Pioglitazone/Glimepiride

Pronunciation: PYE-oh-GLI-ta-zone/glye-MEP-ir-ide
Generic Name: Pioglitazone/Glimepiride
Brand Name: Duetact

Thiazolidinedione antidiabetics such as Pioglitazone/Glimepiride may cause or worsen heart failure in some patients. Tell your doctor if you have a history of heart failure. Pioglitazone/Glimepiride should not be used to treat patients with moderate to severe heart failure. You will be monitored for signs of heart failure when you start Pioglitazone/Glimepiride and when your dose increases. Contact your doctor at once if you develop swelling of the hands, ankles, or feet; shortness of breath; or sudden, unexplained weight gain. Your doctor may need to stop your medicine or change your dose.

Pioglitazone/Glimepiride is used for:

Treating type 2 diabetes in certain patients. It is used along with diet and exercise.

Pioglitazone/Glimepiride is a thiazolidinedione and sulfonylurea antidiabetic combination. It lowers blood sugar by making the cells of the body more sensitive to the action of insulin. It also causes the pancreas to release insulin, which helps to lower blood sugar.

Do NOT use Pioglitazone/Glimepiride if:

• you are allergic to any ingredient in Pioglitazone/Glimepiride


• you have bladder cancer, moderate to severe heart failure, liver problems or abnormal liver function tests, certain severe problems associated with diabetes (eg, diabetic ketoacidosis, diabetic coma), moderate to severe burns, or very high blood acid levels (acidosis)


• you have type 1 diabetes


• you are taking bosentan

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

Before using Pioglitazone/Glimepiride:

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

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


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


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


• if you have had a severe allergic reaction (eg, severe rash, hives, breathing difficulties, dizziness) to any other sulfonamide medicine such as acetazolamide, celecoxib, certain diuretics (eg, hydrochlorothiazide), glipizide, probenecid, sulfamethoxazole, valdecoxib, or zonisamide


• if you have a history of kidney, thyroid, heart, or blood vessel problems; anemia, stroke; certain hormonal problems (eg, adrenal or pituitary problems, syndrome of inappropriate secretion of antidiuretic hormone [SIADH]); low blood sodium levels; or low levels of an enzyme called glucose 6-phosphate dehydrogenase (G6PD)


• if you have stomach or bowel problems (eg, stomach or bowel blockage, stomach paralysis), drink alcohol, or have had poor nutrition


• if you have very poor health, a high fever, a severe infection, severe diarrhea, high blood acid levels, or brain or nervous system problems, or have had a severe injury


• if you have a history of bladder cancer, bone fracture, low calcium intake, or weak bones (eg, osteoporosis)


• if you have swelling problems (edema) or eye or vision problems (eg, macular edema)


• if you will be having surgery

Some MEDICINES MAY INTERACT with Pioglitazone/Glimepiride. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Bosentan because liver problems may occur, and the effectiveness of both medicines may be decreased


• Beta-blockers (eg, propranolol) because the risk of low blood sugar may be increased. They may also hide certain signs of low blood sugar and make it more difficult to notice


• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), azole antifungals (eg, miconazole, ketoconazole), chloramphenicol, clarithromycin, clofibrate, disopyramide, fenfluramine, fluoxetine, insulin, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), phenylbutazone, probenecid, quinolone antibiotics (eg, ciprofloxacin), salicylates (eg, aspirin), and sulfonamides (eg, sulfamethoxazole) because the risk of low blood sugar may be increased


• Calcium channel blockers (eg, diltiazem), corticosteroids (eg, prednisone), decongestants (eg, pseudoephedrine), diazoxide, diuretics (eg, furosemide, hydrochlorothiazide), estrogens, hormonal contraceptives (eg, birth control pills), isoniazid, niacin, phenothiazines (eg, promethazine), phenytoin, rifamycins (eg, rifampin), sympathomimetics (eg, albuterol, epinephrine), or thyroid supplements (eg, levothyroxine) because they may decrease Pioglitazone/Glimepiride's effectiveness, resulting in high blood sugar


• Gemfibrozil because blood sugar may be increased or decreased


• Anticoagulants (eg, warfarin) because their effectiveness may be decreased or the risk of their side effects may be increased by Pioglitazone/Glimepiride

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

How to use Pioglitazone/Glimepiride:

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

• Pioglitazone/Glimepiride comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Pioglitazone/Glimepiride refilled.


• Take Pioglitazone/Glimepiride by mouth with breakfast or the first main meal of the day unless instructed otherwise by your doctor.


• Continue to take Pioglitazone/Glimepiride even if you feel well. Do not miss any doses.


• Taking Pioglitazone/Glimepiride at the same time each day will help you remember to take it.


• If you miss a dose of Pioglitazone/Glimepiride, skip the missed dose and go back to your regular dosing schedule, unless your doctor directs you otherwise. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Pioglitazone/Glimepiride.

Important safety information:

• Pioglitazone/Glimepiride may cause drowsiness, dizziness, blurred vision, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Pioglitazone/Glimepiride with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Do not drink alcohol while you are taking Pioglitazone/Glimepiride; it may increase the risk of low blood sugar. Rarely, alcohol may interact with Pioglitazone/Glimepiride and cause a serious reaction with symptoms such as flushing, nausea, vomiting, dizziness, or stomach pain. Discuss any questions or concerns with your doctor.


• Carry an ID card at all times that says you have diabetes.


• Proper diet and exercise are important in order to lose weight and keep it off. Follow the diet and exercise program given to you by your health care provider.


• Check your blood sugar levels as directed by your doctor. If they are often higher or lower than they should be and you take Pioglitazone/Glimepiride exactly as prescribed, tell your doctor.


• It may be harder to control your blood sugar during times of stress such as fever, infection, injury, or surgery. Talk with your doctor about how to control your blood sugar if any of these occur. Do not change the dose of your medicine without checking with your doctor.


• It may take 2 to 3 months to get the full effect from Pioglitazone/Glimepiride. Do NOT take more than the recommended dose without checking with your doctor.


• Pioglitazone/Glimepiride may cause low blood sugar levels. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.


• Risk of low blood sugar may be increased by severe or prolonged exercise, drinking alcohol, or skipping meals.


• Pioglitazone/Glimepiride contains a sulfonylurea. It may increase the risk of death from heart disease. Talk with your doctor about the benefits and risks of this or other therapies to treat your condition.


• Pioglitazone/Glimepiride may cause ovulation in women who have not reached menopause but do not ovulate. To avoid pregnancy, be sure to use effective birth control while using Pioglitazone/Glimepiride.


• Pioglitazone/Glimepiride may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Pioglitazone/Glimepiride. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.


• Tell your doctor or dentist that you take Pioglitazone/Glimepiride before you receive any medical or dental care, emergency care, or surgery.


• Pioglitazone/Glimepiride may be associated with an increased risk of bladder cancer. Tell your doctor right away if you notice symptoms that could be associated with bladder cancer (eg, a red color or blood in the urine, difficult or painful urination, an increased need to urinate). Discuss any questions or concerns with your doctor.


• An increased incidence of bone fracture has been reported in women who take Pioglitazone/Glimepiride. Tell your doctor if you have a history of bone fracture, low calcium intake, or weak bones (eg, osteoporosis). Tell your doctor right away if you experience any unusual bone pain.


• Lab tests, including fasting blood sugar, hemoglobin A_1c, liver function, and eye exams, may be performed while you use Pioglitazone/Glimepiride. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Pioglitazone/Glimepiride with caution in the ELDERLY; they may be more sensitive to its effects, especially the risk of heart problems or low blood sugar.


• Pioglitazone/Glimepiride should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: Pioglitazone/Glimepiride may cause harm to the fetus or newborn. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Pioglitazone/Glimepiride while you are pregnant. It is not known if Pioglitazone/Glimepiride is found in breast milk. Do not breast-feed while taking Pioglitazone/Glimepiride.

When used for long periods of time Pioglitazone/Glimepiride may not work as well. If your blood sugar has been under control and then becomes hard to manage, contact your doctor. Do not change the dose of your medicine without checking with your doctor.

Possible side effects of Pioglitazone/Glimepiride:

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

Cold-like symptoms; diarrhea; headache; leg or arm pain; nausea; weight gain.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; chest pain; confusion; fever, chills, or persistent sore throat; irregular heartbeat; swelling of the hands, ankles, or feet; symptoms of heart failure (eg, shortness of breath; sudden, unexplained weight gain); symptoms of liver problems (eg, dark urine, severe or persistent nausea, stomach pain, unexplained vomiting or loss of appetite, yellowing of the skin or eyes); symptoms of low blood sugar (eg, anxiety, chills, dizziness or drowsiness, headache, increased hunger, increased sweating, tremors); unusual bone pain; unusual bruising or bleeding; unusual tiredness or weakness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Pioglitazone/Glimepiride side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include coma; confusion; fainting; fast heartbeat; lethargy; lightheadedness; seizures; severe dizziness or drowsiness; tremor; unusual sweating.

Proper storage of Pioglitazone/Glimepiride:

Store Pioglitazone/Glimepiride between 59 and 86 degrees F (15 and 30 degrees C). Do not store Pioglitazone/Glimepiride in the bathroom. Keep Pioglitazone/Glimepiride out of the reach of children and away from pets.

General information:

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


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


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


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

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

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Pioglitazone/Glimepiride resources

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

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• Diabetes, Type 2

Kemadrin Tablets 5 mg

Kemadrin tablets 5 mg

procyclidine hydrochloride

Read all of this leaflet carefully before you start taking this medicine.

• Keep this leaflet. You may need to read it again.



• If you have any further questions, ask your doctor or pharmacist.



• This medicine has been prescribed for you. Do not pass it to others. It may harm them, even if their symptoms are the same as yours.



• If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

In this leaflet:

• 1 What Kemadrin is and what it is used for



• 2 Before you take Kemadrin



• 3 How to take Kemadrin



• 4 Possible side effects



• 5 How to store Kemadrin



• 6 Further information

What Kemadrin is and what it is used for

Kemadrin contains a medicine called procyclidine. This belongs to a group of medicines called anticholinergics. They stop a substance called acetylcholine working in your body.

Kemadrin is used to:

• treat and relieve the signs of Parkinson's disease such as:
  
  
  • stiff muscles, paralysis and tremor
  
  
  
  • problems talking, writing and walking
  
  
  
  • producing too much saliva and dribbling
  
  
  
  • sweating and uncontrolled eye movements
  
  
  
  • depression
  
  



• stop side effects similar to the signs of Parkinson's disease or restlessness and unusual head and body movements caused by some medicines. Some people call these' extrapyramidal effects'.

Before you take Kemadrin

Do not take Kemadrin if:

• you are allergic (hypersensitive) to procyclidine or any of the other ingredients of Kemadrin (see Section 6: Further information)



• you have problems passing water (urinary retention)



• you suffer from a problem caused by too much pressure in your eye called 'closed angle glaucoma'



• you have stomach cramps and pains or constipation.

Do not take if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Kemadrin.

Take special care with Kemadrin

Check with your doctor or pharmacist before taking your medicine if:

• you are elderly. Your dose may need to be carefully monitored to prevent any side effects



• you have an enlarged prostate gland



• you have a mental illness and are taking Kemadrin to control the side-effects of your medicines. Occasionally people who take this medicine may have a psychotic episode



• you have kidney or liver problems.

If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Kemadrin.

Kemadrin contains lactose (a type of sugar). If you have been told by your doctor that you cannot tolerate or digest some sugars, talk to your doctor before taking this medicine.

Taking other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. This includes herbal medicines. This is because Kemadrin can affect the way some other medicines work. Also some other medicines can affect the way Kemadrin works.

In particular tell your doctor or pharmacist if you are taking any of the following:

• medicines used to treat mental health problems (including Alzheimer's disease and dementia)



• levodopa and amantadine, used in Parkinson's disease



• disopyramide, quinidine and nitrate tablets (including tablets that dissolve under the tongue), used to treat heart problems



• cisapride, domperidone and metoclopramide, used to treat sickness, indigestion and feeling sick (nausea)



• antihistamines, used to treat hayfever and allergies



• nefopam, used to treat pain



• ketoconazole, used to treat fungal infections.

If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Kemadrin.

Taking Kemadrin with food

You can take Kemadrin at any time of day, with or without food.

Some people find they feel less sick if they take it at meal times.

Pregnancy and breast-feeding

Talk to your doctor before taking this medicine if you are pregnant, might become pregnant or are breast-feeding.

Driving and using machines

You may have blurred vision, dizziness, confusion or disorientation while taking Kemadrin. If this happens do not drive or use any tools or machines.

How to take Kemadrin

Always take Kemadrin exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

• Swallow the tablets with a drink of water.



• The tablet may be cut or broken in half along the line marked on one side of the tablet.

To treat Parkinson's disease:

• The usual starting dose is half a tablet three times a day.



• This can be increased by half or 1 tablet each day, every two or three days until an effect is seen. This is known as the 'maintenance dose'. The daily maintenance dose is usually three to six tablets.



• The maximum your doctor may decide to prescribe is 12 tablets.



• Although the dose is usually taken three times a day, your doctor may ask you to take a fourth dose before bedtime.

To treat uncontrolled body movements (extrapyramidal symptoms) caused by taking other medicines:

Kemadrin can be used to control side effects caused by other medicines.

• The usual starting dose is half a tablet three times a day.



• This can be increased by half a tablet each day until an effect is seen.



• The daily maintenance dose is usually two to six tablets.



• Your doctor may decide to stop your Kemadrin after 3 or 4 months to see if your side effects return.

Elderly

If you are elderly, your dose may need to be carefully monitored to prevent any side effects.

Children

Kemadrin tablets are not usually recommended for use in children.

If you take more Kemadrin than you should

If you take more Kemadrin than you should, talk to a doctor or go to a hospital straight away. Take the medicine pack with you.

If you forget to take Kemadrin

Take a dose as soon as you remember it and then go on as before.

If you stop taking Kemadrin

Do not stop taking Kemadrin without talking to your doctor.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

Possible side effects

If you are taking a medicine for mental illness (called a neuroleptic) at the same time as Kemadrin:

• you can develop uncontrolled movements of your face and tongue (tardive dyskinesia). The dose of either of your medicines may need to be adjusted.



• unusual body movements, particularly of your hands, arms and legs which may have previously been occuring with the medicine for your mental illness can be made worse by the addition of Kemadrin

If either of these happen, tell your doctor straight away.

Like all medicines, Kemadrin can cause side effects, although not everybody gets them. The following side effects may happen with this medicine:

Common (affects less than 1 in 10 people)

• problems passing water (urinary retention)



• blurred vision



• dry mouth or constipation.

Uncommon (affects less than 1 in 100 people)

• feeling sick (nausea) or being sick (vomiting)



• inflamed gums (gingivitis)



• dizziness, nervousness, feeling confused, reduced concentration or memory, hearing unexpected noises or seeing unexpected sights (hallucinations), anxiety, agitation (feeling irritable)



• skin rash.

Rare (affects less than 1 in 1000 people)

• 'psychotic' symptoms occurring together such as dizziness, confusion, reduced concentration or memory, disorientation, hearing unexpected noises or seeing unexpected sights (hallucinations), anxiety, agitation (feeling irritable).

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

How to store Kemadrin

• Keep out of the reach and sight of children.



• Do not store above 25°C.



• Do not use Kemadrin after the expiry date which is stated on the foil and carton. The expiry date refers to the last day of that month.



• Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

Further information

What Kemadrin contains.

• The active substance is procyclidine hydrochloride 5 mg.



• The other ingredients are lactose, sodium starch glycollate, povidone and magnesium stearate.

What Kemadrin looks like.

Each 5 mg tablets is white with a single score line and the marking 'WELLCOME S3A' on the same side. There are no markings on the other side. Kemadrin Tablets 5 mg come in bottles of 100 or 500 tablets.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder:

The Wellcome Foundation

trading as GlaxoSmithKline UK

Stockley Park West

Uxbridge

Middlesex

UB11 1BT

Manufacturer:

Glaxo Wellcome GmbH & Co. KG

Bad Oldesloe

Germany

Other formats:

To listen to or request a copy of this leaflet in Braille, large print or audio please call, free of charge:

0800 198 5000 (UK Only)

Please be ready to give the following information:

Product name Kemadrin 5 mg tablets

Reference number 00003/5255R. This is a service provided by the Royal National Institute of Blind People.

Leaflet date: November 2007

Kemadrin is a registered trademark of the GlaxoSmithKline group of companies.

© 2007 GlaxoSmithKline group of companies

10000000042602

Diprivan 2%

For further copies of this leaflet, visit emc.medicines.org.uk or call AstraZeneca on 01582 836836.

Diprivan 20 mg/ml (2%)

Emulsion for Injection or Infusion

propofol

Read all of this leaflet carefully before you start having this medicine.

• Keep this leaflet. You may need to read it again.


• If you have any further questions, ask your doctor or nurse.


• If you think you have a side effect, or if you notice any side effects not listed in this leaflet, please tell your doctor or nurse.

In this leaflet:

• 1. What Diprivan is and what it is used for


• 2. Before you have Diprivan


• 3. How to have Diprivan


• 4. Possible side effects


• 5. How to store Diprivan


• 6. Further information

What Diprivan is and what it is used for

Diprivan contains a medicine called propofol. This belongs to a group of medicines called ‘general anaesthetics’.

Diprivan will be given to you as an injection by a doctor. It is used to:

• Help put you to sleep before an operation or other procedure.


• Keep you asleep during an operation or other procedure.


• Sedate you (make you feel sleepy) while you are in an Intensive Care Unit (ICU).

Before you have Diprivan

Do not have Diprivan if:

• You are allergic (hypersensitive) to propofol or any of the other ingredients of Diprivan (listed in Section 6: Further information).


• You are allergic to peanut or soya. This is because Diprivan contains soya oil.


• You are pregnant (see the section called ‘Pregnancy and breast-feeding’).

If any of the above apply to you, do not have Diprivan and tell your doctor, anaesthetist or nurse. If you are not sure, talk to one of these people before having Diprivan.

Children and young people

• When Diprivan is used before or during an operation, it should only be given to children aged 3 years and above.


• When it is used for sedation in an Intensive Care Unit, it should only be given to people aged 17 years and above.

Take special care with Diprivan

Before you have this medicine, tell your doctor, anaesthetist or nurse if:

• You have ever had a fit or convulsion.


• You have ever been told that you have very high levels of fat in your blood.


• You have ever been told that your body has problems using fat.


• Your body has lost lots of water (you are dehydrated).


• You have any other health problems, such as problems with your heart, breathing, kidneys or liver.


• You have been generally unwell for some time.

If you are not sure if any of the above apply to you, talk to your doctor or nurse before having Diprivan.

Taking other medicines

Tell your doctor if you are taking or have recently taken any other medicines. This includes medicines that you buy without a prescription and herbal medicines.

Pregnancy and breast-feeding

• Do not have Diprivan if you are pregnant.


• If you are trying to get pregnant or if you are breastfeeding, talk to your doctor or nurse before having this medicine.

Driving and using machines

After having Diprivan, you may still feel sleepy for some time. Do not drive or use any tools or machines until you are sure the effects have worn off.

• If you are able to go home shortly after having Diprivan, do not drive a car or use any tools or machines.


• Ask your doctor when you can start doing these activities again and when you can go back to work.

Important information about some of the ingredients of Diprivan

Diprivan contains sodium. If you are on a sodium controlled diet, you will need to take this into account.

Diprivan contains soya oil. If you are allergic to peanut or soya, do not use this medicine.

Diprivan contains disodium edetate. During prolonged use of Diprivan for intensive care, you may need to be given a zinc (a mineral) supplement.

How to have Diprivan

You will be given Diprivan by a doctor. It will be given to you as an injection into a vein. This is usually in the back of your hand or in your forearm.

• The doctor will give you the injection through a fine plastic tube called a ‘cannula’.


• The doctor can also use an electric pump to control how fast the injection is given. This may be done if you are having a long operation or if you are in an Intensive Care Unit.

The dose of Diprivan varies from one patient to another. The amount of Diprivan that you need depends on your age, size, physical fitness and the level of sleepiness or sleep that you need. The doctor will work out how much to give you.

You may need several different medicines to keep you asleep or sleepy, free from pain, breathing in a healthy way and to keep your blood pressure steady. The doctor will decide which medicines you need and when you need them.

Diprivan 2% Side Effects

Like all medicines, Diprivan may cause side effects although not everybody gets them.

Side effects that can happen during anaesthesia

The following side effects can happen during anaesthesia (while the injection is being given to you or when you are sleepy or asleep). Your doctor will be looking out for these. If they happen, your doctor will give you appropriate treatment.

Very common (affects more than 1 in 10 people)

• A feeling of pain at the site of the injection (while the injection is being given, before you fall asleep).

Common (affects less than 1 in 10 people)

• Low blood pressure.


• Changes in your breathing pattern.


• Slow heart beat.

Rare (affects less than 1 in 1,000 people)

• Twitching and shaking of your body, or a fit (may also happen when you wake up).


• Unusual colour of urine (may also happen when you wake up).

Very rare (affects less than 1 in 10,000 people)

• Allergic reactions.


• Stopping of your heart beat.


• Build up of fluid in the lungs which can make you very breathless (may also happen when you wake up).

Side effects that can happen after anaesthesia

The following side effects can happen after anaesthesia (when you are waking up or after you have woken up).

Common (affects less than 1 in 10 people)

• Feeling sick (nausea).


• Being sick (vomiting).


• Headache.

Uncommon (affects less than 1 in 100 people)

• Swelling and redness along a vein or blood clots.

Very rare (affects less than 1 in 10,000 people)

• Feeling sexually aroused.


• High temperature (fever).


• Redness or soreness where the injection was given.


• Being unconscious after the operation. (When this has happened, the patients have recovered without problems.)

Other possible side effects

The following side effects have been seen when Diprivan is used in intensive care at higher doses than recommended.

Very rare (affects less than 1 in 10,000 people)

• Breakdown of muscle cells (rhabdomyolysis).


• Heart failure.


• Inflamed pancreas (pancreatitis) which causes severe stomach pain.

The following side effects have been seen in children in intensive care when Diprivan has been stopped suddenly.

Common (affects less than 1 in 10 people)

• ‘Withdrawal symptoms’. These include unusual behaviour, sweating, shaking and feeling anxious.


• Flushing of the skin.

Do not be concerned by this list of possible side effects. You may not get any of them.

If you think you have a side effect or if you notice any side effects not listed in this leaflet, please tell your doctor or nurse.

How to store Diprivan

• The doctor and hospital pharmacist are responsible for storing, using and disposing of Diprivan correctly.


• Store Diprivan between 2°C and 25°C. Do not freeze.


• Do not use Diprivan after the expiry date which is stated on the carton.

Further information

What Diprivan 2% contains

The active substance is propofol. There is 20 mg of propofol in each millilitre.

The other ingredients are glycerol, purified egg phosphatide, sodium hydroxide, soya bean oil, water for injections, nitrogen and disodium edetate.

What Diprivan 2% looks like and contents of the pack

Diprivan 2% is a milky, white liquid. It comes in glass vials of 50 ml or pre-filled syringes of 50 ml.

Marketing Authorisation Holder and Manufacturer

The Marketing Authorisations for Diprivan 2% are held by

AstraZeneca UK Ltd

600 Capability Green

Luton

LU1 3LU

UK

Diprivan 2% is manufactured by

AstraZeneca UK Ltd

Silk Road Business Park

Macclesfield

Cheshire

SK10 2NA

UK

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0800 198 5000 (UK only)

Please be ready to give the following information:

Product name Diprivan 2%



Reference number 17901/0008 or 17901/0009

This is a service provided by the Royal National Institute of the Blind.

Leaflet prepared: August 2009

Diprivan is a trade mark of the AstraZeneca group of companies.

© AstraZeneca 2009

UK PAI 09 0057

P024960

Boots Sodium Bicarbonate B.P.

1. Name Of The Medicinal Product

Bicarbonate of Soda (Sodium Bicarbonate BP)

Boots Sodium Bicarbonate BP

2. Qualitative And Quantitative Composition

Sodium Bicarbonate 100%

3. Pharmaceutical Form

Oral Powder.

4. Clinical Particulars

4.1 Therapeutic Indications

For use as an antacid for the symptomatic relief of dyspepsia.

4.2 Posology And Method Of Administration

Adults, the elderly and children aged 12 years and over: -

Take 1 to 5 g in water 4 to 6 hourly as required.

Not recommended for children under 12 years of age.

4.3 Contraindications

Congestive cardiac failure.

4.4 Special Warnings And Precautions For Use

Congestive cardiac failure.

Caution should be exercised in patients who are on Sodium restricted diets and those with cardiac disease, hypertension, renal or hepatic impairment. A physician should be consulted if the patient is receiving other medications before taking this product. If symptoms persist consult your doctor.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

This product may cause alkalisation of plasma and urine and, as such, may affect the renal clearance of several drugs.

4.6 Pregnancy And Lactation

Data on a large number of exposed pregnancies indicate no adverse effects of Bicarbonate of Soda (Sodium Bicarbonate BP) on pregnancy or on the health of the foetus/newborn child. To date, no other relevant epidemiological data are available.

4.7 Effects On Ability To Drive And Use Machines

None known.

4.8 Undesirable Effects

This medicine may cause abdominal cramps and flatulence. Excessive administration may lead to metabolic alkalosis, especially in patients with impaired renal function.

4.9 Overdose

Excessive amounts of this medicine may cause metabolic alkalosis. Dyspepsia and muscle weakness may occur owing to potassium depletion. Twitching tetany may occur in hypercalcaemic patients. Severe overdosages may lead to convulsions and coma. Treatment consists of appropriate correction of fluid and electrolyte balance and is otherwise supportive and symptomatic. Anti-convulsant therapy may be needed in severe overdosage.

5. Pharmacological Properties

5.1 Pharmacodynamic Properties

Not applicable.

5.2 Pharmacokinetic Properties

Not applicable.

5.3 Preclinical Safety Data

Never undertaken by Abdine Limited. This product was granted a 'Licence as of Right' some 25 years ago.

6. Pharmaceutical Particulars

6.1 List Of Excipients

None.

6.2 Incompatibilities

None.

6.3 Shelf Life

As packaged for sale: Three years

As reconstituted for use: Thirty minutes

After first opening the container: One month

6.4 Special Precautions For Storage

Do not store above 25°C

6.5 Nature And Contents Of Container

A spirally wound, varnished, cardboard tub with a press-fit lid or polypropylene jar and cap containing 100g, 150g, 200g, 250g, 300g or 500g of sodium bicarbonate.

6.6 Special Precautions For Disposal And Other Handling

7. Marketing Authorisation Holder

Bell Sons & Co (Druggists) Ltd

Gifford House

Slaidburn Crescent

Southport

Merseyside PR9 9AL

UK

8. Marketing Authorisation Number(S)

PL 03105/0067

9. Date Of First Authorisation/Renewal Of The Authorisation

12 February 1999

10. Date Of Revision Of The Text

17 /11/2010

11. DOSIMETRY

(IF APPLICABLE)

12. INSTRUCTIONS FOR PREPARATION OF RADIOPHARMACEUTICALS

(IF APPLICABLE)

Qvar Aerosol Solution

Pronunciation: be-kloe-METH-a-sone
Generic Name: Beclomethasone
Brand Name: Qvar

Qvar Aerosol Solution is used for:

Treating asthma. Qvar Aerosol Solution is also used to prevent asthma attacks. It will not stop an asthma attack once one has started. It may also be used to treat other conditions as determined by your doctor.

Qvar Aerosol Solution is a corticosteroid. It works by decreasing inflammation in the airways, which helps to prevent asthma symptoms.

Do NOT use Qvar Aerosol Solution if:

• you are allergic to any ingredient in Qvar Aerosol Solution


• you are having an asthma attack

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

Before using Qvar Aerosol Solution:

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

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


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


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


• if you have an infection or illness, diarrhea, a herpes infection near the eye, cataracts, or glaucoma


• if you have tuberculosis (TB), measles, chickenpox, or had a positive TB skin test


• if you have recently received or are scheduled to receive a vaccine


• if you have had recent surgery or injury

Some MEDICINES MAY INTERACT with Qvar Aerosol Solution. However, no specific interactions are known at this time.

Ask your health care provider if Qvar Aerosol Solution may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Qvar Aerosol Solution:

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

• Before using Qvar Aerosol Solution, be sure that the canister is properly placed in the inhaler unit.


• Each time a new inhaler is used, turn the canister away from the face and press down into the mouthpiece to release test sprays into the air. This process is called priming and will allow you to be sure the inhaler is working properly and will provide a full dose of medicine.


• Breathe out slowly and completely. Place the mouthpiece between your lips and try to rest your tongue flat, unless your doctor has told you otherwise. Your doctor may have told you to hold the inhaler 1 or 2 inches (2 or 3 centimeters) away from the open mouth or to use a special spacing device. As you start to take a slow deep breath, press the canister and mouthpiece together at exactly the same time. This will release a dose of Qvar Aerosol Solution. Continue breathing in slowly and deeply and hold for as long as comfortable, then breathe out slowly through pursed lips or your nose. If more than 1 inhalation is to be used, wait a few minutes and repeat the above steps. Keep the spray away from your eyes.


• Rinse your mouth or gargle with water after using Qvar Aerosol Solution to prevent mouth sores or bad taste.


• Keep track of the number of sprays you use and subtract this number from the number of doses in the container. This will help you know when the container is becoming empty.


• If you miss a dose of Qvar Aerosol Solution, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Qvar Aerosol Solution.

Important safety information:

• Qvar Aerosol Solution will not stop an asthma attack once one has started. If you are also using a bronchodilator inhaler, be sure to always carry the bronchodilator inhaler with you to use during asthma attacks.


• It may take several weeks for Qvar Aerosol Solution to give full benefit. Continue to use it as directed during this time. If your symptoms do not get better after regular use or if your asthma gets worse, check with your doctor.


• Avoid spraying Qvar Aerosol Solution in the eyes.


• Use caution if you switch from an oral steroid (eg, prednisone) to Qvar Aerosol Solution. It may take several months for your body to make enough natural steroids to handle events that cause physical stress. Such events may include injury, surgery, infection, loss of blood electrolytes, or a sudden asthma attack. These may be severe and sometimes fatal. Contact your doctor right away if any of these events occur. You may need to take an oral steroid (eg, prednisone) again. Carry a card at all times that says you may need an oral steroid (eg, prednisone) if any of these events occur.


• Tell your doctor or dentist that you take Qvar Aerosol Solution before you receive any medical or dental care, emergency care, or surgery.


• If you have not had chickenpox, shingles, or measles, avoid contact with anyone who does.


• Some patients may have trouble using Qvar Aerosol Solution correctly. Some may also get mouth sores or a bad taste in the mouth after using it. If you have any of these problems, ask your health care provider if a spacing device may help.


• Corticosteroids may affect growth rate in CHILDREN and teenagers in some cases. They may need regular growth checks while they use Qvar Aerosol Solution.


• Qvar Aerosol Solution should not be used in CHILDREN younger than 5 years old; safety and effectiveness in these children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Qvar Aerosol Solution while you are pregnant. It is not known if Qvar Aerosol Solution is found in breast milk. If you are or will be breast-feeding while you use Qvar Aerosol Solution, check with your doctor. Discuss any possible risks to your baby.

If you stop taking Qvar Aerosol Solution suddenly, you may have WITHDRAWAL symptoms. These may include joint or muscle pain, exhaustion, or depression may occur when you stop taking Qvar Aerosol Solution. Carefully follow your doctor's instructions for stopping the use of Qvar Aerosol Solution.

Possible side effects of Qvar Aerosol Solution:

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

Back pain; headache; dry mouth; hoarseness; nausea; runny nose; throat irritation; upper respiratory tract infection.

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

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; severe dizziness; sudden weight loss; unusual weakness; vomiting; white curd-like patches in the mouth.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Qvar side effects (in more detail)

If OVERDOSE is suspected:

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

Proper storage of Qvar Aerosol Solution:

Store Qvar Aerosol Solution at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Do not puncture, break, or burn the canister even if it appears to be empty. Do not use or store near heat or open flames. Never throw the container into a fire. Contents are under pressure. Do not expose to temperatures above 120 degrees F (40 degrees C). Keep Qvar Aerosol Solution out of the reach of children and away from pets.

General information:

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


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


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


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

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

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Qvar resources

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

Compare Qvar with other medications

• Asthma, Maintenance
• Bronchitis

C-Phen DM

Generic Name: chlorpheniramine, dextromethorphan, and phenylephrine (klor feh NEER a meen, dex troe meh THOR fan, and feh nill EH frin)

Brand Names: Alka-Seltzer Plus Cold and Cough, C-Phen DM, C-Phen DM Drops, Cardec DM, Cardec DM Drops, Ceron-DM, Ceron-DM Drops, Cerose DM, Corfen-DM, CP Dec DM, CP Dec-DM Drops, De-Chlor DM, De-Chlor DR, Dec-Chlorphen DM, Dex PC, DM-PE-Chlor, Donatussin DM Drops, Ed A-Hist DM, HistadecDM, Maxiphen ADT, Mintuss DR, Nasohist-DM, Neo DM Drops, Nohist-DMX, Norel DM, P Chlor DM, PD-Cof, PD-Cof Drops, Poly-Tussin DM, Quartuss DM, Reme Tussin DM, Rondec-DM, Rondec-DM Drops, Rondex-DM, Rondex-DM Drops, Sildec-PE DM, Sildec-PE DM Drops, Tri-Vent DPC, Trital DM, Tussplex DM, Zotex-12D

What is C-Phen DM (chlorpheniramine, dextromethorphan, and phenylephrine)?

Chlorpheniramine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

Chlorpheniramine, dextromethorphan, and phenylephrine is used to treat sneezing, cough, runny or stuffy nose, itchy or watery eyes, hives, skin rash, itching, and other symptoms of allergies and the common cold.

Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.

Chlorpheniramine, dextromethorphan, and phenylephrine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about C-Phen DM (chlorpheniramine, dextromethorphan, and phenylephrine)?

Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Do not use a cough or cold medicine 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 cough or cold medicine before the MAO inhibitor has cleared from your body. Do not use any other over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains an antihistamine, decongestant, or cough suppressant. Chlorpheniramine, dextromethorphan, and phenylephrine 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 drinking alcohol. It can increase some of the side effects of this medication.

What should I discuss with my healthcare provider before taking C-Phen DM (chlorpheniramine, dextromethorphan, and phenylephrine)?

Do not use a cough or cold medicine 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 cough or cold medicine before the MAO inhibitor has cleared from your body.

Before taking this medication, tell your doctor if you are allergic to chlorpheniramine, dextromethorphan, or phenylephrine, or if you have:

• kidney disease;


• liver disease;


• 
  

  diabetes;

  
  


• 
  

  glaucoma;

  
  


• 
  

  heart disease or high blood pressure;

  
  


• 
  

  diabetes;

  
  


• 
  

  a thyroid disorder;

  
  


• 
  

  a stomach ulcer or a stomach obstruction,

  
  


• 
  

  emphysema or chronic bronchitis; or

  
  


• 
  

  an enlarged prostate or urination problems.

  
  

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

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. Chlorpheniramine, dextromethorphan, and phenylephrine 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.

Artificially-sweetened liquid forms of cough-and-cold medications may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.

How should I take C-Phen DM (chlorpheniramine, dextromethorphan, and phenylephrine)?

Use this medication exactly as directed on the label or as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.

Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Take this medicine with a full glass of water. If you use the effervescent tablet, drop the tablet in 8 ounces of water and allow it to dissolve completely. Stir this mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

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

Take this medicine with food or milk if it upsets your stomach.

This medication can cause you to have unusual results with allergy skin tests. Tell any doctor who treats you that you are taking an antihistamine.

Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.

If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.

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

What happens if I miss a dose?

Since cough or cold medicine is usually taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, 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 your 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.

Overdose symptoms may include feeling restless or nervous, nausea, vomiting, stomach pain, dizziness, drowsiness, dry mouth, warmth or tingly feeling, or seizure (convulsions).

What should I avoid while taking C-Phen DM (chlorpheniramine, dextromethorphan, and phenylephrine)?

This medication 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 drinking alcohol. It can increase some of the side effects of this medication. Before taking this medication, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by this medication.

Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.

Do not use any other over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. Antihistamines, decongestants, and cough suppressants are contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains an antihistamine, decongestant, or cough suppressant.

C-Phen DM (chlorpheniramine, dextromethorphan, and phenylephrine) side effects

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

• 
  

  fast, pounding, or uneven heartbeat;

  
  


• 
  

  confusion, hallucinations, unusual thoughts or behavior;

  
  


• 
  

  severe dizziness, anxiety, restless feeling, or nervousness;

  
  


• 
  

  increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);

  
  


• 
  

  confusion, hallucinations;

  
  


• 
  

  slow, shallow breathing;

  
  


• 
  

  urinating less than usual or not at all;

  
  


• 
  

  easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms; or

  
  


• 
  

  nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

  
  

Less serious side effects may include:

• 
  

  blurred vision;

  
  


• 
  

  dry mouth;

  
  


• 
  

  nausea, stomach pain, constipation;

  
  


• 
  

  mild loss of appetite, stomach upset;

  
  


• 
  

  warmth, tingling, or redness under your skin;

  
  


• 
  

  feeling excited or restless;

  
  


• 
  

  sleep problems (insomnia);

  
  


• 
  

  restless or excitability (especially in children);

  
  


• 
  

  skin rash or itching;

  
  


• 
  

  dizziness, drowsiness;

  
  


• 
  

  problems with memory or concentration; or

  
  


• 
  

  ringing in your ears.

  
  

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect C-Phen DM (chlorpheniramine, dextromethorphan, and phenylephrine)?

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

• 
  

  an antidepressant;

  
  


• 
  

  a diuretic (water pill);

  
  


• 
  

  medication to treat irritable bowel syndrome;

  
  


• 
  

  celecoxib (Celebrex);

  
  


• 
  

  cinacalcet (Sensipar);

  
  


• 
  

  imatinib (Gleevec);

  
  


• 
  

  quinidine (Quinaglute, Quinidex);

  
  


• 
  

  ranolazine (Ranexa)

  
  


• 
  

  ritonavir (Norvir);

  
  


• 
  

  sibutramine (Meridia);

  
  


• 
  

  terbinafine (Lamisil);

  
  


• 
  

  medicines to treat high blood pressure;

  
  


• 
  

  aspirin or salicylates (such as Disalcid, Doan's Pills, Dolobid, Salflex, Tricosal, and others);

  
  


• 
  

  bladder or urinary medications such as darifenacin (Enablex), oxybutynin (Ditropan, Oxytrol) or tolterodine (Detrol); or

  
  


• 
  

  a beta-blocker such as atenolol (Tenormin), carteolol (Cartrol), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), timolol (Blocadren), and others.

  
  

This list is not complete and there may be other drugs that can interact with chlorpheniramine, dextromethorphan, and phenylephrine. 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.

More C-Phen DM resources

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

• Bronkids Drops MedFacts Consumer Leaflet (Wolters Kluwer)


• Cardec DM Elixir MedFacts Consumer Leaflet (Wolters Kluwer)


• Ceron-DM Liquid MedFacts Consumer Leaflet (Wolters Kluwer)


• Maxiphen ADT MedFacts Consumer Leaflet (Wolters Kluwer)


• Quartuss DM Prescribing Information (FDA)


• Trital DM Prescribing Information (FDA)

Compare C-Phen DM with other medications

• Cough and Nasal Congestion

Where can I get more information?

• Your pharmacist can provide more information about chlorpheniramine, dextromethorphan, and phenylephrine.

See also: C-Phen DM side effects (in more detail)

Chlorpheniramine/Dextromethorphan/Phenylephrine

Pronunciation: klor-fen-IR-a-meen/dex-troe-meth-OR-fan/fen-ill-EF-rin
Generic Name: Chlorpheniramine/Dextromethorphan/Phenylephrine
Brand Name: Maxiphen ADT

Chlorpheniramine/Dextromethorphan/Phenylephrine is used for:

Relieving symptoms of sinus congestion, runny nose, sneezing, and cough due to colds, upper respiratory infections, and allergies. It may also be used for other conditions as determined by your doctor.

Chlorpheniramine/Dextromethorphan/Phenylephrine is a decongestant, antihistamine, and cough suppressant combination. It works by constricting blood vessels and reducing swelling in the nasal passages, The antihistamine works by blocking the action of histamine, which helps reduce symptoms such as watery eyes and sneezing while the cough suppressant works in the brain to help decrease the cough reflex to reduce a dry cough.

Do NOT use Chlorpheniramine/Dextromethorphan/Phenylephrine if:

• you are allergic to any ingredient in Chlorpheniramine/Dextromethorphan/Phenylephrine


• you have severe high blood pressure, severe heart blood vessel disease, rapid heartbeat, or severe heart problems


• you are unable to urinate or are having an asthma attack


• you take sodium oxybate (GHB) or if you have taken furazolidone or a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the last 14 days

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

Before using Chlorpheniramine/Dextromethorphan/Phenylephrine:

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

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


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


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


• if you have a fast, slow, or irregular heartbeat


• if you have a history of adrenal gland problems (eg, adrenal gland tumor); heart problems; high blood pressure; diabetes; heart blood vessel problems; stroke; glaucoma; a blockage of your bladder, stomach, or intestines; ulcers; trouble urinating; an enlarged prostate or other prostate problems; seizures; or an overactive thyroid


• if you have a history of asthma, chronic cough, lung problems (eg, chronic bronchitis, emphysema), or chronic obstructive pulmonary disease (COPD), or if your cough occurs with large amounts of mucus

Some MEDICINES MAY INTERACT with Chlorpheniramine/Dextromethorphan/Phenylephrine. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Beta-blockers (eg, propranolol), catechol-O-methyltransferase (COMT) inhibitors (eg, tolcapone), furazolidone, indomethacin, MAO inhibitors (eg, phenelzine), sodium oxybate (GHB), or tricyclic antidepressants (eg, amitriptyline) because side effects of Chlorpheniramine/Dextromethorphan/Phenylephrine may be increased


• Digoxin or droxidopa because the risk of irregular heartbeat or heart attack may be increased


• Bromocriptine or hydantoins (eg, phenytoin) because side effects may be increased by Chlorpheniramine/Dextromethorphan/Phenylephrine


• Guanadrel, guanethidine, mecamylamine, methyldopa, or reserpine because effectiveness may be decreased by Chlorpheniramine/Dextromethorphan/Phenylephrine

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

How to use Chlorpheniramine/Dextromethorphan/Phenylephrine:

Use Chlorpheniramine/Dextromethorphan/Phenylephrine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Chlorpheniramine/Dextromethorphan/Phenylephrine may be taken with or without food.


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

Ask your health care provider any questions you may have about how to use Chlorpheniramine/Dextromethorphan/Phenylephrine.

Important safety information:

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


• Do not take diet or appetite control medicines while you are taking Chlorpheniramine/Dextromethorphan/Phenylephrine without checking with your doctor.


• Chlorpheniramine/Dextromethorphan/Phenylephrine contains chlorpheniramine, dextromethorphan, and phenylephrine. Before you begin taking any new prescription or nonprescription medicine, read the ingredients to see if it also contains chlorpheniramine, dextromethorphan, or phenylephrine. If it does or if you are uncertain, contact your doctor or pharmacist.


• Do NOT exceed the recommended dose or take Chlorpheniramine/Dextromethorphan/Phenylephrine for longer than prescribed without checking with your doctor.


• If your symptoms do not improve within 5 to 7 days or if they become worse, check with your doctor.


• Chlorpheniramine/Dextromethorphan/Phenylephrine may cause increased sensitivity to the sun. Avoid exposure to the sun, sunlamps, or tanning booths until you know how you react to Chlorpheniramine/Dextromethorphan/Phenylephrine. Use a sunscreen or protective clothing if you must be outside for a prolonged period.


• If you are scheduled for allergy skin testing, do not take Chlorpheniramine/Dextromethorphan/Phenylephrine for several days before the test because it may decrease your response to the skin tests.


• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Chlorpheniramine/Dextromethorphan/Phenylephrine.


• Use Chlorpheniramine/Dextromethorphan/Phenylephrine with caution in the ELDERLY because they may be more sensitive to its effects.


• Caution is advised when using Chlorpheniramine/Dextromethorphan/Phenylephrine in CHILDREN because they may be more sensitive to its effects.


• PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Chlorpheniramine/Dextromethorphan/Phenylephrine, discuss with your doctor the benefits and risks of using Chlorpheniramine/Dextromethorphan/Phenylephrine during pregnancy. It is unknown if Chlorpheniramine/Dextromethorphan/Phenylephrine is excreted in breast milk. Do not breast-feed while taking Chlorpheniramine/Dextromethorphan/Phenylephrine.

Possible side effects of Chlorpheniramine/Dextromethorphan/Phenylephrine:

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

Constipation; diarrhea; dizziness; drowsiness; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; vomiting; weakness.

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

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; seizures; severe dizziness, lightheadedness, or headache; tremor; trouble sleeping; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Chlorpheniramine/Dextromethorphan/Phenylephrine side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blurred vision; confusion; hallucinations; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; unusually fast, slow, or irregular heartbeat; vomiting.

Proper storage of Chlorpheniramine/Dextromethorphan/Phenylephrine:

Store Chlorpheniramine/Dextromethorphan/Phenylephrine at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Chlorpheniramine/Dextromethorphan/Phenylephrine out of the reach of children and away from pets.

General information:

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


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


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


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

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

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

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