication or special monitoring during treatment.

How should I take Risperdal?

• Take Risperdal exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• The injectable form of Risperdal (Risperdal Consta) will be administered by a healthcare professional. If you are administering injectable Risperdal at home, your healthcare provider will give you detailed instructions regarding preparation, administration, and storage of the medication.
• Take the regular oral tablets with a full glass of water.
• The Risperdal orally-disintegrating tablets (Risperdal M-Tabs) can be taken without water. Using dry hands, peel back the foil on blister. Do not push tablet through the foil as this may damage the tablet. Immediately upon opening the blister, remove the tablet and place it on the tongue. The tablet must be taken immediately after opening the blister and not saved for later use. The tablet will disintegrate rapidly in the mouth and can be easily swallowed with or without liquid. Do not chew or split the tablets.
• Measure the liquid form of Risperdal carefully and mix it with water, coffee, orange juice, or low-fat milk and drink it immediately.
• Do not mix the liquid form of Risperdal with cola or tea.
• Risperdal can be taken with or without food or milk.
• It is important to take Risperdal regularly to get the most benefit.
• Do not stop taking Risperdal without first talking to your doctor. It may be several weeks before you begin to feel better, and you may require continuous treatment for quite some time. Talk to your doctor before you stop taking this medication.
• Your doctor may want you to have blood tests or other medical evaluations during treatment with Risperdal to monitor progress and side effects.
• Store Risperdal at room temperature away from moisture, light, and heat. Do not allow the liquid form of Risperdal to freeze.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication.

What happens if I overdose?

• Seek emergency medical treatment if an overdose is suspected.
• Symptoms of a Risperdal overdose include dizziness; drowsiness; increased heart rate; fainting; fever; sweating; muscle spasms; and uncontrollable movements of the arms, hands, tongue, face, or other body parts.

What should I avoid while taking Risperdal?

• Use caution when driving, operating machinery, or performing other hazardous activities. Risperdal may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
• Dizziness may be more likely to occur when rising from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.
• Avoid alcohol or use it with caution. Alcohol may increase drowsiness and dizziness while taking Risperdal.
• Avoid becoming overheated in hot weather and during exercise. Risperdal may increase the risk of heat stroke.

What are the possible side effects of Risperdal?

• Contact your doctor immediately if you experience fever, sweating, severe muscle stiffness (rigidity), confusion, fast or irregular heart beat. These could be symptoms of a potentially fatal side effect called Neuroleptic Malignant Syndrome (NMS).
• If you experience any of the following serious side effects, stop taking Risperdal and seek emergency medical treatment or contact your doctor immediately:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  • uncontrollable movements of the tongue, face, lips, arms, or legs;
  • muscle spasms of the face or neck;
  • severe restlessness or tremor;
  • severe drowsiness or fainting; or
  • irregular or very fast heartbeat.
• Other, less serious side effects may be more likely to occur. Continue to take Risperdal and talk to your doctor if you experience
  • mild restlessness, drowsiness, or tremor;
  • insomnia;
  • blurred vision;
  • dizziness or headache;
  • nausea; or
  • weight gain.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Risperdal?

• Before taking this medication, tell your doctor if you are taking any of the following medicines:
  • carbamazepine (Tegretol);
  • clozapine (Clozaril);
  • medicines used to treat Parkinson's Disease such as levodopa (Dopar, Larodopa, Sinemet, Atamet, others), bromocriptine (Parlodel, others), pergolide (Permax), pramipexole (Mirapex), or ropinirole (Requip), or;
  • any medicine used to lower blood pressure.
• You may not be able to take Risperdal, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Risperdal may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor.
• Drugs other than those listed here may also interact with Risperdal. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Remeron (Generic name: Mirtazapine)

What is the most important information I should know about Remeron?

• While you are taking Remeron you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking Remeron. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Remeron. Do not stop taking Remeron.
• It may be several weeks before you start to feel better. Even when you start to feel better, do not stop taking Remeron without first talking to your doctor.
• Contact your doctor if you experience fever, chills, a sore throat, flu-like symptoms, or sores in the mouth or nose.
• Use caution when driving, operating machinery, or performing other hazardous activities. Remeron may cause drowsiness and dizziness. If you experience drowsiness or dizziness, avoid these activities.
• Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.
• Avoid the use of alcohol while taking Remeron. Alcohol may increase drowsiness and dizziness.
• Remeron is available in a regular tablet formulation (Remeron) that should be swallowed with water. Remeron is also available in a rapidly-disintegrating formulation (Remeron SolTab) that will disintegrate rapidly when placed on the tongue and can be swallowed with or without water.

What is Remeron?

• Remeron is in a class of drugs called antidepressants. Remeron affects chemicals in your brain that may become unbalanced and cause depression.
• Remeron is used to relieve symptoms of depression such as feelings of sadness, worthlessness, or guilt; loss of interest in daily activities; changes in appetite; tiredness; sleeping too much; insomnia; and thoughts of death or suicide.
• Remeron may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Remeron?

• While you are taking Remeron you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking Remeron. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Remeron. Do not stop taking Remeron.
• Do not take Remeron if you are currently taking, or have taken within the last 14 days, a monoamine oxidase inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate).
• Before taking Remeron, tell your doctor if you
  • have liver disease;
  • have kidney disease;
  • have a manic-depressive disorder;
  • have blood problems;
  • have high or low blood pressure or heart disease;
  • have had a heart attack in the last 6 weeks; or
  • have epilepsy or seizures.
• You may not be able to take Remeron, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• The rapidly-disintegrating formulation of Remeron tablets (Remeron SolTab) contains phenylalanine. People with the disease phenylketonuria (PKU) need to monitor their intake of this additive.
• Remeron is in the FDA pregnancy category C. This means that it is not known whether Remeron will harm an unborn baby. Do not take Remeron without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• It is not known whether Remeron passes into breast milk. Do not take Remeron without first talking to your doctor if you are breast-feeding a baby.
• If you are over 60 years of age, you may be more likely to experience side effects such as drowsiness, dizziness, unsteadiness, feeling uncoordinated, and low blood pressure. You may require a lower dose of this medication.

How should I take Remeron?

• Take Remeron exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Remeron is available in a regular tablet formulation (Remeron) that should be swallowed with water. Remeron is also available in a rapidly-disintegrating formulation (Remeron SolTab) that will disintegrate rapidly when placed on the tongue and can be swallowed with or without water.
• If you are taking the Remeron rapidly-disintegrating tablets (Remeron SolTab), open the blister pack with dry hands and use the tablet immediately after removal from the blister pack. Do not attempt to split the rapidly-disintegrating tablets.
• Remeron is usually taken once a day, preferably at bedtime. Follow your doctor's instructions.
• It may be several weeks before you start to feel better. Even when you start to feel better, do not stop taking Remeron without first talking to your doctor.
• Store Remeron at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

• Seek emergency medical attention if an overdose is suspected.
• Symptoms of a Remeron overdose include confusion, drowsiness, poor memory, and a fast heartbeat.

What should I avoid while taking Remeron?

• Use caution when driving, operating machinery, or performing other hazardous activities. Remeron may cause drowsiness and dizziness. If you experience drowsiness or dizziness, avoid these activities.
• Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.
• Avoid the use of alcohol while taking Remeron. Alcohol may increase drowsiness and dizziness.

What are the possible side effects of Remeron?

• If you experience any of the following serious side effects, stop taking Remeron and call your doctor immediately or seek emergency medical treatment:
  • an allergic reaction (swelling of the lips, face, or tongue; difficulty breathing);
  • seizures;
  • a fast or irregular heartbeat; or
  • fever, chills, a sore throat, flu-like symptoms, or sores in your mouth or nose.
• Other, less serious side effects may be more likely to occur. Continue to take Remeron and talk to your doctor if you experience
  • drowsiness;
  • nausea;
  • increase in weight or appetite;
  • dizziness;
  • dry mouth;
  • constipation; or
  • mild tremor.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Remeron?

• Do not take Remeron if you are currently taking, or have taken within the last 14 days, a monoamine oxidase inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate).
• Remeron may increase the effects of other drugs that cause drowsiness, including other antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves.
• Drugs other than those listed here may also interact with Remeron. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.